rivka

Rough day at work. But I came home and my whole family met me at the door, singing "happy birthday." They presented me with a Dance Dance Revolution game for the Wii, which is what I really wanted. Alex asked for paper and an envelope so that she could write out, laboriously, consulting us on every letter, "From Alex to Mama I hope you have a very happy birthday."

Michael took a brief nap because he's still recovering from the flu. We packed up the family, intending to head out for a festive sushi dinner. And then Alex climbed up into her carseat and abruptly, without a work of complaint or warning, threw up.

I helped her back out of the car and the next couple of rounds hit the sidewalk. We all trooped back inside. Alex is now ensconced on the couch with a basin and a video, but she seems to feel okay nowand she just threw up again. Argh.

When she goes to bed, we'll order sushi to be delivered. And sometime around my own bedtime I may actually get to have a piece of the birthday cake I made myself (because Michael = flu).

Oh, and Colin + congestion from a cold + his first erupted tooth = Bitey McBiterson. Ow.

This morning I was scheduled to present my research at the hourlong general staff seminar, in front of the eminent and notable (and scary) Dr. Institute Director, my division director, and about forty other people.

I had strong work to present. I put together a great presentation. I practiced it in front of wcg and curiousangel, which was especially helpful because my general staff audience was not going to be composed of psychologists.

Two hours before I was due to go on, I had (a) no childcare, and (b) the beginning stages of a raging cold.

Our nanny was sick. Our backup childcare person wasn't answering her phone. Michael had already taken unscheduled time away from work to take care of the kids just last Friday, and we were both a little unsure where his boss would want to draw the line. Oh: and I had a headache and cough and a swimming head.

I finally got through to a friend on the phone, and she was so awesome that before I could get my groveling request out of my mouth she offered to come over with her two-year-old to care for Colin. Michael came home just in case I had to leave before she got there, and then stayed to drive me to work. I actually got there with enough time to spare that I could look over my presentaton a few times before the seminar. I still felt dangerously light-headed as I loaded my presentation, and I had to have a water bottle on the podium to deal with coughing fits.

And then? Then I utterly rocked my prsentation. I hit it out of the park.

It was very well received. People made a lot of comments and asked cogent questions. There was only a little whispering among the senior staff (usually a chronic problem). People seemed to be genuinely interested, which is so not a given when a behavioral scientist gets up in front of a bunch of virologists and immunologists.

Dr. Institute Director was stuck in traffic and didn't arrive until about 45 minutes in, which was unfortunate. Or maybe fortunate. I would've liked him to hear about my research, but I confess that I did feel safer with him absent.

Afterwards, the adrenaline that got me through the presentation ebbed away and I started to feel very ill indeed. Lydia had no trouble believing that it would be better for all concerned if I just went home. Phew. I felt wrecked.

But man did I ever do a good job at general staff. I am proud. And grateful to my community, without whom it wouldn't have happened.

The whole family has a cold.

I was out sick on Friday and felt stressed enough about it to come in today. Since this isn't a nanny day, I've got Colin with me. Fortunately, he's been happy to alternate nursing, sleeping, and crawling around on my office floor playing with toys. (Yes, really crawling. He mastered it this weekend, although he's still kind of slow and careful at it. We are DOOMED.)

If I could only convince him that, when having difficulty nursing due to a stuffed-up nose, it does not help to dig into the milk source with your strong little fingers and sharp little nails? We'd be golden.

I did something dumb.

I missed my Prozac a couple of days in a row. That was careless. This is the dumb part: then I decided that since I hadn't had a bad reaction to missing a couple of days, maybe I could just come off it.

Yes, I can sense the look you're all giving your computer screens right now. Michael delivered the same look in person, trust me.

Today I finally realized that, um, being off the Prozac might have something to do with how short my fuse is these days, and how much current life events are filling me with dread.

Yeah, that ol' Ph.D. in clinical psychology is serving me really well.

I wasn't going to say anything in my LJ about it, but I am trying to be publicly honest about this whole process in case it can help someone else.

I followed up with my psychiatrist today for my postpartum anxiety disorder. ( Read more... )

It's the end of the day, and they're both still alive. I have done my job.

I had planned to go in to work for an hour or two today, with Colin, to coordinate a new venture with my research assistants. But last night, we noticed that Alex was pale and overemotional, and her temperature read 99.6 degrees - just high enough to keep her out of school today. So I had them both home, and we stayed in the house all day.

She was pitiful when she woke up, then fine through the morning. In midafternoon her fever started to rise. She begged to watch the Charlotte's Web DVD she got for Christmas, which she'd never seen before, but about fifteen minutes in she started to sob when Fern is forced to sell Wilbur to the farm down the road. "Wilbur! Wilbur!" Alex cried, crumpling in a heap. I looked at her: genuine tears, pallid skin, red circles flushed into her cheeks. I reached for the thermometer, but I didn't really need technological evidence for her fever.

She remained miserable for the rest of the afternoon - "I'm huddled in a heap," she informed us disconsolately at the dinner table - and then got a bouncy second wind just when Michael and I were most exhausted.

Colin got rather shorted for attention, needless to say. He was pretty much continuously latched on, unless I was changing one of a series of truly astonishing diapers, but he didn't get much in the way of stimulating interaction or tender gazes. I figure that keeping his sister's germy hands off him was the best I could offer him. He chose to repay me by not napping for more than 15 minutes at a time all afternoon and into the evening.

Tomorrow should be a lot like today, except that we'll be having a new boiler installed at 9am sharp, plus the electric company will be reattaching the line to the house (don't ask) at 8am. To what extent will power and heat be disrupted? No one has told us to expect disruptions. I suppose that if necessary we can flee to the church for sanctuary... because our usual fallbacks, like the library or the science center, won't be open that early and, when they do open, will be full of kids who don't deserve Alex's virus.

I am exhausted. But it's the end of the day and they're both alive, so I have rocked my job.

Some phrases have very, very few contexts in which you'd ever want to use them. "My kid's neurosurgeon" is one of them. Nonetheless, I am delighted to report that we saw Colin's neurosurgeon this afternoon, and he thinks Colin is normal.

I know, I know, you didn't know anything about this. And for good reason - it's been a really scary process and a really nebulous one, which is a bad combination, and early on we made the decision not to spread the anxiety around. We've only told a couple of family members who have medical training. But now, hey, everyone can share in our joyful relief.

Six weeks ago I had my 38-week midwife visit, the one where Colin had turned breech. They sent me to the hospital for a confirmatory ultrasound. That ultrasound tech noticed abnormal levels of cerebrospinal fluid (CSF) in two places in Colin's brain: the cisterna magna, which is at the back of the skull, and the third ventricle. The OB brought down to counsel me couldn't tell me much; the clinical syndromes associated with those abnormalities usually involved abnormalities in other parts of the brain as well, and the other parts of Colin's brain looked totally fine. He said we should wait and see.

Michael and I both spent some terrified time wondering if Colin would be severely brain-damaged. One of the terms on the table was Dandy-Walker syndrome, which you shouldn't Google unless you want to be as freaked out as we were. One of my dissertation subjects had Dandy-Walker, and... yikes. But if that were the case, Colin should've been missing a piece of his cerebellum, and he wasn't.

We talked to my sister the pediatrician, and then to Alex's pediatrician. Both of them helped rein in our flights of terrified speculation, and let us know that the worst-case scenario we were looking at was hydrocephalus. Which, you know, still potentially very bad. Best-case scenario: his brain looked funny on prenatal ultrasound because of positioning or something, and the abnormalities wouldn't be present on a neonatal scan.

We waited.

When Colin was born, he had a head ultrasound while he was still in the hospital. The ultrasound showed no signs of an enlarged third ventricle or any other ventricle, which pretty much ruled out hydrocephalus, but there was still an abnormal buildup of CSF at the back of the brain. "Differential diagnosis includes mega cisterna magna, arachnoid cyst, or Dandy-Walker variant," which is apparently not the same thing as Dandy-Walker syndrome. They recommended an MRI at two months. We took the report to our pediatrician, who referred us to a neurosurgeon at Johns Hopkins.

We waited.

Colin seemed so normal. He nursed well, which shows coordination of a pretty complicated physical task. He had good muscle tone, good head control for his age. He seemed very alert. He started to focus his eyes on things and produce vocalizations. We were encouraged, but also aware that we might be grasping at straws.

We waited.

Today was the neurosurgery appointment. They felt Colin's head, measured it, asked us some questions, studied the ultrasound report, and assured us that we were most likely looking at mega cisterna magna or arachnoid cyst, both of which are essentially normal variants which carry no developmental consequences. They feel that Dandy-Walker anything would be accompanied by hydrocephalus, which Colin doesn't have. They don't feel that the likelihood of serious problems justifies exposing Colin to the risks of MRI (sedation) or CT (radiation), so we're just going to have a repeat ultrasound in another three months.

Through all of this, Michael and I have kept reminding each other that we will be the parents Colin needs. If he were developmentally disabled? We'd be the parents he needed. If he needed brain surgery as a tiny infant? We'd be the parents he needed. Our son is our son, and we are his parents.

So now we can be the parents he needs when he doesn't want to have his hair washed, when he gets the stomach flu, when he's afraid of the dark, when he's roughhousing on the playground and breaks his arm, when he doesn't get invited to someone's birthday party. We'll be the parents he needs through all of that too.

Thanks be to God.

Alex has been complaining a lot about illness. "I'm sick. I don't feeeeeel good." It's been going on for a few weeks now.

She was actually sick, before Christmas. She doesn't seem to be sick now. She has the occasional sniffle or cough that just seems to go along with winter, but she's displaying no actual symptoms - no fever, no worrying change in her eating or sleeping habits, no changes in her appearance, no apparent activity limitations. Just complaints. When we ask her what hurts: "My whole body hurts." "Everything hurts." Even, she will insist if we ask more detailed questions, her toenails and her eyelashes. Every part. We've started asking "What do you think would make you feel better?" Sometimes she asks for medicine. Usually she doesn't know.

For a while it seemed like it was related to things she didn't want to do, or things she did want to do. "I can't put away my game because I'm siiiiick" and "I need to watch another video because I don't feeeeel good" are pretty easy to interpret and respond to. Or boredom-related "sickness" in the car. But more recently it's been different. Every morning this week, as soon as I mention school: "I don't feel good. I need to stay home." I will usually tell her, cheerfully, that we'll see how she feels once she gets to school. She's started asking: "WHY are you making me go to school when I'm SO, SO SICK?!"

She still doesn't seem to be legitimately sick at all.

I spent some time this morning talking with her about school. Why doesn't she like to go to school all of a sudden? Because she doesn't feel good, she told me. Is anything happening at school that she doesn't like - anyone being mean to her, any problems, anything scary? No, she said. Nothing is wrong at school, she just doesn't want to go anymore because she doesn't feel good.

This morning at dropoff, I spoke to her teacher for a while. The teacher confirms that nothing overt appears to be going wrong for Alex - no friend issues or anything like that. She will play happily for a while at school, and then come over and tell a teacher that she doesn't feel good and that she needs her mommy. The teachers have been treating this as a plea for attention. They offer her the opportunity to sit or lie down and rest when she says she doesn't feel good, but haven't been calling us or taking her temperature or anything.

I think that what may be wrong is anxiety. I think that my questions about problems at school were off-base, and that rather than worrying about school she may be worrying about separating from me. After all, that's the other thing that happens at going-to-school time. And anxiety certainly makes your whole body feel bad.

She knows that Niblet's arrival is imminent, and that I'm going to go into labor and go to the hospital and have the baby. She knows we've been making plans for who will take care of her. I'm pretty sure that she knows that it could happen at any time and we don't know when to expect it or when things will change. That's probably pretty anxiety-provoking. Also, I've started being too pregnant to do certain things: I can't sit in the back seat of the car to keep her company, I can't bathe her, I can't play active games. That might be anxiety-provoking in itself, if she's worrying about how much I love her or how much I'll be there for her.

I think this is a reasonable working hypothesis for what's happening now.

The sibling prep books we've read have focused on having a baby at home, not on the anxious weeks of knowing that major life changes could happen any moment. We're going to have a sibling's hospital tour and meet with a nurse for a while on Sunday, and I guess that could go either way - it could make her more anxious, or less.

My tentative plan: I'm going to tell her that I spent a lot of time thinking and reading about what might be making her feel bad, and that I think she has a sickness called anxiety. I'll explain that anxiety can be treated using exercises, kind of like Dad's physical therapy, and I'll try teaching her progressive muscle relaxation using some kind of PMR script for children. I'll try waking her up a little earlier so that we have time to do a PMR exercise before school.

Separately from that, I will try asking her whether she worries about leaving me or being gone from me all day, and whether she worries about what will happen when the baby is ready to come. I don't know if I'm going to get anywhere with questions like that, though. This is where you'd think that being a psychologist would help, but it doesn't, because I mostly was trained to work with adults and I have zero experience with interventions or techniques for kids this young.

I would appreciate any advice or theories that people have - especially people with lots of young-child experience, like mactavish, and people with new-sibling-prep experience. Also, if you have any alternative hypotheses about what might be causing these illness complaints, I'd be interested to hear them.

Alex is fast asleep, hopefully to stay that way until morning. At the NP's advice, we added some Vicks medicated stuff (camphor, I guess) to her hot-steam vaporizer in hopes of suppressing her cough. I wedged her door almost-closed with her sweater, to try to keep in more of the steam. Also at the NP's advice, we sprayed saline mist into her nose in large quantities. Poor kid. Although, man, do I ever appreciate the difference between a three-and-a-half-year-old and a two-and-a-half-year-old. She hated the saline spray, but she submitted.

Today I made three more pans of pumpkin-cranberry-pecan bars and also two pans of cornbread for Michael's work lunch tomorrow. (He's cleaning up my baking mess in return, so I consider it an equitable trade.) Tomorrow I don't have to bake anything. On Christmas Eve I am planning to make two pecan pies for the church potluck. I tried to convince myself that no one would expect me to bring anything to the potluck because I was directing the pageant, but I didn't believe me, so: pies. My compromise is using storebought crust. I can't believe how far I've fallen, except that this is the same kind of crust that I used for the baby shower quiches and they were tasty, so it's hard to bring myself to feel the proper amount of shame.

This evening was the dress rehearsal for the Christmas pageant. ( Read more... )

"[Rh incompatibility] wasn't an issue for all of human history until interventions were performed, like episiotomy and early cord cutting or Cesarians. Again, what gives?"

Okay, I have to get this off my chest here, because if I say it in response to the actual post I'm quoting I'll probably be banned: ( medical model espoused below )