Sunday, January 30, 2011

Drew: The First Two Months

I'm happy to report that we've survived the first 2 months of baby #2. Tess was such a difficult newborn that Ryan and I were at a loss to understand why anyone ever had a second baby on purpose. Everyone says you forget how hard it is by the time you're ready for #2. Not the case with me. I remember with perfect clarity just how hard Tess was. But I did learn a lot from her, and I figured that the second baby would have to be easier because I knew better what to expect.

But Drew came with his very own set of challenges and has been just as difficult as Tess, but in his own entirely special way. I haven't been in a position to do much journaling during these first 2 months, but I know I'll want to remember this information later on, even if it's difficult to revisit now.

So here's Drew's story. The First Two Months, anyway.

My pregnancy with Drew went very well. I exercised for most of the pregnancy, and I didn't have any of the blood pressure issues that lead to Tess' induction. Induction was hard on Tess, and I was glad to have a natural labor with Drew, though I didn't really know what "natural labor" would be like for me.
The night before Drew was born I decided it was probably time to take some pregnancy shots.
The view from above.
And from the side.
I had irregular contractions during the last months of the pregnancy, so I didn't think anything of the contractions that started before bed on November 23rd. Drew still wasn't due for another week. But when I woke up at 6 am, I realized the contractions were becoming more regular. Ryan was surprised when I told him I thought the baby would be born in the next 48 hours. It was Wednesday, November 24th, the day before Thanksgiving and Ryan had taken the day off work for a long Thanksgiving weekend. Meredith and her family had been here visiting during Brian's residency interviews, and we were watching Lauren while they interviewed in Front Royal.

For heaven's sake, go to bed and get some sleep!  You're going to need it!
I proceeded to get my bag packed, get things ready for Tess and considered getting my haircut, since that would be tough to do after the baby was born. By 9 am, though, the contractions were coming regularly and strong about every 5 minutes. I called my doctor's office and they said I should come in for an exam to see how the labor was progressing. Only problem is that we had both Lauren and Tess with us, so we called Ryan's parents and Keith offered to take the girls to their house. The contractions were frequent and painful at this point, and I surrendered my plans for a haircut.

Once Keith arrived, Ry and I headed to the doctor's office, which is right next to the hospital. I waited uncomfortably in the waiting room through contraction after contraction. Then we waited some more. Once in the exam room, we waited again. By this time, I was in excruciating pain, and the contractions were coming every 2-3 minutes.

Around 11:30 am, Ryan hunted down a nurse who finally found a doctor to examine me. Of course, it was the one doctor in the practice I really don't like. He determined I was dilated about 3 cm and said, "I guess we can admit you to the hospital."

We made our way over to the hospital, with me stopping every 3 minutes for a contraction. I guess we should have gone to the ER entrance, because I was practically crying during all the admittance paperwork and climbing all over the chairs. It's hard to sit in a plastic chair when a baby is making its way down your birth canal.

I was admitted to the hospital at noon, and finally they rushed me into a delivery room. The first thing I told the nurse was, "I need drugs right now. I'm in so much pain, when can I get drugs?" The doctor came in to examine me and said I was dilated 8 cm and there was no time for an epidural. "Which doctor determined you were only at 3 cm? Oh him...uh huh."

The doctor broke my water and the Drew was born at 12:44 pm. I screamed, "I can't do this!" the whole time. The doctor told me, "Well, you don't really have a choice right now." And he was right. But my body was so exhausted, I didn't know how long I could endure the pain. I asked the doctor how much longer it would be, and he said, "Just a matter of minutes, if you keep pushing." The umbilical cord was wrapped around Drew's neck, and his face was very blue, but he was fine. I had popped blood vessels on my face and in my eye from pushing so hard, but I was so relieved to be free of the pain.

My labor was so fast we didn't even have time to grab the camera, which was in my hospital bag that we'd left in the car when I went in for my doctor's appointment. Ryan managed to snap some photos on my phone camera. The camera is not the best, and I haven't figured out how to get them off my phone. So these are pics of my camera pics.

We were in total shock that the baby come so quickly and that he was here! The night before I told Ryan it was about time we decided on a name for this baby. We'd narrowed the choices down to Alex, Dylan and Drew, but we were having a tough time picking one. Ryan did the final choosing: "OK," he said. "His name is Drew." So we named him Drew Ryan.

Ryan stayed the night in the hospital with me while Meredith stayed with Tess and Lauren. Mom's flight into Dulles Airport that night was delayed, so she stayed with the Higginbothams. The next day was Thanksgiving, and while I was anxious to be out of the hospital, I decided to stay an extra day so they could monitor Drew. I was supposed to receive 2 rounds of antibiotics during delivery for Strep B, but there was only enough time for one round during the delivery.

Mom stayed with me in the hospital that night, so Ry could go home to Tess. We were ready to go home the next morning when a nurse from the nursery came in to talk to me. She told me the neonatologist had been in the nursery and she asked him about a streaky area on Drew's left arm. He told her it was a condition called cutis marmorata telangiectatica congenita. He said it could ulcerate and bleed, but that it would get better. He described the condition as a "normal abnormality." The nurse gave me some information she printed from online.

Drew's skin at 6 weeks.
Drew had marbled and kind of dry skin on his arms, that didn't seem unusual to me for a newborn. I assumed this was what the nurse meant, and that it would improve over a couple of weeks. I joked with Mom, "Do we dare look this up on the internet?" She googled the condition, browsed a while, and said, "No, you don't need to read this. This has nothing to do with your baby." I figured there was no need to jump to conclusions, and that I'd talk to his doctor about it.

Drew's arm at 6 weeks.
When we got home and I told Ryan what the nurse said, we looked it up online together and were horrified with the information we found. We learned that cutis marmorata telangiectatica congenita (CMTC) is a rare congenital disorder that affects the blood vessels, resulting in a mottled look to the skin that doesn't go away, even when the baby is warm.  Drew's skin has the mottled look of a newborn when it's cold, except that his mottling doesn't go away when he's warmed. The mottling is present all over his body, except for his face. The dark purplish veins are particularly prominent on his left arm.

Beyond just the skin, however, in about 50% of cases, other serious defects can accompany CMTC. The list of potential disorders is truly horrific: glaucoma; body asymmetry (including undergrowth or hypergrowth of affected limbs); heart problems; neurological abnormalities; cleft lip; club foot; macrocephaly; problems with teeth; delayed development; and other life-threatening complications.

We had no idea how to process this information. I couldn't understand why I wasn't given more information in the hospital if this was such a potentially dangerous condition. The neonatologist who diagnosed Drew never even came to talk to me about it. Drew was only a few days old, and the thought that he may have to face any one of these difficulties was crushing to think about.

We took this information to Drew's newborn visit with the pediatrician. This was a new doctor at the practice, and he looked at Drew's skin and didn't see any cause for concern. It was what I wanted to hear, so I didn't push the matter. But I knew the doctor didn't really know anything about the condition, so his opinion offered little consolation.

In the meantime, I made a stupid decision to try and close Tess' heat vent by standing on a small table in her room. I fell and badly sprained my ankle. Thankfully Mom was still here to help because I was bedridden for a couple days. I was stuck in bed with nothing to do but nurse Drew and worry about his condition.  

After discussing it with Mom and Ryan, we decided to take him to Tess' old pediatrician, Dr. Kathleen Hamilton, a much more experienced doctor whose opinion I trusted. I felt that if she told us not to worry, I'd be able to put my worries aside. She is still with the practice, but is now semi-retired and is only in one day a week. I was able to make an appointment with her that week.

Ryan gave me a blessing that my ankle would heal quickly. He also gave Drew a blessing that he would not suffer complications, that his arm would continue grow and develop, and that Drew would develop properly as a little boy should. When I was able to walk on my sprained ankle the next day, I had hope that Drew would be fine as well.

Mom came with me to Drew's appointment with Dr. Hamilton. As I explained the situation to the doctor, I just lost it and was only able to show her the information the hospital nurse had provided. After a careful examination of Drew, she said she agreed with the hospital's diagnosis of CMTC. She had heard of the rare condition and said she didn't see in Drew any of the obvious defects that can accompany the condition. But she advised that we take him to a geneticist and a children's dermatologist at Children's National Medical Center in D.C.

I had gone in hoping she would say everything is fine, and instead she was telling me my week-old baby needed to see a genetics specialist. I was sick with worry. I couldn't eat and I couldn't stop crying. Mom was a lifesaver with Tess because I just couldn't cope. Wendy and Keith put Drew's name on the temple prayer roll, and everyone in our family offered prayers on Drew's behalf.

I was able to get an appointment with the geneticist for December 14th. Dr. Hamilton told me to expect up to a 6-month wait to see Dr. Epps, the dermatologist at Children's, but to go ahead and make the appointment now. I called the dermatologist and was shocked when the receptionist told me she was scheduling out for one year. Not knowing what else to do, I told her to go ahead and schedule Drew a year from now.

She expressed disbelief: "Are you sure your doctor is OK with that?" I responded, "I'm sure my doctor is not OK with it, but I what other option do I have? I'm not saying I won't seek help elsewhere, but if this is the best doctor to see I guess I better get on the waiting list." These appointments were difficult for me to make, and I kept it together but my voice was wavering. Drew started crying and she asked, "How old is your baby?" I told her he was 7 days old. She put me on hold for a minute and then said they had a cancellation and I could bring him in on December 20th. "I just don't like scheduling them that far out when they're that young."

In spite of all this drama, Drew was thriving after I worked through some feeding issues. Although I swore I'd never breastfeed again, Drew was able to latch much better than Tess and I was having some success in nursing him. After a couple of weeks, though, he started having difficulty. He was always hungry, even after I fed him, and would fall asleep nursing. Then he started flat out refusing to nurse and would fight and scream when I put him to the breast. I tried pumping and realized I was hardly producing anything. He was starving and never satisfied after nursing. He gulped the formula down like a hungry little pig. I continued pumping and fed him what I produced for 6 weeks, but he's done well on the formula. I'm resigned to the fact that I wasn't meant to nurse. Oh well.

Ryan and I took Drew to see Dr. Lanpher, the geneticist at Children's, on December 14th, which also happened to see Tess' 3rd birthday. Nana and Papa took care of Tess and made sure she had a special birthday. I'd faxed Dr. Lanpher information on Drew, but I didn't know what to expect from the appointment. Dr. Lanpher had read the information I sent and was familiar with CMTC and the various complications that can be present with it. He did a thorough examination of Drew and didn't see any indication of other concerns beyond his marbled skin. He said all of Drew's limbs were perfectly symmetrical, his head was of normal size, and there were no signs of other syndromes sometimes present with CMTC. He said that Drew's skin appeared healthy and there was no atrophy of the skin, even on the more streaky area of his arm. He said that in most cases like Drew's, the marbling fades over the first 2 years of life and he thought Drew would do very well with the condition. He saw no reason for us to have Drew seen by any other specialists other than the dermatologist.

Dr. Lanpher said that very little is known about CMTC at this point. It may be a genetic condition, but it has not been directly linked to any particular gene. Theories are that it may be caused by a combination of genetic and/or environmental factors. Interestingly, the condition usually occurs only once in a family, so there isn't an increased risk if we were to have other children. And they really don't know if the condition can be passed to offspring, if Drew were to have children. Dr. Lanpher said that possibility is a long way off, and they will likely know much more about the condition by the time Drew is ready for his own family.

I don't know that I've ever felt more relief than I did after that appointment (we had real cause for cheer at Tess' birthday celebration that evening). Finally someone who knew what he was talking about, and he saw no need for serious concern. I was even more impressed when Dr. Lanpher sent us a clear and detailed write-up of his exam and diagnosis.

Dr. Epps, the dermatologist at Children's, was also familiar with CMTC. She agreed with Dr. Lanpher's assessment that Drew would likely do well with it, and that in most cases the marbling slowly fades after a couple of years. She said that in a couple extreme cases, she's been able to do laser treatments when the child was older. She agreed that the skin on his arm was not atrophying.  She said that any ulceration usually occurs early on, so we likely won't have problems with that. She took photos of his skin and asked us to come back in 6 months so she can track his progress.

It's been wonderful to let my concerns about Drew's skin become secondary to all the normal concerns of caring for a newborn.  We've been undeniably blessed with the quality of doctors and resources we've had in learning about his condition in such a short period of time.  Very few doctors are even familiar with the condition.  I found that there is an online support group for parents of children with CMTC, headed by two doctors in the Netherlands.  They have two conferences annual conferences a year--one in the Netherlands and one in Washington D.C. in July.  I haven't decided whether or not to attend the conference--I'm not sure how much focus I want this disorder to have in our lives--but it's comforting to know that resources are available if we need them.

I've noticed some gradual fading of the marbling on Drew's skin, particularly around his midsection.  But he's definitely still marbled, particularly on his extremities. He's usually pretty bundled up for the winter weather, so no one has made any comments about his skin, but it will be more noticeable once short sleeves weather arrives. But frankly, if a little marbled skin is all we have to worry about, that's no big deal to me.

Drew is starting to leave the newborn stage behind. He's sleeping longer at night and is alert and happier when he's awake. He coos and smiles and talks all the time. His sweet personality is surfacing and he's finally starting to get fun!

Drew's 2-month appointment was nothing but good news. At 12.1 lbs, He's gone from the 10-25th percentile in weight at 2 weeks to the 70th percentile! He's 24 in long, which means he's grown 3 1/2 inches and is in the 75th percentile for height. And his little noggin is right where it should be at the 50th percentile. He still looks a lot like Tessie did at this age, but he's bigger than she was and does look more like a boy. At her 2-month appointment, Tess was 11 lbs, 3 oz and was 22 3/4 in long.

We're grateful for good news and we're grateful for our baby Drew. Love him to the moon and back.

Friday, January 21, 2011


Tess had her 3-year-old annual checkup yesterday, and she checked out as a healthy specimen.  She weighs 30 lbs. (45th percentile) and is 38 inches tall (65th percentile).  She's meeting all the benchmarks at this age and didn't even need any shots.  (Although she did get a fingerprick.  "Mom, it a baby shot, not a big shot.")  The doctor wasn't concerned about our lack of potty training progress.  I guess she'll do it when she's ready.

A quick peek at some of Tess' creative undertakings.  She does not the house to be too quiet, so she likes  to listen to music and she loves dancing.  

She also likes to set up "tea parties" with her friends all over the house.  The following are common scenes:

Tess likes being at home and doing her own thing, but she's had a tough time with going out lately.  She has a really hard time with mornings.  She loves to snuggle on the couch and watch TV and she can spend 2 hours eating breakfast.  Getting her ready to go anywhere before noon is a real challenge.

She gets particularly worked up if it's a social situation.  This week, she's thrown tantrums about going to church, going to playgroup, going to exercise group at church and going to the gym.  She'll cry and scream and come up with any number of excuses why she can't go.  "The kids take my toys!  The kids take my coat!  The kids take my baby brother!"  Once we actually make it to any of those places, she does fine and usually doesn't want to leave when it's time to go.  But there's just no reasoning with her beforehand.

She has these kind of tantrums periodically and then she seems to outgrow them, so I'm trying to ride this cycle out.  Granted, she has had to adjust to a number of changes around here lately. 

And for the most part, she's taken it all in stride.

Monday, January 10, 2011

How The Grouch Stole the Dinner Salad

Tess has been quite the character lately.  Tonight at dinner, she kept pointing at something while saying, "The Grouch! The Grouch!" and acting like she was scared.  We let it go the first couple times, but she persisted, so I asked her if she was talking about Oscar the Grouch from Sesame Street.

"No," she said.  "The Christmas Cat in the Hat Grouch."

"Oh!  You mean The Grinch?"

"Yes, The Grinch!"

"But why are you talking about The Grinch?"

"The Grinch in the salad."  Huh?

And then we looked at the salad bowl and saw The Grinch.  In profile.  In the salad bowl.

The Grinchy culprit.  I ate the Grinch and then she wasn't scared anymore. 

Ryan's comment:  Tess' reference to the Grouch/Grinch reminded me of a recent comic strip:

Get Fuzzy - December 2, 2010

Get Fuzzy - December 3, 2010

We got a dusting of snow this weekend and rascally Tess had fun playing in the snow and throwing snowballs at Dad.

Tess has also been doing more drawing lately.  I love seeing what comes out of her little head.  This is a portrait of Tess and her baby brother.

And a picture of Tess and her school friends.  She threw Baby Brother in for good measure.  You can tell which one is Tess because she's the biggest and has eyelashes.

Being such a monkey can be positively exhausting.  This is how we found Tess asleep in bed the other night.  I guess it was kind of heavy reading. 

Drew's personality is also beginning to shine.  He's started smiling and talking to us.  I absolutely melt when his little lips curl around to form a perfect little "Coo!"  I could watch this over and over again.  My Cooey Drewey.

My boys.  Do I have a cute family or what?!

Thursday, January 6, 2011

Of Late

Happy to report that I have nothing too eventful to report.  Ryan's back at work and I'm learning to juggle the two kiddies at home alone.

In my need for sanity and rest, Tess has become something of a TV junkie.  Today I thought we'd see how long we could last without turning to the tube.  Tess needs background noise, so I got a bunch of kids music CD's from the library--every one of which drove me batty.

Tess was much more creative today when she wasn't plugged in to the telly.  This is a photo of her "experient," which she defines as "something new I try."  This experiment involved creating a bridge out of cushions and pillows and doing tricks to get across to the other side.

Without cushions, the couch made a "perfect lil bed" for Teddy and Tess read him bedtime stories. 

She also painted, colored, played computer games, helped me with a Valentine's craft, read library books and played dollhouse.  We made it until 4:00, when I turned Curious Buddies on continuous play and let it go for 3 rounds.

Speaking of Valentine's crafts...

Heart pockets just right for love notes and a Valentine's Day treat.

And a paper heart garland that I made because I couldn't find one I liked in the store.  I thought Tess would enjoy helping me "curl" the hearts, but the novelty of it wore off quickly.  Still, she approves of the final result:  "I love all your hearts, Mom!"

Speaking of love...

I may be biased, but this baby of ours is getting really cute lately.  Ryan has a special knack for getting newborns to talk and he had Drew cooing tonight.  Both Ryan and Nana claim they've seen Drew smile, but I've yet to see it.  He is definitely starting to develop a little personality.

Drew's hair is lightening up like Tess' did, but we've been surprised to see new hair growing in too.  Tess was basically a cue ball once she lost all her dark hair.  Tess loves to point out and laugh at his "spiky hair."  Today she was doing a fish puzzle at the library and she held up a puzzle piece shaped like a puffer fish next to Drew.  "Look Mom, the puffer fish has spiky hair just like baby brother!"

Awww...our little baby puffer fish.