Friday, September 28, 2007


So, in the last week or so, we've officially gotten first words around here. Prior to now, we've gotten the odd "mama" and "dada" for months now, but it's been inconsistent, and I haven't always been sure it applied specifically to us. I had actually been beginning to worry that this was a sign my babies were not in fact budding super-geniuses, but thankfully, they've decided to appease me.

I don't know that I've talked much about their personalities, but as anyone who knows us in real life can tell you, they're so strikingly different that you wouldn't guess them to be twins.

Claire, the older twin and the smaller one, is so incredibly busy and inquisitive. She wants to get into everything and to do everything, and is extremely strong-willed and focused on whatever it is she's doing. She is assertive and self-assured, not to mention impish, the type of child that strangers smile at in the grocery store and say, oh, I bet she's a handful. And she is -- not in a bad way, but she definitely requires a lot active and involved parenting. She is sometimes exhausting, but she is also a very engaging child, and it's fascinating to watch her learn about the world.

As for Katherine, a friend of mine told us when she was ten days old that "there's just such an incredible sweetness to her", and nothing in the subsequent year has made me question that. She is more quiet than Claire, and by nature is easy-going and laid back. She is a sharer, and will happily give you any illicit treasure rather than try to run away and then cry when it's taken, as her sister does. She loves to pet the puppies (our three standard poodles), and will often just lie down and snuggle with them, whereas Claire wants to throw the ball for them to chase. If she's content with what she's doing, she doesn't feel the need to get into everything like Claire, who will immediately make a beeline for the open baby gate or the dropped remote control or the carelessly-set-down glass. Being Katherine's mother is an easy job, and a rewarding one filled with the baby hugs and kisses Claire doesn't always have time to hand out.

In view of all that, you won't be surprised to hear that Katherine's first deliberate word is "dog" -- well, really "dah!" but there's no mistaking what she means when she points and says "dah! dah! dah!" at any dog who approaches.

As for Claire, I think it tells you all you need to know about her when I tell you that her first word was, clear as a bell and impeccably-timed as she knocked over my crutches...

.... "uh-oh!"

Thursday, September 27, 2007

How weaning happened

As I mentioned earlier, the babies are now officially weaned. I've had a couple people ask me in other contexts how that went, so I thought I'd talk about it for all of you.

We had always intended to wean at approximately one year. Originally, I really, really wanted to make it to six months, and then to a year if I could. However, we didn't really want to go much beyond that, for several reasons.

One, the idea of toddler nursing didn't really appeal to me, and especially to my husband. Two, we knew we wanted another baby, and with my HA, it would be necessary to wean partially or completely to see if my cycle would return. Three, there is a lot more social pressure put on extended nursing mothers, and I knew I'd get it from family and some acquaintances. I couldn't have cared less in the first year, but when the babies are getting most of their sustenance from solids anyway, the cost-benefit analysis shifts.

I might have dragged the weaning process out somewhat longer if it hadn't been for the surgery, though. Once we got down to two sessions a day, my nursing relationship with the girls really shifted, and in a way I actually enjoyed. It became less about getting them fed and more about it being their special snuggle time with Mama, especially as they are rapidly becoming too busy to cuddle much. I miss this very much, especially the bedtime nursing, and have been tempted to start again on several occasions. Had the surgery not happened, we might have kept this up for another two or three months.

However, the surgery did happen, and it was a convenient fixed-date goal. To be clear, there was no medical imperative that I wean. They could have taken bottles the night I was gone and returned to nursing afterwards. Pain medication would have been something of an issue; I'm not one to generally fret too much about medicine in my milk, but I was taking a LOT of oxycodone for several days there (and am still on hydrocodone two weeks out). However, I could have worked that out with the pump, or with proper medication timing. The biggest issue was that, as my previous surgery showed me, it's really hard to nurse when you've got a hurting and immobilized knee, and when you're drugged and groggy and just want to sleep. As painful as this ACL repair has been, I've been glad I didn't have to nurse them.

We started the weaning process about a month out from the surgery. At this point, they were nursing four times a day (morning, evening, and after two naps), and eating three solid meals. They were not in the habit of snack-nursing or night-waking, although I did sometimes comfort-nurse if a baby was particularly upset. It definitely made weaning easier, that they were already on a somewhat predictable schedule. If you're thinking about weaning and have a grazer, I would recommend that you shift your nursling to a more consolidated pattern as the first step.

The first feeding to go was one of the post-nap feedings. They had been trying to shift to one nap anyway, so encouraging that let me drop one feeding pretty easily. After a week, I dropped the other post-nap feeding, and replaced it with a sippy cup of cow's milk and a graham cracker, which they love ten times more than nursing.

The next week, we dropped the morning nursing, and started taking them straight to their high chairs for breakfast when they woke. This was the one I struggled with, because it meant I had to get out of bed and feed them breakfast instead of catching a few extra minutes of nursing napping! I still miss this one, and I often snuggle with them in bed for a couple minutes while they wake all the way up.

The final nursing to go was the bedtime nursing. I wish I could say I had a well-thought-out strategy for dealing with this one, but I didn't. The last night nursing was the night before my surgery, and after that, I just wasn't available at bedtimes, and let my mom and my husband figure out how to get them to bed.

For the most part, the girls really didn't even seem to notice that I was weaning them. They were somewhat distressed the week following complete weaning, but between the teething and the weaning and the general upheaval, it's hard to say how much was due to any one cause. They don't really pull at my shirt or root around much, with one exception: when they hurt themselves and are very upset, it's clear they want to nurse to make it better. They accept their fingers/thumbs as substitutes, but I still feel a little twinge about denying them.

Because I am prone to plugged ducts, we tried to do everything slowly, dropping one feeding a week. However, I still suffered from terrible plugged ducts, to the point that my entire breasts were rock-hard masses of lumps. Fortunately, this did not turn into actual mastitis, but it was quite uncomfortable, and I was often glad I was already on painkillers.

Two weeks later, the plugged ducts have finally pretty much resolved, but I still have milk ready and waiting at the slightest provocation. I think this is partly due to my hypothalamic amenorrhea -- my hypothalamic/pituitary axis has never been very good at downregulating prolactin, and I've struggled with oversupply. I'm waiting to see if this resolves, but if I still have milk at my yearly exam in November, we will check prolactin and discuss.

As I posted previously, I did actually ovulate and have a spontaneous period toward the end of the weaning process, albeit with minor luteal phase disturbance. I have not ovulated, or shown any signs of it, so far this cycle, which is somewhat disappointing. However, this could easily be chalked up to the surgery, so I'm not getting too upset about it. Obviously, I will have to wait a couple months and see how things shake out, but I'm not ready to declare my ovulatory issues to be resolved just yet.

So, that's the end of our nursing story. Overall, I'm very proud of myself for having stuck it out for a year, and I think it was a worthwhile achievement. I'm somewhat sad that it's over, but I hope I'll have the chance to nurse more babies someday.

Wednesday, September 19, 2007

Oh, for crying out loud

Did y'all see that an Australian IVF patient is suing her doctor because she had twins?

Apparently, the woman in question had requested a single-embryo transfer, the doctor mistakenly put two back, and she had non-identical twins. She considered putting one up for adoption(!), but decided instead to sue him for the cost of raising one of the babies.

This, to me, is just the height of idiocy. Yes, the doctor screwed up, but a) accidents happen; and b) multiples are a fact of life in infertility. Nobody can promise you that there's always just a single follicle, or that the embryo won't split into identical twins(as IVF embryos appear slightly more likely to do). I'm quite sure the woman signed consent forms to that effect somewhere along the way. She darn sure signed them for the IUI procedures she'd had done previously.

If she'd gotten pregnant with IUI twins, or IVF identical twins, the outcome would have been the same. She'd have suffered the physical difficulties of a twin pregnancy, the potential prematurity issues, and the costs of equipping and raising two babies. She accepted those risks, which can't be blamed on anyone else, and it's hard not to escape the conclusion that she's only suing the doctor because she can.

I know it's hard to have a twin pregnancy, to birth two, to equip a nursery, to nurse and comfort and take care of two tiny babies. However, as they grow, I've also discovered the joys of twins -- the way they entertain each other, the "sharing game" they play, the way they elevate my husband to parenting equality rather than being the secondary parent. It requires more work and more money, but I would not trade it for anything in the world.

Admittedly, my pregnancy was not as bad as it could have been, and my babies have been very easy for twins. Still, I find it hard to see what they're so upset about. They don't appear to have had prematurity issues, or any maternal issues beyond bedrest and postpartum depression. I can name five women off my blogroll who have had worse stories than theirs, from a medical standpoint. As for the costs of raising twins, well, I equipped a nursery -- nicely enough that it got photographed in our local paper -- bought a bigger vehicle, quit my well-paying job, and am contemplating buying a larger home. We are not independently wealthy, but somehow we've managed to do all that without landing in the poorhouse. So yes, I find it really hard to muster up any tea and sympathy for them.

I accepted the potential dangers and unpleasantnesses of having two, and judged it a fair trade-off for being able to have any baby. When the grocery-store ladies tell me I've got my hands full, I often respond, "Better full than empty!" And that's how I really feel. Yes, I believe that singleton pregnancies are a better outcome for infertility treatment. However, given the current fiscal and technical realities of IVF and IUI, that's just not always how it works, and multiples are the risk you have to accept. Ultimately, I think it's better that we have multiples than that we have no baby at all.

Whatever you think about the people who have high-order multiples and don't selectively reduce, at least all of their children know that they were wanted. I also think it says something that there hasn't been a lawsuit (that I've heard of) where the clinic gets sued by parents of high-order multiples, who have endured much greater financial, physical, and emotional costs than someone who "just" has twins.

What kind of message will this one day send to her babies, that she didn't want one of them? They won't know which was the unwanted twin, so each will assume it was herself (or, during spats, the other). They'll know that their mom seriously considered giving one of them away, or perhaps selectively reducing one of them (though the article doesn't mention this, I'm assuming that it was probably discussed if adoption was). Their twin bond, and the joys of having a sister, will be the things their mother didn't want them to have. How will that make them feel?

I try not to judge other people's choices, but this makes me angry. This couple chose to do ART, understanding that it carries a risk of multiples. They got a "good" health outcome with their multiples, and have a family that many women would kill for. Now they're suing the doctor, and saying things in court that their children will eventually hear and never forget. I hope that the $400K they're asking for is worth it.

Wednesday, September 12, 2007

Separation anxiety

This has been a week of separations for us all.

First of all, the girls started Mother's Morning Out at a local church last Wednesday. When I dropped them off, there were tears, but none of them came from the babies. I've left them with sitters before, and at the church and gym nurseries, but somehow, it's different when they go to "school".

I think I've mentioned that I quit my job after they were born and went back to freelancing. My workload has increased over the last month or so, enough that I now have a sitter who comes for three hours a day after school, and then the two mornings of MMO. Honestly, it's more time than I really want to be working, but when you freelance, it tends to be feast-or-famine. I just wish it didn't come at the expense of time spent with the girls.

The second major separation was the end of nursing. I've been gradually weaning them for about a month, dropping one feeding every week. Monday night, the night before my surgery, was the last night they nursed before bed, and now we're done. They don't seem to have taken it too hard, overall -- they're a little off-kilter, but I think that's because there have been so many changes in their bedtime routine. It's been hard for me, though.

I worked so hard to be able to exclusively nurse them, put so much time and energy and pain into it. I'm delighted I was able to nurse them for a full year, and overall, it was the right time to stop for our family. They are still young enough to adapt to the change easily, we're ready to hope for a third baby, and frankly, there is something appealing about having my body back to myself again, after nearly two years of pregnancy and nursing. Still, it's made me sad, because it's one more milestone of growing-up, and because I loved the closeness of it.

Oh, and speaking of that third baby -- it worked! I got my period! Ten days after ovulation, so still some luteal phase disturbance, but nothing worth throwing stones at. I feel like the Velveteen Rabbit, like I've suddenly become Real after so much desperate longing. It's only the first step in getting pregnant again, but it's more than I have ever been able to do by myself before. As soon as my knee is sufficiently healed, we'll start trying to get pregnant, and I am so very excited about actually being able to try this time!

The final separation of the week was the night I spent in the hospital Tuesday, after my ACL replacement surgery. As it turned out, once they put me to sleep, they were able to test and discover that my partially torn ACL was only hanging on by a thread, and that it was completely useless at holding my knee together. This wasn't exactly a surprise, given the trouble I'd been having with it, and it did come as a relief that they decided to replace the ligament, so I can recover and move on.

However, the surgery has been no joke. I've had two knee surgeries already, but both of those were for cartilage damage, and I really wasn't prepared for how painful this would be. They actually drill small holes in your leg bones to anchor the new ligament, and this hurts just about as much as you'd think. They recommend an overnight hospital stay for pain management; I was hoping to be able to tough it out and go home, but when I woke up from the surgery, that clearly wasn't even an option. I went home yesterday morning, desperate to see my babies, but there have been some points over the last 24 hours where I've thought that perhaps I should have stayed a second night, because the Percocet just wasn't cutting it.

I am finally moving around a bit more this afternoon, and have managed to stretch out my Percocet doses to the recommended 4 hours, rather than popping two of them every 3 hours. I'll start physical therapy in the morning, which will mainly involve managing the swelling and working on getting motion back into the joint. I'm looking at four weeks of no weight bearing, and two weeks of partial weight bearing after that, which is a damned long time when you have small children. I can't pick a baby up and go anywhere with her, so I'll have to have friends and family stay with me all the time.

It's a big hassle, but I'm still glad I went ahead and had the surgery. I'm glad to know I wasn't making a huge fuss about nothing, and that it turned out to be a surgically correctable problem. I'm relieved that I will someday have a normal knee again, and that I won't have to worry about falling and dropping a baby, or damaging it worse in a future pregnancy. I will theoretically be walking again by the advent of the holiday season, and I have high hopes that this will be the first Christmas in several years where G doesn't have to do the shopping while I am sidelined by health issues.

Overall, things are working out the way I've hoped they will, with the childcare and the nursing and the knee. It's just that the process is tough, sometimes!

Thursday, September 06, 2007

31,536,000 seconds

31-million-odd seconds ago, my daughters emerged into the bright lights, Claire quietly and Katherine with an angry wail. It was, without a doubt, the best day of my entire life.

How that squares up with the fact that each day is better than the next with them, I'm not sure, but you'll just have to take my word for it. I won't pretend that every one of those 31.5 million seconds has been wonderful, but the couple thousand that sucked are vastly outweighed by the joyful remainder.

I have been looking at their newborn pictures today, as you might have guessed, and I'm struck by how different and yet how similar they look now. When I was pregnant, I had no picture in my head of how each baby would look; and then when they were born, I couldn't imagine what they would look like as toddlers. Now that they are toddlers, it's the most self-evident thing in the world that of course they would look like they do now, and yet I can't extrapolate to their two-year-old selves. I have a feeling, though, I'll find out sooner than I can conceive.

When you're pregnant, or have a tiny baby, everyone tells you how fast it goes by, and you shrug your shoulders and say, yes, I know it will. Still, you don't really know what they mean, until one day you look up and it is their first birthday, and your babies have been replaced with two little people who are crawling and walking and going to Mother's Morning Out and playing pattycake and eating grilled cheese sandwiches.

Happy birthday, my darling girls, my Claire-bear and my Kitten. Your father and I love you more than you will be able to imagine for many years to come. We have been richly blessed in each of you, and in the pair of you.