food frustration

Another follow-up with the GI doc last week and it seems that our miniature man is still miniature.  To be precise, a full ounce lighter than our last appointment.  And now we find ourselves at a bit of a crossroads.

We entered this super-high-tech medical world with the goal of ruling out any crazy, rare disease which might explain his rather unusual growth chart (8 lbs at birth, 12 lbs at 4 weeks, 20 lbs 4 oz at 17 months).  JD and I are not basketball players, but neither of us is tiny.  I'd wager that we're both about average height and weight.  The fusspot has always held steady somewhere between 30th-50th percentile (after her rough first month) and in general has very normal toddler eating patterns: nothing new unless it's coated in cheese or chocolate, but very happily eats a wide range of food (Seriously, my oldest turned down maple syrup at the diner because it was "new" but loves her lassis and hundred year old eggs).

We have thus far ruled out a variety of rare diseases: celiac, allergies (no rashes, and he tests negative via blood test, although obviously he could still have something, also no family history of food allergies), juvenile diabetes, thyroid, cancer, parasites ... basically his labwork all looks good and he meets all developmental benchmarks.  He is also super active (except for one test, and doctor thinks it's a false positive.  Needless to say we'll be testing again for C.rohns at his next appointment but not scheduling the scope until he's bigger/older because of the anaesthesia).

And here's where things get dicey.  Anytime you mention toddler failure to thrive, questions are going to be raised about the family/environment.  Stress?  Abuse?  Poor food habits?  I know they need to ask these questions, and I know that they are relevant for many families, but I am truly confident that the dumpling has no sensory issues/no anxiety related to food.  He will very happily eat about 3 bites of anything and then he's done, lips pursed, not another calorie going to enter his body.  We -always- let him self-feed, two hands into the food no matter what it is.  He is allowed to run around and snack no matter how messy (something I would never allow except for above weight issues).  And I am tired of being questioned, of having dumb doctors and even nutritionists suggest "new high calorie foods for him."  No, he has never eaten an avocado even when doused in brown sugar and blended with cream.  No, he does not like peanut butter or butter or cream or whole milk.  I mean, this toddler declined warm chocolate chip cookies last weekend, even when I left a plate on the floor next to the blocks so that he could approach them on his own schedule ... resulting in chocolate smeared all over my carpet but not a single bite in his mouth.

And in order to get calories into him, my previously organic-home-made-meals baby's diet looks like something out of a toddler-version of SuperSize Me.  He has either string cheese or hot dogs for breakfast.  Cream added to his whole milk.  Peanut sauce doused on his pasta.  Goldfish for snacks instead of fruit.  Fruit roll-ups, egg yolks but no whites.  It is the type of diet that would give anyone a stomach ache.  And I'd like to stop.  To step back and say there is nothing medically wrong, and he's just small.  But now the seed has been planted: the fear that this will affect brain development if we don't ply him with high calorie processed foods.  Or that he'll land up needing growth hormones in the near future.  Let alone the fact that we are now thoroughly under medical surveillance and repeat 3-day food diaries are in high demand. 

For a condition where stress can easily be a trigger, it is scary how easily all of this can fall into blaming the mother.  I am tired of chasing my toddler around the apartment with forkfuls of high fat hot dogs while he shakes his head no and runs away.  I'd like to have the perspective to say we ruled out the really scary stuff, now it's time to get back to normal, but I'm not sure I'll be able to.  And yes, I am deeply thankful that all test results were normal.  But now that the fear has been planted, I certainly feel more concerned than I did pre-testing.

ps -and for those wondering about the next medical step, there is a new consult with a new allergist for the end of the month and I'd like to try a lactose-free diet for a week or two.  I know lactose intolerance is rare this young, but so is everything else we looked at.  It does not make sense that an otherwise healthy toddler would deliberately starve himself, so my suspicion is that he may have some discomfort from food, although who knows if we could ever isolate that?

You know when lottery winners complain about the taxes?

I am so that girl right now.  But really, I don't have any other place to think about these things.  I have had a few too many conversations with my one local mom friend who is on the should-we-or-shouldn't-we bandwagon right now.  Of course, she of most awesome fertility (conceived without help at 3 times at age 40+) is really in no rush to make a final decision ... So I am going to write here, and hope that you will be kind (or at least click away quickly and come back another day).

The topic, as you long-time readers will surely have guessed, is Project 3.0.  And the great bloodbath earlier this month means this is a topic we can no longer avoid.

I really thought that I would be ok agreeing not to try.  I need to finish my stupid degree (and a 3rd pregnancy would convince absolutely everyone in my field that I am a joke, but then again they probably already think that after #2 and the related meltdown).  But on rough days like today when I feel entirely incompetent at work and can't even make polite small talk with the one colleague I see weekly as we walk into or out of the building (I cannot describe how grim my work life is right now.  I work in a small office with a door, near no one I know.  I leave my solitary confinement 3-4 times a day, to refill my water bottle or print something or go outside to defrost my hands from the excessive AC but that is it.  No conversation, no interactions, just me and the doubts in my head), I just want to step back and acknowledge that the one thing that I really enjoy on a daily basis is parenting (it's not that JD and I are on bad terms, but I honestly don't see him every day even though we live together.  He's been working until 2 every night for a while now, and is often gone before I get up).  And the idea that we might waste one tiny sliver of my practically non-existent fertility is terrible.

And more than that, I love the spacing between Project 1.0 and Project 2.0.  I love watching them play together, knowing that the fusspot has no memory of life before the dumpling, knowing that if all goes well they will go through life together with shared childhood memories.  And if we did manage to complete our family in the next 5-6 years, we would be plenty young enough to look forward to many years of travel and exploration after the kids grow up (this is very much on my mind as I watch my much, much older local mom friends parent.  I actually have 3 friends who are 39, 42, and 41 who are all "considering" whether to have another baby.  My closest mom friend will spend this year worrying about kindergarten admissions in the big city.  When I am the same age she is now, I will be worrying about college admissions for my second child (lord willing).

Oh, and I firmly believe that nursing helps my fertility (PCOs is not my only diagnosis) and I am terrified that if the dumpling self-weans we'll need major interventions again, and then finances will be a big issue (no, I am not planning to wean him deliberately.  We're just crazy like that).  But the sad truth is that the cost of fertility treatments (even the 50-60,000 we budgeted for 2-3 rounds of IVF for Project 1.0) is trivial compared to daycare costs and preschool and afterschool.  And JD is really worried about the short-term costs of Project 3.0 should we be successful.  Then again, our chance of getting twins is so much lower without injectables (although I do tend to have a million follicles).

If I weren't nursing, I do think we'd freeze some embryos before I get any older, but that's not really an option while nursing (especially since I am prone to OHSS).

In short, my wishes are entirely irrational, despite any attempts at justification above, but then again isn't have a baby in the modern world always irrational?  They are time consuming, carreer-ending, expensive entertainment.  And yet I have no doubt that we'd never regret the decision.  And thankfully it is really looking like a question of when rather than if, JD recently seems to be entirely supportive of Project 3.0, even if he'd rather wait.  And for that at least I am truly deeply thankful, even if it won't be this year.  And yes, there is a very small part of me that looks forward to the possibility of enjoying a newborn without worrying about having no leave and getting back to work immediately and parenting without a real support network, all of which could conceivably be different if we wait a few years.

Of course, I also kind-of thought that I could chart ( a few hours reading deeper into the google informed me this was idiotic with my level of severe PCOs) and had some weird break-through bleeding yesterday and well ... yeah ... who knows.  This whole conversation may be irrelevant.  Or I may never get another cycle after my first post-partum bloodbath and there is no way JD would consider swinging by the clinic right now.  Or we may decide not to try but continue not to do anything more organized than talk about bcps. 

For now, I will just obsess and try to see the virtue in waiting.

Dr. Google is making me nervous

Just got some lab work for the dumpling, and Dr. Google is making me nervous.  His lab results were all fairly normal except for testing positive for "lactoferrin stool test," which seems to be a highly accurate test to indicate either Crohn's or Ulcerative Colitis.  Here's the thing: his only known symptom is slow weight gain.  He doesn't seem to be in pain and he's generally quite a happy guy.  Anyone have any experience with this?  Our follow-up with the specialists is not until Wednesday, although I may just give her clinic a call tomorrow to see if someone will talk to me.  I have had a long, long history of GI problems, but all stemming from a rather dramatic travel illness circa 2002 (it's rather noticeable when you lose a third of your body weight in under 2 weeks).  As a result I have had almost every GI test out there, have a specialist who follows me every 6 months, and have on and off for years had to manage GI symptoms.  But Crohn's terrifies me with its unpredictable flare ups, and seriously, any ever heard of such a thing in a baby?

Edited to add: confirming facts: sudden weight loss, anemia (despite being breastfed and not having his cord cut for at least 10 minutes), and 2-8 times more like in the children of Ashkenzai Jewish mothers (yes, this is a maternal genetic disease, fun times) and also more likely in urban babies

But, Dr. Google also notes that "lactoferrin" increases in the breastfeeding toddler during slow weaning.  

Echos of the past

In the last two days I have had two very unexpected run ins with my past and while neither was earth shattering, they are both odd reminders of situations long forgotten.  Thankfully neither involved my exs, who have the unfortunate habit of either appearing in Whole Foods at 10 pm when I am running out in my pajamas with a fussy baby (twice, folks!) or on the subway at 8 pm on a hot, summery day when I am drenched in sweat and my toddler is threatening to "peep" on the subway seat unless we hurry up and find a bathroom (ah yes, we exude confident elegance wherever we go).

The first run in started with a little disaster.  I went to put more air in a distinctly flat Phil and Ted stroller tire and the entire wheel exploded so violently that it shattered the plastic wheel rim.  And since it's hot and I do not relish carrying a child and my laptop/books/lunch on our mile hike to daycare every morning, I decided to splurge on a standing "board" for our big stroller.  All long background to say that I most unexpectedly found myself ringing the doorbell of our old neighbors' door (ah, craigslist ...) and who should answer but the baby.  The very baby featured in my second ever post on this blog (circa January 2008: http://longdistanceinfertility.blogspot.com/2008/01/what-weird-culture.html).  The baby I mistakenly thought was a little girl.  Now a large 4 year old boy who held the leash to the still-yapping big dogs.  Followed immediately by the toddler who used to fling his shoes at my door when we first started cycling (http://longdistanceinfertility.blogspot.com/2008/03/great-news-before-9-am.html), now a very large 6 year old boy.  Naturally the clueless father did not recognize me for a very long time, but just standing in the doorway of our old apartment looking at two big boys staring at me brought back all of the memories of lying alone and hungry in my bed listening to the baby cry and waking up to toddler shoes flung into my entryway. 

When I feel overwhelmed, I need to remember that it's only been 4 years.  4 years since we started this adventure.  But oh wow, how big those kids got in 4 years.

Ah yes, and how awesome that my dear reader Io was commenting back then, and now folks she's back online and cycling right now. 

The second blast from the past happened this morning on the subway.  I convinced JD to lug the children in to daycare, and so I had the immense luxury of riding the subway in to work.  And who should be sitting on my train car but my orientation leader from college?  Yes, we've been in touch frequently since then because he happens to be in JD's wider circle of friends, but I haven't talked to him much.  So much so that even though I last saw him only a few months ago he somehow had no idea that we had kids.  He's only a year older than me, happily living the single life in the big city, literally running over to the drug store to buy deoderant when we got off the train before a work meeting because he'd forgotten that morning ... and it brought back all of those memories of early college, which was definitely a rough time period for me.  Let's see: my parents divorced, I got evicted from my dorm because everyone was so distracted that no one remembered to pay the bill (and no, it was never sent to me or I would have figured out a way to take care of it), I dated a raving alcoholic (and a few other less savory characters), and in general I just felt alone.  And yeah, it's been a really rough week (I am writing this on 2 hours of sleep.  Hence the massive overuse of parenthesis), and it's good to remember that I've been through rough weeks and months before.  And even though I am pretty sure that I was a clingy, insecure, blabber mouth during orientation (which included a 4-day trip into the backwoods of NH.  Let's all play college trivia, since this college is known for its "camp ---" feel and long orientation), this guy had the kindness to give me a big hug and pick up the conversation as if none of those details mattered.

Only 4 years and be kind, that's today's take-away.  And try to get more than 2 hours of sleep per night.  But you already knew that.

Like ripping off a bandaid

I know it would happen, the big move has been hanging over of us for months.  And now it looks like it's going to happen sooner rather than later.  Probably.

Not to be too cryptic, JD has been offered a new job.  Hopefully a job with much better hours.  In DC.  And he might start later this month.

For a long list of reasons it looks like I am going to stay behind in the big city until Christmas-time.  #1 being that if this particular election results in a new president, his new job might very well disappear.  So there's that.  There's also the immense challenge of finding a new apartment, preschool, daycare, etc.  All in a big, expensive city (oh, and after a 50% paycut for JD). 

And honestly, I am really not ready to go.  I never wanted to move to NYC but now that I've been here for this long, it has so many wonderful conveniences.  We don't own a car.  We have never had to battle carseats on a daily basis.  All of our playdates and activities are within walking or bus or train distance.  I can hop on the subway with both kids and be across the city and at a new adventure in a half hour, usually.  I have found a small group of wonderful mom friends, one of whom lives across the street from me, another who lives a block away from the kids' daycare.  It is going to be really hard to replace those friendships in a new city, especially one in which many more people either work full-full time or not at all.

But we are going to do it.  And at least it is another lovely East coast city.  Not such a big change, even if it is almost certainly only for a few years.

But in the meantime we are going to try and make the most of our last few weekends in the big city together (despite big deadlines for both of us).  I have already found a potential roommate to move into our apartment when JD moves out (I'll sleep on the floor of the kids room) and he is busy searching for the cheapest place he can find in DC for a few months.  And sooner than I think, it'll be just me and the kids again, and then off to a brand new city.

Rather incompetent

I pride myself on being a particularly competent woman.  I can do my own taxes, take care of basic household repairs, talk myself out of a ticket for indecent exposure (ok, that was a long, long time ago and really just a big miscommunication.  I did not manage to talk myself out of the ill-fated night when I happened to offer an undercover cop cash to buy me beer ... on videocamera), handle canceled credit cards and missed trains, the usual.  Let's just say this weekend has been full of spectacular (and yet not serious) disasters.

Evolutionary-wise, I think it makes sense that most people get their first period at an earlier age.  Because, well, it's even more embarrassing to mess up when you are 31 years old and have 2 children in tow.  The highlights:

1. Reading to my daughter in Barnes and Noble on Friday morning.  Let's just clarify here: a crowded Barnes and Noble in the middle of NYC.  Stand up and realize that I have bled through a heavy duty pad, my skirt and tights and am currently rocking a large bright red stain on my rear end.  Delicately drape an ergo across my rear while dangling a child under each arm and desperately calling a friend who lives near the bookstore.  Thankfully she was home, I shoved my children into her door, hopped in a cab and was all clean and ready to start the day again 15 minutes later.   Let's just assume that if anyone I do know saw me running out of the bookstore while dripping gobs of blood down my rear, they were just as much trying to pretend they didn't know me as I was trying to pretend the whole thing wasn't happening.

2. 3 hours later, sans kid.  LLL meeting downtown.  Rinse and repeat, except this time it was me slinking out of the meeting to rinse my jeans in the bathroom sink and then attempt to pat them dry with a wad of paper towels (no air dryer in sight).  Thankfully it was a hot day and I'm sure I did not walk around Tribeca with a wet rear end for more than a half hour or so.

3. Bleaching white sheets at my in-laws house.  Also white mattress cover.

4. And yes, after above and a rather painful day, I did cave and call the midwives.  Imagine this call.  31 year old patient, who happens to have delivered sans drugs 2 babies.  Chit chat, chit chat, "... um, yes, I was wondering about these "cramps" that come with a period.  How bad are they supposed to be, because, um, never had them before? ..."  It had obviously crossed all of our minds that this might not exactly be just my first post-partum period, but one of those all-too-frequent "m---."  Nope, not even going to write it here.  Seriously, the odds that I actually both ovulated and we caught the first post-partum ovulation are under one in a million.  On the other hand, I have thus far a 100% record of conceiving post-ovulation.  Which is to say that I have ovulated twice in my life (at most 3 times, of this I am sure due to blood draws every 3 months for over a decade), and I have 2 children.  And there was a lot of blood.  And, um, big pieces of stuff.  And breathing through cramps for hours on end.  Luckily it was my favorite midwife and she told me that either way not to worry, that I would most assuredly know if it was a late first trimester situation, and otherwise it was even more highly unlikely that I would have complications and need to be seen.

Which is all just to say that apparently, in regards to matters of a delicate, feminine and monthly nature, I am entirely incompetent. 

All those secret looks, the code words, the angst

Do you remember the first girl in your circle to get her period?  I certainly do.  Ms. M.S. was never the most charming kid, but once she got her period she lorded it over all of us.  She was perpetually feeling "too PMS-y" or "just a little tired" or "so emotional."

Then there was my friend whose mother made a big deal of the event.  Fancy breakfast, new clothes to celebrate "growing up," mother-daughter trip to the drug store.

And then there was me.  By far the bustiest girl around (I was larger than the ever-popular Pamel.a Anderson even at 95 lbs).  Attracting non-stop attention from seniors and construction workers alike and ... nada.  Well, I mean there was my first super-traumatic period.  During a sleepover with a friend, of course, when I was 11.  And it lasted for weeks and weeks and weeks.  And instead of a mother-daughter talk and a little zippered bag in my backpack, I got a trip to a world famous RE (thanks to my sister's diagnosis and subsequent surgeries starting when she was 14, so the very year I got my period) who diagnosed me with severe PCOs and anemia and had a "little chat" about why I shouldn't really plan on having a family when I grew up.  I was 11.

Needless to say I wasn't super excited for my period to come back.  And it didn't.  From age 11 to 29 I would not have a single uninduced bleeding episode.  I was that girl.  The one who never carried any supplies.  The one who would just "skip" her withdrawal bleeding while working at a 2 month summer camp.  No inconvenienced beach trips, no embarrassing accidents.  18 years.

Then we did fertility treatments and had the fusspot.   And when she was about 18 months old I got natural period #2, and with speedy dash through our local fertility clinic for some drugs, we landed up with ... the dumpling.  Not until after I'd bleed through a white skirt on a 4 hour Amtrak trip to my little sister's college graduation, gracefully patched things together with one of the fusspot's diapers, and exited the train with a sweatshirt wrapped around my waist and a desperate plea to my mother that we need to get to a drug store now. 

The dumpling turned 16 months old this week.  And I got my period today.  I always expected that this would be a most joyous surprise should it happen.  Should I be one of those lucky few whose infertility is dramatically improved by carrying a baby to term (and also possibly nursing.  I have a second diagnosis in addition to PCOs, and it's quite possible that nursing helps.  I am for the record still pumping at 16 months and nursing on demand with a co-sleeping baby), everything would be easier.  Yes, we still used a fertility clinic for the dumpling but things are radically different when you wander in with a cycle, as opposed to when you wander in and note full and absolute amenorrhoea for over a decade (as with the fusspot).

I am relieved, thankful, excited.  Also more than a bit nervous to even mention it to my darling husband (who is still at work as the clock approaches 1 am and has a 7 am train in the morning, so I think the conversation will be deferred a bit).  As always, I am emotionally ready to try this whole roller coaster again.  As always, it would be an absolutely terrible time career-wise, extraordinarily stressful on our relationship, and I would hardly categorize myself as physically ready (i.e. still anemic, still rocking the is-she-or-isn't-she-belly look).  So I guess the joy is a bit tempered, but by gosh, sometimes it's nice to just feel normal.  Tomorrow I'll pack pads into the diaper bag, and guys, I've never had a chance to do that before.