Mental Health In America

I have many hobbies, one of them is reading. As with most working parents, I don't always put as much time into my hobbies as I used to.  That's probably why it took me almost two months to finish my recent book.  I highly recommend everyone reads Stephanie Giese's memoir, All I Never Knowed.  Since finishing her book, I want to reflect some more.

I'm a pediatrician. I have been called (yes I feel this is truly a vocation) to care for children and to be their advocate.  Some may think I mostly give shots, treat colds and ear infections, and make sure children are growing appropriately.  Those things are only a small part of my job.  Especially during the COVID pandemic, I feel more and more like a psychiatrist and therapist too.  I have families tell me, they've been waiting 3-4 months to see a therapist.  I have families tell me they took their child to the crisis center because their child's mental health deteriorated while waiting for therapy and they started performing self-harm.  I have families wait in the emergency room for days waiting for an inpatient psychiatric bed to open.  I have families tell me they agree they should see a psychiatrist but none accepts their insurance.  I have families tell me they found a therapist or psychiatrist, but they can't afford the self-pay rate.  Receiving treatment for mental illness shouldn't be this hard.

And now let's talk about the school system for a little.  These thoughts are not directed towards teachers.  I have not met a single teacher who doesn't want his or her students to succeed.  Tell me why our current educational model waits for students to fail before they investigate the need for special education?  Tell me why parents have to fight tooth and nail to get a child a 504 plan?  Tell me why schools receive funding based on standardized tests scores and not the social-emotional well being of the students?  And guess what!?!  Having a child fail in school, especially when it could be prevented with the proper accommodations and remediation, increases the rates of mental illness!!!

I honestly thought I had more to write, but I'm tired.  And I'm getting more angry as I think about the broken system, so that's it for now.  Go read Steph's book and keep fighting the good fight!

Neck Pain and Headaches

Earlier this week while getting ready for work and school, our daughter told us my outfit looks better without my neck brace.  I gently told her, it might, but my headaches and neck pain at much better when I wear the brace. It was learning moment that it’s not always about appearances.  

Have you ever heard someone say, I never realized how much I couldn’t see until I got glasses?  I feel the same way about my neck.  The chronic knots I have in my upper trapezius muscles have basically disappeared.  I still get headaches, but they’re less, and honestly, I can concentrate better. 

Tonight we celebrated my cousin’s wedding. I honestly didn’t want to answer questions about my neck brace, so I didn’t wear it. Other days, I’m generally wearing my brace 90 minutes on and 30 minutes off.  Tonight once I reached three hours, I felt the neck muscles starting to fatigue, by about 3.5 hours the headache was there.  I’m functioning and now I’m laying supine to decompress and ice my head and neck.  I know I could have stayed longer at the wedding, but we’re seeing family again tomorrow. I’m learning to tell myself I don’t have to push through. I know I’d be miserable and moody if I stayed longer. So instead, I left a little early and will see them again tomorrow.  

Happy Birthday!

Photo by Jenni Combs

Ok, so life with two kids is exhausting.  My heart is so full, though.  Andrew has definitely experienced 2nd child syndrome.  As you can see, the last update I did was over 8 months ago!

Well, this past Tuesday our baby boy turned 1!

He currently has 8 teeth, four on the top and four on the bottom!

He can say dada, mama, hi, and hello.  He waves bye and blows kisses.

He sleeps through the night and takes about two naps a day.

His favorite things are taking a bath and playing with his older sister.  Man, you should see him dart across the room as soon as he hears the water turn on!

His favorite foods are ham and yogurt.  He shows us he's done by throwing all of his food on the floor, and he hates to wear bibs! (Probably because he wants a bath!)

He's not yet walking, but he's cruising and gets into everything.  One of his nicknames is "Andrew the Destruct-or!"  No joke, you should see how fast a tidy basement can be covered with toys.  He's even pulled all of Bri's clothes from her drawers.

He currently weighs 22 pounds, 7 ounces.  He hasn't had his 12 month check up yet, so I'm not sure on the length (and I forgot to check when I had him at my office this week).

And we're still breastfeeding! I made it to 12 months breastfeeding!  I had to supplement more with him than with big sister, but ultimately, he's had breast milk every day of his life.  I'm pretty darn proud of that.  Now to wean from the pump!

I can't wait to see what this next year has in store.

Photo by Jenni Combs.

4 Months Old!

Good thing we had another kiddo or I don't think this blog would have any posts!

Well, I've been back to work about 2 months now.  I think we have a routine.  For now at least, I'm sure it will change in another month or two.

Andrew has officially graduated to 6 month clothing.  At his 4 month check up he was 13lbs 14 ounces and 26 inches long!  He's eating about 5 ounces every 2.5-3 hours.  I haven't quite been able to keep up with him and pumping, so he gets a formula bottle about once every other day.  I'm ok with that.  When I'm home he eats about every 2 hours.  He's finally in size 2 diapers.  I should have switched him a little earlier, but I wanted to us up all of my size ones.

He's still working on his sleep.  He does about a 5-6 hour stretch, then every 2-3 hours.  I had two nights in a row where he slept 8-9 hours.  I had hoped that was a trend of good things to come, but nope, it was just a tease.

Andrew is doing great with tummy time, and likes watching us.  He can roll from his belly to his back.

Other than eating, I think Andrew's favorite thing to do is kick.  We'll put him in the vibrating chair and he'll just kick, kick, kick.  He also loves to eat his fingers!  I don't feel anything teeth yet, but the drool has certainly increased!

I'm glad Andrew is the second child, he does not like being by himself!  We'll walk out of the room and he'll start crying until someone comes back in to talk to him.  Bri's getting more talkative with him and is starting to understand the concept of "gentle" a little better.

And, I know the statistics aren't in our favor to have 2 blue eyed babies, but his eyes are still blue!

3 Months Old!

And 2 weeks late writing the post!  The photos are from when he's actually 3 months old at least.

At 3 months, Andrew weighed 12 pounds, 8 ounces and was 24.25 inches long.  He's a long skinny boy!  His weight is tracking right along the 25%.  It's so empowering knowing it's my body and my milk helping him grow.  I'm still limiting my dairy, but it seems like he can tolerate cheeses and baked dairy.  Last weekend I ate icecream, and man, back to horrible, painful crying! 

In terms of diapers, we're still squeezing into size 1.  He really should probably be in size 2, but we're using our supply up.  And heck, they're not leaking :)  He's wearing size 3 month clothing (well he was, but now at 3.5 months has graduated to size 6 months).

I love baby smiles.  He's started to have the social smile and it's just so heart warming.

In terms of favorite things, I really think it's eating.  This boy loves to eat.  Fortunately for me, but not really, he didn't really do any reverse cycling when I went back to work.  He's sleeping about 6-8 hours at night and wakes once to eat.  That would be nice if I was able to pump enough milk at work to compensate for what he eats at home.  So since he's not tolerating dairy and he turned his nose up when we tried hypoallergenic formula once, I'm either staying up late or waking up in the middle of the night to add in a pumping session.  So far I've been able to keep up.  I'm not going to lie though, it's exhausting.

Bri has started to become jealous.  Only I can brush her teeth, only I can get her out of the car, only I can put her to bed.  She's overall very good with the baby.  She likes to use his stomach as a drum though...  I'm really curious to find out how she reacts once he starts moving and trying to play with her toys.

2 Months Old!

We made it to two months without a fever!  The pediatrician in me is quite happy with that!  Not that I want him to have a fever, but now if he has a fever he won't automatically need blood work.

Little man is gaining weight like a champ!  At two months he was 11 pounds and 23 inches.  This puts his weight at about the 20-25%.  This is huge for me.  When Bri was 2 months old her weight was about 3%.  It is such an empowering feeling knowing my breast milk has helped him grow and continue gaining weight.  He's eating about 7-9 times a day.  I'm still dairy free.  I tried a milk shake one day, and man, he was a monster the next day!  It seems he can tolerate me eating baked dairy, so I do have an occasional cookie or piece of cake.  I'm surprised by how little I miss dairy.  It's been better that I can't eat ice cream, because I'm not very good with moderation when I start a pint of Chubby Hubby.  I learned I really enjoy almond milk and I've been able to bake with almond milk.

In terms of sleep, he wakes about once a night.  I hope it stays that way, but we'll see now that I'm back to work.

He has way outgrown his newborn clothes and is starting to be too long for the 3 month clothes!  He's officially wearing size 1 diapers.

Right now, his eyes are still blue!  And it's such a handsome blue.  Statistically since Bri has blue eyes, he shouldn't (we have a 1/8 chance of having TWO blue eyed children), but only time will tell.

In terms of things he likes, he LOVES the bath, and of course he loves to eat.  Unfortunately he hates tummy time :(

Bri has realized he's not going anywhere, but she's doing great with him!  The biggest thing I worry about right now is she uses his stomach as a drum...  Fortunately she's stopped trying to pick him up.  She herself wants to be carried more though, which I wouldn't mind if she wasn't almost 40 pounds!

One Month Old!

I swear, life goes faster with two kids around.  Little man turned one month old a couple of days ago. 

I've been going to a breastfeeding support group about once a week, so fortunately I know what his weight is.  On his one month birthday, he weighed 9 pounds 2 ounces.  (His birth weight was 8lb 8oz).  This weight is huge for me!  It took his sister about a month to regain her birth weight, and then she gained very slowly.  I wish I had known about the breastfeeding group with her because I truly think it was her latch that was affecting her milk transfer, which was affecting her weight gain.  I'm blessed to be able to breastfeed my children.

Overall, his demeanor has been decent.  He was very fussy the first week and a half, then I saw blood in his poop, so I cut out dairy.  Since cutting out dairy, his demeanor has improved.  However, it's hard to say if it was time or dairy that improved things since he only had the blood in the stool once.  Joe and I went out to lunch today, so I decided today was the day I do a dairy challenge and ate cheese.  We'll see how it goes.  Even if it goes ok, I think I'll try to stick with limiting dairy but not stress about the "hidden dairy."  Who am I kidding?  I'm craving ice cream.

His favorite thing to do is eat!  I mean, what else does a one month old do?  Eat, sleep, poop.

He's straddling sizes in clothes, I'm moving mostly to the 3 month clothing now.  He's definitely too long for the one piece newborn clothes.

For now, his eyes are still blue.  I don't think they'll stay blue just because they're a different shade than what his sister's eyes were, plus statistically we shouldn't have two blue-eyed kids.

Baby sister is adjusting very well!  The past week she acquired a cold and wanted to cuddle more and did regress to wanting to be carried more, but I think this will pass once she starts feeling better.

I want to try to start working out again.  Last week I did a 15 minute post-natal workout.  I think it's a good way to ease back in.  It is going to be even harder now to find time with the two kids though.  One day at a time.  Plus I can't wait until it gets warmer!

We had another baby!

Well, my goal is going to be at least monthly updates now that WE HAD ANOTHER BABY!  First, I'll say I was spoiled by our first baby coming 2.5 weeks early.  I ended up having C3P0 at 39 weeks 6 days, but damn, it was a long pregnancy!  I started effacing at 34 weeks and I walked around 3.5-4 cm dilated for over two weeks.  From about 36 weeks on I had intermittent contractions, which I never had with R2D2.  They were such a tease, and honestly, not the most comfortable experience.  So, when I had my first "real" contraction, it still felt like some of the contractions I had been having off and on.  The difference, these contractions stayed about every five minutes, and quickly became even more frequent.

I decided I wanted to continue to work until I delivered.  Since I went early with R2D2, after 38 weeks we stopped scheduling patients and I was opening my schedule on a daily basis for sick patients. When I went to work that Monday morning I had no clue I'd be leaving work to have a baby!  I saw my morning patients, I didn't feel any different than my new normal back pain and pelvic pressure.  While I was eating lunch around 12:45 I felt a contraction.  The contraction was strong, but it didn't quite take my breath away and no stronger than some I had the previous weeks.  After I had a second contraction about 7-8 minutes later I decided I should pay more attention to them.  By that time my first afternoon patient was waiting for me.  Well, by the end of that visit, I knew this was the real deal, but I had no clue how fast things would progress!  I called Joe, told him where our hospital bag was, asked him to pick me up, and then proceeded to see my next patient.  Yes, I saw my next patient.  I mean, I had to wait for Joe to pick me up anyway, so what if my contractions were 5 minutes apart by that time?  I warned the family so they understood my pauses during our visit.  Things snowballed after that, I think by the time I left work, the contractions were about 3.5 minutes apart.  I felt EVERY SINGLE BUMP on the way to the hospital, which was 25 minutes away.  By the time I arrived at the hospital, my contractions were about 90 seconds apart and the pain was INTENSE.  They quickly got me back to triage and unfortunately I couldn't even lay still long enough to stay on the monitors.  My pain was best managed standing up and bending over slightly.  There were several times where the pain was so intense I truly thought I was going to pass out (how I deal with pain).  I remember saying to Joe so many times, "this is so much worse than with Bri."  Well, while trying to manage the pain, wham, my water broke.  I looked down and saw it was brown.  Being a pediatrician I knew this was meconium and truly said, "Oh sh!t, meconium!"

After much troubleshooting to get me into a comfortable position (laying on my back made the contractions more intense) the doc was finally able to exam me and ends up I was fully dilated and ready to push.  No wonder I was having so much pain!  Once I heard that I looked at the resident doc and almost begged her to let me deliver.  Fortunately the nurse talked me off the edge and put reason in my head to deliver down in L&D, especially since he was meconium.  Once I knew I was ready, I just wanted the pain to be over.  They immediately whisked me down to L&D, my OB had already started prepping, they transferred me the delivery table, and I was ready to roll.  My OB quickly finished putting her gown on, I looked at her, said I was ready, and started pushing.  Joe and I can't quite remember if it was 2 or 3 pushes, but he was here!  Since he had pooped before delivery, the NICU nurse practitioner was there. They took him immediately over the the baby bed.  He started crying, so they did some mild suctioning, dried him off, and put him back on my chest to transition.

Well, unfortunately my labor story doesn't end there.  At about 10 minutes of life I realized C3P0 was still quite blue for being 10 minutes old and he was making a sing-song noise called grunting that often means the baby is having trouble breathing.  Oh, and we were still waiting for my placenta to detach.  Since I knew panic doesn't make things go any faster, I calmly looked at my nurse and asked her to grab a pulse ox for the baby.  My doctor gut was right, his oxygen level was hovering in the high 60's to low 70's.  Fortunately, the NICU came back and did their thing.  They gave him some oxygen, did more deep suctioning, ultimately he needed a couple of breaths via face mask, and had him pink before taking him to the NICU.  In the mean time, we're at over 20 minutes since delivery and my placenta wasn't budging.  So as I sat there waiting for the labor process to continue I just had to trust the NICU.  I mean, I do, that's why I delivered at a hospital with a NICU, but it was still hard. It's hard knowing how serious things COULD be and I couldn't do anything.  I couldn't go over to the bed and see my child.  I couldn't let my doctor instinct kick in and start taking medical care of him.  I couldn't do anything other than wince when my OB massaged my placenta and hope I didn't need to go to the OR.  Ultimately I received some pain medicine through my muscle (still no IV) and my OB manually retrieved my placenta.  Finally, labor was over.

So, just to put things into perspective into how quick it was, my first contraction was at the earliest 12:45pm, I delivered at 3:36pm.  I always said, I think I'd try labor without an epidural and if I couldn't handle it, I'd get one, well, this time around, I didn't have time to even consider any pain medication!

Ultimately, C3P0 went to the NICU and received 2 days of antibiotics.  He was stable breathing on his own by the time he arrived to the NICU.  He's now 3 weeks old and we're all doing well.  Soon enough I'll be doing his one month update!

C3P0

I have nearly given up on updating this blog of mine.  Here's the latest thing we're cooking up!  We're due in January 2015 :)

We have a 2 year old!!!!

Yes I'm alive. Life has been busy.  This past week our baby girl turned two!!!  I love seeing her grow and develop. She's developing her own little personality too!  We went to Dutch Wonderland for the day. She preferred the water park, and she hated the merry go round!  We had bowling birthday party and she loved it!  We did duck pin bowling, so it was just her size!

Croup

It's tough being a mom and a pediatrician.  This morning my little one woke with a barky cough.  She has croup. Right now it's just the cough, but I have enough medical knowledge to know it has the ability to get worse before getting better, which scared the living day lights out of me. I swear, I've brought home more germs working in the office than when I was primarily in the hospital. 

Race for the Cure 2013

This past Sunday was Baltimore's Race for the Cure.  I initially didn't sign up because I'm taking the pediatric boards tomorrow and thought I would be studying.  I realized I needed some time to relax and wanted to support my family, so off we went!  This is the first 5K I fully ran in probably 3-4 years.  It wasn't a great finish time, but I ran it!

Mom, Dad and Bri did the one mile family walk.  I am so happy to say that Mom is almost one year cancer free now!  She has a couple more founds of Herceptin and then she'll get her port out and be done :)

Ray of Sunshine

I had off work today so we spent some time enjoying the clouding weather out back.  She turned around just as I snapped my shutter.  She's my ray of sunshine!

First Week Down!

I successfully finished my first week at my new job!  I took 4 weeks off between residency and starting my new job.  I enjoyed the time off, however I think I mostly spent it preparing for R2D2's first birthday.  The last week off we did have the opportunity to spend two nights at the beach.  Oh, my, goodness, taking a toddler to the beach is a whole new experience.  Thankfully the weather was nice because she did not like being cramped up in the hotel room.

However, I digress.  I'm loving my new job.  I feel like I'm finally doing what I have trained so long for.  That being said, I am so glad I have had all of that training, it is certainly necessary.  I'm loving meeting new families and getting to know a new set of patients.  It's also great that I have several other doctors here if I have questions.

With having a little more time on my hands, I have ventured back into the kitchen.  I hope I'll get back to posting more recipes, but we'll see.  Now with a little one, I'm spending my free time with her and not so much on the computer.

First Birthday!!

So the photos will finally reveal R2D2's name.  We chose to name her Brianna.  I love her name!  It's Irish for strong and I think it fits her perfectly!

If you haven't picked up on it yet, I love arts and crafts, often to the point of losing sleep to finish them. I knew I wanted to make Bri's birthday special, so arts and craft time it was!!  I used etsy a lot, man I love that site!

We'll start with her smash cake.  For her actual birthday, I made it into a little photo shoot. :) 

I think it's an understatement to say she enjoyed her cake.  I used the Wilton tip 2D to make the rosettes.

 Of course I needed to buy here a special birthday outfit. Ends up, I bought two for her.  I absolutely, absolutely loved her dress.  Photo courtesy of Lisa Marie Photography and dress made by OsEsterninhos.

And her shirt was made by The Sassy Squirrel Mom-mom bought her this chair for her birthday.  She loves it!!

Bib made by Julianne Originals and banner by Creative Party Banners.

I spray painted the letters, made the flowers out of felt, and then glued all onto the wreath.

I saw the frame on clearance in Michael's.  I didn't know how I was going to use it, but couldn't pass up the price.  I like the B in the middle!

 I displayed her basket pictures in our dining room.

 And her cake, labor of love!  Despite being time consuming, I found the cake decorating relaxing.  The butterflies are actually edible, and I thought they looked very realistic. I purchased them from Sugar Robot.  For the cupcake stand, I spray painted Wilton's white cardboard stand.

I think Brianna had a wonderful first birthday.  Mommy and Daddy love you very much!!

12 Months!!!

As the bottom picture shows, R2D2 is beyond excited to be finished with her basket photos!  I can't believe our baby girl is one year old now.  It's been a great year.  We survived parenthood and finishing my last year of residency.  I am so grateful to my parents, Joe's mom, friends, and all who have helped us survive this past year.

Baby girl loves to play and I love watching her learn and figure things out on her own.  I think we're back to baths as her favorite activity.  This girl loves splashing water and we have to make sure Winston's water bowl is up or else she'll play away.  She doesn't like the ocean or big pools yet though.

At her one year check up she weighed 23 pounds (89%) and was 29.5" long (63%).  Well, I guess I no longer have to worry about failure to thrive in this little one.  Now that we have reached a year, I'm going to cut back on breastfeeding.  I'll see how long we want to continue morning and night feedings, but I'm going to stop pumping once I go back to work.  Fortunately she has no problem taking whole milk, and I still have some frozen breast milk we'll use.

In terms of clothes, she's hover between 12 month and 18 month sizes.  She still hates shoes and socks.

And, she's walking!!!  She's slowly started to walk more instead of crawling, but she can crawl faster than walking for now.

We're trying to figure out if she knows mama and dada specifically yet.  I think she knows hi too.  She will always say mama and dada, but sometimes she still says dada when looking at me, but other times she'll keep saying dada until Joe says hi to her.

10 and 11 Months!!!

 Look at my little ham at 10 months old!!

Now above at 11 months old!!

I love being a momma.  Baby girl however, loves every thing I do, so I find my self only being able to get on the lap top after she's gone to bed.  By the time I'm finished checking my email, I don't have time for blogging.  That's ok, I'd much rather be with my family.

As a bonus, today was my last day of residency!!

But back to R2D2.  She loves getting into everything!  Around 10 months, her favorite toy was stacking rings.  Now a days, her favorite toy is playing with stacking cups.  She also loves anything with music.  She'll dance to anything, but she really starts rocking to music from the 60's and 70's.

Baby girl is cruising along.  I keep thinking she'll take her first steps any day now, but that's been my thought for 4 weeks now...  She gets around so quickly crawling that I don't think she's in any rush to walk.

She's finally sleeping through the night!!!  She wakes up anywhere between 5-6am, but I'm still able to get several consecutive hours, so that's great!  Perhaps we'll be able to get her bed time to 7:30-8p and then she'll sleep a little longer...we'll see.

I'm happy to say I'm going to meet my goal of breastfeeding for a year.  Other than momma's milk, she loves basically all foods!

I weighed her on our scale last week and she's about 23 pounds!  To think I was worried about her being underweight.  I'm hoping this weight gain slows down...

In terms of my weight, yeah, I'm not quite back to pre-pregnancy weight yet.  I'm about 5 pounds above pre-pregnancy weight, but I'm ok with that.  I need to get back on cutting out desserts and sugars, but I'm not going to go crazy.  Now that residency is over I'm kicking up my working out and if I lose weight with that, great, if not, as long as I start get to more toned again, I'm good with that.

R2D2's eyes are still blue, I think it's safe to say she's our blonde haired, blue-eyed babe!

Coming to an end!

I have two days if residency left!!!

Hobbies such as blogging have taken a back burner while I try to be present with the family. I'm ok with that. I've taken photos of R2D2 at 10 and 11 months. It's ok that I haven't edited them or posted. She much prefers to blow raspberry kisses and use me as her humans jungle gym. 

My First Mother's Day

I'm so happy I was able to spend the day with baby girl and my mom!  With Mom's diagnosis of breast cancer, it's been a tough couple of months for her, yet she continues to be there for me. I hope when the day comes, I can help baby girl as much as she helps me!

9 Months!

So if you haven't picked up by my paucity of posts, life is a little busy.  I'm reaching the end of residency, getting things set to start a new job, and trying to be a good mom and wife.  So, in an effort to try to keep myself sane and spend time with my family, blogging has been placed on the back burner.

R2D2 is now closer to 10 months old than 9 months, but oh well.  Her pictures are from 9 months at least. 

I can't believe I was once worried about baby girl's weight being too low.  At her 9 month check up, R2D2 weighed 20 pounds, 8 ounces (83%) and was 28 inches (61%) long!!  She fits in a few 9 month clothes, but she's pretty much sporting the 12 month size.

In terms of eating, I'm still breast feeding :)  I love the bond we have and I'm debating if I want to keep up morning and night feeds even after a year of age.  I plan to stop pumping when she's one, i

f not earlier pending my freezer stash.  Unfortunately, I know part of why neck and shoulders hurt is from carrying my pump around every day.  R2D2 is up to about 3 meals a day.  She prefers

to feed herself, Daddy prefers if we feed her (only because she makes a huge mess).  We're letting her try a bunch of things.  She still loves yogurt.

During her 9th month, her favorite thing was probably crawling to try to "pet" Winston or playing with her little tea set.

Sleep was going well, but not now that she's over 9 months, but I'll save that for the ten month post.  For the most part, she was sleeping through the night, even if that meant waking at 4:30 sometimes.

Baby girl still loves to talk.  She clearing saying ba ba ba and using inflections.  And I don't want to jinx anything, but I think the blue eyes are here to stay!