Amazing Grace

Flynn, I want to tell you about an amazing woman.

Tomorrow we will say goodbye to Charlotte Leavell Davis, and celebrate her eternal homecoming.  She was your Oma's mother, my grandmother, your great grandmother (GG) and the only great grandparent who got the chance to meet you.  She was also the grandparent I knew the longest and so knew the best.

You were too young to be able to remember her, but here are some pieces of her (and some of Grandpa Davis) I will love to share with you throughout the years:

- She and G'pa were travelers.  They had several motor homes over the years and I would play in them like they were a play house.  One day I look forward to traveling with your father and I will have been inspired by their traveling, adventurous spirit.

- They collected glass.  No, really, I mean COLLECTED.  I loved it when they would return from one of their spontaneous trips and call, saying they had boxes of glass that needed to be unpacked.  We would go to their house and I got to sit on the floor and unpack each and every piece, until my hands were black from the newsprint wrapping, while they told us the story of their adventure.  As much as they collected, however, they also gave away, especially in more recent years.  At almost every opportunity GG would insist that friends, family, visitors pick a piece of glass from the collection to take with them.  I know, just as they are for me, those pieces will hold memories of her for each of them, possibly even for generations to come.

- She once rescued and raised a baby squirrel that they found in their yard.  She named her Mary and every day GG went outside with some nuts and called for her.  That squirrel would come running, climb up GG's leg, around her back and perch on her shoulder to eat her treats.  We even once took Mary and Susie, the cat, in separate pet carriers on a weekend trip to Luray.  From then on squirrels became GG's favorite animal and I think of her every time I see one (in other words, all the time).

- Every time she hugged you she quick-patted your back then she would squeeze with a "MmmMM!".  They were called love taps, it was her signature move and they will be passed on to you.

- I loved her white bean soup that she served with a piece of buttered bread.  To this day that simple meal is the epitome of home and comfort to me.

- She wasn't a fan of my long, unruly hair that I would keep in a horrible pony tail that drooped down to the middle of my back and wanted so badly for me to cut it but I refused.  One night she offered to give me a little trim and I agreed, but only a trim.  She cut it all the way up to my jaw.

- Hot hands run in the family.  She would touch your hand, exclaim if they were cold and hold them between hers, telling you she would warm them up for you.  Her hands started to get cold in her older age so one year for Christmas I made her hand/wrist gauntlets in pink (her favorite color) and gray with my very limited knitting skills.  She kept them by her chair and I loved seeing her wear them.

- She crocheted hand towels by the hundreds and gave them to everyone she knew every chance she got, almost like a calling card.  She always asked what color people's kitchens were to make sure she made a towel to match.

- She loved jokes and had a great sense of humor.  For example, did you hear the one about the girl who ran into the screen door?  She strained herself! 

- Once I brought the boy I was dating to a family pool picnic at GG and G'pa's house.  He saw a mosquito land on my arm and smacked me to kill it.  GG only saw that he smacked me and was about to come around the table faster than he could blink in my defense to do some smacking of her own.  I think he saw the look on her face and was fearful for his safety but she was looking out for me.

- My favorite GG story is is a true doozy.  Many years ago, when Uncle Edmond was young, she took him on a shopping trip.  She sat in the parking lot, patiently waiting with her turn signal on for a car to leave the parking space she intended to take.  Someone else, however, thought otherwise and whipped into the spot instead.  GG was so angry she asked Ed for a piece of gum, chewed it then crammed it into the offending driver's lock with her thumb!  In other words, don't mess with the Davis women.

By the time your father and I got around to trying to start growing our family GG's mind just wasn't what it used to be.  Signs of dementia were showing more and more and sometimes our weekly phone conversations could be challenging.  She knew she wasn't remembering or understanding things like she used to and it distressed her.  Feeling sensitive to that at first I wasn't sure I wanted to tell her about our pending pregnancy until we were past the first trimester, I didn't want to upset or confuse her if something happened.  Not long after we found out we were pregnant the first time Grandma went to the hospital for health complications.  Suddenly I realized if, heaven forbid, something were to happen to her while she was there I didn't want her to have not known we were expecting her 6th great grand child, so we made sure she knew we were expecting.  Unfortunately we lost the first baby, and the second, but GG turned out to be one of my greatest, most uplifting supporters as we worked through those difficult times.  She told me everything happens for a reason and the losses meant that something had been wrong and the right time would come for us.  She was so right as we were blessed with you.

Finally you arrived and I was thrilled to be able to introduce you to GG.  She had moved into a small group assisted living home as her dementia and health continued to deteriorate.  Sometimes she recognized who was visiting her by face, sometimes by name, sometimes only one visitor but not another and sometimes she would talk about her visitors in the 3rd person.  I quickly had to adjust to just going with the flow when I would sit next to her and listen to her talk about "Amy" as if I were an entirely different person.

With that in mind I imagine it's not hard to understand how surprised I was by her response when we first took you to meet her. Mom greeted GG first and told her Clif and I were there with you.  She wasn't sure about your dad and me, but she immediately recognized your name and started looking around to see you.  Having never met you I was touched and thrilled she made that connection.  At first she was content to smile at you and pat your leg, then I asked her if she wanted to hold you.  She didn't think she could be trusted, saying it had been so long since she'd held a baby she didn't think she could do it right, but I was right there next to her so I just went ahead and stuck you in her arms.

Flynn, she was so happy to hold you she cried.  I have a picture of those very first moments, the tears in her eyes, how quiet, peaceful and content you were, such a perfect angel to her.  Every time I see it or think of that moment I will feel her and be thankful. She held you for quite some time, gently patting your leg nonstop and alternating between telling you how sweet you were and wondering if she felt sure she was capable of holding you.  She patted and patted and you brushed her chin between bouts of snoozing. 

During the last week she was with us, when she wasn't really responsive to us she responded to you.  One time Oma took you to see her and let you sit next to her on the bed so she could pat your shoulders.  A couple of days later we visited again and I held you up in front of her so she could see you and we listened as she called you 'pretty baby' and 'sweet baby' over and over.  You cooed, smiled, patted her leg and held her hand and though I know you weren't aware of the good you were doing I'm so thankful for the wonderful experience it was for you both.

It wasn't just GG that you brought joy to, you were a dose of  baby therapy to all of the other residents.  One day your dad and I were leaving the house and as Oma was saying goodbye to the caregivers I glanced across the room at a resident sitting next to the window who was pointing repeatedly to another resident sitting on the opposite side of the room.  I looked and saw she was quietly crying and immediately walked over to her with you in tow.  She looked up from her lap, saw you and her face lit up, a huge smile spread across her face.  I stood in front of her with your car seat propped against my thigh so she could tickle your feet, stroke your hands and tell you how wonderful you were.  After we spent several minutes with her we visited the other residents to let them all have a quick turn.  The next time we visited you were sitting in GG's room and you started to squeak loudly.  That same resident came down the hall to investigate what was making all that noise and stopped mid-sentence when she saw you.  She didn't come into GG's room but stood right at the doorjamb, leaning in through the door to coo at you, so we went over to her to give her a better look and let her play with you.  For a few minutes I didn't think Oma and I would be able to leave that night, we were trapped by your arresting cuteness and her reluctance to let us take you away.

We didn't take you back to visit GG as often as we should have and that is my fault.  I'm thankful for the time we did get to spend with her and I know we brought her love and joy.  Seeing the joy you also brought the other residents has made me realize that just because GG is no longer with us doesn't mean we can't still share that joy with the ones that remain.  As often as we are able I'll take you to see them so they can gently pat you and call you 'sweet baby', just like your great grandmother did.

In recent years GG would often marvel at her wonderful family and we would tell her it was her fault, she and Grandpa started it.  The obvious reality is that our family, who we are today, is because of so many people who came before us and serendipitous events that expanded our family by marriages but it's also a reality that she was a huge part of molding who Oma was and, in turn, who your aunt, uncle and myself are.  I like to hope that I am a distant reflection of the incredible woman she was and her influence is one of the greatest gifts I'll ever be able to give.  It's a gift I am eager to pass on to you.

Making The Right Choice

In which we ask for some advice on choosing our next step.

The back story:

Flynn was born at 39 weeks to the day, weighing in at 5 lbs 13 oz.  In the hospital he dropped to 5 lbs 6 oz and he was a little bit slow to get back up to his birth weight but he gained it by the goal of 2 weeks after birth.

In the beginning our pediatrician visits were pretty standard, but after a few one of the doctors, Dr. F, the founder of the practice, started expressing concerns that his weight was reading off the bottom of the growth chart and, at one point, the trajectory line of his growth started to drop.  She expressed great concern at this, despite us telling her that Flynn ate until and refused more when he was full, was happy and content when he was awake, sleeping great, producing wet and dirty diapers and so forth.  She didn't seem to be concerned about any of that, instead focusing on the black and white graph. No one else we had talked to or who had seen Flynn seemed to understand this concern any more than we did. 

We had one more appointment with Dr. F where she first introduced "failure to thrive" in her vocabulary to us and stated she felt Flynn needed to have several tests done to determine why he was gaining weight so slowly.  Clif, I know attempting to take a stand against what we felt was unnecessary additional procedures, decided to tell Dr. F that we had spoken with other pediatricians who weren't concerned about Flynn's weight.  The moment the words came out of his mouth I felt a wave of dread as I watched Dr. F's expression flicker.  Clif then added that one of said pediatricians was the one we'd seen at the previous weight re-check appointment.  Cat was out of the bag and I can't imagine Dr. F appreciated being questioned or, possibly, feeling undermined by one of her staff.

We decided that we just couldn't understand Dr. F and were frustrated that she was unable to adequately explain her concerns in a way that made any sense to us, despite us asking questions.  Her approach seemed more of a "see this plot on a graph?  It's bad, regardless of any other factor in play" and Clif and I wanted a pediatrician who listened to us as well as gave us explanations we could understand.  We decided we'd go back to Dr. M, the doctor we'd seen the previous time who hadn't been so concerned about Flynn's weight.

At our next appointment we requested Dr. M (at this practice you can't schedule an appointment for a specific doctor, you can only request when you get there - Clif and I have suspicions about this).  Suddenly she was concerned about Flynn's weight and instructed Clif to have me pump exclusively so we could count how many ounces I was pumping to get a better idea of what Flynn was eating, despite the fact that pumping is not as efficient as nursing.  I agreed to do the exercise even though I thought it was unnecessary and I already knew the information we would gain from it.  Dr. M also wanted some lab work done (blood and urine) and we agreed, if for no other reason than we wanted to get the monkey off our back and I'd rather KNOW he is ok than assume so and miss an underlying issue.

I couldn't help but wonder if Dr. F had somehow gotten to Dr. M, maybe realizing we were suddenly requesting to see her specifically after our last appointment with Dr. F.  I sincerely hoped I was wrong about that but decided to write a letter for Clif to take in with him at the next recheck appointment (at this point we'd been in the office every 2 weeks practically since he was born) to try to figure out where all this concern was suddenly coming from.  After Dr. M read the letter she (according to Clif) said I was right with my points, she was no longer concerned about Flynn's weight, concluded he was as healthy as a "very small" ox and we wouldn't need to come back until his regular 6 month appointment.

Fast forward to yesterday:

Clif finds an afternoon appointment and is seen by a new-to-the-practice-as-of-this-week doctor.  Initially, he said, she seemed to have a bit of an attitude about Flynn's small size.  Throughout the appointment she seemed to back off from her initial reaction and said Flynn was fine, especially with a history of small children in the family, and the fact that Flynn's weight gain at yesterday's appointment put him at a hair below the 3rd percentile on the chart was a vast improvement over being off the bottom of the chart as he has been every other visit.  She did detect a slight heart murmur but they ran blood work on the spot to see if she should recommend a cardiologist, luckily it came back completely normal and she said murmurs in babies are not uncommon (also a history of those in the family).  At the end of the appointment Flynn was given a perfectly clean bill of health (minus his weight on the growth chart, as he has been given EVERY other appointment he has had) and we were told our next appointment wouldn't be until 9 months.

20 minutes later Clif received a call from the same doctor who was suddenly concerned about all of these other possible factors that could be going on to impact Flynn's weight, factors she had NOT mentioned during Flynn's appointment, and she would be mailing an order to us for a panel of tests they wanted done, tests that Clif and I have no intention of having done.  I am now even more concerned Dr. F has imposed herself with this doctor, too.

Here is some brief research I've done:
Failure to thrive per kisdhealth.org (http://kidshealth.org/parent/medical/endocrine/failure_thrive.html) -
"In the first few years of life most kids gain weight and grow much more quickly than they will later on. Sometimes, however, kids don't meet expected standards of growth. Most still follow growth patterns that are variations of normal, but others are considered to have "failure to thrive."

This is a general diagnosis, with many possible causes. Common to all cases, though, is the failure to gain weight as expected, often accompanied by poor height growth.
 
Although it's been recognized for more than a century, failure to thrive lacks a precise definition, in part because it describes a condition rather than a specific disease. Kids who fail to thrive don't receive or are unable to take in, retain, or utilize the calories needed to gain weight and grow as expected.

Most diagnoses of failure to thrive are made in infants and toddlers in the first few years of life — a crucial period of physical and mental development. After birth, a child's brain grows as much in the first year as it will grow during the rest of life. Poor nutrition during this period can have permanent negative effects on mental development.
Most babies double their birth weight by 4 months and triple it by age 1, but kids with failure to thrive often don't meet those milestones. Sometimes, a child who starts out "plump" and who shows signs of growing well can begin to fall off in weight gain. After a while, linear (height) growth may slow as well.
If the condition progresses, undernourished kids may:

• become disinterested in their surroundings
• avoid eye contact
• become irritable
• not reach developmental milestones like sitting up, walking, and talking at the usual age"

Here is a list of projected milestones expected for children between 4 and 7 months of age per babycenter.com (http://www.babycenter.com/0_milestones-1-to-6-months_1496585.bc#articlesection3):
"Your baby is fully engaged with the world now: She smiles, laughs, and has babbling "conversations" with you. And she's on the move – by 7 months she can probably roll to her tummy and back again, sit without your help, and support her weight with her legs well enough to bounce when you hold her. She uses a raking grasp to pull objects closer and can hold toys and move them from one hand to another.

Your baby is more sensitive to your tone of voice and may heed your warning when you tell her "no." She also knows her name now and turns to look at you when you call her.
Peekaboo is a favorite game and she enjoys finding partially hidden objects. She views the world in full color now and can see farther. If you move a toy in front of her, she'll follow it closely with her eyes. Watching herself in a mirror is sure to delight her.

Red flags
Each child develops at her own pace, but talk to your child's doctor if your baby:

• Seems very stiff or floppy
• Can't hold her head steady
• Can't sit on her own
• Doesn't respond to noises or smiles
• Isn't affectionate with those closest to her
• Doesn't reach for objects"

 Here are some facts about Flynn:

- His head circumference is in the 5th percentile, his height is in the 10th percentile and now his weight is right below the 3rd, all of which seems to be fairly proportioned
-He has gained weight and continues to do so, though slowly, is back ON the growth chart and doubled his weight by 6 months, which is the projected goal for weight gain
-He eats until he is full and will refuse more by crying or pushing a bottle or spoon away.  In some cases we have offered food until he spits up, uncommon for him, which makes me feel terrible for letting the doctor's concerns override his needs
-He goes to bed between 7:30 and 9 pm, sleeps until 5:30 or 6 am, wakes up long enough to nurse then goes back to sleep for another couple of hours.  That's 10-12 hours of sleep every night with a pause for a snack in early morning
-When he is awake he smiles, laughs, engages, reaches for toys, coos, chatters, watches his surroundings, etc.
-He shows signs of learning and reasoning: turning on and off the night light in his co-sleeper and interactive play such as understanding when he holds my hand with both of his I shake it like a motor and when he lets go I stop until he holds on again
-Starting to play peekabo and gets excited when I hold his hands with my thumbs and asks if he's ready, he knows it means we are going to practice his sit ups and he pulls himself up
-Not quite rolling front to back or back to front on his own yet but he's about 95% of the way there, just needs a little bit of help starting (front to back) and finishing (back to front)
-Scooting himself in circles on his back or front and starting to put his knees under him to lift his butt in the air on occasion
-Isn't sitting up independently but is doing well when assisted (Bumbo seat, play saucer, etc)
-Happily and eagerly eating cereal from a spoon
-Pats and holds my hand, snuggles in for hugs and kisses, interacts with affection and joy
-He has very small cousins who are not standard in their size but are perfectly healthy and normal children (one is 4 and, though stretched, can wear an 18 month bathing suit)


Here is where we are looking for advice:

Clif and I do not agree with the level of concern exhibited by our pediatricians and I am worried Dr. F, the practice founder, is infiltrating our appointments via other doctors, though that is admittedly an unproven concern.  However, we like the rest of the staff and the proximity of the office to our house can't be beat.  The next closest pediatrician is literally across the parking lot but an online search did not turn up very much by way of reviews of their practice so we would be exploring a big unknown if we go there.  At this point I am unsure which action to take next (past trusting my gut in regards to how Flynn is doing) and wonder what your suggestions might be.

1) Ignore the request for additional testing and schedule 9 month appointment as usual.  Since he is so close to the 3rd percentile on the growth chart and we are discontinuing nursing (a very likely factor in his initial slow weight gain) in favor of bottles and solids my assumption is at 9 months he will have a much more solid showing on the chart and there won't be any reason for any more weight-related concern and we can just continue on having gotten past that hurdle. 

2) Call or write another letter to the doctor that Clif saw yesterday with the same points listed above that I already presented to Dr. M and that should be IN Flynn's file to rehash what we already discussed last time, namely why NONE of the other factors going on with Flynn are being taken into consideration and, if there is a legitimate reason to focus EXCLUSIVELY on the black and white of the chart why that reason isn't being adequately explained to us.

3) Go straight to the source and send a letter to Dr. F explaining our concern and that if we are unable to come to an understanding and open line of communication where we aren't left confused and questioning what is being told to us we may need to seek a new practice and see what the response is.

4) Get a second opinion from the other practice in the lot and/or another practice all together before making a decision regarding continuing with our current one.

5) Abandon ship (get files from current practice without making any further effort to seek resolution and understanding) and find another pediatrician.  At this point we have spent a lot of time and money with our current practice, they know my history and Flynn's, I would hate to just give up without making an effort to make the relationship work.

Hard To Give It Up

Today is Friday, August 1st, Flynn is 6 months old and I'm usuing my last milk storage bag.  For someone with sporadic, selective OCD these are several very rounded out circumstances that will herald the end of my time with nursing.

If you've read almost any other post I've written in the past 6 months you know how much of a struggle nursing has been for us.  We have dealt with everything from latching woes developing into latching preferences escalating to latching insistence, lip and tongue ties that may or may not have truly impacted latching but probably needed to be corrected anyway, not getting meal timing right, fighting with additional and unwelcome but necessary equipment, forever fighting to try to maintain as much of my limited and declining milk supply, needing to supplement with formula to make up for my limited production, strong disinterest in using (re: violent ripping off of) the cover when nursing in public, etc.  My goal for several weeks has been to try to nurse/pump until Flynn was 6 months old then see how long I could continue after that.  Sadly my production has dropped enough that I'm surprised I made it this long and given the above mentioned events coinciding on one day I feel I have received a sign telling me that today will be the last day I need to bring my electric pump to work.  When it goes home with me for it's weekly deep cleaning it will be packed away until we (hopefully) need it again in the future.

This is very sad for me, I have found that I really love nursing Flynn. Our moments together bring me comfort, contentment and peace that just aren't as intense when I feed him with a bottle. We will still have those bonding moments, but they will be different.  Even just the thought of it for the past couple of weeks has pushed me over the edge into tears.  Mentally, emotionally I am not ready for this part of our mother/child relationship to be over but (as I've gone from pumping 6-7 oz to 1-2 oz, hardly enough to mix up a batch of cereal, much less come close to supplementing the 8 oz he drinks in a single sitting) my body is calling the shots and I can't change it.

Because I'm stubborn like that I will continue to offer a snack first thing in the morning, when I get home from work and/or right before bed time, knowing the evening option will need to always be supplemented with a bottle.  Luckily the morning snack before I go to work is enough to satisfy him until he wakes up for the day, though who knows how much longer even that will last.

I can't help the list of What Ifs that come to mind; what if I hadn't manhandled myself into a completely ridiculous allergic reaction that landed me in ICU?  What if I'd had thought to ask for a pump so much sooner than I did?  What if I'd managed to get to a La Leche league meeting for some pointers?  What if I hadn't had to go back to work so I could have nursed instead of pumped?  What if I'd done better sooner about drinking more fluid?  What if I'd started supplementing home therapies for boosting my supply right in the beginning?  What if I'd tried more of them?

But none of those things can be changed now and even if they could there's nothing to say they would have made a difference.  Maybe my supply is what it is and we'd be in this exact place even without all of those other influences.  Maybe our next child will be a hellion (Flynn is darn near perfect except for this issue) but nursing will be a breeze or maybe I won't be able to nurse at all.  We hope time will tell if we are lucky enough to have another baby.

As for right now I am going to try to soak up every second of the time I have left to nurse Flynn; the way he absently pats my shoulder, reaches for and holds onto my finger, gently kicks and drags his feet down my other shoulder and arm, how sudden noises like clearing my throat, sneezing, hiccuping, coughing, talking and/or anyone located within a 5 block radius doing any of those things would startle him to stop eating, stare at me with wide-eyed surprise, eyebrows lifted nearly to his peach fuzz line (there isn't enough yet to call it hair), then break into a grin so big it takes up half of his face.  Part of me would be exasperated at his nosy-ness and if we were in a hurry I'd wish he would just focus and get on with the eating (especially when his violent head-whipping to look around at whatever the noise was that disturbed him resulted in ripping off the nipple shield half-filled with milk, spilling it everywhere and NOT into his mouth which would trigger my production-sensitive mind to lament the loss of any of that more-precious-than-gold liquid).  How usually, but almost always in the morning, he would get so excited with the routine that meant food was coming he would fling out both arms, hands splayed open, eyes wide and practically hissing in eager anticipation of being fed then a hearty full-body sigh as if to say 'finally, woman!  I've been waiting forever!' even if had only been a few seconds.  The feel of stroking is silky soft head, cheek, hands and back while he lay still and peaceful in my lap, his eyes half-lidded in contentment.

I am thankful I've been able to nurse him as much as I've managed and I wouldn't trade it for anything, even with all of the challenges involved.  We may end up saving some time by not fighting the breast-feeding equipment battle and going straight for the bottle and solids, but I'm sad.

In an effort to counter my feelings of loss I'm trying to focus on how that little bit of time saved can be transferred to more time to play and practice skills like rolling over, sitting up and getting ready to try different directions of movement.  There are plenty of things to be happy about (how absolutely wonderful and happy go-lucky Flynn is, and how proud I am of how much he has developed and grown already) and I am glad for them.  I'll be eager to experience what he has in store for us next and will fondly remember the special bonding we got to share, even if sometimes wishing we could have had more might also make me cry a little.