anna in med school

Last night, John and Ari attended Christmas Eve dinner with family and friends.  By request, I sat on my in-laws’ couch watching Bridesmaids while sipping Glenmorangie and eating cocoa-flavored goat cheese on apple slices.  It was my first time alone at home since her birth, and it felt…really good, though I missed them as soon as the car pulled away.

Dear friends,

I wish you and your families a very merry Christmas!  I’m far behind on thank-you’s (my apologies), but this holiday season we are acutely grateful for the outpouring of love that has been shown to our daughter in the last two months and, of course, for the support throughout my pregnancy, in our respective professional lives, and other developments along the way.  2012 has been quite a year!  Simply and sincerely, thank you.

Although Ari is way too young to remember this set of holidays, having a child has definitely rekindled the magic of the season.  I’ve cherished singing a multitude of carols, ingrained in my memory after years of chamber choruses and holiday pops, and watching her respond so predictably (at least in my imagination) to the familiar melody of “Lo, how a rose e’er blooming.”  I’m looking forward to reading her Madeleine L’Engle’s The Twenty-Four Days Before Christmas and celebrating the Oppenheimer family version of a secular Advent.  And I am thankful for the opportunity to introduce her to so many loved ones who have helped make these days together merry and bright.

xoxo

jj & ajx2

This evening Michelle and I will do what I know every parent in America will do, which is hug our children a little tighter.  We’ll tell them that we love them and we’ll remind each other how deeply we love one another.  But there are families in Connecticut that cannot do that tonight and they need all of us right now.  (President Obama)

Words cannot adequately express the heartache I feel for the students and teachers of Sandy Hook Elementary School, and to their families and friends.  This tragedy is simply unimaginable.  

I’m leaving my daughter for part of this night to attend a class party in celebration of the end of clerkship year (for most of us, I still have psych and neuro to complete in the spring).  Although she will be in the loving arms of her father, it will be so hard to leave her.  Not in comparison at all to the horrific events in Newtown, CT, but Aurelia had her two-month vaccines today (one oral, three shots).  I was holding her in my arms, attempting to breastfeed her as this look of utter shock and pain washed over her face and she let out a bloodcurdling scream.  And then I burst into tears.

John said I had to go out tonight.  I told her to be good to her.

Him: I’m always good to her.

Me: I know, but be extra good.  Like, if she were older, it would be the kind of night when she could have ice cream.  And an extra story at bedtime.  It would be that kind of day.

Him: <smiling sympathetically> Okay, honey.  It’s that kind of day.

To those directly affected by the events at Sandy Hook (though in a way we are all directly affected), I am so sorry for your loss.  My thoughts and a great part of my heart are with you tonight and for a very, very long time. 

Clearly trying really, really hard:

She’s been flashing reflexive smiles during (supposedly) REM sleep for a while.  (BTW, isn’t’ it fascinating that babies spend 80% of their total sleep time in REM sleep, while adults only spend about 20%?  One theory as to why is that the primary function of REM sleep is to stimulate central nervous system development.)  Now we’re getting some real responsive smiles, clearly elicited by the most ridiculously animated facial contortions we’ve been making 12-18 inches from her face (ideal distance for her still pretty terrible vision).  This is the best form of encouragement for sleep-deprived moms.

John likes to call home at least once a shift to check in on his girls.  Sometimes he has a hard time holding in his high-pitch cackle of laugh when I reveal a new trick his daughter’s demonstrated.  At two weeks of age, it was the ability to, the moment after I finished bathing her, while she was still naked in my arms, dump of load of mustard-colored stool over my arms and stomach while simultaneously vomiting down my chest.  She was not phased by this experience in the slightest.

At six weeks of age, while we were practicing smiling, she managed to vomit in my mouth.  Apparently I don’t learn, my daughter has perfected her aim, or I find her so irresistibly adorable that I can’t help but continue with the big-mouth smiles, as I have once again found myself spitting out my own curdled breast milk.

Look at her plotting away:

You would think I would be disgusted.  I’d love to know more about the hormones, genes, neurons, or whatever that make us hard-wired to not be completely repulsed by the many things that are expelled from our progeny’s orifices.  Or what makes us inherently proud of each milestone, regardless of how minute it must seem, or each demonstration that the body is functioning appropriately.  I think about this when my heart simply melts with each owl-like coo-hooing Aurelia’s been rocking out recently, or when I exuberantly exclaim, “Nice work, honey!” when she startles herself with her own long, wet fart.

What do you do when you have an infant recovering from GERD who just wants to snuggle?

The answer: watch Christmas movies on ABC Family all. night. long.  I turned the TV to Home Alone just in time to see one of my favorite holiday scenes: when Kevin and Old Man Marley talk in the church while a children’s choir rehearses “O Holy Night.”  I think all choir geeks love this scene.

Other holiday favorites include Jamie’s proposal to Bonita Aurelia in Love Actually, and pretty much anything involving muppets:

Happy St. Nicholas Day!

Poor Aurelia!  It can’t be easy to be the first born of a doctor and a (hopefully) doctor-to-be.  Too many wet diapers and we worry about malabsorption.  Too few, pyloric stenosis.  Of course, the latter has definitely been on the radar because our girl is a vomiter and we have a family history (there is a genetic predisposition).  John had surgery as an infant for pyloric stenosis, a narrowing of the opening between the stomach and the first part of the small intestine that causes projectile vomiting, dehydration, and hunger.  Her recent weight gain makes us much less concerned.  Some kids just vom a lot.

When I fixated on another possible diagnosis, I knew I was being paranoid…who is it that said a little knowledge is a dangerous thing?  Although infant reflux is common, actual gastroesophageal reflux disease (GERD), where the baby experiences discomfort due to the reflux of stomach acid, is less common.  We’re shown videos during our peds rotation of Sandifer’s syndrome, when an infant forcibly arches her head and neck backward to lengthen the esophagus and partially relieve the discomfort of reflux.  John and I watched our darling girl perform the same maneuver accompanied by a high-pitched screech during or shortly after feeding–absolutely heart-breaking to witness.  For about five days, Aurelia was unconsolable for stretches of time (felt like forever, though they were probably only 2-5 minutes each).  One day, she was hoarse from crying, and likely from reflux as well.

We called our pediatrician first thing Monday and, while trying our best not to be annoying, paranoid, know-it-all parents, we presented Aurelia’s symptoms…and we might have politely mentioned our suspected diagnosis.  She was started on a trial of Zantac (a.k.a. Ranitidine, a histamine H2-receptor blocker that inhibits the production of stomach acid).  Two days of treatment and our sweet Aurelia is all snuggles again.  Although I had hoped Zantac would be our silver bullet, I’m amazed by the nearly immediate change it made to her disposition–or, I should say, the affect reflux had on her disposition to begin with.  Then again, considering how reflux during my 35th week of pregnancy affected my attitude toward everything (and yes, I know, just one week, I can’t complain!), I shouldn’t be surprised.

Now if only someone could come up with liquid Zantac that doesn’t have a taste that makes my daughter purse her lips deliberately as though I’m feeding her Campori or something equally disgusting.

Things are getting more fun around here.  The babe is starting to get that curious pucker of the lips, the excited glint in the eye, the thoughtful furrow between the eyebrows–small indications that she’s actually internalizing new experiences, and she thinks they’re totally rad!

We took our first real road trip down to Virginia this weekend post-Thanksgiving for my 10-year high school reunion and the baptism of one of Aurelia’s best friends (so what if they just met this weekend) and John’s Goddaughter.  Somewhere in Maryland, we stopped at a Starbucks for lattes and a quit diaper change.  Normally we carry A around in her covered carseat to avoid losing too much heat.  This time we just ran the 15 yards from car to coffee and back with her tucked into our coats.  As we were running back, a gust of air made the hair on the back of her head whip upward, and this hilarious expression came across her face.  It’s hard to describe, but it was definitely not one of fright, discomfort, or any negative emotion, more something like: “What the…what??!  Wind???!  Huh!  That’s not at all unpleasant.  I don’t know what I feel!”

And then, what do you do when you stay in a home that doesn’t have a baby bath and the kitchen sink is in use?  Well, you take a shower…the three of you.  Game plan: I was to get in the shower first and get myself clean while John undressed our girl.  Then he was to get in with her, hold her while I sudsed her up and rinsed her off, and then shower himself while I exited the shower with a freshly cleaned Aurelia.  Of course, while I was in the shower and John and Aurelia already undressing in the steamy, closet-sized bathroom, we remembered that we forgot to check her diaper, which naturally was heavy with mustard-colored poop.  At six weeks into parenthood, I’m used to being covered in vomit, feces, urine, or some combination, so I told John to just hand her over.  I then proceeded to hold my daughter’s bum right underneath the shower faucet.  And she loved that shit!  The three of us managed to stay clean for a good 5+ minutes until my darling daughter spit up curdled milk from a feeding two hours prior.

Rediscovering the coolness of rotating leaves and animals in her swing:

This will be our first Thanksgiving with family in town.  We’ve only had one other Thanksgiving when we didn’t travel.  It was John’s intern year and he was working.  I ran a five-miler in the morning and was presented with an apple pie as I crossed the finish line.  We had sushi for dinner.  And free pie.

I thought this year would be similarly low-key, as we have a small infant consuming most of our attention and our family coming from NYC has been living out of a hotel since Sandy.  I swear John was on board with the whole Indian/Thai/Mexican take-out idea.  However, while discussing take-out options this weekend, he looked at me solemnly, “Wait…you mean we’re not even having a turkey?  Or stuffing??!”

Thanksgiving is his favorite holiday and, at 32 years of age, he’s still a master at the puppy-dog sad face, and I just can’t say no.  So now I’m making a turkey…and mushroom/fennel/pine nut/prosciutto gluten-free bread stuffing, mashed potatoes, green bean something-or-other, cauliflower whatnot, and this easy and far superior pumpkin pie substitute (thanks Nathalie!).

I had a moment of panic on Monday night while reading online instructions about when to defrost the turkey and how long in can stay defrosted in the refrigerator, as our small bird had been immediately placed in the back of the fridge after purchase on Sunday.  Thoroughly concerned about the prospect of caring for my daughter while nursing a wicked case of campylobacter, I thought to myself, What would Jed Bartlet do?  And I called the butterball hotline, which actually does exist and was profoundly helpful.

Thanksgiving morning and our fridge has NEVER been this stuffed to the brim:

And my little 10 lb 9 oz helper after her 6am feeding (bored with so many variations of the same picture?):

Happy Thanksgiving to you and your loved ones!!!

My refrigerator of a daughter gained two pounds in three weeks–one fourth of her birth weight!

Okay, so I’ve decided to use this new mom-time for my educational benefit (not that I wouldn’t be forced to anyway…this thing has a steep learning curve, yo!).  Whenever I get frustrated that I’m not getting any work done, I’m going to remind myself of all the ways the day-t0-day will help make me a better pediatrician.  (Yeah…I think I want to be a pediatrician, but I haven’t ruled out ED or Ob/Gyn…so if you can make a case for either one, hit me up!)

John says that the last month has been hugely informative for him regarding labor and delivery and normal, well child health.  Recently, his ED got all geared up for a woman who was presenting in labor, thinking that she was close to delivery.  When she arrived, John took one look at her and relaxed, thinking, Dude, I’ve seen imminent delivery, and that ain’t it!

Right now Aurelia is going through a growth spurt, apparently.  Did you know newborns/infants had growth spurts?  (In peds talk, newborn = birth to one month, infant = one month to one year…so as of Saturday, Aurelia is officially an infant!)  We did not.  But she is slamming milk like none other, and my breasts feel like they might rip off my body.  She is also tracking to midline, maintaining eye contact, AND lifting her head to 45 degrees while lying on her stomach (the last one is a two-month skill!).  And to think, all those developmental milestones I struggled to memorize for the peds shelf exam…  The rest of the medical knowledge I amassed this year…questionable at best.

Struggling to stay awake during Doctoring: