Tuesday, March 23, 2010

Uh Oh!

I'm falling back on bulleted lists again, because argh! I'm really busy again.

- LL had his 18-month appointment. He is holding steady around the 30th percentile for height and weight, and above the 80th percentile for head size. He almost always wears baggy shirts because the shirts that actually fit his arms and torso properly will not slip over his gigantic head.

- Inspired by K, I made a list of LL's spoken words: mama, daddy, all done, this, up, down, bear, ball, cheese, keys, no, yes (actually, he says "da", which is "yes" in Russian; thank you Natasha), uh oh, more ("moo"), moo ("mmmm", cow sound; is it weird that he says "moo" for "more" but refuses to pronounce it like "moo" for an actual cow?), arf (dog sound), hsss (snake sound), vroom (car sound), puff (rice puffs), spoon. There is some debate about whether to also include "wee!" which is what he squeals when he's doing something fun, like going down a slide. Also, he only said spoon for one day, and has refused to say it again since, so that one is kind of iffy. The rest are all heard almost every day. You gotta love a kid that manages to fit that entire set of words into conversation every single day.

- I'm told that most toddlers learn "no" long before they learn "yes", so we're rather grateful that the Russian "da" is so easy for him to say. It makes him quite agreeable, and he always says it with a little smile. Natasha asks him yes-no questions all day long because she is so charmed that he answers in Russian. And this morning, he started saying "nyet" instead of no, which somehow makes me want to cast him in a 1980s James Bond film.

- "Uh oh" is a very recent addition. LL learned to say it, and a few days later he said it to a police officer who was writing S a traffic ticket. ("What's the problem, officer?" "I'm sorry, sir, but I pulled you over for speeding." (loudly from the back seat) "UH OH!") Sadly, the officer was not as charmed by LL's sense of humor as I was, and he still gave S the ticket.

- All of the kids I know who are around LL's age seem to have several times the vocabulary that he does. Tons more words, says their own name and the names of other kids, stuff like that. LL's exposure to three different languages (English, Russian, and Spanish) on a regular basis is probably slowing him down a bit, as is his early adoption of the word "this", which seemed to convince him that he didn't need to know any more nouns. Still, I was concerned enough that I asked Dr. K about it. She says that she only gets concerned at this age if a kid has fewer than 10 words or fails the M-CHAT (test for early autism). So we're fine.

- I did answer one question "wrong" on the M-CHAT, but I'm convinced that it's just a bad question. "Does your child sometimes stare at nothing or wander with no purpose?" I said "yes" because although he doesn't stare at nothing, he does wander with no purpose, all the time. So do most kids I know. Dr. K informed me that there is a difference between "wandering with no purpose" and "wandering with a specific purpose that only LL understands." She had no answer for me, though, on how I was supposed to distinguish those things. Apparently the question is meant to identify disengagement with the world, and not whether your child has the heart of an explorer but doesn't always submit a flight plan with his parents.

- Ever since we returned from our trip, LL keeps getting his snow pants out of the closet, putting them in his sled, filling the sled with stuffed animals (usually Winnie the Pooh), and dragging the sled around the house. And now I just feel bad that he's not around snow more often.

- LL has also learned how to sweep. Which is odd, because I rarely sweep, so I'm not sure who taught him this behavior. He gets out the broom, runs it over the floor of the kitchen, gets a dust pan, bangs the dust pan on the floor several times, then puts both the broom and the dust pan back where they belong. Carefully putting them back is the part that kills me.

- My parents, uncle, and grandfather are arriving for Passover in less than a week. Despite LL's attempts to clean the kitchen, our house is a gigantic mess, and I'm a bit panicked about whipping it into shape before they get here. I finally made the seder menu this weekend, did my first round of grocery shopping, and roasted two briskets to freeze until next week. The rest of the cooking will happen next weekend. I'm excited about the menu -- there's an apricot chicken recipe that I only make for Passover, and I didn't make it for the past two years (first because I was pregnant and had a huge aversion to chicken, and last year because the recipe is rather involved and messy and I didn't want to try it with a newborn in my arms). I love this recipe, and I'm excited to have it again.

- Our Passover plans are a bit more scaled back than recent years, mostly because S's family decided not to come this year. First seder will have just 7 people, and second seder currently stands at 22. (For comparison, last year it was 10 and 28; I don't remember the last time second seder fell below 24 people.) For any Jewish readers who are curious about why second seder is bigger: it's a tradition that I accidentally started back in college when I hated the seders run by my campus Hillel and invited three friends to do second seder in my dorm room instead. That first year, I stole most of the seder foods from the cafeteria earlier in the day, and had to take two different forms of public transportation to get to a store that sold kosher wine. None of my friends had a corkscrew, and we had to decant the wine after shredding the cork trying to open it with a pocket knife. After that, I started hosting second seder every year, and it kept growing and growing. By my count, this is my 14th year doing it. It's nice because most people have somewhere to go for first seder, but everyone we invite is generally free for second seder.

- I'm having serious senioritis lately, which is bad because I have a thesis to finish writing and a defense to schedule. In an effort to motivate myself, I'm going to announce some public concrete milestones: by the time my parents arrive on Sunday, I will have decent drafts (ie, good enough that I'd be willing to show them to people) of three (3) full chapters. Possibly without figures, but with full text. One of those chapters might be an appendix, but only if I wuss out midweek. You heard it here first. Check back next week.

Wednesday, March 17, 2010

Mountains and Follicles and Passover, Oh My!

We are back from our long weekend away with friends, and it was fantastic. Just what I needed.

We had eight adults and four toddlers, and we rented a five-bedroom cabin in the mountains. LL loved having all the people around, and he loved sledding and playing outside in the snow. (For comparison: two of the other kids screamed bloody murder every time we went outside, and the third one took half an hour to get used to the weather every single time we went out. While the other children were fairly miserable in the cold weather and thin air, LL ran circles around them and kept trying to hand them snowballs. The other kids spent a lot of time inside the cabin.) One of my friends is hyper-organized, and thanks to all of her pre-planning, all of the logistics went smoothly. We all drove to the cabin more or less together, we stopped together for lunch, we stopped again to play at a park to give the kids a break, we checked into the cabin without a hitch, we each brought a small collection of groceries such that all of our meals were planned and ready to go... it was wonderful.

I was most worried about whether LL would sleep in the cabin, since he usually doesn't sleep well in a pack'n'play, but it actually wasn't too bad. He went to sleep well each night. He then woke up around 1am, and we just brought him into bed with us and he went back to sleep (after flopping around for a bit). In the past, whenever we've attempted to co-sleep, none of the three of us got much sleep. I don't know if all the heavy playing wore LL out, or if he's just older and more adaptable, but this weekend it wasn't so bad. And the cabin was a bit cold at night, so I actually appreciated the hot little body in footie pajamas that insisted on sleeping on top of me.

Best of all, since we were all staying in the same cabin, we weren't constantly needing to leave in order to get kids home to nap or eat or whatever. We all got some adults-only time each day during naptime, and again at night after the kiddos were all asleep. And we traded off subsets of adults playing with all the kids, so we each got a fair amount of time during the day to put our feet up, have a drink, and chat with other adults. Heavenly.

And now... back to reality. I had another follicle scan, which showed that my one and only little follicle had been reabsorbed back into my ovary. It didn't grow, it didn't shrink, it definitely didn't release an egg (if it had, the corpus luteum would have been visible on the ultrasound). Instead, it just faded away. Since I'm already at cycle day 20+, Dr. M gave me a progesterone shot to quickly end the cycle, so we can move on to the next one. We're going to try one more cycle with 200mg of clomid.

In the mean time, I need to turn my attention to more pressing matters. Like the fact that my entire family is arriving for Passover in less than two weeks, and I have done none of my normal pre-holiday prep. Passover seders for 30 people don't just plan themselves. Also, I'm theoretically graduating in less than 90 days, and my thesis isn't going to write itself.

Friday, March 12, 2010

Double Fail

My one and only follicle on Tuesday measured in at 14mm, below the minimum 18mm needed to proceed with an IUI. They typically grow 1-2mm per day, so we gave it three days and came back today to check again. Know how big it was today? 14mm.

Stupid follicle. Stupid lazy ovary. Did I mention how much this sucks?

So, two possibilities. Either I actually ovulated yesterday, and the follicle grew really fast and then shrank again (unlikely, but Dr. M held it out there as a possibility) or the follicle just isn't growing (probably a bad egg). (And now I want to go rent The Bad Seed.) (My mind works in weird ways.) I'm going back for another ultrasound on Tuesday so that he can check whether it has grown (unlikely), shrunk (also unlikely), or just stayed approximately the same (that's where my money is). Based on how it looks, we'll figure out where to go next. Dr. M thinks that I could probably do one more clomid cycle, at the same dosage, based on the belief that everybody has bad cycles sometimes. He also mentioned maybe trying a cycle or two of femara instead, to see if I respond better. Or perhaps it's just time to move on to injectibles.

My hesitation with injectibles, by the way, isn't a fear of needles. S is scared of needles, but I'm not. I know that S won't be able to help me with injections, but I think that I'll be able to handle it myself just fine. I am a little annoyed with the added expense, but our insurance isn't too bad. My bigger concern is that I'll need to switch doctors. Dr. M is my ob/gyn; he's not an RE, though he does handle a lot of fertility patients for his practice. I've never doubted that I was in good hands with him, and I like him a lot. He helped us to have LL, in only three cycles. But, his office is not equipped to do the extra monitoring that's necessary with injectibles. They have too many patients to be able to handle all the extra monitoring appointments, and too few people with the expertise to make the little day-to-day adjustments that are common with injectibles. So Dr. M will be referring me elsewhere if we need to try a completely different treatment.

My biggest concern with injectibles is all that extra monitoring, especially since the appointments would have to be at a doctors office that is much further away. More frequent appointments that are far from both my home and my office? Not exactly what I want to be doing while finishing my thesis and looking for a job. If that's what it takes, then I'll do it. But I was hoping not to have to. Given today's news, though, it looks like that's where we're heading.

On the bright side (yeah, I'm stretching here to find a bright side), since we won't be doing an IUI tomorrow morning, we'll be able to leave on-time for our trip, so no need to come up with an excuse to tell our friends. I had a good one all figured out, too....

Tuesday, March 9, 2010

Under Pressure

You may recall that, way back in January, I attempted a clomid cycle, but my ovaries didn't produce a single mature egg follicle. Were you wondering about all the silence on the fertility topic since then? That silence was the sound of me waiting for that stupid canceled cycle to just end already. I took progesterone pills, I waited, I waited some more, I got a progesterone shot, I waited, I waited some more... and my body finally decided to move on. Weeks and weeks of wasted time. (Along with lots and lots of wasted negative home pregnancy tests -- hope springs eternal, eh?) I finally started a new cycle, this time with 200 mg of clomid. Follicle scan was this morning. The result: only one follicle, not yet mature (only 14mm). We're giving it a few more days and coming back for another scan on Friday, we'll hopefully be able to trigger then, and then we'll do the IUI Saturday morning.

For the last two months, we've been planning a weekend away with three other families, and we're all supposed to be leaving Saturday morning. We were planning to caravan to our rented cabin all together, but the IUI Saturday morning means that we're going to have to leave about an hour after everyone else. And we can't tell them why, because none of our friends know that we've started fertility treatments again. Suggestions on what lie we can tell them to minimize questions are appreciated, because I'm kind of at a loss. Also, I get really nauseous for several days after trigger shots, so the car ride should be a ton of fun.

Thanks to last cycle's ridiculous length, we have a lot of added stress for this cycle, too. S's sister, H, recently got engaged. Her wedding is next March, in a different state. We would hate to miss her wedding because I'm too pregnant to travel. We would also hate to miss her wedding because we have a baby who is too young to travel. (Basically: we don't want to miss her wedding.) I know people whose siblings missed their wedding because of pregnancies, and I think it sucks. You only get married once, and you're usually able to give people an entire year or more of advance warning; is it really too much to ask for your one and only sibling to be available on that day? When I got engaged, I knew that my brother, M, was about to start trying for another baby (yep, he told me when they were going to start trying, which I think is a little icky), and I explicitly asked him to wait a few months so that they wouldn't have to miss the wedding. And they were totally okay with that. (My brother and sister-in-law are very very good at getting pregnant. They didn't want to be in the third trimester during my wedding, so they waited three months, and were 5+ months along at the wedding. I'm unbelievably jealous that they could time it however they liked.) Maybe it was selfish on my part to ask them to wait, but I wanted them to be at my wedding!

Now S and I are in a similar situation with H's wedding. And I haven't changed my thinking on this topic: even with the fertility problems, I think that it would be selfish of us to knowingly try to get pregnant at a time when we would have to miss the wedding if we succeeded.

We figure we'll be okay to travel with a new baby when he or she is about two months old. Our first airplane ride with LL was when he was a little over two months old, and it worked out just fine. Earlier than that would be a problem: our pediatrician doesn't recommend airplanes before six weeks, and it took me a full eight weeks to recover from my c-section anyway. In order to have a two-month-old at the time of the wedding, the baby would need to be born by early January, which requires a cycle that starts in early April of this year. Which is just a few weeks from now. If this cycle fails, and the next one starts on time, a pregnancy from that cycle would be due around New Year's, which would cutting it close but still okay. If this cycle goes long like the last one did, we'll have missed our window of opportunity. I don't think that I could fly in my third trimester while also taking care of a toddler, so I wouldn't want to be any more than 6 months pregnant next March. Which means not trying again until September.

So basically: we have this one cycle. Maybe maybe we have time for one more. After that, we will have to take a five month hiatus before we try again.

After today's mediocre follicle scan, S has already started to lobby for us to just continue trying regardless of the timing. My body's lackluster response to this high dose of medication is likely evidence that my fertility has noticeably declined in just the last two years, and it's not like I was super fertile before. He thinks that we'd be foolish to wait for five months, fearing that it will just get harder and harder to get pregnant, and waiting might mean that it never happens. Which is kind of hard to argue with, you know? But I don't know. I think that planning to miss H's wedding is kind of cruel. Especially since she has her heart set on LL being the ring bearer, which she excitedly talks about every single time we talk to her.

No pressure on this cycle or anything, eh?

Wednesday, March 3, 2010

Gettin' Old

I like to say that LL changes every single day, but I only mean it in a technical sense. Many of the changes are very subtle, the kind of things only a parent would notice. He's a little taller, he's a little more steady, he can move a little bit faster. Then there are periods where it's like a whole new part of his brain suddenly came on-line, and we're like, "Whoa, this is a totally different kid!" We're in the middle of one of those periods right now. Some new link in his brain just came alive and suddenly he's understanding so much, and he's capable of doing so much more. It's really rather amazing. A few highlights:

After adding practically no new words for almost two months, LL is now building his vocabulary. "Up," "Down," and "cheese!" are the new favorites. He's currently eating a lot of cheese, because "cheese" is the only food word he knows, so every time I ask him what he'd like to eat, he says "cheese!" He has also added several new animal sounds (most prominently cows and wolves), which has meant a slight reprieve from the constant barking.

We're having real conversations! We used to have to coax him to say every word he knew, but now he volunteers appropriate words, and he asks and answers questions. He still gets by largely with four words: "Da!" (Russian for "yes".) "No!" "This" and "All Done!" When he wants something, he points in the general direction and says "this!" Then we play a guessing game where I pick things up one by one and ask, "Do you want X?" while he calmly shakes his head and says "No!" until I hit upon whatever it was he was asking for. Then he grins, nods, says "Da!", plays with / looks at / eats whatever it was, then says "All Done!" and calmly hands it back to me. Very civilized. The guessing part kind of sucks, but presumably that will get easier as he learns more nouns. For now, we're just happy that we have a way of figuring out what he wants that doesn't involve screaming and tantrums. And it's great that I've been able to reason with him on occasion: "Let's go change your diaper." "No!" "Why not? Is it because you want to keep playing with your car?" "Da!" "Hm... do you want to bring your car with you while we change your diaper?" "Da!!!" "Great! Pick up your car and let's go to your room!" And then he picks up the car and goes to his room. He wasn't at this level even one week ago.

We're having a lot of luck with avoiding temper tantrums using an "empathy" method that I didn't think would work yet, but miraculously does. The idea is that toddlers get upset about ... whatever (knocking over the blocks; having to wait for something; not being allowed to eat cake for dinner; having a dangerous object taken away from them) but they morph from simply being upset into being a screaming kicking ball of tantrum fury because they don't think that their parents understand why they're so upset. Being denied the cake is bad, but being misunderstood and dismissed is so much worse. So, when you see a tantrum about to start, you name the emotion, accept it, then suggest alternative ways of reacting. For example: "I'm sorry, LL. I know that you're angry that I won't let you have cake. I get angry when I can't have something that I want, too. It's okay for you to be angry, but it's not okay to kick your legs like this. Why don't we go find something else to have for a snack instead? Would you like a banana?" I have to say all of this while LL is still in the winding-up-to-a-tantrum phase, because once he crosses that threshold, I'm out of luck. But as soon as I see him start to get upset, I look him right in the face and start naming the emotion. He usually stops crying by the end of my speech, sniffles a bit, then calmly acknowledges the new activity. It's really quite amazing. It's amazing to me that "I know you want cake, but you can't have it" makes him tantrum, but "I know that you're angry about not getting cake" instantly calms him down. He hasn't had a full-blown tantrum in weeks.

LL is finally learning body parts. After stubbornly refusing to acknowledge eyes and ears, despite lots of singing of "Heads, Shoulders, Knees and Toes," and lots of reading of books like Karen's Katz's "Where is Baby's Belly Button?", he suddenly became obsessed with noses. For one day. And the next day, he was suddenly able to point to many of his body parts, none of which he was able to identify the day before. Mouth, teeth, tongue, nose, eyes, ears, hair, fingers, and toes. He's most consistent with hair, probably because he loves running his fingers through his curls.

He's suddenly into imitation. For a long time, the only behavior that we noticed him emulating was talking on the phone. (Everything vaguely rectangular was a phone.) But overnight, he decided that there are so many other things he could be imitating! He loves trying on our shoes and slippers and clothes (especially belts). He discovered during his last cold that he hates having snot on his hands, so he taught himself how to wipe his own nose with a handkerchief instead. No muss, no fuss! (Why he insists on handing the used handkerchief to me, rather than putting it down somewhere, is another matter.) And in a move that cracks me up every single time he does it, LL refuses to put down his sippy cup unless there's a coaster underneath it. If there's no coaster handy, he'll hand me his cup, run over to get a coaster, put the coaster where he wants it, take the cup back from me, and very carefully place it in the middle of the coaster. Every. Single. Time. We were at a play date last weekend, at someone else's house, and LL managed to find a stack of coasters on an end table, brought them over to where everyone was playing, spread them out, and then carefully moved every other kid's sippy cup onto its own coaster. (By the way, he gets the neatness thing from S, not me. And we've never even tried to enforce a coasters-for-sippy-cups policy. He just watched us do it with our own drinks, and decided it was cool.)

LL is finally reliably giving hugs and kisses. He's been doing the hugs for a while, actually, but the kisses are new. He'll follow commands like "Go give Daddy a hug and kiss," but better yet is that he notices when I'm feeling particularly tired (I lie down on the floor in the middle of his play area and say, "Wow, Mommy's really tired!" I'm subtle like that) and he'll come over on his own, give me a hug and kiss, and then pat my back encouragingly. The lip-smacking sound that accompanies the kisses is particularly amusing.

He's definitely into the "I can do it myself!" independence phase. He takes his shoes and jacket off by himself when we get home. He climbs into chairs by himself. When he's done eating, he takes his bib off and hands it to me before holding his hands out to be wiped off (and he wipes his mouth himself now -- it's very cute!). He loves brushing his teeth. He can stack cups and blocks into towers that are as tall as he is. At the park, he can climb the slide, sit down, and slide back down again all by himself. And he's finally reliably going to sleep on his own without crying. For a long time, he would scream when we put him in the crib; he usually stopped within 60 seconds, but it still bothered me that my peaceful night-night routine always ended with pitiful shrieking. Then suddenly last week, I put him in his crib and, instead of crying, he gently took his blankie from me, hugged it, smiled up at me, and waved bye-bye. It's so nice to be able to blow him a final kiss from the door and then walk out, knowing that he's happy and warm and comfortable and able to go to sleep on his own.

The more I watch LL interact with other children, the more I notice how easy-going he is. At playdates, other toddlers seem to spend much of their time throwing things and banging things and shrieking. LL is usually so much more calm than that. Not that he never throws toys. It's just not his normal mode of play. While other toddlers seem to yell the word "no" to everything, LL has this quiet normal-speaking-voice "no" that is usually accompanied by a gentle shaking of his head. Or, my favorite, he does his very thoughtful, "Hmmmm.... nah!" that is accompanied by a shrugging of his shoulders. How in the world did a one-year-old pick up the body language for indifference?

So, um, yeah. He's getting old. He's just two weeks shy of 18 months. The big one-point-five. It turns out that I'm getting old, too. Tomorrow's my birthday. My age will be a palindrome in both decimal and binary representations. Bonus points to anyone who identifies the other ages where this is true during a reasonable human lifespan. If you always ignore leading 0s, I count six other ages.