the longest journey

I haven't had much time for blogging, although I have thought about topics often. I find that when I am home I am too busy to even open my laptop, and I can't blog at work. So I am going to try on my phone, even though the phone app doesn't allow me to format.

Lucy is sleeping on me right now. Poor girl has her first cold, and she can't breathe lying down. She made it almost 8 months before getting sick, which I think is pretty good. We all had the crud this weekend, just in time for a planned visit with my father. None of us were up for much entertaining, but we made it ok.

My weight isn't getting higher or lower. It has been exactly the same, to the tenth of a pound, for about 9 consecutive days. Frustrating. I had a fill on Thursday but it was tiny. I return in 3 weeks. I can still eat way too much.

I have been to my new gym, and dropped Lucy off with the childcare they offer. They fell in love with Lucy and begged me to bring her back. Pretty cute. I will try to go again tomorrow. After not running during my pregnancy, I am back to square one with fitness. But for now I am just trying to reestablish the habit first.

So far to go to reach my goals! But I am hopeful that I will get there.

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Caution: Extreme Cuteness Ahead

Back to working the band

I have been wanting to blog for quite a while now, and have had many bloggy thoughts to follow up on. Now, I have a spare minute to do it, with baby and daddy asleep, and...my mind is a blank.

It's been hard to find some time to blog lately. Lucy is 7 months old now, and I want to spend all my time with her when I'm not at work. Consequently, I'm never on my computer at home anymore. I can do some limited web-surfing at work (check the news, Slate, etc) but I can't really blog or Facebook, so I'm just not on there much anymore.

I say "limited" because anything that requires real concentration (like blogging) isn't the best thing to do while taking care of a patient, and I couldn't do that. There are definitely moments in a case when the patient is stable, the surgeons are doing something tedious (I work in a teaching hospital, so routine cases usually take a bit longer since there is teaching going on) and I can check out msnbc. But if I become engrossed in writing something...that's not good, so I just don't do that.

Anyway...

I had my upper GI and fill on the 14th. It was good to get back to my original surgeon's office, and to have my insurance pay for this stuff! The upper GI was fine, Dr P said it looked like she had just put the band in yesterday (although it was one of her former partners, actually). She gave me a small fill, which I have noticed a difference from, but I still have a ways to go. I'm working on being mindful about eating, and making better choices, and I think it's helping--I'm bouncing around the same couple pounds, but I'm not gaining. And I switched gyms. Yes, I left my beloved march wellness, probably for good because their one location is really inconvenient now, and they don't offer childcare, so I only ended up being able to go about once a month. We have a 24 Hour Fitness less than half a mile from our house, an easy walk, so I moved over there. I added my husband too, and our dues together are only $10 a month more than I was paying for my own membership at march. And they have childcare. So, win.

Being a new parent, I find myself thinking a lot about how we are going to influence our daughter's attitudes about eating and body image. One thing I think about is that my husband and I have sort of evolved into an ad-hoc dinner style; we rarely plan and execute a sit-down dinner at home for ourselves. We often just grab a snack in the evening instead of making a meal for us both. The nights I work, I will come home sometime between 7 and 8:30 (unless I'm working late, then it's between 10-midnight). Hard to plan, and once I get home I have to put Lucy to sleep because she refuses to sleep if I'm not home (or she wakes up once I get home--don't know how she does it). But I would like Lucy to have a family that eats dinner together. So we'll have to work on this, and figure out what works for our family.

Lucy is growing like crazy. She got her first 2 teeth about 3 weeks ago, and is about to have her upper 2 come through as well. She sits up on her own and crawls on her belly (hasn't figured out how to get that belly off the floor yet). She laughs a lot, often at totally unpredictable things. She loves going on the baby swings at the parks. She usually doesn't like us to feed her solids with a spoon, but she'll eat anything if she can do it herself. She babbles all the time, and says "mama"--it used to be only when she was upset, but now she just says it randomly sometimes. She has the cutest little voice. She is getting so big so fast, it makes us sad sometimes that her tiny baby days are gone so quickly. But we have a blast with her.

A Letter

Dear Left Breast,

I know it is kind of odd to be writing to you. I mean, I don't think you've ever gotten any mail before. But I feel like I owe you a lot these days, and I want to thank you.

Almost 10 years ago, you were huge. I had surgery to reduce you and Right both, which was successful, and which I was quite happy with. That surgery helped me to exercise more and relieved my back and neck pain. You were just too big.

When I had that surgery, though, I didn't realize that one day I really would have the chance to have a baby, and that it would become very, very important to me to breastfeed that baby. I don't regret the surgery, but I had a lot of concerns that I wouldn't be able to provide my daughter with breast milk.

That came true with Right, which has so much scar tissue now inside that my baby could not latch at all, and I can barely express any milk from that side. But you, Left, have been a trooper. Together with some pharmaceutical help, we have provided Lucy with about half of the milk she has drunk in the past 6 months. We grew her strong and tall, with a nice big brain, and have made her very healthy. In fact, so far (knock on wood) she has not been sick once, and she was just a few months old through the winter cold and flu season. Without breast milk, I don't know if her immune system would have been so strong.

Tomorrow Lucy will be 6 months old, and I have weaned off the domperidone. I'm still producing milk, so I am going to keep pumping a few times a day for a little longer--maybe just a day or two--just to see what happens. I am wrapping up this part of my life, and I don't know if I will have another chance to provide a baby with milk. It's hard to say goodbye. But you've given me one of my first important lessons in parenting: that often, things don't go the way you want them to go, and although they might be very important to me, I have to find a way to make peace with it.

Now you are a little droopier than Right, and more painful most of the time. But you've accomplished something remarkable. Thank you for letting me provide something so important for my baby.

Slowly but Surely

I'm tapering my domperidone dose down, and trying to wrap my head around stopping pumping. I have mixed feelings about it, as I think I've shared here before.

The good things are: I've lost 4 pounds, and I have a lot less hunger and cravings for sugary foods since I started tapering. I'm on about half the dose I have been taking at this point. Today I made a Costco run, and was shocked that I didn't even have any desire to get anything in the bakery section (a killer for me, usually) or any sugary goodies. It made the trip much quicker than usual!

The bad, or confusing, things are: I have a hard time letting go of this phase of our lives. Even though pumping doesn't have as many positives connected to it as nursing does, it does feel kind of like weaning from nursing. If Lucy was nursing, instead of just taking expressed milk from a bottle, I would still be doing it and not even considering stopping, even if I gained another 40 pounds over the next 6 months. (Okay, maybe not that much.) But pumping, and only pumping, with a nearly-6-month-old, is tough. Still, I love that I can give her my own milk. It's not saving me any money, between pumping supplies and medication, but it's so good for her, and she enjoys it more than formula, and it's something that only I can make just for her. I will miss that. But this weekend I have another painful blister that bleeds and makes me question pumping at all right now. So I feel it's time to start letting go of pumping, yet I have a hard time with it.

I do want my body back. I do want to fit into clothes and to be able to run again. And I'm mostly sure I want to have another baby, one more, and cannot stand the idea of getting pregnant at an even higher weight and gaining even more weight. I have to give myself these pep talks and remind myself why I am doing this.

Fill and upper GI on April 14!

Coming down to it

This week, I was mistaken for pregnant twice.

This is unacceptable to me. I almost shut down Project Milk right then. I discussed how unhappy my weight and the pumping are making me with hubby. I actually resolved to quit, despite how important it is to both of us that Lucy have 6 months of breastmilk. Then I went to bed.

The next day, I just worried about that day. I am going one day at a time.

I do feel ambivalent about giving up pumping. I do think it is important, and I am proud that I have been able to provided much of her milk despite my physical challenges. At the same time, I have been making every personal decision about my body with my child in mind for 15 months now, and I am ready to have my body be mine again. And I am ready to see my coworkers during breaks instead of spending them huddled in a shower stall every day.

So it starts now. I bought a lovely BOB stroller this week and started the Couch to 5k plan this week. I am slowly tapering the domperidone over the next 3 weeks, but not reducing my pumping frequency yet. And I am watching what I eat. I still won't have my fill until April, but I expect to have made a little bit of progress by then.

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The Date is Set!

April 14 is when I return to my original band surgeon (now that I am back in Portland) and get an upper GI and a fill. About 6 weeks from now, which is actually perfect. By then, Lucy will be 6 months old and I will stop taking domperidone (and probably stop lactating after that), and I'll be ready to start losing weight without fear of damaging my milk supply. In the meanwhile, I am looking for an inexpensive jogging stroller (on Craigslist mostly) to give me more options for working out. I think I might also arrange for our nanny to come once a week so I can go to the gym.

Meanwhile, I'm trying to compile a list of easy-to-prepare, healthy dinners to make quickly and a list of ingredients to keep on hand. Most of the cooking here is done by my husband; sometimes I enjoy cooking, but I don't like the day-to-day meal preparation, and I've never been good at planning ahead for meals, although I know I could save a lot of money if I did.

So, anyone have any favorite go-to recipes for dinner that are healthy and band-friendly (weight loss friendly)? I'd love to hear them!

I'm relieved to start this process. As much as I enjoyed (most of) my pregnancy, and this time of providing nourishment for my daughter, I am ready to fit into my clothes again. I'm also ready to get back into shape.

And there's more. I've been following up on this benign lump in my breast for some time. I've seen a bunch of doctors, and it's not anything dangerous, but they do think I should have it removed. It's large enough that removing it means I need a repeat breast reduction (which I needed anyway) to make things even. But...we still might have another baby, and it would have to be relatively soon if we do (like the next couple years), and I want to try breastfeeding again. Also, I want my tummy tuck at the same time (!). So, I have a referral to a plastic surgeon, but I would need to lose weight first at a minimum. What would make the most sense is waiting for all of that until I've either decided against a second baby or after that baby is born (and weaned). So, that's on the horizon, but I don't think it will be for a few years. Meanwhile, losing weight is definitely part of the plan.

So, one more month of pumping for Lucy. Pumping is so much work. I know I've complained about it before. I don't think if I had a second child that I could do this exclusive-pumping thing again, not with a baby and a toddler running around. It just takes too much time and ties you down too much. 6 months is my max for Lucy because she is already getting too restless to tolerate my pumping schedule. Many pumping sessions get started and abruptly interrupted because she needs or wants my time (and you can't blame a 5 month old for that). I can't see her tolerating it very well beyond 6 months. And it really sucks being tied to that thing every 3-4 hours for at least 30 minutes. I'm going to miss being able to provide milk for Lucy, but not the pumping.

Start where you are!

Looking over at my "About This Blog" blurb to the right, I see that my 4 year bandiversary is coming up on March 13. 4 years sounds like a long time to me. A lot has transpired since my surgery day...I've started and completed graduate school, moved to Spokane and back to Portland, become a CRNA and started a new job, and of course, given birth to the beautiful joy of my life, Lucy. And now, I am getting itchy to get my body back.

I've kept most of the particulars off this blog, like my exact weights, but that feels cumbersome right now, so I'd rather just put it all out there, as I get into a mindset to lose weight and regain my body again after pregnancy and lactation.

A band recap:
Starting weight: 234 in March 2007
Lowest weight: 165 in February 2009
Prepregnancy starting weight: 180 in December 2009
Highest pregnant weight: 209 in September 2010
Current: 196

I actually initally lost all but 5 pounds of my pregnancy weight in the first two weeks post delivery, but when I started domperidone to increase my milk supply, the weight came back on and has stabilized. I've been this weight for at least the last month, with very little variation.

I have very mixed feelings about where I am. On the one hand, I realize that my body is still doing a lot of work in nourishing my child, and it's not the time (yet) to seriously try to lose weight. And I'm happy that I can provide at least some (about half) of my child's nutrition. It's all coming from just one poor post-op breast, so I'm happy I can do this much, and although I still find exclusive pumping hard, I am going to try to make it at least to 6 months. But on the other hand, I really am ready to get my body back, and hopefully get back to my goal weight before (possibly, probably) trying for one more pregnancy.

My goal will be 165. By BMI standards, that seems high, but when I was that weight, I was a size 6 and quite thin. I don't need to be any smaller than that. Maintaining 170 wasn't too tough, but 165 took a little work. We'll see what I am able to do.

Some people get into weight loss mode very quickly and jump right in. I've always found it works best for me to take my time to ramp up to the right mindset. I'm in that process now. I'm just working on paying attention to what I'm eating, not necessarily editing it but making some effort to make good choices. I'm trying to work out still, but am finding it very hard to get out with the baby. Part of it is that I just don't want to spend my time off away from her, so I don't go. I do want to get a jogging stroller now that she is old enough to be in one (around 4 months their necks are strong enough for the jostling) to help me get out more. (That might take some convincing for my husband, since we already have 2 strollers. But I really do think it will help me get more exercise.)

And as for the band? I probably need a fill. I had 1 cc removed at the start of the pregnancy, and haven't had any fill since then. But I definitely need to see how I do with good eating choices first, to determine if I really need one. Because I've never gotten really strong "restriction" signs, and have never felt overfilled, it's always been hard for me to determine if a fill is needed. I suspect I'll find that I want one, but not while I am still pumping, and I doubt they would do it even if I wanted it now. So we'll table that thought for the time being.

Meanwhile, the Lucy Report: She is awesome! She just turned 4 months old, is smiling and sometimes laughing, and can roll over from tummy to back. She's getting very strong and might be sitting on her own in the next few weeks. She can sit in her Bumbo quite nicely. She went through some sleep regression over the last month but has done better the last 3 nights, basically sleeping through the night in her crib like a big girl! We are having so much fun with our sweet girl. She has our hearts for sure!

Pumping Sucks

So, I started back at work last week. It's been a bit stressful--I worked 2 months in my new job/new profession, as a new grad, then took 3 months of maternity leave. Coming back has been, professionally, difficult and rusty, and personally, very emotional and draining. My skills are slowly coming back to me, but I definitely have a lot of moments when I feel less than confident. And leaving Lucy with a nanny has been difficult, although I think we are all adjusting relatively well. I think it's hardest for hubby--he never left his sons with anyone except his ex-wife, and he is actually working from home a couple days a week, so he hears how Lucy does with the nanny (she cries more than with us) and it's stressful.

The worst part might be the pumping. I don't mind pumping at home, really. It takes some time and I'd rather just nurse Lucy than pump and feed, but she doesn't want to nurse. I've given up trying, it's too hard on both of us. So I am pumping several times a day, which is okay at home, but very hard at work. At my hospital, the birth center is very active in making sure women everywhere can breastfeed, and they try to extend this to their employees, but my particular job makes this very difficult. Basically, every break I get, I pump while I eat. Unfortunately, most of the convenient pumping locations are in shower stalls, in the locker rooms, which are uncomfortably close to the toilets. Yuck. There is something about eating your lunch hunched over a breast pump in a shower stall, by yourself, that makes you feel a little less valued as an employee. The logistics are very difficult (packing food that I don't have to heat, getting an extension cord, finding a location to pump in that isn't already in use, etc) and it all takes a lot more time than I would normally be allotted (15 minute break? Hah!). Luckily the staff are pretty accomodating for the most part. But I have, at best, 4 breaks in a 13 hour shift, and if I get to pump for all of them, it's good (except that I spend every break eating in a shower stall).

It's funny, though. We aren't allowed to wear polar fleece in patient care areas because of infection control, but it's no problem to let employees produce their offsprings' food in a bathroom. I find a bit of dissonance in that. And I'm torn between understanding how difficult it is to accomodate nursing moms in this kind of job, and feeling that they could do a lot better. There are some designated pumping areas that are not toilets (this is, of course, a legal requirement), but they are only convenient to me when I work in angio, which isn't very often, and they are frequently already in use. So I leave for a 15 minute break and spend the first 10 minutes going from one location to the next, trying to find a place that is unoccupied. Then once I finally find one, I have to wash up, set up, pump and eat, wash everything, put it all away, and get back to my location. I always tell my relief person that I will take longer because I have to pump. But it's all just difficult, and I totally get why women give up when they go to work.

I'm not really wanting to complain about my employer about this--I am a little bit, but mostly just complaining that in general, this is difficult to do, and I don't know how much longer I will do it. I want to continue for at least this first year, but may not be able to. If Lucy was actually nursing, it would be a little easier because at least I wouldn't be pumping all the time, although it still wouldn't alleviate the work-pumping issue--at least I would have an even better reason to keep doing it. We'll see how this goes.

Born to Run? Running after Birth...

I am starting to wonder how you get any real exercise with a baby. I know, shocking, right? I can walk all over the place with the baby. But I want to start running again. This isn't working out very well so far.

I was able to get to the gym twice and get on the treadmill. I think I posted about that earlier. I realized that I needed to get a new sports bra to accomodate the milk jugs. So I did that a few weeks ago. After getting a few good supportive sports bras from Title 9 (love them), I have been unable to get out to run since. I started to go the day after getting the bras (it's been 2 weeks now) but my husband needed to do some work and so I had to watch the baby. Since then I haven't had any time to do it. Either no one else is available to watch the baby, or I have a zillion other things that have to be done. (I haven't been able to go to the pharmacy to pick up a prescription in the last week, either.) It's frustrating, because I really do want to get out there and get moving again. It's just not happening. Anyone out there have any great ideas? She's still too little for a jogging stroller--she has to be 4 months old, or is it older?, to have the neck strength necessary.

I did return to work this week. It was so hard! We are lucky to be able to have a nanny come to our house, so we don't have to wake her up early and get her ready and take her somewhere. But it was still very, very hard. I get up at 5, pump, get ready for work, and leave by 6. Baby is still asleep, and usually so is my hubby. I don't get off work until 8pm, and get home between 8:15 and 8:30. By then it's time for her to be going to bed (and that's now, in a couple months her bedtime will have moved up even earlier...she'll either be in bed when I get home or she'll be way overtired and needing to be there). Again, I'm not exactly reinventing any mommy problems here. But it's tough.

Not only was leaving Lucy all day hard, but getting back into the job was also very tough. I'm in a new career. I was in my new job for two months, then was off for 3 months. I wasn't really feeling proficient by the time I left, and coming back felt very rough. The second day was better than the first. My job isn't really normal--you don't want your anesthetist to be preoccupied with her newborn baby, or to be feeling like she's off her game for any reason. And then there was the pumping. The closest location I can pump in is the shower stall in the locker room. I get two 15 minute breaks and two meal breaks in my 13 hour work day. During those breaks I have to pump and eat, and getting there and back takes almost 15 minutes in itself. Then there's setting up, pumping (which requires relaxing, ha!), washing everything up, and getting back. Plus the joy of eating in a shower stall on a little stool. This country is so messed up when it comes to supporting working parents. And this is at a big hospital, one that is supposed to be supportive of lactating moms. Needless to say, on that first day, I was only able to pump a little over half what I usually do. Very frustrating.

I think next week will be better, though. I'm orienting to the areas I couldn't work in when I was pregnant next week. The nanny has the lay of the land, more or less. I hear this gets better, and everyone says that eventually I'll be glad to get to work and get away from the demands of parenting for a little while. I'm sure that's true, but for now it's definitely hard!