Weeks 4 & 5

So apparently I am skipping behind in my blogging again mostly due to lack of time and oomph to write. So I figured I'd at least get some photos up and then fill in with some words later!

Week 3

Dear Madelyn,

3 weeks already! And you are growing like a week. An adorable chunky little weed :) We had your 2 week check up this week. The general goal for newborns is to be back to birth weight by 10-14 days of age. When you were weighed at your appointment you were 9 lb 10 oz, which is 1 lb 6 oz above your birth weight! Your amazing breastfeeding has been paying off - and we're going to have to say goodbye to your newborn sized clothes pretty quickly, as you already popped open a snap on your kitty pajamas last night.

Our friends Aimee and Tom were in town for a wedding and came and stayed with us for a few days. Aimee cooked up a storm and we were eating well even after they left!

Your Nana V left after her almost 3 week stay helping us, and we had our first 24 hours on our own together! Poppa and Nana Laney came for a couple nights afterwards so you have continued to have great grandparent support. It was fun though spending all that time with you and a challenge to figure out just how many things I can do one handed since you like to be held all the time!

We tried out a pacifier for the first time - sometimes you like it and sometimes it makes you so mad!

Your favorite place is still sleeping on our chests - so most of my day is spent with you in the Moby wrap so I can get some things done. 

You are working hard at tummy time and just get frustrated when you want to be moving but you can't yet.

Looking forward to what the next week will bring!

Love you more than anything,
Your mamma

Pumpkin Patch!

Madelyn slept through her entire first visit to a pumpkin patch last weekend! Here is a photo dump of our excursion :)

Week 2

Dear Madelyn,

Can't believe we have known you for 2 weeks already! It seems like you arrived yesterday and forever ago. This week I think we have worked on two things - sleep and cloth diapers!

Sleeping. You have actually switched back your days and nights to the proper times pretty easily. I'm not exactly sure when this happened this week but it's pretty great. I think this is helped by the fact that you find sleeping in your crib or pack n play during the day boring, and will only sleep in someone's arms or in your Moby wrap. While for whatever reason you now have figured out sleeping in your pack n play at night (maybe because it's dark? you know you aren't missing out on something?), so you have two distinct types of sleeping. Either way, it's hard to complain when I can stay in bed for 10 hours at a time, just waking up to nurse you every 1-3 hours and occasionally wake up your daddy to change your diaper! You are really noisy when you sleep, with your little grunts and squawks, and flailing your legs and arms every once in a while. You still won't let us swaddle your arms even though I'm sure you would sleep much better at night. But you want what you want! We do get some fun morning snuggles in bed though before we get up for the day.

Cloth diapers. This has been a bit of an adventure. I had done tons of research prior to you being born and had planned to use our big stash of used newborn cloth diapers once we got through the meconium poop stage, so that we only had a few days of disposable diapers to deal with - and then to the one size diapers once you fit into them - guessed that would be 6-12 weeks down the road. So we started off with the plan, using the generous stash of newborn disposables sent over by Lindsey, friend from residency who had her adorable baby boy in May! Got through the meconium days pretty quickly, but then realized that the cloth diapers didn't fold down well for the umbilical stump so we then waited longer for that to fall off, and then your belly button to heal up enough that it wouldn't get irritated. So it took about 1.5 weeks until we switched. Sadly though, despite how insanely cute the newborn diapers looked on your little butt you were out peeing them already! And they barely fit. Clearly these were designed for a much smaller and less vigorously feeding newborn :) So on whim, I tried out the one size diapers to see if they would fit (the package did stay 8-35 lbs after all!) and they fit! Granted now you have a giant fluffy butt, but it is an adorable giant fluffy butt. Still stayed dry when you went over 7 hours without a diaper change while you were sleeping (not for the whole 7 hours straight, I wish!) so we were fully sold and I frantically bought some more to get our stash up to a useable size during a weekend sale. Somehow I only have a photo of you in one of the boring colors, but I'm sure this is the first of many.

Other things of note from this week - baby glamour photo shoot! We had your professional newborn photos taken. The photographer came out to our home and transformed our bedroom into a photo studio complete with a giant fluffy bean bag for posing and a space heater so you wouldn't get cold. 4.5 hours later you were done and while we have only seen two of the photos so far, we can't wait to see the rest!

Also went to the pumpkin patch - I will have a separate post for this so there is room for all the photos :)

You are getting more and more alert every day - and have started having more times of being cranky. I just wish I could tell what you need when you cry! So far between the crew of me, your daddy and your grandma Vicki we can generally make you happy again. And some days you're just happy all the time. We've gone to the dog park again, and also took you out to a burger place and you got to eat in public for the first time which was an interesting challenge in the narrow booth but you did great. Your mamma even got two of the trivia questions correct before we left!

We all love you so much Maddy, and are loving watching you grow up every day.

Love you more than anything,
Your mamma

Week 1

Okay folks, warning for mushiness ahead! I wanted to do weekly updates to match up with her weekly photo, and writing her a letter seemed like the best way. Although understandable a little gushy for an outside audience :) Blame it on the hormones, I am so in love with this tiny human I have no other excuse!

Dear Madelyn,

This has been one of the best weeks of my life. I had no idea I could be so sleep deprived and pooped on and yet so happy all at the same time! Bringing you home from the hospital didn't feel scary, it felt so right. There has been a big learning curve, for the both of us. We learned you absolutely hate having your arms swaddled, so that eliminates one of our main strategies to help you sleep. You will sleep like a charm in someone's arms, so that's how we managed the first couple of nights, taking shifts being your bed. Not that anyone could complain getting to watch all your fun faces you make while sleeping. We've slowly been moving over to having you sleep in the pack n play bassinet while we're sleeping at night. This works the best after 3am, and you like the ocean setting on your sleep sheep and the swaddler blanket hugging your belly and keeping your arms free. You still wake up a lot to eat and get daddy up for diaper changes. You get the hiccups a lot which you hate! We haven't figured out any way to get rid of them other than nursing. Speaking of which, you are so good at breastfeeding! It was one of my worries during pregnancy that we would run into some of the many challenges, but you make it so easy. 

Your outings this week have included going to the dog park when you were just a few days old. You love the Moby wrap!

Going to the doctor for your first check up, we found out you love the car seat. Especially when Tyler lifts it up and down. 

We went to the farmers market on your week birthday with the grandparents and we picked out a new onsie for your weekly photo this week. Then we went out to dinner and had delicious sandwiches while you stayed snuggled up to me in your wrap. 

Your umbilical stump fell off on your week birthday so you have a real belly button now! Still healing so we'll see if it's an innie or an outie. You have great head control already and can lift it up all the way during tummy time. It makes you mad though that you can't do more. You are such a mover and want to go everywhere on your own steam! You love it when daddy swings you back and forth in his arms as high as you can go. 

So far all the critters have adjusted well. The kitties aren't terribly phased overall although they don't understand when I get up with you at night and don't come pet them so they wail more. Rue thinks you're fun to sniff and is mostly concerned with all the strangers in the house from family staying with us. Malcolm had a really hard time the first couple of nights. He would get so concerned when you cried, he thought you were hurting, so he would whine and howl and pace. He had to spend a few nights downstairs sleeping in his crate. Now he has understood that sometimes you just cry (although really not a lot!) and everything is okay. He is always concerned when you aren't happy but is able to sleep back in the bedroom with us. He loves all the family visiting, and wishes they were here all the time!

I am so happy you were born and love getting all your cuddles and have a hard time sharing! You're growing already and I'm going to miss you being so little but I'm already looking forward to what each day will bring as you grow into your personality. 

Love you more than anything,

Your mama

Birth Story

As I sit here on the couch with my daughter asleep in her wrap I will attempt to write her birth story with the one hand I have free :) Mostly so that I can document all the little details for myself for the years to come.

September 26th, Friday:

Went to work for my regularly scheduled shift at 8am. 39+3 today and ready to barrel through the last three shifts I was scheduled for before my leave started. Everyone at work asking me how I was doing and I assured them all that yes, she had dropped but no I was not in labor and I planned to make it through all my shifts. I texted Tyler a little bit later to tell him how my pelvis was killing me - this baby head down there was no joke. He then told me I was going into labor, and again, I reassured I was not. Then around 9:30ish I started feeling contractions. I had been getting Braxton Hicks contractions during my work shifts for some time now, but these were definitely different. I figured this was false labor due to dehydration and set out to drinking a ton of water and continuing seeing patient after patient. They didn't let up even when I was so hydrated I was making a trip to the bathroom almost every 30 min, so I told Tyler this was possibly early labor, and I would keep him posted but not to get excited yet. Apparently he didn't listen and was in a hypomanic state the rest of the day from excitement. As the day went on I decided I should try and time my contractions, which wasn't easy during a busy work day - I would usually forget the time the last one had started by the time I got another. Though they seemed to be coming quite steadily every 5-10 minutes. I finally made it to the end of my shift, thankfully wasn't held over.

I rushed home to let the dogs out and get to my regularly scheduled OB visit. On the drive home since I had a clock in front of me I was able to time things and was having contractions like clockwork every 5 minutes. Still only in the uncomfortable realm though. Made it home for the dogs, got them settled and then drove over to VCU to see my OB. I found great street parking and made it up to my appointment - I had planned for her to strip my membranes (again convinced I would be post-dates and wanted to hedge anything in my favor) but now I actually wanted to know what my exam was to help figure out how real these contractions were. My appointment was fine, actually had a "yes" answer to the leaking fluid/bleeding/contractions question - but I still wasn't impressed by them though they were still coming about every 5 minutes. My exam was good, but not really telling of anything. 1-2 cm dilated and 70% effaced, which is a great starting point for a first time mom. But that may have been change made over the past couple weeks or that day, so my OB said maybe the next 72 hours, but who really knows. Tyler tried to make it to my appointment but just made it to the waiting room as I checked out, so we headed out to Costco to do our final nesting shopping and to prepare for family visiting. Either there is something in the air at Costco or it was all the walking that things really started to get more real. Now I was the giant pregnant lady stopping every 5 minutes to lean on the shopping cart when my contractions came. But still managed to get some ice cream to eat before we left so I figured it was still too early to tell. We managed to buy yet another baby outfit while we were at it, and stocked up on goodies and cereal for our incoming guests. By the time we made it to Trader Joe's though I was starting to have to breathe through my contractions and opted to stay in the car while Tyler made a mad shopping dash so that I wouldn't frighten the shoppers with their idea of a baby getting delivered in the 2 buck chuck aisle. Still, I didn't believe this was really going to be it.

We got home and I was stressed about deciding whether or not this was the real thing, because I would have to let my boss know to get my final two work shifts covered. If things petered off during the night and the next day would be like it was earlier today, I would have rather just gone to work and not missed the hours. So I decided I would lay low and see if I could make the contractions go away. Several episodes of Big Bang Theory didn't dissipate them, so I thought I would see if I could sleep them off. Not only did that not work but having contractions in bed was not comfortable in anyway. So at that point I decided I would just commit to this being the real thing and stop trying to hold them off. I texted my boss, who was excited and took care of the coverage. And then decided I needed to walk around the house like I would tell any other early labor patient to get things going. Tyler dutifully found a distracting movie to put on - The Birdcage - while I paced and huffed and agonized over when I should go into triage. I did not want to be the primip that showed up at 1-2 cm asking for an epidural. I almost wished my water would break so I would have a definitive turning point. Once I realized I could barely even get myself to keep walking because it made the contractions too intense, I decided to call it and Tyler grabbed our gear and we drove over to VCU. Luckily I had finished packing my hospital bag that week, which I was already rather late to the game on.

September 27th, Saturday:

The advantage of coming in after midnight was that the stork parking spots in the garage were free which was great. The trek to triage took a while, as I had to stop every few minutes for my contractions, I think I had about half a dozen on the way up, including one in the full elevator. And then 3 more while registering with L&D. I was so worried I wouldn't have made any cervical change from my check earlier that day, and while secretly hoping for them to tell me I was 5 cm dilated decided I would be happy with 3 cm. The residents that came in for my evaluation basically admitted me on sight based on how I looked with my contractions, which were now every 2 minutes. Still had to do the exam though and I was 3 cm dilated, 100% effaced. So just on the cusp of active labor by exam but definitely clinically active! I agreed to be in their suture study in between contractions, they were comparing the healing process of vicryl and chromic, and then they whisked me off to my swanky L&D suite. I wish they had remodeled the postpartum rooms first, because I definitely didn't give a crap how swanky my room was at that point. I really wanted to hold out until 5 cm for my epidural, so I set out to find the best way to cope with my contractions that were cooking away. The unfortunate part was that I couldn't find a good coping position that was compatible with my desire to sleep in between, as I was already exhausted from my work shift, errands and now over 12 hours of early labor. And while walking would have been logical to help things progress, they made my contractions so intense I couldn't manage it. I managed to stick it out until my next cervical check where they told me I was 4-5 cm so I hailed the anesthesiologist. Getting the epidural was surprisingly uneventful, other than having to hold completely still during contractions which was as hard as it sounds. And oh was it glorious. I was able to sleep for the first time, well doze really because my mind was racing too much to sleep, and just let my contractions do their thing, which they continued to come every 2 minutes. When they rechecked me around 6:30am I was 6 cm dilated, which was great news - excellent progress overall, and the resident AROM'd me (broke my bag of water). Tyler ran home to take care of the dogs, as we didn't have any back up plan for their care in the event of me going into labor before my mom arrived. Sadly my next check around 9am I was still 6 cm, although the residents had changed shifts, so I felt really discouraged and was thinking I would need pitocin if I wasn't changed at my next check. Apparently though the OB attending that day must have been really hands off because they decided not to check me until the early afternoon, or earlier if I was feeling pressure. I really didn't understand the logic behind this but let my team decide what was best - I still was contracting super regularly so I just let my body do its thing (and the glorious epidural do its thing). So finally sometime after 1pm I thought maybe I was feeling some pressure, but I'd just gotten an add on my epidural and frankly couldn't feel too much of anything. But my nurse diligently got the resident to come and check who informed me I was complete and 3+ station, ready to push! All the way dilated and didn't even need to labor down anymore. I couldn't have had better news. So I woke Tyler up (he was much better at sleeping through this watch and wait part of labor than I was) and so began the marathon. I think I have underestimated how challenging and exhausting pushing really is - never again. It took 3 hours of pushing until my little girl made it into this world! I honestly wasn't sure I could do it, I thought I would need a vacuum for maternal exhaustion I was getting so spent. And I could have killed my nurse who kept telling me I was "so close" for about 2 hours, as it took me about an hour to realize that it meant nothing. And feeling first hand how discouraging it is to have the resident walk in, watch me push, and then walk out again. I know exactly what that means! Not going anywhere fast. Also to add in that my temperature was elevated, up to 100.2 and the FHT was tachy in the 170s, so I was just hovering on the border of being called chorio, which I did not want. That would have meant a 48 hour stay in the hospital and likely antibiotics for the baby. Luckily I managed to push her out without any assistance and didn't even tear too badly considering that she was much bigger than we thought - 8 lb 4 oz!

We got to have our skin to skin time, in which I was still in a daze. Madelyn was already asserting herself by getting really cranky when the nurse tried to help her breastfeed. So I fended her off and let her do her thing and she latched on all by herself and breastfed like a champ! Clearly already a genius. Once they finally pried her from me and she had her exam and we found out her weight - we made all the requisite phone calls to family. My brother was at an airport waiting for his connecting flight to New Zealand, and my mom was already in the air on her way to Richmond so we had to wait for her to land to fill her in. Tyler again had to run home to take care of the dogs before we settled in for the night, but made it back before I switched rooms to the postpartum floor. In the meantime I had gotten dinner and devoured it while Madelyn snuggled next to me.

The next 24 hours were a blur of feedings (still a breastfeeding champ, she was way ahead of her feeding goals and even the lactation consultant had nothing to add!), exams for the both of us, social security forms (hello new person in this world!), routine screenings and lots of awkward bathroom trips. I convinced our teams that we could go home at the earliest they would allow, the 24 hour mark, and I don't think there was anything better than walking through the door with our brand new daughter in my arms.

Most of our hospital photos are on the real camera which I haven't hooked up yet, so here is one from my phone so the post isn't photo-less. This is from right after she was born.

Countdown is on!

Critter updates:

Kitties are continuing to sleep as much as possible, only taking breaks to annoy us or beg for food. Lately the cats have decided that my squashed bladder is not adequate conditioning for poor sleep at night and have taken to maintaining a regular howling vigil outside our bedroom door throughout the night, complete with attempting to dig through the door. We are not amused.

Rue is working on getting her ears to stand up straight, although she forgot to grow into them first. She's been at one ear up, one ear with the tip flopped down pretty consistently for a few weeks now, although sometimes they're both up or both down. We're convinced she's done this to copy Malcolm as now their ears are mirror images of each other. She also finished up the last of her puppy food this week and is onto big dog kibble! Her birthday is the day before the baby's due date so it's hard to believe we're so close. It seems like just the other day she was a little puppy riding on my lap in the car to puppy class...

Life updates:

Sabrina came to visit! Best friend from college who is getting a slew of masters degrees at Columbia took the train down from NYC to hang out for the weekend. We had a lovely lazy weekend of catching up, sweltering on the Canal Walk, eating my first attempt at pulled pork (it worked!), meandering through Maymont Park and watching some old episodes of Castle :) I suppose there are some advantages to living on the East Coast if now we're only a train ride away.

Work continues on; I officially am crossing off the days until my last shift on a calendar on the fridge! It seems like lately my mission has been to reduce inappropriate benzo use (mostly Xanax). We have to reconcile the medications for everyone we see - which is a pain but also useful. And I've caught 2 women in their 70s on chronic benzos for sleep aids, which not only is a terrible habit forming medication for sleep but also is on a list of medications that you should not prescribe patients older than 65. Both seemed to be shocked that the meds weren't safe for them, and hopefully the time I spent educating them (of course both times unrelated to the issue that brought them into me in the first place) will amount to something. But ultimately their providers need to be better about their geriatric polypharmacy! And then there was the 20 something year old wanting her chronic xanax refill for her anxiety that she hadn't seen her psychiatrist for in 8 months and just ER hopped for refills. Needless to say she didn't get anymore from me, other than my speech about how inappropriate benzos are for anxiety treatment and how she needs regular care and CBT and sticking to her other meds. Probably failed my customer satisfaction on that one! Also on that note - why do patients feel that lingering in the doorway of their room and looking peeved will make me see them faster? Note to those patients: you came to a walk in clinic and the rooms are all full! Sometimes I have to see the kid with an asthma attack and hypoxia and the elderly man with chest pain that came in after you did, but you came in with a cold so you can wait (also - you're not getting antibiotics for your virus so just give it up now). 

Baby Updates:

Baby Laney is officially term at 37 weeks this week (although she needs to stay in until at least 39 weeks for growing, and 40 weeks for me to finish working!). Still an active little thing but running out of room. Had a giant shopping spree on Labor Day - this is what it looks like when you order 25 things from Amazon and they all arrive at once! Not to mention all the other hippy cloth diaper sales I hit, as well as finishing up our Etsy shopping just to round it all out.

Speaking of hippy cloth diapers, I finally did a few loads of baby bedding/clothes in the wash to fully prep things. Baby Laney now has a good supply of onesies, socks, blankets and fresh sheets on her crib and pack-n-play! I also washed our set of newborn cloth diapers to freshen them up from their prior life and they were pretty adorable hanging out to dry. I hope we can keep up with the cloth diaper plan because these are just too adorable to trade for landfill diapers!

I still need to pack my hospital bag and all that jazz, but overall we're feeling pretty ready. Break and bake cookies were on a managers special at the store the other day so we also have a good stash of frozen cookie dough - so I think we are fully prepared. Babies like cookies, right?

Kindness of strangers...

Ridiculous Richmond observation of the month: 
For the first place prize of crazy bicyclists, exhibit A - Sitting backwards on the handlebars of his bike, no helmet (of course), riding diagonally against the flow of 3-4 lanes of traffic (some turn lanes thrown in). The bike was facing the direction in which in was traveling, but the rider was not. I wish I'd gotten a photo but I think I was so incredulous we were seeing this in person and not reading about it on the Darwin awards that I couldn't process it.

Wonderful Richmond observations of the month x2:
Strangers are so friendly! And the dog park is the social mecca. We had dinner the other week with a couple we met at the dog park, and then again via craigslist when we bought some Ikea furniture from them. They graciously volunteering to save us the several hour round trip drive to the nearest Ikea and picked up some things for us. We then had them and their dog over for dinner and had fun getting to know complete strangers and swapping dog stories! Today at the dog park I chatted with a mom of two young boys that has been at the park a few times when I've been there, and she asked me for my contact information so she could help us get some meals after the baby is born and our family leaves. Amazing! We also inspired their purchase of a child sized ball flinger after her two boys spent a lot of time trying to master our set for the pups. Malcolm of course was happy enough to go after even the zero distance bounce throws.

The park system here continues to amaze. We spent more time on Belle Isle and made it around the entire island, including some creative rock hopping and near flip flop loss. Also some added challenges with hoisting the dogs down a ledge when they refused to climb the ladder. Most recently we went to Pony Pasture park (nothing in it resembled a pasture, unclear where the name came from) and even though it was a Saturday afternoon we were able to take a lovely several mile meandering hike with the dogs scandalously off leash and barely ran into anyone!

Excitement included the dogs crashing into a wetlands pond covered in thick green vegetation (we think Malcolm thought it was solid ground and literally charged in) - for which I was mortified for the delicate habitat our dogs had just likely demolished and Tyler couldn't stop laughing because both dogs had then turned green and smelled horrible; and rescuing a large catfish that somehow got trapped on a fishing line hanging off a pile of driftwood. We have many more parks on the list left to see, and also recently discovered that the local zoo has a litter of teenage cheetahs!

Other random life updates:

• Baby news - the nursery is getting more coordinated. Bought a secondhand glider on craigslist for a steal which is insanely comfortable. We had an Ikea assembling party to take our second hand shelf to a dresser/changing table.
  
  Hung up Aimee's amazing paintings which make the space look so much better.
  
  I finally got some slight motivation for creativity and covered a lamp in fabric and got some minor decorations on the wall. Still have a few more things to assemble and coordinate but while it may not be Pinterest worthy I have at least managed to convince Tyler that my random craft ideas actually do turn out.
  
  Still have a big shopping list to complete but we're not worrying about that yet - hoping for some Labor Day sales to start. I am exercising a lot of self control to not buy every item of clothing when Target brings out new outfits. Baby Laney has been super active and pokey lately. We get to play guess the body part and try not to act like a crazy lady at work when she kicks me so hard I have to stop in my tracks and catch my breath. I also wonder if sometimes my patients can see my belly squirming under my white coat and if that's disturbing? 
• Work news - Tyler is realizing that to get his dissertation written before the baby comes he needs to get cracking, so the fridge is now stocked with Mountain Dew cans and he is chugging away! Still clocking in a lot of miles run each week and keeping busy with his inpatients and clinic patients. I picked up a couple extra shifts this week at my job, their bonus pay is hard to argue with, though I ended up with a string of evening shifts and I miss seeing my husband! I have officially decided that I will never again work full time urgent care, but I did actually have a day or two where I saw more than sore throats and back pain and felt like I did some real medicine which was great. Nothing like treating anaphylaxis to make you feel like a real doctor. I still feel like I'm the only person in the practice who will diagnose pharangytis and sinusitis without reflexively prescribing antibiotics (or low back pain without handing out percocet) but I'm getting used to it.

Still need to work on taking more photos and blogging more often, but better some than none! Missing everyone!

Update Dump

So much blogging catch up!

Baby updates:

• Finally got into see an OB physician for transferring my care after the midwife hoopla (took a lot of phone tag with the nurses and very nearly had my only option to see one of the perinatal specialists). She is amazing! We're very happy with her, and I only wish she was a family doc so that I wouldn't have to start the search over to find a primary care doc for the little one as well. She even tries to come in for her patient's deliveries when she's not on call - which would be great!
• The nursery is starting to come together. Thanks to craigslist (dresser/changing table!), an Amazon coupon and some random Target shopping we've started to get some more things together and it actually looks more like we're going to have a baby. We have some Ikea ordering and assembling to do, a minor art project to put together, a used glider to find and a slew of Amazon registry ordering to do (oh Amazon, why do you make us wait until 30 days before her due date for our completion discount? there are so many things we need to get!) and then we should be pretty set. Until I think of something else to freak out about our baby not having (update: she probably won't be naked most of the time, after some Target/Costco sprees and finding a great consignment store in the boondocks she does have some more clothes! although if she wants to get much fancier than a onsie, possibly with some pants, then she might be out of luck).

• We had maternity photos done! Mostly as an add on for the newborn photos I am super excited about, but despite my lack of desire to have my puffy feeling self photographed (luckily my photogenic husband helped balance things out), so far they look great (the sneak peak photos we got are below)! We even got the dogs in a few of the photos, although Malcolm clearly is the most photogenic of the two, Rue mostly spent her time in a frenzied panting state wondering why a stranger was staring at us the entire time and she couldn't go sniff the ducks.

• I'm still feeling overall pretty well, other than a bit creaky after working. Though between the heat and the constantly on my feet for my work shifts I am wishing someone would design some compression stockings that makes sense to wear when it's 90 degrees out. So far I'm going for the sausage digits are sexy angle. 

Work updates:

• Just finished up my final supervised training shifts, so I'm on my own from now on! The DOS based EMR is still not my favorite, but I seem to have it down. I don't think I'll ever like the strange dictation limbo they have us in to dictate just enough for our level of service, but not any more lines than needed, but I at least am getting used to it. The model of patient care and reimbursement structure I think will continue to drive me crazy, but I just try and ignore the fact that I have to sign off on PA charts that give antibiotics, albuterol inhalers, a steroid burst and cough syrup with codeine to every bronchitis or URI (I wish I was kidding, this is one of the PA's "specials," I've already had a patient tell me point blank that every time he comes here with a virus he gets an antibiotic) and go along and try and save the world from super bugs on my own and singlehandedly bring down the vicodin prescriptions handed out every day (you aren't getting narcs from me unless you have a broken bone!).
• There are also mysteriously no stools for the provider to sit on in the exam rooms, and I have to stand to access the computer anyhow. This along with only 1-2 computers I can dictate at that have chairs, contributes greatly to the previously mentioned creakiness and sausage digits. Not to mention there is no such thing as breaks or lunch for the providers, so I just have to make patients wait when I've gotten to the point of no return with my hunger and then eat like a starving teenager! And we can't leave the building during our shift, so I am brushing up on my rusty lunch making skills.
• The silver lining in this job is that due to the high volume of patients I see per day, I have gotten to see some interesting things. Clinical Lyme disease for the first time, aborted a cluster headache (which I've only previously seen as a boards question!), done some fracture management, sent a patient to the ER for rule out appendicitis and she got her appendix out!

Fun updates:

• We weaseled ourselves into our friends' family visit to the Outer Banks in North Carolina and picked them up from the airport in Norfolk and drove down to hang out with them and check out the beach! Despite the 6 hours of driving that day it was a lot of fun and great to catch up and spend some time with friends and check out more of the area. Rue got to see the ocean for the first time and Malcolm got to see the Atlantic ocean! Neither were terribly impressed and found it salty and too wavy. 

• Went to a "Partners in Medicine" BBQ, which is a support group for significant others of medical residents/interns, in the attempt to broaden our nonexistent social support. Everyone was lovely, but none of the women residents showed up and I was the only significant other of a non-MD resident/intern. So I was awkwardly the "doctor wife" rather than a "doctor's wife" and the only MD there who had completed residency. I was able to have more interesting conversations about what it was like to be an attending with one of the senior residents (also a dad) than able to commiserate with the wives about my husband being on night shifts and on call all the time (because he isn't! I was the one who did that already). But luckily babies are a pretty common subject and there were a bazillion kids there. I simultaneously was admonished for not having my hospital bag packed already in case I went into labor early, and complimented on being so prepared that I have a car seat already. But I feel okay about the former, I'm holding this kiddo in until 40 weeks (okay so I know she'll decide when she wants her birthday, but I can dream right?) and the hospital will give me a gown and underwear, what more do I really need?

Now for the video of the post - fetching in the Atlantic! Or how the puppies ingested more sand than could seem possible:

We're Not in Seattle Anymore...

Richmond thoughts:

• The bugs are terrible. Even if I am barely outside at all, and cover up and/or use my non-DEET hippy bug spray when I am outside for longer than a 3 minute dog potty break, I end up with at least 2 new mosquito bites per day. And they stick around for 1-2 weeks. I think I just need to get used to having legs that look like I have the chicken pox on a daily basis. Somehow they still don't bite Tyler, go figure.
• It has been, apparently, unnaturally cool here lately. Which means that we haven't seen triple digits in a while and there has been rain off and on. Still got up to 90 yesterday and I was melting at the dog park.
• The bicyclists here are crazy. Not hardcore, spandex wearing, eye on the prize, Seattle crazy. But no helmet, no lights at night, not obeying any road laws whatsoever (again, not the Seattle technique of going from car to pedestrian or rolling through a stop sign - but more along the lines of going the wrong way down the street against traffic) Richmond crazy. I think it's a wonder that there aren't more bike accidents here.
• Pedestrians have a prolific "meandering jaywalk." In Seattle we make a big deal about our jaywalking, but that's a joke when you see the people here. Seattle jaywalking still involves looking both ways, often still at a corner, and briskly getting from point A to point B. Here in Richmond, jaywalking is deciding you actually would like to be on the other side of the street and at that very moment, meandering into the road, preferably at a diagonal so you can spend as much time in traffic as possible, and strolling across the street at a leisurely pace, regardless of which cars were coming at that time or how many lanes of traffic it may be taking you to get to the other side. Also included in this are: walking down the middle of the street when there is a large sidewalk available, driving your motorized scooter down the middle of the street against traffic. Ironically, getting drivers to stop for you at a crosswalk is almost impossible. Who doesn't stop for a pregnant lady at a crosswalk?? At least 20 Richmond drivers in a row, that's who.
• Turn signals appear to be optional. Slightly pulled out into an intersection at a green light and not moving? A new guessing game! Are you: (a) stalled and can't go, (b) lost and don't know what's going on, (c) turning left but are confused as to how to communicate this to the other drivers, (d) stopped for an invisible family of ducklings that only you can see. Option C inevitably wins, but I still root for D. There need to be some billboards up about what the stick to the left of the steering wheel does to educate the public. We're constantly seeing wrecks on the freeways and I can only guess that they were among the large group of people that feel that letting people know you are changing lanes is an unnecessary wrist movement, particularly when you are busy on the phone. 
• Taxes here are confusing! I was excited about the 5% sales tax (compared to Seattle at almost 10%), until I realized that food is taxed here at 2.5% (way to support your low-income classes Richmond), and dining out food is taxed at something close to 12%. Which makes it very painful when you try to go out to Thai and have the worst Thai food you can imagine paying for, and terrible service, and still have to pay over $40 for it! Not to mention the fact that we'll have to pay VA income tax since we'll have been a resident for 2 days over their cut off. You would think with all this tax money that they could teach their residents some traffic safety and throw in a food waste collection program for composting!
• The dog park is a social mecca. Our most recent craigslist purchase (a bookshelf/dresser for the nursery) was from a couple that we had met at the dog park and they've offered to pick up a few more things from Ikea for us when they go, since it's a 2 hour drive out there and Ikea shipping is a bit ridiculous. Yesterday Rue took a treat from a stranger for the first time ever! It helped that the lady was giving them giant dog biscuits - who can pass that up?
• The peaches and tomatoes here are incredible. There is a great farmer's market about 15 minutes away, that's like the Ballard market, only you don't have to drive through awful traffic to get there or deal with horrible Ballard parking once you're there. The first time we went we bought 12 lbs of tomatoes and I made a bunch of tomato sauce, the next time we bought a huge bag of peaches and have been eating them every day! Not to mention the amazing freshly made donuts, super friendly vendors (can't find basil? the friendly tomato guy will tell you which vendor has some today), and lots of other delicious food (there is a bagel truck!). 
• The River park system here is incredibly. We've only checked out Belle Isle but have been very impressed. Rue also learned she loves water! Here are some photos from the expedition there a few weeks ago as a reward for getting through all these words (and a naked tomato photo, before I threw them all into the pot):

In which I rant and ramble too much...

Sorry all, apparently I am a terrible blogger. I don't feel like we've accomplished anything exciting yet so it's hard to be motivated to write! Also my big excuse it that I had the flu last week. Nothing like a good welcome to Virginia than getting the flu for the first time in 10 years, while pregnant and knowing no one other than my husband (at work) within a thousand miles! Luckily though either time or tamiflu or both worked wonders and it was a short lived course. I'll blame my poor blogging habits on that for now. Anyhow, here is a smattering of updates from the past week (or two...).

Baby updates: So I've sort of plugged myself into my prenatal care, though we've had some bumps along the way. I had a new OB appointment for myself with one of the NPs to transfer care last week, which proved invaluable when I needed someone to send me in a tamiflu prescription. Although I was given some bizarre medical advice (macrobid is not a pyelonephritis treatment, nor should you empirically treat someone who is pregnant for pyelo just in case! get them to a hospital if you think that's what it is. /rant) overall I got what I needed. Tyler and I did a tour of L&D, as I'm still feeling unsettled with delivering somewhere that I know nothing about. L&D was redone about 6 months ago and is incredibly swanky. The triage rooms almost put the delivery rooms at Swedish to shame. The tubs (in the tub rooms - there are only 4) have LED lighting so you can labor in a pool of rainbow water. However, the postpartum rooms are next on the renovation list and are terrible. They will be where I will be pining for Swedish! They're Spartan, county hospital like rooms. On the bright side, if I win the lotto and feel like I need more pampering, the hospital does have 5 hotel like suites that you can pay $420/night extra to stay in the ritziest hospital room imaginable, complete with private nurse and chef.

The main snafu that we've run into actually is when I went to my first Centering appointment yesterday (group prenatal care visit model - we were in a Centering group in Seattle), we found out that to deliver with the midwives I have to sign on to a nonmedicated birth plan, hook, line and sinker. They will not accept an open mind to my delivery experience, if I want to deliver with them I need to hire a doula, attending birthing classes, read their reading list, etc and have no intention of having anything other than a nonmedicated birth. They are very proud of their 15% epidural rate. So this is very different from the midwife group I was at in Seattle - where they would support whatever kind of birth you wanted (obviously unless you were going to try and talk someone into scheduling an elective c-section, which I don't think anyone will do these days). So, as I had fully intended on making use of advanced in medicine and getting an epidural at some point in my labor, apparently I am not hardcore enough for the midwives and will have to have a physician delivery. Which, you might ask, doesn't seem like a big deal, especially because I am a physician and have delivered many babies - and feel like I do a good job of it! The issue is that there are no family docs that deliver at VCU (which in all honesty would be my preference, but I was hoping a midwife delivery would be the closest I could get on the East coast), and it's a teaching hospital. So I'm going from the crunchy granola supported and attentive delivery that I had hoped for (yes, with an epidural included in that - I've seen plenty of epidural midwife deliveries that were lovely) to likely being managed and delivered by an OBGYN resident (thank goodness I'm not due in July at least!). Which may turn out to be lovely, and really in the end all I want is a healthy baby, but I keep having fears of the stereotypical East coast obstetrician delivery in which I will end up with an unnecessary section because they aren't patient enough to let my body do its thing. Not to mention instead of getting to know a small group of practitioners so I will have a somewhat familiar face delivery my baby, I will have a pool of residents on shifts that I have never met managing my care. But, delivering at VCU makes the most financial and convenience sense for us, so we'll stick with it. Their Centering program is a bit abbreviated so I can still stay in the class, and then fill in my individual appointments with one of the docs (the judgey midwife did at least give me a list of the crunchier OBGYNs). The Centering group also doesn't seem super social, although it isn't filled with teen moms like I had feared! I'm hoping it will improve. I'm starting to get a little stir crazy with my only non-spouse social outlet being dog owners at the dog park! Though to be fair, they are very chatty.

Okay so this ended up being a very long update that probably no one read through, so I will save the rest of my updates for later. In order to include some photos - we did get the crib assembled! Although I forgot to take a photo after we got the mattress in.

And we got a rug (not pictured) for the nursery. I have grand plans for the dresser/changing table and closet organization, but I need to wait until I'm getting paychecks again before we go on an IKEA spree. I've also been having, hopefully irrational, fears that we will not have enough clothes for our baby. I can't figure out how you're supposed to calculate how many onsies and outfits and socks you need for each size! And do babies really need pants? How can I shop the clearance racks and buy outfits in advance if I have no idea if I'll have a 95%ile or 5th%ile baby? And where do people buy cheap baby clothes? I've gone to several consignment stores and unless I was dead set on only Ralph Lauren dresses, Target still seems to be the better choice. Worst case scenario we'll have a wild jungle baby who will run around in a diaper only (although I guess I also need to start buying the cloth diapers we need! maybe she'll have no diapers and we can litter box train her?) and we'll just bundle her up in blankets when we go outside. And I have no idea how cold it gets here in the winter. Do 3 month old babies wear winter coats? I think I can see why I have stuck with furchildren so far, they come with built in clothing and I don't have to make sure we have enough pairs of socks for Rue or if the cats need to wear pants when they go out in public.

Anyhow, your reward for reading through all of this is a video of Rue trying to decide if she will be like a Virginia dog and lay down in the baby pools at the dog park to cool off.

Couches, Mattresses and Thunder, Oh My!

So the most important update since I last posted is that we now have a couch. Or rather a love seat and soon to have a couch. Bought them from a friendly family on Craigslist who happens to have a truck, and took pity on our couch-less plight and agreed to deliver the love seat to us yesterday when we realized it wouldn't fit in our CRV and the original plan was he would deliver both on Sunday because that was when he was getting his replacement couch. I think so far the cats are the happiest about this situation, although they had seemed very happy sleeping on the futon in their domain in the office prior to this. I supposed the lack of cat fur on the couch presented a problem they couldn't resist conquering.

Our next excitement is to pick up our new mattress set today! Although it just started to thunder and we're picking it up ourselves - strapping it to the roof. So I hope it has a very sturdy cover on it! The mattress is long overdue and it will be nice to be back in our bedroom as we've been sleeping in the guest room on our old bed as we were getting too old and creaky to sleep on the air mattress.

Updates in terms of work. So far Tyler is enjoying his internship, he is having a very long orientation process but is having fun getting to know his co-interns and figuring out all the nitty gritty of internship. He is again the only guy in his intern class, also the only one from the west coast, and the only one married, with a kid (on the way) or with pets. Apparently we're just as boring as you can get! Except for the west coast part of course. I'm still adjusting to the fact that there is no food waste pick up here and feel horribly guilty putting corn cobs in the garbage, and am very weirded out by styrofoam take out containers and grocery stores handing out plastic bags like candy.

For my work - I have completed 1 of 4 non-patient based trainings before I get to start my mentored/shadowed working shifts. 3 of them are on weekend days so it's a rather scattered process. I got to learn all about the crazy EMR (electronic medical record) this clinic system has and started learning their protocols. I'm still having pangs of guilt (what is with the guilt issue here? maybe I have a problem) giving up my full spectrum training for a year. I'm going to miss well baby visits, they don't do well child exams under the age of 7; IUD and Nexplanon insertions, the idea of a non-OBGYN doing them boggled the mind of my training nurse so much that I thought she just didn't understand what I was asking at first; doing joint injections and taking care of pregnant women, amidst other things. But - everyone seems very nice and things are going more smoothly than I had hoped in terms of figuring out my upcoming maternity leave so that's good news.

Our unpacking (or rather my unpacking, I have turned into a stay at home house organizer for these couple of weeks) is going well and it's starting to feel more like a home. We just got our crib (thanks Mom and Bradley!) and are hopefully getting a rug (from Craigslist of course) for the nursery today so my nesting urges are kicking in and I'm getting pretty excited! Judging from the kicking, Baby Laney is psyched as well. Or maybe she's just telling me I need to find more quality tacos because we haven't found anything measuring up to our taco bus in Seattle yet.

Apparently I can upload videos - so here is one from the dog park this morning (snuck in before the temperature reached the 90s), the tail end of some zoomies from some poor yard deprived pups (thanks to Malcolm for his tasteful closing act). I'll have to get the video of Rue with her acrobatic ball catching from Tyler's phone now that I've discovered this capability!