Well, my 35th birthday was a day I'll probably remember, but I wouldn't say it was pleasant. Jacob had two doctor's appointments and was cranky for most of the day. But Eric was really nice to go out and get me sushi and chocolate cake and after driving home from work in Oregon. And Tom sang me a really cute version of Happy Birthday. I think they have had a lot of birthday's at school lately because he has been signing it a lot for no reason. So he was excited to get to sing it. Thank you to my boys for making a tough day better.
On Sunday we all went over to Vashon to sort of celebrate my birthday, but mostly because people wanted to see Jacob. Dean made ribs and grandma made chocolate cake. Doesn't get better than that. I brought balloon animals to keep the kids busy. Someone made this hat for Tom. It looked so much like an old lady hat I just had to take a picture.
Tom is really into stickers right now. He has liked stickers for a while and had a stock pile of them. But we just started putting them to good use. One day when I went to pick him up at day care he was wearing a sticker on his shirt. His teacher said that they were offering stickers to kids who helped pick up toys. Once he knew he was going to get a sticker Tom decided to help. He was super excited about his sticker for the rest of the day.
So I figured it was about time we started a sticker chart at home. I made four squares. One for brush teeth, put toys away, being a good boy (with no time outs), and going in the potty. It really helped with brushing teeth. As you can see he has gotten a lot of stickers for that in the last couple weeks. He still hasn't gotten a sticker for going in the potty but we haven't been pushing that lately with how much we have going on.
I don't know how long the sticker chart will be effective, but right now it is working.
Jacob had his two week check up today. Poor little guy. After his two appointments yesterday he had to see a doctor again today. He was doing much better today than yesterday. The appointment went well. Unfortunately they had to take blood out of his heel again which he did not enjoy. But after they were done he was fine. Here is how he measured up to Tom's measurements.
Jacob got his second cast today. On Monday night he got to take the old cast off and get a bath and a bit of a break for the night. It didn't really see a huge difference, but when we went to the doctor to get a new cast she briefly mentioned that there was good correction. Once again it was a short visit. They put a new cast on and sent us on our way. This new cast goes all the way up to his hip so I think he is a little more uncomfortable. He was not thrilled to get into his car seat after his visit. I think because the angle that the cast is at is not the same as the car seat. I fed him and got him to go to sleep and then got him in his car seat. But the poor guy wasn't done for the day. We had to drive right to his next appointment to get his circumcision. He was really upset when I woke him up. Even more upset after the procedure. After 20 minutes of trying to settle him down I left the doctors office with him crying and not wanting to go into his car seat. It was much easier when we did the circumcision at the hospital with Tom because we didn't have to move him around a bunch afterwards. But I guess insurance companies prefer not to do it at the hospital any more because it is more expensive. He eventually fell asleep. He slept fine, but every time he woke up he totally lost it until I fed him and he fell back asleep. And I mean like turning red all over upset. At least he won't remember this later in life.
Tom finally stopped being scared of the sunglasses and will now wear them. I think because he sees daddy wearing his all the time and he likes to try out daddy's sunglasses.
It was time for another haircut for Tom. His hair has grown in thicker now so I bought some clippers. I have never cut hair with clippers before so I wasn't sure how it was going to go or if it would freak Tom out. But he did really well. He didn't hold still for very long so a few spots were a little uneven. But it was good enough.
Tom is doing really well adjusting to having a new baby brother. I think that is because Eric has been able to spend extra time with him over the last 3 weeks. He loves his daddy so much that he doesn't even really pay that much attention to mommy and baby. It will be interesting to see how next week goes when Eric has to go back to work.
The didn't offer to take any pictures at the hospital of Jacob like they did for Tom. So a couple days after we got home I decided to do my own photo shoot. Not as good as the professionals. But I think they are cute.
Jacob went to the Orthopedist for the first time today. It went well. It was actually very fast. For his first appointment the doctor just flexed the foot around and accessed it for a few minutes. They described to us some information about club foot and then they put on his first cast. I have never had a cast so I don't know how they work these days, but basically they just put this wrap around his foot that was sticky. The stickiness went away after a couple minutes and the cast hardened up. He was unhappy about getting the cast put on. He screamed quite a bit. But I fed him right after that. He has been a little cranky today but mostly just when being moved around.
Jacob has been diagnosed with a left clubfoot. It is a very common condition present at birth. Three things happen to the foot: Toes turn down, heel is up (maybe be caused by tight calf muscles); heel turns in; foot curves in. The bones, connective tissues and tendons in the foot are all affected. The exact cause of clubfoot in unknown. In some rare cases in can be inherited. It is not caused by crowding or positioning in the womb. Clubfeet vary in position and stiffness. This means treatment may vary from child to child. The doctor did not seem overly concerned about Jacob's foot. It seemed pretty routine. She said we just have to wait and see how it reacts to treatment.
Treatment
Casting
Treatment is best started in the first few days of life. The foot is stretched to get as much correction as possible and casted. Which they did at his first appointment. Casting is done weekly and is called serial casting. They have scheduled us for 6 weeks of appointments to come and get the foot re-positioned and and a new cast each week . They gradually change the position each time a little more to the neutral position. They don't want to do it all at once and hurt the foot. 6 weeks is the typical time to get it back to neutral but it could be more or less time. They will access it each week. The night before the next appointment we remove the cast ourselves to give his skin a break from the cast.
Surgery
Some times after casting the "toes down, heels up" is still present. A minor surgery releases the heel cord tightness. This is done in the operating room under general anesthesia. They will access if he needs this after the casting process.
Bracing
Once corrected, we do not want the clubfoot to come back. A combination of special shoes and a brace in between the shoes is used. There are three types of braces: A Dennis-Browne bar, Dobbs bar or Ponsetti brace and shoes. If the child can not wear one type of brace we can try the others. At first Jacob will wear the shoes and brace all the time. He will have appointments once a month to check on his progress. After about 3 months, the child will wear the brace only at night and during naps. The brace will be worn for one year. During that time he will have appointments every three months. After that point he will have appointments every six months into early childhood to watch for changes.
Results
The child should have normal function and wear a normal shoe after treatment. The clubfoot and lower leg may be smaller and stiffer the the other. There may be a difference in shoe size.
For Father's Day we went to the seafood sale at Ruston again on Saturday and got a lot of great seafood and got a copper river salmon for Dean. It was a quick trip because I can't sit in the car for that long since I am still sore. we stopped along the waterfront for a couple minutes to take pictures. Tom was supper excited because he saw 4 trains go by when we were there.
On Father's Day the family came out to our house since we were not up for traveling. Tom was so excited to see the family. And Tony, Susan and Lena got to meet Jacob for the first time. We had a great day. We got some great family pictures. In this one Tom is making his "Cheese" face. It looks more like a growl.
When Tom was born I did foot prints as Father's Day gifts. So I had the kids do one again.
Tom and Lena wore each other out. We let Tom sleep in because we knew he was skipping his nap. At the end of the day he was so tired he passed out on the couch.
Jacob went to the doctor for his first check up on Wednesday. The doctor said he was doing really good on eating and that he barely dropped from his birth weight by only 4 ounces. This does not surprise me at all because he was up Tuesday night eating about every half hour to fifteen minutes. They put in the order for us to be recommended to see the orthopedist which we have an appointment for next Tuesday. And they said everything else is looking really good except that they wanted to test him for jaundice. So we went to the lab and they poked him in the heal and squeezed his foot a whole bunch to get enough blood to test. Poor little guy.
So later that day we got a call saying that his bilirubin levels were a too high so they wanted to start him on light therapy. Sounds really horrible, but it was not that bad. They sent a nurse out to the house, which was really nice. She did some vitals tests on him, did another blood test and then showed us how to use the light bed. It's a little portable bed with a light underneath it. There is a little suit that you put the baby into and Velcro it to the top. You basically put them on there any time there not eating or getting their diaper changed. Easy enough to do. I had to keep track of he feedings, diapers and temperature. But other than that it was fairly easy. The hardest part was that I don't think he liked being strapped in much and he got pretty sweaty under the lights. So at night especially it seemed like he woke up even more often.
The good news is that the nurse came back the following day and said that he was doing excellent. She said he ate and pooped a whole lot compared to other kids. She took his blood again and when she called back later that day she said his levels looked good and that he could come off the lights. Jacob seemed to sleep much better last night now that he was off the machine.
When the nurse came today to pick up the equipment and test him again she said that he was already past his birth weight. What a little eating machine.
After we had Tom we had talked about having one more kid because we didn't want an only child. But we didn't really have a specific plan or schedule. It would be more convenient in the Dr.'s office if I had the next one before I turned 35 but it was not really that big a deal. So a little while after Tom turned one we decided to see what happens. It took us a while to get pregnant with Tom, so we were expecting to take a while with this next one, but in a couple months I was pregnant again.
When I found out I decided I would tell Eric in a fun sort of way. When we found out we were pregnant with Tom my parents bought us this Dr. Seuss book that you are supposed to read to the baby in utero. So we read it to Tom before he was born a few times. So I decided to bring Eric the book and sat next to him and asked him to read it to his kid. He called Tom over and started reading. Eric never liked the book much as it has a lot of made up words that are hard to read. He started to get frustrated, skipped over pages and read the last page. "It's a scrumptulous world and it's ready to greet you. And as for myself ... well ... I can't wait to meet you!" Eric said, "I don't know why I have to read this stupid book to Tom when he has already been born." I replied, "I didn't ask you to read it to Tom." Then I gave him a few seconds to put it all together and he said "What!" So I guess Eric was a little surprised it happened so fast too.
Our first ultrasound was on Oct 24 and it confirmed that there was a bun in the over and gave us a due date of June 8. So I guess we made it just before I turned 35. Then the waiting and hiding game began. We wanted to wait until I was 12 weeks to tell everyone which is what we did for Tom. This one was a little harder to keep a secret. I started to show pretty early on. So I started to wear baggy clothes. It was hardest to not tell my softball team. I was taking it easy on the field and just hoping no one would get upset about it. Not to mention my uniform started to get tight.
We had another ultrasound on the November 15th and all was looking good so we decided that we would start telling people. We told my parents first. And then we decided to tell the whole world about Baby Bingham on Thanksgiving.
The next ultrasound was the big one where they tell you if it is a boy or a girl. Eric was able to make it, but it was in the afternoon so we had to take Tom with us. Tom did not like sitting in the small dark room and having to sit still to look at boring pictures on a screen. So Eric and Tom left before the end. The technician was pretty quiet. I wasn't sure if they were annoyed about Tom or if something looked bad. A friend of mine had said that when her ultrasound did not go well they were very quiet. So now I was very nervous. They didn't say anything at the end other than the doctor will call you with the results. I didn't say anything to Eric because I didn't want to worry him till I knew for sure.
The good news is that we found out we were having another boy. But my instincts were correct. The doctor called and said they were seeing bilateral club foot. So we began the adventure of figuring out what that all meant. My doctor sent me to a specialist to get a higher level ultrasound scan. I was pretty nervous, but I didn't go online to read about it or anything because I figured it would probably be best to just hear it from the specialist.
So they did higher level ultrasound and they were only seeing a problem with the left foot. The right foot looked fine. So they began explaining to me the possibilities. Club foot is not uncommon. There are cases were it can be in combination with another birth defect like down syndrome or something like that, and then there is the isolated club foot that could just be that the baby is squished and the foot got tweaked. We had already done a down syndrome test and it came out negative. They also said they so no other problems on the ultrasound so the chances of another birth defect were very low. The gave me some options of other testing but I opted not to because there were risks and a very large needle involved. I had to talk it all through with a genetic counselor, which took a long time because I have a very large and complex genetic family. But in the end as far as they could tell it was an isolated club foot.
So what does that mean as far as treatment? The could only give us scenarios until the baby is born and they can look at the foot. If it is severe it could mean surgery. If it is not severe it could be fixed with therapy, stretching, bracing or a cast. So basically it is a wait and see kind of thing. The specialist asked to see us again in another month for another ultrasound to see the baby's progress. This time the did one of the 3D scans which was pretty cool to see. You can see the shape of the face a lot more on those. We did not have one of those for Tom. On this ultrasound they said that it did not look like the foot was very severe, but once again they would not know for sure till the baby was born. They asked us to keep going to the specialist once a month, but we opted not so since there was nothing more they could do at this time and it was pretty expensive. So we just went about the pregnancy just like we did with Tom. We decided not to tell anyone about it because we really wouldn't know anything until they saw the severity and we didn't want to worry anyone.
And speaking of Tom, we decided that since we now had a fairly decent picture of the baby that we would try and describe it to him now. We showed him the ultrasound picture and then pointed to my belly and said "baby". He was very cute about it. He would point to his belly button and then my belly button and say" baby". I kept trying to explain that only mommy has a baby, but I am not sure he understood. As my belly got larger some times he would ask to see baby. He would say "Hi Baby" and he would even offer to share his cars with baby. He did look at the ultrasound picture and say baby as well. Who knows how much he really understood though.
The biggest change we saw in Tom was that mommy became very boring to him. Sine I was able to do less and less with him be began to get frustrated with the limited amount that I could play with him. Especially since it was now getting nice outside and it became very tough for me to take him outside by myself. Since he only listens part of the time he would run across the yard and get into things he wasn't supposed to. Since I moved slower and slower each day this became very hard on me with the size of our yard. So by the end of the pregnancy only Eric would take him outside. So he started to get kind of upset and act out towards me more. Of course, dad was still his favorite person.
This pregnancy, like Tom was fairly easy. I was a little sick in the beginning but not horrible. I had bloody noses again this time, but since I knew that I would going into it I had less because I was more careful. I did decide for the first time in my life to get allergies to pollen. My mom has a pretty sever pollen allergy, but I have never really had a problem with it. Of course this had to be the year that I got it. For about 3 weeks it was nonstop and that is when I figured it must be allergies. Of course by that time I also got a sinus infection. But after getting some antibiotics and Zyrtec I was better. I started showing a lot faster than with Tom, but I guess that is pretty common on the second pregnancy. All in all I think I was about the same size in the end though.
The weeks leading up to my due date I started to have sporadic contractions. They were mostly mild. But they were happening earlier than with Tom. I also noticed that I was not getting any feet in the ribs at all like I was with Tom. So this baby was sitting lower. Both of these things were a good sign. And since I wanted to do a VBAC and not a C-Section the doctor was optimistic about that. Near the end I was having a little bit of high blood pressure that they were keeping an eye on, but it never got high enough for them to do anything about it. My doctor was concerned about the size of the baby though. Since Tom was large and I wasn't able to deliver him after 3 hours of pushing she was concerned I would not be able to deliver another large baby naturally and they needed to be careful with a VBAC. She had a C-Section scheduled for June 17 since they would not induce me this time as it would be too risky since I had a C-Section the last time. But she said I could try to have him naturally if something started to happen before then. When I went in for my appointment at 38 weeks she said I was 3 cm already which was good. But she did want me to have one last ultrasound to check on the size of the baby. She said that if he was estimated larger than Tom I would have to have a C-Section. So the following week I got another ultrasound. He looked very squished in there, but they only estimated him at 8.1 pounds.
So when I had my appointment on Thursday with my doctor she checked and I was at 4 cm. She stripped my membranes and said that I could go ahead and try to have him naturally. I went home and contractions seemed to pick up more. They would get close together and then I would move around or something and they would stop. The same thing happened on Friday. I was really not sleeping well at night the last few days. I figured I must be having some contractions while I slept. On Saturday morning I had some contractions again but they were sticking around. Then that afternoon they began to get closer together and a lot stronger. I had a feeling that this could be it. At 5:30 they started to come 5:00 minutes or less apart. So I told Eric we better start getting ready. I ate dinner and we fed Tom. Tom was very cute and said "Mommy has owies." Susan and Lena happened to be at her parent's house nearby and said they could come watch Tom until my parents could make it over to town. So a little after and hour of contractions that were coming pretty close together Susan and Lena showed up and we took off for the hospital.
We had Tom at Valley Medical Center in Renton. They have changed their network around a bit and now Covington patients deliver at Auburn Regional Medical Center. So the hospital was only about 10 minutes away. When I got checked into the hospital at about 7:30 the contractions were still coming close together and feeling strong. But when they checked me I was still at 4 cm. So I was thinking that I could be there a while since that was the same as what I arrived at the hospital with Tom. And since that was a 30 hour ordeal I wasn't too excited.
I tried to go for a while with no pain medication, but the contractions were really strong and coming really close together with almost no break. They were telling me to breath, but Tom had given me a cold the previous week so my nose was still a bit stuffed up. After a couple hours I decided to ask for the epidural because I was pretty much just screaming the whole time. I was nervous about the needle since I had problems last time. But I was less nervous about an epidural than a spinal since it is lower. And they said if there was too much stress on the baby they would just go to a C-Section. So before they would give me an epidural they checked me again and I was already at 7 cm. I hadn't expected things to be moving that quickly, but I said go ahead and give me the epidural. It took what seemed like forever for them to order it and get it set up. I am sure it was only a half hour or so, but I was screaming in pain so it seemed like a long time. Then came the part that made me very nervous. They asked me to hold very still and not move. Contractions were very strong and coming about a minute apart or so. Basically I just screamed as loud as I could to keep from moving. It was not easy but they said I did OK. It was especially difficult because I felt like I should be pushing. It turns out they checked me again right after they gave me the epidural and I was already at 10 cm. I guess I probably could have just lasted a little while longer without the drugs, but since they were concerned about too much stress it was probably best that I got the epidural.
They decided to let the medicine spread and give me a little break. My water had still not broken yet so they broke it for me. They also wanted to make sure that the baby was in a good position before pushing. So they had me lie on one side for about and hour and then lie on the other side for about an hour. They they checked me again and said this baby is ready. And by that time it was past midnight and he was now going to be born on his due date. After they got all set up it only took my about 5 minutes of pushing and Jacob Allen Bingham came at 1:26 AM on June 8, 2014. This was such a relief since with Tom after about 27 hours of labor while puking the whole time, I pushed for 3 hours with Tom and had to go to C-Section. And with Jacob there was a bit more pain until I got to the epidural. But there was no puking, the whole thing took about 6 hours of labor and 5 minutes of pushing. It it was a lot easier experience than the first time.
Eric cut the umbilical cord and they took him to clean him up. Everything looked good. They did check the foot and it did curve in a little, but it did not look super severe. We will have to wait to hear more about it from the orthopedist. And everything else looked great.
They weighed him and he was 8 pounds 15.4 ounces, 19 inches long and his head was 14 inches around. Good thing they under estimated on the last ultrasound because he turned out bigger than Tom.
We didn't get a whole lot of sleep the next couple of days. Eric did most of the diaper changes because I was feeling sore. He also wanted to wake up a lot, especially at night to eat. He had a bunch of checkups. We have another eater on our hands. His hearing was good. They thought his breathing was a little shallow and that he might have fluid in his lungs so they did a chest x-ray. It came back clear though, so they said it was just a little bit of a wet lung which can happen when a baby is born really fast and doesn't have time to push all of the amniotic fluid out. They said it would resolve itself.
Since everything was good they released us from the hospital before 1 PM on Monday. We were excited to get home since it had been a couple days since we had seen Tom. He had been hanging out at my parents house while we were in the hospital. We video chatted him on Sunday night to say hi and show him his baby brother. But this was the longest he has been away from us and it was a bit weird. So we changed Jacob into his going home outfit, which happened to be the same one that Tom wore home from the hospital. We packed him in his car seat, which took a while because we forgot to adjust it from the last time Tom used it to the smallest size, which seemed so tiny. And we headed home.
When we got home Tom was in the yard. They had also just go there. He started running towards daddy of course. He was super excited to see us. We got him in the house and he got he first really good look at Jacob. He was really interested in him for about 30 seconds and then went about his business. My parents visited with Jacob for a little bit and then went home.
We have had some really nice days of weather lately so we have got out the little pool. We tried filling it up with the hose and Tom would only put in his feet and splash a little. Our back yard is shady so it doesn't get that hot back there in the afternoon. So Eric brought some warm water from the house and put it in there and Tom loved it. He even tried blowing some bubbles in the water for a little bit. Tom is going to be so sad when the weather gets worse.
