And, just like that, now we are four!

Monday, I delivered a mom's fourth baby. Tuesday, I discharged them and cleaned out my EMR and paper inbox. Wednesday, I went on maternity leave. I had time to get a massage, take a nap, attend a Valentine's Day lunch, and watch one episode of Mad Men (I am looking for Netflix or Amazon Prime series recommendations, for I'm not very used to relaxing and binge-watching TV! Some of my past series favorites have been Friends, Friday Night Lights, The Office, The Good Wife, Breaking Bad, Orange is the New Black, How I Met Your Mother, Downton Abbey, Modern Family, and Call the Midwife).

Then, after an average night's rest (peeing twice, Iver up at 5), Thursday morning at 615, I started having contractions at 38w4d.   Iver was eight days early, so we thought there was a good possibility (and hoped) baby would be here sometime in the next week or 10 days. I didn't actually expect it quite so soon, however!

I got out the peanut ball  (which Iver thinks is his toy!) to breathe through some contractions at home.

Two hours into contractions, I thought I should head to near the clinic/hospital in case things got more active, as I had a fast 7-hour labor with Iver. In fact, I was supposed to have at 0830 appointment where I was going to request membrane stripping to hopefully help get me delivered in the next week and avoid a prolonged latent maternity leave or me asking for an elective or "advanced maternal age" induction because I feel guilty for people covering my patients and OB call!  Kelvin followed me (I had one contraction on the highway) with Iver, dropping him off at school and then heading to his morning clinic to try to see some of his scheduled patients.  When she saw me in the waiting area in probable labor, our clinic coordinator, Karen suggested I come and rest on the couch inside. When Val, the provider on call, called in to rearrange her morning for a different patient, I told her I may be in labor and she asked me to come over to L&D, where I was checked and found to be 8 cm!

Shortly after, we moved into room 1, the same room in which Iver was born, I labored for about an hour in the tub, Kelvin returned after seeing a couple of patients, Val ruptured my membranes, and a few contractions (, screams, and swear words) later, we had another baby boy! I somehow really struggle with the second stage of labor, although the first stage is manageable!

 Here is the first minute or so of life for Niall (pronounced "Nye-all," meaning "passionate" or "champion") Arness Vu, born at 940 a.m., after a fast and furious 3.5-hour labor!  Lauren, while admittedly apprehensive of taking care of a doc she works with, was my wonderful delivery nurse and I think was happy with the experience! I sure was!

 Despite some terminal bradycardia, he came out screaming, along with a tsunami of more amniotic fluid.

 

 

So relieved to be done with pushing!

 

He was 19.5 inches and weighed in at 6#14 oz, 3122g, four ounces smaller than Iver was.

 It was so fun having Val, my friend and colleague, be the delivering doctor!

The timing of the birth was actually perfect. I was rested, we didn't have to inconvenience anyone to help us with Iver in the middle of the night, Kelvin was able to do some more work while my friendly nurses in the birth center took great care of Niall and me, and then Iver came and visited with his new brother after his day at preschool.

I wasn't sure how the meeting was going to go, but big brother was super sweet and it was great!  Although Iver was apprehensive at first to join me in the bed ("Are they going to check me?" he asked, fearing he'd become a patient (at least he doesn't have a cervix!), he got over it and we got some cute pictures of his first snuggles.

 

 

 

Niall had some transient tachypnea (fast breathing) after birth, but it has resolved, he is nursing and pooping like a champ, and we are home now! Kelvin's parents are en route from So Cal to meet their new grandchild, and all is well!

It's so weird to suddenly be in charge of a newborn and be a family of FOUR!

Smashing gender stereotypes

At Costco this weekend, we needed to pick up some pull-ups for our not-yet-dry-at-night toddler.

Iver pointed to the "pink ones" with Minnie Mouse and the "lady doctor" (I am not familiar with Doc McStuffins but she's on there) and said "I want those ones."

I hesitated.

I wondered why he was drawn to that box, instead of the blue-boxed Cars/Simba "boy" pull-ups right next to it (which he currently uses).

I thought extremely carefully before I opened my mouth, contemplating the important-seeming message I wanted to send to my very young, impressionable, three-year-old son.

"Are you sure you will wear these?" I asked (Iver is known to be a bit impulsive, and I was really not concerned about his choice of color or design but rather about having a bulk quantity of 124 unused pull-ups if he changed his mind later). "They may be pink inside."

"I'm sure," he replied.

So we bought them.

I am proud to have a son who loves building towers and knocking them down, playing with his tool-bench, balls, riding bikes, and games of chase, but also who adores reading, singing, music, and art. He would be welcome to play with dolls and any other toy he chooses, without judgment about whether it would be "gender appropriate."

I am proud to have a son who is spirited, passionate, who shows emotion easily, and who is loving and cuddly and sweet, and to whom I will never say "boys don't cry" nor "boys don't volunteer 'I love yous'."

I am proud to have a son who knows that women can be doctors. Or the president. And that dads can do the laundry, cook, pack lunches, and take care of kids just as well as mommies can.

And I vow to raise boys who live and contribute to a world in which it is perfectly ok for them to choose and wear pink pull-ups.

California Redwoods: Lonely Planet's Best in the US

Lonely Planet, which is the only guidebook we use, ranked California's Redwood Coast ("our home"!) the #1 Destination to visit in the U.S. in 2018!

While I certainly do appreciate the natural beauty all around us in Humboldt County, I think that once you live here for several years (we've been here six and a half!), you forget what a stunning "tourist" destination it is here.

Here are some of our local Redwood photos:

From the website: "Lose all track of time (and cell signal) along California's Redwood Coast. Movie buffs might recognize the region’s scene-stealing backdrops from Hollywood blockbusters like Jurassic Park, E.T. and Star Wars. But the full wonder of California’s 2000-year-old redwoods – some reaching 20 stories high – is impossible to capture on any screen. Look up at the forest canopy: that last 100ft of redwood growth marks 50 years since Redwood National Park was established in California's tree-hugging triumph over logging. And this year, in celebration of their 100th anniversary, Save the Redwoods League are offering free entry to over 40 redwood state parks every second Saturday of each month.

In 2018, another kind of greenery has been making headlines as California introduces the state-wide legalization of marijuana. But the draws of the Redwood Coast far surpass changes in this industry, inviting travelers to achieve the ultimate California mellow with its quirky shops, brewpubs, coffee roasters and oyster happy hours."


We are truly in Northern California, rural and remotely located about 2 hours south of the Oregon border and 5-6 hours north of San Francisco and right on the coast.   But if you are ever in our neck of the woods (literally), please come visit and see the stunning part of the country that we call home!

"Could it have been worse?" Wednesday

Wednesdays are my hardest day at work.  I am in family medicine clinic all day, after a gap of a few days since being on OB call (and clinic) Mondays.  Although I sometimes drop by on my "day off" Tuesdays to clear some things out, and work on my electronic inbox from home Tuesdays and before work, there is always a ton of "urgent" paperwork "waiting" for me Wednesday mornings. Before starting my full clinic day, I often have to stop by the hospital and round on/discharge postpartum moms and babies from their deliveries Monday-Tuesdays.  My Wednesday scheduled is always packed and I rarely have no-shows (my medical assistant, Jenn, jokes she should always wear skates on Wednesdays). There are always many complicated, chronic disease management-type appointments and sometimes acute double-books. I rush home over lunch to walk the dog (and today had a zoom-in women's health phone meeting) before getting right back at it in the afternoon. I. (and my MA) Hate.Wednesdays.


Today, things were just a wee bit worse. As I drove into the clinic parking lot just before 8 a.m., a woman leaving the bank didn't look behind her before leaving her parking spot, and backed her SUV right into the rear passenger side of my (new) car, creating quite a bit of damage despite my blasting the horn and swerving (the good news is that it was very low speed, I was not injured in the least, there was no child in the car, thankfully, and she was very apologetic about her fault as well as insured).  I hardly have three extra minutes to pee on Wednesdays, much less to be on the phone with the insurance company, damage appraiser, car rental office (because a rental is covered), body shop, and more, all in between patient visits booked every 15 minutes (when, on a good day, it is already a huge stretch to stay on time with visits and charting).  It was an especially rough day.  While we don't know for sure, I estimate the car will be out of commission for many weeks, unfortunately. And it's hard to plan things when you're still working in clinic for two weeks (including a 96-hour OB delivery call starting Friday morning) with little flexible daytime hours of "free time" for being on the phone and coordinating drop off,  pick-up, towing, etc., as well as being 36.5 weeks pregnant, 2 cm dilated, and not sure if/when labor is going to start or when a newborn will be added to mix of this all.

Additionally, while exchanging insurance information, I realized that my driver's license was not in my wallet. I have no idea where it disappeared to (but Iver swears he didn't remove it from my wallet to play with it as he sometimes does with cards, and I haven't to use it in a couple of weeks, since we got the new car, so I don't know when it could have fallen out).  I can't pick up the rental car without a license.  So I have to spend my "free time" tomorrow at the DMV getting a temporary one, after I locate all kinds of other supporting documents, like a social security card, utility bill, etc. I hope the DMV in Eureka is not as bad as those I've been at before in other metro areas. But the first "appointment" is February 21, so walking in and waiting for as long as it takes is what I'll be doing. Wish me luck...

Then, midway through the afternoon, I realized that in the flurry of all of the above, I forgot to brown the turkey dinner taco meat and start the crockpot for dinner.  And, in my rush to then cook on the stove top after an incredibly long day, I burned the taco shells in the oven.

We have had a bit of additional stress this week because our spirited son has been pretty defiant with fighting pretty much all instructions and is back to waking between 4-5 a.m.  He's leaked through his overnight pull-up twice, resulting in daily laundry.  Pepper has been under the weather (vomiting several times yesterday).  My pelvis also hurts. I'm getting sharp, dagger-like nerve pains in my groin and pelvis (and sometimes down the back of my right leg) with walking or standing sometimes, which makes me yelp randomly in pain (and is far worse than labor), and it seems to be getting more frequent.

This Wednesday put them all in perspective... I don't think a Wednesday could have been worse. I could have used a stiff drink.  Except there's that fetus. At least tomorrow is not a Wednesday.  Thanks for letting me whine and vent.

Good Guys (sometimes) Finish First

Thank goodness for "good news" stories every once in a while, in the relative escape of sport, when sometimes the best man(/person) does finish first.

Here's congratulating Roger Federer, a great athlete and person whose skill, grace, and empathy continue to shine through as he continues to excel in the sport of tennis.  I love this guy.  He won his 20th Grand Slam tennis title (6th Australian Open) today, defeating Marin Cilic (nothing against Cilic but I am and will always be a Fed Fan) in a great five-set match.

If only we could all be as on top of things/one's profession at age 36!

And here's to men who are genuine, gracious, compassionate, humble despite greatness, and who aren't afraid nor ashamed to show emotion in stadiums full of thousands of people. I hope to raise two of them.

+/- Electricity

Our electric company, PG & E, notified us that we would *likely* or *possibly* have a 9-hour power outage during day hours on Tuesday. It was "planned" in advance for them to do some line-work.  While we appreciated the heads-up, it still didn't make it easier to be without power, on a day I usually spend at home!  Kelvin was at work, and Iver was at school a half-day, but Tuesday (my post-call day) was my home day. I did sleep a little (which doesn't require power) after an OB admission overnight, but I realized that being home alone without power is really not that fun. I did get a lot of reading in, but here is what was lacking:
  - Food options! We duct-taped our fridge closed in advanced, to keep things cool and remind me not to open the fridge. I pulled out lunch food and snacks ahead of time, but then that was all I could choose from. I was gambling on whether the power would be on before I cooked dinner, or whether I'd have to last-minute scramble for take-out. Thankfully, it did return with time for me to cook the thawed chicken in the fridge.
- Heat! It's been raining, and was pretty cold (relatively, for CA-- like 50-60) in our house. I had to layer up, but couldn't run anything electric, including my heating pad (for my back) or a space heater. Poor Pepper was also freezing!
- Hot water. I forgot that heat was needed for hot water, so I did without a shower rather than take a cold one (I HATE cold showers).
- TV!  I don't want much TV, but I do love watching tennis, and my recorded Australian Open was on (but unwatchable when I had the time to do it).  The ESPN app on my iPad was also not working, so I was tennis-less until the lights returned.
- Internet. Wireless Internet was down alongside the power. So while I could turn my iPhone into a wireless hotspot, I didn't want to blow the battery on that.... because I couldn't charge my phone (Kelvin actually does external battery/juice pack but I preferred not to use it except for an emergency). I elected not to do an EMR inbox work at home due to the above.

I am thankful that I don't (yet) have a newborn, or frozen breast milk I would have had to salvage somehow with an outage like the above, or an electricity-dependent health issue... It could certainly have been worse.  Midday, however, I got really tired of being cold at home and went into clinic to do some work, then errands, and picked up Iver.  Thankfully, power was back on by 3pm (having been off for 6 hours but on sooner than the estimated 1730) and we all warmed up.

On the electric PLUS side.... I now have a new plug-in hybrid car that runs on electric for about 40 miles on one charge (except I couldn't charge it that day because of the above!), and then uses gas as a backup. I post reluctantly because I feel that "getting a new car" sometimes seems showy, but my 11-year-old Prius has been having battery issues and we don't want to have an unreliable car at this point in our lives. Kelvin (in consultation with my Dad, a Volt owner) did all the research, and we are now owners of a Honda Clarity, which I've just started driving this week!
 


It's big enough to seat five (which will be good for two carseats), and has better trunk space than does the Prius (and is less ugly).  I haven't had a new car in over a decade, and it's a bit new age-y, with buttons, not gears, on the inside, a rear and a side right "roadkill-viewing" (per Iver) camera, bluetooth (for my podcasts!) audio (but no CD player), and a remote start mechanism... but I do think these are all things that I can get used to (and love). I really love that I can now rarely fill gas with my low-mileage driving around our rural town(s), saving our wallets and our environment!

Electricity is good stuff.

ANOTHER WHOLE HOUR

We have had a not-long-sleeping, early-rising toddler for about two years. Iver's preferred wake-up time has been between 4:30 and 5 a.m. after going to bed around 8 p.m. Every. Single. Day. (Luckily, he has been sleeping through the night most nights, so there is at least a continuous stretch of sleep).

However, when we went to my parents' house for Christmas just after his third birthday, we were getting him to sleep until 7 or 7:30 a.m. (which, yes, I realize is 4:30 in California); however, he was going to bed around the same time (between 8 and 9 p.m.) on the East Coast. We were so puzzled.  How could we replicate this 2-3 hours more sleep PER NIGHT when we returned home? What had we been doing wrong?

We wondered if it was the darkness, and so we removed from his room the stoplight ok-to-wake stoplight alarm clock which I think helped us teach him to sleep through the night at around 19 months (it had been staying red until 5 a.m., which is what we deemed an acceptable wake-up time). We replaced it with a small digital clock, which emits much less light, and it's helped (and he now can read time)!

Now, we are having a toddler who (still naps a couple of hours after lunch and) sleeps from about 8 or 8:30 p.m. until closer to 5:30 a.m. (and has even made it past 6 a.m. a few times, which buys him some extra morning raisins and us a lot of wondering whether he's still alive)!. One day, he told us he woke up in the 5 o'clock hour but stayed in bed until 6 just for the raisins! Although we have to now train our bodies to "sleep in" in rather than awaking early as we've been programmed, we are rejoicing!  It's incredible how much difference a later wake-up hour makes in your overall health, well-being, mood, and resiliency.  I am shocked, delighted, and of course questioning what magic happened in his brain (and how I can help this happen sooner than three years in our #2). This has been the parenting miracle for 2018!