Doctors Galore and Your Questions Answered

GYN Appointment
I had an OB/GYN appointment on Wednesday back with my regular doctor (no more perinatologist for me!). It was the first time I've seen him since a few days before I delivered when he came to visit me in the hospital, so it was good to see him, though I could have done without the exam! I was surprised at how many of my old feelings were still with me sitting in the waiting room amongst all the pregnant women there. You'd think having been through a pregnancy (one that lasted, even) and having three babies to show for it, that I wouldn't still feel like a completely inadequate in a roomful of pregnant women. But I was never one of those women...I never had the luxury of taking my pregnancy for granted. I didn't get to ever assume everything was fine because I had a pregnancy that was nearly guaranteed to result in a premature delivery and one in which things seemed to be going wrong every week (and I didn't have as bad a time as I could have). Anyway, I don't mind pregnant women...some of my best friends are pregnant women..I just find it overwhelming to be around that many at once.

The doctor asked whether my husband and I were doing anything about birth control. I missed my opportunity to answer with, "Well abstinence is the preferred method of Congress..." because I burst out laughing. Instead of lecturing me about the fact that there are lots of women who end up with an "oops baby" after years of fertility treatment, he just asked whether I'd be depressed if I ended up surprised by a pregnancy. After I stopped laughing, I told him I would die of shock because it would be the immaculate conception, but that we'd be thrilled to pieces. That satisfied him, so he was okay with me not doing anything to prevent it. I was actually a little surprised not to get a lecture about not wanting to be pregnant so soon after a triplet pregnancy and c-section (I got that lecture from the perinatologist while I was pregnant), but I'm cool with that. I'm very certain I'm not going to find myself surprised with a pregnancy anytime soon, or, like, ever.

I told him I was still bitter about the c-section and he said, "what do you mean?" He was shocked that I'd ever thought I could have a vaginal triplet delivery, and was surprised to learn that two of the perinatologists in the practice I went to have done (and were willing to do) vaginal triplet deliveries. I always knew that the odds were against me avoiding the c-section, but had Abby not been so little, they would have let me try it. Anyway, I told him that I'm all ready for my VBAC because I'm definitely going for a normal singleton pregnancy some day, darnit! I told him that HE was going to deliver my next baby because it was going to be JUST ONE. I'm not sure that I really have that much confidence that I'll manage to get pregnant again, but I'm certainly going to try (while praying that the Big Guy Upstairs doesn't have a sick enough sense of humor to send me quadruplets next time).

Pediatrician
I took Ellie to the pediatrician on Friday for a weight check. Well, I mean, all three babies went, but only Ellie got weighed and seen. I've known our pediatrician for about ten years (we used to attend the same synagogue, long before I had any kids), and I adore him. There are several other doctors in the practice, but I've made nearly all of our appointments with him because of Ellie's weight issues. I prefer seeing him because he's got a better appreciation of the trends we've been seeing with Ellie's progress (or lack thereof) and because I just like him in general. One time when I saw another doctor for one of Ellie's weight checks, she sort of shrugged me off as if I was overreacting. I admit that I was beginning to wonder if perhaps I was overreacting to Ellie's lack of weight gain - she's just so little compared to Abby and Sam. But she remains an enigma. She was 7 pounds, 7 ounces this week... which was only a 7 ounce gain in 17 days. Not terrible, but not quite what we would have liked to have seen, either. Even Dr. B said it would just be nice if she would go one way or another... slightly less gain and we would have known we needed to explore options, or slightly more and we'd know there was no problem whatsoever. She consistently gains less than he'd like to see her doing, but not so much so that it points to an obvious problem. He, like me, is somewhat worried, but not inclined to intervene too much at this point. She's not showing any other signs of reflux (she rarely spits up, she's not fussy when she goes on her all-too-frequent hunger strikes, she doesn't quit in the middle of feedings, she doesn't seem uncomfortable during or after feedings...), so trying reflux medication probably wouldn't do anything other than giving us one more thing to have to keep track of on a daily basis. He doesn't want to torture her with a huge blood draw for a metabolic screen, but he did do a small blood draw to check her thyroid hormone (T4, TSH), so we'll see if that illuminates us at all.

The triplets are scheduled to return for their four month visit in two weeks, and he said we'll just keep an eye on her until then and if I feel that things are taking a turn for the worse in the interim, I'm more than welcome to bring her in for another weight check. I doubt that I'll feel the need, but you never know. It's nice to know that they don't think I'm just an overreacting new mom, but I do wish she would just gain a little more weight a little faster so we could stop worrying all together. Poor baby. The doc WAS impressed that Ellie is pretty consistently sucking her thumb. Thumb sucking is apparently a developmental milestone you expect of a full term baby at 3 or 4 months, so she's about 2 months ahead of schedule. Go Ellie! Anywho, we're back to our wait-and-see strategy with her, and that's fine. I just wish she didn't have hunger strikes!

Your Questions Answered
Allie posted this question in a comment recently:

Is it really going to be cost effective to pay for childcare for 3 kids?? I hear that childcare for 1 is bad enougth...but I can't imagine paying for childcare for 3 newborns!!!! Won't you just be working to pay for childcare costs??

I get this question (or similar questions) a lot and I don't really understand it. No one knows how much I make or how much we'll be paying a nanny, so why do people assume that it's not cost effective? And why does no one ask my husband whether it's cost effective for him to work?? We make the same amount of money! The truth is, it IS cost effective, not only in the short run, but definitely in the long run. I make more money than we'll be paying the nanny. Does that mean we can afford a nanny? No. We still have more bills than we know what to do with. But we can't pay much more than the mortgage and a few utilities with my husband's salary alone and we've eaten through what little reserves we had with me out of work for the last seven months (bed rest for three months and almost four months since... time flies when you're sleep deprived). Anyway, in the short run, yes, it is cost effective for me to work. It would not be if I made less money.

More importantly, however, it is cost effective in the long run. If I were to pull myself out of the job market until the kids went to kindergarten or 1st grade, I would no longer be marketable in my field because the standards and technology are changing too rapidly for me to keep up on my own. So even if we were losing money on a nanny at this point, it would be worth it in the long run because there is no other field that I'm qualified for in which I could maintain my current salary years down the road.

And while it's true that I have little desire to return to work, I find it odd that no one seems to consider the possibility that maybe I like what I do. (I do like what I do, though I'd gladly give it up for the opportunity to stay home with my sweet babies if we could swing it financially). Anyway, enough of that...


Tinker asked:
How do you add calories to breastmilk? Feed it from a bottle and add a supplement of sorts? What kind of supplement?

You can fortify breastmilk by adding a higher calorie supplement to expressed breastmilk in a bottle. Breastmilk and standard formulas have 20 calories per ounce. Preemie formulas have 22 or 24 calories per ounce (I think there is also 27 calorie, but I'm not certain). So Abby used to get fortified breastmilk by adding 1/2 a teaspoon of preemie formula to 3 ounces of breastmilk, which raised it to 22 calories per ounce. She's not getting extra calories anymore, though, because she's done sufficient catch up growth.

Several people have asked whether I will continue breastfeeding when I go back to work and the answer is, of course, yes. I'll be pumping during breaks and overnight (and obviously breastfeeding whenever I'm home with them). I'm very pleased that I've made it this far without needing any formula (who can afford formula for three babies??), and my hope is to make it until they are at least 6 months adjusted before adding anything else to their diets.

Any other questions?