When you’re kinda thankful for American excess

When you’re kinda thankful for American excess

It’s been less than a year since we were last in the States, so the culture shock hasn’t hit us as hard this time around.  The kids have made some funny observations and proclamations about the US (“I hate America because it makes my nose bleeeeed!”), and of course jet lag was a beast, but for the most part, I felt like the transition this time around has felt a lot smoother.

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And then we drove past a shopping mall in Colorado and Isla shrieked with joy, “an American Girl BOOKSHOP!!!!!”  A few months ago, my sister sent her some of the old school American girl books, and she absolutely loves them.  So when she saw a huge store full of the books she adores, she was so excited.

I was a bit too old for the American girl craze when I was a kid, but my memory of them is a set of books about a little girl living through an important part of American history.  You could get a doll and the doll had several different outfits to go along with the different books in the set – a Christmas dress, a school outfit, and whatever else.  So I thought we could go in and see the doll that goes along with the books she’s already read, and maybe get her a new book.

Hello, culture shock.  This store is the epitome of the way America can take things to the absolute, most ridiculous extreme.  First of all, the salesgirl had absolutely no clue what we were talking about when we asked her about Felicity, the character Isla has been reading about.  Um, okay.  And then we saw the hair salon.  Four adult women, whose only job was to style their customer’s – A DOLL’S – hair.

It’s a little girl’s dream and a parent’s (read: wallet’s) nightmare.  We made a quick exit and headed into the mall.  At the entrance they had those little cars that you can push your kids around the mall in.  But instead of a steering wheel, so that your child can feel like he’s actually driving the car, there was a tablet.  For your toddler.  To play with.  While you walk around the mall.

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Hello, culture shock.  Hello, America.  Where something that was perfectly fine when it was simple gets take to the extreme.

It’s overwhelming. Super overwhelming.

But to be honest, sometimes I am really grateful for the extreme-ness of the good ‘ole Us of A.

Last Sunday night, we headed to a splash park with some friends.  To make a long, very bloody story short, Isla fell and needed stitches in her chin.

She’s had stitches before and it was an incredibly traumatic experience for her, so even the mention of them put her into a tailspin.  So we headed back to where we were staying so I could get Ruby and Luka dinner and Caleb and Isla headed over to Urgent Care to get her chin stitched.

But she was freaking out so much that they couldn’t stitch her without sedation, so they sent them to the ER.  There is a children’s hospital super close to where we were staying, so that’s where they went.

And this is the part of the story where I’m thankful for the way things in America just can’t be left simple.  As soon as they walked in the door, Isla was presented with gifts – a book and a craft to work on while she waited.  No need for wheelchairs in this hospital, a happy red wagon will wheel you to your room!  She had her choice of movies to watch while she was stitched up, but since she couldn’t settle down enough, a quick squirt of something in her nose knocked her out for the stitches…. and the rest of the night!

Compared to the last time she got stitches in Beirut… when I had to hold my 2 year old down screaming bloody murder because they wouldn’t give her any pain relief until after violently cleaning her wound… this was a dream (said the person who sat at home with the sleeping littles while Caleb did the whole ER thing!)  Now getting the stitches out…… that’s a whole ‘nother (6 hour long) story!

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Delivery wishes – Birth plan

Delivery wishes – Birth plan

The purpose of this blog is to share our experience as a little American family living in Beirut.  I save work and ministry stories for our newsletters.  I upload bajillions of pictures of our girls on facebook.  But the blog is mostly for my thoughts and experiences related to life in Lebanon.

This is one of those posts that’s not for everyone.  About once a week I get a blog hit from someone googling “delivery wishes.”  I always wonder when I see that what exactly they were looking for and if they found it on my blog.

So I thought I’d share my birth plan that I gave to my doctor before Ruby’s birth.  Obviously a birth plan is a very personal thing – very specific to each individual woman and pregnancy.  But I found it really helpful in writing mine to read over what others had written, so I’ll throw mine out there as well for anyone who is trying to figure out what is important to them in their birth experience.

Last chance for those of you who just want to read about silly language mistakes to bail!  :)

First of all, keep in mind that this birth plan is for a VBAC in Beirut, Lebanon.  There are several points on here that I’m sure my American readers will think are silly to include because they are things taken for granted in the States.  If you want to know more about the reasons I came up with this plan, you can read about it in the post Delivery wishes that I wrote leading up to Ruby’s birth.

So, here is what we gave to my doctor:

Birth Plan

Labor

– Freedom to move, walk, change positions as I feel comfortable
– No IV, only hep-lock in case of emergency
– Limited cervical checks
– No epidural, other meds unless I ask for them
– Fetal monitoring?*

Delivery

– Would like to push when I feel the urge, not just because I hit 10cm
– Freedom to choose various pushing positions (not just on my back)
– Prefer natural tear to routine episiotomy, but prefer episiotomy to vacuum or forcep delivery
– Immediate skin to skin
– Delay cord clamping until it stops pulsing
– Would like to initiate breastfeeding ASAP

Baby care

– No glucose, formula or pacifiers
– Husband will remain with baby at all times

* The fetal monitoring was something I was unsure about.  The problem with the fetal monitor is that it limits your movement.  Initially my doctor said that she’d monitor the baby periodically and while I was attached to the monitor I would have to be in bed, which I was really hoping to avoid.  When I arrived at the hospital, I was already at 10cm, and my doctor wanted me hooked up right away, but there was enough length on the cord that I could move around as much as I needed, as long as I stayed close to the bed, which was just fine because I was pushing, not walking around trying to deal with contractions at that point.

So, that was my birth plan.  I hope it’s helpful to someone out there!  Happy to answer any questions or clarify anything if that helps.  If you are interested in reading how it all went, you can find that post here.

And now back to our regularly scheduled program.  :)

Sunday 11:56pm

Sunday 11:56pm

On Thursday, Ruby’s bilirubin levels had spiked again, so we were re-admitted to the hospital.  A good friend mentioned to us that we didn’t have to stick with the doctor the hospital assigned, so now Isla’s doctor, who we LOVE, is taking care of Ruby.  She was under the lights for about 24 hours, which brought her levels down a good amount.

We’ve been re-testing her blood every 12 hours for the past two days, hoping for the numbers to stay stable or drop so that we can go home, but they have been consistently rising.  Now, on Sunday night, they are back to where they started, so she’s back under the lights.  We’ll re-test in the morning and see what has happened overnight with the phototherapy.

In the meantime, her doctor (the new one, not the one we fired) is concerned that something else might be going on.  She isn’t following the patterns that she should be.   It seems that the ABO incompatibility – where her blood cells are fighting mine – is winding down… the breakdown is occurring at less than 1% when it was originally at about 10%.  But her levels continue to rise.  So, the doctor is also running all sorts of other tests, to look for infection, thyroid problems, and who knows what else that might explain why her levels are just not going down like they should.

I thought holding my 3 day old while she got an IV was bad… holding down the legs of my 9 day old while they insert a catheter is much worse.  Poor baby is so traumatized by all the poking and prodding that when we try to lay her down she gets hysterical.  It’s so sad.

Please keep praying… for a miraculous drop in her levels and a continual decline.  Pray for energy for Caleb and me and for peace for Ruby – that she would relax and not fight against us as we’re just trying to help her get better.

On a positive note, my mom is here!  Let the Isla-spoiling begin!!!

View from the pediatric unit

View from the pediatric unit

We headed back to the hospital the next day (Easter Sunday) to get Ruby’s bilirubin levels checked. They had sky-rocketed over night and she had to be admitted to the hospital for phototherapy.

The hospital-assigned-pediatrician explained absolutely nothing to us (and that is all I will say about that woman, because there is not a nice thing I can write about her), but we’ve since learned that Ruby has ABO incompatibility. Basically the antibodies from my O+ blood are attacking her B+ blood and breaking down her blood cells. Bilirubin is produced by this breakdown process which causes jaundice. Normally the rate they breakdown is 3%, but Ruby’s rate is closer to 10%, which means she is producing way more bilirubin than her little body can handle on it’s own. And I pretty much understand only half of what I just typed. :)

So we were admitted to the pediatric unit, where she was put in an incubator and under the blue phototherapy lights, which are used to speed up the breakdown of the bilirubin in her body until her liver is mature enough to do it on its own.

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She stayed under the lights all day Sunday until midnight on Monday, only coming out to be fed. I’m actually really thankful that they put her on this floor and not back in the nursery, because it means I have complete access to her. It’s been exhausting. She has to wear a protective eye covering, which she absolutely hates and pulls off constantly. Which means I’ve had to watch her 24/7 to turn the lights off quickly when she pulls it off so that she doesn’t damage her retinas. She had to get an IV put in to avoid dehydration from the lights, and every time she moved her arm, it set off the alarm. There isn’t really a bed in the room, even if I was able to sleep, so it was several days of sitting in a chair, literally watching my newborn sleep. Exhausting. No other word for it.

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I can’t even begin to imagine how the past week would have gone if I were recovering from a C-section in the process. Praise God that my recovery from Ruby’s birth was so quick and complication free, because the last week has required a lot out of me physically (emotional recovery, now that’s another story :)). There is no way I would have been able to do what I needed to do if I was still recovering from surgery, or even a more difficult birth.

So, they took her off the lights at midnight on Monday and then re-tested her levels Tuesday morning. Things were looking good, so we went home.

We came back in for another test on Wednesday, and her levels had gone way up. They weren’t quite to a dangerous level, but much higher than expected, so we had to go back in on Thursday for another check. Her levels had gone up even more and were getting really close to an unsafe level, and so she’s been re-admitted.

It’s discouraging. It’s frustrating. It’s so hard leaving Isla again. I miss my little girl.

Right now (Friday night in Beirut, happy one week birthday, Ruby!), her levels have gone down slightly after being under the lights for 24+ hours, so we’ve turned the lights off and will re-check her in the morning to see if her levels continue to climb. If they haven’t climbed too high, we’ll continue to check them throughout the day, and when the decline is satisfactory, she can go home. Best case scenario at this point is Saturday night, but it could be longer.

Pray for us. Pray for physical and emotional stamina. Pray that Ruby responds well to the lights and that her bilirubin levels will get under control quickly. Pray for Isla as she’s being shuttled around from place to place, person to person.

Ultimately, I know that this is a totally treatable problem. A little time and a lot of blue light will fix things. Going through the ER and being on the pediatric floor of the hospital reminds me so clearly that there are others going through things so much more difficult, without the hope of a recovery and even more sad without Hope that things will one day be different.

As I was sitting in the hospital room watching my newborn try to figure out how to suck the one finger sticking out of the bandage protecting her IV line, and feeling so sad about not being there to read Isla’s bedtime story once again, I was reminded that it was Easter Sunday. The day that death was conquered. And I was reminded that this is not how things are supposed to be. That one day every sickness, every tear, even death will be eradicated. Praise God for that hope… may that day come soon.

Healthcare in Lebanon

Healthcare in Lebanon

Since becoming pregnant, I’ve had lots of people ask about (and express concern about!) what the doctor/hospital situation is like here.  Thought I’d share a bit of my experience this week, because it was such a surprise to me!  Now I have no idea if this story is just the way my doctor/hospital runs, or if it is more representative of the healthcare system in general, but I thought you’d find it interesting nonetheless.

At the end of last week, I found myself in a lot of pain.  Nothing wrong with the baby, no worries, but (I now know) I had developed a pretty icky bacterial infection that was making it really painful to do pretty much anything.  Finally on Monday morning I decided just to pop in to my doctor’s office to try to get an appointment to see her.  The office is on the third floor of the hospital around the corner from our apartment, but when I stopped in, the receptionist told me that my doctor wasn’t in the office today, she was working upstairs in the intertility clinic.  She told me where it was and told me I could go look for her there.

I felt totally weird hunting down my doctor in the hospital, but was in enough pain that I did it anyways.  So I got to the infertility clinic and finally tracked down a nurse and asked if there was any way I could see my doctor.  She thought she might be in Labor & Delivery, and offered to take me there to find her.  I was really feeling weird about it at this point, because I knew that even though I was hurting, it wasn’t an emergency or anything, and I knew the baby wasn’t in any kind of danger.  But she had me take a seat and said she’d be right out to take me to find my doctor.

Right then, my doctor passed by.  She looked surprised to see me but immediately asked if everything was okay.  All I said was that I was actually hoping to see her and she immediately found an empty room, asked what was wrong, checked me out and wrote me a couple prescriptions.  She made sure I had her personal cell phone number just in case I had any questions about the antibiotics she prescribed (or anything else for that matter), reassured me that she knew it was painful but that it was simply a matter of treating the infection, and sent me on my way….. without paying a dime, I might add!

Again, I don’t know if this is just the way my hospital runs things, or if me being pregnant made them much more accommodating, but I was definitely impressed…. and very thankful!!  (And feeling much better, by the way! :))

posted by: nicolette