The 10-week mark

Well, today is officially ten weeks since little Luka joined our family and also the day that marks his mommy's first solo voyage into the big bad world.  Unfortunately it involved a rather pressing visit to the chiropractor to finally address the deteriorating state of my lower back following a combined seven weeks positioned in a compromised reclining position necessary for optimal kangarooing, coupled with the not-so-short transfer from Darwin to Cape Town.  I walked out of there with two follow-up appointments and a comment that my back is rather uncooperative for having been left this long without treatment - in the meantime I continue to rise out of my chair hunched over like Quasimodo's long-lost cousin.

I was reminded of all the comments and warnings I received about 'mommy-brains' when I found myself constantly checking and re-checking my few belongings in the mall.  A simple visit to the chiropractor, followed by a visit to the local pharmacy to get prescription eye drops for Luka's final ophthalmologic appointment tomorrow saw me checking, re-checking and confirming my wallet, sunglasses, purse, purchase and mobile phone about twenty times.

In the end, I think the experience was good for me, and also allowed Chris some quality study time with Luka strapped to his chest in his favorite cozy wrap, next to the fireplace, with a rainy Cape Town day outside.

When I returned, I felt strangely invigorated for having ventured out and survived (despite half dozen or so text messages to Chris in the process) so topped the day off with a batch of fabulous chocolate chip cookies and a butternut squash risotto for dinner.

Tomorrow, back to the hospital for follow-up visits with the surgeon, pediatrician and ophthalmologist.  

Luka's other Dr...

...the one doctor that does not have a stethoscope, does not take blood, and does not require medical insurance - the incredible Dr. Seuss.  We figured it can't possibly be too early to introduce Luka to the wonders of story books.

A morning storybook session with mommy and Dr. Seuss'
1963 classic Hop on Pop

...and daddy reading the same work another morning...

Along the road from Birthing Date to Due Date...

The family photographed near our house
May 2011

My 'Google Calendar' proudly announces 'DUE DATE' for today, May 27, 2011, just as I entered it all those months ago.  While we always anticipated this day with great excitement and joy to finally have our (back then still unknown) baby join our little family, little did we know that it would be a second homecoming.

That's right, in the spirit of auspicious dates*, Luka decided to give us a homecoming on his actual due date; only this time it was returning home from hospital where he had to undergo emergency surgery on Tuesday. After what seemed an eternal six weeks in a nursery in Australia, Chris and I both agree that the second time around in the neo-natal intensive care unit (NICU) was actually harder than those initial six weeks we spent in Darwin immediately following the birth.  Something about the optics of 'moving backwards', when we had just finally gotten comfortable with having Luka at home, away from the nursery in the first place.

Mom and Luka

The emotions of having another incubator assigned to us, hearing the friendly nurses introduce themselves "Hi, I am <such and such>, and I'll be taking care of Luka this evening...", the constant hand-washing, breast milk expressing, vitals, everything, was almost too much.  Yet, this time we were also thankful for the progress we have clearly made.  With one of the bigger babies in the nursery now, Chris and I were shocked at how tiny a four-day old prem in the corner was, only to realize he is 40g heavier than Luka was at birth.  Is it really possible that Luka was that tiny, fragile, skinny, jerky and pink?  How soon we forget, and how amazing the human race is at adapting when we have to. Looking at the tiny prem in the corner I was once again filled with empathy for the parents who lovingly, though cautiously, gaze and eventually cuddle their overwhelming little bundle.  Could I deal with that if I had to?  Then I snap back to reality and remember, but wait a minute, I have dealt with that...and I know that they too will be okay.  

There were many similarities between the NICU at the private Life Vincent Pallotti hospital just north of Cape Town, and the Special Care Nursery (SCN) at the Royal Darwin Hospital (RDH) in northern Australia.  Chief among them is the extraordinary people who work there.  I can't help but wonder about the true calling it takes to become a NICU nurse.  As mentioned in an earlier post, take anyone's most precious, most fragile possession, and choose to be the one to help them deal with it... just amazing.

Dad and Luka

There were, of course, also many differences between the public (state) hospital in a socio-economically challenged town in the Australian outback and an expensive, top-of-the-line private hospital in an affluent part of the metropolitan city of Cape Town.  From the emergency room entry we passed through in Darwin just over two months ago, flanked by the local population camping out on the sidewalks, inconspicuously taking swigs from bottles wrapped in brown paper, and less inconspicuously smoking under the 'no smoking' signs, to the 'camp like' lunches and dinners consisting of plastic mugs with pre-cooked instant oatmeal, white wonderbread and orange juice in foil-topped plastic cups ala coach class.  Compared to Cape Town with the comforter-clad beds, wicker furniture, white crockery and juice served in a glass with ice, along with the fact that you could actually turn off the lights in the room at night, and close the door (that it even had a door), connected by art-filled walls and overstuffed sofas for visitors and waiting patients.  Irrespective of the type of hospital environment though, perhaps of more importance is the fact that of the 22 weeks in 2011, we have now completed our seventh in hospital - or almost 1/3 of the year.  Not exactly the ratio we had in mind when planning a non-hospital delivery with a midwife only, but hey - what are plans for if not for breaking?

And so, our second stint in the NICU came to a ceremonious end when the most anticipated bowel movement of my life (and Luka's) finally occurred at 1800 last night, just in time for our pediatric surgeon, Professor Rob Brown, to witness during his rounds.  He agreed that with that performance, Luka and I could room in together (myself as a non-paying, non-eating, life-support only) boarder, and if all went well, we would be going home this morning.

Which brings me to perhaps one of the most telling lessons of the whole experience...the difference in a term and pre-term delivery.  Luka and I were assigned a bed opposite the NICU, sharing a large, comfortable room with en-suite facilities with a mom and baby girl delivered by C-section the day before.  The irony of spending my due-date night in a maternity ward 'rooming in' with Luka to 'establish' breastfeeding, after nearly ten weeks together, cannot be overstated.  For a few hours I had a window into what a "normal" delivery (in the temporal, not delivery method sense) is like.  Lying there in the dark of night, listening to the sweet, delicate whimpers of a newborn crying to communicate with her mother, echoed by the quiet cooing in a combination of Zulu and Afrikaans as a new mother cuddles, caresses and learns to independently care for her baby, brought back so many memories of the hours before we could hold Luka, and the weeks before I could independently care for him.  I recall how quiet Luka was for the first month of his life.  After his initial screams out of the womb, as with the majority of prems, we hardly ever heard him make a peep.  I empathize with this mother as she struggles to teach her infant to latch and feed, only to recall my two-hourly hand-expressing into tiny syringes, to be walked down the dull, institutional, artless walls of RDH to the Special Care Nursery, followed by the tens of liters of milk expressed by means of electric pump, while Luka matured and gained strength for nearly six weeks to get where this mother automatically found herself on Day 1 with her infant. 

Today, nearly ten weeks after we were blessed with a 1.777kg Luka, I am bouncing a 3.3kg ex-prem on my lap and am truly humbled and indescribably grateful to the opportunities awarded us by means of having had access to world-class medical care in both Australia and South Africa to enable Luka to progress as well as he has.  To all the nurses, the doctors, and other service-providers who have assisted us in some way or another, we cannot thank you enough.  For all the countless mothers and fathers of preemies, you too will find the strength and wisdom to get through, and to those unfortunate enough to birth premature babies every single day in places not equipped to deal with them, I pray that you too will some day experience the joy of holding a healthy, happy, hungry baby in your arms.

As for our own journey from birth date to due date, despite the trials and tribulations of the past ten weeks, and no doubt of the future, I can honestly say...I don't think I would have it any other way...there is something humbling, empowering, and oh so full of grace in caring for a tiny premature baby that is perhaps part and parcel to the calling of those who choose to dedicate their lives to them.  Truly God's most special, and dare I say, perfect creation.

Happy original Birthing Day Luka - you are the sunshine in our days and the stars in our sleepless nights.

Our little angel

*   You may recall that out of 365 days, our boy popped out ten weeks early on his father's birthday


** All photographs courtesy of Brenda Wardall, Hearts in a Shutter

Luka's surgery: inguinal herniotomy

On Tuesday at 0400, Luka woke screaming inconsolably for the first time since his birth.  We tried everything to calm in, including the 5 S's of Happiest Baby on the Block fame, which seemed to help temporarily, allowing us a few more precious hours of sleep.  However, he awoke once again and was screaming terribly.  We figured this was indeed the next challenge in raising Luka, the 'colic' we have read are so prone in preemies.

To our horror, there was indeed a clear reason for his screaming - a bulging lump in his groin.  Having studied the essential guide for any parent of a preemie, we were at least partially prepared for the occasion insofar as we were pretty sure we knew what it was, and also, perhaps most importantly, that it would require what was indeed the most common surgery performed on preemies*.  So after calling the pediatrician and all that followed as explained here, we found ourselves once again in a NICU setting.

The little patient immediately after the operation. 

Of course, when your infant is in terrible pain, and you are rushing off to the hospital, one does not necessarily always stop to think and pack - and so, for the second time in ten weeks, we found ourselves under-packed for one of Luka's adventures.  Having reached the hospital and being passed on from our pediatrician, Dr. Carl Wicht, to the pediatric surgeon, Prof. Rob Brown, we knew we would be stuck over an hours' drive from home, at least overnight, but possibly longer - not a distance acceptable to us.  Unfortunately, Luka's surgery was an emergency, so there was little time to plan or adapt until after he came out of theater.  Prof. Brown explained that while a hernia is not necessarily an emergency, it is when the bowel is trapped in the connecting tube, causing a 'strangulated' hernia that requires immediate transport to the nearest emergency room.  After examining Luka, he informed us that his was indeed wedged in tight and would require immediate surgery to avoid permanent damage (read: removal of part of the bowel), then carefully sketched out the procedure for us on a pad and paper.  He immediately instructed his receptionist to book space in the OR, and started rescheduling his entire day to fit Luka's surgery in ASAP.

While waiting for an available operating room, we were booked into the nursery, Luka bathed and changed into a hospital t-shirt, and I administered a dose of caffeine done to assist the lungs in post-operating recovery (of course Chris and I were at this point still caffeine-less and almost demanded our own dose).  We were able to take Luka out to a waiting area with couches where we proceeded to wait for a few hours.  Eventually, the anesthesiologist Dr. Hanli van Dyk came out to the waiting area, introduced herself, pulled up a chair and proceeded to walk us through the entire process of putting our baby to sleep.   She explained that she would be using a general anesthetic, combined with a once-off regional anesthetic, which allows her to reduce the amount of general needed significantly (a good thing for someone born as prematurely as Luka).

Poor guy all swollen from the IV fluids...but so alert and happy
to see his daddy!

Once we got the green light that surgery would proceed, Luka was returned to the nursery where he had to board his incubator. The head nurse and a hospital porter then wheeled him to the operating room on the top floor, with Chris and I in tow.  At the operating ward, I was dressed in scrubs, shoe covers and a cap and followed the porter to a 'holding' area before surgery.  Here Luka was somewhat antsy, so I took him out of his incubator and soothed him. Dr. van Dyk came out and along with the porter pushed the incubator into a large operating room where Prof. Brown, two nurses and a young (presumably student) doctor was waiting.  I was able to hold Luka as Dr. van Dyk administered the gas, before laying him down on the bed, planting a big kiss on his forehead, and then being escorted all the way back out by Prof. Brown all the while explaining what he would be doing during the procedure.  At the door Chris and I went to get our much-needed coffee and a newspaper to try and occupy our minds for the hour we anticipated it would take.

Luka was not kind to the drips in his
arms I believe he went through five...

At roughly an hour and ten minutes Prof. Brown came out to explain that the bowel was so wedged in the sac that it was near impossible to pull it back through, he did manage, but it caused a minor tear in the bowel.  As such, it was not the 'uncomplicated' surgery we had hoped for (during which there was even talk of fixing a potential hernia on the right, should one exist), instead, now it would require an extended stay in hospital and nil per mouth (i.e, now milkies for our boy).  We followed the head nurse and porter back to the nursery with a now very distressed (read hungry) and groggy baby.

Kangaroo care - the only way to go!

The three days in hospital was not great, as we were once again thrown back into the lull of nursery-life, but at least we knew our departure there was rather imminent, unlike the newly arrived prems and their distressed parents.  Seeing Luka in pain, and discomfort the first two days was truly a challenge, but we knew he was being cared for well.  Probably the hardest thing for me was not being able to feed him for three days, since, despite the IV fluids, he was clearly hungry and smacking his lips for a feed - to try and mitigate this we had to revert to a dummy (pacifier), which our boy did not think was funny.

While he lay recovering, slightly sedated, and absolutely starving!  I managed to find a guesthouse nearby thanks to a recommendation from one of the nurses, while Chris ran to Woolies (JC Pennys) to get a packet of underwear and a clean t-shirt for each of us.

Luka being examined on Chris' chest by his pediatrician
Dr. Carl Wicht

For the next three days, we kangaroo cared Luka again for close to ten hours a day in the NICU while we waited for the pediatrician and surgeon to do the rounds to see whether we would be spending another night in hospital - from where we would quickly phone the guest house back to reserve our room for that night again.  Each day Luka was more wakeful, and clearly in less distress than the day before - but we were still waiting patiently for the all-changing bowel movement to manifest!  Imagine a a gaggle of nurses and two doting parents all rooting for the same thing - a big poo!  Well, it eventually happened on the second night, the 26th - which set the ball in motion for us to leave.

And so it were that we were once again released from hospital (after settling the bill of course!) on Luka's due date.  For some thoughts and ponderings on that, please see the next post, From Birth Date to Due Date.

For now, it is nearing sunset here in Scarborough on a gorgeous winters day on the southern point of Cape Town.  Luka is peacefully resting on my lap after his umpteenth feed for the day, and following two fabulous poos - we are closely monitoring him for pain and discomfort and administer Panadol-based seppositories as needed.

The backside of Table Mountain as we drive away
from the hospital this morning.

We are due back for a follow-up with the pediatrician, the surgeon, and at the same time his final ophthalmologic examination next week.  During the visit with the surgeon he may do an ultrasound on the right side of the groin to determine whether there is any need to mitigate that side in an elective surgery as well before it too becomes strangulated, risking another emergency surgery in the future.

Note: I can safely say infant surgery is one of the tougher things of the whole experience so far, but thanks to the amazing staff, we felt confident and calm most of the time.

* 3-5% of healthy, full-term babies can suffer from hernias, this number increases up to 30% for preemies.  Source

Snack time!

After another long day with no feeds for the little guy, the surgeon agreed we could give him a 5-7minute 'snack feed' at the breast lunchtime today.  He was SO grateful as was I!  Now we wait and see whether his bowels have woken up enough and are able to process without vomits or worse.

Keeping our fingers crossed, and thank you so much for the good wishes from around the world!

We hope to be able to take him home tomorrow...get this, on his actual DUE DATE. 

Update: Luka in Hospital for Emergency Surgery

"Hello NICU my old friend...."

Alright, not exactly the post I was hoping to write today, but seems our boy needed to have one more bit of excitement before his due date this coming Friday.  On Tuesday morning he cried uncontrolably for the first time in the nine weeks he has blessed our lives.  We thought the dreaded 'colic' may have finally set in, but were corrected in our thinking when we changed his nappy to find a very enlarged groin.  Seems our boy managed to get a pretty inflamed hernia in the groin area.

We called his paediatrician who told us to be there in 45minutes (we live nearly an hour away considering the road, traffic and ancient car).  Long story short, he examined him then whisked us to the paediatric surgeon.  Must say, we were rather relieved to see 'Professor Rob Brown' on the door, with lots of degrees cum laude against the wall...I mean, if you are going to have your baby operated on...

Long story short, Luka went in for an emergency herniotomy at 1500 on Tuesday afternoon at the Life Vincent Pallotti hospital in Pinelands outside of Cape Town (incidentally exactly nine weeks after he was born at 1500 in Darwin).  After over an hour in surgery, we were told that unfortunately the bowel was extremely constricted through the hernia, when it was pulled back through it acquired a small tear. 

The good part is that we caught it early enough to avoide a 'incarcerated hernia' that would have required removal of part of the bowel.  The bad part is that the bowel did tear and we now have to wait for the bowels to function again before he can have something to eat.  He is currently on pretty hectic pain medication in addition to flagyl for the infection.  In addition he is on a drip with electrolytes, sugars and fluids - think living on gatorade for a few days when you are used to lobster and steak.  And mom, I'm feeding the electric pump again.

He is doing well, stable, slightly sedated.  Mom and dad are okay - the NICU is strangely familiar...more on that later.

In the past 24-hours we have not had any bowel action as of yet, we will follow up when the surgeon does rounds again tonight to see whether he is ready to be fed or not.  Either way, Chris and I have once again booked into a guest house five minutes away from hospital and surviving just fine on our new undies, toothbrush and socks we acquired yesterday.

Help needed: Baby vitamins

Alright, I realize the "Internets" should be able to answer just about every question I have concerning baby-wellbeing, rearing, clothing, educating, and everything in between.  I have, I believe, however exhausted my own ideas for administering what I am quickly beginning to consider a terrible menace - baby VITAMINS!  Known as 'vomit medicine' according to Luka's new paediatrician in Cape Town, I am amazed that some smart folks in white coats with thick glasses have not yet come up with a better solution than foul tasting, foul smelling liquid vitamins.  From the neon yellow pineapple Australian varietal known as Pentavite to the less fruity South African Vi-Daylin version that more closely resembles molasses in consistency and color.  Either which way, I cannot get Luka to hold down a meaningful amount of the mere 0.6mls he is required to receive daily for the next four months due to his early arrival.

I assume the fact that he is required to take the vitamins and iron, means it is important - hence, my interest in ensuring he actually retains some (most?) of it, some of the time.  Therefore, my request for any special ideas other mommy/doctor/nurse-readers on this blog has come up with for administering.  So far I have tried:

1. Administering it on its own
2. Administering mixed with EBM (Expressed breast milk)
3. Administering on an empty stomach
4. Administering on a full stomach
5. Administering half-way through a feed
6. Using a small syringe
7. Using the dropper that comes with the vitamins
8. Using a bottle (which I was not crazy about, seeing as how we did practice for six weeks how to breast feed, I would prefer we avoid 'nipple confusion' at this point)
9. Administering lying down (not good)
10. Administering at a slight incline
11. Burping frequently during the administration and subsequent feed
12. Not burping

I welcome any clever ideas from anyone that I may be missing...otherwise, I suppose we will just power on.

Marx Family Photos

Luka with his favorite "I want to steal him" godmother,
Marie

Ouma Estelle

Oupa Corrie

Luka turns two months!

Luka in his cute "100% pure Baby" outfit
on 22 May, 2011 - his 2 month birthday
(a gift from Nicole and Phil in Senegal)

hmmmm....

And so, with almost a week left before his due date, Luka celebrated his 2-month birthday on Sunday, 22 May with the Marx family in attendance. Fortunately for him the rapture did not impede on the celebrations, and mommy even managed to complete the challenging Lemon Meringue Pie ordered by Luka's Oupa to double as the birthday cake.*


To try and describe the past two months in a post seems almost impossible, but suffice it to say that in two months Luka has lived on two continents, nearly doubled his weight, applied for two passports, and made two people incredibly proud and happy to be his parents.

With ouma and oupa in the backyard

* The pie combined the Lemon Curd and 3-2-1 Flaky Pie Crust recipes from the book "The Secret of Baking" by Sherry Yard, and the meringue topping from Irma S. Rombauer's 1970's classic edition "The Joy of Cooking"   

A Godmothers' point of view....

.... I guess this will sum it all up for you:  I want to steal him!

We arrived from a freezing cold Johannesburg, to a wonderfully sunny, wind-free Cape Town.  To say that the Serjaks old Toyota Hilux is slow is a complete understatement.  I firmly believe I could've run here faster than it took on the trip from the Airport to Scarborough to meet my Godson.  Yes, I know - the anticipation of the big meeting was making everything seem to take very long.

Next up were the 45 steps from the parking to the house and by this time I could see my sister, carefully concealing a bump under a few meters of fabric.  The photo's don't do Luka justice.  Don't say that I'm biased, I don't care who you are - when you meet him you will agree:  he is the absolutely most incredibly beautiful baby I have ever laid eyes on.  He is one tiny bundle of absolute perfection.  There is not a grunt, fart or dirty diaper that can take any of his perfection away.

The only way I'll ever reclaim my heart will be if I am blessed with my own little bundle of joy one day... until then, my heart is firmly planted in Scarborough - en route to Timor Leste in September.  Have I mentioned that I'll be moving to Timor Leste in September to become a permanent Au Pair?  I'm sure a degree in Human  Resources will have some place in raising a little bundle of joy.

My only criticism is the inconvenience of handing him back to my sister when she needs to breastfeed him - the one thing I haven't managed to take over from her yet.  I am the official nappy-changer, cuddler, comforter and dresser of said little bundle of happiness.  Speaking of which, Grandma has now had enough time with him while I had my shower and as I'm typing this - thus, it is time to say goodbye and re-claim my Godson....

But before I go I have so say something of the wonderful parents that Chris and my sister are.  You would think they have done this a million times!  I've never seen parents that work together as such a team.  The love and joy and security that Luka will grow up to know is absolutely incredible.  There cannot be another baby in this world that has a Parent-Team such as this.  Their love and respect for one another is so incredibly beautiful and inspiring - people should come here for lessons!

I love you guys more than there are words in any vocabulary to explain.... but I must admit - now I love Luka even more than that.... he is (after-all) the product of the love of my two favorite people in the world....

Family

For the past few days, Luka has been playing host to his grandparents and auntie Marie.  He fills the days with grunts, smiles, gurgles, stretches, cuddles and a host of other cute baby tricks.  It is wonderful to watch not only his reaction to the loving family, but perhaps more special is their reaction to him, here are some of the memories thus far....

Luka having one of his twenty daily naps with his auntie...

The show-stopper for the evening, Bathtime!

A cute smile for his Ouma

Quality time with Oupa

Zzzzzz......

At last, Luka meets his Oupa...

...and Peetma (godmother).

The proud Oupa meets his grandson for the first time

On May 18th Oupa Corrie, Ouma Estelle and Godmother Marie made the trek down to Cape Town from Pretoria.  With much anticipation Chris set off on the one-hour journey to the airport.  On the way back Marie reckoned Chris was driving way too slow...unfortunately, for the 20-year old Toyota pick-up, that was as fast as it was going.  The wait was worth it however when they emerged at the top of the 43-stairs (for which my dad still blames Chris every time he visits!), to meet little Luka.

What a precious gift to share with family, and the first grandchild at that...

Marie practically bursting with excitement at finally
meeting the man of the hour.

What's in a month...

In sifting through the multiple camera memory cards I have filled to the brim with our photo-chronicle of Luka's arrival and eight weeks with us thus far, I stumbled across a few ones taken by my mom with her video camera in the Special Care Nursery a month ago...I was amazed at how far we have come.  To see Luka back in the nursery with the tubes, much thinner than his current appearance was really telling of what he has been through.

Luka having an infant massage on 18 April

Luka's 'cares' on 14 April

Hanging out with dad on the 18th of April

"Me time"

For the past seven weeks everyone I have encountered have reminded me how important it is to take time for myself.  Well-wishers from around the world constantly remind me how important it is that I take care of my myself, if I am to effectively take care of Luka.  The old saying "sleep when the baby sleeps" is often found in my inbox these days.  Of course, those who know me also know that I am the world's worst napper.  My mom likes to tell the story of how my parents had to tape black trash bags to the inside of my bedroom windows as a child to fool me into thinking it was night time, in an attempt to get me to nap.

Well, I might not nap, but I have found a wonderful way of spending some quality time doing something else I enjoy..

Take one cozy winter afternoon, worthy of a fire...

 ...add one cooperative little bub...

...then add one of my favorite workout instructors from way back when we lived in Venice, California - Mandy Ingber - purveyor of Yogalosophy  (and perhaps best known as Jennifer Aniston's yogi) and you have...

...'yoga with a view'....

Thanks for all the caring messages from all of you!  

First of many Foodie excursions

We returned to the US Consul General south of Cape Town yesterday to register Luka's 'birth abroad' and apply for his passport.  As these things go of course the registration of birth abroad has to be sent back to Melbourne, Australia - which is the Consulate that covers Darwin.  Once they approve it, they return it to Cape Town from where they can process his passport, all of this of course hopefully in time for me to attend my July graduation at Oxford (so if you know the US Consul General in Melbourne, now would be an excellent time to let me know ;)

After shuttling back and forth between the Consul General and a local pharmacy to have proper US-sized photos taken, and a few back and forths with DHL to determine the best address to send the eventual passport to, we decided to reward ourselves with lunch at one of our new favorite spots, Bistro Sixteen82 the modernist bistro-style restaurant at Steenberg Vineyards.  Enjoying delicacies such as my pink tartare (Norwegian salmon tartare served with chilis and lime), and a Garden salad followed by a delectable dessert, we were inspired by Luka's good behavior, albeit overwhelmed by the attention he attracts.

I admit that I do prefer to stay close to home with him still, but from time to time, when we're already out I figure venturing outside the house is probably good for me, and good training for us.   

Laundry with a View

It has been a mere two weeks since the boys in my house have doubled, and already it is evident that one laundry monster is now two.  In an attempt to save on expensive electricity and the environment I have had to go in search of additional space to hang the ever-multiplying laundry ... so it came that Luka's onesies are now being dried with one of my favorite views in the world.  Somehow I am sure his clothes will smell better for having dried there :) Fresh ocean breeze anyone?

The most special of them all...

In our limited experience as parents, pretty much everything seems amazing at the moment...but hands down one of the most spectacular experiences on earth, has to be waking up and just hanging out in bed with a happy, gurgly, cooing infant...

Ode de Ozzies

While Luka does not technically qualify for anything in Australia, he might as well be an 'Ozzie baby' as so many of my Australian friends suggest, for it was entirely thanks to the incredible, indescribable, and amazing support, care and assistance we have enjoyed from our friends down under.  Now while most of my Australian friends remind me that having been to Darwin does not mean we have actually been to Australia, we feel the need to express our gratitude.

Truly, our whole experience has been profoundly influenced by the hospitality, support, assistance and kindness of Australian friends and strangers alike.  From the ante-natal class we attended in Dili taught by the lovely midwives Rachel and Hayley, to our constant monitoring and regular medical check-ups with the Australian Consular doctor, Nichelle - who in the end was instrumental in getting me evacuated on time to ensure a Darwin-delivery instead of a Dili one. Throughout our experience in Darwin we were met with friendly assistance, offers of help above and beyond, and hardly ever experienced a 'no'.

We were constantly amazed at the graciousness and kindness bestowed on us.  From the moment we landed in Darwin and were waved through customs, to the arrival at the hospital and the care and nurturing we enjoyed form doctors, midwives and nurses.  Add to that Aussies who offered assistance in carrying bags back and forth to Dili, renting homes, carrying car seats around the world, getting in touch with people in the Australian embassy in South Africa, the constable who came to the nursery to endorse Luka's passport application, to the Registrar in Darwin who processed his birth certificate in two days, the hospital photographer who came to photograph Luka for his passport and delivered the photos to the nursery, to the professional photographer who did the beautiful shots of Luka the day we left, to the kind person in accounts who managed my health insurance in the US, my Aussie friend in foreign affairs who laid out immigration and passport requirements, to the lovely parents we met while in the nursery.

We can hardly mention all the people who assisted us, but suffice it to say that we were constantly humbled by the extra mile that most people seemed to go to assist us (my speeding ticket notwithstanding - silly law-abiding nation!).

So, from the bottom of our hearts....to each and every Aussie (and many others residing/working in/around Australia), we cannot thank you enough for your assistance over the long six-weeks. If I ever have another emergency medical event in my life, I can only hope I am somewhere within reach of Oz. 

Aussie, Aussie, Aussie...oi...oi...oi!

Dad-dude type stuff

So while I have been updating the blog and perfecting our breast-feeding skills, what has Chris been up to lately...

Purveyor of homemade chicken stock for all the hearty
soups and stews we have been planning for months...*

Mighty hunter of pesky baboon-folk in the backyard...**

Cuddler extrodinaire for our little man while mommy makes
dinner...

* Yes homemade chicken stock makes all the difference in soups

** No baboons were hurt blogging this

More family!

One of the most rewarding experiences since our unexpected arrival has been sharing him with loved ones, and in particular family.  While our time with family has so far been limited by virtue mostly of travel distances (which to a great extent was the catalyst for this blog), we cherish the ones we've had and eagerly look forward to upcoming visits.  Apart from the wonderful visit by my mom in Darwin, we are excited to see my family (consisting of Oupa Corrie, Ouma Estelle and Godmother Marie) this coming week, and are also in countdown mode for Chris' folks flying out from California in three weeks' time.

It has not all been family-less however, as we welcomed Susan's uncle, and Luka's great-uncle, oom Johann Marx for a quick coffee between a meeting in Stellenbosch and a near-missed flight back to Johannesburg on Friday.  Incidentally Johann was one of the first people to put my mind at ease reminding me that he himself (along with his twin-sister) were also born at seven months, and they seemed to have turned out alright.  He also tells the story of my grandmother convinced she was having twins, only to have the doctor dispel the notion repeatedly.  It was not until after Johann's birth while waiting for the placenta, when, nearly forty minutes later my aunt unexpectedly arrived to which my grandmother reportedly exclaimed to the doctor: "You bloody fool, I told you there were two!"

Never argue with a woman's intuition I suppose!  Thanks for stopping by oom Johann!    

How it all Happened Part II: Preparing for our Preemie

Continued from Part I here...

...as our flight proceeded southbound to Darwin, I was still trying to find some answers for the why, and most importantly, any positives on a prognosis for a baby born at this early of a gestation.  Unfortunately my natural birthing books emphasize the 'normal' in birthing (which is what I loved about it) and less so the 'what can go wrong' bits - so we were stuck worrying and wondering.  Midway through the flight Chris thought it a good idea to request we be let off the plane first when arriving, I quickly grabbed him and told him not to say anything until we were on short-final for fear the pilot might be mandated to turn the plane around if someone was in labor (which of course, we were still praying we weren't).

At the Darwin airport Chris and I disembarked the plane along with an elderly lady with a short connection.  We tried patiently to stay with her and the ground staffer, until we reached the gangplank into the terminal when we sped up our pace.  Armed with nothing but hand luggage and a freshly adhered visa in our passport we stood sheepishly in front of the passport control agent who asked for our arrivals cards.  Of course, we completely forgot to fill them in.  He was about to tell us to step aside and come back when they were complete when I suddenly blurted out "I might be in labor" - I have never seen an immigration officer complete two arrivals cards on behalf of passengers so quickly - within 15 seconds we were stamped and on our way to customs.  Again, they looked at us, I pointed to my belly, and they waved us right through (which is unusual for Australian customs agents!)

In the arrivals hall Chris grabbed cash, I hailed a taxi.  "Darwin hospital please" and off we went...

Sitting in the back of the taxi watching the sites of a foreign city we had only visited once before, go by as the last of the sun starts to dip, I was still praying and tearful, yet survival mode was starting to kick in.  "When should we call our parents, which ones do we wake up?"  I wondered out loud which entrance it was again that my doctor in Dili told me to go to when we pulled up outside the Emergency Entrance of the Royal Darwin Hospital.  At this time my courage sank into my shoes.  Having planned a tranquil all-natural HypnoBirth at my lovely home in Scarborough overlooking the Atlantic ocean, arriving at a state hospital in a strange place, where most of the visitors sat cross-legged on the pavement smoking a variety of legal and illegal substances under the no-smoking signs while drinking beverages from brown paper bags, was not my idea of a good compromise.

We rushed in the door to the window where we were immediately directed to go to the 6th floor.  Ascending the elevator to the 'pink' floor, how could I have known that I would be riding the same elevator for the next six-plus weeks, every single day.  We were slightly surprised that the wards were all behind strict security gates with cameras and buzzers, rather resembling a prison than a hospital.  We proceeded to the 'maternity' ward, where we were sent immediately over to the 'birthing center' to which I objected profusely explaining that 'no one is actually in labor here!'   At the birthing side of things were were shown to a room and interviewed by a young man in slacks and a white shirt with no identification.  He could have been a vacuum salesman for all I know, apart from the stethoscope around his neck.  The conversation centered largely around our family health histories.  We went through the drill of how I felt, what had happened, and what my symptoms were.  He said he would return with the doctor in charge, a young female named Dr. Koh, a more-efficient-than-bed-side-manner-oriented type.   This time the conversation went more along the lines of 'hm, interesting' from her side, to 'excuse me, how bad is it' from mine.

Things quickly progressed to include a vaginal examination and other vital signs being checked.  My world started spinning when she said that I was in fact 1cm dilated and that my cervix had started effacing (or thinning).  To confuse matters more, two separate tests for amniotic fluid came back with conflicting results, so we were still not sure whether or not I was leaking.  She had to leave to attend to another woman in labor and I was left trying to keep things together and remain calm, until we met Dr. Andreas. The nice German  had actually participated in the Tour de Timor the year before and we made some small-talk about the island we lived on. It was when he introduced himself as the pediatrician on duty that I panicked and realized that yes, there is a high possibility now that there is a baby in our very near future.  He was also the first one to explain to us not only the risks involved, but also that should it be the case that we have the baby in the coming hours/days, it is very likely that he/she will have to remain in hospital until the due date - that was almost ten weeks away!

When he left, Chris and I had a few minutes to try and grapple with the reality we were possibly about to become parents.  I started crying again, Chris tried to comfort me and we started making a list of all the questions we needed to ask.  Then we turned our attention to the first matter at hand, birthing this baby, if it turned out to be the case that the Bun was in such a hurry.

As it turns out, Australia, much like the UK, has a very strong midwife culture therefore all the nurses on staff in the birthing center, are also midwives.  Having planned a midwife-only assisted birth in Cape Town, we quickly turned our attention to the young midwife assigned to take care of me after admission.  Not only did she bring us dinner (which, at the RDH at 1900 on a Monday evening consisted of a vending machine sandwich), she also tried to make us as comfortable as possible (which, in a birthing room with a single bed and one chair was not easy).  We immediately started talking to her about the perfect pregnancy we had experienced up until 24-hours before, and the equally perfect birth we had been training and hoping for, and whether or not, in the event I did go into labor, I would be able to have the baby naturally.  She comforted us and said that unless something was wrong (cord, breech, low vitals etc) there should be no reason I could not.

Next up was the small matter of logistics.  Here we were, in a hospital at the far northern side of a town where all the hotels were located in the southern end of town.  We had no friends or family, no reservation, no local phone, no internet access, no car, no place to go.  It was nearly 9pm and I may or may not be in labor.  The most important thing for us was to be together and I could not even bare the thought of staying behind in hospital alone, which is exactly where they wanted to keep me for observation overnight.  So we did what every insured person would do -  inquired about a 'private room'.  (Note: At this point, we did not even know whether my insurance would cover any of this, I mean - does one get pre-approval for this sort of thing? who knew?)  Unfortunately we were told, the maternity ward is completely full, so there was no way Chris could stay.  The midwife must have seen the panic on my face because she promised to try one more thing.  When she returned she informed us that we could spend the night in Birthing Room 6 down the hall, unless at some point, someone actually needed to birth in it.  We thanked her and watched them drag a mattress in for Chris to sleep on the floor. Looking over at the bed, I thought to myself there is no way I am sleeping on a hospital bed, since in my mind, I was not exactly 'sick'.  Instead, we removed the couch cushions and created a makeshift bed on the floor for both of us.

In my haste to pack and make the flight, I managed to pack every book on labor and child birth I could carry, as well as a number of other items like my iPod, camera, and a handful of Balance bars.  What I did not pack, were hospital necessities like pajamas, so in addition to the t-shirt I wore over on the flight, I changed into a pair of Chris' boxer shorts.  At this point we knew we had to let our families know what was going on. Due to the timezones we decided not to wake Chris' family at this time until we knew what was going to happen, but opted to call Susan's dad in South Africa - who, months later, told us that when he saw the phone ring from my Timor number so early on that Tuesday morning, he knew that something was wrong.  We explained to him what was going on and promised to keep them updated along the way, explaining that we were going to spend the night in hospital, but that the midwives were still hopeful that the labor would be delayed thanks to the nifidapine I was receiving.  

The midwives who took care of us that night were in a word, angels.  They dragged a lamp into the room so that they could turn the lights off, encouraging us to get some sleep between the two-hourly vitals checks I was receiving.  So once we had brushed our teeth (I did manage to pack toothbrushes), we curled up in each others arms on the floor of a cold birthing room at the end of the corridor in a hospital in a strange city in a strange country far away from anyone we knew, and everything familiar, and we prayed together that this baby please remain inside of me for a few more weeks, or even days.  Tears ran down my face pretty much permanently at this point as we vowed to each other that we would try and get some sleep because whatever tomorrow might bring, it was bound to be exhausting.  I listened as Chris drifted off to sleep and then turned on my back and resumed praying, the constant stream of tears soaking the pillow behind my ears...

Stay tuned for Part III, our birth. 

Latest baby fashion

Preemie-fashion is rather limited, but for our foray to the new paediatrician in Cape Town Luka pulled all the stop signs for coolest boy on the block...

In a t-shirt from his coolest California girlfriend,
Riley - matched with a fashionable hat, and
stylish hippo-socks...I mean, who doesn't need
hippo socks...

Kangaroo Care 2.0

Now that we are home with Luka, in our familiar environment, finally doing so many of the things we envisioned we would once our baby came - fix-its around the house, enjoying our first cool weather in over a year, and yes, lots of cooking - we can't help but realize Luka is not quite the vital newborn we anticipated two active, fit, and yes, big parents would have.  Instead, we are reminded by Luka, and experts in the field alike, that our little bundle of joy continues to require just that extra bit of attention, sensitivity and patience.

In researching the best ways to nurture and care for Luka, still three-weeks short of his due date, we are reminded of the importance of continuing the skin-to-skin or kangaroo care.  Renowned UCLA paediatrician and child development expert Dr. Harvey Karp, M.D, long-term researcher of colic in infants and subsequent purveyor of The Happiest Baby on the Block: The New Way to Calm Crying and Help Your Newborn Baby Sleep Longer,* argues that babies are really cheated out of a 'fourth trimester' and should therefore really be granted the same level of security, warmth and yes, touch and cuddling as they would normally enjoy in the womb - 'womb service' as he calls it. In his opinion, a newborn undergoes such dramatic development in the first three months of their life, evident in the marked difference between a fussy, crying, jerky newborn and a smiling, cute, engaging three-month old.  In reading this, I am once again reminded that the parents of preemies, even healthy ones, must beware to adjust expectations accordingly.  After all, Dr. Karp suggests that parents of 40-weekers beware and sensitive to the need for a womb-like environment, all the more so for the little ones who are still weeks away from their due date, such as Luka.

Aaah, enters that dreaded notion of spoiling the baby.  This concept so present in our western society where parents who pick up crying infants or otherwise see to their needs are quickly labeled as spoiling the infant.  As if someone that is not yet supposed to even be here has the critical thinking skills to come up with a cause-and-effect equation that favors his desires.  Even advocates for strict routine such as Tracy Hogg agrees that you should not try to treat your preemie as a normal (sic) baby until at least its due date.  Indeed, in her book Secrets of the Baby Whisperer:  How to Calm, Connect and Communicate with your Baby she claims that this is the only type of baby that should be allowed to demand feed and enjoy constant cuddling  What is interesting is that Dr. Karp  argues that even the term baby should be nurtured and not subjected to a strict routine until four months.

In our day-to-day dealings with Luka, and in getting to know his likes and dislikes, despite his amazing progress, it is still evident that he not simply wants, but needs closeness, warmth, security and yes, noisiness of the womb. To best accomplish this, we carry him in one of the many pouches we were gifted by our friends and family.  The lovely thing about these pouches are not only the comfort, but that the meters of fabric negates the need for wearing a shirt, and since Luka is only in a nappy, I figure that drastically cuts down on laundry!

Thanks to everyone who has sent us pouches, Amy & Darren, Rita, and Leana.  We really appreciate it, as does Luka!

Luka smiling from inside the organic "Sleepy Wrap"

* Also see Dr. Karp's website:  The Happiest Baby on the Block at: www.happiestbaby.com

Another passport application

In completing the online US passport application for Luka this morning, I couldn't help but think it was a least a little funny to use the same application for infants and adults alike.

Name Provided: LUKA MARTIN SERJAK 
Date Of Birth: 03/22/2011 
Place Of Birth: DARWIN, AUS 
Social Security Number: 000-00-0000 - definitely does not have this yet.
Sex: Male 
Height: 1FT. 6IN. - and growing by the day...
Hair Color: Blonde - for the time being
Eye Color: Blue - like every other infant
Occupation: INFANT - I still think'lactation engineer'  has a better ring to it...
Married: NO  - Does an arranged marriage agreement count?



We're off to the paediatrician and US Consulate today.  Let's see how much the little guy grew in the past week!  More soon.

My essential childbirth reading list...

Many of my expecting friends who know about my penchant for thoroughly researching everything I attempt have asked me for a reading list of books I found useful during my pregnancy, and particularly with the birthing process, I have been meaning to share this much sooner - but alas, everything going on kept me from posting this until now, I hope that it will at least be somewhat helpful to some of you.

Disclaimer - Chris and I decided early on that we wanted a very particular kind of birthing experience and subsequently focused our research on preparing for that particular experience. In no way do I imply that one way is better than another, rather I believe and hope that every woman should have the birthing experience that she wants.

Our approach...
Around the seventeenth week in the pregnancy, Chris and I finally came to terms with the whole idea that we were in fact pregnant.  I had obviously read some of the required pregnancy reading, none of which I found immensely interesting or useful, most of which I did not finish.  Instead, around this time in the pregnancy, I realized that these 'required readings'  spent way too much time on the pregnancy part, and not nearly enough time on the actual birthing process, except it seemed to discuss all that could go wrong.  This intrigued me, since it seemed that for a generally healthy, educated, non-smoking, logical person - that part kind of takes care of itself, and beyond the 'week-by-week' comparisons to beans and eventually fruits, there was little useful information you could not find with a quick Google search if you needed to. Instead, I started wondering about the decisions we make concerning the birth itself.

After my initial readings on pregnancy and childbirth I became fascinated with the negative connotation surrounding 'labor' and birth. Particularly what concerned me was the overwhelming fear associated with it.  Seemed to me that something that is so part of the natural life cycle, should not be as terrifying as the movies and other popular culture has made it out to be. Add to that the fact that the tight grip of private health care means that women were often not even given the option of a natural child birth, rather the whole process was being treated as some sort of medical intervention instead of the natural part of the life cycle that it is.  So I started reading and doing intense research on why and where this fear came from.  From there I re-focused my own research and preparation on reading texts I found presented childbirth in a positive light, as an intimate experience for mother, baby and birthing partner alike, instead of so many of the books that make it out to be some perverse and unnecessary act that would leave your beloved body forever altered and dignity in tatters. Through my readings I realized that what I was really after was a fear-free (note, not pain free)  'Active Birth' (one that allows the mother to move about freely, eat, use a birthing ball, shower, bath - whatever feels good - as opposed to a more medically-prescribed birth lying on the back on a hospital bed tied to monitors and other devices, watched by hordes of medical staff).

Further down the research process, I discovered HypnoBirthing by chance during an online search and after discussing my initial interest with Chris, I contacted the instructor in the Western Cape who came and did a home-class for Chris and I in January. I was admittedly skeptical, I mean Hypno-anything, we're yuppies not hippies for heavens' sake.  And if I was skeptical, imagine my logically-minded, scientifically-orientated beloved.  We decided to at least give it a go, and to see where it lead.  Without exaggeration, within the scope of 48-hours I had left my own fear of  'labor' behind in lieu of actually looking forward to the birthing process.  And yes, I can honestly say that it works.  I loved my birth and wished that I could do it again.  (More on this in the 'how it happened' installment to follow...)

So without further ado, books I found particularly useful during my preparation include:

1. Active Birth: A new approach to giving birth naturally  - Janet Balaskas  - If you are considering a natural birth, I suggest reading this book first. It is approachable, more up to date than some of the older texts, and presents many useful tips on how to approach the experience including preparation for, and what to expect during birth.  She shares helpful tips on practicalities such as positions and natural pain relief.  Mostly she discusses the reasons for, philosophy for going this route.  
2. Spiritual Midwifery - Ina May Gaskin - A classic must-read for a midwife-led natural childbirth.  It is a more dated text but critical to help us understand what a midwife is, and I particularly appreciated the personal accounts of child birth to get a sense of what you can expect, and how it can be done.  If you can read beyond some of the old colloquialisms like the constant use of 'lady' to refer to the women in the book, look beyond the fact that all those in the book did in fact live in homes that could move around, and stop giggling at the circa 1970s hairstyles and fashion, then this book, even only in part, will open your eyes to the way in which childbirth can be a bonding experience for both mother and partner.   The book has some good photographs and other art to prepare you and your partner, and also a complete guide to DIY childbirth at the back, should you find yourself in the unfortunate position of having to do this yourself on that Memorial Day camping trip in your 34th week. 
3. HypnoBirthing: The Mongan Method, A natural approach to a safe, easier, comfortable birthing - Marie Mongan - The book, along with the training workshops, will introduce you to the notion of using deep relaxation techniques during the birthing process.  But moreover, it presents childbirth in a positive, (dare I say, enjoyable) light, as something to look forward to, and prepare for, instead of fear, dread and wish away.  Perhaps the most important contribution of this approach is the importance of the birthing partner as an advocate, supporter and part of the process.  (I saw this first-hand in Chris' active participation in Luka's birth in Darwin).  The use of affirmations and visualization is of particular importance as a technique currently used by almost every professional athlete in their own preparation for a winning performance.  The book is accompanied by a CD that contains a deep-relaxation (meditation-type) track and one with birthing affirmations (which I listened to on my daily exercise walks and incidentally used during my entire birthing in March). Perhaps not for everybody, but if you truly want a natural, un-medicated birth and (dare I say) enjoy it, I highly recommend at least trying it.  I am sure you can read the book and listen to the disc, but we found the course immensely helpful in allaying many of our fears about childbirth.  I have pretty strong views and thoughts on how HypnoBirthing helped me during my unexpected pre-term labor with Luka who came ten-weeks early. If you are pregnant and would like to chat about it, I'd be happy to give you my two cents - just drop a comment and let me know.
4. The Mama Bamba Way: The Power and Pleasure of Natural Childbirth - Robyn Sheldon - This book by Cape Town midwife, this book is a more spiritual approach to the birthing process.  Drawing on both ancient traditions and with a heavy focus on women's innate wisdom and ability to accomplish a comfortable birth, this book also does wonders to allay the inherent fear factor surrounding child birth.  A tad on the spiritual side for me in the beginning (with Chakras and other things I am not that familiar with), but in the end a good read for the personal accounts and reaffirmations of the innate ability of a woman to birth the baby inside her (without unnecessary medical interventions).

Other books I had ordered and looked forward to reading during my final weeks of pregnancy, but never did because of Luka's pressing need to arrive in time for mothers' day include: 

1. The Birth Partner, Third Edition: A Complete Guide to Childbirth for Dads, Doulas, and All Other Labor Companions
2. The Baby Catcher: Chronicles of a Modern Midwife

The books contained in this list helped me to accomplish the birth that I really wanted.  Again, this is not to say that this is the right way, or that my way is better, rather that this is the way that I wanted to, and was fortunate enough to, experience birth.  I wish every woman the right and privilege of birthing her baby the way in which she wants to, however that may be.  I only wish we were not so pre-programmed to be afraid of this wonderfully empowering experience.