Happy Birthday, Ella Jane!

With Ella's birthday 2 weeks after Sara's, I knew that I wouldn't be up for a mom-intensive party. Ella wanted a Frozen party (surprise, surprise) so we called in the big guns. Elsa and Anna. These princesses saved the day. They sang songs, read stories, made snow (real snow, mom. It almost melts.), gave out stickers and did glitter tattoos. They were the best.  We also played "Don't eat Olaf" which the kids loved. The game didn't make a ton of sense to me, but the kids loved it. It's all about knowing your audience, I suppose.

I had great plans to take each girl's picture with Elsa and Anna, print it out, and take it home in a foam picture frame that they had decorated. But of course, our printer decided to wig out and not print properly, so all the photos looked like they had a crazy 70s filter on them. 

It was short and sweet and a fun party. Anna is already planning her Frozen birthday party!

Sara Elizabeth Packer

The birth story. For the books.

I had my 39 week OB visit on Wednesday August 13th. After 2 weeks of being dilated to a 1 didn't expect much, so I was pleasantly surprised to have progressed to a 3.  Dr. Gravelle stripped my membranes and said she expected I would deliver within the week. 

After a day of getting things done (oil changed, pedicure, buying food for Ella's school lunches in case I wasn't home for the first day of school) I started to have contractions in the evening. They were fairly regular, every 10 minutes of so, and after some hemming and hawing I decided this might be the real deal (or maybe it's not! I don't know!) and around 10 pm I called my mom. She came down and we all settled in for the night. The contractions were still consistent but they weren't getting stronger. But it was enough that I couldn't sleep. Around midnight they started getting a little stronger and more painful. I downloaded an app to track them and they were fairly consistent. Around 3 am I decided it was go time and started to get ready to go to the hospital. I packed my bag, combed my hair, brushed my teeth and was ready. But before waking up Ryan and my mom I decided to lay down and time them again to make sure they were still close together. And just like that, nothing. They completely stopped. So I went to bed and slept for a few hours until the girls woke me up at 7. After a bit I realized that I wasn't feeling the baby move. I couldn't decide if this was the norm and for the morning time or if it was something to worry about. I called my friend Amber (who is an OB) to get her opinion. At this point I was starting to feel a little crazy because I wasn't sure if I should go it, if I wanted to go in, if I was being dramatic, if I was being negligent... I was so glad when Amber gently chastised me for not going in the night before and told me to go to the hospital. Yes. Direction. So  Ryan and I packed our bags, left the girls with Grandma Sue and headed to the hospital.

Screen shots of the app I used to monitor my contractions.

As we pulled into the parking lot of IMC 40 minutes later the baby started kicking and moving all over the place. Of course she did. But since we were already there, and since Amber told me to (again, thank you Amber!!) we checked in. They did a non-stress test, and baby's heart rate was a-okay. Then they did an ultrasound to check the amniotic fluid level. It was a 4 (normal is 8-18) so she checked again. This time she got a 5, so she went to see what Dr. Gravelle wanted to do. At this point I was really hoping to be admitted and induced.  My mom was already with the kids, Ella started school in 5 days, this would be an easy birthday to remember (8-14-14)...and above all I would stop having to figure out if I was in labor or not! When the nurse came back and told me that it was a go I was thrilled.

There were 21 deliveries at IMC that day (which is a lot for them) so things were a little slow to get started. But once they gave me a whiff of pitocin, my body responded and the contractions started coming. After about an hour or so, around 1:00 pm I asked for the epidural. They were busy, so it took a little while for them to come. After he was done the Anesthesiologist told me that he was about to go into a c-section, so if the epidural wasn't working I needed to tell him within the next 10 minutes. It worked beautifully except for a 3 inch circle on my left lower abdomen. I couldn't feel a thing anywhere else, but in that circle I could feel the full force of the contraction. The nurse had me lay on my left side to try and coax the medication down, and I think given more time it may have worked. But because of the pending c-section I had them call the Anesthesiologist back. He re-dosed me, and very quickly the circle of pain dissipated. But the increased medication made it so that (once again!) the epidural was too strong and I couldn't feel a thing or move my legs. It is such a weird feeling to see your bent knees flop down if they aren't supported and not be able to do a thing about it.

Things kept progressing quickly. Around 2 the nurse checked me, and I was dilated to a 6. She checked again at the end of her assessment (about 20 minutes later), and by that time I was a 9! The contractions continued, although I was blissfully unaware of them because of the epidural. Dr. Gravelle came in around 3:30 (maybe--I'm really not sure) and it was go time. It was frustrating to push but not be able to feel anything, but everything seemed to be going well. But when the head was coming out things started to get a little concerning. I wasn't totally sure what was going on, but fairly quickly the room filled up with people and when I saw the NICU team was there I knew that there was an issue. Dr. Gravelle told me that the baby's heart rate had dropped to the 50s, and "we can either do a c-section or get aggressive with forceps." I told her to do whatever she needed to, but I was fine with forceps. She worked quickly and after a few pushes (and a lot of tearing) we had a baby (3:51 pm was the official time). She did great and I was so relieved to hear her cry. Although I was never really that worried. Dr. Gravelle did a great job. When they weighed her we were shocked to find out how big she was--8 lbs 4 ounces and 20.5 inches.

The baby was a little worse for wear, and her eyes were puffy and swollen and she had some forceps marks on her. She wasn't our cutest baby--but with a little time the swelling went down and she looked much better.




She was a fairly good baby. She nursed well, and slept relatively well. I had good nurses and overall the hospital experience was great.

With Ella and Anna we had their names mostly picked out before they were born. But we really had no clue what this little one was to be called. I made a list of possibilities the day before, and none of them really jumped out. I loved the name Jane, but we used it for Ella's middle name. I still thought it might be okay, but Ryan thought it would be weird. Ryan and I spent an afternoon going through various websites trying to narrow it down with little success. At the end he said that maybe Jane would work. I jumped on it and started calling her Jane Elizabeth. But I wasn't 100% certain, so we didn't fill out the birth certificate. Once we got home I realized that it wasn't going to work. Ryan would call for "Ella Jane" and I would address the baby as Jane and it was just weird. So we (I--Ryan really left it up to me) tried out Elizabeth. But it just was such a mouthful for me. And I didn't love any of the nicknames. Not knowing her name was really stressing me out. I would lie awake at night pondering it. I kept coming back to the name Sara, even though it wasn't one of my initial favorites. But it started to grow on me, and pretty soon I was calling her Sara Elizabeth. The girls weren't so sure, and they called her Abby for a few days. But I felt really good about it, and a little over a week after she was born I made it Instagram official.

Lobster and Lightbulbs

Less than 2 years after moving in, all six of the lightbulbs in our living room have burned out. Not that big of a deal, except that our ceilings are crazy tall and changing them is no easy task. Brett offered to come over with his 16 foot ladder and help us out. Ryan was in Boston yesterday and brought home a couple of live lobster, so we decided to make a night of it. Lobster and lightbulbs.  None of us were lobster experts, so Ryan printed off instruction sheets for each of us on how to crack it open. We all decided that next time maybe we should just go to Boston and have someone extract the meat for us. 

Thanks, Jess and Brett for the fun times and for bringing light back into our living room!

Testing out the waters. We used a light bulb changing pole as well.

Disneyland, 2014

After spending half of our Hawaii trip in the hospital or stressed out, we thought it would be fun to do a make-up trip with the kids. Where else to go but the happiest place on earth? We tried to find the week that would be the least crowded (after Spring Breaks, but before school let out) and off we went.

We had a great time. Although it started of with a little glitch. We had decided that it would be worth the money to get a room with a kitchen in it so that we could have more control over Ella's food. We ordered groceries online, had them delivered to the hotel, and were ready to go. Until we got to our room and realized it was a two bedroom suite, but the suite part only had a sitting room, no kitchen. When we talked to the manager we found that there had been some miscommunication and not only had we not booked a kitchen, but there were none to be had. After some discussion, Disney really showed their commitment to making things right (or to not getting sued by the parents of a Diabetic child...still not sure of their motives) by giving us our room at a discounted rate and covering all of our food during the trip! As much as I wanted to avoid the breakfast buffet, you can't argue with free, and the girls LOVED being able to eat with the characters. So score 1 for Disney. 

Ella's favorite ride was still Splash Mountain. Anna liked the tea cups. Being pregnant made it easy to decide who was going to go with Ella and who would stay with Anna on any of the exciting rides. Ryan and Janet were the thrill seekers and Anna and I scoped out the characters. We were disappointed in how busy it was. I think that even though it was an "off" week, the fact that some big rides (Pirates, Small World, Indiana Jones, Grizzly Rapids) were closed made the other attractions more crowded. But we did have amazing weather. We had debated going the second to last week in May, but settled on the last week. Good choice. The week before we came the temps hit high 90s every day. We had high 60s to low 80s. Thank you California. 

Disney really is a racket, but you can't help but being enthralled when you are there with a 3 and a 5-year old. Even not really being Disney people, we were this close to buying a season pass. Thanks Janet for joining in on the fun, and thanks Disney for bringing the magic. 

Anna bug

With all of the hullaballoo of Ella's diagnosis, Anna has been ever so slightly neglected. Starting with her birthday 'party.' I made a cake, but we were still new to counting carbs and it was quite the process to weigh out each ingredient for the cake, calculate how many carbs were in the entire thing, weigh Ella's piece and then calculate out how many carbs she was getting. I think we sang to her...honestly can't remember. Good thing Anna was just excited about the tiara on the cake and didn't notice much.

Another milestone in this little one's life came with her first visit to the dentist. He took one look at her teeth and asked if she was a binky lover. Yes she is. She only gets it when she is in her bed, which made bedtime and naptime a breeze. She happily would lie in her bed with her binkie. But the dentist said it was pushing her teeth and no more binkies for her. Amazingly, that was that. She listened to him and took it at face value. No more binky. She never asked for it, fussed about it or complained. But now there was no incentive to go to bed, and naptime/bedtime turned into a whole different ballgame. What was once an easy 1 minute routine turned into an hour (at least) ordeal. And the decreased sleep, combined with having a sister who had quite a bit of attention focused on her, combined with being 3, made our Anna bug not quite as sweet as she once was. Thankfully she has turned a corner recently and the meltdowns are fewer and further between. But we had a rough few months. 

One of the things she does lately that cracks me up is add the word "silly" to the end of her sentences that are directed at you. Like, "Mom, give me some more milk, silly!" Or "Mom. I need a ______, silly!" She does it so naturally that even though it is a bit rude, it is so funny it almost always makes me laugh.

Anna loves her big sister, and wants to do everything like her. I'll ask her what she wants for breakfast, or how where she wants to sit, or if she wants cheese on her sandwich, and typically the answer is "What did Ella choose?" 

I love this video of Anna figuring out "this little piggy..." The first few times she tried she did it perfectly, and as soon as I tried to video her she forgot it all. 

Hawaii, 2014 (part 3)

We got back from the hospital late Wednesday afternoon. We were all still a little shell-shocked, but Ella wanted to go to the beach, so to the beach we went. As she ran around laughing and splashing, I was amazed that already I could see a difference in her. The sparkle in her eyes was back. I hadn't noticed it was gone, but as we thought back we realized she had been difficult lately. Ryan had described her as a moody teenager, and one day she said to me, "Mom, Sometimes I try to have day where I don't whine, cry or fuss AT ALL. And then I cry and think, 'Maybe tomorrow's the day." Broke my heart when I realized that many of the times she was whiney or fussy she was just high or low. And the first night when she conked out after eating a cheeseburger, mac and cheese and fries...? It wasn't jet lag, it was a meal filled with carbs! Seeing her so, so happy made the whole diabetes pill a little easier to swallow. I felt badly for the my mom and dad who were 3,000 miles away, and didn't have Ella's newfound smile to comfort them.

While being in Hawaii when Ella was diagnosed had its perks (a shorter hospital stay, lots of distractions for her, grandparents right there) eating all of our meals at restaurants without nutritional information was challenging to say the least. Trying to guess how many carbs she was eating was really tough. Especially at the breakfast buffet. The first day we let her have whatever she wanted (if we're being honest she pretty much got whatever she wanted from the moment of her diagnosis until we went home) and her plate had something like 2 strawberries, 3 blueberries, 2 pieces of pineapple,1 small pancake, a mini yogurt, 1 piece of bacon, half a box of cereal, 1 pastry and a glass of juice. Ryan and I broke out our iPhones with various carb counting apps and tried to piece it all together. The next day I did insist that she could only choose 3 items.

This is how we looked during most meals

Ryan, Doug and I had planned on going on a helicopter tour on Thursday, but I didn't feel like I could leave Ella so Ryan and Doug went and Ella and I had a girls' day. We went to the spa and got pedicures. Ella picked out 10 different colors for her toes. Pretty cute. We had a good day hanging out at the beach and pool. Ella played, made new friends and hardly put up a fuss when she needed any diabetic cares. In fact, she started checking her own sugar and getting the insulin ready. We were all amazed at how well she handled it. She really was a rock-star.

By Thursday night we weren't quite as overwhelmed as we had been, and we were starting to enjoy Hawaii. We seriously considered extending our vacation. Ryan talked to Delta, and they couldn't have been nicer or more accommodating. But we had a hard time finding a great place to stay, and we were still not sure if it was a good idea for me to manage her diabetes without input from an endocrinologist. It was a close call, but in the end we decided to leave Friday as planned.

Ella brought a camera on this trip, and took most of our pictures. Here are a few...

Ryan brought his new helicopter, and it was a welcome distraction. He and the girls had fun flying it all over. Inevitably, multiple people would come up and want to know what it was all about. 

Many of Doug's colleague's at the conference brought Ella gifts. The Hawaiian paper dolls were a favorite.

On Friday we spent some time at the beach, and then packed up. We had some time between dropping Doug and Janet off at the airport and when our flight left, so we ate dinner and visited the Kona temple. One of the temple workers came out to greet us. He looked like a native Hawaiian, so we were surprised to find out that he was from Pleasant Grove, Utah (about 10 miles from us) and was returning home the next week. Small world.

The flight home went relatively well. We took the red-eye, and Ella slept through all of her glucose checks and insulin injections. I was fairly nervous about it all, but we made it without a hitch.

supplies

girls trying to sleep at LAX

Grandma Sue and Grandpa Paul were dying to see Ella with their own eyes and make sure she was okay. They were at our house waiting for us with groceries when we got home. I had told my mom that she was going to be shocked at how happy and spunky Ella was. I didn't take into account the toll that traveling all night would have on her, and she acted like a tired, somewhat cranky 5-year-old, leaving my mom a little doubtful that Ella was doing as well as I had said. But by Sunday she was doing great, and my mom came back down so she could see it and believe it.


All in all I felt incredibly blessed and taken care of during this week. On Wednesday night, after being back in our hotel room, I jotted down a few of the things I was grateful for so I wouldn't forget them. Here's the list I made:

Tender mercies

I am not having a baby right now* 
It was raining, so we had down time to get the labs drawn. Also, since we weren't doing anything I took a nap, which was helpful when I didn't sleep much in the hospital
Dr. Garvey was able to direct us to the lab, and change the order to stat 
Dr. Lee trained at PCMC and we knew the same people, giving me instant credibility
Not flying to Honolulu
Nurses named Penny and Sue
Pokey the flamingo who was able to help Ella cope
The kind night nurses
When Ella's sugar dropped from high 200s to 196 so we didn't have to poke her at 3 am. I prayed specifically that it would be below 200, even though the trend would suggest she had one more above 200.
Going home today
Finding string cheese sticks that she could eat without a poke
The sun coming out so we could go to the beach.
Doug and Janet being here and loving her.
Ella coping so incredibly well with the shots.
My peace and comfort.

*we had been trying to get pregnant for about a year, and if things had happened as I had hoped I would have been very very pregnant or taking care of a newborn during this time

It's funny how kids have a different perspective. Now when we talk about our trip, most of what the girls talk about are scenes like this one...playing on the beach, picking shells, swimming at the pool.  Mahalo, Hawaii, for being amazing enough to overshadow our little rough patch! We'll be back :)

Hawaii, 2014 (part 2)

Our second day was kind of rainy, so we skipped out on our plans to go on a 4-wheeling adventure. Ryan and I were sharing a room with the girls, and in those close quarters I had noticed that Ella was always asking for water and woke up a few times during the night to go to the bathroom. We had recently had her well-child visit, and she had only gained a few ounces in a year. I thought the worried Pediatrician was probably getting the better of me, but the idea of her having diabetes crossed my mind more than once. I knew I was going to continue to worry about it for the rest of the trip, and we weren't doing anything that day anyway, so I called the hotel doctor (who knew such a thing existed!) and arranged for a lab to check her urine for glucose. Throughout the 14 years I've been in medicine, there have been many times when I've worried that I (or a loved one) have some crazy disease, and it always turns out fine. So I wasn't that worried. But I did have a dream the night before that we had Ella tested and it came back positive. So I was a little on edge. But not enough to keep me from taking a long nap in the hotel after we came back from the lab.

Around 3 pm, the hotel doctor called me back to let me know that Ella's urine had 1000+ glucose in it. I immediately knew what this meant--she had Type 1 diabetes. I was alone in our room when I found out, and went across the hall to Doug and Janet's room to let everyone know. I started to break down a little as I envisioned Ella's (and our) future. One filled with carb counting, glucose checks, insulin and careful monitoring of food intake. Ryan helped bring me back to the present--one in which my little girl did not need a weepy mother. Ryan gave Ella a sweet blessing, but I was still a little overwhelmed to really hear what he said. Janet remembers him saying that Ella would grow up to be healthy and happy. I packed a bag, and Doug and Ryan and I left for the hospital. Janet stayed with Anna, which was a gift--trying to keep her entertained would have made things much harder.

On the way to the hospital I called my dad and let him know what was happening. He was at Temple Square at the time (he is in the mission presidency of the Temple Square mission) and before we even left the hotel I got these texts: "Her name is on the prayer roll at all SLC and Bountiful temples. I love you all" (from my mom) and "She has 200 sister missionaries praying for her in 45 languages" (from my dad). I truly felt those prayers. From that time forward, I was amazingly fine. I felt peace and comfort. I was able to focus on Ella in the moment, and not worry about what this diagnosis meant for the future.

First IV

So glad we brought Charlie and the Chocolate Factory. Nothing like some Oompa Loompa's to keep your mind off of things 

We drove the 45 minutes to the Waiemea hospital and went through the ER. Her sugar was 415 (even though she hadn't eaten anything for hours), which confirmed the diagnosis. The ER was great and awful. The nurses (Sue and Penny--how about that!) were wonderful, but it was there that Ella realized we had to spend the night in the hospital. Up until then she thought she was getting checked out and going back to the hotel. She lost it. Crying, wailing, so so sad. Then she found out she had to get an IV, an insulin shot and her glucose checked. Not fun times. Our saving grace was a stuffed pink flamingo they gave her. I dubbed him "Pokey" and we decided that whatever they did to Ella she got to do to Pokey first. It worked like a charm, and from then on she did much much better.

Pokey

We waited on labs for a while to decide whether or not we could stay on the Big Island or had to fly to Honolulu. Thankfully we caught it early enough and Ella was not in DKA so they let us stay. I think it helped that the Pediatrician in Waiemea did her residency at Primary Children's, and we knew all of the same people. She knew I was well-trained, and trusted (rightly or wrongly!!) that I would be able to take care of Ella without getting the full 3 days of parent training. The hospital at Waiemea had a rule that minors needed to be in a room with a window  and all such rooms were full. The next best alternative was a room in the ICU. Our bed was awful (self inflating and deflating all night long) but at least the nurses were attentive!

Dad and Grandpa brought gifts--crayons, coloring books, etc.

The next day we met with the dietician and waited for our doctor to come and send us home. I called the people at Primary Children's and they gave me a mini-refresher course in diabetes care and set us up with education when we got back home. Ryan had gone back to the hotel the night before, and away from Ella the reality of it hit him hard. I don't think he slept a wink. He was dying to come back to the hospital, but had to wait for Anna to wake up and get ready, and of course she slept in. But by noon we had seen our doctor, gotten our prescriptions are were ready to high-tail it out of there.

My "notes"

This is one of Ella's favorite pictures :)

Hospital grounds. It rained the entire time we were there, and cleared up as we were leaving.