Wednesday, April 27, 2011

"Putting" the Baby

“PUTTING THE BABY”

What is it with our culture that has led us to believe we should prop the baby somewhere, somehow and then run for our independence or sleep? I see this a lot in the field I am in. I am a lactation consultant by trade; a mother by six sons. Human babies are “holding” mammals. They thrive on skin to skin contact, they stabilize their body temperature according to mom’s, they regulate their heart rate in the same way. Babies curl up into a mom’s breast after they feed and fall into a blissful sleep and often have a small smile on their faces. Mom’s thrive along with babies from this continuous contact as well. I often think back to the kind of deep sleep I fell into often following breastfeeding while lying down. I don’t believe I have ever slept that deeply since.

I am not a dreamer and I am not unrealistic. I am a multi-tasker with the best of the lot. I never really enjoyed trimming my Christmas tree with one arm while I held the baby with the other. Typing with one hand is less than efficient. Cooking is extremely challenging. Tying the older kid’s shoes is completely frustrating. And going to the bathroom is an always exception to the rule. But, it was only for a period of time and hey, I got really creative.

I remember early on when I was on kiddo number two perhaps, watching a good friend of mine “putting the baby.” Her baby was about six months old and had just begun sitting up on her own. So, mom would put the baby down on the floor, sit her up right and surround her with the latest Fisher Price toys. Then, this mom would take off like a jet for the kitchen or another room, away from baby. Within a very short time, baby would start to cry, so mom would run in and throw more toys in the pile and baby would cry again. Then, more toys and more crying, and well, you get the picture. I never got it. I always wondered why she didn’t just pick the baby up and carry her as she begged for. While I wondered this, I seemed to always have a baby on my hip

Unfortunately, I was a baby sling failure. I don’t know why. I was a La Leche League diehard and even a leader for some time. Most LLL babies were comfortably cozy in their Maya wrap ring slings. These are made of Guatemalan fabric and give any mom and instant “hippie-granola-mama” style. At the time, I could never figure out what one would do with all that extra fabric and how to use one. I did take a stab at a front pouch for awhile and I did wear a Snugli for a time until I felt that I would faint away from the heat. But, I never really got hooked on these baby carriers that in retrospect, would have been very helpful. I wish I had and now, often recommend them.

But, here’s my current concern. Swaddling. I was at a lactation conference a few years ago when I first saw this very busy booth in the exhibit hall. It was Dr. Harvey Karp and he was promoting his new video, his new swaddle wraps and books. I stood and watched the video and alarms went off in my head as I thought, “something is not right about this.” Swaddling has been broadly embraced. There are hospital nurses who are known for their ability to turn a newborn into an instant burrito, whose swaddling techniques are revered by all. They take that baby and turn it into one inatimate object. Perspective parents are taught swaddling technique in childbirth classes. A good swaddling looks very much like a strait jacket. It has all baby’s limbs tightly tucked inside, with only a head peeking out. The baby cannot move a muscle and it seems to me that this would feel horribly restrictive.

Recently at another conference I attended, I listened to a presentation on the negative aspects of this now common practice. In order to add impact to her talk, the presenter, a well- known author, bound several audience volunteers in scarves and wraps so that their arms were immobilized tightly against their body. These women eventually began to shift in their seats and after awhile, some even began a slight rocking movement. They looked flushed and sweaty and in time, some requested to be unbound in a panicky voice. They all reported hating being bound. Perhaps babies do too.

Worst of all, is the danger to these precious newborns. It seems the goal is to ‘trick the baby” into feeling like he is still in the womb! Swaddling raises body heat. It also restricts hands and arms making it impossible to touch one’s face or to signal with hunger cues. Babies actually sleep through feedings and fail to gain weight appropriately, often resulting in supplementation with formula and bottles. It is a slippery slope and often, a downward spiral from there. But, here the key word is always, “sleep.” If something makes babies sleep longer, this is key and it makes nearly anything, marketable.

What is it with our obsession with getting babies to sleep as long as possible? I know new moms and dads are tired. Oh, they are truly more tired than they have ever been in their lives including those all -nighters they pulled back in college. But, a healthy newborn is NOT supposed to sleep deeply and IS supposed to awaken frequently to eat and to remember at the very least, to breathe. It is NOT healthy or safe for newborn to sleep so soundly and so deeply that they do not awaken regularly, or the unspeakable, not awaken at all.

So, enough with the swaddling. Let’s take off these infant strait jackets and keep baby close by. When he lays down to sleep, you do so as well. Carry him much of the time and let a sling help you do that job. Keep his body temperature cool, as you do yours and let him flail his arms around to his heart’s content. And “no putting” your baby. He wants to be with you, to watch you do all the mundane things you do in a day,that he finds completely fascinating. There’s no running away from him anyway. He is yours forever and madly in love with the very scent and sound and feel of you. Embrace him. The payback to you is huge. I promise.

Thursday, April 14, 2011

Mother Mary Can You Help Me? Help my Son?

My son, Peter, the Chronic Lyme sufferer, is now in what he says is "the worse pain he has ever felt in his entire life." He cannot sleep, he can barely eat, and writhes in bed all day and night. He cannot stand it much longer despite the 42 meds per day that he swallows. Those are in addition to his PICC line administered IV mega-antibiotics and intramuscular shots of morphine with still, no relief. I cannot stand this much longer either. I am sick with the yearning, the begging, the pleading with Jesus Christ at the very least, for relief for my son. Mary, Mary, you know. I know you know. Can you help, short of death, or is that the only distance you know for pain and suffering? I have already given up one son. I cannot lose another.

What is it I need to do? What do I need to not do? What do I need to know? What am I missing? I pray so hard that my teeth clench. I went to the Lenten series last night at my new high falutin’ church with soul. I sat, I kneeled, I buried my face in my hands. I listened to the heartfelt music, some hymns, some more modern sweetness and one rendition of that angelic girl in the heart wrenching movie, In America, singing, “Desperado.” It made me cry once again. If everyone wasn’t so perfectly dressed and coifed in that church, I might have considered (for more than a moment), throwing myself on the marble floor and wailing, sobbing, and begging out loud for God’s mercy on my son. I try different words in my prayers. I try bartering. I try being firm and I try allowing my weakest self to beg shamelessly. My son gets worse instead of better. God, can you not hear me? I am screaming? So many are praying. Still, still, still. Help me, help me, help me.... as Anne Lamott would pray.

Yesterday -- I stared at my son sitting in the medical office for his exam to qualify for disability. I cringed with sadness at his unwashed hair, his messy clothes, his emaciated body that was once that of a star athlete - captain of every high school sports team. I stare at him, mostly in disbelief, wondering how on earth he could have gotten to this limp, devastated state at 26 years old. How, how, how?

Today --changing meds, changing pain killers at the direction of a seemingly very smart pain specialist, invites some withdrawal into the picture. That makes the pain worse while getting off the high doses of opiates switching to lower doses of methadone which one can only increase at a slow and safe rate. She says, “I can’t increase the methadone faster because I could kill you.” I wince. Adding more sleep meds now, the doc suggests we “listen at night to be sure he isn’t having sleep apneas. Check for deep snoring, or irregular breathing. Get a baby monitor and take shifts with your husband to be sure your son is breathing.” Great. I am already barely sleeping. I am in that constant, itchy, someone-please-rip-my-skin-off state. I now need to listen for breathing patterns. My son mentions that this will drive his mother crazy. “She is your mother. That is what mother’s do.” Doesn't every mother have a breaking point or are we made of something other than normal blood and guts?

Which is worse? Being in searing relentless physical pain yourself or watching your child, the one you love with all your heart and soul, in that pain? Has anyone ever answered that question? Mother Mary come to me, bringing words of wisdom, let it be.

Monday, April 4, 2011

ST PATRICK’S DAY 2011 AT THE NURSING HOME

I am wearing my green shirt, my shamrock scarf, and my green striped socks but I always have some mixed feelings on St. Patrick’s Day. It has been many, many years since my days in New York having the time of my life. I would start out by attending the parade and despite it being mid-March, it was always freezing and some years, it even snowed.. Just watching the parade offered an incredible sense of pride (probably misplaced) It was a thin space moment when you felt all was well with the world and moreover, all was well within thine own self. You are okay, simply because you are Irish, wearing a “Kiss Me I’m Irish” button, and feeling connected to this group of happy people. Following the parade, my friends and I would hit the New York bars choosing carefully to find the ones serving free corned beef and cabbage, green beer and sometimes, green bagels. We hung around drinking and dancing and kissing Irishmen, feeling like we were at our peak. Perhaps, we were.

It is different now. For starters, a North Carolina St. Patrick’s Day is a tad tamer, albeit a lot more enthusiastic than it was when I first moved here 18 years ago. I am older, I have a large family and have experienced enough of life’s dings and dents to have lost the unbridled joy of my youth. I was a pretty Irish-American lass then, I am an older, wrinkled, doughy, Irish mother of six now. My freckles have turned to age spots; my healthy, shiny, chestnut hair is gray and despite being dyed, is dull. And, 14 years ago, my quintessential Irish father, Walter Joseph Conlon took his last breath on St. Patrick’s Day in his green shirt at the Wellington Nursing Facility in Knightdale, North Carolina. His last meal was pureed corned beef and cabbage.

Over the years, I have had so many thoughts about this nursing facility that I have never written about but wish I had. It had a profound impact on my perception of the elderly and how we care for them. It piqued my curiosity of the residents and who they had been, how they ended up there, who the workers were and why they work there. I was deeply sad following most visits and I sat in my car crying in the parking lot more often than not. I tried hard to glean wisdom and sometimes I did. In my endless pursuit for someone old and wise to share some life changing words, I never give up searching. Often I thought, it would be helpful if each resident had a resume taped onto their backs so I could see the lives they had lived, no longer being able to share that, and not really finding anyone interested anyway.

My father died in the Wellington following four wretched years there, where he steadily lost weight, his voice, his teeth, his ability to respond, and lost his entire self. There was a sense of relief for him and for us. I was never happy that he was there. When we were moving south from New York, my brother in law came to North Carolina and chose this place for my father. It was brand new (which was a good thing), but, it was far from where we lived, which was not so good. However, I managed almost weekly visits at first, and then longer stretches of time ensued in between visits as I cared for my three boys and a baby. When I wasn’t there, I felt guilty all the time; when I was there I felt heartsick. There were all those meetings discussing how to keep him fed, how to keep him clean, how to unlock his stiffened joints and legs resulting from Parkinson’s Disease. When we visited, I would put my baby, Gregory in my dad’s lap, strap them both in Dad’s wheelchair and take them outside. Then, I would get some ice cream for each of them, desperately trying to bring a moment of pleasure. Because my father’s disease rendered him unable to communicate and his dementia left him somewhere else, I had no idea how I was doing in my mission to bring him some joy.

In 1995, when my two year old son, Gregory drowned in New York, I came back to North Carolina bereft beyond description. I drove to the nursing home, crawled into the narrow bed in which my father slept and wept uncontrollably in his stiffened arms. Tears rolled down his face though he was unable to say a word. I wrapped his arms around me and laid there crying for some time, saying, “Daddy, Daddy, Daddy…”. In October of 1996, when I passed the boards to become an International Board Certified Lactation Consultant, I brought my father my certificate and again, tears rolled down his face. But, overall, we had little communication during those years. The Wellington struggled to keep staff, to serve food that was acceptable, to feed those who needed feeding, clean the bodies of most residents unable to do so for themselves and meet state standards. Much of the time, they barely made the grade. The constant turnover of staff and administration was of concern, but typical.

My father had a roommate named, Joe Kirk who was as Southern as could be. Joe took to caring for my dad and watching what he ate to prevent him from choking. Despite his low level intelligence, Joe could manage to practically run the Wellington. He had a badge and was often paged over the loudspeaker, which made him feel very vital. The activities director was a true Southerner as well, named, Petra. She was born and bred for this position and brought immense joy and laughter to the mostly miserable residents. She kissed them and danced with them, took them to parades and to shop and made them feel quite important. My father loved her and she loved him and she always made a big fuss over his having been the very first resident in the building. She kissed him right on the lips whenever she saw him. He liked that. She always described my dad as being a real “baseball fanatic.” This was odd news to my sister and me since we had never seen my father the least bit interested in baseball!

When Petra got married, she did so in the day room of the Wellington, with Joe Kirk walking her down the aisle. Then, Joe fell in love with fellow resident, Elizabeth and another wedding was held followed by the two of them taking a joint residence in a room called, “The Honeymoon Suite.” The hallways were decked with photos of various events rigged by Petra and there was always something going on. When my father died, Petra held a memorial service in the day room, followed by the announcement that half the building would now be known as “Conlon Village” in honor of my father having been the first resident and a plaque on the wall with his picture declared this as well. My sister and I were honored and touched. We were honored again, several years later, when the town had a ceremony commemorating the tenth anniversary of the Wellington and we were given an engraved memento with my father’s name.

And so, it became an annual tradition for me to visit the Wellington every St. Patrick’s Day in honor and memory of my dad. I would place a green carnation on his plaque, hug and visit with Petra and bring her soda bread and shamrocks. I would bring my baby boy twins each year and she would ooh and aah and it was always sweet. Then, my rounds of visits with residents would begin though mostly with folks I never knew. But, I would stick my head in room after room, and say, “Hey, Happy St. Patrick’s Day to you. How are you doing?” The responses were mostly polite and southern and noncommital. Some years were more difficult than others, and as the twins grew, they disliked going more and more. Nevertheless, I kept going and took them along, feeling like this too, is a part of life that should not be ignored.

We were most disappointed when Petra left two years ago. We considered no longer returning because of that. After all, Ms. Levinia who asked why Gregory’s wrists were so fat and if they had threads tied on them, had died. Adelaide who wore a lot of jewelry and smiled all the time, said she never married because her hands were gnarled so no one would marry her. She was dead now too despite me carrying on each year about how beautiful she AND her jewelry were. She loved that and beamed. Very sadly, Joe whose Southern accent was so thick I could mostly not understand him, died too. Joe’s bride, Elizabeth was hovering at death’s door last year, so I can only imagine where she is now. Rose Parks who was the resident president, died in her sleep.

So, today, I ask myself, “Who in their right mind, would go to visit a very depressing nursing home, where they know no one, where there are sad memories, where the smell can be so disgusting that it often makes me gag?” The pallor of the patients, the hepatic look to their skin, the blackened flesh where blood is pooling under skin, the mouths hanging open, eyes sealed shut, depraved howls shouted out. Who subjects themselves to that? Some go and sing Christmas carols, but who goes in March? However, off I went and in the front door, there was Frieda answering phones. She too, has been there since opening but I have never been quite sure why… completely lucid and youngish, it seems she has no use of her left side and is wheelchair bound, but surely there must have been a better place to have lived her life. My husband used to know her daughter when they were both in real estate. Frieda says she always wakes up on St. Patrick’s Day and thinks, “Well, Walter’s daughter will be here today.” Sure enough, I show up. I always ask her how her daughter is doing and she says she is fine and today reported that she had just been there in the morning and shaved Frieda’s legs! “Huh?” I said. “You shave your legs???” “Oh yes, honey, been shaving them since I was ten years old.”

So, in and out of rooms I go. The smell today was the worst ever and the fecal odor was almost to the point where I felt I would need to leave. The dwarf woman was still in her room with her tiny walker, miniature chair and low to the floor bed. She seemed about the same, though a bit more grouchy. I met Lulabelle who told me she lived on a farm in Wendell, NC and didn’t understand why people went so many places. She said she had been happy to not need to go anywhere her whole life and to just stay put. “Oh, these poor girls who work here. They work so hard. I feel so sorry for them all.” she said. I asked her, “Wait a minute, how old are you?” “89 years old” she said. “And you mean to tell me you are so glad you never traveled, never went anywhere, never saw a thing other than your farm? How is that possible?” “You got that right, young lady,” she said.

Laverna seemed attractive to me with a sharp haircut of white shiny hair so I began speaking to her. Even in old, old age, we are still attracted to the most attractive, aren’t we? Laverna had traveled, EVERYWHERE and was proud of it, so she told me quite a bit. Her photos of world travel were taped to her walls. She was lucid and grateful but said that her 95 year old husband could not take care of her anymore, which is why she ended up here. But, they could only afford for one of them to be a resident. Oh my. She seemed so smart and I asked her what she had done for a living, guessing that she had been a teacher. “Oh no, she said, “I had the most exciting job.” “Really, I asked, what did you do?” “I was an Avon lady for 15 years!” she exclaimed. When I asked her more specific questions about her son or relatives though, she would say, “I’ll have to get back to you on that.” She also said that her roommate, Mabel is totally vegetative, does not know anything and is fed three times a day by feeding tube. “I dread getting like that,” Laverna said. “Oh, but I am in her mama’s bed now,” she said. I asked what she meant. “Mabel and her mama were roommates here, but, now her mama died at 103, so just Mabel is left.” Okay, then.

Frieda found me wandering the halls and said, “Don’t you want to see Wayne?” “Okay,” I said, wondering who Wayne was. “He was here when your daddy was here.” The putrid smell of ammonia was so acrid in Wayne’s room that I found myself literally holding my breath which made it hard to converse. I complimented Wayne on his Harley Davidson bed covers and left the room in the midst of Wayne telling me he could no longer see. He too though, had such a thick Southern drawl that between the stench and that, I could barely follow what he was saying. I felt guilty for leaving, but it was not possible to stay a moment longer.

I asked a large woman in a super sized wheelchair if she was okay and she said, “Well I am, but my roommate here is dying from cancer.” I went to the bedside of this woman with a huge tumor on her forehead, bent over to listen to her whispering voice, but suddenly found that I could not possibly bear the smell coming from her mouth. Isn’t that awful? I had to leave her and felt absolutely terrible for being quite so shallow. Why couldn’t I have stood it for awhile? She looked terrified.

It was shortly after that, when I found my way to the front door, sat in my car stunned, asking myself over and over what the point of my visit was? I had once again seen the abysmal way to live the final years of one’s life. I had not garnered any real wisdom. I had that smell in my nose and in my head that I knew I would not be able to shake off for some time. Perhaps, I felt young and energetic though and maybe that is worth feeling once in awhile, albeit at others’ expense. Maybe, I brought a spark here or there to someone’s day. I’d like to think that I honored my father and that he knew I was there. His plaque has disappeared mysteriously and NO ONE knows what happened to it. But, I will tell you this, when I got to beautiful Oakwood Cemetery, the historical cemetery in Raleigh, the sun was shining, birds were chirping and my father laid in the earth in peace with his sharp looking military gravestone. It seemed like a much better place.


Ann Conlon-Smith, March 17, 2011