July highlights: baby Victoria, an unexpected diagnosis, Elizabeth at 19 months, & family reunion

 1) Baby Victoria Anne is here! you can read her full birth story here. she arrived at 5:18 PM on the Fourth of July, and we are all absolutely smitten. she is four weeks old today. as I've experienced with now all four of my girls, time is such an elusive concept in the newborn stage. on the one hand, it seems she can't possibly already be almost a month old, while on the other, I can't imagine a time that she wasn't a part of our family. 

one of the things I treasure most about this postpartum time is the opportunity to visit with friends and family. I'm so grateful for their support and thoughtfulness in bringing meals and spending time together -- it's nourishing for both body and soul!

Vin and Susan brought us a delicious meal featuring pork belly and pork tenderloin (we had corn on the cob and salad too, but we probably could have all used a bottle or two of Lipitor!)

unbelievably delicious

ladies' night with my best girls (not pictured: pizza and wine!)

photo and cooking credit go to Amelia, who brought me a big batch of this flavorful and filling Moroccan chicken stew. out of the many bowls I have eaten, I never managed to take my own picture because I inhaled it too fast. 

2) A diagnosis of hip dysplasia. this certainly isn't a "highlight" in the positive sense of the word, although it's definitely a blessing that it was identified so soon. at Victoria's one week well check, the pediatrician took a very long time examining her hips. in retrospect, I realized that at the four day weight check, she had also manipulated Victoria's hips more deliberately than usual, but she hadn't said anything at the time so I didn't think much of it. this time, the doctor told us that Victoria's hips were "snapping". as she explained, this often corrects itself as the supporting ligaments get stronger, but she gave us an order for a hip ultrasound to have done in 6 weeks. 

a few hours later, the doctor called my cell. "I just spoke with my husband, who is a pediatric orthopedic surgeon, and he would like to examine Victoria within one week's time. I will give you the number for his secretary and she will get you on his schedule." certainly not the call I was expecting, but I was relieved to getting an expert opinion right away. still, whenever I moved Victoria's legs to dress her or change her diaper, I didn't notice anything out of the ordinary, so I wasn't too concerned. 

the secretary was very kind and scheduled us to come in before the orthopedist's normal clinic day started on a Tuesday, when Victoria was exactly two weeks old. Cecilia wanted to come along with me, while Nick stayed home with Elizabeth (who happened to be scheduled for her own slightly delayed 18 month well visit with the pediatrician later that morning -- we assumed I'd be back in time to take her, but that turned out to be wrong!). our appointment was scheduled at Children's Hospital. I planned to arrive early, as common courtesy but especially since Victoria would be a new patient and also since he was doing us a favor squeezing us into his schedule. well, there was a huge backup getting into the parking garage, and by the time we actually parked and got up to the registration desk, it was just a few minutes before the appointment time. registration itself took at least ten minutes as I was instructed to check in at the kiosk, which went through about twenty-five screens of information and then gave me an error message and said to go back to the desk to register. from there, we were sent to a different registration desk with a live human who was very kind and got us officially checked in (but it still took her a good five minutes of typing to do so). 

after all that, I fully expected the orthopedist to come in, examine Victoria's hips, and send us on our way with an assurance that her hips were within the normal range for newborn joint laxity. instead, he manipulated her hips several times, and then very calmly said, "her left hip is dislocated." I almost fell over. he then showed me how easily her left hip slid in and out of the socket, and explained, "when my wife told me about her, she said her right hip has a 'click' and her left hip has a 'clunk'. a 'click' is okay. a 'clunk' is never okay." he reassured me that Victoria doesn't have any pain, but she needs to be treated right away for the best long-term outcome. 

essentially, developmental hip dysplasia is a relatively common condition occurring in up to 2% of female babies where the hip socket is flatter than normal and thus cannot securely hug the top of the femur (thigh bone) to create a stable joint. it's more common in first born children, females, and babies that were breech during pregnancy. only the second criteria applies to Victoria. if untreated, this can lead to early arthritis and chronic hip pain necessitating surgery. when it's caught this early, treatment involves wearing a soft brace called a Pavlik harness. at this stage, Victoria needs to wear the harness around the clock -- it cannot even be removed for bathing. 

I had done enough preliminary research about hip dysplasia prior to the appointment to know that the Pavlik harness was the standard of care, but I was surprised once again by the doctor's efficiency. he wanted to fit her with the harness right then, but the smallest harness they had in the office was still too big for six-pound Victoria. however, one of their satellite offices did have a preemie size harness, so one of his staff members drove over the other office and back (45 minutes round trip) so that the doctor could adjust the fit on Victoria himself. while she was gone, Cecilia, Victoria and I walked down to the hospital cafeteria for a breakfast snack. I texted Nick an update and asked if he could go ahead and take Elizabeth to her appointment since I wouldn't be back in time. meanwhile, the orthopedist called his wife, the pediatrician, to let her know she was right to suspect something was amiss.  

watching Victoria be fitted in the tiny whole body harness, my heart broke a little -- but she didn't even cry, and I did feel better seeing how soft the harness is and how she can still kick her tiny legs (although her left leg doesn't have much range of motion as it's held up much tighter than the right). I spent that entire afternoon on Google and UpToDate, researching how to change a diaper in the harness (it takes some dexterity to thread the diaper tabs through the back straps!), how to swaddle safely (her Halo sleepsacks are loose enough now, but I did order a few wide based Love to Dream swaddles that are specifically made for the harness), how to clean the harness if it gets soiled (we've had a few spit-up incidences, thankfully nothing more than that!), how to identify problems related to the harness   and on and on. the information overload reminded me of how I felt as a first-time parent where every question led to ten more questions. 

at the orthopedist's office, before he adjusted the straps to keep her left hip flexed up and out

I had to finagle her back into this outfit to come home from the appointment; I couldn't help but think she looks like a thalidomide baby!

now, two weeks later, the harness has become second nature. Victoria can't wear sleepers or pants, but fortunately she has lots of cute onesies and I ordered long socks to keep her legs warm if need be. every day, I check her neck, shoulders, groin, and the back of her knees for skin irritation or breakdown (since she has limited movement) and so far everything looks good! the orthopedist couldn't give me a prediction of how long she will need to be in the harness, but we go for a follow up appointment and an ultrasound later this week, so I'm hoping for more information based on that appointment. everything I have read leads me to believe she will be in the harness at least for two or three months, so we'll see! 

3) Elizabeth at 19 months. she is at such an interesting age, learning new words and tricks almost every day. her antics alternately delight us and drive us to the brink of insanity ;) she loves to unload the dishwasher, which is actually helpful as long as the dishes are clean. she is such a good big sister to Victoria, and loves reading to her numerous baby dolls. (this very morning, she woke up during Victoria's midnight feeding, and spent twenty minutes rocking her baby dolls, tucking them under a blanket, saying "shh shh" and "okay, okay" to them before she went back to sleep herself!) she runs to the door and says "eh go!" (let's go) anytime someone else is getting ready to leave. she frequently takes off her shirt and asks for "ep pee" (help please) when one of her arms inevitably gets "suck" (stuck). just in the last few days she has started pronouncing "uh oh" correctly instead of saying "up oh" and I am not okay with that. she loves singing and doing the motions to Twinkle Twinkle, Itsy Bitsy Spider, and Row Row Your Boat. she's still sleeping in her crib in our room, and for the most part sleeps right through Victoria's middle-of-the-night wake times; she naps typically from noon to 3 or 1 pm to 4 pm. when I notice her looking tired, I'll ask her if she wants to go upstairs for her binky and most of the time she says "yeah", runs for the stairs and says "up" as she climbs each one. it's amazing to me how much they understand at this age even if they can't articulate it fully! 

sister's carseat makes the perfect reading nook!

the oldest big sister and the youngest big sister!

looking particularly Beethoven-esque

I was in the other room and heard her shout "hep! hep!" only to discover her "stuck" in the couch ...

4) Will family reunion. for the past few years, we've gathered in the small town where Nick's extended family has lived for years. we were the fifth generation to be married in the beautiful brick church on the hill! it's always so good to spend time together, especially for the girls to see their second cousins. the weather was absolutely gorgeous, so after sharing a potluck meal inside the church hall, we sat outside and visited while the kids played on the playground. Victoria was just shy of three weeks old and did great on the ninety-minute drive out. the drive back got a bit hair-raising with both Victoria and Elizabeth wailing for the last fifteen minutes, but at that point we were so close to home it just made sense to power through. God bless Greta who was sitting between them and used all of her big sister tricks to help them calm down!

photos from Sabrina!

beautiful Aunt Teresa and Elizabeth!

she couldn't be happier!