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Learning and trying to be kind and living my life as fully as I can stand it.

Tuesday, March 31, 2015

Recognition

I'm not a nurse but I play one one TV, I used to say. Or I'd reference my fake RN degree. A decade into my organ donation career I was more than familiar with certain lab values and vitals signs. Blood pressure, heart rate, oxygen saturation. I knew just enough to be dangerous, to myself. I'd seen patients like my son before. . .but they were dead patients who went on to be organ donors. To my eye he met all the signs and I started to be afraid that they just weren't telling us what they already knew.

Dopamine. Dobutamine. Epinephrine. These were some of the drugs streaming into his little body through needle-thin IV lines. I recognized these drugs as donor drugs--the ones that kept a heart beating and the blood pumping after the brain and the body were capable of maintaining these basic systems on their own. (Note: these drugs are also very normal drugs to give to sick patients in the ICU--so don't start diagnosing on your own please)

When I was an ICU patient my family started keeping a detailed notebook of all the things the doctors and nurses said, as well as all of my vital signs and important labs. This ended up saving my life at one point when my mom used it to question a decision a new doctor almost made and kept them from giving me massive steroids when I turned out to have an infection. It can be helpful as a non-medical person in a hospital environment to write things down. It's harder than you think to remember--you're under stress, things change quickly, you don't totally understand everything people are telling you. There are also a lot of shift changes in a hospital stay--nurses changing every eight to twelve hours, doctors changing at night and then every couple days or weeks. They strive for continuity of care and give one another detailed reports but everyone is different and has a different styles of care so it's good to be your own advocate and pay attention --the patient and the patient's family are one of the few constants.

I tried to do the same--starting writing down Cyrus' vital signs each time we went to the NICU. Looked up at that fucking monitor and transferred all the green and white numbers into a little journal. I did it a few times and then, back in my room after a NICU visit, I sat on my single hospital bed, shoulders hunched, looking down on those scribbles and I knew this could not continue. I had started to hear the name of my company,  the donor network, whispered in the unit. At least I thought I heard it. I was convinced that we, the donor people, were following my son as a potential donor. Writing down his numbers was like being at work, jotting down a referred patient's vitals as we tracked them to see how they trended. It was filling me with fear and a sickness in my belly. I even logged into our database looking for his name. More than once.

In that moment I became a mother. I think they were two or three days old. As I sat there on my bed I realized that the only thing I could do, the best thing I could do, was love that baby with all my heart. Pour my love into him, even if it broke me open and left me unable to recover.

The thing was, I felt him in there. In his body. As the doctors grew graver about how little he was responding, how motionless he was, I held my hand on his little body and I knew my son was alive. Not just hanging on to life but alive, in there, working hard.

There were many times in my career where we worked with families to come to terms with the fact that their son or daughter, father or wife, was dead. Yes, we'd explain. They look alive because the machines are breathing for them. Brain death is actual, legal death. When the doctors do their exams and write those notes, that time of death written in the chart is the person's actual time of death even though he is still laying in bed, chest rising and falling, skin warm. Some people tell us they knew the moment their loved one left their body. They'd say they knew he or she wasn't there anymore. Other people could not accept it. Did not believe it.

I thought of those families with so much more understanding. As I stood by my son's bed, talking to him, singing to him, feeling his warmth, feeling his spirit under my hand, I wondered if it was just the strength of my hope that was telling me he was ok.

I called my friend Nikole and told her I needed her to come. Nikole is a doctor--a transplant surgeon. She is also the medical director of the organ procurement organization I worked for at the time. She is also a mother of twins--they were two months old at that time Lily and Cyrus were born.

"I need you to come look at him and tell me what it going on. I need you to talk to the doctors and look at his vitals and tell me what happened and what is happening. I know too much and not enough."

So she came.


Monday, March 30, 2015

there was a little girl and a little boy

It took two hours for the doctors to come see us. The Benadryl they gave me for the itching made me sleepy and mellow. I didn't feel like a mom. Was I afraid? I can't really remember. I was in a state of waiting and the drugs and numbness definitely helped with that. When the doctor finally came it was a woman we hadn't met yet: another perinatologist. She started updating us, saying your daughter this, and your daughter that. . .she asked us if they had names and then switched to Lily is doing this and Lily is doing that.

That's when I got really scared. What is happening with my son? Why are you not telling us anything about Cyrus?

Things were not looking good for Cyrus. He was very sick--the sickest baby they had. His lungs had been full of blood when he was born and he wasn't breathing. He hadn't taken any breaths on his own before they intubated him and hooked him up to the ventilator. He was on lots of medication to keep his blood pressure up--without it his pressure had been very, very low. Very low. He might have had a seizure but they weren't sure. They weren't sure what was going to happen with him. We couldn't see him yet.

She told me that he was probably the reason I'd gone into labor. That if he had been born any later he would most likely have been stillborn. Somehow the mother's body knows what the baby needs and what that baby needed was to come out.

I'm not sure how long after that I saw them. Did my husband see them first? I can't remember. I know we had to wait until I could feel my legs and, even then, I was pushed in a wheel chair. Pushed through a set of automated double-doors and into the NICU for the first time. Our babies were on the right side of the room, towards the front. There were one or two babies we passed to get to them. Cribs and incubators lined the large rectangular room. There were sinks, monitors, nurses, rolling chairs, nursing screens, blankets, hospital gowns, shelves, lights, soap, diapers, wipes, thermometers, drawers, doctors, posters. Was it quiet or loud? I don't remember. Someone wheeled me up to the two incubators and there I met our babies. I did not recognize them at all. I did not feel a swell of love at the sight of them. I stared hard--at Lily's long, skinny body. Her teeny, tiny fingers. Her tiny chest. Her little head covered in minky hair. Her tiny diaper. At Cyrus.

I actually don't know if what I remember is seeing him for the first time or what I'm remembering is the next few days. He had a tube down his throat and a little mask holding it into place. He had his head wrapped up to cover the wires monitoring his brain activity. They had the oscillator going--can't remember what that was for. The nurses told us how swollen he was but we didn't see that--we didn't know what he was supposed to look like.

I went to him and, when I was allowed to, I cupped his feet with one hand and held my other hand above his head, not touching him where the wires were. He had an IV in his bellybutton. He was so beautiful and so still. NICU babies are so sensitive that they are not to be stroked--if you touch them it is better to not move your hands because the touch overstimulates their skin and they need all their energy to grow and heal. I didn't rub or stroke them but I would sometimes hold one hand lightly on his chest and belly. One hand practically covered him there. I felt him in there and I would sing or stand quietly, touching him and pouring hope and love into him.

One morning I walked to the NICU alone--my husband was still sleeping. It must have been the day after they were born. It was really early in the morning. I was up, pumping the tiny bit of colostrum my breasts were producing and using a syringe to pull out every precious drop from the pump parts. At some point we counted the steps from my room to the NICU but I can't remember the number. One hundred and fifty maybe? You walked through the quiet halls, quiet except for the healthy cries of the full-term babies sleeping in their bassinets in their mothers' rooms. You got to the double doors and picked up a phone hanging on the wall. That buzzed the clerk inside who then let you into the hallway. From there you passed through another door into the NICU itself. That morning I got buzzed in and they saw it was me right about the time I saw that Cyrus' bed was surrounded by doctors and nurses. "You can't come in right now!" someone told me. I stood there, looking in the window at all those professionals hustling over my boy and I started to weep. Someone eventually came and stood next to me, not saying anything. No one looked at me or talked to me. It was so scary and so lonely. And I knew I was not going anywhere because if my son was going to die I was going to stand there and be there when it happened.

He didn't die.

He was so very sick. I found that I could hardly look at Lily. Luckily my husband would go straight to her and talk to her, change her, hold her feet in his hands. I was afraid that Cyrus would die and that I would not know how to mother her in the wake of losing her brother.


Once upon a time. . .

My two older children were born in San Francisco. As a third generation City girl this appealed to me but the real reason behind it was that I was seen by a high-risk obstetrician who worked at California Pacific Medical Center. I have a complicated medical history and that, plus a twin, IVF pregnancy put me square in the category of high-risk for premature labor. Even though we were living in Martinez at the time it didn't seem too crazy to drive into San Francisco for all of my appointments. . .and there were a lot of them. My liver doctor is there. My gastroenterologist is there. Now my OB was there so I was getting all my ultrasounds there. When I was diagnosed with low iron I got two iron infusions there, alongside roomfuls of cancer patients getting chemo. Talk about a strange dynamic. My perinatologist was there--the woman who greeted me at our first appointment with "Oh, I've been waiting to meet you! Laurie called me at the grocery store to tell me about you and once I looked at your chart I couldn't wait to meet you."

Um. Thanks? For doctors who like a challenge I was looking like one sexy patient.

I never really worried about having the babies early, despite all the anxieties of the doctors. My OB always erred on the side of caution and she had me do every test, every extra ultra-sound. She always whirled into my room like a hurricane, thoughts flying, words speeding out of her mouth. We didn't talk much about my labor because she always seemed to be shushing me like, yeah yeah we'll get to that. She was a woman who got what she wanted and more than once I was shoe-horned into last minute, i.e. non-existent, holes in peoples' schedules where I was greeted with poorly hidden rolling of the eyes as if to say "Here we go again". I was always fine. This doctor was like a highly strung master musician. She checked my cervix at every appointment and would stare off into the distance and they tell me something felt off. Off to ultrasound I would go where the tech and then the doctor would assure me that everything was fine.

At the end of May I saw her and she examined me, attuned to her fingers like an artist. "Something is not right," she said. "These babies are coming soon." The next doctor agreed that my cervix was shortening, a sign of labor coming soon. Not right away, though. Come back next week. I went back next week, June 6th, and had three doctors appointments before lunch time. An appointment where they strapped me up to a monitor to check for contractions (they call it a non-stress test). No contractions. An appointment for an ultrasound to check the length of my cervix. That doctor told me things still seemed slightly strange but that I could come back the following week to check in. He debated giving me a shot of steroids to strengthen the babies' lungs but worried that the timing wasn't right and he didn't want to give it too soon. And finally a visit to my hepatologist, my liver doctor. Can't even remember why I went to see her. A regular check-up perhaps. All fine, see you later.

My cousin and I had lunch together and then she went to the opera with a friend while I drove myself home. I sat down to watch TV and my water broke shortly after.

I texted my husband that I thought my water had broken. What?!? he said. I think I'm ok I said. Maybe I should go get checked out but I think it's fine. We discussed driving down the hill to the local county hospital but I called my OB's office where the nurse told me to come to our hospital in the city. My husband was home by that point, around six in the evening I think. He packed up in a hurry, trying to decide whether or not to put the car seats in the car, trying to decide what baby stuff we needed. We brought the car seats, just in case. Just in case what? I was two days shy of 32 weeks pregnant. Full term is 38-40 weeks. If we had these babies we would not be taking them home any time soon.

My contractions started on the drive to San Francisco. My cell phone rang--it was the Berkeley Rep Theater calling to ask if I wanted to renew my season ticket subscription. I tried to get off the phone quickly but the guy wasn't paying attention. I finally said something like "I'm in labor" but I think he must have ignored me, thinking that wasn't possibly what I could have meant. The sky was so beautiful over the Bay. So, so glowingly gorgeous. Tranquil.

By the time we were pulling off Octavia the contractions were coming hard and fast. We timed them and there were about two minutes apart. I was having a hard time concentrating on giving directions--we'd never even been to the hospital together so he didn't know where it was. Even as we glanced at one another, thinking the contractions were pretty close together and thinking that might mean. . . no, I still didn't think those babies were coming that day. No way.

We pulled up in front of the hospital, on California Street. I waddled quickly up the brick stairs only to discover the front door was locked because it was after hours. I huffed in frustration and came back down, following signs taking me around the corner to the ER entrance on Cherry Street. I almost barreled into a couple rounding the corner but they quickly drew apart to let me pass. It was like being in a movie. I think my husband was parking? I can't remember. He must have been. He came to meet me in the chairs outside triage. As we waited I urgently needed to find a bathroom. I ran down the hallway and locked myself in, convulsively throwing up and well let's say emptying everything in every way. Eww, gross. As I sat on the bathroom floor, head on the toilet, heaving, I let the knowledge that these babies were most likely coming that night sink in.

Our triage nurse was awful. I don't think she really had a clue of what was happening. She couldn't get an IV in. She kept us there forever--at least an hour, maybe more. She kept asking us the same questions over and over again and both of us wanted to smack her. We finally got sent upstairs, me in a wheelchair. I kept throwing up, over and over. The contractions were strong. I felt panicky, like if I could just get a second to catch my breath I could actually do this but the puking kept happening and the contractions kept happening. Fast, hard. I hate throwing up.

More of the same questions, more people in and out of the room. I was crying at that point, though still seriously considering how to answer the question "On a scale of 1-10 how much pain are you in?" We hadn't called my parents or my sister yet--didn't want to worry anyone too early. The doctor came in, not my doctor. The on-call doctor--a tall, gentle-faced, gentle-voiced Asian man in his 50's or 60's.

"Ok, let's see how we can keep these babies in," he said calmly as he gloved up to examine me. He put his fingers inside me and took them out almost right away. "No, we can't keep them in. You're 5cm dilated. We need to take them out."

No one asked if we wanted a C-section. No one said they were worried about the babies so I'm not sure why we immediately went to the OR for a C-section. It didn't occur to me to ask or to lobby for a vaginal delivery. We did what they said. I was still throwing up every few minutes. I wanted to rip the monitors off of my belly because they felt suffocating. "Call my mom," I said to my husband. He did and went to put scrubs on to join me in the OR.

I wanted to marry the anesthesiologist. He sat me up and tried to get me to hold still and stop puking for a second so he could stick a needled into my spine for the spinal block. It worked quickly and the relief was so intense that I seriously wanted to hug him. Except I couldn't move very much. As they lowered me onto the table and set me up I mentally observed how the feeling in my legs drained away. My friend Nikole had recently described her C-section to me so I felt prepared and was interested to compare how I was feeling to what she said. I don't think I felt scared--not that I remember. I'm at home in the operating room--I've been in there many times, as a patient and for work. It's cold but it's familiar. They drew the blue sterile paper drape up so I couldn't look down and see him cut into my belly. And then, one after another, our babies arrived.

Lily, Baby A or as we called her "Steak Baby" because she always kicked after I ate steak, came first. We didn't know she was a girl until the anesthesiologist told us. It took her a few seconds to cry but then I heard her. They came and showed her to me--tiny, bright red, unrecognizable--and then took her away to clean her up and check her out.

A few minutes later Cyrus arrived. Before they got him out I felt lots of pressure, lots of pushing on my belly to get him out. The anesthesiologist exclaimed "You've got one of each! It's a boy." We smiled. But he didn't cry. I'm not sure how long it took me to get concerned--not long. I noted the different tone in the room. The quiet, anxious scrambling. And no crying. They didn't bring him up to see me but took him to the incubator to my left, a team of people huddling over him. I turned my head to the side and could see him. Limp. Tiny. Pale. Still no crying. A doctor finally came up to me, not the OB. He quickly and calmly introduced himself as one of the perinatologists. Your son is very sick. We need to take him out of her so we can take care of him. Ok, I said. And they took him away.

I got sewed up. They wheeled me out into the hallway and there were my parents, looking so relieved to see me. I kept going, into Recovery. The babies were gone. My all-over body itching was back, even though I couldn't feel my legs at all. Was I scared? I don't remember. I can't call up anything about how I was feeling right then, except for itchy and kind of stoned. Stunned. I know we named the babies in the OR but as I write this I can't remember or imagine when that would have been. After Cyrus came out, our Ice Cream baby who spent much of the pregnancy shoved up under my ribs by his sister. But he wasn't in there very long and they were working fast so who asked us for names and when? I don't know. My husband and I looked at each other, suddenly parents, and raised our eyebrows at one another like, are we really sure? Are we really ready to name these people who we weren't ready to have met yet? The enormity of speaking two names out loud for the first time, of naming people, sunk in but yes, we were ready.

Lily Helena and Cyrus Wilder. They had arrived. Eight weeks early. Our first NICU experience had begun.

Thursday, March 26, 2015

Frog Park

My brain actually goes blank when the relief of all babies being quiet in their beds sinks in. It's just. . .I have yet to find the words to describe the quality of such a silence. It vibrates. It's as though the rest that each of them is unfolding into somehow latches onto my skin and spreads to cover me, muffle me in cotton. No one is touching me. They are all getting what they need. I am alone which I really need to be.

I don't know how long I have because the Bigs aren't really taking a morning nap these days. They're in an in-between state where they can hardly make it to their afternoon nap without losing their shit but if they sleep in the morning they don't want to sleep in the afternoon. So I put them in their cribs with books and tell them I'll be in to get them in a while. Meanwhile the Littles are napping for real. Daphne and Lily are the sleepers. Daphne will be happily playing or eating and will go from zero to a hundred, screeching like she is on fire. That means "Put me down right now I am tired and I am over all of this nonsense!" She almost always falls asleep within five minutes of that moment. Lily will start laying her head down on things or will walk over to her crib and ask to be lifted in. Cyrus and Cleo would stay up all day and all night for the most part. I see aspects of myself and of their dad in them--two people couldn't be more different when it comes to sleep than my husband and I are. Let's just say Lily and Daphne are my people.

The Bigs are 21 months right now, the Littles are 9 months. We have a lot of birthdays coming up in June for our tribe of Gemini. All four of them are pretty fun these days. And they are also totally exhausting.

We went to the San Francisco Zoo on Tuesday. It was a long day and the drive back home took forever. Seriously, like three hours. A lifetime in a world where you are stuck in a minivan with four small children strapped into car seats. When we rounded the exchange from one freeway to the next and I saw columns of gridlock stretching out ahead of us, I gave up. Cyrus was crying, taking his turn in the symphony of irritation that can be my day where each kids counts the next one in so they make sure there is at most a few minutes in between one meltdown and the next. We needed gas. We were all tired and aggravated. So I pulled off the next exit and followed the instructions Google had provided in response to my "playground" search. Frog Park in Rockridge. Never heard of it, never noticed it despite driving by it many times. It was a good find. I parked us right underneath the freeway we'd just exited because I couldn't figure out how to enter the parking lot. I loaded up one double stroller (not the quad because I didn't bring it with us to the zoo). Cleo stayed in her car seat, hooked onto on seat of the Bob. Daphne got seated in the other stroller seat. Lily got balanced on the front end of the stroller and I carried Cyrus. Who wore no shoes nor socks because he has a propensity for removing them in the car and I had no patience or flexibility to go searching. We entered the gate and we had arrived.

I set the Bigs loose. They were thrilled to be out of the car and immediately explored the little side playground we came to first. It had an unoccupied tire swing and a set up that included a steering wheel, my boy's fave. A dad and his two older kids kicked around a soccer ball on the grass nearby. Nannies and parents accompanied different combinations of kids and no one stared to directly at us but let's be honest, I was the only single woman decorated with four small children. I can feel the glances and I mostly just stare straight ahead, not because it bothers me so much as because I'm tired and don't want to get into a conversation so if I pretend I don't see them we stay in our urban bubbles. MUNI taught me well.

We made our way over to the water fountains where I rinsed and filled and made bottles of formula. Handed out pouches of food. Peeled a tangerine. Took in the scene. Down a small hill was the main playground--a beautiful wooden situation that definitely invited further exploration. I debated leaving without going down there, mostly because you start to know what you can handle and I was pretty sure that playground was teetering on the edge of "no way mama, you're crazy" But I knew the traffic would be mostly unchanged and none of us was ready to get back into the car so down we went.

The Bigs were excited. Cyrus found another steering wheel right away, off to the side near some tables. Lily bee-lined into the main play area and went right for a combination monkey bars/ladder deal that she doesn't quite have the skills for. Were she my only child, I might have gone in with her and either helped her or told her no. Instead I stayed where I was, with the Littles in their stroller outside the playground fence and watched her assess it, start to climb it and then decide she wasn't ready. One of the best pieces of parenting advice I've ever received was via my parents, way before I had kids of my own. They learned it at Sunset Co-Operative Nursery School, where my siblings and I went from ages 2-5.

"Don't put kids into places they can't climb themselves."

There was a sweet little tree in the backyard of that nursery school, right near a climbing structure near the back fence. Most kids wanted to climb the tree or the structure or the red tower at various points of their school career. And they mostly would, eventually, when they could navigate it themselves. If they can't climb up it's a good indication that they can't climb down. A good indication that they're not safe there. It is a great way to let kids discover their own abilities, feel safe in their bodies, and feel pride in their accomplishments when they finally do make it happen. It has been crucial to my child raising because I can't be in four places at once.

A while later Cyrus entered the playground and went straight for the same piece of equipment. He had a similar experience of checking it out, putting his hands on it and then deciding nope, not today. I never said a word to either of them and they never looked my way.

All of this is great and makes me seem like I totally have my shit together, which I kind of do in some ways. Though fifteen minutes later Lily fell backwards onto the cement from the little seat she'd climbed up on. I wasn't even looking at her. She burst into tears and I scooped her up, rubbed her back and her head, looked into her eyes and decided it was time to go. We packed up our rag-tag circus train and headed up the hill and back to the gate. A silver-haired man in his mid-60's, wearing crisp business clothes and a tie looked at us as he tried to decide whether to hold the gate open or close it. I nodded at him and he held it open.

"You've sure got your hands full!"

"Yep."

"Are those quadruplets?"

"Two sets of twins."

"Wow! God Bless you."

"Thanks"

Then to the kids, "Thanks for paying my social security!"

Hahahaha. Best comment we've received so far.


Friday, March 20, 2015

Unedited--logistics

When we would tell people we were expecting another set of twins the reactions were not varied. They mostly fell along a narrow arc of "WTF?! Oh my. . ." and things like that. Then people would almost immediately jump to the questions of "How are you going to take them anywhere? Four carseats. . .strollers. . .cribs" My husband and I would look vaguely at the well-meaning person and not even listen. Didn't they know we weren't thinking about logistics yet? Yes, we were wondering how we were going to do it but more in the sense of no really, how are we going to do this. Not how are we going to take them places or how are we going to do whatever you're asking but HOW are we going to DO this?

Now that we're doing it, here are some notes on the logistics:

Gear:

Strollers
We have five strollers--one we purchased while I was still pregnant with our older twins, the others have all been gifts or hand-me-downs. One stroller is a quad. Yes, a stroller that fits all four kids. It is a beast and I pretty much hate it but I must admit that it makes life possible. There is no good reason to hate it other than the fact that it's heavy when it gets folded up so getting it in and out of the minivan is challenging. I have a few gashes on my shins from the quad. You also have to hold down the break while you push it--similar to pushing a lawn mower. I mostly hate it because it represents how hard the reality of four little kids is. There is no "Hey! Let's mosy down to the farmers' market!" Getting ready to leave the house takes lots of trips back and forth, lots of loading, and then once you get somewhere. . .you have four little kids. So the quad is a great tool that enables us to live this life and I appreciate it for that. But I curse it a lot.

We can either fit the quad or two double stollers in the van. Never did I imagine that an understanding of angles would be so necessary for packing up the darn car. And it's the little things, like trying to close the back door and having it slam into a part of the stroller and bounce back open, that show me how often I am barely holding it together with all this babies. Stupid door! Why won't you close?!

Carseats
We have four car seats. My husband's car doesn't have car seats or bases so the minivan is the only vehicle that can transport the kids. The two big twins sit in the way back, facing out the rear window. Their seats will eventually turn into boosters so we hopefully will not have to buy them anymore. The little girls sit in the bucket car seats that we originally purchased for the Bigs. They sit in the middle row of the van, facing backwards.

Pack-N-Plays
We have three pack-n-plays, though we almost never use them. One of them has been in the backyard for almost a year so it is dusty and full of spider webs. I think I brought it out there because I had some crazy idea that I needed it when I brought Lily and Cyrus, a.k.a. the Bigs, outside to play. Mostly ended up putting them on a blanket and occasionally pulling twigs and grass out of Lily's mouth. (Cyrus has never been one to put random stuff in his mouth whereas his twin sister will put any and everything in her mouth if given the chance.) When we went away for the weekend to celebrate my 38th birthday a few weeks ago we brought two and rented one from Pajaro Dunes, the condo where we stayed. The little girls shared a pack-n-play and it was like WWF in there. Daphne, the younger and bigger twin, was constantly climbing onto her sister and body slamming her so it's amazing either of them got any sleep.

Highchairs
We have four. Well, two of the type of chairs that hook onto a table. We used those for Lily and Cyrus in our old house where we had them hooked onto the counter that looked into the kitchen. It was like being on stage for them--I could dance and sing as I cooked or washed dinner and they could wash me. We had to buy a new table for the kitchen in the new house because those chairs didn't hook onto the dining room table we have. We also bought two plastic high chairs from Ikea. Initially we bought those because we didn't have a table for the hook chairs but they then became the chairs for the Bigs so the Littles could take over the hook chairs. The best configuration around the round table is to have the Littles sit side-by-side so you can reach both of their mouths with whatever tiny spoon you're using to feed them. Although at nine months (today!) they've moved into baby bird mode where we give them bites of whatever we happen to be eating, rather than purely purees.

Schedule
I am not a highly scheduled person. Sleep has been the main area of our child rearing that has adhered to a schedule. As early as possible the Littles were put down to nap at the same time as the Bigs (can't remember when that was. Four months or so? Before that they napped in swings and baby recliners and on the couch) Nap times were 9am and 1pm, with a 5pm nap for the Littles. Each set of twins shares a room and each room has a white noise machine (life savers!) The Bigs are mostly transitioning away from their morning nap now that they're 21 months old, but we still put them down to have quiet time. Also known as "save the sanity of the adults' time". Bedtime is 7pm and has been for most of their lives. It took many months for Cyrus to go to sleep that early--if given the choice he and Cleo would probably stay up all night partying. But they have no choice! We did sleep training with the boy (sleep training a.k.a. "Cry it Out"). Never thought I would get behind that but it worked for us and felt necessary.

Now the babies are crying and I have to go get dressed so we can head down to toddler class. More later.

Tuesday, March 17, 2015

YVR

The first time I drove down Ygnacio Valley Road I missed my turn. I was heading to the house of my friend's parents, can't remember how old I was. Young adulthood or late teens. I missed my turn and found myself driving up this endless hill with no option to turn around. It freaked me out because I didn't really know where I was. This came to mind last night as I drove up that same hill on my way home.

One of the next times I drove on Ygnacio Valley Road I took the exit by the same name from 680 North, this time heading to John Muir Medical Center for something work-related. I recognized the name of the road but still had no context for where the it fit into the town or where I was going. I rarely pay attention to street signs anyway, less now that an iPhone rather than a map directs me to my final destination. This is one of the clues that I am an "N"on the Meyers-Briggs. "N" for intuitive rather than "S" for sensate. We N's give you directions that look like "Drive until you see the 7-11 and take a right. Then you'll drive on a long, windy road until you see that pink building on your left." An S would give you specific directions involving street signs and mileage. I digress. What else is new? Welcome to my brain.

Since moving to Contra Costa County I have driven on Ygnacio (pronounced differently depending on to whom you are talking, sometimes even referred to as YVR) many, many times. It's a main drag. It took me to my husband's work before he was my husband, when I would stop by to bring him coffee and a kiss. It took me to a pizza place in a strip mall for the first moms' group event we attended. When we left I had absolutely no clue where we were other than knowing we were on Ygnacio. Didn't know which way on the road to drive down in order to get home. It took me to my new OB-GYN office when I was pregnant with the girls. And later it took me many, many times to the NICU to visit them every day for the five weeks they were there.

I don't think in similes but it often happens that noticing a road, really noticing it, will call to mind other things. As I drove up it (down it? Still not sure) last night on my way home from the second meeting of my very exciting women's yoga self-care retreat I remembered that first trip up the hill and it made me think of this new group of women I am getting to know. It also made me think of drugs.

I love to sit in a new group of people and look around, noticing things about them such as what they're wearing or what their hair looks like or whether we make eye contact. I take them in, in a vague way, and think about how some day I will look around and know them so much better that I won't even be able to see some of the things I'm seeing on this first day because my eyes will have already changed as far as they're concerned. I feel love and gratitude for these women whom I barely know--because they are sitting there on the floor, committed to asking questions about themselves and their lives. They are curious and hopeful and struggling. These are my people and I look forward to each time I see them.

When I've taken drugs in the past (the illicit kind, not the many different prescribed kinds that sit on my bathroom sink edge) my favorite part has been noticing when my consciousness starts to change. Paying attention to all the shifts in how I see and feel. Feeling myself be me, but altered.

All this from a road.

Saturday, March 14, 2015

Saturday in the 'Set

In my pockets: nothing, wearing sweatshorts. These things were staples during both pregnancies and are taking their place in the rotation once again. My husband is so lucky.

Status of children: all asleep, thank goodness Hallelujah.

Just spent the last hour cleaning the kitchen. Which is annoying because I spent an hour of my "free" time yesterday cleaning the stupid kitchen. It's hard to move on to other super messy parts of the house when the kitchen keeps needing to be cleaned. I tried turning it into a meditation, focusing on the feel of the water rather than the end goal of having a clean kitchen.

Today our family of six drove into San Francisco to attend Sunset Mercantile. I'm not sure if it was a fundraiser or a neighborhood builder or something else but it was a series of tents and food trucks set up in the school yard of Francis Scott Key, an elementary school on 42nd and Kirkham. That was our bus stop growing up. We lived about ten blocks away but went to school at Lakeshore, over by Lake Merced, Lowell High School and Stonestown Galleria. It somehow never occurred to me that that was a result of a decision my parents had made. It never occurred to me that our bus stop could have been our school--it was our neighborhood school after all. My parents chose Lakeshore because someone important (whose name and position I forget) named it as the best example of a racially diverse school in the area. He said that no one race felt like it was their school because there were many different ethnicities and cultures represented. The funny thing is that years later I said to someone that there hadn't really been many black people at my elementary school. And then I looked at a class picture and laughed because there were lots of black students in my class. I think I just didn't notice.

At today's event my mom was telling stories. My friend and her boyfriend traveled up for a quick trip from LA (not for this event but to see me and my family). My dad came up on his scooter from his house several blocks down the hill. My husband and I arrived shaking the wailing and moaning of the hour-long car trip out of our ears. Usually the car is a safe place but today was not a good day for the way back female passenger of our tribe. We drove past the city on the freeway, avoiding the St. Patrick's Day parade and exiting on John Daly. Down the coast with the Pacific on our left. Past the zoo and into the avenues, taking a straight shot down 42nd. Which I'd never done in my life because my dad taught me to drive and I only go the ways he showed me--the ways with the fewest stop signs and the fewest blind intersections. 42nd had a lot of stop signs but no blind intersections and it took us past an alphabet of blocks full of almost-identical houses. Few trees. When I returned from living abroad I thought my neighborhood was so ugly. Bare and uninteresting. Later I appreciated it for it's beachy vibe, it's old-school, family, settled in vibe. It's not beautiful like other parts of the city. There aren't many gardens out front. Mostly cement. Lots of parking spaces, though those are getting taken up more now that it's one of the trendiest neighborhoods in SF. There are boutique coffee shops, great restaurants, lots of young families. Places that serve fancy toast, which is apparently a thing these days?

We parked, walked down the hill. My husband held the hands of our big twins; I blinked and it was my dad holding the hands of me and my sister. I pushed the stroller, laden with bag, Ergos, bananas, layers for the ever changing weather.

The toddlers sat for a tiny bit of storytelling, with Lily climbing up onto Olive the storyteller's lap. The storyteller is her Nana. You could see her trying to take it all in--why were all these kids sitting in front of her Nana, listening to her talk? She listened for a while and then I took her away because she wanted to claim the crystal ball my mom was holding up for one of her stories. We joined her brother and dad at the play structure, where we stayed for the remainder of our visit. No exploring the tents. One quick trip to grab some food but mostly stationary. In that time we saw: the husband of my old best friend; (who also attended Lakeshore), my dad's second cousin who I'd met before (she had heard about us and our two sets of twins from my other best friend--their kids go to the same nursery school in a completely different part of town. Didn't know they knew one another); a woman who runs the very popular Devil's Teeth bakery (whom I'd never met but who also has four young kids and still managed to open and run a bakery and now a new brewery. We exchanged 'holy shit, how do you do its"), a newish mom who was with my brother in the Peace Corps in Ghana several years ago, the head of my old nursery school (who was a parent when I went there but now runs the place), a friend named Andy who runs San Franpsycho (look it up, it's awesome) and a man who asked me if I was Olive's daughter. Meanwhile Cyrus claimed a pink convertible push car and sat in it almost the whole time, Lily went up and down the stairs and slides, and Cleo and Daphne got passed around from arms to arms. It was chaos and comforting.

There were so many children. I remembered my mom doing pull ups on the top bar of a broken chain link fence while we waited for the bus. I remembered gray mornings. The other families we saw there. It was one of the touchstones of the community of my childhood. It felt good to be back.

Tuesday, March 10, 2015

A brother

In my pockets: nothing because I'm wearing a one-piece bodysuit. Obviously. With a shirt over it, extra obviously.

My friend Phyllis is hanging with the little girls in their room. She comes every Tuesday. She is the woman who started my old company. A retired CEO. I loved her as a boss and learned so much from her. Never in a million years would I have imagined that we would actually be friends. Life is surprising and wonderful.

There is so much on my mind. Writing this blog is like spinning the wheel at Polly Ann's ice cream store--you never know what flavor it will land on. Depending on when I actually sit down to write you might get reflections on my old barista-turned-friend Brian and all the things he taught me without even trying. Thoughts on cancer and the ways it is touching people in my life these days and what that feels like. Musings about. . . I forget.

I spoke to Damien last night. He is somewhat of an ex-boyfriend, although we never lived in the same place. We mostly talked on the phone, for hours at a time, every night for months. Into that we sprinkled weekend visits, to LA, to San Francisco, to Nashville, to San Francisco. We met on his birthday. I was already in my pajamas, getting ready to go to bed. Fabio, another person who deserves his own entry, called me and invited me out. I said no, I'm already in my pajamas. Who cares, he said. So they came and picked me up and we went to The Page--a bar in San Francisco. I am not sure what year it was but probably around 2003 since I was living in the huge, rambling Victorian on Steiner with four roommates including my sister. It was August 5, I know that. And I think he was turning 25 so it was probably later than 2003. Anyway. We bonded over a shared love of Push It by Salt N Pepa and our relationship grew from there.

His younger brother died about a week ago. I won't write very much about that because it is not my story to tell and I am still figuring out how to do this blog thing where I write about people other than myself. When I read the news on Facebook I felt it in my stomach like a stone. Oh no. Oh no.

That's all. Oh no.

I didn't write that in the comments because I knew that would not be enough, for me or for him. Even though I knew he didn't expect anything from me. I didn't call him then either, because I knew when I did we would talk for at least an hour and I didn't have the time right then. When I tried to call him yesterday the number was disconnected so I messaged him asking for his new number. New? he questioned. It changed three years ago. Which was confusing because I knew we had spoken more recently than that. Or at least I thought we had. But the squinting and trying to remember specifics so clearly paints a picture of my life these days. At best I can see shadowing memories without being able to fill them in with dates or details. It is like waking up from a deep sleep or getting amnesia, though I've never had amnesia so I can't say that for sure. The point is that it could have been three years since we'd spoken, though I was almost certain we had talked since my first children were born.

He sent his number and we exchanged a few texts, trying to land on a good time to talk. We started our call as I drove away from Sausalito, driving through the twilight with lavender and pale blue brushing the sky. And I had nothing to say. I didn't want to say I'm sorry because, even though I was and am so, so, so very sorry that his brother is gone it is the kind of phrase that is nothing and I just couldn't bear to say it.

Did I actually meet his brother or do I just think I did? I asked him. And I explained my shadowy memory. I felt like I knew him. I could bring to mind a relatively clear picture of Garrett. Just as I could conjure up his voice in my head. A drawl. A sleepy, wry, drawn out way of talking. Hilarious but not waiting for you to get it. Tall. A little dangerous--strong and not necessarily looking for a fight but very ready to step into one if the situation presented itself. A little brother and a big brother, though I mostly thought of him as the little brother.

I write about him because I want to honor him. Share him by putting him on a page. The way he was loved and admired and known and needed by my friend. Because I in no way can let myself even for a moment imagine myself in Damien's position because it makes me want to curl into a ball and weep.

We determined that I had actually met him and perhaps talked to him on the phone. So there's that. Mostly I feel like I knew him because I heard so much about him. So many words spoken of him by a man who is an artist with words that I will never forget him. May we all be lucky enough to be loved that much.

Friday, March 6, 2015

Two twin life

In my pockets: house keys rescued from the floor of the minivan, a green and white polka-dot hair bow, stack of paper napkins, orange plastic cap from. . .some type of bottle, red sparkly headband with a big puffy heart on the front, a wooden puzzle piece shaped like a lion.

Drinking a cup of coffee, sitting to blog while the kids are out on a walk with Stephanie. I turned circles at first, trying to decide what to do. My last post I wrote about being aware of how much energy we have to share with other people. The full statement should be--but giving energy to others means we have less for ourselves. Parenthood makes me aware of how many things are finite. Only so much time. Only so much energy. Only so much attention. Of all my worries the biggest one is that my kids won't get enough of what they need from me. Then I remind myself of how much they do have. How much we have. A home, food, a loving community. We will be ok. And then the worry will peek it's head out at me again, usually after someone bites (again) or someone throws a fit (again) and I go straight to "What am I not doing enough of?"
I had no idea how much room to second-guess myself there would be in parenthood.

The snippet of "life with four kids under two" that I didn't write last night would have said something like:
One kid with a temperature of 103.6, assessed rectally. One kid with a new inhaler after spending five hours in the ER to get an albuterol breathing treatment and a steroid to help with the newly diagnoses restrictive airway disease--inflammation of the lungs caused by the virus of two weeks ago. Steroid cream to rub into the chest rash on the boy who never stops drooling. But the other two are great! And so it goes. . .

This week as been an unwinding, a coming back into place after our weekend away. My husband and I were both taken aback by just how hard this trip was. We had fun! The kids did great. They were curious. They slept through the night in their pack-n-plays, despite the wrestling match going on in the one the little girls shared. They played, alone and together. They had great family time. They explored the beach. The slid down huge slides. They ran down wooden ramps and climbed wooden steps. They marched with sticks. They ate sand.

They also opened the front door and ran away before anyone noticed (they didn't get far). They opened all the cabinets in the kitchen. They opened the oven. They climbed every chair in the place. They lost their ever-loving minds after everyone else left and the overwhelm, excitement, exhaustion of the experience took over and exploded them into absurdity. Screaming, running, flinging. My husband and I looked at each other and slogged through it. Because what else can you do?

Everywhere we go people exclaim over us. "You sure have your hands full!" I want to find a way to add a counter on this site where I can keep track of how many times we hear that. People love seeing the four little kids. They love the quad stroller. They wrinkle their brows as they try to figure it out. "Are all these yours?"

No, I just thought bringing my own twins grocery shopping wasn't challenge enough so I borrowed my friends' kids just for fun.

That's snarky but really I mostly like it. It's fun. It's wild. It's a moment of recognition of "Holy shit how do you do this?!"

You hear it enough and you become used to it. Yes, it's hard. But it's fun. We feel lucky. Yes, we're tired.
All true. And then a weekend like this past one happens, where most things go incredibly well and we have lots of extra hands helping out and it's hard. But then everyone leaves and the kids relax into us and it's REALLY hard. It's constant. And a lot. A big bunch of a lot.

When I worked in organ allocation there would be busy shifts where you would push everything out of your mind and focus on the outcome, several hours in front of you. You felt mostly calm because you were just doing, just working, just making it happen. Almost a Zen experience. Though afterwards it was like forgetting how to speak English because your brain was slowly shedding hours and minutes of checklists and phone calls and problem-solving. That is what this parenting is like. It is one minute to the next, forgetting what day it is. It is loading and unloading, making bottles, changing diapers, bathing, picking up, comforting, losing my cool, reading the same book over and over, unfolding and folding strollers, unfolding and folding tiny pants, trying to think of what to make for lunch, cleaning up most of that lunch from the floor. It is sitting down in a moment of quiet and choosing to write it all down.

And then choosing to go clear off a surface or two in the moments I have left.

Tuesday, March 3, 2015

Tuesday musings

Good grief. Parenting four small children is ridiculously tiring. Fun. Eye-opening. Tender. And so, so tiring.
We went down to Watsonville this weekend in celebration of my 38th birthday. The last time we were down there was for my 36th birthday and I was pregnant with Lily and Cyrus, though we didn't know they were Lily and Cyrus yet. We didn't know their genders and we certainly didn't know their personalities--we just knew that Baby A (Lily) was squashing Baby B (Cyrus) up under my rib cage on the right side. Several of our friends were with us and many were pregnant. We had a great time and once or twice looked around the group, already full of little kids, and marveled that were we to return in a year it would be with five more children. Fast forward two years and we brought six children under two, just between me and my sister. Yowza.

True to form, despite the many thoughts that run roughshod through my mind all the times I am not able to sit down at a computer, now that I have a moment I can't come up with anything.

So, on to bullets.

-I think I've got internet privacy backwards. I post pictures of myself and our kids on Facebook but I feel strange putting them here. It is so hard to imagine a life where your baby pictures can be found by strangers on the internet. What is a respectful way to handle this? Please advise.

-I will get back to the food topic. My last two posts made me feel so self-conscious. Surprisingly slow, actually. Rather than push through that feeling I took a step back and took a break. Then life took over and weeks passed and life kicked writing right in the chin.

-Anne Lamott is so right about the hardest part about writing is getting your butt in the chair.

-I wonder what it is like to be my kids. They get so much attention when we're out in the world. They seem to take it in stride but it must be strange to sit in a stroller and have people ogle you and exclaim about your existence.

-We shaved my son's head. Not bald but a buzz cut, soft and prickly to the touch. He looks so much older. His eyes are luscious and deep and chocolate. He drank a bottle while his dad used the clippers. Then I stripped us down and took him into the shower to wash the hair off his body. In a moment I was back almost two years ago, holding his tiny, tiny body in my arms under the shower spray. He hated baths for a while. Screamed when we put him in the water. He has always been a sensitive guy, turning at every little sound in the NICU. We thought a shower might be less overwhelming than a bath. He was into it and he turned into a slippery little seal pup in my new mama arms. This time he was big and heavy and long-legged, still resting against me, still turning his head to check out the spray of water. Watching children grow is just. . .the fastest slow motion experience of my life.

-Several people in my life are dealing with very hard things right now. Sickness and new babies or the hopes of new babies. I am holding space for them and it reminds me of how much energy we have to share with others. I feel them in my heart and in my shoulders.

-Motherhood is the one thing in my life that I knew for certain I really, really wanted to do. I longed for it, I chose or unchose people based on it, it affected my career decisions. Now it is here and it is so much more in reality than it was in theory. It is ass-kicking and also rich and delicious. There are so many things I thought I would do, so many ways I thought I would be as a mother that I do not, am not.

              * I thought I would breastfeed for a long time and that it would be the most amazing connection to                   myself and to my babies. I did not and it was not.

              * I thought I would wear my babies and go on walks with them snuggled into slings. I rarely wear                    any of them and when we walk it is always with a stroller.

             * I can't think of or remember any of examples at the moment. Because my brain is a big ball of                       mush.

More later, at some point. Off to the doctor. All babies sleeping and Stephanie the magical babysitter is here. Deep breath. Ahhhhhhhhhhhhhhhh.