Tuesday, March 15, 2016

9 Months Later

I'm purposefully posting this last installment of the series today.

A few days after IUGR Awareness Day. 

Because long after the 5k Walk ends and the spotlight on the diagnosis dims once again, the reality of IUGR continues for so many families.  



So where are we today, almost 10 months later?

I am so happy to share that today N is thriving, thank Gd. 

He has had quite the year, including one surgery, a surgical procedure and a working diagnosis. 

N has an endocrinologist, a bone health nurse, an occupational therapist, a general surgeon, an orthopedic surgeon, a dietitian/ nutritionist, developmentalist,  neonatologist and a fantastic family doctor, all who closely monitor and follow him. 

A week doesn't go by where he doesn't have an appointment. 

When we were given the diagnosis we weren't given a prognosis. All we were told is he'll be little. Today, for sure, tomorrow, who knows? Besides that there was nothing.

And that's not good enough.

Today, IUGR is still an unknown. I've actually had a doctor roll their eyes when I've brought it up. When I clarified that my full-term baby was 1774g, he had nothing to say. It isn't taken seriously. Until you're standing in the ER clutching your baby, terrified and listening to doctors trying to decide if surgery should take place tonight or can wait, it's ignored. 

There's no preparation. There's no consideration. Maybe I was just naive, but throughout my pregnancy and all the talk of our baby being, "too small," not once was the NICU mentioned. Not once did someone offer to show me what the NICU looked like or even where it was in the hospital. Not once did someone explain to me that babies born at a low birth weight were at increased risk for so many issues that N has had to face. 

As per the advice of our incredible cousin, who I mentioned a post back, I joined an IUGR Support group. While there is something incredibly comforting about finding a community in this chaos, there is also something so frustrating and infuriating; that we aren't taken seriously. That we're seen as parents who just have small kids.

And then there's this fear. This fear that lives in the back of our minds, that few say aloud and no one can ignore.

Will it happen again?

We've been told (& to a degree we know, as hard as it is to digest) that we were incredibly lucky with N. That our 13 days in the NICU and the fact that he was born at full-term, are amazing feats. But what about next time? If we have another baby, will it be as "lucky"? Is it at an increased risk for IUGR? Is there anything we can do to prevent it?

I insisted on a placenta pathology work-up and follow-up. I underwent voluntary tests, appointments and reached out to others who have experience, to find out if there was anything else I could do. In Hebrew there's a term, "hishtadlus," which essentially means putting in your maximum effort. I'm doing my hishtadlus and I know at the end of the day it's in Hashem's hands, but I need to know. I need to know I've done what I can.

And the results? 

Just like during our pregnancy and just like N's first few months, it's all inconclusive. It seems, "placental insufficiency," is what we're going with now. 

40-60% of IUGR cases go unexplained. So the questions I whispered when I walked into the NICU...

"Why did this happen?"

"Why did my body fail him?"

They never get answered.

And it could happen again.

If they can't find answers they at least need to find a way to support families. Say the word NICU during pregnancy, because having it thrown at you as a possibility 5 minutes before you deliver is not right. Explain to us what having a low birth weight baby means. Don't roll your eyes when we ask about milestones or if his IUGR diagnosis could be related to the reason he needs surgery. 

Spoiler alert: it was. 

Both times.

Like I said in my first post, I wrote this as the series I would have wanted to read. I wrote this from the parents' perspective, from my perspective first sitting in the OB's office, and then through delivery and finally the NICU. There's a lot that hasn't been said and so much that I haven't accepted enough yet to share. 

But at the end of the day it isn't about me.

It's about N.

We need these awareness days and these spotlights, so as parents we can find answers and help our children.

N is remarkable. He's a bundle of energy and noise and chaos and love and was so obviously always meant to be a part of our family. He amazes me at how he really, really believes he can do things. He believes he can stand and crawl and push past any obstacle in his way. And he has! Today N is 5 times his birth weight. FIVE times. He's conquered surgery, surgical procedures, reflux and more. He's meeting milestones. He's succeeding and making us all smile ear to ear (& exhausted...) while at it. His personality is approximately a million times his size. 

So this is it. The end of the series. Thank you, to everyone who's commented, emailed, messaged and been in touch one way or another. Thank you for reading about our experience and sharing in the emotion and chaos of it all.

And to those who can relate. I'm sorry. I'm so sorry. And I won't say that I understand, because I don't have your baby and I'm not in your shoes. But I offer you my story and my experience. I want to give you hope and possibility when I tell you that my now 15lb, 9 month old, says Mama and Dada and crawls faster than I can catch him. That your baby is so strong. 

And so are you. 

And above all, you're not alone. It doesn't matter how many people don't understand your diagnosis or how many doctors roll their eyes, there are people and doctors out there that do understand! And you'll find them! They're out there! 

And there's this tiny baby, your baby, who's stronger than you can even imagine right now, who's ready for whatever comes their way and needs to know you are too. 

You CAN do this.

You WILL do it.

You both will.



If you'd like to read the full series, you can find the links below!

 



Sunday, March 13, 2016

IUGR and the NICU

It was over.

Our baby boy had arrived.

No more wondering when we'd be induced, if he was growing well enough, or what was happening, period.

Now it was time to face the other side.

He had arrived and he needed help.

When I was finally wheeled into his private room in the NICU, the confusion, pain and sheer terror of the past two months hit me full force. 



There were machines everywhere. Monitors were going off. I couldn't even see him through everything that was attached to him in one way or another.

I cried. 

The tears poured and I couldn't stop them and I didn't want to.

Why hadn't I been able to help him?

Why had my body failed?

Why had I failed him?

And now, he was stuck in this clear box, attached to wires and monitors, with a whole team around him and I was a spectator.

I, who had done my best, who had carried him for 37 weeks 1 day, who had just given birth.

I can't describe that pain. 

I had been separated from him for two hours. The nurses and M had a routine down. They were sharing information and he knew exactly what syringes to pass over and what he was doing. 

And I was sitting in a wheelchair, on the edge of the action, numb, thanks to the late onset of the epidural, and useless. 

So I cried.

After a few minutes, everyone noticed and asked me if I wanted to hold my baby. 

I couldn't even speak and I didn't feel worthy, but I nodded.

They opened the isolette and this tiny bundle of blankets, with a handful of wires dragging on the floor beneath him, was placed on my chest.

I said hi, and told him I was his Mommy.

And as the tears poured down onto him, he looked up at me. In that moment I knew that he was stronger than I'd ever be. Those eyes, the mischief and love and strength in those eyes, it was clear as day.

The NICU sucks. I could use a hundred more eloquent words, I could go on and on about the quality of care and how lucky we were to have it, but I don't want to.

Because the NICU sucks.

My dreams of Y running into my hospital room to meet his brother had been unceremoniously slashed. No visitors, no walking through the hall with the new baby, no quietly staring at him preparing to go home.

Instead there were rounds and specialists. Heel pricks and medication. IVs, monitors, wires and hand washing. So much hand washing. 

And then he started choking. And I begged, I begged to switch places. That whatever he was going through I would take it. I would take it times a million and I would not complain. 

But it doesn't work that way.

In went the tube and out came the air and everything he had been trying to get out. In went IV's and in came the specialists. Arguing right in front of us about what to do. 

Let me tell you, when you're lost, when your baby is struggling and when doctors STILL can't get on the same page, Mama Bear comes out. 

Forget that I was numb, forget that I had given birth two hours ago. It was done.

Mama Bear had arrived.

I somehow stood up and spoke up. I got my strength from my baby boy and I knew I could do this. As that day went on I made myself heard. I asked questions at rounds, I stood at that incubator and insisted I did as much as I was allowed. When everyone would leave I'd open his little isolette door and I'd hold his hand. I'd run upstairs to have my vitals checked every few hours and then return right to his side. I walked the halls and no one would have ever known I had just delivered. I cried and didn't even know I was crying through most of that day. My postpartum "healing" lasted approximately two and a half hours and then I was up and dressed and ready to do my part. 

Because that's the NICU.

By the way, any doctors out there reading this, here's something you don't want to do, FYI... When a NICU Mom leaves her baby for 15 minutes to get vitals checked and eat an apple she's being forced to eat since she hasn't eaten in 24 hours and that apple is taking precious minutes away from being with her baby, you don't walk into the room and loudly announce, "I have bad news." 

NO.

The thoughts that ran through my head... 

Turns out the "bad news" was that there was an emergency and our baby had to be transferred to another hospital because he was deemed one of the most stable. 

Let's just say that doctor didn't deliver any more news or even whisper one more word to me for the rest of our time in that hospital. 

I made it very clear that I wouldn't be staying and allow my baby to be discharged alone, so after a lot of confusion and one more check of vitals, I signed whatever I needed to and was on my way. I remember walking behind N's stretcher through the halls of the hospital. I remember sobbing, and whispering that his first carride shouldn't be in a transport ambulance. I remember the looks of the people in the hospital foyer, whispering and staring at the incubator strapped to a stretcher.

I remember M driving slowly behind the ambulance, and my heart in my throat the entire time.

We arrived a few minutes before N did. I walked into our new NICU and I'll be honest... I wasn't happy. We were now in a large room, with over 20 incubators, a handful of nurses walking around and zero privacy. We had come from a private room with our own nurse around the clock. I was scared that his care was being compromised. I recognized that there was an emergency and another baby needed his private room, but my baby needed it too.

I was wrong. And I've never been happier to be wrong.

Our new NICU was the greatest thing that could have happened to us given the situation. From the minute we walked in, we weren't spectators anymore. Even though it was 11:23pm, our nurse was full of love and energy. She offered to let me take N's temperature. She showed me how to change his diaper through two small holes in the isolette. And every time she addressed me, it was, "Mom." For the first time, medical staff recognized me as his Mom! They let me be in charge of my baby as much as I could be. 

And they were amazing. They walked me through everything. They taught me the medical jargon and in a day I was holding N's chart and could understand it perfectly. 

And then they told me I had to go home. The second full day there, I had noticed that by the time evening rounds came, the parents would leave. They were kind enough to give me a rocking chair that first night to stay by his side, but then they insisted I went home, showered and slept. 

After hours of back and forth, I stood up, placed my hand on our little boy's head, whispered our little pep talk phrase to him, and closed the isolette door. 

I sobbed through the hallway, and down the elevator. I screamed in the parking lot, when I saw his car seat in the car, empty.

I had a 15 month old at home who needed me. I couldn't stay and they didn't want me to. I knew he was safe and taken care of and that I would be back in a few hours for morning rounds, but that day I physically felt the pain of my heart being torn. Half of it was in the hospital, a hospital that was a 40 minute drive away, and the other half was at my parents' house, with no semblance of normalcy and waiting for his Mommy too.

Speaking of, our incredible 15 month old. He handled everything beautifully. Even though he spent almost 2 weeks napping in hospital hallways, or having lunch with Daddy at the Eaton Centre and dinner with Mommy in Yonge Dundas Square, he smiled, he enjoyed all the bonus Paw Patrol and he stepped into his role of big brother, seamlessly.

During the NICU experience I was pulled in a thousand directions. I would get home in the evenings so exhausted I couldn't think. I would call our baby's nurse throughout the night when I'd wake up because my body was telling me it was time for a feeding. I'd celebrate on the phone with the nurse when she'd tell me that he took 50cc or when she told me his umbilical cord fell out or that he'd had a great bath. And then I'd hang up and sob. Because I was his Mom. I was supposed to be there doing those things, experiencing those things.

I sat there day after day, doing shifts with M so we could both spend time with our baby. I sat there watching other babies be admitted for a few days and then discharged and hated and was ashamed of the jealousy I felt. I stopped saying the, "H" word. It was hard to watch the nurses redirect their eyes the first few times I asked when they thought we'd be going home. The first hospital had given estimates between a couple of days and over a month. Here they'd just say the same thing, "he's very small..." 

So I stopped asking. I put all of my love and energy into those days. Some days were great and I'd keep it together until I got to the elevators. Then I'd put on my sunglasses and cry all the way to the car. Other days I'd cry at the isolette when a random doctor would show up and causally say, "just here to do an ultrasound and check for any brain bleeds." 

Yeah.

I can't say enough about the nurses. They'd make M & I laugh, actually laugh. They'd pull up a rocking chair on their break and sit there and talk to us about the world outside, a world I was angry at, that just kept spinning. They would tell me about their kids and their experiences. They'd tell me I had a feisty baby and that he was doing great. They'd tell us we were doing great. They took care of our heart and they did it so gracefully and with such sensitivity. They'd meet me at the door and excitedly rush me over to our baby, to show me how they'd put him in an, "I love my Mommy," onesie. They made it okay. 

At this point, I also absolutely need to mention my husband's cousin (someone I had never met or spoken to, someone who lives on the other side of the world) who changed that NICU experience
for M & I. She gave us hope, advice, and  a sense of understanding that touched us so deeply and carried us through our time in the NICU. I still go back and read her initial messages, reaching out, full of advice I still hang on to. She is one of the ultimate examples of strength and courage, and even though we still haven't met, I consider her both a hero and a great friend.

And then the day came... 

I walked into the NICU and couldn't find his isolette and subsequently couldn't find my breath. And then I looked a little closer and realized our baby was laying in a bassinet, on room air, attempting to regulate his temperature and successfully doing so. The first step to going home! Still no one said the H word, but later that day it was suggested I bring in the car seat to run his car seat probe. I called M immediately and we both knew this was the step we needed to get him disconnected from all monitors and IV's. Within a couple of hours M had arrived with the car seat and the next day they ran the probe. I had to leave in the middle, I couldn't watch the numbers fluctuating, that if 89 appeared on the screen it would mean he wasn't sufficiently maintaining his oxygen in his car seat and couldn't go home yet. An hour later I got the message from M on my phone...

"He did it!" 

No more wires, no more monitors! The next morning for the first time since he was born, we held our baby and just our baby. 

We were set to go home Sunday. 

I'm so grateful to my parents, that they gave us the ability to stay in a hotel near his hospital for Shabbos. I couldn't fathom leaving him for 25 hours, so for two weeks I'd go for Shabbos morning, go back and join M & Y for Shabbos lunch in our hotel room and then M would join him for the afternoon. Sunday morning we woke up super early, laid out his coming home outfit (that I had actually brought with me everyday to the hospital) and got ready to bring our baby home.

Turns out the preemie outfit was way too big, but nothing could put a damper on that day. We dressed him and took pictures, collected everything we had kept in the hospital, filled out forms, made follow-up appointments, put our baby in his car seat, all 4lbs of him now, and made our way to the NICU doors. 

That's when I heard the Mom next to our now empty isolette tell her baby boy, "one day you're going to be big like him." 

"Big" like our 4lb baby.

I will always remember that whisper.

It will always take me back to that room, the buzzing and humming, the lights and hand washing and rounds. 

The only place in the world where my baby was "big" at 4lbs. 


Previous Posts in the Series: 


 

Thursday, March 10, 2016

An IUGR Delivery

"Well if the baby's as small as they say, labour will be a breeze."

File that under more comments not to say to someone navigating their way through an IUGR diagnosis. 

15 months before I went into labour with N, I had delivered Y.

That was a twenty-six hour production. And I didn't even know I was in labour! I got to the hospital for a regular OB appointment and the receptionist kindly pointed out that the sharp stabbing pains I kept having at regular intervals, were actually contractions. Who knew?

Not the case this time around.



I ended the last post, 3 hours away from the end of Shavuos and on my way to the hospital.

I have at times been called stubborn, I'll admit it. And most of those times, maybe I was being stubborn... But I was so determined to make it to the end of Chag that no one was going to tell me I was in labour. I had seen the OB and had a full scan Friday afternoon, hours before lighting and all was well - or as "well" as it could have been, given the diagnosis of IUGR. Baby was still deemed better in than out. I don't know what it was about Shavuos. I was well aware that I was allowed to make my way to the hospital, regardless of the fact that it was a holiday. I just felt like we had run there so many times, that so much had been thrown into chaos since our diagnosis, that all I wanted was a quiet, drama free yuntif.

Alas, baby did not agree.

We arrived at the hospital and M and I were totally ready for another 26 hour drawn out experience. Honestly, the contractions weren't bad at all, and I was fully capable of walking around and talking, but I just knew something was going on and I knew I had to go in. 

We were admitted pretty quickly, and apart from declining filling out the questionnaire on our triage experience, it wasn't as complicated as I thought it would be, given that it was Shavuos. 

We got into the delivery room and got comfortable. I walked around and we laughed and wondered if we'd actually be having the baby today. After having to prepare so many times, and having one false go, we just weren't sure. 

But I had made it. And not just to 37 weeks, but to 37 weeks ONE day! If labour stopped again, I knew that the OB was planning the induction for that week anyway, so I was as calm as I could have been. I had read about so many women making it to 25 weeks, or 30 or 32. I knew it was a big deal that we had made it to over 37 although I was still terrified that we may have pushed the baby too far.

And then the nurse walked in. She explained, that if the baby was under 2000g it would be taken to the NICU immediately. I asked what the last estimate was from our most recent ultrasound, but the information was unavailable. I did the math. 2000g... That's over 4 pounds. Obviously, now at "full-term," my baby was going to be at least 4lbs... Right?

The next hour or so was pretty peaceful. The contractions were completely manageable. I was informed that the anistheisologist would be heading into a complicated c-section shortly and if I wanted an epidural my window was closing. I wasn't in pain but figured better safe than sorry. I was at about 6cm with regular contractions. The anistheisologist came in and asked if I was in to be induced today. She was shocked when she found out how far I was, given how little discomfort I was in.

Ha.

So I got the "walking epidural" and got into bed to rest for a bit.

Ha.

My total active labour was 22 minutes. The epidural never had a chance. Truthfully I never clicked the button because I thought I had all the time in the world, because...

Y = 26 HOURS

N = 22 MINUTES

Out of nowhere I had a contraction that seriously had me convinced I was dying. Within seconds I was screaming that I was about to deliver. Everyone assumed it was just hitting me that I was in labour. My OB was actually on-call and he had just checked on me and let me know it would be a couple of hours still. When the nurse called him asking him to come back in, he was reluctant.

He barely made it. 

In 22 minutes and with four pushes, and the most vividly excruciating pain I've ever experienced, I went from laughing and walking around to silence in the room.

The cord was wrapped around our baby's neck twice. And they were all staring at him.

M told me that it was a boy, but I wanted to know what else was going on. 

And then they passed him to me and I knew.

IUGR was in my arms.

Growth restriction, my restricted baby, was in my arms.

I held him as tightly as I could because I did not want him to be weighed. I didn't want that number to enter the room and ruin the moment. 

My beautiful baby. I could see the strength in his eyes, but there was no mistaking the struggle in his size.

He fit in my hands. Not my arms, but my hands.

And the nurse, with the most understanding and compassionate eyes, held out her hands and I passed him over to her. 

And a minute later the number entered the room.

1774g.

I had given birth to a full-term, 3lb 14oz baby. 

You just don't know what a 3lb baby will look like until you've held one. I've had people say, that so and so was so tiny, when now I was realizing, they were basically double my baby.

1774g. A number I will never forget. 

And with that number, my beautiful baby boy, who I had held for far too shortly, was on his way to the NICU.

I begged M to go with him and insisted I would be fine. The second he was rushed out and the door closed I cried.

And cried. And cried.

The nurse, our incredible, incredible nurse held me. 

I asked if my baby was going to be okay and she told me that I had to make sure I was so that I could be there for him.

She stayed with me until I was transferred to a room. She brought me to my room and settled me in. She was there during one of my most difficult hours. 

And then she left.

I had to stay in recovery for at least an hour. The second the hour mark hit, I pushed that nurse button repeatedly. Finally someone came and within two hours of giving birth, I was up and on my way to the NICU.

And then the epidural finally kicked in. Because, obviously right?

So into the wheel chair I went. NOTHING was keeping me away from my baby for another second.

And with that, physically numb but emotionally raw, I received my welcome to the NICU.


Wednesday, March 09, 2016

An IUGR Pregnancy

Intrauterine Growth Restriction.

There are a lot of fancy and scary definitions out there, but let me just lay it out for you:

The baby isn't growing at a healthy pace. It's small, too small. It's not getting the nutrients it needs, it often isn't getting the oxygen or blood flow that it needs. It's restricted in all sense of the word.

I personally feel, "uncertainty," best defines an IUGR pregnancy. No one was ever sure about anything. From why growth had stalled to what to do about it.


After the diagnosis, I was very closely monitored. Twice-a-week I was sent for a biophysical profile ultrasounds and dopplers and every second week they'd add on an anatomical one. You know the long ultrasound you get at 20 weeks? Yeah, every two weeks. After each ultrasound I'd walk down the hallway to my OB's office and wait for his decision.

Let me explain. Every time we went to the hospital for these ultrasounds, we went with the knowledge that our baby could be born that day. That means twice-a-week I grabbed my hospital bag and baby's, made sure my parents were aware so they could come and pick up our toddler, M had to let work know that the baby may be coming today so he may not be in tomorrow and I had to mentally prepare myself that today could be the day this baby came into the world. Over a month early.

Twice a week.

So, I'd go through the ultrasound, beg the technician to tell me if there was any growth, anything promising whatsoever and then walk down that hallway to await the decision.

So many times I saw the struggle painted on my OB's face. The flow is looking okay, not great but okay. There's no significant growth from 72 hours ago. MCA, dopplers, cord flow - all of these were terms I had learned and terms, whose numbers that day, were determining factors in our story.

And it always ended the same way.

"Let's wait."

So we'd get back in the car, call everyone and let them know that baby was staying in a little longer (at least another 72 hours) and we'd try to calm down from the adrenaline and go home.

After taking off so many days, M couldn't make it to one appointment so my Mom came with me. I remember her asking why all this talk of induction and why they couldn't just wait and let the baby come naturally.

In all the chaos I had never thought to ask.

And that's when the OB we saw that day explained why. Because IUGR babies have a difficult time handling labour. That the rate of still birth was higher (for many reasons, from the condition not being detected, from the baby not being delivered soon enough or from stress during delivery, which is why they had decided on a c-section etc).

This new knowledge plagued me. Now I didn't know if I wanted to insist on them delivering our baby immediately or if every day we waited, maybe the baby would grow. If we could just make it to 37 weeks, outside of the "premature" time frame it could mean one less fight for our baby. But could the baby make it in there, not growing? Not thriving?

Susanne Remic said it best. "From the moment you're told your baby is not growing well, you feel a little like a ticking time bomb." 

I'd stare at the OB's face every appointment as he contemplated the facts before him. The confusion and struggle was clear as day. It wasn't until that appointment that I understood this was essentially a life or death decision. What was better, an IUGR 32-weeker or an IUGR baby left in-utero until 37 weeks, potentially not getting what it needed?

I'd ask what I could do. "Take it easy and keep eating and come in the second you feel something isn't right."

I never wanted to leave. What if I missed something that wasn't right. The kicks were never strong to begin with, I rarely felt movement. I had enough guilt that my body wasn't helping my baby to grow sufficiently that the added responsibility of being sent home for 72 hours at a time was overwhelming. 

The goal was 37 weeks. If we could just get to 37 weeks we'd be out of the premature time frame. At 36 weeks I went into labour. It was like my body just wouldn't get on the same page. Induction had been pushed off to 37 weeks but baby was having none of that, apparently.

We headed to the hospital where a nurse, unfamiliar with the situation, excitedly informed us, "you'll be having a baby tonight!" M and I tried to make the most of our first outing since the birth of Y, 15 months earlier, and tried to laugh through the craziness. 13 hours later contractions significantly slowed down and after even more ultrasounds, I was sent home and told not to go too far since delivery was imminent. 

I spent that week like the ones before. Two doctor's appointments, more BPPs and dopplers. More waiting. More worrying. 

I made Shavuos, (which happened to be a 3-day-Chag) and headed into the holiday hoping for rest, quiet and minimal drama. 

At 37 weeks 1 day, 3 hours before Shavous was over, I was on my way to the hospital.

Tuesday, March 08, 2016

IUG... What?

A year ago, I had no idea that IUGR Awareness Day coming up, on March 13th, was a thing.

A year ago, I had no idea IUGR was a thing.

Intrauterine Growth Restriction.

Three words that changed my pregnancy, my delivery and my life. 

Forgive me if that sounds dramatic, but it's the truth.

I don't know how to share what IUGR has meant to our family. I don't know how to put into words the fear, uncertainty, chaos and isolation that comes along with it. 

But I do know that if there was someone out there that could have reached out and understood that my baby wasn't going to be little just because I am, then I wouldn't have felt so alone. That just because I'm all of 4' 11" a 3lb baby wasn't something I should have just expected. I actually had an ultrasound technician tell me, "In my country we say big dog, big puppy; little dog, little puppy." 

Yeah.

So here it is. Here's the series I would have wanted to read. And if someone out there, going through this diagnosis, this uncertainty, right now could, at the very least, not feel alone and at best, feel comforted, then it's worth putting it all out there...

At 30 weeks pregnant with my second baby, I went for a routine ultrasound. Our hospital policy includes a late pregnancy ultrasound, and thank Gd it did. I knew right away that something wasn't right. I saw the look of confusion on the technician's face. Four times I answered what my due date and LMP was but she just didn't seem satisfied with it. I smiled at our little moving bundle on the screen, wiped up the gel and walked over to my OB down the hall for my appointment.

That's where he told me that our baby was measuring small. And not just small but "too small". For 26 years I had dealt with being called small, short etc. But this time no one was laughing it off. This time words like "induction," "at high risk," "closely monitor," "low birth weight," were being thrown around. Something was wrong and it wasn't even something that people could understand. 

I would say, "They're concerned, the baby is measuring too small." 

Everyone else would say, "Well look at you!" or "Ultrasounds aren't accurate!" or "I bet it's going to be 8lbs!"

People would ask how far along I was, and when I'd respond they'd look shocked and tell me how lucky I was to be so small.

Never in my life, have I hated being told that more. 

All I wanted was to be big. I wanted that jump, that huge weight gain which would mean my baby was growing, was thriving and was getting bigger. 

Instead I stayed small. 

I left that appointment feeling a horrible combination of confusion and guilt. I had already been doing everything I possibly could to have a healthy pregnancy. I had cut out fried eggs, deli, caffeine, anything even semi-questionable. I was eating as healthy as possible. I was chasing a 14-month-old and going for walks and keeping active. I never missed a doctor's appointment, and I rested as much as I was able to.

So why had my body stopped helping the baby? Why wasn't it growing?

You get pregnant, you get bigger, the baby grows, you deliver.

Why was my story stalling on the second part?

After being "small," for 26 years, why couldn't just this once, I move passed that? 

I went home, cried and waited for our next doctor's appointment the following week.

Next, I'll share what an IUGR pregnancy looks like. 

Wednesday, March 02, 2016

Celebrate & Simply The Best Babka Ever!

If you read my post at the very end of last year, you'll know that one of the words I'm focusing on this year is Celebrate. Celebrating the big, small and everyday moments with our family. So it's absolutely appropriate that my new favourite cookbook is Elizabeth Kurtz's book aptly entitled, Celebrate: Food. Family. Shabbos.

                           

If I had a nickel for every time I told my husband I need a cookbook, well... I'd be able to afford a ton more cookbooks!

Speaking of, you need this cookbook.

And if my husband agrees that it's fantastic and worthwhile, when I have more shelves than I'd like to admit, packed with them, you know this is a big deal. 

Even though I'm quick to profess my love for cookbooks, I have a select few that are well worn and used meal after meal, week after week. Pages are splattered with various ingredients, there are notes neatly written in the margins and coloured tabs to make flipping to tried-and-true recipes quicker. The recipes made are family favourites, evoking memories of meals and connections. Otherwise, I turn to the remaining endless shelves of cookbooks, simply for leisurely reading and inspiration.

Celebrate is one of those very rare cookbooks, that satisfies both. I've spent quite a bit of time flipping through pages, bookmarking recipes, reading through the anecdotes and gaining inspiration. I've spent even more time in the kitchen preparing fantastic dishes from its pages! If you follow me on Instagram, you'll have already seen a bunch of dishes I've prepared and shared with followers. 


I'm not kidding, in the short span of time we've had it, we've made:

Sweet Challah
Roasted Red Pepper & Jalapeño Dip
Zesty Caribbean Chicken
Roasted Garlic Potatoes
Yellow Tumeric Rice
Pumpkin Soufflé
Easy Creamy Lemon Tart
Shaved Chocolate Pound Cake
Simply the Best Babka Ever
Berry Custard Tart

Like I said, it's become a staple.

The book is clear, concise and very user friendly. The recipes are laid out cleanly and very easy to follow. The added tips within the steps, such as the one included for poofing yeast in the Challah recipe,  help ensure that each dish you choose to make is a success. 


Additionally, recipes come with directions for freezing and storing, as well as, for a vast majority, directions on how to make them Pesachdik! There's even a troubleshooting chart in the cookie section, to help solve any baking issues you may have had before. Rarely is there a cookbook that wants you to succeed so much in making its dishes! It's a comprehensive collection that leaves you feeling 100% confident that not only is Elizabeth Kurtz fantastic in the kitchen, but also completely knowledgeable and trustworthy. She is the blogger behind Gourmet Kosher Cooking, which has had millions of impressions and recipe downloads. Incredibly impressive and after trying a recipe you'll see, not surprising at all!

And like I said, you can completely trust her! Her recipes have been no fail here so far and I'll even go as far as to say, are replacing classics!

                         

For instance, my husband was very particular about the Challah recipe I make every Shabbos. The few times I ventured out and experimented, were unfortunately met with disappointment and, "back to the regular next week?" I decided to test out the Sweet Challah, and I can happily say that I've now taken Challah twice using the recipe and our freezer has a steady supply built up!


Maybe this isn't the biggest deal to, y'know, most people, but the addition of two ribbon bookmarks was just another example of the consideration shown to readers throughout the book! It's so rare that I'm making one thing at a time in the kitchen, so the luxury of being able to bookmark more than one recipe and flip back and forth with minimal work is an added bonus!

Trying to prep Shabbos (or any meal really) while trying to keep my eye on a non-stop 2-year-old, while simultaneously keeping a 9-month-old entertained, is quite the juggling act. The fact that I can cook from this book, with (to date) no errors and great results, is a testament to how straight-forward and clear the directions and recipes are. 


The recipes themselves are sure to be family favourites. New flavours are embedded in dishes seamlessly, so that even the pickiest of eaters won't hesitate to give it a try. The flavours came together beautifully in the Zesty Caribbean Chicken and despite the fact that there were a few we'd be hesitant to try otherwise, altogether it was great!  There are classics and new takes on classics. The Pumpkin Soufflé is light, flavourful and so easy to whip up! We've made the Yellow Tumeric Rice, more times than I can keep track of. After trying the Roasted Red Pepper and Jalepeno dip for Shabbos, my husband also added it to his fish tacos and sandwiches during the week - an example of the opportunities for versatility you'll find within these pages! The recipes are fresh, make use of ingredients you very likely already have stocked in your pantry and bring new dishes to your table while retaining a familiar and classic feel and flavour! 


And the desserts. Oh my, the desserts! The Berry Custard Tart was so simple to make and absolutely fantastic! I can't even relay how much I loved the Creamy Lemon Tart - simple, quick, tart with such a perfectly smooth consistency!

                    

And finally, the babka. I'm always weary of any recipe that includes the word, "best" in its title, but this one truly deserves it. I made this during the boys nap and it was so fantastic we had one of the loaves fresh from the oven that evening, and I just had to share one with my sister-in-law, the next day! 

A few features making it worthy of its title: 

The dough does not dry out at all 
The filling is perfectly creamy and chocolatey, without any hint of a crumbly texture
It freezes and reheats beautifully
It is SO simple to make (re: successfully accomplished with 2 boys under 2)
It makes 4-5 loaves in one shot, perfect for the freezer/ gifting etc 

                     

And once you taste it, none of these reasons will matter because it'll simply taste like the best babka you've ever had!

I've very kindly been granted permission to share the recipe with you, so go make it asap, have one loaf fresh from the oven because it's just gotta happen (& you just made homemade babka, so you deserve a treat!) and then once you realize it really is the best babka ever, go out and get this cookbook and discover all the other amazing recipes within it!

And if you needed just one more reason to consider it (reallllly?!) the cookbook benefits Emunah of America, an organization that, "is all about caring for those who need extra care." They work to restore children and families in distress, back to health, have homes for children in dangerous situations, daycares, counselling and programs for the elderly as well. Throughout the pages of the cookbook, you're given a glimpse into their work and the children and adults they help each and everyday. The purchase of this cookbook will touch the life of a child or adult who relies on Emunah for help.

Now go!!

Enjoy!

Simply The Best Babka Ever
Initially appeared in the Emunah Cookbook, Chef's Confidential. Reprinted with permission from Celebrate.
(Makes 4 Loaves) 

Babka:
7 cups all-purpose flour plus 1 additional cup, as needed, divided
6 (1/4 ounce) packages or 4 1/2 tablespoons instant or rapid rise yeast
3/4 cup granulated sugar 
1 tablespoon vanilla sugar
1 1/2 cups margarine, melted
1 3/4 cups warm water
2 eggs
2 egg yolks
2 teaspoons salt

Crumb Topping
4 tablespoons margarine, at room temperature 
1 cup all-purpose flour
3/4 cup granulated sugar

To make the babka:
Combine flour, yeast, sugar, vanilla sugar, margarine, water, eggs, egg yolks, and salt in a large bowl. Turn out on floured board and knead 5 minutes, adding up to 1 cup of flour if dough is sticky. Allow to rise in a large bowl covered with plastic wrap for 1 1/2 hours.

For the crumb topping:
Crumble margarine with flour and sugar in a small bowl, using fingertips.

Make babka filling (below)

Spray 4 (10 inch) loaf pans with nonstick cooking spray. 

Divide dough into 8 pieces. Using a rolling pin, roll each piece into a 1/2 inch thick rectangle, the length of the loaf pan. Spread filling onto each rectangle, within 1 inch of borders. Roll from long side, like a jelly roll. Twist 2 rolls around each other and place a twist in each pan. Using all the crumbs, sprinkle a quarter of the crumb topping on top of each babka. Let rise for 30 minutes.

Preheat oven to 350 degrees F.

Bake for 30 minutes. Cool for 15 minutes in pan, then remove and cool completely on wire rack. 

This freezes well. Wrap tightly in plastic wrap and store in freezer. Defrost in the refrigerator and serve at room temperature.

For the Chocolate Babka Filling
(enough for 4 babkas)

1 cup margarine, melted
1 (4.1-ounce) box instant chocolate pudding
1 egg
1/2 cup water
2 cups sugar
1 cup unsweetened cocoa powder

In a small bowl, combine margarine, chocolate pudding, egg, water, sugar and cocoa. Use an eighth of this recipe for each section of dough.

Disclaimer: This a review copy of this cookbook was generously sent to me. The ideas and opinions expressed within this post are completely mine, and are the product of truly cooking my way through the book and using it in our home.