That picture is of my nemesis. It's what was left of Squeak's frenulum after he went under general anesthesia to have the frenulum, well, not be there. It's a procedure called frenotomy or frenectomy.
In that picture, you're looking at the underside of his tongue. The tissue at the bottom that I think looks a little scary is where the first surgery was done. This was taken just before he had another frenotomy. Oh yes. It's been quite a week.
So, late the previous week nursing went to hell. And it went there fast. Squeak had had the frenotomy under general anesthesia on the 25th of October. Nursing got less painful and I waited for it to get totally better (it can take time as the baby re-learns how to nurse with all the added mobility in their tongue).
Around the time I wrote the monotreme post, nursing was getting really painful. It seemed to be getting worse. I made an appointment with a speech therapist and was generally really frustrated.
That Friday, nursing became so painful that I had to stop nursing and pump instead. It was unbearable. So I whined on a forum on Sunday about how horrible it was bottlefeeding Squeak (he would cry and fuss the whole time. And it was messy.), and someone suggested emailing Dr. Jack Newman. I figured it couldn't hurt, even though I was sure he'd have nothing to add...
He told me the freaking frenulum can re-attach! I called and made an appointmen to see a nurse practitioner who was a former IBCLC (Lactation Consultant). The first appointment I could make it to was Tuesday morning.
Monday I made the trek up to see my specialist and was told I was dehydrated. Lame. I'm working on drinking constantly...
I also realized that Squeak's frenotomy had been done with a cautery, so I was doubtful it could have re-attached...which made the whole thing a mystery as to why nursing was horrible. I even emailed Dr. Newman again to ask if it could re-attach if it were cauterized, and he said he had no idea. It seems this entire first surgery was out of the norm - it's usually done awake and with a pair of scissors. Squeak's was done under general anesthesia and with a cautery.
Sooooo...I was feeling like a crazy lady at this point. I didn't know what was going on - what the heck could cause nursing to get worse?? And would we be able to fix it??? Of course, I'm at this point fearful there's something neurologically wrong with my baby and he can't figure out how to nurse and OMGOMGOMG.
Tuesday we had our appointment and the nurse practitioner said his suck was coordinated on her finger, and all his reflexes and his tone looked great. He's alert, following faces, realllllly interested in faces, etc etc. And she felt in his mouth and there was still frenulum there. GAH!
Then we went to see the IBCLC who has diagnosed tongue-tie in both my boys, and who has been there with all the latest information and an ear to listen through our breastfeeding challenges with both kiddos. (To my readers and friends who have not yet crossed into Momville, nursing is not "supposed" to be this hard. Starting out has been a trainwreck for me both times. WHATEVER.) The IBCLC could feel that there was more frenulum there, and also noted that Squeak's tongue was tremoring - a sign that he was working really really hard to use his tongue because it was still tied down.
She recommended we have a second procedure done, and we discussed a pediatric dentist in Chicago (about 4-5 hours away without kids...) who does it with a laser and without general anesthesia. There was no way I was putting my baby under general anesthesia again. The Beast was initially reluctant to drive to Chicago and then pay out of pocket for the procedure (insurance wouldn't cover it). But I was having no talk of general - the general was scary, I was separated from Squeak for 30 minutes, and when he was handed to me it was by a nicotine-saturated nurse who had snuggled him on her chest to wake him up. He smelled like cigarettes and anesthesia. It was disgusting.
When it turned out the procedure basically hadn't been completed by the ENT the first time (as opposed to the darn thing re-attaching), The Beast was much more amenable to going elsewhere, and the doctor in Chicago was actually the closest we have been able to find (so crazy...).
In any case...I called the pediatric dentist that day (we're still on Tuesday) and got an appointment for Thursday.
The rest of Tuesday's a bit of a blur, but I did have a postpartum doula come help me pack that night. I was so scatterbrained and I really REALLY needed to sleep. So she came and helped get some laundry done, cleaned up the house a little while we packed, held and soothed Squeak while I packed, and she changed my sheets (which had, at some point, been pooped on by the baby in a spot no one sleeps on. It could have been a day earlier or a week. This is motherhood...). It was a great bit of last-minute help. We came home to clean sheets and a somewhat tidy living room, and lots of clean (and folded!) laundry.
I think I got 3 hours of sleep on Tuesday night. I was up thinking things like, "what if we go up there and the doctor says there's no frenulum to snip?" And, of course, "I wonder if it's possible to cut off my baby's tongue?"
Wednesday morning I took the kids to a playtime/breastfeeding support thing. I had to get us out of the house so I didn't lose my marbles altogether. Then we picked up The Beast and headed off to Chicago.
We arrived in time for dinner and then we all crashed.
In the morning, we all went to the Field Museum. Bean met Sue the T-Rex!
We also sprung the Robo-Sue exhibit on him as a surprise. Bad, bad planning on that one. He was terrified of the moving dinosaurs!! He clung to The Beast and started screaming that he wanted to go home. It took a little while for us to get him calmed down and then he insisted that he did not want to go back to the exhibit. So maybe we should have told him what to expect. Or he might just be too young and have too awesome an imagination. I mean, the very low-tech monster in this scared him (he wanted to be held close and "kept safe" while he watched it over and over and over).
After a good morning and a decent lunch at the museum, Squeak and I headed up for the repeat frenotomy, and Bean and The Beast went to the Shedd Aquarium and then found a park when Bean lost his mind (overtired? Overstimulated?).
As a mom, I've now been part of three very different frenotomy procedures. This was the least stressful. Squeak and I were reclined in a dental chair - Squeak was laying on my shoulder facing away from me. I held his hands and talked in his ear the whole time. An assistant held his head still, and the pediatric dentist used a laser to perform the procedure. There was very little bleeding, and Squeak was alert and ready to nurse immediately afterward.
We went and picked up The Beast and Bean and headed home. We were all exhausted on Friday, and took it somewhat easy today (the good thing about the travel was that we didn't eat any of our leftovers last week and didn't need to cook today!).
Sunday, I plan to spend some quality time re-learning how to nurse the baby. I've been nursing in these crazy positions that are murderous to my back - because that's been the best way to keep him on. The Beast has agreed to take on Bean for the day. We're not planning to cook or clean or do anything but work toward getting this sorted out.
Nursing is going. I'm not sure if it's better or not. Well, it's definitely better because Squeak isn't falling off every few sucks - but I'm still hurting. But not bad enough at the moment that I don't want to nurse. Baby steps. *sigh*
I have to say that if I didn't know from personal experience that nursing will still be "worth it," even if we work at this a bit longer, I think I would have quit last week. I was feeling very hopeless, I reached the point of not wanting to nurse bceause of pain, and I was so, so tired (Squeak is suffering because he takes down so much air as he eats - he was waking up screaming at 3 or 4AM needing to burp and spit up). Or, if I'd not had so much support - including a husband who took most of the last week off. I'm so grateful for everyone who talked me through it, helped me figure out my options, and assisted us in numerous other ways.
And now - onward and upward. Please, oh please.