Welcome to khan.org

First, I want to say thanks to all of our friends and family who have sent cards or gifts, emailed or called to offer well wishes, and offered words of encouragement and support. It is heartwarming to know that Carson comes into a world with such a network of friends and loved ones who extend such warm gestures. The three of us appreciate it very much!

That said, here's an update on how Carson, mom and dad have been doing, and a few random notes, in roughly chronological, bullet form:

• The birthing nurse at the hospital, Pearl, was extremely good to us. She was a key part of having such a problem-free delivery. For those who may have missed the "as it happens" updates on this blog, we were induced on 7/16 with "petocin" a drug that mimics oxytocin, the natural hormone that causes a uterus to contract, both before and after birth.
• Our post-delivery nurse, Christine (not to be confused with my wife) was also very attentive. Some people simply have a very empathic connection with people, and the medical profession needs more of these kinds of folks in their employ. :)
• Christine, Carson and I owe them a visit one of these days to say thanks for their superb professional performance during the labor, delivery and recovery.
• After about 36 hours in the hospital (normally they keep you 24 hours with low-risk deliveries, and 48 hours for C sections), we were ready to go home. At the hospital the principal struggles were to try to get Carson's weight loss (all babies generally lose weight after birth-- they go from having a steady-state stream of nutrients entering their bloodstream to being fed every 3 hours) under control.
• This meant trying to breast feed as much as possible, but breastfeeding, as I have commented to several friends, is largely a lost art in this day and age (compared to traditional/extended family-type societies where it's commonplace). We found that if we didn't introduce formula, we'd be putting Carson at risk of entering the infant care unit (think incubators in a room separate from mom and dad rather than just sleeping in a basinette next to us).
• At first we supplemented with formula only as a last result, but as his weight loss got close to the 10% mark, we began to increase the amount of formula we'd feed.
• In the past couple weeks, we've had a series of medical appointments, including a follow up with the Overlake Women's Center, which focused primarily on the difficulties with breastfeeding.
• Additional followups at the Women's Center with lactation consultants helped us set goals and use techniques to more effectively feed and get his daily intake of food up.
• During these sessions the nurses shared a concern that his tight frenulum (the membrane connecting your tongue to the bottom of your mouth) might be part of the problem with feeding (also called ankyloglossia).
• Apparently midwives of old would keep a fingernail sharpened for the express purpose of severing this membrane (newborns apparently have little to no sensation in this membrane), and we were recommended to the Overlake Ear Nose Throat (ENT) specialists to have it clipped.
• Aside from helping to improve his feeding, it also eliminates a risk of having speech impediments later in life, and gives him the ability to extend his tongue. I suspect this is something he inherited from my side of the family. My dad has a slight lisp, and I can't stick out my tongue very far.
• On a scale of "horrible things you can put your child through", a frenulectomy is nothing compared to a circumcision. The procedure was fast.. A snip with surgical scissors, and within minutes he was breastfeeding to be comforted and to take the taste of blood (there are a few drops after the procedure) out of his mouth. In five minutes, it was as if nothing had happened at all.
• This didn't reduce Carson's fussiness during feeding, particularly where he has been making some disturbing noises during feedings.
• A followup visit to the pediatrician introduced us to a new word: "laryngomalia", which he suspected might be the reason for the feeding noises he makes. (These sound like labored breathing during feedings)
• The good news is that a visit to the ENT specialists at Children's Hospital in Seattle this morning ruled that out. They put a fiber optic camera up his nose and down his throat and found no abnormalities, just a little inflammation of the larynx.
• They believe this is caused by acid reflux, or basically food coming back up the larynx.
• A common cause of this ailment is apparently the use of milk in formula and/or the ingestion of milk by the mother.
• We're now (until Monday) changing Carson's formula to a soy-based version, and Christine has stopped drinking cow's milk. If this goes well, we won't have to take any further steps. Otherwise, some medications (think Pepsid AC kinds of drugs) are often the next course of action.
• Aside from all the feeding/breastfeedings, everything is situation normal...
• On a relatively banal note, for example, Carson quite disliked his first bath (pics to follow shortly), his umbilical stub fell off a few days ago, and I need to produce my first Carson video using iMovie '08 which has AVHDC support for my new Canon HF 100 HD camera (video to follow shortly)...

In other words, stay tuned for more updates from the Klatt household!

One of the things I'm very grateful for is the ability to take off a bunch of work to stay home to take care of Carson. While the "FMLA" law states that qualified individuals can take off as much as 12 (unpaid) weeks per year (for events including for the birth of a child), there's a lot of pressure on parents to take off as little time as possible.

I think it might be a little worse for dads (I've heard comments akin to "you're not the one who actually gave birth") but the reality is that taking care of a child in the earliest days of his life is exhausting work. Not necessarily because it's difficult, but because mom is going through some hormonal changes after pregnancy, the baby has physical and emotional needs, and these needs need often to be met every 3-4 hours a day.

Will these needs magically evaporate after 2, 4, 6, or even 12 weeks? No, but I suppose the more time a parent can take off work makes it that much easier to shift the formerly shared duties of parenting to the other parent for 8-9 hours during the day... And that's in my particular situation, where Christine is a stay-at-home mom...

I can't imagine how two-parent working families would handle a new child, and while I don't condemn the practice, I find it difficult to imagine handing off my infant/toddler to a day care while mom and dad go to work for the day...

So, I try to remind myself that the situation we find ourselves in is actually quite fortunate, while wishing that I could have taken more time off, or be in a business/profession where I could reasonably work from home for an extended period of time...

The reality of the situation is that if I felt no pressure (whether self-inflicted or from my employer) to return to work after exhausting all 12 weeks of FMLA time, I'd probably do it. But given that I don't have 12 weeks of vacation/sicktime accrued (most companies even have caps to make this infeasible) the financial as well as corporate reality is such that I ended up taking a couple days short of all the paid time off I had accrued.

At 1:19am, Thursday July 17th, 2008.

Mother and baby are tired, but doing just fine.

Do you think George W. Bush should be impeached?
If you answered "no", watch this short movie and let me know if it changed your mind:

Now that we're on day 5, I thought I'd offer a few insights on parenthood from the perspective of someone who is only five days in.

• Expect to have your priorities redefined. When "stuff happens", you'll be surprised how easy it is to pop out of bed and deal with them.
• If "falling in love" is the first stage of emotional maturity, the second stage is "the love for a child". The human race probably wouldn't have evolved/survived without the chemical/emotional changes that happen to parents when a child is born.
• This was painfully obvious to me when I witnessed my baby's circumcision (which was the most difficult decision we had to make). While the actual event was probably not particularly painful, they have to strap your baby's legs down to perform the procedure, and that distresses an already distressed baby even more. Seeing your own helpless and vulnerable child flail in front of you is heartwrenching. It's probably one of the most emotional things that has ever happened to me.
• Now I know what my mom meant when she'd chide me in saying "when you're a parent, you'll know".
• My heart goes out to parents who have to take their kids to an emergency room and hear them cry/wail as they receive treatment. You know you're doing the right thing, but hearing your child cry out in pain is the greatest emotional anguish you'll probably ever know.
• That experience makes the other difficult decision we had to make --selecting a name-- seem tame by comparison.
• Our naming process worked like a double elimination sports tournament. We kept on pitting names up against each other until a few favorites were left. Those that got "eliminated" could compete for "middle name".
• The criteria for name selection included: 1) Relatively unique (no Chris or Mike or John) 2) Not so uncommon that it would require him to spell it each time 3) No same initials, 4) Have some kind of heritage that matched one of our backgrounds and 5) Domain still available
• After we decided we couldn't find a name that filled all categories, I decided #4 could suffer at the hands of #2.
• Hence one of the other favorites on our list, "Carson" began to gain favor as a "corrupted" version of Karsten.
• Alexander, which had been a leading candidate, then became available as a middle name. Alexander had a lot going for it as well, considering that it has a Turkish derivative (criteria #4) of "İskender".)
• "Carson Klatt" has a rhyme and alliterative ring to it that most of the other names lacked.
• I'm apparently the 10th guy in the statistic that 9 out of 10 car seats are installed improperly. (The nurse from the hospital asked "You installed this?"... When I said "yes", she gave me a fist bump and said "Nice!"
• Diapers and diaper changes aren't nearly as bad as you'd think. Newborn poop isn't all that foul smelling, probably because they don't have well-established colonies of bacteria in their intestines? Not that I've gotten that close to find out...
• Taking care of a crying baby isn't really tough at all. In fact, it's quite easy. You check if he's wet himself (infant clothes make this easy, with crotch snaps, zippers, etc.), and change the diaper if he has. You check to see if he's hungry, which is simply a matter of touching his cheek (if he's hungry, his instinct is to turn towards something that resembles a nipple). And when you're done feeding him, you rub or pat his back for a few minutes after each meal to get expel any any gas in his stomach.
• Of course, he'll be crying if he is wet, hungry, or gassy, but comforting him is actually really easy too. His website is down right now, but Dr. Karp's "The Happiest Baby" techniques totally work. (If it's still down, just use google's cached version to bring up his site)
• The toughest thing is that we have to keep on waking him up to feed him every 3-5 hours, which means Christine and I are constantly looking for opportunities to take a nap.
• Breastfeeding (we're trying to avoid formula) is really tough. Finding good resources online and in the health care community is key. Friends advise us to "stick with it", which is difficult, but worth it from a nutritional and bonding perspective. Pumping is nice for me because it means I can take a more active role in feeding.

There are probably a few other nuggets to share, but I hear a cooing baby that needs attention (which reminds me a of another tip-- quieting a baby is easier if you catch them before they work themselves up).

Barack Obama disappointed me when he recently voted for the "Telecom Immunity" package allowing for warrantless eavesdropping on US citizens. In his response to the flurry of criticism that followed, Barack stated:

Given the choice between voting for an improved yet imperfect bill, and losing important surveillance tools, I've chosen to support the current compromise. I do so with the firm intention -- once I’m sworn in as President -- to have my Attorney General conduct a comprehensive review of all our surveillance programs, and to make further recommendations on any steps needed to preserve civil liberties and to prevent executive branch abuse in the future.

Our civil rights are guaranteed by the Constitution. Adopting legislation whose "check and balance" against executive abuse is oversight by an appointee by the executive itself is laughable.

While it's fairly likely that Obama will win in November, what if he doesn't? That should be the standard by which any legislation is judged-- not "what is the implication of this policy when used properly", but rather "what is the implication of this policy when intentionally abused?"

Obama continues:

...When citizens join their voices together, they can hold their leaders accountable. I'm not exempt from that. I'm certainly not perfect, and expect to be held accountable too. I cannot promise to agree with you on every issue. But I do promise to listen to your concerns, take them seriously, and seek to earn your ongoing support to change the country. ... And going forward, some of you may decide that my FISA position is a deal breaker.That's ok. But I think it is worth pointing out that our agreement on the vast majority of issues that matter outweighs the differences we may have.

Obama is right, this is a deal breaker for me. I will no longer actively participate in the Obama campaign, and I will no longer make quarterly donations to his campaign. Barring a more viable candidate joining the race, I'll still vote for Barack, but without the taste of kool-aid in my mouth. Instead, I'll invest my political and financial energies on progressives like Darcy Burner who is running for Dave Reichert's seat.

I think it's a sign of the times to register a domain name before you tell anyone what the name of your child is. :)

These words from our nurse were very comforting for Christine to hear.

She's fully dilated, and the baby will soon be on his way!

Contractions picked up pace and soon the pain was unbearable. With the epidural in place (9:21pm), it sounds like we have about 1.5 hours before we'll need to begin pushing.

6:21pm, our doctor broke the amniotic sac... Here we go!

Christine & I checked in and are in the delivery room. They are now administering the petosin which will help induce labor.

We expect to welcome our new addition to the family to the world today.

I'm anxious, nervous, and excited because we called into the hospital, and were told we'd be called back, and that we'd need to show up at the hospital in an hour from the time we're called in... So it's wait-and-see!

I have a list of people to contact when the baby's born, but if you're interested in being in the loop when it happens, drop me a note, and I'll put you on the Cc list!

Justin asked what settings I used for the pic below.

Camera: Canon Digital Rebel, XTI @ 100 ISO in Manual mode. "Bulb" exposure. Manual shutter release, five second exposure.

Lens: 24-70mm 2.8L at 67mm focal length, stopped down to f10.

Tripod: Hakuba HG-503MX with factory head.

I chose f10 and ISO 100 because fireworks are actually quite bright, and I wanted exposures several seconds long to get enough "action" in the shot.

More of the (as always, full resolution!) pics are at this 4th of July Flickr set.