Saturday, September 24, 2011

A Filipino Baptismal Celebration

The baptistry of historic Barasoain Church in Malolos
I am currently planning for Guijo's baptism, and this prompted me to look back at his older sister Narra's baptism held two years ago on August 8, 2009.  What we had then, was a distinctly Filipino baptismal celebration.

Above: Group photo at the inner courtyard leading to the baptistry.
Below: A solemn ceremony with godparents. The rite was administered in beautiful Tagalog.


VENUE: BARASOAIN CHURCH
The church we chose was the historic national treasure: Barasoain church in Malolos, Bulacan - hometown of my husband Oliver's Carsi Cruz side of the family.  Barasoain's baptistry is located deep inside the church, all the way to the back, in a concealed chamber behind the altar, and getting to it is like traveling back to the Spanish colonial era. One has to pass through thick adobe arches, and walk on sturdy adobe paths, through silent courtyards populated by wise old plants.  Most of our guests came from Manila and the church offered charming attractions - its architectural features, a museum with historic artifacts, and a baptismal ceremony officiated in beautiful Tagalog with Bulakenyo flair.   Like most other Filipino couples, we asked a good number of our friends and family to be ninongs and ninangs. Narra had 8 pairs of godparents.

(from left to right) Oliver, Myself, and Narra's Ninong Thunder.
Narra is in her piña gown.
TRADITIONAL CHRISTENING GOWN
Narra's christening gown was made of piña fiber which was elaborately embroidered. It was done in the romantic old style of puffed sleeves, and extra long length, and came with matching booties and cap.  It came from the Tesoro's line of Filipiniana formal  wear, and we were fortunate to get it as a gift from our generous Ninang Alice Tesoro Guerrero. 

With my mother-in-law and Narra's lola, my Mama Rubi Socorro Carsi Cruz who started the family restaurant business.Behind us is the the original Bahay na Tisa.
RECEPTION VENUE: BAHAY NA TISA RESTAURANT
Oliver's mother, my mom-in-law Mama Rubi Socorro Carsi Cruz started the family restaurant called Taberna Maloleña in the first floor of the Carsi Cruz summer home in Malolos, just a block away from Barasoain church. That summer house was made of bricks and had a tiled roof, and locals referred to it as Bahay na Tisa. From its humble beginnings in the 1980's, Taberna Maloleña expanded into a well established catering business - the restaurant itself was renamed Bahay na Tisa, a new building across the street now houses the new restaurant, and they have other operations providing food and beverage services in a hotel, as well as a casino, and most recently another branch of the restaurant was opened in another part of Malolos.  The food offerings during the reception included signature family recipes, including my all time favorite Kare-Kare and my sis-in-law's award winning shrimp lumpia, as well as my favorite deserts of mini turon with langka and sesame seeds topped with a dollop of cream - yummy!


Oliver and Narra inside the new Bahay Na Tisa main dining hall. 
Narra and her Mama.
The entrance to the new Bahay na Tisa Restaurant. The new building retains some traditional architectural features.
With me in the photo are Narra's Ninang Ana, Ninong Tristan, and his fiancee Nona.
Looking back, I found that baptismal celebration simply enjoyable. I did not stress out with the preparations at all - no invitations were needed (we just sent text messages by phone) - we didn't spend on decorations anymore - and not even a cake or souvenirs. We didn't really go for a theme party, but we ended up with a Filipiniana feel because of the location, the food, the architecture, and I think even the lack of party planning - this lent the event an old school sense of celebrating sans the newer party fads. What we did have were all the essentials: a solemn ceremony in a picturesque church, a lot of great tasting heritage dishes from the family's culinary treasure box, and a good many hours of spending time with family and friends chatting the afternoon and evening away in a quiet corner of Malolos. I have fond memories of that day, August 8 2009 (which also marked our first wedding anniversary - Oliver and I were married on 08-08-08). 

I am hoping to have another stress-free and enjoyable baptismal celebration for Guijo.

For those who are considering having their child's baptism in Malolos, I'd highly recommend Bahay na Tisa as a reception venue (shameless plugging - I know!)

Bahay na Tisa Restaurant
79 Independente St., San Gabriel, Malolos
(044) 791-1199


Friday, September 23, 2011

The Difference Between Caring for Baby Girls and Boys


The  photo above shows our first born baby girl Narra having an enjoyable bath. We thought we'd have the same experience with our second child, our baby boy Guijo. We were excited to give him his first bath and we were enjoying the process, that is, until.... he sprayed us!!!  It took a few more swift, sudden spraying incidents before I learned to never ever let my guard down again.  With Narra, I could just have her lying on her back on the bath bed, and I didn't worry about her peeing, but with Guijo, hah!, I now have a few strategies in place so I'd always be ready to dodge. 

First method: blocking! Always have a washcloth or lampin (cloth diaper) on top of his launcher whenever he's on his back for bathing or diaper changing.  Second method: redirection! Turn him to his side when washing or wiping his bottom - this will redirect his urine's trajectory to the walls of the tub and away from his face, or yours. Third method: direct contact! When it's time to clean his privates and covering him with a washcloth or turning him to the side just won't work, hold his "lil pututoy" down while cleaning the area.

Learning to care for a baby boy when you've become accustomed to caring for a baby girl is akin to learning to keep your arms up defensively to cover your face in boxing - it takes practice and getting used to - you need to develop a constant consciousness to never let your guard down or you'll get a beating.  I remember waking up in the wee hours of the morning to change Guijo's diaper - and I became complacent. It happened so fast - I had to change not just his diaper, but also his booties, mittens, and blanket, as well as the pillow case nearby - I had a changing mat under him of course - but the thing with penile trajectories is that they can have an unpredictable reach. 

The household I grew up in only had baby girls and never baby boys, so my mother had little advice to give on the subject of caring for a boy. My Auntie Eva, who raised 3 boys herself, gave me a few helpful pointers on Pinoy-style care for baby boys: first, she thought me to position the baby's penis downwards during diaper changes so that the baby doesn't wet his navel or cord stump; second, I should regularly massage my baby's balls! - apparently, as Filipino folk practice goes, conscientious mothers rub their hands to warm their palms, and gently cup their baby's balls and push them upwards towards the belly in the belief that doing so would prevent hernias, and prevent the balls from becoming "luslos" (an aesthetically unappealing condition of having sagging balls). A third prescription came from another relative, my Auntie Myrna, who taught me of a specific hold for carrying boys, holding them upright, one hand on the crotch, and the other supporting the upper body. This carrying position has the same objective - to prevent "luslos" and hernias.

I don't know if I will pass for a conscientious mother by Pinoy folk standards... I sure have a lot to learn. I thought that after having seen Narra through infancy in the recent past, raising Guijo would be a walk in the park.  Not so. There are differences between caring for baby girls and boys, and I am feeling like a rookie all over again.   

Wednesday, September 21, 2011

Our Baby's Circumcision: A Mother's Point of View


There is a wealth of information on neonatal circumcision available online, and there are robust debates on the pros and cons of subjecting babies to the procedure. Despite the availability of info, I found myself lost and confused and unsure about making a stand on the subject, and I was all too willing at some point to just leave it up to my husband to decide for our son.  Before giving birth, I just pushed the topic aside - but a day after Guijo arrived, on August 20, when Guijo was a day old, our pediatrician Dr. Pia Lorenzo, asked us THE question: to clip or not to clip?

I asked Doc Pia many pertinent questions, and fortunately, I was given a lot of straightforward and relevant answers which ultimately helped me form a stand. By the end of our conversation, I was convinced to go for the circ. The next day, August 21, 24 hours before we were discharged from the hospital, Guijo went for his circ, and I watched the entire procedure from preparation to recovery.  I wanted to make sure I was nearby in case I was needed for breast feeding to comfort him.

One of the questions I asked Doc Pia was: how will the procedure be done? She gave a comprehensive explanation of various methods available in the US (I won't mention them all here), focusing on the Gomco method which will be used on Guijo.  Neonatal circumcision with the use of a Gomco clamp is usually quick and effective and results in very little bleeding. In addition, Doc Pia explained to us that after the procedure, they will take some time for exposing Guijo under a lamp and his wounds would be dry before we take him home.

Who would do the procedure? was my next question. Doc Pia highly recommended our gynecologist Dr. Theresa Henson, as someone who does the procedure perfectly. This was very reassuring news for me. I already trusted Dr. Henson with my life - so as far as I was concerned, if anyone was going to touch our "family jewels" it would be her! Dr. Henson had a very well established practice and had a spotless reputation which was cultivated through years of exceptional work. Circumcision is an elective cosmetic procedure, one that has an aesthetic dimension, as well as real medical risks. We needed someone precise and authoritative.  Truth be told, part of my decision to go for the circ was influenced by the knowledge that it was Dr. Henson who would do the procedure. I trusted her a great deal. If I waited until my son was a pre-teen to do the procedure I wasn't sure if I'd meet a doctor with whom I'd share the same level of trust.

How will my son be handled? Dr. Pia assured me that careful research went into the handling of infants before, during, and after the circ. Everything was studied, how to swaddle them in ways that best provided reassurance and comfort.  I saw this for myself when I watched them prepare Guijo for the procedure (see photo above).  They first swaddled his upper body snugly, to inhibit hand and arm movement, but also to make him feel secure.  They elevated the upper body slightly, and his legs were positioned in a spread-eagle, using folded swaddling blankets tucked firmly under a specially designed board, as restraints.  He looked snug, and securely positioned in place.  Then he was moved to the circumcision room where the operation took place. There was a glass panel from which I could view the proceedings. In typical Dr. Henson fashion, she wielded the Gomco clamp expertly, and worked fast. When the actual clipping took place, Guijo cried and immediately, a pacifier with sugary water was put in his mouth, and I saw him suckle at it vigorously.  He stopped crying in an instant - the diversionary tactic worked! Guijo seemed more focused on the taste and new sensation offered by the pacifier. It was around 11:05 am when they started, and by 11:15 he was being transfered back to the nursery. It was done quickly and I'd say Guijo was handled perfectly. He was exposed under a lamp for a couple of hours, for drying time and recovery.  Afterwards, I was summoned to breast feed him.

When Dr. Pia examined Guijo the next day to clear him so he may be discharged from the hospital, she inspected the circ and said it has healed really well, it looks really good, and it was done perfectly. A week later, when we rushed Guijo to the hospital for an infection, we were worried the circ had something to do with it, but all the doctors who took a look at him that week (there were around half a dozen of them), were uniform in their assessment that the circ was done really well, has healed completely, and is in no way whatsoever related to the infection Guijo had, which was from the Staph Aureus bacteria, a very common bacteria which infected his cord stump.  Whew!

On a lighter note, Dr. Pia told us she's seen a lot of penises in her pediatric practice, and not all circs are created equal - some are prettier than others - and according to her, those done by Dr. Henson are some of the prettiest ones around! This brings to mind the traditional summer time practice of gathering the village boys by the riverside where they would form a line, be made to chew on guava leaves, and their tips would be clipped one by one, quickly and efficiently - with little regard for aesthetics. It's a rite of passage that many parents wouldn't deny their kids. I hope my son doesn't hold in me in contempt for denying him his spot on the chopping line - but in case he questions my decision one day, I'll tell him that if one were decided on going for a circ, might as well do it pretty, precise, and (relatively) painless.

Friday, September 16, 2011

Our Baby in the Hospital for Jaundice and Sepsis

3 days after giving birth to our second child Guillermo Jose or "Guijo", we were discharged from Makati Medical Center. It was Monday, 22nd of August 2011, and we were simply overjoyed. He was an easy baby to care for and we quickly established our feeding routine. A week later on August 29, we noticed a change in his demeanor - he was lethargic and didn't want to feed. After a quick call to my sis-in-law Dr. Winnie Carsi Cruz Cruda, a pediatrician, we were adviced to seek medical attention.

Apparently, with neonates, or newborns, symptoms can be very subtle, so it's best not to leave things to chance. An infection that is left undetected may spread to the blood so parents must act fast. I found myself very worried at how limp he felt in my arms, at how unresponsive he was - he wouldn't cry or even offer a feeble grunt in protest when his nappy was changed. He clamped his mouth shut and wouldn't feed. I knew that breast feeding created an opportunity for an infant's immune system to plug into its mother's more mature system - I could provide some protection for Guijo by sharing some of my antibodies with him and helping him fight an infection - but this can only happen if he actually feeds from me! Those two symptoms - unresponsiveness and poor feeding were enough red flags.

Guijo undergoing phototherapy for jaundice at St. Luke's.
FROM OUR HOME TO ST. LUKE'S
My husband Oliver suggested we go to St. Luke's Medical Center at the Global City in Fort Bonifacio. While I was happy with the quality of care at Makati Med, it was not very convenient in terms of location, due to the traffic, and parking issues (no overnight parking for instance). The E.R. was simply heaven! The pediatric section of the E.R. was spacious, and secluded, and squeaky clean. But as hospital policy goes, a baby as young as Guijo had to be confined at the Neonatal Intensive Care Unit or NICU. We left Guijo at the NICU at around 3 am, and we returned a few hours later to meet with our doctor. A lot of tests were administered to diagnose Guijo, and we had to wait for results. In the meantime, he underwent phototherapy for jaundice. He was yellowish when we took him to the hospital. Another suspect was a discharge found in his cord stump. Tests determined that there was indeed an infection and we needed to rule out (or anticipate and treat for) the possibility of sepsis. This meant waiting for more conclusive results from the blood culture test, which takes several days. Our doctor told us Guijo had to complete a course of antibiotics which lasts for 7 days. Whether sepsis was confirmed or not, we had to follow standard protocols, act conservatively, and start with treatment.

When we found out we had to stay for such a long time we asked if we can take Guijo out of the NICU and have him complete his course of antibiotics in a regular hospital room where I can stay with him and breastfeed conveniently. As it was, I was going back and forth from my house to the hospital, even in the wee hours of the morning, to breastfeed Guijo, and since I had just given birth, the arrangement was taking its toll on me. I was just getting so tired, and it hurt when I walked too far, or sat too long. Our pediatrician was sympathetic to us and was willing to allow us to transfer out of the NICU, but hospital policy prevented us from doing so. Oliver advised me to look for a hospital which has a different policy, one that would allow rooming-in with our baby. We found out The Medical City in Ortigas would allow such an arrangement, and so we started processing our discharge from St. Luke's.

FROM ST. LUKE'S TO MEDICAL CITY
Out of the NICU and in a regular room at Medical City.
The family gets to visit Guijo in comfort.
We felt confident that Guijo could already be moved out of the NICU, and out of St. Luke's because of encouraging improvements in his condition. He gained weight, his skin color looked good, he screamed loudly when hungry, and gave grown-up-sized burps when full. Our pediatrician at St. Luke's, Dr. Ruth Valeriano, was super helpful. She wrote detailed information I could give to the receiving staff at Medical City. So on Sept. 1, after 3 days at St. Luke's, we moved Guijo out of the NICU a little after lunch time.

By 2 pm, we were at Medical City's E.R. and I was in for a shock - the place was packed with sick people, and the pediatric ward, in particular, seemed bursting at the seams with worried parents rushing their kids to the E.R. because of a widespread dengue scare. The situation at their E.R. was in stark contrast to the heavenly seclusion we enjoyed at St. Luke's. I became very worried for my fragile 2-week old son. The E.R. was full because the rooms in the hospital's pediatric floor were all full as well, and there was a long waiting list to get one. Some of the parents I talked to told me they have been at the E.R. for quite a while, some have been there since dawn, and one parent claimed they've been there since the previous night. Scared by their stories, I found myself requesting the nurse to admit Guijo to the NICU! What irony! We took him to Medical City because we wanted him out of the NICU, and we find ourselves requesting to be returned to the NICU! I just wanted to get out of that congested E.R. as soon as possible and reduce Guijo's exposure.

So Guijo was admitted in the NICU and we had ourselves wait-listed for a regular room. By 8 pm, we received news that a room had become available in a non-pediatric floor, and since our pediatrician specified that we must be on the pediatric floor, we had to wait some more. Fortunately by 10 pm, we already had a room on the pediatric floor, we just had to wait for Guijo to be brought to us from the NICU. After a long day of dealing with hospital procedures, it was sheer bliss to finally get to lie down and rest and have my baby in the room with me.

The next few days went by quickly. Guijo was already better and we were just waiting for the course of antibiotics to be completed. His meds had to be administered to him via an IV drip so he couldn't move around to much and needed to be under constant monitoring by nurses, but other than the discomfort of the heplock attached to him, Guijo was in perfect form. The hospital stay gave me a chance to rest and recover as well. As I was tasked to watch Guijo the whole time, I had a chance to focus only on caring for him, feeding-nappy change-burping-bathing. It was a blessing that my parents offered to watch my eldest child Narra, whom I love dearly, but whose energy level I could not yet keep up with given my sleepless state and post-labor aches and pains.

On September 5, Monday, 2 weeks after we brought him home from Makati Med, we brought him home again this time from Medical City, with a clean bill of health! 3 weeks and 3 hospitals...it's been quite a ride. Seeing Guijo healthy though, is worth all the effort.

Related Posts:

Enjoyable Delivery at Makati Medical Center
http://nikki-mama.blogspot.com/2011/09/enjoyable-delivery-at-makati-medical.html

A Simple Celebration of Baby's First Birthday
http://nikki-mama.blogspot.com/2011/09/simple-celebration-of-babys-1st-month.html


Enjoyable Delivery at Makati Medical Center


August 19, 2011. Dra. Henson helps me deliver Guijo!


I gave birth to both my babies Narra (born May 7 2009) and Guijo (born August 19 2011) at Makati Medical Center, and I enjoyed the birthing process immensely, both times! The words "labor" and "enjoy" don't usually come together, but I seem to be a lucky person, so birthing came easy for me (and I have the photos to prove it!). For both of my deliveries, I was smiling from start to finish. But before you think I was born with superwoman birthing powers, I'd have to give credit where it is due: to an excellent team of medical professionals at Makati Med!

May 7, 2009. In labor with Narra.  With Dra. Henson and
Dr. De Jesus behind her. 


It starts with my OB-Gyne Dr. Maria Theresa Henson. She was very highly recommended to me by my friends RJ and Vanessa Ledesma when they were also infanticipating a couple of years ago. I've already met with several Obstetricians and I was searching for "the one" and when I met Dra. Henson, I immediately became a fan. She has this assertive personality that I found very reassuring - she was so confident and eloquent, thorough in her methods, and comprehensive while concise in giving me answers to my questions during consultations. And when it was "showtime" in the delivery room, she had such authoritative command, she had her no-nonsense game face on - and I just knew I was in very good hands.

Dra. Henson seemed particular about who she wants to work with, most especially when it comes to the anesthesiologist. My husband preferred St. Luke's newer facilities and excellent location and was hoping Dra. Henson would agree to have us deliver there instead of Makati Med, but she was firm in stating her preference to work with her "home" team, and with her most trusted anesthesiologist. For both my children, I was in the capable hands of Dr. Gerard De Jesus who had such a steady hand in administering the epidural that all my fears of possible risks and complications were put to rest. Like Dra. Henson, Dr. De Jesus exuded a very authoritative presence. I've heard of horror stories from other women about how their epidurals didn't work out perfectly, and I just thanked my lucky stars mine did. It seems to me that administering anesthesia is not just a science, but also an art, and when done well, it leads to a marvelous birthing experience.

There's a nice sofa and tv inside the room, for companions.

Back in 2009, I gave birth in the old delivery floor where I was first put up in a birthing room then transfered to an OR, then wheeled back to the birthing room for recovery. Now in 2011, we used the newly constructed birthing suites located in another wing of the hospital. I had Birthing Room No. 3, which was spacious, well-appointed, sparkling clean, and comfortable. Preparation, actual delivery, and recovery all took place in the birthing room, and my husband Oliver (and anyone else I would have wanted around) could accompany me through the entire process in comfort. There was a comfy sofa and t.v. on one side of the room where companions could station themselves. The bathroom was also huge, a big plus when you're hooked to an IV drip and have to roll the cumbersome stand along with you when you need to do your business.

A lot of space, and a big bathroom on one end of the room.

When it was time to give birth, I was amazed at how the room transformed in an instant to an OR as equipment were rolled in. The spacious room accommodated teams of doctors and nurses: my OB and her team; the anesthesiologist and his team; the pediatrician and her team, and the equipment they needed to do their job. It was like watching a champion basketball team executing a winning play - everyone's in position - doing their part expertly - with no fumbling about. They kept their composure, and with effortless elegance, I saw myself and my baby being handled with what seemed to me like the best possible medical care available in the world. With every gesture, the entire medical staff, from the doctors down to the nursing aides reeked of experience.

Accommodating nurses at the nursery: they even turned Guijo's head
to face our cameras when my family requested to view him. I heard in
some hospitals, they don't even allow photos (like in Medical City).


And most importantly, the proceedings did not feel cold and clinical. On the contrary, there was a distinct Filipino touch to all of it, a warm and caring approach that makes me proud to be Pinoy! People to took time to chat with me, to smile at me, or touch me in a reassuring and comforting way, and when the awaited moment of actual delivery of the baby happened - my precious child was first presented to me, shown to me, and delivered to my arms, before all other medical protocols were started. I did not feel like some passive patient who was alienated from the entire experience. I felt like a central player in the game, a part of their team. I felt numb from the epidural, but I was coached to push like my life depended on it, and push I did, till my eyeballs felt like they would be squeezed into my skull. And when our bundle of joy arrived, there was a triumphant feeling! The epidural only numbs parts of my body, but the rest of me, especially the "inner mother" planted deep in my being, oh - that part felt all the joy!!! There were smiles all around and people were congratulating me for doing a good job (ok everyone was wearing masks, but their eyes and voices suggested they were smiling under their masks).

The pediatric team working on Guijo. I was amazed at how quickly the
birthing room transformed into an OR as equipment were wheeled in.

As Dra. Henson continued to work on completing my delivery, the pediatric team were working on our baby, and I could hear him crying vigorously (such a wonderful, welcome noise - it was music to my ears!). My husband Oliver was recording everything, and that's another plus - the policy that allows for a birthing companion to be there and to take photos! - that to me, should be standard policy everywhere else! My husband, and his act of recording the event were important sources of comfort for me :-) But alas, some hospitals don't allow it.

Even after delivery, the quality of care continued to impress me. The nursing aides who helped me go to the bathroom in the wee hours of the morning, oh what capable angels they were! Knowledgeable and compassionate, they assisted me in a manner that allowed me to retain my dignity even in the most compromising of situations. I am amazed at the delicate mix of personal touch and professional distance they showed.

The doctors, nurses, and lactation consultants at the nursery and breast feeding room are also deserving of praise. They move briskly to get a lot of things done, but tenderly since they are handling babies, I could spend all day just watching them swaddle babies expertly. And they treat the sleep-deprived mothers with respect, patiently giving detailed answers to questions they must have heard thousands of times. They give their answers matter-of-factly, without a hint of condescension, and they make you feel comfortable enough to forget how disheveled you must look already.

Makati Medical Center is not perfect, there are some things one can complain about... but I am a fan. I have good reason to be. I had two immensely enjoyable birthing experiences there because of the amazing team of medical professionals I had the good fortune to work with. I felt very secure to be in such capable hands. Beyond the medical aspects (which I had no complaints about), I was quite impressed with the way I was treated, with genuine concern and kindness. This combination of medical and inter-personal-relationship skills, makes Makati Medical Center a winner in my book, and I give them credit for my awesome birth stories.

Related Posts:
How Much It Cost To Give Birth: The Anatomy of Our Hospital Bill
http://nikki-mama.blogspot.com/2011/10/how-much-it-cost-to-give-birth-anatomy.html

On Our Baby's Circumcision: A Mother's Point of View
http://nikki-mama.blogspot.com/2011/09/on-our-babys-circumcision-mothers-point.html