Tuesday, May 27, 2014

May 27th, 2014 – 2 month checkup, time to vaccinate!

The time has come for our little Monkey to see his pediatrician for his 2 month checkup.  This checkup is difficult for new reasons.  It is time for Monkey to start his vaccinations.  You might be tempted to think that being married to a pediatrician I just unquestioningly go with what Doc says when it comes to the healthcare of our son.  You would be wrong though.  I ask a ton of questions.  I ask to read the research myself.  I question not only my husband but every pediatrician about the options available.  I am not an uninformed consumer going with the flow.  Anyone familiar with my Facebook feed can tell you I am an outspoken advocate for children’s health care.  It matters to me that I put current information out there for my friends that don’t have access to as many doctors to badger with their questions.  I even connect them with doctors and sources so that they can get the information first hand.  And in the end here is what I concluded was the best treatment option for our son; to be vaccinated on the currently recommended schedule. 

I am not excited about watching my son get 3 shots this week.  I will not love watching the nurse hold my 2 month old down and jab him 3 times while I listen to him scream out.  I will feel as if I utterly betrayed him when I allow this to happen.  But I have to own those feelings and get comfortable with them, because they are not in my son’s best interest.  Without those shots I am putting both his quality of life and actual life up for grabs to the nearest virus.  With each shot I reduce the chances that I will have to watch them stick needles in his back, watch them shove tubes down his throat to help him breath, watch him suffer needless torment because I was unable to manage my own anxiety about getting his shots.  For 5 minutes of anxiety and discomfort I could save my son’s life or the life of someone he comes in contact with. 

There is a lot of misinformation out there about vaccines being spread about by an anti-vaccine movement that has no author other than celebrities.  I haven’t read anything by a board certified physician that supports the anti-vaccine movement.  I have read many of their claims and when I spent the time to investigate further I found they had almost no merit and generally twisted facts to make vaccines sound more dangerous than they are.  Vaccines are incredibly well studied.  Every vaccine side effect must be reported by the witnessing physician, and then reported by the CDC to the public.  There is no conspiracy to keep side effects quiet.  If the risk were as great as these terrorists allege every doctor I know would have unvaccinated children, because they would be the front line for seeing the side effects.  Every physician I know vaccinates and does it on the standard schedule. 

One of the reasons I choose to vaccinate on the standard schedule is that it is the way vaccines are studied.  Children are vaccinated on a schedule that has been found to be most effective at reducing risk of both vaccination side effects and prevention of the diseases.  I don’t want to mess with vaccine efficacy.  There isn’t as much research available for the alternative schedules.  I know that the majority of pediatricians will say the alternative schedule is better than no vaccines, but I don’t have the research to back it up.  There has been no evidence to support the claim that vaccines can overwhelm the immune system of the child.  Healthy children shouldn’t have any difficulty with getting vaccines on the regular schedule. 

My other reasons for vaccinating on the recommended schedule are more practical.  First, I don’t want to have to keep track of the vaccines.  Parents who vaccinate on the alternative schedule are in charge of making sure their children are actually getting all of their vaccines.  It is ridiculous to expect that a doctor can remember 200 different vaccine schedules, so the burden falls to the parent.  I don’t want it.  Second, I want fewer visits to the doctor’s office.  I love our pediatrician, he is a good friend.  I love the office, my husband works there.  However, the pediatrician’s office is a great place to get sick.  The less time we spend there the better.  Not to mention that each visits disrupts our daily schedule.  I also want my son to have fewer negative associations with the pediatrician’s office.  The fewer painful visits the better.  Basic psychology at play there. 

Now I just have to mentally prepare myself for this visit as well as for the things that come after the visit.  I can expect my son to have his first fever this week.  Fever is a very common reaction to vaccinations and a recent study found that treating the post vaccine fever with Tylenol actually reduced the effectiveness of the vaccines, so I will have to just cope and hopefully teach my son how to cope in the process.  Fevers are so scary for parents.  I get that.  However, after years of listening to pediatricians I have come to have a slightly different view of fevers.  They are not dangerous.  I don’t know where we got this fear of fevers or these thoughts that they will bake your brain.  They won’t.  Even really high fevers are safe.  Febrile seizures are even safe, because they are not true seizures and do not cause the damage usually associated with seizures.  These things are terrifying to us as parents, but I am going to have to remind myself they are not dangerous.  And when I am unable to manage my fears I will rely on my pediatrician to remind me that fevers are actually a sign of a healthy immune system.  We are relying on that healthy immune response to help my son produce the antibodies necessary to have made these shots worth it. 

I realize that there are those individuals who are unable (for a variety of valid reasons) to be vaccinated.  Mostly we are talking about the very young, those who are already sick, and in extremely rare cases those who have an allergy to a particular vaccine component.  Individuals who are suffering from a serious illness, such as cancer, may be unable to get their vaccinations because their immune system is busy with a much bigger battle.  Chemotherapy drugs and drug treatments for organ transplants reduce the body’s natural immune system.  Because these individuals do not have the normal immune responses in place they are unable to fight off infections and produce the antibodies necessary to protect them.  We protect them with herd immunity, which is why getting our vaccines and getting Monkey vaccinated is so important. 

It is also important to understand that vaccinations are a preventative measure.  Once a child is sick it is too late to offer them the protection afforded us by vaccinations.  One of the saddest stories I have heard to date is that of an unvaccinated child who was in the hospital being treated for cancer.  The lack of protective antibodies combined with the treatments for cancer made the child susceptible to every disease and illness that walked into the hospital.  Unfortunately the child contracted several all at once and the suffering was intense and long lived.  I cannot imagine that the parents ever imagined that would be the consequence of their choice. 

Saturday, May 3, 2014

May 03, 2014 – The Mommy Wars

    I have been coming across something more and more frequently and assume as I continue to write my blog it will only get worse, so I feel like it is time to address it: The Mommy Wars.  This is a war of women against women over how to raise children.  It is a battle that serves only to inflate egos and divide women (reducing the amount of support available).  It is the separation of moms into subcategories and pitting them against one another; breastfeeding vs. bottle feeding, cloth diaper vs. disposable, schedulers vs. child directed care, stay-at-home vs. working mom, day care vs. personalized care, home schooled vs public vs. private.  At first glance it would seem that these subgroups would allow moms to find like-minded people from whom to gain support.   However, that isn’t where it ends.  It becomes a hot topic debate that divides moms against moms.  She isn’t a good mom because she does things differently than I do.  Why does this battle happen?  Simply put the ego. 
    The most well defended belief I have ever come across in women is that of “I am a good mother”.  This belief is so strongly defended that I have worked with moms who literally treated their children worse than I would treat a rabid dog and yet heard them repeat over and over again that they were a good mom.  Their proof?  They could list the dozens of ways that they hadn’t wronged their children by comparing themselves to other moms they knew of or their own mom, effectively elevating themselves by putting down another mother’s decision.  So yes, they sold their child into prostitution, but they also kept them fed and this makes them a better mom than the mom who refused to do anything and let her kids starve.  It is a completely distorted logic provided to defend her ego against the thought that she has harmed her child or done less than her best for her child.  Looking at it in this extreme example it seems easy to see how dysfunctional this defense mechanism is, yet we all use it to defend our egos in the very same way.  Of course when we use this defense mechanism it isn’t usually to this extreme, but we are using it for the same purpose.  We let mom guilt take over because we feel like we are letting our children down in some way, so we over compensate with the defense of the ways in which we are being a good mother.  We even take these nuggets of guilt and build them up in defense of our ego.  For example Doc and I have discussed allowing our son to attend daycare 2 days a week.  The main reason is so that I have some adult time away from our son.  The longer we sit with this idea though the more likely we are to start defending it as the “right” option.  Daycare will provide good socialization, exposure to germs, it will expose him to a new place with new rules… all of which defend my ego against the guilty thought of “I am a human being who needs time away from my son to focus on my selfish self.”  My initial reason for considering daycare was a valid and sufficient one for placing my son in daycare (still haven’t committed to this), however mom guilt tells me how selfish I am for not wanting to be with my son always.  Don’t I love him more than anything?  And then the thought that I am being a bad mom creeps in and in order to defend my preciously held belief that I am a good mom I begin working on new reasons for my son to attend daycare, ones that sound like it is for his benefit.  Now, if I wanted to participate in the mommy wars I would take this one step further: I would begin to condemn and look down upon mothers who choose to spend all of their time with their children.  Doesn’t she have a life… doesn’t she want him to have better social skills… look at how much better I am at being a mom because I made the decision to allow my son to go to daycare for 2 days a week.  Meanwhile those who choose to keep their kiddos with them defend their choice by pointing out what a selfish person I am and they feel sorry for my son because his mom doesn’t enjoy being a mom enough to do it every day.  See how the mommy wars go?  They divide us instantly.  All so we can defend our egos which really don’t require this much defending because most of the choices we make are really not going to make or break our kids.
    So how do I combat my ego’s desire to participate in the mommy wars?  The first thing I do is acknowledge that every mom (or parent) is doing the very best that they can with their experience, knowledge, skills, and available resources.  I have had so many people argue with me that this is a false premise, but I have never had anyone give me an example of how it is false.  That mom that treated her child like a dog?  She was doing her best considering her extreme mental illness, upbringing, situation, and resources.  Was it my best?  No, but it was her best.  Does that make it okay?  No, but it was her best.  Can she do better?  Yes, if she is given the proper tools (treatment, medications, behavioral plans, skill sets).  See how this works?  You can acknowledge that someone is doing their best and still not be okay with the outcome.  The acceptance of this premise helps to take away our instant hatred of other parents and replace it with compassion, which is what allows us to connect with and help one another.  The second benefit of this premise is that you are also doing your best with your situation, skills, and resources.  This helps to alleviate the need to justify your decisions and choices which means your ego isn’t threatened and you don’t need to participate in the mommy wars!  Peace will reign in the parenting kingdom! 
    I also try and call myself on it when I am being judgmental.  This means owning it when I find myself looking down on someone else’s choice and reminding myself that they are doing their best and that I don’t have all the information that went into their decision making process.  It also means having an open dialogue with the people around me so they can help me avoid participation in the battle against other parents. 
    Finally, I have to acknowledge that my decisions are just my opinions on how to handle a situation and it isn’t any better than anyone else’s.  I may have a lot of experience and education guiding my choices, but really what that education and experience has taught me is that there is no one right way to raise a child.  Amazing people come from a variety of situations and my choice of diaper really won’t be what inspires my son to be a great man. 
    So this entry is me waving the white flag.  I don’t want to participate in the mommy wars.  I plan to share my opinions in this blog, but they are not the only opinions in the world no matter how strongly I may state them.  My hope is that by sharing what works and doesn’t for us it will help other parents find more enjoyable ways to share their lives with their children.  Just because I schedule, breastfeed, and diaper with disposables doesn’t mean I look down on those who choose a different route.  I don’t consider myself to be a better mom for my choices; it is just that these are the choices that work best for me.  I know so many amazing moms and they all do it so very differently from one another and it seems to work for them and their children.  I know great working moms, bottle feeding moms, cloth diapering moms, organic moms and so many other kinds of great moms.  And their success as a mom in no way affects how I feel about the kind of mom I am.  We are all doing our best with the information, skills, and resources available to us and since we have decided that it is okay to do it differently from one another we can all be supportive of each other as moms, which gives us a whole new layer of defense for that most preciously held belief, “I am a good mom.”  

Sunday, April 20, 2014

April 20th, 2014 – Moo Cow

    We have officially been parents for 21 days now!  It has been an interesting journey.  We have had so much to learn and so has our son.  There is just so much that they don’t tell you about being a parent and even what they do say doesn’t make much sense until you live it.  So far we have had adventures with circumcision and upper respiratory junk and had several appointments to see the pediatrician. 
    Our little guy has been quite the trooper as we learn on the fly.  The moment he was born we had learning to do.  My first lessons were in feeding him.  Something that seems so natural and normal is surprisingly complicated.  The first thing I learned was OUCH!  Breastfeeding hurts.  No one talks about that.  Everything I knew about breastfeeding came from watching videos, reading, seeing friends do it, and knowing that pediatricians all recommend it.  In all my knowledge seeking no one mentioned pain!  Breastfeeding hurts, at least at first.  No one mentions that you essentially need to build up callouses on your nipples and that in order to do that they first crack, blister, and become very, very painful just like any other skin that is building a callous (only on your NIPPLES!).  So, for anyone reading this that is planning on breastfeeding I am saying it.  Breastfeeding hurts and it hurts every time you feed until your breasts are healed which is a couple of weeks.  Stick with it if you can, but if you can’t I don’t think anyone can blame you.  Work with lactation specialists and learn how to get your child to latch properly.  Our lactation specialists were amazing and totally saved my breasts!
    This skill is learned in the hospital while surrounded by people telling you what to do.  And while our hospital has an amazing lactation consultation service our nursing staff had their own opinions about how things should be done.  So at times I heard conflicting advice and felt pressure to supplement when I really didn’t need to.  I took the route of the student and asked everyone who came into my room questions.  I took advice from pediatricians (who were also moms), nurses, and lactation specialists.  I breastfed in front of a lot of people just to make sure I was doing it right.  Here is what I learned.  First off, no matter what the nurses tell you, you don’t need to supplement.  If you are waiting for your milk to come in you just need to offer the breast more frequently.  Doing this will help your milk come in.  Supplementing can actually interfere with your milk supply, so don’t do it if you can avoid it.  I started by offering each breast for 5 minutes at a time every two hours or as soon as Monkey started rooting (which was any time he was awake).  By the time I left the hospital I was up to 10 minutes a breast for every session.  The hard part with a newborn is keeping them awake for the entire feeding! 
    Second, all babies lose weight just after birth.  The nurses were freaking out because our little guy was down 5% of his birth weight.  This had them making me feel like a terrible mom for not giving up on breastfeeding and using formula instead.  However, every pediatrician who saw him noted his weight loss and said it was fine and I didn’t need to supplement.  Ask more than one person if you are getting conflicting advice.  If it hadn’t been for the doctors and lactation consultants I would have been shamed into formula feeding by the labor nurses. 
    Newborns need to eat every 2-3 hours and they need to feed off booth breasts in order to help establish a solid milk supply.  We left the hospital a day early and my milk had already come in before I left.  This is super early for a first time mom and I think it had a lot to do with the pediatricians and lactation staff supporting me in continuing to offer the breast instead of supplementing.  The nurses did convince me to supplement on a couple of occasions and what I learned was that our little guy was eating plenty from the breast and he really preferred breast milk to the formula.  The formula also seemed to make him very gassy, which made him fussy and that was no fun for anyone. 
    Finally, offering the bottle and even the pacifier was interfering with his learning to latch properly.  Even still if I offer the breast after he has had a pacifier I have to take him off the breast and work on getting him properly latched.  Improper latch is SO painful!  Toe curling pain.  I have kicked the dog off the foot rest of my chair repeatedly when he latches improperly, it is that painful.  Thankfully our little guy doesn’t seem too fond of the pacifier! 
    I also learned a couple of tips for helping keep the nipple damage and pain to a minimum.  The first was to use hard plastic shields to keep anything from touching or rubbing your nipples.  Our hospital had Medela shields that they offered me.  They look ridiculous (like old school Madonna) but they really do help.  Although once your milk comes in they just get gross, so I stopped using them.  The second is to use lanolin on your nipples to help with the chaffing.  Our little guy would refuse to latch when I used it, so it wasn’t really an option.  He would literally latch and instantly open his mouth wide and remove himself from the breast.  I had several doctors and all the nurses tell me this was nonsense (in my head).  Then I spoke with a lactation consultant and a pediatrician who both had seen it before.  Some babies don’t like lanolin, but it seems most don’t notice it.  This epiphany did lead me to a better solution though.  Instead of using the lanolin, hand express at the end of the feeding and allow the colostrum to dry on the nipple.  This actually healed my cracked nipples in no time.  Much faster than what I was seeing with the lanolin.  So, you might give it a try if you are suffering the way I was.  
    The other side of breastfeeding that I hadn’t really considered much before is that you become the sole provider for nourishment, which means you are up every time he needs to eat.  We are 3 weeks in and the longest Monkey has gone between feeds is 5 hours.  Even that is only once or twice a day.  He averages about 7 feeding sessions a day, so the average time between feedings is less than 4 hours.  Each session takes about an hour.  I get him up, change him, feed him for 10 minutes on each breast, and then we need to spend about 20 minutes up right to help him with his reflux.  That leaves 3 hours for me to get any personal chores done and sleep.  I average no more than 2 hours of sleep at a time for the past 3 weeks.  One day Doc took him and I got 4 hours.  It was glorious.  But for the average day I am seriously sleep deprived.  I have started pumping, but we haven’t really used any of that supply yet.  We are saving it up.  It was recommended to us that we save it for when he is older and gets sick.  I pumped and save colostrum for that very purpose.  We know a pediatrician who swears by it, and since she gave me the rub colostrum on my nipples tip, I believe her. 
    Overall I think breastfeeding has been worth the time and pain.  Little man picked up a little upper respiratory junk and it seems to have resolved quickly.  Doc said he thinks the breastfeeding is what helped.  I think it also helped me establish a schedule, which makes all of our lives easier.   Little man is a very happy and easy going baby and while I think a large part of that is just his personality I also think that the schedule helps with that.  I have noticed that when his schedule is disrupted by visits or appointments he is a lot less easy going and gets fussy.  At 21 days old his is starting to tolerate small disruptions and adjustments to the schedule, but he really prefers when he knows what comes next in his day.  Finally, I think the time I spend feeding him is full of quality bonding.  I was the first person he made eye contact with and it was while he was attached to the breast.  It is a very special feeling to be able to provide nourishment and comfort to your child no matter where you are or what is going on.  If that doesn’t sell you on breastfeeding, then maybe this will… you burn 500 extra calories a day breastfeeding!  That is like 2 snickers bars.  ;-) 

Sunday, April 6, 2014

April 6th, 2014 – Labor, Labor, Labor of Love

    After our 2 previous attempts and failure at inductions I was exhausted.  Bed rest for the week was a breeze because I felt awful all week long.  The contractions had continued all week, so it was very reminiscent of the miscarriage.  My body was exhausted and so were my emotions.  By the time Saturday rolled around I was dreading our trip to the hospital and another round of induction.  Doc and I had spent a lot of time discussing the possibility of a C-section and it was sounding better and better to both of us in comparison to another failed induction. 
    We arrived at the hospital Saturday night and began the process all over again.  I was still only 2 cm dilated and my cervix had actual become less effaced because the baby had moved off of it the day before and flipped himself around.  They applied the cervical ripening agent every 4 hours to prep me for another day of Pitocin.  They also hooked me up to all the monitors and gave me a half dose of Ambien.  Our nurse for the evening was brand new and it was obvious.  She was very sweet, but she was in my room at least once an hour checking on me because I was having contractions so frequently.  I repeatedly explained that it was normal and had been happening all week, but it didn’t seem to alleviate her fear that I would spontaneously deliver a baby without complaint during the night as I slept.  It was a horrible start for what I already knew was going to be a long and rough day.  By the time morning rolled around my fear about another day of Pitocin had ramped up to the point that I felt like I shouldn’t be doing the 3rd induction at all.  Despite this, my new nurse hung the Pitocin.
    In the morning I got a new nurse, one with a lot more experience, and a new doctor.  The doctor was one my doctor worked with frequently.  Apparently it is common for them to labor each other’s patients and then call the other in for the delivery.  It was nice because it meant they kept in contact and didn’t step on each other’s toes.  I felt much better about being in his hands than I had with the previous doctors on call.  The first thing they did was explain that the night nurse shouldn’t have hung the Pitocin.  Again, great start to the day.  Then they explained that they wanted to break my water because they didn’t believe I would progress without it.  Rupturing the membrane allows the cushion between baby’s head and cervix to be removed and increases pressure on the cervix, which usually results in labor progressing quickly.  I have previously discussed my concerns about breaking my water so early.  I had really hoped to wait to do it until I was at least 4 cm, preferably 6 cm and labor was progressing more regularly.  The doctor and nurse were convinced that breaking my water was the answer to my failure to progress, I thought they were under appreciating the fact that my cervix had failed to dilate for a miscarriage and 2 previous inductions.  They did a lot of talking at me.  I did a lot of trying not to cry in front of them.  The doctor finally got called away and the nurse stayed to talk at me.  When I couldn’t hold back the tears any longer she gave us a moment to discuss it.  I felt very strongly about not wanting my water broken this early in the process, but they had made it clear that they thought I was in for another day of labor not progressing without it.  My biggest fear was a full day of horrible labor only to end up in C-section any way.  There just wasn’t a good option available.  I didn’t want the C-section unless I knew I had to have it, but I wasn’t going to find out if it had to happen unless I consented to having my water ruptured at only 2 cm.  It was a hard decision to make on a clear day, it felt like an impossible decision to make after no sleep and dealing with the aftermath of 2 failed inductions.  Bawling and feeling totally overwhelmed and defeated, I consented to the process.  We discussed a time line with the doctor to make sure we were all on the same page with regards to how far we would let things go and how long we would allow me to be ruptured.  Thankfully he agreed with the more conservative pediatrician recommendations and so did my nurse, so that would be the end of the battle and we could go forward on the same team. 
    At 9:30 am they ruptured my water.  No meconium staining and baby boy handled the change beautifully.  Contractions increased immediately.  They increased my Pitocin and my nurse remained with us at all times to monitor my progress.  I opted to labor in the tub again because the contractions were back to back and it was impossible to get comfortable in the bed or to walk.  I spent over an hour in the tub.  Doc and my nurse kept refilling me with hot water because I couldn’t move to do anything.  We played music to help keep me distracted and I got over any modesty I may have had.  My contractions were so intense and so close together that I couldn’t carry a conversation.  I just focused on breathing and floating. 
    Around 11:30 the contractions started spacing out.  By spacing out I mean they were now 2-3 minutes apart.  I decided to get out of the tub, because even that comfort only lasted so long.  My nurse wanted to place internal monitors to monitor the intensity of the contractions, which means I would be confined to the bed.  We discussed it and I agreed it was time for the epidural if they needed me to sit still for the remainder of the process.  I was 4 cm by the time the epidural and monitors were in.  My contractions would follow a strong pattern and then begin to space out.  They would increase the Pitocin, the contractions would increase, and then they would space out again.  We couldn’t get my body to show signs of steady progress despite strong contractions. 
    By 2:30 I had made no additional progress.  My nurse had tried placing me in all kinds of crazy positions.  You haven’t lived until you have been naked, immobilized and had your body placed in positions that make your privates a show for anyone who comes in the room.  The doctor came to check on me and was disappointed that we hadn’t progressed despite all of our efforts.  We asked him for a time line of how far we were going to go with this.  He felt that if we hadn’t progressed beyond 4 cm by 6:30 we most likely were not going to be able to deliver this baby naturally.  He was concerned that being stalled for so long wasn’t good for baby or me. 
    By 6:30 we had made no progress despite continued increases on the Pitocin and my nurse attempting to stretch the cervix by hand.  Baby boy decided he had had enough too and flipped face up and started to struggle a little more with contractions.  I worried every time I heard his heart rate slow and Doc’s eyes were glued to the monitor.  The nurse came in and explained she had been watching the monitor too and it was time to call in my doctor for a C-section. 
    At just before 7:15 I was being wheeled into the OR.  I was so exhausted that I couldn’t keep my eyes open or respond when people spoke to me.  I felt like I was struggling to remain conscious.  Baby boy was born at 7:22, 6 lbs and 14 oz, and 19.5 inches long.  I knew his cry the moment I heard it and fought to find consciousness so that I could see him.  I could hear Doc and my doctor talking.  I heard the nurse ask Doc if he wanted to examine him and I was so proud when Doc responded with, “No, I’m not his doctor.  I’m his Dad.”  It is hard for doctors to separate the 2, and he was starting off on the right foot.  My doctor teased him about his son’s full head of hair (Doc is bald).  They were doing well and that made me so very happy.  As they finished up I began shaking.  The shakes were so bad that I couldn’t keep my arms down on the table.  It was like I was having a seizure.  So not fun.  I couldn’t hold or touch my baby, but I could talk to him.  Doc said he oriented to my voice immediately and when he was held next to me he stopped crying. 
    The first hour after the C-section was torture.  The shaking was so bad that I wasn’t able to hold my son.  I had to wait to regain control over my hands before he could be in my arms.  Doc and I were both madly in love with him from the moment we saw him.  He is just perfect.  Holding him for the first time and nursing him were just magical moments I wouldn’t trade for anything. 
   We ended up leaving the hospital a day early.  I was exhausted and the hospital is no place to try and sleep, so we decided we could all recover better at home.  We have been working on getting a schedule established.  It is important to do it before Doc has to be back to work.  I have 2 weeks where I am unable to drive and I can’t pick up anything over 20 lbs for the next 6 weeks, so I am really glad he is home.  Not to mention recovering from the C-section has its own difficulties.  Baby boy is a good eater and has already begun to gain weight.  His nights and days are confused, like most babies, but we are working on getting that straightened out.  He is absolutely amazing and we adore him, despite the lack of sleep.  Doc and I are both enjoying every moment, but also looking forward to the day when we are able to sleep in the same bed at the same time again.  Until then, we just have to be full of joy for the wonderful thing that is life with our son.  

Thursday, March 27, 2014

March 27th, 2014 – Epic Fail

    We went to the hospital on Sunday as planned and proceeded with the induction process.  When I arrived I was already in labor; contractions had started and my cervix was thinning and dilating (1 cm).  We were all very hopeful that things would go smoothly… but that really isn’t our style, is it?  
    Our hospital is incredibly nice.  We have every luxury available to make the stay comfortable; whirlpool tub, shower, large suite, bed that adjusts into any position you could want, birthing balls, rocking chairs, wireless monitors if you want to walk… but it is really hard to get comfortable when you are settling in for hours of labor.  I was tethered to machines from every direction.  I had to wear the belly monitors constantly to monitor baby and contractions.  One arm had the IV and the other had the blood pressure cuff, which I had to wear non-stop because it requires close monitoring.  I could handle the contractions.  Really laboring surrounded by luxury, friends, and excited anticipation of meeting my son was so much easier than our miscarriage 2 years ago that I don’t think I could even bring myself to complain about pain.  Really there were only a few things to complain about as we got started.  The first was that you are not allowed to eat once you are there and I was so nervous before we left that I couldn’t eat, so the last time I had eaten was around 3 on Sunday.  The second is that the nurses have to check you and I had a few impatient nurses that would try and manipulate my cervix into opening.  OUCH!!!  Finally, once they put the ripening agent in you have to lie in bed for 2 hours.  On a normal day I get up to pee every hour or so.  Lying for 2 hours knowing I can’t move is pretty horrible (but it has a lot to do with my need for control). 
    Once the ripening agent was in I was bed ridden, so they gave me an Ambien (which I had never had before) and I drifted off to sleep.  Fire alarms went off during the night for at least 2 hours and fire trucks were pulling up next the hospital, so I knew something exciting was happening.  Apparently the cafeteria caught fire.  Rumor has it that in my Ambein zombie state, fueled by relentless hunger, I stormed the cafeteria looking for jello parfaits and when I couldn't find them I decided to burn the place down... but I cannot confirm nor deny such allegations at this time.   The plan had been for Doc to get his food from the cafeteria because it was close and easy, so this was going to make things more difficult.  
    Monday rolled around and I was exhausted, but also too excited to sleep.  We started the Pitocin and contractions kept coming.  Despite all the contractions, my cervix wouldn’t budge.  We maxed out on Pitocin and then they gave me more… still nothing but contractions.  My OB came up several times to check on me and write orders, so I knew I was in good hands.  Monday night we decided to try a different cervical ripening agent.  The new one had to be placed every 4 hours, followed by 2 hours of bed time.  Ambien again, which I really don’t like.  It makes me feel drunk and weird and although I get sleep, I feel like I have a hangover of tired the next day.  I tried to refuse it, but my night nurse wasn’t having any of that.  I actually tried to refuse any additional drugs Monday night because I was nauseated, had a headache, and was so swollen my ID band had cut off circulation to my hand.  It scared me to be suddenly that swollen.  My skin felt like it was going to split open. But the nurse had her orders and was going to follow them despite my protests.  The night nurses on our labor and delivery wing are not as nice as the day nurses.   
    The one good thing about failing induction at the end of the first night was that I was given some yard time.  I got 1 hour off all monitors where I could get in the whirlpool tub and eat!  After 26 hours with nothing but clear liquids I shoved as much food in my face as I could stand.  Contractions are hard work!  That hour was the most glorious hour ever!  Contractions in a whirlpool tub are awesome.  There is no crushing pressure, everything just feels better in a whirlpool tub.  J
    Day 2 of our induction was a repeat of the same.  No progress and the contractions were starting to fizzle.  My body was exhausted and not going to progress.  By Tuesday afternoon I had maxed out my Pitocin and was making no progress.  They kept me to monitor the baby for another hour and then let me go home.  Doc was back at work Tuesday night.  I am on very strict bed rest. 
    This morning I met with my OB at his office.  The office staff had never heard of an induction failing, so it must not happen very often.  My poor OB is frustrated and worried, as is Doc.  My son is handling all of this very well.  Contractions have continued, but my cervix remains firm.  It actually has gone from being 80% effaced last Thursday to only 20% today and it remains less than 2 cm dilated.  It is like my body is working in reverse!  My doctor explained that at this point the concern becomes about maternal health, meaning we are really risking my health and wellbeing with waiting.  Obviously none of us want that, so we have had to make some tough decisions.  Here is what we have come up with: we will go in Saturday night for another round of cervical ripening and start Pitocin again on Sunday.  If there is no progress by Sunday afternoon/evening, my doctor will come and C-section me.  This has been a very difficult and emotional decision for me to make.  There are a lot of factors to consider and I tend to put my own comfort last, which in this case could be dangerous.  Some of the concerns are that because of all the drugs I have had this week my body might spontaneously try to deliver my son very rapidly, which is dangerous for both of us and something I know Doc has been very worried about.  Another concern is that they will break my water at 3 cm and then labor will stall and we end up in an emergency C-section.  I discussed this with my doctor today, because OBs have a different time table than pediatricians for how long labor should continue once the water is broken.  There are serious implications for the baby if labor goes too long after water is broken.  Finally, the stress of the drugs and labor may be too much for my body and I could end up with some serious and deadly complications (stroke, organ failure) none of which we want at all.  So, in the end I know the right decision is to go with my doctor on this and consent to a C-section.
    Through all of this my husband has been amazing.  I couldn’t be more in love with him.  He spent every moment comforting me, supporting me, and providing me with anything I needed, sometimes before I knew I needed it.  He was amazing.  He gave up sleep and food and was just my unwavering support.  My sweet friend brought him breakfast and I had to force him to eat it.  He didn’t want to eat in front of me, but didn’t want to leave me alone.  He didn't want to miss a moment of this adventure.  He was just so thoughtful and sweet.  We finally convinced him to go grab some food while my friend stayed with me.  He wouldn’t leave my side unless she was there and even then he was gone for less than 10 minutes.  I couldn’t have felt more loved or cherished by him.  I know he was disappointed that he didn’t get to meet his son and that we have to wait a little longer, but he did his very best to handle those emotions.  When I was reaching my limits he knew.  I would laugh and joke with the nurses and then cry the moment we were alone.  It was a tough few days.  I still feel like I am recovering and I am sure Doc is too.  I hope people appreciate what he has been through this week and the fact that he is still showing up at work and giving 100% there while managing a very emotional and difficult week at home.  I couldn’t be more proud of him.  I couldn’t be more amazed and awed by his magnificent strength of character and compassion.  He has been truly selfless when it mattered most and I will forever be grateful to my hero.  My son is the luckiest boy in the world, because he has the most amazing dad in the world.  I couldn't ask for more.  

Tuesday, March 11, 2014

March 11th, 2014 – So Close

It is amazing how quickly time flies!  In only 2 short weeks we will be holding our son.  I saw the OB this morning and he is keeping a very close eye on us both.  Baby boy is growing right on schedule.  I have a little sinus infection, which normally I would let resolve without antibiotics, but being so close to delivery we decided to treat it.  I worry a lot about our baby being born while there is so much respiratory junk still going around.  We had a long winter and the hospital is full of sick kids.  It will make Doc and I both more paranoid about people holding and visiting with our son.  The problem of knowing too much is very real.  I will be counting down the days until our son is fully vaccinated.  Most people probably don’t give it that much thought, but most people don’t see the horror stories. 

For the most part I have been doing well.  In the last 2 days I have become very swollen, but the doctor said it was just another sign of impending labor.  I made the nurse laugh because I told her the weight gain wasn’t from eating Chinese food this time.  I don’t like the swelling because it means I had to take my wedding rings off.  The only other time I have had them off was when I broke my wrist our first year of marriage.  I really hate having them off.  The doctor said my body is ready for this baby to come and has begun its own count down.  It feels like it has gone much too fast! 

The plan at this point is to induce me at 37 weeks.  Depending on labs and how the baby is doing it could be sooner.  My doctor has been ordering a ton of labs and weekly 24 hour urine analysis as well as NSTs.  He said today that he doesn’t want to skip a week and rock the boat because he knows the moment we take our eyes off of it things will go wrong.  I agreed.  I think we all feel better watching closely, especially this close to the end.  I can handle the sticks, tests, and inconvenient collections.  As long as my son is healthy, I am okay. 

Once we hit 37 weeks I will go in on Sunday for cervical ripening.  This is when they put oxytocin on the cervix to help it soften and efface.  Normally this happens all by itself, but because we are not waiting for natural labor to begin the folks at the hospital are going to help me out.  Then Monday morning they will start giving me Pitocin to stimulate contractions (if they haven’t started on their own).  Even if contractions have started on their own they may still give me Pitocin to increase the speed of labor.  I have been asked a few times why they don’t just wait and let me do it naturally.   The main reason is that the longer they allow me to be pregnant, the higher my blood pressure will become.  High blood pressure during pregnancy is a problem for many reasons.  First, the increased pressure decreases blood flow to the baby, limiting his oxygen supply.  Second, it puts me at an increased risk of stroke, seizures, and organ failure.  During the normal progression of a pregnancy blood pressure increases, and for most people these increases are not significant enough to cause impairment.  In cases of preeclampsia or eclampsia it becomes a much bigger issue.  So they don’t let women with preeclampsia or eclampsia wait until 40 weeks to deliver.  Delivery provides additional risk for these women because during delivery blood pressure increases naturally.  Blood pressure increases as pain increases and it also increases with each push a woman makes during labor.  For these reasons I won’t be allowed to labor naturally and they will attempt to make the process as quick as possible.  So once I am admitted to the hospital I will be stuck in a bed hooked up to a lot of monitors.  I find this very frustrating and it is not at all how I had hoped I would be able to labor, but it is what needs to happen in order for me to bring my son safely into this world.  I am holding out hope that things with the induction will progress smoothly and we will be able to deliver without the need of a C-section, but we will all just have to wait and see.  I am kind of amazed at the reactions I get about being induced.  People seem to think I just can’t wait to meet him or that I don’t want to labor naturally.  Neither of which are true.  I was looking forward to sharing my birthday (or close to it with my son) and was perfectly happy to wait until April to meet him.  I also had been looking forward to being allowed to labor for at least a little while in the comfort of my home or being allowed to walk the halls of the hospital before being admitted for delivery, but those things are out of my control.  When I get my epidural may also be out of my control because pain management is one of the ways they try to reduce blood pressure increases.  It is very difficult for me to give up this much control, especially over my own body.  I am very grateful that I have a friend who is a labor and delivery nurse who has helped me understand what things I can control, or at least ask about, and get a better understanding of the process in general.  I have asked my doctor about a few of these things and he is happy to let me do what I can, but makes sure I understand that at any moment things could change and we may need to do things differently.  It is a tough situation to be in.  I try to focus on the end result of a happy and healthy baby boy who I am looking forward to finally meeting! 

Saturday, March 1, 2014

March 1st, 2014 – Cruisin Right Along

    The final countdown is on.  We are 34 weeks and hoping to make it to 37 weeks.  Last week I had a lovely break from the symptoms of pre-eclampsia.  This week the BP is back on the rise, but that is to be expected from what the OB said.  For the first time during this pregnancy I am actually doing a good job of taking it easy.  I sleep, eat, and rest when my body says to.  The nursery is ready.  Bags are packed and I am ready to head to the hospital whenever Baby Boy decides to make his appearance into the world. 
    Our OB was on vacation this week; he schedules vacations all the time and then cancels them but I told him he needed to take this one before our little one arrives.  J So, I saw one of his partners instead.  I really liked her.  I have had several encounters with different partners in the group and she is definitely my top pick to see when my guy isn’t available.  She understood his treatment plan and followed up the way I think he would have liked.  I didn’t feel like she was going to overlook anything, which was really nice.  She said our little man measures right at 34 weeks and appears to be doing very well.  She wasn’t at all worried and said she will be excited to see him because she thinks he is just going to be an early baby.  She was a 34 weeker herself, so that made me feel a lot better.  She followed up with labs and a non-stress test (NST).  Baby boy is really doing well and could come any time.  J
    Throughout the pregnancy Doc and I have discussed who our son will take after and in what ways.  The running joke has been if he is early or on time then he takes after me, running late and he takes after Doc.  We now know he will be at least 3 weeks early, so apparently he takes after me.  J He has also found his own way to be in charge, so again takes after me.  I was thinking last night about how often I frustrated my mom growing up for finding my own weird way to do things and how I never followed the “normal” path.  It drove her nuts.  Apparently, I am going to see what that is like for myself, because our son seems determined to outdo me on the ‘find your own path’ parts of life.  Regardless we are ready to meet him and find out all of his favorite things.  Our family members and friends are getting their vaccinations up to date.  Yes, we do really require people to have their vaccines if they want to visit before Baby Boy is 6 months old.  Things are just coming together nicely.  Now I just have to sit back and relax! 

Friday, February 21, 2014

February 21, 2014 – Control

    We had our follow up with the OB today.  First of all, he made fun of me for not answering my phone and not staying in the hospital.  Love my doctor!  My blood pressure for the last couple of days has been so low that I have trouble staying awake.  I was a little worried about this sudden turn, but he assured me it is pretty common to see with preeclampsia, so the diagnosis stands.  L
    I am glad that I have been working on getting myself mentally prepared for being out of control, because I feel totally out of control now.  The plan now is to watch me closely, continue my weekly appointments with weekly labs and urine collection, and watch for things to get worse.  There is the possibility of increasing appointments to twice a week or spending additional time in the hospital.  I will most likely spend some time on bed rest to try and make it to 37 weeks.  We all agreed that 37 weeks is the new goal.  I am sad to let go of my day dreams of going into labor at exactly 40 weeks and having the normal progression of things, but I want a healthy baby more than I want the fantasy.
   We discussed method of early delivery and we all agreed that an induction was going to be the way to go, unless things just go wrong in a hurry.  I told him I would like to avoid an emergency C-section if at all possible, but don’t want to put the baby in danger, so he just needs to keep me informed of his recommendations.  We can’t really plan for anything at this point, so we are all just marching along monitoring things as they come.  I still have to do blood pressure checks 3 times a day and weekly labs/visits, and as long as my BP stays low (relatively) I can stay off bed rest.  I still have to take it easy and try to relax and stay calm, but that has been a standing order.  He said if I didn’t have Doc at home watching me he would probably have me being watched more closely.  Thank goodness for Doc!  Doc and I are both just trying to get our heads wrapped around the fact that our son is going to be joining us so much sooner than we planned.  We are both praying for 37 weeks and healthy.  

Tuesday, February 18, 2014

February 18, 2014 – Smoke vs. Fire

    I know most of my friends and family have been keeping up with updates via Facebook, but I wanted to write a little about what happened this weekend.  It had been another busy week.  I know, I am supposed to be relaxing but we had some big events that all came at the same time and I couldn’t miss out on them.  I tried to take them all easy and bowed out earlier than I would have normally, but it doesn’t seem to have made a difference. 
    My sweet niece turned 1 last week!  If you look back in my blog you can see the story of her birth.  We celebrated with a low key party at her parents’ house where we attempted to get her interested in the smash cake I made her.  She was having none of it.  I think she was upset that we wanted to mess up something she thought was pretty and she probably didn’t want to get her cute outfit dirty.  She was very excited to wear her pink tutu with polka dots.  She showed it to all of us before we put it on her.  I wouldn’t have missed it for the world.  She showed off her new walking skills and was just the precious person I have gotten to watch grow this year. 
    We had a few other smaller celebrations and gatherings to attend this week and they were all fun.  I really tried to keep it low key.  Friday I saw my OB for the weekly check in.  I turned in my blood pressure measurements, which had been showing an increasing trend of higher pressures more regularly.  They are still within normal for other people, but high for me.  Of course at the appointment my pressure was so low it was normal for me pre-pregnancy.  The nurse took it twice just to make sure it was right.  For Valentine’s Day he ordered additional blood work and another 24 hour urine collection.  The joys of pregnancy!  Sometimes I think being an OB is all about seeing what horrible and gross things you can get other people to do. I did my collection and turned it in on Saturday. 
    Saturday was our baby shower.  It was amazing.  My girlfriends went all out and so many people braved a gross snow storm to come celebrate with us.  It was just so much fun.  Baby Boy got a ton of fantastic gifts.  If you are wondering what the best diaper rash cream must be I am going to say Boudreaux’s Butt Paste.  I think every pediatrician and pediatric nurse brought a tube.  We will win the battle of diaper rash in this house!  The party was a Dr. Seuss theme to match our nursery and the whole room was Seussical.  Afterwards we had church and dinner out with visitors and by the time we made it home I was exhausted.  Pregnancy insomnia had me up most of the night and I was so busy all day that I didn’t manage any nap time or down time.  I had to lay down immediately and just felt awful. 
    Sunday Doc and I tried to just take it easy and get back into a routine.  I still had pregnancy insomnia strike, but at least I was able to get a nap.  At around 5:30 my phone rang with a restricted number.  I sent the call to voicemail before I realized it was probably my doctor.  He left a voicemail with the news that my 24 hour urine showed an increase in protein in my urine.  This is called Proteinuria and is a symptom of preeclampsia.  It was a diagnosis we had all kind of been thinking would be coming considering my blood pressure seemed to be rising despite decreasing salt, increasing potassium, and getting more cardio.  The OB wanted me to head into the hospital for 24-48 hour observation and to get steroid injections so that our son’s lungs will be better developed in case we need to deliver in the next 2 weeks.  We are only 32 weeks along, full term is 37 weeks.  As I listened to the message I went on a crying search for Doc.  He swung into action like Superman.  We packed a bag, called all the people would could think of that would need to know, made sure the dogs were going to be cared for and headed off to the hospital.  At one point while we were getting ready I just froze in the middle of the living room and he had to get me jump started again.  I told him it is just too soon.  I love my husband.  He knows far more of the terrifying details of what this could mean for us, and yet he was the strong one and made sure everything got taken care of.  We got checked into Labor and Delivery (L&D) and Baby and I were hooked up to all kinds of monitors.  They were having a crazy night, so we were a little inconvenient for them to have to care for, and they didn’t really hide that fact.  Doc and I were not really impressed with the on call OB or the nurses we had, but we keep trying to remember they were having a really horrible night so we were not seeing them at their best.  After a while they said Baby and I were fine and gave me my first steroid shot.  Then we were left alone.  I don’t think they did what my OB wanted them to do as he was hoping to have a base line for my pressures and fetal activity for more than 10 minutes, but it is what they did.  The morning OB was much better, but we were kind of over sitting around at the hospital for no reason, so we checked out and came home.  We had to go back in for a second shot last night, and otherwise we are going to see our regular OB again this Friday. 
    I will say that I have noticed 2 kinds of physicians lately and I definitely have my preference.  The first kind looks for fire and rushes into action to put out fires, they seem to thrive on emergencies.  The second kind looks for smoke in an attempt to avoid the fire and head off the emergencies.  I tend to prefer my doctors, who I think look for smoke.  They learn their patients and what is normal for them, looking for trends in their labs and vitals, so that when something changes they can get to work fixing it before it becomes an emergency.  I am blessed to have found these doctors; because if I were at the hands of the OB we had Saturday I think Baby Boy would end up being delivered in an extreme emergency.  That may still happen even with my amazing doctors, but I know they aren’t going down without a fight, and neither are we.  J

Saturday, January 11, 2014

January 11, 2014 – Birth Plans

    As we enter the third trimester the questions about birth plans have begun.  According to the pregnancy bible, What to Expect, I should be writing down my detailed thoughts on all the possible scenarios for delivery and how I would like them to be handled.  I am going to let you all in on a little secret: You don’t really have a say.  I love my control probably more than the next person, but this is one situation in which I have to accept I don’t get to be in control.  I don’t get to say when my water will break or how quickly (or slowly) I labor.  Unless I want to be the ultimate control freak and schedule the event, which I have no desire to do.  I would like to go into labor because it is time for my son to be born.  Even that may be out of my control though, given my high-risk pregnancy.  If my blood pressure doesn’t chill out my doctor may end up recommending early delivery and I will just have to get on board with that. 
    My birth plan is simple, “Get my son safely delivered into this world.”  Notice that it really isn’t about me, but about my son.  Welcome to motherhood!  I may have to be uncomfortable, in pain, scared, and yes even out of control in order to bring my son safely into this world.  I can accept this right now or I can let myself be full of anxiety and eventually resentment when it doesn’t go the way I planned. 
    I am surrounded by doctors who have spent their fair share of time in the delivery room.  They all say the same thing about birth plans, “things never go the way the mom plans”.  The minute a mom comes in with a 27 page (I wish I were kidding) birth plan everyone knows it is going to be the most difficult delivery of the day.  Nothing will go smoothly or as planned.  It is the kiss of death for a safe and healthy delivery.  Psychologically I understand the need for control and the plan’s ability to help moms process the events to come, however I think too often it creates a psychological block that can interfere with the delivery process when mom clings too tightly to her plan.  Stress can change the way your body responds to everything, including delivering a baby.  It also takes the mom longer to process the fast paced changes that can occur in the delivery room and leaves her to wait longer than necessary to finally okay that emergency C-section the doctor recommends.  I don’t know any doctors who want mom to have a C-section.  Most of the doctors, OBs and pediatricians, prefer if mom can deliver the baby the old fashioned way, because it requires less recovery time.  They recommend C-sections because they recognize that mom is unable to deliver safely the old fashioned way or because the baby is in danger.  Did you catch that last part?  Baby is in danger.  This is another one of the moments where it just stops being about you (or should). 
    By focusing on my desire to have a healthy baby delivered safely into the world I can relax about controlling the events on the day and prepare myself instead to place trust in the professionals I have chosen to help me obtain this goal.  I have heard hundreds of scenarios about how things change, evolve, and frankly go wrong during deliveries.  Every delivery is different and unpredictable things happen.  I should prepare myself to be on board with whatever happens, because it is out of my hands. 
    So how does this control freak get her control fix in a situation so out of her control?  I focus on the things I can control.  I learned everything I could about the hospital where I will deliver, obviously I have an advantage knowing so many people who work there (Doc included).  I learned everything I could about all the doctors who deliver there, because you never know who might be delivering.  Although I know my doctor plans to deliver me, crazy things do happen and we may find ourselves in a situation where he can’t be there and I have to be ready to embrace that change too.  I asked a ton of questions about who receives my son and will be doing his initial check.  I have stated my preference to my husband that the baby be checked before being placed on my chest to warm.  I have even asked who will be checking my baby in the nursery, because at our hospital babies are either checked by the hospitalist group or by the pediatricians from the clinic.  My preference is that a pediatrician from my chosen clinic (the hospital clinic) checks the baby.  This is sheer insanity on my part because my husband is a pediatrician from the clinic and he will have already checked the baby, my best friend who is planning to be there will check him and she is a pediatrician, and the majority of our friends are pediatricians either in the hospitalist group or the clinic and I am guessing they will all check him just in case.  After all, the first pediatrician to examine my sweet niece E after she was born was Doc.  My son will probably be examined by 20 pediatricians (including his own pediatrician because he and Doc are good friends) and specialists by the time he leaves the hospital.  Despite knowing this, I asked just to be sure.  I can also control the environment by controlling how many visitors we have and when we have them.  I can do this at the hospital by stating my preference (you actually get a say about this) and I can do this at home.  I am planning to breast feed, so I inquired early about a breast pump and have asked my mom friends how they felt about theirs.  Our insurance carrier has a nurse that calls to answer questions monthly and they encouraged me to get the pump early and learn how it works.  I asked about lactation experts at the hospital (free to use, so do!) and plan to consult them while I learn this new skill.  I have read and watched videos as well as walked through the process with my best friend as she learned how to do it.  Despite all my planning for this I still have formula on hand, just in case this doesn't work out as I planned.  I have also thought through and discussed with those people who will be around my desire to have some privacy while I learn this new skill.  Obviously my husband will be there while I learn, and since he discusses breast feeding with new moms all the time he may be helpful.  I also think it will be a good time for him to learn even more about it and since I understand how that will benefit his patients and their moms I am cool with him being there.  My brother in law is a frequent visitor to our home and will most likely be helping out with our dogs while I am learning to be a mom, so I discussed it with him and we have set up rules for our comfort.  Otherwise it is going to be a private affair. 
     Finally, Doc and I have started formulating our plan for the first few weeks after our son is born.  We have asked the moms we know what they would have done differently or what they loved having happen in those first few weeks.  If we haven’t gotten around to asking you yet please feel free to email or message us with your thoughts.  So far the majority of moms we talk to wish they had planned for more quiet time and asked for fewer visitors in those first few weeks.  Giving birth is a stressful time of adjustment for a family and the family unit needs time to adjust.  Hosting a whirlwind of visitors interferes with that adjustment and makes slipping into a routine difficult.  So Doc and I have decided to not host out of town visitors during those first few weeks.  Instead we would like to plan to host those visitors once we have settled into a routine so that the visitors can fully bond with our son and spend some quality time with him.  We are also asking that they visit one at a time, be vaccinated before they come, not to come if they are sick or were recently exposed to sick people, and to always wash their hands before touching our son.  Our son is so lucky to have 8 grandparents that are dying to meet him, and it is so important to Doc and me that he have time to bond with each of them.  In order to do that we need to set up some guidelines for visits, because if all 8 show up at once during the first crazy days no one will really get a chance to bond with him.  It would be too crazy and hectic for anyone to enjoy it and that is the opposite of what we want.  We want everyone to have special time with him. 
    So, those are the things I can control.  The rest is just out of my hands.  So here is hoping that my birth plan of delivering my son safely into this world goes off without a hitch!  

Friday, December 27, 2013

December 26th, 2013 – Stress and Bed Rest

    So far the pregnancy has really gone very smoothly; considering it is still a “high risk” pregnancy it really hasn’t been bad.  The few hiccups are these: insomnia, continued vomiting, contractions when I over-do, and most recently swelling.  Twice during this pregnancy I have been ordered onto bed rest for a least a few days, and twice I have strongly disliked bed rest.  I recently learned the main goal of bed rest is apparently to keep a mother-to-be from experiencing additional stress.  When I first heard about bed rest I assumed that moving around was the issue, but I was wrong, apparently it is the emotional stress that is dangerous.  Stress increases blood pressure which causes all kinds of crazy chain reactions when pregnant.  I honestly had no idea.  I know my doctor is always making a big deal about stress, but I always kind of thought he was kidding.  After a crazy couple of months I now know he wasn’t. 
    Here is how stress became a problem in my life… Starting in October we begin attending recruiting dinners for the hospital.  We have done this every year of Doc’s residency.  It helps the residency recruit students who are interested in continuing their education in pediatrics.  We travel about 3-4 hours so that we can discuss our program with students from the medical schools in the area.  Then once the applications for residency are in we begin hosting recruiting dinners at local restaurants.  In past years we have done as many as 3 a week, thankfully we slowed it way down this year.  It adds stress every year, but eating, smiling, and chatting my way through dinners where I am seriously wondering if I am going to barf can be a little stressful.  Not to mention the number of extremely nice dinners I did throw up.  Not exactly something to look forward to.  I continued to do them because it is important for our residency program to be well represented, and it is important for Doc, as chief and future faculty, to meet the residents.
    The second thing that starts during this time of year is prime fundraising season for the hospital.  Our hospital is a non-profit children’s hospital, which means in order to give excellent care we rely on donations from our community.  This time of year is when we are able to get the biggest donations, so the hospital throws party after party and fundraiser after fundraiser.  Doc and I have always thought it was important to be a part of this process as well.  People like to meet the doctors and learn about who they are as people.  It helps put a face to the hospital and reminds them it really is about helping kids, not lining our pockets.  Every year we work hard to make sure the hospital has generous donations so that it can continue to help kids for another year.  It is very important to us, and therefore worth the stress. 
    This time of year is generally overwhelmingly full with just our social engagements.  This year we added more to the pile for the holiday season, which added stressor number 3.  Starting in mid-October we had our first round (of many) visitors.  We are having the first grand baby for our biological parents and they are all anxious to be involved, which is wonderful but can also be a bit overwhelming.  After all, we have 8 parents (4 pairs) between the 2 of us, so they are a crowd unto themselves.  Visits are sweet, but they are also stressful because as a true Southern girl I feel the need to be a good hostess.  That means making plans, organizing activities, and making sure everyone is fed the best food possible.  This is made more difficult by the fact that our current home isn’t really set up for entertaining.  We don’t even have enough chairs for company!  We have lived bare bones for a very long time to pay for Doc’s education; our entertainment budget consists of a Netflix subscription.  It just isn’t possible for me to entertain the way I would like to, add to that pregnancy and I just find company overwhelming and stressful.  Regardless, from mid-October until Christmas we had a long string of company, social engagements, recruiting, and holiday celebrations.  My first day “off” on my calendar was December 22nd.  Every other day from mid-October until December 22nd was full of ‘to do lists’, company, and social engagements.  It is a crazy busy time and normally we don’t have company, but this year we had a lot of visitors.  It was incredibly stressful to have no free time, no days off, and to feel like I had to be ‘on’ for that much time. 
    The fourth stressful thing was probably the most difficult, but least controllable stressor.  Two days before my mom and step-dad came to visit for Thanksgiving she was diagnosed with ovarian cancer.  Nothing compares to the despair of knowing your mom is sick in a way you can’t fix.  My mother, who I know loves me to the moon and back, called my husband with the news because she didn’t want to cause me stress while pregnant, but knew I would want to know.  Doc got off work and came home to tell me.  I spent a great deal of time in shock after the news.  I had known something was wrong, but was hoping that it was something much smaller and easier to fix.  Her ovaries appeared clear in a scan, but she had 3 other masses in her abdomen.  We had to wait on a biopsy to tell us for sure it was ovarian cancer.  It was devastating news.  I would say it came at the worst possible time, but I don’t think there is a good time to hear that news.  There is no good time to realize your parents are mortal.  Even more worrisome was the speed at which they were beginning treatment.  She delayed treatment so that she could still visit us for Thanksgiving, but they began immediately when she got back home.  I am thankful that she is in a place where she is getting the very best care.  She works for Baylor and they are taking excellent care of her.  She has started chemotherapy and we should know after the New Year whether or not they are going to be able to remove the tumors.  My mom is a fighter.  She has never walked away from a battle, no matter how hard, so I know she will make it through this too.  She taught me to be a fighter.  She taught me to get up and dust myself off and to just keep swimming.  The hardest part is that we are so far away and I can’t help.  My step-dad is taking good care of her though, and we talk daily.  We are just putting one foot in front of the other until we see what comes next. I do my best to put worry aside, because worry doesn’t help her and it doesn’t help my son.  She wants me to take the very best care of her grandson and that is where I try to spend my energy.  It is still difficult to know she is sick and to not be able to be near her to take care of her or comfort her.  Thirty-six years ago my mother was exactly as pregnant with me as I am with my son.  I am due exactly 36 years after the day I was born.  It is hard to imagine her as being anything other than vibrant.  I have to acknowledge that I have no control over this situation and continue to do my best here and now.  That is difficult because my mom also taught me to be a doer.  I know we are both struggling with the sit around part of cancer treatments.  My husband likes to remind me frequently that my mother and I are very much alike.  J
    All of these things combined have made managing my stress over the last couple of months difficult to say the least.  I try to keep a regular routine for sleep, eating, and exercise but it has become difficult with all of the disruptions to our routine.  So two days before Christmas when I started having cramps I wasn’t really surprised and figured I just needed to rest.  Lately rest is all it takes to get the cramps to stop.  I just had 2 more days to get through (possibly 4 depending on whether or not we would be having visitors this weekend) and then I could rest.  On Christmas Eve the cramps got worse and began to include a mucus discharge that was clear/white.  I didn’t want to call the doctor because I wasn’t sure it was a big deal and was afraid it was.  My mom is who told me to call, and I did, because who argues with their mom when she has cancer (bet she is wishing she had gotten it when I was a teen).  I like to think I am an overly worried patient, but as usual I was less concerned than the doctor was.  Further proof that I did not attend medical school!  The on call doc ordered me to bed rest for at least a couple of days until the discharge stopped.  She told me that she felt comfortable with me managing it at home, but I had to promise to come in immediately if it got worse or included blood.  Apparently the discharge is a bigger deal than I realized.  The major perk of being married to a doctor in this system is that instead of getting admitted to the hospital I get to be treated at home.  Of course, my husband doesn’t always prefer that as I am far more likely to listen to other doctors/nurses than I am to him.  J
    I cried the moment she ordered me to rest because I was looking forward to going all out for our Christmas dinner and I had worked hard this year to make sure my husband and brother-in-law were going to have a really great Christmas and I felt like I had suddenly ruined it.  Of course the boys didn’t think I ruined anything and they just took over and helped out with getting things ready.  It was still fun, I just had to be sitting down for most of it. 

    I am still stuck on rest.  Just when I think it is safe to do something the cramps and discharge start up again.  I think part of the problem was that I had eaten so many salty and rich foods for the holidays that I was swollen to the point of discomfort.  So the first thing I did was get back to my regular fresh fruit and veggies snacks & healthy meals.  Doc is also helping out by keeping track of my blood pressure, doing chores, and just making sure I know it is okay to not over-do.  I am so lucky to have such a supportive husband; I know that is a real gift unto itself.  The final thing I am working on is saying no and setting boundaries to make sure that I am not over-doing or feeling too much stress.  That means we will probably not be having visitors for a while.  It also means I will probably be cutting back what I do for the residency, which is hard because I enjoy it, but I also really enjoy being pregnant and would like to remain pregnant until my April due date.  Some people will understand and some will be offended.  I can’t control how others react, all I can do is explain with sincerity the problem and consequences, their feelings are out of my control.  

Monday, November 25, 2013

November 25th, 2013 – A New Level

    We had our level 2 ultrasound this morning.  If you haven’t had one before it is just a detailed ultrasound of the baby’s body parts and internal organs.  The whole thing takes about an hour and is relatively easy to go through.  They started with a transvaginal image of my cervix and then the rest was done through my abdomen.
Bringing the foot to mouth
    Our little boy has gotten quite large since we last saw him and he was reclining lengthwise across my abdomen taking a nap with his little ankles crossed when we started (which is how I generally sit when reclining).  It looks like he is growing well, he appeared to have all his parts and be healthy.  The tech had a hard time getting a shot of his little rump while he napped, but he eventually woke up and mooned us repeatedly.  We of course laughed.  He also decided to nom on his toes while we were watching.  Watching our little guy flip and get comfy was just amazing.  It was over far too quickly.  We got a few cute pictures of him, including the toe noming pic.  J 
    They didn’t give us an official report today, so we only have to go on what Doc could see.  We clearly saw that he has all 4 ventricles of his heart functioning well.  His spine is growing well and appeared to be closed.  He had 2 arms, hands, legs, feet, and appropriately placed genitals.  He has long legs like me and Doc’s tulip nose.  He has 2 kidneys and they appear to be functioning.  We saw his tiny stomach, his lungs, his bladder, we saw him swallow and play with his tongue.  All organs appeared to have safely made the journey from the umbilical cord into the correct places in his little body.  His tummy is currently the same size or slightly bigger than his head, so he still has some growing to do.  I can’t really explain the feeling of finally watching our son moving, growing, and so healthy. 
    At the start of the exam the tech asked the general questions about number of pregnancies and live births.  After we explained 0 live births she became quiet.  I can’t imagine how stressful it is to be the person who sees such horrible news play out in front of them.  She was visibly tense until we saw his little heart pumping.  Doc and I talked, laughed and shared our story with her.  She laughed with us when he woke up and mooned us.  By the end I think she was having a good day.  He already knows how to make people smile. J
Munching toes
    We are so crazy in love with our son already.  He still loves the sound of Doc’s voice.  He is a daddy’s boy already!  When he woke up and Doc was talking he quickly flipped so that his head was closest to Daddy’s voice.  He has been entertaining us with the timing of his kicks.  On Saturday he kicked me so much during church that I had to run to the bathroom for fear he would make me pee myself.  Then while we were singing the final song he kicked me so hard it made my voice jump, which of course had us giggling like little kids.  We can’t wait to meet him and learn all about him.  We are already amazed and awed by our special little guy.  

Saturday, November 9, 2013

November 09, 2013 – The Big & Small

    Not a lot has happened since my last post.  I have had 2 more healthy checkups with the OB.  I caught a cold and that resulted in some crazy side effects.  I ended up with reactionary arthritis in my right hand.  My ring finger knuckle suddenly became swollen and so painful I couldn’t move my hand.  I couldn’t make a fist and it would throb all night long.  My amazing doctor sprung into action to make sure I didn’t have an infection that was going to hurt our son.  It really was just a crazy reaction to a cold, but I appreciate that my doctor worked so hard to make sure it really wasn’t hurting the baby.  That is probably the scariest thing to have happened this month.  My knuckle is still slightly swollen and tender, but SO much better than it was.  Doc was in the middle of a crazy month and I am so thankful that my brother-in-law came to help out with chores and walking the dogs while my hand was non-functional.  I am also thankful that my doctor dealt with my crazy worry and just general insanity without hating me.  I have the very best doctors.
    I am still struggling with morning sickness.  It isn’t as severe as it was during the first trimester.  I usually get a few good days in before having a rough one and they seem to precede a growth spurt by our son, so they are tolerable.   I finally caved and took Zofram.  It helped a little with the woozy feeling, but I still barfed my brains out.  I tried it twice and it didn’t work.  My doctor said that happens for some people.  So apparently I should just get comfortable with throwing up.  At least I usually get a lot of notice before it happens.  I can usually tell fairly early in the day that we are going to end the day sick.  I just plan to be home on those nights.  I still haven’t gained any weight, but the doctor said it is fine as long as I am able to eat enough to maintain my weight.  Apparently there are a few perks to starting out a little heavy! J I did have to restrict some of my activities, which was really hard for me.  The one that is the hardest is that I had to give up some of my time with my sweet niece.  Since she was born last February I haven’t gone more than 2 weeks without spending some quality time with her, so it really feels weird to not spend as much time with her.  I still see her twice a week, but for shorter days and if one of us is sick I have to give up time with her.  We just have to be much more careful than we ever did before and that is hard for me.  I adore her and just love my time with her.  I just hope she doesn’t hit 25 pounds any time soon!  She doesn’t hold a grudge about the changes to our schedule and I still get excited greetings from her every time I see her.  I can’t wait to introduce her to our son.  It fills me with absolute joy to think of them growing together! 
    With the bad there does come the good though.  The good is that I was very lucky and began feeling our son move really early.  At 15 weeks I got to feel that magical feeling.  I hadn’t thought I would feel him until I was much closer to 20 weeks, but as I sat at the dentist’s office I was delighted with baby flips.  At first I thought it was just a case of nervous stomach or some other crazy pregnancy symptom, but after 3 runs to the bathroom with nothing happening I finally figured out that the sensation was moving up and down and not across my belly like gas would.  Then I had to laugh at myself for not figuring it out sooner and called Doc crying I was so delighted.  Since then our son has had a few active days and a few quiet ones.  Doc has spent nearly every day trying to feel him move too.  He has had a few instances where he thought maybe he felt something, but last night our son finally let Daddy know he was there by delivering a solid thud against his hand during some of his gymnastics.  We have found a few things that really get him excited and will cause him to boogie down.  The first is music, but not just any music!  Mostly classical that involves pianos and strings, although he also likes Frank Sinatra, Pink Floyd, The Beatles, and Elton John.  Last night we played The Beatles followed by Elton John to get him excited and it seems our son has a great since of timing already as he thumped Doc’s hand during Tiny Dancer.  J The second thing that gets him excited is the sound of his Daddy’s voice.  Already a Daddy’s boy!  Doc had a very intense month last month and was only off for 3 days the whole month.  Baby boy was so happy those days!  Finally, he likes the sound of Harrison Ford’s voice; which Doc and his brother simultaneously said was because he understood Han Solo was the man.  There are few things baby boy does not like.  I know this because he responds by snuggling down into my pelvis and kicking the crud out of my bladder until I stop doing whatever has upset him.  These things are; standing or walking for too long, not eating when he thinks I should, opera music, and flutes.  He is obviously opinionated already (like his momma!).  I am in for a heck of an adventure with this guy! 
    Despite the fatigue, continued sickness, and the need to limit my schedule and activities I love being pregnant.  All of those things are hard but they are all fleeting, and I know all too well how fleeting a pregnancy can be and am cherishing every minute of this one.  So far we are both healthy and that is such an amazing thing all by itself.  My OB visits have been spaced out to 4 weeks between visits, which means our boy is right on schedule and the doctor feels comfortable following a more normal visit schedule.  We have had some additional tests run to check for spinal deformities and we have a level 2 ultrasound scheduled later this month, but so far things are progressing perfectly.  Despite my lack of weight gain baby boy is obviously here in my well rounded belly.  I have no problem with the baby belly.  I have read all of these articles about body image issues in pregnancy and I just don’t have them.  I love the big belly.  I love looking pregnant.  It is a gift to be pregnant and I just don’t want to spend any time hating any part of it.  I am not a fan of all of it, but the changes to my body are the badges of motherhood.  Not everyone is so lucky to get to experience these changes.  I pray every day that this pregnancy continues to be healthy and that our son is healthy and happy. 

    My final comment is a PSA of sorts to those people in health fields.  Several times during this pregnancy I have been asked by health professionals (nurses, doctors, dental assistants) if this is my first pregnancy.  I always say no, because it isn’t, this is my third pregnancy.  If you ask this question follow up with, “how many live births have you had” because it is a horrible thing when the person I am speaking to automatically assumes that means I have 2 children.  Especially if they say something like, “you look fabulous to be pregnant with 2 little ones running around!”  Because then I get to inform them that I haven’t yet had a live birth.  I feel shame and like a failure every time this conversation takes place and it could be so easily rectified if people didn’t assume every pregnancy is successful.  Especially when they know I have undergone fertility treatments, which means I obviously haven’t had an easy time getting pregnant.  I realize I could just as easily claim this is my first and only pregnancy, but why should I have to lie?  I have been pregnant before.  Each pregnancy has been very different and his given me a different perspective to draw on.  I shouldn’t be made to feel shame for having had miscarriages and I shouldn’t have to hide the fact that they happen.  If more people talked about it maybe we would be better at supporting each other through it.  Just a little food for thought.  :-)