Friday, April 30, 2010

Zachary, You're Scaring Mommy!

Zachary hasn't been moving. The last time I felt a lot of movement, which is normal for him, was when I monitored at noon yesterday. Then? Nothing. I figured he was just sleeping. He's entitled to that.

I tried everything last night, and managed to get a little kick here and there. Nowhere near what they want though. I told myself that all was fine though, and went to bed. I planned to wait and see what he was doing this morning before I made any calls. I woke up, allowed myself caffeinated coffee instead of the normal pregnancy decaf, and waited. I blogged. I laid back down. Nothing. I drank apple juice, and that brought on a couple of kicks, but that's it.

I'm getting really worried. This isn't normal. This baby is very active. On top of the decreased movement, I have also been having some abdominal pain in the area between my diaphragm and belly button. It's been going on for 2 days now, and I just assumed it was from the vomiting the other day. I don't do dainty little urps. I violently heave when I throw up, leaving my face peppered with broken capillaries and everything. So that is what I figured the pain was from. But I also know that my placenta is in that region where the pain is, so this, combined with Zachary's level of calm, is rather frightening.

So....I am going into the office today for an NST. I'm a little worried. The doctors don't usually see my contractions. They get reports fom L&D nurses and the home health company about how many I have in an hour. But I am going to be on a monitor in their office and they are getting ready to see firsthand what it is that I do. I hope this does not turn into a hospitalization, and that Zachary is okay.


Zachary is just fine. Little stinker. He still isn't moving a lot, but his heartrate was nice and reactive. I told the nurse as she was strapping me up to the monitor that she was not allowed to freak out about what she saw. Apparently someone had warned her in advance, because she kept looking at my strip (which was behind my back) and saying "Wow! They weren't lyin'." everytime. I was worried about the doctor who would read it until Dr. Surfer Boy stuck his head in the door and said "We're talking about you out here!" Then he saw with his own eyes for the first time and was almost child-like in his wonder. "Look At YOU! Amazing!", as he snuck a peak at the monitor. I had 18 contractions in 20 minutes' worth of recording. Wave upon wave upon wave. He also saw J out in the waiting area and talked to him briefly--I don't think he is going to change plans now, as he mentioned to J that it would be here before I knew it.

I feel better knowing Zachary is okay. And I sort of feel better that they now see what the nurses have been calling them about all along. They know I'm not a hypochondriac now. And at least he let me go back home instead of to the hospital. After all, I'm not even feeling these today. Just feeling an overall crampiness. It also got me off the hook for monitoring, as I just called the nurse and told her where I had been and knew what my uterus was doing.

33 Wks, 4 Days: Not Enough Food in the World

I am seriously bummed about this. I think I mentioned in a previous post, or posts, about my weight gain and loss during the pregnancy. It fluctuates every week. I'll gain a pound or so, then lose 3 by the next time. Same scale, etc. Well, the last time, I had lost 5, finally putting me below my pre-pregnancy weight. Or at least below the weight I was when I first went to my OB at 8 weeks of pregnancy. I've never gotten caught up in weight, but instead worry about my measurements. I've always been a sturdy build. I've got huge muscles in places most women do not from years of competitive swimming, so if I went by "ideal weight" for my height, I would always be very depressed.

None of the people in my little healthcare mafia are concerned with this. The baby is growing by leaps and bounds, so who cares? That tells us he is getting enough nutrition. And I am not actively trying to lose weight. Well, at least not until after the delivery. I just haven't been able to eat between the big baby taking up space in my abdominal cavity, the heartburn and indigestion of the last trimester, all of the contractions, and more. No biggie. But I must admit that I was a little excited. If I am below my pre-pregnancy weight now, then by the time I deliver a 7-pound baby, along with placenta, and all of the extra fluid, I will leave the hospital with a healthy start on my weight loss goals for after the pregnancy. Plus nursing will help me lose even more, as will my return to work. Sweet.

Not anymore. Over the past couple of days, I have been ravenously hungry. And I have this weird attraction to Arby's roast beef sandwiches. They must have swiss cheese added, of course, because they couldn't possibly have been fattening enough on their own. And soft serve ice cream. That too. The ice cream is more difficult for J to satisfy. It has to be soft serve vanilla in a cone, so he has been trying to navigate traffic while holding this enormous ice cream cone, without taking a single lick because of his new-found status as a diabetic. I don't know where this has come from. I should be past the cravings stage. But J does his best to provide what I want. This, of course, is despite the fact that I have turned into a sort of culinary Sybil. Yesterday, I told him to bring home food from some random errand he was running. He went and got me a sub. But he got me the slim-pickings, healthy crap I would have eaten before this stage. And I was so looking forward to my fat fest that my heart fell when I saw what he had brought. And I couldn't eat it. It just didn't taste good to me. Poor J.

This all reminds me of the first trimester. J was so sweet. I was still working. And I would go in at about 6 PM because I was almost always charge/ team leader, and would have to make work assignments for all of the other therapists that night, as well as deal with staffing for my shift and the one immediately after mine. First rounds would always be busy,but right around the time they would be over, I would be starving. We have a fairly decent cafeteria at work, as far as hospital cafeterias go. But it closes at 8 PM, then reopens at 2 AM for third-shifters like me. So at 10:30 or 11, when done with my rounds, they would be closed. Without fail, J would wait for my phone call telling him what I wanted from any of the area restaurants that were open. And at 11 PM, he would be out bringing me food. Often, he would even take orders for all of the other therapists stuck there in the overnight time-warp with me. Of course by that time of night, he would have to come in through the security night entrance, and I would always be too busy to wait for him, so he had to constantly give them my name and tell them to beep my pager. As a result,the security staff at the hospital began to tease us, and even got to the point where they knew he would be bringing food and would make their own requests. So the end result is that J ran his own little Meals on Wheels operation for night hospital staff. Priceless. What a guy!

So anyway, my new little love affair with food is going to ruin my goals and I am bummed. Not bummed enough where I am going to do anything about it, though. I figure these last couple of weeks are the last where I can eat what I want and not feel bad about it. After all, I will never be pregnant again. But if I go into the doctor on Tuesday and have gained it all back, I know what is to blame.

Thursday, April 29, 2010

The Perils of Cuteness

(Okay, FAIR WARNING! This post is going to sound completely arrogant and snobbish. And brag-ish. Just be warned, and hear me out!)

Every mother thinks her kid is beautiful. None of us are exempt. But when you see babies so much in your occupation, or even when you work with kids, you know. You just know. There really is such a thing as ugly children, regardless of age. There are even kids who may be physically pretty, but are so obnoxious that they are ugly. You know, even though it may not be politically correct to say as much, that I am right on this one.

E was a pretty kid. He still is. When he was a newborn, he was even beautiful, though most newborns are decidedly not pretty. But he had that perfectly round c-section head. His skin was soft and flawless, despite months soaking in amniotic fluid. He had a slight case of newborn jaundice, which was not enough to require treatment or make him ill, but just enough to make him look like he had a tan. He was big for his gestational age, but still petite. As he grew, he remained small, so he would be walking and people would be struck by him because he looked way too young to be able to do so. We got attention everywhere we went.

But some attention you just do not want. I was blissfully ignorant back then. I didn't work in health care. I knew nothing of MRSA, VRE, C.Diff, and more. There was no swine flu. And people would come up and stroke his little cheek or otherwise put their hands on him, and I was too polite to tell them to not do so.

But now, I know too much. And since we are anticipating Zachary to look just like Big Bro, I am seriously thinking of doing this, though I find it completely hilarious.

Please. Don't. Touch. The. Baby! I must admit this is not my picture. I stole it from here. You can incidentally purchase these labels by visiting the link.

I must say, I cannot look at the picture without laughing. I doubt I will really do this. But the fact that there is even a market for such a thing astounds me. Why would someone come up and touch your kid? But I know they do.

So anyhow, I had to share.

33 Wks, 3 Days: Randomness and Looking Forward

13 Days until my amnio! Is it wrong that I am hoping that it breaks my water and they have to deliver then and there???

I'm hoping this one is not like the one with E. I am thinking of banning J's presence during the procedure. I don't get squeamish around needles. I stick them in people's arteries for a living, for crying out loud. And I can hang with shots. But I do not like to see the needle going into me. During E's amnio, I looked away. I knew the needle was fricken huge. And going into my very pregnant belly? No way. So I focused on the screen, and told J to tell me when it was over. Well, he spoke too soon, and I looked just in time to see that enormous needle withdrawn from my belly. We will not have a repeat of that, though he still thinks it is hilarious.

In the meantime, summer is in the air. We've had some unseasonably cold days lately, but today was sunny and 70 degrees. E has about one month left of school before summer vacation starts, thanks to his school being very judicious about calling off for snow this winter. I grumbled and complained during winter, when all of the public schools were closing and we still had to transport E to and from. But now we are reaping the benefits, as they have to go longer into the summer. This is his spring school pic, and I had to post it because it broke my heart! Where did this grown-looking kid come from and what did he do with my baby??? They tell you time flies and you know it to be true, but you never realize just how quickly the days pass. He looks like such the little man that it tears my heart right out of my chest. (And incidentally, he looks identical to his father!)

So as the weather is warming up, we are all starting to make preparations for the change of season. I have been slowly but surely aquiring summer clothes for E this year. It's been difficult with my physical limitations right now. I'm used to just hitting the mall and having a little shopping marathon until I have everything for him that I need, but that just wasn't happening this year. So I think I am finally finished, and I perch myself on the floor of his bedroom to take inventory and make sure. And this is precisely when J ended up in the Doghouse!!!

Our house is a little backward. The living room, dining room, kitchen, and master bedroom are all upstairs on ground level. The laundry area, a partial basement, E's playroom, and E's bedroom are downstairs. The bottom line? Since bedrest struck, I don't go downstairs. J is now responsible for the laundry. (A task I was reluctant to relinquish control of, as I am anal-retentive about every aspect of laundry, from how the clothes are washed to how they are folded and put away.) So I haven't been in E's room either. In a very, very long time. So there I sit, going through dresser drawers and his closet as best I can without popping out a baby, and what do I find? Good Lord! 38 pairs of shorts. Thirty-Eight!!!! None of them worn out, all looking like new. All designer labels. But J didn't tell me this as we were shopping. Why, you ask? Because he didn't know! They were all stashed in corners of dresser drawers and on the shelves of E's closet because my husband is the least organized person on the planet. So this is, of course, in addition to the stuff I just bought him. And I bought him, as usual, enough clothes to last 2 weeks. So my kid has 52 pairs of shorts for summer. Insane. Obscene. Ridiculous. If J, in our ten years together, would have learned anything from my organization skills, he would have known this, but now, instead, I am going to end up dressing some needy child very, very well for the summer.

Of course with the warmer weather comes an increase in my restlessness. This is precisely the part of my maternity leave to which I was looking forward. I plan to go back to just work (as opposed to work and school) sooner than the normally-required 8-week c-section recovery period. I feel like I have to because of all of the time I have been off of work prior to deivery. But regardless, I will still get a large chunk of time off to spend with my family. E will still be in school for about the first 2 weeks post partum, long enough for my incision to heal a great deal. Then he will be out of school and we can spend our days together with J and the baby. I am having visions of long family walks,breaking in the new stroller. Of afternoons at the park and picnics. I cannot wait! Then, once I return to work, I will only be doing my obligate 3 12-hour shifts for the week, leaving 4 days a week with them for the remainder of the summer.

I am still waffling on the return to school. Being ready to return for fall will be a pig push, so I am thinking of returning in winter instead. But I did contact the College of Business this week, and discovered that being a Nerd has it's priviledges. I don't even really have to apply in order to change directions, as my straight A's means all I really have to do is formally notify the college and university of my intent. They even have a part-time MBA program where the majority of my courses will meet in the evening, freeing up J to finish nursing school during the day while E is in school and I am home with Zachary. Could it be possible that we can have 2 kids, 2 adults as full-time college students, and my full-time work and still not need to spend $500-$600/ month on daycare? (The going rate around here right now.) Where there is a will, there truly is a way.

But regardless of whether it is spending time with my boys, returning to work, or going back to school, I am really looking foward to the day where I won't be so restricted. Most pregnant women consider the time before delivery as the last days of freedom. Anyone who has gone through a complicated pregnancy knows the opposite to be true, and instead looks forward to a time where they don't have to worry about every tiny movement adversely affecting the health of their baby. I am no different. I don't worry about recovering from a c-section or sleepless nights with a newborn. Those don't phase me in the slightest. I'm just ready to get on with our lives.

Wednesday, April 28, 2010

Her Baby

My mother.

She raised 7 children, of which I was the baby. That was her job. I can't recall a single time she hired a babysitter for me. She was always there. She never worked outside of the home. Would do everything for her family, even to her own detriment. A true mother. And we fought like cats and dogs. Looking back, I like to think this is becaue we were more alike than even we realized. All of us 7 children had our labels: the Crazy One, the Smart One, the Mischievous One, the Responsible One. My title? Simple. I was Her Baby. All of my years growing up.

My senior year of high school, I was working on college applications when they told us Mom was in the final stages of lung disease. I couldn't leave her. I refused. But then something happened, and she seemed improved, and we decided I would go. And so I did. But everytime I would call home, it would seem, she would be in the hospital. I will never forget the phone call I made one day, when she told me she had signed the papers. What papers? The Do Not Resuscitate Order. When did it get that bad? I took a leave of absence from school for a week to go home and assess the situation. The plan was to see how things were, and return and finish finals if she seemed okay, but to withdraw if not. She acted fine. Same ol' Mom. So on the Sunday night before I was to make my return to class, I was getting my things loaded into the car. She knocked on the glass of the window beside her bed, and I went back into the house. She was crying, and hesitated some before asking me if I remembered my purse. It seemed like there was something strange going on, someting more she wanted to say. The purse question was just so silly. But she insisted all was fine, and I started the 2-hour trip back to campus, driven by my then-boyfriend.

But I cried the entire time. Something was telling me that I should've stayed home. She died the next morning, surrounded by my brothers and sisters, and my father, her husband of 32 years. She died before my sister, with the help of the college staff, could locate me in my freshman psych class. The entire way home, I didn't even know she was gone. The hospital staff had warned my sister that, once she finally spoke to me, she should not tell me my mother had died over the telephone. So she didn't. She just told me mom was okay, but that I needed to come home. I thought I was doing so to say goodbye. I never dreamed my opportunity for that had passed when she had asked me a silly question about a purse the night before.

Had I have known, I would not have left that night. I would've stayed there with her, holding her hand and apologizing for all I said and never said. I would've made sure I had every detail of her face, her laugh, her voice memorized.

She was ever the mother. Looking back, there is no doubt in my mind that she held on until I left that night. Later recounts of her last breath revealed to me how much I was loved by her. The story goes like this: She was holding my oldest sister's hand on one side, and my father's hand on the other. And she looked at them all, her children, her life's work, and said "Just make sure My Baby is taken care of." Meaning me. Still. Her Baby.

That year, and the years following were cruel to me. She died in April. The following month, May, was one of those years where her birthday actually fell on Mother's Day. May has always been difficult for me for that reason. I hate May. It's been 14 years, and I still do. The idea that the world keeps turning on its axis without her here is still so unbelievable to me. Over the years, I have learned to put on a happy face to mask her absence for E's sake. He brings home macaroni art and construction paper cards from school, and I act like it is the best day in the world for his sake. J knows the truth, and knows I don't want him to buy me cards or jewelry or flowers. Mother's Day is not a celebration for me. Mom isn't here.

I've missed her in my life. She wasn't there when I got married. She wasn't there when I became a mother. Not physically. I have even made my living taken care of people who are dying of the same condition. I would be lying if I said there weren't days where I see her in my patients. Those are the hardest ones, but also the ones I can help the most. And I can honestly tell their loved ones, as mom or dad slips away from this world, that I have been where they are.

I ask myself everyday if she would be proud of me. Is she looking? Yes, I think she is. Because she always has a way of creeping into the big moments. When J and I married on Christmas Eve, a ceramic angel figurine fell onto a tile floor without breaking. The night E was born, when I was finally able to sleep, I dreamed of her laughing and playing with him in a field of the greenest grass I had ever seen. We never told him anything more than that his grandma, Mama's Mom, is in Heaven. But one day, out of the blue, he referred to his Angel Grandma. And the day I graduated with my degree in respiratory therapy? Well, it fell on Mom's birthday.

So here I am. All of these year later. And we have E. And we are having Zachary. My amnio, I just realized, is on my Mom's birthday. It will now be the day I find ot my son's lungs are okay. How bizarre. He will be born in the same week she was, the week of Mother's Day. He'll have her birthstone, and I will be constantly reminded of the emerald jewelry she always cherished.

But why? Why May? Why the worst month of the year for me? Easy. I really think it is Mom again. I don't think she could stand that there was a whole month where Her Baby was sad. Once again, she is fixing something for me. Zachary is coming to give me reason to celebrate again.

Of Sapphires and Emeralds

So I have to tell you the story that has been a source of embarrassment for me since that fateful night in September when E entered the world. I bring this up now because J brought it up to one of my nurses the other day.

I had endured HELL! Picture the experience I have had with Zachary's pregnancy, with the same exact complications, but prolong it for a month, an that was E's pregnancy. It may have also been made a little worse by the fact that we were less financially stable, so there were more money issues, which made for more emotional issues. Plus E's pregnancy was planned.

Picture the scene. I had endured months of preterm labor and contractions. I had endured every prenatal test known to man. I had even had a fetal fibronectin done back then, which is no big deal to us now, but back then? There was only one lab in the entire country that processed them and the samples had to be flown out to that location. It was high tech and new-fangled then. We had even lost everything we had and had moved into J's mother's basement. It was bad. I had been to the hospital the day before, on August 30th, and of course it is me, so I wasn't dilated. But they could feel E's head pressing on the other side of my cervix, trying to make his way into the world. I got sent home, with a little red sleeping pill, to try to rest. We didn't know then about my cervical dystocia, so we were just waiting for some changes to take place.

The contractions never stopped. J had already called in at work several times because "this was it". But it never was. And this was a new job of his, as we had just moved to the area. So when the contractions were even worse the next day, I called the doctor on call for my OB. He didn't know me, but I was able to recount for him every test I had, the results, and when I had them. I could recount every hospitalization, every treatment for preterm labor. I told him that I frankly was not going to go the hospital unless he would deliver me. He told me to come in and he would assess the situation, but that he didn't have a full say, as he was not my doctor.

I will never forget that relief I felt. He came into my room at the hospital, took the monitors off of my belly and palpated my uterus as the contractions came and went. It was very intense, as he sat there staring in my eyes, with his hands on my belly, helping me to breathe through the contractions so I didn't tense up, giving him a better feel of what my body was doing. And he looked at the nurses, telling them that they should've done more, that I was having hard contractions, and that my body was trying to deliver this baby, but for some unknown reason, it was not working. (Later, while he was in there for a c-section, he found enormous areas of dense scar tissue and the cervical dystocia was diagnosed.) He left the room, saying he had to call my doctor, and returned to tell me that he was going to deliver after doing a surgery to treat an ectopic pregnancy, and I was prepped for surgery while he was doing that.

So fast forward an hour or two. I am strapped to the OR table. J is perched on a stool by my head. I am awake and hearing and seeing everything going on around me, but they had given me morphine along with my spinal, so I was in a sort of haze that is hard to describe. There was a surgical drape in place, so I was staring straight up. The only thing in my real line of sight was the clock on the wall. The initial incision was made at 11:52 PM on August 31st. But at 11:55 PM, the hands on the clock stopped moving. It seems the clock had died. We were stuck in August.

I certainly had more important things to worry about. I was having a baby 6 weeks before my due date. I had just survived the pregnancy from hell. But I had some good drugs on board and could not help myself.

"STOP!!!", I yelled. "It's August! We're STUCK in AUGUST!!!! August's birth stone is ugly. I want a SAPPHIRE in my mother's ring. Wait! Please, just wait 5 more minutes!!!"

E entered the world with the lustiest cry I have ever heard. 6 Weeks early, and all I could think was "his lungs are okay", as tears were streaming. The clock on the wall still said 11:55 PM, so the time on E's birth certificate was actually from the monitor that was recording my vitals. E was born at 12:05 AM on September 1st, 2001. His birthstone is a sapphire. The hardest, toughest gemstone next to the diamond. Believed by some to have healing properties. One of the most precious stones known. How very appropriate.

Am I silly? Yeah. Crazy? Most definitely. But I not only said it, but shouted it for all to hear. It was the joke around the Labor and Delivery unit of the hospital at least until I was discharged. And for our 7th anniversary, J did the most amazing thing for me. He was unemployed, and I was the breadwinner then too. But he saved every ounce of money he got--birthdays, Christmas, etc.--and he bought me an anniversary band with alternating stones of diamonds and sapphires. Precious to me for many reasons--the perfect symbol of our little family.

So the story of the sapphire came up again recently, when we thought Zachary was going to be delivered at 34 weeks or so. His birthstone would have been a diamond. But instead, since I am delivering in May, it is to be an emerald. Emerald is known as the Christian symbol of hope, and is also one of the most precious. It is supposed to represent harmony, wisdom, and love. To heal the heart. Oh, Zachary!

33 Wks, 2 Days: A Dream of Zachary

Yep, I'm awake at 3 AM...Again!

Last night, J and I were watching tv when I smelled the most noxious smell coming from my beloved husband. I literally gagged, and got so sick. I haven't done that in at least a month. The pukey part of this pregnancy has long since ended. But I was sick, so I ended up in bed after ensuring that our Cincinnati boy, Chad, was still safe on Dancing with the Stars. (I won't refer to him by his last name. I still cannot believe he changed his last name to a Spanish number because that was what all of us Cincy people called him. What a goofy thing to do!) But once in bed, I intended to read, and ended up waking up at 3 AM with the lights out an J snoring softly beside me.

What woke me was a dream I had of Zachary. We were bringing him home from the hospital. Nothing eventful happened. We were just bringing him home. He was nestled into his carseat, with his tiny baby legs curled up like newborns do, and he was so sweet and small and cute. My baby. I don't have anything profound to write about the dream. I think it has just hammered home that this is really happening. I am going to have two boys. One would think I would have gotten used to the idea somehwere in the past 33 weeks or so, but I haven't. Zachary will probably be E's age before I finally do. I have to cut myself some slack on this one: E has been an only-child for almost 9 years. (He'll turn 9 on September 1st!)

I cannot wait to meet this little guy. I don't know how much I believe in miracles. I simply have learned too much about science and medicine. But if miracles do exist, both of my boys are examples of them. E was supposed to be a miscarriage at 18 weeks, and Zachary probably would not have survived when I first went into labor at 21 weeks. Either God or the Marvels of Modern Medicine, whichever, is the reason behind both of them.

I'm reminded of my favorite quote from Cormac McCarthy's The Road. "If he is not the word of God then God never spoke." That may be a complete misquote, with puctuation or one or two words off, but I am recalling it off the top of my head. I remember when I read it, I thought of E. If God exists, there is no better evidence than the presence of my son in my life. Now I can say my sons, plural.

Tuesday, April 27, 2010

This Blog's Future?

Hmmmmm. My amnio is in 15 days. I need to start some sort of countdown.

But I have been thinking about my future beyond this pregnancy. I cannot really continue this blog beyond then. It's whole point was to document the pregnancy struggles I have faced. But that struggle will be over in a matter of a couple of weeks. My original intent was to use one of those services that turn your blog into a book, so whenZachary gets older, he will have a memento of what we actually endured to bring him into the world. I tried keeping a journal for E in the same fashion when I was pregnant with him, but found that I just didn't stick to it. Something about typing online is so much easier to do than writing it all out longhand.

But do I want Zachary to read this one day? Do I want to let him read about the day where I prayed for an end to the pregnancy, instead of being the selfless mother who thought of only her baby? Do I want him to read of the emotional and financial woes that have marked my pregnancy with him? Of the sacrifices we have all had to make?

This all started out as proof of my love for him. As a way to say that "I loved you so much that I endured this." I am left to wonder now if he should have that knowledge. If it will leave emotional scars on him in some way. Qute simply, I have not censored myself at all. I have said everything I have thought that I wasn't supposed to say out loud. Moms just don't do that. So now I cannot decide if I wll have this put into print for him or if I will just let these words waft around in cyberspace anonymously.

But I have found that I like blogging. It may be that nobody ever reads it, other than a couple of people, but for me, that isn't the point. I like doing this for me. It is a way for me to voice every frustration, thought, feeling that I have without my words impacting the people I love. Almost like a sort of therapy. So I want to start a new blog, and I know now will be the time to do so, when I am reaching an end to this one, and still have some time off before my life is once again consumed with career and education and family and new baby. If you are one of the people reading this, and are so inclined, you can find it here.

33 Wks, 1 Day: Relief

Yesterday,on what was to mark my 33 rd week of pregnancy, I went to see my doctor. It all started like it normally does--I went into the little vestibule where they check weight and blood pressure. I got on the scale, and the nurse got concerned, made me step off and back on again. I had lost 5 pounds since last week. Same scale, roughly the same clothing. And I know it wasn't all water weight because I was never really swollen to begin with. I told her it was probably right, that I haven't been able to eat all week. Which prompted the question: "What's wrong?" And so the floodgates opened. I told her a brief synopsis of everything, and as I was sitting there, the high-risk clinic nurse, who sees only us problem patients, came walking in, saw me crying, and got in on the conversation. Before I knew what was happening, they were crying too from my story.

So we go into the exam room, and she hands me the little disposable sheet, to which I just handed it back to her, telling her no, I'm sorry, I just cannot tolerate an exam right now, as I am in too much pain. She agrees and in less than 2 minutes, the doctor comes in. It's the one I like, and he comes through the door with a hearty "Duuuuuuude, what's UP????" This is why the L& D nurses refer to him as "Surfer Boy". He's young, and blond and tan, to go along with that personality. But he is also the one who listens to me, who promised me I would not suffer any longer than necessary, who finally offered me pain relief.

So we talk. I tell him I am miserable, as the tears start again. By the way, I think this is the first time he has seen me cry in all of this. We talked about the ridiculous number of trips to the hospital, the brethine pump's future with all of this tachycardia, and more. As soon as he said "36 weeks", I started crying yet again, and told him no, that I couldn't. Because then when I come back at 36 weeks, someone else would change it to 38 weeks, and so on.

Then he looked at me and said "No, I'll do it!" At which point the nurse handed him a calendar. I heard something about amnio, then something else about the next day. Huh? It has really been a long time. I remember the amnio with E taking almost a week to get back. I literally started laughing at this point. Amnio at 36 weeks, then c-section the same week? I could deal with that. 3 weeks.

Then he started explaining. We think of lung maturity, because that is the biggie at this stage in the game. But we want his brain to be developed, too. And his bowels. Nectrotizing enterocolitis is a big one in preemies. I agreed. "Plus," he said, "Little Dude wouldn't be able to eat yet!" At which point I laughed again. This is honestly the first time someone has referred to Zachary as "Little Dude" instead of the "baby" or "fetus".

He wanted the amnio on May 13th, but the perinatologist is unavailable on that day, so it was scheduled for the 12th instead. I was going to have my c-section, assuming amnio results are favorable, on the 14th, but now we aren't sure. I asked him after the date was changed, and he said they would call me, that he had to look at his schedule, that he should be able to find an hour in there somewhere. That was almost comical and completely strange to me: something this big and life-changing on my end is just a spare hour to him. Weird.

So the bottom line is that I am staying on all of this junk: the brethine pump, the monitor, etc., until then. He admitted that the pump isn't doing the trick, but that he is afraid it will be even worse for me without it. He refilled the pain meds and told me to continue taking them, that I was fine so long as I used discretion. I told him that was not a problem,that a few years ago, I had to have my knee reconstructed, and I am so leary of pain meds that I took about 10 total through that entire process, but that I was actually needing them now.

He ended the converstaion with this: "Please tell me you aren't having any more!" No, I'm not. But they all keep telling me this, and I wonder if it is a concern for my well-being or a concern for them, not wanting to deal with another of my pregnancies. They cannot say I didn't warn them--I had been telling them, as early as my first appointment, that it would get bad, long before it actually did. I consider that fair warning.

So in a little over 3 weeks, I will be holding my youngest son in my arms. Somehow, since finding this out, I have been able to relax a little. I'm still hurting and exhausted, but this knowledge has instantly made it more tolerable.

Sunday, April 25, 2010

32 Wks, 6 Days: Again

Back to the hospital. It went like this:

I got them to change my orders on my monitor. Instead of 6 or more contractions in an hour, they changed it to 6 or more painful or overly strong contractions in an hour. In other words, unless I hit the little marker on the monitor 6 times, I should not have to go to the hospital.

Or so I thought.

All day yesterday, I was hurting pretty badly. I took some pain medication and slept most of the day, then woke up to do my required monitoring. The nurse called me back, very concerned, saying that I had 36 true contractions, and that while she realized my orders had been changed and I didn't mark any of the contractions, she felt like she had to call my doctor. The same doctor who told me only painful contractions would count, that we would wait until 37 weeks, that they didn't care was the same doctor on call yesterday. So I thought I was safe. I understood her concern and told her to go ahead and call if she had to, but that I expected him to dismiss it.

He didn't.

They had me go in. Gave me a liter of fluid, but this time, the nurses felt so bad for me that instead of treating me like a pin cushion, they called IV Therapy. Iv Therapy makes up the Kings and Queens of Vascular Access in our hospital, and she got my IV on the first stick. I actually got my hopes up when the nurse told her to put an 18-gauge in me "in case we end up sectioning her". They also had me stop my pump while there for heartrate again.

Of course the contractions didn't stop. They called the doctor back, and he said it was okay for me to go home. Per the request of the home monitoring nurse, I called her to let her know I was home. She tried to remain professional, but could not even try to hide the exasperation in her voice. She told me her day job is still to be a L&D nurse at a large high-risk OB hospital, and that she has never seen them send someone home who was contracting over 30 times an hour. The poor woman was so flabbergasted that she was literally stammering on the phone. I found myself feeling sorry for her--she knew I didn't want to go to the hospital and was so apologetic about sending me, but was honestly concerned, only to have her worries and professional opinion completely disregarded.

And now? Now I am in complete pain. The weight of my ever-growing uterus has done things to my body that are too embarrassing to mention, and this was exacerbated by the pelvic exam and laying in a hard stretcher for hours last night. I didn't sleep last night. Finally, at about 4 AM,I took 2 pain pills and dozed for about 2 hours, only to be awakened by more pain. That's it.

I've been taking the pain meds religiously every 6 hours today, and have not even been able to move until now. Still, I cannot cough, sneeze, strain, laugh, or switch positions without this pitiful whimper that escapes my lips no matter how hard I try to control it. Each time, J and E come running to check on me. The nurse who is on today called to check on me, and told me she could hear the misery in my voice without even laying eyes on me. All I could hear was pity in hers, which I hate. I told her I would not be monitoring today. All that would do would be to put her in the professional dilemma of calling when I didn't want her to, or of being completely complacent like my doctors, against her better judgement. I don't think I could tolerate that bed again, or another pelvic exam with this pain, so I want to avoid another trip to the hospital at almost any cost. I think the only thing that could get me there now would be if I honestly thought Zachary was in some sort of danger.

Saturday, April 24, 2010

Really the Last Time: On Family Planning and a Sort of Mourning

Awhile back, I posted about the conundrum of whether we would have more children. We will not. If anything, the events of the past week have taught me that I cannot, and should not, try this again.

We have been pursuing options for permanent family planning. This has been difficult, as I work for a Catholic healthcare system. The ideal would have been a tubal ligation while they were already in there for my c-section, but that is forbidden. I've searched high and low for a loophole--medical necessity being my primary approach--only to find nothing. The next step was to pray that there was something so wrong with my uterus while they are in there that they have to remove it. I doubt that will happen. I even asked about an elective partial hysterectomy while they're in there, and was told it would be too risky.

So that brings us to vasectomy. We have toyed with the idea for a while now. We talked before I became pregnant, as this option is cheap (my hospital privately funds our insurance, and so will not pay either), and can be done in a doctor's office. Before I became pregnant, J said an emphatic "No Way!". Actually his exact words? "No one is coming near this area with a scalpel", as he made a sweeping gesture of his nether regions. Seriously, what is it with men and their testicles? Is it not enough to know that he is so virile that he made two sons? Then somewhere around 26 weeks, when I got shipped to OB Mecca, he changed from an emphatic NO to a "we'll see" approach. But he is still waffling. This is rather frustrating for me, for several reasons. First of all, I am the one who has to endure hell to bring our children into the world. And it seems silly for me to recover from a c-section, only to return later to have another procedure, regardless of how minor it may be. Furthermore, why the hesitation? We have been together for a decade. Our marriage isn't going anywhere. Is he afraid he will want another kid with another woman someday?

So anyhow, how to solve the problem of our fertility??? Well, my doctor mentioned that they do the Adiana procedure in their other office. I am seriously thinking of going this route. But what does that do to me psychologically?

I realized the other day that, no matter how far my doctors try to stretch this pregnancy, I will be having this baby within the next month. With that being said, this is it. This is the last time I will feel that wonder at a life growing inside of me. The last time I will feel the indescribable sensation of having a baby move and kick and squirm within me. And this isn't about just current pregnancy milestones. The home pregnancy tests I took marked the last time we would have that experience together. And what of those moments when I first heard his heartbeat or saw him on an ultrasound screen? All of that---the last time. And my experiences with Zachary: never again will I have the joy of hearing my newborn cry for the first time, or cry the tears of joy that are so unique to becoming a mom. These moments that are coming up are it for us. The end.

My fear is that, in the terrible-ness that has been this pregnancy, I didn't cherish it all enough. I cannot go back and fix any of that. All I can do is ensure that from this day on, I will cherish every bit. Every milestone, sight, touch, smell, feeling.

I sort of knew I would be coming to this decision eventually. I know this is what I have to do, for my safety and the safety of any children who would have come down the road. But nevertheless, I'm sad. Not only for the fact that I won't ever have these experiences again, but for the end of an era. I am ending my fertility. I'm in my 30's. Next comes 40, then 50. Is making it so I can no longer have children putting a premature end to what makes me a vital young woman?

The hardest part is not so much the having to admit that this is my last child, but to have to say this is the end of this stage of my life. All that is left is for John and I to grow old together, raising our two sons.

32 Wks, 5 Days: Silver Linings

Bedrest is horrible. I think I've made that abundantly clear. I cannot put into words the toll it has taken on not just me, but my entire family as well. But yesterday, as I was trying to cheer myself up, I came to the realization that some very positive things have come from this, too. Things that probably wouldn't have happened any other way.

I have actually had to slow down. And rest. Last summer, I caught pneumonia bad enough that it caused partial collapse of both lower lobes of my lungs. I had to miss some work and school, as I was in the hospital for a week. But as soon as I was released, I was back in full swing. My own illness was not enough to make me realize that I was pushing myself too much. But when the health of my unborn child hangs in the balance, I have no choice. I don't think anything else, barring (Heaven forbid!) E bcoming ill, could have made me do this.

I've actually spent the past 3 months of my life being with noone but my family. We take our moments with our loved ones completely for granted. In my hustle and bustle of school-to-work-to-school, I missed my boys. I knew I did, but I didn't realize how much I was missing until I was here with them, each and every day. For once, it is my signature on report cards and permission slips. I am the one who gets to help E with his math homework. I have the priviledge of hearing him come home from school and tell me all about his day, whether good or bad. I've been able to snuggle with him and read books or watch tv without worrying about what task it is that I am leaving undone. And J! We have spent the past few months being a couple again. Sure, it stinks that we can't do much more than talk--there are no trips to romantic restaurants or exciting "dates"-- but he has been here every step of the way. He reminds me daily of why I fell in love with him from the beginning.

And for the first time, I have been able to sit and reflect on what it is I truly want out of life. Free from the influence of my work or anyone else. And I've discovered that I really do love my career. I always thought that, while I love what I do, I wanted much more. While it is true that I will still want the higher degrees, because that is just my nature, I do not have to chase prestige and money to be fulfilled in that way. I can instead spend my efforts building on the foundation I have already established and still be just as happy.

I have always believed that everything happens for a reason. I would not call myself religious. Actually, the complete opposite is true of me. But I have always believed there is some force out there guiding us. I can honestly look back at the events of my life and come up with some positive life-altering result of even the worst crisis I have experienced. (And there have been quite a few, let me tell you!) The death of my mother rocked my world, but I can honestly say that I was forced to grow up, free from her coddling me, in a way I never would have otherwise. When Iwas told I had a brain tumor years ago, the scare was great enough to push me to pursue everything I wanted in life--returning to my hometown I had missed so much and finally going after the education I have always wanted. And when we lost everything during E's pregnancy, and I thought we would never bounce back? Well, that forced me to finally get the education needed to establish a career I love so much. Without it, I would have remained a college dropout for the rest of my life.

When I became pregnant this time, I knew in my mind that something was going to come from this. It was just too serendipitous. We used to want another, and had long since given up. I had not been on birth control for over 8 years, and it never happened. We were just about to pursue permanent birth control, anticipating the start of med school for me. Plus, I was so busy that I didn't even have time to do what it is one does to even become pregnant for months on end. (I will not permit myself to go into anymore detail than that. That would be....gross.) Yet still, in that tiny window of time, after 8 long years, I got pregnant. I just knew in my heart, once the feelings morphed from shock to disbelief to happiness, that Zachary would make a profound contribution to our lives. That he is here to fill some void we didn't even realize was there in the first place. For all I knew, he could grow up to contribute something amazing to medicine or society. But now???

Now, I'm starting to wonder. Is this Zachary's gift to me? I realize how horrible this sounds--children are not here for us, we're here for them. But seriously. Is this why he is coming to us? To force me to realize what I had been missing? To show me the true value and beauty of my family? To instill in me an appreciation for the life I have built for myself?

Wednesday, April 21, 2010

32 Wks, 3 Days: From a Deep, Dark Place

I have a confession to make. About once a week, J, E, and I would cheat and go and get something to eat. I really saw no difference between this and going to the kitchen to make myself a sandwich, which was allowed. It kept me somewhat sane.

I don't want to anymore. I don't have any desire to do anything. It is all I can do to bathe. I cannot believe I just publically admitted that on the internet, but I don't even have the gumption to take a shower. Of course I do, because I am not an animal, but that is about all I can manage.

The pain rips through my body like a tornado. There are no longer breaks between these contractions. I am spending my time in a Percocet fog, in bed, no longer able to see an end in sight. My doctors continue to insist that I go to the hospital for more than 6 painful contractions in an hour. How do I explain to them that I have more than that in 10 minutes, consistently? That they all hurt.

I'm having flashbacks to 2 weeks ago. At my appointment, when I told them that I would get to this point, and I was reassured that they would not allow me to lay and suffer any longer than needed. How stupid was I to believe that? I simply do not matter. And I could live with that a little while longer. I really could.

What can I not live with? The fact that my 8-year-old son tried to hug me last night before bed and I screamed out in pain. What scars am I leaving on him??? And J. Bless his heart. He left with E yesterday and returned with dinner from my favorite pizza place and a movie I have really been wanting to see. He just wanted to make me smile, so I faked it. I made myself sit through the movie, when all I really wanted to do was curl into a ball in bed, away from the rest of the world. I feel so badly for them both. They do not deserve this--the endless trips to the hospital, the mentally-absent mother/wife. E has a field trip to he zoo on Monday, and he desperately wants one of us to go. I obviously cannot. And J had to say no also, because how could he leave me alone for 6 to 8 hours, not knowing what emergency could develop? My kid deserves to have a normal life. There are just some prices children should not have to pay.

The hardest part for me? My own thoughts. I cannot help but to think "what if I hadn't gotten pregnant?". I would be in school right now, finishing up. I would still be working away. I wouldn't have pain. I would be free. When my son wanted an expensive new toy, I woudn't have to stop and thnk about what it was going to do to the family budget. There would be no telling him that mommy can't go to this function or that function, or this place or that place. I could once again make him smile. But then I feel overwhelming guilt and sadness. Because Zachary does not deserve for me to have those thoughts, either. But I am only human.

The other day, J an I were going to the hospital, and we passed a pregnant woman in the hall. We heard her giggling as she talked to someone at a desk, when they asked her when she was due. "Last week", she giggled as she stroked her belly. And J looked at me and asked why that could not be me. Why can't I be bouncing around, happy and content? Why can't I feel the delicious anticipation of a new baby coming, as I plan and shop and decorate a nursery? I simply do not know.

I have been trying and trying, since Tuesday when the doctor uttered the dreaded "37 Weeks", to get myself out of this mood. I cannot. Honestly? I want to die. I cannot live like this anymore, but before someone gets all worked up about that statement, let me assure whoever is reading this that I am not that stupid. I want to, but I won't. I would do nothing to hurt this baby or myself. I realize this is temporary, that I will have my life back, that I cannot possibly be pregnant forever. And so I will keep fighting.

32 Wks, 2 Days: Can I Call It or What?

I hit the 32-week mark Monday, and I was excited. Until they sent me to the hospital again. That was the 4th time in roughly the past week. It seems my brethine pump is doing strange things to my heart, and the insane contractions of Saturday still have not stopped. Again, not dilating. So I follow-up in the office Tuesday as planned, and the doctor I saw pretty much told me that, while he did not want to sound heartless, it doesn't matter how miserable or uncomfortable I am, so long as baby is fine. So now they are saying 37 weeks. I knew it would happen. I've been to this show before and I know how it ends.

Tuesday afternoon, I did my required monitoring, and of course my uterus was doing insane tricks, so the nurse had to call my doctor, and of course my doctor had to tell me to go back to L&D. Trip number 5 in 8 days. I begged and pleaded, and tried to "respectfully decline" to go, at which point I was told I would be labeled a non-compliant patient, which would cause issues with my insurance company. I had no choice but to go. In the process, they had me stop my pump temporarily because my heartrate was 136, a contraindication of brethine. Nothing changed. Everything was the same, except the contractions were bigger and badder, but still not causing me to dilate. They tried giving me a one-time dose of Procardia (nifedipine) which did nothing other than cause my blood pressure to lower and gave me a raging headache that lasted into this morning. I was sent home with the same instructions I got Saturday, Monday, Sunday, and at the office on Tuesday morning.

So what are my instructions? I have been thoroughly educated on the symptoms of uterine rupture, as it seems I am a prime candidate right now with all of these contractions. I also found out by complete accident that, while my external incision from E's delivery was transverse, my actual uterine incision is classical. If you aren't well-versed in c-section lingo, this is bad. A classical incision is straight up and down and an even higher risk for rupture. I didn't know this until someone mentioned it in conversation. Apparently they got it from the OR report from E's delivery.

In a nutshell? I am still at home, having over 40 contractions per hour, on narcotic painkillers that are no longer working, and waiting for a crisis. A crisis that could kill me and the baby. My home nurse told me today to not even monitor, as the doctors don't seem to be doing anything about it and it is completely futile at this point. The only result will be that I will have to rush to the hospital again. They keep having me temporarily suspend my brethine infusion for heartrate, then start it back up when my pulse is again under 120. My nurse from the call center, my home health nurse who administers my progesterone injections, and even my case manager from Humana are all infuriated that this is being permitted to continue, that not only is it permitted, but they are actually prolonging the pregnancy. But they are not my doctors and can essentially do nothing. They will not even do the amnio at this point. When asked why, he said "Why risk infection?"

Why. Risk. Infection????

Because I do not want to die. Because I do not want lose my unborn son. Because I don't want to ruin my heart with the medications. Because I am tired of disrupting E's life. Because I cannot stand the pain anymore. Because after steroids and the best prenatal care money can buy, odds are that Zachary is okay now. I am not anymore, on the other hand.

A simple course of antibiotics can cure an infection. There is no simple cure for anything mentioned above.

Sunday, April 18, 2010

31 Wks, 6 Days: Crunching Some Numbers

2: The number of times they made me monitor yesterday.

34: The number of contractions I had in the first hour of monitoring.

3: The number of brethine boluses I got between attempts at monitoring.

54: The number of contractions on the second strip. Yeah, that's right. Not a typo. The OB nurse at the call center said she has never seen anything like it in her 25 year as an OB nurse. And yes, I felt them all.

4: The number of nurses at the hospital that it took to get my IV.

13: The number of sticks it took the 4 nurses to get my IV.

2: The number of IV bags they gave me. Also the number of Percocet it took for them to get me to be able to sleep.

5: The number of hours I slept once I got home.

36: The number of hours this has been going on. They will not stop. And so long as I am not dilating, they do not care. I wonder if my uterus could spontaneously combust. If it could, at this point, I am sure it would. Today, I actually had 0 contractions. Great right? Nope. Because now they are so frequent, that they don't even last long enough to be considered contractions. Just very frequent waves on a monitor strip, which resembles an EKG more than it does uterine activity, according to my husband. Just wave after painful wave. As soon as one stops, another starts, to the point that I cannot even feel distinct contractions anymore, but rather this wrenching feeling like my guts are being ripped from my body.

They offered me morphine at the hospital yesterday. I should have taken it instead of the weaker Percocet. But there is honestly something wrong when the pain is so bad that they offer me morphine. Me, a pregnant woman. The offer makes me realize that they realize how miserable I am. If they know am that miserable, isn't it time to act?

But nobody cares. My home health company doesn't even care anymore. I ran the strip today like a good girl, and since I was seen yesterday and the doctor on call didn't care, they don't either.

I have no faith in the 34 week mark anymore. I have a feeling they will change it once I get there. As in, "Well, you made it this far. Let's see if you can make it to 36 or 37."

And I will lose my mind.

I am a prisoner in my own body, and I cannot endure another day of this.

Thursday, April 15, 2010

31 Wks, 3 Days: Feathering the Nest

Somewhere over the past few days, the nesting instinct has kicked in, big time! I have made J work his tail off! If I could tolerate it, I would be up and doing everything. J and I were talking and realized that I have about 2 and a half weeks (after today) before I am 34 weeks and they stop my drugs. If things go as predicted, Baby Zachary could be here in that little amont of time. I just feel like I have to have everything ready.

Over the past few days, we have managed to clean the basement, clean E's room, organize everything upstairs, clean out the car. Well, J has. I just perch somewhere with a cold drink and watch and direct. There are still a few more things to do. The kitchen cabinets need to be organized to find a space for Zachary's bottles, bowls, spoons, etc. And all of his clothes need to be laundered. I have those piled in baskets and ready to go in the wash, but cannot carry them to the laundry room, so J wil be doing that today.

We got the Pack and Play assembled and it is ready to go. The stroller is put together. I still need to stock the changing station in the Pack and Play and organize the drawers of the big changing table. All of the supplies are there, having already been purchased, but they are all still in the packaging. J can do that today,as well.

J finally installed the carseat in the car yesterday after he cleaned it out. It is so surreal seeing a carseat there. I thought those days were long behind me, yet here we are. It was tricky maneuvering it in there and finding it a permanent home. When E was a baby, there was no LATCH system, so we had to cruise my car's manual to find out where in the heck the hooks were in my seat. And first we had it on the side, and realized this was not good because of the side curtain airbags. My car literally turns into a pillow on impact, as there are 8 airbags in it, so we had to find a space where Zachary's carseat would fit that was safe from all of them. This also was not on issue with E, as airbags then came in the standard dual ones in front. Wow, times have changed! And poor E is going to be squished against one of the sides. Also not a problem when E was little: he was the only one, so he could sit in his throne in the center of the backseat without it impacting everyone else. Of course once we got Zachary's carseat in there, I realized that, while it is fine now, about the time he switches to foward-facing big-dog carseats, we will need a bigger vehicle. Unless I choose to only transport one child at a time,which is not going to happen!

So hopefully, after today, everything will be done. We'll be ready for him. All we'll be missing at that point is the baby. I cannot wait to see him, to hold him. But I am also scared. J's sister's baby was about 6 months old at Christmas when we went down there to visit. It was the first time we had seen him, and when I held him, it felt so strange and awkward. It has been so long since I have held a tiny baby. My life has pretty much consisted of work and school for so long, and E has been a big boy for years and years--I just don't encounter the little ones these days. So I am out of practice. I know I will be okay. I wasn't a baby person when I had E, but I learned. And I know that it is really different when it is your own.

So anyway, now we just wait.

Wednesday, April 14, 2010

Rub My Head, Please!

Baby Zachary is like his mother, I think. J wants to deny this. E is more like me: a city kid, into reading and school, sensitive, and more. Not the tough-talking country boy like his Daddy. So J insists Zachary is the one who is going to take after him. But we know there is one thing he got from me.

When I was little, my mother would help me go to sleep by playing with my hair. Still, to this day, it makes me fall asleep. I doze off in salons, even. If I am having trouble falling asleep, J will play with my hair and it works everytime.

Last night, Zachary was kicking up a storm. And it was actually hurting, as this is not some little tiny zygote anymore, but a 5 1/2 pound baby boy. I could feel his little head, right there above my belly button. He's in there, curled up, with legs pointing down. So I just started rubbing the area where his little head is, and he stopped. When I stopped, he started up again. We did this a few times, and finally I just sat there rubbing my belly for a while. Not long after, I stopped feeling movement other than a few twitches. I really think I put him to sleep by rubbing his head! It was so stinikin' cute that I could barely stand it.

31 Wks, 2 Days: Random Stuff

Saw my doctor yesterday, and all was well with my BP. I finally gained some weight, 1.8 pounds, making my net gain for the pregnancy totalling 12 pounds so far. Not too bad. We discussed my situation, and I left the office reassured that they will not let me go any further than necessary with the pregnancy. His exact words: "You're in pain, and we're concerned that you are in pain, and we are not going to let you suffer any longer than necessary." So the plan is still to wait until 34 weeks, stop everything and do an amniocentesis to test out Z's lung maturity. They cannot plan a c-section that early without a medical indication. I don't think I will last more than 8 hours without the meds before I am contracting. But what they can do is let me start contracting at that point, then do my c-section.

We discussed the end of my FMLA job protection on May 1st. The doctor had the idea that maybe, once I reach 34 weeks, they can let me return for some piddly 4 hour shifts a couple times a week to try and buy me more time. I would be thrilled with this idea, but for the first time ever, I had to make the statement that I don't think I am capable. I am so de-conditioned right now that it isn't even funny. I'm relying on the post-partum period to gain some strength and get my chops back before I start running around the hospital. I hated admitting that to him. I really miss work, and would give my eye teeth right now to return.

So speaking of work: Yesterday was the big Gainsharing disbursement. In lieu of giving huge sign-on bonuses, my hospital has this employee incentive they call Gainsharing. Basically, the hospital keeps tabs on those patient satisfaction surveys, compares them to the national average, and if we meet certain criteria, since it is a private hospital, they determine a portion of the hospital's proceeds and disburse it to employees. The amount you get is based on the number of hours worked for the year. 2080 hours is considered full-time, and thus earns you the top-out, maximum amount. I worked 2,778.4 hours last year. Since I work 36 hours per week, that was the equivalent of 77.178 weeks of work in 52 weeks. Kinda like me squeezing an extra 25 weeks out of the year. So of course I got the full disbursement amount. The check had to be picked up in person, and each department in the hospital has a big to-do over it: catered lunches, mandatory meetings, etc. My boss was going to allow J to pick up mine, considering the circumstances, but I wanted to do it. J dropped me off in front of the door, parked the car, and came and got me in a wheelchair to take me to my department. I got a very warm reception, making me think that the feelings I had of being snubbed were more my perception than reality. I'm sure that, just like anywhere else,there are people in my department who talk about me behind my back, who think this has been a vacation for me or some kind of lame excuse to not work. But for the most part, everyone got it and seemed genuinely concerned. My supervisor's exact words: "just have a healthy baby, recover, and get your butt back here ready to work!" as she hugged me before I left. This gives me hope that they see my value there and will not post my job.

Of course the money could not have come at a better time. I was sort of bummed that I couldn't just go on a binge and spend it like I did last year. Instead, this year, I used it to pay bills. The plus side is that I can now breathe a little easier, and will be until I am back to earning my full salary. I paid a couple of rent payments (through June) and huge advanced payments on electric and phone/ internet/ cable. My car-loan disability insurance came through, so I no longer have to pay that. They actually calculated my post-partum period to end 8 weeks from my scheduled c-section, so I am free from car payments until July 27th. And my bank, since I have been a Good Girl and never been late or short on any payments, actually restructured my other loans (education, personal, overdraft line of credit, etc.) into my car loan, refinancing my car to a payment that is actually lower. So when the insurance pays my car payment, they will be paying toward all of my loans. This frees up my income from my short-term disability pay for simple living expenses like groceries, gas, etc., for the next couple of months, at least. I can breathe again.

We did have a little fun, though. I treated myself to a stack of books that I cannot wait to lose mysef in. And E: that kid has been sitting quietly by, watching every spare dime that comes into the house go toward baby stuff. I'm sure it has been harder on him than he lets on. He is used to getting everything he wants. It is bad enough that my earnings have reduced so drastically, but then to have to watch any little extra go toward another baby? Poor E. And he has been so good about it. So I was going to buy him a new bike. He outgrew one a while back, and got a new one from his Grandma, but he has a little problem: the kid is short! And small. So while his old bike was too small, the next size up was way too big and no matter what adjustments we made, his little feet could not adequately touch the ground. Too dangerous for my taste!So the new bike is still brand new and in the basement right now. It has been for almost 2 years, as we kept stalling on buying him one, thinking he would grow into it. But summer is either coming, or is here, and my kid still doesn't have a bike to ride. We took him to the store to find one that would fit. Of course none did, so I gave him the equivalent in cash to spend how he wanted. I did place some guidelines on him, though. No video games, no dvd's, no computer games. Toys or books only. He made some good choices. As for the bike, I think Iam going to have to wait until later in the summer when I am back to work and take him to a cycling shop and get something customized for him. We then swung by and bought him some summer clothes. This is my favorite time of year for that. Usually I am a kid/ baby clothes snob. My child has been dressed in designer everything from the time he was born. But somewhere around the time he started school, I changed this a little. I think it was the first time he went outside to play in summer in a brand new Ralph Lauren outfit, and chose to roll in mud, and the outfit ended up in the garbage, as it was too ruined to even donate to charity. So in summer, we buy cheap clothes. And I have found that if you are choosey, you can find clothes at the discount stores for dirt-cheap prices that look like designer labels. So for once I can get him an entire summer wardrobe for a couple hundred bucks instead of the thousands I spend during the school year. Bonus for mom! And on the way home, E says this: "Thanks, Mama, for the ...." And rattles off a list of every litte tiny item I bought him, all the way down to the candy he got in the checkout lane. Arrrgh! I love the kid so much it hurts!

Tuesday, April 13, 2010

My Nightmare

Yesterday morning, I was awakened at 3 AM by a nightmare I had. I've been thinking about it ever since. Aren't dreams supposed to you subconscious in action? I'm wondering what this says about me.

In the dream, I was at the hospital, in the OR, having Zachary. The surgical drape was in place, and I had been given my anesthetic. My lower body was numb, so I couldn't move. My doctor was starting the c-section when he got a call to a laboring woman in another area of L&D. And he left, telling me he would be back in a few minutes. The entire OR team followed him, leaving me alone, strapped to the table and unable to move. Whether from panic or anesthetic, I had an asthma attack. I thought I was going to die. I screamed for help and nobody came to my rescue. I didn't have an inhaler. Then I thought: epinephrine. We used to give epinephrine as an asthma drug, before they came up with safer options. And I knew that epinephrine is kept in the top drawer of our crash carts. There was a crash cart next to the anesthesiologist's area, right by my head, so I broke the little plastic lock on the cart and self-administered the epi. While I waited for it to work, I grabbed the Ambu bag from the anesthesiologist's cart. I knew it would be attached to oxygen and going, in preparation for it's emergent need. We always do that so it is ready should a patient crash on us. I held the mask loosely to my face, inhaling the oxygen, and praying someone would show up to help me.

I was there for what seemed like hours. The spinal wore off, and I could move my legs. I freed myself from the table, and felt around on my belly to see how far the doctor was into the surgery before he abandoned me. My belly was flayed open, and I had surgical retractors protruding from my abdomen. He got that far. My uterus was cut too, and you could see Zachary in the transparent balloon of amniotic fluid. I wailed as I tried to decide whether to leave him be or take him out. I knew I was trained in neonatal resuscitation, but did I know enough to save my own son? I am trusted with the loved ones of others, but do I trust myself with my own?

Finally, one of the night shift OB nurses showed up in the OR. I don't know why it was her. I'm not even that close with her. We are just acquaintances at work. But she told me there had been drama in L&D, that everyone was gone except for her, that they all got fired. I asked about my doctor, and she said he was gone, too. She told me one of his partners was on his way to finish me up. I asked her if anyone was on standby for the baby: "Is Children's on the way?" (When we have a baby that needs help beyond our abilities at my hospital, we call in a transport team from Children's Hospital. If we know before the delivery that there will be problems, we call so they are there and ready.)

She said yes, that I was only 31 weeks, so they are coming. And then I woke up.

I never have dreams that I can recall with such detail. Never.

So what does it mean???? First of all, my doctors are consummate professionals and would never do anything like this. To anyone. But is it because I am afraid of them not considering me? That just because I cannot dilate, they consider me to be second-class, coming behind women who do? And the details of work? J says I just need to go back, that I miss it even more than I realize. I think he's right.

31 Weeks, 1 Day: I Take It All Back

I have been a whiny baby lately, complaining about this pregnancy and how I am "done".

I lied. I'm not done. I wish it were easier, but I want him to be healthy. And be in there as close to full-term as possible.

I'm nervous. Today, I have to go back to the doctor to "check everything out". They're worried about my BP and pregnancy-induced hypertension. Not pre-eclampsia yet, as none of my lab values mesh with that. Urine, blood..everything was normal but my blood pressure. My BP has always been perfect. As a matter of fact, when pregnant with E, I was on Procardia for preterm labor and they had to stop it because it would cause my normal BP to drop, then when I would do anything that would cause it to lower more, I would randomly pass out. I had to take cold showers bcause the heat would cause me to vasodilate and John would hear a big thunk! where I would hit the floor. So when oral brethine didn't work this time, that is how I ended up on the pump. They didn't want to add nifidepine to the mix.

So yesterday, when they sent me to the hospital for PIH, I was the talk of L&D. From my stretcher in triage, I could hear the doctors and nurses at the nurses' station talking about it. "She's here for PIH and on a brethine pump!" They kept implying that it would have to be stopped, and the doctor that sent me to the hospital in the first place even said so much--that if BP became a problem, they would have to stop it.

Hmmm. Stopping the brethine pump.....

I've been fantasizing about this for weeks. What it would be like to sleep without worrying about rolling over on the tubing and occluding it. Of worrying about the syringe emptying in the middle of the night, causing me to miss a scheduled bolus and wake up contracting. To be able to take a hot bath because there is no catheter on my thigh that cannot be submerged in water. To be able to go to a doctor's appointment or anywhere else and not have to worry if I have enough batteries or meds to survive the trip without going into labor. About not having something constantly attached to my body.

And if they stop the pump,they are going to stop everything. My progesterone shots. Most likely my home monitor that works in conjunction with the pump. I'm getting scared.

The truth is that, while I have been getting really sick of this stuff, I also realize that there have been countless times where I have avoided hospitalization because of it. And as much as I hate it, I hate being in the hospital even more. And I know that, while they have spent months trying to find the delicate balance of injection frequencies and infusion rates to keep me from having breakthrough episodes of contractions, those breakthroughs would occur more frequently without the stuff. Or my contractions just won't stop, period. And my beloved son will be born too early. Or if he isn't, I will lay in misery in a hospital bed, contracting away, in pain, with my needs not being taken into consideration as I incubate him longer. Neither one is an option I can live with right now.

I'm really scared for myself. And terrified for Zachary.

Monday, April 12, 2010

31 Weeks: Back to the Hospital and Baby Ginormo

After having pain in my old c-section scar had me doubled over, I had to call my doctor to see if I needed to be seen today or not. Of course I was told to come into the office, so I went. My BP was 175/ 82, so I was immediately sent to L&D, where I went through the usual routine. But this time they did a full ultrasound to ensure that everything was okay. It was. My BP normalized, and the pain was deemed to be the result of scar tissue and adhesions in there.

Zachary is measuring, at his current gestational age of 31 weeks, at 5 pounds, 4 ounces. His gestational age calculated by the ultrasound: 35 weeks, 1 day. Still huge.

We got some awesome pictures of him, though, and even got to see him yawn. J had gone to pick E up from school, so he got to be there to see his baby brother on the screen for the first time, instead of just looking at grainy pictures. He saw it all, the yawning, squirming precious baby boy, complete with the little heart beating away. A wonderful experience for him.

A perfect little leg, from thigh to toes.

And speaking of toes...

The sweet little profile

Angel face. We can see he looks like his brother.

This one required some explanation. The ultrasound tech gasped, "Look at all of that HAIR!" Apparently the white halo-like shadow around the top of his head is his hair, lilting in amniotic fluid, and he already has a head full!

Sunday, April 11, 2010

Decisions, Part II: The Last Time?

Am I really ready for this phase of my life to be over? There is no feeling in the world like a child moving within your body. Of making a life with someone who was once a total stranger, and being there together as you bring a new life into the world. Of holding a warm bundle snuggled in a blanket, close to your heart. The buttermilk smell of a newborn's breath. Toothless smiles. The sound of little coos and grunts.

There is nothing in the world like watching a child learn. Lke seeing them reach milestones. Like witnessing first steps and first words. Like seeing a personality form before your very eyes. Expressions of glee at a new discovery. Sloppy toddler kisses. Chubby baby fingers learning to manipulate an adult world.

There is nothing like watching them get on the school bus for the first time. Like being there for their triumphs, as well as their defeats. Like mending skinned knees and wouded egos. Trepidation at sharing them with the rest of the world. Realizing that they do not belong only to you, but are going to make an impact on others as well.

Am I really ready to give it all up? For this to be the last time I have these experiences? I once was sure. I'm not anymore.

To make the decision, one has to consider the potential cost. I'm not speaking of dollars and cents. I'm speaking of the trials and tribulations of a pregnancy like this. When I became pregnant with Zachary, I had a glimmer of hope that this time would be different, that the old adage "every pregnancy is different" would ring true. It didn't. History does repeat itself. And while the details have changed, the situation has remained the same for me. Can I do it again?

They tell you that you will forget the pain you endure as soon as you hold your baby. I don't want to burst any bubbles for anyone, but I don't entirely agree with this. Because I remember. The pain took on a different shape and morphed into something much more tolerable when I first laid eyes on my newborn son, but it will never be forgotten. It will always be there, at the back of my memory, serving as a reminder of my love for someone I had yet to even meet. And instead of feeling resentment toward him as a result of the struggle, instead there is a deeper love. Because I endured pain and grief and heartache to bring him into the world, he is more precious to me than my own life.

So am I really finished being a Mommy after Zachary? I'm still not sure. I have to trust that time will tell. And I am not going through with the plan for any permanent prevention.

30 Wks, 6 Days: A Small Victory

Guess what today is!!!!! Well...

Today is the last day that, should I go into labor, they would send me to dreaded OB Mecca. From now on, I am deemed far enough along to deliver at my hospital. This may not seem like a big deal, but everytime they have told me to go to L&D, I have run the risk of being transported, and I hate that place.

Well, I guess I should be fair. There is nothing really bad about the place. They must know their stuff, because that is where all high-risk pregnant women go in our vacinity. That or University, a Level 1 trauma center. And then we have Cincinnati Children's Hospital. I am blessed to have state-of-the-art medical care from tons of different facilities all within 10 minutes of my house.

I just don't want to have to go. The place depresses me. I spent over a month there when pregnant with E. It felt like jail. And that was when we had no children and J could come and stay with me. It was a thousand times worse for the few days I was there this time, when I couldn't see E.

But those days are behind me.

Saturday, April 10, 2010

Decisions, Part I: Letting Go of a Dream?

By now, it's pretty much common knowledge that E was to be an only child. Zachary, while an amazing blessing to our family, was an accident. Not a mistake, but definitely not on purpose. To say he is a mistake would imply that I regret becoming pregnant, and I do not. It just took us by surprise is all. After 8 years of no family planning at all, we just assumed one of us was infertile. We were never diagnosed, and never really gave conception a real effort. But when it just never happened, combined with the memories of the trouble I had with E's pregnancy, we assumed it couldn't, and gave up. Somewhere around my late 20's, we just faced the fact that this is it: this is our family. And moved on.

Then I turned up pregnant. And from then on, we realized, okay, we really are still fertile, so maybe we need to make it so we aren't. 8 years from now, when I am in my early 40's as opposed to my early 30's, I don't want to do this again. So from my first OB appoitment, we have discussed permanent family planning options. We still haven't decided which option is best, just that we are most definitely going to pursue one of them.

Or so I thought...

Last night, J and I were watching tv together, alternating with watching Zachary move around in my belly. I can picture him in there, playing around, and J makes the statement that it is the cutest thing he has seen in a long time. Then he uttered the dreaded sentence:

"You're going to want another one."

Six months ago, I would've killed him for less. But lately, I've been having these thoughts in the back of my mind somewhere, and was actually going to write about it, but needed time to sort through my feelings first. What if he's right?

My upset over becoming pregnant was mainly rooted in fear. When I became pregnant with E, we were dumb newleyweds. Literally. I was a college dropout. J worked at a factory and I was working some dumb dead-end job I hated. And when the pregnancy complications surfaced, we were taken under. But we really didn't have much to lose. This time was different. I had established a career that I love. Our financial picture is completely different. And I bit the bullet and went back to school. I have wanted to be a doctor since I was a kid. Somewhere around my freshman year of high school, Mom got sick and my family was not as well-off financially, and Mom talked me out of it. She told me medical school was for the wealthy, and we were not wealthy anymore. But when I entered the world of healthcare when I went back to school as a non-traditional student, it became obvious to me that it was still what I wanted to do. And when I managed to maintain a 4.0 GPA, even when taking 24 credit hours per semester to get finished quicker, it became obvious that I still had the ability.

It's been difficult. First of all, it took me 3 years of working as an RT to finally go back. I've never failed at anything I have ever really tried. And getting into medical school is difficult for the 20-somethig kid fresh from college. But I am a grown woman with a family and career, making it doubly hard. Can I do it? Yeah, most likely. Everyone has strengths and weaknesses, and while I may not be beautiful, academia is my world. I excel there. I have not taken a single college course in my days as a student that has ever been a true challenge. That seems really arrogant, and I realize that, but it is true. But do I still want to?

In order to finish pre-med, I was working anywhere between 60 and 70 hours per week, and would limit myself to 18 credit hours at school. Age was not on my side, and I felt rushed to get finished to be able to make my applications to med schools. I would literally go days without sleep. My routine was like this: 12 hours of work, go to class in scrubs all day, then go home and shower/change and go back to work for 12 more hours. I ate my meals in the hospital cafeteria before my shifts would start. I would nap in the car in-transit, as J would drive me and drop me off everywhere so I could do this. My backpack was always with me, because whenever any free time would come up, I would have to study: at work, waiting on an appointment, in line at the bank, wherever. About every 3rd day of this, I would collapse in exhaustion and have to sleep. My professors would always know what I was doing, so if I had to skip a class to sleep after having been up for 72 hours, they would understand. And my grades were always immaculate, so they couldn't argue, so long as a didn't miss labs or exams. This was what I was doing when I got pregnant.

But long before the 2 pink lines showed up, I was starting to have misgivings. I missed my son. And the seed was planted: what would happen if I didn't do this? What if I just kept my current career and spent my off-time raising my little family? Would I be able to live with that? Would I be happy? Because the truth is, if this is hard, when I get to medical school, it will be a lot worse. And residency. By the time I finished, E would have been 13 years old.

But now there is to be another son. More missed time with another child. And the prospect of becoming a doctor is going to be even more difficult. An lately I have been thinking that maybe it isn't what I want to do anymore. That scares me. It may not seem scary to anyone but me, but when you have dreamed of something your entire life, it is a frightening thought to suddenly change courses. To give it up would not mean I would give up on higher education as a whole. I love my current career, but I don't want to be stagnant in it. The next logical step to advance it would be a business degree, so I could go into upper management. Of course I would follow that with an MBA. My academic prowess would ensure I would do well in that also. It makes sense to me. That way, when I am older and tired of the physical demands of grunt work in my field, of the demands of 12 hour shifts and running to codes, I can change roles.

So now, the choice to make Zachary the last one isn't so obvious anymore. We know now that we can expect all of my pregnancies to go this way. There is no way the endeavor to become a physician could withstand this again. But if I take the other route, maybe we could down the line a few more years.

I need to sleep on it....

30 Wks, 5 Days: My Meltdown

I did my required monitoring strip in the early afternoon yesterday, and about 5 minutes after sending it, I got a call to tell me I had 26 contractions in one hour. I couldn't feel them, but just felt a constant tightness in my belly that was uncomfortable. The nurse had me give myself a bolus, then wait an hour and give myself another, then re-monitor. On the second strip, it actually worsened and I had 29 contractions. So they insist on calling my doctor.

Of course the nurse is still at the doctor's office, as it is during business hours, and she tells my home nurse to send me to the hospital....again. And that she will let the doctor on-call know I am going. I really don't want to go, and am concerned that the instruction to go is some knee-jerk reaction, that they aren't keeping in mind who this is, that I do this. So I call the doctor myself, and pretty much beg him to stay home. I'm worried that this is it--that I will get there and they will keep me until I deliver. He tells me this is not necessarily the case and says we will see if I am dilating any and go from there.

So I go, and of course I get a nurse who has never had me, but she is older and seasoned and has seen it all, so she doesn't panic. She is more worried that my blood pressure is up, as is my heart rate. I tell her the history of the pregnancy, how badly I wanted to stay home, and she understands.

They call my doctor, who gets one of his colleagues at the hospital to check me, and they want to do a fetal fibronectin. I'm not really happy about that. I know those can take forever to come back, and I also know that as I get further, with my history of preterm delivery, it is likely to be positive. So they check me afterwards, and of course am not dilated any but the doctor notes that my cervix is very soft. And after waiting, we find out the fetal fibronectin is negative. Good! They are calling my doctor at this point, and I am waiting for word that I can go home.

Wrong. He wants to keep me. "Just overnight, sweetie," the nurse says. He wants me to stay for observation overnight and IV fluids.

No. NoNoNoNoNo. NO! I start crying hysterically at this point. I know this song and dance. and I have a complete meltdown on my poor nurse. This is what I tell her:

They'll put me in with "just IV fluids". And the monitor. And I will have contractions all night, because it's me we're talking about. And in the morning, another doctor will be on for my practice and will see that I am contracting, so then it will be mag sulfate. Then someone else will be on Sunday, and they will say, "Gee, you aren't quite 32 weeks, so let's ship you to another hospital." And so it goes.

And I would be fine with all of it if I were feeling the contractions, or even if the mag sulfate worked for me, but I know it won't. It didn't with E at this stage of the game, and it didn't the last time with this pregnancy.

I want to go home. I am not dilating, the FFN was negative, I am not in pain (other than back and hip pain from the way they keep making me lay on the uncomfortable stretcher in order to keep Zachary on the monitor).

No. I'm going home.

The nurse asks me if I will sign treatment refusal forms, and I cry and tell her yes. I don't want to upset my doctor, as I respect him too much and understand why he wants me to stay, but I have to go. I just keep telling the nurse, "I'm DONE. I'm sorry, but I'm just DONE!"

I want to be home with my husband and son in these last days of the pregnancy. I want to sleep where I am comfortable and be able to eat. I want to be able to bathe. If I stay, I tell them, it is because they are going to deliver this baby. I've had enough.

This has been going on for 11 weeks. Painful injections, first every 7 days and then every 5. Having to stick myself with needles every 2 days for my pump. Heart palpitations from the medicine. Lowered blood pressure from the medicine. Hospitalizations, both inpatient and outpatient. Scars all over my arms and legs from needles. Probable nerve damage in my left hip from the time someone gave me my shot wrong. The times in the hospital where they wouldn't even let me bathe myself, one of the most basic of human needs. $2K worth of just insurance copays per month. Medical bills piling up- a $500 copay for every inpatient stay. My most-likely-lost job. My abandoned education. J's abandoned education. Being alienated from everyone I know.

But you want a healthy baby, don't you?

You're damned right I do! I have done all of this for no one but him. I have had no benefit. J has had no benefit. And E most certainly has not had any benefit from this horrendous pregnancy. And I will endure more. More contractions, more painful injections and needle sticks. More of everything as the pregnancy reaches it's end.

But I am finished. And I am going home.

I don't know what happened from there. I know she called my doctor again and told him what had to say about the probable chain of events. That I was willing to sign papers stating I was leaving against medical advice. She said his response was , "And she is probably right". So he agreed to let me go, without signing papers, so insurance would pay.

Now I'm worried. I'm afraid I have upset my doctor, whom I absolutely love. Or the L&D nurses I work with and rely on. I'm afraid that, since I couldn't feel these contractions, that when I do my required monitoring, the whole process will start over again later today. That I will have to do this over and over before I finally deliver.