Tuesday, May 18, 2010

Battle Won, Fight Over

You know, today I would have been 34 weeks, 3 days pregnant. Instead, I am awaiting FedEx to come and pick up the large box of medical equipment used to sustain my pregnancy for months while my newborn son snoozes quietly beside me. I've been wanting to write this for days and have been procrastinating because I know some tears will be involved.

There was nothing spectacular about the way May 13th started out. A normal, run-of-the-mill Thursday morning. My phone rang and it was my OB's nurse, calling to tell me that the earlier I could get to the hospital, the earlier they could start, and that my pre-op appointment was really more of a suggestion. With that in mind, J packed my bags in the car and we left. We waved goodbye to our neighbors as they headed to work. J stopped to get a drink at a gas station. Nothing out of the ordinary.

I walked to the Women's Outpatient Center at the hospital to check in, and was told to wait in the waiting room until they were ready for me. It was so bizarre. Having a baby by schedule. Bringing a life into the world in nice little schedule blocks.

Of course J's mom arrived sometime after anesthesia came to see me, my belly was shaved, and my IV was placed. She knew of the trouble we were having, but hasn't seen me since Christmas. I wondered if she could see on my face the months of struggle and hardship, etched into me like the tiny crinkle of crows' feet that are beginning to emerge. I think she could. She and J, along with E, were buzzing with excitement awaiting Zachary's arrival. But me? I was terrified. I was waiting there, staring at a clock, knowing that they were just waiting for the surgery case in one OR to be completed, and that was all. All of this time, all of the pain, the suffering, the tears...It all boiled down to that. What if he wasn't ready? What if the tests were wrong? What if something went wrong and I did not emerge on the other side to watch my boys grow? I could hold on. I could do it just a little longer. Maybe we should wait. We could wind backward the hands of the clock and I could survive one more day, one more week of monitoring and brethine boluses and contractions. Stop! Just. Wait.

But we weren't waiting. Before I knew it, I was watching J's and E's smiling faces disappear behind double doors that separate the cold sterile world of the OR. And I was sitting hunched over, leaning on a nurse I did not know as the anesthesiologist did my spinal. And I felt the tingle of numbness spreading up from my toes as a team of hands lay me down on the table. This was it. We joked as we waited for the doctors to come in. I remarked that the entire OB practice was going to have a party now that I would no longer be pregnant. And I felt the anesthetic working. How strange to be able to breathe, yet feel as if you are suffocating because you cannot feel your muscles in action. To need to cough and not be able to generate enough force. To only want J, and count down the seconds until they would let him back to the OR, to perch on a stool by my head. They asked if he would pass out, and I told them he would not, that we had done this before, to just keep him from taking pictures of my guts.

And then J was there. And I felt the tugging and pulling. I smelled the burn of my own flesh as they cauterized the bleeding parts of me. With E, I didn't recognize that smell. This time, my experience in medicine told me what it was. And the doctor was commenting on how big the uterus was. And J was saying "there he is". And the doctor said "Hello, Little Guy!".

And I heard it.

The cry that was more like a whimper than the rage that was E's first cry. Already so different from his brother. And my attention was directed to the place over the curtain where his little face appeared. Masses of black brown hair, wet and clumped. Face scrunched up. Mouth agape in a perfect O-shape, showing toothless gums and a quivering tongue as he tried to cry out the fluid that had sustained him all of this time. Zachary. 7 pounds, 4 ounces. 19.5 inches long.

J left my side to go and take pictures. I kept hearing the word "NICU" and "breathe". J was with him. This I knew. But I am the respiratory therapist. What was going on? The doctors were still working on me. So I asked the anesthesiologist to tell me what was going on with the baby. He just kept assuring me it would all be okay. Then Zachary's nurse came to me. She knows I am an RT there. And she tells me that he is acting like a 34-weeker. Nothing more than that. She knows that I know exactly what that means. It means he is sluggish. That, although his lungs are mature, his body isn't telling him to breathe often enough. He isn't maintaining his oxygen satuaration like we want. And I say the words that I never wanted to have to say.

"Don't wait for him to completely wear out on us. Send him before he needs to be intubated." And that was it. They finished me up. They took me to recovery. J kept showing up to show me pictures of my baby and give me updates. "Go!", I would tell him. "Be with Zachary. I'm fine."

Those pictures and the tiny glimpse of him in the OR were the only images I got of him for 5 hours. I went to recovery with empty arms. I was taken to my hospital room without him. The bassinet in the room remained empty. And my arms ached for him. The entire time, I thought to myself that it was my fault. If I would've held on...
But just like that, he was returned to me, free of the goo and mess of childbirth. Emerging from the burrito-like bundle of flannel blanket, the most beautiful sight I have seen since September 1, 2001. Shocks of chocolate-brown hair covering his tiny head that can fit in the palm of my hand. Tiny rosebud mouth. Smooth, flawless skin like velvet. He weighed more than E, but must be solid, because he is tiny in stature. He has the smallest hands and feet, the shortest legs, the most petite features. And he is perfect. Absoutely perfect.
Since then, I cannot put him down. The nurses in the hospital teased me the entire time, because each time one would come in my room, Zach would be in my arms. He stays there. How ironic that my body spent months trying to get rid of him, and now that I am free, I will not let him go. I spend every waking minute wanting to take care of his every need.

So it's over. The long, hard fight was won. This is the blog's 100th post, and it is the last. My Zachary is here. My family is complete. We are whole. I will re-emerge in the Blog World here, if you are interested.

Thursday, May 13, 2010

35 Wks, 3 Days: Zachary's Birthday

How ironic that last night, the night I thought I would not be able to sleep,. I was actually sleeping like a baby. That was until my pump started beeping and vibrating to let me know it was out of brethine. They don't want me to stop it until I get to the hospital this morning.

Of course this is also the day my stomach is turning inside out. I never want breakfast! But this morning, I woke up so hungry that I am nauseous and cannot eat. Not even sips of water. So I keep dry-heaving, which has to be the worst feeling ever. (Aside from these contractions, of course.) I can endure it, no doubt, but my mind keeps telling me that they will not allow me to eat later today, either. Oh well. I don't care. Because today I AM HAVING MY BABY! I have to report to the hospital in 4 hours, to be exact.

Of course Baby Zachary must be asleep in there--he is being very still, and I cannot wake him up with sugary snacks and drinks right now like I usually would do. I know from yesterday that he is head down, in the business position, and the little appendages I have been feeling in my ribs, on the side of my body, are indeed tiny feet. I want to feel him kick. This is my last chance to feel that, the true confirmation that there is a little person in there.

With them changing the plan on me, it was a toss-up as to which doctor from the practice will get to do the honors. Ironically, it is Dr. Nice, whom I have spoken to many times, but never met in person. Usually they get a resident to assist them, but for some unknown reason, 2 of the docs from the practice are coming to deliver me. I have speculated on this all night. Do they expect complications? Is it a bragging thing? That they get to say they were there when the pregnancy from Hell, of the woman with the uterus that is stuff medical mysteries are made of, was finally brought to a close? I know this hasn't been a cake-walk for them, either. They were at the receiving end of all of those phone calls about my dysfunctional uterus. Whatever the reason, I feel blessed to be getting the A-Team of the obstetrical world to deliver my baby. 2 high-risk OB's for the price of one.

With that, I am going to try to go back to sleep. I feel like I should get all that I can right now. Of course later, I will be on some heavy painkillers and will be sleeping like a rock in between nursing Zachary.

I'll catch you on the flip-side.

Wednesday, May 12, 2010

The Amnio And the End

I went for my amnio, and which perinatologist should walk in the room but Dr. Big Shot. Dr. Big Shot is the head of obstetrics and maternal-fetal medicine at OB Mecca. He is also the doctor who took care of me when I was pregnant with E. Talk about a blast from the past. They did the amnio, and I didn't look. I had my requisite monitoring afterwards and waited the 2 hours for the result. Hospital employees can take their badge and get the results. So I tried to, but they wouldn't let me. They said we could only do that after 48 hours. But the ultrasound tech had told me that they would do the entire test in-house unless the lungs were immature, and then they would send those to OB Mecca for further analysis and testing to determine how immature. So I didn't have my results, but I did know that the test was completed, which meant lungs were mature.

I called my doctor when I got home to make sure, just in case, so I could give J's mom the go-ahead to start her trip here tomorrow. The high risk nurse told me what I wanted to hear, and when I asked for a ballpark time for Friday, she couldn't tell me. As it turns out, they never put me on the schedule officially for Friday, and have since booked up. She told me to be ready and just not eat anything after midnight tonight, but she would try to get me an answer tonight. About 30 minutes later, she called to tell me to be at the hospital at 10:30 tomorrow morning for delivery.

I cannot quit crying for some reason. It is all over: the pain, the misery, the anticipation, the worry, the paralyzing fear. I cannot believe I have survived this. I cannot believe it has gone on this long, that I have carried him to almost full-term. That this is my last night of pregnancy...ever.

I will hold my baby boy tomorrow and it will all be okay. I will never forget this. The time in my life where the bottom almost dropped out. The time in my life where career, education, and everything else I held dear was put on hold while I prayed and suffered and worried for someone I have yet to meet. One day Zachary may read what I have written about this pregnancy, and I hope that instead of seeing the negative this has brought to my life, he will see just how much I love him. I did it all for him. My precious gift of a child I never even knew I wanted or needed until he was here. A child I have given my life over to, even though I may have griped and complained through it.

I may post something in the wee hours of the morning like usual. I doubt I will sleep much tonight. But regardless, I will be absent for a few days. I will return with the story of his birth and, I am sure, some pictures. With that, this journey will end and a new one will begin as I go on with my life with my beautiful and amazing miracles.

35 Wks, 2 Days: Hoping for Lots of Bubbles

This is so bizarre: the very career-oriented respiratory therapist waiting on a test to determine lung maturity. My amnio is at 1:30 this afternoon, and I, as usual, cannot sleep. This is essentially where the rubber meets the road- what I have been gearing towards since January 29th, when I was first hospitalized for preterm labor at 20 weeks.

I have been talkng incessantly about it, but then realized that the layperson may not realize what all of the fuss is about. We all know that the lungs are the last to mature in a fetus. Lung development actually takes place in 2 stages. First, Baby Zachary had to produce all of his tiny little alveoli and his bronchiole tree. All of the exchange of carbon dioxide and oxygen occurs through a very thin membrane called the alveolar-capillary membrane. A single alveolus is very small-not much surface area for this exchange to happen. In its beauty of organization, his body has grown a ton of these little grape-like clusters of alveoli. More of them means more surface area for the all-important exchange vital for life outside of the womb, when my body will no longer be taking this role over for him. But that simply is not enough.

The second stage is the production of surfactant. What in the hell is that? Well, it is a slick, soap-like substance that lines and lubricates these alveoli. We all make it via these cells called Type II Alveolar cells. We see pathophysiology in adults, even, when the surfactant in their lungs is depleted. Without it, we can compare breathing to inflating balloons. No regular balloons either. Think of those teensy, tiny balloons you use to make fill with water for a water-balloon fight. And you blow and blow into the balloon, about to pop a blood vessel in your forehead trying to inflate them. That is essentially what it is like to try to breathe and inflate all of these little tiny alveoli without surfactant. So the surfactant acts to reduce surface tension, making this job easier. Once they are inflated, the body also does something else to make it easier--the functional residual capacity of the lungs. Basically, with each breath we take, a small amount of air remains in the alveoli after exhalation. Just like it is easier to inflate the tiny balloon once there is a small amount of air in it, it is also easier to breathe with the FRC.

A newborn's first breath is vital, and is also the most difficult, stressful event of his birth. Because after this development takes place, he "breathes" amniotic fluid to practice. This is how they are able to determine lung maturity from a sample of amniotic fluid. There will literally be traces of what is in his lungs in the actual fluid they withdraw from my belly via a very large needle poked through all of the layers of my belly, my uterus, and into the amniotic sac. If adequate surfactant is present, agitating the sample will produce bubbles like soap will, and we know that the cells in his lungs are working. (It's actually a little more complicated, as they actually send the sample to be chemically analyzed.) So when a baby is born vaginally, the process of childbirth actually squeezes this fluid out. Obviously, with a c-section, this doesn't occur, and often the baby will require invasive suctioning. Then his work begins. It takes an astounding amount of pressure to take that first breath. Even with the help of surfactant, his little body still has to generate enough negative pressure to pull in that first breath, overcoming the remaining fluid in his lungs and the collapsed alveoli. Once accomplished, the air literally pushes out the remaining traces of fluid in the alveoli, through the alveolar-capillary membrane, and ultimately into the his lymphatic system to be carried away.

In the meantime, a fetus's circulatory sytem is still geared to life in the womb. Our bodies, as adults, are designed to do all of the work for us. We filter our own blood. It goes in and out through different circuits, because it has to first go through the pulmonry circuit to be oxygenated by the lungs and rid itself of carbon dioxide before it can go through the remainder of the body to oxygenate the rest of the body tissues. For months and months, a fetus has had this role performed for him by Mom. In a portrait of efficiency, as a result, the fetus's body has these shunts in place. There are several--the Foramen Ovale, the Ductus Areteriosus, the Ductus Venosus--all designed to bypass the organs in his body that are not yet needed while in the womb.

Ever read about or talked to someone with a preemie who had a "PDA"? That is a Patent Ductus Arteriosus. Basically, birth is what we in healthcare call a "hypoxic event".The baby isn't breathing while he makes his transition to life outside of the womb in those first seconds. Without breathing and exchanging gases, the concentration of oxygen in his blood drops and the concentration of carbon dioxide increases. This shift in concentration causes changes in the pressures in his blood vessels, which triggers all of those shunts to close so his circulatory system can switch to that of an adult. In a PDA, this fails to occur.

So there you have it--a primer on what took years of college for me to learn, summed up in one little blog post, off the top of my head. Of course it has also been years since I have studied perinatal pulmonary development. But this is what we are waiting for so anxiously. This is why the biggest problem with a premature baby is usually respiratory in nature. Without proper time to "cook", the baby's lungs just aren't ready to do this on his own, which usually means intubation and machines doing it for him while his lungs finish developing. Then failure of the lungs to do this work results in a failure on the part of circulation to close all of the shunts. A steep, slippery slope.

Of course we have the tecnology to do a lot of this. We even have artificial surfactant we give. The biggest brand name is Survanta. We simply administer it through the endotracheal tube once the baby has been successfully intubated. Then we literally tip and tilt the baby around to make sure it gets to as many of those alveoli as possible. Picture greasing a cake pan. You pour a bit of oil into the pan, then tip and tap it around until it has covered the entire surface. We literally do the same thing with these tiny babies. But no matter what we can do artificially, nothing is as good as the Real Thing, like Mother Nature intended. Being on a ventilator opens the baby up for a host of complications. As with anything invasive,there is the risk of infection. There is the risk of damaging the tiny, fragile lungs with too much pressure or volume. There is a risk of pneumonia.

Knowing all of this has been my greatest strength and my greatest weakness throughout this horrendous pregnancy. I know exactly what can go wrong, making it even scarier for me. But I also know what we can do for the preemie outside of the womb, making it all the more harder to endure to give Zachary more time. When one has been a part of the successful resuscitation of a preemie so many times, and you see these babies go home with their families, it gets hard to picture any other result for your own child, and each painful contraction gets harder to endure.

I am almost positive Baby Zachary is ready. The combo of how long I have managed to carry him with the administation of steroids means we are most likely to see the results we want today. If we don't, however, I will have to stay pregnant longer. This would be awful for me, for obvious reasons. But if his lungs aren't mature, it means that after delivery, we can guaruntee he will need to be on a ventilator of some sort. I don't want that. No mother does. So if the results aren't favorable, I 'll have to endure whatever comes next, which will most likely be more steroid injections and more waiting. More pain and contractions. But at that point, I will know, without a doubt, that it is necessary, making the thought of it easier to handle.

Tuesday, May 11, 2010

Not Ready

How in the Blue Hell is that possible???

I have 3 days left of being pregnant. (Of course there is always the slim chance that we don't get the results we hope for from the amnio, then I will crap my pants and require heavy tranquilizers to stay pregnant.) Of those 3 days, I have today free and clear. The amnio is tomorrow, and I am sure to feel crampy and uncomfortable afterward and won't want to do anything. Thursday is occupied with my doctor's appointment and my mother-in-law arriving, plus the arrangements to get all of this blasted equipment back to the home health company. So really, that just leaves today.

And yesterday, while lying in the hospital wondering if they were going to just do the deed, I realized something. I haven't packed a bag. Holy Procrastination, Batman! So that is my mission for today, assuming the pain subsides a bit and I can function for a little while.

I'm passing up the cutesy nightgowns and robes. I don't sleep in that crap at home. I'm more of a baggy-tee-and-scrub-bottoms kinda girl. Hot, right? But I've been to this rodeo before, and don't really care, so that is what is going with me to the hospital. And the biggest maternity panties I can find--the kind that, should they catch a gust of wind, could carry me away. And they can't be the cutesy under-the-belly variety, because where those fall, I will have a big 'ol incision. Plus they have to accomodate the pads that resemble sitting on a box for days. Unless of course I want to wear the oh-so-attractive mesh ones they give you.

Hmmmm. What else do I need? Shampoo, conditioner, hairspray, elastics, makeup. The last one I wouldn't care about but I am looking rather pasty and anemic after months of no daylight, and at some point, I am going to be in a pic or two. Toothbrush and toothpaste. Deodorant. Lotion. I wish I would have bought purse-sized versions of my standards, but I didn't. I have to smell like a girl, and not a cheap girl, either. And my facial stuff. I have to have my Clinique or my face rivals a pubescent girl's. Then I need a camera and its charger, and maybe a good book and mp3 player.

For Zachary? Itsy-bitsy socks. I keep the room cool to sleep and the bambino's tootsies will freeze off. PJ's for the same reason. And take-home outfits of different sizes. I have a tiny preemie one that I was planning on using when we thought he was coming at 34 weeks and anticipating a 6 pounder. E was 6 lbs, 7 oz., but was so scrawny that newborn sizes swallowed him whole. Now I am over 35, almost 36, weeks, and wonder if the kid is going to be 9 pounds. So I am covering all of the bases. Some good receiving blankets, unlike the cheapo hospital ones. And of course the carseat, which I think still has tags and manuals attached--have to check on that.

Of course my luggage smells stale from being put away in a musty basement, so now I have to find laundering instructions for Vera Bradley stuff, because if my clothes smell like that and not detergent, it will drive me bonkers. And no doubt it will have to air-dry, which will probably take all day and hinder the whole packing thing.

Plus J's mom is coming, so I have to launder all of the bedding for her. I also have to make sure all of the receipts/ price tags are removed from the premises or destroyed. I can already hear it: " You spent $200 on a crib blanket????? Why didn't you buy an old one from a yard sale?!?!" or "That baby outfit cost that much? He's just going to puke on it!" I really should listen to her. The woman could cure the national debt in about one week with the way she manages money. But I like what I like, and up until bedrest, I worked hard for the money to match my expensive taste.

So I have a few things to do today. Feeling a bit overwhelmed. And I should be getting started, but J and E are still asleep, so I can't without waking them. Instead, I am going back to bed for an hour or so.

35 Wks, 1 Day: Really? #$%^&

So I called the doctor's office yesterday to speak to the high risk clinic nurse. The cramping and lower body pain reemerged sometime late yesterday morning. Either that or the narcotics all wore off. Of course I am told to go to fricken L&D. Couldn't I just come into the office? Ummmm, no! Because they wanted to monitor Zachary and make sure I wasn't "abrupting". So I go.

I'm leaning against the wall in triage, waiting to be signed in, when who comes walking around the corner but Dr. Surfer Boy. He is all smiles and says "What's upppppppp?" like it is a social visit. I just gave him my look--the look that says "do not #$%^& with me! I will kill you", and he just laughs. I really do like him, and could see hanging out and joking during an overnight shift, had we met under different circumstances. Instead, now everytime I run into him at work, I will do so with the knowledge that this man has seen my hoo-ha in all its glory. It is hard to work with someone who has literally had their hands inside of you. It's always been a problem for me. Almost to the point of a phobia. And since most hospitals' insurance plans require you to go to their docs, this means I am the worst patient ever when it comes to taking care of business down there. I mean, really---picture sitting next to someone in the office all day, every day, with someone who has had their face in your crotch with a bright exam light, and that is how I feel. And the c-section? They lay you down on the OR table, with nothing covered but your chest as OR nurses, techs, doctors and anesthesia people come and go. I will never be able to get my 3 AM grilled cheese in the cafeteria again!

So anyhow, back to yesterday...

They joke. There's the requisite "Oh my God, you're BACK?", to the "Where have you been all week?" Yep, I actually managed a full week at home without a trip in! And my fave? When they handed Dr. SB my chart--complete with a plastic bin full of all of my uterine monitoring done in-house. They actually have a bin of them. How sick is that? My nurse joked that she needed a cart to push my chart back to my room because of its heft. Then thrust it at Dr. SB again, telling him he had been working out and he could carry it himself. (I should remind you that I am one of them, and they would not do this to any other patient!)

So they put me in my bed, and I get strapped to a monitor by a nurse who doesn't know me. So I have to warn her about what she is going to see. And the contractions? It must have been monitor placement, because they were LITTLE! I gave her the rundown---that I was to have a c-section Friday after an amnio on Wednesday. And she said what I have been dying to hear all along: "You're past 35 weeks, and they're delivering you Friday! They should just do it now." Then she asked when I last ate. I really had my hopes up.

So I waited. And waited. And waited. We heard Brahms' Lullaby 4 times, which explains the wait. Dr. SB was most definitely busy with at least one of them. (If you don't know, they play the lullaby over the PA when a baby is born.) Finally, after 2 hours, he shows up, says the strip looks good, so I am not abrupting, and says he is letting me go. Yay for the going home part. Boo for the continuation of the pregnancy. He did ask who was doing my c-section on Friday, and when I told him, he looked at the nurse and said "I thought so. See?" Which tells you how paranoid I am, because this freaked me out. I sat up in bed and said "What?!? What's wrong? You better not renege on the plan. I may hang you up by these monitor cables!" His response? "Oh, but you're doing so well this week. Maybe we should postpone it to next week." I was rearing back, ready to let him have it, when he started cracking up laughing to let me know it was a joke. Then he asked if I could believe it was almost over. Really? This has had to be the longest pregnancy ever. Yes. Yes, I believe it is almost over. I'm done.

So I left. And came home. And slept for 4 hours. And woke to horrendous pain. I literally made a nest of sofa cushions on the living room floor and J spent hours massaging my hips and lower back while I cried. Then he started to get mad, saying they should have just delivered the baby yesterday. That he cannot watch me in this pain anymore. This is the first time he has had this reaction. Up until now, he has been torn between watching his wife suffer and having his son have a better chance, or them ending it and risking his son being severely ill. But even he is seeing that enough is enough. I couldn't agree more.

So am I angry? No, not really. I've done some research. ACOG has really tightened the belt on these docs when it comes to elective early c-sections. And hospitals follow ACOG guidelines. The head of OB at my hospital is actually one of the docs in the practice I go to, so how would it look if he bucked the guidelines? They are actually doing what they are supposed to at this point. C-section before 39 weeks only if medically necessary--as in an emergency where fetal or maternal health are at extreme risk. In the event that they have to deliver early electively, they should confirm lung maturity first via amniocentesis. Hmmmmm. Sound familiar? So really, I can cuss and gripe to ACOG, but really not to my team of docs. I hate to admit that, as I need a scapegoat right now, but it's true. And truthfully, it probably isn't ACOG's fault either. Instead it stems from all of the mothers before me, unable to hack the discomfort of last-trimester impatience and aches/pains, who insisted they be delivered early. Without all of the prenatal testing and drugs that comes with a high-risk pregnancy like mine, they drove up the rate of late-preterm babies, and people started to notice these babies that required more care after delivery because they just weren't ready. So now, people like me, who are safe to deliver, have to suffer. Because unlike mine, the standard pregnancy doesn't receive ultrasounds by the dozens, close monitoring, thorough testing, steroids and beta-adrenergics. There! I am now stepping down from the soapbox with this comment: The wussy women before me ruined it for me!

Monday, May 10, 2010

Learning How to Fight

I was posting yesterday about the hurts from which which you cannot protect your children. That got me thinking back to the time 2 years ago when E was going through a very difficult time. It still pains me to think about it. It was then that I made this little video.

E had a horrible first grade teacher. Horrible for him, anyway. He has always been very bright and creative. And had a love of learning like I had never seen in a child his age. Gradually, he started getting into trouble at school more and more frequently. He would come home with these pink slips where he would have been sent to the office that day, and I trusted the school, and would punish him at home as well, desperate to end the cycle and trying to put on a united front with his teacher. I tried everything. I scheduled meetings with the guidance counselor, the teacher, and anyone else. His teacher kept hinting that we should medicate him, but the change was sudden. Our family had just emerged from my brain tumor, from that horrible ordeal. I was back to work at a new hospital, and there were lots of changes in his life. I was worried he had internalized it more than we knew and this was manifesting itself in his behavior at school. While this was going on, E changed even more. We suddenly found ourselves having to fight to get him to go to school, to do his homework. This was such a change from the little boy who would literally cry if he was sick and had to be absent.

One day, he came home excited about an art project he had done that day. They had used pastels to draw pictures of owls. He said everyone's was the same, but that owls are birds and can fly, so he did his of an owl in flight. He was so proud, as was I. His was different, original, creative, and reflected a knowledge about the animal.

In another effort to intervene, I scheduled another meeting with his teacher. I didn't care what it took. I just wanted to fix my baby. J and I went together, eager to hear the opinion of the educational expert of children E's age. We were very open-minded to what she had to say, even if she pointed a finger at us and told us it was our fault. Just so E got the help he needed. The only suggestion I was opposed to was simply just putting him on medicaton. I believe ADD/ ADHD can be a real problem, but I also believe that it is completely overused in anyone who does not fit a certain mold.

So we went. We sat in the short little chairs across from this woman, and we listened. She had even saved samples of E's schoolwork and samples of his classmates' work to compare. She showed us handwriting samples-E's is as sloppy as his father's. She showed us his math, which was perfect. Then she pulled out a stack of construction paper and started going through pictures of owls. "These," she said, "are what his classmates did." Pictures, one by one, that all looked the same, like cookie-cutter images. "This is what your son did." She said it with pride, like it would seal the deal for us. There, on the paper, was the bird in-flight, like he had described. It was obvious what it was. He even colored in a midnight-blue sky, knowing that owls are nocturnal. And my heart sank. Not because my kid was different, but because I had been backing this teacher at home, trusting her without question, and punishing my baby. It was obvious she didn't understand E at all, or even make an effort. And me? The one ally he was supposed to have, who should have been behind him without fail, had failed him.

She brought up medication again. She offered us free help from the school counseling system. It was a relatively low-income area, and she had assumed we were no different. But I wanted to do this my way. I have insurance and an above-average income. I would handle it. I took E to a very reputable child psychologist. He sat there on the floor with her, building an elaborate city of legos, and told her everything. Articulating to her in a way unheard of in children his age. And it took all I had not to break down in front of him. He spoke of how the other children called him "retard" because he got sent to the office all of the time. How he tried to tell the teacher " like mama said" and the teacher told him she didn't have time for tattlers. He spoke of how he didn't like class trips to the library anymore. He liked books like Harry Potter, and the Judy Blume chapter books, not baby picture books, and his teacher told him he couldn't possibly be able to read those, that they were too hard for him, which fueled more ridicule from his classmates: they called him a liar. (In fact, he had been reading chapter books at home for some time--my fault--I didn't think the way they were teaching him to read was really reading. Sight words. Memorize the way a word looks instead of sounding it out. So I bought him books without pictures so he would have to learn to sound them out on his own.) He spoke of math time in class, of how he would get done with the work and the teacher would just give him more and more of it to do because his classmates weren't finished, and if he acted like he couldn't do it or didn't have enough time, she wouldn't give him so much more than the other children, which wasn't fair. That he likes going to the office because he gets to talk to the grown-ups there.

The psychologist sat me down and told me what is both every parent's dream and every parent's nightmare at the same time. She told me E had a "freakishly high intellect". That my then-6-year-old baby was literally a genius, based on his IQ. That he may have some hyperactivity going on, but it was hard to say if it was rooted in pathology or just boredom. That the school was failing him. That he thinks differently than other children because of his high ability. I cried that night. All parents want their children to be smart. But I didn't want this. I wanted him to fit in, to have friends his age. To be normal. I remembered back to when I was labeled as "gifted" when I was a child. It was horrible. I just never felt at-home with the other kids. I didn't want this with E. So I tried to take this new knowledge to the school, thinking it would help him. Instead it got worse. The teacher almost seemed to have a personal vendetta against my son.

The final stand-off occured over a broken pencil. E's had broken and she had told him to borrow his neighbor's. The pencil got broken. E was sent home for "intentionally damaging others' property". I assumed he had actively broken the pencil in half out of anger. I mean, they sent him home ! So I grounded him to teach him that you cannot do that to someone else's things. Then I found out that he just broken the lead. Just like he had broken the lead of his because his teacher had told him to press harder on the paper. The pencil just needed to be sharpened. That is the day I went to Staples and bought an entire case of yellow no. 2 pencils and took them to the school. In front of the entire office staff, I slammed them on the counter and told them that if pencils are such a rare commodity in their school that they had to torment my son over broken lead, then they could have some on me. And I withdrew E from the school. He is now in a small parochial school. The tuition is killer,but there are only 13 second-graders, total. He has teachers who take the time to know him, to recognize his strengths and weaknesses and play to both. They have the time and ability to keep him with his peers, yet still challenge him by giving him more enriching work. When he goes to the library with his class, they personally escort him to the more challenging selections, and when he finds one on a topic that is particularly interesting, they even allow him independent-research time in the computer lab and he gives the class a lesson on what he's learned.

This is my prime example of how no one will love your child like you will. How there are people out there who will hurt them and you cannot always take it away. E still shows the ill effects of that awful time with the horrible teacher. He doesn't fight us to go to school anymore, and there are no more trips to the office. He shines academically, but still doesn't have the same sparkle in his eyes as he did before. But I, as his mother, learned valuable lessons from it all. I learned how to fight for my son. How to advocate. And from now on, I will protect my children with a fierceness that is unparalleled.

35 Weeks.

4 more days after today.

This is it. If I can even hold out that long. Late yesterday morning, the pain got too intense, and I had to call the doctor. I was advised that I could take 2 Percocet at a time, up to every four hours as needed. I was also told I could go to L&D and get myself checked to see if I was dilating, and if not, he would not keep me. Honestly, why bother? So I stayed home, took my drugs, and lay in my little nest I have built for myself in the bed. I tried to read a little, but it took all of 15 minutes for the drugs to soften the edges and I was out. I spent the whole afternoon that way. I would wake for a few minutes before I had to take more of the pain medication, then out I went again. So much for Mother's Day.

We have this beautiful little plan for the week. Wednesday, I go for the amnio for lung maturity. Thursday, I get those results and my pre-op instructions. As soon as I do, I am to call J's Mom and she is starting her 4-hour journey here. This is also the day I am to call the home health company and arrange for the pick-up of the thousands of dollars' worth of equipment I have in my house. Friday, E will stay out of school so he can be there, and we will all head to the hospital to meet Zachary. J is excited beyond words. Me too, for that matter. But I am also Debbie Downer for the moment. The idea of days more of misery, then the pain of the c-section, is clouding that excitement. The amnio, the spinal, the IV, the Foley catheter, the incision, the Pitocin...all of it painful for me. Then I turn to a bitterness that I haven't felt through the whole horrendous experience: Why me? How is this fair? It isn't.

Last night, J woke me to watch the special from 19 Kids and Counting on TLC. They were bringing their grossly-premature baby home after 4 months in the NICU. And I cried. I just sat there, with my hand on my belly, feeling Zachary kick, and watching their family's struggle on television, tears literally streaming. And J made comments on the baby's appearance. It was then that I realized that he just didn't know. He hasn't seen or held these tiny preemies in the palm of his hand like I have. That knowledge, that burden, was mine also. As the NICU staff was saying goodbye to the family, he honestly thought I was crying because that is what I do for a living. In a way, he is right. Patients come and go from my life like minutes on a clock. The successes are the ones you never see again. They go on to live their lives with their families, not needing your help any longer. The ones you can't fix are somehow more tolerable because of them. When people realize what it truly is that I do--that I have to be the one to pull the plug when the family has decided it is time, to be the one who tries to resuscitate people who are trying to die on me--they ask how I can do it, and that is what I tell them. Because for everyone you cannot help, there are ones you can. So yeah, J was a little correct.

But did he really think that was all? Did he not realize that their story was almost our story, not just once,but twice? That both of our boys are stories of near-misses? He has to know. He was there, holding my hand and crying with me when the doctor came into the room 9 years ago and told us I was actively miscarrying E. It's hard to make the connection that the little boy who knew what hypothermia was at 3 years old, who likes planes and computer games, almost never was. Maybe he does know, and this is his way of blocking it all out, of making the disconnection in his mind. If so, I will not take that away from him. I wish I could do the same.

Sunday, May 9, 2010

34 Wks, 6 Days: Bittersweet

5 More Days, if today counts.

Hip pain is extreme right now. I almost soaked my bed in urine a minute ago because I was stuck there, unable to move, and J had to literally come and move my left leg for me so I could get up and go to the bathroom. And I don't know what my uterus is doing. I refuse to monitor because I want to spend these last few days home with my family. I do know that the contractions are spaced further--about 4 minutes apart--and seem to be stronger. Instead of focusing on the misery of it all, I am consciously choosing to focus on the fact that this is truly the last time I will feel this.

This time next week, Zachary will be in my arms. It seems unreal to me. And I would like to say that the pain will be gone. But motherhood can be painful too. There will be times where he hurts and I cannot fix it. And when that happens, it literally tears your heart out of your chest. The world can be a very cruel place, and regardless of how beautiful or smart or amazing your child is, no one will ever love them like you do. This week will serve as the last few days that I truly can protect little Zachary from all of that. For the next 5 days, I can still keep him safe in his little bubble. After that, I can only do my best.

Today is Mother's Day. The day on the calendar that I struggle with the most. It still is hard. I miss my mother every day. And I know that if she would have survived to meet him, E would have been the light of her life. The Baby's baby. Zachary too, for that matter. This year is a little different for me, as I instead focus on the blessings that have fallen upon me in place of the void that has been there since she passed away. By this time next week, I will have given birth to 2 amazing little boys. After all, E never ceases to amaze me, and I know Zachary will be no different. I look at E and cannot believe that I carried this little person under my heart for all of that time.

E is turning into a Big Boy before my eyes. I don't remember the exact moment he started to get self-conscious and close the bathroom door when he bathed. Or the exact moment he got too big to be rocked to sleep. Or when he stopped asking me to kiss his boo-boos. I just know that I still live for the moments where he comes and puts his little head on my shoulder as he hugs me, when he isn't worried about looking "cool" in front of his friends. In those moments, he is still my baby and I can practically feel how he kicked in the womb. I can still smell his buttermilk newborn breath and feel the exhaustion that was colic. I have always felt guilty that I didn't keep tangible mementos of his growing up, and I have vowed that I will for Zachary. But what I never realized is that I don't need objects to remind me. Every stage and moment is locked into my mind as if to freeze him in place for me.

I love these children so much it hurts. Zachary too, which is so bizarre to me. I never dreamed I could ever love anyone like I do E. And now? To feel that degree of love for someone I have yet to meet? I cannot put into words the degree of strangeness for me. So this Mother's Day, as contractions rip through me still, and I miss my mother in a way that is almost palpable, I have that to ease the pain.

Friday, May 7, 2010

Crash Course in Embarrassment

Gah! I refuse....REFUSE, to do any more shopping for this baby. The only thing I have left to get is the highchair, which we don't need yet, and the swing, which J's mom is buying. I keep saying I'm finished, then figure out some other things that I need.

We went to Target. I waddled into the store and got on my scooter. We went to the baby section. Which leads to my little rant. Why? Why is every other section of the store designed with huge, roomy aisles, yet the baby sections are always packed as tightly as can be? The stores do this, knowing damned good and well that mothers come in with strollers and carts full of children and carseats and more. My fave is the cart that has the little bench-like seats attached to the end closest to the handle. Have you ever tried to steer one of those things? It's like driving a boxcar.

We really just went to get the overhead gym thingy. Then I discovered that they carry Medela products compatible with my breast pump ( Pump In Style Advanced), which saved us a trip to Babies 'R' Us, or the shop I lovingly call the Boob Store (can't think of the name, but a little boutique that specializes in breastfeeding). I need storage/ freezing supplies because I plan to turn myself into a milk maid over the next 6 weeks so J won't be tempted to sneak Zachary formula while I'm at work one night. So I find my freezer bag doo-dads and they are in the cart. Then I saw a sign over a rack of little shorts outfits that says "Newborn size: $3". Oooooooh! I couldn't resist, even though The Kid Needs No More Clothes! That is when it happened.

I wrecked into an entire rack of clothing. As in I literally knocked it down. Picture a sea of brightly colored miniature outfits on the floor, with me right there, my face the same exact color as the hot pink bermudas I am wearing. So I turn around to get J's help, but J's nowhere to be seen. But I know he is there somewhere, because I can hear him snickering. But where? So I start timidly calling out: "John?" All I get is more laughter. "JOHN??" Even louder laughter. "JOHN!!!!!!!". Finally he shows up to help me, but he is ducking like someone he knows is going to see him. And he actually says, "Here, Ma'am, let me help you." Like I am some random stranger he doesn't know instead of his wife of 10 years. Bastard.

So we literally flee the baby section. I want to flee the store, but I am not finished shopping, and I do not want to do this again.

Let's just sum this up--I literally left a wake of destruction through the entire store. I knocked off a box of dishes (thankfully not breakable) from some random shelf. I took out a row of shoes trying to turn a corner to look for a cheap pair of sandals for E to get dirty in this summer. I clobbered a rack of camisoles trying to find nursing-friendly layers for the summer. But my absolute favorite? The poor girls behind the glass display in electronics where I was trying to buy a new camera. They literally had a look of terror in their eyes as I approached. It was horrible. I have become an power scooter expert over the past 4 months, and I can honestly say Target has the worst ones.

But I got all of the crap I need. If I wanted to spend any more money, I would be hard-pressed to find a justification. And trust me, I am the Queen when it comes to rationalizing shopping. But I can honestly say that if Zachary doesn't have it now, there is no way he needs it.

34 Wks, 4 Days: A Little More Freedom

One More Week. (Is this getting annoying or what?)

Yesterday I did my monitoring as required. It really is futile, as they do nothing about the contractions anymore. The nurse called back and told me that the strip looked like any other of mine, and actually told me to stop monitoring. I don't know how many contractions I had, but it must have been bad. How can I not know? Well, I don't count anymore, and it has gotten to the point where my uterus is in a state of relaxation less than it is a state of contracting. One after the other after the other. The scariest ones for me are the ones that seem to build on top of each other: I'll be having a contraction, and before anything has had a chance to relax, another one starts and builds on top of the last one. Here lately, Zachary hs started flailing his little appendages in there with the contractions, which hurts like hell. I think he is getting tired of being squeezed. Sometimes, just having the monitor on my belly is enough to set him off, as if to say, "Hey! Something is pressing on me!"

So anyhow, I am now free from the monitor. Unless something feels different, then I can do it as needed. So the 17P shots are done and the monitoring is done. Now I just have to lose the brethine pump. I think that is happening Thursday when I go in to get my amnio results and pre-op instructions. Since a c-section bypasses nature and the uterus doesn't contract down to size on its own like in a vaginal delivery, they give you pitocin afterwards. I cannot imagine they would want me on a tocolytic before they do the deed. Which means Thursday night, if they do stop the pump, is going to be awful for me. I doubt the contractions can get any more frequent, but they can get stronger without the brethine infusion my body has been getting all along. Ugh!

Which leads me to the dreading of the pitocin. That was by far the worst part of E's delivery. I cannot even remember how long it was that they kept me on it, but that was very painful. Imagine contracting against a fresh wound, when your muscle is completely worn out from all of the contracting done beforehand. I didn't rely on pain meds a lot after having E, but I do remember that I spent those hours in a narcotic-induced fog.

But regardless, today starts my official last week of pregnancy. It's very surreal knowing when it will all end. It has its advantages and disadvantages. I can be completely ready, with bags packed, nursery ready, and more. But I also have time beforehand to think about what is going to happen, to dread the bad parts. And while having a plan made me feel better at first, now it is having the opposite effect. When the pain gets to be too much, I can't help but think that it is just a week away, and wish for them to just do it already. And it is frustrating not knowing a time, but they won't give me one yet. They are worried that the amnio on Wednesday will do me in. I have a high level of fluid, a big baby, and a worn-out uterus that is distended beyond where it should be. Inserting a needle in there at this point could have the same effect as putting one in a balloon overly-filled with water. If that is the case, I will be having him Wednesday. Or Thursday. Thus, no official time planned. Just a date.

Thursday, May 6, 2010

34 Wks, 3 Days: On Saying Goodbye, Rude People, and Gloom/ Doom

8 More Days!

Last night, Home RN came to give me my last 17P injection. I've been counting down to the last one of those for some time now. The first few didn't hurt as bad, but after they increased them to every 5 days, I think my hips had such little time to recover between injections that they started hurting more and more. And the expense! My copay for each injection visit was $135. Multiply that by 6 shots in a month, and add the other stuff like doctors, hospitals, pump, and monitor, and you can quickly determine why it is that I have been broke. But what I did not count on was feeling sad. The same nurse has been coming to my house to give them the whole time. It may be because we have something in common with my career in healthcare, but her visits were almost social. She got to know me and my family, learned to read the expression on my face and know when it was that I needed a pep talk. We would talk about everything from history to our kids. She won't be coming by anymore, except, as she mentioed, coming to see the baby when I get home with him. As she was leaving last night, she hugged me and told me how proud she was of me, that I am going to have a healthy and beautiful baby, and reassured me that everything is going to be fine. Today, I plan on writing a letter to the company to let them know how awesome she is!

After she left last night, my little family headed to Wally World. Gah! I really do hate that place and swear with each trip there that I am going to become one of those people who boycott the place. But where else can you find everything you need under one roof? It's right around the corner from us, too. Target is about 15 minutes away. So we are here, and get on my little scooter, not because I am worried about popping out a baby anymore, but because I cannot walk more than 5 steps without the contractions getting horrendous. All I needed was small stuff for Zachary's arrival, but we had E with us, and I always end up getting more than I need when he is. So J was pushing a cart, too. (We did manage to score the Baby Einstein entertainer thingy I have been looking at--it was the only one and looked like it may have been a return from an online purchase, and we got it for $65 instead of over $100, which is what it normally is.) So I have the baby items I need, and we head over to cosmetics/ health/ beauty section. I just wanted to get travel sizes of my toiletries for my bag to the hospital, J needed razor blades (he looks like Grizzly Adams and when I nagged him to shave, he informed me he was out), and cotton balls for Zachary's umbilical cord. It should not have been a big deal. But I swear, my inner trailer-park almost came out and I was about to get arrested. There was this younger woman with an empty cart in the shampoo aisle, taking up the entire aisle. I politely stopped, with J and E behind me, to wait for her to pass so I could go. She looked directly at me and rolled her eyes, then scooted her cart over so that I only had about enough space to pass with about an inch to spare. I didn't want to run over her foot, so I kept waiting. This is when E said, "Mommy, just say 'excuse me'." She looked at my son and said, and I kid you not, "Tell your Mommy to get off her lazy ass and walk!" To my kid. My. KID. Granted I don't look disabled at all. I'm very visibly pregnant, and I am sure after all of this time that my face has a haggard appearance. But you can't always tell by looking at someone. So I looked her straight in the face, and hitched the leg of my shorts up a half an inch to reveal the huge plastic bubble that protects the infusion site and catheter from my pump. Of course, once that was done, she couldn't miss it or the bright-blue tubing that runs from my leg to my pump that was in my purse in the basket in front of me. I feel kind of bad now, though I know I shouldn't. I have never played that card before. J is a nursing student and even he hates to see my infusion site becaue it honestly looks like this plastic piece is embedded in my leg. And the girl looked horrified. But I couldn't help myself--I was not only angry that she thought she had the right to speak to my young son that way, but that she assumed that I was just being lazy. I think it probably took a few hours after the trip for my blood pressure to return to normal.

So anyhow, on another note...

Over the past couple of days I have been kind of worried. C-sections are safe. They scare you because they have to let you know of every potential risk. Ahhh, the joys of Informed Consent legalities. You never think you will be one of the ones who has a freak incident occur, though. Especially when you are just having a spinal. Eliminating general anesthesia cuts out some of the risk, at least. But lately I have been wondering: what if I am one of The Ones this time? I don't know why I am thinking this way. I had no fear at all when I had E. Of course there could be several reasons behind it. I've started my career in medicine since then. We medical people make the worst patients because we know exactly what can happen, regardless of how rare it is. And on the heels of the pregnancy from Hell, is it possible that the delivery will go that smoothly? But in truth, I think the real reason rests on the incident from last summer and E's reaction. J's sister (I'm calling her X) had a baby by c-section last summer. E was down there visiting his grandpa when it happened. Apparently, her doctor botched it or something didn't hold, because while they were all visiting after the baby was born, my son included, her blood pressure bottomed out and she almost coded. Apparently she hemorrhaged from an artery. They had to take her back to surgery, and she ended up on a ventilator in the ICU for a day or so while her blood count came back up. Of course while this was all going on, J and I were up here, and J's parents were at the hospital with E. I kept telling J that we should make the trip to pick E up, but it was a 4-hour drive one-way, so the decision did not come lightly. But when we called J's dad to tell him E didn't need to be in the middle of all of that, he insisted E was fine, that he was playing games with everyone in the waiting room and was oblivious. I was still worried. E is very,very intelligent, and with that, he absorbs everything like a sponge and doesn't forget a thing. We didn't know just how he was impacted until months later, when he overheard J and I talking about my repeat c-section. For days, his little face was clouded with worry, until he finally spilled it. "Mommy, just don't lose your pressure, okay? X lost her pressure, Mommy, and she almost died. Please don't die, Mommy." That didn't just pop into his 8-year-old mind. He heard it. Turns out he wasn't so oblivious. And it tore my heart out. Of course I promised him that Zachary and I will both be fine, that what happened to X will not happen to me. That he was born by c-section, and he and I were both fine. That it will all be okay. So maybe my gloom and doom lately is rooted in this. Because everything has to be okay. I promised.

Wednesday, May 5, 2010

34 Wks, 2 Days: Just Waiting

Waiting waiting waiting. 9 More Days.

I am having terrible hip pain today and had the hardest time getting out of bed. I'm not even supposed to be out of bed yet, but whatever! I'm having him next week, so I don't even care anymore as long as the baby is safe. Unfortunately, the pain is keeping me from doing what it is that I really want to do. And tonight I get my last ever progesterone injection! WooHoo! Those suckers really do hurt, even though my home nurse is the best at giving them. I've had one where I had to get it in the doctor's office, and one where I had to get it in the hospital, and I will take her technique over theirs anyday! The concoction is thick and oily, and so once the medicine starts to spread in the tissue of my hip, a simultaneous burn and ache spreads down my entire leg on whatever side she is injecting. Sometimes the burning is intense and lingers for hours, at which point J laughs at me because I will literally sit with an ice pack on my bum. But no more after tonight. I cannot complain. Something has kept Zachary in there, and I really think these were the answer.

Other than the hip pain, I am just feeling anticipation. What will Little Booger look like? Will he have J's eyes or mine? My petite nose or J's angular, straight one? Will he be quiet and peaceful or will he be high-strung and spirited like E? How big will he be? I'm predicting a little over 7 pounds because of the last full ultrasound I had done where he was measuring 5 lbs. 5 oz. a few weeks ago. Most importantly, will he be okay? Is he as ready as I am?

Tuesday, May 4, 2010

Yes It Is

We watch Grey's Anatomy. And we used to watch ER. And J used to always ask me if that is really what it is like to work in a hospital. That is where this post's title comes in.

Yes. It is. Drama-City.

But I have not felt relieved and as appreciated as I did today when I called my boss to tell her that they would be delivering Zachary next week. She had this indescribable tone to her voice when she told me she missed having me there and cannot wait until I come back. Apparently, my shift at work has tried to implode since I have been gone. Usually day-shift positions are much-coveted, so there is competition to get them when one opens up. The end result is that all of the therapists with more tenure have those, and the younger staff covers nights. I am the exception-I actually prefer nights, as it enables me to do what I want with school. So while the night-shift crew is wonderful, they are green and immature, making me, at the ripe ol' age of 33, one of the oldest, more senior of the staff.

I have always been a sort of outcast at work. Since much of the night staff is new grads fresh from college, there is a lot of partying. I participate in baby showers and weddings and other celebratory events, but I am not there to meet my new BFF. At the end of my shift or on my days off, I am either in school or home with my family. I am at work to be a respiratory therapist, not to gossip or be catty.

So apparently while I was gone, there has been drama. As in call-the-whole-group-into-HR drama. Coworkers sleeping with other married coworkers. Someone deleted someone else from their Facebook friends. Someone else talked about someone else. And now the whole group is at war. This is the best news ever for me!

Why could this be good news? Well, my FMLA job protection was up May 1st, meaning my boss could choose to either hold my job for me or post it as vacant. I was worried. Very worried. Instead when I called, I discovered that my attitude and performance at work has come to be much appreciated by her. Quite simply, my job isn't going anywhere. I even told her to aim to put me back on the schedule full-time around June 14th or so, that this will give me almost 5 weeks, and she said no. That is too soon, and she will start me back the week of the 27th, to take my time and heal, that she "really needs" me back on nights. Then she must've looked at a calendar, because she said , "Andrea, that's next week! You're gonna have that baby next week! I cannot believe it is here already." Ha! Glad someone thought it was short. She then told me that she would have the infant CPAP ready and waiting to "ward off evil spirits". This may mean nothing to a layperson, but we healthcare people are a superstitious bunch, and when you aren't prepared, that is when something happens. It is the same concept behind us putting the crash cart outside of an ICU room of a patient who has bradycardia or dropping blood pressure.
When you are ready, it doesn't happen.

Of course this does make me a little nervous of the work environment to which I will be returning. The only thing to ease my mind is that I was not there, and have nothing to do with anything. I am Switzerland. Very neutral. But I am still employed. Could life get any better for me right now?

34 Wks, 1 Day: The Game Plan

So I go to see the doctor today. I almost didn't go, as I am beyond frustrated. I spent the greatest part of yesterday with ice packs nestled in my nether regions from severe groin pain that I can only attribute to Zachary's size right now. He may not be a 10-pounder, but keep in mind that I have never been this far along before. I am having flashbacks of the doctor on my first OB visit telling me that the second pregnancy is worse and that I would eventually feel as if everything is just going to "fall out". Boy, was he right!

I had called last night, though I was very reluctant to do so, but was concerned about the pain. I got a doctor from the practice whom I have never met. And I can honestly say this-whatever plan the docs have to keep each other informed sure does work! He laughed so hard that he snorted when I told him, "I don't know how I managed to get this far in this pregnancy without meeting you face-to-face, but..." Anyhow, he knew me, knew the meds I was on, about the contractions, the home monitor, and everything! I ran the pain by him and asked him if he thought it was someting that could wait until this morning, that I really did not want another trip to L&D. And he was awesome. And he said what I have wanted to hear for some time now: "Andrea, I think by this point we are all tickled that you have made it this far. And if it gets to be too much, call me at home and we'll just do your c-section tonight." He then explained that he had purposefully identified his number on my caller ID (I have one of those privacy blocks on my phone, and the on-call service makes you disable it for the doctor's call, making it up to them if they reveal their home number to you or not.) So his attitude left me questioning where the hell he has been or the past few weeks! I could've used him!

So anyhow, on to today...

The doctor I saw today is the only female in the group of 9 doctors, and I really do like her. She has a dry sense of humor like me, knows her stuff, and is no-nonsense. I don't think I have seen her since I was 22 weeks, in the hospital contracting every 2 minutes. So the first thing she says to me is, "You missed me, didn't you?!?" Then she explains that Dr. Surfer Boy put me on her schedule for Friday, May 14 sometime after my appointment last week. Huh? Well, apparently, my c-section has been scheduled all along, ever since we knew the amnio was scheduled for the 12th. Nice. The plan is this: I go for the amnio. Then, on th 13th, I go to see her in the office to get my pre-op instructions and amnio results. If all is well and lungs are mature, I will be having Zachary on Friday, May 14th. If lungs aren't ready, it's another round of steroids for me.

I am so excited and relieved. Of course we called everyone. This is how we dicovered J's mom plans on staying here at the house and not a hotel. She is more than welcome here, especially since she is making a 4-hour drive to help us with E, but my house, after 4 months of bedrest, is not exactly visitor-ready. J tries, but is not exactly the best housekeeper. So I have a crap-ton of stuff to get ready for her visit. Plus, this weeknd, J and I are going to go back to Babies 'R'Us to get the teensy piddly stuff I remembered that I still need. And I need a new camera. This past fall, I splurged on the Nikon I wanted, only to have E drop it and break the touch screen at the zoo. So that has to be done. (I'm sad--I can't afford to purchase the same again and will have to settle for a cheaper model.)

So anyhow, it's busy, busy, busy here. But whatever. I don't even care. I can't even feel the damned contractions today. I am on cloud nine! Zachary will be here in 10 days, at which point I will only be 3 short of 36 weeks. Who would've thought we could keep him in there this long! Almost full-term!

Monday, May 3, 2010

34 Wks: Finishing Touches

Finishing touches in more ways than one!

I cannot believe I have a 7-pound-or-so little person squirming inside of me. I used to just feel his kicks and rolls in one area of my body. Last night, I could feel little appendages kicking down toward my groin, while at the same time feeling little nudges up by my liver. I got to play with him a little last night--he would nudge up by my right rib margin, and I would nudge back. Then he would kick again. And so it went, back and forth. And I want to see him so badly! One of the L&D nurses who knows me very well by now made a comment about how J and I obviously make such beautiful children, and how she cannot wait to see this one. She, of course, was referencing E, who has already learned which of the nurses he can charm out of popsicles and Jell-O while I'm at the hospital. I keep reminding myself that Zachary is not E, but instead will be his own little person. My knowledge of the laws of human genetics tells me that he could have my green eyes, J's brown ones, or the blue eyes of my father and J's mother. He could have our brown hair or the red hair of J's father. We already know he has a good deal of hair, as it was seen on an ultrasound.

Last night, J's mom called to get info on my amnio date and dates of possible birth. I wish I could have told her an exact date. I'm hoping to get that squared away at my appointment on Tuesday. She has put in for tentative vacation "sometime in May" at her place of work, and will be making the 4-hour drive up here to help us with E. They'll have a ball together as they always do, as she will take him to her hotel and let him swim in the indoor pool and feast on junk food to his heart's desire. My kid loves hotels,for some unknown reason. He thinks spending the night in one is the coolest vacation ever, even though it may only be a block away from his home. He relishes continental breakfasts, even. Strange, I know. I'm reminded of the time we literally forgot to pay the electric bill and were out of power. We went to stay overnight in a local hotel while we waited for the electric company to open the next morning, and E thought it was the greatest adventure instead of being the day my Mommy License was almost revoked. (In my defense, that was in the first trimester, when I was still working like a fiend, managing my full-time pre-med schedule,and suffering from the beginning stages of Placenta Brain!) Anyhow, I am grateful for her help. I think some bonding time with Grandma in the midst of the whirlwind of bringing his new baby brother into the world will make him feel special and help combat any jealousy that may arise. Of course I could be wrong, and he could throw a fit to stay with us. If he does, I'll blame J. There was one time where J's mom came up here to get E to take him to her house to spend the week over the summer. E didn't want to go at the last minute, but we knew he would change his mind as soon as J's mom drove away. So J pretty much put him in his mom's car anyway. Now E is suspicious everytime he stays with Grandma, that we are going to pull a fast one on him. And there is going to be such a mix of emotions in the little guy when he is no longer an only-child that we need to handle this delicately, lest I should have to pay for therapy bills later. We have tried to prepare him, to let him know that Zachary will take up a lot of our time, but that he is still out little Prince. That we love him more than words. I think he gets it: the other night, as he was saying goodnight before bed, he told me he loved me, he told J he loved him, "And," he said, "I love Zachary, too!"

Last night, I packed Zachary's bag for the hospital. And got the diaper bag ready. I managed to remember how I liked to keep the hospital room cool when I had E, so I packed some little sleepers and and his take-home outfit. Tiny socks, too. My heart lept with joy as I folded the tiny clothes, picturing the baby who is to fill them. My youngest son--the baby I have always wanted but was too stubborn to admit. It's been so long that I had to remind myself, when getting the diaper bag ready, what exactly goes in a diaper bag, aside from diapers. It was so surreal. Just as it is surreal, after all of these trips to the hospital, to look to a day in the near future where there will actually be the birth of a baby involved. When we will dress him in the clothes we bought months ago, secure him in the carseat that has been installed for weeks, and bring him home to grow and learn and live with us.

I cannot believe I have survived this, yet again. I know the battle is not over. I am choosing to remain in ignorant bliss over the different things that can go wrong at this stage in the game. But when you have braced and prepared yourself for months to have a sick child, 34 weeks may as well be full-term. It certainly isn't 21 weeks, or 22, 23, 24, 25 weeks. I can picture E's birth at 34 weeks, how he was a picture of health and beauty, and know that I have made it just as far this time.

Sunday, May 2, 2010

33 Wks, 6 Days: Counting

So far, I have survived the following:

14 weeks of bedrest and no work.

16 progesterone injections.

73 days on the brethine pump.

25 days on oral medications before switching to the pump.

22 ultrasounds.

8 weeks' worth of cervical lengths.

3 Fetal fibronectins.

34 trips to Labor and Delivery.

148 hours of home uterine monitoring.

4 hospitalizations greater than 2 days.

1 emergency transfer by ambulance.

18 days on magnesium sulfate.

I have my amnio in 10 days. In the next 7 days, I will get 2 more progesterone injections. At 36 weeks, they are no longer indicated, and the home health company will automatically stop them. I am assuming my pump and monitor will stop then, as well. There really is no point in continuing them at that point, but I haven't gotten the official order.

I'm both excited and antsy. The whole family is ready to meet Zachary. I thought knowing that they will test lung maturity in X amount of days would make it easier, but it hasn't. Yesterday morning, I awakened to what I thought for sure was IT. Contractions that were just different. About the same intensity, but in my back instead of my belly. Very intense, further spaced, longer in duration. About 18-20 an hour. About the only relief I could get was getting down on the floor on all fours, with J applying pressure to my lower back. It went on all day before I finally listened to my doctor and went to L&D. I thought for sure, with me being 34 weeks tomorrow, that they would just end it and do my c-section. Instead, I got the standard: "You're not dialting.", "You want a healthy baby, right?", etc. If they wait on me to dilate, I will be pregnant forever, but they just don't get that. I refused the IV fluids this time. It is getting harder and harder for them to get vascular access on me, and I want them to be able to in 10 days or so, when it really is time to deliver. In other words, let's save the veins I have left. The doctor was even saying something about mag sulfate again, and I threw a fit. Absolutely not. I will never be on that stuff again. So I left the hospital in a disgusted state, still in pain, and about to refuse all care from now on. Of course once I calmed down, I realized this would be irrational, but it gets harder and harder to endure with each passng week.

I keep reminding myself that it is almost over. That I will forget some of this once I hold my baby boy. The person who tells you that you will forget everything once you have your baby is a lying sack of #%^&. Just like everything else in life, there are some things that do not go away, but leave permanent scars. It is lessened to a great degree, but you always remember. Instead, as time passes, it just gets to a point where you aren't consumed by it anymore. I am reminded of the hell I endured for E all of the time. I will be with Zachary too. My love for them just serves as a sort of pain medication for it. The end result is a justification.

Now, I'm just waiting on my justification for this one.