Friday, July 29, 2011

Just Another Update

This is another “update” post…as opposed to an introspective post that might actually be of some use to someone.  I apologize.  I’ve been staring at my computer for hours over the last two days, trying to remember all of the clever ideas for posts I’ve had in the past.  I can’t remember them…but I’m working on it.  So, for now, you’re stuck with a crappy update (and this weekend…I’m going to do a “book review” of the three donor egg children’s books I bought…real creative, I know).

  • I’ve started taking oral medication for gestational diabetes.  My fasting blood sugar levels were consistently elevated, so Dr. B made the decision to put me on an oral medication at bedtime with the understanding that, if it does not help, I may be looking at the use of insulin during my pregnancy.  This isn’t a matter of diet (although, lack of exercise could be having an effect).  My blood glucose levels are very consistent (and within normal limits) throughout the day, while I am eating (indicating that my diet isn’t the issue).  But the fasting levels are the important ones…and they aren’t so good.  We’ll see how well the medicine is working at next Wednesday’s Week 16 appointment.

  • I am crying constantly.  I feel like a crazy woman.  I cried while struggling with infertility, but I was under so much stress and dealing with so much pain and disappointment, I knew my crying was justified.  I’m happy right now…so why the incessant bawling?  Sometimes at work, I start crying for no reason at all.  And worse yet, at night my mind tortures me and I end up “fantasizing” about giving birth or breastfeeding…causing me to cry tears of joy and fear for hours on end (hours that I would much rather spend sleeping).  I’m not depressed or even anxious.  I’m just hormonal…make that REALLY hormonal… I guess.

  • I feel more and more certain every day that we are having a boy.  I selfishly am a little hopeful that I am wrong…as I am dying for pink and frills and bows.  The Prince keeps joking that perhaps we will get lucky and our baby will be “a perfect little clone” of him.  I say, “Yeah.  We can only hope” [insert eye roll].  I have no idea what is leading me to believe that the baby is a boy.  I don’t say Baby Hamish anymore (although The Prince won’t give the nickname up).  But I say “he” and “him” whenever I am referring to the baby.  Both of our families keep thinking that we know the gender and just aren’t telling them…and that our male pronoun usage is a slip-up on our parts.  In reality, it is 5 more weeks before we find out the baby’s gender…5 VERY LONG weeks.

  • The Prince got re-motivated to work on our kitchen and nursery renovations.  He spends hours each day, after work, drilling, sawing, measuring and doing various other construction activities (Last night he broke a giant wrench in two while removing a radiator from the space where the refrigerator is going to go…my Muscle Man).  I’m just so thrilled that we are finally making some progress.  Two weeks ago I was convinced that our baby would be getting his diapers changed on top of the dishwasher that is currently in the nursery room.  Now I have hope that we may make our deadline.

  • And last, but certainly not least…Yesterday we FINALLY heard the baby’s heartbeat (loud and clear) on the home Doppler.  Our baby is either VERY strong or my uterus is REALLY sensitive, because the baby’s movements are really evident whenever I am laying down trying to sleep.  I’ve heard that baby movements feel like a butterfly fluttering, but that is not my experience.  Mine feels like a pinky finger is gently scraping or pushing out on my belly, from the inside.  It isn’t painful, but it’s not some tickling fluttering feeling either.  Yesterday, when I was trying to take my after-work nap, the baby was moving like crazy.  So, since I could tell exactly where the baby was, I decided to try the home Doppler.  It took about 10 seconds to find the heartbeat.  I brought the Prince in to listen and I started crying when I saw him getting choked up (again with the crying).  Every day we are making progress in our pregnancy journey…and those little milestones make all of the difference in the world to me.

Tuesday, July 26, 2011

A Little Bit of This...A Little Bit of That

Lots of things have happened since my last post. Here’s the quick highlights version (I don’t have the energy for anything better than that):

  • My mother-in-law announced my pregnancy on her Facebook page and, after receiving messages and questions from people who saw her post, I decided it was time to announce my own pregnancy.  I believe I made a tasteful and sensitive announcement…I hope so.  I would be lying if I said that it doesn’t feel wonderful to have everyone know about my pregnancy and to see the outpouring of love and support from family and friends.  Also, I was surprised to find out that many people knew (or at least suspected) that The Prince and I were struggling to get pregnant.  The beautiful messages of support and sincere congratulations have helped me to be a little more at peace with what we went through during those three long years of infertility.  I’m realizing that I wasn’t as alone as I had thought.

  • My hyperemesis came back last night and this morning…with a vengeance.  I thought I had at least gotten past that aspect of the “rough pregnancy.”  No such luck.  For whatever reason, my blood vessels all burst in my face this time, so I have giant red spots and blotches in certain areas, and tiny freckle-looking spots in other areas.  Perhaps the worst is that a blood vessel broke in my eye, so it looks like I have some disease that is causing me to cry tears of blood (no blood is actually coming out of my eye…but it is down in that part of my eye…not pretty).  I’m embarrassed and tired of the HG.  But, I’m determined to beat this, so I am going to just keep eating and drinking, no matter how many times I get sick.  I’m determined not to end up back in the hospital.  I also just keep rubbing my belly to remind myself that there is a lot of good going on along with the bad.

  • The Prince and I had an argument last night about the “doula” issue.  He believes (with all his vast medical knowledge) that I am going to end up having a planned C-section because of all of my surgeries, adhesions, etc.  Accordingly, he feels the money we would spend on a doula could be better spent on other things.  I am sympathetic with his position about the money, but, even if he ends up being right about the C-section…which is a big IF, I’ve read about the support a doula offers during C-sections…and I want that support!  The father travels with the baby to the nursery, after the baby is taken out of the belly, and the mom remains on the table for 45 minutes to an hour, being stitched up, usually with no information about what is going on with the baby (and The Prince knows this because his sister just went through it).  When you have a doula, she stays with the mom in the OR and coordinates with the medical staff to give the mom updates on the baby’s progress.  She can also advocate for the fastest possible return of the baby, so that the bonding and breastfeeding can happen as quickly after birth as possible.  I want that!  I printed out articles for The Prince to explain why it is in his best interest for us to have a doula and we had a more civil conversation about the issue this morning.  He (possibly to avoid having to read the articles) has agreed to let me pursue whatever option makes me the most comfortable.  Hopefully he will stick with that…as I’ve already contacted three doula candidates to set up interviews.  I’m really hopeful that, during one of the interviews, everything will click and we will just know who we are meant to share our miracle with.

  • I got the three egg donation children’s books that I ordered.  One of them is a glorified pamphlet…the size of a CD cover…and I could have written it in my sleep.  Very disappointing.  The other two are a little better.  Having the books gave me this weird proud feeling about our choice of using egg donation to conceive.  I thought the books might make me sad, as they would sort of “confirm” that I am going to tell our child that there was a third party involved in the child’s conception.  But that isn’t how I felt at all.  Instead, I felt confident in our decision to raise our child always knowing about his or her origin.  I feel ready for this…and the egg donor part of our story (at least for now) doesn’t scare me.

That’s about it.  I have no other exciting news to report and nothing clever to write about.  I’m really hoping that my second trimester honeymoon period kicks in soon and I can get back to being the blogger that I want to be…instead of writing my posts in a stupor.  Thanks to everyone who is sticking with me through this.

Saturday, July 23, 2011

I'm Home Again (a.k.a. The Longest Post Ever Written)

I am home…and happy to be here.  My hospital stay actually ended up being quite brief.  I was discharged almost exactly 24 hours after being admitted.  For the most part, the experience was extremely frustrating, and I hesitated to write about it before having some time to contemplate which of my feelings were valid and which feeling were likely over-reactions.  I feel like I’m ready to talk about my experience now and I apologize ahead of time for the length of this post…but I want to get my thoughts out and then just move forward, without dwelling on my frustrations.

After writing my last post, I was moved out of the very crappy treatment room I had been in and ended up in a private postpartum recovery room.  It was much nicer and I can see now why so many women in my area prefer the quaint little hospital over the more impressive larger hospitals in the area.  My care was spectacular during this hospital stay.  The nurses were kind and attentive and really went out of their way to make me comfortable.  The engineering department even brought a brand new air conditioner into my room because I was too hot and the older air conditioner that had been in the room just wasn’t cooling me off enough.  Every nurse was able to find my baby’s heartbeat with ease and, while it was a little slower than normal, the heartbeat was always strong.  Even more exciting, the baby happened to give an impressive kick against the doctor’s hand when she was feeling the baby’s position.  I had been feeling little tugs in that area, but assumed it was my uterus stretching, as 14 weeks is much too early to feel the baby moving (according to the pregnancy books I own and Dr. Google).  However, the doctor confirmed that what I was feeling was actually the baby’s movements.  Our baby, in addition to being quite stubborn and hyperactive, is apparently also quite strong.  So, the doctor explained, I get to enjoy that extra bonding with the baby already…a gift.

That was the good part about the hospitalization.  Here’s the cliff-notes version of the bad parts.  The first night of my stay, I was told that my ketone level was already within normal limits, after taking in only 2.5 liters of IV fluid (pushed through in just under five hours).  Accordingly, I “couldn’t have been as dehydrated as they had thought.”  My blood pressure also went from very high to VERY low – 87/52.  I had to wear a cuff for constant monitoring and was forced to get up three times in the night to walk around to get the blood pressure back up.  There was no explanation about why my blood pressure acted up and no one hypothesized that the fainting could have been caused by a rapid BP shift (which is a logical conclusion I would think). 

By the time the morning rolled around, I was tired, a little scared, and very frustrated.  I was told that Dr. B would be in “early,” and that she would likely be discharging me.   Knowing that I was going to be discharged without an explanation as to why I was getting so sick made me even more irritated.  I spent the whole morning crying and getting more and more agitated, waiting for Dr. B’s visit.

When Dr. B finally arrived at 10:00 a.m. (her “early” and my “early” are very different), I was too worked up to be polite.  I explained that I wasn’t frustrated with her, but I was frustrated.  I had been offered no explanations for why I had dropped five more pounds during the few days that I had been able to keep food and fluids down.  I had received no explanation as to why my ketone level went from insanely high to normal in a matter of hours or why my blood pressure was all over the map, or why I fainted.  Dr. B’s initial response…”It is probably the heat.”  I explained that I fainted first thing in the morning…having been in an air-conditioned room for hours and I really haven’t been in any heat, as I stay inside all day, every day.  Then I got “Well it could have been low blood sugar.”  I pointed out that I ate before getting out of bed (as I always do now), and that my fasting blood sugar each morning has been testing high.  I asked for an explanation of why my blood sugar is behaving so strangely (high when fasting and dropping throughout the day…even after meals).  At that point, it seemed that Dr. B was also getting frustrated and didn’t feel like answering my questions.  She said, “You weren’t as dehydrated as you seemed but your electrolytes are still off.  So we’ll give you some potassium and send you home.”  I asked “Did the electrolyte imbalance cause me to faint…and to have high blood sugar…and high blood pressure…and a high ketone level?”  Dr. B conceded that it probably did not, but that “Some women just have rough pregnancies.”  I am “apparently just one of those women.” 

Then Dr. B added the ultimate insult…”Nerves can also contribute to complications during pregnancy.”  I lost it a little bit, spitting out in between sobs, “Well…fainting for no reason and being rushed to the hospital because my whole body is supposedly going crazy will cause some ‘nerves.’  And being treated for symptoms only, feeling like no one cares to determine and treat the root cause of the problem can also cause ‘nerves.’  Perhaps if I had some assurances that I wasn’t going to end up back in the hospital in another two weeks, with the same unexplained problems, my ‘nerves’ would be better.”  (Perhaps I was a little nicer than that…but perhaps not).  Dr. B said that there is no guarantee that I won’t be back in the hospital in two weeks, two days or two months.  In fact, given my hyperemesis gravidarum, Dr. B feels it is more likely than not that I will end up needing fluids again, but she isn’t willing to give me a portable IV device or to set-up an outpatient IV treatment.  Dr. B then gave me a huge list of things I should do to “help” my pregnancy along, including many contradictory directives.  For example, I am supposed to continue to work, take short chaperoned walks each day, and get out of my chair at 15 minute intervals, throughout the day, to keep myself from getting “muscle fatigue.”  But I am also supposed to limit my physical activity and do nothing that might cause my heart rate to rise.  How exactly do I balance all of that?  Another example is that I am supposed to graze on food throughout the day, eating small snacks at least every 10-15 minutes, and sipping liquids every minute or two throughout the whole day (no full swallows).  But, I am also not supposed to eat and drink at the same time.  Even with my Type-A, schedule-loving personality, I don’t think I could manage that.

Initially after this conversation with Dr. B, I considered changing OBGYN’s.  I am frustrated with her attitude and lack of sympathy.  Her bedside manner was part of why I chose her…but she wasn’t displaying much charm during our last conversation.  However, after talking with The Prince, he helped me to realize that Dr. B is only human and no other doctor is likely to be better, given the realities of an OBGYN’s job.  Dr. B had performed surgery all day on Wednesday, left the hospital at 5:30 p.m. (after talking to my nurse about my condition and seeing that my admission was complete) only to be called back to the hospital at 9:00 p.m. to deliver a baby.  She left the hospital after the birth, sometime after 2:00 a.m. (after, again, talking with my nurse about my progress), and then was back to see me less than 8 hours later.  She doesn’t have the time to research the cause(s) of my symptoms…not when she can eliminate the life-threatening causes of such symptoms, treat the symptoms quickly, and make sure there has been no harm to the baby.  I still wish she would just say that to me, instead of guessing about why I am having problems and then giving me some non-descript “rough pregnancy” diagnosis to explain away a lot of potentially troubling problems.  Perhaps I really want Dr. B to be a fairy godmother…to wave her magic wand and fix all my problems so that I can enjoy this pregnancy a little more.  That’s not realistic…but a pregnant girl can dream (providing she is able to get some sleep).

Wednesday, July 20, 2011

Hospital Stay Number 2

I’m writing from a hospital bed…again.  And I am NOT happy about it!

I had been doing so well the last few days…not vomiting and finally eating food again.  I was feeling great until yesterday, when I got incredibly tired at work.  Pregnancy has made me tired in general, but yesterday’s fatigue was beyond anything I had experienced before.  I literally just slept at my desk for an hour.  Then I went home, slept for three hours, got up to eat dinner, and went right back to bed.  When my alarm went off this morning, I just let it ring while I continued to sleep.  After a couple of hours, my husband came in to try to wake me up.  I asked for juice and crackers, thinking that maybe I had low blood sugar and just needed a pick-me-up.  After eating and drinking, I stood up and started towards the bedroom door.  I took two steps and knew I was going down.  But by the time I knew what exactly was happening, it was too late for me to stop it.  I fainted.  I landed on my knee and side, not my stomach (thank God).  It still sucked.

I’ve been missing so much work because of the first trimester vomiting, I decided that, even though I had fainted, I needed to go to work and was okay to drive myself to work.   I felt good driving with my air conditioning on.  But as soon as I got out of the car, the blackness started closing in again and it was all I could do to walk to my office building.  I sat at my desk, crying because I couldn’t make the spinning stop.  Finally, at 9:00 a.m., I called Dr. B’s office.  They told me to go home immediately and call them in an hour with an update.  On the way home, I started to go off the road three times, snapping-to only after hitting the bumps they put on the shoulders of the highways.  When I called Dr. B with an update, she told me to come into the office…but NOT to drive myself.

I called The Prince to tell him I needed a ride to and from the doctor’s office.  He acted very inconvenienced and actually said that he wanted to take me and drop me off at Dr. B’s office, leaving me to take a cab home, because he had personal training and didn’t want to cancel on his trainer.  I flipped out on him and we ended up hanging up on each other.  So…I called his mother and asked her to give me a ride.  She is a teacher and has the summer off, but she also lives 45 minutes away.  Still, I knew I couldn’t take a cab and she was the only person I could think of who wasn’t at work.  She was more than happy to help, but I guess she was as angry with The Prince as I was.  I got a call from him 10 minutes after my call to his Mom, and he said that he was canceling his gym appointment and would take me.  He mentioned that his Mom had called him and expressed her opinion that the baby and I were more important than his personal trainer (Go Mother-In-Law).  When she speaks, he listens.

At the doctor’s office, I was informed that I have high blood pressure, high blood sugar, high ketone levels, and urine that indicated severe dehydration.  It is unclear what is causing all of this, especially given that I am finally keeping food and liquids down.  But something is seriously wrong, so I have been admitted to the hospital again.  I’ve had oodles of blood work done already, and was told they will be doing follow-up blood work every three to four hours.  I am getting IV fluids at a fast pace and a medication to lower my blood sugar.  Perhaps the most aggravating thing is that I am being treated as if I am vomiting.  I’m only allowed to have clear liquids…and I had to beg for those.  I have to call a nurse every time I want to get up to go to the bathroom or to have something to drink.  I’m frustrated and tired and I really hope that the doctor figures out what is wrong and fixes it quickly.  I am trying not to be a baby about this, but really…enough is enough.

The one saving grace in all of this is that the doctor easily found my baby’s heart beat with a Doppler in her office.  The heart beat is strong and steady.  The doctor said that babies take what they need as far as nutrients and blood, regardless of the effect it has on the Mom.  Accordingly, my baby is likely unaware that I am in any distress and is just having a ball in my belly.  That thought makes me smile and is going to keep me going throughout this (hopefully brief) hospital stay.  I’ll post an update tomorrow, when I know more.

Tuesday, July 19, 2011

The Doula Dilemma, Part 2

The comments on yesterday’s post were great.  This is a big decision for me/us and I like hearing different points of view to help me think about which way I want to go.  To hire a doula or not to hire a doula, that is the question.

The “pros” of hiring a doula are as follows:
  • I won’t have the added frustration of The Prince not being supportive during labor, which means we can enjoy the experience more as a couple.
  • The Prince will get to take the back-seat role that he desires.
  • Massages!
  • I feel like I’ll be more prepared for the birth experience by speaking with the doula about the things that no one likes to talk about (ex., pooping during labor).
  • The hospital we will be using has a hydrotherapy pool, birthing balls, reiki and other alternative therapies available.  However, I’ve heard that a patient really has to be insistent to get the use of those therapies.  I’m not sure how much of an advocate I can be if I am in active labor, so I would like having someone there to advocate for me.
  • I see the doula as a type of hooker (I know how awful that sounds, but let me explain).  While I could possibly get the services she provides from someone I know, I like the idea of her seeing parts of me that I don’t want anyone to see, and then being gone from my life.  I feel weird about carrying on a relationship with someone who has seen my lady bits (or has seen me pooping on a table).  A doula goes away after the dust clears and what happened in the labor and delivery room stays in the labor and delivery room.
  • Supposedly, the use of a doula helps the mother at least wait longer before getting an epidural.  While my feelings could certainly change when the “birth day” rolls around, at this point, I would like to hold off on an epidural as long as I can, so that I can help the labor along by walking, standing, squatting, moving, etc.  Having someone encouraging that fits into my “ideal” scenario.

The “cons” of hiring a doula are as follows:
  • The cost – we could get a lot of baby stuff for $400-$600 dollars.
  • I know that I will likely get an epidural at some point during labor.  Doctor B already told me that labor is going to be a lot more painful for me because of the uterine suspensions I’ve had.  I don’t want to be made to feel guilty when the time for an epidural comes.
  • I am not interested in a home birth and I know that some people find that doulas strongly advocate for home births, leaving the mother feeling guilty about choosing to use a hospital.
  • As with any profession, not all doulas are created equal.  I would be really angry if I spent the money on a doula and didn’t feel like she fulfilled her duties.
  • If I haven’t gone into labor on my own by one week before my due date, Dr. B is going to induce me (in which case, I will be jumping straight to an epidural, as I know I can’t handle pittosin contractions) or do a C-section.  If I have a C-section, I don’t need a doula…but I won’t get my money back.
  • The Prince may be uncomfortable with a stranger in the room with us.  He is not good with new people and, even if he meets with the doula ahead of time, it is unlikely that he is going to bond with her.  He also hates hippy/ new age stuff, and (right or wrong) he puts the use of a doula in that category.  I want this to be a good experience for him too. 
  • I don’t want my doctor or nurses to feel like the doula is stepping on their toes, and there is generally some degree of animosity between healthcare professionals and doulas.  My doctor is pretty progressive, but if the doula is too pushy, that might tick off the doctor.  I definitely don’t want to tick off the doctor.

Some of these concerns could be resolved in the pre-screening interview of the doulas (like their feelings about hospitals, inductions, and epidural usage).  Some of them (like The Prince’s social phobia) can not.  I think I’m going to wait a little longer and hopefully I will get one of my famous “gut feelings” that will steer me in the right direction.  Thanks again for your comments…they definitely helped me to see the “pros” and “cons” more clearly.

Monday, July 18, 2011

The Doula Dilemma

Lately I have been thinking about hiring a doula – sort of a professional labor partner – for the birth of my baby.  The Prince has been very open about his feeling that I am going to be woefully disappointed with his “support” during labor and delivery.  He is uncomfortable in hospitals, uncomfortable with pain and uncomfortable expressing emotions.  His anxiety about the labor and delivery process is higher than mine.  He doesn’t want to go to childbirth classes (though I’ve told him his presence is non-negotiable, and I mean it).  But realistically, we both know that he is never going to massage my back, feed me ice chips, put a cool cloth on my head or talk me through the rough times during labor.  I’ll be lucky if he can keep from “going home for something he forgot.”

I know that a lot of women have husbands who aren’t quite up to the challenge of being a birth partner.  However, a lot of those women have mothers or sisters to step in and assume that role.  I don’t.  I have a mother and a sister, but they live a few hours away and they would not be the calming, supportive presence I need.  The Prince recommended that I have his mother in the room to help me, but I’m not okay with that either.  I adore my mother-in-law but the things that she would see if she was in the room are things I’m just not comfortable with her seeing.

I also don’t have any friends who could act as a birth partner.  All of my friends either are struggling with infertility, have small children (meaning that they can’t just take off whenever I go into labor to spend an unknown amount of time with me), or have jobs that would be considerably disrupted if they had to drop everything at some unknown date and time.  I know that many of them would be exactly the support that I need, but I would not feel right about putting them out.

Which leaves…hiring a professional.  There are a handful of doulas in my area.  Most seem to focus on home births, but will attend hospital births as well.  They all seem to advocate a medication free childbirth.  They all would meet with The Prince and me a few times before the birth, to go over a birth plan and medication-free relaxation and pain relief techniques.  They are on call 24 hours a day in the month prior to your due date and they are guaranteed to be present throughout your entire labor.  Some of the doulas also make post-partum visits to help with breastfeeding concerns, infant care concerns, and to perform light housekeeping duties.  Prices for these services vary, from $400 to $600.  

The Prince has balked at spending that kind of money, but I have explained that we only get one shot at the birth experience.  Does he really want me to spend it angry and resentful towards him because I am feeling like he isn’t helping and doesn’t care about me, or does he want us to both enjoy the birth process  in our own ways, without stepping on each other’s toes?  When I couched it in those terms, he conceded that we need to have some type of support person in the room for me.  He just wishes that support person was less expensive.  He still keeps asking “What about ‘so-an-so,’ couldn’t she do it?”  But ultimately I have been given the green light on pursuing the hiring of a doula and it looks like I am going to need to do so.

So why can’t I make the call?  Now is the time to start interviewing the potential candidates, as they can only take one or two patients a month, thus causing their schedules to fill quickly.  I’ve done my research, narrowed the candidate pool to three doulas, and I even know what questions to ask them.  But I still can’t seem to make myself pick-up the telephone to get started.   Perhaps it is the financial commitment or perhaps it is the fact that speaking with a doula makes the impending labor that much more real.  The baby’s in there.  It has to come out.  But I would be a liar if I said that I am looking forward to the “coming out” process.  I’ll keep you updated on my progress in this endeavor.