The Home Stretch

This pregnancy has felt like it's lasted forever.  I joked at work last week that everyone in the office might think that I've only been pregnant for 9 months, but in reality, I've been pregnant for 2 years. And it really does feel that way.  It's been hard to believe there's ever going to be an end in sight.  Except that delivery is now less than two weeks away.  My last day of work is a week from tomorrow.  In one week, I'll be on maternity leave.

I have been so focused on all that I've had going on this pregnancy that I've not really focused on the baby that's growing in me.  That's not to say that I haven't reveled in the fact that he's so active (he moves 3-4 times more than Finn ever did on a pretty constant basis) or not spent a lot of time rubbing my belly. No, I've definitely enjoyed those parts of pregnancy.  But what I haven't done is spent much time really thinking about what this baby is going to be like, and what life is going to be like with two.

Last week I finally got around to getting some books for Finn about a new baby in the house, and those books are what I thought about when I woke up in the middle of the night last night with my regularly scheduled pregnancy insomnia.  And it occurred to me that in less than two weeks I'll be awake in the middle of the night again, but this time because there's a baby that needs to be fed.

And that's when it finally seemed real. We're about to become a family of three.  And I'm so excited and nervous and thankful all at the same time.  And a little overwhelmed, too.

I have no idea what Chimi is going to be like.  I know as an occupant of my uterus, he's very opinionated, and will let me know if I'm in a position he doesn't like.  He gets the hiccups quite frequently, likes it when I have dark chocolate, and loves to ram his butt into my rib cage (when he isn't trying to wedge a foot between it and my liver, that is).  But unlike when I was pregnant with Finn, I really have no sense of what his personality will be like once he's born.  At first that bothered me, but now I'm looking forward to getting to know this new little boy.

A new perspective about having a child conceived from donor eggs hit me a few weeks ago, and I've worried much less about that since then, too.  I've spent a lot of time worrying about how he'll feel when he's 10 or 20, knowing he's not genetically related to me.  But until recently, I hadn't thought about how he'd feel it when he's 6 months, or 2 years, or 3 years old.  Because of course, at that age he won't understand.  Which means that he won't care.  For the formative years of his young life, all he'll know is that I'm his mommy and that I love him unconditionally, with all of my heart.  And once he is old enough to understand what it means to have come from donor eggs, I hope that the foundation of security in his place in my heart and our family will be so strong that it will never be something that makes him feel sad or angry.  I know that the closer delivery comes, the less important the details of his conception have become to me.  He's my son, and that's all that really matters.  I really hope that he truly understands that, and never questions his place in my heart.


Holy shit.  Ten days from now, I'll have two kids!

Settling In

Breakfast in the new house

I can not believe how absolutely exhausted I am.  Beyond exhausted.  And yet so full of gratitude for the blessings of wonderful friends who have made a difficult few weeks so much better than they could have been.

I somehow managed to forget how physically draining the last month of pregnancy can be.  Or maybe I didn't realize, because last time I had nothing going on and was able to rest every evening.  This time I had the move, a toddler, and I was on call (rounding at the hospital) all week this past week.  I worked on unpacking for about 2 hours this morning and was then so overwhelmed with feeling exhausted and horrible that I let Finn watch tv for 2 hours while I sprawled on the couch next to him.  I've taken it much easier the rest of the day, and while I didn't get even half the stuff on my list done, I feel much better, so I think I've made the right choice to be mostly lazy today.

The hardest thing about today was that I ran out of my long acting insulin last night - I had enough for about 1/3 of my dose.  I can't believe I did that, and yet I shouldn't be surprised, as I've felt like a zombie all week.  But my blood sugars did great until supper, when I overate just a little, and didn't take my lack of long acting insulin into account when I took a little mealtime insulin to cover the overeating.  And so my sugar has been high for 2 hours, and I'm feeling SO guilty.  These last two weeks are the time that determine how Chimi will do after delivery, and I hate that I've had a high blood sugar less than 13 days before his delivery.  I'll have to be absolutely perfect between now and delivery...I can do it!  I've gained one pound since the beginning of October, most (but not all) of my blood sugars are good, and in less than two weeks I can eat ANYthing I want.  I will be perfect for the next 13 days, and just suck it up.  But I still feel guilty about today.

Finn has adjusted really well to the new house.  He talks about our "little house" a little, but doesn't seem to miss it too much.  There's just so much room for him to run around, and now that most of his toys are unpacked, he's happy, despite the miserable weather making it hard to get outside. We've met some neighbors already, and I'm looking forward to better weather so we can meet more.  He has spent two entire nights in his bed, and when he does come to bed with me, it's rarely before 3am (much better than at the old house).  He was pretty sleep deprived when we first moved in, though, and I don't think he's settled in enough to get over that just yet.  I'm hoping he sleeps a little late in the morning and then naps well for me tomorrow, too, as that's all it would take to get him back on track, I think.

If I can keep up with just a box or two a day, I might just have the house at a point I can live with before Chimi arrives.

*The rest of this (very long) blog entry is more to help me remember the past few weeks - feel free to skip right over it, as it's probably not all that interesting to anyone but me.*

The short of how horrible the move was - the movers didn't finish packing my house on Thursday like they were supposed to do (and what they did pack was poorly labeled, if labeled at all, and frequently several different rooms objects were/are in one box).  So they had to pack on Friday, and as a result we didn't leave the old house until after 4pm, and after a much-too-long stop to empty my storage unit, we didn't get to the new house until 6:45pm.  Which means they left the new house at 11pm.  This from the highest rated moving company on Angi.e's Li.st.  At least they were until I put my review on there.

Unpacking has been a chore, complicated by the poor labeling of all the boxes, and the fact that Saturday morning after the move I realized that all the dining room furniture was in the wrong place, and so nothing from that room could be unpacked.  Since they labeled everything from the dining room as kitchen, there are a lot of partially opened boxes sitting around.

But here's the good part - Saturday morning two of my amazing coworkers (the other doctor who was taking her boards with me this past fall and the head of our diabetes center) showed up with breakfast and stayed ALL day to help me unpack.  We got just about everything in the kitchen put away (minus the still missing crockpot, aluminum foil and dish towels), as well as Finn's room and bathroom.  Another friend showed up in the late afternoon to make the process even easier, and we even rearranged boxes so the living space downstairs was useable.

The rest of the weekend and the next week was full of me gradually getting boxes in my bedroom unpacked, my bathroom settled, and then I decided that I'd move one piece of furniture from the living room to the dining room by myself.  A few dents and one huge bruise later, it was moved, and I was able to unpack a bunch more boxes.

And thanks to all this, I had a night of some fairly strong contractions and a lot of nausea, and decided that maybe I should not work quite so hard.

So the unpacking is going more slowly, but I'm making progress.  The same coworker who spent all of our first Saturday here came by with her husband last weekend and put together the crib, and today my assistant and one of the lab techs came with their big burly husbands to move the rest of the furniture in my dining room.  I still have a few projects I can't do on my own, but nothing that can't wait a few months.  And now I have things arranged so that I can get most of the boxes out of my living room and dining room over the next few days.  Maybe.

2013 - A Year in Transit

It feels like all of 2013 has been a year in transit. Not transition, but actually transit, as almost everything I've done has been working towards something, rather than actually getting somewhere. And it's been a ridiculously long year as I'm pretty sure this pregnancy has lasted at least 18 months already.  When I look back, I can't believe how much has been crammed into one year.  I don't know that I can say 2013 has been a good year, but I've been very blessed this year, and I'm hopeful that everything that's happened this year is setting things up for an amazing 2014.

While awake in the middle of the night with some fun pregnancy insomnia a few nights ago, I made a mental list of all the big things that have happened this year, and I think I need to write them down here so I can remember what a crazy year this has been.

• Learned my last attempt at IUI hadn't worked, despite lots of supplements and dietary changes to promote fertility
• Decided to skip IVF with my OE due to low chance of it working, and made the decision to go with donor eggs
• Struggled with learning how to parent my two year old - it's still a challenge, but I feel like I've finally figured out a few things that work well with us, and am better able to avoid some of the meltdowns and fights that were so rough earlier in the year
• Said good-bye to my sweet Vagus on the same day that a sperm met an egg and became my Chimichanga
• Took lots of hormones to prepare for embryo transfer and was thrilled to get a BFP!
• Endured a miserable first trimester with bone deep fatigue and crippling nausea that felt like it would never end
• Was disappointed to learn that my second baby was going to be another boy, and then suddenly found myself having a hard time imagining life any other way, and feeling so happy and excited to be welcoming another boy into the family
• Studied long hours to recertify in endocrinology and then waited months before learning that I'd lucked out and managed to pass
• Decided that boards, a two year old, and pregnancy weren't enough to occupy me for the second half of the year, and signed a contract to build a house
• Today, the last day of the year, I officially closed on my new house!

For years I've dreamed of being the mom to two kids in a warm and inviting house in a nice little neighborhood.  I can't believe that as of next Friday I'll be in that house, and just 4 weeks later I'll be welcoming my second child into the world.  I know that there are going to be some really hard days ahead, and that 8 weeks from now I might be a frazzled, sleep deprived, sobbing mess with unwashed hair and two screaming children.  But even then, I'll be a contented, frazzled, sobbing mess. At least I hope I will be. I hope I can remember how much I've longed for this life, and I hope I can be patient with myself as a mom and a person as I learn to parent two children as a single mom.  

Wishing all of you a wonderful 2014, with love, happiness, fertility and children who sleep through the night.  

Gestational Diabetes

My trusty Dexcom sensor

You may remember that I started myself on insulin back in July, before I'd even seen my OB, because my morning blood sugars were running high.  My sugars were weird from the very beginning, so I've intermittently been wearing a continuous glucose sensor to make sure I wasn't missing anything, and was lucky enough for the first two trimesters to be able to eat just about anything I wanted to.  But at 24 or so weeks that changed and I became very restricted with my diet. Last week I finally switched my insulin from NPH to the newer, longer acting Levemir - and wow has it made a difference.  I'm constantly wearing my sensor now, and am amazed at how much better my blood sugars look, and so happy that I've been able to add some things (like fruit) back into my diet.

Dealing with this for the past few months has given me such a different perspective on managing my patients with gestational diabetes, both from a diet and medication standpoint, as well as from a personal interaction standpoint.  We've been taught that the best way to manage diet is to follow what's known as the Jovanovic diet, and for many women that does work best. But I have discovered that my sugars do much better with following the similar 3 meals and 3 snacks a day regimen as is prescribed with the diet, but with less carbs at lunch and supper.  I have a better idea of when NPH insulin works, and when Levemir is better.  And I know firsthand what it's like to look a donut in the face and think, "Is this food worth the health of my baby?"

Damn, it's hard to follow this diet!  Intellectually I knew that, but it is so much different to live it.  And I'm lucky enough to really understand the diet and insulin before getting the diagnosis (or should I say, giving myself the diagnosis), so I didn't need lots of training. I have access to things like a continuous sensor (I now can't imagine having insulin requiring diabetes without having a sensor!), and other endocrinologists and diabetes educators to bounce ideas off as I've tried to manage my sugars the past few weeks.  I think it's much easier for me than it is the average patient, and yet it's still frustrating.  I hope that this experience makes it easier for me to help my patients; I know that it has already made it easier for my patients to accept my recommendations once I share with them that I also have GDM, and that I'm also taking insulin.

I haven't eaten Fruity Pebbles in years, and yet that's all I think about when someone asks me what I want to eat.  Fruity Pebbles, PopTarts, Oreos, donuts, Peeps, milkshakes (I had one almost every day of my 3rd trimester with Finn), bagels, pasta and pizza all dominate my daydreams.  I cannot wait to be able to eat whatever I want to once this baby boy is finally born.

But on the bright side - I've eaten so much healthier this pregnancy than I did with Finn. I have a leafy green salad for lunch every day, I'm eating tons of veggies and a reasonable amount of fruit.  And I've actually lost two pounds in the past month.  I'm pretty sure that while I started out this pregnancy 10 pounds heavier than I did my last pregnancy, I'm now just a few pounds over where I was at this point with Finn.  While my stomach has gotten bigger, the rest of me has not, and that has been really lovely.

Is it wrong that one of the main reasons I hope I can exclusively breastfeed again this time is so that I can eat whatever I want and still lose weight?

24 Week Update

Twenty-four weeks.  Viability.

It drives me crazy when people wax poetic about how great it is to reach viability, as it makes it sound as though they're being completely oblivious to how difficult it would be to have a baby born that early - and that viability is still no guarantee that all will be well.  But of course, there is no guarantee, ever.  Bad things happen.  Loss happens.  Tragic things happen.  All of us in this community know that.  And yet we all continue to be willing to risk tragedy, because without that risk the beautiful, wonderful, joyful things that make life worth living would never happen, either.

The reality is that it is reassuring to meet this milestone, knowing that if my baby is born now, he at least has a fighting chance. But at the same time, I really, really, really, really hope he decides to wait until he's fully cooked.  Are you listening, Chimi?  Stay put until February!

Chimi almost 3 weeks ago

It's amazing how different this pregnancy is.  Last time I was less stressed, had more rest, started out 10 pounds lighter, had mostly good blood sugars but always had borderline blood pressure, and exercised 2-5 days a week the entire pregnancy. I have barely exercised this entire pregnancy, my blood pressure has been consistently 10-15 points lower, I'm now only 5 pounds heavier than I was at this point in my last pregnancy, and have had a lot harder time with my blood sugars.  I'm now wearing a continuous glucose sensor because my sugars have been so weird that I was worried I was missing things with just fingersticks (and I was), and in the past week I have suddenly had to start following a much stricter diet to keep my sugars at target.  Not to mention that I'm on insulin at bedtime and taking metformin.  I'm starting to have dreams of all the food I'm going to enjoy once Chimi arrives...cake, doughnuts, pizza, pasta, rice, apple pie, pecan pie, pumpkin bread...and fruity pebbles cereal.  I haven't had fruity pebbles in years, but suddenly now that I can't have them that's all I can think about.  Yummm, fruity pebbles.

I'm really hoping that as things calm down just a little (finally it feels like it could happen), I'll start to have time in the evening for a quick workout, something more than the walk around the block Finn and I take a few times a week.  I really think my sugars would be better if I could do that - it's just a question of squeezing it in.  Somehow.

One really great thing that's better with this pregnancy is my back pain.  Or lack thereof.  This time last pregnancy my hip and low back hurt constantly.  At this time last pregnancy, there is no way I could have survived a day at Disney World without a wheelchair, and yet last week I had barely a twinge of back pain.

I credit the massage therapist at my acupuncturist's office for this.  I saw her for fertility massages last year, and in the course of my first massage, she discovered that my hip and back pain was caused from muscle spasms in the front of my hips, not the back.  All it took was 5-6 massages before getting pregnant, and the pain that was always there even when not pregnant, and definitely plagued me my entire pregnancy (despite weekly chiropractic and acupuncture sessions) is gone.

Of course, I'm not yet feeling that pull on my abdomen from the weight of the baby - as long as I hold my abs tight when I stand up, I barely feel different at all, until I try to lean up against a counter, that is.  So I'm prepared for it to become a problem again. But considering I was miserable starting at about 9 weeks last time, I'm thrilled to have this respite, even if it doesn't last.

I can't quite believe I'm more than halfway through.  16 weeks left (and no more, since I'll be a scheduled c-section).  The first trimester felt like a year, but the past 6 weeks have flown by.  I'm feeling a little more bonded these days, as he's so incredibly active and is constantly making sure I know he's here.  I'm grumpy just about all the time at work, but I still find lots to smile about every single day.

Life is hard.  And yet is really is beautiful, too.

And the Verdict Is....

It didn't take long during today's ultrasound for Chimi to get in the perfect position to answer the big question...

It's definitely a BOY!

I have to admit, my first reaction really was disappointment.  I had a hard time focusing on the ultrasound and not on the two big worries I have about having two boys.  The first is the whole circumcision thing.  I did have Finn circumcised - and then wished I hadn't, because it was so traumatic for me.  I can't imagine having the two boys different, so I'll do it again.  But I want to be sedated for it.  (Only partially kidding.)  The second is that I had this idea that if they were different genders, it would downplay the difference in genetics between the two.  But I know that's silly - and I also know that boys are less likely to worry about that sort of thing than girls are, anyway.

Chimi was bouncing all over everywhere, though, so it wasn't long before I forgot about my disappointment and was oohing and ahhing over the perfect little fingers and toes, the adorable profile (which, even at 16 weeks reminds me of Finn's), the beautiful 4 chambers of the heart, and that breath taking view of the spine.

Everything looked great, he was healthy and wonderful, which was a huge relief to see.  I do have a partial placenta previa, but I did with Finn, too, and it resolved by 20 weeks, so hopefully this will do the same.  I go back in 5 weeks for a fetal cardiac echo (now recommended for all IVF babies) and to check on the previa.  The MFM is also going to do a little research on neuroblastoma, and while she agreed with everyone else that it's not an inherited thing, she also understands that this will be a constant worry in the back of my mind.  So she's going to see if there are any references for identifying those tumors in utero so that they can be sure to look in the right places, and help reassure me that all is well.

This morning Finn told me he didn't want a baby sister any more, he wanted a baby brother.  This afternoon he said that he didn't want a baby brother, either.  "I want a baby Chimichanga!"

Almost 16 Weeks

"Baby Chimichanga in Finn's tummy!"

I'm pretty sure that June and July were the longest months ever recorded in human history.  And now here it is, almost the end of August and I'm almost 16 weeks pregnant.  (If you go by my transfer date, I'll be 16 weeks Tuesday, if you go by the due date my RE gave me after my first ultrasound, I'm 16 weeks tomorrow.)  My nausea is finally easing up - last week I was able to cut down and then completely eliminate Zofran, and this week, I was eating almost normally.  Tomorrow I'm going to try going back to salads for lunch again, though I'm a little worried about what that might do to my blood sugar.  When I was feeling my worst, I was shocked to discover that my after meal sugars were only high after eating less carbs instead of more.  Even this past week, when I switched up the croissant on my turkey melt for the healthier option of whole wheat, my sugar spiked.  It makes no sense to me or my partners at work, but thus far they've prescribed a high carb diet for me.  Which is lovely, but it feels so unhealthy.  I'm ready to start feeding this baby healthy foods!

Tuesday is my anatomy scan.  Over the past few weeks, I've revisited the time immediately before and after my anatomy scan with Finn.  It's such a pivotal moment in a pregnancy, at least it is for me.  The moment when a few of the maybes and possiblies become realities.  The moment when the list of potential names is cut in half, when I know if I should pick up that cute pink onesie in the store, or go with the blue one, when I can start using he or she instead of he/she or it.  When I can tell Finn, "your baby brother" or "your baby sister" instead of "your baby brother or your baby sister" (which usually results in me being corrected by Finn, "baby SISTER.")

I'm not going to lie.  I'm going to be a little disappointed if it's another boy.  Not devastated disappointed (as I have a suspicion I might be a better boy mommy than girl mommy - and boys are pretty darn great), but disappointed nonetheless.  So these last few days - hours - of not knowing are a little bittersweet.  If I find out that Chimi is a boy, I'll feel a pang that will quickly pass, but it's almost nice to be where I am right now, not knowing.

Almost nice.  But not nice enough to decide to wait until the baby is born to find out!  I have been talked into a gender reveal party at work, though.  I was already feeling a little disappointed that almost everyone will find out via text, call or blog, and almost no one will hear the news in person, so I'm glad that I got talked in to this!  A drug rep friend is going to have a cake made for us at work - I'll call her after the scan and let her know the gender, and then she'll bring the cake by for lunch on Wednesday.  That means I'll have to keep the secret for a little while longer at work (which will be hard, I know they'll be pestering me!) and I'm going to delay my announcement on Fac.ebook by a day.  I still haven't made this pregnancy FB public, yet, as I'd decided to hold off until I could share the gender at the same time. Another day won't make a difference, I don't suppose.

And now I need to get back to studying.  Blergh.

New OB Appointment

I finally had my new OB appointment today (at 13 weeks and 3 days!) and despite all the hassle getting the appointment scheduled, I think it was worth the wait.  Dr. L was as wonderful as everyone has said she is, and I really enjoyed our visit. She was completely fine with my management of my gestational diabetes, especially when I reassured her that I was discussing my sugars and diet with my partners, so I am getting input into how I managing it.

I explained to her that I wanted to avoid the use of the words donor egg on my chart as much as possible.  Everyone in the office knows who I am, and while I don't think anyone would deliberately snoop, it would be easy for someone to see that information, and then hard for them to keep it to themselves.  I asked her if she would be comfortable using the same language that another DE mommy friend of mine had on her OB records, "donor conceived."  And she was completely fine with that, and understood my reasoning without requiring a lengthy discussion.

The best part about our visit was when she discussed my delivery with Finn, and c-section versus VBAC.  Some of you might remember that I tried to do natural childbirth, and managed many hours on pitocin without an epidural, before finally giving in to the epidural, and then hours later to a c-section.  I told her about that, and that while I was really disappointed by not getting my natural delivery, I felt at peace with the entire process because my midwife and OB were so great.  I know they were certain by 6pm that I was not going to delivery vaginally.  But Finn was not in distress, and so they were comfortable waiting until it was clear to me as well.  I told Dr. L how much I appreciated that, but that I also felt badly for making such a long night for everyone taking care of me.  She reassured me that allowing someone to labor for hours was just part of the job - an important part of the job, as a good OB will realize how important the birth experience is for a mom.  It's amazing how those casual words have made me feel so much better about that part of Finn's delivery.

We then talked about VBAC.  The group that delivered Finn (who no longer deliver babies at all) were the only ones at my hospital that would do VBACs.  I had even considered going to a different hospital so I could try, but my insurance coverage is really bad for anything non-emergent that is done at another hospital, so I decided to stay here just for financial reasons.  Dr. L told me that in her training they encouraged VBACs, and she missed that part of practice, but the group had decided that the cost of malpractice insurance was just too high if they offered them, so they don't.  And then she said, "But based on your labor history with Finn, you'd be a poor VBAC candidate, and would probably end up with a second section, anyway."

Coming from a doctor who is actually pro-VBAC, that made me feel much better about my decision.  Of course, there's all the other pros that go along with a scheduled c-section, like being well rested and being able to plan for childcare for Finn and for my work schedule.  I do regret that I will never be able to experience natural childbirth, but that regret is no longer such a huge deal.  It's just a little regret, like saying no to that cute guy who asked me out years ago because I was dating someone else who later turned out to be a jerk.  (Though, come to think of it, that might actually be a bigger regret.)

First Trimester Screening

From the very beginning of my pregnancy with Finn, I felt a deep connection with him.  I felt like I knew him, and could already imagine him as a 2-3 year old.  And much of how I imagined him is exactly how he is now.  That wonderful bond we shared when I was pregnant was one of the main reasons I loved being pregnant.  Even before I could feel him move, I felt him there.

This pregnancy has been much different.  I just haven't felt a connection with Chimi.  That's not to say that I'm not already attached to this baby, it's just that I haven't felt the same deep connection I felt with Finn.  I think a large part of it was the way Chimi was conceived...I took some hormones to prepare my lining and then walked in to a clinic, had a catheter slipped inside and one little embryo transferred...while the process was actually much more complicated, it still felt so much simpler and less involved than my injectable IUI cycle with Finn.  It's just been hard to believe that I'm pregnant.  It's all been so easy that a part of me is still waiting for the other shoe to drop.  I read the RBA threads frequently (when I should be studying) just to reassure myself that women who have traveled a lot longer roads than I were able to get their happily ever after with the same simple visit to RBA, and maybe, just maybe, there isn't another shoe that is going to drop.

Another big part is how sick I've felt.  There are plenty of women who feel worse than I have, I know.  But I'm still miserable.  The first few weeks it was reassuring.  But now, going on 8 weeks of some level of pretty constant nausea, it's just exhausting and awful.  I have an hour or two of relatively no nausea first thing in the morning, and then it just builds throughout the course of the day.  It reminds me of how I feel with a stomach bug, right before I finally give in and throw up for the first time.  Always on the verge of throwing up.  I'm hungry, but nothing sounds good.  I want to eat healthy food, but all I can stomach are the bland carbs that I'm growing to despise.  After a few days of feeling a little better, this past weekend was just horrible.  I was so miserable by the end of each day that I actually cried myself to sleep a couple of nights in a row.  And that's with taking Zofran.  That awfulness from the weekend and Monday and Tuesday seems a little better today, so I'm really hoping that was the worst of the worst.  (If not, I might brave the fatigue and try adding some Unisom, as suggested by JustAnotherJenny based on this post from Bionic Mamas.)

If you're still with me, there's a point to all this complaining.  And that point starts this morning, when I walked into the ultrasound room at my MFM's office.  Joanne (who I've known for 9 years - for about 4 months I shared office space with the MFM) is the RN who does the first trimester screening, and she was thrilled to tell me that I was their first patient on their brand new ultrasound machine.  Which meant that we were going to have to spend more time on the ultrasound, since it was going to take her a while to figure it all out.

The warm jelly squished onto my tummy as I tried to contain my anxiety.  This was my first scan since I stopped all my hormones, and I was nervous.  I've been trying to imagine Chimi wiggling around in there, but I've just not been able to visualize it.  Like I said before, it just doesn't seem real.

And then the probe was in place, and suddenly I could see the baby.  MY baby.  Wiggling and jiggling all over the screen.  When it did its first backflip, I felt a little twist in my heart.  There it is. There's my child.  There's that connection.  It's different than with Finn...this may sound really new age, but I've always felt like I've known Finn forever.  If there's such a thing as past lives, we've been together before.  But this little one?  I think we're new to each other.  I don't know this child, but my heart is smitten.  We watched Chimi twist and turn and do somersaults, before finally cooperating with the exam, and holding still for the nuchal translucency measurements, and then posing for a few pictures.  The new ultrasound machine was amazing, the images were so clear - we could see the ventricles of the heart, the kidneys, the brain - so amazing that 10 weeks ago it was just a circle of cells.  The pictures didn't come out as clear, unfortunately, but I still have the image of that beautiful, squirmy child in my head and I'm holding it close.

I still feel horrible.  I'm still really ready to be done feeling so sick.  I'm still really ready to get my 800 calories at lunch from a burger instead of a damned baked potato.  But now I also feel some excitement and joy in this pregnancy, too.

We tried to get a look at gender today, but the little stinker had the umbilical cord between its legs the entire time.  Until my last ultrasound I had decided this baby was a girl, but now I have no idea.  I guess I'm just going to have to wait until my anatomy scan on August 27th.  Four long weeks.  Four weeks that will hopefully be filled with joyful anticipation, instead of resentful nausea.  

Super Sweet

Sleep more appealing than cookies?

I finally have my new OB appointment scheduled for August 7...by then I'll be over 13 weeks.  My first trimester screening is this coming Wednesday, though.  I'm hoping the MFM will let me do the Materniti21 test, both for reassurance that Chimi is trisomy free, as well as for the added benefit of knowing the gender a few weeks early.

The entire OB/Gyn group that delivered Finn stopped the OB part of their practice about a year ago.  There are only two other groups in town, and thanks to my health insurance, I'm stuck going to either one of those groups.  The group I decided on was basically by exclusion - I really dislike several of the doctors in the other group, and only mildly dislike a few of the doctors in the one I went with.  Now I dislike the group I decided on even more, thanks to the jerks they were around scheduling my first appointment.

I see a lot of patients from both groups (mostly with diabetes in pregnancy) and I know how they do things.  So I know that despite the fact that I had some high sugars after meals while pregnant with Finn (even after passing the glucose tolerance test with flying colors) and the fact that I had a baby who weighed 9lb13oz, they would not have had me checked for gestational diabetes yet.

Nevertheless, I've been monitoring my sugars since I got my first positive pregnancy test.  They started off fine.  But then about 3 weeks ago, the fasting sugars started to increase about the goal of less than 90.  So I started myself on metformin, and then increased the dose up to the max dose of 2000mg a day.  But still my fastings were high, in fact, Friday morning my fasting was 104 - WAY too high in my opinion.  Surprisingly, my post-meal sugars are excellent; even eating things like mac and cheese and giant baked potatoes, my post-meal sugars are all well within the normal range.

So I started myself on insulin on Friday night - 12 units of NPH.  And this morning my blood sugar was perfect.  Finally.  Thank goodness.

I'm so annoyed to be on insulin - my pregnancy is now officially high risk (though I guess it already was based on my age).  I'll have a lot more monitoring later in pregnancy, which is going to be a hassle with my work schedule.

But more than that, I'm relieved.  Sometime in the past week or so, the baby's pancreas has started making insulin, which means that the baby is going to be affected by my high sugars (my sugar passes into the baby's bloodstream, and the baby's pancreas has to work harder than it should to make more insulin - this increases the risk of low sugars after delivery, breathing problems, feeding problems, as well as increases the risk of obesity and type 2 diabetes for the baby later in life, among other things).  So I'm relieved that I caught it very early and was able to treat it on my own.

Like I mentioned, it's unlikely my OB would have tested me this early, even if I'd already been seen.  What's even scarier is that it's unlikely that my elevated sugars would have even been found with the current testing my OB (and a LOT of other OBs) do, as my sugar would have probably been fine on the one hour screen.  Several years ago the ADA recommended that the current two step testing for gestational diabetes (the one hour post drink test followed by a 3 hour test if that's abnormal) be changed to a standard, two hour test for everyone, that starts with a fasting blood sugar and is followed by a 1 hour and 2 hour check.  If any of those are out of target, you have GDM.  This recommendation was based on the International Diabetes in Pregnancy Study Group paper based on a lot of clinical trials, but primarily the HAPO study, and I was at the IDPSG meeting in 2008 that those recommendations come from.  The argument against this recommendation is that it increases the number of women diagnosed, but if you were one of those women (like myself) who would be missed with a standard screen, wouldn't you want to know? Wouldn't you want the chance to do everything possible to have a healthy child?

Ultimately, I will do anything I can to make sure this baby is healthy.  I'm very thankful that my postmeal sugars are fine right now, as I doubt I could follow the diet.  I am still so sick most days, and am still surviving on carbs with as much protein as I can tolerate (which isn't much).  But as soon as my nausea resolves, I'm following the GDM diet (though if my sugars stay good, I will allow myself cheats here and there!)  The less weight I gain now, the less likely I am to have high sugars later in pregnancy.  I hadn't really planned on watching my calories, and I guess I won't now, but the very act of rationing my carbs will end up limiting my calories somewhat.  And while I'm doing this all for Chimichanga, wouldn't it be lovely if I ended up weighing less after delivery than I did before?

Bullet Post

I think this might be the longest I've gone without posting an update since I started writing this blog.  It's not that I don't have updates, I just have no time.  So here's a bullet update, with no whining or complaining.  (Well, not much.)

• I had my third ultrasound last Friday, and Chimichanga still looks great!  I've been released to my OB...although getting an appointment with my OB has proved to be ridiculously difficult.  From refusing to let me keep my appointment last Tuesday ("What if something bad happens at your ultrasound on Friday and then we've done all that work for nothing?") to insisting that they get a full report from my RE - who doesn't do full reports, presumably because most people don't want DONOR EGG splashed all over their medical records.  I'm 11 weeks today and still don't have a new OB appointment scheduled.  At this point in my pregnancy with Finn, I'd already had my first trimester screening.  I miss my old OB.  I wonder if she'll break her ban on no more deliveries just for me?  (A girl can dream!)
• Thank goodness I'm a doctor, because I've already been monitoring my blood pressure and blood sugar, and was able to get one of my partners to write me a Zofran prescription.  (Who needs prenatal care anyway?)
• Zofran has worsened my constipation, but at this point, I don't care.  I can function during a good chunk of the day.  And sometimes even eat real food.  Well, protein and carbs.  Still no veggies.  :(  But still, I'm feeling better.  And that feels like a miracle right about now.
• Finn is a funny kid these days.  One of his favorite phrases is "I like ____" or "Finn likes ____".  Recent examples:
• "Mommy, what's that?"  "That's a mushroom."  "I like mushrooms." 
• "Go up hill! Finn like hills."
• "Want to eat On the Border. I like the border on there." 
• "What's that, Mommy?" "Those are orca." "I like orca. Orca eat Happy Feet." 
• I bought him a play kitchen and surprised him with it on Saturday morning.  Better than Christmas!  He is in love with his kitchen, and is very good at making applesauce, coffee, and refried beans with cumin.  Oh, and mac and cheese.  That's his favorite.

This week is a crazy week - out of town all day tomorrow to give a talk 3 hours away (I have a driver, so I'm watching a movie, and doing board review on the drive).  Work meeting one night and going to see Dave Matthews Band one night as a late birthday present from LB (will be taking an extra Zofran that day!)  I'd really rather just sleep the week away, but it doesn't look like that's an option.  

Mama Guilt

I was prepared for the first trimester to be hard.  I was not prepared for the guilt.  I feel so guilty that Finn watches an hour or more of tv every night, instead of going on an evening walk with me, helping me in the kitchen, or just hanging out together outside.  I feel guilty that I'm not as active playing with him on the floor or chasing him around the house.

I feel guilty that I'm not cooking meals, and I'm not eating healthy (unless you call baked potatoes and Bojangle's egg and cheese biscuits healthy.  And as of today, I can't do the biscuits anymore.)  I know how important a healthy diet is for the baby's health, and yet I can't stomach the thought of a vegetable right now.

I feel guilty that I don't listen to my pregnancy meditation at night with my hands over my lower abdomen, imaging the new life growing.  I really feel guilty that the most I think about this pregnancy is how bad it's making me feel, and how much I hope Finn will like being a big brother.

I feel guilty that I'm doing such a crappy job studying for boards.  I do NOT want to have to retake them next year, but at the rate I'm going, that's exactly what I'll be doing.  But I just can't focus, or manage to stay awake long enough to be productive.

I even feel guilty about complaining when I know I'm damn lucky to be 42 and pregnant with my second child, when so many are still trying for their first.

This shit is hard.  I know it's worth it - oh, it will be so worth it.  But right now, it sucks.  And I really wish I were married, or had someone who could help shoulder a little bit of the responsibility for just a little while.  But then I'd probably feel guilty about that, too!

Ok, I'm going to stop whining and go to bed.  Thanks for listening.

Ultrasound #2

This morning's ultrasound was perfect. There was that moment when I held my breath as I could see what looked like an 8 week old fetus come into view, and then as the tech zoomed in, I could see the little heart beating away. I breathed a huge sigh of relief, and got a little teary eyed as the sound of the heartbeat filled the room. My RE was able to be there, so he narrated everything we saw, including the now much smaller yolk sac, the placenta, the clearly visible femur and arm buds, and then, as we were watching, the baby moved! Not much, just a little head wiggle, but it was so cool! 

I have the day off today, and so does Nanny M, so Finn had to come with me to my appointment. My friend Lisa met us and held Finn during the scan - he did say "Baby!" when watching the screen, but I'm sure he didn't really get what he was seeing. I'm holding off officially telling him "Mommy has a baby in her tummy" until my last ultrasound with my RE in two more weeks. Then I'll feel comfortable telling everyone. 

I figured that placental hormone production must have really kicked in this week, because my nausea went from icky to awful. Waves of fighting back throwing up, and just plain feeling awful. I wasn't quite sure how I could survive feeling that bad, then an OB friend suggested less drowsy Dramamine. Wow, does it help. It's supposed to last 24 hours, but seems like it only really lasts for about 12, but at least I can eat now. I don't feel well by any means, but this level of queasiness I can handle. 

RBA called just a little while ago and confirmed my theory on placental hormones when the nurse told me I can cut my estrogen patches down to 2 instead of 4 - which is lovely, as I hate taking those things off! It always hurts, and takes me a few minutes to steel myself to be able to remove each one. (I know, I'm a wimp.) I also get to decrease my Crinone from twice a day to once a day - also lovely since Crinone is just gross. Hopefully decreasing these hormones will also help my nausea so I can stop the extra medication. 

While we were at my RE's, we walked past the room where I had my IUI with Finn. Of course, I couldn't miss up a photo op, and so I took his picture standing just inside the room.

My computer is once again in the shop (but this time covered under warranty) so I'm posting this from my crappy work computer.  No idea what's up with the font on this post!

Terrible Twos

I must have all my toys in the pool!

This is a terrible age.  And it's a wonderful age.  Sometimes in the same 5 minute span. 

Friday morning was a rough morning of epic proportions.  Finn woke up before 6am (we don't have to get up until 6:45).  "Good morning, Mommy!" For a few minutes he was content to play a game on my phone, but then, "I have to poopy, Mommy!" So up we went.  He sat on the toilet and while he did pee, there was no poop.  He then ran around naked for a little bit, but then came in to my room with his shorts and wanted to get dressed.  I had an idea.  "Why don't you put on underwear, instead?"  So he went to his room, got his underwear and managed to put it on himself.  (As an aside, I had no idea how exhausting it was to be with a child who wants to do EVERYTHING HIMSELF.  Even the things he can't possibly do.  EVERYTHING.) The epic struggle to put on his underwear with no help from mommy ended with a triumphant, "I did it!" a huge hug and kiss for me.

With a reminder that if he needed to poop, he should let me know so he could go on the potty, I got in the shower.  I got out of the shower to find my powdered eyeshadow all over the counter (and on Finn).  While I cleaned this up, I let him out on the porch off my bedroom to play.  I was putting on my makeup when he came running in, "I have to go poo!" I started to take off his underwear, and then got suspicous, reached out and felt his butt...yep.  There was poo. 

Have you ever tried to take underwear full of poo off a two year old?  It never ends well.  I got the underwear halfway down his legs and - plop - the whole big pile of poo fell onto the floor (conveniently on top of his pajama bottoms).  After I'd flushed that and wiped the poop off my arm and his legs, I sent him back out on the porch, with a strict warning to come back in if he felt like he needed to potty again.

But I quickly grew suspicious (running theme these days), and stuck my head out the door to find him peeing on the floor.  At least it was outside and I was able to clean it easily.  But that won him a fresh diaper and the end of running around naked.

In what I am sure was an act of defiance, he managed to open the bathroom closet door and get out some of his lotion.  Which he covered himself in - but only after dumping out half the contents of  a bottle of hand sanitizer all over the floor. 

At this point it was almost 8am.  Nanny M walked in the door as I was carrying him and his dirty laundry down the stairs.  I've never been so relieved to be able to hand him over to her as I was on Friday morning! 

Of course, he stood at the door and waved, yelling "I love you!" and "Bye-bye!  See you later!" and "Peace out!" while blowing kisses as I drove away. 


******

I'm still feeling pretty crappy.  Usually it's just a constant low grade nausea, but there's waves of much more intense nausea that hit at random times and just about knock me over.  I'm not a thrower-upper, so I've managed to avoid that so far, but I've come pretty close.  What really worries me is that I'm only 8 weeks tomorrow, so there's still a chance it could get worse.  I am lucky that while this nausea is a lot worse than it was with Finn, it's not debilitating, so while I'm not feeling up to doing much of anything, especially in the heat, at least I'm not lying on the floor unable to move for fear of throwing up. 

I've also been having a lot of spotting.  It's been pretty constant this entire pregnancy, but usually just pink or brown. Today it was more a dark red - still spotting, mainly on my Crinone (I know, gross) and not when I wipe.  Spotting can happen in normal pregnancies, but it's impossible not to worry about it, especially since there was a definite change today.  My next ultrasound is Friday and I'm trying hard not to feel anxious about it.  The second ultrasound seems to be the magic scan - if all is well with the second scan, then all will be well with the pregnancy.  (I know that's not completely true, but it does make me feel better.) 

I have also worried about how I'll feel about this baby compared to Finn.  Will I love him/her as much as I do Finn?  Will I feel sad that he/she doesn't share my genetics?  I've read before that your heart expands with each child, that your capacity to love grows as each new child is added to the family.  I'm starting to see that's true - the fear I feel when I think of losing this pregnancy is much more than the fear of having to do all this again, it's the fear of losing this little baby - this Chimichanga - that I've already come to love so much. 

Pre-scan Anxiety

I wonder, does anyone ever go to a pregnancy ultrasound - especially first trimester ultrasounds - without some anxiety?  I guess maybe my former nurse does, as she announced her third pregnancy on FB before the pee stick was even dry (and of course that baby is now and adorable 9 month old).

She wasn't nervous at all, and yet here I am, pregnant with an egg that's even younger than hers, and yet I can't stop worrying.

This week has steadily gotten worse with nausea - I usually wake up feeling fine, then feel worse and worse as the day goes on. I've eaten grilled cheese, egg and cheese biscuits from Bojangles (just about the only way I can get protein in), crackers and lots of ginger ale.  Then today at lunch I gave a talk and forced myself to eat some rice, chicken and grilled veggies so no one would wonder why I wasn't eating.  And by the time I'd finished with my talk, I was ravenous.  I went back to my office and had 2 black bean and cheese burritos and a huge pile of chips and cheese (leftovers from a catered lunch I missed), and then had 3 mini peppermint patties.

It was heavenly to eat and enjoy my food, but of course I also worried that this meant something was wrong, especially when I didn't immediately feel sick after eating so much.  I'm feeling a little off now, 7 hours later, and definitely not at all hungry, which is not normal, but still not sick.  Why can't I be happy I'm not feeling sick, instead of worried that it's a bad sign?

I've also had some slight pink spotting ever since before my BFP.  I know this is not uncommon, but of course I worry.  And then today when I wiped there was just a little more pink than I had been seeing.  Cue more worry.

Wouldn't it be great to be blissfully ignorant of all the reasons that a woman should worry during pregnancy?  Wouldn't it be great if I could stick to my plan of not worrying this pregnancy, and just sitting back and enjoy it as it comes?  Wouldn't it be really great if I'd stop worrying and start counting my blessings?

Less than 12 hours until my ultrasound.  I hope I can sleep tonight.

Beta #3

This is a bad idea...

I was overwhelmed by the responses to my post the other night - I felt so awful for losing my temper and popping Finn.  Everyone's empathy (and suggestions for other things to try) made me feel so much better.  Last night was another difficult night - Finn started kicking me when I told him it was time to get ready for bed (he was lying on the floor).  When I told him to stop he hit me, so I got up and walked away.  And it didn't phase him at all.  Then a little while later he was bringing me a book he wanted to read, and threw it towards me.  It didn't hit me, so he picked it up again and acted like he was about to throw it.  I told him not to throw it at me, but he did, and it hit me on my knee.  It didn't hurt, but it could have, so I was going to scold him (which never really works).  Then I had another idea, so instead I said, "Owwww!" and wrinkled up my face and started to pretend cry.  That worked wonders.  He dissolved into tears and came over to hug me.  He had to tell me he was sorry, and then kiss my knee and then we cuddled for a few minutes until he stopped crying.  I'm going to have to try that one again!

*****

My third and final beta was yesterday - 9510!  That's at 19dp5dt, so a good, solid number.
 Every piece of good news makes me feel just a little more secure that all is well.  My ultrasound is scheduled for next Friday morning, when I'll be 6week and 3 days.  I found out from RBA that I'll get a total of 3 ultrasounds, at 6, 8 and 10 weeks before I'm released to my OB.  I wasn't really expecting that, but am so excited that I'll have that many chances to make sure everything is ok during the time in pregnancy that I worry the most.

Parenting Fail

I woke up feeling nauseated on Saturday. It seems way to early to be nauseated, so I thought it was just a fluke, but it's steadily worsened to a pretty constant level of seasick queasy.  But otherwise I was feeling pretty good, until the fatigue kicked in today.  I remember how tired I was with Finn....I know this fatigue is going to get worse.  I've been really worried about that, and it's upset me more than I would have thought that it's kicked in so early. 

Cue tonight's parenting fail.  I came home worn out.  Finn had already eaten dinner, and was upstairs with Nanny M getting a bath.  I sliced up some sweet potato for my dinner and threw it in the oven to roast, then went upstairs to a little boy who was so happy to see me come home.  Nanny M and I visited for a few minutes, then we all came downstairs and I ate dinner while Finn watched Mickey Mouse. He had napped early today, and then spent the afternoon at the pool, so he was exhausted, too. 

My first mistake was probably taking too long to go upstairs, and my second was expecting that he was going to be sweet and cuddly and ready to go right to sleep.  Instead of sweet and cuddly, he was frustrating and defiant.  He wasn't really in a bad mood, he was just overly tired, and EVERYTHING was a fight.  He kicked me when brushing his teeth, he screamed for his stuffed Nemo when he was getting his diaper on (for the first of many times), he decided he wanted a snack and instead of asking, he immediately started yelling.  I couldn't get him to do anything I wanted him to do - at one point he hit me because I wouldn't let him play with the wet wipes.  I put him in time out, and he refused to stay.  I needed a minute to calm down just as much as he did, but he wouldn't sit in one spot on the floor.  Back and forth - once second he was screaming and fighting me, and the next he was sweet and funny.  All I kept thinking was how much worse these evenings were going to be as I got more and more tired over the next few weeks.  Of course, most evenings aren't like this, but I wasn't thinking about that.  I was envisioning months of misery.

Then I was trying to get his diaper back on after his last potty time before bed.  He was wiggling and fighting and hitting and about to bash his head on the door frame.  He flipped over with his little bare butt in the air - and I spanked him.  Not hard, my hand didn't sting, but hard enough that it made a noise. And Finn immediately stopped fighting me and started crying. 

One thing I said I'd never do was spank my child.  I'm trying so hard to break him of hitting, and I say over and over again, "We don't hit in this family."  And then I hit him.  What makes it even worse is that it worked.  After he calmed down and stopped crying, we hugged, we both said we were sorry, and he was done fighting me.  We had lovely storytime cuddles, he giggled with his favorite tickle book and gave me lots of kisses at bedtime.  He got out of bed once because he said he had to poop (he didn't) and after warnings of closing the door if he got out of bed again, he got back in bed and went to sleep, happily snuggling Nemo and Monkey. 

I feel so guilty for spanking him, especially since I did it with no conscious thought. I really need to find something else that works as well at getting his attention and snapping him out of bad behavior, because I just don't want to ever spank him again.  Any suggestions? As it is, I'm tempted to go upstairs and bring him to bed with me right now, just so I can snuggle with him and make myself feel better for my parenting fail.

Second Beta!

The nurse who called me back for my labs this morning was the same one who left me the message on Wednesday that I was going to get good news.  "I wasn't supposed to call you, but I was just so excited I had to!" she said as she gave me a huge hug.  Then another one of the nurses passed by and Libby called out to her, "Shannon has good news!" and so I got another squee and another huge hug.

I didn't have to wait as long for my results this time; just after lunch I heard from RBA, my beta has almost doubled from 251 to 495.9.  That's close enough to doubling for me!  I've got another beta next Friday, and I guess I'll get an ultrasound the week after that. 

I'm a lot less worried about this pregnancy than I was with Finn's, but I'm still feeling pretty cautious.  I didn't realize how cautious until I was talking to my mom about my plans to move next year, and she told me she thought I should wait to move.  "But if I have another baby, there just won't be any room at all."  I didn't realize I'd said "if" until my mom corrected me, "You mean, when you have another baby." I don't think I'm going to fully believe it until my ultrasound.  It's not that I'm worried something bad is going to happen, but that somehow there's been a mistake, and I'm not really pregnant.  Absurd, I know!  But I feel like I'm such a faker, that I'm not really pregnant, and we're soon going to discover that my labs and HPTs were mixed up with someone else's.

Though my heartburn is starting to make me believe that it might really be true.

My Birth Story

I wrote this in part while still in the hospital, and finished it this afternoon– my labor and delivery experience was so amazing, I don’t want to forget it, and I’m afraid that if I wait to write it out until I'm more rested and coherent, I will forget most of it.  A lot of the details are already fuzzy, so I can honestly say this isn’t an exact representation of events as they occurred, but it’s pretty close.  And be warned, it's a long one - feel free to skip this one if it gets boring!

Tuesday night before induction was a long, sleepless night.  I was still leaking a little fluid, but not having regular contractions, so my doula and I decided I should just stay home unless my contractions changed.  She suggested I check my temperature every few hours, to be on the safe side, and I decided to do both that and a check in with my doppler whenever I woke up to use the bathroom.  I fell asleep fairly easily, but then a huge thunderstorm blew through and I could never go back to sleep after that.  I spent most of the night tossing and turning, using my doppler repeatedly and listening to my labor and delivery meditations.  I was so relieved when my alarm finally went off and I could get up and get ready.

My contractions never picked up, so I didn’t go to the hospital until my 7am check-in time for induction.  Heidi drove me there, and then my sister Jamie met us at the hospital just an hour or so later, and my doula came up around 10 – I had a wonderful support team already lined up and ready to see me through the day.

I was happy when I got there to see that Stephanie, a nurse I knew, was going to be taking care of me.  Of course, it took 4 tries to get an IV in me, but once it was finally in at around 8:30, Cindy (my midwife) checked and I was dilated to 3cm and 50% effaced, so she broke my water (it was just a leak after all) and had me get up and walk.  Heidi, Jamie and I walked laps in the halls and I started to notice more frequent stronger contractions, but still nothing regular, about every 6-10 minutes. 

Me and Jamie walking the halls

My friend Liz stopped by around 11 just as we decided it was time to start pitocin.  The pitocin meant that I had to stay on the monitors and so I couldn’t walk the halls anymore, but I still was up and moving.  I went from the birthing ball to walking in the room, to sitting up in the bed, to standing leaning over the bed – doing squats and sways as I was able.  They let me have clear liquids for breakfast and lunch, even once the pitocin was started.  For future reference, beef broth is never a good idea, especially when in labor.  Yuck.  Gummi bears and Heather’s amazing chocolate chip cookies are highly recommended while in labor, however.  Just don’t let the nurses catch you eating them!

At first the contractions were regular but not too painful.  I was able to stay on top of them just by breathing through each one; visualizing that each contraction was moving my baby down, and giving myself over to the pain instead of fighting it made a huge difference in how each contraction felt. 

I’m not sure when Liz left, or what time another friend, Lisa came by.  In fact, a lot of the day feels very timeless.  I know I spent several hours standing by the side of the bed, as this seemed to progress things more than anything else.  The contractions gradually grew more intense to the point that I had to lean over the side of the bed whenever they hit.  I wasn’t comfortable, but it wasn’t unbearable or awful – I know just having the support of the women in the room with me made a huge difference.  At one point, Alex was on a stool behind me massaging my low back and applying counter pressure with each contraction, as Heidi massaged my shoulders and Jamie and Lisa held my hands and rubbed my arms.  

Lisa and Jamie

I was completely focused inwards, but I could feel their support around me holding me up.  We talked occasionally, with random funny exchanges in the middle of it.  A few of my favorite:

“Shannon, if you could find one word to describe your pain right now, what would it be?”  
Me:  “Ouch.”  

Jamie:  “Are you using that magazine as a focal point?” after I had been staring at the same article for over an hour.  “No, why do you want to read it?”  Jamie:  “Yes, I really do.”  (Ok, maybe you had to be there for that one, but it was funny.)

Me:  “One of my meditations talks about how the hormones in labor are similar to the hormones with sex, and references the close link between pleasure and pain.  Makes me wonder if labor is easier for women who are into S&M.”

Me and Alex

Like I said, time was very fluid, but I was so surprised to look at the pictures later and see that at 6:15 I was rating my pain a 9/10, with contractions every 2-3 minutes when the pitocin was at 17.  I no idea I had been that uncomfortable and on that amount of pit for as long as I was.  At some point I started to feel a lot more pressure, so Cindy checked me and I was only dilated to 6cm, but almost 100% effaced, and he had moved down, so we were a little encouraged.  Three hours later, I was starting to get really tired.  The contractions were getting much more intense – I threw up after one of them – but I still wasn’t feeling any change like he had moved.  I kept waiting to feel the overwhelming urge to push, but it just wasn’t coming.  Up to that point, I had felt in control.  But after a couple of hours of not feeling like anything was changing, except that the pain was getting worse, I went from welcoming each contraction as another step towards seeing my baby, to dreading each contraction and tensing up with each one.  So around 11pm I asked Cindy to come check me, so I have a better idea of what was going on.

At that point, we were all ready for me to start pushing.  Alex had coached Jamie and Heidi on ways to help me push effectively, and while I was feeling overwhelmed, they were energetic and supported me through the brief moments while waiting for the midwife.  When Cindy said that I was still only a 7, I almost started crying, I just couldn’t believe that all that pain had only advanced me another centimeter.  Instead of crying, I took a deep breath and said, “That’s it, I just can’t continue without an epidural.”  And I was ok with that decision.  I’d gone far longer than I ever imagined I could while on pitocin, so I didn’t feel like I was giving in, I was just accepting my limitations.

The epidural was blessed relief, but of course I had the standard reaction to an epidural with a huge drop in my blood pressure.  My nurse empirically gave me a dose of epinephrine (and based on how I felt, I told her I agreed with her decision – she laughed and told me to stop being a doctor).  I didn’t realize it, but I got another dose of that and two doses of neosynephrine, because when my blood pressure dropped, so did the baby’s heart rate.  I didn’t know what was going on until they came in with an oxygen mask for me, and asked me to turn over onto my left side.  My entire pregnancy I’ve been uncomfortable on my left side, and it turns out Finn didn't care for it either, since his heart rate dropped down to 90-100 when I was on my left.  They quickly turned me back onto my right side, and then decided that plus the oxygen and the meds had helped bring my blood pressure back up to the 140s, which then helped him, and he was back up to a heart rate in the 130s (after 7-8 minutes with a heart rate in the low 100s).  Alex pointed out that it was probably the knowledge that my baby was in distress that did it, not anything else, and she was probably right. 

Cindy called Dr. T to come in, and she checked me again while we waited.  After less than an hour with the epidural, I’d dilated to 9.  Dr. T looked at the strips and told me that he could go ahead and recommend a c-section right then, but since he was doing better, and I was finally progressing again, he thought it was reasonable to go a few more hours and see how I did, since I’d already worked so hard.  I couldn’t believe it – I was sure they were going to insist on a c-section, but instead they were going to let me continue to try for a vaginal delivery.

I was freezing, even bundled up under all the blankets I couldn’t get my hands warm, and I couldn’t stop shaking.  Someone suggested that I put my lucky socks on my hands, and that did the trick.  With warm hands, I was able to sleep.

Lucky Socks for Mittens

A few hours later, Cindy came back and checked me again, and I was still only at 9cm.  At that point, it was clear there was no other option.  I’d done the best I could, but my body just wasn’t cooperating, and it was time for a c-section.  The nurses all few into action, getting me ready (which included putting my lucky socks (the ones I wore for my IUI) on my feet, and Jamie gowned up in her cute white body suit, and we were off.  I was wheeled into the OR at 3:47am, Jamie came in a few minutes later and I could feel the pressure as they worked on getting him delivered.  A few random things I heard while they were at work,  “Oh, wow, he’s big!”  “Oh, he’s so cute!”  “Shannon, he looks just like you!” and from Jamie, “You should see the looks on the NICU nurses faces at how big he is!”  And then at 4:11am he was born!  As soon as I heard him cry I started to cry.  It was the most beautiful sound I’d ever heard.  Cindy held him up over the drape so I could see him for a second, and then the NICU nurses were cleaning him up, suctioning his mouth and cleaning up after his first poop.  Jamie stayed by my side, giving me a play by play until they told her she could go over and take pictures.  Finally they brought him to me and I was able to touch him with one hand and get a better look at him. 

Me and Finn

Cindy then came and held him for a minute so she could sing Happy Birthday to him, while I continued to cry.  I’m crying now just writing about it!  Once he was ready, Jamie was able to go with him back to recovery and hold him while I was closed up and cleaned up.  (Cool aside, my external incision was sealed with Dermabond, a glue, which means no stitches or staples!) 

When I was brought back to recovery, I was still dizzy from another low blood pressure, so it took a while before I was able to sit up enough to hold him, but we did put him at my breast right away.  He wasn’t too interested in latching on or sucking, but he did want to cuddle.  The nurses were so great at following my birth plan, in fact, they charted that they gave him the eye drops about 30 minutes before they did, so they’d still fall in that 1 hour time frame on paper, but still allowed me to take advantage of his newborn wakefulness and look him in the eyes.  They also held off on giving him his vitamin K until I was holding him, which is what I’d asked for. 

Holding Finn for the first time

We were finally wheeled back to my room, which was cleaned up and ready for me and baby, with Aunt Heidi anxiously waiting for her first look at Finn.  I really don't remember anything about those first few hours back in the room, and really most of the day is a huge blur, too.

One final picture - since Heidi took all the pictures except for those in the OR and in recovery, I have to add my favorite one of her and Finn here.  The wait for his arrival, the delivery and the first few days after he was born would have been almost impossible if she hadn't been here for me!

Heidi and Finn

My delivery was technically not what I wanted, but the experience was so incredible, and my OBs really worked with me to give me every chance to deliver how I wanted, so I’m not at all disappointed at how things turned out.  I really think my body knew that as big as he is, a vaginal delivery would not have gone well for me or for him – I really think that everything went exactly as it was supposed to happen. 

The Plan

Thank you for all the wonderful, thoughtful and informative responses to my post yesterday.  I woke up this morning about 5am and had a mini-breakdown – and then I read the responses on my blog and was able to get myself back together and go back to sleep for another hour or two.  Anxiety and hormones are a bad combination – I’m so glad I can turn to all of you for support!

When I woke up again, this time to get ready for my OB appointment, I was thrilled to see a little pink spotting on the toilet tissue.  And then I had to laugh – the very thing that would have sent me into a tailspin 30 or so weeks ago made me very happy this morning.  Crazy.

Heidi (who has been so amazing to give up her life for the past two weeks and spend them with me instead of her cozy NYC apartment) and I drove to my appointment, and first went in for the ultrasound.  He passed the biophysical profile with flying colors, but, since he’s running out of room, we couldn’t really get any good pictures.  His cheeks were about all we could get a good view of, and they are HUGE!  So is he – he’s measuring 8lbs14oz!  The measurement could be off by a pound or so either way, of course – let’s hope it’s an overestimate. 

The good news is that there is a least a little action going on with my cervix.  I was dilated to a whopping one centimeter, and while he’s not fully engaged, he’s definitely down more than he was last week, and my OB is pretty confident that he’ll be able to continue to move down (which is something she wasn’t so sure of last week). I did ask her about an elective c-section, but she said based on the state of my cervix, she would recommend we try for a vaginal delivery.  Having her say that is such a huge relief.

She gave me two options – Cervadil to ripen the cervix, which means that I’d get admitted tonight and put on the fetal monitor, or using a foley catheter (the catheter that is usually put in the bladder to drain it) to ripen the cervix and staying at home tonight.  Of course, I chose the foley.  I’d never heard of this before, but basically what they do is insert a foley into the cervix, and then inflate the bulb in the cervix to manually dilate it.  It was actually a LOT less painful that I thought it would be, just some cramping when she got to the end of inflating the bulb.  I’ve now got a lovely rubber catheter hanging out of my hoo-hoo – it’s awesome.

I’ve had quite a few irregular but very painful contractions since she inserted the foley – which has me hopeful that I won’t need the induction in the morning because this will be enough to really get things going.  I had an acupucture session this afternoon that was just lovely and am now sitting on my bouncy ball to further help things along. 

And, while I was writing this, I had a liquid that is definitely not urine come out of my vajayjay.  It’s either the fluid in the bulb, or my water just broke!