Personal: June 2007 Archives
You know, before I got pregnant, I promised myself that I would not become one of those pregnant women.
You know the ones, the ones who can't stop talking about their pregnancies. The ones who seem to think that there is nothing much that extends beyond the radius of their expanding bellies. I was going to remain able to discuss business, life, politics and crafting without having to refer to my "condition". Especially on my knitting blog.
So to those of you who have had enough of the my abdominally focused talk, I'm not going to apologize, but I am going to encourage you to take a pass on the post today. No knitting. All gestational. It's just where my head is at, and writing about what's going on in my life usually proves to be good therapy.
I'm beginning to get a little ambivalent about my pre-natal visits. On one hand, it's good to know that I'm getting good care, and that I'm being watched carefully so that we can all make sure that both Z and I make it to the finish line happy and healthy. On the other hand, being watched carefully often means that more things come to light than you really want to know about. Like glucose levels. Or cervical dilation.
So, this morning I headed off to the doctor figuring I'd more or less gotten past the big stuff to be worried about and I'd dealt with the idea of being confined to Chicago. I got a Bella Band last weekend that seems to be doing good things for me in terms of belly support and relieving some joint pain. It makes a girl feel more or less comfortable with the idea that she's going to have a nice routine visit and then get to head off on her own adventures for the rest of the day.
Queue up the ominous music...
Of course, this morning my blood pressure was high. High when I was sitting up. High when I was laying on my side. Not high enough to be considered high blood pressure if I was not pregnant, but, since pregnant women usually have lower blood pressure than normal, high enough to raise some warning flags. The OB I was seeing did the rest of my checks to make sure everything else seemed good, told me she didn't see any signs of me having pre-eclampsia, but also told me that when it came to things like this, it was better safe than sorry. She walked me down for an immediate ultrasound (the office has it's own) to make sure that the baby looked good and my amniotic fluid levels were right (both were fine -- perhaps the bright spot of the day was seeing the baby on US screen and hearing that she's the perfect weight and size for where she is supposed to be developmentally) and booked me a bed over in the labor and delivery ward of Prentice so that they could run some more tests to see what was going on.
And we all know how much I like hospitals.
But I got settled in there. John came from work to make sure I had company. Testing for pre-eclampsia isn't so bad. Mostly you lay in a bed with a fetal monitor and a contraction monitor and a blood pressure monitor. In my case, you get a very friendly nurse who shares your name and explains everything that is going on, and draws blood more painlessly than anyone who has ever done it before. And you get to have a couple of special urine tests for protein. And your husband feeds you water and juice and takes advantage of the wireless internet at the hospital to get some work done while you work hard at resting.
My OB visit started at 10... I left the hospital around 3:30. Apparently my baby has a beautiful heartbeat and activity level. My blood work is just fine. There's no protein in my urine by either the low or high sensitivity test. My blood pressure has not dropped to where it has been in the past, but its in the "mostly ok" range and it's relatively stable. All signs point to no pre-eclampsia. And that, my friends, is a very good thing. I to talk to my OB (so nice to see her and talk to her) about what could be going on -- and get a realistic discussion of what to worry about with the blood pressure. And I get sent home with instructions to rest and to collect my urine for the next 24 hours so that they can do a more conclusive protein study.
And so here I am at home. Trying to be restful until my return to the OB's office Friday afternoon. I'm not so good at that whole restful thing. And I'm concerned about the fact that my blood pressure is still a bit higher than will likely pass muster (we have one of those little home measuring units), because it implies a good deal of bed rest in my future as part of the management plan. I don't like confinement all that much. So while I'm happy about the lack of eclampsia concerns... I'm feeling a little concerned about what might happen if my blood pressure doesn't fall back into line.
So I'm trying to remember the most important thing... the small person who is growing under my heart. We're so close to the finish line (34 weeks), and in the great scheme of things, this is nothing. Just my own issues with not liking to be out of control of the world around me. So I'm trying to focus on listening to the fetal monitor earlier in the afternoon, hearing her little heart beat, changing ever so slightly when she moves. I've been told that maternal heart sounds are soothing for babies. But right now, it's her heartbeat that's helping me feel better.
I am coming into the home stretch with my stack n' whack stars. This is the 10th out of 12 blocks. It's my hope to get them all finished up this week so that I can get the quilt assembled before the Z Baby arrives. The quilt is destined for her nursery, and, in the interests of time, if I can get the top finished, I'm going to have it machine quilted by someone else. Just a few too many other things on my plate between now and her arrival. I'm happy with this completed block and think it embodies the "groovy" qualities of the fabric I started with.
As a follow up to yesterday's post, I just wanted to say that my trip to the OB's office Monday morning had a much better outcome for me than Thursday's trip. The fasting blood sugar levels were absolutely fine, the doctor expressed no concern over the fact that at this point the Z baby seems to prefer a head-up position and I don't have any signs of pre-term labor that would suggest that my bit of dilation is anything to be concerned about. In fact, exercise is fine as long as I don't over do it and it doesn't irritate my sciatica too much. I'm still not supposed to get too far from home, but that's a do-able restriction, since I wasn't planning on any real travel after June anyways.
Probably the biggest surprise for me with this visit was having the OB I saw today (amazing for the fact that her own baby is due in two weeks and she barely looks like she's started her second trimester) tell me that Dr. Serious had reservations about my condition due, in part, to what she felt was worsened sciatica (I assume because it suggests increased downward pressure on the nerves that might indicate the baby getting into position or my uterus getting active). She never mentioned this to me -- if she had, I would have happily told her that the sciatica was no different than it had been for the past couple of months that I've been dealing with it. I guess this falls into the "hazards of a large practice" place where my previous mentions of it to other doctors didn't get entered into my (what is becoming a very large) file, thus it appeared to be a warning signal and really wasn't It would have been nice to have this explained to me by Dr. Serious. Certainly it would have made for a better experience. Probably for both of us.
Timing is everything.
I've thought about writing this post three or four times. When I first started to think about putting it together, I was a distinctly unhappy camper. Today, my attitude is significantly changed. Whether that change is due to the passage of time or one of those magical growing up moments that still seem to sneak up on me and metaphorically whack me in the side of the head with a 2 by 4, I'm still not sure. But the net outcome is the right one, so I'll accept it either way.
It all started bright and early Thursday morning at around 10:30 AM (well, this is bright and early relative to me, anyway... I still have a bit more time before the Z baby changes all of that) at my OB appointment. I have to say, I wasn't really looking forward to this appointment all that much, because the OB I was seeing isn't one of my particular favorites (my primary OB is part of a relatively large practice that includes a number of OBs and the idea is to try to meet with them all a couple of times before delivery). She's not bad person or anything, she just doesn't have quite the right manner for me -- she seems to be one of those folks who wants to make sure you understand all the ramifications of everything, and gets a little too focused on the things that could go wrong. Just not quite the right mindset for me. Anyway.
Well, after the weight and blood pressure measurements (just fine), the first thing that happens at this appointment is the usual urinalysis and it appears that they are detecting some sugar that they don't like. So that leads to a blood glucose test (fortunately just one with one of those little meters diabetics use instead of a full on blood draw). It's still a little high (125 mg/dl), but probably inline with the fact that I had breakfast not too long ago, and between the cereal, yogurt, milk and dried cherries, I've probably eaten 25-30% of my daily carb requirement and I really haven't had anything to drink (I forgot my water bottle in my hurry to get to the bus to get to my appointment) or got very much exercise.
I don't think too much about this. After all, I've passed my glucose tolerance test with flying colors, and I figure since I have another OB appointment in 2 weeks, things can be rechecked then and probably everything will be fine. But the OB feels that I need to come back ASAP and have my fasting blood glucose levels measured again. She starts to pressure me about this. Could I come in next week? Do I have a glucose meter at home. And I can feel that little bit of panic rise. Well, I'd prefer not to, I just don't have that much time I can take off of work, I say. She frowns and sort of makes it clear that she doesn't think that that is the right answer.
So next we move on to the fun stuff -- measuring my belly, hearing the heartbeat, feeling the baby's position. The heartbeat is fine, but as she feels around, she frowns again and says This baby is in breech position. Now, this should not bother me. She moves constantly and she was head down when I had my last appointment. And I know that 32 weeks is too early to worry too much about baby orientation yet. But the way she says it has that sound of a warning message. And that raises the fear state just a little bit higher. She also takes this opportunity to make me feel a bit guilty for not fully registering at the hospital and having a pediatrician all picked out. But I can see the light at the end of the tunnel. There's only one more thing to do, and then I get to part company from Dr. Serious -- my travel check.
Now I almost didn't have them do one. I had one about 10 days ago (because I forgot about this appointment) and everything was fine -- for those of you who might not be familiar with what this is, it's basically the OB checking out your cervix to be sure you're not dilated -- and I hadn't felt anything that made me think this might have changed. No contractions of any kind I could detect. So I wasn't worried she was going to find anything and I was focused on the happy thoughts of getting out the office and on my way to Ann Arbor.
She does the check. She gets a strange look on her face. She checks a bit more. Looks back to me. This isn't your lucky day. I think you're about a centimeter dilated. I'm not going to put you on bed rest, *yet*, but I don't think you should travel.
But I was really hoping to go to Ann Arbor this weekend for Father's Day. And I haven't felt anything that feels like regular contractions. Is it really going to be a problem for me?
You're an adult, I can't tell you what to do. But I want you to come in first thin on Monday morning and be re-checked. And you can have your blood glucose checked at the same time.
And what happens then?
Well, possibly bed rest. Possibly hospitalization and steroid treatments.
By now I am beside myself. My mind is racing. I don't know very much about this stage of things, but I do know that I want Baby Z to stay put for a bit longer. Supposedly to get dilated I had to have contractions, but I haven't felt any contractions and a lot of the baby's motions are those big pushing on the uterus motions now. Could I be having contractions and not know about it? Bed rest? I'm not prepared for that. Hospitalization? Are there no "take it easy and we'll monitor the situation options"? Suddenly the issues with the blood sugar and the breech positioning combine with this to freak me out completely. And I start feeling like I haven't even had the baby yet and already I'm being a bad mother. My sugar is too high, she's not in the right position and I'm too inexperienced to know what a contraction is. The doctor leaves to take care of my paperwork and make sure I can get an appointment at short notice. I get dressed and continue to alternate between panic, frustration and being depressed.
About the only thing that rescued some of this morning was running into my primary OB as I was on my way out. She still told me she probably wouldn't travel, but also made comments to the effect that "a lot of women hold out okay" and "once you get a couple of weeks farther, we get a little less concerned". Not overwhelmingly re-assuring but better than "hospitalization and steroids".
So I head back home, get on the bus, hardly remember the ride and get home before breaking down completely while talking to John on the phone. I'm conjuring up all sorts of terrible things in my head. John, sweetheart that he is, offers to come home and work from home, and we both decide that maybe it's best to stay in Chicago.
Enter a close friend and the Internet. As I start to google my situation, I start to realize that a lot of women dilate and don't immediately go into labor. A good friend who just had a baby and also is a physician tells me that the first time they did this check at 36 weeks, she was 3 to 4 cm dilated and she delivered just past her due date and she had never felt any contractions up to that point either. She and my mom supply me with a few more examples of people who walked around dealing with the same thing and delivered when they were supposed to. I spend most of the rest of the afternoon with my feet up on the couch, feeling the Z Baby move and trying to determine if there are some motions that aren't really fetal motions but contractions. Nothing. But I do feel closer to my baby, get in a good nap and discover hat my feet aren't their usual level of swollen. So that all seems to be good. And I don't feel so panicked. But I still feel a little depressed about being in Chicago. I almost put this post together, but decide against it. I just feel too whiny.
The depression starts to subside by Friday morning, and I go to work, but the anger starts to set in. Now I'm completely torqued at this doctor. Torqued that she created such fear in me. Torqued at the insinuations that I'm not doing this gestating thing correctly. Torqued that I'm at work instead of enjoying a vacation day with my parents. And, of course, I'm still not feeling anything that even remotely smacks of what I've read of pre-term labor -- not that I want to, mind you, it's just that clearly the sky is not falling and it probably wouldn't have been a problem to travel. After a nice dinner out with John at our favorite brew pub I'm feeling a bit mellower, and think about putting a post together again. But I just can't get the bitter feelings to completely go away. My baby has been happy and active all day long. I hug my belly, decide I just don't have the energy to be bitter in electronic print, and enjoy some more time with my feet up.
With the start of the weekend and a good night's sleep (and a lot of helpful email dialog from my friend) I start to get some perspective and start to think about things. John and I have a couple of very nice days to do whatever we feel like because we didn't really have anything planned. I do some quilting and some knitting and some reading and even watch some TV. John gets set up for his first all grain mash brew. We pick up the Z Baby's crib. And through it all I'm taking it pretty easy, feeling for any sign of the Z Baby's possible early departure (and finding none) and being amazed by the fact that in spite of the heat I can see my ankle bones and the sciatica that has been bothering me is almost non-existent.
I even start to give Dr. Serious the benefit of the doubt.... I don't have to like her, or how she delivers information, but given all the problems OB's face these days with malpractice, I can sort of understand where she might be coming from. If something was really wrong, I wouldn't have been allowed to leave the doctor's office without any real restrictions besides staying away from travel and heavy labor. She's probably forced to do a lot of CYA maneuvers. Luckily, I don't have any more appointments scheduled with her. And I'm praying she won't be the one in the hospital when it comes time for me to deliver.
And after a weekend of close personal uterine monitoring, I've come to the conclusion that no matter how good the doctor, no one spends more time in my body with my baby than me. All my instincts right now tell me that everything is good. My baby is active and while I get a little fatigued, I feel incredibly good. I've been through one round where everything is clearly not good. I know what "not good" feels like. While I have no intention of ignoring a doctor's well considered and experienced advice, I also need to trust myself as well. No two pregnancy experiences and no two women are the same.
I have to admit, me being me, I still feel that I'm being a bit screwed by the system... if I hadn't had a travel check no one would have done this until 36 weeks and then if I was dilated, it wouldn't bother anyone unless I actually started to feel my uterus getting ready to hunker down and get serious. Better safe than sorry is probably a good mantra for me at this point, and clearly there is a more important goal here than simply being right, since a small, growing person is depending on me to take good care of her and give her the best possible start I can. I'll have my check early Monday morning, talk through some more things with a different doctor (one whom I like better) and try not worry too much unless there's something to really worry about. I'll be a good pregnant woman and stay close to home, try to put my feet up and take it easy while I look forward to meeting my daughter. Surely if there are no signs of impending labor, no one is going to tie me down to my couch. And, in the end, it is my choice. The doctor is right. I am an adult. I do get some voice in the decision making.
I called my dad Sunday night to wish him a happy Father's Day. I was sitting in the rocking chair he made me, which is now sitting in the nursery. It seemed like the right place to be. He told me a couple of times how much he's looking forward to the baby and how good he feels about me becoming a mom. That he thinks I'm going to be a good mom and the fact that I decided to stay in Chicago this weekend is just more evidence of how much I care about my baby. Mom's just aren't like regular people he tells me they're special. They know they have to focus on something else. You're being a good mom.
I love you, Dad. Only you could help me put it all together so simply and help me feel better at ease at the same time. I call you on Father's Day and you give me a special gift.
It was at this point that I felt good. And I decided to sit down in front of my computer, and tell another story.
