Tuesday, November 27, 2007

Placenta Non Previa!

The placenta's out of the way. No problems anticipated with a vaginal delivery. Baby's measuring 32 weeks 1 day (plus or minus seventeen days) which is pretty much spot on. He had a very full bladder and was resting with his face smashed up against the placenta.

I guess with this kind of news I can deal with the onslaught of relatives inviting themselves for the holidays.

And yes, you're all quite right. My sister's earned herself a gold star, hasn't she? I didn't mention this, but she also bakes the best brownies in the world, and when she does come to stay, she strips down her bed afterwards, puts the dirty sheets and towels in the washing machine, and turns it on before she goes.

Maybe she gets two gold stars.

Monday, November 26, 2007

Long, Detailed, Grouchy Rant

Dear Universe,

I realize you have granted me a normal pregnancy when I expected, and for a while seemed to be getting, a repeat of previous high-risk and/or early miscarriage pregnancies. For this, I am profoundly grateful.

Geohde mentioned "Sod's Law" in a comment to my last post. Not being from Australia (or indeed the UK), I have a rather vague idea of what this phrase means, but I do believe it roughly translates to "Murphy's Law" in Americanese. And so, I believe that the following disastrous confluence of events can be firmly attributed to either Sod or Murphy, whoever or whatever they were.

We begin on September 12th of this year. After inviting herself and my father to fly down and stay at our house for Christmas, my mother books plane tickets for the two of them. I am pleased to be having them come to stay, despite having no idea if at that time I will be (a) hugely pregnant, (b) mother to a premature infant currently in the NICU, (c) hospitalized for repeat preterm labor, or (d) devastated by a second trimester pregnancy loss. My mother comes to help and actually HELPS. She vacuums. She does the grocery shopping. She takes D out to the park so I can take a nap.

Quite soon after this event, my sister lets me know that my mother has also invited her to fly down and join the celebration. My sister, who is quite polite, asks if this is okay and makes it clear that she has other options if I'd really rather not, and that no offense will be taken. We laugh at my mother's lack of discretion at issuing invitations on my behalf despite items (a) through (d) above. My good humor regarding the holiday remains intact.

2 months pass. At some point during this period, I discover while in conversation with the two women I have become closest to since having D and moving to this area, that none of us are planning to travel for Christmas, and it occurs to me to invite them, their husbands, and their children (each almost exactly D's age) over for Christmas Day. (All of us settled here in Southern California quite far from all other members of our families.) Before issuing this invitation, I check with my mother, who has offered to do the bulk of the cooking (see items (a) through (d) above). Mom is all for it, and invitations are made and accepted. One family will be bringing their inflatable jumpy house to put up in the backyard to entertain the kids. I am content with the Christmas we have planned, despite the lingering uncertainly regarding this pregnancy.

The end of November approaches, and my husband's family apparently all think to themselves, "Gee! Christmas is coming! How can I irritate the shit out of May this year???"

Unbeknownst to me, my mother-in-law e-mails my mother (not me, but my mother) to see what plans my parents have made for Christmas. My mother delicately lets her know they will be staying with us. In a response to this news, my mother-in-law makes it clear (again, to my mother) that she is assuming that she and my husband's younger brother would be welcome to invite themselves at the last minute, and that indeed this is what she is planning to do herself, despite the fact that my brother-in-law has apparently made plans to visit his new grilfriend's family for the holidays. My mother-in-law claims to "help" and yet inevitably makes things ten thousand times harder. Plus, she drives everyone up the wall, which my husband feels especially guilty about.

My mother forwards me copies of the abovementioned e-mails, disavowing all knowledge of what they contain and saying the messages will self-destruct in twenty seconds.

H and I hastily confer on what's to be done. We decide (a) she's coming anyway, regardless of anything we might feel or say, and (b) at this point the best that can be hoped for is to avoid having her also staying in the house, on top of everyone else. My sister, ever polite, at this point changes her plans from staying at the house to staying at a nearby hotel. H and I decide to invite both his mother *and* her gentleman friend, making it unlikely that they will want to both sleep on couches. We also drop broad hints regarding limiting the length of her stay. (I should mention at this point this this week is her last at her current job, since her company has just been bought by another company and she has been laid off. She thus has oodles of time on her hands and no plans as to what she will be doing with herself, aside from "helping" me.)

My mother-in-law accepts without giving us any idea of when she might be coming or going. We still don't know.

My brother-in-law decides to invite himself as well, changing his original plans for the holidays. My sister (again, oh so polite and yet quite wily) asks me if she should e-mail him and offer to share the cost of a 2-bedroom suite, thus ensuring that he will not assume he is welcome to sleep on the couch. I endorse this brilliant plan, which seems to have failed when brother-in-law calls and broadly hints that he'd prefer to sleep on the couch, but he apparently picked up on the unsaid, and contacted my sister and agreed to her plan. He still hasn't booked anything, though.

My father-in-law (he and MIL divorced after 30-plus years of marriage) calls to laugh at me for the recent chain of events. He has made it clear to H in a previous call that he was going to make other Christmas plans due to what he thought was an obvious state of bad timing for us regarding Christmas. Having now learned that D's three other grandparents had invited themselves, he was clearly feeling left out. I told him at this point he wouldn't be making anything worse, and he was welcome to come if he wished. He will likely decide to come for one of his drive-by vists, involving Christmas Eve and Christmas Day only.

Now, universe, I understand you are mocking me. I understand you are enjoying yourself immensely. But how, exactly, did I end up involuntarily hosting Christmas dinner for SIXTEEN while 9 months pregnant? What did I do to you? And why on Earth can my mother-in-law not take a hint? She just invited herself out here a few weeks ago for D's birthday. I thought I was done with her for now. May I ask, please, that you inspire her to at least limit the length of her stay, or to let us know before the day of her arrival, when that arrival will actually be?

Sincerely,

May Problem Uterus

PS Tomorrow's ultrasound is supposed to reveal whether or not I'll be undergoing a scheduled C-section for a low-lying placenta at 36 weeks. 36 weeks is December 23rd. Ha freaking HA.

PPS Please stop messing with me.

Sunday, November 25, 2007

32 Weeks

He's got the hiccups. I'd forgotten about this part.

With D, hiccups were annoying. She invariably had them when the nurses were trying to get an hour of contraction and fetal monitoring data for my chart. It would add 20 to 30 minuites to a process that was already occupying about a third of my waking time every day and required me to lay very still in exactly a certain position and made my back, already unhappy from weeks in bed, even crankier.

This time, it's just hiccups. My belly has the hiccups. 32 weeks. Wow.

Cervix holding strong. Dr. Favorite mentioned the words "induction at 39 weeks if you're feeling really uncomfortable" at my appointment last week. Induction! Me!? Hmph.

I am so incredibly fortunate.

Saturday, November 10, 2007

30 Weeks

Who can believe it? 30 weeks and going strong. For comparative purposes, I haven't been in the hospital for 5 and a half weeks. I'm not on IV magnesium sulfate, terbutaline, indomethacin, and nifedipine. There isn't a midline catheter in sight. I can take as many showers per day as I want. I think I'm actually contracting less than I have been recently. I'm even going nearly three weeks between OB visits. (It's supposed to be 2 weeks, but H just left for a week-long conference in Orlando, so I'm waiting to go in again until he gets back. Let's hope that decision doesn't come back and bite me in the ass.)

What I can't even begin to fathom is why I'm not thrilled. I think the realization that this pregnancy may actually work out just fine is bringing home an unexpected reality-- I'm going to have two children. Two. Yikes. And since I don't know the second one yet, I'm only able to think about what this is going to do to the first one. Why the hell do I feel like I'm ruining her life?

Mostly, though, those thoughts don't occupy my day. Mostly it's counting down the days until the end of the semester. Or dealing with the recent epidemic of family members inviting themselves to our place for Christmas. So far, the following people have invited themselves: my mother and father (who also invited my sister), my mother-in-law and her gentleman friend, my brother-in-law, and most recently my father-in-law. Including us, that makes 10 people.

We have a three bedroom house. If I'm still pregnant, I'll be 36 weeks and cranky as hell.

Sigh.

Thursday, November 08, 2007

A guest blog entry, bought to you by the Great Blog Cross-Pollination!

Hi there! May and I are swapping posts for the day, courtesy of Geohde’s Inaugural Blog Cross-Pollination. I’m not from these parts – actually, I’m not from this hemisphere. Downunder with the crocs and Opera House is where I live, and no, we don’t have kangaroos jumping down the street. (Well, not in the cities anyway).


May and I have something in common – we’re both “up the duff”. I have one beautiful son who turns six very soon. Over the last few years, hubbie had a vasectomy and bout of chemo. After I underwent a particularly lovely round of IVF - voila …. preggers!! (Sounds so easy). Just out of the first trimester, I can’t WAIT for my next scan, to see the baby looking more … baby-a-fied.


I’m a freelance writer, redhaired, slightly psycho recovering alcoholic who can’t believe her luck that fertility treatment worked on the first try. Can you guess who I am?


After you’ve left your guess, feel free to click HERE to view my blog.


Thanks!!

Wednesday, October 24, 2007

We're Home and Safe

This is a crazy place to live right now. Everyone's off work pretty much for the week. My college as well as my husband's are closed all week, although H is physically located at a company near his college that was partially open for business today, so he went in for a few hours, mostly I think to have computer access without being disturbed by our cabin-fever-ridden 2 year old. I have revised my syllabi and e-mailed all my students our new schedule after missing this week of classes, so my work is done.

Instead, we're all glued to the internet. It has proven to be a much better source of information about the fires than the TV. I'm particularly fascinated by the maps. The San Diego County Emergency homepage has been publishing maps every few hours showing burned areas, evacuated areas, etc. with giant red dots over the areas of active burning. The whole thing is overlaid with the Thomas Guide coordinates so you can really follow what's going on. If you look at one of them (go to http://www.sdcountyemergency.com/ and click on one of the blue links for Countywide Fire Map Perimeter) you can get an idea of how close the fire came to our house. Without posting my home address on the internet for all to see, I'll just say that the fire came within half a green-outlined rectangle-height of us. Yeah.

I can't bring myself to watch the TV footage of people returning to their burned-out home wreckage.

Other than that, it's kind of like it was right after 9/11. No one can really bring themselves to pick up the thread of everyday life again, but this persistent state of limbo is feeling stale. We can't go outside, because the air quality is horrible. This is particularly bad for children, who are understandably uninterested in sitting around inside all day while Mom and Dad sit at their laptops with the TV turned to the news in the background. I've been pretty creative with entertaining D, but she's definitely picking up on the tension in the air and is completely and totally attached to her blankie (her lovey/transitional object). She is very clingy and not wild about the disruptions to her routine. I have no idea what to do with her tomorrow. We're supposed to be staying off the roads to keep them clear for evacuations and emergency crews, but I'm hoping that eases up a bit tomorrow so I can take her somewhere. All I can think of is the mall, but (1) many of them are outdoor malls in this part of the country, (2) the nearest one is pretty close to an area still under mandatory evacuation, (3) I bet every other parent in the county has had the same idea, and (4) if I walk any distance I start to contract heavily. I'm going to continue to brainstorm.

In other news, my brother and his wife are at an injection class this evening for their first IVF cycle. I want this to work for them so very very much. Those of you readers that are IVF or stim cycle veterans-- what would be the best thing the stereotypical pregnant sister-in-law could do for them? Send flowers? Some sort of thoughtful gift box? Keep my mouth shut? My brother's wife started birth control pills this week and progresses to Lupron injections at the end of the month. I was considering sending flowers near their retrieval time but now I'm wondering if that's the best plan. Any assvice welcome.

Monday, October 22, 2007

Cities On Fire

Well, apparently Southern California's current state of being completely on fire has made the national media. At least, judging by the number of phone calls I have received today.

I was awakened at 4 AM by my neighbors knocking on my door, wondering why there weren't any lights on in our house. Everyone else was packing up. The police and their bullhorns had issued mandatory evacuations to homes just a few blocks away and the street behind our house was cordoned off. They were encouraging everyone to get out and not letting anyone back in.

So, we packed up and left. We're staying with friends about 20 minutes away from our house. Now we're wondering if this house will also be evacuated. It's going to be a long night. But, we're all safe, we had enough time to pack irreplaceable items into the cars, and we can move further away at a moment's notice.

Mr. 27 weeks is well. We "modeled" for a conference our perinatology office was holding on Saturday to teach a bunch of nurses and physicians specialized ultrasounding techniques, so I have a nice new crop of pictures. He was too smashed up against the uterine wall for my promised free 3D ultrasound, but we had a good time. My cervix still looks excellent. And we have very convincing photographic evidence of his... erm... manliness.

So, for now, just keeping my fingers crossed that our house doesn't burn down.

Monday, October 15, 2007

Better (Warning: Contains Gushing Over Daughter)

Apparently a lot of my recent anxiety had to do not with the status of Mr.-26-weeks, but the status of my 2 year old, who had outpatient surgery today. It went very smoothly (her surgeon was AHEAD of schedule) and we're all now home and recovering.

I feel much better, about everything. D was such a trooper. I'm so proud of her. She didn't shed a single tear. The nurses brought us back to meet her in the recovery room and she was just sitting there, clearly thinking "How did I get here? Where am I? What happened to the big Sleeping Table with the Strawberry Mask and Mommy in a hairnet and scrub suit? What's this tube going into the back of my hand? Why do I feel so weird?" And then we showed up, she thought briefly about crying, and we reassured her that all was well and so she kicked back and watched "Pink Elephants on Parade" from the Dumbo DVD playing on the TV. (Great choice for those coming out of anaesthesia, don't you think?)

Her nurses liked her so much she got not one, but three new stuffed animals. This was much better than previous surgeries.

Whew. Off to unwind with some suitably mindless television.

Saturday, October 13, 2007

Hiding Out

Still here... just in my cave. Who started the cave... was it Tertia? Anyway, I've got about 6 posts half-written, and they all degenerate into whininess, so I'll spare you.

26 weeks tomorrow. 15 days to go until our first big milestone. I cannot wait.

Wednesday, October 03, 2007

For Electriclady

Phew! What a relief!

A complete and total false alarm. Dr. Favorite (my first appointment with her this pregnancy! At last, at last!) said I was the third patient this week to be diagnosed with low fluid levels by the ultrasound people, only to check out perfectly fine in the OB office. So, the usual warnings... stay hydrated, try and rest more, she asked what my lecture schedule was like these days and made sure my department was "on alert" that I may just not be able to turn up for class one day (and yes, they know...) and she asked how we were holding up.

Well, and there's that. How are we holding up? It really depends. You can ask, and we can answer, but 5 minutes later the answer may be the complete opposite. It only takes the smallest thing and H and I completely lose our grip. Deep down, I knew from the minute I heard the technician yesterday talking about low fluid levels that it was probably nothing. I'd had an upset stomach the previous day, and maybe I was a little less hydrated than usual. I also knew, deep down, that it was probably all fine again this morning when the OB office called. And yet, I was a basket case the whole day. My body was trembling from the huge volume of adrenaline I dumped into my circulatory system. I checked H's pulse while we were waiting in the exam room, and it was 110. The look of panic on his face when I told him the OBs wanted us to come in today was terrible.

We really need to find a way to get a grip. And yet, tomorrow is the exact gestational age where things collapsed with the pregnancy with D. Maybe that gives us the right to be a little fragile this week? I don't know. I just wish I could keep it together a little bit better. That may have to wait until we get past 28 weeks. But, for today, all is good. Several large pockets of fluid. Cervix long and closed. Growth is right on where it should be. The kid kicks constantly. Even my wieght isn't out of control. Why do I keep waiting for catastrophe? Can't I just enjoy this?

I wish I could have a glass of wine. I guess I'll do the next best thing and go soak in the bathtub with a Dick Francis novel.

Trying not to panic

My OB office called. They got the report from the ultrasound after the radiologist looked at it. They seem rather concerned about the fluid levels. We are going in right now to get checked again.

I've got my emergency hospital bag (whose existence has been unknown to my husband until now) and the phone numbers of people at work to call if I get hospitalized. D is napping at my friend's house. Please please please let this be nothing.

Tuesday, October 02, 2007

Whew

It's been a bit of a week.

D turned 2. We had a party. It was fabulous, but exhausting.

My mother-in-law came to stay for the weekend and the party. She brought her "gentleman friend" of a little over a year to stay as well. It was hilarious watching this completely creep out my poor husband. I'm delighted that she's seeing someone. She still drives me nuts, but I believe that's the main item in her job description as my mother-in-law. (Note: where can I see a copy of said job description? I'd like to know what to expect next. After reading incoming text messages on my cell phone, of course, which did indeed happen this weekend.)

Monday D had her 2 year checkup at her pediatrician's office. They have confirmed what I already knew: D is huge. She is back on the height chart (after the incident of the 100th percentile), but they confirmed what we already knew, which is that she's an inch shy of being the same size as the average three-year-old. Well, she's always been this way, so no worries. Quite an accomplishment for my little not-quite term child.

Today was the follow-up level 2 ultrasound on little gizmo. Now weighing in at an estimated 1 pound, 9 ounces. They were able to get the cardiac views we didn't get last time, and also checked in on those wacky non-cooperators, the placenta and my cervix. The cervix is maintaining champion status, remaining longer than 4 cm, while the placenta is still marginal, but with time remaining in which it can get the hell out of the way (we hope). The technician thought the fluid volume looked a bit low, so another item to add to my worry list, but all in all a good visit. We'll get the official report in a few days, I hope, or at the very least hear about it at our next OB visit next Tuesday. We're 2 days away from 24 weeks 4 days, which is where everything went crazy with my pregnancy with D, so we were relieved to see absolutely no sign of preterm labor or a funneling cervix. I woke up in at 4 AM this morning with what felt like menstrual cramps (note: this is a sign of preterm labor) but I was able to go back to sleep knowing that I was due for an ultrasound at 10AM anyway. Today: no cramping and only the normal level of contractions, so I am calm(ish).

Thursday, September 27, 2007

Good

All is well, cervix excellent, mother-in-law visiting... I shall attempt to write more once she goes away.

The cervix looks good. Man, I am so happy. Even my mother-in-law can't dampen my spirits, and that's saying something.

Tuesday, September 25, 2007

The Madness Continues

I'm cleaning my oven. Yeah, you heard me right. I've never cleaned an oven in my life. And yet, here I am. I've really gone 'round the bend.

Note: apparently the oven in our current house is "self-cleaning." There's a button that says "clean" and so I pressed it. 30 minutes in, all the gunk on the bottom of the oven has burst into flame. Is this normal?

I am really in pregnancy-distraction mode. And yet, I also followed the link from Mel's blog over to Meg's blog and read through all of her archives, ending on the post announcing her third second-trimester stillbirth. I cried. How heartbreaking. I so wish that none of us had to live through any of this crap. I'm angry at the world, and yet in a reasonably upbeat mood at the same time. How is that possible? Maybe I've already gone 'round the bend.

Next cervix check: Thursday morning. I'm contracting like a madwoman over here. Let's hope this cervix is still behaving as if it's made of stainless steel.

Speaking of which, I also cleaned the front of the kitchen appliances with stainless steel appliance cleaner. What's wrong with me? I'm not like this. Really. My idea of housekeeping is to wash a load of laundry and dump it on the bedroom floor. I suspect this weekend's upcoming visit from my mother-in-law is somehow involved.

Wednesday, September 19, 2007

Energy Burst

I've been going crazy around this place. The following unusual activities have been sighted around my house:

1. Vacuuming and mopping
2. General tidying
3. Organizing of the garage
4. Cooking that doesn't involve moving something from freezer to oven or microwave
5. Laundry has been both folded and put away in a timely fashion

I think I am enjoying the freedom that comes from having a child old enough to not be held or closely watched all the time. We can get out of the house, run errands, go to social events and even manage the occasional restaurant experience without anyone pulling out all of their hair. I have enough energy to get me through the average day without completely crashing. This state of affairs has taken two years to achieve.

I'm starting to think that these days are more numbered than I thought. Whatever happens, they will definitely be gone come January. (This frightens me, but is a topic for another day.) As my contractions seemingly intensify and also occur over a larger part of the day, I'm wondering more and more what the next cervix check will bring. I am very hopeful that my feelings from last time prove true (that I'm just a person who contracts a lot, and without that precipitating bleed from my pregnancy with D, my cervix is fine with this). But, I am also very afriad that the next few weeks will bring me an order to stay in bed for three months. I don't know if I can do that again without losing my sanity. I am terrified. I'm not sleeping well. I'm afraid to confide my fears to H because he's already so very anxious himself.

And so I'm ignoring these fears, to the very best of my ability, and getting things knocked off my to-do list at an astounding rate. If this keeps up I may unpack some of the boxes in the garage from when we moved into the house, 2 years ago.

Well, then again, let's not get crazy. If I haven't needed anything in there in 2 years, perhaps things are best left as they are.

Thursday, September 13, 2007

Whew

42 millimeters. Yeah, baby! Now I have 2 weeks in which I can work myself into a whole new panic. For now, I am much relieved.

Surely there's a warehouse store somewhere where we can go pick up a 2-pack of kids and avoid all this pregnancy crap?

Wednesday, September 12, 2007

Hiding in My Hole

I can't blog. I've gone from over the moon ecstatic and optimistic, to terrified of what tomorrow's cervical measurement will bring. We're right in the middle of where things tanked with my pregnancy with D and I am not handling it well. I'm contracting all over the place and H is nervous and his anxiety is rubbing off on me. Which is weird becasue deep down, I really am starting to think that I am just a woman who contracts a lot while pregnant (my mother says she was the same) and the thing that made that matter when I was pregnant with D was the subchorionic bleed, which by all accounts was a fluke and unlikely to recur this time around.

I know that makes no sense. I need to go to bed. Tomorrow we'll know what's up in there. Then I get to go give my lecture students their first exam of the semester. Giving an exam is much easier on me than lecturing for three hours. I really hope everything goes well tomorrow. It feels like a particularly crucial checkup to me. Maybe that's because at 21 and a half weeks, we really are teetering on the brink of viability here.

Long cervix. Long cervix. Breathe. Breathe.

Monday, September 03, 2007

Doh-dee-doh-dee-doh

I don't have anything in particular to say but I feel like I should post. So, perhaps we'll do bullet points today.

--It's hotter than hell here. All of Southern California is having "unseasonably warm weather." Unseasonably warm my ass. It's a friggin' sauna. And I've got this thing squirming around inside my uterus. I don't think crabby and grouchy are strong enough words to describe my mood. I do not handle heat well.

--I'm having a hard time adjusting to the idea of this child, if born safely, being a boy. Which is odd, because I had really thought D was going to be a boy and I had to get used to the idea of her being a girl. Now I'm mourning the loss of her potential sister. Go figure. H has picked up on this and is afraid to express excitement over our potential son because he doesn't want to upset me. That poor man. I don't know how he's going to tolerate me if I keep this up.

--We bought a new car on Friday. A family car. My teeny convertible got me through one kid, but even I could see we needed something bigger. My husband loves it. I'm ambivolent. Friday was an expensive day.

--Yesterday I hit 20 weeks. Halfway to the mythical 40 weeks of a "normal" pregnancy. I'm on the downhill slope of this one. Of course, I have not failed to note that I am now past the last point in my pregnancy with D where my cervix was well-behaved. They measured it on Friday at 41.9 mm so now we wait and see if things are headed down the same path as with D. Oddly enough, now that we're into the preterm labor danger zone, I am calm. 20 weeks is still too soon for viability. I think I'm going to lose my grip when we get into that area where the baby could survive but would likely have major problems. 24 to 28 weeks is going to be hard for me.

--I made my first new baby purchases (besides the car, of course). I carefully read and considered all return policies. I got a pouch (I hated my old sling) and some new and improved bottles. I find it odd that right as we enter my personal pregnancy danger zone, I feel comfortable enough to buy things. I am insane.

--My next appointment isn't until the 13th. I don't know what I am going to do with myself until then. I'm no longer supposed to do anything active in the evenings (this is when I tend to contract). Other than that, I am to use my own judgement.

--Oh, and we checked out double jogging strollers today, too. The one I like is $530. Um, I'm sorry, but that is INSANE. I will now haunt Craig's List in the hopes of finding one used for a sum that I am willing to part with.

I'm sorry this post is so lame. I've been putting off posting all week due to the heat and my associated mood. Maybe I should have kept that up. Oh, well. I'll try and sleep and hopefully things will be better tomorrow.

Monday, August 27, 2007

But, wait! We're totally unprepared for GOOD news!

We had our level II scan this morning. Or the mid-pregnancy ultrasound. The Big One. The only ultrasound many people get.

We got into the room (FINALLY 45 minutes past our appointment time... my bladder was very very angry) and the technician asked, "Is this your first ultrasound?" I managed not to fall off the table while laughing. Um, no. This would be... let's see.. this pregnancy? Number... hmm... twelve? Yeah, I think twelve. Ahh.

Heart... check. Beating. Ventricles. Atria. Valves. Aortal arch. Head. Present. Appropriately sized. And so on. Our main concern was, as usual, what was going on at that pesky place where the placenta had set up shop on my twitchy and uncooparative cervix. Cervical measurments both transabdominally and transvaginally were 3.9 cm and above. Excellent. And... wait for it... the placenta is NOT sitting over the cervical os! Can it be? Placenta previa no more???

Official diagnosis: marginal low-lying placenta. Mostly on the left. That sucker MOVED, people. It's still too close for comfort were I to be delivering today, but I've got plenty of time for it to creep over a few more millimeters. I can't believe it.


And oh, yeah. That girl we thought we were having? Let's just say there's... tissue... between the legs. This kid's a BOY.

I'm so happy.

Friday, August 24, 2007

Contracting Away in Southern California

Seriously, isn't it a wee bit early to be having all these contractions? The new semester started this week and I was on my feet a LOT. I lecture three hours Thursday nights and then teach a three hour lab on Friday mornings, where I'm either lecturing or wandering around helping the students with their lab work. My uterus had a field day. I'm going to have to bring this up at my appointment next week.

Next week is pretty appointment-heavy, actually. Monday is the big level II ultrasound at the perinatology office. Baby organs and placenta will be minutely inspected. I'm so focused on what the placenta will show that I've almost forgotten to worry that the ultrasound will turn up some other kind of problem with the baby itself. (Herself? Himself ? I should just pick one and go with it.)

Then Friday is my normal cervix check at the OB. Wednesday D has a checkup with her eye surgeon. (Have I mentioned D's eye issues here? Probably not. Anyway, she's got lots of doctor appointments of her own.) The fun never stops around here!

I am relieved to have the first week of classes under my belt. I tend to get myself pretty worked up before the new term starts, and then I get through the first week, remember that I both enjoy my job and am good at what I do, so I unwind a bit and it's all fine. I did have a conversation this morning with the former department chair. He just finished 2 years as department chair. So, at the start of his term he just missed having to deal with my abrupt disappearance midway through the summer session when my pregnancy with D went crazy, and at the end he just missed having to deal with the possibility of it happening again this semester.

What did happen with Former Department Chair was that he neglected to include me in the e-mail that went out last spring organizing who was going to teach which classes this fall. In his defense, I was moonlighting for a different department last spring while one of their full-timers was on sabbatical, so I wasn't officially teaching in his department that semester and I just fell off his radar. Anyway, by the time this was discovered, he had to do a lot of scrambling to find a lecture and a lab for me to teach. He managed it in the end, but it took a long time and a lot of e-mails back and forth. I didn't end up with times that I liked, we had to switch around D's daycare, etc., but we worked it out.

So this morning I ran into him and his wife in the faculty parking lot. I should mention that they are in their late forties, are childless, and he's mentioned that they had issues of their own in the childbearing department. So, I think they would have liked children but it unfortunately did not happen for them. He didn't know I was pregnant again until he saw me today. He made a comment about how he'd gone to all that trouble to arrange classes for me to teach and now it looked like I may bail partway into the semester again and leave everyone else scrambling to cover my classes! I laughed it off but I was rather upset. I do hope he realizes that we have not made the decision lightly for me to continue teaching this fall. We've asked our doctors repeatedly if they think it's a good idea and they keep telling us it's fine. Anyway, I let it go with the former chair, but it still rankles. Maybe I'm just being overly sensitive and cannot take a joke.

I'm very, very glad it's the weekend.

Wednesday, August 22, 2007

Night of Panic

Every night I wake up at around 2:30 AM with a bladder that's simply bursting. I go and pee, get back in bed, have a few contractions as my uterus resumes occupation of the space my bladder was hogging, and after a while spent trying not to dwell on those middle-of-the-night negative thoughts, I eventually go back to sleep.

Last night all went as usual until I got back in bed and took note of the expected contraction. It was crampy. Not a painless tightening like I'm used to, but the ouchy kind that sets off alarm bells. This went on for some time. So, I lay there, engaged in my normal mental debate. Should I wake up H? Should I call the OB answering service and have them page the on-call doctor? Should I go to the hospital and get monitored at triage? Who should we call in the middle of the night to stay with D if H needs to drive me to the hospital?

I'll skip to the end and say that eventually a small rational voice in the back of my head piped up and noted that (1) pregnant women tend to get, erm, well... backed up, shall we say? and (2) previous experiences of this nature have been resolved when nature and my large intestine managed to work things out amongst themselves. I calmed down, eventually relaxed enough to go back to sleep, and this morning step (2) above indicated that indeed, this was what was going on.

The experience has reminded me how much safer I feel in the hospital when having a terrifying pregnancy. You're constantly being watched, monitored, ultrasounded, poked, prodded, blood pressured, etc. One of your doctors checks in on you every single morning and asks if anything new has come up. In the middle of the night, a nurse would be just a few feet away to strap on that contraction monitor in the above situation and either tell me everything's fine or administer an injection to stop the contractions. (Ahh, terbutaline... how I love to hate you...) All of the pressure to keep the pregnancy going is taken out of your hands entirely. And while I cannot emphasize the lousiness of hospital bedrest in strong enough language, there is indeed the advantage of having the responsibility removed for deciding what's a subchorionic hematoma causing preterm labor, and what's, well... constipation.

18 weeks and 3 days. Sigh. How far I have yet to go.

Monday, August 20, 2007

Better but Outed

OK, so the back thing has mostly resolved itself. Whew. I took it really easy all weekend and I'd say I'm back to about 95% today. Bullet: dodged for now. It makes me very nervous for the future, though. I am going to have to be really careful.

Yesterday one of our next door neighbors knocked on our door and said they were having an appetizer party in the evening in the street. It actually wound up being in our driveway. It was pretty cool. Lots of people came and brought a plate of something to snack on and something to drink. We've all lived here 2 years now (it's a new development so we all moved in at pretty much the same time) and it was nice to feel like we're becoming a community. It went quite late. We put D to bed and then just brought the baby monitor out into the driveway with us so both H and I could go.

But, I've now been outed to the neighborhood. One of my neighbors knew about the pregnancy and asked if it was okay if she told people, and as I was sitting there drinking water with my belly sticking out of my maternity shirt I figured we weren't going to be able to stay in the closet much longer, so I said okay. Then it evolved into a "why on earth aren't you telling people if you're 18 weeks?" conversation so I got into details of some of the complications with neighbors I don't know well, and I got all defensive and strange about it. Sigh. Well, at least it's done. Several people were really rather sensitive and empathetic, which was nice.

Life with D has been challenging of late. She learned how to get out of her travel crib while we were on vacation, and this skill has translated to her normal crib here at home. So, the sleeping isn't going very well, which makes everyone crabby. And she has become very possessive of me, which is both endearing and frightening for me, if indeed she does end up needing to share Mommy with a little sister/brother. I am getting more worried about this pregnancy as we approach the stage where things went wrong with my pregnancy with D. I am trying to focus on the fact that for now, my cervix looks long and closed, and that they're watching it closely enough so that if things go wrong again we should be able to manage it more effectively than last time.

We got our first baby gift for this new one and I realized I have done nothing at all to prepare. The office is still completely an office. I looked at double strollers a few times and then decided I was jinxing myself. So, this gift for the new baby is sitting at the top of the stairs, just looking at me. I need to decide if I want to assume we're likely to get a take-home baby from this one and get ready now, since realistically there's a good chance I'll be spending some or all of the later part of this pregnancy either in bed or in the hospital, or at the very least with some serious activity restrictions. It still feels too soon for me though. I guess it's time to suck it up and try and act optimistic. I really don't want to have to live with an empty nursery though. Nor do I want to have what happened with D's room... no chance to prepare, so no nursery really. To this day it's just a room with a crib, a dresser, and a rocker in it. We never decorated. We never got her a bedding set, just 2 solid fitted sheets for the crib. No cute bumper, nothing on the walls, etc. It would be nice to do the normal expectant parents nursery prep this time. My heart's just not in it, though. Hmm. I must give this some thought. It seems unfair to go to town on the new room and leave D's all stark. It looks like we're headed for a "big girl bed" with her soon, though, so maybe we'll just do both rooms at the same time.

Okay, this is degenerating into random thoughts. Time to go and be productive.

Thursday, August 16, 2007

Ouch

So there I was, this morning at 11, lifting my 27-pound toddler into a high chair at local-amusement-park-which-shall-not-be-named, when it happened. That horrible feeling of something ripping in my lower back. Who knows what it was: a muscle, a set of muscles, an already-misshapen disc in my spine... I have once again thrown out my back.

The last time this happened, I was in grad school. My husband was still my boyfriend. Having chldren was a vague plan for far off in the future. I took a few days off, popped painkillers and muscle relaxants like candy, went to a physical therapist for a while, and was mildly inconvenienced.

Today, however, I have a husband who just took 2 weeks off work and can't really take any time off to allow his wife to recline in bed while he cooks, cleans, and does kid duty. I have a job that doesn't come with the opportunity to be sick without massively inconveniencing the rest of the department. I have a rapidly expanding uterus, putting strain on an already dicey lower back. And, of course, I have the 27 pound toddler, too small to climb into her own carseat or high chair.

Well, shit.

On the plus side, tomorrow D goes to day care, and then it's the weekend. I am hoping to have myself somewhat functional by Monday. Wish me luck.

Wednesday, August 15, 2007

Vacation is Over!!

I'm back! I must say, two weeks is a very long time for a vacation. And a nearly 2-year-old along for the ride makes the whole thing considerably less relaxing for everyone involved. At any rate, we survived, we're home and I am very relieved to be done with travel. We're all exhausted. One night so far in everyone's own beds has helped, but I think it's going to take a few days to settle in. I put D down for her nap about 20 minutes ago, and so far all I'm hearing on the baby monitor are sounds of her jumping up and down on her mattress, shrieking "Boing boing boing!"

First order of business upon our return was to check back in with our OB group. We'd had an appointment July 30th, which was the day before we left, where I had my first measurement of cervical length, which was 3.5 cm. The placenta was still sitting smack on top of the cervical os. Today's appointment: cervix about 4 cm (!) and some possible migration of the placenta away from the cervical os (!!!). It seems to be moving anteriorly(is that even a word?) as the uterus expands.

Need I even say how pleased we were with this? We were somewhat worried before the appointment, since I have been noticing quite a few contractions over the last few weeks (mostly in the evenings), which is typical for me. Dr. um... let's see... Dr. Likes2Knit switched to the transabdominal ultrasound to get a better look at the placenta, after which we tried to detect some boy parts. None were immediately forthcoming, but the baby was being rather coy, and the resolution of this ultrasound machine wasn't the greatest, so we couldn't be sure. Dr. Likes2Knit said her guess was 80% sure that we have another girl in there. I think my guess is along the same lines. We could catch glimpses of something that might be... well... no, maybe that's umbilical cord... hmmm.... So we gave up. For now.

H confessed he was a little disappointed not to see boy parts. He quickly added he'd get over it and then joked that it gives us a reason to try for a third child. Ha, ha, ha, I say. Ha bloody ha. What a comedian that boy is.

Anyway, originally we were supposed to have our big fetal anatomy ultrasound a week from Friday at the normal imaging center. But, while on vacation, I got a call from the OB office. Remember that mysterious referral to the perinatology group that I specifically asked about and was told not to bother with? Yep, you guessed it. That was for us to go see the perinatologists for the big ultrasound so they can get a good careful look at the placenta. So, I was told to cancel the ultrasound appointment I'd made at the imaging center and make one instead with the perinatologists. I resisted the urge to ask if maybe they couldn't have sorted this out on July 30th when I looked at the instructions they gave me for making an appointment at the imaging center and asked if maybe they didn't really intend for me to make an appointment with the perinatology group instead? Oh, no, they said.

Sigh. The world will be very different when I am in charge.

So, I made the appointment today, but of course they're rather full so I couldn't get in until the following Monday. 12 days of waiting. I need to go buy myself some patience.

Thursday, July 26, 2007

Contact!!

Dr. Favorite just called. I feel much better. She's just so calming. She talks me off my ledges without patronizing me, belittling my fears, or smoothing over risks.

Main points:

1. The uterus was about the size of a fist when they saw the previa. There aren't many places for it to sit down that *don't* threaten to or cover the cervical os.

2. The bulk of it is posterior, which means they were looking around/through all sorts of stuff when trying to see it clearly. They're looking for shadows, basically. It's possible that things are better than they thought.

3. She may have hinted that the perinatology group can be a bit, well, alarmist.

4. She thinks there's a reasonable chance it could still migrate.

5. Even if it doesn't, it doesn't really change our plans for managing the risks for this pregnancy, but adds in a c-section at 36 weeks after an amnio to check for lung maturity. Note: 36 weeks falls on December 23rd. Merry Christmas.

Then we discussed the plans for managing my old nemesis, preterm labor with a cervix that doesn't stay shut. She seemed surprised that the perinatologists don't want to put in a cerclage. I explained that they weren't convinced I really have an incompetent cervix and she practically snorted. I get the feeling her money is on a progressively shortening cervix over the next month or two followed by a cerclage. Place your bets now.

In other news, I am done with my grading. Lab reports: graded. Final exams: graded. Raw numbers input into spreadsheet: check. All I need to do now is set my curve, assign letter grades, and submit them to admissions and records. And then, I am DONE with the summer session. Hooray!! We leave on Tuesday for 2 weeks at my parents' house. H and I are hoping to leave D with my mom and sneak off for a couple days at a B&B here. Wonderful.

Wednesday, July 25, 2007

Miscommunications

I think I got a little spoiled at the RE's office. They were professional and competent. People answered the phones, transferred you to the appropriate staffer if they couldn’t answer your question, and even (gasp!) called when they said they would. Even better, the person who called was often armed with exactly the information I wanted to know.

It was glorious.

Now, of course, we're back with our old OB/Gyn practice, with occasional forays down the street to the perinatology group. So far I've been in to the OB office once and then went to the perinatology group for the nuchal scan that turned up the placenta previa. Our next appointment with our OBs is on Monday.

So, there I was, minding my own business, when a referral to the perinatology office dropped into my mailbox. I got it yesterday. It was dated last Friday, and says that Dr. Favorite at my OB office is referring me to the perinatology office for a “consultation and scan.”

I applied a little mental energy to the situation and concluded that Dr. Favorite must have seen a report on the unusual placenta from the perinatology office, read it, and said “Oh no! Poor May and H! Let’s get them some more information from the high-risk experts on how this will likely affect this pregnancy!” She then put in for a referral for us to go back to the peris, look and see what the placenta has been up to, and talk it over with one of the perinatologists. Makes sense, right? This is one of the reasons I have been reluctant to insist that our care be transferred entirely over to the perinatology group. Dr. Favorite is always looking out for me, and never hesitates to send us over to the perinatologists if she feels they can handle something better than she can, but overall we get a level of care at the OB office that I’m not sure we could duplicate anywhere else.

So, I called and left a message for Dr. Favorite’s assistant, saying I had received the referral, and that I was assuming it had something to do with our new placental issues, and was there a particular week of the pregnancy in which she’d like me to go see the perinatologists?

Dr. Favorite’s assistant called me back and said that she had the results of our scan and not to worry, they were all normal.

(Um, excuse me, but WTF?)

I explained the situation to the assistant and she paused, and said she’d talk to Dr. Favorite and let me know. This all happened yesterday.

This morning I discovered a message on my cell from Dr. Favorite (whom I have not yet seen or spoken to in person this pregnancy) saying congratulations on the pregnancy and that she had my first trimester screen results, which were normal. If I wanted the exact numbers I could call her; she’d be in today until noon and all day tomorrow.

So, I called back and tried to get her personal voicemail. No luck. I was transferred back to her assistant’s voicemail, where I left another message saying I had gotten Dr. Favorite’s message this morning, but there still appears to be some confusion. I've had the results of the first trimester screen for a while now. Do they want me to go back and see the perinatologists again regarding the placenta? If not, why did I just get this referral? Have they even received a copy of a report on the scan in which we discovered its strange and unusual characteristics? What’s going on here, people?

And now I’m waiting for a return call. And grading another enormous pile of lab reports. Ugh.

As H says, "Our health care system in action." Sigh.

Saturday, July 21, 2007

Harry

I read it. I'm done. It took me most of the day. I can now lift my self-imposed media blackout so that I didn't inadvertently discover how it ends.

Wow. It's all over. Sniff. H read me the last one aloud when I was in the hospital, pregnant with D. It's the end of en era.

Off to bed. Feel free to send me an owl if you want to discuss the book.

Friday, July 20, 2007

Nuchal Results are Back

And they look nice. My particular favorite is the mere 1 in 10,000 chance that this baby has trisomy 13 or 18. The Down's risk wasn't nearly that low but was still "in range," or screen negative.

Whew.

I'm watching my friend's son today (he's 15 months) in addition to D. Two kids. Wow. A taste of the future, one would hope! I'm starting to show a bit. It's easier to hide a pregnancy longer when you never really got out of the maternity clothes from the last one. I think my students are starting to suspect. We did a lab last night in which they do urinalysis on urine samples that they provide. There were many inappropriate jokes, but one student made a big production to me about how, if we wanted to, we could see who in the room was pregnant right now. I was tempted, but I kept my mouth shut. I haven't told any of the other faculty yet except the department chair, who needs to know in case things go south and he needs to find a replacement for my fall classes. I'm seeing a few of the other faculty next week, though, so I may have to let the cat out of the bag at work at last. One of them was the department chair 2 years ago when I called her one day and said, um, I can't give the two exams I'm supposed to give tonight, and by the way, I'm in the hospital and won't be finishing the semester.

That was fun. Let's hope that doesn't happen again anytime soon, shall we?

Wednesday, July 18, 2007

Placenta Update

OK, so here's how last Thursday went down.

Nuchal translucency scan: too early to be completely sure, but the word in the ultrasound room seemed to be that the results would probably be fine regarding our risk of a chromosomal trisomy like Down's Syndrome and the like. Full report in 5-10 days after they get the blood work done, etc. And, much to my surprise, it was a transabdominal scan. I got to keep my shorts on. Very civilized.

The fetus is starting to measure rather large for its gestational age. I am concerned that gestational diabetes is looming. This is a minor concern at this point, because of the real "uh oh" moment. The ultrasound technician was very bright and cheerful as she completed her photographs and measurements and said she'd be gone for a few minutes and then the doctor would be coming in.

Doctor? Coming in? My blood pressure shot through the roof. Doctors being fetched during routine ultrasounds has never worked out well for me, and Thursday was no exception. She returned alone, however, and said the doctor wanted her to do a transvaginal ultrasound to see if she could get a better view of the placenta, which looked weird. She still was having issues clearly seeing what she was looking for, so in came another staffer, who then went off to grab the doctor out of a room where he was currently WITH ANOTHER PATIENT. Up went the blood pressure another notch.

Well, to summarize the next few minutes, the placenta looks funky. It's definitely covering the opening to the cervix. This is called placenta previa, and it can be very bad. However, when diagnosed early in pregnancy, it quite often resolves over time as the uterus expands and drags the placenta upwards, away from the baby's potential exit to the world. This would be good. But, this being one of my pregnancies, it isn't that simple. The placenta isn't in one large mass as it should be. A lot of it is on the posterior side (this is good, between my uterus and my backbone) but there appears to be an extra extension crossing the cervical opening and setting up shop for itself on the anterior side. No idea if that will affect the possibility that the placenta may migrate away from the cervix over time. Here's something on wonky placentas.

Interestingly enough, some of the complications during my pregnancy with D were eventually revealed to involve an extra lobe to THAT placenta, which (1) may have been sent out after part of the original placenta peeled away from the inside of the sac after there was a bleed in there (this is called a subchorionic hematoma), and (2) this extra bit of placenta was so deeply dug into the wall of the uterus that it wasn't delivered with the rest of the placenta, and indeed lingered there malevolently until I started hemorrhaging uncontrollably 5 weeks after D was born, and wound up in an ambulance and then had emergency surgery. Placentas that are too deeply attached are called placenta accretia. Also of note: a major risk factor for placenta accretia is placenta previa. Fabulous.

So, best case scenario: this spontaneously resolves itself over the next few months and causes no more trouble than the state of panic that can currently be found in the Problem Uterus Household.

Middling scenario: the placenta previa remains where it is, but my cervix behaves itself until 36 or 37 weeks, thus not causing any vaginal bleeding or loss of blood supply to the baby, which is born via uneventful planned C-section 3 to 4 weeks before my due date. Merry Christmas, everyone.

Other scenarios, of which I am considerably less fond, include:

(a) cervix begins effacing and dilating early, causing attached placenta to pull away in places, causing vaginal bleeding, panic, and likely hospitalization, tocolytic drug therapy, and bed rest. I'm guessing the likelihood of this scenario increases when one considers my history of preterm labor. It this is the case, let's hope it starts as late as possible. They would hold off delivery as long as it seems safe for the baby, and me, but premature delivery seems quite possible.

(b) Part of the placenta is so deeply embedded in uterine wall that upon removal of the placenta, uterine bleeding cannot be controlled, necessitating blood transfusions, and/or a hysterectomy. Possible maternal death.

(c) Cervix misbehavior during pregnancy is rapid and causes unexpected and complete detachment of the placenta (this is placenta abrupta), leading to severe bleeding, loss of blood and oxygen supply to fetus, yadda yadda yadda. Possible maternal and fetal death.

Today I choose to stick my fingers in my ears and loudly sing songs from the new Springsteen release. There's absolutely nothing we can do about this except watch and wait. And, importantly, we have advance knowledge. This is a good thing. We can be as prepared as possible for whatever may be coming.

However, I am mourning the loss of "there's a 70% chance you'll have a completely normal pregnancy." I’m in week 13 and I just used the phrase "maternal and fetal death." I wish we hadn't discovered this so early.

Ignorance is indeed bliss.

Monday, July 16, 2007

Punny

I hate puns.

People around me know this, and thus attempt to torture me all the more. My father and H in particular. My father-in-law stayed with us this past weekend, and so last night H and I took the opportunity to go see the new Harry Potter movie after we'd put D to bed. This is the one where Harry and the gang start their secret Defense Against the Dark Arts lessons, which take place in the hard-to-find Room of Requirement. I should mention this was only the second in-theater movie I have seen in, oh, the past year or so, so it was an event.

Unfortunately the occupant was parked firmly on my bladder, so I spent much of the exciting conclusion to the film squirming around in my seat. As we crossed the parking lot after we left the theater, I was speculating that what we needed was a sort of instant-expanding uterus that went from walnut to watermelon sized at, oh, let's say 37 weeks or so. H suggested that maybe the answer was some sort of external uterus where you could park the occupant at inconvenient times. He even suggested a name.

Wait for it...

The Womb of Requirement.

What do you think? Shall I just smack him with a two-by-four?

Friday, July 13, 2007

Spoke to OB

New instructions:

Pelvic rest.

For those of you who have never experienced this delight, it basically boils down to NO SEX.

ARGH!!!!

Thursday, July 12, 2007

Nuchal Fun

Today's visit to the perinatology clinic was eventful. It seems likely that the nuchal screen results will come back normal. We won't know for a week or two. The measurements were low, though, which is very good.

But, during the scan, they noted some irregularities to the placenta. I am still processing this and consulting Dr. Google and I have someone at my OB office trying to get a copy of the report so that I can ask one of the doctors some of the nine million questions that I now have, all of which completely escaped me this morning when the perinatologist looked me in the eye and said, "Do you have any questions?"

Anyway, it's not an immediate crisis, but it looks like we may be adding a new layer of complexity to an already high-risk pregnancy.

Damn it.

Wednesday, July 11, 2007

Screening Time

Tomorrow I'm going in to my perinatology clinic for a nuchal translucency screen. I got the last possible appointment I could have gotten that both works with my schedule, and is also before I'm too far along to have the test done. Unfortunately, it's at 8:30 AM and it's pretty far away. I am going to be grouchy tomorrow. And I teach that night until 10:15 PM. It's gonna be a long day. We're paying out of pocket for this test since I'm under 35. Insurance companies are so arbitrary about what they will and will not cover. On the other hand, this pregnancy isn't costing me a $15 copay every time I go in for an office visit, and with cervix checks every 2 weeks from 16 weeks onward that would certainly add up if the pregnancy went full term.

Ha! Full term! Ha ha ha ha ha... Whew. That was a good one... [wipes eyes]

So... I didn't have this done with D so I'm not sure what to expect in terms of turnaround time on the results. I'm not even sure which doctor I'll be seeing. I do know they require cash up front. I hope they accept checks too, or it could be a very short appointment.

I am still going to my stroller walk workouts. I'm nervous about it but my doctor assured me the exercise would be good for me. I'm careful not to get my heart rate up too high and that I don't get overheated. Still nerveracking. I'm going to stop the minute anyone sees anything wacky going on, cervix-wise. There are women doing these workouts that are clearly nearing the ends of their pregnancies and they do more than I do-- I skip the big hills, etc. I wish I was so comfortable in my pregnancy that I wasn't worried about walking up and down a few hills.

I guess I don't really have much to say today. I'm still buried under the pile of grading I got last Thursday. Speaking of which, writing blog entries isn't getting me any closer to being done with that. I guess procrastination time is over for today.

Wednesday, July 04, 2007

Happy Fourth!!

I meant to post yesterday after my first OB appointment, but I was just too grouchy. It went fine, in terms of the fetus (it's now a fetus!!!)-- measuring right on, wiggly as a worm, good heartbeat. BUT, what a colossal pain in the ass. I left my house at 11:40 AM and got home at a quarter to six. A little long for a doctor's appointment, don't you think? I'd forgotten how long appointments at my OB's office can take. Ugh. I shall break it down for you:

11:40 AM: depart for day care lady's house.

12:00 PM: drop D off so I can pay $40 for her to nap nearly the whole time I'm gone.

12:01 PM: reflect that I ought to go into the daycare business.

12:02 PM: remember the 6 years I spent getting my PhD and ponder what being in your house all day with 4 small children must be like.

12:03 PM: decide things are just fine the way they are.

12:30 PM: after driving a total of about 30 miles from house, arrive at chinese restaurant where meeting H for lunch before appointment.

12:31: restaurant closed for fourth of July.

1:15 PM: finish lunch at restaurant next door and head to doctor's office up the street. Doubt husband's navigational abilities only to be proven wrong. (I hate that.)

1:30 PM: emerge from depths of parking garage to arrive on time for 1:30 appointment.

1:30-2:00 PM: sit in waiting room.

2:00 PM: escorted back for weight and blood pressure check after having given urine sample (first of the day).

2:01 PM: assistant doesn't know how to use scale properly, or else I magically lost 20 pounds since yesterday. Ponder speaking up and decide to let it go and see how they react next time when they think I've gained 25 pounds in three weeks.

2:05 PM: finish disrobing and sit on exam table in inadequate paper vest and paper square for covering bottom half.

2:05 PM to eternity: remain on exam table as bladder slowly refills.

2:45-ish: nurse practitioner comes in with inch-thick chart, which she has clearly been browsing through. Nurse practitioner immediately disappears to fetch medical records I brought from RE and gave to receptionist.

2:50- 3:00 PM-ish: have lovely conversation with nurse practitioner regarding history of preterm labor. Decide will do what perinatologist recommended, which is transvaginal ultrasounds every 2 weeks starting at 16 weeks to look for a shortening cervix or evidence of funnelling. Discover must go back to perinatologist and pay out-of-pocket for nuchal translucency screen since I'm under 35 and they don't do them in the OB office anyway. Get lab slip for OB blood panel and thyroid hormone levels. Have exam, swabs, etc.

3:00 PM: nurse practitioner departs and says doctor will be right in for ultrasound.

3:05 PM: ponder emptying bladder before ultrasound.

3:05:15 PM: doctor comes in. This is the new one since I had D, who we've never met. Plans of reunion with Dr. Favorite fade.

3:06 PM: doctor fails to get clear ultrasound shot of fetus since fetus is being cruelly squashed by increasingly full bladder. Doctor claims has never had to ask a patient to empty bladder to get good picture. Doctor applies increasing pressure with wand against full bladder. Doctor chides me for allowing bladder to get so full and irritate already well-known-irritable uterus.

3:07 PM: doctor becomes apologetic after I testily remark that bladder was completely empty when I was first escorted into exam room about an hour ago.

3:10 PM: doctor mercifully asks me to go empty bladder.

3:13 PM: doctor gets a quick grainy ultrasound picture and measurement of fetus and immediately vanishes.

3:15 PM: H and I make another appointment for July 30th and gratefully leave the office.

3:15 - 4:00 PM: I fight early rush-hour traffic to do what should have been a 20 minute drive to pick up D.

4:00 PM: take D across street to lab and give 8 or 9 gallons of blood for lab work. Experience first attempt to provide clean catch urine sample (second of day) while juggling a 21-month-old.

4:30 PM: sit in traffic jam due to terrible car accident at intersection on way home.

4:55 PM: emerge from traffic jam and drop off prescription.

5:25 PM: emerge victorious from pharmacy with barely intact sanity.

5:25:15 PM: start car and gas light comes on. Groan and slap forehead.

5:35 PM: arrive at nearest gas station and fill up car.

5:45 PM: arrive home with 45 minutes to spare before need to leave for work and give 2.5 hour review session to lab students.
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You can perhaps see why I did not, in the end, post yesterday. Having slept somewhat of a full night (my class doesn't end until 10:15 and it's a fair distance away) I am feeling somewhat more refreshed today. But, I do not want to have to repeat this experience every 2 weeks. What to do? I love the doctors at this practice, and they were great during the chaotic disaster that was my pregnancy with D. Plus, they deliver at the hospital with the best NICU for micropreemies and the special unit for bedresting pregnant ladies. We used to live much closer to their office, but we moved out here to Siberia right after D was born and I don't want to switch to someone local. If I did, and we had more preterm labor fun and this baby was delivered early, the hospital up here would send the baby in an ambulance down to the hospital this practice delivers at anyway, leaving me stranded in the Siberian hospital and far away from my terribly sick child. I think I'm just going to have to deal with the distance and leave things as they are.

Sigh. Off to decorate my flag cake. Firework fun tonight!! I hope D doesn't panic.

Sunday, July 01, 2007

I was getting a bit cocky there, wasn't I?

Today appears to be freakout time for me again--I am telling myself over and over again today that we are much more likely to lose this child to prematurity/preterm labor than a late first-trimester miscarriage. This is how I reassure myself. Great!!

I think distraction is the name of the game. We took D to the beach this morning and she ran around and threw cars down cliffs and got hit in the face with big waves and dug big pools and the tide flooded them. She loved it. She collapsed for her nap when we got back and she's still sacked out. Once she wakes up, though, we're going grocery shopping to get a few nights' worth of dinners and stuff for the Fourth. We're going over to a friends' house for BBQ and I'm responsible for dessert. I'm leaning towards this. Patriotic, eh?

H is currently attempting to turn up enough of our hideous clay soil in the backyard so that we can mix in some planter's mix and get a bed in reasonable enough shape to (finally) plant our herb/vegetable garden. We got all the plants yesterday so now we have to get them into the ground before we kill them from neglect. This has happened before. We are not gardeners. But we try.

Friday, June 22, 2007

SoCal

I am not originally from Southern California. I would probably be incredibly insulted if someone assumed I was. I grew up in the lovely, green, and maritime yet mountainous Pacific Northwest. People were always moving there from California. We natives hated it. They would sell their houses in California for huge sums and then buy houses in our area for more than we thought they should, driving up real estate values and thus property taxes. Traffic worsened considerably. Surburban sprawl got out of control. Now, I understand that these were common problems experienced by many urban areas in the eighties and early nineties, but where I come from, all the blame was put onto Californians. The entire metropolitan area seemed to unanimously elect the state of California as our scapegoat.

And yet here I am. I was pondering today, and I think I've unintentionally become one of THEM. It was your typical perfect Southern California day. D and I each went through not one but two bathing suits and towels apiece today. One for her morning swim lesson and one for our afternoon visit to the local playground/water spray park combo. We had mexican food for lunch with everyone who came to playgroup today at a local park. I drove around in the perfect summer sun with the top down on my car. We wear flip flops year round. I think $700,000 for a house is reasonable. We rarely use either the furnace or the air conditioner. My PhD diploma (from a public California university) is signed by "the Governator."

What happened to me? Unless we move soon, my kid(s?!) are going to grow up thinking this is normal. How very strange. It's odd how you can end up living an entirely different life than the one you always thought you'd have.

---

Pregnancy news: I came out of the closet to my playgroup. These women comprise the majority of my social life since we moved here. They know about our issues, so they were thrilled. One of them brought a neighbor I'd never met and her 2 children to the group, and after introducing me, added excitedly "and she's pregnant!!" The neighbor glanced down at the 40 pounds of bedrest pregnancy weight I'm still carrying from D and said brightly, "Yes, I can tell!"

Ouch.

Thursday, June 21, 2007

Graduation Day

It's official: we've graduated from the RE. They even gave us a certificate embossed in gold. Our doctor seemed embarassed and called it corny, so we proceeded to harass him mercilessly. I really like this guy and am sad to be leaving his practice behind. He always shakes hands with both of us when he comes into the room. Today right after he took my hand I blurted out about the strep. He glanced quickly down at the hand I had just shaken. Go ahead and wash them, I teased. (He did.) It's nice to meet someone as obsessive about germ transfer as I am.

The embryo is measuring spot on: 9 weeks 4 days. Good heartbeat. It was noticeably larger than last week. Lots of twitching around. We saw some nice fingers and lots of umbilical cord. The nurse gave me a hug before we left and I almost cried.

So now we look forward. We discussed screening options for chromosomal defects. When I got pregnant with D I was 28 and we weren't very worried about this stuff. We did the triple screen and that was it. Now I'm 31. Still youngish, but over 30. I don't think we'll do an amnio, but I am definitely going to sweat the triple screen (is it a quad screen now?) more than last time and am thinking of calling my OB office and inquiring about having a nuchal translucency scan done. I think they need to be done at around 11 weeks (?) but my first OB appointment isn't until 11 weeks 2 days. I need to read up on this a little.

H seems to be on an emotional roller coaster today. So far it's gone like this:

First waking thought: I wonder if May's throat and ear are still really painful.
30 minutes later: Oh good, she seems better today.
On the way to the fertility clinic: I wonder if we'll see a heartbeat today.
9:42 AM: There it is! Still beating!!!
9:43 AM: Nuchal translucency? What's that?
9:44 AM: Trisomy 13? Trisomy 18? Turner Syndrome? Those wouldn't necessarily have shown up on the ultrasounds already? Are you freaking kidding me?

I abandoned him in the parking lot a few minutes later, so hopefully he's thinking about work now and has stuffed all his pregnancy worries back into their box.

I am feeling wholeheartedly optimistic. I know we haven't gotten safely through the 20 week fetal anatomy scan, and there's a big risk of preterm labor again, and all the associated appointments and melodrama are looming, but all of that seems comfortably far off in the future. For now, I feel safe. What a refreshing feeling. I am going to enjoy it as much as possible for as long as it lasts.

Wednesday, June 20, 2007

Snarkiness

Teresa has a post up over at her blog describing some comments she recently made to people she works with who were being obnoxious. Now, I am an intelligent person with a quick mind. But I rarely manage to make the comments I want to. Dr. Doolittle, for example. Why didn't I demand a rapid strep test when I was in her office last Friday? I thought of it on the way home. Not terribly helpful. My brother always comes up with appropriate remarks in time, either hysterically funny asides, or else cutting remarks when people are being idiots. I never seem to be able to earn my share of this glory.

I was bemoaning this failure to say things at the right time when I remembered something that happened at the scan before last. My RE was observing with my husband as the physician's assistant did the ultrasound. The PA pointed out the embryo's (empty) skull. (This scan was at 7 weeks 4 days and the brain really doesn't start to develop until the following week.) So, we were all looking at the empty skull on the screen while she narrated, "There's the skull. No brains."

I leaned over toward H and remarked, "Well, now we know it's yours."

I guess I do have my moments, after all.

Tuesday, June 19, 2007

Plague

So, an interesting weekend. We begin Thursday afternoon, right after I put up my last post. I had awakened Thursday morning with that "I must have slept with my mouth open" dry sore throatiness that usually goes away over the course of a day. I was so focused on Thursday's ultrasound that I didn't think much of it. However, by Thursday night I was in a lot of pain. Mostly on the right side. No fever, no other symptoms. Aha, you say: she has strep throat. (But of course.)

An aside here on medical groups. Since we became very close to our OBs during the pregnancy with D (I did see them daily on their rounds for months, after all) we were hesitant to change doctors when we moved up here to Siberia three weeks after D was born. So, despite the drive, we decided to stay with the practice for any subsequent pregnancies. This means I must also see a primary care physician who participates in the same medical group. I have one I've seen maybe once in three years. It's a 45-minute drive.

Friday morning I am in severe pain and we call my primary care physician (let's call her Dr. Doolittle) and get an appointment that morning. I figured one office visit co-pay, one in-office rapid strep test, one antibiotic prescription and a trip to the pharmacy on the way home and my entire weekend needn't be hellish, right? You can see where this is going.

Dr. Doolittle did a careful exam and decided it was a viral throat infection, localized to one side. She said there were no white spots, no fever... she didn't think it was strep. Apparently my look of absolute disbelief registered on my face since she added, well, it is Friday... so I'll do a swab for a throat culture and write you an antibiotic prescription just in case. But, before you fill it, call me on Sunday for the results of the culture (she said she was on call all weekend and could access the lab results online) and don't start the antibiotic unless it comes back positive. Fine, I said, not wanting to take anything while pregnant unless absolutely necessary. She handed me a prescription for amoxicillin. Skeptically, I asked if this wouldn't cross-react with my penicillin allergy. Oh, no, she assured me.

Two hellish days later, I called Sunday around 10:30 for the lab results. She promptly returned the call to let me know she didn't have the results yet and would call me by 6. No call. The next morning (Monday) I called her office. Oh yes, the receptionist said soothingly (to an admittedly quite irate me), she'd have a nurse call back right away with the results. That call came through today at 10:30, nearly 4 days after the throat culture, and the morning after my first lecture of the summer session. Let me tell you, talking loudly for two hours through a raw throat was just a treat.

Well, you can guess. A "heavy growth of group A Streptococcus" and I should "start antibiotics immediately." No fucking shit, people.

It gets better. I broke all speed limits over to the pharmacy and handed the assistant at the register the prescription, carefully mentioning that I was (a) pregnant and (b) allergic to penicillin, and that I had doubts about my doctor's choice of antibiotic in this case. She consulted the pharmacist, who agreed wholeheartedly and immediately got my doctor on the phone. I left shortly thereafter with Azithromycin, safe for use in pregnancy and for people allergic to penicillin. The pharmacist seemed shocked that any physician would prescribe amoxicillin to someone allergic to penicillin and asked me if I had mentioned the allergy to her. I said I had told not only the woman who checked me in and took my blood pressure, but also asked the doctor outright about her choice of amoxicillin when she handed me the prescription, saying, "And this won't cross-react with my penicillin allergy?" The pharmacist sighed and shook his head. After I mentioned the 4-day wait for the diagnosis he also wondered aloud what kind of doctor's office doesn't offer a rapid strep test to someone presenting with my symptoms. An office about to have one fewer patient, I replied acerbically. I chugged my antibiotic in the parking lot with the last of my morning's forbidden delight, the mocha frappucino.

What do you think? Just change doctors, or dash off an angry letter as well? Am I overreacting? Let me mention that I have been absolutely miserable. I'm normally pretty stoic and this has had me in tears several times. I'm living from dose to dose of Tylenol and specifically mentioned my acute discomfort to Dr. Doolittle in her office Friday and again on the phone Sunday.

In other news, we told my mother-in-law about the pregnancy. We’re out of the closet! Hooray for optimism!

Thursday, June 14, 2007

Perfect

Well, today's scan was just about perfect. Our RE clearly didn't have anywhere pressing to be, so we got the full treatment. Heartbeat: nice and fast. Length: measuring 8 weeks 5 days, or 2.1 cm. Yolk sac: still appropriately sized. Arm buds: present and waving. Umbilical cord: nicely visualized. The embryo twitched and wiggled about. We got a bunch of different views.

H took a very deep breath and visibly relaxed. Our RE got H to talk a little about his nervousness and H said he was still feeling especially anxious since a friend of ours recently had a miscarriage at 9 weeks, after seeing a good heartbeat. Our RE calmed H down considerably by telling him that in his experience, you usually have some sign if that's going to happen in a pregnancy as extensively ultrasounded as ours has been. Either the yolk sac is a little too big, or the heart rate is in the normal range but at the low end, or the gestational sac has an odd shape... something is just a tiny bit off. He said with us, everything has been spot on once we got the dates sorted out. He feels very confident that we will safely emerge from the first trimester.

(I know; knocking wood, throwing salt over my shoulder, etc.)

So, our worries have officially been transferred from another first trimester miscarriage, to another second trimester preterm labor fiasco. But that won't be a concern until the baby gets big enough to start putting some pressure on my cervix. Probably 18 or 20 weeks-ish. So, for now, we are starting to unwind a bit. I need to call my OB and get on their schedule. Next Thursday should be our last visit to the RE's office. I can't believe it.

I can also quit the Metformin, cold turkey. I'm frightened of gestational diabetes, but not so much that I'm not grateful to jettison those three pills a day. Progesterone continues for another week and a half or so. And my thyroid still needs to be monitored. The RE office checked it in January-- I had a TSH of 1.2 or something similar. Then they rechecked it after I got my first positive beta for this pregnancy, in May, and it had crept upwards into I believe the low threes. Should have written those numbers down. Anyway, still in the normal range, but climbing. He said to make sure my OB rechecks it fairly early in the second trimester. He'd rather have my TSH at the low end of the normal range because he says it's healthier for the baby. I need to read up on this a bit.

Anyway, it was really great. I have about seventy nine million things I ought to be doing while D takes her nap, so I'd best be off. Time to clean house.

Wednesday, June 13, 2007

Ahh, Wednesday.

I feel better today. I'm trying not to freak out about this. Pregnancy symptoms come and go. Who was it that came up with the blue fingernails pregnancy indicator idea? The minute your pregnancy starts going south, your fingernails would turn bright blue. Wouldn't that be nice...

D usually goes to a baby sitter's on Thursdays. This gives me a day to prepare my lectures, do my grading, and more recently, go to the RE for ultrasounds without committing that most serious of faux pas: bringing your toddler into the waiting room of the fertility clinic. I got a call this morning from one of the other moms whose son goes to this baby sitter's. Did you hear about the pinkeye, she said? Yes, pinkeye. Running rampant through the population that goes to this sitter. Now the sitter has it. She was closed today and will be closed again tomorrow. So, now I've got a friend of mine attempting to take her 19 month old and my 20 month old to a local amusement park tomorrow morning while H and I go to the RE for our scan. I have instructions to get out of that office as soon as humanly possible and zoom up the freeway to join them at the park. I REALLY hope nothing goes wrong tomorrow. I hate having anything else planned for later in the day of an ultrasound. I like to protect that time for crippling grief, all the while thinking that if I make the time to sob all afternoon, it won't actually be required. i can't imagine anything worse to do after not seeing a heartbeat than heading out to a Southern California amusement park in June.

Sigh. Pinkeye. Fabulous.

Monday, June 11, 2007

Ugh

I thought I'd dodged this bullet. Constant waves of mild yet thoroughly debilitating nausea. At least it means there's still something going on in the ol' uterus. It's nice to have the reassurance that I am still pregnant.

Why do they call it morning sickness if it lasts all day? And isn't 8 weeks a little late for it to join the party?

Bleh.

Thursday, June 07, 2007

Starting to Believe

It all went perfectly. Gestational sac, embryo, and yolk sac are all appropriately sized, with a good heart rate. We saw the skull. It's empty (as it should be at this point). Apparently my task for the next 7 days is to grow some brains in there for the embryo. It measures 7 weeks 6 days, plus or minus 3 days. If you go by my last period, I'm 8 weeks tomorrow, if you go by suspected ovulation, then I'm 8 weeks on Sunday. Both within the margin of error.

I'm starting to think this might be okay. At least the first trimester miscarriage thing. I'm not even thinking about second trimester preterm labor stuff. It's just... well, the only other pregnancy I've had that made it this far resulted in my daughter. I guess that was a bigger mental milestone than I thought. My husband, on the other hand, is getting more freaked out the further we get. I think for him, the more real it starts to seem, the more we have to lose. He told me he was really nervous as I sat, pantsless, on the exam table waiting for the PA. The last couple of weeks we have only discussed this pregnancy while at the fertility clinic. The rest of the time it's just not mentioned. This is odd for us; we usually talk about stuff quite a bit. I guess there's just not much to say. It's either going to continue or it's not and there's absolutely nothing we can do either way.

But, for now, all is well.

Wednesday, June 06, 2007

Unwelcome Surprises

Nobody tells you how much bleeding is normal after you give birth. The nurses on the postpartum floor supply you with pads that seem appropriately sized for, oh, a hippopotamus, which gives you a teeny clue. But, every woman is different, blah blah blah. They do warn you that nursing causes your uterus to contract and that you'll probably bleed more while actively breastfeeding.

I spent the majority of my time the first 5 weeks after D was born trying to breastfeed. It did not go well. I had a low supply, my nipples were absolutely trashed, and D didn't use her tongue properly to draw the milk out. Instead she used more of a chewing motion. Fun for everyone. I did discover that nursing her certainly increased the rate of my postpartum bleeding. This was an item of rather minor interest until one afternoon when I was attempting to feed her and felt... well, let's just call it a large clot. I stood up to discover I had bled through my pad, underwear, pants, and done significant damage to the cushion of the armchair I had been sitting in. I set D in her bouncy seat, dashed upstairs (we had been living in our brand new house for about 2 weeks at this time) trying desperately not to drip blood on the new carpet, did a quick cleanup, and put on my oldest, ugliest maternity underpants, and a pair of workout shorts. I went back to get D, checked the new pad, and decided a trip to the emergency room was in order. I called my husband (at least an hour away at work) and a couple of friends, one of whom left work instantly, came to my place, and assumed care of me and D. She dropped me off at the ER and took D to her house to look after her.

H met me in the ER, where I was given an ultrasound and diagnosed with "retained products of conception." The bleeding had stopped, so after talking to my OB, the ER doc on call discharged me and said my OB's office was expecting me first thing the next morning for a D&C. On the drive home, the bleeding resumed. I was attempting to get my OB on the phone, when I apparently passed out from loss of blood and scared about 15 years off my husband's life. He called 911 and the paramedics arrived.

So there I was. 5 weeks postpartum after nearly three months in bed, eating mostly See's Chocolates and Wheat Thins. (Let's just say I was not at my slimmest.) I hadn't showered that day. I was clad in nothing but a breast milk-stained tank top, the aforementioned maternity underpants, and my workout shorts. There was also a fair amount of blood involved. I was untidy.

Well, they scooped me up and brought me back to the hospital, where I was admitted by the same doctor who had sent me home not an hour earlier. Deemed too unstable to be ambulanced down to the hospital where my OB-Gyn group had privileges, I had the D&C done there at about midnight that night by a doctor who heard my history and promptly tried to get me to leave my current group and come to his local practice. I think his pupils actually turned into dollar signs as he looked at me.

D was, at this time, very hungry. She didn't react well to the abrupt transition from bring breastfed (albeit very poorly) to being bottle fed formula, which her stomach kept violently rejecting. It was a long night for everyone. Eventually, though, I was deemed likely to live, discharged, and sent home, where D was very happy to be reunited with my breasts.

Did I mention this all happened on my husband's birthday? Every day I am amazed that he ever recovered enough from all of this to agree to try for another child. Later I learned that he followed the ambulance to the hospital in his car, hoping all the way that the lights and siren would just stay off. As long as they were off he was managing to keep it together. Poor guy.

Anyway, we're braced for tomorrow's ultrasound. 9:30. Let's hope there aren't going to be any unwelcome surprises.

Wednesday, May 30, 2007

One-Eighties

When I was pregnant with my daughter, despite having had a miscarriage just prior to her conception, H and I were pretty laid back during the first half of the pregnancy. Once we saw her heartbeat, we really relaxed (ha! just relax!) about the whole thing, and we made a lot of plans and remarks that assumed a good final outcome. Looking back, I can't believe how naive we were, but in our defense, I suppose most people are that way unless they've been through hell during their efforts to build a family.

Anyway, we looked forward to the 20-week ultrasound as a chance to discover her gender, rather than dreading it as a chance to discover what horrible thing was going to happen to us next. And for the most part the ultrasound turned out that way. They told us they were pretty certain she was a girl, we got some nice profile pictures, they measured my cervix as long (greater than 3 cm) and closed, and that was that. The only problem was that she went to sleep partway through the ultrasound and wouldn't move, so the technician wasn't able to get a good shot of all four chambers of her heart. Everything else looked perfect, though, so the technician sent us home.

Dr. Favorite duly reviewed the footage and called to tell us it all looked good, but for completeness' sake she wanted us to return in a week or two for a follow-up to get that last image of the four heart chambers. So we returned. The technician got the shot of the heart, and then she said that since we were there, she'd take another look at my cervix. Once she did, her demeanor changed markedly and she said she'd just hop out of the room for a second to ask the radiologist something.

Well, still being quite naive, H and I weren't too concerned. Eventually she returned and said the radiologist saw a lot of funneling in my cervix (note: this is very, very bad) and wanted me to go home immediately and lay down, and he'd have one of the physicians from my OB group call and tell us what to do next. The technician said she thought they'd have me get a cerclage, or a stitch placed into the cervix, to hold it closed and keep the baby in. For some reason we thought this sounded reasonable and manageable and we didn't freak out. After all, the demonic pregnancy book that we owned included a brief discussion of cerclages, so they couldn't be that big a deal, right? (Note: at 24 weeks I was past the latest point at which they like to place cerclages.)

So, we went home and I called into work (I was teaching two courses that semester) and explained the situation. My lab associate drive down from campus to pick up the exams I was due to give each of my classes that evening, and said they'd found people to cover them, no problem. I assured her that I'd be back in a few days at the most.

A comedy of errors ensued with the OB on call that day, and he didn't get a hold of me until nearly 5 PM. He wasn't overly concerned with the radiologist's opinion that there was severe funneling since it was a radiologist speaking and not an OB, and since I already had a checkup scheduled for the next morning, he told me to take it easy overnight, and then they'd look at my cervix the next morning.

The next day I saw Dr. Favorite, who measured my (now incredibly shortened) cervix, told me to get dressed and sit right there in that chair, and was across the hall in her office on the phone with a perinatologist in about fifteen seconds. To summarize a lot of panic in a few sentences, within minutes I was admitted to the hospital, gowned, IV-ed, and being treated with the most drastic tocolytic (anti-labor) drug they have, which is IV magnesium sulfate. They gave me two injections of the steroid beta methasone over the next 24 hours to hasten the baby's lung development in preparation for a possible premature delivery. This last fact was what really brought it home to us that after 24 weeks and 4 days of pregnancy, I was in active labor, and there was a good chance our daughter was about to be delivered as a micropreemie.

That week was the worst that it got. One of the NICU neonatologists came to my room and had a frank conversation with me about the baby's chances, were she to be born. There was a 50% chance she would die immediately. If she survived, there were horrifyingly high chances that she would have lifelong disabilities as a result of her prematurity, including blindness, paralysis, and cerebral palsy. He gently questioned me about whether we would want the neonatal team to take extreme measures to preserve life at all costs, or if there was a point at which my husband and I would prefer to let her go.

(I should note that the IV magnesium sulfate (aka "mag") I was on at that point works by relaxing the uterus that is, after all, simply a large muscle. It has the rather fortunate side effect of relaxing every other muscle in your body as well, and also made me pretty loopy. If you're going to deal with something like this, doing it while on mag is the way to go. My poor husband had to deal with all of this stone cold sober. Poor lad.)

Anyway, I responded well to the mag. Things stabilized. The perinatologist Dr. Lunatic (another favorite of mine- I like a wild sense of humor) did an ultrasound where he identified a small area of bleeding between the placenta and the inside of the amniotic sac, called a subchorionic haematoma. This, he believed, is what kicked my irritable uterus into active labor. A normal uterus would not have reacted in such an extreme fashion. We waited ten days and eventually weaned me off the mag and onto some oral medications with similar uterus-relaxing properties. I was discharged and sent home, there to remain on strict bed rest, and with instructions to call day or night if I had more than 6 contractions in an hour. After we had to return to the hospital for contraction monitoring three times in a week, and despite additional medications at increased dosages, my cervix shortened even more and I was readmitted to the hospital, put back on the mag, and there I remained for all but the last three days of my pregnancy.

I was sprung from my perinatal prison ten days after an amnio done at 34 weeks showed that the baby's lungs were starting to make some surfactant. So one Saturday morning, we had the ceremonial turning off of the mag. They thought I'd deliver within 24 hours. The next day I was still contracting away, but it didn't seem to be going anywhere. So, at last I was sent home, with strict instructions to return with all possible haste if anything changed, so as to avoid giving birth in the car. Thursday at about 4 AM I woke up in the middle of a painful contraction, and we were off. By the time we got to the hospital, got checked in and onto the labor and delivery floor, I was 7 cm dilated. A couple of hours (and just two pushes) later, we were handed our scrawny little troublemaker. After 11 weeks of bedrest, I had my girl just three days shy of 37 weeks and being considered a full term infant.

-------------------

Today: after a week of thinking I was experiencing miscarriage #3, we saw it. Instead of an empty gestational sac, we have a perfectly round, 4 mm by 4 mm yolk sac, and a little blob of a fetal pole with a flickering heartbeat. I can't believe how quickly everything can change.