Monday, October 31, 2011

Weeks 6-8: Into the Great Wide Open

To say the last three weeks have been the longest of my life is not an understatement. Looking back, it's hard to believe only a month has gone by since the fateful trip to Vegas where we celebrated both my baby brother's 21st birthday and the news of my pregnancy. Indeed, parents and siblings thrilled and cried at the news...though The Brit's mum (in typical Jewish mum fashion) worried that it was "bad luck" to share the news so early.

Perhaps we should have listened to her.

The following are snippets from an ongoing e-mail chain with my beloved Birthing Committee -- four very special friends who happen to be recent moms and have been my rock over this past month. I share them here not for sympathy or attention, but because the topics herein seem to be so hush-hush. It's not until you nervously mention symptoms or irregularities that you hear, "Oh, that's normal," or "Yeah, that happened to me," or -- worst of all -- the dreaded "we don't know why that happens, but you just have to muddle through. There's nothing you can do."

My anger about that last one has hit fever pitch over the last few weeks. The state of actual medical knowledge about women's health -- particularly pregnancy -- is appalling. And the calls for further research are few. I don't care if you've just conceived or are pushing the kid out -- we deserve answers to our questions, even if the answers aren't full of sunshine and light. And we also deserve to be treated with respect as thinking beings, not robotic babymakers whose only job is to smile nicely and do what we're told.

The snippets tell the tale...

October 13:

Last night, I had some spotting around 7:15pm. It stopped in the overnight, but needless to say I freaked out (especially after the missed miscarriage this past Spring). I luckily had a Week 6 exam scheduled for today. The doctor said she saw some blood, but the cervix isn't open (very good). Then she did a transvaginal ultrasound, and they couldn't find anything -- they should be able to see cardiac activity by now.

So the end news is there is no news. We don't know if miscarriage is imminent, or if I'm just behind schedule and this is a freaky series of events. I had even! more! blood! drawn this afternoon, so should get an HCG reading in the next day or so. They also want me to go in and have a stronger, more precise/specialized ultrasound middle of next week.

Of course, the wrench in all of this is that I'm supposed to go to NYC (for work) on Sunday for almost a week. I'm leaning toward cancelling the trip, unless anything drastic happens in the next 24 hours. I don't know.

October 19:

The good news is there's no real news, here at the start of Week 7.

The spotting hasn't really come back. I'm going in for the high-powered ultrasound this afternoon. If they don't find anything, we'll try again next week. All good thoughts appreciated.

Needless to say, I did NOT go to NYC. The decision killed me, but c'est la vie. I know it was the right thing to do.

No test results thus far -- but then, I haven't bothered my OB's office to check.* As great as this office is when I'm there in person, they're not so good about follow-through on things like test results. All the more reason I'm switching to Donna the Midwife starting next week.

We're meeting with a perinatologist for a genetic screening consultation next Tuesday. If I'm still having question marks, I'll ask him/her about them at that point, too.

* = They never did call me back with the test results. And ordered doubles on some blood tests while somehow "losing" my 1-hour glucose test. And screwed up sending all of my lab work to my new midwife until I hounded them repeatedly. In case you're wondering why I switched providers.

October 19 (later):

So I think you all know the news now, but just in case...WE'VE GOT A BABY!

It's a little curlique and has a fetal heartbeat of 113. The ultrasound techs weren't supposed to tell me anything**, but one was in training so I asked questions when they said something to each other. Best guess is my dates are off by a week or so...hopefully I'll know more in the next day or so when I talk to the OB/nurse.

** = Can you believe this?! Here I am, freaking out for close to two weeks about whether or not I'm actually pregnant and the techs won't at least confirm if there is a heartbeat -- which they measured and listened to without my knowledge. And then they resorted to whispering. If the situation hadn't been so critical, I would have raised holy hell.

October 20:

And in today's installment of The Fetal Chronicles...guess who has a bicornuate uterus?

If you're like me and said, "A what?!" -- apparently, my uterus is misshaped and has two "horns" at the top. It's also known as a "heart-shaped uterus," though I prefer to think it's like devil horns and, therefore, my uterus is TOTALLY METAL. Or something. It's genetic and something I've had since birth.

Anywho, the doctor didn't sound concerned about it and told me to stay off the Internet until I talk to the perinatologist on Tuesday, when I'll hear more about genetic screening, my ultrasound results, and any revised baby dates.*** Naturally, I obeyed her for seven whole minutes before Googling.

What I've found out is that much depends on the severity of the shape. There are two concerns: 1) If the fetus is attached to the septum area (it will probably miscarry if so because there's not enough blood flow); or 2) If there isn't enough room for the baby to grow. I'm also at higher risk for C-section due to possible breech (again, the space issue). Other than that, it's no big thing...women with bicornuate uteri have babies every day, even if they have to have a few extra ultrasounds to be safe.

And that's it! I'm starting to feel a little queasy today, which I hope is a good sign that I might be getting some morning sickness. Not too much, mind you -- just enough to know I'm at a lower miscarriage risk would be grand. And yes, I am the only woman in history who WANTS morning sickness.

*** = So I get to the perinatologist and immediately ask for feedback on this situation. They looked at me with blank expressions and said, "I'm sorry, but we don't have any ultrasounds to discuss." And then they took pity on me. Read on...

October 23:

Scary bleeding today -- including a palm-sized blood clot. While at the sports bar, watching football, of course. I refused to leave (only me, I know). By the time we got home three hours later, I had one more rush of blood and then practically nothing since, except very minor brown spotting. I AM A FREAK.

Honestly, I think the best thing I'm doing right now is putting myself on modified bed rest. At least until I see Donna the Midwife on Thursday. I'd kill for a nice long walk at the moment, but I'm nervous about so much movement/being away from the house.

October 25:

Just got back from the perinatologist. After further scanning, he does NOT think I have a bicornuate uterus, but instead a 3cm fibroid off to the right. That, along with the normal Y-ish shape of the uterus leading into the Fallopian tubes, is probably what made the other techs assume I had a METAL UTERUS. He said my midwife might want to do a couple more ultrasounds to make sure, but that's his counsel. Wow. And the fibroid should be no problem, except for monitoring it for blood flow (it's in a place where it wouldn't interfere with the cervix, etc. -- though all of this possibly explains my ridiculous PMS pain on the right. FINALLY!).

Re: the clot and bleeding -- the doctor said it just is what it is re: 1st trimester bleeding, though he could see where the clot came from on my uterus (he said it looked like it was healing just fine).

All that said, our Pumpkin Seed (We've been upgraded! And how seasonal!) is about 1.5 cm and has a fetal heartbeat of 158. Chugging right along where it should be for Week 8. They're not changing my dates at this point, so still due 6/6/12-ish.

October 27:

We met with Donna the Midwife this morning...and I don't think I've ever made a better choice in my medical care. We simply talked for 20 minutes or so, so she could get up to speed with the shenanigans of the last 2-3 weeks. Then she said, "You know, I could do an exam or even just poke your belly. But I'm not going to. You're OK as far as I'm concerned for a few weeks. Let's have you back just before Thanksgiving and I'll worry about other tests then. Oh, and by the way, the fact that you've seen a strong heartbeat? Your chance of having a miscarriage now is only 2%."

She also said we asked smart questions...and "you're so well-educated about all of this!" What a change!

So: next appt is Nov.18. We also scheduled my 1st trimester nuchal/PAPP-A screening the following week. YAHOOOOOOO!!!

October 28:

And on today's episode of As the Uterus Turns...

So we have more bleeding. Not too much and no clots yet (and still no cramping/tissue), but honestly. I'm getting really tired of this rollercoaster. I cancelled my dinner plans for tonight, which is devastating as I really need to get out of the house.

Did anyone else have breakthrough bleeding around Week 8 or 12? It's about the only semi-maybe-we-don't-know explanation I'm getting, besides threatened miscarriage.

Called Dad to ask if Mom had any bleeding with me, my brother, or prior to her miscarriage.**** He doesn't remember either way (and he also doesn't remember what week Mom was when she had her miscarriage). My grandma and the aunts don't know yet, so I can't call them. This no mother nonsense really, really sucks -- now more than ever.

On-call nurse told me the same thing as before -- watch and wait and if it gets worse (clots, heavy flow), go to ER. If I bleed through the weekend, she said to call first thing Monday and they'd sneak me in for an exam. Which is what I expected her to say, but still.

I don't know if I can do this for 32-ish more weeks. How do you cope? I am feeling completely alone and angry and just let down by medicine, feminism, my body (with whom we all know I have a stellar relationship anyway)...you name it.

I'm sorry for being so needy, but I just don't know what else to do.

**** = For those not aware, my mom died from colon cancer when I was 10 years old. Needless to say, the impact on my life has been immense, but my day-to-day just is what it is. I'm also incredibly lucky to have the World's Best Stepmother (and baby brother, thanks to her), whom I can't imagine not having in my life. That said, pregnancy and impending motherhood is bringing up all sorts of buried grief and unanswered questions, the likes of which I haven't felt or dealt with in 25 years. I'm sure this will be discussed at length in future, but there's the context for now.

October 29:

Well, the bleeding stopped about 6-ish hours after it started yesterday...and really, it was just a bit here and there after the initial rush.

The Brit and I had a huge talk this morning and we've decided I shouldn't go to the ER (ever) unless drastic things happen. I'm sticking to the status quo until my appt on Nov. 18. A long wait, but it's not going to change anything either way.

We also discussed my situation with Missing Mom, which is really the hardest part of all of this for me. After much waffling, I finally broke down and called my grandma and told her the news. My aunt happened to be over at the time, so she found out too. Both are sworn to secrecy, but they did tell me that my mom's pregnancies were pretty normal -- no bleeding that they can remember. So no real light shed on any of this, but I'm glad they know. We're going to have a big talk at Thanksgiving -- I have lots of questions for them that I hope aren't too hard to handle.

In somewhat spooky news, my iPod and the radio have been playing all sorts of songs lately that seem to be Messages from Beyond. I was laughing at myself for thinking such nonsense, then "Green-Eyed Lady" (Mom's all-time #1 personal theme) came on the car radio this afternoon. So you know. I don't know what to believe anymore, but I'd LIKE to believe that she's trying to hold down the fort from above...just like the miscarriage happened earlier this year so we would make up our damn minds on whether or not to have a kid.

~*~

Which brings us to the end of a very long October. Halloween came and went in a not-so-spooky rush. I'm still laying low and experiencing some minor brown spotting, but that seems to be status quo for my body. Donna the Midwife is encouraging me to start doing some light exercise, such as 15-20 minute walks and hand weights, but I'm nervous to get too far from the house by myself.

In many ways, I'm in complete awe of what my body is going through. Seeing and hearing the Pumpkin Seed's heartbeat at the perinatologist's office was an amazing, tear-inducing moment. On the other hand, I feel extremely trapped in a series of events over which I have no control, yet said events have complete authority over my every move and decision. I'll admit I am also more than a little angry at the Pregnant Woman Police and The Eternal No on every possible food, drink or environment decision. I would kill for a (small) glass of wine and some sushi right now, but there is no in-between. Of course not, because women can't think for themselves based on risk/benefit analysis.

That said, I know 1st trimester is particularly fragile. I've voluntarily given in through the end of 2011 on this point alone. But ohhhhhh the philosophical discussions being raised as I get deeper and deeper into this experience. Selfish? Perhaps. But is it really selfish when you consider I'm a human being, not solely a reproductive vessel? And one of those fundamental human rights is to make my own decisions based on information to hand? If your response is, "Oh, it's only nine months!" then brother, you haven't been pregnant. Or scorned enough as a patient.

To quote my ever-wise grandma: "Oh honey. Pregnancy is like being old. Neither one is for sissies."

You bet your sweet bippy they ain't.

Saturday, October 8, 2011

How Babies are Made...or, A Recipe for Risotto

Every woman has her story about how and why a kid. Some are sudden, some are planned, some are full of wonder or heartbreak. Ours is very roundabout.

In early 2011, after a decade of extreme PMS cramping, I finally bit the bullet and scheduled a laparoscopy to get to the root of my lady issues. Dutifully, I showed up at the surgicenter on an early March morning, filled in forms, signed my life away.

"Okay," said the nurse. "I just need a urine sample and we should be good to go."

After passing the sample through the door, I stayed in the restroom to gown up. Not 30 seconds later, a knock on the door. "Hang on, sweetie," said the nurse. "You're pregnant."

My response: "No, I certainly am NOT!"

Her: "Yes, you are. And it's STRONGLY POSITIVE." I suppose I've always been an overachiever.

Needless to say, the procedure did not happen that day. My husband and I went home completely bewildered, and figured out I was somewhere around Week 11 or 12. I had not a single symptom. In fact, we had just returned from a week in Spain where we ate and drank our way around the country. Great.

Two days and a blood test later, I found myself in my ob/gyn's office getting an ultrasound. He found nothing. "My guess," he said, "Is you miscarried somewhere around Week 3 or 4 but never noticed it since it would have seemed like a normal period. Well, normal for you."

Until that week, both my husband and I were 100% ambivalent about parenthood. We truly could have taken it or left it and either would have been fine. Over the last five years, we've both asked the other to just make a decision because my ovaries weren't getting any younger, but neither of us could. Therefore, my miscarriage was not a tragedy -- in fact, it was a blessing in disguise. Some may say a nudge from beyond to make a freakin' decision already.

After 72 hours of pregnancy, we made a decision. We actually did want to give this parenting lark a go.

My body didn't heal completely until May. Then the summer was busy and we had plans. "After Hawaii," I told the husband. "Then we'll really start trying."

Three days after returning from Hawaii...boom. Conception.

I forced myself to wait until Day 29 of my cycle to pee on a stick. I fully woke up exactly 15 minutes before our 8am alarm (miraculous, considering I am not a morning person). I already knew, and said knowledge had been supported by the Magic 8 Ball That Never Lies and told me "It is decidedly so."

Indeed, it was. Those tests are supposed to take two or three minutes. Mine popped positive in less than 30 seconds. STRONGLY PREGNANT, again. Just a blastocyst, but the size of a poppy seed.

Week 4 became a blur of reading to understand our little Poppy Seed and it's associated swirl of hormonal side effects. Phone calls to make appointments with potential ob/gyns and midwives (my beloved gyn has sadly retired from OB work). I learned that most providers don't want to see you until Week 8, yet the most dangerous time for birth defects is Weeks 5-8.

"What do women who aren't as nerdy as I am do?" I angrily asked my husband. "What if they don't have access to quality websites or can't afford books?" It's a mystery I still don't understand. Fine, don't see me until Week 8 -- but why not fax, snail mail or e-mail a few "do this/don't do that" instructions to the newly pregnant?

I insisted on "meet and greet" appointments during Week 5. So far, this is the smartest thing that I have done and I encourage any newly pregnant woman to do the same.

At this moment, I am at Week 5, Day 3. Our Poppy Seed is now "the size of a grain of arborio rice" (the children...they grow so fast!). Therefore, our nickname for it is now "The Risotto." According to a lovely nurse practitioner I met with this week, we have the Lima Bean, Gummy Bear, and Alien phases to look forward to next. Aside from a little breast tenderness and a whole lot of digestive cramps, I'm feeling fine. No morning sickness. Yet.

(You will notice I have no problem calling the embryo/fetus/baby an "it." For many reasons, we are not finding out its sex until it appears on the scene. For sake of easy pronouns, "it" is it.)

Today, we are telling our parents the news. The husband's family lives overseas, so they will get a phone call in an hour or so. As for my parents and brothers...we are actually off to Las Vegas this evening for 21st birthday craziness with my baby brother. Our over/under re: them guessing the news is approximately 20 seconds after I order a club soda instead of a cocktail.

After years of my "when/if" indecisiveness, I know my folks will be over the moon over the news of their future grandkid. We're kind of excited to know him or her, too.