Fact: There is nothing like changing a tampon in a public bathroom stall while wearing a one-piece bathing suit and a toddler on your back while the older kid stares at you to make a person reconsider her objections to tankinis.
Did this pop up in your reader once already, when it was much, much shorter? Thank the awkward interface of the WP ipad app!
Hey, look! I got as far as a title for that post I didn’t write on Tuesday! Fancy that!
I was sneezing my brains out, and the state of my pelvic floor is such that I was put in mind of the notion of…let’s say ideas escaping a bit at a time. Then my allergy meds kicked in and I was left with the cognitive skills of a not-so-bright houseplant. So you missed out on an extended pee metaphor, is what I’m saying.
I know. I’m sad for you, too.
Meanwhile, in no particular order:
Item: The mother of one of the Bean’s friends, who also has a six-month-old, says of taking care of the two of them, “it’s really fine. As long as you don’t want to do anything else.” That about sums it up so far. Jackalope, praise heaven, remains about as easy to care for as it is possible to imagine for a baby her age (7 weeks
today yesterday). Sometimes I also do one other thing, like some laundry or most of the dishes. We do not always leave the apartment. I shower on the weekends.
Item: I have found this game invaluable for achieving a sanity-sparing trance state while nursing. I have even won, once. If you are troubled by excess productivity, give it a try.
Item: Yes, I play games while caring for my children. I also mess around on the Internet and, in the rare occasion that I have access to both my hands and a source of light, read books. (I have been known to talk on the phone, too, though not so much now that I have lost the one person I could call anytime, even when there wasn’t much of a story to tell, and just…talk.) On Friday I was chided in a faux-friendly way by a (childless) acquaintance for bantering on Facebook rather than giving my children my undivided attention.
Item: I do not give my children my undivided attention at every moment.
Item: I do not feel bad about that. They do not need my undivided attention, most of the time. There are moments when one or, merciful heavens, both need all or most of my attention, and in those moments, I do my best to give it to them.
Item: I am a fully-fledged adult human, with a big brain and wide-ranging interests. No one needs my undivided attention at all times.
Item: Speaking of gender essentialism (because I believe that’s what is in play above), it continues to amaze me how casually it crops up in my life as the mother of a boy child. (I expect the girl child parts will kick in soon.) The mother of the Bean’s friend mentioned above expresses genuine surprise that I am not teaching the Bean to pee standing up. As if the presence of a Y chromosome demands it. (Or maybe it’s the testicles? An issue of airflow?) For the record, the first person to inform him that such an option exists gets to teach him; such behavior will be for outside of the house only until he is able to be in charge of cleaning the bathroom. Meanwhile, another friend — and a butch lesbian, at that — expresses relief that she is expecting another girl, because she knows “what little boys are capable of.” I am baffled.
Item: Our particular little boy is capable of more and more things, lately, almost all of them good. Potty training, pee-edition, is suddenly going much better. (Let us not speak of poop.) He prefaces questions with, “I’m curious,” and tonight at the computer remarked, noticing the connection for the first time, “it’s funny that you guy call that a mouse.” He “imsisted” the other night that I stop doing the dishes and instead eat ice cream. I was helpless to comply.
Item: Jackalope is up to new tricks, too. Last night, age exactly seven weeks, she had her first absolute fit of smiles, cracking up over my singing along to the Mendelssohn and Mozart Sugar was playing. She’s a funny baby in general. For reasons only the gods of hand-me-downs know, we own in her size what amounts to a black unitard. I tried, later on last night, to get her to smile for a camera, but was treated instead of pose after pose of hamming. Method baby, I guess.
Item: We have all gone to our respective doctors again. The Bean had has three-year check up, passed with flying colors. Suddenly he is in the 40-somethingth percentile for height and, more surprisingly, for weight. This from a child who spent much of his first year clinging to the bottom five percentile points. He weighs in the neighborhood of 31 pounds and is roughly 38 inches tall. He is extremely glad to now be able to reach the green button that releases the lock on our building’s front door. City kid milestones.
Jackalope is huge. At that appointment, at which point she was five weeks and change, she weighed in at 9 pounds 12 ounces, somewhere in the 60s by percentile. Two pounds over her birthweight, three pounds over her lowest recorded weight in the post-birth drop. Imagine what she’d weigh if she didn’t spit up so much! She is deemed otherwise healthy, and now her acne is clearing up, too.
I took Jackalope with me to my six-week OB check-up. It was lovely, really. As different from the postpartum appointment of abuse and despair as can be imagined. We were thoroughly fussed over by everyone from the receptionist to that very young OB I only met once at my first appointment. I stuck my head into the office of Dr. Joy, the OB who delivered Jackalope, and she was so completely charming in her neon pink lipstick and her exclamations that I wasn’t even annoyed that she had to ask my first name. She clearly remembered me. “Oh! Was it better for you?? You were so traumatized! I just really wanted it to go really well for you!! And you did so well!” She danced around the room holding Jackalope and praising her and me for ages, even though I know she had a patient waiting. (Sorry, patient, but I did need that.) I just love her. I almost want to see her now for my annual exams, instead of the doctor I came to the practice for. But I also love her! Maybe I’ll let them each do one cervix.
For the actual appointment, I saw the younger of the two OB midwives, whom I didn’t meet before Jackalope was born but who gets a gold star in the birth story I will eventually write, for being the person answering the phone when Sugar called to say I was having contractions. Young Midwife could hear me in the background and, in marked contrast to the bitch of a nurse at Dr. Russian’s, who in similar circumstances told Sugar, “she needs to calm down,” said, calmly but firmly, that we needed to leave for the hospital, even if I’d only just started having contractions that made me sound like that. Thank you, Young Midwife, for your help in making sure our daughter was not born in a cab.
At this appointment, we mostly just chatted. My poor, tattered hooha had started behaving itself again, so no treatment for that. Isn’t it always slightly more frustrating than relieving when symptoms resolve prior to an appointment? My pelvic floor is nothing to write home about, but it does seem to be getting stronger; I kegel every time I think of peeing on myself, which is often enough that I occasionally overdo it and exhaust everything. YM told a story of being invited to the country house of a homebirth client and making an ill-advised decision to get on the trampoline with her kids. My own hopscotch misadventures pale in comparison. She asked about penetration and I said I’d let her know if the children were ever simultaneously asleep; she countered with a story of nursing while…multitasking. (Why is it that they tell you no penetration with anything prior to the six week appointment, and then, at the six week appointment, ask how it’s going? C’mon, people.) I am cleared to do everything, including sit-ups, but I told YM I’d be much, much to busy attending to my precious children to do anything so selfish as that. The Bean and I celebrated with a bubble bath.
Hey, y’all, she remarked sheepishly. I am sorry it has been so long. I thought I remembered about this phase, how it means just nursing 27 or 28 hours a day, but I crucially forgot that nursing a newborn requires, at least for me, both hands. Also, by 28 hours a day I mean 40.
But anyway, here I am. Mostly because how many places am I free to talk about my nipples and hooha hurting? Y’all are a special group, internet. I don’t have real hope of managing a narrative post in the next two years, but I will indulge myself in some categorized items. (Spoiler: my nipples hurt. Also my hooha.)
[Several hours later….]
Where to begin? Jackalope, I suppose, since she’s the most novel:
Item: She’s marvelous. Disregard all the time I spend begging her to go the hell back to sleep at 3am. She’s healthy and growing and sleeping more than the Bean did, even if I could frankly use a lot more hours. She seems to be that proverbial easier baby that some people have. Now I understand the magical beliefs that persist about babies — how they give explicable cues before screaming that they are hungry, for instance, and how they like things like swaddles and pacifiers and soothing. I imagine some of this is our being more experienced parents, but mostly I think she’s just a wildly easier baby than the Bean. (Knock wood, knock wood.)
Item: She’s huge! She was almost two pounds heavier than the Bean at birth (7/13 to his 6/1), and she’s growing much faster. She was over eight pounds at her last appointment, at age 2.5 weeks.
Item: She’s tough. At five days old, she reached down during a clothing change, took hold of her umbilical cord stump, and tore it off. No crying.
Item (related): She nurses well! This, I believe, is both cause and consequence of being larger (and born two weeks later). Consequence, because her mouth is larger, her stomach holds more, and she is just more coordinated and, well, finished than the Bean was. She latched on and nursed better in the delivery room than he did for a month.
Item: I have SO much more milk than last time. Funny, it’s almost like a person is healthier when she keeps most of her original complement of blood. Someone should study that.
Item: Nursing a baby who is into it while yourself making adequate amounts of milk is SO MUCH EASIER than nursing a weak, tired, young baby while making not enough milk. It still takes forever and wears me out and hurts my nipples and drives me a little crazy, but really, not at all in the same ballpark. I did have a small nervous breakdown at her first out-of-hospital doctor’s visit, when she had lost still more weight and I imagined us spiraling into the same nightmare we had with the Bean. I took home formula samples and cried and refused to use them, which confused poor Sugar badly. I couldn’t decide whether it was more irrational to begin supplementing a baby I knew didn’t really need it yet, or to dig in my heels, the way I did last time, and allow us to go back down the road of failed exam after exam, needlessly starving baby, etc. (Side-item: I really wish we’d been able to see our preferred pediatrician for that visit instead of her young partner. I think she might have been able to calm me down.) But then, like in the books, my milk came the rest of the way in, and at our next appointment, she’d regained her birth weight. Just like they say happens!
Item: As much as I like the lactation consultant we ended up eventually seeing with the Bean (as opposed to the ones we saw before her, who were various flavors of useless), I like not having to see her even more. And even more than THAT, I like having a baby who can just be fed when she’s hungry and gain weight, without my having to go through routines of timing and facial exercises and diaper changes to wake her back up and horrible teas and pumping and crying and guilt. Funny.
Item: At the second weight check, when she’d regained her birth weight, I also had my first experience of really feeling like an experienced parent. The NP we saw that time, who had repeatedly praised her weight gain, asked about her sleep. At the time, she had been sleeping a 4-6 hour stretch at the beginning of the night, which, I’m sure you can imagine, was heavenly. (I mean, the Bean doesn’t even always do that, and he’s THREE.) Oh no, she said, you can’t let her go that long. You need to be waking her up to eat. And I thought, lady, you just said this baby is gaining weight and looking great; like hell I’m waking her up. But what I said was, “We’ll see.” Because I realized in that moment that not only did I not have to do that, I didn’t even need to tell her I wasn’t going to.
Item: We don’t always get that stretch anymore. Or it isn’t always at night. Sugar generally ends up in the Bean’s room, and I am alone with Jackalope, who likes to have a couple hours of being awake for no earthly reason sometime in the 1-5am stretch. I am tired.
Item: On Monday, my first day home alone with both kids, she stayed awake from 5am until 10:30, napped for 40 minutes, was back up for a couple of hours of continued, constant nursing, took another cat nap, was up again, etc. There was a period when all three of us were wailing. It was precious.
Item: On Tuesday, Sugar came home from work early and I took Jackalope to a department meeting at adjunct-institution-community-college. I had written to ask permission and not heard back, and I need brownie points over there. No idea if I scored them with the right people. I missed half the meeting, including the topic I’d come to hear about. A woman next to me was snide at me while using FB on her phone. It was one thousand degrees and packed; turns out my comfort level with public nursing does not extend to the front row of such a setting. I had the unsettling experience of realizing that the woman I thought was the chair of the department isn’t. But several people said kind things on their way out the door, and I reminded the person who hires adjuncts that I’d like work in the fall.
Item: Poor Jackalope is a second child when it comes to pictures, I’m afraid. We remember to take them, sometimes, but then they are stuck on the camera.
Item: We had a tiny little party and a cake with trains on it. My mom tried to send the trains for his last birthday, but they arrived too late. He liked it.
Item: Still not eating many foods or sleeping through the night or reliably using the potty. But he can do a 100-piece jigsaw puzzle with almost no help. (Still figuring out how to work that “but” into his doctor’s appointment on Monday.) I am an unabashed puzzle pusher, and am beyond thrilled that he likes them, too.
[There’s Jackalope waking up….]
[And then the rest of the afternoon and the evening and the night happened, and most of the next morning. There was an interlude for an unexpectedly early first brother/sister bath, which damn near killed me with the cute.]
Item: The Bean is so much better with Jackalope than I thought reasonable to expect. He likes to put his nose against her toes. We failed utterly to move him to a big bed and decommission the crib/toddler bed in time that he wouldn’t associate the loss of his familiar spot with the arrival of the baby, but as soon as it was converted back to its baby configuration (he helped), I heard him stop mid-sentence, correcting himself to call it “Jackalope’s bed.” She was fussing in there one afternoon, while I was stuck on the toilet. I was a little concerned when he went in to her — he is a lot larger than she is and unaware of her comparative fragility — but he sat down on the floor with his legos and said, “don’t cry. I am making you a tower to make you happy.” Melt.
[Whoops, there went the whole weekend. My dad visited. There’s a lot to say about that, almost all unbloggable. He is charming with babies.]
Item: Our older cat, Michaela, died. She was diagnosed with kidney failure right before Jackalope was born. Sugar learned to give her sub-cutaneous fluids every night. There were supplements but no real hope of recovery. She seemed okay for a while, and then suddenly wasn’t. We all miss her, and of course this has started another round of questions and pronouncements from the Bean about his dead grandmother and great-grandmother, with lots of crying from me especially. I know these questions are a typical part of being his age, but really, the last four months have been over the top for our family. I am so sick and tired of death.
Item: Michaela came to us as a teeny kitten found in the woods, so dirty we didn’t know she was white. (Really, she was a secret calico, with a smear of grey and buttery-tan on her head as a kitten.) She lived with us in Massachusetts and Chicago and New York. She nearly died of hepatic lipidosis in 2005 and after recovering, slept on our feet every night. Despite being standoffish with strangers (“Michaela has boundaries,” said an approving friend, comparing her to our more dog-like Orson), she turned out to adore babies, both ours and others’. We called her the Bean’s nanny. Here she is with the Bean, in 2011, and with Jackalope:
Item: Yesterday morning, Sugar’s paternal grandmother died. (Her maternal grandmother died in December.) It wasn’t a surprise, but it is awful. I am so tired of death.
Item: Sugar is going to Chicago for the funeral for the first part of the week. I’m not ready to be alone overnight with both Jackalope and the Bean, but, well, I guess I’m about to be ready.
My Addled Brain
Item: Despite everything, I don’t seem to be depressed. At least, I don’t think so. It’s almost weird. I am sometimes sad and sometimes overwhelmed, but yeah, not depressed. I do still cry about my mom a lot, but I have a hard time categorizing that as pathological; crying seems pretty rational to me, and naturally I think of her all the time, especially looking at this baby, whom she would so have wanted to know. There’s not much I can do to make that not awful.
My Body, Upper
Item: Remember that Cold of Filth I was complaining about before Jackalope was born? (COF is trademarked to either May or Mrs. Hairy, not sure.) I had this fantasy that somehow the intensity of labor would drive it out like a demon. Yeah, no. Instead, I was sick for a solid month, coughing my brains out. (Other things also coughed out, too, thanks to an enlarged uterus and a pelvic floor that went on strike altogether.) The Bean and Sugar were sick, too, but luckily Jackalope was not, nor does the codeine cough syrup I was living on seem to have bothered her. Still, I do not recommend the experience of being that sick immediately postpartum.
Item: Dateline: NIPPLES. The Reynaud’s is back. For new readers, this means that my nipples are spasmotically seizing up in response to breastfeeding, and if that sounds horrifically painful, well, it is. I got on the nifedipine in short order this time around, following some minor difficulties getting my OB to prescribe the extended release version in place of a “take as needed” regime of regular capsules. (Let me tell you, you take one of those at the same time as a slug of cough syrup and WHOA, good luck standing up.) Unfortunately, the nifedipine isn’t working quite as completely, though things are a great deal better than they were a few weeks ago, when many tears were shed. Now I mostly have spasms at night, and they aren’t so terrible.
Item: I can’t try a higher dose of nifedipine, apparently. I called the OB office a couple of weeks ago, when things were getting very bad, to ask about that and about some renewed locchia. The nurse insisted I come in to see a midwife. On the one hand, it was nice to feel they were concerned about my health, in marked contrast to Dr. Russian’s nurse. On the other, schlepping into the city is not easy, nor was there a point. As I had suspected, the bleeding was normal. Meanwhile, they are afraid my blood pressure will bottom out on a higher dose. I suspect that’s not right — my understanding is that, while nifedipine does lower BP in people with pathologically high pressure, it doesn’t have much effect in someone like me, whose body doesn’t have difficulty maintaining a steady BP. Certainly my BP while I was taking it last time was at my usual level every time it was checked. But, since my usual level is on the low side and I don’t want to pass out all over the place, I guess that’s how it is.
Item: I started taking some extra B6, on the advice of the internet. Hard to say whether that helped, but I already had it in the house. At least I won’t get pellagra.
Item: The Reynaud’s has new tricks. Several times a day, associated with let-down, I have what I think must be massive spasms in my milk ducts. (This happened sometimes with the Bean, but not this early or this fiercely.) The only reason I’m not weeping over this is that it doesn’t last that long, just a minute or two each time. It is more of a sore feeling than a sharp one, but it is intense, like each duct suddenly has a fist inside it. Not recommended.
Item: It was an act of purest optimism to have ordered that breastpump, wasn’t it? Sigh.
My Body: Lower
Item: I know y’all mainly read this blog for hooha news. It’s cool. I mainly write it to talk about my hooha.
Item: In so many, many ways, my recovery from Jackalope’s birth has been nothing at all like my recovery from the Bean’s. Thank whatever it is you like to thank. I am healthier and happier and in much, much better shape.
Item: My pelvic floor is shot, but recovering. For a while there, advertising algorithms were chasing me across the internet with ads for protective undergarments. Depressing. Now I am mostly okay as long as I go to the bathroom a lot and, I discovered yesterday, don’t attempt any hopscotch games. Bad idea.
Item: The hemorrhoids are likewise retreating, like big, ugly glaciers. Butt glaciers. Thank God for witch hazel.
(Gratuitous witch hazel shot because I also love the plant, mostly because it blooms so early.)
Item: Stitches still beasts. The proverbial they say you don’t tear as much the second time, and I guess I didn’t, inasmuch as I’d already, erm, resected my vaginal septum and it’s hard to tear more than that. Nevertheless, I was fairly shredded, inside and out. My new vocabulary word is “sulchal.” That all hurt in a predictable way at first, then got worse around week two, when everything got irritated and the lines of stitches felt like they might rip right out every time I coughed. Or God forbid sat up. Things improved again, with a delightful interlude of suture ends poking me in personal places.
Item: Except now I have these hard spots I suspect are scar tissue, and nothing is stretchy enough. As in, it hurts to sit again, in sharp little ways, and then there is blood. Not a whole lot of blood mostly, but I think I am tearing a little bit every day now, just from sitting. I am so not into this, I can’t even tell you. I have my postpartum appointment on Tuesday, and I sure hope there is something to do about this problem. I’d like to, um, use that part of my body again someday, for one thing. Ahem.
Item: Sara started blogging again! Check that OUT.
Item: I have spent an absurd amount of time giggling at this, featuring drawings the Bean describes as “some funny folks!”
Happy Monday, internets. The Bean and I are lolling around the apartment, while the fire alarm I can’t knock down even with a broom beeps intermittently, in its death throes but far beyond my reach. Heavy snow outside, the wet kind people carry umbrellas against. I’m in the leggings that always fall down, because the others need washing and I can’t stand pants anymore. The Bean is in monster underpants, which is more than he usually has on these days.
Jackalope remains fashionably clad in an amniotic sac and my uterus.
Sugar has gone to work today, for the first time since Thursday. I made her stay home on Friday, because I was so sure I was going into labor. Oops.
In my defense, I had a rough day Thursday and woke up several times on Thursday night with what were clearly labor-type contractions, not the long, strange ones I’ve been having for ages. These were relatively short (1-2 minutes? I didn’t time them), repeating, and felt like the books say they do, starting in my back and wrapping around to the front. (I never felt anything like that when the Bean was born, only back and later back/hip/leg pain. Possibly there was some abdominal action that I just couldn’t discern because the other parts hurt so much.) Meanwhile, Jackalope seems to have suddenly figured out that the way out is down. Lots more pressure and cervical stabbing, accompanied by some relief at the thought that s/he’s not going to try to actually crawl through the fundus, as previous behavior has suggested.
Childcare connections were alerted. I wrote to our doula and my father. I felt justified in having told the food coop that I needed to start my maternity leave early. We all waited for the contractions to ramp up and find a rhythm.
Ah, waiting. The through-line to the whole TTC experience, from Two Week Waits to this. Well, one of the through-lines, if you count obsessive monitoring of mucous. Or maybe that’s more of a goopy set of bookends.
We are still waiting. No contractions to speak of since Friday. Did more walking this weekend than I have in a while (though essentially none by my usual standard), which might count as a burst of energy or maybe just cabin fever finally overpowering me. Meanwhile, apparently 38.5 weeks was some kind of towel-throwing moment as far as my abdominal skin’s resisting stretch marks. Oh, well. Guess I won’t be able to hawk my Think Method alongside the more traditional snake oils advertised in the parenting magazines after all.
I gather this experience — thinking one is in labor only to be sheepishly still pregnant several days later — is a common one. It is, however, the opposite of my experience with the Bean, when I was in labor for at least 24 hours (maybe more like 36) before my denial broke. File under “each pregnancy is different,” I guess. I thought I was supposed to be more savvy now that I’m what Penny Simkin calls an “experienced mother.”
File under: “things I would only tell the internet” my adventures in, erm, self-exploration last night. Although I feel confident that refusing cervix checks at the OB office has been the right decision, given that there’s nothing to do with any result (since the follow up to any finding in that setting is, “normal, could mean anything”), I admit I am curious. So in the tub last night, I made a good attempt at finding my own cervix, something I can usually manage when not pregnant. (I use the singular here because the medical consensus is that the other has wriggled up somewhere out of the way as my uterus has stretched, for which I am grateful.) No luck; I blame short arms/big belly syndrome, though possibly it’s also that it hasn’t shifted forward yet. What I did feel, however, was a head. Sort of through the, as it were, roof of my vagina, as if it had acquired a hard-top. Like I’d grown a bone there, which I suppose, in a sense, I have.
So. That’s something.
I don’t mind still being pregnant, for the record. Yes, I am uncomfortable and can’t sleep for beans, even with unisom, my constant companion. But I am happy to have made it to ACOG’s revised version of full term. I’ve had a 38 week baby, and find the new “early term” definition (37w – 38w6d) a sensible distinction; yes, he was healthy and basically fine, but I am hopeful that a slightly more cooked baby may have an easier time nursing and just generally adjusting to the world. (But please still be small enough that I can get you out, okay, Jackalope?)
Dateline: 38 weeks, 4 days.
Item: I am still pregnant.
Item: I wonder if that will be true for much longer.
Item: Had a nice visit at the OB’s yesterday. Sweetly enthusiastic u/s tech kept enthusing during my BPP, making me feel a bit jaded in comparison. (Partly, I’ve been spoiled by the image quality at the high-risk place I go for growth scans.). She really was adorable, taking care to point out specific bones, to enthuse over how Jackalope was practicing breathing, “which they don’t do all the time so we don’t always get to see it!” Apparently both placenta and fluid levels are fantastic, or words to that effect.
After a rather too-lengthy wait for the OB portion of the visit (not because anyone was late but because there are few slots for BPPs, and this was the best we could do), a punchy and overtired Bean accompanied me back to the exam rooms, where he roll on the floor. Blood pressure up a bit, which I suspected as I’ve been having these darling little panic attacks, but not enough to worry anyone; weight down a bit. “Undress from the waist down,” said the nurse, and I said no, I’d wait to talk to the doctor before setting myself up for cervix rummaging, thank you. I do not remember that fondly at all, and have decided I am not submitting myself to painful procedures without good reason.
This, it transpired, was perfectly fine with Dr. White*, who came in wearing yet another pair of hip glasses. (Between my previous visit with her, this one, and my doula’s report of meeting her at a delivery, no repeat frames yet.) She agreed that there wasn’t much to do with the information except satisfy general curiosity and encourage me to go to the hospital quickly when labor starts if it happens that I am secretly already fairly dilated. “But,” she said, “that is already what you are planning to do, so it doesn’t matter.”
* Who is, point of order, not white. But I am into using fairly obvious nicknames this time around (why have I been protecting Dr. Russian and pals?) and the other obvious ways to alter her name are not nice.
I really like her. She was so encouraging about everything, saying she really thought everything was going to go well and I would do great and my birth plan looks good, too. She talked to me for a long time, wanting to hear again a bunch of details from my labor with the Bean, and here, gentle reader, is where she really won me over. I was describing the Horrible Cab Ride, and how even though it was Horrible, I was apparently at 4 cm both before and afterwards (leading to my point about how much better and faster everything went after the epidural, not matter what the books say). “It sounds like you were in transition,” she said.
Internets, I was floored. YES, that is exactly what I thought at the time. Everything about how I was feeling and acting was exactly how transition is described, except supposedly I wasn’t because transition is said to happen from 8-10cm. (This led to some real shock at the hospital when the resident said, brightly, “you’re at 4 cm!” not realizing I had been told the same four hours of agony previously. “WHAT??” I said, or perhaps roared. “Um, maybe four and a half,” she said, in a frankly adorable attempt to mollify me.)
When I told my mother about the transition confusion, she said the same thing (minus the cab) had happened to her when I was born, and that moreover, when she was in med school, they were taught that transition was a kind of labor, not a particular point in dilation. (In other words, maybe many people experience transitional labor in the 8-10 cm range, but that doesn’t mean the two are synonymous). Until Dr. White’s comment, I have never heard anyone with more recent training agree with that concept, and I can’t tell you how relieving it was to hear that maybe I am not crazy, and that did happen. Redeeming, that’s the word.
Anyway, yay, Dr. White. On the basis of nothing except our chat (which included how I’d thought I was going into labor last Thursday and then not and then that being able to walk to a restaurant two blocks away for my date (!) with Sugar on Monday made me think I was having a pre-labor burst of energy and then how I could barely sleep that night from pain because in fact I was not up to that walk and how I’ve been having these panic attacks, sometimes without even consciously thinking about anything that worries me), anyway, on the basis of that long parenthetical, she mentioned cheerfully several times how if I happened to go into labor in the next couple days, she would be on call. “Go ahead and make an appointment for next week, just in case,” she said. She almost rolled her eyes when I asked about their induction date policy. (It’s 41 weeks. I never bothered to ask before because I never expected this pregnancy to last longer than the Bean’s. But here I am, still knocked up.)
And then I went home. And then I lay on the bed in various kinds of back pain and contraction exhaustion for several hours, while the Bean covered me with stuffed animals and trucks. And then I lost a great deal of sleep last night in the same way, unisom notwithstanding, and had a pretty rough morning, to boot. And I am starting to wonder if she might be onto something.
At least we have made it to the lunar new year. The Bean and Sugar are both rabbits, you see, and I have been secretly hoping for a little horse, like me.
Oh, and post-scriptural Item: Thank you for your many kind and encouraging comments on the birth plan. I do want to clarify that many of the things you thought it was horrible to have to request are, in fact, standard at this hospital. I know from being there all but plan-less with the Bean that they always hurl the newborn onto your chest and assume you will all room together. (In fact, the dumb tour guide we had last time said that was mandatory, which sounded intimidating. That was only one of many things she was wrong about. The LCs at that place…I don’t have much good to say about the two I encountered last time. I plan to skip the whole business this time and just see the good one I eventually found in Brooklyn if needed. And my insurance will pay! Thanks, Obama!) As far as I know, non-gestational parents can hang with the baby post-caesarean. Nor do I think anyone’s penis gets automatically docked in the absence of a specified desired to leave the thing alone.
The yelling and so on — well, I certainly hope none of my providers would do such a thing. It’s just that I’ve been so wrong on that count before, and felt so helpless to do anything about it (or even, for a long time, to admit it had happened). Really, putting all that in was mostly an exercise in showing myself I could be an advocate for myself, taking control and all that.
I really do like and trust the OBs in this practice, as much as my twice-shy self can trust anyone. Even Dr. Smarm I think is probably okay, despite not being my favorite: she gets very good reviews online, and Dr. Ready seemed genuine when she assured me that, weird appointment or no, she would not do the things I fear. I feel a bit defensive on this point, partly because of my own history, but also because I often feel sort of demographically pressured to believe I should see midwives instead of OBs. I like midwives, in the abstract, but sometimes the praise of them necessitates a villain in a way I find problematic. Point of order, I have good reason to have chosen OB care, both times. I really like this hospital, and no midwives deliver there. The local midwifery practice everyone loves delivers at a hospital I do not love. The hospital with the fancy birth center and therefore more midwives is farther from our house, and the present cab ride is sufficiently long. In particular during my last pregnancy, I was thought to be at increased risk of needing a c-section, and I thought on the whole I preferred to know the person performing it.
This is part of a longer rant on the problems of birth activism’s concerning itself with abandoning medical systems in favor of options (midwives, home births) that may be great for many people but require, among other things, “good” health. Midwifery has a problem, in my ever humble etc., if hospital-based practices risk out patients for things like gestational diabetes. More to my point, it is not ultimately appropriate to advocate that “healthy” people abandon hospital care en mass as a primary response to problems in that care, inasmuch as removing the most privileged (in health but also, statistically, in race, class, and education) from the system, leaving those less well positioned to advocate for themselves stuck in a system activists would do better to improve. (Mind you, I am talking about activist rhetoric here; a given individual’s decision to have a home birth I have no ideological argument against.)
But meanwhile, my back hurts. I am going to take a bath.
Were you in Oliver! ever? I was. Eight grade. I do not love that show. Sorry if this song is now in your head for the rest of the day, too. I don’t know what gets into me. We were instructed to wear our fathers’ old shirts for that scene, so while the rest of the orphans (whose fathers were bigger than mine, I gather) looked waif-ish, I looked like a blue, permanent-press sausage. At least I got to sing the pretty rose seller bit later, in a peasant blouse.
Sorry, as ever, for the silence. I’d say it has been difficult to find time, but the real issue is energy. I am just so beat these days. I feel fine in the morning, but by evening, forget it. Makes me rather nervous about what’s coming next.
Meanwhile! Pease porridge and items:
- Thank you for your many thoughtful, um, thoughts, about the doula situation. I/we have not decided what to do, but your comments have been very helpful. After meeting with friend-doula, I feel about the same as I did before: I think she is a good personality match for me, but I am worried about the experience issue. On the other hand, it is very, very valuable to me to know her personality well enough to trust that she won’t be crazy at me during labor. The doctors I have met at my new OB place all seem very nice and swear they aren’t insane, yet I find I am having enormous difficulty believing that. Just having that concern out of the way about a doula might be valuable enough to make up for a lot. As for the “morning-after” problem, I never saw my last doula after delivery, and I think that on balance that hasn’t been so great for my mental health. I do plan to have some pretty clear guidelines for anyone in this role, namely: pay more attention to me than the baby; tell me what a great job I did more times than anyone could possibly need to hear. Especially if this isn’t the kind of birth people carry on about the beauty of.
- Speaking of mental health, I did go see that therapist last week, and I have an appointment for next week. She seems good, I think. She said several good things, things many of you have said, but it is different to hear them from someone who doesn’t like me, you know? (Wait, maybe you don’t like me, either? Someone who I’m not trying to have a friend-style relationship with, anyway.) I chose her because she has training in CBT and EMDR; a cognitive approach to this situation feels much more to the point than still more mucking about in my feeeeelings. Of course, what did I do? I talked about my feelings for a fifty-minute hour, that’s what. But I am a narrative gal, and I did need to tell her the story.
- I only cried once! Rather suddenly, at the point where I said the thing about how, when I imagine things going well this time, I imagine myself surrounded by warriors. That was surprising timing, to me. The therapist — she might need a bovine name, not because she herself seems at all cow-like, but because the waiting room of her otherwise very midtown office (converted apartment, doorman, and so on) is entirely decorated in strangely urbane cow art. Let’s call her Caroline, as long as we’re on a musical kick, for the new, blue, true, moo cow in Gypsy, the one who is willing to moooove to the city with Baby June. Anyway, Caroline stopped me and asked me to dwell on the feeling that brought up, and woman, I wanted to shout, all I DO is dwell! But anyway, I think that went about as well as expected.
- I paid another visit to the high-risk place with the fancy u/s machines, for part two of the anatomy scan. It was…a bit of an ordeal, frankly. (With the obvious caveat that I mean “ordeal” in the limited way the word can apply to a situation with a good outcome.) Sugar had an important work meeting, so it was just me; God bless my friend the Dane for taking the Bean in addition to her own kids for the afternoon.
- First, there was the Great Cervix Search, the longest stretch (as it were) of dildo-camming I have as yet experienced. My cervices, you may recall, are of particular interest because having the two of ’em means I am at increased risk of cervical incompetence, number two on my list of most-despised obstetric terms. (Number one is “habitual aborter.”) On the MRI I had prior to ever being pregnant, the two of them are smack next to each other; before the Bean removed my septum with his head, they were fairly easy to find on physical exam, since each had its own little vagina. How cute. Post-Bean, one — the one he used — has been easy to find by hand, as it were, one much more difficult. When I was in labor, they only found one, so my hunch is that the other made itself scarce in late pregnancy, and many thanks I send it.
- So, back in the stirrups: the tech spent a while poking around with the ultrasound wand, pursing her lips and printing pictures and, as they all do in these moments, interrogating me about how I knew there were two, anyway. (MRI, plus I used to bleed out of the un-tamponned side, plus the other tech found it a month ago.) This is a slightly annoying conversation to have while being dildo-graphed. After a while, she stopped but told me to stay put while she found a doctor to decide if her pictures were satisfactory. Enter doctor. “I’ve never done this before,” she says, and off to the races we go, complete with the same interrogation. Eventually, she gives up, too, and in comes the senior doc on duty, who is very luckily the southern one I like so much. “How does it feel to be a medical marvel?” He has a firmer hand with the whole business (GOD, I do not like being able to compare technique in this way, but there’s only so long I can stare at the ceiling and think of England.) After quite a hunt, at least punctuated with jovial asides and no dubious eyebrow twitches, he declares himself defeated by my marvelous anatomy, too, but willing to assume things are okay in the absence of symptoms, given the fine state of the less shy cervix and the full-term status of the Bean.
- Now is the part where I insert a little prayer that Jackalope doesn’t get any funny ideas about using the untested one. Do you hear me, young…person?
- Jackalope, who has been kicking up a storm through all this, has fallen asleep, and in a position not conducive to measuring anything relevant. Now we see what fun toys the fancy place has at its disposal, like the tilt-a-whirl electric bed I am soon sliding off of, head first. (Seriously, I braced myself only by putting a hand on the wall behind me.) I am basted with more and more gel and rotated like a rotisserie chicken. The paper under me tears into little, goopy pieces. Just…yuck. Eventually the creature shifts enough to show off everything except what the tech keeps calling “the gender.” I resist the urge to parrot a women’s studies lecture at her. Jackalope has her feet between his legs, or the other way around. As I am instructed to roll over again, I mention that they did, after all, get a look last time, but apparently they have to look again. Lord knows why — is it all that likely to have changed? I guess that would be noteworthy.
- Eventually, the tech’s rolling and prodding and jiggling pay off. She releases me to attempt to squeegie some gel off of myself, though it is clear this is more a job for a pressure washer than a paper towel. Dr. Southern returns to say everything is fine, Jackalope is a good size, the cord, which they couldn’t see well last time, is inserted in the expected manner, and while the placenta is still marginally previa, it’s only by 2 mm, which even I can’t manage to fret over. And no cervix searches again until the third trimester, though I’m back for another growth scan in a month. Phew.
- Because she is an angel, the Dane has not only kept the Bean all this time but has also made enough quiche that I can inhale half a pie-plate’s worth upon my return to Brooklyn.
- I did at least get lots of pictures to show to Sugar and the Bean, who respectively described the Jackalope as “a barracuda” and “scawy.” So now you have to look at them.
I think all that dust is on the scanner and not in my uterus, but who knows?
…But maybe I also see where the “barracuda” idea comes from. Still not half as scary as the dragon-lizard the Bean appeared to be at a similar age.
- Speaking of the Bean, he is charming, obsessed with street sweepers and the alphabet, awfully tall all of a sudden (36″), and still not much of a sleeper, very much to my consternation, though it is Sugar who gets the brunt of the night work, since he refuses to let me be the one to come in when he wakes. He mostly still naps (and is a holy terror if he doesn’t), but he rarely falls asleep before 10 pm. This would be annoying enough if he could be allowed to just stay up, but he really cannot function that way. So we start bedtime at 8 or 8:30, read books, brush teeth, all that, and then one of us sits in the dark for an hour or so. Every night. Thank God for iPads. (If he does not nap, he falls asleep much more quickly, but you will have to take my word for it that his mood and behavior for the last several hours of the day in that case are such that, NO. Artificially shortening his nap does not speed up bedtime.)
- I did not answer the cat-torture question because I kept hoping I would find an answer or at least discover that his current delight in pestering the household felines was a short-lived phase. Ha. I don’t know what brought this on, but I know I want it to stop, pronto. Also a thing that could stop any time: “knocking” (read: hitting) his mothers.
- He’s down to refusing all food except smoothies for dinner. (At lunch he will usually eat a peanut butter sandwich.) I don’t know anymore. He loves to cook and talk about food, just not so much to eat it.
- He is very sweet about the baby, though, hugging and kissing my stomach and whispering, I love you, baby, in that not-very-whispery two-year-old way. This is very clever, as it is impossible to remain annoyed with whatever shenanigans he has been pulling when he does that.
- Potty training is under way, in the most lazy way possible. His little butt is extremely cute in underpants. It is extremely hilarious when nude, as it often is, especially when he starts practicing being an acrobat.
- This post is even more scattered than usual. Winning!
- Sugar did come with me to today’s OB appointment, with the original doctor I know in the practice, the one who dealt with my Return To Stirrups last summer and also with Sugar’s menacing ovarian cysts, back in the day. She is very nice. She says no one at that practice is going to yell at me in labor. I have some trouble believing she can really know that about her colleagues, but I at least think she would not, so that’s a start. She did say, however, that she favors having women hold their breath while pushing, which I found ridiculous and panic-inducing. But we will work on that next visit, I guess. Time for another lit-review….
- In the meantime, I am to acquire a blood sugar monitor in preparation for testing four times a day for two weeks, starting around week 26. This strikes me as overkill, but still better than having my brains scrambled the way they were by the glucola last time.
- I asked whether it was really okay to be taking unisom every night, because if I don’t the first time I get up to pee is the end of sleep for me. “It’s not a great idea to take anything every night,” she started, but when I asked what I should do instead about being up for the day at 2am, it turns out she didn’t think half a tab was such a big deal, after all.
- (Don’t you always stick around, just to see if something comes after the credits?)
- I’m going to DC for the weekend, for a baby shower. This is emphatically not the kind of thing I usually travel for, but the gravid friend in question organized my shower from DC, so it seems the least I can do. I will be there Saturday and Sunday, basking in the glory of the closed museums and terminally borked transit system, and while this was supposed to be sort of a treat, it isn’t feeling like much of one. So let me know if you are around or have great ideas for something nice to do that doesn’t involve alcohol or the federal government.
Before I begin, I want to just say, in a small voice, how crushed I feel by May’s latest news, by the utter un-rightness of it, by how badly the universe is flubbing its lines. This is not how the story is supposed to go, dammit. I know we talk a lot about how unfair all of this business is, but sometimes the unfairness is just so fucking unfair. It is not the only thing that has been Not Right lately; that doesn’t make it any less wrong.
I am wondering if any of you happens to know what counts as a normal postpartum drop in hemoglobin and what doesn’t. Imagine you have this patient who, after two days of fairly heavy vaginal bleeding, arrives at a hospital in labor. Her hemoglobin at that point is 13; her hematocrit is 37.8. Following a vaginal delivery, her numbers are 7.3 and 21.7, a drop in the neighborhood of 44%.
Question one: Is that normal? If not, how abnormal?
Question two: Are there causes of postpartum decreases in hemoglobin other than blood loss? Does the placenta itself (or the baby) in some way count towards the starting number?
Question three: Do you do anything about those numbers, beyond suggesting an iron supplement? Do you do anything if the patient calls three weeks later complaining of continued extreme fatigue, dizziness, breathlessness, etc.?
Question four: Supposing a patient with this history is pregnant again. One likely source of postpartum bleeding (vaginal septum) is gone, though possibly the vaginal wall where it attached has scar tissue. Is postpartum hemorrhage in such a case likely to recur? Do you do anything in particular to lessen the chances of her feeling terrible for months again? Is there anything you can say to her to help her feel less frightened?
Question five: Is this patient a good home birth candidate? Just kidding.
My hospital records — the short version only — from the Bean’s birth arrived this week. I’d put off ordering them for a couple of years, which I guess is good, considering that I find myself a little taken aback anyway. This is just the abstract — test results and some nonsense from the lactation consultant, an extremely silly person. There are errors: I am listed as having a didelphic uterus (nope, not that normal), and hemoglobin and hematocrit are reversed in one place. (I flatter myself that a hematocrit of seven might have been more worthy of note.)
Also this week, I finally tracked down a picture I didn’t know existed until recently, of Sugar cutting the Bean’s umbilical cord. That is to say, it’s a picture of my crotch, post delivery but prior to the arrival of the placenta. I thought it might feel sort of empowering to see that, since I was scared to look at that part of my body for weeks after birth, not wanting to see all the stitches. Maybe it would have been, but I found it hard to pay much attention to my flesh, finding the pool of blood I was apparently lying in rather visually distracting. When I say pool, understand, I mean pool. I don’t mean the bed was a mess. I mean liquid. I mean depth. I mean volume.
I thought I was done finding new things to feel angry and scared about, regarding the Bean’s birth, but I guess I was wrong.
I haven’t written in much detail about how sick I was after the Bean was born, partly because at the time, I was filled with confusing hormones, alternately elated and distraught, and, well, sick. I’d been pretty thoroughly conditioned to believe that only people with (unplanned) c-sections were allowed to feel sick or sad after birth, anyway; the websites said I should be exulting in my all-powerful womynhood and resuming my exercise routine while teaching the baby French. All that matters, as you know, is that the baby is healthy. The vessel has done its job.
So, here: I was pretty sick after the Bean was born. For the first week or so, I had an annoying tendency to black out every time I tried to nurse him. The nurse I asked about it told me that was “oxytocin, filling your body with feelings of well being.” Later I realized that was the only time I wasn’t lying flat. I couldn’t hold him during the lactation class and was grateful that lesbian privilege meant I alone among the women there had someone to help. (Men weren’t allowed.) We left early because I couldn’t sit up anymore.
For the endless rounds of pediatrician visits for weight checks in the first few weeks, I took cabs. One day Sugar had a work meeting, and I couldn’t carry the Bean in his carseat. I could barely carry the car seat. We tried to take the subway once. Sugar carried the baby while I shuffled behind her, hips still entirely disconnected, like a troll aunt of some kind. (Sugar got lots of congratulations for her new baby in those days. She deserved them, but my own invisibility beside this gorgeous, healthy, thin woman and her perfect baby was sometimes hard to take. “Don’t worry, honey,” one woman said, “you’re next!”) Sugar went to the store for a different kind of iron supplement for me while I took the dwindling Bean to a lactation group. I remember feeling such utter hatred for the other woman there, so pink and healthy with her fat, pink baby, who was younger than the Bean. While Sugar was gone, I started shaking convulsively. I was losing my vision, trying to figure out how I was going to get myself onto the floor without dropping the baby, who was so, so heavy. Sugar arrived just in time, and held him while I lay my head on the desk and shook. No one asked if I was okay. I took a cab home.
It’s hard to write this without feeling I am exaggerating things, but this happened. Other things happened, too, many of them good. I stayed conscious for the ride home from the hospital, even if I did have to go immediately to bed and so missed the cats greeting the Bean. Friends came over, and I sat and talked with them. But it was months before I could walk around the neighborhood normally. Going up the gentle incline of the train station left me breathless, my vision blotchy. I feel existentially queasy looking at pictures of me with the Bean in the early weeks, because I am so very grey.
I got better. The human body really does have amazing powers of restoration. But does the patient’s recovery mean the treatment regime was wisely chosen? The heroic medicine doctors, the bleeders and purgers and givers of mercury, thought their treatments worked because their patients often survived, when the truth is those patients recovered in spite of the medicine. Regardless of whether I should have had different treatment in objective terms — and I gather from google that sources differ on the guidelines for iron infusions and blood transfusions and so on — I feel sure the other aspects of treatment could have been better. Only one nurse, when I was already in the process of being discharged, mentioned my hematocrit drop and asked if I really felt okay. (Desperate to leave, I said yes.) The nurse practitioner at my OB office told me I should expect to feel tired when I described my trouble breathing while walking. At the infamous postpartum appointment, Dr. Russian didn’t know my hematocrit levels and dismissed my questions on the topic. None of that was helpful, even if it was the case that the best course of action was waiting for my body to rebuild itself. It’s a kind of gaslighting, I think, not to tell a patient that how she feels is not in her head or her weak moral constitution.
Besides angry, I feel a bit scared by these new documents, in particular the picture. My septum is gone and presumably won’t break and bleed again. I expect it caused some of the trouble, in addition to other tears. The midwife at my new clinic says that didelphic cervices can bleed a lot, and suggested they might try rectal cytotec in addition to pitocin if it seems necessary. (I haven’t talked numbers with her, just my experience of being anemic.) If the pre-labor bleeding was a placental abruption — and we’ll never know, since the head of the OB practice didn’t see fit to take it seriously — there’s a chance that won’t happen again, and a 100% chance I won’t let it be ignored this time. I have the reassurance that I did survive, however sick I got. But there is still that nauseating feeling of almost having been run down by a bus, not realizing it was even there until it passed.
Hello, Gentle Readers. Greetings from thank-God-we-are-finally-pulling-out-of-St.-Louis, aboard Amtrak’s Texas Eagle. We are running late, which I would be more annoyed about except that Sugar flew home yesterday and was so much later in so much less pleasant a way. She spent most of the day in the Detroit airport, spent $100 on a cab home from Newark, ate a soggy tuna melt from an all-night diner at midnight in our kitchen, while discovering that the freezer door had been just slightly open for the last two weeks. In contrast, I was fed a steak dinner and gelato and lay on a reasonably comfortable bed and read A Bargain For Frances to The Bean during our delay. Advantage: Amtrak.
The other reason trains rule with toddlers: no seatbelts. “The cars and trucks are going to meet their friends,” he says. (This wholesome, wooden-toy moment brought to you by several hours of puzzles on the iPad.)
Thank you for your spotting reassurances. It hasn’t come back, and there was so very little that my working theory is self-inflicted crinone-applicator wound. Mad skills. I has them.
I should have written sooner to tell you, except that I’ve had my hands full managing my father at my in-laws and wrangling the Bean. I’ve also been quite drowsy, thanks to my new best pharmaceutical buddy, doxylamine succinate, AKA, Unisom.
I’m not taking it for insomnia, though I have been having trouble sleeping for several weeks. I’m taking it because remember how I was puking in trash cans? Well, it turns out this stuff is a whiz at sorting out nausea, and, get this, it is category A for pregnancy. Category fuckin’ A, y’all. Do you know how many things are A? Not bloody many, thanks to the difficulty of ethically arranging the kind of studies the FDA requires for that designation; it’s pretty much folic acid and this stuff.
So why didn’t anyone mention this to me (or maybe to you) before now? Doxylamine in combination with B6 used to be used by 40% of pregnant Americans, as a drug called Bendectin. There were at least 25 studies and two meta-analyses, which basically say: this does not cause birth defects. But if Bendectin wasn’t a teratogen, it was, says a friend of my father’s, a lit-ogen: that is, it caused law suits.
According to dad (whose business this is), about 3% of babies have a serious birth defect of some kind. No one likes that. A certain number of parents sued the makers of Bendectin. And even though the science is absolutely, uncommonly clear on this subject, law suits wear a company out. Eventually, the drug was taken off the market simply because its maker tired of defending it in court.
Meanwhile, some corners of the popular press believe that smoke always means fire, and jumped happily on the Blame-Bendectin Bandwagon (also the name of my new ska band). Bendectin is used in a third of pregnancies of children with birth defects! Well, if it was used in 40% of pregnancies, excuse me if I think that’s good news — if 40% of all pregnant women took it and it’s only present in 33% of cases of birth defects, that almost sounds protective, the was I figure it. Anyway, the magazines said, you can make something just as good at home: just combine half a tab of doxylamine with some B6…. *headdesk*
Folks, I gotta tell you, this stuff is great. I haven’t tried combining it with B6 yet, because I haven’t been able to find the B6 in small enough doses. But half a unisom a night, and I have almost no nausea, let alone reasons to defile public transit property. Twice now, most recently two days ago, I’ve decided to stop taking it, and both times my body has made me aware in no uncertain terms what a stupid decisions that was. Morning sickness definitely still in effect, when not masked.
I keep re-googling this, convinced that anything I’m getting this much benefit from must be terrible for babies, even if I did learn about it from my OB’s website. Eventually, I asked myself why I was so anxious about it, given that I take my nightly singulair without concern, and there’s hardly any data at all on that one. I think the answer comes down to thalidomide and the curse of Eve.
Did you see a lot of thalidomide documentaries as a kid? I did, or at any rate, the ones I saw made a big impression. And I think my psyche stored away somewhere the idea that what happened to those children was not just a horrible accident but a judgement of sorts on their mothers, for trying to escape a natural but unpleasant part of pregnancy. Chalk that up to one more subtle way ideas of the natural as applied to women’s experience are always ready to become a cudgel.
The unisom is kicking in now, and Little Rock comes early in the morning; I must to bed. But y’all: what we need more of is science.
Gosh, internets, thank you for all the love and enthusiasm. Warms the cockles, I tell you what.
I keep thinking I’ll pull together the mental wherewithal to organize a proper post, but I’ve been spending all my wherewithal talking to insurance companies and billing offices. Herewith, the Insurance Items:
Background Item: Since the Bean was born, I have been on Sugar’s health insurance (Aetna, lifetime health cover loading), first because I wasn’t working and then because I wasn’t working in the right place to have my own. However, that insurance doesn’t have the kind of gold-plated fertility coverage I require, so this spring I accepted two night classes with a wretched commute in order to return to my old insurance (Empire Plan) long enough for an FET or two. This coverage ends in late August, at which point I will be back on Sugar’s plan.
Item: I screwed my courage but good and called the office of the nice OB — you know, the one who said four hours of pushing didn’t mean I wasn’t trying and used the word “horrified” more than once as I quivered on her exam table, trying to explain why coming in for a Pap smear had me so anxious. I like her a good deal and trust her about as much as I’m currently able to trust any member of her profession (midwives included, I’m afraid), and even so, I was quite dizzy with nerves as I waited on hold. (This bodes well for the coming months, eh?) I finally made it out of the holding tank and then through the nine million questions necessary to schedule early pregnancy appointments (knock wood, practice belief, knock wood), at which I point I casually mentioned that my insurance had changed since my last visit.
Guess who doesn’t take my current insurance, only six or so plans with remarkably similar names?
Cue panic attack.
After a lot of phone calls and mental math, I decided that the cost of seeing the good practice for a couple of out-of-network visits before returning to their accepted Aetna plan (three, I’m guessing) is lower than the cost of patching my mental health back together if I have to find a new practice, even just for a couple of months. I have a few hundred dollars of deductible to cover, after which my insurance will pay 80% of “reasonable and customary” charges; someone from billing is supposed to call me back this week, but she sounded like she thought they would likely work with me to charge amounts my insurance finds acceptable. This will still end up costing us quite a bit more than seeing someone in network, but therapy ain’t free, either. Especially at a time when I can’t avail myself of the kind sold in fifths of a gallon.
And anyway, that deductible has nearly take care of itself already, because…
Item: I am suddenly outside the bounds of my coverage at the Baby Factory, despite not being released as a patient yet.
My insurance considers the Baby Factory in-network for fertility care only, not for pregnancy care. This seems like no big deal, since the Baby Factory doesn’t do OB, but it did cause me some stress three years ago, when I started bleeding after they had released me but before I’d found an OB. At that point, Empire Plan considered a heartbeat on ultrasound as the boundary between fertility and obstetrics; I had a first beta, a second one week later, saw a heartbeat two weeks after that, and was sent on my way. It all seemed perfectly reasonable. We know too well that a positive first beta does not mean a Real Live Baby, but the rate of miscarriage drops significantly after a heartbeat.
Imagine my surprise, then, when having been relieved of yet another vial of blood this Sunday, I was handed a bill for the second beta (and progesterone and estradiol just for fun, I guess), to the tune of $300 and change. We can send it out to a lab your insurance pays for, said the lady in billing, but you won’t get results quickly. My cheapness fought my anxiety; cheapness is strong, but anxiety has throwing stars. So even though I had a sinking suspicion I wasn’t pregnant anymore, I decided to bet on good fortune and pay the bill, hoping that money would count against the deductible I’d spend at the OB’s anyway, assuming I got there.
So far, so good. Which brings us to…
My father’s family has been going to this particular place on the shore of Lake Superior for a bit more than hundred years; there’s a gathering of cousins there planned for the end of June. We go there rarely, and I so want the Bean to see it. It is so beautiful, I won’t even pretend to do it justice in a rushed blog post except to say that it is what I picture when I think about heaven. And I’m not really a cold weather girl. It is also quite remote. The only telephone is several miles from where the cabins are; the nearest hospital certainly over an hour. It is sublime, but it would be a hell of a place to have an ectopic rupture.
I asked Dr. BF back in March what he thought of our going the on the heels of a May cycle. As long as your betas are unambiguous, he said. If they look potentially ectopic, I might have to tell you to stay home. Fair enough, I agreed. Just because this place is like heaven doesn’t mean I want to die there.
All this time, I’ve been refusing to quite believe that this trip will happen as planned, but the plan is to leave on Friday. (We are going to a wedding in DC, then to Sugar’s parents’ in lower Michigan, then to the UP, then home (Sugar) and Arkansas (the Bean and me, to see my mother). It’s quite the odyssey, even by our standards.) So after the first beta, I called Dr. BF to remind him of our deal, and that this means we will not be in town for their preferred viability ultrasound at something like 10 days past the second beta.
“You’re leaving Friday? Just come in Thursday morning for a scan. We won’t be able to see much, but as long as we can see something in your uterus, you can go.”
The first problem with this plan is the “Thursday” part. Thursday is Dr. Paternalistic’s shift. I do not want to get bad news from his mouth. I’m not even sure he’s capable of giving me good news without being an ass. But all my scheming about whether I could convince a babysitter to wait in a playground with the Bean (and our luggage?) so that I could go on Friday instead, on our way to the train (pause to appreciate the crazy scheme), was displaced on Sunday by fretting over the cost of the ultrasound without insurance. (Both, of course, a form of distraction from the more obvious anxieties attending such a scan.)
Happily, many phone calls later, it transpires that the prices of everything except the progesterone test are within the bounds of “reasonable and customary.” I confess shock that the blood tests are, frankly, and suspect this has less to do with chemistry than lab monopolies, but whatever, not my (immediate, individual) problem.
Item: The plan. Scan Thursday, very early so that Sugar can come before work. Probably too early to see a heartbeat, so we’ll try not to think about that part. I will see if I can sweet talk a nurse into jiggering the schedule so that we get the fellow I like instead of Dr. Paternalistic. If not, I guess I’ll live. On the other hand, this might be my last chance to kick him from the stirrups….
Item: this post is absurdly long. Sorry.
Item: I think that today I entered the part of pregnancy when I can’t have coffee anymore without feeling really sick. This lasted for the duration last time, and boy, is caffeine a more important part of my life with an early-rising toddler than it was pre-Bean.
Item: This morning also marked the first convincing nausea of this process (doxycycline excepted). Not so bad, as these things go, but still not my favorite.
Item: I’m not sure if this quite rises to the level of a craving yet, but holy Moses, is beef all I want to eat in the whole world. I could have wept for joy at the sight of hamburgers grilling at Sunday’s pool party.
Item: this post is absurdly unstructured. Sorry.
Item: I will leave you with some Bean cultural anthropology, inspired by his asking after the whereabouts of our local ice cream truck at six or seven on Saturday morning:
ME: Many people do not consider ice cream a breakfast food.
BEAN (thoughtful, serious): Maybe some do.
(And then, in the spirit of self-fulfilling prophecy, he fell backwards off a picnic bench while we were out to brunch with a friend, smacked his head on the concrete patio, acquiring in the process a magnificent goose egg and a free gelato from a sympathetic waiter. How is it so many people survive being toddlers?)
Hi, internets. Sorry for the wait. Valium remains my favorite drug, which is why I didn’t write yesterday.
So. The transfer was fine. After striking out with our usual sitters, thanks to the holiday weekend, I found a former student to stay with the Bean. I was beginning to think I would have to go to the clinic alone, which was a sad thought. Of course all my monitoring appointments have been just me, but a transfer feels more momentous (or at least potentially momentous), and a person likes to feel she isn’t acting unilaterally, you know? It was unexpectedly cold, so Sugar and I had a chilly walk to the clinic from the subway. It rained a little.
At the Baby Factory, we were directed upstairs, to the floor with the ORs. Dr. BFs office, the exam rooms, and the blood draw room are on the lower floor. The last time I was upstairs was the day of the Bean’s transfer, but I always think of the first time I climbed these stairs, when we paid our $450 gay tax in the form of that stupid “counseling” session. Luckily, Starrhillgirl distracted me with a picture of the blue mountain view where she was waiting, and I reciprocated with a picture of the lot beside the Baby Factory, which, despite what I can only imagine must be an astronomical value, has been vacant for at least four years. To give you an idea of the kind of money we’re talking, that tall building in the background is the UN.
Soon enough, a very solicitous nurse with an English accent led me back to the changing room, buckled me into my hospital bracelet, and gave me that Valium I’d been pestering everyone about. I changed into a Baby Factory gown, but unexpectedly I got to keep my own socks and sweater. I might have chosen more special socks, had I realized, but I was very pleased that I’d worn my softest, most comforting sweater. And the socks were red and striped, so it could have been worse.
I sat in a backwater of the recovery room for a while, waiting to be reunited with Sugar and meet the doctor. A man in Hassidic dress — long, black, silk coat, white stockings, round, flat, black hat — hurried back to meet his wife behind a curtain. A tall, Russian nurse strode in and out in scrubs. I am almost certain her shoes, with blue, gauzy surgical covers wrapped and tucked around them, were either flip-flops or the cheap, mule-ish houseshoes people here wear in the summers. She had lovely ankles, but all that bare flesh still seems odd in an environment with so many sharps containers. Then again, I was walking around in socks.
Because of the shoe covers, I can’t say for certain that these are the ones she was wearing, but neither can I guarantee they aren’t.
By the time someone took me to the antechamber by the OR, the Valium was kicking in a little. A nurse took some blood from my left arm; I’m still letting the right recuperate following its refusal to yield anything last week. Sugar met me there, and Dr. Friday, an unknown quantity, arrived to talk about our embryo. It turns out I like Dr. Friday, though I admit that her almost cartoonish voice — it’s possible my mental fog exaggerated the pitch and speed — baffled me for a moment. Pre-transfer googling (what?) leads me to believe she, unlike most (all?) of the other Baby Factory doctors, also still does some OB/gyn work, and she certainly seemed more gyn-ish than the others, in that she seemed interested in hearing about how my septum had behaved in delivery (and, following some clipped statements from me to the effect that I had not been pleased with my medical care, who my OB had been). I know what you’re thinking, but her practice is in Connecticut.
She gave us some papers to sign and said some complimentary things about the embryo in question. The embryology lab, we are told, is put in a very good mood by embryos like this. Later, when I was looking at the creature itself on a screen in the OR, she said “it doesn’t even look like it’s been frozen!”
I’m glad she said all those things, because in truth, it doesn’t look to me quite as textbook-perfect as the Bean’s. I expect it isn’t, but I’m hoping that doesn’t matter, and I certainly know that less than perfect looking embryos have turned into actual people. (Who knows? Perhaps even my own embryonic beginnings were not so glorious.) It’s a 4BB, from what I saw on the chart — only maybe one of those Bs was lowercase — and something about it was “95%”. I don’t have much of a sense of what that means in the scheme of things. Regardless, it’s the one that’s inside me now, so alea iacta est, you know?
Off Dr. Friday and I went to the OR. Nurse Flip-Flop helped me into the most spread-eagled stirrups ever. The embryologists put the embryo up on the TV screen. It was fascinating to watch it change radically as they shifted the focus of the microscope; I wouldn’t have guessed it had enough height to make depth of field an issue, but it did. (Must be the donor; I am quite short.)
Dr. Friday cranked the speculum open to 11, and I must say, it was excruciating. The pain burned from two lines, top and bottom, running the length of my vagina; I suspect this is where my septum was. I have had occasion on my own to notice that what I assume are those areas do not stretch as well as the surrounding tissue. Indeed, Dr. Friday said she could see the septum’s remains, which was almost interesting enough to make up for the pain.
The transfer itself was perfectly smooth, like the way other people often describe IUIs. No wonder people don’t think this is a big deal! (I’ll still ask for Valium if there is a next time, though, if only for the sake of my nerves.) Unlike Dr. Paternalistic, who always hogs the ultrasound screen, she left it tilted enough that I could see it. She and the nurses pointed out the image of the catheter entering my uterus and then, after it retreated, the glowing, white ball of fluid enveloping the embryo it left behind.