Take Two

It’s been a long time since I’ve posted.  In my defense, I’ve been a bit busy.  Earlier this month, I delivered our second beautiful baby boy.  And so it begins.  Again.

I figured we would be finished with one.  WE were good with one.  He fit well into our lives, and it was just starting to get easier.  We had it all figured out.

But then we would watch him playing alone.  Watch him watching the other kids.  Watch him begging us to “Play!  Play!”  And we knew.  We had to give him a sibling.

So we started on the journey again.  Oh, it wasn’t without doubt.  We had many many conversations about the process of pregnancy.  I had a pretty rough pregnancy with our first, and wasn’t looking forward to doing it again.  My husband wasn’t thrilled with the prospect of picking up the slack while I would be theoretically laid up on a couch for 9 months.  But, we figured, it was only temporary.  And hey – they say that every pregnancy is different!  Maybe this one would be easier!

So we persevered.  And were shocked and over the moon when that second pink line appeared, ever so faintly.  It was going to happen!

And then… Pregnancy.  To save you the suspense, they were right.  Every pregnancy IS different.  This one, unfortunately, was much worse.

Granted, I am now two years older.  And more tired, chasing around a toddler.  But when it HIT, I was not prepared.  The nausea – let me tell you about the nausea.  This was not a little bit of seasickness.  This was literally throwing up 10-15 times a day.  This was opening the fridge, and catching a whiff of something that I swear was rotting, and bending over the kitchen sink while everyone else swore they couldn’t smell anything.  This was vomiting after walking past a batch of “rancid” strawberries in the grocery store.  This was putting my work conference calls on mute (thank GOODNESS I have the flexibility to work primarily from home) to vomit into the wastebasket.  It was horrible.  Literally the worst feeling I have ever felt in my life.  And it NEVER ENDS.

Doctors wanted me to take Zofran as they were worried about dehydration.  Zofran, FYI, is an anti-nausea medication that is commonly prescribed to chemotherapy patients.  Are there risks, I asked?  Minimal, they answered.  And so of course I turned to Dr. Google.  And subsequently decided that no matter how bad it got, I wouldn’t take it.  Paranoid?  Maybe.  But I could never live with myself if something went wrong; I would forever blame the fact that I had opted to take the Zofran.

So I tried acupuncture.  Multiple times.  Didn’t work.  Tried the ginger, the Vitamin B, the teas… In short, I tried everything.  Nothing worked.  Depressed.  Isolated.  Staying out of the kitchen helped.  Avoiding strawberries helped.  Throwing away the pear-scented hand soap that I could smell on my husband or son a mile away helped.  But other than that, there was nothing to do but subsist on the couch, in my office chair, or in bed until it finally began subsiding around 5 months.

Then the relative bliss of the next few months.  I felt alive again!  Could make (and keep) plans!  Could finally think beyond the misery of the next moment to hours, days, and weeks ahead.  Pulled out of the depression.  It was wonderful.

Now the focus went beyond my own misery to the baby.  I had done a CVS again, so was assured that genetically things looked okay.  I was seeing a wonderful OB (who had delivered my first child) and a top perinatologist, so knew I was in good medical hands.  So far so good.

Then the next challenge.  The perinatologist lets me know that my HCG levels are too high in about the 25th week of pregnancy.  Since genetic issues can be ruled out, it likely means that I could later struggle with placental insufficiency.  What is placental insufficiency?  Well – it basically means that the placenta is working too hard, too early, and will likely “poop out” (doctor’s words) towards the end of my pregnancy.  He concludes that he wants to continue to see me to measure baby’s growth, placenta’s growth, and ensure we catch it if it starts to fail too early.  He also advises that he does not want to see me go beyond 39 weeks of pregnancy, even if all looks well, because at that point the risks outweigh the benefits in a woman “as young” as I am and with some of my test results.

So we continue to see both doctors.  Everything seems to progress normally and after 32 weeks, I am “graduated” from the perinatologist.

About two weeks later is when the baby’s growth really begins to slow.  In fact, almost decrease.  I am given Non Stress Tests (NSTs) to ensure all looks okay.  And then come the scares.  This baby NEVER MOVES!  I share that with my OB.  Sure enough, she does an NST and his heart rate is flat.  She sends me to the hospital for two hours of additional monitoring and a biophysical ultrasound.  Ultimately all looks okay.

Then a couple of weeks later, a car accident.  A minor one, but I am shaken.  And baby stops moving.  Once again am sent to the hospital for monitoring and ultrasound.  And baby looks okay.

Then a third time, on Christmas Eve.  Go in for a routine OB check-up, and they notice via NST that the baby’s heart rate is once again flat.  Am sent again to the hospital for the same monitoring routine.  Four hours later, we are discharged.  Baby looks okay.

And then the final and fourth time.  Am once again in the OB’s office when they see only a flat heart rate on the NST print out.  Go to the hospital.  After several hours, am told that baby appears okay.  Am also told that I am having contractions (which I have begun feeling).  My doctor calls.  Says that if we would like, she will induce tonight because of all the scares with the baby… But that she recommends just waiting another day or so.  She feels that I will go into full blown labor on my own by the following day.

We take her advice.  Come home and I labor, albeit inconsistently, through the night.  The following day my husband goes to work.  I labor inconsistently throughout the day.  At times during my walk with the dog and toddler, I have to stop.  I finally give up and plop the toddler in front of Sesame Street so that I can sit myself.  I do end up being able to take a short nap.

Hubby gets home and we take a family walk around 7pm.  I have to stop several times, take breaths, wait for the pain to pass.  But the contractions are still inconsistent.  I get ready for bed, and lie down about 9pm, figuring I can get some sleep before I am certain I go into full blown labor the following day.

By 9:10pm, the pain is pretty bad.  Enough that I am shuddering through the contractions.  But they are still 10-15 minutes apart.  We call the hospital.  They say to wait until the contractions are 5 minutes apart.  Hubby asks if we should call the friend who will be watching our toddler during the hospital stay.  I say No – we have time – and go and lay back down.

By 9:17pm, I am almost crying through a contraction and have him place the call.  By 9:20pm, contractions are suddenly 3-4 minutes apart and I can’t take them.  I have him call the friend back to see how far out she is.  He packs the car and gets everything ready so we can just leave once she arrives.

Finally she is here.  We fly out the door and I am contracting all the way to the hospital.  We arrive and I have to stop 4 times between the car and the entrance.  The entrance is closed due to construction!  They say we have to go around the back entrance.  Hubby pleads with them, they take one look at me, and they usher us through.  We get up to Labor & Delivery.  Hubby calls the front desk: “I think we’re having a baby!”  Panicked.  They let us in and I am bent over a chair, contracting.  Nurse says “We’ve got a live one – Put her in Room 3!”

Within 2 minutes I am in a hospital gown and they have confirmed I am 5cm dilated.  I am begging for the epidural.  They have to wheel me into the delivery room.  Once there, only 10 minutes later, I am 8cm dilated.  I am BEGGING BEGGING BEGGING for the epidural.  Crying.  They are telling me to “breathe through the pain.”  Screw that.  GIVE ME THE EPIDURAL.

Turns out some paperwork wasn’t completed.  Then they didn’t put my IV in correctly.  Then they realized I don’t have a hospital band and they don’t even know who I am.  The anesthesiologist finally arrives and calls a TIME OUT.  The nurses huddle and then start over.  I am begging him for relief.  He advises me that at this point, an epidural will kick in too late.  “The head is RIGHT THERE.”  I tell him I don’t care: GIVE ME THE EPIDURAL.  The nurse says I need to go through a full bag of IV fluids first.  I shout at them to CALL MY DOCTOR.  I want the epidural!

Then finally.  The head nurse comes in and says she has to talked to my doctor, and she has advised them to give me the epidural.  They do so, reluctantly.  I wait for it to kick in.  Through another contraction.  Then two more.  The contractions are fast and furious now – no time in between.  I still feel everything: the checks, the catheter, everything.  I complain between the searing pain.  They say they told me this would happen as I am too far along.  I ask when my doctor will be here.  They say within 30 minutes and don’t push yet.  I feel the urge to push but I am not delivering this baby without her.  More tears.

Finally my doctor walks in.  “Thank God you’re here!”  She takes one look at me, and turns to the nurse “Um, doesn’t look like your epidural is working.”  She begins to suit up.  “Where are my booties?”  Nurse: “I don’t know.”  Once that is figured out, she asks the nurse why nothing has been sterilized.  The nurse tells the doctor that SHE is supposed to do that.  Hubby and I stare in disbelief as the nurse continues to argue back until the doctor, being the bigger person, simply does it herself.

Finally it’s time.  They let me know that I am going to need to push.  I wail like a baby.  I can’t!  I am too scared!  It hurts too much!!!!  I CAN’T DO IT!!!!

They prod me more aggressively and I give a feeble push.  Baby shifts.  Contraction ends.  Second contraction.  Second push.  Stronger.  Crowning.

Then: “The cord is around the baby’s neck and his heart rate is dropping.  We need to get him out this next push.”  And that was all it took.  Gritting teeth.  Sobbing.  Grunting.  Pushing.  And he is out.

More tears.  Of joy this time.  The doctor expertly unloops the cord from around his neck.  He begins crying.  He is red and flushed.  They lay him on my belly and we hold him.  Rocking.  Crying.  Joy.

Unlike with my first, who experienced a traumatic delivery and was immediately taken from me, we are able to luxuriate in close to two hours of skin-to-skin time with our baby.  The time flies by.  We are left alone.  It is the peak of the entire pregnancy.  Those fleeting golden moments.  Just baby, mother, and father.  Precious.

Finally they take him and weigh him.  6 pounds and 11 ounces, much smaller than my first baby.  They bathe him.  Hubby takes pictures.  I watch in awe.  He is perfect.  The moments are perfect.  He is brought back to us for more bonding.  And I notice that my heart has immediately expanded.  Is overfilled with enough love for both of our children.  Dripping.

And I know that our family is complete.

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11 Things Never to Say to a Woman with Severe Morning Sickness

So there is morning sickness and then there is MORNING SICKNESS.  AKA Hyperemesis Gravidarum.  All-consuming, debilitating, depressing illness.  Make no mistake – they are not one and the same.

Typical morning sickness comes with some nausea, vomiting, and general not-feeling-well-ness.  Hyperemesis Gravidarum results in severe vomiting, dehydration, trips to doctors, depression in many cases, and pressure to take Zofran (anti-nausea medication for chemotherapy patients).

Neither are fun.

And due to a lack of real knowledge about either of these conditions, sufferers are subject to constant tips and tricks from well-meaning bystanders who may have no idea how serious this can be, especially in the case of Hyperemesis Gravidarum.

So based on my own experience, I’ve compiled a list of things NOT to say to women suffering from severe morning sickness.

1.  Try Saltines.  Unless the mother-to-be is lucky enough to only have a very mild case of morning sickness, Saltines do not work.  They do not help.  They do nothing but ensure that your next vomiting session includes the white salty goo that these turn into.

2.  Try Ginger.  Ginger does not work.  In my case, it makes me even more sick.  After investing in cases of ginger ale, ginger candy, and raw ginger, I quickly developed an aversion that led to nothing but waste.

3.  Try Sea Bands.  I really wanted these to work.  I really gave it a go.  Day in and day out with those little balls pressing into my wrists, leaving indentations and redness.  I will save you the suspense: they don’t work either.  Again, maybe for minor nausea, but for severe sickness – they do nada except mark up your wrists.

4.  Try Acupuncture.  I had high hopes for this.  Heck, if it is good enough for Fergie then it is good enough for me.  I went 4 times, and each time left as sick as I had arrived.  Once I even vomited on the way out.  Now, I will say that the acupuncturist and staff were extremely nice and caring – that was sweet – but as far as any actual relief, well, you know the story.  Did leave a dent in my wallet though.

5.  Try Hard Candies/Prenatal Pops/[Insert Other Consumable Product].  NOTHING like this works.  Nothing.  I have tried it all.  I did succeed in creating some new aversions for myself.  And in trying some new foods.  But none of it helped with the sickness.  And I was a bit offended that well-meaning advice givers were minimizing my all-consuming and debilitating illness to the point that a simple piece of candy or food could relieve it.

6.  It Will Only Last for 3 Months.  How the frick do YOU know????  That’s what I felt like saying every time.  There are certainly stories of poor pregnant mothers who are severely sick up to and even during delivery.  Even if the woman is lucky enough to find some relief after three months, how does three months of misery sound to you???  Imagine a hangover combined with food poisoning that doesn’t let up for THREE MONTHS.  My acupuncturist shared a true story with me: one of her newly-pregnant patients was suffering from some severe morning sickness.  Her not-so-compassionate hubby told her, ah don’t worry about it, it’s only for three months.  That same hubby woke up the next morning with a bout of food poisoning and, as men do, laid in bed all day whining and begging for help.  The wife, every so sweetly, told him “don’t worry Honey, it will only last for three months.”

7.  At Least it Lets Up in the Evenings.  For those living in the dark ages, “morning sickness” is a misnomer.  It does NOT only occur in the mornings.  Unfortunately some of us suffer all day and night.  I would literally wake up in the night to vomit.  When it is severe, there is NO period of relief.  So to imply to a pregnant woman that she has some hours of relief during the day can be completely false and once again minimize the misery she is going through.

8.  At Least You Will Feel Better Once You Vomit.  NOT TRUE!  If you are hungover and vomit, yes you will feel some relief.  If you have the stomach flu and vomit, again you will feel some temporary relief.  The sick joke that is morning sickness ensures that no matter how often or how violently you vomit, there is no temporary relief afterwards.  The nausea is still there as strong as before.  So all the vomiting does is make you tear up, bring up stomach acid, burn your throat, and make a mess.  The woman does not feel one ounce of relief afterwards.

9.  I/My Mother/My Sister/My Friend Never Experienced Morning Sickness.  Well whoopty-do for you.  That’s great.  Really, it is.  But it is not what I want to hear when I am doubled over and heaving into a toilet or sink.  Especially when it’s my 12th vomit of the day.

10.  Just Try Not to Think About It.  My usually-considerate husband had the audacity to mutter this to me one morning.  Lord help him.  You might as well just say “it’s all in your head.”  I promise you, it is not in my head.  I swear to you, if there was any way possible that I could focus on anything OTHER than being so ill, I would be the first one to do so.  Well-meaning advice givers, I can guarantee you, it is not in the mother’s head.  It is not a matter of simply not thinking about it.  It is a real and serious illness which has no cure and only questionable treatments.  Telling her not to think about it is simply ignorant and, frankly, not possible for her.  Do yourself a favor and keep this little tidbit to yourself.

11. [While in Mid-Vomit] Quick, Get Out of the Kitchen/Bathroom/[Fill in Location].  Newsflash: Once the vomiting has begun, it cannot be stopped.  You cannot simply move the woman to another room or away from the smell and expect the vomiting to stop.  That ship has sailed.  Instead, hold her hair, rub her back, comfort her, and help her clean up.  From experience, I can tell you that all you will accomplish by telling a vomiting pregnant woman to “quick – get out” is a pissed-off and exasperated monster who, if you’re not lucky, may decide to aim your way.

So what CAN you say to a woman who is going through the throes of morning sickness or, worse, Hyperemesis Gravidarum?  Nothing.  The key is not to talk.  Not to offer advice.  Just to listen.  Let her vent, let her cry, give her a hug, offer to lend her a helping hand, and check up on her often to see how she is doing.

No advice needed.

Picking a Pediatrician

Earlier this week, a friend of mine who is expecting her first child emailed me with a quick question about who our pediatrician is and whether or not we would recommend that person.  Of course, being the long-winded person I am, I could not give her a simple answer – and ended up responding with all the pros, cons, and other tidbits I could think of regarding our experience with our particular pediatrician. 

Although we had completed our due diligence during pregnancy (interviewing various pediatricians, asking what we thought were the “right” questions, etc), we have the benefit of hindsight now that we’re on the other side of the fence.  We’re reasonably happy with our pediatrician so I suppose got lucky; but if I could go back in time, this would be my new and improved selection process:

• Ask for Referrals.  Duh.  I didn’t even ask my OB-GYN.  I should have.  I did ask a couple friends, but their pediatricians were out of network for me, so I let it go there.  I admit I ended up resorting to Yelp for my top candidates.
• “Scope Out” Referrals.  Once I had a list of referrals from trusted sources, NOW would be the time for me to scope them out.  Check their websites.  Go to Health Grades and search for reviews.  And yes, now would be the time to even go to Yelp.
• Check Scheduling.  Sure, it seems trivial now, but when you’re a new mom wanting to take your baby in with issues…  Or having to take your baby in as often as every month or two for vaccinations… You’re going to want a pediatrician who has a schedule in synch with yours.  I found many that were only open a few hours a day, Monday through Friday.  And only a handful (if that) who were open any Saturdays at all (which was important for us).  Are you going to want to schedule appointments for weekends?  After work?  Then make sure your potential candidates can accommodate that.
• Confirm In Network.  Ah, the joys of medical insurance.  Before moving any further, I would now contact my insurance company to make sure my top candidates are “in network.”  ‘Nuff said.
• Request Consultation.  At this point I would call each office and request a consultation with the pediatrician.  I felt a bit awkward doing this at first (after all, I’ve never contacted any other type of doctor for a consultation), but apparently it is pretty common.  All candidates I called except for 1 had special hours for these consultations.  That 1 was scratched off the list.
• Ask the Right Questions.  Here is where I semi-failed.  I didn’t have the baby yet, so I didn’t have the right questions.  You don’t know what you don’t know.  If I could do it over, these are the areas I would focus on:

– Confirm hours of operation and urgent visit policies.
– How can the doctor be contacted after-hours?  What is the response time?
– What hospital affiliations does the doctor have?
– Can I email you with non-urgent questions?  What is your response time?  (I would have never thought to ask this.  Fortunately, my pediatrician offers it.  This has been a lifesaver for me – I am able to email him questions, pictures, and even videos of non-urgent issues so he can take a look and respond.  Has saved me a LOT of trips to the doctors’ office)
– Will you always see the same doctor?  (A family practice was important to me; others have a group of doctors and it is only guaranteed that you will see one of them)
– When will you come to the hospital post-birth?  How many times?  (I think once is standard; however, mine came every day I was in the hospital which was appreciated)
– IF APPLICABLE, What are your views on modified vaccination schedules?  (I ran into an issue where my pediatrician and I had differing view on this – led to several tense conversations and emails, and I wish I had simply asked upfront)
– What are your views on breastfeeding vs. formula feeding?  (Even if you plan to breastfeed, it doesn’t always work out.  You want a doctor who will support you in whatever you choose instead of adding even more guilt and pressure)
– Who covers in the event that you are unavailable, on vacation, etc?
– Any other questions about their medical views on nutrition, antibiotics, disease, as well as probing to get a feel as to how they interact with the kids.

• Talk to Parents in the Office.  How long have they been using this pediatrician?  What do they like/dislike?  How long do they have to wait to see the doctor each time they come in?  etc.
• Hire.  By this, I mean that you simply let your birthing hospital know who your pediatrician is, and let the pediatrician know that you’ve decided to go with them.

Now that I’m a parent, the things I most appreciate about my pediatrician is that I never have to wait (once we arrive, we are seen right away), they are great at handling urgent issues (since they don’t overbook, I’m able to come in at any time and be seen almost immediately), I’m able to contact him via email, he knows me and my family personally (e.g. we’re not just a number), he is open one Saturday a month, and he has accommodated some of my requests despite disagreeing (e.g. a modified vaccination schedule).  These are not all things I thought would matter to me before the baby had arrived.

I continue to learn how important the mother/pediatrician relationship is, so do pick someone you trust, can talk to openly, and who will not downplay your concerns.  Pick someone who you would be comfortable discussing poop patterns with.  Someone who you would be comfortable sending pictures of dirty diapers to (yes, we have done this).  And someone who will care for your child’s health almost as much as you do.