The High Tech Way

Breastfeeding, jaundice, and the LC du jour

Birth story still to come, but wanted to update to today.

We finally busted out of the hospital on Sunday.  We were delayed by a day due to jaundiced James who looked like he'd gotten a hold of some of that fake tan spray and used it liberally while I was passed out on percocet in the bed next to his bassinet.

I got the OK to go home on Saturday (if I promised to go to the office to get my staples removed this week) but James held us up.  He was still having the meconium poo.  And his numbers were up for jaundice to 15.7.  They put him under double lights far away from me in the nursery.

Now by Saturday I was losing my mind being confined to that hospital room. I. WAS. SO. BORED. No Internet, except on my web phone with its tiny screen.  No books (cause I brought them last time and didn't read a thing). Crappy summer TV.  Not so many visitors because everyone was sort of visiting each other instead.  And when they took James out to get his ultraviolet suntan, it got even more boring.

Meanwhile, each new nurse and lactation consultant was giving me different and conflicting advice about how to establish nursing, how to get the new guy to latch, etc.  Reminded me of the nurses and lactation consultants in California.  By Friday night I was engorged and not much was flowing.  I fed the kiddo and pumped and pumped.  James got circumcised during a thunderstorm.  I prayed that the doc would not be cutting when the big clap of thunder came. (all went well.)

I alternated ice packs and warm towels on the boobs after doing a Google search Saturday night on my tiny screened web phone.  And I pumped some more on Saturday, in between when they brought James in for feedings.  I supplemented what he pulled out with what I'd pumped, fed to him through a syringe.

They said they would send us home on Sunday with a Wallaby, which is like an ultraviolet light blanket.  They said visiting nurses would come and check on him twice a day.  But by the time he took his final blood test (he has many many many pokes in the heels of his feet), his numbers had dropped enough that they sent him home without all that equipment -- satisfied with just my promise to bring him in for more blood work at 7:30 on Monday morning.

He continues to improve. His weight is starting to go up instead of down.  His blood test numbers are not getting any worse.  And his poop is finally a color that reassures pediatricians.

I am healing very well too. Staples came out Sunday, since I was still at the hospital.  A med student took them out.  The same med student who a day early had mistaken the tape mark from my incision dressing for a previous c-section scar.  But he was a good staple remover.

Overall my hospital experience was very positive. I actually liked this place better than the one in California, and I have more respect for my doctors now that I have spent so much more time with them.

Still, after spending what seemed like 47 days in a sensory deprivation cell, it is not an understatement to say I was elated to feel the oppressive humidity and heat of the outside air again.  And listen to the bickering of my husband and mother-in-law who may have spent a little too much time together during this last week. 

It is good to be home.

I have no idea if this post will work...

James, born July 25 at 11:08 am. 8 lbs 11 oz. Hoping we can both go home tomorrow.

(if this works, posted via email from my cell phone)

Really not so much into hospitals, but oh well

I'm headed off to the c-section tomorrow as labor is showing no signs of arriving before then.  The typical stay, they say, is 3 to 4 days.  So I'm shooting for two...

Meanwhile, in my nervousness over the whole thing I am thinking, stay in the moment, stay in the moment.  Go with the flow and don't let these people and their processes stress you out.  All will be well and you will be home soon with the new guy and Jack and David. Deep breaths. Yoga breathing.  Let go of the anxiety.  It won't help.

As David doesn't have posting rights, yet, new news is not likely until I get back. 

Other details of my last doctor visit

Cervix, unchanged (80 percent effaced and closed)
BP: 128 over 80
Forgot to bring in my urine sample - duh

I asked the doc my chances of going into labor before my c-section. He said 10-20 percent.  I asked what my deadline was for going into labor before the scheduled c-section at 10:30 am on Wednesday.   He said if I got there and was in labor they would let me try for the VBAC.

He said, "well, I know this may seem like a ridiculous question, but..." and then asked me if I wanted my tubes tied.  I laughed very very hard.  He said getting your tubes tied has been shown to reduce the incidence of ovarian cancer, and I told him my sister-in-law died of ovarian cancer last year.

However, when I quizzed him on the study he had no answers for me. 

I asked him what is the incidence of ovarian cancer and how much this surgery is shown to reduce it.  He didn't have any actual numbers for me but took guesses, based on some charts he remembered at some presentation a while ago.

I asked him whether the study showed it reduced the incidence of ovarian cancer for young women or for all women (since most ovarian cancer cases occur in women who are 70 or 80.)  He said it's a risk reduction over the patient's lifetime. 

I should have also asked him whether the study stratified the reduction in ovarian cancer depending upon when the women had the surgery performed (at 28 or 38 or 48 years old). I was thinking this might make a difference because stuff that reduces the number of times you ovulate in your lifetime -- being on the pill, breastfeeding and having babies -- have all been shown to reduce your chances of ovarian cancer.  And while getting your tubes tied does not reduce the number of times you ovulate, it made me wondered if it was a similar kind of thing.  So if you got your tubes tied when you were 28 when you had many more years of ovulation to come it would reduce the risk more than if you did it when you were, say, 42 and you'd already done nearly all the ovulating you were going to do anyway.

Back in Silicon Valley my doctors would have had these answers at the ready.  And I wonder if that's because there are so many engineers/scientists there who ask those kinds of questions about the science rather than accepting some random fact unconditionally because it is delivered by someone who is supposed to be a trusted source.   I don't know. 

Anyway, I just felt like it was a no-brainer for me to choose NOT to get my tubes tied.   And he didn't persuade me otherwise at all.  I'll be glad when I'm finished with these docs for big things and can just go to them for a pap smear.

How to scare the crap out of me

Long story short: at the non-stress test today the fetal heart rate was consistently 185-190 with no variability.

It was pretty much close to a straight line.

If you are unfamiliar with how it is supposed to look, it is supposed to be between 110 and 160 and they want accelerations after fetal movement and then decelerations back to the baseline. They want to see this three times during your test.

New guy usually excels at this, but today as I saw the read-out after the nurse left the room I started getting nervous.  Then I started to panic.  The nurse came back in after 10 minutes later

She looked at my sheet and immediately  summoned the doctor who sent me to Labor and Delivery at the hospital for monitoring.

I started planning on having the baby today via c-section. I stopped caring about all the other little things I had been planning to do (buy a stroller for the infant car seat, write a story for work, etc.)

But once I was over at the hospital the rate started to go down.  It went down until the baseline was in the 140s again and it was only going up to the low 170s.  The hospital doc, who I think was 14 years old, took a look at it and declared it normal.  She called my doc.  And then they sent me home.

But still I have no explanation for the cause of the fetal tachycardia, which worries me. They don't know what was wrong, and yet they sent me home and told me to do kick counts.

Initial Google searches point to maternal fever as a major cause of this.  Other ones are not so reassuring.

When I got there the nurse at the hospital asked me if i was dehydrated. I said I thought I probably was. (No water yet  due to too much running around, no sink or faucet in my kitchen, remodeling, mother in law visiting, etc.) The nurse was nice.  She got me two cups of water and I drank them both.  She said drinking water prevented premature labor. I told her that no worries on that at this point, since my due date is this coming Thursday.

I asked her about the causes of fetal tachycardia and she didn't have an answer. I asked her if the outcome was always good and she hesitated for a long time before she told me to do the kick counts, etc.  All that makes me nervous nervous nervous.  And it makes me want to call the doc on call at my practice and press for answers. 

And now for something completely different

My mother likes to say that I did not get the "shopping gene" or the genetic material that makes me want to or be any good at shopping.  But her idea of shopping generally refers to clothing, and I am admittedly fashion-challenged. David says I do fine when I pay attention. However, when I wake up tired and have only enough energy to lift a coffee cup and think in one-syllable grunts, what matches what is the last priority. Indeed, perhaps the thing I selected may still have a grease spot from my ineffective laundry washing. (I'm also inept in this category. Thankfully David excels at laundry.)

But in spite of my fashion problem, I do like to shop for other things, particularly gadgets.

A month or two ago a friend bought and sent us a Roomba. Really, this is a fabulous gadget for people with no time who put house-cleaning at the bottom of the priority list.  It's a robotic vacuum. It's about the diameter of a big dinner plate and an inch or two high. You tell it to vacuum a room and it does it.  And it doesn't just randomly circle the room. It REMEMBERS where it's been and focuses on the areas that have not yet been touched.  And it detects when a particular area is dirtier and stays there for a while.

It's not great on shag rugs, but if you have carpets that aren't too thick or padded, or if you have hard floor surfaces, the Roomba is really nice to have. 

Granted, it takes longer than you would take to do the same room.  It might take Roomba a little over an hour to do what you could have done in 10-20 minutes.  But YOU aren't doing it. You are out getting a pedicure or in the other room taking a nap. When you return you have a clean floor. (I marvel the same way over my crock pot, sicko that I am.)

Our friend bought us this device at Woot.  This site typically offers one product a day at a deep discount. When the product sells out, that's it for the day.  Sometimes the products are very cool and sometimes they are not.  Many of these fall into the tech gadget/electronics/home entertainment/computing categories, but there have also been bottles of wine, basketball toys, vacuum cleaners, emergency road side kits, etc.

Since our friend sent us this device, I have been moderately obsessed with Woot. The product descriptions are really well written narratives that can be vastly entertaining on their own. 

Once in a while, every month or two, they have a "Woot-off."  This event means that once one product sells out, they immediately put up another product. I'm told these woot-offs can last anywhere from 24 hours to a few days.  There is a woot-off going on now.

So enamored I have been with our Roomba that I have been waiting for the Scooba to come up for sale.  This one mops hard floors (not for use on unsealed hardwood though :-( )

38 weeks, 5 days -- quick stats

Blood pressure: 122 over 76

Weight: up 2 lbs from last week

Estimated baby size: close to 8 lbs.

Urine: normal

Cervix: closed, but 80 percent effaced

The doc did not sound terribly optimistic about me going into labor before the scheduled C-section, which is now 8 days away, but said anything could happen.  Keeping my fingers crossed and my legs open.

Waiting for the so-called "burst of energy" -- a ramble

Instead I am having the opposite. So. tired. today. Forgive the disjointedness please.

Went out on Saturday to pick up needed items at the big Baby store such as a new diaper pail and new baby bathtub (we gave ours away on craigslist before departing for the east coast). And a car seat. And some tiny socks and wash cloths.  You get the picture.  Had to stop shopping because it wouldn't all fit in the car.

Yesterday we went to that birthday party, which was fun but at the same time David and I would have both loved to take a long long long nap instead. David has lost his voice, is not feeling well, and is having trouble waking up today.  I just have that last symptom today.  If I put my head down on my desk I'm not sure I would wake up in time to leave for my much-needed hair appointment.  And my company might notice that I didn't produce anything today.

My mother came over on Saturday to help me shop (while David and step dad worked on wiring the basement offices).  She thought that I had "dropped" some.  But, you know, I still can't feel my cervix.  But there is a doctor appointment tomorrow so I may insist on an internal check. And ask if they could please use a ruler to do it or something.

Also, heard from the homeowners insurance company today about my lost baggage claim.  They are paying a good portion of it.  So the question is, do I use it to replace some of my jewelry that was lost? Or do I put it towards a credit card bill?  Or a little of both?  I have replaced most of the day-to-day items that were lost already. 

On the one hand, it would be a bit of a relief to get the credit card paid down a bit, since we put part of the last IVF on it.  And my income is about to drop significantly for the next few months. On the other hand, it's not like I would ever see that money again to even make a token replacement of the jewelry that was lost.  This is the only chance I'll get at that.

It is a tough choice.

Where are those lazy days of summer?

On Wednesday I woke up all achy in the belly area and even had trouble just walking around.  Really, I couldn't straighten up because then the achiness turned into a sharp pain. And I kept having more and more of those Braxton Hicks.  But sometimes I would be all achy and in pain when I wasn't having the Braxton Hicks.

So I spent some time consulting the great font of wisdom, Google, to see if it could lend any insights into whether this could be related to oncoming labor or not.  And I checked my cervix.  (I saw someone post something recently SOMEWHERE wondering why they tell you not to do that when you are in late pregnancy.  She said that they were OK with you putting a penis in there, and certainly not a freshly washed one, so why not your very clean finger?  Wish I could remember and give credit to who said this.)

Google report: who knows

Cervix report: my finger is not long enough to find it right now.  And, believe me, I've had plenty of experience finding it at other times during my TCOYF days.  Maybe this is where the penis comes in handy.  The penis I use is longer than the finger I use.  But the penis is unwilling these days, afraid of traumatizing our youngest child with abrupt motion changes.  (Although there doesn't seem to be a problem with driving fast in very bumpy parking lots when my bladder is about to burst.)

Thursday morning I felt much better physically (yes, that achiness lasted the whole day. I could barely walk as the pain sometimes went from my groin down my inner thigh).  However, Thursday started out not so well emotionally.  Jack was super crabby when he woke up.  He wasn't interested in breakfast.  He refused to get dressed.  Couple this with the fact that David had scheduled an appointment to get his car inspected at 8 am, so we were kind of on a schedule to get out of the house. Forcing the getting dressed issue made things go from bad to worse and it all cast a very dark shadow over my mood and the rest of the day.

Really, I was so upset by the morning experience that I couldn't concentrate on work at all. Finally in the afternoon I put my head down for a little while and woke up feeling better enough to actually do some work.

When I picked up Jack I learned that he'd had "the runs" in the morning and was clutching his belly. But after two watery poops, he felt much better.

Of course, the tough morning didn't set him out on the right foot either.   Soon after his pooping relief another child took the ball he was holding in the toddler play  yard.  Jack did not like this and bit the other child.  However, when he was told that biting was not allowed and not nice, he apologized to the other child and gave a hug.

Score:  Jack's been bitten twice but he's only bit someone else once.  These episodes all happened since the move in March.

But by the time I picked him up Thursday ( a little early because I was so freaking upset about this morning and worried about him and about me) he was a happy guy again.  What a relief.

After these past two days though (during which David actually primed and painted the kitchen, mowed the back 40 and we each did multiple loads of laundry as I waddled around the house all bent over) I'm thinking we are all very much in need of some fun.  It has been such a crunch lately and we are all feeling the effects.

Here is the schedule for the next few weeks:
July 13: lunch with colleague. Look at lights at home depot
July 14: David paints kitchen ceiling while Jack and I go somewhere else
July 15: 75th birthday party for friend
July 16: way overdue hair appointment after work
July 18-20: kitchen floor ripped out and installed.  Counter guys also said they could come at this time, but they can't both be here at once.  don't know what we will do.  But having a kitchen sink is dependent on the counter guys finishing their thing.  AND I MISS HAVING A KITCHEN SINK!!!
July 20: I think this will be my last day at work, but maybe not because
July 23: Mother in law arrives for 10-day stay.  I just hate the part where you sit around with people and they just stare at you, waiting for you to grimace or move funny. Makes me want to go off into the woods and give birth there all by myself. My mom was like this when I was at the end with Jack and it drove me to the brink of insanity.  However, I think my mother in law will not be as much like this as just wanting to put stuff away in the wrong spots in my new kitchen.
July 24: Preop stuff at hospital
July 25: scheduled c-section
July 26: I stop paying attention to schedules longer than 2 hours.

Maybe we can have a family fun day or something on July 21. Would be nice to have a last day like that with just the three of us, because things have been so grueling lately we haven't had much of a chance to enjoy each other's company.

My scheduled c-section doctor, and an epiphany about my labor fears

I immediately liked my scheduled c-section OB.  She is from San Francisco originally. When I told her my Jack c-section story she laughed (anyone who laughs at my stories already gets high points).

(Jack c-section story rehash: I was paranoid to go overdue because of my online acquaintance who did and lost her IVF baby to a stillbirth. So I went in Friday night for an induction. The cervidyl did nothing and I spent all Friday night listening to women screaming up and down the hall.  Thus, when they offered to let me keep trying induction or to go with a c-section the next morning, a c-section sounded less frightening to me)

Dr. P thought this was funny. She said that in San Francisco and the Bay Area as it is called by those who live there everyone is all "naturalistic" and so they don't want epidurals.  She seemed to imply that you don' t hear so much screaming here in Pennsylvania as women here know the value of good drugs.

So I've been reading about VBACs online, and labor experiences.  The women who write their personal accounts and the stories about how to cope with the pain all talk about how you get to a point where you just have to have faith that your body knows what to do.

I was thinking about this as I was driving to my appointment today (long long drive).  And I realized that ever since the Trisomy 18 diagnosis I have lost faith in my body.  Until then I'd really worked to create the perfect environment for my embryos, giving up the things I was supposed to give up, staying in reasonable shape, eating well, etc.  But it didn't fucking matter, did it?  One of my eggs was bad, but it fertilized and it just kept going. Perhaps because of the tremendously healthy environment I had created for it.

Dr. P again said to me that Trisomies are a freak occurrence. You cannot point to anything you did or didn't do to cause it.  Maternal age is the only factor that plays a part. And even at my ripe old age of 39 (at the time) my odds of conceiving and carrying a trisomy 18 baby were 1 in 440.  How unlucky is that.

So I realized during my drive today that the Trisomy 18 experience, the emotions it caused, and my knowledge of things that went wrong for other people  likely swayed me from trusting my body to do the right thing in labor.  I mean, that happened and then the acquaintance with the still birth.  We both trusted our bodies and they fucking let us down, and down really hard.

Having just realized today this might have been part of my problem back then, I wonder if it is possible to get beyond it in the next two weeks.  I mean, I have these prenatal yoga flash cards and I can follow the meditations and breathing and asanas.  I can look up more VBAC and labor stories on the Internet.  But can I really cram as if I were doing an all-nighter for a college exam? Is that an effective approach to learning again to trust your body?  Will that get me to where I need to be successful in time for going through labor and childbirth?

And will it even matter?  I may not even go into labor before July 25, the date of the scheduled c-section.

(although this time the baby is in a good position, according to Dr. P, presenting with his head just in the right place. And amazingly, we looked at my belly today at the appointment and could SEE him breathing. It was very very cool, and Dr. P said it was a good sign for a healthy guy.  Last time Jack's head was canted off to the side and the OB said that was probably why my cervix did not "ripen" at all)