All or Nothing

Its amazing that when you are pregnant and not doing as fabulously as you hoped that there are really very few options.

Its been a rough week - the contractions came back with a vengeance.  Fortunately my cervix is still holding stable.  I wouldn't exactly call it fort knox - it is a little stumpy - but not technically to the point where I am considered real preterm labor.

What I find a little weird is that we as obgyns see it a little as all or nothing.  Either the cervix is changing and its really really bad . . ..  or the cervix is stable and everything is fine.  I can't really tell where I fall into this picture because I am not sure that I am either one of these.  I was to the point yesterday that not only could I not stand through work without huffing and puffing through contractions, but I couldn't sit and stop contracting either.

So I took a trip to my 2nd home on labor and delivery, only this time I was the recipient of care as opposed to the giver.  All things checked out okay and after they made me lay down for a while - of course I did better and stopped contracting. (I am not complaining here because every day she stays in is a day I am thankful for).  Problem with work is I can't just stop everything in the middle of a day and lay down for a while to make myself feel better.

The question is what to do with my life though.  I don't meet technical requirements to stop working and go on bedrest (and believe me thats not what I want and its really never been proven to help), but at the same time I have cut everything else already and the hours I am working are obviously not working for me.

There is no way to say - okay I am ready to work 20-30 hours a week now instead of my 40+.  There are just too many patients to see and too much work to be done - and technically I am not being diagnosed with preterm labor so I don't even have a justifiable medical reason.  The ironic thing is I could probably work longer if I could take it a little easier.  The weekends are going really well because they are mostly spent on the couch - but then I get hit when I go back to work each monday.

There is nothing more important to me than keeping this little one in - if someone knew in their crystal ball and told me that quitting my job would be the only way to have a healthy baby, I would throw out my umpteen years of training in a heartbeat.  But nobody can tell me which way this is going to go.  I myself have seen people contract like this their entire pregnancies and then need to be induced for post-dates.  I have also seen absolute disasters and now that I am almost to the viable stage I am terrified she could be born so premature.

I am thankful for my husband for waiting on me every night after I assume the position on the couch.  I am thankful for my little fetus who doesn't seem to be at all bothered by this.  I will be very thankful if I am still pregnant in a few weeks.

So for now, I just keep going along like everything is normal.  Time will tell.

juno

Well - I cant sleep.  My schedule is a bit screwed up right now.  Since I have dropped some work (and a good chunk of my regular income) in favor of sitting around more . . .  lets just say I am no where near as tired as I normally am.  This is good for the cleanliness of my house and the progress of the afghan I am knitting.  It is however bad for the online shopping for baby stuff that I am doing.  (mattress here, swing there).  It is all worth it however to my uterus which has quieted down nicely.

So anyway, juno is on and its just one of those movies that makes me smile.  Of course I identify with the jennifer garner character's situation, but I really love the interactions between Juno and her parents.  I have this thing for stories of teenagers and supportive parents - possibly because if I have ever ended up in any kind of trouble I am pretty sure that my parents would not have been supportive at all.  (It was the end of the world once when I got a B - I can't imagine how they would have reacted if I ever had a real problem).

So while I can certainly see the viewpoint of the type A woman who so desperately wants to be a mother, the mother I admire is the the step mother cutting out the magazine pictures of dogs and the one to yell at the ultrasonographer that makes an inappropriate comment to my daughter.  The parent that is there to take care of her and help her.

I hope I'm good at this.

Happy 11-11-11, Happy Veteran's Day and a Happy Me

I am 20 weeks!!!  I have actually made it halfway . ..  and better yet  . . . My cervix is closed!!!  Sure its not super long - but its not short enough for bed rest and its not changing yet!  The amount of relief is HUGE.

I went to my groups OB M&M yesterday.  In medicine there is the practice of reviewing patient cases where the outcomes are bad as a way to keep educating the staff and to look into if anything could have been done better.  I think every type of medicine does it - Ours are really educational.   We have the neonatologist team and the perinatology team come too and we talk about all aspects of care.  The topics though are usually a little depressing - and nerve racking when you are sitting though it thinking what could go wrong with your own life.

Anyway I was sitting next to my OB and she leaned over and whispered "I think I am going to ban you from these conferences until you are 30 weeks".  Its not a bad idea.  Exposure to complicated cases is not what my head really needs right now.  I already know everything that can go wrong - the reminder is not good.  I need to try to forget what I have learned and remember what I know - the majority of pregnancies have no problems at all. (must keep repeating the mantra)


On a separate note - I ran into my old infertility doctor at my prenatal visit while I was waiting for the restroom.  He is quite possibly one of the nicest and most brilliant physicians but he does not do IVF - but he oversaw some of my clomid /injectable cycles and was the one who was so disappointed it wasn't working.  He smiled at the belly - asked me how many cycles it took.  "Only one" I responded.

He dropped his head, smiled this huge smile and looked up.  "Isn't that just amazing"

yes it is.


Happy 11-11-11 and Happy Veteran's day!  I have lots of happiness today and a lot to be thankful for!

20 kids and counting . . . really?

I find the Duggars personally offensive.

They are probably very nice people with very nice children, but I find their number of children obscene and their attitude about it naive.  Is there a twinge of jealousy for the fertility that she has - yes, absolutely.  How wonderful it must be to be able to have the family of your dreams.  But really . . .  20?  

They just keep re-iterating that it is up to god with really irritates me because if it was up to god I would never be able to have a family at all.  Is that because they are so wonderful and god loving and I am such a terrible person that I am not worthy of a child?  It just accentuates the unfairness of it all.  The further problem that I have with it is that they seem to keep saying is that god will tell them when to stop - but things didn't go so well last time with the very preterm birth of their youngest daughter due to preeclampsia.  If it were not for good medical care - there would have been no mom and baby at the end of it.  Perhaps that was the message.

I am really hoping for the sake of their unborn child that everything goes well for them and that it is born healthy and mom does well, but if I was her OB I would have advised her against another pregnancy with her possible complications and multiple previous sections.  I understand that some people don't believe in birth control, but I am pretty sure that abstinence is an option endorsed by the big guy. (At least thats what they taught me in religion class growing up.)

Sure these are my personal values and they have theirs and there is no right or wrong answer here.  This is just how it makes me feel coming from the totally opposite perspective.  I wish them well, but I am rooting for the little couple more.

Still preggo!

On the bad side - I am still contracting.

On the good side - I am still pregnant with no more bleeding.

So whatever these contractions are I am hoping that they are not doing too much.  I am taking it easy - sitting down lots, walking slowly.  Keeping my feet up when I chart.  My but has been planted on the couch more in the past week than ever before.

Have my cervix scheduled for a check in days . . . crossing fingers.

On another note - I keep talking to her - telling her that she should be happy to be warm and swimming and that my uterus should be the best place for her.  It sounds totally silly - but I figure it can't hurt.

So kid . . . stay in there.  Mom's orders.

hmmm

Something tells me that work may be short lived.

I worked sunday night, a 10 hour day monday, got called in the middle of the night monday, worked a 10 hour day tuesday and my uterus had enough.  I guess it was my signal that I need to limit things a bit.

While I appreciate the advance notification that I pushed things a little too far, I would like to tell my uterus that it can stop now.  Message received - loud and clear.  I had been cramping on and off since before the beta, but not like this.

Weird how a muscle can have such a mind of its own.  Now I am contracting every time I do pretty much anything.  Stand up - contract.  Lay down - contract. Change positions - you betcha, Restroom - check.  Seriously uterus?  I am only 18 weeks.  I got a long time to go here and you need to simmer down now.

While I am still technically okay - my cervix is definitely shorter than it was before.  I get it rechecked in 2 weeks and the B word was mentioned as a possibility.  I am taking the day as a vacation day, but I return to work tomorrow.

Everyone asks me how long I am going to work - all I am saying is "as long as I can" but that may not be as long as I thought.

I saw red

I had my first little freaky experience last night - started bleeding.

Not much, but enough to freak me out.  Had just gotten home from work and was getting ready to get on a flight for a much anticipated business trip and low and behold . . . there it was.  Bright red.  Definitely coming from the place I did not want it to be coming from.  And then . . . contractions.  She hadn't been moving much yesterday and I couldn't feel her on my way to the hospital.

S**T

The good news is I have friends in high places and I basically facilitated my own workup and had an exam and ultrasound very quickly - all of which revealed no clear reason and that kiddo was completely unaffected.  So while I was internally freaking out, I didn't have to freak out for very long.

The bad news is that I know EVERYTHING that can go wrong so despite the reassuring physical findings, I know that while it is likely NOTHING, it could be a harbinger for badness.

Anyway, my butt is glued to the couch today as I work remotely.  Business trip is cancelled but she is way more important to me.  I contract every time I get up but at least they have slowed down and no more blood.

I try very hard to not have anxiety about this pregnancy.  Hard not to after all the infertility.  Even my colleague commented that I seemed abnormally calm about all this - I reassured her that I was in fact an internal mess.  Can one really ever expect a normal pregnancy after IVF?  My job-brain says yes, but my personal brain says no.  I just don't know how to reassure myself.  After all that infertility that is the one skill I missed out on and something tells me I am not going to gain it now.

It is funny though . . . every time I start to get upset she thumps me.  Little Miss Reassuring.  She must already know its the only thing that works.