Still Workin'

Well, saw the doc and I'm good to go back to work if I want to.  (I forgot to ask about improv shows, but I figure if I can work a 12-hour nursing shift, on my feet, then I can do a 2-hour improv show.) 

It's up to me now when I want to stop working.  "Let me know when the twelve-hour shifts get to be too much," the doctor said.  "Usually somewhere between 28 and 32 weeks, they get to be too much."

"Ok," I said.

I'll see how I feel.

Issues

So last Thursday night I did an improv show.  We do one once a month, and this was like any other.  I am pregnant onstage, which is kind of special, but my belly is still remarkably small, so it's not like I'm super pregnant.  We make pregnant jokes as part of the show, but actually we've always done that.  Turns out pregnancy is a great thing to joke about.

Anyhoo, we came home after the show, had a late dinner, watched some TV, and went to bed around 1am.  As I'd been lying on the couch watching TV, I'd noticed some contractions.  Now, I've been having quite a few contractions off and on throughout the last few weeks -- the previous Sunday I'd had so many at work that I called the doc (he told me to call and describe my contractions if I had four or more in an hour).  I ended up talking to the nurses at the Childbirth Center at the hospital, since the doctor was temporarily unavailable.  They told me to go home, lie down, and drink lots of fluids.  They told me that's what the doctor would tell me to do, too.  So I left work early, at 2:30pm, went home, lay down, and took a little nap.  That didn't quite make my contractions go away, but after I woke up, I got up and walked around a little, then sat at the computer and surfed the net for a while and that made them go away. 

Then Monday, Tuesday, and Wednesday were quite normal.  I even worked on Wednesday and it was a hard day, but I was fine and didn't have any contractions worth mentioning.

Back to Thursday night.  Well, the wee hours of Friday morning, really. 

I went to bed at 1:00 and fell asleep immediately.  Then I woke up at 3:00.  Or was awakened, I should say.  By a very strong contraction.  I got up, peed, and went back to bed.  But the contractions kept coming.  Every few minutes.  And it felt like my uterus didn't even relax between contractions, really.  Like it was just really tense.  I laid in bed for an hour or so, wondering what was going on, whether I should call the doctor, what I should do. 

Trent happened to be up, so I got up and went to talk to him about it.  As they had the previous Sunday, my contractions slowed and even stopped once I got up.  We talked for a while, then went back to bed around 5.  It took me a while to get to sleep; I think I fell asleep around 6.

Then I was awakened again.  At 8:30.  By another strong contraction.  My uterus started doing its contracting thing again.  I didn't know what to do.  I peed again, then went back to bed.  I lay in bed exhausted, not knowing what to do.  Should I get up in hopes that that would make the contractions go away?  But I was so tired...

And worried. 

I mean, I've worried a lot throughout this pregnancy (I worry a lot in general), but this was making me especially worried.  Was I in preterm labor?  Was our baby ok?  Was his placenta getting perfused enough with all these contractions?  His little home kept shrinking on him -- what effect did that have on him?

So I decided to finally call.  The hour was decent; it's a lot easier to call the doctor at 8:30 than it is at 4:00. 

I got the answering service, who asked my name and how far along I was in my pregnancy.  "Twenty-nine weeks and five days," I told them.  Then I was connected to one of the midwives.  I described my contractions -- uncomfortable but not painful, maybe five minutes apart.  I told her there was a lot of pressure in my pelvis.

"Well," she said, "it sounds like you're in early labor.  Wait until the contractions are three minutes apart, then come in."

"But it's so early!" I said.  "I'm only twenty-nine weeks!"

"Twenty-nine weeks?" she said.  "They told me thirty-nine weeks.  Oh yeah, you better come in and get checked."

So Trent and I got up, got dressed, grabbed something to read, and headed out to the hospital.  I had no idea how long we'd be gone for.  I made sure I had a toothbrush and a cell phone charger, just in case.

Were we on our way to have a baby?  Oh how I wished I were thirty-nine weeks along.  If I were thirty-nine weeks along, this would all be so happy.  Not terrifying.  Visions of premature babies danced in my head.  

When we got to the hospital, they took a urine sample to check for a UTI (a common cause of contractions) as well as signs of preeclampsia.  Then they put two monitors on my belly.  One to measure baby's heartrate, one to measure contractions. 

Baby's heartrate was fantastic.  140s-150s with all the nice variations they like to see.  Whew.

I sat there in bed and waited.  The contractions had slowed down in the car on the way over.  I wondered if they would come again.

The nurse came back in and did a vaginal swab to test for the presence of fetal fibronectin, a protein that binds the fetal sac to the uterine lining and which leaks into the vagina if a preterm delivery is likely to occur.

Then we waited some more.  The contractions came back.  I was sort of glad (one does want the doctor to be able to see the thing about which one was worried), but also scared.  They were regular and sort of strong.  Painful, even.  I sat very still, and they kept coming.  You could see them on the monitor.  Their little waves were recorded on the strip.

They were really happening.

"You are showing some uterine irritability..." the nurse said.

The fetal fibronectin swab went to the lab. 

I watched the clock and felt the contractions.  I knew, from talking to OB nurses previously, that our hospital's NICU didn't take babies born at less than 32 weeks.  Less than 32 weeks went to UCSF.

An ultrasound tech came in to do an ultrasound of my cervix and check its length.  They do an ultrasound rather than a manual exam so as to avoid irritating the cervix and causing it to efface or dilate where it hadn't before.

The midwife came in while the ultrasound tech was there.  "How's her cervical length?" she asked.

"Three centimeters.  No, three-point-five," the tech said.

"Great!" the midwife said.  "And your fetal fibronectin test was negative, which means you have a ninety-nine percent chance of not delivering in the next two weeks."

Translation: Everything is ok.

I asked the midwife about working, like whether I should keep doing it.  I was supposed to work the next three days -- three twelve-hour shifts in a row.  I told the midwife I was nurse, that I worked right upstairs. 

"Oh yeah, you're done," she said.  I had told her I had a doctor's appointment the following Tuesday and that I would talk to him about work then.  She told me to call in sick until then.  I asked if I could have a note.  A note from a doctor (or midwife) never hurts.

She wrote a note recommending I be off "for the duration of [my] pregnancy."

I wasn't sure if I was ready for that, really, though.  I didn't know what to do.  I was so damn tired.  And still recovering from such a terrible scare.

Trent and I sat down in the lobby to talk about what to do, vis-a-vis work.  We decided to buy some time, to explain what the midwife had recommended, but to say that I wanted to talk to my doctor about it before making any decisions regarding the entire rest of my pregnancy.  My manager was out, so I wrote a letter to her and to the staffing office explaining I needed off till Tuesday, that I would see my doctor then. 

As I dropped it off, I ran into one of my coworkers complaining about how grossly understaffed our unit was.

"That is not my problem!" I thought loudly.  "Right now, I have several problems which are undeniably mine, which I cannot delegate, which belong to no one else, but that is not one of them!"

"Oh," is what I said.  "Gee."

As soon as I dropped off the notes, I speed-walked out of the hospital, almost losing poor Trent.  I didn't want to talk to anyone else just then.

It was sunny and gorgeous as we walked out to the car.  I felt a bit worried as to what to do about work.  I felt tired.  I felt relieved.

"Well," I said to Trent, "at least we're not on a plane to UCSF right now."

At least the baby's still inside me. 

 

It is now two days later.  I've gotten a lot of sleep since then.  I've had no abnormal bouts of contractions.  What was all that? 

I feel like it's a little early to go off work.  Like 30 weeks is too soon.  Even though I'd be eligible for disability benefits, I like going to work.  It makes me feel secure.  The paychecks are steady, whereas disability would take a while to kick in. 

It feels a little too soon to even enjoy going off work.  I think I'd enjoy it more 3-6 weeks from now. 

If the doctor says it's ok, I want to go back for a while.  It's just a few weeks we're talking about, after all. 

And, while I'm asking, can I keep doing improv shows?

Goorak Lives!

So, if you've read my last couple of posts, you know I think I'm faking this whole pregnancy thing.  Well, on a good day, when I think I might actually be pregnant and all that ultrasound and pee stick stuff was real, I still like to worry that the baby has somehow died inside my tummy.  I mean, he's awfully quiet in there.  No kicks yet.  Nothing definitive, anyway.

I was worrying about that today, like I do, and texting a friend of mine.  I was lamenting that the floor I work on in the hospital has lost its doppler machine, and wondering if the progressive care unit I was sitting on that day might have one I could use to check and see if baby's heart was still beating.  She suggested that I go down to the OB department where they would probably do it for me.

Really?

Do they really do such things?  Would the nurses really be nice enough to just -- off the record -- check and see if my baby was still alive?  I mean, I had no other cause besides preexisting endogenous Crazy to think that the baby had died -- no bleeding or cramping or pain or fever or any such thing.  They'd be doing it as a favor.  It didn't even seem legal.

I went up to my home floor and asked a coworker -- one who had birthed two babies downstairs in the hospital OB department -- whether the nurses might do such a thing.

"I don't know," she said.  "Want me to call and ask?  I know 'em down there."
"Would you?" I gasped.  "I'd love that!"
"Sure," she said.

She called, and they said they would.  Well, to be exact, the nurse on the phone said they couldn't do it, but they could look away while I borrowed their doppler and went into the break room and did it myself.

Good enough for me.

So I went down to the hallway outside the childbirth center/OB unit.  Their door is locked to prevent infant theft (or to just limit traffic through such a sensitive area of the hospital).  I pressed the button on the intercom.

"How can I help you?" a voice asked.
"I, uh, need to borrow your doppler..." I said.
"Oh!  Come on in."  The voice chuckled.  "We heard about you."

Once inside, I was quickly taken under the wing of a very nice nurse -- a different one than the one my coworker had spoken to on the phone.
"So you want to hear your baby?" she said.  "How odd.  What a strange thing to request."  She winked.
"Yeah, uh, sometimes I just worry, you know?" I said.
"Sure," she said.  "Come with me.

She led me not to the break room nor to the restroom, but to an empty patient room.  She had me lie down on my back on the bed.  She spread a little goo on my belly.  As she searched for the heartbeat, she talked about baby kicks and demonstrated with a little tickle on my leg what the first kicks might feel like.

There were a few seconds there where I was worried she wouldn't find the heartbeat, and my fear was slightly consoled by the fact that in that event, at least I had had good cause to come to the OB department and get the baby's heart dopplered.  But I only had 10 seconds to pursue that line of worry/planning, and before I had had much time to think about it, a rapid, rhythmic swishing was emanating from the doppler's speaker.

"There it is!" she said.

I smiled, then closed my eyes for a moment, to let the beauty of that little heartbeat sink in.

Goorak's little heartbeat.

He was fine in there all along.  Just quiet.

I like to think about what, if any, Goorak's consciousness might be like right now.  I wonder if Goorak can feel emotion.  I like to think that Goorak is blissfully happy right now.  Filled with the
joy of existence.  He's so happy to exist.  He's never existed before at all and this is his first time.  I like to think he feels absolutely wonderful in my womb -- floating in soft, warm liquid, knowing no hunger nor thirst nor cold nor fear.  No real sensory stimulation whatsoever.  But maybe consciousness?

Pure existence. 

Only Good Things

Well, I went to the doctor and it was great.  The medical assistant told me our first round of tests (the ones to tell whether or not you're carrying a mutant baby) were all negative.  My blood pressure was great, still under 120 systolic.  She hid my weight from me, per my usual request.

The doc came in and was super nice.  Totally not mad that I was three weeks late for my appointment (I was trying to get on a jury so I could get a few weeks off work).  He didn't even mention it; when I finally did, he said, "Oh, that's fine."  He answered all the questions off my list, even the one about vaginal tearing, though he murmured, "It's a little early..."  He felt the fundus (top) of my uterus (at 15 weeks it's halfway between my pubic bone and my belly button) and I'm pretty sure I could feel it too.  It was like a muscular sort of shelf, right where he said it'd be.

Then we listened to the baby's heartbeat with the Doppler.  The baby's big enough that we can do that
now.  He put the little thing to my belly, right to the top of the uterus, it looked like.  Right away we heard a nice, rhythmic, "Swish swish swish swish swish swish."

"What's that, 138 beats per minute, did it say?" I asked.
"I can't see the screen, but listening to it, to the rhythm of it, it's more like 150," he said, nodding his head to the beat of the swish.  I smiled, hoping I looked appropriately excited.

"Well," he said, as I sat up.  (I realized halfway up that he was offering me a hand to help me up, which seemed odd enough to me that I missed his gesture.)  "Everything's normal.  Only good things happening inside."

"Only good things happening inside."  What a lovely thing to say, given all the things one can worry about during a pregnancy.  It was like a little blessing.  "Only good things happening inside."  Ashe!

Baby Crazy

One of the main reasons I started this Little Creatures blog was so I could ask the question, "What is a human being?"*

What are we, really?  We do ask ourselves this question, sometimes.  Other ways it is asked are, "Is there a God?" or "Do we stop existing after we die?" or "Are we just animals?"  or "Is there such a thing as 'free will'?"

Are we more than our DNA**?

Beats me.

It's heavy shit, though.  I mean, think about having children.  Especially when you are intentionally having children, as we are.  First, you have no children.  You are just you and your partner.  Perhaps you have no real plan or intention to have children in your life.


Then, one day, you change your mind.

And it stays changed.

So you and your partner -- necessarily a male and a female in this example -- decide to have children.  You decide to create new human beings.  To bring about people where there were no people before.

How exactly does this happen?

Sure, we all think we know -- it's sex, right?  We, educated enlightened adults, know what sex is and we know how babies are made.

But what are the details?  What are the steps in the creation of new human beings?

Well, if you are intentionally creating human beings where you had not been creating human beings before, you must first remove whatever barrier(s) you had in place to prevent the creation of new human beings, for making more of itself is, above all, the fundamental drive of your body.  Arguably, reproduction is your body's only true drive.  Much more so than longevity for its own sake, your body strives to stay alive only insofar as it enables it to make more of itself.

Ok, so you cease your efforts to prevent your body from reproducing itself -- IUD out, artificial hormones removed, latex away.

Then what?

Sex, right?

Right.

Sex.

You've been doing it for fun for years, but now is the time to do it with a mission.  It's like doing it for fun, but more stressful.  You have to do it at the right time of month.  You have to do it to fruition (or at least the male partner does).  Worrying whether or not you and your partner actually have working gametes is optional (I opted yes on that one).

Then?

 You wait.

What do you mean you just wait?

You just wait.

No, no, no.  This is a huge important deal.  This is the creation of a new human being.  Surely you should play a more involved role than just sitting around avoiding liquor and taking prenatal vitamins.

Nope.  That's it.  Just do basic take-care-of-yourself stuff -- eat right, exercise, get plenty of rest, laugh as often as possible.  Same old health spiel.

You mean I don't have to sit around focusing on the error-free copying of DNA?  I don't have to make proteins and differentiate cells and organize tissues with my mind?

Um, no.  You couldn't if you tried, now could you?  I mean, really, could you make even one single stem cell, even if you had all the right proteins and all the right information?

Well, no.

Before you started looking into this baby-making thing, did you have any idea that your eggs were arrested in Metaphase-II of meiosis until they are fertilized and if they are never fertilized, they never even complete meiosis??

 No.

Before you started writing and researching this very blog post, did you know that human blastocysts hatch??

No.

Did you know that the zygote itself carries the information, not just for the baby, but for the placenta as well?

No.  I guess I hadn't really thought about it.  I figured the placenta was kinda like part of the uterus.

Nope.  It's more like part of the baby.

Crazy.

Yeah.  This whole thing is crazy.  Crazy beyond you.  And if you think about it too much, you will make yourself crazy.

So relax.











And just wait.




*Other great questions are "What is life?" and "What is love?" though only one of of those will have you bopping your head to a catchy tune.  
**Note: This does not look like human DNA to me; it looks more like bacterial DNA.  But I don't really know my stuff.

The Gandalf of Embryos

I keep worrying about the baby.  I mean, how do I know it's ok in there?  I can't see it.  I can't feel it.  I can't check on it.  How do I know it's not growing deformed?  Or worse, how do I know it hasn't died in there?

Luckily, throughout our pregnancy, T has been optimistic and reassuring.  It's a role reversal for us; usually I'm the sunny, optimistic, everything-will-be-alright one and T's the more pessimistic, "realistic" (as pessimists like to say) one.  But ever since we got our first positive pregnancy test, when I was sure it was a chemical pregnancy and we'd have a mini-miscarriage within hours, T has always been like, "This is the real deal.  You're pregnant.  We're going to have a baby."

It's been wonderful to have him there reassuring me.  While I've kept up a steady hum of worry about miscarriage, he has never engaged in that, never thought we were going to miscarry.

This morning I woke up at my usual 4:40*am for work.  T got up off the couch where he tends to sleep on my work nights.  Even though I was feeling nauseated and constipated -- two symptoms that mean my pregnancy hormones are flowing well -- I worried to T:

    "How do I know the baby's ok in there?  How do I know it hasn't died?"
    "Because it's good at living," he answered.  "It knows what it's doing."
    "It does?"
    "Yeah.  If you're trying to imagine all the things it has to do in there to grow and form, and if you're thinking you could never do it, don't worry, because it's way better at that than you are.  It's like Gandalf in there.  Just when you think it's gone, turns out it's just TCB at Isingard.  It's got everything under control."

Wow.  Gandalf the Embryo. 



* 440 hertz is Concert A.  It's nice to have one's wake-up time have a musical reference.

One Month Down. Eight More to Go.

It's September 1st.  The interminable August has finally ended.  It has been exactly one month since I found out I was pregnant.

Embryo at 8 weeks, average length 0.63 in

The last 31 days have passed so slowly.  Unbearably slowly.  I haven't had such slow days since I was at army sergeant camp in 2003.

I guess it's the discomfort that makes time go so slowly.  The discomfort, and the eagerness to be at a time in the future.

I'm mentally, emotionally, and physically uncomfortable right now.  It's easiest to explain those in reverse order.  Physically, my symptoms are pretty textbook: fatigue, nausea, appetite changes, mild pains in my lower abdomen.  The nausea is unpleasant all by itself -- a queasy, seasicky feeling whose only upside is that it makes my pregnancy feel a little more real.  The other symptoms tie in more with my mental and emotional discomfort.  The fatigue makes me feel like I'm depressed.  It also makes me feel less able to tackle the daunting tasks of packing up, repairing, and painting the house before putting it on the market.

The appetite changes make me feel sort of guilty about eating so much.  It doesn't feel right.  It's not how I used to do things.  My changed appetite also makes me feel less able to tackle our weekly local organic produce boxes.  Summer squash with beets and radishes sounds unstomachable to me right now.  Even the cute little orange cherry tomatoes don't go down without a fight.  The pains in my abdomen are fine -- thank goodness the books and internet told me they were normal -- and let me know that I'm pregnant.  If I get an unusually sharp twinge, however, it starts up the miscarriage worry.

Miscarriage worry is one of the things that makes me most mentally and emotionally uncomfortable.  The books disagree on miscarriage rates -- one said that "experts estimate that up to 50% of all conceptions end in miscarriage."  So my baby has a 50% chance of dying right now?  That's terrible.  Just terrible.  I wonder what the rates are if they adjust for chemical pregnancies, though.  And what if they adjust for smoking and drinking and other behaviors that might put one's fetus at an increased risk for spontaneous abortion?  What are the rates after one reaches 7 weeks 3 days of term, as I have today?

Another upshot of feeling nauseated is that mild to moderate nausea is associated with lower rates of miscarriage.

*sigh*

Once I've stuck it out to my second trimester, things will be better.  The risk of miscarriage will have plummeted to a mere 1%.  An ultrasound should be able to show that our baby is growing well and healthily.  Physically, I should have less nausea and fatigue.  Some of the books claim that, come second trimester, I should have "more energy than I know what to do with."  That would be wonderful, for I have so much to do.


I must work on this transformation, you see.  Our family is undergoing an incredible transformation right now, changing from a couple of adults in a simple romantic relationship with each other, 
to two adults in a romantic relationship, who are also parents to a brand-new human being who will be experiencing existence for the first time -- surely not an easy thing for the little tyke to do.

In addition to this massive internal transformation, our family needs to undergo an external transformation as well.  T is graduating from college and will go from college student to family bread-winner.  I will go from family bread-winner to homemaker, from career woman to full-time mother (and maybe part-time or per diem nurse -- like one shift a week -- I don't want the kids to be in day care too much).

In this process we also need to physically relocate.  We need to move from the sleepy, foggy, hippie northwest to a more bustling and prosperous area -- somewhere that offers T opportunities to excel professionally.  Somewhere that offers something for the children besides, well, drugs.  Much as I love this area, I can't raise my children here.  There's just not enough.  And there's too much bad stuff.  Too much meth and way too much weed.  This area is so physically beautiful (stunning, breathtaking, magical), but so socially and economically rotten.

So as our family transforms, so must our home.  This cozy little house that has been our home for 7 years -- twice as long as any other place has been my home -- must go from comfortable reflection of our selves and personalities -- thoroughly decorated and made our own.  Bits of our character are everywhere -- guitars on the walls, musical instruments everywhere, paintings, posters, records on the walls, tchotchkes and souvenirs on the shelves, a thorough coating of our very own personal family dirt on the walls and floors and in the nooks and crannies.

All that must go away.  Everything must come off the walls and get packed up.  The house must be cleaned and painted, made shiny and desirable to passers-by.  Our house must go from our home to a model home.

It pains me to do this.  I've grown so attached.  I've never had this in a home --cards and pictures on the fridge, even on the inside of the front door because I ran out of room on the fridge.  My little writing dojo is a hommage to Oingo Boingo and a few of my other favorite things.  It's messy and cluttered.

I've been able to indulge my inner packrat here.  I've given myself over to keeping cards and postcards and letters and photos.  I realized, "Hey, we only live but so long.  It's not like I'm going to acquire an infinite amount of this stuff; it's bulk will be limited by my own very finite lifespan.  It doesn't take up that much space.  This stuff is important to me.  It represents my relationships with other people, their communications to me.  I want to keep them.  So I did.

I have lots of other little things I've kept.  Miscellany.  Little bits of paper.  Toys.  More paper.  Little important things spread all over my room.

But I don't really need any of this on a day-to-day basis.  Hence, it is in this room that I will start my packing.  Tchotchkes and records and posters can go in boxes first.  Their absence will make the biggest visual difference and, as I've said, it's not like they're useful.  So this is where I will begin my work on the transformation of our house.

My work on the transformation of myself is more nebulous and difficult.  Much less straightforward.  Luckily nature is taking care of the physical aspect for me...