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Wednesday, July 1, 2015

Pregnancy Sciatica, Pelvic Girdle Pain, SPD...whatever you are, please go AWAY

Since about 9 weeks this time, I've been graced with a somewhat new and unwelcome guest - shooting, searing hot pain in my right butt cheek and down the right leg into my foot. It started with a sneeze (I feel like that could be a whole book chapter on post-partum life). My entire right leg went numb and I instantly fell to the floor. If it sounds dramatic, it's because it was. I laid there for a few minutes hoping to collect my shit and get up and head out the door for work. Well, that did not happen. Fast forward to almost 5 weeks later, and it's a daily presence that is seriously, legitimately, a pain in the ass.

I am going to see the chiropractor weekly or every other week. I've gotten a full massage. I ice. I heat. I rest. I walk. I stretch. I use pillows to prop when lying down. But without fail, the pain is there every time I re-position, stand up, put weight on my right foot, sit down for too long, cough, laugh, blow my nose, bend over forward, roll over at night, put on pants, sit down to pee. Basically, it never goes away. It's getting really old already, and I'm only just 13wk6d.

If that's the only complaint I have this entire pregnancy, I'd be ok with that. After the last two times, I'm ready for a road without any major issues. The nausea (which was passing and not awful at all this time) is nearly gone, and other than some weird soreness or other passing things, I have very little to be bothered by other than this constant butt/hip/leg pain.

I know that the sciatic nerve is being irritated, either through compression of the piriformis or from a vertebrae/disk issue. I don't know that it's true sciatica, it could be pelvic girdle pain or some form of SPD like I had last time. I'm willing to try whatever I can do for relief, because this is already taking a toll on my emotional health and I'm constantly fatigued (both from pregnancy and from being in constant pain/fear of pain). I'm trying mindfulness techniques and using the skills I've been learning in a year of therapy for anxiety to try and deal with this to the best of my ability, but man, sometimes I just want to complain and have someone commiserate about how unpleasant the pregnancy process can be!

Wednesday, June 24, 2015

12w5d and new pics of Baby Smith 2.0

Yesterday we got to see little Smith 2.0 again on ultrasound for our first trimester screen. Little stinker was being quite stubborn and did not want to wake up or move for a while, so we had to coax it out of the little ball it was in! After much cajoling, we were able to get the baby to flatten out enough to get the measurements they were looking for, and get a good estimate of growth. Looks like baby is on track and measured right at 12w5d, which was exactly my estimate! The nuchal translucency and my blood work results indicated a very low risk profile for any of the trisomy diagnoses (1:10,000) which is a giant relief. I also had been screened last time and I'm not a CF carrier, so we can rule that out for this baby as well. It's nice to have an ultrasound in the Fetal Diagnostic Center without needing a consultation and potentially difficult news from a high risk OB for once! Even though we did see our good friend Deb Berman, MD, who has been involved in my OB issues from the beginning, and she reassured us that as of yesterday, everything is looking great and she is hopeful that will continue for us this time around going forward.

Up until now I've had a pretty solid feeling that this is just going to be a boy. Everyone in real life (other than my mom who stands firm that it's a girl) has guessed boy, and the pregnancy has been so very different that I just assumed it had to be a boy. But...because I'm HORRIBLE with surprises, and I just love to putz around and guess about things like this, I've put up some of the pictures on a few forums for people to guess the sex based on clues in these early images. So far...100% GIRL guesses! I'll still be SHOCKED at our next scan if they confirm it's a girl, but it's really fun to guess and wonder about the possibilities either way! I guess the "nub theory" is what people are guessing by, and here are the shots they are using to guess:

We didn't get as clear of shots as we did with Norah, but evidently there is enough shown for people to give very consistent guesses! Now we just have to wait another 7 weeks to confirm at our next scan on 8/15...I'm sure it will go by quickly ;)

Saturday, June 6, 2015

The one that comes after...

Most of the things I've read on the subject of pregnancy after miscarriage are meant to be reassuring. Most women go on to have healthy, normal pregnancies even after one ends sadly. But the way our society treats miscarriage, it's hard to talk about, and there are few articles that actually highlight the emotional toll it can take, not only at the time of the miscarriage, but long after. Into the next pregnancy. Perhaps even more anxiety arises when getting pregnant again, because all of the fears about the unknown resurface, and especially if there was not an identified cause of the loss.

I lost our second baby January 3, 2014. It was early, around 6 weeks. And at the time I brushed it off, telling myself it was best that it was over quickly, and I wasn't as attached. I hadn't known the sex. We hadn't thought of a name. We'd barely known about it, and then it was over. But as time went on, it settled in. A son or daughter we'd never know, not in this life. A sibling for Norah she'd never meet. A piece of us that would never join our family in this world.

I'm currently 10w2d with our 3rd pregnancy. And from the moment I saw two lines on the test this time, I felt afraid, anxious, worried. I worried about the possibility of it ending so soon, I didn't want to get attached to the idea of being pregnant again, let alone acknowledging that we could have another child in our family by the end of the year. I worried about all of the things that could be going wrong in the very earliest stages of development, right under my skin, and I'd have no control over the outcome. I was afraid to bond to the baby, because honestly I just assumed there was a greater than average chance that this one would end, too.  I was immediately aware of how tenuous the entire thing is, and how stressful and all consuming and terrifying pregnancy could be for me, given my experience the last two times. Then, the fears of another traumatic and life threatening delivery loomed over me as well. I don't want to go through that again. I don't want Matt to go through that again. I can't bear to think of Norah losing her mama, for something we could have chosen not to do again. I felt responsible for causing not only myself, but my family, potential grief and anxiety, for wanting to do this again, and for getting pregnant at all.

Fast forward to this week. We had our first prenatal appointment on Monday, my 32nd birthday. We talked about my history, reviewed my birth records and pathology reports and discussed risks of recurrence. We were able to see the baby on a quick ultrasound, and confirm a little beating heart and a fully formed teeny babe. It was a relief. The past 5 weeks of anxiety felt lifted, and I just felt a calm sense that this time would be different. This baby was here to stay. This baby, as surprising as it was to get here, this baby I wanted and needed to be in my arms eventually.

Then, Friday, my midwife called to discuss my lab reports. My glucose was normal, my A1c was normal, indicating the gestational diabetes is still at bay. But, I had tested positive for a rare antibody called the Kell antibody (my titre level is currently 128). I either acquired this through one of the multiple blood transfusions I had after the post-partum hemorrhage, or was sensitized through my pregnancy with Norah (if she is +Kell). Matt now needs to be tested, and if he is positive for the antigen (heterozygous would give 50% and homozygous would give 100% chance the baby will also have the +Kell antigen) we will need to transfer from the midwives to high risk for extensive monitoring. If the baby has the antigen, we will need to have ultrasounds and special dopplers done every 2 weeks to monitor for a condition called fetal hydrops and severe fetal anemia, both of which could be fatal either before or just after birth.

Essentially, it is similar (although more severe) to Rh incompatibility.  One difference is that with Rh factor incompatibility, there is a shot the mother can receive (rhogam) which greatly improves outcomes. There is no such treatment for the Kell antibody.  The Kell antibody in my blood crosses the placenta and enters the baby's body, and if the baby has the Kell antigen, my antibodies are essentially fighting off the baby.  It makes it difficult or impossible for the baby to create its own red blood cells. So, the baby could have a severe lack of red blood cells, and become significantly anemic, requiring intrauterine blood transfusions. One of the risks is that these babies are often delivered early, between 33-37 weeks, because the risk of doing further transfusions after that point outweigh the risk of early delivery.

This could all be a non-issue, if Matt tests negative for the antigen. From what I've read, about 45% of kell+ moms got the antibodies from a transfusion, and the other 55% were sensitized from a first pregnancy with a Kell+ baby. So, it's about a 50/50 chance that this baby will have the antigen. If it's negative, I believe we will still monitor serial titres on me throughout the pregnancy, and if they continue to rise there may still be a reason to monitor the baby for anemia. All we can do right now is wait. Have Matt's blood tested, and wait.

It makes me so sad and angry that I have another stressful condition to monitor, once again, in this pregnancy. My relief from Monday was fleeting, and all concerns I had about bonding to this baby have instantly gone out the window. I am now all-in. I want this baby to make it through this crazy thing, to be in our arms this winter, for Norah to meet and love and play with. It just seems unfair that one person should have such bad luck when it comes to pregnancy. Sure, I can GET pregnant. I only have a 50/50 record of staying pregnant so far. And I have a 0% batting average for uncomplicated, low-risk pregnancies. I feel like I am just not made for this. If this pregnancy ends in any other way than a baby we take home with us...I am not sure I'm ever doing this again. I don't know that my body is capable, and to be honest, I don't know that my heart is either.

I'm not a spiritual or religious person, but I believe in the power of shared strength. Please, if you wish, think good thoughts, pray if that's what you do, but send your good energy out into the universe for this one thing to go OK. For the test results for Matt to be negative, and for this to proceed as an uncomplicated, low risk pregnancy. It takes a village, doesn't it?

Tuesday, January 13, 2015

Mirrors usually tell the truth

When I glanced at my reflection tonight, quickly darting over the parts I know too well that I'd rather not focus on, and going to the ones I can usually find something kind to say to myself about, I couldn't help but think "Who the hell is that woman?". The dark circles seem almost physically imprinted under my eyes, like the shadowy hollow that is left after being really ill. The color I might normally have swiped over my cheeks and lips was long gone. The mascara flaking off my tired eyelashes. The "clean" shirt I changed into after work already stretched out, wet from tantrum splashes and a writhing, wet kid at bathtime. And, my first thought was not "man, I need more sleep" but more along the lines of "surely I don't look that bad in real life, right?".

And then, my thoughts were broken up by a still-screaming preschooler who has been having one tantrum or another for nearly the entirety of the 2 waking hours on either side of the work day I've been with her. And, I would say this is just a particularly rough day, everyone surely has these moments...but lately it's been the norm for her to scream/cry/whine/hit/kick/thrash/go limp/go ninja for somewhere in the neighborhood of 2-4 hours of the day, as long as she is in my presence.

Instead of meeting her needs with kindness, with strong, welcoming, supportive arms, with all the right words to soothe her tears and build her confidence like the mother I always imagined I would be, I meet her screams with my own. I mirror her tears with the same salty, burning hot ones from my own eyes. I swear. I shout at my spouse. I seethe with red-hot anger at myself for the fact that I have absolutely no idea what the hell to do.

When I screamed at her "YOU ARE MAKING ME SO F*&%ING ANGRY" and her tiny reply through tears was "well you are making ME angry!"... I remembered that we tend to mirror each other, and what we see across from us is probably what the other is looking at, too. We butt heads because we are so alike. We are both seeking acceptance and love from the other. She needs me to keep on being here for her, even when she's terribly hard to be around. I need her to keep on being here for me, and reminding me that she does still need me, and that she keeps asking for my love, even when I'm not so great to be around, either.

So, yeah, next time I glance at my reflection and think "who the hell is that exhausted, burned out, glazed over woman?"...the mirror probably is telling the truth. It's me. I'm just a mama, trying her best, plain and simple.

Wednesday, May 21, 2014

Don't bend me or I will break

I haven't written in nearly a year. I have so many stories that need to be told, stories that my life has written out in those many moments. Stories that make me laugh, and stories that took a piece of my heart when they marched on. But there's no way to catch up on life lived out, only stand in the present, looking ahead.

And the present, it hasn't been the easiest place to stand. It's not that much of my story hasn't been told before, by working mamas, by wives, by those in professions wherein loss and heartache are the norm rather than the exception. But my own unique experience of those's an amalgam of the joy and pride I feel in being a mother and spouse, in having a career I should be confident in, and fear and insecurity about the uncertainties of the future, of my own success, value and worth to those around me.

I have the beautiful privilege of walking with families through arguably the most difficult experiences any family will know. It's my job to be something for them that they cannot be for themselves. I've taught myself how to balance being emotionally present with them without shredding the tender pockets of my own least I thought so until this week. And like I've told myself for the past four years since the last one that brought me to my knees and almost put an early end to my career as a medical social worker, there will be others, surely, that will tap little cracks into the harder shell I created around that tender heart.  Until now, it hadn't happened.

But, now it has. There is a tiny little baby boy in our care who desperately needs a liver transplant. But his body is too sick, too septic and malnourished, to receive one right now. We can't even offer the parents the promise that we will do everything we know of to save him...because we know what to do but aren't in control of when that can happen.

Today, as I walked into his room, his mother curled up in the hospital crib, cradling his tiny frail body in the curves of hers, as though she wanted to crawl inside his skin instead of him. I know that's what she's thinking, because it's exactly what I would do if my baby were in that crib instead. Giving her strength over to him, telling him to fight for something harder than anyone should have to in their whole life, certainly not at 4 months old. And watching her husband, a military man who is due to report back to base in 3 days, hold them together while talking to the physician and asking questions he must never have imagined he'd form words to ask...that harder shell I thought I'd built...started cracking wide open.

Leaving that place at the end of the day, to walk out into the sunshine and play music in my car, drive myself to teach Zumba, to move and push my body to feel alive, to think about my family and what we will eat tonight. To know that my own baby has been missing me for 12 hours, and that is my biggest hardship today. The sense of caregiver guilt has become a battle I had forgotten about fighting. Why do I deserve the happiness and health my family has? Why isn't it my baby in that bed? Thank goodness it isn't...but what does that make me to think?

These are questions I can't answer. They only bring more questions into my mind. Like, how am I going to go back there tomorrow...check the census and scan for his name. Will he be there? Will the conversation with family be one of relief that another night has passed and he's with them? Or will it be one of grief and loss and planning something they never wanted to plan in their lives? Will I hold them up, or will I break down too?

These are the thoughts in my head this week. And then, just like that, I'm also thinking about whether the spaghetti stains came out of Norah's new shirt, and did I remember to brush her teeth tonight, and shoot the car needs gas before driving to work tomorrow. Oh, and she needs milk. Picking out my outfit for the day in my head...only to realize tomorrow that I can't find that belt, and that top isn't really clean. And, oh, will that sweet baby boy be curled into his mamas body tomorrow, or will she have to pull herself away from his tiny, puffy, line covered body for the last time? And, will I break, or will the shell hold this time?

Friday, September 6, 2013

Summer catch-up

Well...the summer is over and I only updated this blog once! We really had some great adventures and made some wonderful family memories with Norah, now that she is getting old enough to actually talk about and recall things that happened longer than 20 minutes ago.

We took a family trip to Boyne this July and Norah absolutely loved every minute of it! Rather than re-upload 800 pictures, I'll share the link to our photo album and if you want to flip through feel free :)

We have pent lots of time outside, riding bikes, playing on her slip n slide, taking walks, going to "the blue park" and generally soaking up as much childhood summer whimsy as we can. Mostly I've had my iphone handy for taking photos, so these shots are the best I can do for a taste of our summer:

S'mores by the bonfire

ice cream dates with mama

Down the slip n slide

and a duck! 
So many bubbles! 
On my head!

and a beard! 

Daddy's birthday cake 
Being a doggy doc

new leotard for gymnastics, won't take it off (even slept in it)
Elbel Field band practice 

First game day, waiting for the band to march by
there they are! 

so excited!

hairuts, haircuts! all around!
tea party with Mary Read's vintage tea set (she was like a grandmother to me growing up!) 
tea party with Julia

Sunday, June 23, 2013

Strawberry Jam 101

So, after picking 23 lbs of strawberries, one must decide what to do with some of that beautiful bounty. They were almost too pretty to cut up, but once I started I was on a mission. 

The first step in making jam (or canning anything) is to gather your supplies. You need: 

a large canning pot (preferably with a canning rack inside)
jar lifting tongs 
clean mason jars with lid rings and new lid inserts  
whatever you plan to use to fill the jars. I didn't have a wide mouth funnel, but using a 1/2 c. measuring cup worked just fine.  

You need to sterilize your jars and utensils to be sure no bacteria gets sealed into your jars and ruins your jam (that would be a complete travesty!).  I threw everything I would be using into the dishwasher and set to the sanitize cycle.  

Next, to start making your jam, you have to make it in small batches or it won't set.  I followed the proportions from the original Ball Canning recipe.  

Per batch:

5 c. mashed strawberries 
1 box Sure-Jell pectin
7 cups sugar (I know!)
4 T. lemon juice
1 t. butter

Start by mashing up your hulled strawberries with a potato masher until you have 5 cups of fruit. Pour that beautiful mess into a large saucepan.  

Add a small pat of butter, which helps to reduce the foam produced as your jam cooks (which you will have to scrape off later, but this decreases the work at that step)

Pour your pectin in, and whisk to be sure all clumps are dissolved.  Add the lemon juice.  Now get that strawberry pulp boiling! It needs to get to a rolling boil for at least a few minutes - the longer you boil it the more the fruit breaks down so if you want chunkier jam just let it go a few once it gets up to a rolling boil (this means you can't stir it down, it just keeps boiling despite stirring).  Then it's time to add ALL that sugar...there are recipes that call for less, and you have to use a special low-sugar pectin, but for my first try I thought I'd go old school and do it the way our grandmas all did. I mean, jam isn't supposed to be sugar free, right?

Once you add the sugar, bring it all back up to a rolling boil again. Let that go about 1-1.5 minutes once it gets there, and then turn off your heat. After it cools a few minutes, scrape off any foam that formed (but don't throw it away! It's still delicious, just doesn't look so pretty in your jars of jam. Just think of it as a sample.)

While your jam is cooking, you need to multitask to prepare your jars.  Get enough water in your canning pot to cover at least 2 inches above your jars. Put the sanitized jars on in there, and get the water simmering. This is to ensure that the glass and the jam are about the same temperature so when you fill them they don't burst! 

In another pan, get your lids in simmering water as well. The sticky part of the ring needs to heat up to get gummy enough to make a good seal.  Be sure you have some metal tongs or a special magnetic wand to lift them out of the water when you need them.  

Ok, so when your jars are ready, your jam is ready, and you are ready, it's time to fill them up and get canning! One at a time, take a jar out of the large pot using your jar lifter tongs, drain the water back into the pot, and set on the counter. Fill it with jam, then wipe the top of the ring off to be sure you catch any drips.  If it seems like there are bubbles in there, you can tap your jar on the counter, but be careful because it's hot! Or, you can slide a knife around inside the jar.  To be honest, I skipped both of these steps and it turned out fine! 

Next, get a lid out of the pan, center it on your jar, and put a ring on, screwing just enough to get some resistance (i.e don't screw it on super tight or you'll never get it off!).  Repeat with all your jars until your jam is used up.  Place them back into the large pot of boiling water, and be sure they are all upright and covered with water. Cover the pot and boil at a rolling boil for 10 minutes, and then take the lid off, letting them sit in the water for 5 minutes before removing them to equalize the pressure.  Then carefully using your jar lifters, take each one out, and set it on your counter. Do not mess with the jars, they will seal and you will hear "pop-pop-pop" as those lids seal while the jam cools! Music to your ears after all that work :) If any don't seal, don't worry, just toss them in your fridge and they will last for weeks...if you don't eat it first.