A Life Was Grown Here

I read a post today about baby bellies and "birth markings", or more commonly, stretch marks; about the way society portrays perfect women's bodies, even those who have had children, probably even more so those who have and have nothing to show for it leftover on their exterior selves. The video "Birth Markings is lovely, and definitely worth watching. 

I think as Westerners, we are programmed to think that a woman is more desirable even after having a child if she "bounces back", and quickly. But it isn't just about losing the baby weight, it's also about not having been biologically predisposed to developing a road map of stretch marks anywhere that experienced rapid growth during a pregnancy.  Stretched, saggy skin just doesn't read "Sexy" as well as smooth, tight, tanned, supple young skin does in our culture.

Of all of the complications and challenges that my pregnancy presented, one of the things that was hardest for me to accept emotionally was the fact that I started to get stretch marks all over my belly around 34.5 weeks. I knew, and my friends reminded me, that they would eventually fade, but when they first started to show up, they were dark, purpley red, angry looking marks that turned into the beginning of the horrible PUPPS rash that ended up lasting for the next 11 weeks. But those marks didn't go away when the hives faded after delivery. They are just now, 9 months later, starting to fade from the dark purplish color they started out as to a more subtle, pinkish lavender. But even though my weight is right back where it was before getting pregnant, my belly just isnt the same.  There is a pocket of looser skin, strewn with light scars that will continue to fade, but will never disappear completely.

 Many mamas, in real life, and in the video above, say that they feel that their stretch marks are their badge of motherhood, their pride in knowing that their bodies grew someone so precious to them. But, I am not 100% there yet. It may be vain, and I never felt that confident about my belly in front of others even before pregnancy, but I don't love my stretch marked belly now. I love, I mean, love, that my body was able to create and support her life as it developed until she was ready to join our world. I was amazed as I watched myself grow and stretch, beyond what I even thought possible, and I loved feeling her move and imagining what she would be like when she was here with us. I am lucky that this is the only lasting physical scar of what ended up being a challenging pregnancy and a really scary delivery.  But all along, I hated those stretch marks. I didn't take any bare bellied pictures once they showed up, not even for myself to look back and remember just how big I was, or even just what that giant basketball of a belly looked like with all of its fresh new stretch marks (and yes, ridiculous hives). And yet, while I don't love the way my belly looks bare at this moment, and I'm not sure I will ever be comfortable baring it in public again, I can appreciate that they are an ever present reminder that underneath that skin, my body grew hers. I don't know that I feel I need those scars to remind me of what happened there, but since they are there with me for the long haul, I might as well start accepting them!  Maybe my belly isn't sexy, or magazine quality perfection, and probably won't ever be without surgical intervention which I don't think I could ever quite justify, but it is mine, "birth markings" and all.

Who Let the Dogs Out? PUPPs made their way baaaaack :(

Well, as heartbreaking as it is to write this, the PUPPs hives are back.  And they are more widespread than they were before, although not yet as horrible in terms of redness or inflammation.  I know it's PUPPs because they are exactly the same as they were when they started spreading initially, and the ones in the belly area are still contained to just within the stretch marks...weird and fascinating and hellishly maddening at the same time.  I called Holly's office yesterday and she said she hasn't heard of PUPPs coming back this far out from delivery, although she has heard of it taking a while to go away. I suspect that despite the fact that mine went away almost immediately it never really cleared systemically, and it has just crept back up to the pronounced state it's in again.  Nonetheless, she said this far out from delivery I should run it by my PCP and possibly see Derm...so that's what I'm doing today.  Hopefully someone can give me something to try to make it go away for good - I'm open to a course of oral steroids or different topical steroids or whatever at this point as long as it's safe while breastfeeding, just whatever will make these hives GO AWAY.

I have had emotional and tearful moments on and off since Norah was born on account of post-partum hormone levels I'm sure, but last night I really was just devastated that this seems to be coming back.  For whatever reason, the flare-ups are worse at night, and it also happens that Norah's fussy time is 9:30-12:00
PM.  I just couldn't handle not really being able to discern what she needed to calm down and cope with my insane itching on my legs simultaneously and I just melted down.  Poor Matt has been so strong for me when I have these moments of feeling helpless and pitiful, and he just reminded me that we're doing everything we can for Norah and we won't always be able to help her stop crying right away, but it doesn't mean we are not good parents.  He also calmly reminded me as he did before to stop scratching and put something on my skin before I made a mess of my legs again.  I don't know what I'd do without his calm, steady demeanor and his loving support.  He has been just what I needed throughout the end of the pregnancy and these early weeks as parents, and I'm so grateful that he's so committed and involved and devoted to making our family happy and successful.

We will figure out what to do about this PUPPs sooner or later...I just hope it's the former! Until then, I just keep reminding myself to look at Norah and remember that she's perfect and it gets me through :) I mean, look at that face!

Happy Easter Sunday...too bad the Easter Bunny skipped our house!

That Easter Bunny is tricky...we were hoping for a little Easter basket surprise with our very own jelly bean birthday today.  However, it looks like that ol' hare was busy at other houses this time, since there is still no sign that baby Smith wants to join us today.  Not that I'm counting (OK, I am) but she's now 3 days "late" and I'm getting antsy!  Of course, I know that due dates truly range up to a month, with the specified date falling in the middle, but really once you get past that date it all seems unfair to keep waiting!

I read the report from our Non-Stress test on Thursday, and she's doing just fine in there, thank you.  She is moving, responding and thriving just as she should be.  The amniotic fluid level is within range, and her heartrate is solid with a baseline in the 130s.  It was disappointing to read "Contractions: None" - would have been nice to see the monitor picking up activity I wasn't aware of, but no dice. We could see her little lips sucking away, swallowing fluid, and practicing for the outside world.  It was really cute! Now come out already!  We're scheduled for another test next Thursday, at 41 Weeks, if she's not here before that.

Matt and I get daily texts, phone calls, Facebook messages, emails etc. asking how I'm doing, how am I feeling, any signs yet, any contractions, when is that baby going to get here?  I know everyone is excited as we are and wants to let us know they are thinking of us, but every day when I have to respond "No, nothing yet. We promise to keep you posted." it reminds me that I'm still pregnant and we haven't met our girl yet.  I also love that many of the other pregnant ladies I know, some with due dates after mine, have delivered and are spending this beautiful weekend with their babies in arms, and I'm tromping about hauling my giant self around trying to walk her out of me!  We went for an hour long hike in the woods yesterday, and hopefully will go again today to enjoy the weather...hoping it will be a birthday inspiring one today!

On the bright side, I'm going to tempt fate and say that the PUPPs rash is doing a bit better.  The hives on my palms, wrists, finger webbing, and belly seem to have more or less dissipated.  The skin there is now really dry and still somewhat itchy, but at least not welty.  My legs, according to my dear and loving husband (said in the most caring and supportive of ways, of course) still look like the topography of the moon.  I do mean that when I say he's been caring and supportive - I could not, honest to God, have gotten through the past week without his help and support.  My legs are not as inflamed, but do still itch pretty frequently.  I've been more or less able to sleep through the night spared from the "Itch Crises" that make me cry for the past 4 nights or so, but I'm now getting to the point where my joints ache and my muscles hurt and I'm waking several times at night for those late-pregnancy related reasons.  It's really just time for her to come out! My belly is stretched, my body is sore, my stamina is wearing thin, and Mama and Daddy just want to meet our baby and start falling in love with her rather than cursing her stubbornness already!

By the way, she will be a Taurus, the Ram, the most stubborn of the Zodiac :) Yeah, we already guessed that!

40 Weeks, EDD, Full Term, Fully Baked or, AFTER TODAY CHILD YOU ARE LATE

Today is it...your due date little tater.  April 21st, the day we've been charging towards for months.  Will you be one of the 3-5% of babies born on your EDD?  I'm guessing probably not based on today's exam, but there are still 12 hours left in this day! Holly checked things out again, and not surprisingly there is not much "progress" since last week in terms of dilation or effacement...however still looking good that this could happen on its own soon.  She did do a second membrane stripping, so maybe it will work this time.  We talked more about induction options and she answered some of my questions and explained their protocols a little better. I feel like if we end up needing induction for medical reasons or for reaching 42 weeks, I will be less anxious about it and more able to make that decision than I was last weekend.  She also did a second Group B Strep test because my "old" one expires next week, so if I still haven't delivered by 4/28 it would be outdated and we'd have to look at it like I had never been tested...here's hoping it's still negative! 

Since I have Gestational Diabetes, I have to start having "non-stress tests" twice weekly now that I'm at 40 weeks until she's born to check her vital signs and reactivity.  Basically, I go to the perinatal assessment center and get hooked up to monitors for 20-30 minutes and they watch her movement, monitor any contraction activity, and her heart rate to make sure she's responding to movement and "stress" adequately to endure the labor process.  They also will do an ultrasound to check amniotic fluid levels and I'm guessing they'll take a look at her position, and then most likely send us home to wait some more :) So we have that at 3:00 today.  

The PUPPs rash is still raging, but there are spots that it seems to be improving.  It's pretty much gone from my belly (thank goodness) but my legs are a terrible mess still.

Not the best pic, off my phone, but this is the back of one of my legs - the hives have all just run together now and form one giant "plaque" - I have patches like this everywhere.

My palms and fingers get pretty crazy itchy at times, but other times they are OK.  I blessedly don't seem to have it on my upper torso, back, face, or really on my arms other than a few renegade spots, so I'm hoping like hell it stays that way.  Last night was the first night in many that I didn't wake up in a full blown "Itch Crisis" that tore me from a sound sleep, although I still only got about 4 hours of sleep total.  After reading just about everything online available about treating PUPPs (at least the symptoms) I have developed quite the arsenal, and I think maybe some part of it is working.  Here's my daily plan of attack (family and friends, feel free to skip this part if it's not interesting to you! I thought I'd include it in case someone reading this found my blog online, and hopefully it's helpful to someone else):

• 3 Dandelion Root capsules 3X/daily - to "cleanse" the liver of bile salt build up...I'm on day 6 and I think it might be helping
• 1 T. flaxseed oil - started yesterday, also to "cleanse" the liver
• Triamcinolone prescription steroid ointment up to 3X/daily 
• Washing my skin with "Selsun Blue" dandruff shampoo (1% Selenium Sulfide) - just came up with this one on my own, but it seems to help some with the itching
• Tea Tree Oil and Arnica Oil applied topically after bathing/showering - I honestly think this is helping the most to dry out the rash. The TTO has a pretty strong smell, just beware!  
• Soaking in a warm (not hot!) bath with either Aveeno Oatmeal packets or Epsom Salts at least once/daily
• Alternating prescription Atarax or Benadryl 50 mg at night before bed to knock me the hell out so I can sleep - not sure it helps much with the itching but at least I can close my eyes for a while

Then there is the array of other topical applications that I rotate to help with mini "Itch Crises" during the day time (they seem to be more manageable than the middle of the night ones).  I've found using one thing repeatedly seems to lose its effectiveness, so I mix it up between: Sarna Lotion (smells like a Grandpa, but does cool and take the itch away for a while), Aloe with Lidocaine, Band Aid brand Itch Relief Gel (camphor is the main ingredient, and this works really well but my tube is almost empty and our Rite Aid doesn't carry it, so I'm sparingly using it for emergencies), California Baby brand Diaper Rash Cream (the zinc oxide apparently helps, and the lotion rubs in better than other mainstream brands like Desitin, so I'm not a white pasty mess).  I have an array of other things I've tried that have been cast aside (Ivy Dry, Calendula Gel, Aveeno Baby lotion, Gold Bond Medicated powder) but some find those to be helpful, too.  I found this website to be a really comprehensive list of things to try so if you're out there dealing with PUPPs and haven't found it yet, take a look: http://www.naomikritzer.com/motherhood/PUPPP.shtml

Whew...so PUPPs drama aside, we're just waiting for you little one! Here's what mama looks like today after 4 hours of sleep: 

The belly is RIDIC! It's like this whole other part of me at this point - it doesn't even feel like an extension of me anymore...it feels like this whole separate entity strapped on to the front...it looks unreal without clothes on!!  I'm up 5 lbs in 2 weeks according the doctor's scale...which is a little frightening but whatever. I think at least one of those lbs has to be water because I'm so swollen from this rash everywhere.  That has my total weight gain at 22 lbs.  More than I would have liked, but still within recommended guidelines, so I guess I can't complain.  Maybe managing the GD with a tightly controlled diet helped keep my weight gain in check, and that's certainly not a bad thing! 

We will keep you all up to date as usual if anything changes (IF! Ha...WHEN...I mean there are only a maximum of 14 days left from today, so it's a matter of when, right?).  Hoping to have news very soon :) C'mon Tater Tot...the world is waiting for you! 

Postponed Induction for tonight

So I felt in my gut that I just wasn't set on having an induction tonight...despite this miserable rash and lack of sleep, I just felt that inducing for a non-medical reason wasn't the way I wanted this to go, at least not yet.  I may still end up being induced in order to get her here, but for now I'm going to try and get through each day at a time and hopefully she'll make her debut very soon, on her own accord. I was weighing the pros and cons of induction, and the potential for a cascade of interventions just won out as the reason not to do this yet.  The other was the thought of an IV taped to my itchy skin and continuous fetal monitors strapped to my belly for the duration of labor...on top of these horrid welts? No.thank.you.

As much as I am ready, ready, ready to meet our girl, I don't want to force her into this world for what might only be a few extra days of this rash.  I have a different prescription for the itching to go pick up today (Atarax) and with Matt's help we are doing our best to distract me when the welts flare up a few times a day.  I figure it's good practice for labor coaching for him anyway, and he's doing a great job! I'm also trying Dandelion Root which I've found online to be a remedy that some have found works from the inside out to help cleanse the liver where the bile salts build up, causing the ensuing rash. I figure it's not going to hurt anything, and it just might help in a few days, so why not try?

We'll be sure to keep everyone up to date when something does change, but for now, no baby news tonight. Maybe she'll decide tonight's her night anyway!! Thank you for all the thoughts and support - it's been so helpful as the past week has really been a challenge.

39 Week Update

Had our 39 week exam today with Holly, and things with baby look great. Her heart rate is steady in the 150s where it should be, and her position is mostly favorable for delivery - she's head down and seems to be sort of sideways facing the left right now.  Her head is low, about a 0-station, so engaged in the pelvis which is also good news! My cervical check showed about 80% effacement and a fingertip to 2cm dilated, with soft and stretchy tissue.  Because the PUPPS rash has gotten worse over the past few days and is impacting pretty much all of my sleeping and waking hours negatively, we discussed possible induction this weekend.  She said that they calculate a score called a Bishop Score to note how "favorable" conditions are for a successful induction, and she said my score was "high" but didn't give me an exact value.  Basically, she felt that my cervical status (haha) was such that it would likely respond to induction and have a higher likelihood of vaginal delivery.  I could try a round of steroids first for the rash, but neither Holly nor I felt that at this point that made much sense. I'd rather not put myself and baby through the side-effects of steroids when we could just get her out and solve the problem.  The rash won't necessarily go away immediately, and could take days to weeks to get totally better, but it will begin to improve following delivery.  Holly swept my membranes today as well, which could get labor going within 24 hours, but is certainly no guarantee.  That was about 7 hours ago now, and I have to say I haven't noticed much change, perhaps a few more contractions that typical, but nothing consistent.  So, we wait and see.  Depending on scheduling at the hospital, we could get in for an induction Saturday or maybe Sunday, but Holly was going to give us a call and follow up.  She's not on call until next Tuesday, so it's unlikely she'll be the one there for delivery unless I hold out until then for induction.  Keeping in mind that Monday is a Full Moon, and it's bound to be crazy full on L&D Monday and Tuesday!

I'm doing my best to weigh my options, and I'm not 100% sold on induction just for the selfish reason of resolving my discomfort from this rash.  It could go great and I could end up having a vaginal delivery with no additional interventions, or my body could just not be ready and I could end up not making enough progress and have a c-section.  Or the Pitocin induced labor could be so intense that I end up with an epidural way early, can't feel well enough to push effectively, and end up with a vacuum delivery.  Are those risks worth avoiding a few extra days of intense itchiness?   I don't know.  Of course, there's still no guarantee that she'll come on her own even after her due date, and I might end up facing induction then, too. As far as the actual induction goes, I'd still be followed by the midwives for delivery, but would obviously need an IV and have continuous fetal monitoring.  Holly said the rooms have telemetry monitors, so I could at least walk around and not have wires tied to the monitor, and they are waterproof so I could still labor in the water for pain relief, either the tub or shower.  I'm leaning towards going ahead with the induction this weekend if she doesn't spontaneously decide to arrive tonight or tomorrow, and just see how it goes, because nearly every inch of my skin is covered with itchy welts at this point (my face and back and upper torso are saved so far...) and it's not going to get better the more I wait.

So tonight and tomorrow I will just keep talking to this little lady and encouraging her to come out on her own...surely it will be better out here than in there, I'm trying to convince her ;) Send your happy, spontaneous labor thoughts our way! We'll be sure to update everyone if anything changes, of course!

Biding my time

Well, I'm officially on day 4 of "maternity leave" although right now it's just "me leave" since I'm still not a mama...even though I'm thisclose.  Baby is just holding out it seems, stringing everyone along to get as close to her due date as possible.  10 days left until that date that has been looming for 40 weeks arrives, and with it either a baby or not...we'll all just have to wait and see what she decides.  I hope that she is able to choose her own birthday without being coerced to join us by chemical hormone induction...but I guess time will tell.

So, what am I doing with myself while I sit and wait, wait, wait?  Well, the first two days were pretty much that - sitting, and waiting - and it made me a little crazy.  I decided I need some things to occupy my time, even if they aren't major tasks.  Baby stuff is pretty much ready - the nursery is set up, her clothes and diapers are ready, her gear awaits her tiny body.  In another life, I might have attempted to pre-make baby announcements by hand and pre-address/stamp envelopes until she is here, and then we could tack a picture on and send 'em out...but I'm thinking Shutterfly has just what we'll need and I am perfectly happy with that! However, I have been working on scrapbooking my friend Abby's wedding album that was promised to her as a gift nearly 5 years ago...and has been sitting in a well-intentioned to-do pile for that long.  I've had a sudden burst of creativity and I feel good about the pages I'm turning out! I'm happy to be working on something for someone else right now, too, because I know that once our little girl arrives, she will be the only someone else who will be getting my undivided attention for a while.

At this point, the one thing that has increased my overall discomfort the most is this rash...I'm 95% sure it's PUPPs - Pruritic Urticarial Papules and Plaques of Pregnancy.  It sounds nasty, and it is.  It's basically itchy welts that start within stretch marks most commonly on the lower abdomen during the 3rd trimester, and often spread to arms, legs, hands, and feet. The only real treatment for it is delivery...and symptoms vary in their ability to be managed with topical creams/ointments, oral antihistamines, or steroids. I do not want to take steroids at this point being so close to delivery and hopefully the end of this madness, so I'm just hanging out with my itchy welts and taking Benadryl as often as allowed, while icing and slathering and oatmeal bathing and any other means of managing the head to toe itchies that seems to help at a given time.  Such joys, pregnancy.

On a sunnier note, the weather seems to have finally settled on spring in Southeast Michigan.  It was a warm 82 degrees here on Sunday, followed by some awesome midnight thunderstorms that have brought green to the grass and blooms to the crocus and iris shoots.  While I don't think temperatures like that are quite here to stay, our 10-day forecast seems to favor highs in the 50s-60s, which is definitely acceptable!  The geese seem to have returned as well, and I'm sure we'll soon be seeing little goslings trotting along behind their parents.  Here's what it looks like out in our garden today: 

Yellow Crocus

Miniature Iris

Cute little sprouts...not sure what these are

Matt and I are off to the theater to catch a movie in a little while, and I'm enjoying just spending some time together while it's still just "the two of us".  Who knows...many mamas that I've talked to said they were in the theater at a movie when their labor started/picked up...so maybe it's a good luck charm to get things going! No matter what, it will be nice to get out together on one of what may be our last outings without any baby baggage (other than the load I'm carrying around the front!). 

  

Stretch Marks

This is totally going to be a flat out whiney-ass post about how much I HATE stretch marks...feel free not to read any further if my "I'm pregnant and feel that is my ticket to whine about how much this state of being has come to suck, even though I clearly asked for it and knew what was coming" will just annoy you :)

I'm well aware that at least 50% of pregnant women get stretch marks somewhere on their bodies during their pregnancy...I know many women will swear they love theirs because they are a "badge of motherhood" and a reminder of what they went through to have their beautiful children.  I know they tend to fade with time (I've had other stretch marks from growth spurts earlier in life, and yes, they've faded to nearly invisible in most places).  But none of that makes me want to love what I see when I look at my belly these past 2 weeks...right about 35 weeks a few small, light purplish marks started to show up under my belly button.  I was hopeful that would be all and I would escape the last trudge of the pregnancy without any more.  That went right out the window the next day when a few more showed up, and the next day, and the next day...I couldn't even count how many there are now, or even accurately describe the intensity of the reddish-purple hue they have taken on.  They are all still below the belly button and above the underwear line, mostly just in the middle third of the belly, but there are so many and frankly, the second most obnoxious thing is how uncomfortable they are! No one tells you that the process of your skin stretching to the point of literally tearing from the inside is terribly unpleasant, and you will go between scratching the living shit out of the epidermis and wanting to cry because it feels like fire ants are gnawing their way out from under your skin.  And then, you look in the mirror at the hot mess you've just made of your already fire-engine red belly, and realize there is no way this is ever going back to how it was, no matter what creams, oils, rubs, or laser treatment you decide is appropriate (for the record, I think laser is probably out of our price range, so I'll inevitably spend at least half of what that would end up costing trying every other cream, oil, rub etc that claims to reduce the appearance of stretch marks and still end up mostly dissatisfied. At least my behavior is predictable!).  I'm normally a person with pretty solid self esteem, and I've gotten to the point of not utterly hating parts of my body as I did in high school...but this is challenging my reserves, friends.  It's not even like I plan on wearing a full out bikini, probably ever, anyway, but it doesn't change what it looks like when I saunter past the mirror getting dressed every day.  I honestly have loved my pregnant body and have felt good in my skin (so to speak) until the end here, and now I'm just uncomfortable and my skin is buckling under the pressure to the point that the marks are almost raised they are so deep.  If this child is not born by her due date and continues to grow, I'm afraid my belly is going to burst like an over-ripe heirloom tomato and start to go bad...and we just don't want that.

So, basically what that was all about is reminding my sweet darling daughter that it's ok for her to make her entrance any time now that I am full term.  And I'll do my best not to flash her my scarred abdomen in an effort to show her how much I love her and what I went through for her when she is 16 and informs me that she hates me ;)

And scene.