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Tales of a bad momma and the report of my first OB visit.

September 15, 2006

As I start to actually write this entry my mind is full of all the things that have been going on since I last paused long enough to contemplate what I want to process through this forum.  It's been a difficult and full week since I last wrote.  John is neck deep in his job transition and I really underestimated the affect it would have on me.  The transition to firm life with billing expectations, an assignment of a trial right out of the shoot has added a lot of intensity to his work and I'm afraid I'm not being as understanding and supportive as I'd like to think I am capable of being. 

Friday night John didn't arrive home until after 7:00pm, well after the tasty dinner I'd prepared was ready to eat.  I was being petty and small and decided not to call and find out where he was, just seethe silently and wait.  It turns out he was assigned to a trial late in the day and was trying to get himself familiar with the facts.  That work bled over into the weekend where he spent the entire day Sunday at the office.  Literally.  He left home around 8:00am and returned home around 7:00pm.  He didn't call, not even once.  Sunday was a rainy, gloomy day and Ava was battling a little bug that left her clingy and made it somewhat impossible to do much but hang around the house.  Monday morning rolls around and John is up and out the door by 7:00am.  As he was leaving I asked if he could tend to Ava for 15 minutes while I showered.  He just didn't have the time.  By this point I am steaming.  For context, the overwhelming majority of mornings John takes Ava to day care and I pick her up in the afternoon.  And most of those mornings I have the time and flexibility to take Ava through the morning with out a lot of pressure to get to work.  So we have breakfast together, I get her dressed, she'll usually watch a Dora while I tidy the kitchen.  It is one of the huge advantages of the job I currently have. 

Monday morning I was feeling pressed for time because I had a meeting at the office earlier than usual.  John blew out the door without one bit of support and frankly I was kind of maxed out after spending the whole day Sunday cooped up inside with a slightly sick, bored 3 year old. I mean there are only so many pictures to draw, play-do to play with etc...  Ava must have known something was up, because she became almost immediately impossible to deal with.  She dawdled and dawdled through breakfast.  Finally I told her it was time to go potty and watch a little Dora while I took a shower.  She would not go to the bathroom.  She woke up dry (as she does almost every morning) had a glass of juice (cut with water) with her breakfast and she told me that 'the pee-pee won't get out of there.'  I was in a bit of a toot, so I put her pull up back on, parked her in front of Dora and took a shower.  So I'm running around like a crazy fool trying to get ready, trying to get her ready...  Ava didn't like the outfit I picked out (of course), she would not go to the bathroom despite repeated attempts and I was at my wits end.  Ava's sitting on the potty for the third time that morning refusing to pee and I totally snapped at her.  I don't think I've ever lost my cool like that with her and I felt awful as soon as I heard the words come out of my mouth.  She stuck her little lip out and started to cry and said, no joke 'Momma, please don't use mad words with me.'  Dagger à my heart.  I felt about an inch tall.

So I put her dry pull up on, calculating that it had been 13 ½ hours since she had last gone to the bathroom, stuck her panties in my purse and huffed us into the car.  On the way in to daycare I told her she could go ahead and pee in her pull up and she said 'no momma, only babies pee in their pants.'  (Um, then why doesn't it bother you to poop in your pants? Anyway....)  We get to daycare and she can't let go of me.  And I just feel like the worst mother on the planet.  I'm late for work already, I'm sweating, I look like a frazzled mess and I can't unwrap my usually fun loving independent daughter from my leg.  And of course this is ALL JOHN'S FAULT.

I don't want to belabor the whole process of how this whole thing sorted itself out, because frankly we are still in the midst of that.  (BTW, Ava went to the bathroom shortly after I left having successfully 'held it' for over 14 hours.)  And I do want to underline that John is a wonderful partner, a good man, a phenomenal father and that I believe we will weather this transition just fine.  But right now it is hard and frustrating and I feel kind of overwhelmed by it all.  I'm sure he feels all of that and more given that I am kind of riding his a** right now. 

Wednesday was Meghan's birthday.  She chose dinner at PF Changs to celebrate, but couldn't go to dinner until after 7:00pm because she had practice.  Ava typically goes to bed around 8-8:30pm, so I just didn't see how we would be doing anyone any favors to take her to dinner at 7:30pm.  It seemed like a recipe for a 3 year old to take over a 19 year old's birthday celebration.  We arranged for a sitter and enjoyed a dinner with just John, me and the older kids.  But it came at a cost to our sweet girl.  Thursday morning she woke up sobbing (I'm not kidding) saying 'I missed you so much momma, its just me and my families for feckest (breakfast), right?'  And for the second time in a week I felt wholly and utterly inadequate. 

Thursday was my first pre-natal appointment with the doctor who delivered Ava and who has been my ob/gyn since.  He is such a wonderful doctor I feel very lucky to have found him and only wish I could just stay with him through the rest of the pregnancy instead of rotating through the practice.  The thing that has been weighing most heavily on my mind is the issue of pre-natal tasting/diagnostics.  It was a bit of relief to process that with my doctor and it went a long way toward resolving much (but not all) of my anxiety.  To begin my appointment his nurse took an exhaustive health history (which you would think they already have, seeing how I've been in this practice almost six years, but anyway...)  When the doctor came in he basically led with my pre-natal testing options, like he knew that was at the top of my mind.  I am considered to be of 'advanced maternal age' (nice) because I will be 35 when this baby is born so I have an array of choices.  He laid my options, saying, in short, that he could refer me for genetic counseling if I wanted more information, do a non-invasive diagnostic ultrasound, coupled with a blood serum analysis to check for markers for chromosomal abnormalities, do a CVS, do an amnio or do nothing.  We talked about the options, the risks, the benefits and ultimately I have decided to start with the minimally invasive diagnostic ultrasound, coupled with the blood serum analysis.  As I understand it, this test will more accurately quantify my specific risks for this baby to have birth defects or chromosomal abnormalities.  For example, right now my chances might be 1-400, based on nothing but public health odds.  This test will check the markers, and more specifically quantify MY risks based on that information.  With that, John and I can decide if we want to proceed to more invasive testing like a CVS or amnio.

Ultimately my decision was made when my doctor told me that right now the odds of miscarriage from an amnio or CVS were statistically higher than the odds of anything being wrong with the baby.  However, based on the experiences of a number of my friends, I am leaning toward having an amnio unless this initial test removes most, if not all, of my fear and anxiety.  None of this is a decision we make lightly.  It is informed  by our experiences and our own comfort level.  This is one of those situations where I wish more than anything I wasn't such a worrier, that I could be more calm, have greater faith that things will work out for the best.  But I also feel fortunate that there are options available to provide more information that will hopefully ease my anxiety and that I have access to compassionate, imminently qualified health care.

The rest of my appointment was good.  I haven't gained any weight so far.  Well, I guess that's not quite true.  Technically I weigh 1 pound more than I did at my annual exam last September.  I don't even count that, 1 pound could be my outfit, or some salty food!  The nurse was able to find the heartbeat of our little swab, despite the fact that I am just over 9 weeks along.  The heartbeat was chugging along at 168 beats per minute.  Isn't there a wives tale about a fast heartbeat being a girl?  We had a little talk about which due date to use – the ultrasound or the date of my last period.  Does it really matter?  We landed on my ultrasound date, which is April 17 ^th.  I had the unpleasantness of the internal
(cervix is firm and closed, tmi?) and pap. 

And finally, I spent some time discussing my options of a scheduled c-section vs a vaginal delivery.  My labor and delivery with Ava was a brutal experience.  My water broke at work in an ocean of fluid, but I wasn't really in labor.  When I checked into the hospital I hadn't dilated at all (maybe a fingertip) and nothing was softened and ready to go.  22 hours, a truck load of pitocin, an ineffective epidural and a wicked episiotomy later Ava was drug into this world with the assistance of forceps.  An experience I'd like to avoid repeating if at all possible.  My doctor talked to me at length and while I believe it would be his preference to see me deliver vaginally, he said that if I wanted an elective cesarean he would certainly understand and would do it for me.  I am in the information gathering stage of this.  I will say I am leaning toward a vaginal delivery, shying away from major abdominal surgery.  But I would welcome you to share your experiences with me.  Overall I believe labor and delivery is a natural process and the main reason my prior experience was so horrifying was because Ava just wasn't quite ready to be born.  Had my water not broken she probably would have waited a few more days.  What are the odds of that happening again?

John and I have shared the news with Meghan and Lane and they were just terrific about it.  Even better than I could have hoped or expected.  I told my boss today and he couldn't have been more wonderful and supportive.  He told me he would work out whatever I needed to in terms of leave and offered sincere congratulations.  I think we're going to tell Ava this evening although I am struggling a little bit with how to help quantify how long it is going to take.  She has a vague idea of seasons – winter is Christmas, fall is when the leaves fall off the trees, so we'll try that.  I am guessing it is going to mean a lot of repetition about how long until the baby is here.    Each day it feels like my belly gets poochier and I'm really struggling to fit into my clothes.  I bought a Bella Band over my lunch hour today and I'm hopeful that will help until I can move into full on maternity clothes.  It is reportedly a life saver and I'm in need of that right now because I have about two pairs of pants, that aren't jeans, that I can comfortably wear right now.

John and I are looking at another busy weekend.  He has work to do in the office.  Ahem.  Be more zen like Kate!  We have a political event tonight and Sunday.  Saturday is Meghan's parents day for her crew. It should be fun – a BBQ at the boathouse (which my club shares with her college) and the opportunity to row with the team.  I can't wait to put John in a boat! 

This has been kind of a marathon entry, so I suppose I should wrap up and get it posted.  It feels like there's a lot left to talk about....  But I suppose it will have to wait until next time. 

Thanks for reading—

--Kate