Wednesday, May 30, 2012

Labor & Delivery Day (take two)

Tomorrow we try again with the labor induction. I don't doubt we'll be successful this time. I saw my obstetrician today and she said that I've dilated another centimeter and I'm 50% effaced, so I've made progress in the last four days. This is great news, because it means that this time around my body is more ready for labor.

I'm doing my best to envision a positive birthing experience, particularly one without the need for a C-section. I've spooked the anesthesiology department with my revelation that in all three of my experiences with general anesthesia, I was very difficult to intubate -- my most recent one took 30 minutes, even with a glide-scope. I'm "anterior" -- whatever that means -- the first anesthesiologist repeated it to me over and over again as I was being taken to recovery. I remember her urgency, saying I needed to remember that one word to give to a doctor if I ever had to go under again. So now the Labor and Delivery team are on notice that Anesthesia needs as much lead time as they can get if it looks like a C-section is needed. The mid-wife's response?  "We'll just have to make sure we won't need a C-section then."  I liked her immensely after that :)

I've had time to relax this week since I got the last of the preparation work done last week. I'm feeling much more rested and centered.

I'm kind of dreading breastfeeding. I've been having those nipple vasospasms two and three times a day, and instead of dragging myself into the shower in the middle of the night, I've been having an ounce of alcohol--which my OB says is ok, especially after she witnessed first-hand just how painful they are. The alcohol is a vasodilator that counteracts the vasoconstriction, usually within 5 minutes or so. It's blessed relief. On top of that, I've been having breathtakingly painful charlie-horse muscle spasms in the groin area the past few nights, so I'm eager to push the little guy out.

I'm looking forward to getting my bladder back, and my stomach, too. Solid food isn't sitting well with me, hasn't for weeks. Most of all, though, I'm looking forward to this next stage of my life.

In some ways I'm still in disbelief that I'm having a baby, even as the reality of it kicks me in the diaphragm and bounces on my bladder. But I'm just crazy about M and we've got a good life and a beautiful home and it seems natural for the baby to be the next thing. After that, who knows?


Monday, May 28, 2012

Back home, no baby -- yet

I had no idea that labor induction could fail, until it happened to me.

I went in on the evening of May 25th and they started me on Oral Cytotec to try to soften up my cervix and start contractions. Well, contractions started, but over the course of 36 hours there was no change in my cervix.  I was given the option of going home and seeing if nature would take it's course over the next few days (and coming back on the 31st if not) or changing up to Pitocin and using a balloon to widen the cervix.

At first I was leaning toward more intervention. I was already there at the hospital and I was tired of being pregnant. I'd also overheard three other women give birth in the room next door, and wanted to move on with labor so I wouldn't have more time to dwell on what it sounded like they were going through. But after talking with the mid-wife, nurse, and OB-on-duty, I chose to go home. I Do Not Want A C-Section, and putting me on Pitocin when I'm not even 2cm dilated means hours and hours of the baby's head slamming against my cervix until it dilates and we 1) have a vaginal birth, 2) have a baby in distress and they to do a C-section, or 3) wear me out and I need to do a C-Section. After thinking about it, the battering ram approach just didn't sound like a good way to start the labor and delivery process -- so I'm back home as of yesterday noon.

Today there is a little discomfort -- a big improvement over yesterday, as I was very sore in my lower abdominal area from all the induced contractions. I continued to have some contractions throughout the day and hoped they would continue into today, but I haven't noticed any, which is a big bummer. It looks like our hopes that the Cytotec would jump-start the laboring process even once the drug left my system isn't panning out. Ah well.

In the meantime, I'm being as active as I can. I may even get out there and do some gardening. The nurse midwife said to go home and have sex, and try some nipple stimulation. I've been having very painful nipple vasospasms lately so the thought of stimulation makes me cringe, and I'm tender enough in my nether parts after the contractions that the thought of sex also makes me cringe. We'll see what the next few days bring.

Naturally, I'm feeling disappointed, but I'm also pleased with my decision to go home and not force the labor. The OB on duty told me he thought it was the right decision. I don't want to increase the risk of a long, hard labor that ends in a C-section -- it's not the best thing for me or the baby. He'll be here soon enough. We just need to balance the benefits of letting him choose his time against the risks of placental and amniotic deterioration that are more common in women my age.

In the meantime, my step-mom will be around until the birth, and I'll get some more just-us snuggle time with M. Not a bad trade-off.


Wednesday, May 23, 2012

Try a little tenderness (instead of pissiness)

I was up and around after 4 hours sleep.

The "up" part has become a lot more challenging this past week. It's something I do s-l-o-w-l-y so the baby weight in my uterus has time to shift with me. If I get up too quickly it just plain hurts, so I ease into a standing position and make my way around the house with the help of the walls until I've got my equilibrium and momentum. I cleaned the kitchen, fed the cats, took my morning vitamins, and got to work finishing the data migration from my old MacBook Pro to the new one. I know if I don't have it done before the baby comes it could be months before I've got a fully-functioning personal computer again.

The wind woke M up about 10 minutes earlier than his usual time. It's been gusting up to 40mph here for at least 36 hours and the wind downed a gorgeous old olive tree across the street yesterday. We spent a little time together before he fired up the computers for work and play, and by 10am I felt an uncontrollable urge to nap.

We had another workman come in today, and after I found dealing with yesterday's workman so tiring, M decided to work from home today to help me out. The window for his arrival was 9:30-11:00 and at 10:50am, while I was napping, M got into the shower. He thought the guy was going to be a no-show. Nope. At 10:55 the doorbell rang. Then some knocking. I yelled for M to get the door, not knowing he was in the shower. The doorbell rang again and more knocking. I realized that if I didn't get to the door soon, the guy might leave, and the hole in the wall (left by the plumber who repaired a leak in the master bath) would go un-repaired. So I leaped out of bed (a feat that hurt so badly my knees almost buckled) and hobbled to the door as fast as my legs and the walls would support me. This 60 foot dash had me a little out of breath as I opened the door, still in my pajamas and clutching at my belly. I'm sure I wasn't a pretty picture, and as a result of my humiliation and disappointment, I sought out poor M while he was still in the shower and got pissy with him. It took me about half an hour to get over my pissyness, even after he'd apologized a couple of times and gave me a hug. Grr.

The good news is the contractor did a great job of patching up our wall. If we had regular drywall I would have patched it myself, but we don't. The walls in our circa 1950 house have two layers of wallboard--one is cementboard and another is a plasterboard that was a precursor to sheetrock, for a combined thickness of about 3/4". I didn't feel like wrestling with trying to find a combination of furring strips and sheetrock that would make the right thickness to match the rest of the wall, or doing the amount of messy mudding (spackling) it would take to build the surface up if I had to use just 5/8" drywall--even if I wasn't 39 weeks pregnant :) The best thing about being "handy" is knowing how to do a cost-benefit analysis that helps determine whether or not to let a pro do the work.

This afternoon we snuggled a bit and had a mini-talk about how the baby is going to impact our lives. I told him he's going to have to step in as the primary source of attention for Jasper, who is a very social animal and needs interaction with his people, or he acts out. It's rather funny, actually.

I also told him that I want him to let me know if he is experiencing an attention deficit, because I'm going to be tuning into the baby's needs and may not be as attuned to his. I've gotten very good about letting him know what my needs are, even making an effort to give him advanced notice where I can, and I've also gotten very good at anticipating his needs (which he loves--who wouldn't?) but realistically, I'm not sure I'm going to be able to maintain that level of presence with a newborn on my hands. I know a lot of couples go through a tough time the first 6 months because the father feels like a third wheel and an afterthought and I'm hoping to avoid that by reminding M that he has a better chance of getting what he wants if he has the presence of mind to ask for it ;)

Tonight he plays poker with his friends, and I get the evening to myself. Probably the last evening alone in a long, long time.

Tomorrow night we'll have our Last Supper as a childless couple.

And Friday morning we initiate labor. Finally.

Wish me luck!


Monday, May 21, 2012

Final letter to my unborn son

Dear baby boy,

On Thursday May 24th we start week 40, you and me. If you don't show signs of making your way out into the world before then, I'll be at the hospital first thing Friday morning to start the process of inducing labor. Even though this pregnancy has gone remarkably well, my age and the fact that you are my first child puts us in the "high risk" category, which means the obstetrician doesn't want us going past 40 weeks.

We're mostly ready for you, dragon-baby. Your father had hoped you'd arrive Sunday May 20th for the solar eclipse, but alas, it wasn't meant to be. This gives me a few more days to finish up some things I am hoping to complete before you arrive.

There is a fair amount of anxiety floating around in the house these days. Your father and I are feeling nervous and afraid. We've completed the environmental preparations for your arrival -- clothes, diapers, a place to sleep, breastfeeding supplies, etc -- but mentally and emotionally we've both admitted we're afraid we're not ready for parenthood. We're set in our ways, I admit it, and we like the way our life together has been running the past few years. We're content together, our relationship works very well, and we have a lot of freedom. And that is changing soon -- as soon as you arrive.

But even more than the fear of lifestyle changes and the fears of possible parental inadequacy, there is a fear your father and I haven't talked about. The fear that something might happen during childbirth, to you, or to me.

So in some way the purposes of writing this letter is to address the possibility, however slim, that I might not be around to raise you. There. I said it. After my brush with my own mortality and the deaths of three other family members the past few years, I'm pretty ok with death and dying. Or at least I thought I was. But deciding to bring you into this world, choosing to become a parent -- well, that has changed quite a lot. It's not all about me anymore, whether I live or die. I've made the commitment to be a mother and that means my life isn't my own anymore. You are wholly dependent on me, both while in the womb and for months (years) after you're born. And I'm afraid, more than anything else, that I won't be there for you.

Your father had a really difficult time of it when I was so sick with septicemia -- witnessing the fact that I'd almost died scared him, affected him deeply. It changed our relationship significantly, brought things into sharp focus. It isn't until you face the prospect of losing someone that you realize how important they are to you. In the months that followed we chose each other, chose to take what lies between us more seriously, and that is a powerful thing.  Powerful enough to create the possibility of you. I worry about how your father will handle things if something happens to me as a result of childbirth. He's a good man, a deeply sensitive and caring man, and I worry about how devastated he'd be if I died. And how that devastation would impact his ability to care for you.

The odds are in our favor, of course, and it's unlikely this fear of mine will come to pass, but over the years I've learned to face my fears head-on rather than run and hide from them. My own mother is gone and all I have are memories, and I know that in the event that I die while you are still an infant, you won't even have memories of me.

Oh, there will be some photos, and some recordings of my voice, and a fairly significant body of writing both personal and professional -- so I think when you're older you'll have an idea of the person I am as of today. And hopefully the mother I would have been...

A week from now I hope I'll feel silly for writing this. I'll probably chalk it off to pregnancy hormones and a healthy dose of fear. Still, it's all worth saying, and better said than not.

If I didn't write this now, you wouldn't know about the hours I've spent rubbing you through my belly, or the time I've spent telling you silly little anecdotes about my sisters and my grandparents. You wouldn't know how much I've come to love you, love the feel of you moving inside me -- you -- the embodiment of the love and possibility that exists between your father and me.  You might not know that even though I didn't plan on having children, didn't really think I wanted children -- that I want you, and that I'm looking forward to building a new life around you with your father.

I would want you to know that your father makes me laugh like no one else can, and that he and I have had a deep emotional bond for 8 years now -- a good, solid basis to build a relationship as parents on. That I have freckles on my nose and a mole on my upper arm and a widow's peak inherited from my father's mother. If you like your nose it means you got your father's nose, or my mother's nose -- because I've got my dad's nose and I don't like it much :)  I want you to know that if your taste in music is different from your father's -- if you end up liking jazz and blues and tribal beats -- it's because I listened to it when you were in the womb. If you're good at math and piano you get it from your father, and if you can't pick up playing musical instruments no matter how many lessons you've had, you get that from me. (Sorry!)

I'd want you to know that I don't have a favorite color. When I was a little girl and the other kids were picking favorite colors it occurred to me to feel sorry for the colors that weren't chosen, so I never picked one. My color preferences are mostly dictated by my mood.  I don't have a favorite flower or food, either. I tend to live in the moment, and appreciate whatever is here in this moment -- something that having preferences or favorites can interfere with. Your father and I both learned to read very young, so you probably will, too. My favorite books from childhood are the stories of Winnie-the-Pooh, and The Warm Fuzzy Story, and the stories of Pippie Longstocking, Sinbad the Sailor, and Puff the Magic Dragon. Your father will probably start you on Tolkein. I hope you like his work, but if you don't, your father will blame me :) If the Disney movies terrified you when you were little, that's on me as well. I took things very literally when I was a child. If you don't like TV or movies much -- if you'd rather read or otherwise feed your brain you get that from me -- but be a good boy and try to sit through your father's shows with him. He will appreciate the effort.

Most of all, I'm a loving, affectionate person. I love hugging, snuggling, and massaging the people I care for. If something goes wrong, I just want you to know that I am so looking forward to splashing love and joy and affection all over you, and it makes me very sad to think we might miss out on that.

There are other things I'd want you to know, things I've learned over the years. For example: You don't get what you don't ask for. * Life can be tough at times, and we're all in this together, so don't forget to ask for help when you need it. * Be clever if you can, but never forget to be kind. * Don't let anyone tell you that there is something wrong with you--you're perfect and complete just the way you are, and everything you need to be happy is already inside you. * Love isn't something to be hoarded. Instead, love like you're trying to give all the love inside you away by the end of the day--you'll be full again in the morning, I promise, and you and the people in your life will be better off for it. * People are more alike than they are different, and if you remember that, you'll always have common ground. * Your only limitations are the ones you believe in. * It's ok to be afraid--everyone is afraid--but most fears are creations of your own mind, so don't let them get in your way. * The only regrets people tend to have in life are the things they didn't do. * It's ok to make mistakes. Mistakes are often acts of creation. Just remember to own up to them and make amends when you can. * Your thoughts and attitudes are creative and causal forces in your life--as you think, so you are and so your life is. * Own your present and your future: Be the change you want to see in the world and it will come to pass. * Be playful. * Be grateful. * And most of all, Be Happy. *

Love,
Mom


Tuesday, May 15, 2012

10 days and counting

May is a gorgeous month here in the San Francisco Bay Area. Or at least it is gorgeous south of the City.  This weekend it was nearly 80F at my house, but a jaunt into the City uncovered a dampy, foggy wind and temperatures in the 60s. Needless to say, I didn't stay there long.

The pregnancy is going remarkably well, I'm told. No signs of preeclampsia, no gestational diabetes, I've kept my weight down, and all my bloodwork looks good. The latest ultrasound shows the baby in the desired head-down position. But at 38 weeks, I'm getting worn out, and the baby isn't showing any signs of wanting to make an appearance. My feet have started to swell, so I'm wearing flip-flops most of the time -- not the most stable footwear for someone who can't see her toes anymore. I've got a permanent crick in my pelvis/low back that sometimes turns into a sharp knife-like pain when I'm out walking--so I'm sticking close to home these days. It is getting more and more difficult to find food that agrees with me, so I'm mostly eating frozen greek yogurt, trail-mix, and rice with a bit of milk. My nose sometimes bleeds for no apparent reason, and my ring and pinky fingers are getting numb and tingly. These are all things that are known to go with pregnancy so I'm not worried, just tired.

This weekend I put together the last of the baby-related furniture and got things organized so that changing and dressing him should be relatively easy. I hope. I've been going through closets and dressers and dropping things off at GoodWill. Cleaned the guest room and prepped it for my my parents' upcoming visit. My step-mother is a nurse and it will be good to have her with me for the delivery. Moved most of the cleaning supplies out from under the sinks to the garage (it's never too early to start developing new habits). We've still got some bins to go through from the move into the house a year ago, but some of that will have to wait.

Our friends and family have been so generous with regards to baby gifts that I've had to add things to the baby registry. I'm not big on accumulating things that we won't need or use until months down the road, so most of what has been on the registry list has been newborn through 3 month needs. Our living room is full of cardboard boxes from Amazon -- we've been breaking them down and recycling them for weeks but more keep coming.

I'm already working on my to-do list once the baby is born. There are a lot of things I just can't do right now. Or don't want to do because it might bother the baby inside me. Like using the circular saw :)  I want to finish building the side panels on the rolling bamboo gate that camouflages the garbage bins, but handling lengths of lumber and using power tools isn't a good idea right now. I've also got a burning desire to move the gorilla storage racks in the garage, and that will have to wait, too. And planting. I've got a 40 foot long planting bed along the back of the house but I don't have what it takes to plant and maintain it right now, so I've held off on the tomatoes and carrots and snap peas. Plus, I need to dig down and put some hardware cloth in place to keep the gophers/moles out of the garden.

Well, time to finish this up. I've got plumbers coming in to fix the leak in the master bath soon. And I need to go over the bids for the sewer lateral work we're having done. And take my neighbor to the doctor this afternoon (she just got out of the hospital a few days ago). And then I get to nap :)

Monday, May 7, 2012

Wading for the good baby

I feel like I'm living at a very high altitude these days. High altitude, or under water. All movement seems to require so much effort, and I feel the need to take great gulps of air -- only I don't have room to expand my lungs. The baby keeps kicking me in the diaphragm, which isn't helping. Sunday afternoon I was laying on my back, vise grips in hand, trying to tighten a bolt on the new Toto toilet that arrived this weekend, and the baby kept kicking my diaphragm, making me cough, which in turn worried my partner. Yes, I'm 37 weeks pregnant, but I'm the handy type, and I'm not good at laying around watching someone else sweat. I insist on helping, and M is gracious enough to wait for me while I move around like I'm wading through water. The only thing I seem to do quickly these days is void my bladder and refill it.

Anyway, the Toto toilet and washlet is installed now, and it's a real treat to use, but the tools are still laying about. It makes me a bit nuts, probably because my father was incredibly anal about his tools, and I used to get my butt kicked if tools weren't cleaned and put away where they belonged. I just didn't have the energy to put them away today, and M probably didn't either. Not to mention that he just sort of puts things on the gorilla shelves in the garage wherever they'll fit, instead of where they were when he grabbed them. He just doesn't have the motor-memory of where he got them from, even when he gets instructions from me as to where to find them. However, when I handle a thing, I can remember both the place I found it, and the last place I saw it. He doesn't have that talent, and relies on me to tell him where he left things. He usually asks before he starts searching, just on the off chance my mind has noted an object's whereabouts. I'm hoping this doesn't happen with the baby or poopy diapers or we're in trouble ;)

I'm losing a couple of pounds a week these days. I just can't seem to take in enough calories to meet the baby's needs and my own. I just don't have the room in my stomach right now. I've stocked the fridge with sopressata and genoa salami and sliced cheeses for quick calories, along with sugar snap peas and baby carrots. I also picked up some Healthy Choice fudge bars to complement the frozen yogurt bars I've been sucking on when my tummy is unhappy with me. When all else fails, it's protein drinks and bars. I'm getting sick more now than I did in the first trimester. I suppose I shouldn't whine about it too much. There are lots of women who end up with gestational diabetes and have to be very careful a bout what they eat. Luckily, my blood sugar has been in the 70s and 80s.

My Group B Strep test came back negative, so no need to run prophylactic antibiotics in the delivery room. I wasn't sure what to expect for the test results -- after my bout with septicemia and the mega-doses of state of the art IV antibiotics I received for 6 weeks, I expect whatever bacterial colonies I've got now are highly resistant to conventional treatment. A few months ago an area of skin infection had to be excised because antibiotics weren't clearing it up. Fortunately, the healthy tissue healed up very quickly.

I find myself wondering what the baby is going to look like. I'm hoping he has his father's brown eyes. Mine are brown, as well, but there is something about his eyes... I'd love to look into our child's face and see his father's eyes. Of course, both of us having brown eyes doesn't guarantee that the baby will be brown-eyed. Eye color has multi-genic heritability, and we've both got blue eyes in the family -- and green on my side, as well. My big hopes are that he gets his father's nose and metabolism instead of mine. M hopes that the baby gets the tall genes that run on my father's side of the family.

Being pregnant when it is hot really sucks. I'm having difficulty staying hydrated when I'm out and about at all the prenatal appointments, shopping for groceries, and picking up the last bits of things I need for the baby's arrival. The heat also makes it difficult to muster interest in food, which impacts my energy level. Thankfully the house has stayed cool even without the A/C on. It's 85F outside and 72F inside.

I think I'm going to lay down for a nap. I woke up wildly hungry at 3am this morning, and again at 6:00am with the birds.I'm starting to keep breastfeeding hours, I think :)             

Sunday, May 6, 2012

Two weeks until Delivery Day

We have a completely new HVAC system for the house as of Thursday. Boy does it raise and lower ambient temperatures quickly! And it's all high-efficiency so we'll see a difference in our gas and electric bills. We decided to get it done before the baby comes, instead of afterwards. Sometime in the next 9 months we'll have the floors insulated from the crawlspace -- before winter comes and the baby is crawling around on cold hardwood and stone tile floors. Of our 1900 sq foot house, only about 500 sq feet is carpeted.

I had someone come in to tackle cleaning the bathrooms and floors, and she did a beautiful job for a fair wage. I'll probably ask her back in a few weeks.

The Graco pack n'play bassinet has been put together and is situated by my bed. It's going to be a good height for handling middle of the night changes and breastfeeding. I've already got diaper-changing and feeding-related stuff in two canvas bins in the top half of the bassinet. God, I hope I'm ready for that!

All the baby clothes and linens that came in this week have been washed and stashed. Yesterday we stopped by Ikea to pick up a dresser and cloth bins to compartmentalize the drawers so those tiny little socks and whatnot don't get lost in the shuffle. M wanted to be a part of the baby furniture decision-making process, but he's only available on weekends, and our weekends have been full of classes and house-related projects and his usual techie puttering. Hopefully we'll get the dresser assembled today.

Speaking of classes, I had the breastfeeding class and the newborn care class yesterday. I'm not sure what I was thinking when I booked two 2.5-3 hour classes back to back. All that sitting in hard chairs made my feet and ankles swell. They're still swollen this morning. Grr.

I'm getting frustrated and tearful a lot more these days, mostly with M. I know it's not fair for me to expect him to read my mind and anticipate my needs, but there are times when I wish he was a better listener -- especially those times when I've had to repeat myself. He's also used to me being his reminder system, but I'm not very good at it these days -- not when my brain is mushy like it is now. Living with M is like living with an artist or musician or an absent-minded professor. He's always thinking and imagining--which I love about him. He's got a big, sexy brain. Before we lived together he'd forget to do things like make meals, do laundry, and feed the cat -- so I took all the domestic stuff on. And now I'm a bit overwhelmed. It's frustrating when he asks me about something as simple as how I make his bacon sandwiches -- which I make the way he told me he likes them -- but, I should be happy he's making the effort, right? Right. Right.

Sleeping is no longer the deep, restful sleep it once was. I'm constantly adjusting positions because something is tingling or I can't breathe right or the baby keeps pounding on the same spot like he needs more room. I'm resting/napping a lot more. I experience the burning-eye need to lay down two or three times a day now. The good news is that this phase is only for 2 more weeks.Once the baby is born I'll be sleeping less, I know, but I'll be experiencing a lot less physical discomfort (I hope) and much better mobility. Two improvements which should have a marked impact on my emotional state.

Still to do are the bag for the hospital, the installation of the car seat base, purchasing some newborn disposable diapers to get through the first few days of toxic waste, and finishing the re-organization of my bedroom so I'm not tripping over bins and boxes.

Monday, April 30, 2012

The soon-to-be-new-mom freak-out hour

We're moving the induce-by date up to the weekend of May 19-20. The weekend is more convenient for everyone, and if the baby is delivered Sunday afternoon between 4-7:30 there will be a ring-of-fire (annular) solar eclipse occuring over the Bay Area. Pretty cool.

I had an appointment with my primary care physician this morning per my obstetrician's recommendation.  I'm experiencing some mild angina-like symptoms along with the occasional flutter (arrythmia) and given that I've had hypertension since Hell Year 2008 and pregnancy adds extra work for the heart, it's probably a good idea to get a cardiac check-up prior to the delivery marathon coming up in 20 days or so. The EKG showed mild sinus tachycardia -- not unusual during pregnancy, so that's good. Next time my heart races and my BP drops I'm supposed to drink water as my doc suspects my blood volume is getting low.

The fact that we're counting down in days now, rather than weeks, has me on the edge of freaking out. This pregnancy has happened very fast seeing as I didn't know I was pregnant until I was nearly 16 weeks. So that is part of it. It also seems like there is so much left to do, and I'm really impatient with my physical limitations right now. I'm bringing someone in on Thursday to clean the bathrooms and the floors, especially since we're having workmen in this week changing out the HVAC system. New furnace, new ducts, new A/C this week.

Fortunately, I've had some friends step up to help me figure out how to organize the baby gear and determine what is still needed. I'm normally a very organized person but all the tiny little baby clothes look alike to me. Now they've been sorted into bins for newborn, 0-3, 3-6, 6-9, 9-12 and 1 year +. After a lot of hunting around, I'm pretty sure I'll be heading to Ikea this week to pick up some Trofast frames and bins for organizing all the baby stuff. Once he's off on his own in his own room, the bins will be great for toy storage and the like, but for now, I'll use them for storing diapers, ointments, clothes, even as a changing table. So much STUFF.

Everything is going to change very soon. I've lived a mostly tetherless, responsibility-free life for the past 25 years, and now, at a time when my friends are becoming grandparents, I'm having my first and only child. All my adult life I avoided even having pets because I wanted to be free to go places and do things without having to worry about who was watering, walking, feeding, and paying attention to pets. I avoided getting married because it didn't make sense if I wasn't having kids. I even avoided accumulating much in the way of things (except books) because it seems to me that people become owned by their things and tied to a place because things need space.

And now there is a baby coming, and I can't return him to the store if he's too much bother ;) I can't just make a quick 10 minute trip to the grocery store anymore. Every move is going to have to be planned, every moment of the baby's time accounted for so that he's not unaccompanied.  I've never minded being tied-up, but the knowledge that I'll soon be tied-down is freaking me out. 5 years ago someone I was dating told me I was commitment-phobic, and at the time, I thought that was rubbish. But CW was right about a lot of things, and it looks like he was right about that, too. I should send him an email and let him know. Men do love it when women tell them they're right :)

Saturday, April 28, 2012

Got extreme nipple pain?

Welcome to the world of nipple vasospasm and/or Raynaud's of the nipple.

I am writing this as a public service, because I thought I was being a whimp about nipple pain and losing my mind, and I think there are more women out there like me than the medical community realizes.

Note: It appears that the anti-hypertensive drug Labetolol can cause extreme nipple pain as a side-effect. A lot of women experiencing hypertension during pregnancy are put on this drug. See my comment below dated 11/01/2016 for NIH and journal articles.

When we are pregnant and nursing (breastfeeding), women are told to expect a certain amount of breast-related discomfort. When we complain about extreme pain, we are sometimes diagnosed with mastitis. If treatment for mastitis fails, then we're told it's probably a fungal infection, like thrush. If treatment for fungal infection doesn't relieve the pain, mothers are told to grin and bear it, or give up breastfeeding. Thousands of women choose to suffer through agony because they know that breastfeeding is what is best for their children. Thousands more give up on breastfeeding entirely, feeling inadequate as mothers and unsupported by their physicians. I recently learned that nipple vasospasm, and particularly Raynaud's of the nipple, are leading causes of breastfeeding failure -- and no one knows about it.

Really. I first started experiencing it at about 5 months in to my pregnancy, when I started taking Labetalol for hypertension. I finally spoke of the throbbing, burning pain, I was told some women experienced that as their milk came in, and that it would fade. I knew that this level of intense pain just couldn't be 'normal', so I started researching online.  It took me several hours of digging to turn up the information on Raynaud's/vasospasm of the nipple. My OB had never heard of it. She talked to another OB and that doctor told her she'd had a few patiednts with it over the years, but it was rare. I was referred to a lactation consultant who said my symptoms were characteristic of Raynaud's and recommended a medication(nifedipine) that I can't take while I'm pregnant. I have to wait until I'm breastfeeding. Meanwhile, I suffer.

What are the symptoms of Raynaud's or vasospasm of the nipple?
1-Extreme burning pain, the kind of nipple-on-fire pain that has you crying hysterically, wakes you up at night, doesn't respond to Tylenol, and makes you wish you could take drugs, drink alcohol, or knock your head against a wall until you find oblivion.
2-Extremely hard, puckered nipples and areolae, as if you'd been exposed to intense cold.
3-A blanching (whitening) of the tips of the nipples.
4-The areolae turn a very dark reddish, purplish, or bluish hue.
5-The edges of the aureolae sometimes turn a bright, angry red.
6-The pain lasts anywhere from just minutes, to over an hour.

If these symptoms are triggered by exposure to cold, it is called Raynaud's, otherwise, it is called nipple vasospasm. Whatever they call it, it is maddeningly painful.

I've tried Tylenol, sunburn gels, nipple ointments and numbing sprays, my hairdryer, warm washcloths, etc. The only thing that helps is a long, hot shower. The problem is, being pregnant, my tolerance for long, hot showers is pretty low. The other night I got out of the shower after 20 minutes, still with pain but bearable, and crawled into bed. 90 minutes later I was awake again. It took 30 minutes in a hot shower, with me feeling lightheaded and my knees about to buckle, before the horrid fucking pain abated.

I've experienced this for 5 nights running. I'm exhausted. I'm cranky. I'm dreading breastfeeding. As I emptied my dishwasher this morning, I was actually tempted by steak knives: I contemplated sawing off my nipples.

Several causes and treatments of nipple vasospasm are hypothesized. Causes could be too much caffeine, not enough B6 vitamins, exposure to cold, etc etc. Treatments recommended are heat, avoidance of vasocontrictors like caffeine and nicotine, ingesting vasodilators like nitrates, alcoholic beverages, niacin, and certain herbs. Based on the feedback I've been getting from other women, hypertensive meds, particularly Labetalol, may be causing this.

Ibuprofen helps some women, and Nifedipine usually works within days, and requires no more than 6 weeks at a low dosage to prevent recurrance. So the literature says.

I'm not sure what I'm going to do, especially on those nights when the pain outlasts my endurance of hot showers. Perhaps a bit of alcohol. This late in my pregnancy I'm not turning to ibuprofen and I'm not very tolerant of NSAIDs anyway. I might hit my doc up for prescription-strength topical lidocaine or procaine. Or maybe I'll get lucky and it will just disappear. I just know that I can't take another 23 days of this. 

I hope that my research helps other women out there who are going crazy with nipple pain.

http://www.nbci.ca/index.php?option=com_content&view=article&id=52:vasospasm-and-raynauds-phenomenon&catid=5:information&Itemid=17

http://www.llli.org/nb/nbjulaug99p120.html

PostScript:
I was at my doctor's office for a routine fetal monitoring when this hit again. I sat in the chair and cried silently until the RN came in to check the tape and saw me. My pain tolerance is legendary so she was shocked. She asked what was going on. I showed her my breasts. Dark purplish aureolae and nipples, with the tips a shocking grayish white. She went and grabbed my OB. She examined me, gave me lidocaine cream and hot towels but they didn't make much difference. She asked me if anything helped. I defiantly told her about 1/2 ounce of scotch or Bailey's Irish Cream worked within a few minutes and I figured such a small amount wasn't going to affect the baby. She said I was right. She said that the stress hormones I was pumping out due to that level of pain was much worse for the baby than a small amount of alcohol. So now I've got doctor's orders to drink next time I have one of these vasospasms. Whee!

Saturday, April 21, 2012

Childbirth. Must I?


I had a high pain tolerance once. I could function well enough at level 10 that one of the paramedics didn't believe me when I told him it was that high. I offered to scream and projectile vomit for him (which I was trying very hard not to do) at which point his partner guided me onto the gurney. In the emergency room it took 3 doses of morphine to bring my pain-level down to a point that my body would lie still for an MRI of my internal organs. That's pain.

Nearly four years ago I was admitted to the hospital with a wound that had gone septic and beyond, to septic shock. I apparently came within hours of dying, had a couple of surgeries, weeks of hospital and home health care, and ended up with an 8-inch long & 4-inch deep open wound that had to heal up from the inside out. Endless bags of antibiotics until my veins were exhausted and I cried through IV pumps rather than admit it was time to change the IV site and invite even more agony (lesson learned: demand a PICC line if I'm going to be on an IV for more than a few days).

Talk about pain. The memory of the pain is still with me: it brings tears to my eyes. It cut through my dilaudid-on-demand; it made my whole body tremble and jerk, even in my sleep. I spent 10 days checked-out from my body, burrowed deep into some remote place in my mind. Those 10 days are lost to me, just pained haziness punctuated with moments of extreme agony. I vowed that I never, ever wanted to experience that kind of pain again.

Childbirth. On a scale of 1-10 it's just over 11, I've read.  I am assured that the memory of labor pain fades with time. And of course, it does. It must. It's the thought of that in-the-moment gut-wrenching pain that freaks me out. I just don't know if I can muster the courage to face that kind of pain again, even with the help of an epidural. Sometimes I think about scheduling a C-section just to avoid it. And I probably would if I didn't want to have to deal with recovering from major surgery.  I also know it is better for the baby to experience vaginal birth. Its like a full body massage--it gets the blood and lymph flowing, stimulates the muscles, etc. And that matters to me more than the memory of pain.

Childbirth. Never intended to go through it, feel completely unprepared to handle it. But it's how human life begins, so... meh. I'll keep trying to pysch myself into it. Perhaps the Labor & Delivery Tour at the hospital next weekend will help take the edge off some of the anxiety.