The Dairy (1) is Now Closed

I've been writing this entry in my head all week. But every time I try to sit down and put the words on screen I hesitate for a myriad of reasons sensible and senseless all at once.

BooBoo is now 100% on formula. And I could not be happier.

I read a lot of stuff. (Stay with me. There is a point to this). Some at the library, more online. One of the biggest complaints my family had throughout BooBoo's (2) gestation was that I read too much and knew too much about what was going on with my body. I shouldn't have been reading so much, it would make me worry too much.

Victorian/Edwardian much? Ignorance is bliss? Reading was one of the few things I could do to maintain some semblance of control during a process that was very much out of my control.

• I was not surprised when I had to put away my lovely bras in favor of quasi-sport style bras and tanks with snaps and cutouts.
• I was not surprised to have to buy shoes that would expand enough to fit my feet during the last months of pregnancy.
• I was not surprised to find, three days after delivering BooBoo, that the shoes I had purchased in point 2 didn't fit. I left the hospital in a wheelchair, sporting socks. If it had not been December, I would have forgone the socks altogether and left barefooted.

The weeks wore on and the two of us settled into some kind of rhythm. Even though it was still taking almost an hour to nurse him. Even though I had to give him both breasts every time. Even though it continued to hurt like hell every time he nursed off my right breast (which was every time he nursed). Even though the only time he seemed to not be hungry ½ an hour after finishing was when J gave him a bottle with formula. Even though he was barely above his birth weight and J was giving a bottle every night to help him gain.

Week eight came and went. I was still getting only an hour of sleep at a time. I was becoming increasingly depressed, to the point where I was contemplating hurting myself. I was not eating. I had no time and was not hungry anyway. I resented BooBoo. I resented J.

On the Monday morning of the ninth week I spent an hour nursing BooBoo. I put him down on his play mat for a few minutes so I could get something to eat. From the kitchen I could hear him crying. He was hungry. Again. He had finished nursing only five minutes before and he was screaming as if he had never eaten at all.

And the thought of me putting him to my right breast, of experiencing another ½ hour of burning pain that had no cause, was too much. I reached for a bottle. 2 ounces of water, a scoop of formula, shake like crazy.

And BooBoo took the bottle. Hungrily, easily, happily. When he was finished he looked at me with a contented expression and feel into a comfortable sleep.

And I experienced a moment of mental and emotional peace that I had not felt in months. I decided that today was a good day to start weaning BooBoo for daycare. Pump and bottle feed during the day, nurse in the morning and at night.

It was a good plan that didn't work. I didn't produce enough milk to send what he needed to daycare. I altered the plan. Give him formula during the day, nurse in the mornings, breast milk from a bottle in the evenings.

Which worked for two weeks, until I got food poisoning and the milk supply quit altogether. Quit cold. The painful weaning that I read about? Didn't happen. I just stopped producing.

I read a lot. A lot of blog entries from other women who have quit breastfeeding because it just didn't work for a myriad of reasons. And a I read the comments, supportive and cruel. Comments from women who were able to successfully breastfeed their children for a year plus yet got that sometimes it just doesn't work. Cruel comments from “lactation activists” (3) about sucking it up and soldiering on, no matter the mental, physical, emotional cost.

Since I stopped, being with BooBoo has been a joy. It is a joy to get up at 5:00am, while he is still sleeping, so I can be showered and dressed when he wakes. It is a joy to listen to him cry (he is not a morning person) as I change and dress him for the day. To make funny faces and silly noises in the off chance that he will smile. To hear him learning how to laugh.

And I know, deep in that part of me that just knows, that I would not have felt this if I had continued trying to do something that was fundamentally not working.

Thank you, from every fiber of my being, to those who offered support through emails and comments in these past weeks. Your kindness amazes me.

There has been one surprise. I was surprised to discover that my very flat feet are now flatter and the first few steps I take whenever I get up from a chair hurt.

(1) Quoth Jeff to a friend “We have a dairy in the back of our fridge” when I was still pumping out a decent amount every day. A very apt description.
(2) The Alien has graduated to the nickname BooBoo.
(3) I refuse to invoke Godwin's law in an entry about breastfeeding. Not going to do it.

The Good, the Bad, the Ugly

Summary: J and I are now proud (and sleep deprived) parents. Our child, L, was born on Saturday afternoon, at 3:58pm.

The Bad: Labor. The whole thing. From the membranes breaking on Friday at 11:30 in the morning while I was at work, to the drive to the birth center, to the back-and-forth from birth center, to hospital, to birth center and finally back to the hospital over the course of 28 hours.

Highlights included witnessing the driver of an 18 wheeler do a u-turn in the middle of Stanwix street,  denting the guardrail and nearly taking out a convention center support beam and several cars, vehicles driving the wrong way up Penn Avenue and two trips to the hospital, the first to assess why my blood pressure had become so unstable and to do an ultrasound, the second as a formal transfer, as my contractions never developed any rhythm due to L flipping to a posterior position (aka “back labor”) and I was dilating too slowly to remain safely at the center.

The Good: The hospital staff, from the anesthesiologist who applied the epidural and took the time to explain not only what he was doing, but how and why, the midwife and hospital nursing staff who worked together to prevent a knife-happy OB/GYN from forcing me to have a cesarean section and J, who hid his fear and anxiety until after L was born.

Surgeons were consulted on L's positioning. Nurses not assigned to the labor stopped by to offer suggestions and moral support. The neo-natal unit was called down to take L at birth to ensure that he was healthy. I can confidently say that I would not have made it without their support and care.

The Ugly: J's parents showing up while I was in labor and in no shape to see anyone, in total and complete disregard of my previously and repeatedly expressed wishes that they stay home until otherwise instructed. J's parents do not handle hospitals well. They came into the room to make themselves feel better and I found myself wasting time and energy trying to reassure his mother that I was OK. I finally quietly and politely asked them to leave the room.

My parents also showed up in defiance of my previously expressed wishes. I took their arrival slightly better, if only because both of my parents are nurses and they know how to behave in such situations. They stayed only five minutes and I did not have to ask them to leave.

That it took two people, a surgeon and the midwife over thirty minutes to stitch me back up.

That J's sister showed up with her husband and children (against the express wishes of the hospital that children under the age of 12 remain at home) in the maternity ward at 8:00pm (visiting hours end at 8:30pm), after being told by J's parents that both of us were exhausted and NOT to visit us on Saturday. Her explanation? That they were “too busy” to come visit on Sunday, Saturday was more convenient for them. J refused to allow them into the room and the family went home angry because they were not permitted to see me or hold L, and complained to J's parents about how unwelcome they felt.

For the record, this is the same sister who was offended when I stopped her from touching my stomach.

Filed Under...

...things you should not say to a woman entering week 37 of pregnancy:

“Oh, you are too high! You are not going to drop for weeks. Its gonna be a while yet before you have that baby”.

Then giggle and start talking about how you did 10 jumping jacks on a hot summer day to make your water break, which it did the next morning, and how horrified you were because 10 jumping jacks may have ruptured the placenta.

Continue in this vein for several more minutes, bragging about how early all your children were and offering unsolicited advice while ignoring the frosty silence and stiff smile of the luckless pregnant woman forced to listen to such twaddle.

Compound that with having to listen to conversation about "how wonderful" it would be to have an infant at Wigilia this year, as if my sore, sleep deprived, learning-how-to-breastfeed ass will want to do nothing more than feed the infant, pack myself into a car, drive an hour and subject myself to 30+ people in a small room.

Programming Note

To hapless spouses of first time pregnant women everywhere:

It does not behoove you to complain about giving up four Saturdays over a forty week period to attend some childbirthing and don't kill the baby classes. Especially when pregnant spouse has actively encouraged you to go out with mutual friends, continue playing the sports that you love, pushed you to get exercise and spend time with your parents and siblings and essentially done everything within her limited power to make sure that you continue to maintain some sense of normality during a highly abnormal period of time.  You sacrificed four Saturdays. Your spouse, on the other hand, has sacrified her physical being and emotional sanity. She wins. Stop being a jerk.

Too Many Days

Less than four weeks. I'm uncomfortable, cranky and offering myself up as a willing guinea pig for any person willing to cast any sort of voodoo spell that will shorten the end of the alien's gestation.

I'm not willing to put up with too anything from anyone. After almost 36 weeks of restraint, my mother decided to pull out the clichés during a post-Thanksgiving dinner conversation and was promptly smacked down. In the defensive, injured air put on by any individual who knows better, but goes ahead and does it anyway, she protested that she had exercised restraint over the past 35 plus weeks. I pointed out to her that if she had been successfully able to hold her tongue for over 35 weeks, four more should have been easy.

Last week, for the first time in my life, I yelled at a healthcare provider. Concerned that I might be leaking amniotic fluid, I called the midwives, who squeezed me in for an appointment for an internal exam and to take a specimen. The nurse who examined me neglected to mention that because of the potential risk of infection, she would be unable to use any lubrication or that I might be “extra sensitive” until after I started yelling at her while on the table.

She was apologetic about the incident. Which soothed my feelings, but not my poor parts, which ached for the rest of the week. The leakage turned out to be a false alarm,

I feel subtle changes. I'm getting sweaty. The migraines, which never went away completely, have increased to their pre-pregnancy level of intensity and duration. Tylenol is completely ineffective as is the only other cure available to me right now – a solid night of sleep. And the nausea of the first 20 weeks has returned, in a slightly more manageable form.

The first of now weekly checkups came with a list of instructions. When to call the midwives – if I have another full blown migraine(1) or my water breaks. What to do if I start early labor near bedtime – call the midwife and take a Benadryl(2) to get some sleep.

My crankiness has increased since I started this post, three days ago. I feel incredibly isolated, angry and lonely right now and acting in ways that are highly counterproductive, such as isolating myself even further so I don't act out against the undeserving, including J. Who feels the tension and anger anyway and has responded by inviting a bunch of our friends over to our home on Saturday to watch the Penguins/Blackhawks game. It is the correct thing to do – I'm too uncomfortable to go out for extended periods of time at this point and I need to socialize with other people.

Too many days left.

(1) It is interesting to observe what healthcare professionals will freak out about. I've had several migraines over the course of this pregnancy, just of a lower level of pain and shorter duration, mild enough that it never occurred to me to mention them. Especially since not every woman experiences a cessation in migraine activity during pregnancy. I mentioned the headache because I was curious if it acted as a precursor to labor, a sign that my hormone levels were returning to a non-pregnant state. From the midwife's point of view, it was an indicator of something more serious.

(2) I had no idea how many off label uses there were for Benadryl until I got sick in the past month.

Bent

Nothing speaks “humiliation” like throwing up up on one's shirt, coat, bag and pants while on a moving bus. Nothing adds insult to such injury like having to use the brand new scarf, a shower gift sent all the way from a friend in Germany, to clean oneself up.

And nothing makes a person question the general humanity of the population like listening to the witnesses of my unfortunate display of stomach histrionics make fun of me, without a single soul taking two seconds to ask if I was OK.

It is not as if I feel like I'm entitled to any sympathy. I just can't help but wonder what is wrong with the world that half a busload of grown adults (not teenagers, not college students) can watch a woman throw up all over herself, then do her damnedest to clean herself and her surroundings up while crying so hard she can not breathe and not only not feel the slightest bit of pity but find it entertaining to audibly and clearly make fun of her.

Suffice to say, I checked in with my boss and went home for the day. I'm not proud that I completely lost my composure acted the classic stereotype of a woman in late pregnancy. But I could not face dealing with the world yesterday after what happened on the bus.

People really, really suck sometimes.

Postmortem of a Baby Shower

First, a digression in the form of this recent verbal exchange:

J: Did you put the bananas in the freezer?
Me: Uh, No.
J: Are you sure?
Me: Yes, I'm sure. I took a banana last night, that is the last time I touched them.
J: Because I don't remember putting them in the freezer.
Me: You took one this morning. It had to be you, you are the last person to touch them.
J: Are you sure?
Me: Yes.
J: I was really out of it this morning.

Saturday could have been worse. Much worse. I could have been forced to play “Guess How Fat the Pregnant Guest-of-Honor Is”. Instead I had to listen to 10,000 variations on how our life will change and 10,001 variations on how I'll change my mind about being pregnant once the first one is born.

I had to physically block J's sister from touching my stomach. She was offended, possibly because since I am family, she shouldn't have to ask permission. It is interesting that the biggest offenders in the pat-the-pregnant-belly game have been members of J's family. I have not had this problem with my family members, total strangers or even J (who checks first, because sometimes the muscles are so sore that I could cry).

As I am of the persuasion who believes that pregnant women and infant children are not public property, even to family members, I was indifferent to her outrage. And I will continue to practice that indifference after the alien comes and the full on assault of complaints about hand washing and limited traveling begin.

Other than that incident, the shower went smoothly. I managed to maintain a straight face through lunch, while listening to a friend of J's family talk about how hard she had prayed for her daughter to have a child (uh, maybe her daughter did not want to be pregnant?) and how she can't understand why anyone could be an atheist after experiencing the miracle of conception, pregnancy and childbirth. My friend B, who was able to come and sat next to me during the meal, got a great deal of enjoyment out of watching me maintain that straight face and was able to bear witness to the the craziness of J's family.

And my friend B received, as a prize for baby bingo, a “Keep the Christ in Christmas” magnet, which I found hilarious, as B is an agnostic who appreciates the irony in spreading an anti-consumerist message by selling something.

Listening to my MIL attempt to organize baby bingo into special games was also entertaining and led me to make the crack "You can't tell this is a room of Catholics" to my sister-in-law.

The gifts were lovely and not too Christmas themed. The atrocity of the day belongs to a soft pink Winnie-the-Pooh layette set, given by an individual who must really, really want an alien of the female persuasion.

Sunday was spent sorting and storing all the paraphernalia, writing 38 thank you notes and washing, folding and putting away clothes. J spend the morning hanging pictures and the afternoon with his family, who asked him when we were planning on having another child.

Oy. The first (and only) one has not even arrived and they are already salivating over the possibility of a second. I can not help but think that they intentionally waited for a time when I was not present to ask this question, as my response would have been extremely snarky.

Under Pressure

This past weekend my friend K admitted to two of us that she was feeling pressure to get pregnant. She is in a difficult position, with me 10 weeks 6 days (but who is counting?) from my due date, a second mutual friend about to embark on the long road of fertility treatments and M, who quietly announced to K and myself (after putting her foot firmly in her mouth over some comments about my food choices) that she was 5 weeks along and on her second attempt to have a baby. (1)

M and I were blunt in telling her that just because every woman she seemed to know right now was gestating, there was nothing wrong with her not wanting to have children, either right now or ever. I pointed out to K that my pregnancy was more an accident then anything else, that I had considered terminating, that the depression was bad enough to keep me from getting out of bed some mornings and would be a major factor . M reminded K about the horrors surrounding the end of her first pregnancy.

We both stressed that this was not something a woman did because her friends were doing it. This was something a woman did because she felt it was the correct decision for her. We were both brutally honest in discussing our feelings.

I hope it helps her.

(1) I ordered a salad with gorgonzola cheese and an iced tea. In an attempt to be funny, she asked me if I knew about the prohibition against pregnant women eating unpasteurized cheese and drinking caffeine. My response was not good natured and J, listening in on the exchange, politely told her where he thought the medical establishment could stick their food rules. M pulled me aside later and explained that she had been trying to be funny, recounting the ordeal of her first pregnancy, which ended in an abortion at 16 weeks when she learned the fetus tested with a 1/5 chance of Trisomy 21.

Because You're Weak

There is no way for me to adequately convey my irritation at my upcoming baby shower. On a purely rational level it is illogical and hypocritical of me to complain because a group of people want to get together and give me gifts. I should quit whining. I agree.

But as J succinctly put it, when I whined “why did I agree to this?”

“Because you're weak”.

On an emotional level, the fact that I agreed to participate in this charade in the purely mercenary hope of getting one or two necessary items leaves me wishing that someone had smacked me upside the head hard before I agreed to participate in such a venture, if only to rid me of the high delusion that I would receive anything useful out of this party. I'm getting a great deal of passive-aggressive pleasure out of the fact that we decided not to gender the alien before birth, as it will marginally decrease the atrociously gendered clothing and crib sets that may be coming my way. (1)

My first objection to this ritual, aside from the fact that I hate showers of all stripes on general principle, is that my input on the type of party I would like to have ended when I submitted my guest list to my MIL. I would have been happy, nay thrilled, to have gathered in a back room at Dino's, where the guests could munch on semi-stale popcorn, order garlic wings and cheese fries, and had themselves a beer and a good chat in between the opening of gifts and watching college football on the enormous, flat screen televisions. I could have eaten cheese fries and snuck sips of beer.

Instead it is being held at the same venue as my bridal shower and will be a semi-formal, catered lunch with soup or salad, a quiche of some sorts accompanied with coffee, iced tea or water, capped with a yellow cake with vanilla icing sporting storks, baby booties and Congratulations!, all in alternating blue and pink icing because J and I have the nerve to refuse to find out the alien's gender or theme the nursery.

I also have trouble understanding what is so entertaining about watching someone else open a pile of gifts in such a public fashion, as both the gift giver and the recipient. I enjoy giving gifts to other people, but I could care less if they open it in front of me or not. (2) I don't fake enthusiasm for bad gifts very well, my sense of humor is such that it takes a mammoth amount of self control to put off making fun of truly heinous items until the giver is two states over and to the left from where I am standing.

Then there is the growing panic that I am going to be forced to participate in shower games, specifically a popular and truly atrocious one called Let-Us-Humiliate-the-Guest-of-Honor-by-Guessing-How-Fat-She-Is-! which requires party guests to cut a piece of string into what they think is the circumference of the MTB waist. The strings are wrapped around the MTB and the winner is the individual with the most accurate string length.

Why the panic? Because the hosting duties have transferred from my normally sane (other than her heavy hand with the guilt trips) MIL to a sister-in-law, one of J's older (in their 40's) female cousins, my mother, J's sister and her two daughters, aged five and seven.

A five year old and a seven year old are co-hosting my baby shower. I know these little girls well. They are lovely, bright, outspoken (which I quietly encourage as much as possible) mostly well behaved children who would nonetheless thoroughly enjoy measuring their aunt's expanding waistline and would not understand, egged on by the older cousins who find such games amusing, why their aunt would be bothered by such entertainment. The shower is scheduled to last three hours. A lot can happen in a three hour period.

Over fifty women have been invited to my shower. Out of those fifty, thirty-five of the invitees are either friends or family of J's mother. My mother and I have a combined list of around twenty and I can think of at least three off hand from my list who will be unable to attend for one reason or another. I am completely outnumbered in the moral support department on this one. If I refuse to participate, then I shall be labeled as unreasonable and can hear, clearly, the voice of my mother instructing me to stop making a scene.

I am weak.

(1) I'm still reeling from the pink crib set that a neighbor dropped off at our house. There is pink and then there is pink. This is pink.
(2) I openly admit that I'm still a bit bitter that I was forced to open our wedding gifts in front of a mob instead of in the quiet of our home, just J and myself, with some soft music and a glass of wine as a way of winding down from a weekend of non-stop activity.

Ugh II

I rolled (almost literally, I'm getting rather round) out of bed at 5:40 AM Monday morning in order to reach a downtown lab for round 6001 of miscellaneous indignities that a pregnant woman is forced to suffer in the name of gestating a healthy alien.

Today was the much dreaded one hour glucose tolerance screen and third trimester CBC blood screen. As I'm pretty certain that I shall fail the one hour screen, because the gods hate me and want to see me suffer through repeated needle stabs over a three hour period, I put off the appointment for a week and a half before trundling off to the bus in the pre-dawn of a chilly fall day.

But first I had to eat something, as fasting before drinking 50 grams of sugar solution is generally considered a bad idea. At 100 grams (the amount I'll have to drink in a few weeks when I'll get stabbed repeatedly with needles over a three hour period) it is required. J was also up early and bought me breakfast – a travel mug of tea and a glazed cinnamon yeast pretzel doughnut. Apparently J did not get the memo in the form of me repeating, verbatim, multiple times, the midwife's breakfast instructions, which were “Eat protein and healthy carbs. Don't eat a doughnut”.

“I can't eat that”. J stared at me, looking slightly offended at the rejection of his customary morning tea and glazed offering.
“I'm trying to make you feel better. What's wrong with it?”
“The midwife specifically said no doughnuts. Go ahead and eat it”.
“Are you sure? Why not eat it later”.
“Fine, put it in a bag, I'll have after the appointment”.
“What do you want then? And at least try the tea, I didn't put that much sugar in it”.
“Toast with butter. Do we have protein bread?”(1)
“Its the Omega 3 bread”.
“That is fine”.

As J stalked back downstairs to make me toast, I took a couple of sips of tea and left the mug sitting on my dresser, as I could not tell how sweet it was. And left it there, where it is still sitting unless one of the cats knocked it over during a stroll across my dresser.

The waiting room of the downtown lab was empty when I stepped through the door a few minutes before 7:00 AM. One customer in the office behind the locked door, registering for blood work. Not another person to be seen or heard except for the phlebotomist.

The customer left suddenly. What I collected from the conversation was that she had a condition that was counter indicative of having her blood drawn and the phlebotomist had advised her to wait until the condition was resolved.

I was called in, registered, given 50 grams of a bland orange sucrose solution to drink in five minutes , instructed to avoid throwing it up and made to sit in the still empty waiting room for an hour. I passed the time listening to a podcast of “Wait, Wait, Don't Tell Me” and watching white collar employees come and go

At the appointed time the phlebotomist called me back, took my blood in possibly the most painless fashion I have experienced in the past seven months and sent me on my way with the admonishment to eat something that did not contain much sugar, since the solution made me feel slightly woozy – a repeat the time my freshman year of college when I combined too many Oreo cookies with too much caffeine during finals week.

I was tired for the rest of the day, a result of the subsequent sugar crash, and ended up eating far too much sugar and carbs anyway, in a purely reactionary response to the fear that I will have to endure the three hour tolerance test, fail that and eat nothing but protein and leafy greens for ten weeks.

(1) During the height of my nausea, when I could not stand the smell of any meat or peanut butter and wanted crackers, tea and toast J started buying protein enriched bread in order to get something other than carbs and fat into me. My aversion to meat went away, I still can't bring myself to even smell peanut butter, which is another one of nature's jokes since peanut butter is a nutritional staple for many pregnant women. And we continued buying protein enriched breads because they were multigrain and tasted fairly decent, if a bit heavy.

Pain

I'm in pain. Not just the ongoing emotional pain that I have endured for the past 28 weeks and is gradually increasing. Mainly because my physical discomfort is getting worse.

Many years ago I developed this weird little twitch in one of the muscles over the ribcage on my left side. It was not painful, just an annoyance that would routinely catch me off guard as I went about my day. As the twitch developed during the same time frame as my asthma, my doctor ordered an echo cardiogram along with several standard diagnostic tests for asthma, to rule out any issues with my heart.*

No heart issues. Just a twitch from the electrical impulses in the muscles going haywire. He offered to write a script for muscle relaxants and a painkiller, which I turned down because the twitching was neither often enough to warrant a muscle relaxant nor painful enough to warrant prescription drugs.

The twitch has evolved, must likely because of the expansion in the rib cage, into a constant, burning spasm that has driven my already depressed self into even more despair. Forgoing the bra is not an option (and didn't work). Wireless does not work. And sleeping in any other position other than on my back (which I'm not supposed to do) makes the pain worse, especially when I roll over and am awakened from a dead sleep by the searing burning sensation.

Other things that have not helped in recent weeks – the constant gloom and doom of my mother, who can not help herself from uttering at least once during every conversation that I might end up having a cesarean section. As if I exist on planet la-la land, where pregnancy complications never happen and every birth is done vaginally, without painkillers and produces powerful orgasms that instantaneously wipe out the memory of the pain of labor.

The edema is not encouraging either. I was prepared for foot and ankle swelling. I went out and purchased two pairs of shoes, a pair of Sanita clogs in blue faux snakeskin and a pair of Wolky Stage wedges in red patent leather, because I knew I would need room in my shoes for my feet. The shoes were embarrassingly and almost prohibitively expensive, a sum of money that I should be saving instead of dropping on shoes.

But the shoes work. They work so well that I don't notice when my feet are swelling until after I have removed the shoes and seen my toes nearly disappear into each other. The first time this happened was Friday night. My shrieks of horror provoked first concern, then annoyance in J, who offered the following solution to my problem: “don't look at them”.

There has been some hilarity. Men especially seem to like the clogs and I've collected quite a few compliments on their style in the week I have been wearing them. The highlight of this past week was the clerk at a local used media store, with whom I shared the following exchange:

Clerk: Nice shoes. Great color.
Me: Thanks. I'm not going to be able to see my feet in another month, so I decided to go with something a little bit obnoxious.
Clerk: (long pause) Won't be able to see your feet?
Me: I'm pregnant.
Clerk: (with relief) Oh. I thought you were going to have them amputated or something. Is that real snakeskin?

It is a better story in the telling then in print...

*This is probably an example of the type of testing overkill the right claims is driving up insurance costs. The doctor who ordered the tests was a personal friend of my both parents, had worked with both of them for years and was an excellent and instinctive diagnostician who knew in the office that I probably had asthma. Nonetheless he was not going to be on the hook to explain to my parents why he missed a potentially fatal heart defect.

The Opening Salvo in the Parenting Wars

I have thought for some time that with the amount of miscellaneous work necessary to prepare for the upcoming arrival of a child, first time parents-to-be would be too busy to start oneupmanship contests with other gestating couples.

I was most unfortunately incorrect in this perception. With fourteen weeks still to go, I have already had to extricate myself from a conversation that was less about the care and feeding of aliens and more about establishing some kind of moral authority over the question of which is superior – cloth or disposable diapers?

Or rather, I stated that we intended to use disposable diapers and was treated to a lecture by the non-childbearing member of the couple on how the decision was wrong, wrong, wrong. Evidential proofs were tossed (“Babies with cloth diapers don't get diaper rash! It is less expensive in the long term! Hire a diaper service if you don't have the time to wash them! My mom used them on me when I was a child!)

Silently I cursed the gods for ruining a perfectly good evening out, imbibing garlic parmesan wings, eyeing mixed drinks lustfully and feeling overall like a normal, non pregnant, female being for a couple of hours to the service to making him feel smug and pretentious over using cloth diapers (1). I tried, twice, to explain in very simple clear terms that we had neither the money to pay a diaper service nor the time to clean them ourselves (2). He continued lecturing.

So I changed the topic by asking him if his wife was planning breastfeeding, playing the odds that any couple that committed to using cloth diapers was probably also going to be breastfeeding instead of using formula. The gambit paid off, we found a topic of common agreement and the conversation turned to other things as agreeing about breastfeeding is not as interesting as probing for other proto- parenting decisions to criticize.

(1) I suspect if they find out that their budget can not stretch to paying a diaper service they will revert to disposables after a few weeks of trying to clean them.

(2) Massive digression that probably needs a separate entry. In our house this would translate to me cleaning them, as the laundry has evolved into my primary duty. Most of the time I am actually OK with this, as J handles all the outdoor yard work, including mowing our little patches of lawn, caring for the five rose bushes we have lining the driveway and up the steps to our house and tending to the flowerbeds. This actually consumes as much time weekly as doing the laundry, so it is a fair division of labor. And prevents me from killing the plants, as my power to keep living things alive does not extend to things green and leafy.

To be fair, I should say “did” the laundry as J has stepped up laundry duty in the past months as a natural consequence of me first being too overwhelmed with all-day morning sickness and fatigue to keep up with it, then becoming too unbalanced on my feet to properly navigate the narrow basement steps with a full basket in my hands.

However, as good as J is at remember to start the laundry, he is not very good at remembering to finish it, leading me to ask him at least twice every weekend and once during the week to bring the clean clothes upstairs for me to fold. As there is an unspoken expectation that I will be taking over laundry again once the alien has arrived, my desire to spend additional time soaking and cleaning nappies on top of the addition of onesies, pajamas, layettes, burp clothes, crib sheets, blankets, and towels to our regular weekly loads, is nil. In our conversations about disposable versus cloth I got the sense that J would prefer to use cloth, but since I will end up as the party responsible for cleaning the things, I elected to veto for the sake of my sanity.

Muddlng Through

I hate being pregnant.

There are the biological and physical changes. Weight gain. Tiredness.(1) The increase in my (already substantial) bra size coupled with a serious lack in supportive lingerie to offset the increases, topped off with the sickly sour, rotten cherry of far too many lectures on why pregnant-women-should-not-wear-underwire-because-it-is-bad-for-you.(2) The complete absence of anything resembling sexual desire.(3) The occasional episodes of public dry heaving in restaurants and on the bus. The constant aching.

There are the emotional changes, which can be summed up as me having the most spectacular episodes of depression I have ever experienced. Too many days spent having to call up every ounce of will power I posses to get out of bed, get on the bus, carry on with my day. Flashes of anger so intense that I don't recognize myself. Random fits of crying. My first ever episodes of hysterics, which lasted well over 15 minutes and was spent on the bed, J sitting next to me not saying anything, just stroking my hair, telling me to breathe and cracking highly inappropriate (but truly funny) jokes.

At the end of the hysterics, J confessed that washed the kitchen floor earlier in the week because he had smashed an orange in a fit of anger. He suggested that I try it and volunteered to wash the floor again.

I said no thanks, a smashed chair was enough for my lifetime.(4)

There are all the tests, the sodding tests that I have to go through. As of this date, two ultrasounds, a first trimester blood draw (nine vials), an urinalysis, a repeat blood draw because the lab screwed up and lost my blood type/antibody results(5) and the doppler at every checkup. Upcoming I have a third trimester blood draw, including the infamous 1 hour glucose tolerance test. Followed, most likely, by the even more infamous 3 hour, multiple draw, blood glucose test, since 15-23% of the women who take the 1 hour test fail it, since it is only a screening, not a diagnostic. Out of the 15-23% that take the 3 hour test, only 2-5% actually have gestational diabetes.

A digression – why am I taking a screening test which such a high false failure rate?

I hate the clichés. At a recent family gathering, I managed to score BINGO on my mental “pregnancy cliché BINGO card” in under three minutes just by listening ONE person, the mother of one of my in-laws.

All of this is intensified by the awful feeling that all those well intentioned offers to help are nothing more than hot air.

In spite of my repeated requests, J has yet to visit any of the daycares that I asked him to check out several months ago, leaving me the inevitable feeling that I will be forced to take yet more time off, in between doctor appointments and lab tests, to tour centers. The longer J puts it off, the more difficult it will be to find a decent placement. The current budget impasse in PA state legislature has lead to cuts in funding, causing over 100 centers statewide to close. Those that have managed to stay open have limited availability and it is very difficult to find an infant care placement. Which means that staying at home may go from an option to a necessity.

I resent the hell out of the fact that J has yet to do the one thing I specifically asked him to do. I resent having to ask him over and over again. I resent listening to him say that he'll take care of it, but then doing nothing. I resent being angry at him about it. I don't want to feel this way. I'm tired of hearing that if it is that important, I should do it myself. He is the father. He is equally responsible. Not “should be”. Not “could be”. IS.(6)

I still have no idea how much maternity leave I will have. The feelers I have put out to see which of our friends and family would be interested in helping us out after the alien is born have been met with a lukewarm reception. So lukewarm that I almost feel compelled to send out a mass email apologizing for the inconvenience I am causing by delivering the alien at Christmas, thus keeping people from their orgy of shopping, cooking, gift wrapping, gift unwrapping and eating.

But mostly, right now, I hate the fact that I will have to wait at least 17 weeks, 6 days for a shot of tequila.

(1)I have not seen the inside of a gym in months and probably will not see the inside of one for at least six more. Common sense would dictate that I cancel my gym membership. J insists that I maintain it, even if I'm too tired to go right now, and is helping me to figure out a way to get there 2-3 days a week once I'm cleared for exercise.
(2)There is absolutely no such thing as a wire-free supportive size [enter my ridiculously large size here] bra. It does not exist. Stop telling me that it does. ESPECIALLY if your breasts could be described as “lemon sized” on a good day, as almost every sales clerk I spoken with possesses. You have no idea what you are talking about.
(3)All those websites and books that claim that I would get happy hormones at some point? They lied.
(4)A long ago incident provoked by a run in with a misogynistic attorney while negotiating the sale of our first house.
(5)This turned out to be a surprise. For years I was under the impression that I was B+. As it turns out, I'm not. I'm A+.
(6)As I was writing this, J asked for time off to go tour the centers.

Bad Manners

If I had any sense at all, I would have realized that my encounter with the elderly lady on the corner of Forbes and Murray on Friday afternoon was a predictor of the sudden and wild change in weather from the temperate (albeit slightly rainy) summer that has made sleeping under a down comforter a comfortable necessity to the sudden and unexpected 80+ degree temperatures the city will swelter under for most of the upcoming week.

On Friday afternoon I sat on a seat in shelter, quietly waiting for a bus to take me back downtown. The stop was completely empty when I arrived, the passel of teenagers missing from the church steps, both the shelters devoid of humanity. I took a book (J. Martaan Troost's Lost on Planet China) out of my bag and commenced quietly reading.

The bus stop began to fill up with people. A woman sat down next to me. As we were sitting there, I quietly reading my book, she looking around, an older woman walked up to the shelter.

What transpired next was one of those moments in which I, humbly reading my book and minding my own business, suddenly become the target of an absolute stranger's ire because I lack the ability to read minds.

The woman beside me (WBM) offered the older woman (OW) her seat. OW refused offer of seat with expected comment about “age before beauty” and WBM needing the seat more than she does. OW then segued into an indirect harangue of indeterminate length (I really should time these things) about my rudeness in not offering her my seat first, before WBM.

I tried, very hard, to keep my mouth shut, my head down, my face expressionless, my eyes focused on the text of my book as OW expressed how “[her] children were raised better than that” and how disrespectful “the youth” of today were towards their superiors. But something inside me snapped at hearing OW snidely say “Here comes someone who really needs a seat. I wonder if she'll have one offered to her”.

I looked up from my book. I wished I had been calm enough to look OW straight in the eye, but I could not. I know it would have been more effective, but it took a lot of will to get the words out.

“Ma'am, I'm 20 weeks pregnant, I'm tired and I'm not moving”.

There was a momentarily pause as OW digested this information, suddenly aware that perhaps I was not the teenager she assumed me to be. Then she snapped back “Be quiet, I wasn't talking to you”, moved closer to WBM and lowered her voice to a mummer. I put my eyes back on my book. When the bus pulled up I waited as OW cut to the front of the line, boarded the bus and sat in one of the seats near the front.

Then I got up, hauled my tired, pregnant self onto the bus, walked to the back and sat down.

J's response when I told him this story: “What are you doing to attract these people?”

Role Reversal

I fully expected to receive some push back on my declaration that this will be the one and only child J and I will be having. Surprisingly, there has been far less than I had anticipated, although that may very well change this weekend as we are attending a family picnic hosted by J's cousin, none of who are shy about expressing their opinion on how we should be conducting our life.

I did not expect J to receive as much push back as he seems to be getting right now, and it surprised me. J is irritated, he has had far too many conversations in the past several weeks with co-workers who absolutely refuse to accept that maybe the two of us have a pretty good grasp, after nine and a half years of marriage, of where our collective limitations end. To wit, they end with one child.

The pattern of the conversation is always the same. J mentions an alien is gestating, coworker responds with an exposition on the joys of parenthood. This is followed up by an interrogation on our current parental status, continued with statements on how eager the two of us will be to have another once the first is past the helpless alien stage. J responds that we intend to have one child. Coworker counters with the classic “you will change your mind”. J, unable to make himself walk away at this point, proceeds to explain all the logical reasons (time, money, resources, overpopulated planet, I don't want another child and hate being pregnant). Coworker dismisses explanations as the lunatic ravings of a nervous, first time father. The fact that I have no desire or intention to go through the experience again does not enter into the coworkers consciousness as a legitimate reason.. After all, once married, ownership of my reproductive organs passes onto my husband. I'm just the safe holding the goods. J gets to decide how the goods are used.

J shuts these conversations down by explaining that I have a history of depression, pregnancy has been far more difficult on me than he had anticipated and that he has no intention of putting me through such an experience again. Coworker shuts up.

Not wanting to be pregnant again? Not a reason. Not wanting your already crazy wife to become even crazier. Perfectly acceptable, after all there are children involved.

My parents were in the city over the weekend, to see Til Death Do Us Part: Late Nite Catechism 3. J and I met them at Six Penn Kitchen (home of a killer lobster macaroni and cheese dish that I have yet to try with the lobster) for brunch on Sunday morning.

Brunch began as the breezy and fun meal it is supposed to be late on a Sunday morning. Dad ordered an espresso and a green pepper stuffed with various meats, mom an iced tea and cheesecake stuffed french toast. J voted for coffee and an omelet stuffed with various meats while I opted for decaffeinated tea (served loose in a press pot), fresh orange juice, huevos rancheros and a side order of the macaroni and cheese*.

Remarks were made on my very gradual weight gain (I'm still in most of my regular clothing and only appear pregnant to those in the know), as gaining weight gradually is supposed to be less stressful on the body, lead to less weight gain overall, easier loss of weight post-pregnancy and, as told to me by my father-the-expert on such things, fewer and lighter stretch marks. Oohs and aahs were expressed over the twelve week ultrasound photos. An update on the Perkins restaurant that burned down several weeks ago was given.

This discomfort began once the details of the meal had been settled. J's mom wants to throw me a baby shower, an announcement that the majority of my female friends, knowing and sharing my deep aversion to showers bridal, baby and otherwise, greeted with much hilarity and the promise to present me with some highly inappropriate gifts to keep my spirits up during the execution of the event**.

As the alien I will be expelling is number six in a line of grandchildren on J's side and the first for my parents, it felt only appropriate and correct that my mom get first crack at torturing her daughter in the fashion of a baby shower. Except that, as carefully as I phrased the question, I could not find a way of explaining myself without sounding mercenary and made my mother very uncomfortable, as it had not occurred to her to think about hosting a baby shower.

As J and I have been trolling Craigslist in recent weeks for gently used infant clothing, a second hand crib made within the past three years, a second hand stroller and other baby related items, it was frustrating to come across as an individual who was begging for stuff. The only new items we intend to purchase are the breast pump, the infant car seat and the mattress for the crib. We are not assuming that anyone will providing us with anything.

After mom made it clear that she was more than willing to pass the shower honor on to J's mom, the conversation turned to our future plans.

J has a very bad habit of asking, in an audible undertone, if we should share information in front of the very people that I may want to withhold information from, at least in the short term. Over the years, I have gotten better at explicitly telling J to avoid certain topics of conversation, but once in a while an item will slip and he has never caught onto the concept

Such as the fact that I am seriously considering staying home.

My mom, who quit working when I was twelve to stay at home, did not approve. At all. And argued against it. My explanation, that out of the two choices, living with less money stressed me out less than the thought of the getting the alien bathed, fed and to/from daycare while holding down a full-time job, did little to appease her. J's explanation that I would be doing unpaid work for a friend part-time appeased her a little, but not much. All the contingencies J insists on putting into place to ensure that I get out of the house did little to appease her.

I shrugged her objections off, only to have them come back to haunt me at 4:30 in the morning. By the time J got up I was in tears and anxious.

And J was he gentle blunt self. “When have you honestly felt like you mom really supported you?” he asked me in the kitchen, after my bout of histrionics.

“Rarely” I replied.

“There's your answer. Do what makes you happy”.

*The ability to order an enormous amount of food without commentary is one of the few remaining prerogatives a pregnant woman has these days, after being denied lunch meat (including roast beef), sushi, rare steak, various cheeses, most seafood, chocolate, beer/wine and caffeinated beverages. And it is a prerogative that is slipping away as the media becomes increasingly enamored in shaming pregnant women for completely natural weight gain.

I also feel compelled to go on record and state that I did not finish all that food and took the rest home. The rest of the huevos made an excellent Sunday evening dinner and the macaroni and cheese is tonight's meal.

**A flask was mentioned. A full one. With wine. As for why I am opting to go through this particular torture, I may not be mercenary, but I'm also not a fool.

Options

J has been searching for a job for several months. Because of the gradually tightening economy, his success has been non-existent. Messages from recruiters have dropped to zero and his calls to them go either unanswered or offer no progress.

He received an email last week informing him that a product manager position has opened up at a company J left five years ago. The email came from an ex-coworker (and good friend) still employed at the company. He proposed J's name to management and received an enthusiastic response to the idea.

The job is ideal for J. Highly technical, with opportunities to interact with clients on a regular basis and attend major developer conferences, for a decent salary, working with individuals that J knows well and still maintains a good relationship with these many years later.

It is also highly stressful, with travel ranging from two to seven days every month and an average burn-out rate of a year. At a company that made J so miserable that I nearly moved out of our home near the end of his tenure there, rather than put up with one more day of his bad attitude. When he finally found new employment I threatened to leave him if ever went back *.

The interview went well, but he is only the first person interviewed and we think the company is balking at J's salary requirements.

J and I have both tried to live by the general rule of not stopping the other from doing something we really want to do, as long as it does not violate the boundaries of our very bourgeois marriage values. Ninety percent of the time it works out well. J is free to buy the Porsche, I am free to fly off to Paris for a week by myself.

But the thought of the amount of travel he will have to do every month, no matter how minimal, leaves me stressed, as it is becoming painfully clear, in spite of our best intentions, that if I continue working I will be overwhelmingly responsible, at least for the first year, for the care of our child. Feeding, watching over, getting to and from day care and doctors appointments. Even if he does not take this job, I feel an incredible amount of the burden falling on my shoulders. And I'm a little bit angry that the dictates of biology and culture make it this way.

So, I quit. Or am quitting. Maybe. Possibly. When I sit quietly and weigh the two options in my mind, being home makes more sense. J had put out feelers among his network of developer friends and one is interested in hiring me to test on a part time basis. I could work on the sketches for the children's story I wrote seven years ago. I could spend some time writing. And J insists that I keep my gym membership and figure out a budget for hiring a sitter, to get me out of the house alone a 2-3 days a week.

Then my common sense weighs in and tells me that I'm crazy to quit in this economy and need to tough it out. That we can get by on one income, but I need to be employed in case J becomes unemployed. That it is worth giving up 1/3 of my paycheck to childcare and my temporary sanity to ensure that we stay afloat in the long term.

This sucks.

*Obviously an empty threat.

Things I'm Thinking of Rather Than Working

Because I'm writing this on a sunny Friday afternoon when I should be working...

It is my general philosophy to not attribute to malice what can be explained by stupidity, but I suspect Robert Hanlon never had to deal with health insurance company.

Conversations with all involved parties have allowed me to piece together the factors that precipitated Coventry's determination that the Midwife Center is an out-of-network provider. A brief time line:

1. The Midwife Center faxes a standard letter to Coventry notifying the insurance company that the center will be providing my prenatal and birth care. The letter contains my name, group number and insurance number. The letter does not contain the Midwife Center's provider number, as the center is not billing Coventry for any services at this time.
2. Coventry sends me a letter stating that the Midwife Center is an out-of-network provider.
3. I call the Midwife Center and inform them of the letter. They call Coventry, verify that they are in-network and tell me that I need to call the insurance company and try to determine where the mistake happened.
4. I call Coventry and speak with a very nice CSR. She explains to me that the Midwife Center has two provider numbers, probably due to a change in the name of the center sometime in the past. One number is out-of-network and essentially defunct. The second is in-network. It appears that an employee assigned the fax to the out-of-network number. In order to change it, I need to get the Midwife Center to refax the information to Coventry, with the correct provider number. Once they receive the corrected information, they will send me confirmation.
5. I call the center back and explain the situation. The woman who handles the billing is completely bewildered as the center has never put the provider number on this type of notification. She also does not seem to understand why it is necessary to refax the information with the provider number included. She says the situation will resolve itself when the Midwife Center bills Coventry at the end of the pregnancy. She seems to have missed the simple fact that this company has pre-emptively refused to pay in-network for a service and will stick to that decision until told otherwise.
6. After hanging up, I remind myself that I paid a considerable sum of money for my older, but still highly functional CDMA/GSM hybrid phone, and breaking the phone by throwing it across the conference room is a bad idea.
7. I decide, instead, to spend my Sunday composing and filing an appeal with Coventry, using the information that the very nice CSR gave to me. Copies of this appeal will be sent to Coventry, the Midwife Center, the PA Department of Insurance and the PA Attorney General. Coventry will also be receiving a copy of the formal complaints I will be filing with the PA Department of Insurance and the PA Attorney General.

My week was rounded out, on Thursday, by my first official "pregancy scold" lecture from a co-worker who felt that I should not have indulged in a sushi dinner earlier in the week. She felt it was "too risky" as "you never know, with all the physical changes to your body, what might make you sick".* While I have experienced a significant aversions to some foods, such as the smell of peanut better and well done (overcooked) meat, I have not become suddenly and mysteriously allergic to raw fish.

The sushi was magnificent.

* The dinner consisted of spider rolls (cooked, soft-shell crab), sweet shrimp sushi (also cooked) and crazy tuna rolls (raw, ahi tuna mixed with wasabi served on warm, lightly fried rice rolls). The combined amount of seafood in the meal maybe reached 8oz total, most of the food was cooked and wasabi is used with sushi because of its anti-microbial qualities.

Insurance Battle Number 1

I received a letter from Coventry Health Assurance today.

Coventry Health Assurance has decided, in spite of my diligent checking three months ago*, that the Midwife Center is an out-of-network provider and that I will be responsible for a $2,000.00 out-of-network deductible plus any overages above what Coventry Health Assurance feels like paying as reasonable cost to the Midwife Center.**

Oh, and I have a right to appeal, but it will not be considered an urgent appeal, so Coventry Health Assurance could, in theory, tie up the appeal past the point where I would be able and permitted to switch to an in-network OB.

The next person who tells me that nationalized health care will send the United States down the road to rationed care is getting punched in the nose.

* A phone call to the Midwife Center to confirm they were in-network and several hours digging through a provider search interface designed to create the maximum amount of aggravation with a minimum number of results. The search options are Find a Doctor, Find a Hospital, Find an Ancillary Service Provider, Find an Urgent Care Center or Find an Allied Health Professional. You can not search by clinic or practice name. You can not search by individual name if the provider is anything other than an MD, unless you try Ancillary Service Provider or Allied Health Professional and your guess about which category a CNM falls into is as good as mine. You can search by specialty, but the only names that come up are, once again, MD's.

** My interpretation.

Don't Panic - Episode I

One of the more pleasant aspects of visiting the midwives is that I am handed my chart as I walk through the door for an appointment. Rather then endure the borderline humiliation of being weighed by a nurse, I go into the bathroom, weigh myself on the old fashioned scale and note it in the chart.

Task done, I took a few moments while waiting for the midwife to read through my chart, including the results from a very unpleasant procedure I had several years ago and the more recent reports from the ultrasound done earlier this month.

Noted in the ultrasound report - Placenta: previa (complete).

Oh. No.

I digress to openly admit that I read way to much sometimes. Once I accepted that this pregnancy was real I became acquainted with the Mayo Clinic's website and have become obsessive at learning about all the things that could possibly go wrong during a pregnancy. But in all my worries about birth defects, gestational diabetes (because I hate the idea of having to stick myself with needles multiple times a day) and pre-eclempsea (because I hate the idea of forced bed rest and possible stroke), that I might have the condition known as placenta previa never occurred to me.

In this, I have potentially hit, at once, all of things I fear with frightening pathology - forced bed rest, repeated ultrasounds, steroids, needles, knives, surgery and death.

Dana the midwife* calls me back to the office and we sit down to chat. She asks me if I have any questions. I ask her about the "previa (complete)" notation on the ultrasound report.

Dana explains to me that this condition is very common into the second trimester of pregnancy and that the placenta usually moves upwards as the uterus expands. If I had not had the ultrasound, I would not have known. They will check again at the 18-20 week ultrasound and take necessary action if the placenta has not moved by then.

This should have been enough to calm me down, at least until I have the next ultrasound. In the short term, defined as the sixteen hours between the end of my appointment and this morning, it was.

Then I had to look up the complications. I knew that previa meant c-section. It did not register in my first round of reading that it might also mean enforced hospital bed rest, steroids to speed up fetal lung development, premature delivery, excessive bleeding, hysterectomy and possibly death. Finding out the resolve rate for partial previa is 95%, complete previa 90%, did not help much, because there is that 10% to worry about. And 10% is a lot when you are not quite ready to shuffle off the mortal coil.

J is calm in contrast of my controlled panic. Calm, but irate, the way men become when they will not allow themselves to panic. He wanted to know why the doctor, who told us "everything was normal", failed to mention the previa.

I'm not as curious. He's a doctor. He sees a previa, note that I am just finishing the first trimester, assumes that it will resolve and moves on. Does not want to deal with giving an already stressed out woman potentially bad news about a life-threatening condition that usually resolves itself.

The bills from the first ultrasound and blood tests are starting to roll in. Almost $600.00 towards my $1000.00 deductible already reached. The insurance breakdown came first, followed by a bill from National Chain Lab who has not sent the results of my blood work two weeks ago to the midwives. They sit on the dining room table waiting for me to match up the statements, to ensure that I am not being overcharged for any service. The next ultrasound should eat up the rest of the deductible. Then the fun of explaining to multiple parties that I have fulfilled my deductible and that they need to take it up with the insurance company begins.

*There are five midwives in this practice. Patients are rotated through all five over the course of a pregnancy and receive labor and delivery care from whomever is on call at the time labor begins, whether at the center or in the hospital. Even if I go to the hospital, the midwife will be there for support.