Birth Story, Part Four

Oh my, oh my! Looks like those other two babies either have beaten me (I'm guessing, here) or are poised to do so! Squeeee!

Where were we? Ah, yes. Monday afternoon. We were on the subway. Of course. Where the hell else would we be, with me 4 cm dilated, completely effaced, having been contracting regularly for twelve hours or so? Surely not NEAR THE DAMN DOCTOR’S OFFICE WE HAD JUST LEFT, WHICH IS FOUR DAMN BLOCKS FROM THE MOTHERFUCKING HOSPITAL.


A to B: A Rational Person's Route



A to B: My Route


It’s possible I’m not entirely over how incredibly boneheaded that decision was. All I can say is that denial is a powerful thing. (For more on how I got into this mess, see parts 1, 2, and 3.)

To make sure you understand how stupid this was, please note that not only is it 45 minutes to an hour to get home from the doctor (actually a bit faster than driving, which was part of the attraction), but also: we don’t live on that train line. Or the train line we transfer to next. So that’s three trains home, and one of the transfers is up stairs. But I wanted to be at home. I didn’t feel good. I didn’t want to eat any of the food I could think of getting in Midtown, and I certainly didn’t want to walk around there in the cold drizzle. And cabs are expensive and nerve-wracking, and the subway is familiar and cheap. So off we went.

The story would be more exciting if my water had broken on the train, it’s true, but if that had happened even I might have had the sense to get off and hop a cab back uptown. In fact, the ride was okay. I had a few contractions; they didn’t really pick up until we were under the East River, leading me to believe that the Bean just wanted to be born in Brooklyn. And a little while later, I thought he might get his wish.

My sense of time gets pretty shaky from here on out. I think we must get home around 3:30. I am ravenous. I’d tried to eat the bland food they tell you to have in labor in the morning, but my bowl of grits was left to congeal. (Grits are my go-to bland comfort food, which I mentioned in our birthclass brainstorm only to have the teacher say that although oatmeal was a good labor food, grits might be okay in very early labor. Yankees! ) Bland food made me feel gross in the first trimester, and it seems gross now. So I eat the spicy beef leftovers. And they are awesome. And I am glad I was so shameless about asking for them.

Then everything starts to happen at once. Nature, as they say, calls. Insistently and for quite a while. I discover just how very, very, very much I hate having contractions on the toilet. I know some of you were into laboring there or in that position, and I am here to say that you are out of your tiny minds. Once my body has, erm, cleared the decks, the contractions go wild. Sixty to 90 seconds long, every three to four minutes. Instead of counting and groaning, I am counting and yelling and clawing the bed. I bend over the couch, I slow-dance with Sugar; nothing helps. At one point, I accidentally bite Sugar’s leg (which doesn't help that much either).

Even before the tooth marks can fade, Sugar calls the OB office to say we’d like to go to the hospital. (For me, not her leg. I didn’t even break the skin, okay?) While she’s talking to that dumb bitch of a nurse you remember from the Vasospasm Chronicles, I have a contraction. And Nurse Helpful says, “You have to get her to calm down.” Because you know, being quiet while in bone-crunching pain is really, really important. There goes my Good Girl Gold Star for Laboring Like A Lady, I guess. (Sugar, who is wise beyond comprehension, doesn’t tell me about that comment until much, much later. I PROBABLY wouldn’t have insisted we stop by the office on the way to the hospital and throttle her anyway.) However, the nurse agrees that if I want an epidural, we should head in. So we call a car again.

Only now it’s rush-hour.

While we’re waiting for the elevator, I feel a little excited. Mostly afraid I’ll have another contraction and fall down in the hall, but a little excited. I am in labor! This is happening! Who’d have thought it would happen today? (You know, besides anyone who’d thought rationally about the events of the previous 36 hours.) By the time we get to the stoop, I am back to petrified. I get walloped with more contractions; when the car arrives, Sugar has to run tell it to wait until I can walk again. I curse my decision to deliver at Kips Bay Mega Hospital rather than one in Brooklyn. Sure, I had my reasons, but LICH is so close.

In birth class, there was a lot of talk about how giving birth in real life isn’t at all like giving birth in the movies. In some respects I guess that’s true: my water didn’t burst out all over the stage while I gave a speech for my entire company and Dr. Baby Factory didn’t just happen to poke his head into the room during the pushing so that I could grab him by the neck and scream, YOU DID THIS TO ME!!!! But this part of the story, from when Sugar trundled me into the cab until the epidural was in? This part was exactly like the movies.

Cab driver, I wish I knew your name, because you deserve a medal for patience, fortitude, and grace under fire. You could give a seminar in how to treat a laboring woman, and several of the medical professionals we dealt with ought to be required to attend. You did your job without comment and you did it well. I cannot have been your favorite fare that day, but I trust you at least got a good story out of the deal.

What he didn’t get was much peace and quiet. For the whole ride in — at rush hour, remember — I am doing my level best to cope like they said at birth class. So Sugar and I are counting out my contractions, in eights, the whole way in. And I by God keep up the counting, even though my yelling progresses rapidly to screaming.

About five blocks into the trip, I begin to wonder if I could be in transition. I can’t make any other sense of what was happening. My autonomic nervous system has gone completely haywire; I am roasting to death and convulsed with chills. The contractions get longer and longer and closer and closer together; at times there are no breaks at all. The advantage to counting through contractions is that it gives me a sense of when one might end (at about 14-2-3-4-5-6-7-8); the disadvantage is how terrifying it is to be still counting in the twenties and thirties. (Sugar says she remembers being in the forties at one point, which I have blessedly forgotten.) I am out of my mind with pain. At one point, between contractions, somewhere still deep in Brooklyn, I look up at the brick tower alongside us and it occurs to me that there will be a time in my life when I no longer feel like this. The idea is so strange that it transfixes me for a moment, until I feel a gush and yell out that my water is breaking.

(What an unwelcome thing that must be to hear as a cab driver. Luckily, we have a towel.)

At around this time, I start to feel a strong urge to push. Oh, God, the baby is going to be born in this cab and I’m never going to get my epidural. I stick a hand in my pants, but I don’t feel a head, so I try not to push. Or at least not hard.

At some point, it occurs to me that this back labor thing really is happening. To me. I’ve long ago stopped feeling anything in my belly, nor do I feel anything there for the rest of the labor. What I feel in the car is that someone has decided to replace the bones in my back and my thighs with iron rods. The rods are set on the ends of my bones, and at each contraction, they are slammed into the bones over and over like jam-hammers, reducing me into rubble. Absolutely nothing about this feels “natural” or “productive” or any of those other reassuring things. At one point, alongside the ruined houses of Admiral’s Row, I wonder if I will die.

I know I am given to hyperbole in my writing, but in life, believe it or not, I don’t go in for hysterics. (My preference to be left alone and not bother anyone when I’m sick or in pain is what leads me to do dumb things like this.) Part of why it’s taken me so very long to write this story is that I spent a terrifically long time crippled by shame over how I behaved at the points of labor when the pain was at its worst. I didn’t hurt anyone or endanger the baby or say anything rude (that I regret), it’s just that I didn’t expect to be so out of control. After everything was over, I felt so embarrassed about it (no thanks to some of what was said at the hospital), and I felt that I hadn’t lived up to the example of your stories, that I hadn’t been strong or powerful or amazing but rather weak and overwhelmed and whiny and over-dramatic. When they said in birth class that being in labor meant letting go of your “social self” I thought that meant I would shut down the way I do during the GI/endo bouts, that I would not want to talk or be talked to and that I would do some moaning. I didn’t expect to be screaming — scream-counting, but still — or making these terrible dry-sobbing noises.

But there I am, making them. When I am able to think, I am beset by a series of fears:

• What if the baby is born in this car?
• Or, oh, God, what if the baby isn’t born in this car and I just have to keep doing this?
• What if I get to the hospital and the baby isn’t born yet but they say it’s too late for an epidural (never mind that the “it’s never too early or too late” policy was part of the appeal of Kips Bay) and they make me just keep going even though I’ve made it in?
• Oh, God. They’re going to make me be on an IV for an hour, like the books say, and I’ll have to be in the hospital knowing they could give me an epidural but that they won’t.
• Oh, God! Before they’ll even do that, I’ll have to go to triage. Triage! I cannot handle triage! They’ll make me move from room to room and I will die. Or kill someone.

I interrupt my anxiety spiral to notice that we are SO not on the way to the hospital. Car service drivers tend to have their own opinions about how best to get to the bridges and it doesn’t do to tell them their business, but it has been forever and we are still in fucking Brooklyn. Traffic is heavy, and we really do hit every light. I am bent over sideways in the backseat, looking up at the world as I did on long car trips as a child stretched out across the backseat. At some point, I lift my head up and see that we are at the Navy Yards. Does this guy think we’re going to Queens? What if he’s taking us to the wrong hospital? WHY ARE WE STILL IN BROOKLYN?????

So calmly, so beautifully calmly, he answers, because it is rush hour and I am avoiding the traffic jam downtown approaching the bridge. Cab driver, I mentally send you flowers every time I think of your gentle tone and your impressive withholding of epithets at that moment. God bless you. Later, when I screamed at you that you were driving past the hospital, it was kind of you only to say that the hospital I was seeing was Bellvue and withhold any suggestion that perhaps I belonged there.

I had a few moments of clarity before arriving at the hospital. I remember thinking that because each of our cabs had chosen different bridges, we would be able to tell the baby about going over both the Brooklyn and Manhattan bridge while he was coming. That seemed really cool for some reason. Later, as we crawled up First Avenue (thank you, cabbie, for not taking the FDR), there was this strange break from everything and it seemed perfectly normal to remark to Sugar on the unexpected presence of a European restaurant in the heart of Chinatown. ( “Look, they sell Swedish food.” ) Sugar reports finding that a bit surreal.

Another thing I had imagined was at least kind of being able to walk when we arrives at the hospital. Instead, I only have eyes for the lone wheelchair mercifully abandoned by the entrance and scream until the driver backs up, switches lanes, and brings me to it. Sugar runs around trying to figure out how to push me and deal with the luggage. Some presumed neurologist (bow-tie) leans over and asks if my “erm, companion” has gotten help. This all seems to take forever, but then Sugar is back, rushing me to the elevator. Which is absolutely packed, naturally, so I try to scream quietly while the neurologist and others chat about their weekends.

Our arrival in L&D is also cinematic: I am sprawled across the careering wheelchair, wailing. I hope I wasn’t screaming “give me my damn epidural,” but the possibility exists. However, one fear is instantly assuaged: turns out that if you arrive at Kips Bay L&D having clearly lost your tiny mind, you do not have to go to triage.

In the room, off go my rather soggy corduroys and everything else. As the nurse starts my IV, I whine at her, “Am I going to have to wait a really long time for my epidural?” She says no. “Are you lying to me??”

I am sure she is lying to me. Hell, I would lie to me. But she isn’t. The anesthesiologist comes in right away. He is a short man with comically tall hair and a horrible, sing-song, chipper-camp-counselor voice. He introduces himself and commences cheerfully upbraiding me for yelling.

I know how this works. I know that I will need to sit up, bend over, hold still. I am trying to move between contractions, only there isn’t any “between” anymore, so it’s hard. And his stupid monologue about how I need to stop carrying on is not helping.

This is when Sugar and I learn something about what is and isn’t part of that social self that disappeared on the ride in. Apparently preferring silence while in pain, which I would have bet was pretty deeply part of me, is surface stuff. But the Teacher Voice is primal.

So here I am, screaming, moaning, trying to turn to sit, wishing there weren’t so many people touching me and talking all at once. And then Dr. Jerkwad comes out with his most enraging and unhelpful line thus far, a merrily hostile, “You’ve got to get some self-discipline.”

And, reports Sugar, I go suddenly silent, to everyone’s surprise. And out it comes, low and loud and firm and clear, the Teacher Voice. And it says, heedless of the fact that this is maybe not the brightest remark to make to someone poised to put a needle in my spine,

“Sean.

"Don’t be an asshole.”

Better Living Through Chemistry

(It's taken me two days to write this, so the time references are all off. I know you don't care, but For The Record.)

This morning, during the twenty minutes that the Bean deigned to sleep not on me (not that it isn't adorable, but pretty soon I'm going to form adhesions to the Boppy and the couch) I wrote my GP a thank you note.

Now, I am southern and everything, but I am not that devoted to the note-writing -- I'm not caught up with the baby gift thank-yous (or COUGH the wedding ones) -- but sometimes it is just Called For. And now, a few glorious days into my new life as a person who doesn't spend six or more hours a day gritting her teeth and feeling her eyes protrude from the pain of invisible vice-grips on her nipples, now is one of those times.

In short: Nifedipine is amazing stuff. My GP rules. I am ever-more angry at Dr. Russian's nurse, the practice as a whole, and, sadly, Dr. Russian herself.

(Ha! I just got back from several hours outside, where I walked around pain-free in only a tanktop! I nursed outside, even, without agony! Yes, it's beautiful and warm today, but it is usually hot as blazes in our apartment at night, thanks to a very enthusiastic heater over which we have no control, and that never stopped my nips from seizing up for hours on end.)

In long: I started having vasospasms over a month ago. Or at least, that's when I realized I was having them. It took me a little while to sort out that pain from the typical surface pains of early nursing and the pinching of Mr. Crocodile-Jaws's lazy latching (corrected by the Hippy But Not Dippy LC), but those things don't turn your nipples white even when you haven't nursed in hours or leave you cussing like a sailor while clutching your chest in an attempt to warm them up through two layers of cloth nursing pads, two shirts, a thick sweater, a wool shawl, and a coat when it isn't even properly winter any longer. Once I figured out that's what they were, I told myself to be patient, that it was all due to an injury from a bad latch that was fixed now, that I was exaggerating. I also managed to repress that my mother has Reynaud's and that we both have migraine, which is related.

After a week, I called my ob's office and asked about nifedipine. The nurse called back, all patronizing and unhelpful. "Oh, we wouldn't do that." Why not? No reason, just vague admonitions about taking medications while breastfeeding. Use warm compresses. I am, I said, and it's not helping. Use warm compresses. I lost it. Not pretty. Crying. Raised voice. Accusations that they didn't care about my health -- I'm going to stand by that one. The fact is that they did not care enough to, you know, do anything about the quarter or more of the day (and I mean out of 24 hours) that I was spending in pain. Only it wasn't pain, I guess, since the nurse kept referring to it as "discomfort." (This is the same woman who, when Sugar called in to ask if we should go to the hospital and I was having a terrible contraction in the background, told her that I "needed to calm down." Because back labor is so much less painful if you're quiet about it. Very helpful bitch, she is.) She called back later, probably because I was so obviously enraged, said she'd talked to the doctor (whoever was in that day), confirmed that they wouldn't prescribe for me but here was the number of the LC around here who is also an MD...who doesn't take insurance (reprehensible) and who charges you to read her website (seriously).

So I wrote to the HBND LC, and even though it was Friday afternoon and she takes Shabbat seriously, she wrote back immediately with a number of suggestions. I dutifully added more horse pills to the supplement brigade (calcium/magnesium and oatstraw in addition to prenatals, brewer's yeast, folic acid, and vitamin D) and tried to soak my nipples in hot salt water (which is awkward as hell and just left me with a damp, salty baby nursing the non-soaking side while the first side went bananas the minute the air hit it anyway). I heated nursing pads in the microwave -- they went from scalding to clammy in a nano-blink -- and tried unsuccessfully to position a heating pad over the first boob without letting it touch the baby as he nursed side two, electric boogaloo. Eventually, I gave up everything but the supplements, dressing like a wrestler trying to sweat down a weight class, and weeping. I made extra-warm flannel nursing pads and layered them until I looked like I was stuffing my already ginormous bra. I tried not to scream at the baby for crying, although every time he did so, the let-down reflex made my nipples crush themselves. My efforts to avoid cussing while nursing met with mixed success. (Mother of the YEAR, I'm telling you.) I refused to leave the house.

At six weeks postpartum, I had my ob check-up, at which my mention of vasospasms was ignored. When, at the end of the appointment, I mentioned that I thought it would be nice if they made a postpartum phone call to check in before then, Dr. Russian treated me to a strangely vehement tongue lashing, complete with raised voice and pointed use of my first name. I was accused of wanting them to do things "no one" does, of asking them to follow up with the baby (which would have been strange, considering how many times we went to the Bean's pediatrician for weight-checks). It was strongly implied that I had called the nurse too many times, despite the fact that every call I'd made had been for something on the hospital discharge paperwork, like a high fever, UTI symptoms, and a large and terrifyingly hamster-like clot. She kept returning to the idea that "this" was a job for family -- "We're not your family, Bionic, we're DOCTORS" -- as if I'd asked for emotional support rather than medical help. As it happens, many of my family members are doctors, and try as I may, I can't imagine any of them behaving that way to a patient, no matter how pushy and crazy the patient was. It was horrible, not least because it forced me to admit that her similar behavior during labor wasn't clever tough love intended to motivate me but just plain emotional instability. Farewell, Dr. Russian. I liked your shoes and your sass and your meat obsession, but if you aren't family, I don't have to put up with that shit.

As a confident, independent, properly-raised woman, it pains me to admit what a funk that visit left me in, but there you are. More weeping, more telling myself that this pain was something I just had to deal with, that it wouldn't even bother a good mother. I wondered how soon I could give up breastfeeding without hating myself for doing so.

Eventually, my pissed-off, entitled side beat the weepy bit into submission. I read up on nifedipine and discovered that the bitchy nurse was full of shit -- it's perfectly safe for breastfeeding and plenty common enough that problems would have turned up by now. Even the NIH thinks so, and they don't even think you should take aspirin because your baby might magically get Reyes Syndrome from the teensy bit that gets into your milk (not to mention that the Reyes/aspirin connection is not actually that convincing, says my father, whose field this is, after all). I trolled PubMed -- and yes, I will totally be using this as an example of why my students should PAY ATTENTION on the days we spend in the library, learning database searching -- and found several articles to the effect that Reynaud's of the nipple is real, is serious, and ought to be treated, if only because it hurts like hell and will keep people from breastfeeding. (I suppose it is too much to ask that it be treated just because it makes the mothers' fucking nipples fucking hurt, regardless of whether it might mean the babies get formula and therefore become dyslexic, asthmatic axe murders.)

I called my GP, whose receptionist told me to talk to my OB, but she agreed to see me anyway. (Meanwhile, Sugar went to see her ob/gyn, who asked after me. When Sugar mentioned the vasospasms, she said, "Why isn't she on nifedipine?" She assured Sugar it was very safe and said I should come see their practice if the GP didn't prescribe it. I had wanted to go to that practice in the first place, but they weren't accepting new ob patients when I got pregnant. Now that I'm a plain old gyn patient again, though, I am so there.) At the appointment, my GP listened to my description and the logic of my self-diagnosis and asked, "is there a treatment?" I trotted out my notes; she copied down my citations and wrote me a scrip for the dose I had found in the articles.

Sugar and I go to the same GP, and at times we have wondered whether her willingness to put us on or take us off of drugs we ask about means that we like her for the wrong reasons, because she does what we want rather than saying no. But really, why shouldn't she? We don't come to her with frivolous or dangerous requests, for one thing, but also, shouldn't we have some say in our own healthcare? If I want to try a drug that won't hurt and has a good chance of helping, maybe my desire (and pain) should be important enough that my doctor is willing to learn something new. My GP didn't do anything Dr. Russian couldn't have done. Even if Dr. Russian and her practice do not generally treat vasospasms (which, PS, they should -- 20% of women in childbearing years have some version of them), she could have listened to me, read the journal articles and/or consulted with colleagues, and done something to help, instead of turfing me to another doctor (on my own dime, too), and blaming me for needing help. As a child of doctors, I've spent a lot of my life arguing with people who claim that all doctors are arrogant. Besides my own family members, I grew up surrounded by doctors, and most of them were more like my GP than not. Most of them were like my father, who works insane hours seeing patients with tricky diseases, dictates notes late into the night, goes into the hospital every weekend (which requires sacrifices from families, too -- no camping trips or even full Christmas Days together), and still finds time to listen to his patients and their parents and think more about their needs than his ego. It pisses me off to no end (though I will end this post someday, promise) when a doctor acts like such a stereotype.


Enough ranting for the moment. The nifedipine is wonderful. The Bean is wonderful, too. He's smiling more and spending a higher proportion of his waking hours not screaming. We take baths together every night, which I love -- I haven't had a good bath buddy in 25 years. This morning, I think he really saw one of our cats for the first time. I'm so happy to be out of pain and able to focus on having a good time with him and bombarding my friends and family with pictures of his every move. Since you've been so good as to suffer through this interminable post, allow me to bombard you:

Quick Questions

Hello, internets. I owe you a post or ten -- or at least some pictures (I got one with a smile yesterday! A smile!) -- but as I am typing one-handed, marooned under a finally-sleeping Bean*, I must beg your continued patience. However. I am seeing my GP tomorrow -- one of the stories I owe you is "In Which I Realize I Must Break Up With Dr. Russian" -- and, being sick to death of being in pain and (horrors!) losing precious sleep over this vasospasm business, I intend to talk to her about trying a low dose of Nifedipine (see here). She isn't likely to know much about it (as this is more in the purview of obstetrics, but See Above), but I've poked around PubMed and, since I'm already taking a large handful of supplements from the hippy-but-noy-dippy LC and doing everything else suggested in the article**, I think it's time to try it. I'd like to come to the appointment as educated as possible.

Right. The afforementioned Questions:

Any of you spasm-y sorts ever look into Nifedipine? Your thoughts appreciated.

Less pressingly but also of interest: What did your ob/midwife/Very Surprised Cab Driver do in terms of post-partum care -- appointments, calls, what-have-you?

And while we're here: 13 nursing sessions a day? Is it possible The Bean thinks he's a marsupial (as, in fairness, my mother says I did)?

*oh. He woke up. But he is nursing the non-typing side first. Score!

**except giving up my one daily cup of coffee, which, dear God, is an unacceptable request to make of a new parent, particularly one who is losing sleep above and beyond the usual and whose offspring refuses to sleep in the day except on her body or in a rapidly moving stroller near heavy traffic, making her own napping a difficult not to say dangerous thing to attempt. Next person who tells me to sleep when the baby sleeps gets stabbed right in the eye.

Resolve

Update: 1-minute contractions every 10 minutes from 4am on. They start in my back, then come around to belly and shoot down legs. Maybe a bit more frequent now.

Talked to Dr. Skinny late last night, because I didn't understand that this blood business was just going to go on and on (intermittently). Frankly, she was kind of a bitch about it. Poop on her. (Actually, if she ends up at the delivery, perhaps the opportunity to do just that will be the silver lining....)

So, FYI, since all the books and stuff just talk about "blood-tinged mucous": apparently if your bloody show looks like a heavy period and the doctor says that's okay, you should not expect it to stop.

I don't know if this is early labor or pre-labor or what, but I do know that whatever it is, it is not shaking my resolve vis-a-vis that epidural. Just for the record.

A Confession, A Rant, and The Rest

I keep thinking that if I wait, all these things in my head will coalesce into a real post, but it isn't happening. So here comes a big mess. If you'd prefer not to see a bunch of mental clutter, here is an alternate post for you:

What should we be registering for that we've forgotten? Discuss.

Still here?

Okay then.

First, the confession part. It concerns birth stories. Yours and yours and yours and probably yours, too. Your amazing, beautiful, dramatic, powerful birth stories that you put so much care into and that I never comment on, even though I read them again and again and again. Even though I can see page after page of comments making it perfectly clear that all I have to do is say, "Amazing! Beautiful! Congratulations! Thank you!" and my work will be done, I don't write a thing and (if you think about it at all) you must assume I don't read them, since half the time I'm writing a novel in your comment box. I hope that doesn't hurt your feelings.

The truth is that I don't comment because your stories scare the ever-loving crap out of me. Half the time I have to have a little meltdown after reading them. The other half the time, I have the meltdown while reading them, to save time. I know enough to know that I shouldn't say *that* in your comment box -- I am hopelessly self-centered, but I am aware, in a conceptual way, of manners -- and for some reason I can't bring myself to say anything else.

So now you know. I read your story -- and yours and yours and yours -- probably more than once. And I was glad it was there to read, because I am an emotional over-packer, and I know that stories help me. So please accept my inadequate thanks for writing yours.


Two, the rant part.

Dr. Sears, please go fuck yourself sideways on something pointy.

Ahem.

Maybe I should start by talking about Wednesday's birth class instead. This week was "Interventions and Things that Can Go Wrong," and I have never been happier that we picked this class over the others we were considering. Although most of the class (at least the ones that talk about it) seem to be planning for unmedicated births -- at least half of them in the local birth center rather than a hospital -- and although the previous three classes have been all about non-medical ways to deal with contractions and so forth, both teachers were calm and even-handed when talking about monitors and epidurals and all that. One even went so far as to suggest that even though lots of people love The Business of Being Born, that possibly it had gone a tad far in its excoriation of pitocin. [Holy Moly -- I just went to youtube and watched that part, since I've never seen the movie. Heart now racing. Talk about your scare tactics! What the hell is up with that cartoon?] Our favorite teacher talked about a patient of hers who had apologized to her when requesting an epidural and told us in no uncertain terms that she did not disapprove of that decision. The only editorializing -- and it was announced as such -- was a plea to please not ask for an induction for a frivolous reason, which seems pretty sound.

When we were shopping around for birth classes, I wrote to various teachers and explained that, due to the double-cervix situation, I am at a higher-than-average risk of needing a c-section, and that it was important to me not to set myself up to think of a vaginal birth as successful and a c-section as a failure. One of the major reasons we chose this class is because I felt good about the teacher's response, and last night bore that out. The whole course has been about letting your body do its thing, asking doctors and midwives for all the options, etc. Our classmates are not the elective c-section type -- if they were, they wouldn't be in this particular class. But who can predict what will happen in labor? I loved that the screen of notes on c-sections began with "C-Section: An amazing, life-saving procedure" (or words to that effect).

None of that stopped me from weeping through the discussion of how emergency c-sections worked, of course. Possibly I have a little hangover from all the furious speed of egg retrieval day. We learned that, in the event of an emergency, the surgical team would work efficiently and fast, "just like NASCAR." I can only hope the OR isn't covered in logos for Laughing Clown Malt Liquor.

The whole evening, I was impressed with how calm and open the teachers were, talking about things that probably weren't on their ideal birth list when they decided to become midwives. I'm sure they knew that the Other Pregnant Lesbian and I have been comparing notes on epidural policies at the hospital we're both going to, because I have a nasty habit of being that person still shouting as the room goes quiet after break, but neither had anything especially bad to say about epidurals during that section of the class. They passed around an epidural catheter so we could see how slender it is and explained how to keep changing positions even with one in. It's almost as if they meant it when their response to my email said their goal was,

"to offer childbirth education that focuses on making your birth experience a satisfying and joyful entrance into parenthood, no matter what twists and turns and challenges you face, no matter what your personal desires and goals."

Go figure.

And then there's Dr. Sears.

An old friend sent us a box of baby-related hand-me-downs recently, including the Sears' Pregnancy and Birth books. I tend to agree with Dr. Sears on about 80-90% of things, and find the other 10-20% hopelessly nutso, but I decided to take a look. In a bookshop, early in the pregnancy, I'd been very impressed with how calmly and thoroughly he dealt with first trimester bleeding -- most books just say "well, it might not be a miscarriage, but PROBABLY IT IS" which is silly considering how common it is -- and rather turned off by his section on weight gain, which took the usual tack of assuming you are just itching for an excuse to become morbidly obese and added the nicely tuned guilt trip of "plus you are making your baby fat, you lazy cow." But free is free, so what the heck. I turned to the birth stories section.

The stories themselves are what they are. Only one of them makes me actively gaggy. It is an induction story, and the second paragraph begins, "Dad likes having a baby this way." (I'm all for having both partners involved and everything, but I've already told Sugar that any statements like that of the father Dr. Sears praises for saying "we had a vaginal exam" are...unwelcome. Unless she's up for hopping in the stirrups alongside me for moral support.) Okay, I also want to do a consciousness-raising session with the author of "I Witnessed Myself Become A Woman -- VBAC Water Birth," but whatever.

Dr. Sears is a proponent of "natural" childbirth, by which he means no drugs. (I hate that term, personally -- it's a bit of an emotionally loaded dichotomy for my taste -- but whatever.) I'm a proponent of letting women decide for themselves what they do and don't want to be part of their birth. This is where we diverge. I expected that, but I didn't expect quite the level of paternalistic bullshit found in the commentary on the birth story of the Woman Who Dared Ask For An Epidural.

"A Medically Managed Birth" is about a woman whose doctor tells her to go the hospital when her water breaks. Ten hours later, she gets some pitocin. Some time after that, things get intense and painful, and she starts to feel hopeless. She can't concentrate on the baby, only the next contraction. She requests and gets an epidural, feels confident again, promptly dilates to 10, pushes the baby out -- able to concentrate on it again, rather than pain -- and feels happy about it.

How dare she! Incredulous, Dr. Sears, et al., "interviewed her about whether or not this style of birth ["American"] left her "less fulfilled" as a woman." Rude much? She says no, on the contrary, she feels great about it. "

There was no doubt in her mind that she gave birth, and the fact that she didn't experience the intense sensation of a drug-free birth did not lessen her fulfillment."

Mother gives birth to healthy baby, isn't hung up about it; everybody wins, right? Wrong. Dr. Sears goes on to remind us that she didn't have the chance to have natural, gradual contractions -- okay, fair enough. Everyone says pitocin sucks like that. It's the closing that pisses me off:

"We wonder whether her Lamaze instructor mentioned the importance of taking the contractions one at a time [...] thinking of the baby, not the next contraction."

I'm going to go out on a limb and guess the instructor did mention that, since the mother mentions the loss of her ability to do that after...chronology is a little unclear, but at least 12 hours, probably quite a bit longer. Maybe, just maybe, she was trying to do that and it was too damn hard. So she should have what, tried harder? What is the big fucking problem with an adult making a decision to use a very safe drug to lessen pain? Labor pain may be "pain with a purpose" or whatever, but so is the pain of passing a kidney stone, and no one talks about how virtuous people enjoy that.

I in no way mean to denigrate women who choose to give birth without painkillers. I really, really don't. But I think that the important thing is that the laboring woman -- not some moralizing jackass judging her story later -- makes that decision. There's so much B.S. out there about epidurals -- most of which was either never true or hasn't been true in 25 years -- that the last thing I consider acceptable is telling a woman with no negative feelings about how her birth went down that she should feel bad.


You are all such clever people that you no doubt figured out 20,000 words ago what this post is really about: my fear that you'll think less of me if/when I get an epidural. Even that "if" was a pretty big lie -- birth is unpredictable, but the epi is in the plan, for sure. I've done my research, and I feel good about it from a scientific perspective: one reason I'm happy we're going to Kips Bay Mega Hospital is that their epi policies are excellent. (OB anesthesiologist on 24/7. Standard use is light-dose, patient-controlled, which all the studies agree is the way to go in terms of pain relief and side effects if you have the staff. The intent at least is to keep the dose light enough that patients can go to the bathroom themselves. No "window" -- you can have one whenever you want and the OB thinks is okay; Dr. Russian says I can have one now as far as she's concerned.) If the cervices don't behave and I need a c-section, I'd just as soon already have the epi in, and if not, I'd rather not be feeling every bit of my septum breaking, which it may well. Even without those special circumstances, useful as they are for shutting down any "your birth will be fine because mine was" stuff, I think I'd be leaning this way. I've experienced plenty of severe pain in my life, what with the migraines and the endo/GI situation, and I haven't noticed anyone giving me a medal for the times I've done so without painkillers. Other people have had worse pain than I have and make other decisions; that's okay. I'm okay with being a wimp on this one...

...as long as y'all will still be friends with me.

The Slippery Slope of Bad Parenting

I gave my stomach a week off to recover from a rough Christmas, but the DHA gel caps are still giving me horrible fish burps. That is just it.

Bean, you are going to have to find a way to be smart without that particular supplement. One more thing to put on your list for therapy.

A Wish For Today

I'd like to find the fellow who invented the glucose tolerance screening procedure.

And then I would like to puke on him. And kick him for a bit.

Related: Should I really still feel like donkey shit, ten and a half hours after the test? Does this mean that my body is not, in fact, any good at processing glucose, that I will fail the test and be told to do the three-hour one? Because...no. Have no risk factors and no family history of diabetes. Am getting lots of scans of The Bean* anyway, because of the PAPP-A thing, so there will be plenty of chances to keep an eye on its growth and well-being.

Dammit, I was perfectly healthy** this morning, and then I went to the doctor and they made me sick as hell.

My apologies to any who are hurt by today's "pregnancy sucks" tone. Pregnancy -- at least this one -- does not suck. I am happy to be pregnant and enjoying it very much, I assure you. I do not enjoy being made to feel nauseated, faint, weak, disoriented, achy, and generally awful***, but pregnancy didn't do those things to me (at least not all at once).


*Including today! Everything fine! Pictures when one of us is well enough to scan them. Sugar remembers all kinds of cute things that are a bit of a blur to me, so maybe we should make her post about it, eh?

**If you don't count the heartburn and the rib thing, but let's not.

***And POSSIBLY a TINY bit emotionally overwrought.

Items From Our Catalogue

Item: This post is coming to you from my dismal office, as I wait an hour for the next bus to ferry me to the train station, the first step of my 2+ hour commute. It will be even longer tonight, because I missed the early bus. I had (somewhat irresponsibly) let class out early so I could catch it, and then I spaced out and missed it anyway. Is this "pregnancy brain" (gag) or ordinary incompetence?

Item: I have become too lazy/dull/generally pathetic to participate in my own meme. Will this be in the DSM-5?

Item: You should check out (and submit to, in all senses of the word) starhillgirl's very fun new tumblr blog, Lunch. Make your lunch famous on the internet! I'm going to pull a fast one and call my Thanksgiving Sandwich entry my Come And Eat post for this time.

Item: I made half as much sweet potato pudding this year, since Sugar had requested a savory sweet potato dish. I should have made more pudding -- it was gone in a day, and I only got one sandwich out of it. The savory option is currently dying a quiet death in the back of the fridge.

Item: All that frantic eating seems to have led to another growth spurt. Internets, I am certifiably enormous. I am back to running into things every five minutes. I am in denial about the fact that turning sidewise to slip by objects or people has become comic in the extreme. (Imagine it -- I, not un-wide, approach a narrow passage. I pause, turn 90 degrees, thus rendering myself twice as wide, and proceed to shove my way through.) I would say picture to follow, but I think we can all agree that said picture is more likely to actually happen if I don't make any promises.

Item: While spending a very nice weekend with friends outside of Boston -- and the fact that I can call the weekend very nice, despite how much of it was spent dealing with a teething toddler, a sudden lack of heat and hot water, and an obstreperous landlord ought to give you some idea how wonderful these friends are -- I discovered that I could cleverly heft my (considerable) self out of their comfortable but very low armchair by pushing down on its arms and hovering my butt in the air such that my legs swung perfectly underneath me. I was very proud of being strong (and short) enough to manage the feat and performed it more than necessary.

Item: Pride ever goeth before costcochondritis, as it turns out.

Item: This is plenty bad, but how much worse it would be without Dr. Russian, who was on call last night when I left a tearful message with the answering service, after a day of increasing agony. "Take the percocet!" quoth she. Good doctor, that.

What We're Googling, 17 Week Edition

cribs

drop-side cribs

CRIBS FOR SHORT PEOPLE

(Seriously, thoughts, fellow shorties? How the hell am I supposed to reach all the way over the side?)

cold sore

cold sore pregnancy

cold sore depression

cold sore pregnancy treatment

lysine

lysine pregnant

valtrex

valtrex side effects

...

quickening

Egg Retrieval Story

Hey there, folks. How are you? I'm much better than I was, happy to say. I have been all blown up like a water balloon from a touch of OHSS, which wasn't particularly painful but was kind of tiring, but on Sunday night I peed like I have never peed before -- I think someone told my kidneys there was a talent scout in the house -- and suddenly I can wear pants again. If I do end up pregnant, I know this will be only the eye of the storm, but I am enjoying it nonetheless.

As far as other ailments, I know Sugar told you I've been rather sick, but I want to make clear that pain and vomiting did at least happen on different days. The pain was very bad the day after retrieval -- probably because of all the endometriosis -- and then not. The nausea was bad around transfer (5 days post-ER), and I am convinced was a side effect of the progesterone. Now that my body's used to it, I'm fine. (The doctor tried to sell me on nausea as being because of the bloating, but I haven't felt sick when at my most bloated; when I felt nauseated was between the post-ER bloat and the real OHSS ballooning.)

I said before that your ER stories were all of so much help to me at my own retrieval, so I figured I'd better tell mine before it fades in the haze of the percocet-filled days that followed it. It's looooonnnggggg. I hope it will help someone later.


On the morning of retrieval, I was hungry and scared. My clinic says no food or drink at all after midnight the night before, and my procedure wasn't until midmorning. I have a touch of hypoglycemia, and that long without food leaves me a hot mess: shaky, frightened, easily confused, possessing the emotional self-control of a nap-less toddler. On the other hand, my ovaries felt so big and my back was so sore that if someone had handed me a grapefruit spoon, I might well have dug the eggs out myself. I was, shall we say, ready as I'd ever be.

We took a cab to the clinic, which was very empty because it was Saturday. After filling out payment contact forms for the anesthesiology department, we went up the the second floor of the clinic, where they have operating rooms. I really liked that I didn't have to go to a separate hospital. Not only was it less nerve-wracking to be in a familiar place -- a VERY familiar place, given how much monitoring I'd been having -- but it was also calm and uncrowded. Most of the nurses I saw that day I had met in the blood draw room at one point or other, which was comforting.

When we got to the second waiting room, there was one man by himself and one male/female couple. After a few minutes, the woman was called back. About ten minutes later, the nurse called her (presumed) husband back through a different door.

Wow, I thought, if he's already going to meet her in recovery, this really IS a quick procedure.

Very soon, a brusque nurse I hadn't met before called me back. "Okay, she'll come find you after she's done," she said to Sugar, prompting a freakout from me. The materials we'd been given all said that "depending on time and patient flow," she could meet me in recovery. Not anymore, the nurse said, new policy. I felt angry and even more scared. I would have been okay if I'd been expecting it, but I was in no state for surprises. I began to suspect that the nurse thought Sugar and I were just friends, that we weren't being treated like the het couple that had gone before us.

"What about that guy? How come he got to go, then?" I demanded. The nurse claimed no knowledge. I was rattled and pissed.

After that, I went to the locker room, where I exchanged my clothes for two nice, cloth gowns (one tied in back, one in front), little socks with rubber treads, and a shower cap that was extremely awkward for my long, heavy braid. The key was on a springy loop that I put on my left wrist. I then met the nurse in a tiny room with a table, where she took my pulse and BP (high for me -- "maybe you're a little nervous?" she said, rather kindly) and had me fill out more consent forms and so on. When we were done and the OR still wasn't ready, she totally redeemed herself in my eyes by fetching Sugar and letting us sit there together until it was time for me to go.

When they were ready, I walked with the nurse to the OR. The way there was through recovery, and I suddenly understood why Sugar couldn't meet me there -- there were just too many patients. The recovery area at the clinic is a series of curtained nooks (like you see in ERs sometimes) arranged around a nurses' station. Because some of the patients weren't conscious yet, all of the curtains were open. No partners were there, and I did understand that the nurse was right when she said that having partners come in had been a problem, since everyone was talking and people who were just coming to got confused. The atmosphere was very quiet and calm, even if it was still pretty weird to walk by the woman from the waiting room, out cold with her mouth wide open. She looked like a child or a rag doll.

The OR itself looked, well, like an OR. There was a table with white sheets and "stirrups" that were really just long things to put your calves in. I was standing in the big, open part of the room on the right hand side of the bed. To the left was lots of equipment. There were what seemed like a ton of people but was probably only 4 or so doctors and nurses bustling around. Everything was moving really fast. I got scared again.

"Hop up," they said, after having me take off one gown and "loosen" the other. (It turned out that by "loosen" they meant "completely untie." It would have saved some time and frustration on my part if they'd just said that. I felt like I was already supposed to know all this stuff, like in a weird dream.)

Hop up HOW? I thought. The bed was too high for me to get onto easily. They pressed something and it lowered down, I got on it, and everything started happening really fast. A man in green scrubs grabbed my left hand and pulled it out to the side, where there was a little table at a right angle to the bed. He started telling me to make a fist and so on, so he could start the IV. At the same time, a nurse I knew from the blood draw room was telling me to scoot down the table farther, so that my butt was at the edge of a hole in the bed that I could see because it was covered with a pad. Then she told me to put my legs up, then scoot more. Also at the same time, the anesthesiologist was asking me lots of questions about my history with IV anesthesia, my drug allergies, and so on. Only the anesthesiologist, on whom I have developed a bit of a crush, introduced himself.

At this point, I came a bit untethered. The man in scrubs -- who I recognized at some point as the surgeon, Dr. Saturday (and wouldn't it have been nice if he'd introduced himself?) -- put the IV in. It hurt like hell. In fact, it never stopped hurting for the rest of the day and I still have something of a bruise there, because it wasn't in right. I wish I had known that it wasn't supposed to be like that and that I should have asked him to do it again. (On the bright side, many people reported that the first stuff in the IV stings, and I barely felt that....) Everyone kept telling me to do things all at once. Someone put a BP cuff on my right arm, which inflated itself every minute or two. I started to cry, just a little.

"Oh, no! Don't cry!" said the sweet anesthesiologist, an Italian man of roughly my father's age. "Whenever I see a pretty lady cry, I start to cry too." I pulled myself together and explained that I was worried about the IV sedation, because when I had that for my wisdom teeth, I woke up in the middle and threw up for several days afterwards. He listened to that and to my saying I was going to need real pain medicine after, because tylenol doesn't do jack for me, and assured me that he would make sure everything was ok.

It was then that I really appreciated tbean's story, which scared the hell out of me when I first read it, such that I required much buoying from friends who'd done IVF themselves. As upset as I was at the time, my experience wasn't anything truly traumatic, but it helped during the worst part to remember what tbean had said about how this is surgery, no matter how much they act like it's just a "procedure." I looked up at the ceiling and told myself that everything that was happening was normal and how it was supposed to go, that these people were doing their jobs and that my job was to look at the ceiling, try not to think about how much my hand hurt, and trust that Dr. Italian would take care of me. The nurse tucked a white blanket around me so that my right hand was against my chest (nice touch), and the next thing I knew, I was in recovery.

My bed was facing the window, so I could see the green vacant lot next door and the bridge beyond. It was a sunny day, the view was pretty. I don't remember feeling anything but awake -- no groggy period or confusion. I knew where I was, why, and everything else. A nurse noticed I was awake and came over to check on me. She took care of me for the whole recovery period and was great in every way. She asked if I was in pain, and except for the &^$%ing IV, I mostly wasn't.

After a few minutes, I started to be. My belly was sore in the gas/endometriosis kind of way it had been that morning, my back was a little bit achey, as it had been for a week or more. My vaginal pain was very slight and never got bad, ever. Less pain than I have after a pap smear. I told the nurse and she said she would have the anesthesiologist see me as soon as he was out of the OR. That took 10-15 minutes, by which point my belly had started to be more of a problem.

Dr. Italian came out and gave the nurse something to put in my IV, and I started to feel better right away. He later gave her a syringe of the same something to give as an IM injection, which would last for the ride home.

I was my typically chatty self under the influence of drugs. I asked Dr. Italian to repeat his name a few more times. I ended up remembering it almost right. I told him, somewhat in awe, "I didn't wake up!"

"That's my job," he said.

The nurse brought me some apple juice and graham crackers, which were awesome. At some point, the nurse asked if anyone had told me how many eggs they got. She brought me a paper and pointed at the number 32. My eyes bugged out of my head.

I reminded her that I really needed a scrip for something that wasn't tylenol, and she had the fellow write for what turned out to be very necessary percocet. "Tylenol doesn't do anything," I said, "I might as well take water; it tastes better."

"That's my kind of lady!" said Dr. Italian, passing by.

A while later, she said it was time for me to try going to the bathroom, and helped me very slowly get up, carried my IV bag to the hook in the bathroom, and left me sitting there, with firm instructions not to try to stand if I felt weird.

So I sat there.
For a long time.
Nothing.

I had had two bags of IV fluid by that point, but nothing was happening. The nurse called to me that I should come out if it wasn't working. I was desperate not to stay longer than I had to, so I asked for an extra minute, turned on the sink, tried every mental trick I know, and peeds maybe 3 drops. When I wiped, I was shocked by how bloody the toilet paper was.

The nurse declared that even three drops counted, and I graduated to a recliner with the leg cushion out. Eventually I was allowed to sit up normally. Dr. Italian dropped by again and said "Good work, young lady," which I loved. (Seeing a theme? Why can't this man just be constantly passing through my life, praising me?) A while after that, she detached my IV from the cord (leaving it in my hand), and sent me to go put my real clothes back on. (I stopped to get a dreaded hospital pad from the bathroom, as I'd cleverly left the one I brought from home with Sugar.) Once in the locker room, I realized my fatal error: my key was attached to the wrist of my IV hand, which still hurt like hell. I had to gingerly stretch it over everything, which sucked. Nicole: put the dang thing on your right hand.

I returned to the chair, carrying my bra, because hell, no, it was not going back on. The nurse took out my IV, gave me my scrip, and sent me home with Sugar. As we left the 6th floor, I explained to Sugar my understanding why she couldn't be in recovery, but said I was still confused about where that first husband had gone.

"Dude. He went to give a sperm sample."

Oh. That's probably why the nurse didn't explain, huh? I hope the other waiting husband at least thought my outrage was funny.

We took a cab home, I retired to bed with my percocet, and everything was basically fine. I ate and drank normally. I peed. At some point, I stopped bleeding. The pain got bad the following day, probably as a combination of some OHSS and a lot of endo, but I don't think that's typical. In short (TOO LATE!), I was scared but nothing terrible happened. If I have to do this again, I don't think I'll be that upset.

Lying Down All Over Town

Today we did the embryo transfer!

I took the day off work to be able to go with Baby to all her various appointments - acupuncture, transfer, acupuncture, home - and in order to do so I told my office that she was having 'surgery.' Now they are all worried about her, and probably think she has cancer, since I was so unspecific. On Saturday she actually had surgery (egg retrieval) and I was all worried about her, but didn't manage to talk to anyone about that, since it was Saturday. Between Sunday and this morning she has been quite sick - in pain, vomiting, the works. But now this evening she seems a lot better, thank goodness.

So here was our day:

6 a.m. vomiting (Baby)

8:30 We take the train to midtown and go to Baby's acupuncturist's office there. Baby goes to lie down. I wander around in search of breakfast, saltines, and a seasickness bracelet for Baby. It is ridiculously hot outside.

10:30 We take a cab to the Kips Bay Baby Factory, where everyone is surprised that we are early. The nurse clearly thinks Baby has already had some Valium at home because she is moving so slowly and acting spacey, but we convince her that no, it's just the puking and the lack of sleep. The nurse gives Baby some Valium.

10:45 We are seated in front of this sign. I had not previously realized that the doctors here think of themselves as ganstas.

yo yo YO!

10:50 Dr. Thursday comes to talk to us. He is disorientingly jovial. Also he has tiny feet, which I find myself staring at. However, all the news he gives us is great. 26 of Baby's eggs fertilized, and 20 of those are still growing. There is a good looking blastocyst to transfer and there will be some to freeze, somewhere between 4 and 10. We won't find out how many they actually froze until tomorrow afternoon.

11:00 Baby and Dr. Thursday go into a Laurel and Hardy routine about left and right cervices. Dr. Thursday says Dr. Baby Factory told him to go in through the right cervix, but Baby says he must have meant Dr. Thursday's right, i.e. Baby's left, etc., etc. After a while Dr. Thursday agrees to poke around and not jab anything too hard until he figures it out.

11:35 Dr. Thursday breezes by me in the waiting room and says I can go back to the recovery room. He waves his arm around saying 'it's to the left.' I try the door he came out of, which is locked. I sneak through a different door and stick my head past the gansta sign into a completely empty hallway and shout. Eventually a nurse wanders by and directs me through two totally other doors to where Baby is lying down. She seems calm and happy and has this picture printed out and lying on her chest.

our first blastocyst

12:30 IT IS SO HOT OUTSIDE, WHY IS IT SO HOT?

1:00 We sweatily arrive at another office near the Baby Factory where Baby's acupuncturist also works. Baby goes to lie down and have needles stuck in her again. I read a trashy vampire novel.

2:00 Back on the train to Brooklyn.

3:00 Baby lies down in our blessedly air-conditioned apartment. Because there is no food in the house, I prepare for the trek through the blazing heat to the Food Coop.

4:00 (presumably Baby is still lying down) I search for popsicle molds (no dice) and stuff to make miso soup, which Baby has requested.

6:00 I make miso soup.

7:00 Baby and I eat the soup. Nobody vomits. Score!

ET Phone Home

Okay, I know that post title makes no sense; I just felt like it.

The fact that I am aware that it's meaningless should indicate to you that I am off the percocet. After a fairly wretched Sunday and a somewhat rough Monday morning, my belly stopped aching and I didn't need it anymore. Acupuncture probably helped, too. I'm still somewhat bloated -- only up 2 lbs. from retrieval day but it's all in my suddenly barrel-shaped tummy -- and my back/hips/thighs hurt the way they have been ever since my ovaries got big, but nothing really excruciating. Walking sucks a bit because of the legs, but it's also 90+ degrees, humid, and smelly out, so staying in isn't such a problem. (Although I also think being sedentary is part of how my back got so bad....)

Saw Dr. BF today, who wanded and specul-ized both vaginae and declared me fit to fly without anesthesia. Yay! He thinks a tenaculum will be involved -- UNyay -- but it almost always is when my cervix needs crossing, so at least I'm pretty used to it. He didn't come right out and say it had been silly (lazy?) to suggest I needed to be knocked out, but he did say, again, that they really only use that for patients who can't stand a speculum at all. Here's an idea: maybe they could have left that decision to someone who's met me when conscious, not just gone by the word of Dr. Saturday. (And folks who can't stand a speculum and do IVF anyway? HATS OFF to you. You are at least eleventy-million times braver than I.)

It turns out Sugar can't be there anyway, because they just don't allow that. Poo. She'll come with me to the office, and I know the important part isn't whether she's physically with me for that particular 20 minutes but that she's with me in the ways that count throughout all this. I'm gonna stop before I make y'all yack on your keyboards, but the point is: my wife pretty much rocks.

So! We're on for a valium-inflected ET tomorrow. I asked how the ol' emby gang is doing, and while I didn't get numbers and letters (and frankly don't really want them at this stage in the game), Dr. BF says they're doing great, better than typical. Genuises, all, playing suzuki violin and writing plays, I'm sure. I really hope we'll have some to freeze, so that it doesn't feel like everything is hanging on this cycle.

Thanks for all your ET stories. I'll think of you in my valium haze, while trying to ignore the spikes in my cervix.

Updates and Such

Hey there, internet. It's been a rather rollercoaster-y day around these parts, so I'm not sure how peppy I can make this.

Let's start with good things:

• We now have two dozen fertilized eggs. Obviously 24 is too many to put back, but luckily vitrification and FET means we can have two, reasonable pregnancies of 12 each....
• The red gatorade isn't so bad if it's really cold.
• After no percocet overnight, I felt great this morning. Better than in a week, in fact.

...that's all I can come up with.

Less good things:

• Stopping the percocet was stupid, stupid, stupid. Midmorning, I was suddenly in so much abdominal pain that I freaked out. Luckily, I did the responsible thing and called the Baby Factory. The doc on call there said she wasn't a bit surprised, given my age, battery-hen-style egg production, and extensive endometriosis. She told me to get back on the percocet and stay the heck in bed. Although it took several hours for the percocet to get back to its former level of effectiveness (because it always works better if you don't let the pain get away from you), I am basically okay now. I am also still in pajamas, which now have gatorade stains. Classy.
• Way too sick to go to acupuncture, even if I hadn't been forbidden to leave the bed.
• The nurse who called with the fert report announced that I would be having anesthesia for my ET, per the doctor who did the ER (Dr. Saturday, not Dr. Baby Factory), who never introduced himself in the OR and put my IV in badly so it hurt like hell the whole time.

Dr. Baby Factory and I had already talked about ET procedures, as he knows my ornery cervices better than anybody, and he did mention that anesthesia was a possibility. He mentioned it in a "in case you think *you'd* like this" kind of a way, just as information. We decided that valium was enough. Now some guy I don't even know has just announced that my care is changing, because he feels like it. I feel out of control and angry.

I also feel really, really sad about the idea of not being conscious for the ET. So much of the IVF experience is so distant from what I want the conception of our child to be like. I am grateful that I have the opportunity to use IVF, grateful that it may save us from infertility. But the experience is not without loss, you know? I've read so many IVF blogs, and ET day seems for so many couples like the day it becomes personal again, as they watch the embryo on the screen, hold hands as it goes in. I want that.

Doctor On-Call wants me to come in tomorrow anyway, to get checked for OHSS and so on. Since Dr. Baby Factory is also Dr. Monday, I hope to talk to him about it. I just hope I can keep from crying. Because crying hurts my belly so much right now.

Oh, I forgot one other good thing: a big shout out to my wonderful acupuncturist, who wrote to check in on me and is just generally a blessing.

Eggy Update

Hey, y'all.

I'm back from retrieval, chillin' in the bed with my good buddies percocet and gatorade. I will write the whole story at some point, but the important parts are:

• I made it. I was definitely scared, but even though I won't say it was all peaches and ice cream, it was nothing as bad as I'd feared.
• THANK YOU THANK YOU THANK YOU for the messages of support and especially the stories. All the stories -- even tbean's scary one -- were helpful in one way or another. I'm gonna get all weepy if I say more than that now, but the bottom line is you are all amazing. And that's not just the drugs talking.
• How many ounces are there in a quart*? That's how many eggs there were up in my ovaries. No wonder my back's been hurting.

*32. Thirty-fucking-two. Yes, I am on OHSS watch.

It's time

I've been in stirrups so many times in the past week that I've started wearing skirts to the clinic, just to save the trouble of taking my pants on and off. I take my shoes off anyway, because not doing so seems somehow inappropriate, even though there's no real need.

I went into the Baby Factory for blood work and ultrasound this morning, as I have for the past seven consecutive days. First stop: blood draw room. There are lots of nurses, most wonderful, and I hadn't had this one before. She said something sympathetic about how much time I've been spending there -- both arms are pretty bruised at this point -- and I said I didn't mind, that I appreciated being watched so closely, that it helps me worry less. And anyway, I like having more data.

Oh, she asked, do you work in medicine?

This question comes up a lot. I don't work in medicine, but I was raised by two doctors in an area where hospitals and labs are major employers. Medicine is my mother tongue.

So I told her no, that my parents were doctors, though. And then she said what easily fifty percent of people do after that revelation:

"Aren't they disappointed that you're not a doctor?"

Now I ask you, what kind of small talk is that? To tell you the truth, I'm not entirely convinced they're not disappointed, though they never say so. Heck, sometimes I'm disappointed in myself for not being a doctor -- I'm pretty sure I'd be good at it -- and I never wanted to be one. But is this really a conversation I need to have with a stranger first thing in the morning? Public Service Announcement: If you find yourself about to ask someone who is not a very close friend whether her parents are disappointed in her, JUST DON'T.

Onward to ultrasound.

At the Baby Factory, all IVF patients on a given day are seen by the same doctor, no matter who your regular doctor is. Each day of the week has a doctor assigned to it; Dr. Baby Factory, for instance, is Dr. Monday. Ultrasounds are done by one of a trio of lovely fellows -- all women, just to complicate the nomenclature -- or by the doc of the day. Today I met Dr. Thursday, a jovial, paternalistic jackass.

First of all, I appreciate it when folks introduce themselves before sticking anything up my privates. Call it a quirk of my Southern upbringing. Second, when I tell you, since I'm not counting on your having read the details of my chart, that I have a vaginal septum and that you should aim to the right with that dildocam, the preferred response is, "thank you for telling me." Not:

"Why didn't somebody take that out?"

Luckily, my pre-cycle anxiety dreams had prepared me for this moment (only with more knives), so instead of blubbering I managed,

"Because it belongs to me."

The examine continued in that vein. Dr. Thursday is the only one of the docs I've seen who didn't adjust the u/s screen so I could see it, and I bet he wouldn't have told me the follicle measurements I'd asked for if he hadn't had to call them out to the resident in the corner. He ended the session with a pat on my knee and a "Good job" that made me feel like livestock.

So now I know why they want you barefoot in the stirrups: a kick to the face is bound to hurt less that way.

ONWARD.

I am triggering tonight. Ten minutes to midnight, which my sweet, strictly diurnal Sugar is bound to hate. I'm nervous as heck about the shot and mostly about the retrieval and continue to appreciate your reassurances and general support.

Biggest follicle is about 19.5 mm. Dr. Thursday said about 10 on each side. So now I'm nervous about OHSS, too. E2 is 3364. Talked to Dr. Baby Factory, and he sounds a little nervous, too, but not nervous enough to have me trigger with Lupron. So I guess we just hope for the best and stock up on gatorade.

Retrieval is Saturday.

Which means a 5-day transfer would fall on...Dr. Thursday's shift. Awesome Sauce.

More To Say

...but not tonight. Holy Moses, this stimming business has me worn out, internet. I seriously do not know how some of you have done this and had real jobs, other kids, etc., at the same time.

Things continue apace around here. Back still hurts, but other side effects have tapered off. Mostly between a 4 ("My pain is not fucking around") and a 6 (Ow. My pain is super legit now) on Hyberbole and a Half's* brilliant pain scale. Definitely nowhere near 10 ("I am actively being mauled by a bear").

E2 rising. Follies growing in fits and starts. I've been in for monitoring every day since Friday, as my quicker than expected response made them think OHSS thoughts. It's sort of annoying to schlep in every day, but mostly it's comforting to feel so cared for.

They said today I'll probably trigger tomorrow or Friday ('course, they said that yesterday, too), which means ER this weekend. I'm still a little scared, though mostly I'm too tired to remember to be anxious.

That said, your "it was no big deal"-type ER stories are very appreciated, in comments or links.

xo

Bionic

*Do you need more funny in your life? 'course ya do. (Try this one, for instance.) Exercise extreme caution when reading Hyperbole and a Half at work, as Sugar points out that sudden, repeated laughter in your cubicle is not very professional.

Sleepy Updates

Hey, y'all. I keep thinking I'll find energy to write a coherent post, but apparently not yet. In the interest of keeping you abreast of the situation chez Bionique, here is a disjointed post, instead.

Things are basically okay. Stim dose keeps going up and down. Things happened faster at 225 than they expected, so it went down to 187.5 and then 112.5 -- thanks for helping me brush up my 37.5 times tables, Gonal-F. Just got told to put it back up to 150, as E2 isn't all that different from yesterday. (Now at 1347.) Hoping this doesn't spell doooooommmmm.

At today's ultrasound, looked like a bunch of little follicles on both sides, the biggest about 11mm. Lining is 12mm -- the doc on Saturday called it "beautiful," which helps make up for her rather fierce dildocam technique.

In side effect land, I'm pleased to report that the bad headache (plus attendant vomiting -- Go Team Migraine!) only lasted a day. I've been having little headaches on and off since then, but nothing to write home about. Besides, I'm too distracted by my aching back (ovaries) to notice. Thank you, whoever invented heating pads. Acupuncture also helped for a few hours. I remain crazy tired, but that might be partly because I'm not sleeping well, thanks to the backache. A little mood-swing-y, but is that so different from usual? (Don't answer that, Sugar. It's the drugs.)

The shots themselves have been less bothersome than expected, especially since Sugar's doing the scary part. (And, full disclosure, since I've been using the spray numbing stuff we have on hand for waxing -- yes, we are cheap enough to do it at home, thank you very much.) Gonal-F is just a little pinch. Ganirelix/Antagon stings, not gonna lie. I get a nice red patch there for the next hour or so, and it feels like a bee got trapped in my pants.

I finally got the HCG situation dealt with today, by getting a new scrip and walking it to a regular pharmacy, since the mail-order place STILL says they haven't received (read: can't find) the paper scrip sent to them two weeks ago. (My insurance company requires me to use the mail-order place, but I'm allowed one-time amnesty.) The mail-order place is considering waiving the co-pay on the second shipment of Ganirelix due to arrive tomorrow, since it's their fault they read a 5 as a 3 and sent too little in the first place. Everyone on the phone there is super-nice, but sheesh.

I wish I had a funny picture or a clever thing to put here, but as I said, I'm wiped out. In the interest of keeping this blog vagina-oriented and overshare-y, I will offer you the following New Math:

IF

High Levels of Estrogen = Increased Cervical Mucus

AND

High Levels of B Vitamins = Highlighter-Yellow Pee

THEN

Sky-Rocketing Estrogen Levels + Prenatal Vitamins =

Buckets Of Highlighter-Yellow Cervical Mucus

Some Good Advice

Internets! Hello from day 4 of stims.

Things are going pretty well. I went in for blood work today, and they say I'm showing a good response. My estrogen is at 545. So tonight, Gonal-F went down to 187.5, and tomorrow we're going in for more b/w and the first u/s look at what's up in the ol' egg cartons. I'm to bring the Ganirelix with me, in case it's already time to start antagonizing the follies.

In side-effects land, I've had a bit of a backache, especially on Cysty Lefty's side. Yesterday I had a tiny headache, which reached "blinding" this afternoon. Yuck, but Dr. Baby Factory said I can take the codeine I have for migraines if I need to, so it's down to "splitting" now. I sure hope my head doesn't just feel like this from here on out, but I feel I can't complain much, since I'm not teaching right now and I can, in fact, lie down and groan if needed.

I can also lie down and nap, which is a darn good thing. I can't believe how tired this stuff is making me. Sugar points out that I am, after all, growing a bunch of stuff, so maybe that's why. Or maybe it's just my native sloth. Lordy, though. I took a nap as soon as I got home from the Baby Factory and other Manhattan errands this morning. When I woke up, I felt like I could really go for a nap.

...which brings me to the advice portion. I was whining a bit to the splendiferous Fat Chick about all of this -- do you all read her blog? Do you already know how brilliant and marvelous she is? I certainly hope so. (If not, I am dead jealous, since you get the pleasure of finding her blog for the first time.)

Here she is on side effects. I think I should print this out and stick it to the bathroom mirror:

Oh Bionic, you are a sweet, sweet noob. Here's the thing: No matter what you are feeling, whether it be emotional or physical, if it is in the slightest way disconcerting, annoying, painful or otherwise negative - in your opinion or the opinions of those near and dear to you - it is always, always because of the drugs. If, on the other hand, you are feeling something positive, it is because you are such an emotionally and physically strong woman that you are able to do the impossible. Namely, you are able to function at a high level despite the added hormones.

Some examples, for clarification purposes:

Road Rage: Drugs
Laughing: You
Small Kitten Cuteness: You
Loud Neighbor Annoyances: Drugs
Inappropriately Unpleasant FB Update: Drugs

All clear?

I <3 Fat Chick. As does my Native Sloth:

Your Questions...ANSWERED

Hey, internet. How's it?

Things are chugging along, chez Bionique. I'm astonished (and a little frightened) to report that I am already feeling occasional soreness in my ovaries. This is getting worse before it's getting better, I know. Oh, well. This is the perfect time in my year to be incapacitated. I'm in between teaching gigs -- I'll start summer school in July -- so I am more or less able to just lie down and whine. Which I plan to.

I've been devouring blogs about IVF lately (surprise), and I keep finding myself reading really old entries and then being annoyed that the author hasn't talked about something or other I'd like to hear. But I'm just as bad, I'm sure -- I'm lousy at keeping track of what I've said here and what I've only obsessed about quietly to myself (read: "yapped Sugar's ear off in re:").

So. Anything you'd like to know? I'll start off with a couple questions that have come up in comments lately and update this post to address questions in the comments.

Kristen asked at some point what we were up to in early August, i.e., are we going to BlogHer. Happily/sadly no, we are not...because we're getting hitched again! Or at any rate, we're having a big party. We are extremely behind in planning same, but the room has been rented, so we're doing it. When we got married in November, we only had our parents and two friends with us, because we thought we'd have a party 1) in decent weather and 2) when we had more time to plan it properly. (We almost didn't even have our parents there, but our two friends -- who have each known one of us our whole lives or close to it -- pointed out that our parents would kill us.) So no BlogHer. I am a bit jealous of all y'all who will be there getting to meet each other and all that, but, well, my wife is pretty damn awesome.


Pomegranate asked what manner of IVF cycle this is -- lupron, antagonist, etc. It's a basic, stripped-down, no fancy-stuff antagonist cycle. We'll do Gonal-F for a bit, then Gonal-F plus Ganirelix, which will keep my eggs from busting out before their time. Then HCG trigger, egg retrieval, progesterone, and transfer, hopefully on day 5.

I don't know all that much about what determines the cycle type they try first, except that I'm thinking it's partly to do with my endometriosis. I gather we endo gals can be not-so-great responders, so maybe that's why no lupron? In case it quiets things down too much?

So far, I'm glad it's this kind of cycle, because I have limited stores of patience, and this one is quick.


So. What else you wanna know?

Helping

So last night Baby had to do her first injection for IVF using a little needle attached to a pen that goes into the flesh around the navel. After a couple of hours of waiting for the on-call doc to call back and explain what to do when the pen dosages don't match up with the dosage instructions (wtf Gonal-F?) it was time to do the deed. Baby swabbed her stomach with antiseptic and then stood there poised. And stood there.

"I can do that, if you want." I said after a few moments.

"Maybe that would be a good idea."

She handed me the pen, told me the procedure, and looked away. So I squeezed a pinch of her stomach and stuck in the needle and depressed the pen. This felt a little creepy. But it was also kind of awesome. This was the first time I felt like I was actually doing something to help this pregnancy thing along. Yay! I helped!

During previous cycles I mainly stood around like a third wheel while the doctor stuck his hand up Baby's hoo-ha and shot in yet some other guy's stuff. It's disorienting to feel like an unnecessary body guard during the possible moment of conception of your own kid. So I'm surprised but pleased to find that moving on to what is a more difficult, physically taxing, and 'medical' attempt to knock Baby up has at least one positive result - involving me in the process. Hopefully it will also work. Fingers crossed . . . .