Or, if you prefer They Might Be Giants to Alice in Wonderland, “It’s not my birthday, it’s not today!”

Last night was quite a night. I finally understand the contractions that people always talk about; all of my others have been silent or at least painless. This time they were 3-4 minutes apart for hours, and painful. If I consider them painful, that’s saying a lot — the doc estimates that my 5 out of 10 pain rating might be someone else’s 10 out of 10. My bizarrely high pain tolerance is sometimes unhelpful (as when I didn’t feel any contractions at all at 28w), sometimes handy. “Do you want pain medication for the contractions? We can give you the medication we give to women in labor.” Naah, 6 out of 10 pain I can take. The pill pushers (and IV pushers) don’t know what to do with me.

Somehow, despite many hours of full-blown contractions last night, my cervix stayed at 5 cm. And eventually the mag kicked in, and the contractions have stopped.

My reaction to the drugs is also blowing minds around here. With my first mag experience at 28w, I had plenty of side effects, but fewer than average. This time, almost nothing. It’s having the desired effect, but so far not the usual side effects. Vastly preferable to my reaction to fertility medications, where the desired effect was on the low side (except for Infamous IUI #7 in which I had enough follicles to set new world records for higher-order multiples) but I had plenty of bitchy side effects. All of the good and none of the bad on mag? Am I being punked?

The head perinatologist doesn’t think I’ll give birth today, or even tomorrow. I’ll stay on the mag for two more days, long enough for this round of steroids (first was at 28w when I was originally admitted) to take full effect, and then we’ll see what happens. If my cervix resumes dilating during or after the mag, we’ll just deliver.

Know what that means?

October! T minus 4 hours and counting.

In my mind, the plan to stay on mag for a couple of days is the doctors’ secret plot to get me to October. Of course I know it’s not, and DH thinks I’m obsessed with October, but a girl’s gotta have goals.

No matter how long it takes (very likely this week, but maybe at 34w, probably not beyond), I’m definitely having the babies here in this big hospital (>1 hour from home) instead of at the little hospital 15 minutes from the house. Now that I’m this far dilated, they won’t release me, and my regular OB won’t take me back! I feel more confident about the care for myself and especially the babies here, with a proper NICU and high-risk OBs/MFMs on the premises 24/7 for whom my case is no big deal rather than frightening.

As my bloggy friend Carrie (30.5w along with triplets) has been saying since August, “October or Bust!” At the risk of jinxing us, it looks like we made it!

Now I have to come up with a new goal. How about “as long as possible”? Or “any day that’s not today”?

33w: Milestones

September 29, 2009

When I was admitted to the hospital five weeks ago, I had a series of milestones in my mind that I wanted to achieve before giving birth.

Not August? Check.

DH’s birthday? Check.

Autumn? Check.

The Jewish New Year of 5770? Check.

Past the Days of Awe and Yom Kippur? Check. (Bedrest and hospitalization did not allow for Tashlich, so last year’s will have to do).

October? Hmm…

I’m back in the hospital at 33w. 5 cm dilated, having more contractions. Can these babies wait another 26 hours until October? I’ll let you know either way.

I’m not afraid for their health anymore. But I’m a little freaked out that after all these years, I’m finally going to meet my babies.

Put To The Test

September 29, 2009

[Pregnancy update for those who have been concerned due to my silence over the past few days: 33 weeks today. Still at home for now. As of yesterday, cervix dilating a bit more and Baby A’s head apparently can be felt through the cervix, so I have no idea whether birth is imminent, whether I’ll be back in the hospital tomorrow, or whether I’ll be able to come home after I see the perinatologist. I will post something in the evening so that I don’t leave anyone anxious with suspense.]

A year ago I wrote about an old friend of mine, one who is likely to struggle with infertility due to her medical history. I also wrote about how we’re no longer close enough for me to bring up such topics.

Today, after almost a year since our last contact, she emailed me, asking if anything was new.

Obviously, being 33 weeks pregnant with twins qualifies as news.

Here is my chance to practice what infertiles preach: the art of the gentle pregnancy announcement.

  1. Do I just tell her about the impending babies, and that’s that?
  2. Do I tell her about the babies with a subtle hint about the length of time we’ve been waiting, leaving the door open for her if she wants to talk about IF?
  3. Do I flat-out tell her how these babies came to be, and extend the hand of infertile friendship?

1 or 2 would be my natural inclination, but I wonder if the situation calls for 3.

What would you do if you were me? That is, what would you do if you were generally secretive and taciturn, but also trying to be caring and helpful to someone who was your close friend more than a decade ago but is now a very casual acquaintance?

Thoughtful ThursdayOver a year ago, Mel wrote a BlogHer post on the topic of purchasing baby items during post-infertility pregnancy. Many fertiles seem to run out and create a registry before the pee stick is dry. A lot of infertiles, on the other hand, are too fearful of something going wrong to make purchases, especially if they’ve experienced prior losses. In the comment section of Mel’s BlogHer post, Lori had a turn of phrase that I particularly liked: “Don’t buy until you see the whites of their eyes.” She didn’t buy anything at all until after the birth of her daughter.

Here is the progression of my thinking about buying baby items during pregnancy.

  • Too early
  • Too early
  • Too early
  • Hmm better start thinking about it; I’ll make a registry but I won’t show it to anyone
  • I’ll get a few things but it’s still too early to make major purchases
  • Let’s see what other people give us
  • Eek! I almost went into labor and we have none of the essentials!
  • I can’t very well buy things when I’m afraid of losing one or both babies
  • We’ve passed the danger zone, I guess we’d better get moving and stock up
  • What am I waiting for?

…which brings me to now. I actually might have put off major purchases even longer, but during the drive home from the hospital on Tuesday, DH declared, “The registry. We need to get going, now.”

I had basically nothing whatsoever for the babies (if you don’t count a couple of things I bought in Spain right after the first BFP like a mobile and a rattle) until the 4th month of pregnancy. I visited a Mothers of Multiples sale (just to scope it out) and bought a few clothes and a few toys at low low prices, but nothing big.

During the 5th month of pregnancy, I visited a close friend who is parenting twins after infertility. She gave me all sorts of hand-me-downs, mostly clothes. Suddenly I had full wardrobes for the babies’ first 6 months and partial wardrobes for the next 6 months.

Then I visited my mother-in-law, who heaped all sorts of garage sale purchases upon us. We rejected about half of what she bought, and we still filled up our entire car trunk and back seat.

Then came a CraigsList phase. I checked the listings many times a day. Via 4 transactions, I filled out the rest of the babies’ wardrobes for their first year, plus a few bigger purchases like swings and slings.

Suddenly the babies’ room, my home office (which essentially serves as a big filing cabinet), and the linen closet were filled with brightly colored plastic and cozy cotton. But still, I didn’t have essential items like cribs or car seats.

It was a little embarrassing when, on the day of my big preterm labor scare, both hospitals asked if I was “prepared” for the babies and I had to say no. Not that embarrassment was my biggest concern that day.

My fear-based procrastination was vindicated somewhat when I met with a neonatologist. He commended us for not having car seats yet, because we don’t know how much the babies will weigh and many seats are too big for preemies to leave the hospital. He told us not to buy car seats until the babies are born. We will probably buy them once the babies’ weights pass the minimum size for those car seats, hopefully in a couple of weeks.

Now, at DH’s insistence, the wheels are in motion. Apparently these babies really are coming, and with (most likely) less than a month to go, I’d better get ready. Family members have started picking items off the registry, and soon the babies’ room will be bursting with paraphernalia. Any procrastination on my part at this point is based on bedrest fatigue, not fear.

Does infertility/loss affect your attitude toward preparing for a baby’s arrival?

32w1d: Tuesday

September 23, 2009

Tuesdays are the best day of the week: the day the babies’ gestational age turns over. It all started when I had my IUI on a Tuesday, way back when, and since then every Tuesday has been “turnover day.”

On Tuesdays I systematically go through the different online week-by-week fetal development websites, and learn that my babies are now the size of jicamas or that their toenails are fully developed.

On Tuesdays I open the spreadsheet I made to track gestational age and post-birth visitors (which requires all sorts of if/then decision trees). Maybe the best moment of the week is deleting the prior week’s gestational age column — yesterday, goodbye 31w. It simultaneously satisfies my OCD list mentality and also signals that yes, we really have reached a new milestone. The projected NICU stay goes down by one week with each deletion. It’s no longer out of the question that they might have little or no NICU time at all. This little ritual has become even more meaningful since I was hospitalized a month ago for preterm labor. The initial prognosis when I was having contractions 4 minutes apart and dilating quickly was that I might deliver that day (28w0d) but that maximum I’d maybe make it to 31w or 32w. 32 weeks, here I am.

On Tuesdays (and now also Fridays, since I’ve been in the hospital) I have an ultrasound, and every other Tuesday it’s an extended ultrasound to measure their growth. When I’m on the table, I say to myself that this is the best moment of the week. Listening to their heartbeats has lost its novelty after being hooked up to the TOCO and fetal monitors for more than an hour each day (down from over 2 hours per day when I was first hospitalized), but the ultrasound thrills me every time.

Yesterday was an even better every-other-Tuesday than usual, because I came home from the hospital. I was so afraid to leave the hospital a couple of weeks ago, but now it sure is good to be home.

Murphy

September 21, 2009

I knew it. I just knew it.

Less than a week after predicting that the eldest of DH’s younger siblings would probably have a baby in 2010, and that I’d win the baby race by only the tiniest margin, I found out she is pregnant after all. I found out one day after she POAS. She got pregnant the first cycle after going off the Pill. The Pill that she’s been on since I first met her, over 15 years ago. And I am the only person she has told about the pregnancy. Now I must counsel her daily on pregnancy symptoms and crib safety and how long her wedding dress will still fit and when she should announce to the family and which hand-me-downs I will be giving her. Did I mention that she is 4 weeks pregnant?

After DH read my Dibs post, he said, “Not 2010! Maybe 2011.” And I corrected him, “No, 2010.”

DH: She’s not even getting married until the summer.
Me: But she’s already pulled the goalie. She’s just gone off the pill.
DH: How do you know?
Me: Don’t ask me why, but she confided in me.
DH: That’s really weird. You’re not close at all.
Me; Yup.
DH: What is her hurry?
Me: It probably has something to do with me being pregnant. Who knows.
DH: But you have no way of knowing that she’ll get pregnant right away. Maybe it will take 7 years like it did for us, and she’ll have a baby in 2017.
Me: No, it will be the first cycle that she tries.
DH: Why?
Me: Murphy’s Law.

At least I saw you coming this time, Murphy, you bastard.

Thoughtful Thursday: Patient

September 17, 2009

Thoughtful ThursdayInfertility has tried my patience, and it has made me more patient, but that’s not the kind of patient I mean.

What kind of patient are you? How has infertility changed that?

In all realms of life, I straddle a line between following directions and thinking for myself. My rejection of directions is usually based on some combination of logic, my own research, my assessment of the validity of the directions, and doing what I feel like.

This certainly applies to health care. For example, after I had my wisdom teeth removed, I followed all of the instructions for cleaning the extraction sites, but I completely ignored the prescription for narcotics. After the day of surgery, I didn’t even take any Advil.

During infertility treatments, I almost always followed directions to the letter, except when I thought they didn’t matter. For instance, when I was told not to eat after midnight prior to IVF #2 retrieval, I bumped back the time on my own because my retrieval was scheduled for late morning. I know the purpose of being NPO, and I also know that the midnight instruction is the same whether the surgery is at 6 a.m. or 11 a.m. If six hours of fasting is enough for an early morning appointment, then it should be enough for a late morning appointment, in which case eating something at 4 a.m. is fine.

My most egregious case of ignoring doctor’s orders occurred during the infamous IUI #7, in which we didn’t bother to have sex in addition to the IUI because in my mind the whole cycle was pointless anyway. Result: currently 31w2d pregnant with twins.

As a pregnant woman, I have been amazingly dutiful. I have followed doctors’ and books’ recommendations as much as possible (as a vegetarian, 100 grams of protein requires a lot of work but is feasible, but 150 or 200 grams just doesn’t happen no matter how hard I try). When advice has conflicted, I’ve evaluated the relative merits and acted on what seemed to be the most prudent course of action.

And then my cervix started shortening and I was put on bedrest. I followed bedrest instructions to the letter (didn’t go anywhere outside the house except the doctor, didn’t sit up for more than 15 minutes at a time for meals, etc.).

And then I went into preterm labor and I was admitted to the hospital.

This whole time, doctors have remarked on what a “good bedrester” I was and continue to be. They tell me how some other patients interpret bedrest as cutting down on housework or being quicker about grocery shopping. When DH said to the head perinatologist that a high-activity day on bedrest for me meant that I went up the stairs once to go to the kitchen, she laughed.

They’ve been pleased, and a little bewildered, at my openness to staying in the hospital as long as they deem medically necessary. They talk about patients fighting to be discharged — particularly those with other children at home, or those whose husbands are incompetent/unwilling with housework. When I told DH about the latter, he got a little defensive and said, “You told them I’m not like that, right? That I’m not one of those husbands?” I certainly couldn’t manage total inactivity without his constant help.

Doctors and nurses have remarked on my cheerfulness, and one doctor makes fun of me for being so cheerful. They applaud my wisdom when I give them my stock explanation for my compliance and good attitude: Better here than in the NICU.

How did I get to the point of winning some sort of Best Patient award? Sure, I try to maintain perspective in everything I do. But in this case, I’m a model preterm labor patient because I dealt with seven years of infertility, and because I read infertility and loss blogs. It took a hell of a lot of time, money, and work to get this far. The stakes are clearly higher for me than they are for the patients down the hall that the nurses roll their eyes about, the ones who are still smoking (WTF?). Because of the heartache of my bloggy friends, I know that not all babies turn out fine, and I know that some babies die. Often there’s nothing that the woman or anyone else could have done — but if there’s anything I can do to help these babies make it into the world safely? You’d better believe I’ll do it.

What kind of patient are you? How has infertility changed that?