One year out

Just have a couple of thoughts as we hit the one year mark (!), not on parenthood but on the aftermath of pregnancy and all the crazy bodily changes, so thought I'd post them here in case they might be of use to somebody else wondering about that later set of indignities.

• So, a number of you are bummed that you had a c-section. Longer hospital stay, recovery from major surgery, further restrictions on your ability to move around and get some part of your life back on track. Thought it might help to hear that vaginal birth is no bed of roses either (and since I got induced, nothing about my delivery really Went The Way I Imagined either, other than avoiding surgery). Anyway, many indignities that have lingered far past the first few weeks, namely,
  
  
  
  1. Hemorrhoids. These were something I never really knew anything about, other than laughing about some ads on late-night TV. Now I know more than I ever wanted! Apparently all that pushing just blows the anal veins into a tangle of complaint. I've been awakened in the night with ass-itch. I've had blood in the toilet after a poop. And I've quadrupled the amount of toilet paper that it takes before I'm convincingly wiping clean. Gross, I know, but there you have it. Preparation H may help, but basically this is just part of my new life (helping me feel old). They apparently don't do surgery for these critters any more, although if the bleeding recurs, I'm going to ask my doctor about UV cauterization...
     
     
  2. Incontinence. Apparently your bladder is one of the things that doesn't bounce back after a pregnancy. The baby squashed it, and now it's settled into a new part of your abdomen. For me, this means that I'll never go padless again -- at least, every cough (including those "it's just cold out here" complaints from your lungs) is likely to mean a few drops, and when I play racquetball, I pretty much pee myself with all the swings and dives and running around. A panty shield is enough most days, but r'ball or a cold mean the maxi. I'm pretty unamused by all this and am likely to go for a fairly common surgery that [insert hand-waving] lifts your bladder and reattaches it to the abdominal wall or something, such that you empty it better and regain better sphincter control. If it weren't for how scary hospital-acquired infections are (and for my gynecologist's lingering belief that I intend another child), I'd have done this one already.
  
  
• Ok, so function in your nether regions isn't too spiffy. How about getting your figure back? I have better news here, but also mixed with catches.
  
  
  
  1. Weight. My advice is to not try to lose weight so long as you're breastfeeding. Some people (including my cousins) lose a ton of weight painlessly during the later months of breast-feeding -- heck, the kid is pulling hundreds of calories at that point -- but most people do not. For my part, I was pretty noteworthily hungry and often had an afternoon muffin snack in addition to the double-oatmeal breakfast that I was powering down and various whole-milk cravings, etc. However, once I weaned, all that dropped away, and I was able to lose weight with a relatively moderate set of changes -- e.g., keeping ice cream out of the house, passing on seconds, getting lots of fruit and vegetables into my meals -- without being hungry or feeling deprived at all. I even ate a full Thanksgiving dinner (complete with all the desserts), had a little chocolate around Christmas, and still managed to lose something like 20 pounds in 4 months and get back into my pre-pregnancy pants. Of course, I only got there in the last month or two, so it's taking a while to remember how I used to dress (and feel!) when I had more than 2-3 pairs of pants to choose from... heh.
     
     
  2. Boobs. I have to separate these out from general weight issues. I went up some 4 bra sizes during pregnancy, stayed there during breastfeeding, and basically, 6 months later am down only one size from the maximum. I gather that these outcomes are completely unpredictable -- you might go back to your previous size, be (or just feel) smaller after "deflation", or stay at some larger size. A lot of folks seem to hope for that last outcome, but for myself, having started at the large end of Sizes You Can Actually Find in Stores, I'm not all that excited, and I may well have troubles in ever buying a dress off the rack again. After a flurry of online shopping, I've found some non-orthopedic-looking bras that make me feel human again, but I'm not getting rid of any of my favorite maternity shirts...

Edit: Almost forgot! Additionally, there was a Weird Hair Thing. The books warn you that during pregnancy you stop shedding hair, so a couple weeks after delivery you may see a lot in the shower drain. Fine. What nobody told me to expect was that six months later, when I stopped breastfeeding, I'd have another hormone shift that would affect my hair -- that is, about a third of it either fell out or broke off. I knew it wasn't looking great, but what with having to pull it back every day (because of Grabby Baby Hands), I didn't realize the extent of the damage until one day I realized that some 1/3-1/2 of my bangs were about 3/4 inch long! A very understanding hair stylist made me feel much better when he shortened my hair all around and "invented" some extra bangs from farther back on my head until such a time as the rest grows back -- the short stuff is still only about half the length of the rest of my bangs (and presumably there's short stuff all over my head too), but I think I can see the end of the tunnel. Still, I thought I'd start feeling human again when I could get back into some of my civilian clothes; didn't expect this other weirdness to hang around!

So, that's all I've got. Hopefully nothing new will turn up. Lots of thoughts on parenthood and the cuteness of my kid, but that's fodder for a different discussion...

The fourth trimester

I feel like I'm remiss in providing some kind of take-home here for the post-pregnancy (that is, Welcome Home Baby!) period of time. There's a lot to say, but I think I can boil it down to a few top points.

1. The first two weeks with the new baby are one of the hardest things/times I've ever been through. You're simultaneously recovering from the physical trauma of labor (and, really, from the last few weeks of pregnancy), while being totally paranoid about this fragile tiny thing you've been entrusted with, and all of that on totally inadequate sleep. It's mind-blowing and perspective-killing. I didn't have any overt post-partum depression, but had plenty of stretches of thinking "People get through this?" in addition to the obvious "they do it more than once??" Days seemed to gape long and difficult, especially once I was on my own during the day. Some tips:
   
   
   
   • Keep visitors at a slow pace. No more than one (or one couple) at a time, no more than an hour per visit, no matter how beloved. That's just how little mental resources you have available. Really, this rule holds for about the first month. (Partner should help run interference, although he's likely to be as brain-fried as you are.)
     
   • Have the house stocked with as many easy-to-prepare meals as possible, and take-out menus handy. You'll be plenty hungry, but have neither brain nor energy to shop or cook.
     
   • Take as many naps as you can. Baby won't always sleep as much as in the first week or so, and you need to make up the deficit whenever you can. Nap on the couch near the basket, on the floor near the crib, or stay in bed with the bassinet nearby. Really, mid-afternoon or whenever. What else do you really have to accomplish?
     
   • Be easy on yourself. I wasn't good for much other than TV (hello, TNT!) and baby advice books for a long time. Just go with it. The idea of reading a book or surfing the Internet will become imaginable again in time. That first trip down the block is a huge victory, but some day you'll go to a nearby restaurant with the kid in the stroller on a whim.
   
   
2. Progress is slow. Yours (see above, heh) and the baby's too -- it's really a sack of potatoes for a long time, just eating and sleeping. Then for a while it's awake in stretches, but just stares blankly, and you feel like you should be entertaining or otherwise stimulating your potatoes, but you don't get much feedback for the waving of toys and jiggling of limbs. Hang in there. The six weeks to that first smile can seem like a long long time. Meantime, you're re-mastering the art of functioning like an adult -- cooking, reading, having conversations of more than a few minutes, leaving the house with the baby. But slowly, like your aches and pains subside.
   
   
3. By the end of three months you'll be in a totally different place. The baby giggles and plays games with you; you're confident about its favorite toys and that it knows who you are; you're probably getting decent stretches of sleep; you are an old hand at diapers, feeding, soothing or singing, etc.; and you have a sense of your baby's temperment and how much of a schedule/rhythm its daily needs have, and you've learned to work within those constraints to do some of the things you used to do. It's important to realize that all these things really will happen, and you'll feel competent again and glad that you undertook this whole project. Of course, just as things start to reach a manageable state, you may be headed back to work, which means finding a whole new balance of life and parenting, but at least you aren't a paranoid zombie, and you've fallen in love with this little spark and its giggle.

That's it in a nutshell -- I really think a "fourth trimester" is a good way to view things, since, while there are many changes and developmental milestones still in the future at that point, there is a unit of "mental arrival" of the kid and recovery of the parent that's quite tangible in this window. I hope that this little summary helps somebody else know what to expect.

Additionally, I recommend finding a mother's group for moral support once you can get out of the house -- lactation support is a good one, or maybe a yoga class for moms and babies -- just for reality checks and social interactions when both seem most lacking. You might get some bonus friends out of it, and it's great to see some older kids so you can look ahead to what's to come at various points. All very helpful as well as fun. Good luck!

Labor report

Ok, here's how it went:

1. Check in (Tuesday evening) around 7:30, sit around for an hour, then get set up for an I.V. (heparin lock), visited by various low-level doctors, given an internal exam, etc. Finally released to go up to Labor and Delivery at, say, 10pm.
   
   
2. In delivery suite, hooked up to an IV (lactated ringers), more visits, finally given Cervidil (to soften cervix) around 11-something. Pretty much set up to spend the night -- changed into a night shirt, took out contacts, etc. Glad I had put in a pillow for labor, as it was much more comfy for sleep than the cheap hospital pillows. Settled in for the night, and managed to sleep a decent amount, despite the incursions of various nurses to check my vitals, replace my IV bag, admire the flow-through in the toilet (which they caught and measured in a little bucket) and test it for keytones, or have me test my blood sugar levels.
   
   
3. Dull morning (Wednesday) as I waited for the Cervidil to reach 12 hours. Spouse came back around 6am and we frittered the morning together, chatting and watching bad TV, etc., while nurses continued with the incursions listed above. [At some point in here I had external fetal monitors (just like those used for the NST's) attached too.]
   
   
4. Eventually they removed the Cervidil, after which we waited around for another hour or two for somebody to certify that everything was ok and we could proceed to the pitocin. Pitocin added to the IV drip, at the lowest level and inched upward. The nurse explained that the goal was to end up with "regular contractions at 2-min. intervals."
   
   
5. We hit regular contractions at 2-minute intervals at the second dose level! Couldn't feel them at all though. (yay?) Sadly, they also didn't cause anything to progress, so we kept the doses inching upward.
   
   
6. Cut ahead several hours, when contractions have been decent sized, just marginally tangible, and going on for some time, but with no progress. (Still around 1 cm dilated.) Haven't even called the doula to come yet, because more bored than stressed -- did a little web surfing during this period. Finally, doctor suggested breaking my water, because we "need to get things going" and because if I'm still not being bothered by any of the contractions, then we're not getting anything done. We agreed with this idea. [Tried to summon the doula at this point, but I think she thought we were consulting her about the water-breaking, so she didn't come until later.]
   
   
7. Aha! feeling the contractions now! eek. Did some walking around, sitting on yoga ball, etc. Best position for weathering contractions appeared to be on ball, leaning back against Spouse, breathing. Whew, hard going. Rode them out for around 2.5 hours, only to find that I'd picked up just over a cm of dilation. I could have weathered that longer, but at that rate, I thought I'd die before I was dilated enough to do anything with.
   
   
8. Asked for an epidural. [Ironically, this is when the doula arrived. She did some nice distracting things like stroking my legs during contractions while we waited for the anesthesiologist, but I fear that we missed the period when her input might have saved me the most.] Application of epidural pretty painless (some odd sensations of cold, etc., along the way), and it started to dull the contractions quite quickly. Once it was all at a steady drip and effectiveness, they turned off the lights so I could get some sleep and recover my strength. [Spouse and doula caught a few z's in chairs in the suite too.]
   
   
9. Something like 1.5 hours later (with pitocin inched up a bit while I was under), I had gone from 3 to 10 cm dilation! They told me it was time to push. The epidural was dialed down a bit so that I could feel enough to push, and off we went! A nurse was urging me on, with cheerleading and describing the sensations I should push toward, and I gripped some handles to pull against while I pushed down. Things got harder as (a) I got more tired and (b) the baby came down far enough that I got no relief from the ache between contractions/pushes. Eventually my legs were being held upward to keep the baby from sliding back too far between pushes (doula held one and Spouse held the other, between grabbing water for me to sip), I was moaning and complaining, but somehow progress was being made. In the end (when a cluster of doctors appeared), it took about 1.5 hours and then the kid was squozen out! They stuck her on my chest, all covered with sticky white goo, but I have to admit that my enjoyment was a bit undermined by the distraction of getting some stitches, having a resident focused on getting the placenta delivered, etc.
   
   
10. From there, some checks for the baby (blood sugar being a primary concern; they gave her formula very early) and then (probably two hours later, but who could say) I was wheeled up to the recovery zone, and two days of timeless introduction to parenthood ensued . . .

Sorry it took me so long to find time and mental energy to summarize all this. Guess that's also it for this space, although I may decide that logging some parental experiences justifies another online venue in the near future. More then.

The future is almost here!

Week 40: Well, this week is when I'm due, and this week is when I'll be induced. (For those who don't know, both my age and my gestational diabetes increase risks of trouble if you go past your due date, largely due to the possibility that the placenta will stop doing its job. So no such option.) In fact, contingent on hospital bed availability, I'll be going in tonight for the first step ("cervical softening" overnight) of induction (which will continue the next day with pitocin to get the real business underway). So if you don't hear from me, that's where I am, with spouse and doula to keep me sane...

You must be kidding

(Still Week 39) Went to a "Babycare basics" class last night, which was useful -- got advice on sponge baths, practice with swaddling and diapers on dolls, and various other tips. However, right in the middle of it I started to have a visual disturbance. It started as a small blurry spot (kind of like the after-effect of a bright light can cause a grey spot briefly) right where I was looking, but gradually spread to encompass a third or so of the left half of my visual field. I initially thought it was an effect of looking at the teacher against a vibrating blue video screen (esp. since it was sort of oscillating), but then it was pretty clear that it was something else. After running some, um, diagnostics (still there with eyes closed; visible in left part of what each eye sees) I got up and got a glass of water, did some deep breathing, made sure I wasn't dizzy, checked my blood sugar, etc. Basically it just hung around for about a half hour (ramping up and then ramping down) and then went away, but everything else was fine.

After the class, since we were already at the hospital, we stopped by the Perinatal Assessment unit and asked whether this was something to worry about (a blood-pressure drop? sign of trouble?). The two results of that were: (1) an additional two hours hanging around the hospital -- a combination of data time (a new non-stress test, bp, urine, a quick neurological work-up, and some other busywork) and down time (waiting for the resident and/or attending to stop by). yawn! (2) Eventually the attending told us that this was not that uncommon (a bunch of the staff had been trading stories about similar incidents during pregnancy) and called it "visual migraine." Because pregnancy hasn't involved screwing up enough systems yet, and I was due for a little malfunction of [blood vessels of] the visual cortex. I mean, really.

So I guess that's water under the bridge, but a bit freaky at the time. I hope that by mentioning it here I can at least reduce the scare factor for any of you guys who might have a similar experience. Let me say, it's just more fuel for my Get This Done, Already jets!

Ready for the next thing!

Week 39: Well, I may have been lucky with aches and pains up until now, but the various discomforts that I described in week 38 have all become quite painful and are starting to switch my mood from amusement with my unweildiness back toward a put-upon morosity. The doctor suggested that my between-belly-and-hip pain might be a hernia, but didn't really advise any intervention other than a support belt (and I get no relief from lifting or clamping my belly, so am unconvinced); I don't really understand hernias, but does that explanation make sense with something that hurts a lot when I walk across the room, but works itself out when I walk a block or two? Anyway, the short-term effect is that I'm no longer commuting (by sidewalk/subway or bus) but am getting rides from Spouse -- I guess if I made it to the last two weeks of pregnancy, that's not so bad. Means the end of just about any exercise that I get, though, except for climbing stairs at the end of the day.

Now we're closing in on my due date (next Friday), which means that we're looking at likely induction in the middle of next week. I did a little prenatal yoga last night to help me relax and encourage Speck to drop (although in the short term it made my hip joints ache, sigh), and will probably spend the next week trying to shift my body and mind from "things to do before Speck gets here -- hold on!" to "ok, now is a good time" and see if that helps move things along a bit. My natural inclinations are non-interventive, but since I'm not really being allowed to wait for labor to start on its own (because of the diabetes et al., however well controlled), I guess I'm leaning toward getting this underway and thus moving on to having a baby! Hope I can follow that through without last-minute unhelpful panic . . .

Flashing the belly

I feel really big, but trying to compare pictures from multi-week intervals, it's hard to see. Anyway, here's the bulge for public admiration...



37.5 weeks when this was taken; 38 weeks today! Doesn't look like this should make it hard for me to walk . . .

Something's up

Weeks 37-38: Generally this period has been more of the same, but in the last 5 days or so (end of wk 37 into wk 38), I've become consistently uncomfortable. Standing up is now a matter of a pained unfolding, walking only partly unkinks that below-belly muscle, and my joints et al. make even a couple of blocks feel like a major undertaking. This may wreak havoc with my commute to work. Also, rolling over in bed at night is not just hard but also somewhat painful, again involving those same belly/hip muscles. I don't know if my belly is just getting larger (although some more t-shirts have been lost from the repetoire) and starting to sag/pull against nearby parts, or if it's something more, but it's a drag, and I'm glad it didn't start before this.

For medical context, I don't think I've had much in the way of contractions, and certainly there's no dilation (and only a little softening) of the cervical realm. [And who designed this rebuild-the-port system??] My doctor says "we're more happy the more uncomfortable you become," which indicates that the aching is probably a sign of some kind of progress, but there's no evidence that the baby has dropped either. So, um, just more for the grump bucket, I guess... Doc is talking about induction either next week (if there is cervical progress) or the week after (if we have to make it all happen from scratch) -- I'm working down the list of old wives' remedies (spicy food, sex, next comes bumpy drives, heh), but it's pretty much up to Speck from here!

Quick out-take

I just thought that, amid all the grumping and recording of symptoms, I should take a moment to recognize that, in fact, I've been pretty lucky on some fronts. In addition to my and Speck's general good health, I've been spared the following common ailments of pregnancy:

1. Morning sickness! This one should count twice, since queasiness really affects your whole life outlook, and I've known people who had to tiptoe around their sensibilities for many months. I wore "sea bands" for a week or two, and I'm eating a lot of ice now, but there was no danger of losing my breakfast at any point. whew!
   
   Edit: this should include the good fortune that I've been able to take prenatal vitamins with no problem (even in the morning!); perhaps it helps that I started months before I was pregnant. Who knows.
   
   
2. Back-ache. I don't know if I was just in pretty good shape going in, or if some combination of the baby's smallness with my build just protected me, but I've made it into the ninth month with no aching back woes. My joints (esp. hips) get stiff, and there are plenty of other discomforts, but again, major back pain is the sort of thing that can color your whole experience to a much more substantial degree, and I appear to have gotten lucky. In fact, have considered a pregnancy girdle, and generally concluded that I don't have any sagging or pulling that needs intervention.
   
   
3. Stretch itch. In fact, only in the last week or so (say, week 35-36) have I had any stretch marks, and then just a couple of them (reddish welts) just in front of my hips (where I have other whiter marks from a weight gain in highschool). Have rubbed my tummy pretty religiously with a pleasant, thick, lanolin/cocoabutter cream from the moment there was a tangible bump, but really haven't had much sense that things were being painfully distorted. (Of course, this might just mean that I was a bit pudgy to begin with, so I did more rearranging than stretching, or it might reflect decent abdominal wall strength holding it all in...)

Hopefully the act of making this list won't tempt the fates. I am having various discomforts now (week 37), especially in finding good sleeping and sitting positions, and am tired and a bit queasy on and off all the time, but pregnancy is a long haul, so anything that's limited to the last <3 weeks is a pretty easy load . . .

Count-down time

Week 36: Well, this is it; anything from here on out is "full term." That means that my busywork doctor appointments now include an internal exam to see whether any dilation or effacement is occuring (no, and a tiny bit), and next week we'll talk about a date for induction, should such be necessary. Meantime, am trying to get one literary project done and out the door, and we're having some folks over this weekend as a last gasp of adults-only gathering time.

Things I'm aware of this week: starting and stopping. That is, when I've been sitting for an hour or so, it's hard to get moving -- in particular, I have a pain in the small geographical expanse below my belly, as though it had been getting bent uncomfortably, and it takes a few minutes of moving around to work it out (and I walk stiffly meantime). Conversely, when I've been walking for a while (as when commuting, but also while doing stuff around the house), I find myself huffing and puffing when I stop; I guess this means it's more effort than it feels like? Anyway, it all makes me feel more afunctional than I already did . . .

The end is near...

Weeks 34-35: Most of my experience now is More of the Same from the last couple posts -- unwieldy belly, very challenging to roll over in bed, lots of kicking at night when I'm trying to get back to sleep after a bathroom trip, chewing ice most of the day. Have had some new belly discomfort -- some feels like a renewal of round ligament stretching, other more achey muscle stuff -- and a couple of definite contractions; not sure whether they were isolated "real contractions" or belated Braxton-Hicks (which I've otherwise never perceived), but I decided to sit with my feet up and wait them out. Also, I have a very faint vertical line on my belly now, from a few inches above to a couple inches below -- almost subliminal, but real. That was described as something that might happen months ago, but I guess not (or my pigmentation is so low generally that it took until now to be perceptible, heh).

The main thing is that delivery is starting to seem like a concrete thing (not a threat, but the next thing to work out). Have packed a bag (actually two -- one with me/baby stuff for hospital stay, and one with comfort/distraction stuff for labor itself), but it's still upstairs for another week or two. We're having some people over this weekend, as a last blast of adult-only socializing, and basically I have to be prepared that things could happen any time after that. (After 36 weeks is full term anyway, and they'll induce by my due date if need be.) Has lit a fire under me in terms of the couple of intellectual projects I want done before Speck arrives!

More low-level tribulations

Week 32: Well, my bellybutton is essentially gone -- it's flat, with a little bruising below (part of stretching, or did I just bang it into something?). This comes close to grossing me out, irrationally. Additionally I've had some periods of mild nausea -- out come the sea bands again -- and the heartburn is a constant friend to the tune of some half-dozen Tums per day (and into the night), although I can get away with no propping in bed. Of course, my belly is starting to make it just a bit harder to get comfortable to sleep, although the pregnancy pillow helps, and Speck is into rumba overtime whenever I'm still, including some impressive somersaults at night and other activity that I've described as "weasel in a bag"...

Made a note to mention two things that developed a while back but never got mentioned here: freckles and skin tags. The latter developed really early (month 3?), perhaps in response to the heat; I have a bunch under one armpit (not the other!), and little bitty ones under my breasts. I understand that they stick around, yay. As for the freckles, I have red hair, so have lots normally (light in winter, darker in warm months), but there have definitely been changes in my chest area. (1) Reasonably early I got a couple of large dark freckles on each breast -- like near-black. (2) I got a number of new/darker small freckles on my upper chest and onto my neck sometime later; the top of this smatter is visible in a crewneck (and odd for this time of year). (3) I am just starting to get a third wave of large light freckles all around and onto my breasts. Now, I haven't been sunbathing (heh), or really even spending an unusual amount of time nude in the (sunny) bedroom. So I just have to guess that skin pigment is another system that in some way responds to hormones...

Week 33: Ugh. Had several nights this week of insomnia. It felt physical; surprisingly, not my unweildy belly, but just sort of restless leg action. I'd get all comfy (and I'm plenty tired) and then fidget, kick around, etc. for ... a couple of hours. One night I think I got all of 4 hours sleep by the end, and that night I even propped myself up. I've tried taking a Tum (in case I'm missing some low-level heartburn), Tylenol (because my hips do get achey), water, potty visits, and the usual distractions one tries in the wee hours, all to little avail. Luckily, I slept like the dead last night, so back to semi-functional to wrap up the week.

On other fronts, I have some odd low-level gut sensations that are just short of nausea but also a bit much to overlook (especially in the car). I find that sucking on/eating ice seems to dull it, so am spending a lot of time either eating ice or fantasizing about it. (It's not just thirst.) Spent a lot of my holiday vacation sitting around with cups of chipped ice nearby...

Also new this week is the start of new medical fun: non-stress tests. They're doing them on me in part because of my age and in part because of the diabetes, but essentially they seem like a sort of physiological test for the baby's well-being. You sit in a recliner with a couple of monitors strapped to your stomach (one for the baby's heartbeat, the other apparently to watch for contractions) for, say, 20 minutes, and then the doctor just looks at the chart (which has been tracing two needle-lines like an EKG). My experience doesn't entirely jibe with descriptions I read online, but I guess they're just looking for a steady heart-rate that occasionally jumps upward (presumably when Speck moves around), rather than showing any drops (that might indicate distress of various types). I'm going to have this test weekly for a while, although they threaten a biweekly frequency as we get toward the end -- eek! (I feel like I'm doing tons of medical busy-work visits already!) One amusing point: folks keep giving me charts to monitor fetal activity via kick-counts -- as though I ever go more than ten minutes while sitting without a full karate exhibition! hah, you can keep the form.

Becoming unweildy

Week 31: Well, the belly is definitely becoming the defining aspect of my experience now. I struggle to roll over in bed at night, am awakened by discomfort in abdomen and hips, get out of breath doing simple things, find it increasingly difficult to work my shoes and socks. (And, you know, find my tiny line of belly fat, way down there almost out of sight, when insulin time rolls around.) Have also had a couple of bouts of nausea that kept me lying on a couch, and every time I stretch in bed I risk triggering a series of leg cramps (at any level of my leg!!)... Plus, Speck's little kicks and roiling have become pretty eye-opening all on their own at times.

At the same time, I find it faintly alarming that we're down to a two-month countdown! The bedroom may be ready, but there's still plenty on the To Do list!

Shoe-drop, part B

(Still Week 30) Looks like it's insulin for me, three times per day for the duration.



Somewhat a relief, as I don't like the idea of following this for another week (we're already two past the test) without doing something to spare Speck the sugar overload and consequent risks (not to mention the prospect of delivering a linebacker). Will take some tweaking, based on my ongoing finger-pricks, to get the doses just right, and I could imagine a need to space my meals more evenly than the default, but still, I should be able to handle this -- am pretty capable with a needle, motivated, and already a high-compliance patient. (I once would have fretted about the possibility of needles, but some of my pre-pregnancy experience involved small injections with the same kind of syringes, so I know they're virtually painless.)

The other shoe drops

Weeks 29-30: Well. I knew that this eye-of-the-hurricane period couldn't last, that the transition into the final weeks' growth spurt and other physical changes would mean some kind of shift in my experience again. But I wasn't really expecting the big news to be this: gestational diabetes. My weight gain is in the target range, my belly is the right size, I'm active (in a lumbering but regular way) and eat mostly healthily, but none of that matters. The hormone surge makes your cells insulin-resistant, and either your pancreas can ramp up insulin production to compensate, or it can't. Apparently mine can't. And that brings all kinds of risks for the baby, from huge size to delivery complications, so we want to get it under control...

So, I got some equipment last week for testing my blood sugar, and then had home visits from an R.N. to explain the concerns and interventions, and from a dietician to lay out a new (and somewhat bizarre) mode of eating that I should follow, in hopes that that (and getting exercise) will be enough. Basically it involves making meals smaller and having more snacks, and also making sure that you never have carbs (bread, milk, fruit) at a time that you don't also have protein. Logical, but not how most people eat. Not least, my morning Cheerios should have eggs alongside, and I'll have cheese cubes or nuts as snacks between every meal, measure down lunch and dinner, blah blah. It's manageable, but means much more attention to food than one would prefer to need. And I'm aware of being hungry much more often, without knowing whether it's a symptom of the diabetes or just the next phase of pregnancy. (The same could be said of any number of belly sensations. meh.)

After a few days of this regulation, I'll report the results (from those many finger-pricks per day) to the nurse and my doctor, and either things will be ok or they'll decide I need insulin shots. I rather suspect the latter, given my early blood readings and the fact that I'm already active, etc., so may not gain much through the lifestyle recommendations. But who knows.

Initially I found this news/diagnosis very depressing. I think I've been rather proud of my general fitness and careful handling of the pregnancy, and this felt like all that had failed, somehow. Also, going from a near-normal period to a medically regimented lifestyle is about the worst transition that could come, short of late-stage morning sickness. But I'm feeling a bit calmer about it all just now, probably from the combination of Spouse's rising to the challenge of helping me figure out meals and snacks that will work with the regimen, plus my natural geeky/scientific tendencies that fit well with the careful blood sugar note-taking, spiffy gizmo involved, etc.


In other news, I've also been warned that the third trimester can bring a return of some first trimester symptoms, including nausea and progesterone-based mood-dampening, which should really dovetail nicely with my new hypochondria and related worries. Looking like a fun stretch ahead!

New theme II: The rumba

Week 28: Man, when I first felt Speck kicking, it was a faint flutter that I only gradually learned to distinguish from gas bubbles or other internal shenanigans. Well, no longer! It seems like any time I'm sitting down (i.e., most of the day), she's flipping around in there, sometimes giving me a two-foot rabbit kick, and generally constantly active. Much of this is mighty enough that you could feel it outside my clothes really moving my belly (although the vast majority of the action is still down in the bikini zone, so not really getting shared with the general public). Somewhere between amusing and distracting/annoying. I guess I can expect the motion to feel a bit less wild as the space in there gets tighter (Speck is currently estimated around 2.5 pounds), but of course there will be more muscle behind it too. Not sure whether this is something I look forward to or dread . . .

In other news, appetite remains "normal" by pre-pregnancy standards, indigestion a regular thing (but Tums and Zantac effective), energy generally good (although residual cough and holiday flurry mean I'm not at max, but who ever is?), foot swelling less of a problem, belly tight (almost muscle-achey). More updates as situation changes, heh.

New theme: The Belly

Week 27: Making an entry now with what I forecast will be the increasing theme of the months ahead: my belly taking over my life. It's not that it's so much bigger than a few weeks ago, but it's starting to be a tangible presence in ways that are a little hard to put a finger on. Yes, I'm losing a few more shirts from my repertoire, but a it's more a steady feeling of tightness at the muscle level (not just skin stretch) and a lack of forgiveness after larger meals. Speck is some two pounds now, and going to at least triple that over the next three months, so I suspect that the shifts in available space (for food, air, etc.) will become more noticeable, and there may be shifts in posture and new muscle aches to follow. More when I see how this pans out...

Fighting with myself

Weeks 25-26: Despite having a flu shot the month before, I have some kind of a bad cold or a mild flu that has me coughing incessantly. Sadly, I am Forbidden (again) from many familiar remedies, and Spouse spent some time stalking the obscure back corners of the pharmacy to find drugs from the Allowed list that might provide some relief. (It got bad enough that I had to sleep on the couch where I could prop myself nearly vertical and thus weather some of the phlegmy assaults and coughing fits. meh.) No fever or nausea, but I do have my usual sickness-related decline in appetite, so Speck had to make due with a trickle of bullion, juice, and tea for the worst of it while my feeble immune system tried to get the upper hand.

Pregnancy-specific aspects of this suffering period include not only concerns about my diet (although I've put on enough stores already that I'm sure there was no fetal starvation threatened) but the war between my need to minimize coughing and my desire to minimize heartburn: for example, milk helps with the latter but makes the former worse, and the reverse for, say, lemon tea... Also, night coughing means getting more and more tired, just when I could really use some reserves for the ongoing paint battle, etc., and sometimes I can't get quite a deep enough breath to really get the job done. The only good thing about the timing of all this was that my depleted sick days were somewhat spared because I had already taken off one day in the worst part (for Election Day, which I barely worked) and had planned to work at home a second day that same week, so a couple of low-function work days and one under a quilt got me through. Cough still not gone, after two weeks (and even 10 days of optimistic Amoxicillin use), but I think it's a combination of exhaustion and allergies at this point. Perhaps the Thanksgiving holiday will give me a respite. My rib muscles ache from all the coughing.

The eye of the hurricane

Weeks 22-23: I'm starting to feel better on the hunger front (less urgency less often), ok on energy (although the joint arrival of a contractor and two houseguests threatens that). On the down side, I'm starting to develop more belly, with the result that it gets ever harder to bend over, tie my shoes, etc. On the wacky side, I feel my first kicks, which it takes me a little while to recognize, since they feel more like gas bubbles than anything else. (Or perhaps like a goldfish careening off the sides of the bowl.)

Week 24: The snacking drive is almost entirely gone -- I can now eat meals at my usual (fairly long) intervals, and I don't need a late-night smackerel to make sure I don't wake up hungry in the wee hours. A welcome relief, although I expect a new onslaught of hunger when the big growth spurt hits in the next month or so. Also, I feel almost 95% myself now mentally (although that's a bit susceptible to the distance of memory, heh), taking on household tasks and updating web pages like a new person (probably slightly in excess of what's reasonable, but there's so much to paint!!). Sleep-wise, things are a bit better (with the introduction of Zantac into my evening routine) and also a bit worse (between stiff joints and the return of the nasal drip/cough) . . .

Shifting gears

Weeks 18-20: This appears to be a transitional period. On the one hand, my reward-response structure is normalizing, with the return of my desire to play my online game, slight decrease in the frequency/urgency of snacking, return of more energy, etc. On the other hand, foot swelling continuing, and in week 19 I find I'm having trouble crossing my legs -- some combination of the larger stomach with changes in overall weight and joint stiffness. (I can make my legs cross, but it's no longer an alternate rest position. meh.) My in-laws made me laugh hard, and scored some major points, with the card at the right; seems a good summary.

I should also note, having somehow left this out, that I'm several (four?) bra sizes up from where I started (having started to grow around 6 or 8 weeks along), but the flurry of bra purchases seems to have stopped. Don't know whether there will be another burst of growth toward the end of pregnancy (and preparation for milk), or whether I'll be about this size. It's definitely a factor now in the determination of whether an item of my clothing still fits, but otherwise this seems manageable, and so far I haven't had to sleep in a bra (which a cousin counselled me to expect) or anything like that. For anybody else who is well-endowed to begin with and looking for something comfortable in these new sizes, I really recommend this bra, which gives good support, has the material characteristics (wicking, etc.) of a sports bra (designed for "that ultimate 9-5 sport"), and keeps the wires out where they don't press on breast tissue and give you problems. What maternity shops sell are nursing bras, which will be needed eventually but right now just mean limited selection and unnecessary padding...

Week 21: It got cool enough for my long maternity pants to come into play, and also some fall/leather shoes. Or rather, the latter might have, if anything fit. Looks like I'll be in sneakers and one pair of lace leather shoes for most of the cold months. (One hates to sink money into shoes for 3-4 months of wear ever!) My fingers are getting a bit of the puffiness that my ankles have suffered, making me wonder whether my wedding ring will eventually go the way of my engagement ring (which is to say, somewhere that won't involve cutting my finger off)...