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 . . .