Fruits (and vegetables) of my womb

DC was initially cautiously unenthusiastic about the idea of a younger sibling. We got a lot of, “Why do you want another baby?” and no amount of “You’re so amazing, etc.” seemed to allay hir confusion and mild anxiety about the idea.

What started getting hir a bit more in tune with the idea was being able to visualize what was going on with the baby. Checking books out from the library helped, but before that we hit up the internets and their multitudinous pregnancy-week-by-week websites. Especially when the site compared the baby’s size to fruit.

We started with grape. Mommy has a grape-sized baby in her belly. “Mommy has a baby-sized grape in her belly?” DC guffawed. Nooooo, a grape-sized baby. This big. “This big?” Every week (on Tuesday) we check for the new fruit. Every week the same ritual. “Mommy has a baby-sized peach/avocado/grapefruit in her belly?” Noooooo, a peach-avocado-grapefruit sized baby! “This big?” This big. Ze did have to ask what a grapefruit was (“Remember that fruit you refused to eat when we went to the bed and breakfast? So mommy ate yours?”)

It has helped. So has being able to feel the baby kick with hir hand to belly.

Pulled from the internets:

week 7: a grain of rice
week 8: raspberry
week 9: grape
week 10: prune
week 11: fig or walnut
week 12: kiwi or lime
week 13: peach
week 14: lemon
week 15: apple
week 16: avocado
week 17: red onion
week 18:  Grapefruit
week 19: large heirloom tomato
week 20: length of a banana
week 21: length of a carrot
week 22: spaghetti squash
week 23: weight of a large mango
week 24: length of an ear of corn
week 25: rutabega
week 26: “an English hothouse cucumber”
week 27: cauliflower
week 28: chinese cabbage
week 29: butternut squash
week 30: cabbage
week 31: four navel oranges
week 32: jicama
week 33: pineapple
week 34: cantaloupe
week 35: honeydew melon
week 36: crenshaw melon
week 37: swiss chard
week 38: leek
week 39: mini-watermelon
week 40: small pumpkin
week 41: baby

If you have more than one child, how did you get the older used to the idea of a younger? (With me it wasn’t an issue as I had been lobbying for a little sister for years before I got one… DC, otoh, has been perfectly happy as an only.)

Wheat

is currently the bane of my existence.

I threw up a lot first trimester.  After all sorts of stuff.  Coming into second trimester (and weaning off metformin), one thing still makes me throw up.

Wheat.

I’ll eat something with wheat in it, purposefully or not.  (Oh, Tempura… Oh, Worcestershire sauce…How you wound me.)  Then an hour or two later, I will empty the contents of my stomach.  I will repeat the process after the next meal no matter what I ate for that second meal.  I will spend the next day or two feeling queasy depending on how much wheat I ingested.

I hate this.

The internet tells me it could be two things.  I could have a wheat allergy or I could have celiac (wheat intolerance is less likely).  Both can be triggered by pregnancy.  If it is an allergy, it might go away.  If it is celiac, I am stuck with it for life.  If it is an allergy, according to the ‘net, it could become life-threatening by suddenly causing me to be unable to breathe (so I should carry around allergy meds just in case).  If celiac, it could hurt the baby’s growth if I’m not careful.

I brought my inability to eat wheat up at the doctor’s appointment and she was all, “Just don’t eat wheat”… and I’m like, Lady, it could be an allergy and could go away or it could be celiac, and celiac is pretty serious.  So basically she was no help.  (This was one of many reasons I switched back to my original doctor the next day, despite doctor #1’s overbooked schedule.)

The internet suggested a test to me to see if it is more likely to be celiac or an allergy (since throwing up is a symptom of either, and it doesn’t stay down long enough to present other symptoms).  Apparently rye has gluten in it, so you can’t eat it if you’re celiac but you can eat it if you’re allergic.  So I ate some rye wasa wafers and was fine, so hopefully the internet is right and it’s an allergy that will go away in a few months (because insulin resistance + celiac = misery).  Of course, I’m a bit sick of rye wasa wafers from overdoing it on them even before the anti-wheat stuff popped up.

I LOVE Indian food.  I love lentil flour.  I love papadam and pakora and methu vada and some of the dosa.  One of our admin assistants told me there’s an Indian place in the city that does gluten-free lentil noodles– man I wish I could try those.  I was loving sushi (cooked or veggie only) until the tempura mistake.  Also sweet potato is on my “ugh” list because a lot of things just don’t taste good anymore once you’ve tried them the other direction.  I’m getting a bit tired of brown rice cakes and a bit tired of oatmeal (recall, I can’t eat refined grains because of glycemic load… so there are a lot of corn, rice, and potato options that are closed to me).  We keep a pot of cooked quinoa or brown rice in the fridge at all times.  Sometimes I’ll use beans in place of noodles.  While the family enjoys spaghetti… I pretend I’m in a different part of Italy.

Last time around I was unable to eat wheat for a while, but it was combined with my inability to keep *anything* except fruit down.  So it wasn’t just the wheat.  And it went away by now, I think.  (My memory is kind of fuzzy at this point, but I think it stopped shortly after 2nd trimester started.  Definitely after I’d gotten off Metformin.)

So… not much point to this post, but that I’m feeling sorry for myself!  I could do wheat-free OR insulin resistant, but doing both SUCKS exponentially.  And I am so glad a good Indian place came to town last year so I can eat there at least once a week.

Why take a Bradley class?

Forget the epidural vs no epidural part.  Bradley classes are a wonderful thing and it would be great if more folks took them, even if planning on pain medication.  I can’t remember exactly, but ours were once a week for a couple of hours for 2-3 months.

Childbirth isn’t 100% natural.  Evolution must have relied on culture in order to make it work, just like breast-feeding doesn’t come 100% naturally.  In the past there were always women around to give tips on what worked for them.   Though, of course, childbirth is more natural than we make it in many hospital settings… for example, I really wanted to squat while pushing, but other heads prevailed and I ended up on my back in a position from which it would be more comfortable for the doctor to catch the baby.

The 1-3 hour childbirth classes from the hospital really don’t cut it when it comes to everything that’s going to happen with the birth and before and after.

The best part of Bradley classes, IMO, is the information on pain management during pregnancy as well as during labor.  The Bradley method heavily borrows from cognitive behavioral therapy techniques (CBT) for relaxation including breathing, positive visualization, progressive muscle relaxation and so on.  Prenatal yoga also borrows some of these techniques, but I’ve been told from people who have done both that the Bradley techniques are better and more focused.  In addition to the CBT techniques, a Bradley class will provide exercises that help stretch or strengthen the exact muscles that need to be stretched or strengthened.  I remember the first day of class when we learned the pelvic tilt– a collective sigh of relief from pain we didn’t realize could go away came from all the prospective mothers.  And I remarked to DH, just learning that one stretch made every penny we’d spent on the class totally worth it.

Bradley classes also provide valuable information for after that helps another unnatural/cultural gap:  breast-feeding.  There are a lot of counter-intuitive things about breast-feeding that cause insecure young moms to doubt their abilities, when in fact, it’s just the natural order of things.  Things like how a newborn’s tummy is the size of a marble and how and when one can expect it to grow, what colostrum is and when milk is expected to come in and what it looks like, where to find help for nursing in the community, and so on.

Yes, it would be great if the doctor’s visits gave this information, but most doctors visits seem to be focused on the medical aspects — blood pressure, what’s in your urine, and drugs, not exercises or relaxation.

I did have a natural childbirth.  It really wasn’t so bad (not like my crippling fear of anesthesiologists).  I don’t particularly buy the propaganda that a natural childbirth is what’s best for the baby, but I tend to believe that it does speed up childbirth in normal cases (I also believe that an epidural can speed up childbirth in a subset of cases), and may help avert c-sections.  I will say that I only know two kinds of mothers who successfully had natural childbirths– those who had premature babies and didn’t make it in time for an epidural and those who took Bradley classes.  (I know a few women who did Lamaze or hypnobirthing, but did not end up with natural births, but I don’t know as many women who did those classes, so it could just be a small n.)

When the contractions came at first, it hurt a lot.  Then my mom, a Bradley class veteran from 20-odd years prior said, “Shouldn’t you be breathing or something?”  And I did.  And my doula timed my contractions in 10 second intervals, just like in that awful exercise in class with the super-cold water (which, btw, hurt more than my contractions), and I alternated a hot shower with a heating pad.  And really, it wasn’t so bad once I remembered to breath.  There were other techniques we learned and tried that didn’t work so well (like the positive visualization or playing the calming CD we’d been listening to while snuggling each night, and other positions and stretches), but other mothers in the class said worked great for them.  The main thought that stuck in my head was, “How do women who didn’t learn these relaxation techniques survive before the pain killer kicks in?”  Unimaginable.

If you ask most Bradley instructors, they’ll tell you that their main job is to give the woman control– control of her birth experience, control of her body, and the ability to trust that she and her birth team are making the right decisions.*  No woman should regret her birth experience.  And I think having information, not only on when a birth goes right, but also information on things that can go wrong and what the various options are and pros and cons for those options so that nothing is a surprise, really does help in that respect.  I knew what to expect during labor and in the delivery room and what the words they used when monitoring meant.  If I’d had to have a c-section I would have known that it was a necessary c-section.  No second guessing, no regrets.  And I think that’s powerful too.

But really, it’s all about the pain management during pregnancy and labor (especially prior to an epidural).  Most awesome thing ever.

Have you taken a Bradley class?  If you’ve given birth, how did you deal with pain before getting to the hospital?

*Yes, some are preachy people who suck.  Sadly that seems to be true in every area of life.  But the ones in our town are the good kind who just want to give women agency so that birth is a positive experience.

Shouldn’t be complaining about m/s

Because the last time I did I had unexplained bleeding.  So I’m not going to complain about it, per se, I’m just going to discuss it.  In reality I am delighted for this constant reminder that the baby is probably still there.

It’s just that my morning sickness is a bit perplexing.

I’m fairly sure it’s caused by a combination of metformin and prenatals and should let up some at the end of first trimester when I can wean off the metformin.  (Well, a combination of metformin, prenatals, and being pregnant… prior to pregnancy there wasn’t so much of the actual throwing up.)

First off, because of the PCOS and insulin resistance, I cannot have sweets.  (DC often reminds me it’s because of the medicine that I can’t have sweets.  That’s not technically correct, but it’s close enough.)  I cannot have refined carbs.  Metformin takes care of a lot of the insulin problem, but I don’t always remember to take it on time (and twice so far I’ve woken up feeling AWESOME… only to realize I forgot to take the previous night’s pill), and I’m fairly sure there’s a two hour window where the extended release is no longer releasing quite so much.  Since it is *probably* (but they don’t know for sure) the insulin spikes that cause the higher increased risk of miscarriage in women with PCOS, it is safest to control that both through diet and through medication.  So no saltines for me.

Of course, saltines wouldn’t work anyway because baked goods with wheat continue to be anathema to me, even the ones I’m allowed to eat. DH made a wonderful banana bread studded with dried apricots and nuts from the New Laurel’s and managed to remove all the refined carbs and I had two big slices and it was delicious (though not as delicious as with sugar would have been)… and then I couldn’t keep it down and that was unpleasant.  So no more banana bread.  I don’t understand why I can’t keep wheat down.  Other people can eat wheat… I’m not normally gluten intolerant and I’m definitely not celiac.  *Sigh*

My body also HATES iron.  I’m often anemic, and have had deficiencies in vit D (taking extra vitamins for this!), vit B12 (though I don’t have that now) and iron (though I don’t have that now).  Prenatals with iron are the most horrible awful things ever.  (Side note:  On the internet people say:  Take the gummy prenatals!  They’re sooo easy to digest!  They’re easy to digest because they have no iron and actually have less of the needed prenatal nutrients than a Centrum.)  This means I recently divested myself of a spinach salad with steak from the most expensive restaurant in town.  For some reason I also don’t like chicken or turkey.  I don’t know why.  I’m still occasionally eating pork, but the problem with pork is that the tastiest kinds disagree with metformin in the other direction (this is something true even without pregnancy), which is painful.  Note to self:  do not eat half a package of bacon or kielbasa when on metformin.

In terms of vitamins, I alternate:  Whole Foods’ only prenatal that doesn’t always get thrown right back up, then Centrum the next day.  On days when I can’t face the Whole Foods prenatal, I take one of DC’s children’s chewables.  A previous doctor told me two children’s chewables would be fine, but ze currently has enough iron in hirs that I can’t keep two down.  Maybe the next batch I will make sure it doesn’t say “with iron” on the package and I’ll do the two children’s chewables.  (There are some important heuristics with prenatals– they need to have more than 100% folic acid, less than 100% vitamin A and so on.)  The evil super-expensive non-formulary prescription prenatals that were supposed to be magical on the stomach sit unused next to the sink.  They did not behave as advertised.

So what do I eat?  I always eat fruit.  Fruit is my best friend in the whole world, and smoothies are my extra special bestest friends.  Oats are also still getting along with me.  My bowl of oatmeal keeps me fortified every morning until 9:30 at least.  I drink a lot of ginger tea.  And fizzy water.  I’m hooked on Knudson Farm “Sparkling Essence”, even though they’re expensive and we have to drive to the city to get them.  Trail mix provides me with substance.  So far sweet potato products seem to get along with me.  Most of the time, but not always, I can do brown rice.  Despite the iron, I occasionally crave beef.  Other times I avoid it like the plague.  I’ve been using beans on occasion in place of say, spaghetti noodles.  Actually not so bad.

Most of the time I can have frozen mixed veggies (microwaved with a pat of butter).  I can eat most kinds of vegetable pickles, including multicultural cabbage pickles (at least of German or South Korean varieties).  Whenever I have to go out with people I order a salad (but no more spinach ever ever again).  I seem to be able to eat a lot of seafood too, though that has to be limited to 2x/week because we’re poisoning our seafood with heavy metals.  I mostly stick to things lower on the food chain for that reason as well.  I ate really well at a sushi place the other week… lots of eel and other cooked seafood.

Also:  thank goodness for ice cream.  If I keep it below a certain level of sugar (and get full-fat), I can eat that.  Occasionally I’ll have a yogurt parfait for breakfast rather than my regular oatmeal.

We’ve completely given up menu planning at our house.  Our eating out expenses have gone way up– if I think of something I can eat and crave, DH rushes out to get it.  And I’m incredibly grateful.  There’s also no Trader Joe’s, so the frozen fruit for my smoothies is a lot more expensive.  Food is my number 1 thought every moment of the day.  Except the brief but frequent moments when I really have to use the restroom.

And the sad thing is…. this was all much worse with DC.  At this point in my last pregnancy, I was eating fruit all day because that was all I could eat and it takes a lot of fruit to fill up a hungry pregnant lady.

Re:  morning sickness medications:  There are none that have been proven both safe and effective.  There is a kind that is available in Canada (but banned in the US) that is supposed to be both.  The first part of my DC pregnancy was in a part of the country that is very leery about giving medications in which the overwhelming preponderance of the evidence isn’t there yet, and I kind of agree with them.  I also know that a lot of these problems are caused by medication and I don’t like taking medication to fix problems caused by medication.  I kind of prefer listening to my body, even though it is sure it does not want as much iron as the doctors think I need.  When it gets really bad I will stop the damn prenatals and do children’s chewables.  And in a few very short weeks I will be able to completely get off Metformin and loosen up on a lot of the carb restrictions (since they’re only contraindications for first and third trimesters, so long as I don’t go crazy).  In the mean time, lots and lots of ginger tea and fizzy water.

update:  It wasn’t iron– it was that the vitamins weren’t gluten-free.

A scare and a heartbeat

On Thursday night I had a bleeding scare.  Brown blood mixed with mucus.  Friday morning we called the doctor and gave them some information.  No, no fever, no intercourse, no chills, yes lower back pain, no abdominal cramps…  They said bedrest (which I know doesn’t work first trimester, but we don’t live in a city) and go to the emergency room if the blood turns red or cramps start.  We asked… should we get a baseline beta (blood test)?  They said sure, why not.

To make a long story short, the bleeding stopped on Sunday and we spent the next few days playing phone tag and finally gave up and changed doctors.  My previous doctor is good, and actually delivered DC as the backup for the amazing OB/GYN who moved to Australia… but it is impossible to get an appointment in her office less than a month in advance, and it is difficult to get in touch with her nurse.  The new doctor recently moved to the area and was able to fit us in in a day’s notice.

So, while waiting to hear back from the nurse about the second beta (if they go down => miscarriage… if they go up… that may be ok or may just be the placenta making hormones), we went to the new doctor and did an ultrasound.  This one was abdominal rather than transvaginal, but the baby and heartbeat showed up just the same.  I cried.  She was also able to give us our beta results since she’s in the same hospital system as our other doctor.  Heartbeat is healthy.  Growth exactly on track.  Everything is fine.  Six days of tension and fear melted away.

Now, the new doctor said some things that aren’t factually correct.  I mentioned my PCOS.  She said, very confidently, there’s no difference in miscarriage rates between PCOS women and normal women.  Maybe I should have contradicted her, but I didn’t say anything given it was our first meeting.  But, if there’s no difference then why the heck am I on 1500mg metformin?  I’m pretty darn sure the only reason I put up with it is because 1500mg metformin has been shown to lower the chance of miscarriage for women with PCOS to that of normal women in the first trimester.  My previous doctor said new research has come out in the past 5 years suggesting I should stay on it for the duration of the pregnancy because even though it doesn’t change chance of miscarriage or stillbirth past first trimester it has been shown to improve other outcomes.

But I can see the new doctor if I have sudden bleeding, and I have to wait up to 4 weeks to see the previous doctor.

The problem is if I have other issues that are beyond her area of expertise.  These days it really seems like you have to become an expert on whatever problems you have.  We do so much asking and suggesting to the doctors based on empirical research and what other women’s doctors in larger cities who really are experts suggest to their patients.  I wish I could have an OB/GYN who is as awesome as DC’s pediatrician.  When we went in to the pedi with a problem we hadn’t the slightest clue about, he was able to look at DC, ask a couple questions, do a couple of tests, diagnose the problem (“Nursemaid’s elbow”), fix it, then explain how to avoid it or fix it ourselves.  If something like that happens to me… I’m just up excrement creek.  As long as things I can Google happen I’m fine, but once I’m out of my league, I really wish I were living in a city.

But the baby is alive.  And for now that’s what is important.  Hopefully there won’t be any more bleeding scares.

And now I can get back to work… there’s a lot of stuff I didn’t do in the past week that really needs to get done.  But it’s much easier to do without that overwhelming worry.

Pregnancy after a loss

I’m afraid to schedule this post.  I’ll update it if I miscarry before Tuesday… it won’t have to be changed much.

As of now I am in the very early stages of a pregnancy.

The first time I got pregnant it was after more than a year and a half of fertility treatment.  I had a monitored clomid cycle (my eggs popped out later than normal) and an IUI.  I got a negative 14 days after ovulation, but a positive a bit after that.  Rising betas, and suddenly I miscarried at 7 weeks.  I’d eaten white bread at a conference the night before.  My reproductive endocrinologist (RE) only believed in Metformin at 500ml, even though the literature has found 1500ml to be effective in getting the early miscarriage rate of women with PCOS to match that of normal women.  Maybe it was just a chromosome abnormality.  I take comfort in the fact that I will never know, but only because I have proof now that I can bring a baby to term; at the time I did not.

Miscarriage is the worst thing that has ever happened to me.  Loss of a wanted pregnancy is a horrible wrenching pain.  I lost a child.

I bled and stopped, I bled again and stopped again.  My betas went down like they were supposed to.  I upped my metformin to 1500 just in case, behind the doctor’s back.  I had a horrific time on a trip when I needed my last beta checked out of town… I had a breakdown because even though we’d set everything up in advance, and were supposed to get the ok with everything someone messed up somewhere and we spent 20 or 30 min trying to deal with the insurance lady when finally we realized if we just gave them $80 in cash they would stop asking me questions.  So we did.  I almost divorced my perfect husband that day.

The RE office wanted us to take a month off from trying (use protection!), then a provera challenge, and then another clomid cycle.  We weren’t sure if we wanted to keep trying.  But since I didn’t cycle by myself I figured I might as well start the provera challenge and then decide given some time.  So I took one of my remaining 40-odd mail order pregnancy tests because you’re supposed to check just in case before taking provera.  There may have been an evaporation line but it was hard to tell so I delayed provera… I wasn’t in a hurry to make the decision so any excuse to delay was fine with me.  The next day it looked less like an evaporation line and more like a faint line.  By that Monday the line was a real line and I called the RE office.  Despite having told us not to try, our tech was excited for me.

I wasn’t ready.  I was in shock.  I didn’t believe it.  I had just bought $600 of professional work clothing literally two days before.  I still hadn’t gone through the stages of grief with my first baby.  I had anger, guilt, and most of all, fear.  I did not want to lose this one.

I took pregnancy test (HPT) after pregnancy test until they drove me crazy with their increases and decreases in darkness.  Turns out my second morning urine is actually the best… has something to do with acidity in some women’s urine.  The ovulation prediction kits (OPK) were much more comforting since they only got darker.  Eventually DH suggested I get rid of the lot so I would stop freaking out so much and I sent them to a friend who was also trying to conceive (along with DH’s leftover Fertility Blend for Men).

I went in and got the blood tests… at 7 weeks I saw the heartbeat… and our child was eventually born.  It was a few months after ze was born before I believed ze wouldn’t just suddenly die.

There was a weird sort of cognitive dissonance for me.  Initially, I was so very afraid of loss, I was afraid to bond with the baby.  But the winning emotion was the thought that each week was another week longer that I got to spend with my precious baby.

Pregnancy after a loss can be frightening.  I didn’t buy any baby items until two and a half weeks before my due date, and even then sent out my mom and husband with a credit card.  We never did get around to buying a crib– we got a pack in play and were going to get a crib when ze hit 3 months but ended up cosleeping instead.

It’s hard to enjoy pregnancy when you think it might be taken from you.  Terrible side effects are a huge comfort because they indicate that the baby is probably still there.  Whenever ze would get still in the calmer second trimester, I would have to drink some orange juice just to make sure ze will still alive and could kick.

I’m worried now.  I’ll be less worried when I see a heartbeat (or maybe just hear it… I’m not sure how the u/s technology is in our small town), and less worried when the baby is born, and probably less worried still when ze is mobile.  And in kindergarten.  And I’m scared… not of the life changes or the increased expenses or time for our oldest… those worries are too far down the line to even dream of.  Almost every moment of the day is spent wondering and wishing and hoping and praying.  I’m afraid to plan too much ahead, afraid to complain, afraid to take anything for granted.  This time around I don’t have a box of OPK or HPT… just the occasional overpriced plastic thing from the drugstore.  (Hint:  ept sucks, go with first response instead.  Pink dye is easier to read than blue.)  Will I have another baby?  I still don’t know.  I hope so.

Here is a list of things not to say to someone who has had a miscarriage.  #2 *always* said the right thing.