Old News: Past Blog Posts

Saturday, December 20, 2014

Dear NICU Mom

Dear NICU mom,

I saw you this morning in your hospital gown, an IV dangling from your forearm. You were half raised from your chair and peering into a lonely isolette at a tiny miracle, sleeping soundly amid leads and wires and monitors. That expression on your face spoke a billion words to me and made me want to give you a hug that could maybe speak a few words back.  

But I didn't want to be creepy, so I just walked on by and instead, I am writing you this letter that you will never read.  

See, there are some things you should know that might just help you get to the other side of this; some things I am still learning on this, my third trip through the NICU.
You should know that you will be okay. Despite what may come and how you may get there, today will eventually be nothing bigger than a memory and you will only be stronger than you were even just a moment ago.  

You should know it's okay to feel whatever you are feeling. I saw your eyes go watery and I heard that stuttered sniff and I know you were swallowing back tears. Please know, you are allowed to be sad and scared and confused and yes, even angry. Watching your baby -- literally a piece of you -- born too soon or too sick, struggling with even the most basic needs, is just barely one step shy of maddening. Plus, the new-mom hormones make it difficult to get through a Pampers commercial with dry eyes, so guess what, you get a free pass on this one. 

Cry. Do it. Whether it's at your baby's bedside or in the middle of the supermarket checkout line. The urge will hit you both places, trust me. And you know something? People may get uncomfortable for a minute, but they will most definitely get over it and you'll feel always better after you give in to the tears.

You should know that sometimes these things just happen. There has been no adequate explanation for my early babies. It makes me frustrated and discouraged and yes, pissed that no matter what I do, I can't seem to carry a baby past 34 weeks. I followed all the rules, went to all my appointments, took all the vitamins and quit eating and drinking all the appropriate things. By this, my third pregnancy, I did some pretty drastic things involving a carefully selected specialist, activity modification, a very uncomfortable surgery, and more drugs than I can count, yet here we are again. 

It's easy for John Q Nobody to think that NICU moms brought this situation on themselves, and it's easy for us to worry that maybe he's right. Sure, there are unfortunate circumstances when mom's decisions during pregnancy may increase the risk of landing in the NICU. But you know who you are in your heart and what sort of mom you are capable of becoming, so quit worrying about what Mr Nobody thinks and focus your efforts on things you can control.

Speaking of control, you should know that you will have very little of that, but welcome to motherhood (preemie or otherwise). Try to engage as best you can in your baby's care and put some trust out there in the doctors and nurses and therapists and whatever higher power you might be familiar with. It may not be easy or comfortable but it will be necessary. 

You should know that you may feel a little bit alone. People don't always know how to react to a sick or early baby and sometimes it's easier for them to just not react, or they might not say all the 'right' things. You may find yourself doing your postpartum shuffle past the healthy newborn nursery and feel a pang of jealousy for all the plump, sleeping newborns, free from monitors and g-tubes who will go home with their families in a day or so. You may develop a yearning to connect with someone -- anyone -- who can understand and commiserate with your complicated feelings and help break you free from this strong sense of isolation. 

Finally, you should know that you are stronger than you think. Just because you are presently being held hostage by your postpartum hormones and just about everything makes you cry, it doesn't mean you are weak. You are strong enough to wake several times in the night to a hospital grade breast pump instead of to a crying baby. You are strong enough to march (ok, waddle) in and out of the NICU several times a day to participate in cluster care and allow your infant feel the heat of your skin on his. You are strong enough to immerse yourself in medical terms like 'O2 saturations' and 'tachycardia' and 'gavage.'  You might even be strong enough to walk that narrow and delicate balance beam between parenting a newborn in the NICU and parenting a toddler or two at home. I won't lie. At times it will seem damn near impossible and like you are completely flailing, but I promise you that you can do this. 

I'll say it again, because it bears repeating: You should know you will be okay.

Best of luck, 
Another NICU Mom

Wednesday, December 17, 2014

The Epic Week of Delivery: PART THREE



Friday I am antsy. I wake up feeling compelled to do things. I am determined to finish addressing Christmas cards. I move and fold laundry and carry small stacks of it up the steps to put away.  

And it's not just me, apparently. Our new mattress is delivered unexpectedly and we get a visit from the furniture store to repair some minor dings from the delivery of our head board and night stand. 

I change positions slowly and frequently, nervous to stay in one place and anger the uterine gods but also nervous to move too quickly or in the wrong direction. It occurs to me that my uterus is calling the shots now. I take lots of breaks and drink lots of water. I find myself sitting on my feet next to the coffee table hunched over piles of white envelopes and my laptop. I take a short trip into the world to the nearest branch of our bank with a drive-through to collect cash needed for delivery of our mattress. During the ride, I realize I am shifted sideways and reclined in a white-lady gangster lean, squirming with every crack or irregularity the pavement, making for a ridiculous sight in the seat ahead of two car seats and a shifting and sliding pile of picture books and snack traps. 

When I get home, I start to wonder how long I can live like this. I am so pleased to still be pregnant, but the debility leftover from just two days in the hospital and the discomfort from no longer medically managing my unruly uterus is leaving me a mere shadow of myself. I feel like this bloated, winded, contracting animal just sort of wading through life at speeds and an efficacy generally reserved for the shifting of continental plates.  

I am not nice to the dogs because I am crabby and they are there...and because they always forgive me, God love them. 

By the time my husband returns home in the late afternoon, I have given up on my to-do list and am testing out the new mattress. 

I am also contracting at regular intervals.

I had been feeling them creep on as I folded the last load of laundry and by the time my hubs returns from dropping our old mattress at his parents house, they are starting to jump up and down and beg for attention. I spend just about an hour on our new mattress before I decide I can no longer avoid their persistence. The contractions are coming every 2-4 minutes and lingering for around a minute each (according to my app...how DID we function pre-smart phone??) 

We arrive at the hospital with a better idea of where to park this time. We also quickly discover that L&D has had a busy day. The receptionist tells us they've had twelve babies in as many hours and the place is hopping.  

Maybe that's not what you want to hear between contractions, but I am learning to accept my life as one long series of calamities. I stand with my elbows propped on the receptionist's desk and endure the waves of pain for what can't be more than 7 minutes but feels more like a century or so. In between, I try to act cool and no one buys my act. The receptionist apologizes a lot and finally just walks us back to the triage unit where we find an amped up tech changing linens and looking ready for shift change. 

It takes another 15 minutes or so for the nurse to arrive. I pee twice in that time and pace around the room trying stupidly to walk off my labor. 

The monitor finally connects with my baby and even the unseasoned ear can tell you there's something wrong. The high cadence gallop of his usual heart rate has slowed to lazy, whimpering walk. 

In less than a minute, the room fills with busy bright blue scrubs and crisp white coats with reassuring words (directed at me) and less reassuring words (directed at each other). Someone slips an oxygen mask over my nose and mouth ('for baby'). Two women start fishing around my left arm for a vein to stick asking me to flex and supinate and extend and grip while tugging my limb in all directions and being openly unimpressed with the quality of my veins. 

One of the lab coats identifies herself. She is a short, pleasant-faced, gray-haired women who looks like someone's grandmother. It's the same doctor who checked my cervix at 3 am two days earlier. She recognizes me, which makes sense because basically nothing about me has changed since early Wednesday morning: I am still in labor and my cervix has gone from being dilated to one to being dilated to two. She tells me this and then explains gently that there will be a c-section because, 'baby is ready to come now.' I am not dumb enough to believe means that things are all Bon-bons and Cumbaya inside my uterus. This statement doesn't mean that she just had a cup of tea and a lovely conversation with my baby and he would just be thrilled to have his birthday today. Still, it takes until the third or forth 'it'll be okay' for the tears to come. 

The contractions are coinciding with the dips in baby's heart rate. I am hearing numbers like 60 and 80 and I know this is trouble. Things are moving even faster now. More people arrive and more chaos ensues. The IV ladies are still struggling to find a cooperative vein and I am busy trying to listen to 18 different instructions and also remember to breathe (that being about every other instruction). 

My eyes scan the crowd to find my husband. Somehow in the middle of this tiny three-ringed circus, he has magically donned a pair of scrubs, scrub top, and an expression that makes me instantly feel better and also certain that he is the absolute best choice I could have ever made for a husband. I want his hand, but it is too far away. 

The IV ladies finally find success on my opposite arm and now we are moving. The instructions continue to come from all directions and it seems someone has located my doctor (whom I have decided is either secretly cloned into a small army of men or actually resides in the above ground lot between his office and the hospital). I am aware that they may need to administer a general anesthetic, but not sure where that decision has landed. Fewer people are taking the time to talk to me now. 

When we arrive in the OR the light is brighter and I am instructed to 'scoot' over to the operating table from my gurney. I am grateful to have been given a task. I am given a mask and a pretty dark-haired lady introduces herself as the anesthesiologist from behind the mask. My husband isn't there. Someone allows me to squeeze their hand. I am reminded, absurdly, of gripping my dad's hand as a child with long, unruly hair while my mother brushed the tangles out. I am just about to ask about the general anesthetic when the room and everyone in it vanishes. I swear it's just like the movies when the protagonist loses consciousness and screen goes black. Those movie guys really nailed that.

Just over 30 minutes since first applying the monitor to my belly, I became a mom for the third time in so many years. 

Seconds later, I am awake again and things are still bright, but they aren't quite as busy. I am only momentarily disoriented. People are telling me my son is here and he's doing well. I am nodding a lot.

I am wheeled into a patient room for my recovery period. My husband is beaming and showing me photos on his phone of a baby I have never met with a little mess of chestnut hair and a breathing tube. Other than the tube and the leads attached to his torso, I marvel at how substantial he looks. He lacks the wrinkled skin and wiry limbs his older brothers had in their first photos. I hear real pride in my voice as I say, he looks like a real baby!

Before long, I am wheeled (bed and all) into the NICU to meet my newest baby. They are already removing the breathing tube for less substantial respiratory support when we arrive. Only a few hours old, my youngest son is already amazing me. After a few more minutes, I am peering at him and reaching through the portholes on his isolette to touch the velvety skin along his tiny right arm. 

I know that every moment of every day, in all corners of the planet, mothers are bringing babies into this world under all sorts of circumstances. And this is not a new phenomenon in any sense. It's not even really new for me, even though, (cliche alert) every baby is different!

Still, I am humbled by the enormous gravity of the event. There is this whole new person here in the world. He will grow and develop and make an impact on people and places. He has already taken up residence in my heart, where I didn't realize there had been a spot waiting for him all along. Anyone can see by the pride on his father's face that this baby is completely adored. 

Welcome to our family, little man.  It's chaotic and noisy and there are lots of messes and diapers and barking dogs and sometimes there is time out. You will get more screen time and processed foods than your mother wished for her family and you will hear her curse more than once. She won't be with you as much as she wants to be because she has lots of student loans to repay, but she will never stop thinking about you on some level or loving you completely. 

34 weeks, 2 days
5lbs, 2oz

The last hospital bed I hope to see for a good, long while.  

Sunday, December 14, 2014

The Epic Week of Delivery: PART TWO



I am sleeping. And it's nothing short of glorious. There was a little cheating involved, I suppose since I took an OxyContin, but the end result is a beautiful, restful, smack-your-lips-together sort of sleep; the type that leaves you aching for just a little more, just one more hit from the sandman. 

It's not too long after 3am when I wake to shuffle into the bathroom, so I find myself reaching for the narcotics. Just before I pop another chalky white magic pill, I remember my doctor's practical advice to count kicks before rewarding myself with prescription pain-killers. So I grab a couple swigs of water and crawl cautiously into my pillow-top with one hand on my belly.  The irritability in my uterus is persistent, so I am not just looking to reap the rewards of the oxy's fatigue-inducing side-effects. I am however, silently congratulating myself on my growing ability to identify the regular and persistent contractions from the usual activity and position-related unrest in my uterus. 

I feel one solid kick, shortly before 4am...then nothing.

I poke my belly.
I roll over.
I drink again.
I look at the clock.
I get up.
I go down to the fridge and eat a leftover bratwurst.
I hobble back upstairs and crawl into bed.
I poke again.
I look at the clock.
I drink some more. 
I remember to breathe.
I roll again.
I poke some more.
I look at the clock again.
I swallow some tears.
I roll and poke.
I rationalize.
I breathe.
I look at the clock.
I text my mother.
I wake my husband.

Very soon, the house is stirring an hour earlier than normal. My husband is showering and I am remembering to breathe as I pull on a hooded jacket and sweatpants. My parents are in town partially due to circumstances and partially due to a previously planned trip to 'borrow' our children for the weekend. Now they are walking through the front door shaking the sleep off and looking concerned. I need help with my boots, partially because I have trouble flexing my hips without pain and partially because I am having trouble remembering to breathe while I do benign tasks. 

Soon, we are at the nearest hospital where I delivered my past two early babies. A man in an official security looking jacket greets me at the front door and eyes my belly with a smile. I blink back tears and return his smile, making my way past the Christmas decor of the lobby. The sterile smell of the halls and the elevator brings back vivid memories from my previous deliveries. The air seems somehow electric and I veer my thoughts to a positive, rational place. This is okay. We are okay.

Now I am sitting in a small, familiar room in the Women's Examination Unit across from a nurse in scrubs who breezes me through the intake form and seems used to gathering information from women who are just barely holding themselves together.

In no time, I am strapped to monitors and listening to the steady and very reassuring gallop of my baby's heart. My breath returns to normal, I feel the tension in my shoulders loosen. 

Baby doesn't like to preform for an audience and squeezes by his biophysical profile without meeting the 'practice breathing' criteria (though manages to get in a few good hiccups now and then). No problem, says the resident just need a good twenty minutes on the monitor to assure a steady heart rhythm. One episode of a dip in his heart rate earns us another hour and forty minutes held hostage to the monitors. 

Now I am feeling bad because the whole ordeal has left my husband late for work, my over-tired parents scrambling to get my son to school, and me feeling less in control than ever of this insane pregnancy.  

We discharge sometime after 8am with strict instructions to drink plenty of fluids and watch this kid carefully. I spend the morning acting like I can handle a trip to Target, a couple quick errands, and 20 minutes alone with my 1-year-old, then reside to my bed for most of the afternoon. 

My boys strap into their car seats for a long weekend at Gammy and Nonno's house and I watch them leave, experiencing a strong mix of sadness and relief and a nagging sense of foreboding.

At least it's not a hospital bed...

Saturday, December 13, 2014

The Epic Week of Delivery: PART ONE



Magnesium sulfate, my darling old nemesis, it seems we meet again...you dirty rat bastard.

I would gladly nudge you casually down a flight of stairs if it weren't for the inaccessibility of such a thing in my present state. Plus, it seems we're tethered together via that peripheral IV which is anchored securely to my forearm so, I suppose the joke would then also be on me.

And so I am resigned to endure your heat, the weight of you sitting heavy on my eyelids and your persistent pressure on my temples.  

This dance with intravenous magnesium sulfate is intended to suppress my third episode of early labor (in so many years) and lasted just about 20 hours in total. It left me boggy, headachy, and staggering a bit, like any self-respecting hangover might do, but it has granted me access to the 34th week of pregnancy; uncharted but highly anticipated territory. So I will try not to be too ungrateful...maybe.

Now, 12 hours later I am perplexing the night nursing staff with my frequent and undetected contractions. It feels all too familiar. The bag of tricks I have acquired in calming my uterus is running dangerously low, having exhausted shuffling and stooped trips to the toilet to empty my bladder, swallows of ice water (thus sending me back to the toilet), visualization and amateur bouts of meditation combined with pursed lipped breathing and occasional muttering profanities from behind closed eyelids, and scare tactics which include recounting the grizzly details of my past two deliveries to a bewildered looking nurse as she prods my belly and squints at the monitor. 

Still, the contractions leave me groping the plastic bed rail and hissing through clenched teeth for a minute or so at a time, coming in regular 2-3 minute sessions, but they don't always register on the monitor and I am somehow feeling like a fraud or imposter or--at the very least--a giant weeny.

Thus, it seems I have moved into the mystery phase of this epic labor I have been experiencing at some level since my cerclage was placed at the dawn of my second trimester. In the early hours of the morning, my symptoms aren't aligning with what the medical books proclaim as gospel truth of labor and delivery.  It's too early. It's too vague. It's real pain but they seem to want numbers and frequencies and bioelectric read outs and things aren't that substantial. Worst of all, I am not dilated beyond 1 cm as of 3 am, meaning all this pain is in vein. It's now 530am and although sleep is not an option for those of us in the trenches, we are calculating our next moves based on the desire to least inconvenience the next players (my doc, my husband). 

The persistent though perhaps foolish optimism of my doctor and myself had the audacity to propose this morning would include a quick hospital discharge. I then envisioned the day would evolve into an cheerful afternoon of addressing Christmas cards and wrapping gifts.  Perhaps this fantasy had been aided by the magnificent epidural I had received prior to the doctor digging the knotted piece of glorified packing strip known as my cerclage out of my hoo-ha. I appreciated it as it had been the only thing standing in the way of my delivering a baby until this point and also I wanted to murder it, as it was causing me increasing misery and varying levels of debility and general aggravation. the epidural provided a pain-free state I had forgotten was even possible. Those things are the shit

The night before my (foolish?) optimism had sent my sleep-deprived husband home so he might dare to consider a full night of sleep on something other than a glorified vinyl chair. I was then administered the most worthless Ambian in the history of sleeping pills, and had begun contracting with some very convincing frequency and growing intensity starting around 2am.

When my doctor finally arrived at 10am, he finds me clinging to my bed rail, earbuds feeding me a soothing 'Genius' inspired playlist including artists like Sia and Alexi Murdoch and intending to help me remember breathe and also not throw myself out the window. He also discovered there hadn't been any real progression in the proceeding 7 hours.  I was still dilated to only 1 cm. And because: Childbirth! There's an app for that!...I can tell you that my contractions were coming fast and furious at this point, lasting over a minute each at a frequency of 10-15 in an hour.  

And yet, no official labor.  We had spent weeks -- no, months -- taking every possible measure to ensure a strong cervix and now suddenly my cervix was proving itself iron-clad all on it's own. 

Having made it safely to 34 weeks, a place where baby's immediate health is generally not seriously threatened by delivery, the doctor has decided to bail on all our previous efforts to keep me pregnant. No more nifidipine, no more magnesium. What comes will come. He instead orders a hot shower, a light meal, two percocet and the possibility of a nap. I haven't graced the unconscious world for greater than a 45 minute stretch in over 80 hours so once I've been escorted through the delicate process of showering one-handed with a seran-wrapped IV and persistent contractions, I swallow some cereal and 2 narcotics, crawl into clean sheets and a pile of pillows and slip into a 2 and a half hour coma. 

I awake early in the afternoon to a relatively calm state of the uterus.  Shortly after dinner, I am headed home. Feeling bewildered, but still very much pregnant.

For now...

Peace out.

Thursday, November 27, 2014

Lessons My Sons Might Learn from Ferguson

My boys are not even out if diapers yet (with the third still cozy in the womb), but tonight, I cannot help but worry about what sort of world they will encounter as they venture away from our nest and what sort of people they will be when that happens.

Three months ago, a mother not far from my St Louis home lost her teenage son to a violent death which ignited a frenzy of protests (both violent and non-violent), legal drama, political scheming, media sensationalism, and social network-based hostility. The case of Michael Brown's death is news to you only if you have been living in a locked closet since August.

I cannot wrap my brain around the heartbreak that must come from losing a child or how it could possibly feel to watch his killer be absolved of (criminal) charges. I cannot speak to whether or not the Grand Jury decision to not indict Darren Wilson is 'right' or 'wrong' or how the prosecutors handled this case because the legal mumbo-jumbo is beyond my understanding. All I can really do is place my faith in the system and hope that Mr Brown's family can find a way to eventually come to peace with the results and move forward in a positive manner with the healing process. 

I am not ignorant enough to deny the fact that my sons have already been given a leg up in our society simply as the result of being born with fair complexions and big blue eyes. I have the benefit of not losing sleep worrying how others might perceive them based on the pigmentation of their skin.


LESSON 1: Don't claim or strive to be 'color blind.' Try instead to understand how another person's appearance and/or culture might contribute to how they've experienced the world and how they might then act because of that. It may indeed help you to be a more sensitive person and build better relationships. Don't pull a Michael Scott and get hung up on those things (see The Office: Diversity Day), just keep them in the back of your mind. And don't you dare assume that your place in society as a white male -- traditionally the top if the heap -- gives you a free pass to act like a dick. 


It's enough to worry about the fact that my sons are boys and will become teenage boys who will undoubtedly make some bad decisions one day (not to imply teenage girls don't make bad decisions...my memory isn't that bad). Michael Brown was one such teenager who made bad decisions, a series of bad decisions that ultimately cost him his life. And even now that we have heard from him publicly, we still cannot presume to know what Officer Darren Wilson was thinking when he pulled the trigger (repeatedly). It would be unfair to assume he did so in response to the color of young Mr Brown's skin. Still, the question is hard to push entirely from our minds and indeed this question fuels much of the weeks events. It's equally unfair to assume that the fault lies entirely with the victim. I've heard repeatedly that 'that's what you get' when you don't obey the law and I can't quite agree with that statement either.


LESSON 2: When making bad decisions, for the love of all things held holy, don't do it around firearms.


Regardless of motives or the specific sequence of events, we are now faced with a situation where a white police officer has ended the life of an unarmed black teenager. Those facts are undeniable. The specific circumstances of this case are now argued at extreme ends through the embroiled emotions of people who feel they've been personally wronged in one way or another, of people who have lived their lives in only one skin and hold inflexible opinions and stubborn vantage points. The facts of the case are tainted and clouded by an increasingly 'us' versus 'them' mentality. This mentality is reflected in the comments section of news items and perpetuated by ignorance and misinformation.


LESSON 3: Don't go through life looking for a fight. People are complicated. Situations are never really black and white (so to speak). There's not a good guy and a bad guy. Be compassionate, not combative. 


Yes, I believe we can all agree that violence and destruction is not productive. The rioting and looting that has occurred this week is criminal activity which put(s) the safety of civilians and peace officers at risk and causes devastation in it's wake. The day after the jury verdict was announced an entire city block was left in ruins, at least 61 arrests had been made overnight, a handful of injuries occurred, and the value of the damage caused (both physical and psychological) is yet unknown. The images of a city on fire are burned into the retinas of the country as we try to make sense of the senseless.


LESSON 4: If you want to make change or be heard, do it in a peaceful, productive and positive way. Use your words. Destruction and violence only hurts people and makes them angry. Worse, it totally delegitimizes your 'cause.'


Hate isn't something that's born in our hearts, it's placed there as a seed and then cultivated over time. Those who walk around with it feel somehow compelled to spread it for reasons unclear to me. Maybe they do so in order to justify it or so they won't feel so alone with it. Likewise, I don't believe that hate is always recognized as such by the handler, people are fond of saying 'I don't hate anyone' or 'hate is too strong if a word' but it certainly rears it's head in times like these. It seeps out of the hearts in subtle and not so subtle ways.


LESSON 5: There is no room for hate in this life. It will rot you from the inside out and make you unhappy and unpleasant. More importantly, it is a dangerous emotion. Cultivate only love for others...or try to at least like them a little. Look for the good in all people, even if you have to work a little harder to see it.


My Facebook feed the night following the Grand Jury verdict was primarily positive, with my own little personal community offering messages and support and hopes for peace to one another.  But there were a few sporadically placed words of antagonism on both ends. I did my best to hold my thumbs and not engage, but then in the darkness of the early morning hours, feeling the weight of a world in chaos, I made the mistake of responding to one such status which came from several states away and a poster I do not know well.
I urged the poster to and presumably any curious followers to refrain from    name calling and instead be part of the solution; to teach our children to speak with less polarizing statements. The counter-response I reviewed was ugly -- much uglier than the original post -- and I quickly regretted engaging in this public form of dialogue.  The misspellings and poor grammar were far less offensive than the content itself, which suggested that as a St Louis resident, I 'should know better' and was somehow at risk of being raped by intruders, in front of my children no less, in response to my 'white privilege.' The poster, it should be noted, has served our country as part of the armed forces and has also apparently worked in a prison (in what capacity, I am unsure). He has obviously seen some ugly things in his still relatively young life and therefore his vantage point is clearly skewed, but obviously fueled by the 'us versus them' mentality I mentioned earlier. The suggestion that I might be sexually assaulted in my own home simply due to the color of my skin is offensive, alarmist, and entirely missing the point. 

We simply cannot live in a state of irrational fear of one another. Sure, there are some deranged mother F-ers out there who might find it suitable to get their jollys off by gross criminal conduct. Indeed, many of them have recently congregated in Ferguson and other parts of my beloved city. But those sick SOBs come in all shapes and colors and I will not presume they are a dime a dozen or that I should fear that they will invade my home once they realize I am Caucasian. The suggestion was obviously made in a desperate (and unnecessarily) defensive move to make a point that I have already deemed to be 'part of the problem'.

If we stand around talking about how wronged we have been (or could be, hypothetically) we are somehow justifying violence and counter-violence when it might not be otherwise considered. We are simply fanning the flames of an already very volatile situation instead of running for the fire extinguisher.  


LESSON 6: Engage in productive dialogue only. Listen to others carefully and try to understand what they are saying to you. If you find yourself making or receiving outrageous or hurtful statements, it's time to re-evaluate the possible outcomes of the conversation. It might be time to step back and try again with a new approach when things are less heated. If you really want to make an impact on another person's opinion, speak with respect and reason and listen closely. 


Tuesday morning, I belted myself into my car and drove to a spot just a few short blocks away from one of the heaviest areas of Monday night's protest and entered my place of employment where I am easily considered a minority as a white woman. I was greeted at work by a very distraught colleague who was near tears as she described lying awake listening to helicopters circle her neighborhood and fearing for all the young people in her family and community who were being called to violence. It was heart-breaking to hear the devastation in her voice, but it felt totally fitting to be engaged in a dialogue with her, to listen to her experiences and offer my own. She's a person I respect whole-heartedly so that made our conversation easy. I realize that the conversations that need to happen in order to make real progress will be more challenging and need to happen between people who are perhaps less willing to listen to each other. 


LESSON 7: Don't be afraid to have difficult conversions. The most productive dialogue I have had in my life has always been the most uncomfortable. Often, they were conversations I delayed out of fear and had to build up significant courage to initiate. Some people thrive on debate or inciting conflict, but ironing out some marital spat or professional issue tends to be outside of my comfort zone. Still, I have found that the outcomes of these discussions were always well worth the anxiety.


The plain fact if the matter at the end of the day is that we are all stuck together on this planet and we need to find a way to coexist without killing each other ... literally. Sure there are parts of the world which have sunk into deeper violence and despair than this little corner of the Midwest, but I refuse stand by and watch in silence as my beautiful city crumbles under the weight of hate and bigotry and senseless violence. 

I think about my children and how I am lucky now that they are so small and so entirely unaware of this big nasty mess happening a few short miles from their comfortable little home. I have friends who are struggling to explain these complicated and disturbing events to their children as schools are closed and televisions are tuned in to the unfolding events. Someday my boys will learn about the ugly parts of life. It is unavoidable. Until that time, I hope I can teach them to be good people; to be kind; to be part of the solution. 

Divided We Fall.

Tuesday, November 25, 2014

Grief and Gratitude

It's true that my tiny little corner of the 'blogosphere' has been suffering from an extreme silence as of late. I assure you though, it's not from lack of material or even motivation to write. In fact, I have at least a half dozen mostly-to-partially-complete 'posts' sitting idle and stale and cluttering up my notepad. I just somehow haven't managed to bring myself to publish any up to this point.  

I could easily spend the better part of our savings for a licensed mental health professional to conclude any number of reasons for why I am occasionally compelled to publicly disclose my deepest insecurities and inner (slash outer) dramas. I also know that more than one (former?) reader has expressed their distaste toward being exposed to such personal subject matter and frankly, I can't blame them. I've started re-reading old posts with new eyes and the fragments I have composed in recent months have easily fallen into the tired and pathetic realm of over self-indulgence and unpleasant self-pity and thus have been systematically deemed unsuitable for public consumption.

I have written rambling prose detailing how my forced workout hiatus has robbed me of my favorite leisure-time, most effective stress-relief, part-time income, social support system, healthy body-image, a major part of my identity, and a big chunk of self-worth.  

I have fretted about my apparent innate inability to 'take it easy' and how my stubborn pride has taken a left-right sucker-punch combo by my present circumstances. 

There are lengthy compositions whining and sniveling over a body that was previously perfectly strong and capable, which is now held captive by an irritable uterus and contractions that impair my gait, disturb my sleep, occasionally cause me to cry out in pain for no apparent reason other than to call my sanity into question by the casual observer, and more than once rendered me almost completely paralyzed by pain. If this kid ever asks how long I was in labor with him, the official response will be 'more than 4 months' -- followed by a swift kick in the pants.

I'll spare you any more boring and self-serving complaints. And I most certainly won't launch into my (thus far internal) response to the suggestion that my symptoms are simply 'the baby kicking' or 'normal pregnancy discomfort' (because you don't need to see me acting even more ugly and hostile). 

In summary, these last few months have been less than ideal and frankly, I'm not wild about the (adult) person who is currently inhabiting this body I don't recognize (the baby seems cool at least). I am suddenly struggling to be a effective employee, decent mother, and adequate wife. The people around me on a daily basis are resigned to watch me flinch and shuffle around and fumble through even the most menial tasks. It's embarrassing and strangely humbling. Have I mentioned I am also not an ideal patient?  Flailing is my new status quo.

Here are some positives (finally): My friends and family have been beyond supportive, sympathetic, and helpful. I am eternally grateful for the occasional meal or offer of childcare, even if it goes against the very fibers of my being to accept well-meaning help without feeling somehow damaged and flawed. I am left worrying that I haven't offered enough support and sympathy to the people in my life when things weren't running so smoothly for them in past or present situations. 

I am also acutely aware of the fact that I need to get a grip already. People have ugly shit in their lives. Things get messy and complicated, and yes, even physically painful at times. Those cosmic sucker-punches land all over the place, all the time, every single day and in much more devastating ways than I have experienced in my life. I mean, as I type this, part of my city is in flames (more on that later....)

The difference is that others don't immediately feel compelled to type up their grievances at 2am and send them into cyberspace for all the world to read. I  suppose I have become an emotional exhibitionist, and even I find that to be utterly annoying.  

And so, consider this my swan song in terms of wallowing...at least related to this pregnancy. I will update as I see appropriate, sure. But, from this point further, consider me a cautious and determined optimist. It's November after all, and I have resolved to join the ranks of the ever-grateful Facebook poster. 

For example:

1. I am thankful for modern medicine. It has brought me two thriving little boys and safely to the happy sanctuary of the third trimester with my current pregnancy.  There are so many women in the world who have not been so fortunate and I would be remiss to appear ungrateful for these enormous blessings.  

2. I am thankful for a 'long cervix'. Every other week (and now weekly), I hold my breath, eyes focused narrowly on a glowing monitor, as a cold probe invades my body to determine the status of my cervical mucus plug. While my outrageously knowledgable MFM has advised against my entering any 'cervical length competitions' (causing me to briefly ponder the actual existence of such a bizarre event), mine has stayed relatively steady and strong over the last 14 weeks. The wincing, waddling and bruised ego are a very small price to pay for this sweet piece of reassurance.  

3. I am grateful for an unbelievably well-informed specialist who spouts off results of peer-reviewed research with mind-spinning speed and has stopped at nothing to keep me pregnant. This is a man who doesn't hesitate to acknowledge and treat my symptoms (I am presently on seven prescribed meds and in desperate need of a pill box) or return my weekend calls to the exchange.
4. I am eternally thankful for a loving husband and thoughtful friends and family. Even during another insane season of 70-80 hour work-weeks, my husband has stepped willingly and without complaint into super-husband/daddy mode: keeping our household running efficiently, preparing meals, carrying the endless parade of laundry up and down stairs, and kissing away the inevitable toddler head 'bonks' and unexplainable tantrums. He endures tears from all directions and has soothed and comforted me as I've writhed in pain while awaiting the chemical effects of my meds. 

Family has provided meals, morale support, and last-minute childcare without flinching. Friends have endured my drama, sent encouraging texts and FB messages, and hugged away my hormone-fueled tears. We even received an amazing lasagna and salad from a remarkably thoughtful sorority sister, who was years ahead of my pledge class and practically a stranger outside of Facebook. It's enough to make me wonder how saintly I must have been in a previous life, because the person I am presently embodying doesn't deserve such outstanding love and support.  

4. I am grateful for a steady job and understanding coworkers. Though they have every right to talk smack behind my back about the uselessness of a physical therapist who can't provide adequate treatment to any patient requiring more than only a small amount of physical assist, I have heard no such complaints. In previous pregnancies, it bothered me to no end when patients or coworkers commented on my continued participation in the daily physical demands of my profession. I spent my days reassuring people that I was fine, and it's certainly plausible that I was fine and cannot conclusively determine the role of my activity level on the prematurity of my deliveries. However, the irritability and discomfort presently triggered by even the most basic movements (or positions) which I have experienced over the last 17 weeks -- since my cervix was stitched together by a glorified packing strip -- is something entirely new to me with this pregnancy and I am still struggling to make sense of it and appropriately compensate for it. During moments of need, my generous co-workers generally jump in to help without hesitation or (in some cases) without being asked, in a generous and compassionate act I find to be deserving of my eternal respect and gratitude. 

At 31 weeks and 6 days, I am officially more pregnant then I have ever been and I am beyond thrilled. As a very pregnant Facebook friend quipped about my newly accomplished gestational period: Welcome to hell

I am so happy to be here.

Tuesday, August 19, 2014

#ALSIceBucketChallenge Backlash Backlash

I'll keep this short because people seem to be quickly getting #OverIt.  But I have just a few quick things to say about the #ALSIceBucketChallenge before everyone goes back to watching cat videos and bitching about politics.  

1. If you'd never heard of ALS (Amyotrophic Lateral Sclerosis) or Lou Gehrig's disease before this month, you are not a bad person (unless you are a physician. If that's the case, then WTF?)

2.  If you dumped a bucket of ice on your head instead of donating 100 bucks to ALSA, you are not a bad person. 

3.  If you declined to participate, you are not a bad person.

4.  If you only donated a few dollars, you are not a bad person.

5.  If you openly questioned others motives for publicly dousing themselves in frigid water, you are not a bad person.  You're not my favorite person on the planet, but you're not a bad person.

There are bad people out there.  Sure.  There are people who use questionable, excessive and deadly force against others.  There are people who think setting fire to a convenience store and stealing shoes and liquor will bring about justice.  There are people who exploit the tragic death of a beloved celebrity.  There is death and violence and illness all over the world.  And dammit if that doesn't bum me out completely.  But please don't criticize me or anyone else for choosing to participate and perpetuate a cause that is worthy.  Even if it's just that one cause. And just this one week.  

Did I also decide to spend this week donating money to and spreading awareness for Neuroblastoma or Parkinson's Disease, or Multiple Sclerosis, or Spina Bifida, or any other neurological disease process? Did I send money to developing and/or war-torn countries? Did I write my legislators to encourage them to help improve public education or healthcare access in my state?  


The truth is, what I have done this week was five loads of laundry, took my 2-year-old to his first day of preschool, made an emergency visit to my MFM's office to calm an irritable uterus, and provided approximately 12 hours of skilled physical therapy services to some nice folks at work (none of whom have ALS, but many have equally nasty and debilitating illnesses). I also dumped ice water on my head and sent some money to ALSA.

And no, I don't think dumping ice-cold water on my head and making a meager donation makes me a 'philanthropist'.  But some blogger's criticism doesn't make them anything better.  

Go ahead world, call me and my friends narcissistic, self-serving assholes with short attention spans and questionable motives. I've been called worse (and it's possible so have they).

Or maybe we could just take it easy on each other instead? Can we instead just sit back and enjoy a nice, positive trend that isn't pointless and strange (planking, parcour), actually narcissistic (sexy selfies), potentially illegal or career-ending (sex-ting), psychologically damaging (bullying), or just plain annoying (posting endless pics of your children and blog posts about your boring life...GUILTY!)

I'm sorry, but I just can't get enough of watching my friends and family dump ice-cold water on themselves. I laugh every time. 

And call me crazy, but isn't it nice to laugh?

Monday, August 11, 2014

The Week the World Turned Dark

My gut told me things were going to get worse before they got better.  And it turns out, my gut is pretty reliable. See, in a town called Ferguson, just about a 20 minute drive north from my house, in an area I have frequented for work purposes in the past (and never felt remotely unsafe), a teenager was gunned down in broad daylight on a Saturday.  

I will stick with the vague facts here, because it seems like a case that has and will be painted with a thousand different brushes over the next few weeks and months (and probably years) and frankly the rumors and possibly exaggerated statements are what fueled the fire for the next bit of news.  

The victim, 18-year-old Michael Brown, was involved in an altercation with a policeman which apparently began in the backseat if a squad car where the officer's weapon was fired once (it has been alleged that the young man was 'reaching for the gun').  The teen then apparently fled the car and was shot and killed by the officer involved.  The media reported that 'multiple shots' were fired by the policeman, but that the number of shots hasn't been disclosed by authorities.  The victim was supposed to start college this week.

The following day, what began as peaceful gatherings in the area, grieving the loss of a young man's life morphed over the course of the day into a violent and destructive mob, destroying property, looting businesses, and setting fire a convenience store.  

Like most things in my life these days, the story initially unfolded on my newsfeed but eventually also on our television (some days, mommy gets lots of screen time) and then was debated with my husband and neighbors.  I responded as a mother, immediately imagining one of my sons being involved.  I am well aware that the judgement of an 18-year-old male is often questionable at best and I live in constant fear that a poor judgement call on the part of one of my boys will result in anything from a night in jail to a senseless death, but this case smelled fishy to me.  My husband who made his fair share of poor choices as a teenager (and I often wonder how he came out alive and without a criminal record) argued that this is just something that can happen when you tangle with the law.  I argued that we rely on law enforcement to make us feel safe, and shots fired in a public area at an unarmed teen just makes me feel confused and sad.  

As is often true of cases like this, the underlying issue quickly became a question of race.  The victim was African American, the officer's race hasn't been disclosed (but as the force has only three black men, is presumably white) and the protesting crowd pictured on the 5 o'clock news was a mix of ages and ethnicities.  But the shooting has already been likened to the Treyvon Martin case on a number of occasions (the Martin's lawyer is already representing the Brown family). I have a Facebook friend who quickly responded to the incident with a post 'that this is one of the main reasons' she and her husband were 'always on the fence' about having children.  She was obviously incensed and finished her post with the statement that if it was her child, she and her husband 'would be dead from shooting up the police station.' The comments section below became a debate over raising young black men who can easily become a target of racial profiling and settles with waiting to hear more details before passing judgement and praying for the victim's family.  
The problem is that my friend was not the only one outraged by the incident -- not by a long shot, and probably not without just cause -- and while she apparently worked through her initial anger and desire for further violence, others felt compelled to take their frustrations to the streets.  

In a way, I can understand how people could become so furious.  The internet is hot with rumors about the case.  The victim's mother alleges that her son was shot eight times and I have read accounts stating there were as many as 10 shots fired.  One rumor alleges that the officer fired twice from his car and then shot twice more at close range.  A clip can be seen of an eyewitness telling reporters that she watched the young man stop, turn and that he was facing the policeman with his hands raised when the officer began firing.  The boy's body apparently lay in the street, exposed and uncovered for 4 hours after the shooting. There are rumors that the teen was guilty of no more than walking peacefully down the street when he was harassed and eventually killed.  I even read that the boy had a friend with him during the incident who was found dead later that day behind a pizza place, insinuating a police cover up (it's notable that the case was turned over by the Ferguson city police almost immediately to the county police force and  will eventually probably also involve the FBI).  

Sure, it's unsettling in the least and if I believed all the gory details to be 100% true, I might be calling for heads to roll too. I might even drive 20 minutes to throw a slushy at someone and holler some profanities while I'm at it (and quickly leave, because angry crowds make me very nervous).  If It was my son who met with such a violent and senseless death for apparently nothing more than walking down the street, I don't honestly don't know how I would respond (though it's highly doubtful my response would include a gun).  

But that's the problem.  As I was dozing on the couch Sunday night, people who firmly believed that this was a clear cut case of abuse of power, racial profiling, and cold-blooded murder were storming the streets and answering violence with violence.  

I remember learning about the 'mob mentality' as an undergrad psych student and how people can suddenly morph into something other than rational human beings.  It's dangerous and devastating.  It can result in property destruction, injuries, and innocent loss of life.  It's maddening to know such a thing can happen. 

It has been an embarrassing week for our city.  News of the initial incident and resulting violence spread quickly across the country and it feels like all eyes are on St Louis and we all look like animals.  It's true that we are among the top racially divided cities (top six) and tensions seem to run just high enough on a daily basis that we were just one (or possibly two) bad judgement calls away from near racial warfare.

I arrived home from work Monday to a television showing images of outraged community and church leaders calling for action (which frustratingly seem to lack in specifics, other than the prosecution of the officer involved in the shooting).  

In a town neighboring mine, two department stores were put on 'lockdown' due to rumors of looting and fighting in the mall we frequent.  I couldn't help but wonder how I would have felt had I picked up my boys from the sitter and headed to the mall with them, as we've done before.  When I couldn't handle the news any more, I took the boys to play across the street. As I gazed at our cozy Dutch Colonial with it's sturdy brick porch, potted plants, and overgrown lilac bushes, I suddenly felt overwhelmed by sadness and a deep sense of insecurity that is thankfully pretty foreign to me.  The world is full of senseless violence. People can be batshit crazy and I am lucky to live in a country that isn't run by those people (at leaast not entirely) and living in constant conflict and fear.  I have been lucky enough to have led a life where this senseless violence typically only happens on my TV (or newsfeed) and not in my backyard.  So maybe I am naive, but it makes me feel hopeless and sick to my stomach.  

The 9 o'clock and 10 o'clock news Monday night showed us live footage of police gathered in riot gear, some with guns drawn.  The next morning, there were reports of looting overnight in south city (also not far from where I live and work) and on Tuesday night -- the third night of near violent protests -- a young rioter who pulled a gun was shot by police.  

More violence.

My St Louis moms Facebook groups were overrun with comments by women who were keeping their children home from school and canceling doctors appointments in order to stay off the streets and keep their kids safe.  It all seems somehow surreal.  

And somewhere in the middle of all of this Robin Williams, a talented and beloved man somehow went to a dark enough place that he was compelled to take his own life.  

The world has gone completely mad. And all I can do is go to work, do the laundry, clean my house, and try my damnedest to raise children who are smart and kind enough to not contribute to it's madness.  


Friday, August 8, 2014

Boy VS Girl

I have this fringe friend whom I respect greatly, and though our relationship is based mostly in the virtual worlds of Facebook and Instagram, I would totally would spend more actual time with him if he wasn't so busy vacationing in Cabo and Aspen and happy houring at the hottest new foodie venues and generally way too cool for me.  Anyways, when I was pregnant with my second boy, he told me, 'I know I don't know you that well' (which he doesn't) 'but you seem like you'd be a really good mom to boys'.

Now, I immediately took (and still take) that statement as a complement.  Granted, he could very well have meant 'Anyone who wears their hair like that probably shouldn't produce any female offspring' or 'I always took you for a closeted lesbian' but I still think of it as a complement nonetheless.  

As my pregnancy ambled along and the official 'anatomy scan' loomed closer, I found myself spending more time thinking about the possible outcomes of that scan.  Honestly, I am a person who really enjoys a good 'surprise.'  I like to fly through life by the seat of my pants, not knowing exactly what to expect around each twist and turn of the road (which perhaps at least partially explains why I seem to be churning out offspring with the proficiency of a damn rabbit).  If it were totally up to me and my instincts, I would prefer to wait until the day our little bundle arrives to learn what sort of genitals we'll be dealing with.  I just love to linger in suspense and anticipation.  

Unfortunately, being a working mom of a one- and two-year-old who can just barely make it out of the house with everyone properly clothed and is generally operating just one spilt sippy cup short of a nervous breakdown, I have learned the grand benefits of operating two steps ahead of life when possible.  

Plus, with biweekly ultrasounds to monitor the competency of my mommy parts, concealing the gender of our baby will become harder and harder as my pregnancy progresses.  I would much rather find out intentionally then unintentionally.  

The plan with my first born was for my husband to be the one to deliver the delightful news of the baby's sex in the delivery room.  When my son made his dramatically rapid appearance, my husband was busy racing his way back from the dinner I had insisted he have with his sister.  

Therefore, the long awaited news came instead from a doctor -- whose name I ashamedly cannot remember -- as he tried consoling my post preterm delivery tears with the words 'he's doing great' and was probably a little perplexed when his use of a gender-specific pronoun only made me cry harder.  Nothing had gone as expected, and this was the icing on my shocked and overwhelmed cake.  

With our second, we were determined for things to go drastically different (i.e. normally) and somehow I felt that I could take some semblance of control over my previously uncooperative reproductive system by learning the baby's gender in advance.  

We had a nice little party with our closest friends and family where I insisted everyone guess at the gender before the big reveal.  By wrapping my ponytail in a pink bandanna and snatching up an un-inflated pink balloon, I found myself both outnumbered by our party guests and also wrong.    

This is how I look when I am wrong.

My friend who had been given the sealed envelope from the ultrasound tech and subsequently poked holes in all the pink balloons, gave me an apologetic smile as the air seeped pathetically from my pink balloon.  The millisecond of disappointment I felt stemmed (yes, it happened) less from learning it was another boy and more from my genetic predisposition that lends me to hating being proven wrong.  

Still, I quickly got excited at the prospect of having two boys who would grow up together so close in age.  I am, after all, a 'good mother to boys.' The word 'princess' frankly makes my blood boil a little and these days, I apply makeup about as often as I change the oil in my car.  I enjoy wrestling with my boys and have a low tolerance for tea parties (pretend, political, or otherwise).  As a child, I once openly declared my disgust for my growing collection of 'kitchen sets,' tore the wallpaper filled with tiny pink hearts from my bedroom walls as soon as I had the chance, and have since become a woman who can barely boil water properly.  It's true.  I am probably a better mom to boys than I would be to girls. 

But that doesn't mean I would decide to negotiate a baby trade with some other expecting woman if this one turns out to be female.  Sure, I would probably experience a whole new level of anxiety and maybe arrange for an extended vacation that could be taken alone in 15 years when the kid subsequently becomes the monster that is a hormonal 15-year-old girl (take it from me, I was no picnic at that age). 

Come to think of it, I'm not crazy about teenage boys either.  I think I'll book that trip either way.  

Still, I can't help but think it would also be kinda great to accept the challenge of raising a strong, smart, confident woman in a world that seems to favor empty-headed stick-figures with boobs.  

So at yesterday's routine biweekly lady-part check up, the ultrasound tech casually asked if we already knew the gender.  When we responded in the negative, she asked if we'd like to know.  I had convinced myself they would save that info for our official 'anatomy scan' scheduled in a couple weeks, so I just stammered for a minute or two before accepting her offer, given she would just write it down and seal it in an envelope.

So now we have this envelope.  
"I know something you don't know!" 
--Mean Envelope

At one point early in my last pregnancy, I honestly thought the gender of our second child would determine whether or not we would have another to 'try for a girl.'  Maybe in part, I felt this because the whole world seems to be rooting for all families to include one of each sex (and no more).  If that were actually the case, that would put a heap-load of pressure on the contents of this envelope.  But at this point, I honestly don't know what I want.  I know it's P.C. and relatively common for an expecting parent to say that the only thing they really care about is that the baby is healthy, while secretly yearning for one gender or the other.  But I think I'm just the right combination of both wishy-washy and paranoid to actually mean that now.  My very sincere answer to the inevitable question: 'are you hoping for a girl this time?' is that I really just want a nice, fat full term baby.   My cervix measured at 4.4cm yesterday (which is good) and that was the most important news we left with.

Still, now that we have the envelope, I am feeling totally preoccupied by it's contents.  We haven't opened it yet, but now I feel pretty certain I can't let it remain a mystery for much longer.  It's not that I'm rooting for one or the other, I'm just curious beyond belief.  Now it's like when someone teases you with their knowledge of a juicy secret that directly involves you. It sits there lifeless in my living room, taunting me.  

Maybe it's a boy.
Maybe it's a girl.

We do know it's a human child and that we will love that kid like crazy either way...at least until he/she turns 15.

Saturday, July 26, 2014

Cerc You Very Much

For decades now, women with inadequate mommy parts have been on the receiving end of a procedure called a cervical cerclage.  Allow me to educate you on the two basic types: 

1) A surgical stitch that reinforces the cervix at the level of the cervix, known as either McDonald or Shirodikar depending on the type of stitch.  

2) A stitch above the cervix known as a TAC (transabdominal cerclage).  

If you think this sounds barbaric, you should know that a woman who's desperate to carry a baby to term will agree to just about anything.  

Friday, I receive a 'modified modified McDonald' which was developed by and is the signature move of the specialist I am seeing, who is considered to be the reigning King of Cervical Issues in our area and is credited by countless woman for his ability to work reproductive miracles.  Dr P was referred to me by a friend who'd had him deliver her a beautiful rainbow baby last winter, and my local Facebook moms groups seem to worship him.  I actually told him that before we went into the OR and I think he was embarrassed.  He then asked how many of those ladies had him place a cerclage and I said it hadn't come up.  He gave me a look that I wasn't sure what to do with and next thing I knew, I was suited up in a heavy purple gown, matching non-skid socks and surgical cap, tucked under about forty heated blankets, being pedaled down a hallway of fluorescent lights.

A very sweet and friendly nurse anesthetist introduced herself and proceeded to give me excellent instructions and a play by play of how she'd administer the spinal tap.  I was first seated up at the edge of the OR table and instructed to slouch ("like your mother always told you not to do" -- it's a line I use sometimes in my practice, so it made me chuckle) to prep me for the spinal tap.  Dr P had told me earlier that the length of the procedure can depend on how long the spinal tap takes and with 'skinny patients' of which 'I was on the list' (he obviously either didn't see my weight from my admission that day, or he deals with an abnormally obese population) things usually go more quickly.

I had been particularly worried about the spinal tap, having heard my fair share of epidural horror stories, but the anesthesiologist put some of my concerns to rest when he explained that the spinal tap is less complex than an epidural and there's less room for error.  When the nurse pricked me first with the lidocaine injection ("little bee sting with a burn," which should have made me extra nervous given my last bee sting experience) then told me the worst part was over, I relaxed and even heard my heart rate slow over the beeps of the monitor which echoed in the cold, sterile room.

Next, the OR team situated me on my back with my legs up in the stirrups as my lower body quickly warmed and numbed, starting with my buttocks and working down to my toes.  I could still feel pressure as the doctor aggressively prepped my nether-regions with Betadine which worried me for the moment it took him to mention that I should feel pressure in my skin, but not cold.  Then I had a brief flashback to my neurology class during the first year of PT school when we learned that the spinothalamic tract of the spinal cord carries both pain and temperature sensations together to the brain.  The fact that I no longer felt the frigid cold air of the OR on the lower half of my body (despite being so vulgarly exposed) was now extremely comforting and again, the beeping of my heart rate slowed.  

As the pressure sensations continued and seemed to climb north into the expected area, I was able to turn my attention to the conversation my nurse anesthetist had seemed to deliberately be initiating, probably as part of her job.  I had mentioned previous visits to an OR as an observer when I was a student and she easily chatted me up about my job and recent family vacation.  She mentioned her nephew had married a PT who had graduated from my alma mater around the time I was there and we had one of those small-world St Louis moments when you realize there's only 3 degrees of separation between yourself and everyone in the room.  This discovery also served to earn me the little respect that is sometimes given when people discover I have a doctoral degree, without me mentioning it (which I rarely do...except for just now).  

After about 20 minutes, the procedure was complete and for some reason everyone kept congratulating me for how well I'd done.  I suppose it's just a talent I have, lying still with my feet in stirrups.  

*Insert obvious dirty and probably degrading joke here.  Go ahead, I clearly set you right up for it*

From the OR, I was wheeled under a different set of beaming fluorescent lights to the recovery room.  There, I was greeted by a new team of nurses, one of whom asked if I felt like I could sleep.  I laughed and told her as a pregnant, working mom of a one- and two-year-old I always felt I could sleep.  

Which of course, turned out to be totally untrue.  

Instead, I discovered I was feeling too wired to sleep.  I was wired, bored, and wondering how I would last another hour or so lying flat on this tiny cot without access to social media...or any form of media for that matter.  Oh shit, I am a slave to my iPhone!  I tried sleeping, I really did.  But when that failed, I just butted in on the nurses conversation with each other. They had been discussing American Girl dolls and (not that I have any particular interest on dolls) I saw an opening to break up my boredom.

The chatting passed just enough time for my sensation to return and it didn't take too long for me to regret not having napped when I had the chance.  The nurse anesthetist had told me that the wearing off of a spinal block was like taking off a pair of pants and that sensation would return from my hips down.  As the warm and comfy 'pants' slowly peeled away, I discovered that they were being replaced by a giant, freezing vice grip clamping down on my trunk.  At the same time, I was apparently also donning a nice fuzzy nausea shirt that came all the way up to my throat (a nausea turtle neck?)

While I was slipping into something a lot less comfortable, the recovery team hooked my IV up to a PCA (patient controlled analgesia) pump loaded up with Fentanyl and gave me doses of some version of Tylonal (also for pain) and of Toradol (to quiet the cramps in my outraged uterus).  I was entering a whole new world of pain and it seemed like a good time for me to get acquainted with a whole new world of painkillers.*

Apparently, monkeying around with one's cervix does not make the rest of the reproductive team very happy and the uterus takes revenge by contracting rather angrily.  Also, coming out of a spinal block can trigger nausea.  I had been told to expect cramping, but I had not been prepared for the fact that the cramps would be continous rather than coming in somewhat predictable waves as they do during labor.  In fairness, the possibility of nausea had also been mentioned, but I have a tendency to assume things like that won't apply to me.  You know, because I am an idiot.

I think the best way to describe how I was beginning to feel would be to equate it to a really super extreme case of food poisoning with nausea, stomach cramps, and extreme temperature swings.  One minute, I was requesting more heated blankets, and the next I was kicking them away and asking for a cool compress.  At one point, I was struck by such an intense moment of nausea that I was certain I had about a milisecond before I would be covered in vomit.  While one nurse dashed away to find an emesis basin, another heroically tore open an alcohol swab and held it under my nose.  

"This seems a little strange, I know. But it usually helps" 

And I'll be damned if it didn't help.  Next time you're nauseous, find a bottle of rubbing alcohol to sniff on.  You can thank me later.  I didn't yak.  At least, not right then.

It's my understanding that the whole point of the surgical recovery room is to monitor patients coming out of anesthesia just to be sure they don't die (or get covered in vomit).  It's probably a mostly boring gig, watching people sleep and monitoring their vitals.  Occasionally, there are probably patients like the man they wheeled past me and parked about three spots down, who was disoriented and wanted to take off his oxygen and get up.  But mostly, they're probably like the little lady across from me who just seemed to be quietly asleep.  I was supposed to stay just long enough for my sensation to return and for my doc to come back with a sonogram machine to check in on the baby.  This was predicted to be just about an hour if not a little more. Unfortunately, while my doctor is widely known for many, many good things, punctuality is not on that list.  I overheard that his next proceedure was a D&C and immediately decided I had no reason to be annoyed with his tardiness and also that I should be grateful for every moment of pain because it meant I would ultimately end up with a beautiful little person. 

After over two hours of waiting, it was determined that I could be taken to the room where I would stay for my overnight admission and that the doctor would just have to come find me later.  It's also possible the recovery nurses were tired of watching me wriggle around and moan uncomfortably and on a Friday evening, most of them were also probably interested in leaving themselves.

By the time they were wheeling me to my room on the antepartum unit, I was literally writhing in pain.  It seemed like all of my senses were consumed by the pain, I couldn't hear or speak or see.  It was agony.  As we wheeled off the elevator and I peaked out at my surroundings, I had this wild and unreasonable thought that maybe if I could just make it to my room, the pain would stop.  And I think maybe it's possible that the nurses transporting me felt the same given the speed and sense of urgency they had.  Or maybe they just wanted to minimize the amount of time they'd be associated with the squirming, moaning lady.  (Or maybe their shifts were supposed to be over as well) 

As it turned out, the pain didn't get better when I got to the room.  (Raise your hand if you're surprised)

It's also interesting to note here that while I might be a giant baby in the face of pain, my mama raised me to be a polite young lady.  Therefore there were a number of pleases and thank yous and if it's no bothers that sputtered out between moans and groans.  I even tried to crack a joke at one point--maybe to prove that the cervical terrorists hadn't won. The joke fell pretty flat in it's delivery and was met with only vague chuckles.  I sort of doubt the formalities or pathetic attempts at jokes made me any easier or more desirable to work with me though.

The crescendoing cramping near the base of my abdomen made me wonder if a full bladder wasn't partially to blame for my discomfort.  After all, I am used to peeing every five minutes and it had now been over 3 hours.  When I mentioned the possibility to my new nurse, she suggested we give the bathroom a shot. Unfortunately, my knees buckled when I stood from the bed (giving both me and the nurse a bit of a scare) and I was forced to try a bedpan.  The attempt failed at emptying my bladder but succeeded in making me even less comfortable (have you ever been on a bedpan? I think it's pretty miserable under the best of conditions), I just resigned myself to the pain.

After an indeterminate amount of time my husband arrived.  At that point, I almost lost it and spent a whole lot of time apologizing to him for reasons that were unclear, even to me.  Sorry I am acting like a small weepy child?  Sorry I splattered neon green vomit on you (no joke, that's what vomit from an empty stomach looks like)? Sorry my cervix is so grossly incompetent?  Sorry you feel obligated to sleep on a paper thin mattress atop a cross bar and prickly, squeaky springs while I inevitably keep you up all night navigating my way to and from the bathroom? 

Finally, I was brought a dose of my new best friend: percocet. I eagerly swallowed the pills and (reluctantly) a saltine cracker and soon my suffering dampened enough to allow for sweet, sweet sleep.

In my experience, there's always some hospital device that wins out above the others for the Extreme Annoyance Award.  In this case, the clear winner was my pulse-oximeter (a plastic device clamped on the tip of your finger which measures heart rate and oxygen saturation in the blood).  Once the percocet and exhaustion mercifully kicked in, I found myself finally dozing off only to be roused by my husband who'd been instructed to ask me to take deep breaths if my heart rate or SPO2  dropped.  I didn't hate him for it specifically, especially because he was coming from a place of obedience and probably genuine concern, but it did make want to give him a good whack alongside his stupid head. He was spared for the following reasons: 
A) I was afraid to move least the pain would return and kill me.
B) I was so exhausted that each time, I basically slipped back to sleep each time and barely remembered later.
C) Whacking him would have required me to open my eyes.

Dr P eventually surfaced sometime during this period just in time for me to tell him horsely that I hated him and to also show me that baby was doing great (which made me hate him a lot less). He also reassured me that things couldn't have gone more smoothly and that what I was experiencing was normal.  Only one of those things was comforting to me.  I had secretly been hoping all the pain he had been promising over the past few weeks was sort of like an up-selling technique where if he assured me extreme pain, then any discomfort would be construed as no big deal.  Turns out, he's just a straightforward guy.  So when he promised I would feel much better in the next couple of days I was beyond relieved. Overall, his visit was hazy through my narcotic/exhaustion cloud I remember watching a dancing baby on a black and white monitor and him pointing out a full bladder.  Sometime after that, I experienced my first (and God willing, last) 'straight catheter' which didn't seem nearly as terrible as it sounds, either because I was still somewhat numb below deck or because I was still floating away on my fluffy cloud of narcotics and fatigue. 

I also barfed a couple times.  If you ever have the opportunity to vomit up stomach bile while being crushed across the middle by a giant metal clamp, you will know exactly how much fun I had last Friday night. 

At some point in my delirium, I overheard a conversation about food that made me gag a little and awoke at some point later to a dark room and a tray of what might normally (if not been served up at a hospital) have been really tasty choices including hummus and veggies, yogurt and fruit, an omelette and a strip of bacon clearly ordered by my thoughtful husband who knows (but doesn't appreciate) my love of breakfast foods at all hours.  

Unfortunately, after more than 24 hours without even a bite to eat, I wasn't ready to tackle more than a cold and crumbly piece of stale toast and a few spoonsful of yogurt.  

The rest of the night was a blur of epic, hourly trips to the bathroom each of which included an elaborate tango with IV tubing, an IV pole, the PCA pump, SCDs (sequential compression devices which act as both leg massagers and shackles, neither of which is their intended purpose), and my new nemesis: the pulse-ox clamped on my finger (a necessary evil due to my use of the PCA).  

I quickly discovered that in order to reach my feet and un-shackle my legs from the SCDs (which was less than comfortable for my contracting belly) I had to remove the pulse-ox, which immediately unleashed the infuriating beeping that had earned it the Extreme Annoyance Award earlier in the evening.  By the time I would arrive in the bathroom, the amount I could void and the comfort that resulted didn't really seem worth all the trouble.  The whole fiasco would come to a pause when I would crawl gingerly back into bed, resituate myself, click my PCA button, and say a silent prayer for sleep.  Generally it would take less than an hour before the whole process repeated itself and occasionally, my routine was interrupted by my nurse with pills or a blood pressure cuff.  

Morning came too quickly and although I felt better, I was still pretty quick on the PCA trigger to keep the vice grip from returning in full force.  The hubs (who amazingly didn't file for divorce sometime in the night) and I even ordered up an actual meal while we waited for the doc to return.  The nurse encouraged me to lay off the PCA and I agreed to do so, partially because I was ready to rid myself of the devil pulse-ox and have all my digits back.  It was after noon before the good doctor arrived, but all was forgiven when he admitted to having come down with the flu -- and kept his distance while giving me my discharge instructions.

I was pleased to hear I would be leaving with a prescription for narcotics* and permission to resume normal activities as I felt able.  I spent the rest of the weekend shuffling around the house looking and acting like a drugged up housewife and relying heavily on my husband and mother to pick up the slack and keep my kiddos alive and happy.  True to form however, it took me until Sunday night to figure out that I was still basically worthless (when I failed at a simple laundry folding task) and should probably call in to work for the next day, rather than drive in and try to treat patients while on OxyCodone. 

I surveyed my fellow IC mamas on FB who reported it took most of them 1-2 weeks to feel 'normal' again after a cerclage.  But you know what?  Not one of them said it wasn't worth it.  It's very likely that the pain of this procedure will soon be a distant memory, much like the pain of childbirth (they're pretty parallel experiences actually) and all that will be left worth remembering will be this amazing little person who I'd already do anything for.  

*before freaking out about my taking prescription analgesics as a pregnant woman, please remember that I am under the close supervision of a skilled physician who specializes in high risk pregnancies.  Unless you are also a skilled physician who specializes in high risk pregnancies and are intimately familiar with my medical history, then kindly remember your opinion has no baring on my situation.