Old News: Past Blog Posts

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.

Sunday, July 20, 2014

Air Flight or Fight

I've always been pretty Zen when it comes to flying. In the past, I generally have had a moment just before boarding when I reflect on my life and find it to be satisfactory enough that if I were to go down in a fiery ball of furious screeching metal that I wouldn't be altogether devastated by my premature demise.

That was naturally, before I became a mother and thus lost all capability of achieving a Zen state.  

As we came to the culmination of the several months of planning required to travel by plane with a one- and two-year-old, I began to realize the full extent of my newly achieved anxiety. 

My typically award-winning procrastination efforts were totally thwarted by the undeniable need to figure out the logistics of transporting or acquiring necessary baby accessories including car seats, booster chairs, and a Pack n Play (to name just a few) well in advance of our departure.  The whole exhausting effort involved multiple lists, emails, and a lot of time on Amazon.com and really busted me out of my usual comfortable go-with-the-flow, deal-with-it-tomorrow attitude.  It was not altogether unpleasant, but definitely monkeyed around with the usual boundaries of my comfort zone. 

As we boarded the plane, after holding up an increasingly hostile group of travelers due to some misinformation about stroller checking procedures, I struggled to find my Zen-ness (it's a word, I promise) and quickly realized I was downright not okay with the vague possibility of going down in flames.   

The passengers on this particular aircraft included my boys, my husband, my parents, and a tiny person, barely the size of a plum, buried deep in my uterus.  No way was I letting the universe take us all down.  So long blasé single traveler in sweatpants and earbuds, hello fierce mama lion hyper-alert and determined to get her cubs to their family reunion totally unscathed by any means necessary.

Of course I also had the usual parental anxieties about how my boys might behave while trapped in a metal cylinder traveling at 30,000 feet with a hundred or so strangers.  We packed a heap of silent but amusing books and toys as well as enough crackers, Cheerios, and tablets to occupy an entire pre-school for at least a day.  

And on the flight out, things went pretty well.  There were some occasional protests and baby squawks that cut through the normal light chatter and usual white noise of air travel.  But a man with a full sleeve tattoo sitting across the isle slept the entire flight with his head flat on his lap tray and the business looking man behind us just laughed when we apologized for any disruptions, telling us he had four children at home and didn't think anything of it.  

The flight would have been considered an all out victory if I hadn't missed my chance to use the lady's room before we boarded and was tragically (though almost comedically) confined to my seat by the seatbelt sign and turbulence for the first twenty or thirty minutes of the flight.  Add to that a 17-pound child squirming around on my pregnant bladder and things were pretty desperate.  Finally, I was sure my bladder would either burst inward and drown the baby in urine (a physiologically impossible event) or I would just piss myself and be forced to dig out my emergency carryon clothes to avoid arriving in Florida smelling like a urinal. So in complete disregard to the both the turbulence and pilot's orders to stay seated, I finally swiftly passed the baby to my husband and fled to the restroom at the back of the plane.  I didn't even bother worrying about the fact that a male flight attendant was only one isle up taking drink orders.  

My husband dutifully played the pregnancy card for me in my absence to which the flight attendant good-naturedly responded that he'd never tackled a passenger for insubordinance in the past and wasn't going to start with a pregnant one.  He even joked with me about it when I was headed back to the bathroom for a second visit just before landing (ah, the joys of pregnancy).

During our 10-day stay in Florida, two things happened that amped up my anxiety levels for the flight home: 

1. Malaysian Flight 17  tragically went down with it's 298 passengers.


2. The Huffington Post published a blog piece written by an irritated daddy blogger (whom I've read before and typically enjoy) about flying with children.  

Sure, the MH17 story made me a little nervous about air travel (and more so about the apparently increasingly unstable state of international affairs) but since the flight from Florida to St Louis doesn't include Ukranian airspace, I figured we were relatively safe.  

It was the blog post that made me nervous.  If you didn't read it, I'll summarize: daddy blogger Mike Julianelle (Dad and Buried) believes that parents shouldn't feel the need to apologize for their desire to travel with infants or young children.  He writes about the fairly recent phenomenon of traveling parents compiling 'goody bags' for fellow passengers as a preemptive strike against the potential backlash against their children's possible disruptive behavior during a flight.  His version of the goodie bag includes a handheld mirror 'to take a good look at yourself and consider what kind of person gets pissed off at parents traveling with a toddler' and the world's smallest violin for passengers to play 'while being whisked through the air at astonishing speeds to someplace far away while watching TV and listening to music through headphones that block out any noise from the toddler a few rows back.'

The piece is doused in sarcasm and could definitely be interpreted as unfriendly.  As a blogger who embraces sarcasm and frequently leaps onto her own personal soapbox with an axe to grind, I can definitely relate. However, I suppose I could also understand why some folks might finish reading his words and come out feeling somewhat defensive.  

And believe me, there were more than a few haters who came crawling out of their hate-lairs in response to this piece.  I made the mistake of haphazardly clicking on the 'comments' responding to the article and was appalled at the level of maliciousness our Mr Julianelle stirred in the HuffPost readership.  

Julianelle is called everything from a a twat to an asshat and parents and non-parents alike chime in with instructions for the author and each other, some of which include doing unspeakable things.  Mostly, the consensus seems to be that if parents can't 'control' their children, they are considered unworthy of parenthood, air travel, and/or existence on this planet. It's ugly. Here's a sampling of the comments:

"While I don't need a goodie bag ... I also don't need to hear about how fucking miserable your children are making your life.  So over people who think they need an award because they have kids*

"You chose to populate the already over-crowded planet with your mini-me versions so take responsibility like any normal parent.  *My* mother never allowed me to misbehave..."

"Having children is a choice. YOUR choice. Thinking that everyone else should have to deal with your shitty kids is beyond ignorant. You had kids, you can deal with them. And if you don't get to travel because of it guess what? Not my problem. Flight isn't a right it's a privilege. Get a sitter or travel via car, but you don't have the right to force your kids on others"

Russian missiles aside, the hostility of what seems to be a sampling of my fellow travelers was terrifying.  

Fast forward to our flight home.  It was scheduled for departure at 830pm by ignorant fools who thought their children would sleep peacefully through the 2 hour flight.  

The previous night was a rough one. Perhaps having hit his limit of late bedtimes, inconsistent naps, and a diet consisting of almost exclusively crackers and French fries, my precious one-year-old woke twice in the night and was wide awake at 530am, begging for attention.  Because we were booted from our condo at 11am, we spent the day in the oppressive Florida heat visiting the zoo and stupidly attempted to nap in a Winn Dixie parking lot with the AC of our rented minivan blasting. The naps lasted approximately 17 minutes and we found ourselves arriving at our gate 3 hours early for a flight that had been delayed by almost an hour.  When all was said and done, I found myself boarding our plane with clutching over-exhausted and already screaming child.  

It was a nightmare.  

His shrill cries and howls were probably highly annoying to nearby passengers, but to me, they were chipping pieces away at my heart and downright devastating.  I literally wrestled with the poor little guy as he wailed uncontrollably.  He would desperately grab and pull at my hair and my pearl necklace (which I had ignorantly assumed would make me appear to be a responsible and respectable parent but instead just gave my son a fancy noose with which to strangle me).  He would fling his head violently backwards, often smashing me in the face and once, squarely and very painfully on an emerging pimple with a force that almost brought me to tears. Then I would swivel his tiny (but alarmingly strong) body around to grip him in a bear-hug and he would push and extend again, nearly causing me to lose my grip.  

Occasionally, I would successfully land a bottle or cracker in his mouth and he would reluctantly chew or swallow for a moment of blissful silence but quickly he would resume his violent protesting and high-volume complaints. I sang in his ear and cooed and babbled and blew raspberries. I cuddled and snuggled and rocked and petted and pleaded. I covered him in kisses and told him how much I loved him. I begged him to just sleep already. I tried toys and books and even an iPad in a futile attempt to distract and calm him. A couple times, I passed him to my husband who fought a similar battle and was just as unsuccessful in finding the off-switch.  

I couldn't even bear to sneak a peak at my fellow travelers.  And frankly, I didn't even care about them after the first five minutes.  I just wanted my poor little man's obvious suffering to end. It was miserable and I didn't even have time to worry about who might recant this event and bash my parenting while recounting how inconvenienced they were in the comments section of some blog someday.  

The flight attendant came by twice for either drink orders or to make sure we weren't violently beating our child (which might have been a reasonable conclusion given the desperation level of the cries he was producing). 

So finally, the really helpful thing that me and my hormones did was to also start crying.  Shortly after blinking out the first few tears, I realized that my stress was only adding to his stress and this of course only made me cry harder.

It was a parenting fail of epic proportions.  Luckily, my precious two-year-old who values his sleep more than anything in the world was snoozing soundly in the seat next to me shortly after take off, snuggled up with a stuffed monkey, frog blanket and his father and oblivious to his brother's misery.

Finally, after what could have been nothing short of an entire lifetime (but was probably more like 20 minutes), the little guy wore himself out. He was mid-chew with a (thankfully) dissolvable animal cracker in his mouth when exhaustion finally overcame him.  I felt his body go mercifully limp before his eyes even closed completely and he was snoring in seconds.

My tears took a few more minutes to subside and I found myself flashing back to the delivery room when the agony of childbirth was over and all I could do was cry.  

About six months ago, I witnessed a plane filled with hundreds of troops returning from Afghanistan, one of which was my amazing brother-in-law.  I remember expecting to see elated smiles and exuberant behavior when they were dismissed into the crowd filled with their loved ones.  What I saw was somber exhaustion winning out over enthusiasm.  There were hugs and kisses and grins, of course.  But mainly, they looked like they'd just woken up from a coma or landed on a foreign planet amid an extra-terrestrial species.  

I could never equate my briefly unpleasant flight to being immersed in a war-torn county and witnessing unimaginable horror, but I found my brain wandering back to those faces as we landed at Lambert airport.  I know I probably looked pretty miserable as the harsh white lights came up around me, with my makeup smeared and my hair totally disheveled.  And naturally, the first thing that happened was that the little man woke up, blinked pathetically into the light, and resumed his shrill shrieks, thus bringing attention back to our sorry little clan.  

As people stood and began collecting their belongings, a man two rows back loudly proclaimed that we should have brought something for the little guy to suck on because his cries were due to his popping ears (you know, the cries that started before we boarded?).  Rather than hurdling the two seat backs between us and beating the man senseless, I turned in my seat, locked eyes with him viciously, and thrust the Tommie Tippie I was holding into the air asking in a voice filled with exhausted rage that surprised even me, 'Oh? Like this??'  My boarder-line psychosis scared us both into silence and all he could do was bob his head stupidly and wave his hand in a gesture that might have been in agreement or might have meant, please don't kill me crazy lady.  

We exited the plane in a flash of carryon luggage and screams with the enthusiasm of a Jewish family fleeing Nazi Germany. I was so thrilled to break into the vaulted ceilings and open spaces of a nearly empty terminal that I almost started crying again.  

Over the past 10 months or so, I've learned that people often offer to help a woman juggling an infant and a toddler.  However, as I bounced the still-sobbing little guy on my hip and struggled to restrain my curious 2-year-old next to the baggage carousel while my sister-in-law pulled suitcases off the belt and my husband retrieved the car, there were only pensive faces laced with either judgement or annoyance or mild fear (perhaps word of my likely instability had spread).  

Whatever the reason, people were not interested in tangling with a questionably pregnant woman (Just barely into my second trimester, I am tragically either already 'showing' or I ate too many ice cream cones on vacation) as she simultaneously balances an overtired and squirming baby in one arm, hoists a 40 pound suitcase onto a cart with the other and blocks a two-year-old into his stroller with her foot.  If it hadn't been so tragic, it would have been comical.  

I have never been happier to climb into the cab of my husband's pickup.  My sister-in-law mercifully worked her auntie magic on the little one as we pulled onto the interstate for the brief drive home and we enjoyed a ride free of shrieks and sobs. It was during this drive that I slipped into the maniacal phase of my growing lunacy and laughed like a banshee at my SIL's (not meant to be funny) stories of the border currently caring for her brother's cat. A day later, I can't even remember what was so funny. There was something about a cat named Harold whom I imagined wearing a fedora and playing bridge. As you can imagine, I derailed from there.  

We are home now. Our bags are mostly unpacked and life is resuming some semblance of order and routine. The trip has left me feeling somehow baptized by fire into true motherhood. Like, I might have been a 'mom' before, but now through some sick hazing ritual, I had finally earned the merit badge that made it official.

At the end of college and into the first part of grad school, I would fly to Florida fairly regularly to visit my boyfriend who took an internship then a job there (Sidenote: it's very convenient that most of my exes now live in non-neighboring states).  I would cram my clothes into a carryon sized bag, pop my earbuds in, slap a bored expression on my face, and settle in behind a good book to avoid contact with strangers. I would secretly people watch and daydream about their lives. There was something about traveling alone that made me feel somehow unrestrained and empowered; like I could board a plane going anywhere and just figure it all out when I got there. It was both liberating and thrilling.  

That fearless and somewhat ignorant young woman is gone now.  She's been reborn into an exhausted, pregnant mother of two who is feeling more world-weary by the day.  My adventures aren't over though.  They're just different now.  They happen in my living room when my youngest claps along with 'patty cake' and my oldest proudly counts to ten using only six numbers.  I suppose I am still a little bit fearless.  See, now instead of dodging interactions with strangers on a plan,e I will apparently even willingly confront them with an angry gesture and overt hostility.  

While boarding our planes, I don't experience that moment of satisfaction with my life or accept that it could end quietly without significant dismay on my end simply because there is too much to lose now.  Others may find my little guy to be a disturbance, and "thinking everyone else should have to deal with [my] shitty kid" may be "beyond ignorant" but I'll be damned if that matters to me. I got to spend 10 days uninterrupted actually enjoying my boys during their fleeting early years: teaching them colors and shapes and counting, singing silly songs to them, reading them stories and wrestling with them, introducing them to the beach and sand and sea creatures, and watching them splash and explore and soak in this great big, curious world were we live.  Spending real, quality time with her children is more precious than gold to a full-time working mom.  

Sure, there were some snags, but I would do it all over again in a heartbeat.  

Saturday, July 12, 2014

Judgement Call

When I was growing up, I quickly became that kid who worried every minute about my image.  I can still remember avidly campaigning for the role of 'teacher's pet' in second grade and in junior high, choosing an outfit for a school dance could be paralyzing while potential snide comments about how I looked in each would run around in my head.  Into my college years, I would silently size up any new acquaintance before determining the best way to proceed in order to win their approval.

It was exhausting.

Fast forward to 29th year.  I honestly believed I had grown past these juvenile tendencies...though often I  relied on the power of my finely tuned charm to win over the occasional crotchety patient. 

I found that the genuine smiles and heartfelt congratulations that followed the news of our first pregnancy were like a warm blanket where I could wrap my anxieties and take shelter from any fears about diving head first into parenthood.  Everybody loves a woman pregnant with her first child.  I basked it the acceptance and affection of nearly all of society.  It was lovely.

When our son arrived 9 weeks early, I quickly realized I had apparently evolved very little since that 7-year-old version of me who ran around at the heels of her teacher, begging for approval.  I was suddenly fixated on every passing comment I'd heard from friends or coworkers, questioning my decision to keep running and lifting through my pregnancy.  I couldn't stop replaying the conversations I'd overheard or been a part of regarding an acquaintance who's baby came early, in which everyone sat around speculating about what she'd done wrong.  

When we announced we were expecting our second baby a month before the first turned one, the enthusiasm level of the responses was dulled slightly and I knew people were wondering why we had decided to transform our lives into a circus sideshow by indulging in two babies under two.  And naturally, I fretted about it. 

Most of us would probably agree that the second baby's arrival is generally met with less pomp and circumstance than the first child.  In our case, we found ourselves greeted by a familiar team of NICU doctors and nurses tasked with caring for our second 31-weeker in a mere 15 months.  You guys again?  

The outpouring of support that had come with our first tiny preemie was (at least in my mind) in part dampened by conclusions drawn that this situation must be somehow self-inflicted.  Or maybe it was just the result of the usual growing apathy for the arrival of second children, no matter what the situation.  Whatever the reason, it would seem that fewer people are compelled to bring a casserole to a woman who is perceived to be unable to figure out birth control or how to carry a full term baby.   

Luckily, the free time I had to spend brooding over everyone's opinion was cut short by the more pressing need to care for a newborn in the NICU and a young toddler at home.  I was either evolving, or just plain exhausted.  It's difficult to determine which, even in hindsight.

Now I stand before you with an announcement. 

Put on your judges garb and grab your gavel because even the most righteous among you will most certainly pass immediate judgement on my next statement.

I am pregnant.

Yup, our little family sideshow will balloon into a full-on three ring circus sometime before the end of January.  And yes, statistically speaking I run about a 70% chance of experiencing pre-term labor again.  But in my heart, I know that my husband and I are thrilled that our family is about to grow, and we found the best MFM in the bi-state area who will stop at nothing to keep me pregnant to term.  

Was I initially terrified about what you might think or say behind my back?  You bet.  In fact, I spent the first few weeks of my pregnancy loosing precious sleep over it.  

When we announced our news to close friends at our son's first birthday party, my friend was snapping pictures and I was a little alarmed to note that my face looked somehow apologetic.  What was I apologizing for?  I'm sorry we will soon be a family with three children under three and making plans with us might become next to impossible?  I apologize that I've given you a really interesting piece of gossip to take home with you along with your beach pail goodie bag?   What gives  When will I finally evolve to a state where I just don't give a shit?

And remember, these were our friends.  Friends who have shown us nothing but un-conditional support during the past 27 months of insanity.  Friends who's reactions to the news were genuine smiles amd congrats and one delighted exclamation that 'you guys are machines!'

Now, at 12 weeks, we are going public and announcing our news to the entire cruel world.  All of Facebook (and the handful of you who actually read this terrible blog) is/are now free to raise eyebrows and drop jaws in genuine surprise and come to whatever conclusions may arise.

After scrolling through the photos from my son's party and being appropriately appalled by what I saw on my face, I think I am finally starting to adapt a much healthier attitude about this pregnancy and even life in general.

At some point in my college career, I learned that humans are hard-wired to make snap decisions about people and situations.  It was part of our initial evolution and essential to survival.  

Hungry lion = bad.  
Attractive potential mate = good.  

If we didn't pass quick and simple judgement, it might mean we'd find ourselves on the wrong side of dinner and thus, the losing side of evolution.  Therefore, it's just human nature that compels us to immediately file every situation neatly away in either the 'good' or 'bad' box.  

Do I need to sit around worrying about which box my news is landing in for that high school classmate I haven't seen in 14 years?  No.  

The really important thing is that I have shifted my focus on the responses of those people who really, actually matter.

1. My husband.  I can still see the look of immediate and genuine delight on his face when he got the news.  

2.  My parents.  Their reactions were, without hesitation, overwhelmingly ecstatic and downright gleeful.

3. My MIL and FIL.  Joyful.  Thrilled.  Elated.  

4. My friends.  Genuinely supportive and appropriately awesome.  

'Good' boxes, all around.

Without a doubt -- no matter what my old volleyball teammates, sorority sisters, or ex-coworkers think about the matter -- this child will be loved.  

Our baby has already taken his or her place in our chaotic little world and frankly, it feels like exactly the right thing for our family.  

So perhaps my insecurities over your opinion will continue to plague me, or maybe I really am finally over it.   I've spent so much of my life people-pleasing, it's hard to say if it's an affliction that will ever actually resolve.  But I only have a finite amount of space in my brain allotted to things like worry and concern, and frankly it's a pretty busy spot these days, so I think I will spend it worrying about things that are actually important.  

EPILOGUE: I wrote most of this post a couple weeks ago with the intention of posting this week when we became 'FBO' and woke up this morning with an epiphany on the matter: you don't care.  Most of you really couldn't give two sh*t's if I have one or a dozen children.  If anything, with each additional child, my posts become more interesting.  Sure, you may still make passing comments on the matter, who doesn't when they see a man or woman toting around more than a couple children?  I myself couldn't help but generate brief commentary over the woman who brought five children on our flight this week.  Still, in the larger sense, no one actually cares.  If someone chooses to first pass judgement then actually carry out a sentence of treating me poorly or differently due to my very personal decisions, that says a lot more about them than about me.  

That is all.