Still Pregnant

Not sure if anyone is still checking in on this blog, but I thought I’d drop by and give a little update, just in case someone really wants to know if I’ve had my baby yet.

The answer is no.

I will officially be 41 weeks tomorrow.  Little Miss Whatsit has her own schedule that I am not privy to.  🙂  Unfortunately, my amniotic fluid levels have been low and if they haven’t improved by tomorrow, my doctor wants to induce.  I hear that doctors always want to induce you if you go past due, but at least she has a medical excuse.  So, tomorrow morning I will find out if we are going to speed things along or just keep allowing them to unfold in their own time.  I’m of two minds about it, actually.  I think that, in most cases, women and babies would be better off waiting until they were ready.  But, I’m getting a little tired of being “on call” as it were.  I’m not horribly uncomfortable or anything; I feel like I could stay pregnant a little longer without going out of my mind.  I actually feel better now than I did in the first two trimesters.  It’s just the waiting with no real notion of when things are going to start happening that’s getting on my nerves.  That, and all of the doctor’s appointments.  I see my doctor twice a week and starting this week, I’m supposed to be getting non-stress tests twice a week.  I had one on Monday and everything was great.  If we don’t schedule an induction, I have another one tomorrow after my doctor’s appointment.

In other news, I got an email from a journal today notifying me that I have been listed as a co-author on a paper that was submitted to them.  It appears to be my thesis paper and I am first author.  It would have been nice if Advisor had sent me an email about it.

Placenta Previa, or Why This Baby Will Be an Only Child

So, on Sat. I started having some spotting (I’m at 25 weeks now, btw) and possibly contractions.  So, I stopped moving bookshelves,* drank two glasses of water,** and laid down.  The bleeding stopped, the contractions went away and Husband left for his business trip as scheduled on Sunday.  I already had an OB appt. on Monday and at that appt., the OB checked the location of my placenta and guess what!  It’s right up against the cervix.  The OB couldn’t tell if it was going around part of the cervix or covering it.  The transvaginal ultrasound would tell her more, but she doesn’t want to do it for fear of causing more bleeding.  So–bonus!–no more internal exams either.

This condition is known as placenta previa and I am now at a much, much higher risk of bleeding uncontrollably and dying.  The fun never ends.  Because I only had that one incident of spotting after I had obviously been overdoing it, my doctor put me on restricted movement instead of bed rest.  No exercise!  No sex!  No lifting!  Take it easy at work!  (Not a problem there.)

If the placenta is just very near the cervix, as the uterus expands and pulls the placenta away from the cervix it might pull the placenta far enough away to allow for a vaginal birth.***  If the placenta is covering the cervix it is unlikely uterine expansion will pull the placenta far enough away from the cervix and a c-section will be necessary.  I’m imagining they would do it somewhat early as well considering that there is a huge risk that you will bleed out and die if you go into labor.  It probably depends on how much of the cervix is blocked.

So, I’m pretty much sitting at home and knitting for most of the rest of my pregnancy.  I’m not particularly concerned that I will start bleeding uncontrollably any time soon because I’m pretty sure my OB would have stuck me on bed rest if that were the case.  But, I really don’t want to do anything that might cause spotting because then I will be on bed rest until mid to late November.  And dudes, it’s only August!  Can you imagine laying in bed for the next several months????  And, what about my restless legs?  They will drive me insane if I get put on bed rest.  So.  Sitting at home.  Knitting.  Sewing.  Embroidering.

 

*I have heard there are men who will not allow their pregnant wives do anything remotely strenuous.  Husband is not one of them.

**The advice given on my “preterm labor” sheet from the OB.  I guess dehydration can cause contractions.

***Or, according to my OB, my placenta might not move at all.

Amniocentesis, or Why I Sometimes Hate Medical Doctors

I have passed the mystical age of 35 (by 2 years) which puts me into a “higher risk” group for just about everything pregnancy related.  Particularly, doctors are concerned about increased risk of genetic abnormalities.  Apparently, at 35 years old, you cross a threshold in which the risk of having a baby with a genetic abnormality is greater than the risk of miscarriage from amniocentesis.

Husband and I talked a long time about whether we wanted to do amnio or not.  Pretty much, it came down to the question of, “Were there any circumstances in which we would terminate the pregnancy?”  I originally thought there weren’t, but then I read a little on some of the nastier trisomies (fortunately quite rare).  Husband and I decided that if our baby had a genetic condition that caused 50% of babies to be stillborn, 80% of the ones who lived to die in the first month, and 90% of those survivors to die in the first year, well, frankly it would be a mercy to the poor little tyke to terminate now rather than have it go through all of that suffering and damn the Pope and the Church for thinking otherwise.

So, we scheduled an appt. for my 16th week.  My ob doesn’t do amnio herself, she refers her patients to a specialist, Dr. M,  with whom she has been associated with for at least 15 years.  So, Husband and I went to Dr. M’s office and talked to the genetic counselor* who recommended blood screening for cystic fibrosis for me and Tay-Sachs for Husband (who is of French Canadian descent; apparently, being French Canadian increases your risk for being a carrier of Tay-Sachs to 1 in 30).  Then, it was time to do the amnio.

In case you are unfamiliar with amniocentesis, the procedure is done by doing an ultrasound to determine the position of the baby so the doctor knows where to insert the needle.  A pretty comprehensive set of sonograms were taken and Dr. Assistant I  (perhaps a resident or a fellow?) took all kinds of measurements on the baby (bone lengths and such).  He also measured my ginormous fibroids.  Then, Dr. M (a white-haired man who conceivably could have been doing amnio since it was first offered) came in to do the procedure.  Well, he moved that ultrasound do-hickey around for a long time but between the position of the baby and the apparent minefield of little fibroids I have (not to mention the big ones), he was having trouble finding a good spot to poke me with the needle.  So, Dr. M recommended I come back in two weeks to allow my uterus to grow more (evidently, fibroids do not grow as much in the 2nd and 3rd trimesters as they do in the first) to give him more surface area to work with.  So, I scheduled another appt.

That appt. was today.  In contrast to the previous appt. when we had a very good experience with the staff and doctors, this appt. was fairly disastrous.  First, I had been having menstrual-type cramps most of the morning, so I wasn’t in the best state going into the appt. (though glad I coincidentally had a doctor’s appt. that day so I didn’t have to call up my ob).  Second, the office was running an hour behind and the waiting room was so small that there were not enough chairs and husbands were all standing.  Then, I was taken into a much smaller and less attractive exam room than my previous appt. (seriously, it looked like something you might find in an ancient, abandoned clinic somewhere) and Dr. Assistant II did all kinds of measurements AGAIN.  I told her about the cramps.  She seemed completely unconcerned, which was fine except that she kept asking me if I had been having contractions (yes, I think that’s what the cramps are!) and then proceeded to push the ultrasound do-hickey hard on one spot and ask if it hurt.  Yes, thank you, it hurt quite a bit!  So, she tells me I’m having a contraction there, but her primary concern about that seemed to be that it would interfere with the amnio.  Okay, fine, I know you can have contractions pre-labor, though I didn’t think would start so early.  However, I was starting to get very irritated and was about to say the following:

1.  Stop asking me whether I had a contraction the last time I came in.  I have already told you three times that nobody mentioned anything about it and I sure as hell didn’t feel anything.  My answer is not going to change.

2.  Stop telling me to relax.  It’s very hard to relax when you have someone constantly admonishing you, “You must relax!  You have to relax.  Relax.  Relax the muscle.”

3.  If you don’t stop pushing that damn ultrasound thingy on the spot that I am apparently having a contraction I am going to take it from you and choke you with the cord.  The contraction doesn’t hurt, you pushing on it does.

So, then Dr. M comes in with Dr. Assistant I.  Now, there are three doctors, me, and Husband in this tiny little room in which I am supposed to be relaxing.  Dr. M starts scanning my belly and looking for a good spot to do the amnio in between my field of fibroids.  He says I have low fluid volume.  I ask if it’s still safe to do the amnio in that case and he says, that it makes it more “technically challenging” is all and low fluid volume has “nothing to do with the amnio.”  Um, excuse me, if I’m not mistaken, you are about to remove some of the fluid which you have just pronounced to be at sub-optimal volume.  How can that not be related to whether the amnio can be done?  So, he’s looking, looking, looking and he says that the contraction is making it difficult to find a good spot to do the amnio so he’s sending me out to the waiting room to “relax” and to sign a consent form for the use of terbutaline which they will give me to relax the uterus to make it easier to do the amnio.  And he leaves the room.

Dr. Assistant II left some time ago.  Dr. Assistant I is rushing us out of the room.  “What are the risks of taking the medication?” I ask him.  “What?” he says.  “Are there risks associated with taking the medication?” I ask.  “Yes, yes, of course there are risks, that’s why there is the form for you to read.”  And he ushers us out into the waiting room and hands us a clipboard with a form on it.

It is now 1.75 hours since we entered the clinic.  The amnio is not done.  The doctors are not talking to me.  I’ve been given a consent form (with several typos in it, not the most reassuring thing in the world) that explains what the medication is, what it’s supposed to do, what the side effects are, and the risks to the baby but I have no time or internet access to research the drug myself.  I’m feeling rather overwhelmed.  That’s when Husband asks if it’s okay if he goes outside to do a teleconference (!) until the doctor calls me back.  I say no.  He tries to persuade me it will be okay, he’ll come right back in when the doctor comes.  We argue.  In the waiting room.  Where I’m supposed to be “relaxing.”  Suddenly, it’s all too much and I start crying silently.  Another woman in the waiting room disappears back behind The Door to the examining area and comes back with a box of tissues to give to me.

At that point, I go to the desk and say, “Look, I’m freaking out here and the longer I wait, it’s only going to get worse, so I want to speak to the doctor right now or I’m going to leave.”  But, instead of the doctor, I am taken into the back (blessedly out of sight of the rest of the people in the waiting room) to talk to the genetic counselor.  So, I explain what’s going on, that the doctor hasn’t talked to me about this AT ALL, that I want to know what the risks are of doing the amnio under these conditions, that I’m being made to make a decision about a medication I know nothing about and nobody has asked me if I’m currently taking other medications in case they interact badly, and frankly, I’m no longer sure that I’m willing to take the risk of doing the amnio under these conditions.  The genetic counselor (who looks to be too young to need amniocentesis, and therefore I don’t believe she can understand where I’m coming from) is trying to tell me that the risks haven’t changed.  This makes no sense to me whatsoever (and I tell her so) because the doctor has already stated that the amnio will be “technically challenging” that it will be difficult to not nick either the fibroids or the baby and that I’m having to take some medication for this to even work at all so this should put me into a different category than the one in which the original risk was calculated.  My cost-benefit analysis has changed and I’m not sure how and I’m not being given enough time to decide if it’s what I want and I’ve not been given privacy to discuss this with Husband and the damn doctor won’t talk to me!**  Nevertheless, the genetic counselor tells me that the worries about the drug are that it can cause increased heart rate and dizziness in me, that taking it will make the procedure easier and that if there still isn’t a good spot, the procedure won’t be done.  Husband is okay with all of this and as I calm down, I’m starting to be more okay with it.  But, as I told Husband, if there was any hemming and hawing on the part of the doctor, we were outta there.

So, we go back down to where the exam rooms are and Dr. Assistant II is trying to rush me into the third-world exam room because the good one is taken again.  I insist upon going to the bathroom first and when I come out, husband says they are now talking about sending us to another one of their clinic locations.  That is so not happening.  So we’re in the waiting room, AGAIN, and I tell Husband I am waiting exactly five minutes and then I’m leaving.  Nobody else is in the waiting room, I am now the last patient of the day, even though it’s only around 12:30  (it seems they go to another clinic location in the afternoon, this is why they were talking about sending me over there).

Finally, I’m back in the rinky-dink exam room.  Dr. Assistant I tells me they are going to look with ultrasound to see if there’s a good spot.  When I remind him this has already been done (did he forget me already??) he tells me that the baby moves sometimes after you walk around a bit and so the situation may have changed!  Why the hell didn’t they mention this before?  Why wasn’t that the first suggestion?  Dr. M does his scanning thing again and, lo and behold, the contraction is gone, the baby has moved, there’s a good spot for doing the amnio and the thing is done without any medication whatsoever.***

So, now I am at home, on bed rest for the rest of the day as is routine post-amnio, complications or not, and I am supposed to take it easy the rest of the week (no exercise, no lifting over 20 pounds, no air travel, no sex).  The results are supposed to be back in 10 days (they need to grow the cells, first, this is the longest part of the wait).  If I wanted FISH done, I could have results back on trisomies in 2-3 days but it’s an extra $350 and we have some time yet if the results are bad.

So, that was my experience.  I have to say, from a patient-friendly point of view, it was appalling.  The clinic only does ultrasounds and amniocentesis and they seem to do them in a rather drive-thru-like manner.  They had clearly overbooked for the day.  There is no time or opportunity to sit and talk with the doctor doing the procedure.  If the doctor had taken five minutes to tell me exactly what was going on and to address my concerns, everything would have gone much more smoothly.  The fact that they send you back out into the waiting room to make a fairly important decision instead of giving you privacy and the fact that they expect you to sign a consent form without speaking to a doctor is inexcusable.  Really, as soon as this all started happening, we should have just left.  Left and rescheduled or left and decided against doing the procedure.  It was not a life and death decision.  There was no need to make the decision right now other than not wanting to have to go through this all over again.

What this whole experience has done (aside from convinced me that I never want to step foot in that clinic again) is reinforce my conviction about having a birth doula (which, it turns out, my insurance will pay for so there’s no reason not to).  There really needs to be someone who is not emotionally involved to make sure that my rights as a patient are being respected.  I still would like to have an ob do the delivery (although, if I wasn’t taking so many medications, I’d look into switching to a nurse midwife just to avoid ridiculous doctor and hospital mentalities that are so pervasive in the United States).  But, I’m bringing along my own advocate.

 

 

*In which the following exchange happened:

Counselor:  How familiar are you with genes and chromosomes?

Me:  I have a PhD in cell biology.

Counselor:  Ah, well, I guess I’ll just skip this next part, then.

**I should mention that mixed in with this mess was the fact that I’m currently taking a master’s class at a local university that meets 8 hours a day for three weeks and that I was already missing one day of class and I didn’t want to miss another.

***It was fairly uncomfortable and nerve-wracking to have the needle shoved into me, but not especially painful, though Dr. M did warn me that if the needle touched a nerve ending I could have pain in, “all kinds of unexpected places,” whatever the hell that was supposed to mean?

An open letter

Dear Maternity Clothing Designers,

I am writing to ask you to reconsider one of your Summer 2011 design choices.  Please know that I appreciate your attempt to provide a stylish alternative to dowdy and/or childish maternity clothing.  However, I think you may not have thought through one of your designs very well.

I am 4.5 months pregnant and have a bit of a belly.  I am assured that I will continue to gain weight throughout my pregnancy and that the weight will not all be distributed in my belly and bust.  Some of it will undoubtedly settle on my thighs and butt.  Therefore, dear Maternity Clothing Designers, your contribution of itty bitty short shorts with a belly band is most unwelcome.  And given that, in every maternity section I go to, there are racks upon racks full of itty bitty short shorts, my fellow pregnant women agree with me.

Please put some capris and walking shorts on the market.  I think you will find they are better sellers than the itty bitty short shorts.

Sincerely,

Mrs Whatsit, Phd (+1)

Unsolicited, unwanted advice–check!

I have hear from several sources that something happens when you become a parent in which the normal rule of other people minding their own business suddenly gets replaced by other people imposing their advice and words of wisdom on you as though it is their God-given right.  Fortunately, my mother, grandmother, and mother-in-law have blessedly refrained from doing so thus far.  However, two nights ago, at knit night, I was whacked upside the head with unsolicited advice in a surprise attack by a friend who is the mother of a 5 month old.  Let me give you some background.

I have thought quite a bit about the sort of childbirth I would like to have.  Primarily the words “calm” and “pain-free” come to mind.  “Natural” makes it on the list, but it’s somewhere after calm and pain-free.  I have pretty much rejected whatever method it is that has you breathing short, gasping breaths (popular on TV shows) because it does not seem to be pain-free.   Ever since I heard of it in college, I have been intrigued by the notion of self-hypnosis as a means of coping with childbirth.  Therefore, I picked up a hypnobirthing book at the bookstore and have read it cover to cover and looked up childbirth and hypnosis on pubmed (not too much data there, unfortunately).  There is a lot that makes a very great deal of sense in the book.  The basic premise is that childbirth does not have to be an extremely painful experience and actually isn’t in many non-Western cultures, and, indeed, a woman’s body is designed for childbirth.  However, the notion of childbirth as a horrible, excruciating experience is so ingrained in our culture that women (whether they realize it or not) experience quite a bit of fear going into childbirth.*  During the fear response, blood is directed away from non-essential organs (such as your uterus) to essential organs.  Therefore, the muscles in your uterus will not be able to function at an optimal level and this causes you pain.  If, however, you can teach yourself to relax and remain calm during the birthing process, your uterine muscles will function better and you will have an easier birthing experience.  The exact mechanism of how this all works is mostly supposition, of course, but it seems as though it does work for quite a few women.  The relaxation necessary is achieved via self-hypnosis, though I suppose how you become relaxed is less important than being relaxed and staying relaxed.

Given that I have anxiety problems to begin with,  I am all for learning techniques that will help me relax.  Husband is on board with this approach as is my psychiatrist.  Not sure how my OB will react, but hopefully, she will be supportive.  My mom and grandma seem a bit dubious that it will work but are mostly supportive.  In fact, my mother primarily experienced pain-free childbirth herself.  She didn’t use any specific technique–she reports that, for whatever reason, she didn’t feel her contractions.  Recordings showed her contractions were off-the-charts, yet she had to have a nurse put her hand on her stomach to tell her when she was experiencing a contraction so that she knew when to push.  She felt very little pain overall except for when my brother was born and the doctor used forceps to yank him out (standard at the Army hospital at that time).  So, there is hope.

So that is my reasoning.  However, upon mentioning that I was going to be going to a hypnobirthing class, my friend, M, began to tell me what a bad idea it was.  Apparently, she had some friends who tried hypnobirthing and it “didn’t work” for them.  What she meant by “tried” is unknown (Did they attend classes or only read the book?  Did they practice the relaxation exercises every day for several weeks as is recommended?) and I don’t know in what way it “didn’t work” (Did they end up using a different technique, getting an epidural, having a C-section, getting induced?).  M said several times that she wasn’t trying to tell me what to do while at the same time telling me what, exactly, she thought I should do.

During the course of our “discussion” it became clear that M did not know much about the hypnobirthing method beyond the fact that it didn’t work for her friends.  Her main point seemed to be that you should learn many techniques because “you never know what is going to work for you,” and, “you don’t know how you’re going to deal with childbirth until you are in it.”  The ideas of using different positions, breathing techniques, visualization, and time distortion were all things she mentioned that were necessary and, although I pointed out that hypnobirthing incorporates all of those things, continued to try to convince me that hypnobirthing was not the way to go.  In the end, I just smiled and nodded because it was clear nothing I said was going to register with her.

I think I would have been somewhat more receptive to what she said if it had been couched in terms of her experience (“this is what worked for me” kinds of phrases) and not absolute statements (“this is how it is,” “this is what will happen to you”).  Or, if she was the mother of, say, five children instead of one.

I’m absolutely willing to accept that hypnobirthing might not work for everybody, that, in fact, it might not work for me.  What I object to is being told that it absolutely won’t work based on the limited experience of one person.

 

*This reminds me a lot of panic attacks.  Panic attacks are triggered by an automatic negative thought which can pass through your brain so quickly, you don’t even notice it.  The panic attack then seemingly comes from out of nowhere.  Cognitive behavioral therapy then often focuses on learning to become aware of these automatic negative thoughts.

In which I’m horribly ill

So, a couple weekends ago, I had just gotten to the point that the worst of the first trimester woes had passed and I was actually feeling pretty good.  I was down to one nap a day instead of three!  I was even ready to tackle cleaning up the apt. (I have church stuff all over creation due to preparing for a special event).  And then, I started sneezing.  I thought it was allergies or something, but I woke up the next day with a cold and felt absolutely miserable.  I barely got out of bed and didn’t even shower, that’s how bad I felt.*  The universe is cruel.

So, I’ve been recuperating this past week and I actually feel quite a bit better, although both my grandmother and mom say I sound awful (thanks, guys).  Basically, I’ve been laying around the apt., drinking OJ and tea with honey and taking lots and lots of naps (and coughing up a lung and using boxes of kleenex).

But, I’m looking forward to getting back to a good version of my old self soon.  So, I’ve informed Husband that, as soon as that happens, we are going into full-fledged baby prep mode.  I have no idea how long I’ll be feeling good and I hear that the third trimester is pretty miserable, so we’re going to make the most of this time while it lasts.  This will involve purging enough books to eliminate one of our bookshelves (out of six) to make room for the desk from the study (aka the baby’s room) in the living room and repainting a dresser** and moving it to the baby’s room.  Also, we need to rent a storage unit and move everything out of the baby’s closet into the unit and a lot of the stuff in our little storage space next to the apt. to make way for baby stuff.  Oh, and move the cat litter from the baby’s room to a hall closet (where we shall also keep the diaper pail; it’ll be the stinky closet).  Then, we’ll have room to move in baby furniture and accoutrements.  It’s a lot of work and it’s not the kind of thing I can do when I’m 8 mos. pregnant, so we’re going to try to get it done now.

Of course, there’s also the possibility that we’ll move (which, due to lease constraints, probably won’t happen until I’m 8 mos. pregnant).  We’re waiting to see if Husband will be getting much of a raise in July.  If he does, we’ll be looking for a place that’s slightly larger and, more importantly, with a washer and dryer in the apt.  Right now, we have to drive to the laundry facility in our complex and that’s going to suck after the baby gets here.

So, big plans afoot.  Just as soon as I get better (Hello!  Immune System!  Time to get a move on!).

 

*Even during my absolute worst case of depression, when my doctor started suggesting I go to a hospital, I still showered everyday.

**The dresser belonged to my mother when she was a girl and my grandparents let her paint it herself.  It’s really very sweet–white with large, sixties-ish blue flowers–and normally I’d want to keep it the way it is due to it’s family history value.  But, the paint’s peeling in a lot of places and God knows if there’s lead in it, so I’ll be repainting it.

Not smug

So, I’ve been struggling a bit these last few weeks.  I have been tired, run-down, no energy to speak of, irritable, reclusive and increasingly depressed.  I’d like to take this moment to say pregnancy sucks.  Don’t get me wrong, I’m happy beyond belief that around Thanksgiving, Husband and I will finally, finally have a baby.  But, all the stuff between now and then?  Sucks.  I know my situation could be worse.  I could be having more complications, for instance.  But, dude, this blissed-out feeling earth mother feeling that I’ve heard about?  Not coming my way.

I hear it gets better in the second trimester.  As I am now at the end of the first trimester, I’m wondering when that’s going to happen.  I can’t imagine I’m going to ever get to the earth mother stage, though.  I mean, it’s not like I’m the first woman to ever get pregnant.  Or the first mammal for that matter.  And, I’m only having one (according to the ultrasound, thank God), not carrying around a litter like cats, dogs, and mice do.  Nor do I have to be pregnant for almost two years, unlike elephants (really, really thank God for that one!).  Or have to sit on a nest for days on end like egg-layers do (though that might actually be better if I could get Husband to do it for awhile after he gets home from work).  So I’m not sure what there is to get high and mighty about.  Frankly, at this stage in the game, I’m actually a little irritated that this whole thing is going on inside me where I can’t observe it.  Do other scientists feel that way, too?  I mean, if I had my way, I’d have high-resolution ultrasound every other day so I can see what’s going on.  I had one a few weeks ago and my doctor pointed out the head and limb buds (correct number of everything, fortunately, no homeotic mutations visible), but I’m pretty sure things have changed a bit since then.  How many ultrasounds is it safe to have?  Do you suppose there’s a research study I could join that does them weekly?

Anyway, getting back to the point of this post I’ve been feeling like crap.  Yesterday, I went to see my psych doc for our monthly meeting (I’ve been having them pretty much once a month since I started going to see her; I’m guessing it will increase as we get closer to the due date and certainly after the birth).  And, here’s the thing, how do we determine if I’m feeling like crap because I’m pregnant (and am, essentially, a walking bag of hormones) or if I’m feeling like crap because I’m depressed?  Or is it both?  Having never been pregnant before, it’s difficult for me to tell, exactly, but it feels like a mild depression.  So, we eventually decided to up my SSRI and see if that helps.

Another reason this whole thing sucks is that it is spring and normally this is the time of year I feel really good, sometimes almost a little too good.  This really good feeling lasts until about mid-summer when it starts to change into just feeling good by the end of the summer, okay by mid-fall, and bad by winter until around March or so.*  So, I feel a little gypped out of my really good time of year.  In fact, I would have to say that I’ve mostly slept through spring.  And spring is really lovely here in the bay area.  Today, in fact, it’s 85 degrees out.  I’d go for a swim if I wasn’t so damn tired.**

So, that’s what’s going on in Mrs Whatsit-land.  Please tell me you guys are doing better.  I need to hear some good news to balance my mood.

*Given that cycle, it really would have been better for me to get pregnant in the fall and give birth in the spring so that I won’t get hit with the double whammy of postpartum depression and seasonal affective disorder.

**I’ve got another rant about maternity clothes, btw.

Migraine + Pregnancy = No fun

What do you do when you have a migraine while pregnant?

Sadly, I suffer from migraines.  Fortunately, they rarely make me significantly nauseous, nor do I get the “aura.”  They are, however, quite painful and since they are usually located behind one of my eyes, that eye waters.  My simple, but effective technique for dealing with them over the years has been to take 800 mg ibuprofen at the first sign of a headache, put a cold pack on my forehead, lay down in a dark, quiet place and attempt to take a nap.  I am sure not every little twinge in my head would have developed into a migraine (some probably would have been your run-of-the mill headaches), but with migraines it is important to head them off as quickly as possible because it is much more difficult to get rid of them after they fully develop.  I understand this is actually true for pain management in general, and though I’ve never heard why, my guess is that those particular receptors take a long time to turn over making them fairly inaccessible to pain medication once the pain starts (though someone should correct me if I’m wrong) (look, science content!).

As you may know, you cannot take ibuprofen (or aspirin, or aleve) when you are pregnant.  So, when I felt a headache developing the other night I was pretty concerned about how I was going to deal with it since, in the past, Tylenol has not touched my migraines.  Nevertheless, I took two Tylenol, put an cold pack on my head, and went to bed.  And, as I feared, I woke up in the middle of the night with a migraine.  Took more Tylenol, put another cold pack on my head, and went back to bed.  And woke up this morning with the migraine still going strong.  So, I took more Tylenol and this time added my secret weapon:  caffeine.

If you look at the back of a bottle of  extra-strength Excedrin, you will notice one of the active ingredients is caffeine.  Caffeine is actually good for relieving migraines (if it is not what causes your migraines in the first place, it can do both).  You may have heard that pregnant women are supposed to stay away from caffeine, but if you do the research, it turns out that you can have up to 200 mg caffeine a day which is about the amount in one 12 oz cup of coffee or several 8 oz cups of black tea (depending on how strong you brew your tea).*  Of course, green and white tea have even less caffeine so you can have a whole teapot of one of those, if you want.

At any rate, I took more Tylenol, had a cup of strongly brewed tea (I hate coffee), laid back down, et voila!  Migraine gone.  For some people, I know, it would not be so easy.  These unfortunate people likely take something quite a bit stronger than ibuprofen for their migraines and fortunately, some of those can be used during pregnancy.  However, I think drinking some caffeine could be something to try if you are stuck with only Tylenol to soothe your pain.

*This is a useful number to have handy in case someone (your mother-in-law, for instance) gets on your case about having a caffeinated beverage.  Not that I would know anything about that.

Things to NOT say to your pregnant wife

Scene:  Bedroom, trying to go to sleep

Me:  I’m really worried about the weight I’m gaining.  I’m worried I won’t be able to get rid of it all after the baby arrives.

Husband:  Well, maybe you should count calories more.

Me:  That was not what you were supposed to say.

Husband:  I’m sorry.

Me:  You were supposed to say that of course I will be able to lose the weight and even if I didn’t you would still love me and find me attractive.

Husband:  Of course you will lose the weight and even if you don’t, I’ll still love you and find you attractive.

Me:  Too late.

Husband:  Sorry.

Finis

I am now 9 weeks pregnant and I have already gained 10 pounds.  Despite finding some ridiculous nutritional recommendations online (which wanted you to substantially increase your intake of all food groups yet somehow not add more than 300 calories to your diet), I ended up adding just 1 serving of fruit, 1 serving of veggies, and one serving of dairy a day to my diet.  That really doesn’t seem like enough to have caused me to gain 5 pounds a month.  Not only that, but for awhile I had decreased appetite and a bit of nausea so I wasn’t eating much of anything at all, which you would think would lead to me gaining less weight (I usually lose weight when I’m sick).

Now, it turns out I have some mega uterine fibroids that have probably grown as a result of the influx of large amounts of hormones.  So maybe that accounts for some of the weight (for real, they’re huge*).  I mentioned this to my mother and her response was, “Oh, no, I don’t think so.”  Turns out she gained weight right away whenever she was pregnant.  She said it was like her metabolism just stopped, it didn’t matter what she did, she gained weight.  She gained an average of around 50 pounds each time (she was fortunately only 109 lbs starting out).  And she did lose it all every time.  Unfortunately, she had a serious eating disorder at the time, so there’s no telling what would have happened if she had actually, I don’t know, ate after she delivered her babies (or didn’t take massive amounts of laxatives).  Since I am not keen on developing an eating disorder (I have enough mental health problems, thank you very much), it looks like I’ll have to take the traditional route of diet and exercise.

In addition to causing me some concern about my post-pregnancy self-image, the added weight has caused another problem.  Since the extra pounds all collected on my belly (in contrast to where I normally gain weight which is on my butt and thighs), I am actually starting to look pregnant a lot sooner than I expected.  So much so that I’m starting to wonder how much longer I can keep it a secret.  Originally, we had planned to tell only a handful of people until I was in the 2nd trimester when the risk of miscarriage decreases considerably.  I’ve been trying to disguise my growing belly with baggy clothes, but that really can only take you so far.  I have a feeling it won’t be long before somebody’s curiosity overcomes their politeness and they ask me about it.  In fact, somebody at church has already asked A who replied that she didn’t know and they should ask me (which was a total lie, she did know; that’s an awkward situation to be in, lying to people at church, poor A will have to go to confession about it for sure).  At this point, I almost wish it was still a taboo subject, that way I could avoid having to answer the questions of nosy acquaintances, potentially letting them in on the secret before the rest of my family even knows.

So, we’re thinking of telling our families at the end of next week.  That’ll be 10 weeks.  That’s close enough to second trimester, right?  And, I’ve already had an ultrasound and little Emmy (short for embryo) has a heartbeat, so we’re probably in the clear.  Right?

Right?

*One is 6.3 x 7.2 x 6 cm and another is 3.7 x 3.4 x 2.7 cm.  My little embryo, in contrast, is about an inch long.  My ob does not seem terribly concerned about the fibroids, though, so I’m trying not to worry about them.

PSA: Go to a bra shop. For real.

Since becoming pregnant, there have been some changes with my body.  The worst one, as far as I’m concerned, is that my breasts have basically been hurting continuously, day and night, for the last 5 weeks.  It’s not excruciating, but it’s always there.  It’s a bit like having a minor headache for 5 weeks straight.  It’s not the end of the world, but it’s unpleasant and, frankly, it’s not helping my mood any.

Well, last night, I decided I had had enough.  I looked at Husband (who has been hearing me say that my breasts hurt every day for the last 5 weeks) and said, “I can’t take it anymore.  I’m going to a bra shop.  It will be crazy expensive.  I don’t give a damn.  This. Has. To. STOP!”  He (very wisely) answered, “Okay, that sounds like a good idea.”

I had heard very positive things about bra shops in general from various female friends, who are, shall we say, a little on the busty side.  I had heard words like, “the most comfortable bra I’ve ever worn,” “life-changing,” and, “it made me look 10 pounds thinner.”  Basically, women who had been to bra shops could not say enough positive things about them.

My friends, it is all true.

This morning I went to a shop recommended by a friend.  I went into the store and told the woman working there, “My breasts hurt.  They need more support.  I’m willing to do whatever it takes.”  She looked slightly taken aback, but assured me she could help.  I explained that I am 7 weeks pregnant, and she put me in a lovely fitting room, measured around my ribcage, showed me why my current bra was not going to give me what I needed explained what she thought I did need, and brought me bras to try on.  It was beautiful.

As soon as I put the first one on, I knew I was hooked (no pun intended).  It was the most comfortable bra I had ever worn, it was life-changing, and it did make me look 10 pounds thinner (for real, guys).  And my breasts no longer hurt.  The salesperson (and I hesitate to call her that, because I really feel she deserves a more grandiose title like, “Bra-fitting Goddess”) explained that she was bringing me bras that were particularly stretchy in certain regions because my breasts were going to continue to grow (Oy!  Say it ain’t so!) and with pregnancy, I would likely put on weight in my ribcage.  So, she wanted me to have a bra I could grow in a little bit, while still providing me with the support I need.  She also said she was bringing me a very popular, basic bra that was in the low end of their price range.  “I can bring you $200 bras if you’d like, but since you will probably need a larger bra in a couple of months, I thought you might not like to spend that much.”  Indeed.  I remarked that I would likely need these bras again when my breasts decrease back to normal, they will go back to normal, right?  “Don’t count on it,”  she said.  Double OY!

With each bra, she evaluated the fit and brought me another size if it didn’t fit the way she thought it should.  I could tell which ones fit properly and which ones didn’t simply by how comfortable they were.  Additionally, she said women who get diagnosed with “blockages” (whether in milk ducts or lymph ducts was unclear) often have ill-fitting underwire bras that are putting too much pressure in one spot of the breast tissue.  I’m not sure what the data is for that, but I can see how it could be true, given where the underwire on my old bra was ending up under my arm.   She showed me where the underwire should end up under my arm for a good fit.  She mentioned breast-feeding that women who breast-feed unevenly often end up with uneven breasts, so beware!

In the end, I bought two bras which cost about $140 in total.  This was a whole lot cheaper that I thought it was going to be (I was prepared to spend up to $150 per bra if necessary, that’s how much distress I was in!) and, actually, not much more than I had spent on two of my ill-fitting bras.  I did try on one very pretty (and sexy) black bra with stretch lace at the top that would also allow me to grow that was a little over $100, but I decided to save it for next time (because I’m absolutely sure there is going to be a next time, and probably in about a couple of months).  She didn’t pressure me to buy the more expensive bra, she just asked if I wanted her to write down the brand, model, and size in case I wanted to come back for it.  She didn’t even mention buying a matching panty (which I’m sure they had).  Her goal was to get me in a well-fitting bra that I liked, not to get me to spend as much as possible in the store.

I wore one of the new bras out of the store.  I really couldn’t bear putting the old one on again.

To give you an idea of what kind of change we are talking about here, I walked in wearing a 36D (the size recommended to me by the saleswoman at Victoria’s Secret) and walked out wearing a 38E.  The 36F was a little too snug around the ribcage even though the cup size was right.  I was a little distressed about the cup size.  The Bra-Fitting Goddess tried to soothe me, “Don’t worry about it, it’s just a letter.”  Yes, but it’s a letter that indicates I will probably always need to buy the more expensive bras (although, as I said, the two I got were not that much more expensive than others I owned).

Why did I wear such ill-fitting bras for so long?  Well, one reason was that I had balked at the idea of going to a bra shop because I thought all of the bras would be at least $100 or more and I didn’t want to spend that much on a bra.  This was somewhat faulty thinking, though, considering how much I wear each bra (I usually only have two or three at a time and therefore wear each one about 3 days a week).  Really, given how much time I spend in each bra and how important I feel it is to be comfortable, a very good, expensive bra makes a lot of sense and is a smart investment.  I had come to this conclusion about my eyeglasses a few years ago (I wear a pair of glasses 16 hours a day, every day for two or three years, so it’s worth it to me to buy a nice pair that I really like), but really hadn’t put the same kind of thought into undergarments.

The other reason, I think, is that I was “comfortable enough.”  I didn’t feel like I was falling out of my bra because it looked pretty good from the front and I didn’t have the double-boob thing going on.  The band didn’t feel “too” tight.  (And, it wasn’t possible to try on a larger cup size in the places I typically shopped for bras.)  There’s a lot of, “just suck it up and deal,” advice given to women in just about every area of life.  We are meant to think that some things are slightly uncomfortable and that’s just the way it is.   I hated wearing a training bra before I really had breasts–I thought they were uncomfortable–so when I truly had to wear a bra (because being without one was more uncomfortable than wearing one), I didn’t necessarily think that it should be comfortable.  On top of that, my mother is an A-B cup and so didn’t have the same experience I have had, dealing with much larger breasts, so she didn’t teach me the importance of a well-fitting bra (not that A-B cup ladies don’t deserve to have well-fitting bras, they absolutely do, but it’s my impression they have less to worry about in terms of support, weight, and pain–please correct me if I’m wrong).  So, I was pretty much screwed from the beginning.

The key difference, I think, in shopping at a proper bra store versus shopping at a department store, or even shopping at Victoria’s Secret, is that the saleswomen in a bra store are professionals.  They really know what they are doing and this doesn’t seem to be a part-time or temporary job for them (the woman who helped me had been mentioned in yelp reviews going back at least three years).  I actually worked at a Victoria’s Secret right out of college, before I found a research tech job, and none of us were given any training in how to properly evaluate bra fit.  We only got a very brief talk about how to measure someone for a bra.  And we always, always had to suggest the matching panty.  All of the advice we were given was about how to increase a sale.*

Given my experience at this store,  how comfortable I have felt since putting on this bra and how much better I look, I will definitely be going back to this bra store in the future and if I move elsewhere, I will track down a bra store there.  I may be preaching to the choir, here, but if you’ve never been to a proper bra store (and you will know right away if you’ve found one by how knowledgeable the saleswoman is) I really very strongly urge you to go hunt one down.**  It might not be as expensive as you think and you have nothing to lose.

 

*Even though we were not paid on commission they did keep track of each saleswoman’s sales and if our sales were routinely low, we had to have a talk with a manager.  This is why it is important to remember the name of the person helping you in clothing stores and to mention it at the counter when you go to purchase something.  They key in a code before scanning in the merchandise which allows the computer to keep track of each person’s sales.

**Bra stores are a bit of dying breed, though.  If you don’t live in a major metropolitan, it may be difficult to find one.  But it will be worth your time.