Obstetrician

I got to meet my OB today. Woohoo. He was actually pretty nice. Kind of grandfatherly with Riley, and nice to me. He didn't say or do anything that offended me, and when he saw I had been to see the endocrinologist at Surrey he got a twinkle in his eye and asked, "Did he bring out his whip?" I guess this endo has a reputation.

;)

I laughed and said, "Oh yes, he did!"

I was able to communicate that my goal is a natural birth, provided there is no placenta previa. And he said that sounds great to him.

He thought I was nuts for requesting the fetoscope. He couldn't actually hear the heartbeat through the fetoscope (he blamed his age), and seemed a bit exasperated with me, but said my baby is moving lots so it's just fine.

He only wants to see me once or twice more, depending on when I go into labour, and he said as long as I go into labour on my own and my baby is head down, he doesn't have to be there for the birth itself at all. Which I appreciate: I can still have a midwife attended birth this way, just with an OB who happens to know I'm there and know me and know my history. Maybe that's kinda nice, just in case, you know?

But of course we discussed at length my previous birth, including the fact that Riley had 'some degree' of dystocia and was born flat: my midwife attributed cord compression because he handled labour so well right up til the last two minutes, and because she saw his cord behind his shoulder blade. I also pointed out there was some discussion as to *how* flat he was, because the compressions that were done were not agreed upon as necessary. We don't know in retrospect whether he needed them or not, because the nurse running the resuscitation called out, "Heart rate less than 100, start compressions," which is incorrect. If an infant's heart rate is less than 100 they need oxygen and a bag valve mask, and if their heart rate is less than 60, they need compressions. So either the nurse misspoke, or he didn't need compressions. He also recovered quickly and completely, which speaks more to cord compression than dystocia. It also indicates he wasn't as flat as was possibly thought. Anyways, we talked about it for awhile. We also talked about rupture, VBAC, long term obstetrical health, whether I want more children, why I want to avoid a cesarean (I stuck to health facts and didn't mention the emotional side), why I think a drug free birth is important, and diabetic management, research, outcomes, and issues around the globe.

He wasn't a midwife, and it wasn't an empowering visit per se. But it wasn't overtly negative, or bullyish, or even interventive. He didn't order more tests, he didn't mention induction, and he didn't seem opposed to physiological or natural birth. It was evident he believes in physiological birth, but he's also a 'worst case scenario' thinker. We also talked about the difference between the midwifery approach and the obstetrical approach: midwifery looks at the statistical probability and says, "this is safe," whereas obstetrics looks at the worst case scenario and says, "this or this or this could happen." And he responded that this is because the buck stops with obstetricians. They're the ones ultimately looked to for expertise and answers in worst case scenarios. This makes sense to me, like the captain of a ship. No matter if s/he's sleeping off watch; if the ship crashes, s/he's responsible.

But it's hard to know that worst case scenario thinking actually causes problems when it inspires more fiddling with the physiological process than is absolutely necessary, and fully trust this type of thinking. If there were a way to believe in and trust birth and yet still be an expert surgeon for worst case scenarios, THAT would be the ideal obstetrician.

Now I need some more help from you guys.

#1, suddenly I'm petrified of my ability to give birth to this baby. Suddenly, I've lost my belief in myself. Suddenly, I'm thinking the baby's too big, I'm too small, it can't be done, my uterus will rupture and explode and we'll both die, I can't, I can't, I can't...

#2, I have my intrusive ultrasound tomorrow to determine the position of the placenta. PRAY. We need a 2 cm margin. Please, please, please, please....

A Gift of a Day

I have to be honest, I'm not doing the best these days emotionally. Lots of crying. Lots of worrying. Some ups and downs.

Today was a gift of a day. We woke up and it was clear and cold and SUNNY! Sunshine in our climate in January is pretty rare. It has been a gorgeous day all day.

My blood sugar has been good today. Not perfect, but good. I've found the magic number of insulin units plus the magical formula of physical activity and foods (type and amount) plus the type of insulin to take at the magical times of day to keep things moderately well controlled.

[hilarious aside: I forgot to take my overnight insulin last night and my morning blood sugar was lowest it has been all week! This is because I found a combination that lowered my bedtime sugars, not because the insulin doesn't work...if I'd taken it, maybe I would have finally scored a fasting blood sugar below the target number! That has happened NEVER ONCE, though I've come close].

Anyways, it's good for me emotionally to feel like I've found a balance that appears to be working. It's a complicated balance that is *nearly* a full time job in itself (you know, in addition to the more than full time job of having 3 kids). But I can do what I need to for the next several weeks IF it works. If it doesn't work I'll fall into despair and not do anything. Sort of joking.

We went to church. I like my church a lot (lack of public breastfeeding aside). All 3 boys ran to their classes without looking back, including Riley, which is not generally normal for him. He tends to act like a wuss. (tell me you know I'm AP oriented and am joking!) I got a seat (miracle!) next to a couple I know (double miracle!), liked the sermon, loved the singing, loved the sunshine coming in the windows, realigned my heart away from anxiety and desire over this birth, and felt peace.

We ate lunch, the boys played in our fabulous backyard with the dog in the sunshine and mud, and then we went for a walk. We walked the Fort to Fort trail in Ft Langley (not the whole thing, but about a 1.5 km portion, then back again) in the sunshine. Did I mention it was sunny?

=)

Taking little kids outside in the first spring(ish) sun is like turning horses out to pasture with fresh green grass after a long winter of eating dried hay. There's lots of shrieking and running around, and very little rule following. But it's so beautiful to watch, you don't really care. Everyone was covered in mud, but who do you think had it inside his boots, in his hair, and even on his underwear? Who got stuck in the mud so deep he nearly lost his boots? Who got water in his ear? On days like this, I make very broad rules: no walking amongst the trees on the river side of the path. No hitting. No whining. Keep up with mommy. Otherwise, get dirty and have a blast!

I even remembered to bring snacks for everyone, something even I can eat, and my glucometer so I could time my snack correctly, and the stroller to carry all of the above and Riley. I still have contractions when I push the stroller uphill, but at this point I'm far enough along to worry more about blood sugar than contractions. So far, they always go away if I rest afterwards, and I don't lift anything heavy during the rest of my day. Everyone else thought a sunny afternoon in January was a perfect time to walk the Fort to Fort, too, but it was still spectacular. I figured it would be busy, so it wasn't as bad as I thought it might be, and then there were people around to help me when Matthew got stuck in the mud so deep his boot nearly got eaten by a mud swamp monster (really, seriously, it almost disappeared completely). There are bonuses to populated paths.

We drove home, the kids drank hot chocolate, and are watching a movie while I blog. Perfect, wonderful day. Days like this one help me remember why I like what I do so much. Why I like being a parent and being active and being here, on earth, just living as much as I can.

And I laugh at myself a lot lately, because I keep catching myself thinking about all the stuff I'm going to get done or be free to do, after the baby is born and I'm not pregnant anymore. Except, I keep forgetting that when I'm not pregnant anymore and the baby is born, I'm going to have a BABY! Right! A baby, who eats and poops and NEEDS 24 hours a day! I'm so funny sometimes. Though a #4 baby; how bad can it be? I'm hoping it will be a smooth transition without a ton of change or stress, since we're already swinging and baby can just hop on and swing along with us.

=)

Good Article on Breastfeeding in Church

My old church was a breastfeeding friendly place, largely (ironically) because I made it so. We were part of a church plant and I was the first (by three weeks) to give birth, and just breastfed in church. No one really batted an eye as far as I ever heard, and the many moms who gave birth after me followed my lead.

Enter: new church. Nobody breastfeeds inside this church. NOBODY. Except me; I nursed Riley in church for the first 4 or 5 months we attended, he was around 18 months old, and wasn't keen on the nursery yet.

Now, this baby who is yet to come will be a different type of breastfeeder than an 18 month old. Sure, nobody sees nursing toddlers in church but he was quiet, quick, and nursed maybe once per sermon. Newborns are loud, long, frequent breastfeeders. I think I'm about to shock the pants off our new church, in a few short weeks or so....

At any rate, here's a beautiful post on the subject by Peaceful Parenting. I especially like the art!

National Awareness Campaign | La Leche League Canada: Mother-to-Mother Breastfeeding Support and Information

National Awareness Campaign | La Leche League Canada: Mother-to-Mother Breastfeeding Support and Information

I went to the diabetic clinic yesterday, and left reassured, emotionally supported, and with renewed hope and renewed energy to tackle the latest high sugar pattern.

At first when I went to this diabetes clinic I hated being there, I didn't trust the nurse, and I resisted treatment although I considered their advice and appreciated the information and insight they gave me. Now visiting them is the total opposite! Which is hilarious. THEY haven't changed, I have. It helps that my dietician had a home birth herself, and that both she and the nurse are respectful of the fact that all treatment decisions are my choice. Always.

It helps also that I went to the Surrey clinic for an endocrinologist consult: their clinic is rushed, impersonal, busy, big, and very pressure focused. I didn't really post about the endocrinologist, but I'll highlight two of my favorite statements from him (he took 1 hr 15 minutes of his time to devote to me, so I can't fully complain, although he seemed at a loss as to what to do with me by the end of the appointment, because I wouldn't concede and go on insulin THAT DAY~I wanted to research what he was telling me and think some more). So, amongst an hour and fifteen minutes of information, these were his gems:

"I'm worried about the health of your baby."

(and I'm NOT?)

And, as a last ditch effort right before the end of my appointment/pressure-to-start-insulin session;

"I just wouldn't want your anxiety disorder to make this decision for you."

(((( ))))

That is me, speechless. Excuse me?

Let's just ponder how rude this man was to say such a thing to me.

So lets just say my experience with the impersonal, condescending nurse, the CRANKY dietician, and the high pressure salesman of an endocrinologist at Surrey, I had a renewed appreciation for the staff at Langley. Plus the dietician at Langley is my kind of dietician. Eat real food! Avoid aspartame. If you are hungry, EAT: just eat vegetables and protein instead of carbs (every other type of food out there). Research for yourself. Make choices. Have a good pregnancy.

The nurse and dietician at the Langley clinic helped me devise a plan of attack. Well, first they said, "You are a really complex case!" Validating and verifying how difficult it is for me to manage this whacked out body of mine and its whacked out blood sugars. They stopped me from injecting insulin EVERY time I eat, which I had resorted to, and increased my meal insulin, my overnight insulin, and then advised I take the slower acting, overnight one midafternoon, to help keep my evening readings from rising (frequent problem). Also, assess what I'm going to eat~if there are more than 30 g carbs or a type that spikes me, take more insulin. Today, my readings were much better: still needing to increase but only slightly, so by tomorrow I should be on top of the daytime numbers. Nighttime is still ridiculous. Goal: 5.0 or less. Insulin: 25 units (most women are good with 4-6 units). This morning's blood glucose: 6.4. Six point four, with twenty five units of insulin?

I also went to my midwife today. She's awesome.

BP 100/60

FHR 140

Fundal height 36 cm at 35+1 weeks pregnant

Baby head down and LOP

Maternal leg discoloration Dx fungal infection. Rx citrucidal liquid diluted in water, 4 x daily, and chickweed cream as needed. Hooray! No flesh eating disease.

She wants another ultrasound measuring growth and placental health. I don't. I'll go for the invasive one to detect placental proximity to cervix, but why measure? It's not going to change anything. Not the way I do things, not the way I plan the birth, nothing. So why do it? She argued with me (politely) that the old diabetic management protocol had ambiguous results in research, but the new protocols which include new, stricter blood sugar control levels, could result in better outcomes.

I argued that in my opinion, it is recognition, diet, exercise, and insulin that improve outcomes, and frequent ultrasounds and non stress tests which do not (and IMHO, probably even out the statistics by causing far more problems and interventions than are healthy or necessary). It's my choice, but it's clear what she wants. It's part of why I like her: she's strong and smart and opinionated, she thinks outside the box, operates outside the box, and sometimes I guess we disagree.

=)

Gotta go eat a snack.

xo

-Food has become my enemy. During my previous pregnancy, food and I became good friends. I actually developed a love affair with food, by which I don't mean I stuffed my face, I mean rather that I started to engage with food authentically. In a healthy way. Rather than see food as an irritating necessary means to an end, I started to love food because it was GOOD, and because it was fun to eat, and fun to cook, and fun to have other people eat after I cooked it, and express appreciation. I LOVE it when people tell me food I cooked tastes good. Maybe a little too much

=)

This pregnancy, food is awful. There is so little I can actually eat. And I can't just follow my body, I have to follow this tiny machine and the clock which dictate when and what and where, and although I'm on insulin it's still tough to balance. Insulin needs can be inexplicably finicky. What worked last week suddenly doesn't this week. A handful of cucumber slices and a tablespoon of hummus would skyrocket my blood sugar. I feel trapped. I keep upping my dose and upping my dose and STILL freaking syrocketing....

I'm at the point where I don't crave ice cream, I don't crave candy, I don't even crave chocolate. I crave dried fruit. Dried apricots. Raisins. Dried cranberries. I also crave milk. I want to cry. All food is too much for my pancreas. Even straight up protein and vegetables. I just want this to be OVER! It's hard to feel constantly guilty eating anything at ALL.

-On the flip side, I have milk! I've been wanting to post an entire post dedicated to breastfeeding through pregnancy, but I guess I haven't really got the energy quite yet. My milk dried up a few days after Riley's second birthday, way back in August. He was still an enthusiastic nurser, and I wanted him to keep going until he was ready to stop, or until he was older. In order for him not to forget how to latch properly, I kept it up through months of painful breastfeeding...the pain would increase for several weeks and then subside, but never completely go away. Especially when Riley's latch would get lazy or tired, or he was super enthusiastic about latching on. Ack. It was a bit about surviving rather than enjoying our cozy nursing relationship for so many months. And now, I have milk again. Not tons, but colostrum. The other day Riley popped off and said, "Mommy! Dat have milk in dere," and went back to nursing happily. And I can hear him swallowing again. Hooray for not being the human pacifier anymore! Well, not solely.

=)

-Brent's shift pattern at work has been changed, so he sometimes works noon to midnight, or 2:30 to 2:30, as well as his regular 6 to 6 or 7 to 7 shifts. At first it seemed nice; there is a 1pm to midnight shift at my work that I like quite a lot. But I gotta tell you, this is the fourth day of this new shift pattern and I HATE it, and so does Brent. He hasn't seen our older kids in four days. He's sleeping or working at all the most hectic times of day for me, so I basically have NO help from my best partner in crime. He's tired. I'm exhausted. My kids miss their dad. I miss their dad. It sucks. I also have no time to exercise, and no energy because I'm so filled up with mommy duties, which I don't mind in the least, but which are hard to keep up when I'm THIS frickpregnant.

-Today I had several extra bonuses, however~when B did wake up, I fell asleep for two hours. I've been driving him crazy lately with my snoring. I always snore when I'm in late pregnancy, and now I've got a cold, I'm heavily pregnant, AND our furnace needs cleaning so I even wake myself up sometimes. So when I woke up he and Riley were giggling about how I was snoring in the middle of the day. There's always also a puddle of drool on my pillow. Yech. (Matthew woke up in the middle of the night with a nosebleed puddle of blood on HIS pillow, poor kid). The second bonus was that BOTH my older kids got invited for playdates today so I didn't have to pick anyone up from school, and it was peaceful and calm in my house til 5 pm. So nice. Obviously, I would detest having my kids away til 5 pm daily, but once in awhile it's nice when I'm in coping parenting mode. Sweet bonus.

-I have this red and white patterned skin discoloration on my lower legs. It looks like a cross between cellulitis and nec fasc (necrotizing fascitis; flesh eating disease), but it feels itchy. I noticed it first last Wednesday morning after water aerobics and figured it was dry skin because I was too distracted to remember to put moisturizer on after the class. It hasn't gone away. It's not pitting, but capillary refill is slow. Only the red bits itch, the white bits are just pale. Last night I got myself into a state because I was so worried about it all of a sudden, like I've got nec fasc and I didn't even notice! But even I knew that was ridiculous. So yeah. I'm falling apart and not even my skin will perform its proper functions.

I feel beat up. Beat up by my own body. Beat up by fate. I don't have much fight left in me. I've gone from picturing myself greeting my baby to picturing myself crying in relief that the pregnancy is over. I'm never, ever doing this again. Largely because it would be almost a sure thing that I would get GD again.

-Riley's latest sweetness was throwing his arms around my legs today and saying, "Me lub you so much, mommy!" Aw, jeepers, it's worth every painful latch and nighttime disturbance and toddler get dressed tussle when he says something like that! His dark side showed later when he stabbed Matthew in the shoulder with his fork at suppertime, because he was mad at me. He also likes to dump my dirty laundry basket out on the floor and use the basket as a boat. He also likes to use the kitchen stools as building blocks all over the livingroom furniture when I'm not looking. And he nearly bit me today for confiscating a yarn loop he was using as a necklace. I wanted to have a shower and not worry he'd be hanging himself while I was in there. The other day he came up to me and said, "Look at my necklace," and he had an elastic band around his neck so tight it was leaving a mark. Ack! If any of them die before adulthood I won't be surprised. How does one watch three tasmanian devils with eagle eyes all the time?

-My new house is awesome.

-I think we should bring back multigenerational cohabiting. It really would be so much better to have people around other than myself to keep each other company and help each other through the rough spots in life. Physically getting through my day is getting harder, and I've a ways to go yet!

-I can't wait to like food again.

-xo

Can I just say how much I love my kids? They're fricktastic. They wear me down, they push me to the edge, they ransack my kitchen with flour (see FB), they squabble and ransack and pretend to shoot me dead EVERY SINGLE DAY, but I love them. I couldn't live without them for even a few minutes. They are funny (see also FB). Riley tells me "Me lub you mommy" every day, Matthew makes funny faces and hilarious off the wall comments and he's just so positive and enthusiastic about life, and Ayden is alternately wild and stubborn and introspectively quiet. Nobody but Riley likes my kisses anymore. But to accommodate their boyness I use other modes of affection: I ruffle their hair a lot, give side hugs, tickle, and playfully shove. And I love that I see them do this to each other! They don't know it, but they're loving on each other and being affectionate. I hate shameless bragging, but I don't think this qualifies, I think it's just celebrating! I also hate chronic negativity. Isn't it easy to point out flaws? Isn't it easy to complain? Isn't it easy to get all wrapped up in one's head about a cesarean birth and forget to notice the hilarious commonness of everyday existence? So I appreciate them. A lot. Even when they pee on the toilet seat. Or the rug.

=)

Visualizing

I started going to prenatal yoga a few weeks ago. I go once a week, in the evening, and I LOVE it. It's an oasis of calm, focus, self care, and love that just can't be replicated anywhere else. The class is an hour and fifteen minutes, and much of the time I spend visualizing my placenta moving up, up, up, away from my cervix and out of danger. Much of the rest of the time I spend visualizing my baby in the vertex (head down) position, chin tucked, and spine facing my bellybutton. And the class refreshes me like swimming in the clearest river, just cold enough to wake me up, but not so cold I'm uncomfortable. I never have contractions after yoga class. And I sleep like a baby.

I've always been one for considering as many outcomes of a situation as I can, in order to prepare myself mentally. I have felt that mental preparation would make me better equipped to deal with undesired outcomes, which would make experiencing those outcomes less painful.

This has not actually been the case. In the past two years since my experience with post partum anxiety I have realized that I anticipate too much, too often. And mental preparation only makes the anticipation more painful, rather than better equipping me and making things less painful if the outcome is not ideal.

In light of this, as much as I can, I try to remind myself that I have the strength and skill to cope with things as they happen, and that I don't need to live in a number of possible future scenarios, diminishing my experience of the present moment. Which, of course, is all we really have.

Paired with this is 32 --oops, 33-- years of habit. A habit of anticipating. I've been trying to live in the present moment regarding the possibility of placenta previa, and mostly I've been succeeding. There is no point getting upset until I know. And I have had no bleeding, which is so often associated with previa. But it's tough because I'm afraid. In church today the theme of the sermon was dealing with mountains in our lives. God can move mountains, and sometimes he does, and sometimes he doesn't, but He's always with us. My mind kept wandering over to how it would feel to be wheeled, prepped, numbed, cut, emptied, sewn, wheeled, medicated, and to heal from surgery, again. I've been there. I've been through natural birth. To go back to surgery again feels a bit like volunteering to go back to the Goulag, or some Asian jail at the top of Amnesty's list or something. I DID my VBAC. I proved to myself that my body can do it. I just didn't anticipate ever needing to come back here, to this place. I had considered the possibility of an emergency cesarean, during the process of birth, and I knew that my chances were as likely as any other multip that an emergency would arise and I would need surgery. That was okay. But THIS? Back again to a sterile, labourless, robotic, assembly line process, for some reason is drastically different for me. Even though complete previa would be an undisputed necessary cesarean.

Did you know that my first cesarean put me at greater risk for this exact complication in future pregnancies? And that the reason for my first cesarean (breech baby) has been reevaluated by the Society of Obstetricians and Gynecologists of Canada and is now no longer an automatic indication for surgery. Breech vaginal birth is back on the list as safe. Riskier than vertex birth, but considered as safe as surgery by the SOGC (and in my mind, safer). So as I have mentioned before it looks like the first cesarean was NOT necessary, and now may be causing a second one. Isn't that not cool?

All of this is something I'm trying to keep at bay as much as I can, until I know more. But I need to be gentle with myself and allow myself some anticipatory wondering. And some tears. Hooboy. This is hard.

The Blessing of a Skinned Knee

I just picked up this book for our next book club, The Blessing of a Skinned Knee. It's about taking basic principles of Judaism that pertain to the development of character, and applying them to parenting. So far I'm on page 37 and already have too many quotations that I want to burn into my own brain. Here are a few;

The purpose of having children, according to the teachings of the Torah, is not to create opportunities for our glory or for theirs. The purpose of having children and raising them to be self-reliant, compassionate, ethical adults is to ensure that there will be people here to honor God after we are gone. So the rules regarding child-rearing are not primarily about making children feel good, but about making children into good people.

In relation to giving of ourselves, not in specific amounts, nor with the ideal of achieving perfection, but rather to try and give something:

"It is not your responsibility to complete the work [of perfecting the world] but you are not free to desist from it either." -Rabbi Tarfon (from a collection of ethical maxims dating back to before the first century)

And in relation to the author's emphasis upon moderation, celebration, and sanctification (particularly in recognizing the holiness of the present moment):

There is one question that sums up everything I have learned about the power of Jewish teachings to guide us in every generation. It's a question that rabbis like to ask schoolchildren:

What's the most important moment in Jewish history?

The giving of Torah on Sinai?

No.

The parting of the Red Sea?

No. Right now. This is the most important moment in Jewish history.

The author also talks about the dinner table being a family altar. The table where we eat can embody the principles of moderation, celebration, and sanctification in our lives on a daily basis, making the present moment holy. If my dinner table is a holy place, it changes how I approach it. It changes the food I put on it to feed my family, it changes our actions towards each other in a more respectful direction (hopefully!), and it changes how we behave. And it certainly imbues the present moment with a holiness that I might otherwise overlook.

I've read and heard repeatedly how important family dinnertime is for children~those families who eat together daily produce children with bigger vocabularies, fewer mental illnesses, more moderate weights, fewer social problems, and less drug and alcohol use in teenagers, amongst a myriad of other reports. I've often wondered, how on earth? By dinner time we're all tired and cranky, sometimes all I want to do is shout "SHUT UP!!!" at anyone who makes the slightest noise, and we rarely talk about anything profound. But I think what this author is trying to say is, that dinnertime builds character in our children, which I guess is reflected in all of these 'studies' which report great benefits from eating together daily.

Who knew such a mundane everyday thing as eating dinner could hold so much?

Read this book! You might anyways by the end of me reading it, from me quoting most of the book to you....

It's Foodie Friday

I've not done Foodie Friday a whole lot (I think I did it once), but since much of my life recently has been revolving around the eating or not eating of FOOD, this one was on my mind. Yesterday I had this recipe twice! There's nothing like pregnancy to bring on some weird food eating. =) Like eating something twice in one day. These are called Haystacks and are a meal salad:

Enough lettuce to fill the bottom of the bowl(s) you are using

A variety of vegetables~I had and used the following, diced or chopped;

-coloured pepper (yellow or red)

-carrot

-cucumber

-tomato

-green onion

-pickles

-garlic stuffed green olives

-grated cheese

-avacado

Original recipe calls for crumbled tortilla chips at this point, which I eliminated for diabetic reasons but really adds some crunch and a low glycemic index carbohydrate for those without diabetic concerns

Drizzle with ranch dressing (I prefer blue cheese)

Top with warmed brown beans in tomato sauce (for vegetarian option: it would work with beans in pork too)

I also cooked chicken breast and added that to the top too, because of the high protein needs of diabetics, but we usually have this salad as a vegetarian meal (my mom originally got this recipe from a 7th Day Adventist recipe and they are vegetarians).

This salad is to die for. Here's an internet photo that SORT OF looks like what I made and ate yesterday (twice)~enjoy!

Hanging in there...

Thanks for the support, friends. This really is hard! It's hard not knowing, and waiting, even though I CHOSE to wait!! Part of why I waited is because if the placenta is partially covering the cervix, it can move up as the uterus expands, making vaginal birth possible again. So if it WAS too close/over, we would need to repeat the ultrasound in a few weeks anyways to check where it is THEN: in order to reduce exposure to ultrasound waves (safe, but little research since the 70s to measure a threshold of exposure, and some risks of repeated exposure include small for gestational age babies, and increased incidence of left handedness~nothing wrong with being small, or left handed, but if a prenatal test MAKES you that way, is it really harmless?~ amongst other risks), I opted to wait the few weeks and have one more scan. So, we wait. February 1st I will have another scan to determine the placenta's position, and we will know more then.

I had to laugh at Caryn's comment, "When your baby is born she will have some explaining to do"--the same thought has occurred to me more than once! Caryn's hilarious. She always makes me laugh. It's so cool that through blogging I've met so many smart, funny, likeminded, diverse women, and kept in touch with some pretty amazing friends and family in my life. Blogging's not a relationship exactly, but it helps connect people in a certain way that is pretty cool, and opens up the opportunity to meet other people whom you wouldn't otherwise meet! It's an odd way to get to know people, because of course it's very filtered and edited, and entire chunks of life are left out entirely (like, for example I'll talk about sex with friends face to face quite openly, but I NEVER blog about it), and you never get to see any of those all important non verbal communication cues. Anytime I've gotten to know someone local who also reads my blog it creates an awkward too soon intimacy. But all that suffice it to say I'm grateful for you who read, it's a cool medium for communicating and I really appreciate you all.

Blood sugar update: I've found a daytime pre-meal dose that works; still working on the nighttime dose but it's coming down.

Weather update: it's snowing big, beautiful flakes outside thick and fast. I love snow.

Baby update: s/he seems to have a lot of elbows and knees. Like, a LOT. Eight or nine. The other day I was lying on my bed and there was lots of visible activity going on so I called everyone over to see. Ayden and Matthew thought it was the coolest thing ever~Matthew especially liked to feel it and see it at the same time. But it freaked Riley out like nobody's business. He knew it was the baby, and I think he thought it was coming out RIGHT THEN, and the rest of the night he kept grabbing at his tummy and shrieking in fear, and yelling about babies coming out of tummies (he is adamant he has a baby in his tummy too). Fortunately he forgot by the next day. Hilarious!

House update: I love it. Oh my gosh do I LOVE IT! We have enough space! We have no strata rules! We have a backyard and a playroom and a huge livingroom/kitchen/eating space with tons of windows and lighting and a double garage and WOW, it feels fantastic. We're unpacking at a good pace, so at some point I'll find that camera cord and share some pictures with you. I know my sad sorry blog is photoless far too often.

xo

And The Shit Hits The Fan...

So. I started insulin last week. It was a relief by the end, to begin, and to admit defeat and to accept a treatment I am convinced I need, and especially one which would increase my chances of a successful natural non interventive BIRTH~which is far more important to me than a non interventive pregnancy. So far, I haven't found the magical amount of insulin to completely control my morning fasting sugar, but it's coming down and I'm getting closer. Also, I've determined I need some daytime insulin as well.

And then. And THEN, I went this morning for my ultrasound. I agreed to one because my midwife really wanted a good sense of fetal size and the age/health of my placenta. Apparently higher than average blood sugar can age a placenta faster than normal.

Baby is big (keeping in mind that ultrasound is not an accurate measurement of size; but I know that it is bigger than average). I knew it, but I was hoping for a bigger-than-average as opposed to a Monstrous. 95th percentile. Argh. So frustrating, after all the work and diet and exercise and cutting of carbs down to miniscule amounts that really actually aren't that healthy, being too small of portions~any less and I'll starve my fetus (after several weeks of overfeeding, ha!). But it does confirm that my decision last week was the right one: start insulin.

The doctor who did the ultrasound was predictably conventional. We *need* ultrasounds every two weeks to monitor the well being of your baby. We will *need* to induce you at 39 weeks to avoid the risk of unexplained stillbirth (not associated with GDM, but rather women who are diabetic prior to getting pregnant: PLUS, dude, you had to play the dead baby card). You *need* to keep your baby small or you have a high risk of shoulder dystocia and your baby could die (oh look! Dead baby card reappears!). I didn't argue with her because she's not my care provider and it doesn't matter what she thinks we *need* to do~but there's no way in hell I'm agreeing to an induction with a VBAC scar. Sorry. Data is clear there: 400% increase in risk of uterine rupture (and high risk of fetal death if that occurs catastrophically, which with inductions it generally does). NOT SAFE. I think she saw in my face that I wasn't buying it even though I didn't argue.

But the hardest news was that my placenta is LOW, implanted down near or covering my cervix. A placenta covering a cervix is incompatible with vaginal birth, both baby and mother are at risk of severe bleeding. You can see how one cannot give birth THROUGH the placenta. The doctor wanted to do a vaginal probe ultrasound, but I wasn't fully prepared to do that immediately without thinking about it~I believe it's necessary, I just have issues with foreign objects in my vagina. I need mental preparation if it's going to happen. So I booked another appointment for 2 weeks from now; the position of the placenta is so low it's impossible to see if it is beside or over my cervix from a regular abdominal ultrasound. Marginal placenta previa can resolve itself as the uterus grows and lifts the placenta away from the opening of the uterus. PLEASE PRAY that this is what I have, because the only way to give birth to a complete previa is by cesarean section. This is a loooooong way from HBAC water birth, I gotta tell you. I feel like I've been hit by a torpedo; a little bit numb, a lot of diffuse pain, and mostly a sense of deep disbelief. Like THIS is what railroads my hopes for this birth? Not ruptured uterus, or shoulder dystocia, or failed induction, or large baby, or anything related to VBAC or GD: but placenta previa? WHAT ARE THE CHANCES, PEOPLE?! My kharma is really F*&^%$%ing crappy right now.

My midwife called this evening after she read the faxed report and WOW does she ever make a difference in my mental health. She said she was glad we had had an ultrasound, which I am too, because otherwise this may not have been recognized. She also reassured me that she's never had a client with complete previa who did not have any bleeding by 28 weeks: I'm 34 weeks (nearly) and have had no bleeding at all. Not an absolution, but a grain of hope. She talked to me about the vaginal probe ultrasound and, as I know, said it's important. She also reassured me that in any case, everything will be okay, and I'll be well supported and receiving evidence based care.

At this point I've reached a rock bottom line mental state; similar to my bloggy friend Rachel's pregnancy, all plans and all bets are off, and I'm at the absolute basic bare bones of my birth plan. All I really want is for this baby to come out my vagina. I don't care where it is, I don't care how, I don't care when, I don't care if it's drug free, water free, standing on my head in the OR with 50 obstetricians in the room and no husband to support me. Vaginal birth. That's the rock bottom for me, all else has been stripped away and even that might be a fading dream. There's nothing like a little drama to make you realize what REALLY matters to you. And you know what? Healthy baby in arms is incredibly important to me, but it's not the only thing that matters. I can't explain it eloquently, but I can say it's not comforting when people reassure me that a healthy baby is all that matters in the end. It isn't all that matters to me. I don't value vaginal birth ABOVE the health of my baby, but I also highly value physiological birth.

Pray hard.

Pray long and hard.

And oh my GOSH is this hard.

MOVED!

We moved!!! Our house is still a disaster but we're in it and getting used to the new digs. Which I LOVE, but still feel like someone else's digs!

Thank you so much for your supportive comments about birthing in hospital~seriously, it really, really helps. My midwife yesterday was also reassuring. I'll write lots more on this topic as I process it, I'm sure.

It's my birthday tomorrow.

It seems like everyone I follow online is having a home birth.

I'm happy for them! Sad for me.

Thanks for the moving day wishes! We got the keys early and went over tonight to show the kids before we actually move. It was fun! It's odd, too; it still feels totally like someone else's house! But we LOVE IT!

I'm pretty bummed when I look in the bathroom and think, I'm not giving birth here. =(

I was okay with this yesterday! Please pray for me, I know what the right decision is and I need to follow that regardless of my feelings of loss. It's about more than home birth, right? Can you bolster me up with stories of beautiful hospital births?

xo

x

Would somebody stop me from posting linkeys? Seriously. But there's so much I want to share....

Here's a post about "How to support Breastfeeding Without Being a Boob" from a formula feeding lactivist with a unique and inspiring perspective (let's work together! Amazingly cool idea). I want to post this on Mothers of Change but need to wait at least a few days for other posts to be digested. Part of posting it here is so I don't lose the link in the meantime!

I also posted on MC an update on this pregnancy, if you'd like to read it!

A blog friend of a friend had a terrible experience with airport security while trying to fly with 18 ounces of breastmilk: read her story and send her some love if you have a few minutes!

Will somebody please come to my house and make dinner, clean up, referee the children, and put them to bed so I can figure out how to solve world peace while wasting time on facebook?

We move in 4 days. I'm in full procrastination/exhaustion mode...

Good Article on Unconditional Love and Parenting

This article actually ties into the parenting conversation ongoing around here, and particularly into some of my feelings on grace based parenting. Check it out!

I'm taking a post title holiday

(I usually really like to come up with post titles but just now I'm lacking in the imagination and decisiveness department, so I'm taking a post title holiday)

You guys know our kids are energetic like crazy. I like to tell stories about their antics and noise and how the light fixtures in our downstairs vibrate and rattle from all the jumping when the kids are upstairs. =) Because it's true. My house VIBRATES from their energy sometimes, it's wild! But I have to say they are good kids. Energetic and earthquake imitators, and exhausting, and neverendingly talkingtalkingtalking, but they mean well and have the best of intentions. (mostly)

The past few days we have gotten some really nice feedback from semi or total strangers on the kids' behavior; a few nights ago we were running really late so we went to Boston Pizza for supper. The waitress said to us at the end, before we paid our cheque, that the family two tables over from us (who had left at this point) had told her that they had never seen three kids behave so well in a restaurant, and that they were impressed. Then the waitress said that she thought our kids were adorable and very well behaved~I thanked her for passing that on. It can be so rare to hear positive feedback on this labor intensive emotional job of parenting that it's really nice when someone takes the time to tell you you're doing a good job.

Then yesterday we picked the boys up from school and had to go to our Notary to sign papers for the sale and purchase of our house, our will, and some power of attorney papers. It took at least half an hour and the kids were SO well behaved, it was awesome. The Notary commented several times about how well behaved they were, and then at the end she said, "You guys are doing a great job with them." Ah, so nice to hear twice in a few days. None of the five of us are perfect by any means, but we try hard.

In fact, on the walk home today there was a fair amount of shoving and crying, and there may have been some yelling on my part. :D

The best we can do is good enough.

And I thought, since I complain and struggle on here sometimes that I would balance it with a report of some good kids and kind adults.

Hey guys, thanks for hanging in there with my quiet blog lately. You would think perhaps I was being productive, packing the house, getting ready to move, etc. You would be wrong. I do put a lot of effort into managing my blood sugar, which makes me too tired to pack or clean or do much of anything really! My latest morning sugars were 5.8, 6.0, 5.6, 5.5, and 5.3. So those are going down again, instead of up: yes! I've noticed that in the evenings my bedtime blood sugar is higher than it should be, so I'm not sure what to do but I think that could be easier to address than the fasting sugar, so maybe, maybe I can stay off insulin? A few weeks ago I decided: insulin it is. I was fully prepared to do it. But then the numbers started going down and I thought, well maybe not? And my midwife said not, unless I wanted to.

Then yesterday I went to the endocrinologist at Surrey Hospital and he talked for an hour about increased risk to the baby of developing Type II diabetes, which I researched at home and it is true. It's tough because there's little evidence to show why exactly this is the case, and whether breastfeeding and a healthy active lifestyle mitigates that risk at all. If the baby is LGA (9 lbs or more) and the mother had GD, the baby is at a significant increased risk (but I don't know what the % is, I couldn't figure it out from the publication of the research project). So I do have GD, which increases the child's risk already, and then if the baby is bigger than 9 lbs that doubles its risk. So if I can keep the size down below 9 lbs there is still that risk from me having GD but not the added risk of being big.

This makes decision making more complicated. I'm still thinking: especially because this morning's blood sugar was 5.3~ insulin is started if diet and exercise don't work at 5.3 or higher, and if my morning sugar is consistently 5.3 I won't feel that insulin is necessary. But then there's my bedtime/late evening elevation....

OMG WTF sometimes the responsibility of making health decisions is just too BIG!!!

Brent thinks I should go on insulin. There are only 8 weeks left and already this baby has been exposed to higher than normal sugars for 4 weeks, stressing its pancrease. It seems odd to me that I'm in that minority of minorities: women who can't seem to control sugars solely with diet and exercise. I know I've said that before.

Otherwise, the kids are back in school. I noticed that by the end of the 2 week break, Matthew didn't have a single sentence without stuttering, and often 3 or 4 words within each sentence had 3 or 4 repititions per word: this is without sleep deprivation or any particular stress I could think of. I think it's the lack of structure that does it to him. We're pretty structured and predictable, as a family, the kids have regular bed and meal times and we don't generally stray too far from the routines because they work well for us. But school offers more structure and more focused work time, and I guess he really thrives on that! Plus the lack of an older brother hovering around that one is VERY intent on competing with.

The weather has been freezing lately; clear and sunny and cold and frosty, which I like. And there was snow predicted for yesterday which rather waited until this morning and came down more like slushy sleet! Icky, but it could be worse I guess. We did have that sunny frosty reprieve.

We're packing up our house, Brent's doing most of it, and I've done a few boxes. In a few minutes I need to go back and do more. It's sad! We've been here 8 years! All the kids were brought home to this house. So much growing up happened here, for all five of us. We've definitely outgrown it though.

Only 7 days left til we move! Holy crikey!

xo

Proud Momma

Matthew just read an entire book to baby #4.

=)

"That's Not My Monster"

by Usborne books

Reflections on 2010

I feel a bit overwhelmed at the thought of looking back a whole year and trying to remember it enough to reflect upon it, but I've an inkling that if I just start, it will be easier than I anticipate. And worth it, to look back and reflect.

-January last year saw several rounds of illness in our house, and the beginning of my Breastfeeding Course for Health Care Providers. It was also an enormous blessing for me to think back to "this time last year (2009)" as far as my anxiety disorder. It was a blessing I didn't know was even possible to live largely within a more balanced mental state~something I can't overstate. The freedom is just...beyond words. Like I was in a prison and I'd not actually realized it and then suddenly someone opened the exterior door in increments, over the span of several months, and then I stepped out. And it was shocking to me to see how other people lived with these wide open spaces and incredible soft quiet, and sleep. Blessed, wonderful, beautiful sleep.

-I learned so much in my course, and enjoyed pouring myself into school again. It was nice to be a student again, especially of something I'm so interested in.

-February was the 2010 Olympics. SO COOL! I wasn't a fan of the Vancouver Olympics at first, and I'm still not convinced the cost of the infrastructure was really the best use of government funds, but since it was here we embraced it. I went to one Olympic event (the luge) with my sister in law, and it was pretty wild to be so close to such fine tuned excellence and dangerous speed. Brent and I also took the kids to downtown Vancouver twice to experience the spirit of the games: we happened to be at the corner of Robson and Granville (major intersection with a two story television screen broadcasting olympic sport events live) when the Canadian men's hockey team won gold. The city erupted, it was wild! I was scared one of the kids would get lost or trampled, but we did okay.

The second time we went down we did so via bus and train, and took the West Coast Express train back, which was an adventure in and of itself! I was grateful to live so close to the action.

-We also saw Matthew's urologist for the first time in February. It was good to start the process of investigating exactly what was/is going on for Matthew in that department. It wasn't so fun stressing about a medical appointment and a trip to Vancouver alone with two kids, and grappling with the ramping up of anxiety that surrounds an appointment like that for me, but I was very relieved to be starting the process of helping Matthew with his issues.

-In March we bought a van. We had also been talking for several months about having a fourth baby, and started trying in March.

-We were in the process of putting renovations on our house into high gear, because the two major things we wanted to accomplish (read, Brent stipulated) before adding a fourth child were to buy a bigger vehicle and to move to a bigger house, to accommodate said fourth child. Done and done. =)

Well, we haven't moved yet but we do in eleven days.

-I can't remember exactly when Mothers of Change started up, but I know we got more established as each month went by, and by March we were in a groove with our website and starting up as an organization. It's been a major blessing to be a part of an advocacy group like this one, and I love being a part of it.

-I finished my course in April and didn't get pregnant.

-I worked one or two shifts per week. I got bullied at work. I put up with it because that's the ambulance service for you. I loved the WORK, I hated the atmosphere and politics.

-I started baking. I like to cook, and I'm good at it now, but baking was The Final Frontier that I've barely started making a dent in...which of course is on pause now until after #4 arrives...

-We went to the tulip festival a week after it ended but got some pretty good photos and had a nice family annual day trip to Mt Vernon Washington~and didn't even get hassled at the border. WOW! May 26th was my last period, because in June I got pregnant with #4!

-Our summer was fantastic; Regina for Canada Day and my brother in law's graduation from police training, camping on Pender Island, and camping at Otter Lake, and visits with family and friends and good times at the water park and in the backyard sprinkler. I was sick with early pregnancy nausea. Somehow I survived. I got a very good mark on my course from the previous winter, which bolstered my confidence after a rejection letter from UBC's midwifery school. Which of course would have been hectic since I was having a baby anyways but it was still a bit disappointing.

-This fall my older two kids were in school full time and I've been enjoying watching them develop in leaps and bounds, learning all sorts of amazing skills and growing up SO FAST before my eyes. SO beautiful. Riley started talking in the summer and has taken off this fall, and is developing a charming two year old attitude. =)

Additionally, my health took a downward turn. I was sick for five months of this pregnancy, itchy, exhausted, full of aches and pains and vertigo and early painful contractions and, of course, that dreaded gestational diabetes diagnosis.

But it was fun and magical to feel the baby move. And watch its development through my body, which is spectacularly normal in its ability to grow a baby. Isn't it cool? I don't give my body enough credit.

-Matthew saw his urologist again and got a slightly different diagnosis than last time which fits my intuition of the situation better and has no treatment but the test of time (medication is an option but we opted out). He also had surgery on his ears and we have already seen an enormous improvement in his hearing this winter compared to the past four winters! Thank goodness, for his continued health and language development and success at school. He has been tested by the school speech and language pathologist and we got the results right before christmas. He has some major gaps that are all explainable by early childhood hearing loss and addressable with continued therapy, but best of all the greatest gaps that were major roadblocks two years ago now no longer exist. He still stutters, but 'mild.' His speech is now consistently clearer than Ayden's. He communicates well and is learning to read in leaps and bounds, typical of Matthew: slow start, then 0-60 in .25 seconds. He has now grasped the concept of spelling and is a very good speller; he can ace a test without studying (but we still study). His gaps are things like associations (like, "What goes with a shoe?" answer: a sock, a shoelace, a foot, etc~he can't do that one at all), and memory sequences (remember the following numbers: "Five, seven, two, nine." What numbers did I say?~he can't do that one beyond 3 numbers, about age four developmentally), etc. I'm just so proud of his tenacity in life and his ability to work through the sometimes unfair crap life throws at him. He's a brilliant kid, in so many ways.

-Of course we also had birthdays: I turned 32 last January, Ayden turned 7, Riley turned 2, Matthew turned 6, and Brent turned 35. The whole lot of us are getting freaking old!

We also had celebrations: easter, family events, birthdays, graduations, thanksgiving, christmas, etc. My life is full. My heart is overflowing. And I'm very, very grateful.

Here's to another year of overflowing fullness of life in 2011

♥

Happy 2011

Holy crap #1: it's already 2011! Jeepers. What happened? I kind of feel like time should have stopped somewhere around 2003 when Ayden was born. Because I don't *feel* any older than I was then but somehow 8 years of age crept up on me and leapt out of the dark corners and yelled, "AHA! Gotcha!"

New Years festivities for me included six phone calls with my mother, several hours devoted to a post on Mothers of Change, and 2 episodes of PVRd Criminal Minds. I heard the fireworks at midnight and shushed the dog when he barked at them. I went to bed shortly thereafter and slept like a baby all night. Woke up to blood sugar of 5.7~the lowest I've had since before Christmas! That's a good way to bring in the New Year.

New Years resolutions this year? I don't have the energy. Other than a normal, uneventful, beautiful birth, my goals are pretty everyday. Peaceful year. Lots of blog buddies are asking for the same thing; modest goals that add up to a peaceful, uneventful, happy, healthy year. Sounds fantastic to me. Avoiding postpartum anxiety this time would be fantastic, too.

Holy crap #2: we opened up a can of worms on Mothers of Change regarding formula advertising....It's tough because I feel like I want to present what I have learned without sabotaging anyone's maternal confidence, regardless of feeding methods. You guys know me; passionate about women first, and breastfeeding second. It's a long, long fight to protect breastfeeding and to give women who want to breastfeed the best possible chance for success, and at the same time strive to make it obvious that I support women's right to choose ANY informed choice. But few people comment in agreement or support on blogs like MC, (those who do are generally board members! lol!) and the comments we get which disagree or criticize make me want to withdraw to private blogging again simply because I'm better known here. You guys don't agree with me all the time, but you know ME first and my opinions next, so I generally feel like even if you think an opinion is "out there," you trust my intentions.

This is a distinction I'm learning to grapple with as both kinds of writers with different audiences.

[please don't anyone feel dissuaded from disagreeing with me or questioning me; this is me processing my learning curve, not wishing for no dissent]

It's tough, too, because I don't want to come across too wrapped up in conspiracy theory type thinking, but when it comes to birth and breastfeeding, there is a lot in our system which works against nature's design but appears to be in the best interests of the health of women and babies. Many people don't realize how obstetrical trends have interfered with the birth and breastfeeding process and continue to interfere, and so when I spout my ideas I sound crazy because they're so different from the accepted norm. And then for me to start talking about formula companies undermining and sabotaging breastfeeding efforts through ads and commercials which seem benign makes me sound like a conspiracy theorist. Sigh. I guess I just have to come to terms with being a conspiracy theorist. Call me CT. Nice to meet you =)

Which reminds me that I haven't yet done a review of The Politics of Breastfeeding on here. I really passionately want to, but its a daunting task because the book is so good and goes deep into the history of infant formulas and their ads and close alignment with the medical establishment and unethical marketing practices like dressing representatives up in nurse's uniforms and sending them to maternity wards in Africa to 'educate' women on the superiority of infant formula and inferiority of human milks: women who were formula feeding their infants were asked why they chose to do so and the women would reply with, "Because the nurse at the hospital told me to!" This was in the 1960s and I believe this practice disappeared shortly thereafter, although I wouldn't be surprised if it were found somewhere still.

What's the big deal? Here's an example of what happens in developing nations when infants are formula fed:

This woman gave birth to twins, a boy and a girl, and was incorrectly informed that she would not be able to produce enough breast milk for both babies and advised to formula feed one and breastfeed the other. She travelled quite far to meet up with UNICEF aid workers in Pakistan, asking them to take a photograph to document how ill her formula fed twin was. She was devastated and her sick baby died the following day (source).

I get kind of passionate about infant feeding practices.

I will do a better review of the book at some time soon~that and another book I read that I didn't like nearly as much and have much criticism against; Breastfeeding Older Children by Ann Sinnott.

Happy new year everyone! Peace and love for 2011...