Health Update

Maggie is sleeping on my lap, but I have one hand free, so I'll try to write a little.

My gallbladder was removed two weeks ago. I'm healing well and feeling good. Thank you to mom and Ashley for coming to help. And thank you to grandma for sending the food I was craving. I have a follow up appointment with the surgeon on Monday. Hopefully, I never have another digestive episode ever again.

Maggie was sick right before my surgery. She had a rash, body aches, and sore throat but no fever. Then almost her entire body peeled. It was scary enough that I took her to urgent care and then to the pediatrician a few days later. Strep test was negative; otherwise, it acted a lot like scarlet fever. Fortunately, she's better. Just a little clingy and cranky today. We all have those days.

Lucy seems to have her own allergy cough, mostly at night. More than once she's coughed so hard that she's vomited. I had been giving her Benedryl but switched to Zyrtec three days ago. It's a little better. I'm also doing the vapor rub and sock treatment to her feet and running the humidifier. I've offered honey and cough drops, but she refuses those. I hope we can get it under control. It's messing with our sleep.

Matt's cough is a little better with Flonase.

Maggie's 1-Month Checkup

Maggie is perfectly healthy. She made some faces during the exam but only fussed a little once. She weighs 9 lbs., 1.5 oz. (26.4%) and is 21.5 inches long (40.9%). She's gained about half a pound a week, right on track. There's not much more to report about our calm, perfectly healthy baby. Next month she gets her first shots.

Post-Pregnancy Digestion

As I figured out my digestive issues after Lucy was born, I realized that each pregnancy slowed my digestion and altered my IBS: from IBS with diarrhea before Neil to something like normal after and then to IBS with constipation after Lucy. I hoped that Maggie wouldn't slow things further, and I don't have an answer to that yet. Until last night, I would have said things weren't running slow; however, my other health issues might have affected me. While I was congested, I was swallowing what I coughed up so that the mucous wouldn't come into contact with anyone or anything and spread the infection. But that made my stomach kind of upset and caused loose stool for several days. Throughout my pregnancy, I took stool softeners every day, and they worked. I didn't throw up or need an enema to relieve constipation that was keeping my stomach from emptying. I've continued the stool softeners and hoped for continued good results. 

But last night after our family walk, I started hurting. I didn't feel like I was going to vomit, but the pain felt like a combination of back pain and digestive problems. Doing the stretches the chiropractor showed me helped a bit before bed, but I woke in the middle of the night in serious pain. I put Maggie in a bouncy seat in the bathroom while I tried to feel better. I thought I might need to go to the chiropractor first thing Saturday morning. I decided that the one thing I could try immediately was an enema. If it helped, I might get to sleep. If it didn't help, I'd just get help for my back as soon as possible. So the enema did its work, and I still felt bad. I took a couple of Motrin, which I figured would help back pain but not do much for gall bladder pain. Once again, I'd either get relief or more information about my condition. I took Maggie back to the recliner and suffered as she leaned against my abdomen while nursing. When the back spasms started, I started composing a text to Mom to pray. And then I felt a gurgle in my intestines, and all of the pain and spasms suddenly and completely stopped. I was fine for the rest of the night. So it seems that constipation is still causing me problems and is doing so despite higher than maximum doses of stool softeners. I had some urgent bowel movements later this morning, but that seems to have settled down. So I don't know if my condition is significantly worse, but I definitely need to see a doctor to see if we can get this straightened out. Fortunately, I've met my deductible for the year by having a baby, so anything I get fixed is free from now on. 

My back is also a problem while I'm recovering from surgery. I'm sure I'm using my back muscles in unusual ways to compensate for weak abs. I need to slow down a bit, carry Maggie less, and slowly build strength. I'm really looking forward to getting back to the pool after my 6-week check up. Moving in the water does more for my back than anything else I've tried.

One Week

Maggie is one week old! It's been a good week with a few moments of craziness. Here's how we're doing.

Maggie
Maggie is doing really well. She eats well, often and efficiently. She sleeps well, even by herself in the cradle. She burps easily, hasn't had gas problems, doesn't mind wet diapers, and cries infrequently. She likes to cuddle and listen to stories and songs. She seems to like her sister. She's just a really sweet, easy going baby. (I don't want to label Lucy as difficult or high maintenance, but even with frequent feedings, Maggie has required much, much less effort than Lucy did or does.)

Lucy
Lucy has been sick part of this week. As usual with Lucy, there weren't really symptoms. She didn't feel well, and it affected her behavior, making her prone to meltdowns. We know it was illness and not just a reaction to a new baby in the house because we took her temperature and she had a fever over 102. On Saturday, she seemed more volatile than usual. Alice came to stay with us while Matt was at graduation, and Lucy refused to have anything to do with her most of the time. Fortunately, Alice doesn't take such things personally. That night nothing made her happy. She cried and complained for a couple of hours. Few suggestions met with approval, and then she didn't really want what she said she did. That was when we found she had a fever. Eventually, after a bath and some ibuprofen, she curled up under her blanket and with no pajamas and fell asleep. She has remained a little volatile to varying degrees, but she seems a little better every day. The only other symptom is digestive. She didn't poop for a few days. Then her stool was loose. Last night she took her diaper off, and while Matt was getting her a new diaper, she suddenly pooped on her bed and the floor. She couldn't control it, and she was horrified. Bath and ibuprofen helped again. Despite not feeling well, she has continued to be sweet to Maggie and usually remembers to be gentle with me. She also does a good job of being patient. We do have to keep an eye on how helpful she's being with Maggie, but I told Matt that if Lucy were to harm Maggie it would have been motivated by love and kindness. She has started giving Maggie kisses, which is sweet but potentially dangerous because she has a fever. We've tried to limit but not discourage the kissing. We want Lucy to love her little sister, but we want Maggie to be healthy. So far so good with both goals.

Natalie
I'm doing pretty well. I move pretty well. but I tire quickly. I can now cough and laugh without feeling like I'm flying apart. The external incision seems to be healing well. You can't ask for much better a week after a c-section. My biggest problem has been a herpes outbreak on my face, first on my lips and then in my nose. I'm sure it's just the opportunistic virus taking advantage of an immune system working to heal me while being further taxed by stress and lack of sleep. But because the virus is so contagious, I've been unable to kiss Lucy and Maggie for most of the week. I have to constantly wash my hands to make sure that I don't spread it to my nipples or other parts that are currently being handled more often than usual. I've been taking an antiviral prescription, and hopefully, the outbreak will clear up soon. Other than that, I'm mostly just tired. Feeding Maggie every 2-3 hours while also trying to let Lucy know she still has a mom hasn't left me a lot of time to sleep. I'll keep trying to get more naps.

Matt
Matt is healthy so far and doing his best to get enough sleep. He's been sleeping on the floor next to Lucy so that he can help her when she wakes in the night. Lucy has adapted well to cuddles with daddy instead of mama, but cuddles from a two year old can still make it hard to sleep. Matt turned in grades by Monday, so his semester is over. Normally, he would take a day or two to lounge and recover. He's not getting nearly as much lounge time as usual, but some of it is done while holding a sweet, snuggly newborn, which has to make it better. We've done a good job so far of taking turns with the kids. We quickly size up the latest situation and divide and conquer. We each get opportunities to care for ourselves a little, too.

Other than a couple of minor health issues unrelated to delivery and recovery, we've done really well in our first week.

Appointment 34-1: Aw crap!

We've got so many appointments lined up that I've decided to use a notation system to refer to them. This is our first appointment since reaching 34 weeks yesterday, so today's visit is 34-1. On Monday, we'll have our second appointment of this gestational week (34-2). Next Friday will be 35-1. We hope to at least reach 36-1.

Vitals
Same weight and good blood pressure for me. Emmie's heartrate was a solid 140. My fluid was only a tiny bit higher but still at the low end of normal.

BPP
She breathed for the entire BPP, way more than was necessary. She had to be prompted to move around a little. Apparently, morning is breathing time. She passed the BPP, but we went to the hospital for the NST anyway.

NST
Emmie's heart was fine, but she was not as reactive as they wanted, so I ended up being on the monitor for two hours instead of 30 minutes. After they let me eat some lunch, she became much more reactive, and we got to go home.

TORCH
The TORCH panel is the blood test they ran on Tuesday to see if I have any infections: Toxoplasmosis, Rubella, Cytomegalovirus, and Herpes Simplex. Unfortunately, in addition to the herpes we already knew about, I tested positive for toxoplasmosis. I have no symptoms, but adults don't usually show symptoms of toxoplasmosis infection. The question is whether Emmie has it.

We don't know much from our doctor yet. He thinks I've caught it fairly recently because the test differentiates between current infection (IgM) and antibodies formed from previously having the parasite (IgG). My IgM test was positive, and my IgG test was negative. Since Dr. Reynolds just has one set of test results that he got today, he can't be sure of much yet. He is going to consult with some other doctors to figure out the best thing to do now. He said he'd call when he knew more.

Matt and I have done some googling to get a better idea of what my results could mean. Here are some options:

Positive IgM, Negative IgG can indicate a false positive, so I might not have toxoplasmosis. (Unlikely, but possible.)  Further testing is likely in my future.

Or Positive IgM, Negative IgG can mean I was infected, probably in the last six months.

However, positive results can occur up to a year after infection, so we don't know for sure when I got it. And timing really matters.

If I had it long enough before Emmie was conceived, then she may not have it at all. (Unlikely, but possible.)

If I had gotten it in the first trimester, she would probably be dead already or showing serious malformations, which she hasn't, so that's highly unlikely.

If I got it in the second trimester, the chances of her catching it from me are low, but the damage if she does have it would be serious. She could have calcium deposits in her brain or liver.

If I've caught it in the third trimester, then she has a good chance (at least 60%) of catching it from me, but the damage would be less severe because most organ formation was already done by then.

If she has it and appears normal at birth, she may eventually have hearing loss, vision loss, motor development delays, and/or cognitive delays due to congenital toxoplasmosis. Patients with congenital toxoplasmosis may develop eye lesions as late as age 30. Matt's googling indicated that problems often present in the teenage years.


The good news is that the doctor tested me and knows Emmie might have it. They normally don't test for it, so it was her small size and family history that prompted the testing, which found this possible problem. I may receive antibiotics, which would also help treat Emmie. Emmie can be tested via amniocentesis or after birth and receive treatment for her first year, which would lessen the severity of the damage.

So what we know is that I've tested positive for toxoplasmosis. We don't know what that means for us yet. It could mean nothing if Emmie doesn't have it. Or it could mean that my gardening caused my daughter to lose vision or hearing or to have physical or mental disabilities. (Toxoplasmosis is spread through cat feces. I don't like cats, but cats like gardens and sandboxes; so I could have caught it from my garden or Lucy's sandbox--although I've seen no evidence of feces in either place--or from under-washed produce.)


LUCY
Although we were gone for 5 hours, Lucy had a good time with Erin Steele. Erin goes to our church and is one of Matt's students. Her mom reads my blog (Hi, Alice!) and her parents let her know we needed help with Lucy. So Erin emailed Matt to offer to watch Lucy today. That was a godsend. We were scrambling to find someone to watch Lucy for an indefinite amount of time on short notice. As it so happened two of Erin's classes today were cancelled because they were Matt's classes, so that turned out well. :) Erin and Lucy played outside and inside and watched Shaun the Sheep. We asked Lucy if she would like Erin to come over and play again and got an enthusiastic YES! Erin came by later to return our keys, and Lucy cried when she left. She told me, "Me sad friend Erin go." And Erin liked it well enough to be willing to do it again sometime.

We changed our 35-1 appointment from Thursday at 8:30 to Friday at 10:30 so that Matt wouldn't have to cancel Thursday classes again next week. We were lucky they could fit us in. Erin said she could watch Lucy after noon. Now we just have to find somebody for 10-noon.

Between Tuesday and today, we spent at least 11 hours getting medical care for Emmie. We certainly hope future appointments are less dramatic and time-consuming.

34ish Week Appointment: A Long, Long Day

I was not really looking forward to having an OB appointment on Neil's birthday, but this one was worse than I had hoped but not as bad as it could have been. First, Emmie did not pass her BPP. She moved just fine, but she refused to show off her breathing. So we were going to have to go to the hospital for a non-stress test. Second, they checked growth, and Emmie seems to have fallen off of her growth curve. Her overall percentile was 16%. It had been in the 30s. Like her siblings, her femurs are short, which will drag down the percentile. (Although short fetal femurs mean little to height as she ages. Lucy had short femurs, and her height is in the 90th percentile at 2.5 years.) We're also not sure that they're getting an accurate head measurement because of her position. That would also drag down the percentile. Her abdomen is around the 50th percentile. At 4.5 pounds, her weight is in the 30s percentile-wise. So there are enough excuses to believe that she's not really at the 16th percentile. And we were told that the abdomen size is a better predictor of her health than the other measurements. But we are us, so they did two more ultrasounds and some blood work to check for infections. The ultrasounds were to check for blood flow in her brain and umbilical cord. The umbilical cord blood flow was fine, but they had trouble getting a good angle on her brain because of how low she is. Dr. Reynold's response was to have them follow up with a vaginal ultrasound to see if they could see the head better from that angle. They tried and tried and tried, which irritated Emmie enough that she was punching, kicking, and moving her head around to make it impossible to record anything about her brain. So they gave up on checking brain blood flow and sent us to the hospital for the NST. Emmie did really well on the NST. The nurse, who I recognized from Lucy's birth because she LOVED Lucy, was impressed with her heart read-out. Emmie fought the fetal monitor a little, but I think she was worn out from protesting the vaginal ultrasound. The lab tech who took my blood was really nice and took extra just in case they thought of something else to test, which knowing doctor Reynolds was a good idea.

Dr. Reynolds decided that we should start going for BPPs twice a week and despite whether Emmie passes them or not, we'll also go to the hospital for non-stress tests (NSTs) every time. We had weekly appointments already set, but they had to scramble and double book ultrasounds for the Thursday appointments, which they couldn't always get at times which work well with Matt's schedule. So he's going to have to cancel classes, and we're going to have to find childcare for Lucy because we can't expect Shawn and Susie to drop everything twice a week for keep her. And we won't know for sure how long we'll need someone to watch her each time. If they've double-booked the ultrasounds, I'm not sure how long we'll have to wait. The BPPs can take as long as 30 minutes. Then we'll see a doctor. Then we'll check into the hospital for an NST that takes at least 30 more minutes. And hopefully, they find nothing wrong at any point, or they'll admit me to the hospital to get Emmie out. And taking Lucy with us isn't a good option with the NSTs being done in the hospital, even if Matt was willing to miss the ultrasound to keep Lucy in the waiting room. He'd have to keep Lucy out of the hospital, too. And both Matt and I want him present for anything in the future because there's actually a chance they'll find something and get Emmie out. And we'd have to do something with Lucy if they admitted me to the hospital. If it was an emergency, Matt might not get to be in the OR because he would be keeping or transporting Lucy. It's a lot to deal with and plan for.

I was pretty bummed by all of this and cried quite a bit. I was not emotionally ready for any bad news. They did admit that almost all of the precautions they are taking are because of Neil. Emmie's situation without our history would not cause this much alarm. But the last time we had a small baby, he died. He didn't die because he was small, but ultimately the problem was a blood flow issue. And if Emmie isn't growing, she might have a blood flow issue, too. The specialist in Louisville considered that I just have consistently under-performing placenta. If I had any doubt before (and I didn't really), today convinced me that this is my last placenta. We're not going through all of this again.

On the bright side, I lost a couple of pounds last week because of increased consumption of fresh produce and increased activity in my garden. And my blood pressure was fine and got better each time it was taken. And my fluid level was a little higher but still at the lower end of normal. If fluid dramatically increases or decreases, they'll get Emmie out. In fact, we're now doubting that we'll make it to 38 weeks. If they find the least reason to get her out at or after 36 weeks, they'll do it.

Lucy had a better day today than she did last Tuesday. She still cried when she was put into the red car. She legitimately does not like to ride in a car that is not her blue car. Because she had done it last week and she wasn't in quite as bad of a mood today, the crying was not as severe. She was also heading to the park with Shawn, which may have helped a little, too. She had already told us this morning that she wanted to go to the park. According to Shawn, they had a pretty good day. There were a few tantrums and other two-year-old behavior, but she didn't melt down or destroy anything. And she seemed to have a good time.

Now I just want to go to sleep. I'm worn out. Tomorrow I'll try to find someone to watch Lucy. Tomorrow I'll try to get more done around the house just in case. Tonight I'm taking a Tylenol PM and getting as much sleep as possible so that I have the energy to deal with tomorrow's problems.

Reasonable Pain

I'm understandably anxious about my health while pregnant. I try to limit my fears to reasonable ones. There are so many to have. It seems that everything is dangerous for pregnant women. We should all be packed in bubble wrap and fed a safe solution of necessary nutrients so that we don't accidentally eat fish with too much mercury or lettuce or lunch meat with listeria (one I do worry about after the salad recall that cleared Kroger's shelves) or cats (a joke from my first visit with nurse during my first pregnancy). Every visit with my OB includes a list of things to watch for and entreaties to come to the hospital if I have any of those problems. I always tell them, "Don't worry. If anything is troubling, I will absolutely come to the hospital." The trouble is figuring out whether something is troubling. Blood is always troubling and would, of course, send me to the hospital. But what about the symptoms for preeclampsia? Headache and swelling of face, hands, or feet. Is every headache a potential problem? If I have a headache and swollen ankles (fairly common late in pregnancy), is that a problem? And since my cervix was measured and found short, which tends to happen in women with a history of pre-term labor, should I scrutinize every ache and pain to make sure it's not a contraction? If I have a headache, I ask Matt if I look puffy. He's honest, so I don't worry about his saying, "No, dear, you look radiant." If I hurt, I sit down and sometimes take some Tylenol. Tylenol wouldn't do anything for labor pains, so if it helps, I'm probably not in labor. I also try to consider what I was doing before the pain started. Did I over-exert? Did I lift something lighter than a cast iron dutch oven that was still too heavy for me?

So today I hurt and had a headache. I was fairly certain that both were caused by unusual exertion, but I hurt pretty bad. The unusual exertion was running across campus to catch Lucy. She wanted to play on the steps under the clock tower (one of her favorite things to do) while Matt dropped off some paperwork at an office, so I said I could handle watching her while she played on the steps. We were fine for a while. Then she headed down the sidewalk between the theater and Carter Hall. I followed. She picked up speed, so I told her to stop. That's when she bolted. She ran downhill toward the chapel, which is bordered on two sides by roads and on another side by a parking lot. She turned toward the road she would have to cross to get to Chik-Fil-A. I ran as fast as I could and faster than I should have to catch her before she got to the road. Just in front of the chapel, I grabbed her hair because that was what I could reach and stopped her. Both panting, we collapsed in the grass. "Mama pull me hair" was Lucy's response. "I can't take you anywhere. I can't keep up with you to keep you safe" was my response. If I can't watch her for a few minutes on campus, I really can't take her anywhere. What if I had fallen? What if I hadn't reached Lucy before she reached the road? I took her hand and walked her back up the hill with only a little protest from her, which is fortunate because I couldn't have carried her up the hill. We would have had to sit and wait for Matt to find us.

So I hurt bad. I had a headache. I felt like I had strained something in my lower abdomen. My back hurt, both through my ribs and my lower back. I started having small back spasms, which were potentially concerning after the back labor I had with Lucy. Quite honestly, everything below my hair and above my knees hurt. I was also a little worried about the jostling that Emmie got, but she didn't seem to mind. She's stayed perky this afternoon and evening. I took Tylenol and lay down for a nap after we got home. I woke up about 45 minutes later and still hurt, so I rolled over and napped some more. A little later, I felt a little better but still hurt, so I rolled over and napped some more. I napped until I stopped hurting. I'm still a little sore and stiff and have taken more Tylenol. The good news is that this is reasonable pain with an identifiable cause, not the alarming kind that would send me to the hospital. But until the Tylenol and napping kicked in, I was a bit worried as well as sore and exhausted. That's not a fun combination.

Lucy is indefinitely grounded, especially since telling her to stop made her run. I'm not taking her anywhere alone without her being strapped into a stroller or cart. I can't do it while I'm pregnant or recovering or hauling around a newborn. I like for her to move around and explore, but keeping her alive and safe is a higher priority. I'm sure it will hurt her feelings sometimes that mama won't let her run, but that, too, is a reasonable pain.

Spring Break Sniffles

Earlier this week Lucy had a snotty nose, itchy eyes, and a tendency to melt down every few minutes. The weather had turned nice, and people with spring allergies were suffering, so I thought she might have allergies. The other option was that she had a cold. I wasn't sure which to root for. I didn't want her to have a cold, but allergy attacks keep coming back. As someone who got allergy shots as a child, I really didn't want her to have allergies. Yesterday Matt and I discovered it wasn't allergies. We were both getting sick. So far we're in pretty good shape. The symptoms aren't too bad: runny noses, Lucy's occasional cough, a slightly stuffy head-achy feeling that improves with Tylenol/ibuprofen/"treat." Lucy felt well enough to play on the slides at Burger King today. And I discovered that our Burger King still has Coke Icees, which will come in handy if I get a sore throat. If we can rest and recover for a few days, I think we'll be fine. Emmie is pretty lucky that she isn't catching things from her sister yet. She's been very perky today.

This week is spring break, so we have the time to get better, but it's also the week of the International Conference of the Fantastic in the Arts (ICFA), which Matt goes to every year. I've gone, too, but not since Lucy was born. We take Matt to the airport on Wednesday, and then it's just Lucy and me (and Emmie). And that's why we've got to get better soon. I have a hard enough time keeping up with Lucy when I'm healthy and rested. Fortunately, Susie has offered to let us sleep over a night or two at her house. We needed to start doing that anyway so that Lucy can get used to sleeping there before she has to sleep there when I'm in the hospital with Emmie. I plan to take Lucy to Bounce as often as possible because the swimming pool is closed for spring break and Lucy needs to exercise. I'm also planning to put the gate up on the back porch to give Lucy somewhere safe to play. I may also join the ends of the fence in the living room to form a baby cage in case I need to go to the bathroom and don't want to worry about what Lucy will destroy while I'm out of the room. We'll do what we have to to make it to Sunday when we pick Matt up again. I'm sure we'll both be glad to see him.

After spring break we have our next ultrasound, so we'll get to see Emmie in action before getting another Rho-gam shot. And then the next day is Lucy's 30-month well baby visit to the pediatrician. I don't think there are shots at that one. Other than the current sniffle and some eczema on her back, Lucy is in good health. Over those two days we'll find out how big both of our girls have gotten. Then it's Easter, and then it's April, which is right before May. Time is flying!

A Bright Spot

I'm finally ready to tell about our visit to the fetal medicine specialist in Louisville. Let's start at the end so that the suspense doesn't kill you. The blood test showed Emmie is at low risk for the three most common genetic trisomies. Hurray!

Back to the beginning. We see a fetal medicine specialist because they have the really good ultrasound equipment and can scan thoroughly to let you know if there are any problems or possible complications. The ultrasound takes an hour. That's how thorough they are. They document and measure arm bones and leg bones, several organs, and even several parts of the brain. And they can even examine the placenta and umbilical cord, which are what concerns me most after Neil.

Emmie made things difficult for the ultrasound tech, but the scans looked good except for a bright spot in her heart called an echogenic intracardiac focus (EIF). According to Wikipedia (and our doctor), EIF "is thought to represent mineralization, or small deposits of calcium, in the muscle of the heart. EIFs are found in about 3-5% of normal pregnancies and cause no health problems. EIFs themselves have no impact on health or heart function. Often the EIF is gone by the third trimester. If there are no problems or chromosome abnormalities, EIFs are considered normal changes, or variants." Emmie's heart looked perfectly fine except for the calcium deposit, so her heart is fine.

The problem is that EIFs are a "soft marker" for Down syndrome. Up to 25% of Down syndrome babies have this condition. Having the condition doesn't mean that you have Down syndrome, but babies with Down syndrome have the condition more often than other babies do. And my "advanced maternal age" is also a risk factor for chromosomal anomalies. The ultrasound showed no other indicators of Down syndrome, so the likelihood of her having it were low; however, the main rule of obstetrics is "better safe than sorry,"although sometimes is feels like the rule is "panic at every opportunity." 

The doctor gave us options for testing if we wanted to prepare ourselves in case Emmie did have Down syndrome. She didn't recommend an amniocentesis because of the risk of miscarriage, which might have been higher than Emmie's risk of having Down syndrome. We chose to do the Harmony test, a cell-free fetal DNA test which just required a blood draw from me. The test looks for fetal DNA floating in my blood and determines high or low risk for Trisomy 21 (Down syndrome), Trisomy 18 (Edwards syndrome), and Trisomy 13 (Patau syndrome). Trisomy means an extra copy of a chromosome, giving you three instead of just the two you're supposed to have. None of these trisomies are good, but Down syndrome is the least life threatening.

We got the results today that Emmie is at a low risk. It's a screening test rather than a diagnostic test, so it's not 100% conclusive, but it's very accurate. According to the testing website, "Harmony delivers exceptional accuracy with detection rate greater than 99% and a low false positive rate of less than 0.1%." That's good enough to put our minds at ease.

We have a follow up appointment for another ultrasound in Louisville in five weeks. The calcium deposit should take care of itself eventually. They just want to make sure that nothing else develops. If that scan is OK, they'll let our regular OB take it from there. Hopefully, everything is OK. We've had enough excitement.

Lucy's 2nd Birthday

Lucy's birthday events were spread over a week, from the first card in the mail until the 2-year check up with the pediatrician. Here's how we celebrated Lucy.

Monday, Sept. 14
Lucy received a card from Gram and Papa (my parents) that plays the Pointer Sisters' "I'm So Excited." The card also has a cardboard cut-out of a dog that twirls around during the song. Lucy LOVES that card. She plays the song over and over and dances, sometimes with her dolls. Lucy's word for music is "doo doo," which makes sense if you sing "doo doo doo," but she doesn't sing it. She is starting to put words together and calls her singing card her "dog doo doo." So thanks Gram and Papa for the "dog doo doo." :)

Tuesday, Sept. 15
The local bouncy house play space is free for kids under two, so we went one more time while she was still free. There were no other kids that morning, so I jumped and climbed and slid with her. She had a good time.

Wednesday, Sept. 16
On Lucy's birthday I tried to do things she wanted to do. I took her for a pastry at the local coffee shop. I let her pick a seat, and she picked one right next to a man that may be homeless. He didn't look dangerous, so we say there. I still haven't figured out how she judges people. Some people cause her to hide and run, but this man was someone to sit next to. I must admit I was kind of proud. Lucy refused to eat either pastry I bought, but she agreed to drink a little chocolate milk. Then we went swimming at the university pool. Lucy has been refusing to wear a flotation device in the pool, but she agreed to try a pool noodle. And she swam well with just a pool noodle. Since then she's started using a smaller noodle and has even tried swimming without support. She went under water and I had to pull her up, but she's brave and will keep trying. After we went swimming, I asked what she wanted for lunch, and she responded enthusiastically for chicken strips, so we went to Dairy Queen. There she discovered the white gravy that comes with chicken strips, and dipped her french fries (and her fingers) in the gravy. She refused to eat the chicken strips. [Have I mentioned that she turned 2?] She randomly decides what she will or won't eat at any given meal. She still likes a wide variety of foods, but she's likely to declare something she likes is "blech" at every meal. When Matt got home from school, we let Lucy open her gifts from family members. Ashley got her cute clothes. Grammie and Papa (Matt's parents) sent a card with money, which she was very excited about. Rick, Cathy, Drew, and Katie got her a couple of Curious George books, for which Matt was also grateful since he reads at least one Curious George book every night. Gram and Papa got Lucy some puzzles, which she likes but is still growing into. Grandma Tanner made Lucy a princess play dress that velcros so that Lucy can put it on and fasten it herself. Matt and I gave her a package of reusable doll diapers to go with a combo doll changing table/cradle/bathtub that I got at the Peddler's Mall. I am happy to report that when the two naked babies received diapers, they also wanted clothes, and they have remained diapered and clothed for a week now. If only I had known what the formerly naked babies really wanted, I would have gotten diapers sooner. We ended the birthday with ice cream at Baskin-Robbins with Shawn and Susie. It was a good day.

Saturday, Sept. 19

 We had Lucy's Curious George birthday party at the church. Several friends came, so Lucy had plenty of kids to play with. Susie painted Curious George for us. Other than that our decorations were plastic table covers and some Dollar Tree balloons, but it looked like a party. I splurge on a huge George balloon on Ebay, which you can see near the presents. It's almost as big as Lucy. We ate a sub sandwich from Wal-Mart again this year with chips and veggies.

Lucy doesn't like it when groups of people sing, and she doesn't like the "Happy Birthday" in particular, so we didn't sing. (Oddly enough, she's fine if I sing the church "O Happy Birthday to You" that I grew up with.) And she refused to blow out the candles on the Curious George cake I made, so Matt blew them out. [Have I mentioned she's two?] She got a lot of nice gifts, including a puzzle, Play-Doh, a doctor's kit, clothes, sidewalk chalk, a Marvel story collection, and a Curious George story collection.

I had gotten a pinata on clearance at Dollar General the week before, so we ended the party with that. It took amazing effort to open an already-banged-up clearance pinata.

Eventually, it did open, and the candy, bracelets, fruit snacks, stickers, and whistles inside were enjoyed by about 10 kids.

Monday, Sept. 21
Lucy's check up went pretty well. We had to wait for about an hour for our appointment. Lucy seemed to think the fun people were all in the "sick" side of the waiting room, where she wanted to crawl and roll on the floor. At times I had to hold her upside-down and swing her to keep her entertained. She played a few games on the Kindle, but what worked best was reading her a Curious George book on the Kindle. She sat still for the whole thing. She did not sit still for her exam. She resisted everything they did to her. I had to hold her and twist her this way and that so that the nurse could take her temperature and the doctor could feel her belly and listen to her heart. [Seriously, can she be any more of a two year old?] But as soon as the doctor was done and her clothes were back on, she started smiling and waving at him in the hall. She actually likes Dr. Mike from a distance. :) Her growth and development are on track. She is now 34.5 inches tall (76th percentile) and weighs 26 pounds, 7 ounces (47th percentile).

It was a good birthday week. Lucy seems to learn something new everyday. She's repeating words and putting words together.

Lucy at 20 Months

Lucy is 20 months old! She has grown so much in the last few weeks.

Physically
She finally had her 18-month well baby appointment on a couple weeks ago. She is growing and healthy and hitting all her developmental milestones on time. She is 33.25 inches tall (78th percentile) and weighs 24 lbs., 12 oz, (70th percentile). She cried through most of the visit, She started when they closed the door to the exam room. She doesn't like enclosed spaces like dressing rooms and elevators, so being shut in the exam room freaked her out. Being poked and prodded by strangers didn't make her feel better, and she ended the visit with her last Hep A shot. She was fine after we left. And we don't go back until September.

Her physical skills are still ahead of what development charts say is normal for her age. She can walk up and down steps without assistance. We still assist her because she gets careless and clumsy sometimes, but she's capable of handling stairs. She can jump and get both feet off the ground at the same time. She can walk backwards. She can alternate hands when drumming and has been practicing crossing her fingers. She throws and kicks a ball like a much older child. And we discovered last week that she can catch, too. People are often surprised to learn she's not yet two years old.

Intellectually
Lucy's language skills are steadily improving. Two weeks, she requested a second bun-length hotdog for lunch by saying "hotdog." And later that week, she started doing sign language as well as saying new words she had never attempted before. I tried to teach her to sign last summer and fall, but she didn't take to it, so I gave up. Apparently, something stuck. When Matt came home from work, she did the sign for "dad" when she said dada. And later that day she signed and said "more" when she wanted more candy. She had never tried to say "more" before. It has become one of her favorite words. She said "bowl" a couple of days ago to insist that I put her snack in a bowl (as I normally do) instead of being lazy and eating it out of the package. Today she combined bowl and more to request more cereal. And she is repeating what we say and attempting more words than ever before. For a long time, I wondered how we'd ever get her to talk if she wouldn't attempt to repeat what we said. Her words aren't always clear because she still has trouble with k's and r's. So cookie sounds more like goo-gee when she repeats it. But her progress has been swift.

She has learned more body parts. In addition to the basics of eyes, nose, arm, leg, etc., she now knows nostril, eyebrows, shoulder, knees, and elbows. And she attempts to say some of them. Eyes, nose, knee, and elbow are her favorites to say.

She has finally taken an interest in animals and their sounds. Two weeks ago, she brought me her stuffed duck and announced, "DUCK!" She has been pointing out ducks ever since. One day she heard a bee on our back porch and said "zzzz". When she saw the bee, she pointed at it and said "bee." She is learning other animal sounds. She says "woof woof," "moo," "meow," a nasally "wack" for duck, "oo-oo" for a monkey, and she blows through her lips to imitate a trumpeting elephant.

She is still interested in numbers and letters. She always recognizes O, and sometimes recognizes other letters. She is also showing interest in colors. Today she picked up a blue crayon and said blue (or boo). She is good at matching pictures. We played Memory with the cards facing up, and she did great.

Her imagination is really developing, too. We got her a kitchen set and a little table and chairs. She loves to make meals and serve them to her stuffed animals. A week or so ago, I heard her babbling while playing and then heard her "oo-oo" monkey sound followed by more babbling. I looked in on her and saw that she was sitting across the table from her stuffed monkey. She was supplying both sides of their conversation.

Socially
Lucy still gets really excited when she sees other kids. She gets so excited that we've given up going to library events. When there are so many kids and so many toys to play with, she just can't sit still and listen to stories. We're working on setting up playdates with some friends so that she gets more interaction with kids. Maybe if seeing kids isn't so unusual it won't over-excite her.

She is delightful most of the time, and she becomes more amazing every day.

15-Month Appointment & St Lucy's Day Celebration

Lucy's 15-month check-up was today. She is now 31.75 inches long (87%) and 22 lbs., 6 oz. (67%). She's not as comparatively huge as she was at her last appointment, but she's a healthy-sized girl. They also retested her lead levels, and they were normal this time. I think it helps that she's not putting things in her mouth as often. She got three shots. She was not happy about anything that happened after we got into the exam room. I think she remembers past visits. She fought being measured. She batted away stethoscopes. She writhed as they gave her the shots. Fortunately, Matt was with us this time and helped hang onto her as she fought. I'm not sure I could have handled her alone. She's fine now, napping peacefully. We go again in three months. She did get her first prescription today, an ointment for the eczema on her face. She has been a very healthy child so far.

We held a small "name day" party last Saturday, Dec. 13, which is St. Lucia's Day. The day is a big deal in some countries like Sweden, which has various traditions. One tradition is that a girl wears an evergreen crown with lighted candles on it. Last year I made one for Lucy out of a little wreath and a string of battery-powered lights from Dollar Tree. It's pretty cool for a $2 crown, and it still works, so we used it again this year. The crown with lights is part of the St. Lucia legend. St. Lucia (who may or may not be a real person) was taking supplies to Christians hiding in the catacombs. She needed to take a lamp to light her way, but she wanted to carry two armfuls of supplies. Her solution was a crown that lit her way and freed up her hands. I love this story. Lucia wanted to help with both hands, and so she invented head-wear to solve her problem. I'd love for my Lucy to be someone who wants to help with both hands and is open to solving problems creatively. Here are some pictures from our celebration.

St. Lucia's Day - 2013

St. Lucia's Day - 2014

She rode on the kitchen cart. It was one of her favorite activities.

She also liked playing with the battery-powered candles on the tables.

Candles in and out of the holders like little puzzle pieces.

And she let Susie play with her, too.

Maybe I Just Need Some Pepcid

I had my appointment with the surgeon today. After hearing my symptoms and pressing on my abdomen, Dr. Watkins said he's not sure I have a gallbladder problem. I have gallstones--the ultrasound showed that--but 30% of people with gallstones don't have gallbladder problems. I may be in that 30%. He said that there's no sign of inflammation on the ultrasound, neither fluid nor thickening of the gallbladder. My friend, Dr. Annie Skaggs, had told me not to have my gallbladder removed if there's no inflammation, and Dr. Watkins agrees. He said that we should try a prescription for Pepcid twice a day for a couple of months to see if that helps. We can reassess then. He said that he could take my gallbladder out, and it's pretty safe to do so; but he's not inclined to remove organs without more evidence that it will help. Matt and I were both relieved to know my surgeon wasn't overly eager to slice me open and hack bits out of me. I asked about the possibility of digestive problems after gallbladder surgery and told him that my Irritable Bowel Syndrome (IBS) had gotten better only relatively recently and that I don't want to return to life with IBS. Dr. Watkins said that gallbladder removal sometimes makes IBS worse. Yet another reason to try to keep my gallbladder! I don't have answers. But I have a prescription and an expert opinion. So I'm going to take my medication and continue/renew my weight-loss efforts and healthier diet as Dr. Annie recommended.

I had a little digestive/pain episode on Sunday afternoon, but before that it had been quite a while since my last episode. And my episode on Sunday didn't end with my vomiting. Stretching, a warm bath, and strangely enough breastfeeding Lucy kept the episode from escalating. Now I've got the Pepcid, so maybe that was my last episode. That would be nice.

Trying to lose the fat and keep my organs

My nurse practitioner's nurse left a message that my ultrasound showed gallstones. A doctor who goes to my church and works at the hospital recommended a few surgeons. I have an appointment set with Dr. Watkins for July 29. I'd like to see him sooner, but that's his first available appointment. I'll keep calling in case he has a cancellation.

The doctor-friend from church also gave me advice about deciding whether or not to have my gallbladder removed: if it's not inflamed, don't have it removed, but try a low-fat diet and weight loss instead. Large gallstones that could never fit in the duct aren't a reason to have surgery. I was glad to get the advice. I'm reluctant to have an organ removed.

First, I'm not sure it can be definitively known whether my gallbladder is causing my pain and vomiting. Some of my symptoms are textbook gallbladder attack, but some are not. Surgery might not help my current symptoms, but it could cause new ones. After I heard I had gallstones, I looked online for information about the surgery and recovery and found a message board full of people who had continued pain and new digestive symptoms after surgery. I don't want to continue in pain and gain diarrhea. I'd rather live with my current symptoms without adding another one.

Second, even safe surgeries like gallbladder removal aren't 100% safe. Dying is unlikely, but I don't want to take risks that aren't absolutely necessary.

Third, the logistics of caring for Lucy while recovering are tricky. Matt can care for her. But when she's sleepy, she wants mama and milk. Matt can't provide that. When she doesn't get mama and milk, she cries for a long time until she passes out from exhaustion. We would have to try to change her expectations before I had surgery so that we're not all miserable. Also because she is still breastfed, I would need to have a supply of milk frozen for her to drink while I'm on pain meds.

Fourth, timing is also an issue. I'm teaching this semester, so I don't have time for surgery, especially if I don't see the surgeon for a consult until the end of July.

Whether I have surgery or not, the low-fat diet is going to be a good idea. If I don't have surgery, it's still what my doctor-friend recommended. And if I do have surgery, I may need to eat less fat to compensate for no longer having a gallbladder to release stored bile to digest the fat. So I've started eating more mindfully. It's easier to do in the summer when there's so much good fresh produce, especially if that produce is growing in my yard. (Garden update soon)

9 Month Well Baby Report & Medical Update

Lucy did well at her checkup today. Everything is perfect. She weighed 18 lbs., 12 oz. (60th percentile), was 28 inches long (65th percentile), and has a 17.5 inch head (67th percentile). She gained 3 pounds and 2 inches in three months. Her first tooth broke through on Sunday. She is crawling and pulling up and climbing everywhere. She is right on track developmentally. We think she has figured out "dada" and "mama," but she doesn't use them regularly enough to claim that she is talking. She eats nearly anything. Last night she ate a few (pasteurized) blue cheese crumbles, and she sucked on the lemon that came with my water at lunch today. She wants to be big so bad. She wants to walk and eat crunchy things. And recently she has discovered that big people use toilet paper. Hopefully, we can leverage that interest while potty training in the future. The nurse noted today that the only appointments Lucy has had are her well baby visits. Other than a very messy stomach virus a couple months ago and roseola two weeks ago, she's been healthy. We are very blessed. Matt believes she inherited his immune system. I'm all for that.

I also had a doctor's appointment today. With all of the medical visits in 2013, it seems like I go to the doctor all the time. But I hadn't seen my primary care nurse practitioner since April 2012, just after the bowel infection. After my most recent backpain/vomiting episode last week, I decided to get another opinion about my problem. The stretches the chiropractor showed me help when I have attacks, but if something could prevent the attacks altogether, I'd prefer that. The nurse practitioner scheduled a gallbladder ultrasound for tomorrow morning. I have a follow-up with her on June 30. While I was there, I got refills on a couple of my "as needed" prescriptions, had her look at a 3-week-old tick bite (nothing wrong), and had her freeze off a plantar wart on my toe. It was all very efficient, and I really like Nurse Tammy. I'll post an update when I know the results of my ultrasound.

My Baby Makes Me Puke

There are many things about babies that you could say might make you want to puke (typically figuratively speaking): poopy diapers, curdled milk spit into your cleavage. But Lucy literally makes me need to puke. OK, so it's not just Lucy. It's partially from falling at KMart and having a C-section (not at the same time). But Lucy makes it happen more frequently. I should start at the beginning (or at least a little earlier in the middle).

For a while, even before Lucy was born, I've been having what I call "digestive episodes." First, it feels like heartburn. Antacids don't help. And it gets worse as pain starts in my back and ribs. A few times it has ended with a bowel movement (which made me think it was constipation), but most of the time it ends with vomiting. The last few times I've made myself vomit after several hours of pain so that the episode would pass and let me get back to caring for Lucy. (Last time I held her to try to bring on the vomiting--holding holding Lucy makes me feel worse--but I gave her to Matt before the actual vomiting started.)  I've considered that the problem was gall bladder or poor diet. I even noticed that it happened about the same time every month and thought it might be hormonal. But I decided to ask my chiropractor about it since there's back and rib pain. He said pressure in the mid-back can cause my symptoms. Of course, you'd expect a chiropractor to say something like that, but I decided to go with that answer for now because it doesn't involve lots of expensive medical tests. And I already knew I have mid-back issues. I asked the chiropractor what I could do if an episode struck when his office wasn't open, and he showed me some stretches. On Monday, I started having an "episode" in the afternoon and was able to make an appointment with the chiropractor half an hour later. I tried the stretches before we went to the chiropractor's office, and they helped a little bit. When the chiropractor adjusted me, I popped all over the place, top to bottom, especially in my mid-back. When I got home, I took a nap and woke up feeling fine. No vomiting necessary. I think the chiropractor might be right about my back causing my digestive issues.

What would be ideal is to prevent the episodes altogether. That may be tricky. I will try to strengthen my back muscles, but my back is permanently jacked up because of an accident. When I worked at KMart after my first year of college, I fell carrying boxes and because my arms were full, my torso caught all my weight as I landed on an empty wooden pallet. I knocked some ribs out of place and injured my mid-back. For several years, I needed regular adjustments to nudge the ribs back in place. And my mid-back problems are still the ones most likely to send me to the chiropractor. (I've also had injuries to my neck and tail bone, which get adjusted at the same appointments, but which don't usually cause me to make appointments.) I asked a chiropractor years ago if there was anything I could do to fix my back, and he said that my back is hyper-flexible, which makes it easy to get out of whack. So there's no easy fix.

My only solution is to change what I do so that I can try to keep my mid-back from getting out of whack as often. And that's where Lucy comes in. My episode on Monday came after Matt had been out of town and I was the only one picking Lucy up for several days. I was also trying to get her to sleep in her crib, which meant extra lifting. I think that's why my back was in such bad shape and set off an episode. And yesterday I was carrying her to the kitchen to find myself something to eat and regurgitated into my mouth. I promptly put her down and was fine. (See. My baby makes me puke.)  Carrying Lucy puts a lot of pressure on my mid-back, so I've been trying to carry her less. I carry her directly to some place and set her down instead of holding her while I'm doing something. Fortunately, she's getting pretty good at playing by herself, so I can leave her in the living room while I heat her baby food and do other little tasks like that. I also try not to run errands with her any more than I have to. Getting her into and out of the car is tough. Matt is picking up the slack by picking Lucy up more often. He transports her like he did after I had the C-section. (The C-section didn't help my core stability and so is also part of the back problem.) Unfortunately, the inability to lift her has set back our sleeping plans a little. We were trying to get her used to the crib, but that's too much lifting for me, so she sleeps part of the time on a mattress on the floor and part of the time with me in the recliner. At least my goal of being able to put her down and get other things done is met. Today I got a lot of cleaning done in the kitchen while she napped on the mattress for an hour and a half.

Other than not carrying Lucy, the only things I've figured out to do are to regularly stretch my back as the chiropractor showed me and to go for adjustments as soon as something feels out of whack instead of waiting for an episode.

I feel bad that I can't carry Lucy around, but I try to make sure that we sit together to make up for the other holding that she's missing. There is a silver lining: she gets more practice being alone for a minute or two at a time and entertaining herself as well as more time with her daddy, both of which are good things. And a puke-free momma is certainly a good thing for all of us.

Quick Update - She's Growing

I started a post last Friday, but it started sprawling and never got finished. Lucy weighed 7 lbs., 7 oz. at her doctor's visit, a gain of 5.5 oz. in 7 days. It was short of the ounce a day goal but good enough to keep us from needing another weigh-in before her one month appointment. I realized the other day that I could weigh myself at home and h myself holding Lucy and see the difference to figure  out how much she weighs. My scale measures in .2 pound increments, which is 3.2 oz. She weighed 7.8 lbs., which if correct means she gained 5 oz. In 5 days and is back up to birth weight. Hurray!

She's been insatiable at times recently. We're thinking it may be a growth spurt. It may also be a supply issue because I started pumping over the weekend. Or it might have been an unhappy coincidence that pumping and growth spurting happened at the same time. There have been a few times she's not been satisfied after taking all I had to offer, and Matt had to try to pacify her while we waited for me  to make enough to feed her without frustrating her. It's been frustrating for everyone at times, but we think it's getting better.

Update since the last paragraph was written in the middle of the night: supply is a not an issue this morning. Lucy and I were so tired that we slept 6+ hours between feedings. Thank goodness for the natural  automatic emergency pressure release valve (and breast pads). :)  Bring on the growth spurt!

Keeping My Batteries Charged

I've posted before about how taking care of myself is a part-time job in itself. I thought I'd elaborate on that a bit. Most people probably aren't aware of how much of my life revolves around monitoring and maintaining my energy level. Everyone needs to recharge their batteries sometimes, but mine take more effort than most because of a combination of traits and conditions.

First, I live with chronic depression. I have had symptoms of depression since 2nd grade. I started receiving treatment after college, when I was in therapy and started taking anti-depressants. After I dealt with some initial issues in therapy, I was able to work through other things myself. More than one mental health professional has told me I'm "insightful," so I haven't found talk therapy very helpful for a while. But the depression didn't go away. I wasn't crying or sad, but I was lethargic and seemed to catch and keep every illness that went around. My primary care doctor recognized that my body was still depressed and recommended that I increase my dose of anti-depressants, especially when I was sick or getting sick. And it helped. My brain needed an extra boost to help my body and immune system be well. I'm still on daily anti-depressants. I still deal with the physical symptoms of depression even at times that I'm not dealing with emotional symptoms. Mostly the physical symptoms are about energy. I fatigue easily. Sometimes sleep disturbances start the fatigue cycle, and sometimes they just exacerbate it.  When I'm tired I am more likely to get sick and have trouble getting well. I'm less likely to take good care of myself. And I'm more likely to have emotional symptoms of sadness, helplessness, and loneliness--though I've never been suicidal.

My already low energy is further affected by the fact that I'm an introvert with some social anxiety. Whereas extroverts gain energy by being around people, introverts use energy to be with people and gain energy when alone. That describes me pretty well. Being with people, even people I like, uses energy. I have no trouble leading large or small groups even with no advance notice. Teaching gives me kind of a buzz before it leaves me wiped out. But it does wipe me out. The social anxiety kicks in in more social situations. If I'm leading a group, I have a defined role, and the purpose of the gathering is something other than socializing. Getting together with a few people for a dinner party, however, is nerve-wracking. The personal interaction is more intimate than leading a large group. And more interaction tends to mean more energy exerted and more fatigue.

So between the introversion, social anxiety, and chronic depression, a lot of my life is about regulating energy: maintaining consistent sleep patterns, taking care of myself, not over-committing my time and energy, and limiting participation in social activities. Unfortunately, these problems affect the way that I interact with people. I don't want to be standoffish, but interacting with people makes me tired, and being tired puts me at risk for illness and depressive episodes. And once a fatigue cycle starts, it's hard to break, so I try very hard to avoid starting one.

And now I'm hoping to be a sleep-deprived new mother. Well, I'd rather be a rested new mother, but I'm not sure those exist. I want to be a mom, so I'll live with being a sleep-deprived one. But with my conditions, I am going to have to try even harder to stay rested and energized, especially because I'll only get worse if I feel I'm failing my child by being sick or sad all the time.

As we near the end of the Mongolian period, I think it's important for people to realize that my responses to group celebrations and helpful, supportive actions after the baby arrives may not meet expectations because of my energy levels and my need to maintain them. My cloistering behavior may seem more extreme than the average new mother, but it's necessary because I'm not starting with the same pre-baby energy level as the average new mother. I have many people in my life who love me and want to help. And I really do appreciate it. But no matter how much I love you, you are a person, and interacting with you uses up my energy. Since my energy supply may be low to start with, my priority is to use it on Elsie, me, and Matt if any is left over. I tend to feel a responsibility to be gracious to well-intentioned people, but for a little while I can't be responsible for anyone else. I may feel guilty if people let me know they want more from me than I can give. Feeling guilty doesn't increase my energy. And if I attempt to meet others' expectations, then I would be using up the energy reserved for Elsie and me. I can't do that. If I have a surplus of energy, I will reach out. But if I only have enough for Elsie and me, everyone else will have to wait.

Specifically, this means that if my energy is needed elsewhere, I may not spread the word that I'm in labor. Labor is draining, so I won't be giving updates during it. I don't want people contacting me during labor for updates. If there is an emergency, Matt will contact the family/friend phone tree as soon as he's able. Otherwise, no news is good news. When there is (hopefully) good news of the arrival of our daughter, Matt will let people know as soon as possible. Pictures and details will be shared as soon as we (people without smart phones) can do it. I don't want to be visited in the hospital. Anyone who drops by our house in the week after we get home probably won't see me or the baby. I don't want to shut anyone out, but I need to keep me together. I want to keep blogging about our adventures with Elsie but may not be able to do so immediately. As soon as I am able to receive visitors and share information, I will do it. But if you don't hear from me, it's because I can't handle it yet.

I'm making my wishes about labor and early baby days known so that you can continue to love me by being patient. You can trust that I will continue to share and be open, that I'm not trying to exclude anyone. I'm trusting that you will respect my wishes, especially now that you better understand my physical/mental situation.

Having established all of the above, I have an update on induction. We were expecting a scheduled induction on Sept. 23, but the doctor surprised us and moved it up to next Monday, Sept. 16. If I don't go into labor earlier, we will be heading to the hospital Monday morning to have a baby. Now that you know when I'll be in labor and when I'll be at the hospital, I'm relying on everyone to be patient, suspend expectations, and let me interact when I have the energy to do so.

A word of caution for people who are really excited about the induction news... We are still going Mongolian until there's actually a baby to celebrate. We learned Neil had died two days before a scheduled induction; in fact, he was delivered on the day the induction had been scheduled for. Scheduling an induction does not mean we've reached a goal. It's just a sign that the goal is closer in sight.

Kicking Me When I'm Down

I normally enjoy feeling Elsie kick. For one thing it means she's still alive. It's reassuring to wake up in the morning and get a strong kick. It's also nice that I can count on a good 11:30 p.m. kick. I don't know if these are friendly "hi, mom" kicks or something else, but I'm glad they happen. She has even started kicking when I'm in the bath tub or swimming. In the past, if I was in water, she was still. She doesn't kick much when I'm active, but if I take a little break she takes her turn to wiggle and kick. I tend to smile and compliment her when she puts together nice combo moves: jab, cross, kick.

However, there have been a couple of times I felt sick and she became active and made me feel worse. There was the time when my lactose intolerance triggered colon spasms and freaked her out. At least that event didn't last long. But last night I felt bad all night: I was tired, I had been a little too active, and I had eaten a cheeseburger at 10:00 p.m. Yes, I did it to myself, but I felt pretty bad. She played a little at bedtime like she normally does, but she's gotten better about settling down when I make shushing sounds, rub my belly, and tell her it's sleepy time. (She didn't pick up on that as early as Neil did, but I'm glad she's catching on. It's especially interesting because I had expected her to react to my voice like Neil did but she doesn't seem to care what I say. She goes nuts for Matt but doesn't pay any attention to me when I talk. I tend to sound a bit petulant when I express that opinion. Her calming down when I shush and speak soothingly makes me feel like we've connected in a new way.) When she accepted it was sleepy time, I fell asleep quickly. But, of course, I woke up a few hours later to go to the bathroom. And shortly after I climbed into bed still feeling sore and sick, Elsie got the hiccups. Ugh. She banged against my sensitive digestive system and bounced off my tightly-stretched and already sore belly. It was awful. I knew she couldn't help it, and I sympathized with her. Hiccups are no fun, even if they mean that her diaphragm is practicing and strengthening for breathing after birth. And she didn't get just one case of hiccups. As soon as one set would subside, a new set with a new rhythm would start. About that time I heard Matt in the kitchen and called him in. I was tired and sick and feeling alone and told him I didn't expect him to do anything about the first two issues but that he could at least help me not be alone. He sat with me for a while with his hand on my belly and got to feel the hiccups, too. We complimented her on her strong diaphragm, which will be important when she's in band one day. (I think we're pulling for a woodwind instrument but would be OK with brass.)  :)  I got the most relief when I was sitting completely upright with my legs in butterfly pose. Being upright let gravity assist me with the heartburn, and butterfly pose opened my pelvis and gave her a little more room so that she didn't slam into my organs quite as hard. Eventually, I found a way to prop myself in that position and fell asleep for a few more hours.

I woke still sore and uneasy but still thankful for my wake-up thump from Elsie. Some OTC digestive aids, Tylenol, and a warm bath with Epsom salt and a little stress relief aromatherapy bath salts from Bath & Body Works (and some Googling to reassure me we weren't gravely ill) got me in good enough shape to go to work. My digestive system is still uneasy, and she was particularly active between 9:30 and 10:30 this morning. But both my stomach and my daughter seem to be settling down at least for a little while.

75% Complete

We had our 30 week appointment with the OB today. Hurray! 30 weeks is 75% of the way to 40 weeks. The plan is to have a baby before 40 weeks, so we're more than 75% done with this pregnancy.

The appointment went well. I haven't gained weight, but no one's worried. My blood pressure was 99/65, which is much lower than it has been, but no one's worried. The doctor did do an unplanned ultrasound. We don't know why. Matt thinks he was killing time. He had a scheduled C-section in another hour or so, and we were the last patients of the day. So we got to see Elsie again. Her hands were by her face, and her jaw was moving; so we think she was sucking on her fist. She kicked a little. Her thighs looked kind of chubby already. There was a good amount of amniotic fluid keeping her afloat. He estimated she weighs about 3 pounds. (That's his guess not the computer's projection based on measurements.) The doctor was a little obsessed with her bladder. It was full, and he wanted to watch her pee; but she refused to urinate on command. We spent more time looking at her full bladder than we did looking at her face. It was a remarkably large bladder compared to her other parts. Matt was impressed with her self-control, her ability to hold it so well. I'm thinking of future diapering and wonder if she'll hold it a long time and then wet through everything when she finally does release it. We may have to double diaper her if we don't want to change the sheets and her clothes every time we change her diaper.

Also for no apparent reason, the doctor wants us to come back next week. We were supposed to start weekly appointments at 32 weeks, but he wants us to come back next week and then start weekly ultrasounds the next week. He said we're "special." We have no reason to think anything is wrong other than the fact that they've withheld concerns before to keep us from worrying needlessly. The doctor seemed impressed with everything he saw today, so we're assuming he's being overly cautious. We're seeing the other doctor next week, and I've wondered if he'll be confused to see us again before 32 weeks. I was certainly confused while making next week's appointment.

I did learn from the receptionist that their standard procedure is to contact ultrasound patients if the ultrasound tech is going to be gone for the day so that they can reschedule. If she's going to be gone for a whole week, they send you to the hospital for a non-stress test instead; but if they can just reschedule to another day that week, they prefer to do that. That's good. We'd prefer to do that, too.