Margaret Ellen Oliver

 This was written over several days. I'm finally getting it posted.

Margaret Ellen Oliver was born Tuesday, May 10, 2016, at 8:19 a.m. She was 19 inches long and weighed 6 lbs., 11 oz.--not small at all! All her measurements--including her 13-inch h were in the 45th-50th percentiles for her gestational age, just short of 37 weeks. We are calling her Maggie.

We thought we were going to have a scheduled C-section, but this one was unscheduled. Maggie decided that May 10 was her birthday and started coming. My water broke at 4:30 in the morning. The only warning we had was that my mucous plug came out exactly 24 hours earlier. (That was a little dramatic because it had fresh blood in it, but a call to the hospital told me it was OK.) Matt had recently gone to bed but got in motion quickly when I turned on the light on my way to the bathroom and returned a minute later with a towel announcing that my water broke. Lucy was asleep between us and didn't even stir. Shawn and Susie came over right away to stay with Lucy. We got to the hospital around 5:30. They admitted and started prepping me, and then we waited for the doctor to arrive. Surgery went quickly: I was in and out in about an hour. I bled quite a bit because I've been on aspirin, but the bleeding stopped well. Maggie cried long and loud when she was delivered. I got to see her before and after she was cleaned a bit. Matt went to the nursery with her while I went to recovery. We were both in really good shape.

The doctor looked up my latest toxoplasmosis numbers and told us that they had gone down. The first result was a false positive after all. We heard from Louisville on Wednesday that the result of their test was negative for live parasites. Maggie is just fine.

She nursed as soon as I got to hold her when I got back to my room. With my experience and her natural talent, it went really well. She nursed again a couple hours later. Then she went 8+ hours without eating. She just wanted to sleep. Eventually, her blood sugar started decreasing, and we convinced her to eat a bit. Four hours later the nurse brought a very alert Maggie to me, and she ate like a champ again. Sometimes she really eats, and sometimes she just wants to snuggle. She's very sweet. She's lost only 7 oz. since birth. She's had no signs of jaundice. Her hearing, vision, and circulation tests have been perfect, especially impressive because she was born before 37 weeks.

I don't remember exactly how we came up with Maggie's name. I did look for a saint name so that she gets a name day like Lucy does. St Margaret's day (Nov.16) doesn't have traditions like St Lucia's day, but we can make our own. St Margaret was an English princess raised in exile, who married illiterate King Malcolm of Scotland. She read the Bible to him, converted him, and had a great civilizing influence on Scotland while caring for the poor. Her story isn't as flashy as Lucia's, but she was a devout woman who changed a country by reading and caring for those in need. Those are traits we'd like Maggie to have. Margaret is a Persian name that means "child of light." Ellen is a Greek name that means "light." I've been thinking of the meaning of her name as "light from light," a phrase from the Nicene  creed describing Jesus. Ellen also happens to be Matt's mom's first name, although she goes by her middle name, Kay. And Maggie shares Matt's initials (MEO), my doing not his. I don't remember how those pieces came together, but it shows the kind of thought we've put into both of the girls' names. (Both of our girls are little lights.) We also think Maggie is a cute nickname.

Lucy came to see us around 4:30 on Tuesday. At first, she was a bit shy. She's never been in a hospital before, and seeing mama in a weird gown and attached to multiple machines was probably strange. She sat next to me and looked at "baby Emmie." We'll get her used to the name change eventually. I'm still getting used to it myself. Eventually, Lucy got close to Maggie and repeatedly called her "sweet baby." She didn't touch the sweet baby the first day, but it was a successful first meeting. Lucy had a busy day with Shawn and Susie. She handled our being gone when she woke pretty well, and Susie sent me a message that dinner, bath, and bedtime at their house went really well. Matt went home with Lucy for a while on Wednesday. When they came to visit us at the hospital, Lucy was willing to hold Maggie. She wanted to hold her again and again. While Matt or I held Maggie, Lucy rubbed her hair. At least one of those times, Lucy's fingers were covered in Cheetos. Lucy is going to love her baby sister to cheese-dust-coated pieces. Lucy told a nurse "that one sweet baby is Maggie." Lucy watched me nurse Maggie, and she's been told that Maggie only drinks mama milk and can't share the ice chips and Cheetos that Lucy has tried to share. When Maggie cries, Lucy motions for her to go to me and says "come eat." Lucy also told another nurse that baby Maggie "eat mama armpit." Well, it's something like that. The nurses got a kick out of it.

I'm doing as well or better than I'd hoped. By Wednesday I was already moving better than I did when we left the hospital with Lucy. The anesthesiologist put something in my spinal to manage pain for 24 hours. Whatever it was worked terrifically. I got out of bed twice with assistance to sit in the rocking chair in the first 24 hours, and walked the halls on Wednesday. Percocet has managed the pain well, and the doctor said Motrin can be even better if taken regularly. We're heading home on Thursday.

Appointment 36-1: Waiting on Bloodwork

Today we went to Louisville and saw Dr. Cuthrell, whom we've never seen before. They took measurements again at today's ultrasound. By digging the ultrasound wand into my pubic bone (Jenny is much gentler), they got a more accurate but still incomplete look at Emmie's head. That brought her percentile up, but they're using the wrong due date, so we didn't bother to pay attention to the number. They estimate that she's 4 oz. heavier than yesterday's estimate, a little over 5.5 pounds. Grow, Emmie, grow!

Then the doctor came to scan me a little more and talk to us. He didn't see any evidence of calcification in Emmie's brain or liver. The results from yesterday's blood test aren't back yet, so he didn't have more information to go on. The results we have aren't able to tell him when I got toxoplasmosis. With no calcification, it's either very recently or a long time ago, and timing matters a lot to Emmie. The doctor didn't express an opinion about which scenario was more likely. He was not in favor of doing an amniocentesis to know for sure if Emmie has toxoplasmosis, and if we don't know for sure, he can't give me medicine. So what he did was take more of my blood to see if there are live parasites currently in my bloodstream.  If there aren't, then the toxoplasmosis is either an old infection (pre-Emmie) or a false positive, so Emmie should be fine. We'd still have her tested after birth to be 100% sure. If there are live parasites in my blood, we deliver Emmie ASAP to end her exposure to my blood, start her on medication, and hopefully limit the damage. The blood has to be sent out, so results will take a few days. So we're waiting to see if Emmie needs to be born before week 37. The doctor did say that he doesn't think Emmie's size is a problem; she's small because I tend to have small babies. So that's good news.

Over the next few days I'll try to do all the things I feel are absolutely necessary before Emmie's arrival: clean the kitchen enough so it's no longer disgusting, get some extra stuff out of the nursery so that four of us can fit in there, swim while I can since it keeps my back functioning, and cuddle with Lucy because it's one of my favorite things to do. If there's time, I'll transplant squash and buy a few more groceries.

Appointment 35-2: OK

Ultrasound: Emmie did not pass her BPP. She breathed but not enough to pass. We've found that she does really well in the morning and not as well in the afternoon. In some ways that's not a problem. We know we can breathe. On the other hand, after she's born she will have to breathe in the afternoon whether or not she thinks it's breathing time. Since we were already going to the hospital for an NST, we didn't mind that she didn't pass. My fluid was 9.5, so I'm still at the low end of normal. They also checked growth. Emmie has stayed in the 16th percentile. They estimated that she's gained 14 oz., so she's just about meeting the half a pound a week gain that they expect at this point in the pregnancy. The head measurement was still small. The assumption at this point is that her head is engaged in my pelvis just as it should be for a vaginal delivery. When the head is tucked that way, ultrasounds can't measure the full circumference of the head, which is one of the measurements that the percentile is based on. So she's growing and gaining weight and holding steady percentile-wise.

Vitals: Good blood pressure and a pound or so of weight gain for me. Emmie's heart rate was a good 148.

Appointment with Dr. Reynolds: Doctor Reynolds felt my belly and said that if he didn't have ultrasound growth information, he would say that Emmie felt like a normal 35-week baby. She doesn't feel particularly small to him, so that's good news. In this case, his hands are probably more accurate than the ultrasound. He ordered another blood test for toxoplasmosis. According to him, you only have to wait two weeks to retest. If we're lucky, we'll have test results by the time we go to our appointment in Louisville tomorrow morning. According to Matt (I must not have been listening very well), Dr. Reynolds wasn't worried about Emmie not passing the BPP and said that the BPPs are mostly helpful to decide if she'll be born at 38 weeks or 39 weeks. We haven't even considered 39 weeks, but apparently Dr. Reynolds is. However, we see Dr. Ackermann next Tuesday. I'm pretty sure he's not considering 39 weeks. But by the time we see him, it will be 36-2, so it's highly unlikely that we'll have a Final's Week baby.

NST: Emmie did really well. She fought the monitors a little, so she was reactive enough. While we were there, I signed all of the Women's Center paperwork necessary before a c-section: I agree to anesthesia, a blood transfusion if necessary, supplementing with formula only if absolutely necessary, etc. So once we check into the hospital, the nurse said I'll just need an IV, a shave, and compression socks before going into surgery. "Is that all?" was my response. Invasive procedures but no questions or signatures. Sure.

We got home in only four hours and then went out to eat with Shawn and Susie. It feels like we just drop Lucy off with them and never get to socialize anymore. I want to socialize, but we take up so much of their time with childcare that I don't want to tax their schedules even more. It was really good to talk to them. And it's good for Lucy to see us all together. She's been fussing as soon as she sees them because she assumes that as soon as they show up her parents will disappear. She did well with them today after I left. Before I left, he didn't say anything about not wanting me to leave, but she didn't want Susie to stay. I'm sure Susie's staying and my leaving were connected in her mind, but she didn't directly protest my leaving. Fortunately, we won't have to leave her for our appointment tomorrow.

Appointment 35-1: Reassuring

This week was certainly better than last week. Again today Emmie passed her BPP very quickly. We also got to see her swallow a little. My fluid was 11, a little higher than it has been but still at the low end of normal. Today was culture day, so I got swabbed for Group B Strep and examined. My cervix is a firm 2 (not a ripe 2). The nurse practitioner seemed to think that cervical dilation might be another reason to bump our delivery date sooner. She also measured my belly with a tape measure and said that I'm measuring bigger than expected. I don't know if that's bigger than 16th percentile or bigger than anyone at 35 weeks. Either way it's a good sign that Emmie is not as small as they feared, especially since I didn't gain any weight this week. I'm not concerned about a big belly; my belly measured big with Lucy, and she was still under 8 pounds when she was born. After the office visit, we went to the hospital. It was very busy and took a while to check in. Eventually, we got to our NST, and all went well. Emmie battled one of the monitors a little. She hasn't been doing that like Neil and Lucy always did. While hooking me up to the monitors, the nurse, Connie, felt my belly to see how Emmie was positioned so that she could put the heart rate monitor in approximately the right spot. The other nurse in the room (who has felt me while hooking me up to monitors before) asked Connie if she thought Emmie felt small. They both agreed that Emmie doesn't feel especially small. Hearing multiple people say she doesn't seem small is reassuring, the exact opposite of what we felt last week. Connie asked when we would be coming next week, so we told her about Tuesday and then Wednesday in Louisville. She frowned. I was afraid she was going to say that we really needed to come in for an NST at the end of next week, so I asked why she was frowning. She said she was concerned about our toxoplasmosis result because we had enough to worry about already. She was much less concerned--in fact, she smiled--when she heard what Dr. Ackermann had said about a false positive. It's nice to know how much the nurses are rooting for us. If not for the long wait to check into the hospital, we would have gotten home in a little over 3 hours. We still got home in less than 4, so we spent about 8 hours on medical stuff, much better than last week's 11 hours.

Lucy was asleep when we left this morning. We weren't sure if it was better to wake her and immediately say goodbye or to let her sleep. We opted for sleep. Shawn was here when she woke, and I had breakfast ready for her. I haven't talked to Shawn to know how that went, but Lucy didn't seem upset about it when I asked later. Then Susie came and took Lucy outside for a little while. When they came inside, Lucy insisted on taking a bath. After Lucy's bath, Erin came to watch her for the rest of the afternoon. They watched TV, played trains, and played outside a little while, too. There were a couple of tantrums, and Lucy stubbornly sat in the stroller for 10 minutes even though Erin told her it was too hot to go for a walk. But it seems things went pretty well. And we were home before 2:00. I made sure that Lucy got cuddle time as soon as we got home and again before I took a nap and again after my nap. In fact, we're still cuddling.

I needed the nap because I didn't sleep well last night. I was hurting when I went to bed and took some Tylenol. When I woke up a couple hours later, I still hurt. Eventually, I got up and took a warm bath with Epsom salts. When I got out of the tub, I didn't hurt anymore, but I felt jittery and had trouble settling down. I now wonder if the mid-evening Coke Icee I had was too much caffeine too late. During all of this, Emmie was really active. She's never been so active. Part of the time she had hiccups. I was a little worried that all her activity would make her lethargic today, but it seems like it just got her warmed up. I was awake for about three hours in the middle of the night before falling back asleep for four more hours. I think I just overdid it yesterday. I never felt like I was overdoing it, but apparently it all added up and caught up with me.

Our plans for the weekend include resting and cleaning. And I have a little more work to do in the garden if weather allows. I want to get my squash plants transplanted in the ghetto. And I want to plant green beans, purple hull peas, corn, snap peas, herbs and chard in the Pea Haven. That sounds like a lot because of the variety, but the quantities aren't large. Hopefully, we can get the house straightened out this weekend so that if we have a baby in week 36, we're prepared.

Appointment 34-2: How do you spell relief?

Today's appointment went much better. Emmie passed the BPP in 10 minutes. She moved and breathed right away. The thing that took the longest was finding enough fluid. The first two times Jenny measured, she came up with around 7.5. They want me to have at least 8. The third time she checked, Emmie had moved and revealed a couple pockets of fluid, and we measured over 10. The average was a little over 8, so we passed. My blood pressure was good. I'd lost a pound or two because the warm weather encourages me to eat more produce and be more active outdoors. Emmie's heart rate was good, too.

Dr. Ackermann was happy with our progress. I asked what we were going to do about the toxoplasmosis. He said that he thought it was a false positive. He said that pregnancy causes all IgM scores to go up, and my score was just barely positive. And my IgG score was negative, which would be odd if my positive score was so low that it looked like I was recovering from the infection. He also said that toxoplasmosis is so rare that he's never had a patient actually have a true positive result. The rarity isn't necessarily reassuring. We've had other rare problems before. I asked if we should retest to verify the result. He said that you can't retest for a month, and I'll have a baby by then. I asked if treating me would have enough benefits to outweigh possible side effects. He said, "That's why I'm referring you to Louisville." They deal with high risk pregnancies and would be more familiar with what the options are and which make the most sense for us now. So we're going to Louisville again. The referral was faxed to Louisville, and they should contact me in the next two days to set up the appointment. We have to get one soon, or we may have a baby before we can have an appointment.

Then we went to the hospital for the NST. I ate a snack on the way so that I wouldn't be hungry this time, and maybe Emmie would be more active. The nurse also brought me a ham sandwich to eat during the test. Emmie appreciated the sandwich. Just to be sure that she was active enough, I rested my tablet on my belly while I read (she kicks things that rest on my belly) and pressed the television remote to my belly like an ultrasound wand, which also gets her stirred up sometimes. She showed enough reactivity to pass her NST the first time they came to look at the tape.

If we hadn't had such a long wait in the waiting room, we would have gotten through all of it in less than 4 hours, a long time but an improvement over the five- and six-hour days we had last week. It was a much better day than either day last week. The Louisville appointment will replace a Lebanon appointment, so it won't add craziness to our schedule. It may even make things easier because Lucy can come to Louisville with us. She's allowed in the ultrasound there.

Speaking of Lucy, she had another good day. Matt's co-worker (and our friend) Justy kept Lucy for the afternoon. Justy has a 4-5 year old daughter who has played with Lucy before, so Lucy had a good time. She did freak out when she had to get into Justy's red van because it wasn't her own blue car. But she recovered quickly. When we went to pick Lucy up, she was running around the front yard in a nightgown that looks like a princess dress. The girls were playing with a younger girl that Lucy knows from MOPS. Lucy was very sweet with the smaller girl. She hugged her and put her arm around her. Lucy plays with other kids so infrequently that it's always interesting to see how she interacts. Apparently, she's very sweet and big sister-like. That's good news.

I'm still feeling well. Most of the time I don't feel huge or heavy. I've had only a little heartburn. I do seem to go from starving to stuffed quickly because Emmie is squishing my stomach. I still get occasional pains where my stretch marks are stretching just a little more. The nurse thought my ankles were retaining a bit of fluid today, but they didn't look bad to me. I'm not always sleeping well, but it's hard to fit three people and my belly in our full-size bed. I eventually move to the recliner. Sometimes I get back to sleep, and sometimes I give up and do laundry or something else productive. Overall, these don't seem to be bad symptoms for the last few weeks of pregnancy.

Emmie is getting bigger and more active. She likes back rubs. She seems to like story time with Lucy when Matt or I read books to them. She gets excited when Lucy is loud. She doesn't seem to have favorite foods, but she appreciates a meal. I got her to play pat-pat with me a couple days ago. I pat my belly three times and say "pat, pat, pat," and she taps back twice. We're 3/3 for babies who play pat-pat before they're born. We'll see what else we can learn about her in the next few weeks before we meet her.

Our next appointment is Friday unless we get a Louisville appointment very quickly that would replace the Lebanon appointment. We'll be at 35 weeks by then, no more than 3 weeks from a baby if all goes well.

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.

33ish Week Appointment

All is well with me (gained a little weight, lower blood pressure and fluid are still within acceptable range) and Emmie (passed her BPP much more quickly). Dr. Ackermann says I don't need a DTAP because I got one when I had Lucy. To clarify exactly what date we were looking at as 38 weeks since our weeks change on Wednesdays while they normally schedule c-sections for Monday mornings, I asked whether we would be going on the Monday that is 37 weeks, 5 days or the Monday that is 38, weeks 5 days. He said we'd go on Wednesday when we're officially at 38 weeks. The date doesn't matter much to him he said, but the government is keeping an eye on early deliveries because some doctors have scheduled deliveries for their own convenience at the expense of newborn health. He said we can go ahead and schedule the c-section. The receptionist did not schedule it yet, and Dr. Reynolds may come up with a reason for a Monday delivery, so nothing is set. Wednesday would give Matt a couple days to recover from the semester and help me with final house preparations, and it would mean that Susie would get back in time to help with Lucy. That would be good. Of course, all that assumes that we don't run into problems before then. Dr. Ackermann said that if my fluids are low or I'm having contractions at 36 weeks, they'll get Emmie out. And I'm with Matt; if it was safe to get her out today, we'd vote for that. I want her to be fully developed and healthy, but I also want her to be alive, which she certainly is today.

The possibility that Susie would be back in time to help with Lucy could not have come on a better day. We experienced why you really need two people to keep up with Lucy. Lucy had a rough day and made Susie's day pretty rough, too. Lucy was tired and out of sorts but excited to play with Shawn and Susie, so I thought everything would be OK. Then we started hooking up the car seat in Susie's car, and Lucy lost it. She screamed and cried and tried to run away. "No ride in Susie's red car. Me ride blue car." She has ridden with Susie before, so this was unexpected. We had to hold her down to get her into the car seat. I could tell that she would fall asleep in the car. I had estimated 5-7 minutes. Apparently, she screamed for 15 minutes. She would start to doze and rouse herself to scream some more. Eventually, she did sleep until Susie had to stop for gas. Then the crying started again. When Shawn got out of a meeting, they took Lucy to a park, and she was happy to run around. Susie told Shawn it was his job to get her back into the car. Shawn just said, "Lucy, do you want to go see your mom? Let's get in the car." And she hopped right in. I'm sure the incentive was important, but the asker probably also affected the outcome. Lucy would do nearly anything for Shawn. He keeps marvelling at how weird it is to have a girl like him and want to sit by him. Well, most girls don't have the bearded, bespectacled academic as their paradigm for manhood. To Lucy it's just like having another daddy in a slightly different shade. :) And Lucy loves her daddy. However, no one is like mama. Mama is just barely a separate person from Lucy, so it's not possible to have mama in another shade, even though Susie would be a good fit for "mama in a different shade" if such a thing were possible.

It was tough to see Lucy so unhappy when we left. I knew she would be fine. She would be safe and cared for and loved. I was also pretty sure that my leaving was not exactly what was causing the meltdown. She was tired, and her idea of what was going to happen was not being met. If we had dropped her at their house or left her on campus in the stroller, she probably wouldn't have shed a tear. She did talk this evening a little about how mama and daddy were gone today. That seemed to bother her only a little. She was adamant, however, that she did not want to ride in the red car again. Appparently, her attachment to our car was more important than her attachment to her parents. :) We'll work on the car thing.

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.

Down to the Wire

Today we started weekly appointments with ultrasounds for biophysical profiles (BPPs). To pass the BPP, Emmie has to move a little and show off her breathing skills. She was reluctant to do either. She moved a little when Jenny (the ultrasound tech who we've gotten to know fairly well because of all of our BPPs through 3 pregnancies) poked my belly with the ultrasound wand. Emmie wasn't seriously disturbed, but she wiggled a little. And she tried breathing once. There's a certain number of times she's supposed to breathe within a certain time period. So we waited for her to breathe some more. And we waited. And we waited. And I turned on my side to see if that would get her to do something. It didn't. And we tried talking. And I tried humming. I tried sucking snot from my sinuses to my throat, which sometimes gets me kicked (but not all the time like Neil used to do). Nothing we did seemed to matter much. And I didn't have any snacks with me to try eating something. Then I asked what the likelihood of having to go to the hospital for a non-stress test was if Emmie didn't show off her breathing in time. The answer was 100% if she doesn't breathe in the next 25 seconds. I find non-stress tests to be very stressful, so I sat up a little and said, "Breathe, Emmie. We don't want to go to the hospital." And she started breathing. And she passed her BPP at the last second. Whew! My fluid was on the low side of normal, which for me is better than the high end of normal, which might signal a blood sugar issue, which they are looking for.

My blood pressure was excellent. My weight gain was reasonable, especially considering all the fast food we've eaten in the last week while I've been in a funk. Dr. Reynolds is very pleased with how things were going. And he thinks that Paul Ryan will be the Republican nominee for president. It's one of the least far-out things he's probably ever said to us while talking about something non-pregnancy. :)

I also asked about what he was thinking about timing for Emmie's arrival. We have been assuming 38 weeks (like with Lucy) unless they get antsy and move it to 37 weeks or unless at any visit in the next 8 weeks there's a problem that indicates that immediate delivery is best. He seemed to think the 37 week idea was crazy. I was asking because Susie has to be out of town on the Monday of 38 weeks, the likely delivery date. So Shawn would have Lucy by himself... overnight. Lucy loves Shawn, and Shawn loves Lucy, so we know they'd be fine together, but Lucy with one caregiver at night can be a handful. If worse came to worst, Matt could go home at night. I think we'd both feel better if he could stay at the hospital with me for at least the first 24 hours. But if the c-section is first thing in the morning, then he could be around for at least the first 12 and come back the next morning. We'll make it work. We've got about a month to work the kinks out of our plan and attempt any necessary behavior modifications for Lucy (or Shawn for that matter). :)

It was another long day, but because Emmie passed her BPP, it wasn't as long as it could have been. Hopefully, she doesn't put us through this every week.

Third Trimester and All is Well

I had another check-up today. I've gained a little weight, have reasonable blood pressure, and passed the three-hour blood glucose test. Emmie feels like a normal size and had a heart rate of 160. Nobody's concerned about anything right now. Of course, we did see Dr. Ackermann today. Dr. Reynolds would have found something to be concerned about.

Although I passed both blood glucose tests, Dr. Ackermann said he's sure I'm going to be diabetic eventually because I am obese, so he encouraged me to begin eating as if I were already diabetic. I feel like I've been less careful about my diet this pregnancy. I just don't have the energy to think about what I'm eating. I eat to keep from being hungry. I don't buy much junk food. I keep fresh fruit on hand. But I haven't made a special effort. I'll try to do so. I have been getting much more exercise for the last month or so. Lucy and I go to the pool everyday. I don't swim laps, but I keep moving for an hour or more. And with the nice weather this week, I've been doing some light gardening. Eating better will be easier when the fresh garden produce starts coming in.

Our next appointment is in two weeks, at 30 weeks. We have a growth ultrasound scheduled, so Susie is going to keep Lucy. Lucy isn't allowed in the ultrasound room at our doctor's office. I'll also get another Rho-gam shot then. I found out today that Rho-gam shots only last 12 weeks. My last one was at about 23 weeks, so it will only last me until 35 weeks, which is too soon for Emmie to arrive. So I have to get another one to get me to 38 weeks. That will add a couple of hours to a day that already has an ultrasound and a doctor's appointment.

We set the rest of our appointments for the rest of the pregnancy today. At 32 weeks (early April) we'll begin weekly ultrasounds for biophysical profiles (BPPs) that check movement and breathing practice. We'll probably add many ultrasound pictures to the album I started for Emmie.

We've finally reached the third trimester. Normally, that means you're 2/3 of the way through. Because we expect to go only to 38 weeks, we're almost 3/4 done. We may be less than 10 weeks from the end. I'm trying to enjoy being the mother of one for a little while (which is a little difficult on some days with a two year old), but I'm also ready to be done with the stress of pregnancy. Part of me will be holding my breath until Emmie is safely delivered. At least we don't have anything specific to worry about since Emmie and I are both healthy and doing well.

Lord, Have Mercy!

First, I must share that often after I catch myself saying "Lord, have mercy!" or "Good Lord, have mercy!" I begin singing the Kyrie from Schubert's German Mass. I first heard the German Mass while working at/attending Luther Memorial Church in Madison, Wis. They use it in their services at the end of October and beginning of November every year because Reformation Day, All Saints, and Christ the King Sundays, which are all a big deal to the Lutherans, are back to back in the late fall. Luther Memorial hires extra musicians and has all of their choirs participate. The German Mass is beautiful and very singable. I've sung both the Sanctus and the Agnus Dei to Lucy as lullabies. I find that singing a beautiful song that says "Lord, have mercy" tends to dissipate the mood that caused me to say it in the first place. It also gives me some perspective and reconnects me with what is important. Some days you need that.

Today was one of those days. The events of today really started on Saturday morning when I smelled something like a blown out candle when I got out of the car at the grocery store. I thought it was the car next to me and went about my shopping. When I got out of the car at home, I smelled it again. My car was the stinky one. I had noticed the day before that we were overdue for an oil change, so I got Lucy ready and took her to Wal-Mart for two hours while our oil was being changed. I told the ladies at the desk about the smell and asked them when I picked up the keys if the mechanics had noted anything. The mechanics hadn't left any notes (as the ocassionally do), so I hoped that the oil change fixed the smell. It didn't. It was still there on Sunday. I asked advice at church and was told to see a mechanic right away. I showed up at AutoSmart when they opened on Monday morning because even though it can be difficult to get an appointment, they are very good about looking at your car really quickly to give you an idea of whether it is safe to drive until you can have repairs done. Since we had an OB appointment in Louisville on Tuesday, I wanted to make sure the car was safe for that trip. Two guys at AutoSmart looked at the car and found absolutely nothing wrong with it. So I left and stopped at Kroger on the way home because they mark down their perishable items first thing in the morning, and I can get half price milk, bread, yogurt, and produce sometimes. When I got back to my car, I decided to check my tires because it had occurred to me that the smell had started to remind me a little of hot asphalt. Sure enough, I could see steel threads poking through the front driver's side tire, and there seemed to be deep cracks in some of the treads. So on my way home I stopped at Firestone to have someone look at my tires. The guy very quickly said, "You need new front tires." I asked him if they would be safe enough to drive to Louisville." He said, "I wouldn't drive to Louisville on those tires." Well, if he wouldn't I probably shouldn't either. I needed to get home to Lucy so that Matt could get to school, so I left the tire guy my phone number so that he could let me know if they had the tires in stock and when I could get an appointment. It turned out the tires weren't in stock and couldn't get there until Tuesday afternoon, which is when our appointment was. Matt had already cancelled his Tuesday classes so that we could go to the appointment, so rescheduling wasn't a good option. I called Enterprise to find out about renting a car. The cost was reasonable for a one-day rental, so I made plans to drop my car at Firestone on Tuesday morning, have Enterprise pick me up there, and then take the rental home so that Matt could put Lucy's car seat in it. It was going to complicate my day, but it was a reasonable plan.

So  I got up earlier than usual this morning to put the plan into motion. Everything was fine with the drop-off. In fact, the tire guy was waiting for me in the parking lot and said he could smell my car before I even got into the lot. It was getting worse, so it was a good thing we were having it fixed. After I gave him my keys, I decided to walk a couple of blocks down Main Street to Harden's Coffee for a Chai Latte while I waited for Enterprise. I called Enterprise during the walk to let them know where I'd be. That's when they told me that they didn't actually have a car to give me yet. They were waiting for two to be returned. It might be an hour or more before they would have one. I decided to go ahead and get the Chai and then try to walk home. I knew that the walk was a little long, but Main Street to campus is a reasonable walk. And campus to home is a reasonable walk. And Matt's office in Carter Hall would be a good place to stop for a rest. So that's what I did. l talked to some friends/Matt's colleagues for a little while until I felt ready to walk home. On the walk home, I called Enterprise again. At approximately 11:00 they told me they still didn't have a car. We needed to leave at 12:30, and Matt still needed to put in the car seat, which doesn't tend to be as easy as it seems it should be. Around 11:30 Enterprise called to say they had just gotten a car and were cleaning it up. By noon I had the car home and Matt was installing the seat. I was exhausted already, and we still had an hour and a half drive and an ultrasound ahead of us.

Part of the reason that renting the car seemed like a good idea is that we are interested in getting a new car. We would like something slightly bigger so that we can fit two car seats and me in the back seat. Our Honda Civic is 11 years old and still in pretty good shape. The fan that blows air from the heater and air conditioning is unreliable, so we have some climate control issues, but we haven't had any major problems with it not caused by armadillo smashings. The rental car was supposed to be a little bigger than our normal car so that we could try it out and see whether we needed slightly bigger than our current car, perhaps a Honda Accord, or even bigger, perhaps a hatchback. We were also going to take this opportunity to turn Lucy's car seat front facing. Enterprise gave us a Ford Focus. We now know that we do not want to purchase a Ford Focus. It seems to have less space than our Honda Civic, and my seatbelt was incredibly difficult to fasten,which is extra frustrating when you feel extra confined. In addition to the irritation of being more squished than normal and significantly more squished than I had expected to be, Lucy was very upset about the new car. She loves her "blue beep." She cried until I was able to distract her with food. So after a more complicated morning attempting to get a car, the car itself was disapppinting.

After we had gotten on the road and eaten the lunch I had packed, I was feeling better. Then Matt asked if I had brought the directions to the doctor's office. Nope. I was so focused on transportation that I had not thought about directions. I thought that I had the clinic's number in my phone, but I didn't. So I went through my phone's call log until I found likely numbers and called them until I found the right one and asked for directions. Fortuneately, the directions worked for us and we arrived on time. Whew!

That brings us to our 2:30 appointment. We had another ultrasound to check Emmie's growth. They took a lot of shots of her heart. She was much more cooperative this time. They didn't say anything more about the calcium deposit in her heart, so it seems like it's no longer a concern. It hasn't caused any problems. They measured her. They estimate that she's 1 lb., 13 oz. I asked the ultrasound tech for a percentile, and she said 32. Below average, but that seemed reasonable. The doctor then came in to talk about concerns about growth restriction. Good Lord, have mercy! Not again! Neil was growth restricted. It's not what killed him, but it caused us a lot of stress. The doctor then started explaining growth restriction to us. Nothing we didn't already know. Her concern was not the 32nd percentile overall but the abdomen measuring in the 9th percentile. I had noticed earlier that they seemed to be using the due date from my last period rather than the one from date of conception that was confirmed by a growth ultrasound at 7-8 weeks. If my due date is June 1 instead of May 25, then they are expecting Emmie to be one week older and bigger than she is. I asked what difference that would make to their percentiles. The doctor had someone call my OB to confirm the change of due date, and it was confirmed. So they refigured, and Emmie is actually in the 44th percentile with an abdomen that is small but within reasonable parameters. So she's not growth restricted after all. The doctor did talk to me about what causes growth restriction. High blood pressure, diabetes, and smoking are not problems I have, so the only cause would be a less-than-adequate placenta. That would mean that my resting is even more important. Emmie gets more blood and more nourishment when I'm sitting than when I'm active. I don't feel terribly active. I try to rest a lot and even feel kind of guilty that Lucy isn't getting as much from me as I'd like. So I'll keep resting just in case my placenta is lazy. I certainly hadn't rested enough so far that day. Emmie was fairly active during the ultrasound, but she was tame compared to her sister. Lucy wanted to look out the window and count cars, and she wanted to draw, and she wanted to explore. Fortunately, the ultrasound tech thought she was really cute and didn't mind her wandering around a little. She didn't even mind cleaning up when Lucy sneezed a mouthful of water ALL OVER the room while she was sitting on Matt's shoulders. She mostly hit one of the monitors that families watch, so at least it wasn't the most expensive equipment. And it was so unexpected and amazingly explosive that everyone in the room laughed. Good Lord! That girls is something else.

Since we leave Campbellsville so infrequently and shopping options are limited in Campbellsville, we tend to stock up on a few things when we get out. We went to Trader Joe's. Trader Joe's is always so tempting. Everything looks good, and almost everything tastes good, too. There are a couple of things there that I use a lot of. My special drink is sparking water rather than sodas, and they have 1 liter bottles of raspberry lime sparkling water for $0.79. I also get high quality parmesan cheese wedges, the kind with the rind. I actually have a couple of recipes that call for parmesan rind, so I buy the pieces with lots of rind. Really good parmesan can be used sparingly, so as long as I store it properly, it lasts a long time. I also use a lot of their chicken stock concentrate. It is my secret ingredient to soups. There are soups that I have made with regular chicken broth and thought were OK and then made again later with the concentrate and raved about. It makes all the difference. The cost is comparable to buying cans or cartons of stock, but the concentrate comes in little packets that save a lot of space. And I find that I need less concentrate in my water than the packets suggest to get good flavor. Instead of using 5 packets in 5 cups of water, I'll use only 3-4 packets in 5 cups of water. The taste is still fantastic, and it makes the concentrate even more cost effective than cans and cartons. We also really like the cherry cider. If I'm going to drink a caloric beverage, it is likely to be a juice (or an Icee), and cherry cider is fantastic. I did splurge this time and get a couple of boxes of cookies for myself. They are good enough that I can be satisfied with only 1-2 at a time, and I hide them from Lucy so that they last longer. I don't tend to buy desserts for myself, so Trader Joe's cookies are my special treat. I got hazelnut sandwich cookies (two cookies made from ground hazelnuts with nutella in between), Kona coffee shortbread, and lemon thins. I've never had the lemon thins, but I do love a light, crisp lemon cookie. I also got a package of frozen spinach because theirs isn't tough like regular store-bought frozen spinach and a tray of frozen spanikopita (Greek spinach and feta pastries), which are a nice light supper with a salad. One of the Trader Joe's employees was really impressed with Lucy and gave her about 15 stickers as she left. Trader Joe's is one of my happy places, and I think Lucy likes it, too, because of the stickers and food samples. They always have one food and one drink to sample. The drink today was tart cherry juice. I tried a little and said, "That IS tart," and gave the rest to Lucy to try. She took a sip and said, "That tart." Every sip afterwards was declared "tart." I'm not sure if she knows what it means, but it was cute.

The other store I wanted to go to was Target. My primary purpose was buying diapers, but I also found a couple of long sleeve maternity shirts on clearance. I'm hoping to make it to the end of the month in my non-maternity clothes, but I've started getting out some of the maternity shirts because they cover my belly even when I raise my arms. My regular shirts are getting a little short. There are a couple of deals sites that I follow online. One of them is southernsavers.com. One of my favorite things about it is that it puts together a lot of diaper and baby product deals. The site will tell you about a sale and then tell you what coupons to use with it, even giving you links to printable coupons. It's very handy. Target has a deal this week that they will give you a $25 gift card if you spend $100 on diapers and some other baby stuff. So even if you don't use any coupons, you're getting the diapers at 25% off. I printed out coupons to save $3 per package on boxes of Pampers before I left home. The deal on the website came out to $15.75 each for big boxes of diapers that normally sell for $25 at Wal-Mart and Target. That's worth a trip to Target. When I got there, I found they had diapers on clearance, and they would count towards the deal. So I ended up getting even more diapers than planned at a better price per diaper. Another thing I like about southernsavers.com is that the lady who runs it once posted an article about what a good price per diaper is for each size of diaper and also gave recommendations for how many you need if you want to stock up. I got almost 300 size 2 diapers for $.1556 per diaper (within the $0.14-.16 good price range). I also got some size 1 and size 4 diapers. According to my inventory and the southernsavers.com recommendation, we already have about enough size 1 diapers already. We need a few more size 2 and quite a few more size 3 to get through the first year. We'll probably need a few more newborn size, too. This means that we are remarkably prepared for Emmie's arrival. I used the $25 gift card to buy the maternity shirts and a couple of other things. I had enough left over to get an Icee for me and Lucy and enough left from the Icee to get another one in the future.

Before leaving town we ate at J. Gumbo's. Wheel of Fortune was on the TV, and Lucy got excited when she saw it. We watch it at home most nights. She likes it because it's a show about letters. A show where people stand around and say letters that she recognizes is very interesting to her. While she ate supper, her eyes were glued to the TV. I told Matt that when I see her excitement at watching Wheel of Fortune I feel like we're raising our two year old to be an 80 year old. He was fine with that. We made one more stop at Half Price Books, where Lucy and I read a Pete the Cat book we'd never read before. She enjoyed it, so I'm going to add it to her wish list. We left Louisville at around 8:30, and Lucy was asleep within minutes, an hour or two early for her. She slept until we got back into Campbellsville and fell back asleep pretty quickly after we got home. She may be up early tomorrow. I'm sure I will be. I have to return a rental car and pick up our car with its new tires. I hope it doesn't stink anymore.

It was a very full day. It was complicated and tiring at times, but overall it was pretty good. We have more pictures of Emmie, who is healthy and growing. I have Trader Joe's cookies and several more months of diapers for Emmie. I just hope that tomorrow is more restful for all of our sakes.

Live-Blogging the Three-Hour Blood Glucose Test

8:02 a.m.
I arrived at the doctor's office and picked up my lab orders. I'm the only patient here, so I should be able to get in quickly. That will probably be the only quick thing about this morning. I ate half a peanut butter sandwich, a few apple slices, and some milk at 11:15 last night. At this point I've been fasting 8.5 hours.

8:10
First blood draw is done, and orange flavored glucose water was consumed. The lab lady asked what I scored the first time. When I told her 137, she looked at me funny. I asked if that was bad. She said that it's a passing score. I thought 125 was the cut off, but it's 139 for pregnant women. She thought I must not have been told the right number, so she checked my file. Sure enough, I scored 137, two points below the cut off. I PASSED THE 1-HOUR BLOOD GLUCOSE TEST!!! I knew this would happen! I knew that if I was anywhere close to the line, I'd have to do the 3-hour test! And it happened. Ugh! The lab lady tried to make it sound like this was normal and due diligence, but the look on her face when I told her my score leads me to believe that having me do this 3-hour test is unusually cautious. Now I'm feeling grumpy as well as tired. Fortunately, I'm not yet hungry.

8:35
I am also now feeling nauseated. The spike in blood sugar on an empty stomach is making me feel ick. I'm not sure what will happen if I throw up. I'm not sure if they'll make me drink again or tell me to come home another day. NOT GOING TO VOMIT! I'm looking up anti-nausea pressure points. I don't know if it will work, but it's worth a try, and I don't have many options available.

8:50
A couple of ladies just sat down next to me with breakfast from McDonalds. It's a good thing I'm not yet hungry. If they did that a couple hours from now, I might have to be restrained. The nausea is better, but I'm belching orange-flavored glucose water. My stomach is not exactly settled.

9:10
Second blood draw is done.

9:45
Starting to get hungry. Fortunately, I'm about halfway through the test. I've got leftover peanut putter sandwich and apple slices for after the test. That will at least hold me until I can pick up some KFC on the way home. Looking forward to it while trying not to think about it.

I bought some post-Valentine's clearance chocolates yesterday. We'll break those out tonight to celebrate my completing the blood glucose testing gauntlet. I was that confident about passing this one. Even more so now that I know I passed the last one.

I've been passing the time by reading things on Facebook, typing this blog entry, or reading Over Sea, Under Stone by Susan Cooper. It's the first book of a series that includes a Newberry Honor Book and a Newberry Winner. I may end up writing another blog about Lucy while I'm here.

10:25
Third blood draw is done. She switched to the other arm because the first first arm had a tiny bruise after being stuck twice and the vein was feeling squishy.

Alia, who has watched Lucy a few times on campus, is coming to our house this morning to watch Lucy. Matt is skipping office hours, and I'll try to get home as soon as possible, but we were afraid there would be 15-30 minutes between parents, which is not acceptable when caring for a two year old. If she were ten, we'd be OK, but she's two, and so we got a baby sitter. It didn't seem worth Alia's time for me to ask her to come for only half an hour, so she's going to be there an hour and a half. Matt will be able to get ready without watching Lucy. I don't have to hurry quite as much. Lucy gets a playmate, and Alia (who graduated in December with a theater degree) gets a little spending money. It's working for all of us. Alia is adopted family to Susie, and Susie is adopted family to us, so Alia is extended adopted family.

Emmie has been quiet but not exactly still this morning. She kicks enough to let me know she's OK. I expect her to perk up when we get to eat again. One more hour to go!

11:20
All done! The lab lady told me it was nice to do a 3-hour glucose test with someone pleasant. There was no reason to be unpleasant with her. It's not her fault that I had to get up early, fast for 12 hours, sit around a waiting room for three hours, and have blood taken from both arms a total of 4 times. That's Dr. Reynolds' fault.

12:05 p.m.
Home at last! Lucy had a good morning with Alia. Lucy wanted lots of hugs when I got home and talked to me about how mommy went to the doctor outside in the beep. I was gone when she woke up, so this story is how she made sense of her life this morning. On the way out of Lebanon, I stopped at KFC for some food. I had eaten half a peanut butter sandwich and some apple slices within minutes of ending my test, but I knew I needed something more. I also stopped for a chocolate sundae cone, which I ate on the road. I was crazy hungry.

7:00 p.m.
I just got up from a two-hour nap. I was exhausted. After lunch, I played with Lucy and continued to eat anything that looked good. I didn't overdo it. But I ate a couple handfuls of apple cinnamon Cheerios before my nap and just had some shredded mozzarella from the bag while prepping a frozen pizza for supper. It's been a long day. I'm looking forward to a good night's sleep and a slower day tomorrow.

Let's Try That Again

I failed the one-hour blood glucose test just as I did when I was pregnant with Lucy. I've scheduled a babysitter to keep Lucy next Tuesday so that I can take the 3-hour blood glucose test. It's no fun at all. I really have to make sure I get that 11:30 p.m. snack because I won't be able to eat until after 11 a.m. I expect to pass the 3-hour one as I did when I was pregnant with Lucy. I'd hate to have another complication to add to my advanced maternal age and short, soft cervix. Every new problem ratchets up the subconscious stress that becomes conscious when I get too tired, which I have been lately.

Lucy has been a handful for the last 24 hours. More than once I've been in a situation where she refuses to do what I ask or command even when I offer reason and/or incentives. She is 2 after all. In the past, I probably would have physically removed her from a situation, which tends to move her past her stubbornness and reset the situation.  But I can't move her without risking straining myself. It leaves me feeling kind of helpless. Today she refused to go down the attic stairs, and I couldn't get past her or carry her down. And then I started getting light headed. And so I sat down on a step and cried. Lucy said "Mommy sad" and laid her head on my lap, which was sweet but unhelpful. I told her I was frustrated because I was trying to keep us safe, but I couldn't keep us safe if she wouldn't go down the steps like I asked her to. That didn't convince her. Eventually, she saw something on a lower step that she wanted and went down a few steps. Then she stood up to put her hat on, which sometimes knocks her over even when she's not standing on stairs, so I took away the hat and threw it to the hallway at the bottom of the stairs to give her a reason to go down. It didn't work. She sat down on a step and cried and said, "Me sad." I explained why I did it and pointed out she could have the hat if she would just go downstairs. That didn't help. She just had to be sad for a little while, which still left me stranded on the stairs. After a while, she went down a few more steps and got to within three steps from the bottom. By this point I really needed to go to the bathroom, so I held her arm and guided her her down. I didn't lift her, but I man-handled her a bit. I didn't want to do that higher on the stairs because if I had lost my grip she would have fallen down the stairs. I decided she'd probably be OK if she fell down only two steps. Fortunately, she didn't fall. She wasn't happy with me, but I was really glad to be off of the steps.

When I feel helpless, I wonder if spanking would get better results. I know that in the moment, it would not make the situation better. She would sit down and cry, and I'm pretty sure being hit my mommy would make her more sad than having mommy throw her hat down the stairs. I'd still be on the stairs if I'd spanked her. I don't want her to bury that sadness and get used to mommy hitting her. That's horrible. So I wouldn't want to spank her for anything less than something dangerous. Associating a dangerous situation with fear and pain wouldn't necessarily be bad. My appeal to safety would be more persuasive if she had a better understanding of risk and fear, but she's two and made of rubber. But spanking her in unsafe situations doesn't necessarily make the situation safer in the moment, which is more important than teaching a lesson. And spanking after the danger has passed would associate safety after danger with pain and fear. That's not what I want either. But let's be honest, part of the reason that spanking occurs to me when I feel helpless is because I want to do something and I feel angry that a child has made me feel helpless. Hitting Lucy would satisfy that angry part of me for a second. But hitting out of anger is definitely not OK. It's not good for her or me. So I'll just have to be the adult and deal with the frustration and anger of feeling helpless. And I'll keep thinking of ways to get Lucy to comply quickly in dangerous situations.

Well, that post departed sharply from blood glucose testing. I guess it's all about my mental state. I'll feel better with more sleep, which I plan to get this weekend.

Emmie's Ash Wednesday Fast

By an interesting coincidence of scheduling, Emmie and I started fasting at midnight on Ash Wednesday for a blood glucose test. The fasting made a long morning feel even longer. Actually, a short night also made the morning feel extra long.

We ate dinner around 8:00 last night, and I fell asleep when Lucy did at 10:30. I didn't wake up until 2:00, so I missed my opportunity for an 11:30 snack. That meant that my 8-hour fast ended up being a 12-hour fast. At around 3:00 Lucy woke up as she typically does and got into bed with me. Unfortunately, she couldn't settle and cried inconsolably. We gave her some ibuprofen, but that didn't help. We couldn't figure out if her legs hurt or if her belly hurt or if she had had a bad dream or if her pajamas were bothering her. All seemed like possibilities because of the way she acted. She climbed out of bed, walked into the hall, look confused, and cried some more. She refused to go back to bed, so we went to her room. I changed her from footie pajamas to her Elmo Abby pajamas. She cuddled up next to me in the chair and after about half an hour finally fell asleep still gasping and hiccuping from all of the crying. That was around 5:00. I waited a while before moving her to her bed. Sometime during the 2+ hours of soothing Lucy, Emmie became active. She might have been bothered by my rumbling stomach. Or she may have been reacting to Lucy's cries. I've noticed her being more active when Lucy cries. I'm not sure if she's sympathetic and offering comfort or irritated by the noise. I've also considered that she thinks there's a riot and is trying to join in. Eventually, she settled down, too, and I got another hour or so of sleep before I needed to get up, drive to Lebanon, and get my blood tested.

I got ready quickly and discovered that my phone was missing. I called my cell phone from our home phone and narrowed the location to the study. I still had trouble finding it and had to call myself five more times before I found it in the bag with Lucy's toy cars, rolled into the play mat quilt that Grandma made her. I finally got on the road, driving slowly because of road conditions. Several times it started snowing again. By the time I arrived at the doctor's office, I was exhausted from focusing so intently on the road.

The blood test went fairly quickly. Hopefully, I did really well. I have a feeling that if I'm within normal range but not close to ideal, then I'll have to take the longer test because our doctor is being so cautious. If I didn't pass, I'll get a call sometime this week. In addition to the blood test, I had an appointment this morning.The nurse weighed me (down a pound thanks to the pool being open again) and took my blood pressure (normal). I saw the nurse practitioner. Apparently, my trip to the emergency room last week was not in my records. When I told the nurse practitioner about it, she asked if they did an ultrasound. They didn't, so she ordered one. She wanted to make sure that the placenta hadn't slipped down over my cervix. So I got to see Emmie again. This time because of the 12-hour fast, she wasn't moving as much. She was still wiggling, but she wasn't obstructing the view this time, so I actually got a profile picture and a shot of her yawning. The placenta was right where it should be. They also did a vaginal ultrasound to measure my cervix. It was a little short. The nurse practitioner did an exam and said it was also softer than it should be at 24 weeks. She wasn't overly concerned, but she put me on "vaginal rest." As far as I can tell, that just means no sex. Let's be honest, if some part of me has to be on doctor-ordered rest, my vagina is probably the part I can do without the most. Most of my other parts are essential when taking care of Lucy. I'm also supposed to rest and get off of my feet frequently. I've been doing that anyway. I've been more tired and in more pain during this pregnancy.

I ate only a few bites of a sandwich before heading home. Matt is supposed to be at school at 11:00, and I was going to get home after 10:30. Fortunately, driving conditions were better on the way home. About 10 miles out of town, Emmie started kicking me insistently. I told her we'd be home soon, and we'd eat something. I could hear Lucy excitedly shouting about my return before I even got the door open. Matt was in the shower. I told him about my morning and showed him the photos. And then Emmie and I had pancakes left over from yesterday. We were both glad to end our Ash Wednesday fast.

Our next appointment is in Louisville in a couple of weeks. If that goes well, we won't have to go to Louisville anymore. Then we already have two appointments, including a growth measurement ultrasound, scheduled with our OB in March. And then we'll be in April, when I expect weekly visits to begin. If all goes well, Emmie will be here in about three months.

A Little Sore, But All Is Well

Yesterday got a little more exciting than we wanted for a little while. I discovered blood on my toilet paper after going to the bathroom. That is not where you want to see blood when you're 23 weeks pregnant. I was concerned. I googled "23 weeks pregnant spotting," which is a dangerous thing to do because you can find horror stories, and was mostly reassured. But mostly reassured isn't quite enough with my history. I lay on my right side for a while to see if Emmie would move. She didn't. I was more worried. I ate some peanut butter crackers, and she still didn't move. More worried. I lay on my back instead, and in just a minute Emmie greeted me. Less worried.

I never had spotting with my first two pregnancies, but I've had spotting every couple of months with Emmie. It's nerve-wracking every time. Previously, she's been so little that if the spotting meant there was a real problem, there wasn't much to do about it. The solution to many problems in pregnancy is to deliver, but that's not an option at 10 weeks or 16 weeks, so you just have to hope and pray and wait. But at 23 weeks there's at least a chance that she could live if she were delivered. And so if my body is telling me there might be a problem, I should make sure that everything is OK. I would hate to lose a viable baby because I ignored blood.

So I called my doctor's office. My doctor's office really needs to rethink what they play while you're on hold. I think it was a radio station. The first thing I heard was the obituaries. Just what I needed. And the first song they played was Electric Light Orchestra's "Living Thing," the chorus of which says, "It's a living thing. What a terrible thing to lose." Seriously. I don't know that English majors are more superstitious, but we've spent a lot more time considering foreshadowing than many people. As I heard these things, I told Matt, and he found them as comically ominous as I did, and that's one of the many reasons I love him. If we were superstitious, it would have been ominous but not comical. Eventually the nurse told me (predictably, because we're special) to go to the emergency room. I immediately called Shawn and Susie, who dropped everything to watch Lucy while we went to the hospital in Lebanon. I'm not sure I can ever express how wonderful Shawn and Susie are.

We checked into the ER and the Women's Center. They checked my urine to make sure that I didn't have urinary or kidney problems. Then they hooked me up to the fetal monitor. Emmie had been moving during the car ride, so I was pretty sure she was OK, but I always hold my breath when they check for a heartbeat. They weren't sure the monitor would pick her up because she's so little, but the monitor found her fairly quickly. And then she found the monitor. We have quite a bit of experience with fetal monitors. All three of our babies have been hooked to them at some point. And we knew that Neil and Lucy had fought the monitor, pushing and kicking to get it off my belly. Neil was more methodical, but they were both tenacious. It turns out that Emmie is similarly tenacious, and she did try both quick kicking and sustained pushing to move the monitor. She kicked the monitor so hard that I felt it bounce against my belly. I asked Matt if he wanted to watch to see if he could see her move the monitor. After a few minutes he saw her kick hard enough to make the monitor bounce again. She's less than 6 months, and she's already affecting the outside world. The nurse was very impressed, not just with the kicking but also with how well Emmie's heartrate tracked for half an hour on the monitor. She showed the doctor the print-out and said, "Have you ever seen a 23 week track like that?" He hadn't. So Emmie is strong and exceptional.

The lab found no problem with my urine sample. The monitor showed I didn't have any contractions. The doctor did an internal exam and found no blood. He also found my cervix was "holding up well" (for a third pregnancy? despite my advanced maternal age?). So everything was fine. He decided I should go ahead and get my Rho-gam shot (routine because Matt and I have different blood Rh) while I was at the hospital, which sounded good to me. It ended up taking three hours, which is two hours longer than it's ever taken before. My Kindle ran out of energy, and I had time to delete almost 200 text messages from my phone. We hadn't had supper, so a nurse brought us some snacks. It was a long day.

We talked to the doctor about why I had bled in the first place. What we figured out is that pregnant women should not lift six-quart enamel-coated cast iron Dutch ovens. I had been doing dishes, and when I picked up the Dutch oven, I grunted because it was heavier than I expected. Apparently, it was heavy enough to make me bleed a little. And it was heavy enough that my entire abdomen is still feeling tender 12 hours later. So no more lifting. I'm not even lifting Lucy at this point.

We were so glad that Lucy was in good hands because we didn't get home until after 10:00. Shawn and Susie played with her outside while we were leaving. Lucy waved goodbye and talked to them about her "beep" and then ran to the back yard to play some more. She didn't miss us at all for more than 5 hours. They took her for supper in the university's dining hall. She even got to eat with her friend Selah, who she hasn't seen in several months. I asked if she freaked out when Selah left. Lately she cries "friend, friend" so pitifully when one of her friends leaves that it tugs at my heart. She was getting upset until Selah ran back to give her a bracelet, which made the parting OK for Lucy. After they got back to our house, they played and watched Shaun the Sheep. Lucy just said "Shaun Baa" for the first time today to name the show. Previously, she's just bleated to request it. She's been saying "Shawn" for weeks. In fact, yesterday she was lying under the dining table naming who each chair belongs to: "me seat, Daddy seat, Mommy seat." And I expected her to skip the fourth chair at the table, but she labeled it "Shawn seat." She's right. That's where he sits when they come to dinner and when he plays games with Matt. So Shawn was part of her vocabulary before Shaun, despite the fact that she's spent many more hours watching Shaun. Tonight she transferred all of her Daddy and Mommy ideas onto Shawn and Susie. She used Shawn as a jungle gym like she does Matt. Mommy doesn't play that way, especially now, so she seemed to assume that Susie wouldn't either. I also tend to be pretty tired in the evenings, so she's been spending more time cuddled up with Matt than she used to.  When we got home, she was cuddled up to Shawn playing Daniel Tiger on her tablet. I don't know how she would have handled bedtime without us if we had been out later, but it's good to know she can be fine so long with Shawn and Susie. Our plan is for them to keep her while I'm in the hospital having Emmie and recovering in May. I think this test run was a success.

So despite a scare it turned out to be a good day. I'm fine and have a comment-worthy cervix. Matt has to do all the heavy lifting per doctor's orders. Emmie is active, strong, and exceptional. Lucy can see us leave and have someone watch her for hours, all without a tear. And we have the best friends in the world. (We already knew that last part.) It was a long but reassuring day.

Training in Progress

Lucy seems to get bigger every day. People who didn't see her during Christmas break keep telling us they're sure she grew six inches during that time. All of the 18-month clothes have been moved upstairs now. The 2T clothes are now in her dresser with the 24-month clothes. Some are a little big, but she's growing into them.

Lucy is also showing new skills nearly every day. She adds a couple of words a day to her vocabulary. Yesterday she looked at her wrinkled fingers in the pool and said, "Mama, me pruney." I probably should have taught her the word wrinkled first, but it works. She is learning more verbs and making more sentences. She still refuses to say her name. The other day I asked her what her name is, and she said, "Me." Well, yes, me is "a name I call myself" according to The Sound of Music. She is starting to build with Duplo blocks all by herself. I typically join her and add to the complexity of the sheep house that she's building. That's what she always builds. She attaches the rooms to the Duplo table and adds other blocks and puts people and animals inside. She has also gotten into playing with the Little People House and her magnetic doll house. She "measures" everything with her measuring tape. She still recognizes letters and numbers. The other day she was scribbling on a chalkboard and suddenly stopped and pointed to some of the marks she had made and told me it was a Y. She was right. She didn't make a Y on purpose, but she recognized she had done it.

She is making progress on showing self-control and patience, even though she's still independent, strong-willed, and two. She tends to help clean up her toys, sometimes without prompting. Every once in a while, she'll refuse to help for a few minutes and sometimes pitch a little fit, but when asked again later, she'll eagerly jump up and help. If we could just fix that occasional pitch-a-fit stage, she'd be pretty well behaved. She's still energetic and doesn't sit still for long, which some people would consider being poorly behaved, but I'm OK with her need to go and do and move at this point as long as she isn't hurting anything or anyone and is making progress in controlling herself. She doesn't tend to hurt, and she is making progress, so I can be somewhat content with that for now.

Since Lucy is getting so big (and our lives are about to get more complicated), we've been working with Lucy on a couple of life skills. Getting Lucy to sleep has always been a problem. Since I'm expecting to live in a recliner for a couple of months after another C-section, we needed to get Lucy to a point where she could get to sleep without my lying next to her. We have succeeded! Matt and I both go to her room with her for bedtime. I sit in the recliner, and Matt sits next to her mattress on the floor. We read books until she gets tired. I offer hugs and kisses, and she grabs her water bottle (her comfort item) and lies down on her mattresses and falls asleep. Some nights are better than others, but she's doing really well. A couple of nights she has needed more human contact to fall asleep, so she has cuddled up to Matt on the floor and fallen asleep. That's fine with us. She even gets into bed herself on Thursday nights when Matt is at game night. It's pretty fantastic. The freedom makes me a little giddy. I tend to fall asleep in the recliner, sometimes before she's asleep.

The other training we are doing is potty training. We haven't pushed her. We've just kept talking up life without diapers and giving her opportunities to sit on her Elmo potty seat. The training has been stalled for a while. She was willing to sit but almost never peed in the toilet. Yesterday she started refusing to even sit on her Elmo seat. I was OK with stalled but not OK with regression. So today I stripped her naked from the waist down and made her stay on a vinyl table cloth in the dining room for a couple hours. We played together, building sheep houses, and we ate snacks. She didn't like being confined to the table cloth, but she stayed fairly well. She peed on the table cloth twice and was horrified both times. The first time we dried the table cloth with a towel, and I took her to sit on the toilet and reminded her that she should let me know if she needs to pee so that she can do it on the toilet or on a potty seat (two of which were on the table cloth with her). The second time she peed, she immediately jumped up and said, "Mama, pee! Agh!" We dried it and sat her on the toilet, and she peed on the toilet! She had stopped herself when she realized she was peeing and finished on the toilet! She was praised lavishly and given a sticker to put on her shirt. She stayed diaperless until Matt got home from work (the deadline I had given her). Then she got to wear a diaper again. I thought we could do that every day for a while and gradually increase the amount of time she spends without a diaper. Today was successful. I hope this method continues to work for her. I don't have a time table for potty training her. I'm just glad to be making progress again. I just ordered a huge supply of her size of Elmo diapers (Pampers) from Amazon, so we're ready for however long it takes her. And if she doesn't use them all, we'll save them for Emmie.

Speaking of Emmie, she is quite a kicker. I told Matt that I think she's gone from wiggling and fluttering to full-blown kicking faster than her siblings did. And boy can she kick! Yesterday, she kicked me hard enough to knock my hand off my belly. She was also doing somersaults, which feels like my organs went on a roller coaster without the rest of me. She appreciates it when I rest and when I eat, but I haven't noticed any other preferences yet.

I've been talking to Emmie, typically saying, "Hi, Emmie," when she kicks. Yesterday Lucy said, "No Emmie!" I explained (again) that Emmie is her baby sister. I then told her for the first time that Emmie was in my belly. Lucy refused to believe that. I informed her that she had also once lived in my belly. She refused to believe that, too. I don't blame her. It's weird. Lucy doesn't get the baby sister idea yet, but we're working on it. I bought a baby figure for her Little People house. We already had baby gear (high chair, changing table, cradle, stroller) but not a baby. We've started playing baby and big sister with her Little People. She loves putting the baby on the changing table to pretend to change the baby's diaper. I'm hoping that we can provide enough story lines about babies that will become familiar to her so that when a baby comes home she'll have an idea of what's supposed to happen. She hadn't really experienced snow before, but when it snowed a couple weeks ago, she immediately made and threw a snowball. She knew what to do in the snow because of Curious George and Shaun the Sheep. I'm hoping we can do the same sort of thing by playing scenarios that will tell her what to do with a baby. We'll see how it goes.

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.

The Mongolian Covenant

Let's review the rules of "going Mongolian."

1. You are free to talk to anyone EXCEPT me.
2. If you tell someone, you must update them with bad news.
3. I will keep you updated via this blog.

If you don't recognize the phrase "going Mongolian," you can check out this post to explain it.

If you remember the phrase "going Mongolian," you've probably guessed I'm pregnant. Now that you know, you are bound by the rules of Mongolianism. I don't want your congratulations or questions. I assume that you're happy and praying for me. I appreciate it and don't want to hear about it. I really, really don't want to talk about being pregnant. You may tell other people (it's not a secret anymore), but they will also be bound by the rules of Mongolianism, and you are responsible for telling them if something goes wrong and we don't get a happy ending. I don't want congratulatory messages from distant relatives in June if I don't have a live baby. "Going Mongolian" worked really well last time. It saved me a lot of emotional wear and tear, and I'm hoping it will do the same thing this time.

Now to uphold my end of this Mongolian covenant. Here's what we know.

• I'm expecting a baby girl in May. The due date is June 1, but a c-section is planned for at least a week before that. 
• We're calling this baby Emmie until she's born. Matt and I have had multiple girls' names picked out for years. However, previous experience has made us reluctant to give unborn children names that we want our children to carry all their lives. So we are not giving our daughter a name until she's born. Until then, we are calling her Emmie. Let me repeat, HER NAME IS NOT EMMIE. That's just what we're calling her until she gets her permanent name. (Yeah, I just updated that paragraph from last time. I don't have a better way to say it.) We did this last time with Elsie/Lucy, and it worked really well. It took me a few days to make the switch after she was born, but it gave us a name to use during the pregnancy, which made her feel more real than if she had just been "baby."
• We've had two ultrasounds recently, and all of the baby's measurements were right on track. She seems to have all her parts. During one ultrasound, she was sleeping with her hands by her face, and her ankles were crossed. At the other she was uncooperative. She kept covering her body with her hands so that the ultrasound tech couldn't see anything. If the tech was trying to look at her heart, she put her hands on her chest. If she wanted to scan the face, Emmie put her hands on her face. She also used her legs to keep the tech  from being able to see. Some of the time he feet were over her head like Lucy used to do in ultrasounds. We may have to start a circus with our acrobatic daughters. However, Emmie didn't keep her feet over her head. When the tech tried to look at her genitals, she tucked her legs under her and crossed her ankles. She was pretty determined, but eventually we saw all we needed to. She is healthy, well formed, and a normal size.
• So far I am healthy. My blood pressure has not been a problem. I'm supposed to watch my sugar intake and my weight. Neither has been a problem yet, but family history and my starting weight make them possible concerns. I've gained more weight than I'd like, but I find that inevitable in winter. It's easy to lose or maintain weight in the summer with gardening for exercise and plenty of fresh produce just outside my door. However, the swimming pool opens again next week, and I'm making more of an effort to eat vegetables and fruit. Despite the weight gain, I just switched to my "fat pants," the next size up from normal, in the last few weeks. I hate maternity pants, so I'll try to get by without them as long as possible.
• We are also seeing a fetal medicine specialist in Louisville. I'll give an update about that in a separate post. 
• We've got a lot of appointments in the next few months: two in February and two in March already. About the time we get past those, we'll be having weekly appointments for BPPs.
• Lucy is unaware that she is getting a little sister. I asked her a couple of months ago if she would like a baby to live at our house, and she said yes. Of course, she didn't know what she was agreeing to, but at least she was agreeable. She has been present for one of the ultrasounds, and we've mentioned her sister to her. She doesn't care. We'll figure out eventually how to get her on board with this big sister/little sister thing.
• I've felt Emmie move a little. She wiggled nonstop during one of the ultrasounds. She didn't flail or kick, but she wiggled and shifted her hands and feet in the way. She's a busy girl. I look forward to getting to know her.