Archive for January, 2010


So I started getting weekly progesterone injections (17P) to reduce the risk of pre-term labor this go around. I’m not new to progesterone injections, they don’t scare me, and honestly they don’t even hurt me. I can’t for the life of me figure out why a nurse has to come out every week to administer the injections… it’s not like I’ve never done it before. (The nurse is here anyway, because of the PICC line, but even if she weren’t already coming, they’d send her out to just doe the injections if that’s all that was going on with me)

I’ve had about 100 progesterone in oil injections and never had any issue. Despite dire warnings about the sesame oil that it is in, I never reacted in any way, other than some discomfort at the injection site as the PIO got absorbed into the surrounding muscle.

The 17P injections aren’t quite the same as the PIO I used, but the 17P is also progesterone in oil. And now? I am itching like MAD at every injection site. It’s worst very shortly after the injection is given, and it starts to fade toward the end of the week, and then when I get the next injection, it’s all itchy at that site, as well as all the other injection sites that have been used. It is maddening.

Fortunately, this is but a minor issue for the moment, but it’s still annoying.

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I spent Sunday night/Monday morning at Labor & Delivery for contractions and other fun stuff. Tuesday I had my already-scheduled OB appointment. The doctor said that the goal is to keep me out of the hospital as long as possible (I hadn’t known that was on the table, but okay…). I told him I spent Sunday night at the hospital, and he responded “Oh, really?” Call me picky, but while I realize it’s a large practice, wouldn’t it make sense for there to be some sort of notation in my chart so that the other doctors who see me know before they walk into the room with the patient?

He declared that I’m measuring just right and the baby’s heartbeat was fine, so he said, “I guess that’s it.” Um, not so much – I had a list of questions both from myself and things the home health care company wanted to bring up with him. Virtually all of my questions were met with “That’s a good question for you to ask the perinatologist tomorrow.” There’s a national shortage of adult multivitamins for infusion, and apparently Folic Acid (for the IV) is also in short supply right now, so the home health nurses wanted me to ask him to write me a script directly for the MVI (Seth can get it filled – it’s good to have connections) and to ask if it’s okay to do the folic acid every other day, or every few days, etc. Good question for the perinatologist, apparently. I asked about the extreme pain in my pelvic bone which is making it excruciating to walk (especially stairs) and that was met with “Hmmm.” I asked him what my threshold should be in terms of calling the office or on-call doctor since if I used the standard “more than 4 in an hour” rule, I’d be calling every hour. Apparently, that was also a good question for the perinatologist, which I don’t understand, because if I call someone at 2 in the morning, then it’s not going to be the perinatologist I wake up – it’s going to be HIS practice members that get woken up. Pretty much everything was “Talk to the perinatologist.”

The one thing that did get resolved was that he said, “The question is, how are we going to get your glucose tolerance test done?” You got me! But since I’m eating so little, I doubt it will be an issue. But since there’s a 98% likelihood that I will throw up the glucola (sp?) , there’s not a lot of point in suffering through it. SO, I get to take my blood glucose levels 4x per day. Fun, right? Um, not so much.

So I went to the perinatologist today for cervical assessment and a growth scan (the baby’s growing just fine and kicked the transducer a fair number of times to prove it). I told the sonographer I had some questions for the doctor and she said he was over at the hospital with a sick patient. This is fine, I was happy to wait if need be, but also happy to find an alternative. So she sent his clinical nurse in to talk to me. Regarding the contraction threshold, she said I just have to use my gut. Right, because that’s going to work so well. She said that regarding the glucose tolerance test, probably the only way around it was to do blood sugar testing, but that 4x/day is probably overkill and I could just do some random BG checks. She didn’t have an answer re: the MVI and Folic acid, but said she’d check with the doctor when he got back from the hospital. Regarding the excruciating pain when I’m walking – well, she said that everything in this pregnancy is going to be more pronounced, as this is my second pregnancy and I’m older now, and… Um. Right. But it’s kind of comparing apples to oranges. The last pregnancy involved THREE baby humans. This pregnancy involves ONE baby human – so the “it’ll all be more pronounced this time around” argument doesn’t entirely fly with me. Nevermind that I know plenty of women who have had two, three, four, five, six or more pregnancies without having excruciating pain with every step just because it wasn’t the FIRST pregnancy. She recommended an abdominal binder to see if that would help. I’ll try it, but I’m not expecting miracles. She called later regarding the Folic Acid and MVI and Dr. P. was adamant that since I’m not eating/drinking more, I must have both (if they can be gotten – otherwise, well, not so sure what the answer to that is).

So I’m not a lot more enlightened than I had been Sunday night. I still don’t know whether I should call the doctor, for, say, the extreme cramps and contractions I’m having RIGHT NOW. Probably nothing to worry about since my fFN was negative, so I’m not going to freak out. I’d just like to feel better. Sigh. I’m just frustrated. I’d probably feel less frustrated if I didn’t have other things going on as well, but obviously, life moves on around me, regardless of how gross I feel.

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So, um, I get that I’m a disgrace to this prestigious community of infertile myrtles, but I have a confession:   I never checked cervical position when I was trying to get pregnant prior to heading to Ye Olde Fertility Clinic.  That’s right – back when we were still deluded that sex = pregnancy.  Hah!

Anyway, I never checked cervical position, because (honestly) I never could make heads or tails of it.  I can’t figure out what it’s supposed to be, what the difference is between them, and truthfully I wasn’t really all that eager to learn.    Since I didn’t do any of that, I never really took the time to learn what it *should* be.  You know, say, during pregnancy, for example.

The nurse at the L&D unit last night seemed really surprised that I apparently had a very low cervix.  Um.    But what does that mean?

ETA: Jess did explain it to me, and I’m gathering there’s nothing to be alarmed about (I wasn’t terribly alarmed – I was putting more stock in the negative fFN than in a nurse’s guesstimate on cervical competence)

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First trip to L&D so far

I just got home from what I suspect will be the first of many visits to the Labor & Delivery unit. I was having a lot of cramping, low back pain, and pelvic pressure. Indocin didn’t help at all, so off to L&D I went, per my doctor’s instructions.

Surprise, surprise! I was having contractions. Good news is that my fetal fibronectin test was negative. This means I’m unlikely to deliver in the next two weeks due to cervical incompetence. I got three terbutaline shots, 20 minutes apart. Gah. I forgot how much terb sucks. Particularly if it’s not on a pump. My contractions slowed way down after the first two injections and the plan was to send me home after a bit of monitoring after the third injection. Except my contractions were back in full force after the third injection. My pulse was also through the roof (terb can do that), so I got to stick around L&D for longer than I cared to. Much to the nurse’s surprise, the doctor said I could go home despite contractions 2 minutes apart since the fFN was negative.

Of course, now the terb is making me so jumpy and shaky that sleep is elusive. Not to mention the nausea – I missed dose of Phenergan because of the visit – so I’m now all caught up on the meds and waiting for sleep.

Really, technically this baby is “viable” – but I will be most grateful if I don’t have to test that theory right now.

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My husband and Sam both appear to have a stomach bug, courtesy of my MIL. I really hope I don’t get it. Yes, I’m washing my hands. A lot. But I still am not holding my breath about not catching it. Sigh.

Today’s been a hard day, pregnancy-wise. I’m having a lot of menstrual-like cramping, back pain, and this odd (yet painful) pressure in my pelvic region. Also I have thrown up more than I care to. That’s always the fun part. Every time I think maybe I should call the doctor, I start feeling better. A couple hours later, I wonder again if I should call but then it gets better. So I guess I’ll just wait until tomorrow.

Ellie had MRSA a couple months ago, and now she has some sores that look pretty much the same as she had back then. The doctor-on-call (not my favorite doctor in the practice by any stretch of the imagination) said it needs to be looked at, but can wait until tomorrow. I didn’t figure it was a pressing emergency – but I did want to check in with the doc, just in case.

I had a fever for a couple days last week – which completely freaked out the home health company. I do not, however, think I have an infection with the PICC line, as they feared. I appear to have some sort of cold/upper respiratory infection. It’s good times – but I’m fine with that vs. a PICC infection. That would have sucked.

The triplets are definitely two year olds, with random tantrums galore. If it were just one of them, the tantrums wouldn’t seem so frequent, but there’s nearly always one of them in a snit about something. I feel badly for them, for I know it stems from their own frustration and lack of ability to communicate their needs. But I also enjoy nap time a lot. You know, on the days that they DO nap, that is.

J is “Star of the Week” next week for his class. Which means homework for me. I mean, technically it means homework for him, but let’s be real, okay? He gets to take home Rocky (the class stuffed animal – a dog) and take pictures of his activities with Rocky and document his adventures in a journal. And he gets to make an “All About J” poster. That is, I get to make it, just like I made it last year. Hopefully he’ll help more this year. Hah! No, I’m not doing his homework for him, per se, but the teacher and I both know that forcing him to do homework isn’t teaching him any good lessons and only frustrates us all. He doesn’t do weekly homework like the other kids in the class and a big project like this isn’t fun for him – it’s horrifying. He’s dyslexic and with his attention issues (he’s not well medicated in the evenings), this is too overwhelming for him. So he gets to help, but I do the lion’s share. Fun times.

Oh, and the last day of his “Star of the Week” week is the 100th day of school, so he has a 100 day project, too. Hooray!

I don’t understand cats. They sleep, like, 23 hours a day. How do they do that without getting muscle cramps?

That’s just about enough randomness for me.

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Last Saturday, I went to shul against my better judgment. Truthfully, I felt so yucky, it wasn’t a great idea. But the triplets were in their wagon ready to go and J wasn’t ready yet, so I told Seth I’d bring him up myself once he found his coat/shoes/whatever it was that he was missing.

It was that day that I got told I am “complaining” if I answer the question “How are you feeling?” with anything other than “Fantastic! How about yourself?” I walked into another room and a very-well-established member of our congregation asked me when I’m due and the inevitable “How are you feeling?” She said that she threw up every day while pregnant with one of her kids, “But I didn’t mind because I didn’t gain any weight that time.” I told her I’d lost 25 pounds.

“That’s okay – you needed to lose those 25 pounds anyway. If you’d been skinny to start with, they’d be worried and would have put you in the hospital.”

Um. I really have nothing more to say about that.

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Parenting Fail

Why is it that we don’t get “do overs” on at least one or two days in our lives?  Monday was a do-over day, for sure.  It’s not just that none of the plans I had came to fruition.  It was the complete and utter lack of control that I had over Monday’s happenings.

My darling husband had to work Monday, but my nanny was off work for MLK Jr. Day, as was I, so it was single-parenting day.  Normally, this isn’t such a big deal – but when you spend half your day throwing up, as I do, well, it becomes a more complex matter to handle.

We had originally had plans to visit another triplet mom out in VA, but those plans were canceled.  Instead, I made plans to visit a friend up near Baltimore in the afternoon.  Best laid plans, and all, I will give you the spoiler:  we did not make it to Baltimore.

J’s mother came to visit him for an hour or so in the morning, which would have been fine, but J wouldn’t take his medicine before she arrived.  I admit, I didn’t try as hard as I normally would have, but such is life.  They went to the park and he rode his scooter up and down the sidewalk in front of our house (something he doesn’t get a lot of time to do, since he’s got three toddler siblings).  He came back in the house mopey, weepy, and exhausted.  She headed out and I tried to get J to take his medicine after giving him something to eat – no dice.  Fine, I said, then please play in your room until you’re ready to take it.  He went to his room, but didn’t play – he slept for the next five hours.

That, alone, would have been reason to  cancel the trek to Baltimore, but (alas) that was *not* the full extent of it.

While I was making lunch for the triplets, I heard them playing in the sunroom, and could hear that they were probably into something they shouldn’t be, but I put their lunch on the table, called them to come eat, and promptly forgot about checking out the sun room.  I called my friend to let her know it wasn’t likely that we’d be making it to see her.  A mother of four herself, she completely understood, and we had a nice chat instead.  Unfortunately,  I had to cut the call short – sigh.

I looked over and saw that one of them had pulled some things off the mantle – how they did so is beyond me, but that’s another story.  I went to go clean up the mess, and noticed that my hand-painted, irreplaceable nesting dolls that were brought to me from Moscow  were on the floor.  And at least one of them was broken.  The smallest one, which is about a quarter of the size of my pinky nail (no joke!) is missing.  I know it’s just stuff, but…  gosh.  It had to be that stuff?  I cleaned up the mess and realized that Ellie needed a new diaper, so off we went to change her in the nursery (where the changing table is).

While changing a rather disgusting diaper, I heard a *CRASH*.  I dashed out to the living room and saw that Sam had pulled my Lenox Vase off the mantle and dropped it (I’m sure it was unintentional, but…).  I know it’s just stuff… but did it have to be that vase?  I love that vase.  I picked him and Abby up (did I mention I’m not supposed to be lifting more than 10 pounds at a time and each of my kids is 28-30 pounds?) and put them in their room.  They were both barefoot and I didn’t want them stepping in shards of anything.  When I brought them to their room, I realized Ellie was still patiently waiting on the changing table with her legs in the air and her pants half on/half off (I was putting her pants back ON when the crash happened – so at least she wasn’t still sitting in a poopy diaper).  I finished getting her dressed, and put them all in their beds (it was naptime anyway) and I went to go clean up the shards of vase on the living room floor.

When I was about halfway through cleaning the vase up, the giggles in the nursery had turned to cries, so I went in there to check on the trio of terror.  Much to my dismay, I saw immediately that the mistake had been mine – normally we take the changing table/diaper pail/laundry basket OUT of the room for naptime and bedtime.  I had forgotten to do so, so they’d opened the drawer and pulled out the Balmex.  Abby was covered, head-to-toe, in Balmex.  Sam’s hair was caked in it.  Abby’s pillowcase was totally white, and Piglet (her lovey) was another casualty.  I sent out an SOS message to a local group of triplet moms, because I had remembered that another mom in our group had a similar problem a few months ago.  Balmex isn’t the easiest thing to get out of hair.  Or clothes.  Nor, as it turns out, is it easy to get off of a hardwood floor, oddly enough.

Well, I got them cleaned up, pulled the changing table, diaper pail, and laundry basket out of the room and reminded them that it was nap time.  I resumed the great vase cleanup.  I got up as much as I could, but realized I was never going to get all those shards out of the carpet (it’s one of the LL Bean braided rugs).  The rug was on its last legs anyway – a bunch of stitching had come undone, and it was in terrible condition.  Had it been brand new, I would have tried harder to deal with it, but I’m petrified of my barefoot little children getting shards of a stupid shattered vase in their tiny little feet.  So I rolled up the carpet, planning to just get rid of it, but as I was doing so, I realized that there was far too much giggling going on in the triplets’ room.  I went in and found…

Three naked toddlers.

Awesome.  I was… not as amused as you might think I was.  I got everyone dressed, admonished them and reminded them that it was naptime, and left the room.  And I went to move the rolled up carpet to the sun room (too heavy for me to get any further than that), and discovered the disaster that the triplets had created while I was making their lunch. The piano bench was overturned, toys were strewn everywhere.  And worse – I have a bookshelf by the front door where I tend to put incoming mail.  They had gotten the whole pile down and had shredded it and spread it all over the floor.

So I cleaned that up, called Seth and said, “WHEN ARE YOU COMING HOME?” and then went to check on the triplets.  Ellie was trying to sleep, but Sam and Abby?  Not so much.  And guess who was naked?  Abby (and Sam was missing pants, but still had a diaper).  Abby got backwards footie pjs and they both got put into bed.  Another phone call to Seth, “NO REALLY!  WHEN IS YOUR SHIFT OVER AND CAN I EXPECT YOU HOME WITHIN 30 SECONDS OF THAT TIME?”

If I weren’t pregnant, this would have been a good time for me to take up recreational drinking.  But aside from being pregnant, I’m still hyperemetic, so it wouldn’t have been any fun anyway.  It’s no fun to throw up BEFORE you’ve gotten plastered.

Finally, Seth came home and I handed the reigns over.  And then I went and got some Phenergan (which I’d needed for hours, but couldn’t get downstairs to draw it up because of the turmoil of the day).  J woke up eventually and demanded dinner – and I left that to Seth as well.  I was done.

It was, unfortunately, one of the more memorable days of parenting.  I really can’t wait until I’ve forgotten all about it.

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Random Thoughts

In no particular order…

  • I really am tired of not feeling well.  I know that my eye needs to stay on the “prize” at the end of all this, but I really am just so tired of it.
  • Having three mostly-typically-developing two year olds is an experience that isn’t easy to put into words.  J never got into things at this age – he never stopped moving long enough to notice that there was a drawer he could empty, shelves he could scale, or mantles to climb.  The triplets have figured out all of these things, they learn from each other, and they work as a team.  It seems nothing is safe any longer.  Temper tantrums abound, but I could live with those.  The thing I can’t live with is the hair pulling.  Specifically, Sam and Abby (mostly Sam) seem to making a great sport out of pulling Ellie’s hair out.  Obviously, the instant I see it happening, I put a stop to it and it’s an immediate time out.  But once that tuft of hair has been pulled out, it’s not going back in – the damage is done.  So much, damage, in fact, that I no longer have to worry about Ellie’s hair falling into her eyes or her eating it because it’s in the way.  Her scalp is nearly visible on the top of her head.  Not bald, for sure, but definitely thinning.  I feel awful for her, but haven’t found a good solution.  J’s developmental pediatrician gave me a few ideas, but nothing I hadn’t already thought of.  Though he did agree that a very, very, very short haircut for Ellie might be in order until we can break the other two (mostly Sam) of this habit.  It just seems such a shame to cut her golden locks – but I don’t want her to be traumatized daily either.
  • More problems with J’s medications.  We have an appointment next week with Ye Olde Developmental Pediatrician to discuss next steps.  Seth is understandably concerned about the potential long-term effects of neuroleptics.  I am concerned about the potential long-term effect of not properly treating a child who so clearly has a need for treatment.  Both are valid concerns, I think.  Where is the happy medium?
  • We went to shul yesterday, something I avoid doing for the most part.  How do I answer the inevitable question, “How are you feeling?”  Truthfully, I feel terrible.  There’s no getting around it.  I look awful, too, so it’s not like I can just universally lie about it.  A friend saw me yesterday and asked if I’m feeling better.  Truth?  No, I feel worse, most days.  Later she came back because she’d noticed my Zofran pump.  Oh my goodness! she said, you’re wired!  Yep.  I’ve had my tether since October.  I haven’t kept any sizeable amount of food or fluid down since September.  “I didn’t realize!  I’d heard you complaining that you were sick, but I didn’t have any idea it was this bad.”  How much more clear could I have been?  I have hyperemesis, I spent a week in the hospital, I’m  not eating a thing.    But if I explain any of that, it turns out, I’m “complaining.”  I don’t mean to complain, I just don’t know how else to answer “how are you feeling.”
  • Along those lines, another friend of mine (J) noted that she’s had to explain to other people that when I say I’m not eating, I mean it.  We were both at lunch at a mutual friend of ours a couple weeks ago and the hostess said to J, “I hear Karen’s been really sick and isn’t eating much.”  J said, “no really, you have to understand.  When she says she’s not eating, she means she’s NOT eating anything.”  No one seems to get this.  How do I explain this without people assuming I’m just “complaining” about it?  People who haven’t had much in the way of pregnancy-induced-nausea/vomitting, especially those who had a very bad several weeks in the first trimester but nothing after that, just don’t get it.  I think people assume that I eat normally, but feel nauseated all the time.  I can assure you, I do not eat a normal 1500-2000 calorie diet.
  • This baby does acrobatics in my uterus.  I wish it would do acrobatics that moved it into a vertex position.  I know that there’s still plenty of time for this kiddo to move, but it sure would make me feel better, however illogical that is.
  • The progesterone injections definitely seem to help the PTL symptoms, contractions in particular.  My next injection is tomorrow (they’re weekly injections), but my contractions which were not frequent during the week, were back in full force by Saturday and aren’t much better today.
  • I am tired.  I am considering a nap.   The triplets and Seth are all napping, why shouldn’t I?

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    That would be a No…

    My perinatologist had recommended that I see the midwife practice that is part of the OB practice that finally took me.  The midwife practice is owned by the OB group, but they operate relatively independently within it.  Since they’re part of the OB practice, though, there’s *always* an OB back up should it become necessary (this practice always has an obstetrician on site 24/7 at the hospital I’ll be delivering at).  When she’d first suggested it, I still hadn’t found an OB to take me on, but I made an appointment for today (several weeks past my original call – but it was the first available appointment).  In the meantime, I’d gotten an appointment with the OB practice and they’d agreed to take me on, but I figured it wouldn’t hurt to talk to the midwives anyway.

    And it didn’t hurt to talk to them.  They were lovely.  Not comfortable taking on my care, but lovely nonetheless.

    So I’ll be sticking with the OB side of the practice (unless, by some miracle I get off the Zofran pump, get the PICC line out, and cease needing IV meds – in which case, they’ll slide me over into the midwife practice… let’s just say I’m not holding my breath).  This is fine, and essentially what I had anticipated anyway.  At least now I know and I won’t have to wonder later why on earth I didn’t try to see the midwives.

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