ChezPerky

Have you met my friend, the Zofran pump?  I take him with me wherever I go – but I’m beginning to understand the hazards of my tether.  Sometimes if I’m sitting down for a while, I actually forget that I *have* the pump and I’ll stand up and walk away, only to be tugged back by the weight of the pump sitting on the chair or the floor.  Still, a minor inconvenience given that it’s giving me continuous medicine which, theoretically, is making me feel better.

But there are other perils as well.  The being woken up in the middle of the night because the syringe was displaced, or worse – empty.  The inconvenience of always having to bring it along and explain myself to curious onlookers.

But it’s really the five feet of tubing from my PICC line to the pump that presents the biggest hazard, most of the time.  The other day I hopped in my car to move it to a better location so my nanny could have easy access to it – but when I hopped in for this really simple move that should have taken 20 seconds at most, my tubing got caught around the steering wheel and it wasn’t easy to untangle it.  My 20 second task took over five minutes.  Later, I was driving my husband’s car (Accord) instead of my van (Odyssey) and my tubing got caught in the door of the car.  I hadn’t noticed until my pump started beeping at me that the line was occluded.  For some reason, I never get the tubing caught in the door of the van, but it seems to happen every time I drive the Accord.

Worst and best of all is that my pump provides important medication on a continuous basis.  Obviously, this is a good thing.  But occasionally, it’s less good – I never realize exactly how crappy I feel until something goes wrong with the pump – it turns out I’ve become quite dependent on that 42+mg/day through the pump.  By far the most perilous thing about this pump is that it is man-made, and therefore, not without flaws.

Friday afternoon, the display on my pump became non-functional.  Unfortunately, I didn’t notice the issue until a few minutes after 5pm – which meant that I could only call the after-hours center in Philadelphia, rather than calling the local office where my primary nurse works.      The nurse at the after-hours center said I should turn off the pump and disconnect, since we couldn’t know whether the pump is working properly without a working display panel.  Fair enough, but their solution was to suggest that I take oral Zofran in the meantime.  Um.  Right.  So a large part of the reason that I’ve got the pump is because I couldn’t tolerate the oral medicine – not even the ODTs – I just throw them right back up.  Fortunately, I do have IV Phenergan, so it wasn’t a *total* disaster .  Just mostly.

I did finally get a new pump Saturday afternoon, but I definitely do feel the ill effects of not having the continuous medication push for 16ish  hours.  Well, at least I know it works, right?

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So, I’ve often heard that it isn’t uncommon to get leg cramps in pregnancy – but it wasn’t one of the things I experienced in my triplet pregnancy, at least not any more than usual. People seem to suggest eating bananas to help prevent them. I expect that the reason is that people are attributing muscle cramps to low potassium levels. Turns out, low potassium does occasionally cause muscle cramps, it more frequently causes muscle weakness. Also? That banana everyone keeps suggesting? Has about 400mg of potassium in it. You’ll get more than double (sometimes triple) the amount of potassium found in that banana in tomatoes, wheat bran, apricots, currants, potatoes… Why bananas have such a reputation for being the potassium-king is beyond me. Low magnesium and low calcium levels more frequently contribute to muscle cramps – particularly those that occur with pregnancy.

So… who cares about any of that? Not me, but it’s still relevant.

About a week ago, I started having an issue where my thumb or the rest of my hand would seize up and be impossible for me to move. For a while it was just in my left thumb, which was annoying, but I could deal with it. Now it’s my whole left hand – and it happens at random times. And then, in the midst of muscle spasms in my hand (not remotely related to what kind of work I’m doing with my hand at the moment – just that it seizes up.

And then yesterday, my legs and even my feet started cramping- I woke up at 2:30 this morning in tears from the pain. Ugh. I just hope this is transient and will go away once my little parasite is evacuated from its temporary home. Sigh.

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I can’t recall a year in which I was more eager to say “Good Riddance!” as this one. 2009 can suck it – and I can only pray that it wasn’t just the appetizer course to a long road of sucky years ahead. I often do a month-to-month matrix with the over view of the Good vs. Bad things that happened each month. Usually this reminds me that the good always outweighs the bad. I’m not making quite the same matrix this year – because frankly, 2009 sucked and I don’t need a fancy little grid to rub it in.  So good BYE 2009.  Don’t let the door hit you on the way out.

I’ve read through some of my archives from last year and I see in those posts an over-stressed, over-extended, sleep deprived, and severely depressed person.  And small-wonder, really.  I spent the first couple months of the year not sleeping at all because I was working to coordinate an extraordinarily large volunteer effort for a local triplet family that lost their house to a catastrophic fire.  We had a $6000 plumbing problem in our front yard.  Shortly thereafter, Ellie landed herself in the hospital when she got what was probably RSV which triggered her RAD (reactive airway disease).    This left us fearful every time she got a cold or a sniffle for the several months following.    Sam landed himself in the ER after getting a deep (but small) gash above his eye.  Abby, thankfully, was spared any hospital visits.

Our tax bill was astronomical, as we’d made some … poor calculations at the beginning of 2008.   Our oven door was shattered thanks to our cleaning lady – it would have been fine if it hadn’t been just a few days before Passover started, and you know, if we weren’t dealing with an enormously large tax bill, so that $400 or so to get it replaced really hurt.   I had four failed IVF cycles.  The upside, of course, is that I had a fifth, successful, cycle and found out I was pregnant.  Just after I’d been laid off from my job and Seth was starting a new job, so the insurance situation was… precarious.

I got admitted to the hospital for 8 days (all of Sukkot) and while there, Seth landed himself in the hospital with a back injury for three days.   True, we got a little quiet time together, but not the ideal way to make that happen.  Seth, fortunately, did not need surgery (yet?) but did get a series of epidural steroid shots and still isn’t quite back to his normal self.  Hopefully PT will help.    The hospital bills for us both are still coming and it’s a convoluted mess because neither of us had insurance coverage when we were admitted to the hospital, though ultimately the COBRA election was processed for us both and we were able to get retroactive coverage – but it’s a nightmare to sort out.  My OB fired me, several OBs “declined to accept me” as a new patient.  I’ve had two PICC lines and several emergency room visits.  Yes, it’s great to be pregnant – but gosh, does it have to happen like this?

I’ve never spent a year more tired, more stressed out, or less capable of truly enjoying the blessings that I do have.  And I have a multitude of blessings – I have four beautiful, amazing children who, despite their challenges are by and large good kids and have nothing but love for the world around them.  I have an amazing husband who, despite his own state of exhaustion and stress, takes care of me even when I’m not capable of asking for help.    There were times in 2009 that I wanted to walk away from all of it.  And, frankly, I’m pretty sure I would have been justified in doing so.

And still, I’m reminded that 2009 wasn’t all bad.  Several women that had IVF cycles at the same time as some of my cycles brought babies home before the end of 2009.  Women that I care about reached their dreams of motherhood in 2009.  None of them deserved infertility – no one does – but they kept a sense of grace and humour and pushed forward and achieved their dreams.  For some women, 2009 was the year that made their dreams come true.

So although 2009 wasn’t my best year – well, it was good for many.  My family is one step closer to completion.  I have everything I ever dreamed of, despite the struggles throughout 2009.  My best hope is that 2010 is slightly less of a struggle to see all of the good.

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As you know, I didn’t love the new OB who agreed to take me on as his patient. I’ve been thinking about it all week. I remember the first time I saw my perinatologists’ office with the triplets. The doctor rubbed me completely the wrong way. I wasn’t ready to hear anything she was going to say that day.  A week or so later, I concluded that part of what was going on with me not liking her was that I picked out the things I didn’t like and those were the only ones that formed my initial impression.  I did the same late in my pregnancy when I met the one member of the practice who I hadn’t seen up until that point.  I hated her from the first time I talked to her on the phone through the day of that first appointment with her.  By the second appointment I had with her, she was one of my favorite doctors in the practice.

Truthfully, pregnancy is such a difficult time to be making emotional decisions, judgments, etc.  My judgment can’t be trusted these days.  So in the interests of fairness, I must remember that odds were against me liking this OB from the get-go.  I don’t like change.  I don’t deal well with new people, new situations, particularly when I’m this stressed out.  So the obstetrician gets at least a partial buy on account of my emotional instability.

Truthfully, there was a lot more good than bad in that visit.  The OB didn’t have any qualms with me wanting to have a VBAC delivery.  He didn’t bat an eyelash at me stating unequivocally that I do not want an epidural in place (with the caveat that I needed to understand the risk that I may have to have general anesthesia in the event of an emergency caesarian).  He never questioned whether he would take me on as a patient – it was a given from the minute he walked in the door.  He was fine with continuing the protocol that I’m on for the hyperemesis, didn’t push TPN (he agreed with me that so long as I’m not nutritionally compromised, which I clearly am *not*, that we didn’t need to move to TPN).  His office staff is exceptionally nice, and although his office isn’t nearly as convenient as my former OBs office, it’s not exactly off the beaten path either.  Possibly most importantly, the practice has a midwife practice within it.  I have an appointment with one of the CNMs for January 14th.  No telling whether they’d be willing to let me have a midwife-attended delivery, but I can hope.  My perinatologist pointed out that even if they’re not willing to deliver me, I might get more personalized care from the midwives than the OBs, making for an overall more positive experience for the rest of the pregnancy.

So there’s lots of good.

Speaking of good:  I had my anatomy scan on Wednesday and Dr. P. came in and went over every detail of it with me after the sonographer had finished getting all her measurements.  I don’t remember going over the anatomy results in such detail with the triplets – though truthfully I’m not sure I could have laid on a table for that long with the triplets.  The baby has all the requisite parts – fingers, toes, all the proper parts of the brain, heart, etc.  It was hard to get a visual on the kidneys because the little monster was curled up like a pretzel, but we’re pretty sure they’re both there.  Baby is measuring just on time.  My cervix was shorter than it was 2 weeks prior, but still in a more than respectable range.  So far, so good.  Except, you know, the hyperemesis etc.

I know that this is all “worth it” for the toy surprise at the end, though I could certainly live with an uneventful pregnancy while still getting the toy surprise at the end, but since that’s not an option, I’ll take what I can get.   At least with my history/current medical state I’m getting a lot of looks at this little one – I’m at the perinatologists’ office every 2 weeks, and will at some point move to every week.  This kid may end up with almost as many ultrasounds as I did with the triplets – I had 33 ultrasounds with the triplets.  Crazy!

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Some of you may remember my tales of the Soap Fairy from over a year ago.  If you don’t, here’s the heart of the matter:

Until these babies came into our lives, I never realized how well Seth and I work as a team.  We never talk about it, but our lives are just pieced together seamlessly… effortlessly… in a way that makes our world keep moving.  For example, the babies came home I was washing my hands so much more often than I used to and I ran out of soap in the dispenser in our bathroom.  I scratched my head for a minute and realized I had absolutely no idea where we keep the soap to fill the dispensers.  It’s not so much that it’s “Seth’s Job” to fill the dispensers, it’s just that in six years of marriage there’s always been this magical “soap fairy” that has gone around filling soap dispensers and it had never occurred to me that this was a job that had to be done by an actual person.  I decided to look under the sink, and lo and behold, there was a very large container of soap which I used to fill the soap dispenser.  Turns out, there’s one in each bathroom.  My soap fairy had not let me down.  I had never realized that this was something Seth had always taken care of for me, and I called him that day to thank him for being my soap fairy for six years.  The first thing he did was apologize for not having filled it before I needed him to.

I’ll point out that I don’t think I’ve re-filled any soap dispensers since the night of that post.

Fast forward to today – now I’m pregnant, high maintenance, and, well, needy.  I have this stupid PICC line.  I get home IV fluids, I have a Zofran pump, I have IV medications and a million needs.  You’d think I could take care of myself, but I don’t – I’ll sooner sit there counting contractions than have it occur to me that I might need fluids.  Seth takes one look at me and sets up my IV without a word.  I invariably fall asleep without checking to see if I’ve got enough Zofran in my pump to get through the night – but Seth changes it when he comes to bed without a word.  He’d be so justified in telling me to take care of my damn self, but he doesn’t.   He draws up my meds, he reminds me to get fluids, he prepares my fluids (vitamins etc. get added to them) at night.  If I disappear without warning, he takes it in stride and then asks me if I’m okay when I return.  He’d be justified in being annoyed with my utter incapability to be dependable, but he’s never mentioned it.

I couldn’t ask for a better person to share my life with.  Sometimes, it’s really nice to know that you’ll be taken care of.  I never have to wonder who’ll take care of me.  I’m taken care of even despite myself.

I can’t imagine being more blessed.  Four kids and another on the way, and the best husband in the world.  Could a girl ask for more?  (okay, don’t answer that)

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I saw Yet Another New OB (YANOB) today. I don’t like him, but he’s willing to take me on. He didn’t give me any crap about a VBAC, nor about not wanting an epidural in place (provided that I understand that in the event of an emergency C-section, if they can’t get a spinal in, they’ll do general anesthesia and my husband won’t be present at the delivery. Frankly, that’s the least of my concerns – and anyway, if I don’t get to be there, why should he? We’ll have a lifetime to bond with the baby, so in the unlikely event of an emergency, I’m willing to forgo those few minutes).

He talks fast and doesn’t really act like he’s listening. He’ll ask a question, I’ll start to respond, and he’ll be talking over me before I’ve got two words out. I hate that. But so long as the perinatologist is on board, he’s willing to manage my care concurrently with them. He’s fine with me doing Progesterone injections for PTL prevention. If the perinatologist doesn’t want to order it, he will. He’s fine with the steroid course I’m on. He’s fine with my home health care company. The office staff is all really nice (at least the ones I’ve interacted with so far), which is a plus. It’s a huge practice, which in my opinion is a downside, but on the other hand, it also probably contributes to why they didn’t shy away from taking me on.

I just wish I had the luxury of picking a doctor that I like. Meh. I guess it doesn’t really matter.

He doesn’t deliver at the hospital that’s five minutes away (where Seth works, for crying out loud). So I’ll have to go half an hour (or more, with traffic) away to deliver, but I’ll live. It’s a fine hospital to deliver at, so I don’t really have an issue with that – it’s just way less convenient and frustrating because it would have been nice to be at the hospital my husband works for, but beggars can’t be choosers.

So, yay?

I wish I were more excited about it than I am. I would probably be more excited if I’d loved him, but I don’t. Oh well. I’m seeing my perinatologist tomorrow, and then back to YANOB in two weeks. We’ll see how it goes. At least I have someone I can call if something goes wrong now…

Um, that’s not an invitation for something else to go wrong.

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My officemate, who I haven’t seen for over a week because she was on vacation, looked at me today and said, “Every time I see you, you’re skinnier than the last time.” Admittedly, when I turned to the side to show her my profile, she knew exactly where its all going. Still, it’s disturbing that I’m thinner yet… you know, pregnant.

Well, you know? I always said I was just one triplet pregnancy away from my ideal body weight. Turns out, it’s just pregnancy. Maybe I’ll be a perfect size 6 when this is all done and over with.

Ahem. I am not counting on that, just for the record.

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So I don’t really feel like the steroids have helped a whole lot with the hyperemesis. I felt marginally better the first few days and kept a couple crackers down here or there, but not enough improvement to really be able to say it was the steroids that made it better. But there *have* been some benefits:

• The inflammation around my PICC site is almost entirely cleared up. I am quite certain that it is the steroids responsible for it because when it gets close to time to take the next dose, it starts gettting puffy and itchy again and recedes within half an hour to an hour of the steroid dose.
• My headaches/migraines are much improved. Not absent, but not constant either.
• The sciatica that had left me nearly completely immobilized last week is almost gone. I have occasional twinges here and there if I step down wrong, but nothing crippling like before I started the steroids.
• My overall itchiness? Just about gone. Before starting the steroids, I was so agonizingly itchy that my skin was raw from all the scratching. Nothing had helped it. Also? I no longer seem to be getting a rash from the Phenergan – I don’t know if this is related to the steroids, or just that I have acclimated to the drug. Either way – less itchy is awesome.

But, by far, the most intriguing side effect of the steroids is that I have a ridiculous burst of energy much of the time. Even yesterday when I felt more dreadful than I’ve felt in weeks (possibly months) – I had plenty of energy. My husband was working in the afternoon/evening, so I was on my own from about 2:30 on. Just as the triplets were waking up from their nap. I expected this to spell disaster given how yucky I was feeling, but I had plenty of energy for them. I gave them a snack, played for a bit, and did a bunch of cooking. I made three large mac n’ cheese casseroles (2 for the freezer) and toffee/chocolate chip/pecan cookies. Last week I made a big pot of beef stew (frozen in 1-2 person portions, depending on the person), curry chicken, schnitzel, sweet potato pies (I had three of the most ginormous sweet potatoes I’ve ever seen in my life – and they made three pies!), and white-cholate-chip brownies (the brownie mix came in a box, so it doesn’t necessarily count – but J helped and had a ball. He also helped with the mac n’ cheeses and the cookies).

I have never been good at cooking and freezing things. If I cook something, I want to eat it now, not later! I always think I’ll take a Sunday and cook kugels and casseroles and soups for the freezer so that I’m not so slammed all the time when it comes to cooking. But it never works out that way. Recently, though, J has been super interested in cooking with me, and it gives us things to do together with relatively low stress. It also makes him SLIGHTLY more willing to try foods if he’s had a hand in making it. Though he still wouldn’t eat the mac n’ cheese casserole. Oh well.

I wonder if this is what "nesting" is like. It’s way too early for me to be nesting (I hope!), and with the triplets, I never got to really know what nesting was like – I was on bed rest forever and so sick I didn’t have any energy most of the time, but I did have a couple days here or there when I would freak out about needing to clean and so and purge. I remember one day when Seth and J were out doing yardwork and I suddenly freaked out about space and I waddled out and said, "We have to get rid of the piano. I never play it, I’m definitely not going to have time to play it with three babies in the house, and it’s taking up SPACE! We could put a whole shelf, a changing table, feeding table, something, ANYTHING in that space! It has to go!" Seth looked at me, looked over at J, and turned and said, "I think perhaps we’d better come inside to work instead of being out here. I spent the rest of the afternoon in the attic freaking out about all the stuff we needed to get rid of. And purge, I did. But that was the exception, not the rule. Technically I shouldn’t have been up there at all, but fortunately, that was before some of the scarier times in the pregnancy.

I have niggling little thoughts about all the crap in our attic often, reminiscent of that summer day with the triplets, but hopefully I’ll be able to squelch it this time. Surely the cooking is at least useful. And I do have in my mind that we need to have stuff in the freezer, because I’m petrified that I’ll get to a point where I just *can’t* cook and I’ll have this family who needs to eat. J could live all year on chicken nuggets and apple slices, but Seth hates cutting up apples. And surely, the triplets ought to have more variety than that, lest they end up with such a limited palate as J.

It’s not nesting, really, but the energy sure is welcome.

So the steroids kind of suck (side effects e.g. severe reflux and oral thrus aren’t any fun), but overall? I’d argue that my quaility of life, for the moment, is largely improved.

Except, you know, the throwing up part.

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We’ve joked (okay, we were never joking when we said it) that the triplets combined are still less work than J is. And really? It’s been true. Part of that is the challenge of handling a child with ADHD, learning disabilities, and anxiety, and part of that is that the older a kid is, the more complex his needs. He’s less content to sit and play with blocks all day than he was when he himself was 2. He’s got school projects, therapy appointments, field trips, friends he wants to see… it just *is* more work to care appropriately for a six year old than for a two year old… even when the two year old comes in triplicate. But mostly, it’s the ADHD et al.

Until now.

I think we’re finally reaching a point where the triplets are higher maintenance than J. (Certainly, they are higher maintenance than he was when he was 2 – he never stopped moving long enough to get into anything, climb anything, empty anything out, or wreak havoc in general…)

The triplets, see, they are a team. And they’re crafty – plus they teach their tricks to the others. Ellie’s a master climber and although Sam couldn’t get the hang of climbing for a long time, inspiration from his sister got him moving and climbing. Abby can throw a temper tantrum better than any two year old I know – and she’s taught her tricks to the others along the way. Sam and Ellie got tired of being pushed, poked, pulled upon, and hit by their sister Abby – so now they gang up on her. Ellie and Abby mastered climbing in and out of cribs and Sam had to get in on the fun (though it took him almost a year longer to figure it out than it took the girls).

And now. Now the diapers. The girls have been little houdini-diaper-escapers for a long time. At least a year, I think. We’ve tried onesies. We’ve tried duct tape. We’ve tried backwards footie PJs. We’ve tried a onesie over a backwards footie PJ over a duct taped diaper. But they can get out of anything, especially Ellie. Not Sam. He was the good one. The one I said gets to go to college on account of his good behaviour (and his apparent lack of creativity necessitating more thorough eduction! JUST KIDDING). Until yesterday, that is.

Seth was working all day, so I had the four kids on a day when, you know, NOTHING is open so no activities to take them to. Seems like there’s this universal affinity for celebrating Christmas. I don’t begrudge it, but it sure would have been nice to get out of the house to a child-friendly activity. Who am I kidding, though? I probably wouldn’t have gotten motivated enough to get out of the house anyway… it was a Friday, after all.

Anyway, yesterday I put the triplets down for a nap. And of course they have no cribs anymore, so naptime is always a crapshoot. If I’d been smart, I would have stayed in their room until they fell asleep, but I wanted to get some things done. So instead, I wasted even more time by going back to their room to put them back in their beds over and over and over. At some point, it was clear that they were having a … little TOO much fun in there, so I went to assess the situation.

And I found three completely naked babies running around like maniacs. Yes, even Sam.

It seems that no one’s going to college. 😉

It could have been a fluke, right? I mean, Sam’s never done that before and it’s been WEEKS since I’ve found the girls without diapers. This was just a one-time thing, right? RIGHT????

Nope. Fast-forward to bedtime tonight… three toddlers running around like maniacs. Naked. I re-dressed them, put them down, waited for them to calm down and get sleepy, and then left the room. I heard them up afterward, but they weren’t too wild, and it was clear that they were winding down and getting tired.

Until I heard Sam screaming hysterically, so I dashed to the room as quickly as this pregnant body would allow only to find:

1 wide awake Abigail, fully clothed, and laying on her mattress sweetly,
1 frantic Samuel diaperless, PJ-less (though he still had his onesie on… and socks), soaking wet with pee,
1 sleepy Eliana, face-down on her bed, stark naked, with a moist, crumpled diaper next to her Teddy Bear.

I suspect we’re in for a few weeks of hell until they get over this particular fascination of theirs. But it’s fair to admit, at this point, that the triplets are starting to become just as high maintenance as J – in their own special ways. There’s much more refereeing to be had with the triplets, much more negotiating, much more parental attention to ensure they’re not hanging off the ceiling fans.

Why, J is looking downright low-maintenance right now. Provided he takes his medicine. At least, when all else fails, I can sit him down with a book, the computer, or a quick activity to get a break. And he’s also becoming much more helpful in general – he loves to help sweep, setting the table is a special chore I “let” him help with, he wants to cook with me as often as possible, he even helps clean up the triplets’ messes without (much) complaint. He can make his own bed (not perfect, but who cares about perfection?), he’s good at cleaning up his room (most of the time), he has simple needs when it comes to food (one benefit of being the world’s pickiest eater is that I don’t have to struggle to give him new flavors – he won’t eat them anyway… I”m kidding, of course, I do have him try new things often, but there’s comfort in knowing he’s got his old standby’s to eat and won’t get bored of them).

I wonder how I’ll feel about the high vs. low maintenance aspect when I have a ten year old, three six year olds, and an almost four year old….

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