Monday, August 31, 2009

Don't Worry

I am learning a lot about health care professionals through this pregnancy. Namely: Many of them think about your uterus, your fetus, your vagina as if looking at images of them in a medical textbook. It's all clinical. Routine. They do, after all, lack the emotional attachment you have to that fetus (and, let's face it, you're pretty attached to your uterus and vagina by now as well). They forget that there is an active mind – and heart – a few feet above those organs.

At least that's what I think was behind the actions of my favorite nurse last week, because I know she's not mean or unintelligent. As I drove to work on Friday I picked up a voicemail message from her, which she'd left the night before. She told me that she needed to go over my ultrasound results with me but she "didn't want me to worry" and I should call her at home. I don't know what kind of a person/robot/tin man could hear that message and not worry – a lot – but it ain't me. I called the answering service, which of course was no help at all (I really need to figure out a direct dial to reach those nurses before 9 a.m.). The minutes from 7:30 until 9:15 when I finally talked to the message-leaving nurse I think left me 20 years older. "What's wrong?" I said first. "I told you not to worry," she said. (Oh, okay.) Turns out, they just needed some additional pictures of the baby's heart because one part of it wasn't visible last week. And the reason she couldn't have simply said that in her voicemail is....?

Naturally when I heard the real reason for her call, my second feeling (the first being relief) was excitement that we would get to see the little guy on TV again. And this morning's follow-up ultrasound came at an opportune time: I got a sunburn at my friend's wedding yesterday, was certain that I had fried the baby, and glad for what I hoped would be a reassuring scan.

You know, in addition to learning about health care professionals, I'm learning that everyone else has been right: Worrying doesn't really do much for you. Because the thing is, what's likely to happen is rarely the thing that you thought of to worry about. It's usually something you never even considered. So it's not like worrying prepares you or anything. Because I definitely wasn't expecting the ultrasound tech today to tell me I was about to get reacquainted with the long-lost vaginal probe. She suspected placenta previa, she said, and needed a closer look. I sort of freaked (just a little). She told me it wasn't a big deal, and added, "You're a big worrier, huh?"

"Gee, where'd you get that idea?" almost slipped out of my lips automatically, dripping in sarcasm. But I held it in. She did, after all, take another quick peek at my baby's nether-region, to remove what I thought was a shadow of a doubt left by the other tech that it was a boy (this one was certain). So I guess I owed her one.

I have placenta previa – the good old wand told us so. It means that the placenta is lying low in my uterus, covering my cervix. I have been told how common it is. How in most cases, it resolves by the third trimester. I have been told to avoid jumping, aerobic exercise and running (which is really going to put a damper in my nonexistent exercise regimen), and to keep everything out of my vagina until they scan again in about nine weeks. I immediately asked about the giant plastic probe that had just been in said vagina moments earlier, but for some reason that doesn't seem to count (having been granted immunity, apparently, by the vaginal customs agency).

I have been told not to worry.

I am trying. I vow to try to stay off of Google. To try and take comfort in the statistics (they are on my side) and to trust the textbook medicine that my smart providers rely on. I am trying.

Tuesday, August 25, 2009

Team Blue

I always appreciate a good moment of comic relief when I'm overcome with anxiety. So I was actually more than a little relieved when the cap flew out of the gel bottle yesterday as the tech squirted gel on my middle in preparation for my 18-week anatomy scan, sending a big clump of warm goo sliding down toward the top of my pants. I laughed out loud, though the tech (who seemed, overall, lacking in humor), ironically, didn't think it was as funny as I did. It broke up the intensity of the moment.

She started the scan and, for inexplicable reasons, opted to first focus on one of the uterine fibroids that, yes, I am aware that I have. Can someone please tell me why they do this? Are they trying to drive us crazy? I came here to make sure that the child growing inside of me is thriving and healthy. Would you mind leaving that benign mass on the other side of my uterus alone until we get that 411? I asked her if she could please first take a quick peek at the baby to be sure he or she was okay ("go with the flow" is, unfortunately for health care providers, not my motto in situations like this). She assured me that she'd already seen the baby move before focusing on the fibroid, wrapped up her scrutiny of other parts and then panned over to the baby, whose steady, beating heart we saw immediately.

She slowly made her way across the anatomical landscape of the baby, pointing out the four chambers of the heart, the stomach, the kidneys, an arm bone and the umbilical cord. She spent a little too much time on the baby's brain, which sent my decreasing anxiety right back up the scale. Sensing this, she suggested that maybe she wasn't talking enough, telling me what she was doing. I told her a play-by-play would be really helpful, and it turned out to be, particularly as I squinted at the screen trying to decipher what I was seeing. Frankly, I don't know how they get anything from those images. I kept uttering "uh-huh" everytime she asked if we could see certain things, only because I felt it would be a poor reflection on my nascent motherhood if I admitted that actually, I couldn't see my baby's parts at all.

But I did see the baby's gorgeous, unmistakeable profile. The stretching out of long fingers and the adorable heel of a foot. A real, boisterous baby moving every which way inside of me. And oh, would it be impossible for someone to stop themselves from falling head-over-heels.

We'd told her that we wanted to know the gender, but as she was wrapping up she still hadn't gotten a clear view. She got a couple more pictures and then said she had everything she needed. Come again? She may have had everything she needed, but we were missing our one opportunity to get that critical information. I asked her, I'm afraid in a voice that may have had a tinge of whine in it, if she could do one eensy weensy last quick scan to see if she could find the gender-identifying part. I wasn't sure what she'd say – as I said, she wasn't the warmest – but she complied. And this time she found it right away. She asked if we could take a guess based on what was on the screen. I didn't see anything distinguishable, so I assumed a girl. "Look again," she said. "I don't think so." We took a closer look, and my husband (naturally) saw it first. She couldn't get a clear view of the whole thing, which made her think there was a small margin for error. But unless there is a random twig or pencil or other foreign object in there, we're having a boy. The other tech looked at it and said, 100%, it's a boy.

A boy. Oh boy. Let the fun begin. Though I felt terrible guilt admitting to myself that I was wishing for one or the other (how could I, after everything I'd been through, dare to hope upon hope that the baby would be anything but whatever it is?), I've always imagined myself as a mother to boys. Loud, rowdy, larger-than-life boys that I would drive around to hockey practice and other boy things. And here, spinning around in my uterus, is one of them. How can I describe the joy?

Tuesday, August 18, 2009

Take a Number

I think I'm starting to get the hang of this prenatal visit thing.

You sign in, a nurse calls you back, you pee on a tiny matchstick-sized paper with two colored dots on it and show it to her so she can determine if the dots changed color or something (All I know is it is impossible to know what to do with this stick once you pee on it for the required few seconds. You are still on the toilet, peeing, and you need your hands to wipe and pull up your pants. But you're holding a tiny stick that has pee on it, so eeew, you don't really want to set it down on the sink because then you may put microscopic drops of pee on the sink that other people have to use. But you don't want to put it on the floor, either, so really, do you have a choice?). Then you go back to the waiting room. Then eventually they call your name again. But first you might learn that your doctor has been called to two deliveries. And you therefore might end up seeing a different doctor in the practice, but at that point you don't care because a) you've already been waiting an hour and a half, you have to pee again and you're hungry, and b) as long as someone with an MD from an accredited medical school (doesn't even have to be top-tier) tells you everything is fine, that afternoon, you know you'll be a happy camper.

Such was the case for me, last week, at my 16-week prenatal visit. Need I even tell you – I was incredibly nervous, upset stomach, blahblahblah. The doctor who finally met with us turned out to be the head of the practice (so yes, he had an MD, from Harvard it turns out, so he passed), a man with kind eyes and a demeanor that instantly put me at ease. He came in and asked how I was feeling. I told him a few of the symptoms I'd had (mainly headaches), which he pronounced completely normal. I asked him if it was normal for the ravenous hunger of the first trimester to wane a bit; he looked at my chart and suggested that, since I'd gained nearly seven pounds since July 15, I was probably eating enough.

Then he did measurements – felt where my uterus was (halfway up to my belly button, which apparently is where it's supposed to be), measured its height and listened to the baby's heartbeat. I took out my list of questions, mentally crossed off the more neurotic ones and asked him a few. Then my husband and I were on our way.

An hour and a half wait for a ten-minute visit. But I got what I went there for: reassurance and more reason for confidence. For that, I would've waited all night long.

Thursday, August 06, 2009

Self-Fulfilling Normal Pregnancy

This morning I had an appointment at the hospital for my second trimester screening. This is the last third of the integrated screening (first trimester blood work and ultrasound + second trimester blood work), and at the time that I made today's appointment it seemed quite far away and impossible that it would ever come to pass. I imagined that if the day ever did arrive and, miraculously, I was still pregnant and in need of the test, that I would have become a different person. That I would've passed through some imaginary force field on my way into the second trimester that made me much wiser, more poised, a vision of maternal serenity.

Yeah, that didn't happen.

Instead, I lost everything in my stomach three times over before finally breaking free from my house and driving myself to the hospital. Doesn't matter that I was just going for a blood test and wouldn't even get any sort of results today. Like Pavlov's dog my body has learned that hospital trip = good time for intestinal overdrive.

Once in the waiting room, I strategized how I might finagle a heartbeat check. The test is done in the maternal-fetal medicine section of the hospital, not in my regular doctor's office, so I knew it would take some smooth talking. Still, I thought, how could I possible leave the place without reassurance? I resolved to get it.

But a funny thing happened once I got called back and sat down in the chair. As the nurse started chatting with me, her making small talk about lighter traffic and me lamenting that my ID stickers now listed "33" as my age, I felt like a normal patient. Like just another pregnant girl who would come the nurse's way today for a routine test that would probably come out okay. And I realized that I wanted to be her – just another pregnant girl. I didn't want to be the neurotic patient the nurse had this morning who tried to get her to do a test she wasn't scheduled for. I didn't want drama, I wanted normal. And I realized that if I chose normal and calm it just might make me feel...normal and calm.

So, even though the nurse was super friendly and I quickly assessed that I almost certainly could have talked my way into a doppler heartbeat check from her, when the blood was drawn and the band-aid on, I stood up, thanked her, walked out of the hospital, got into my car and went on with my day.

It felt good.

Saturday, August 01, 2009

Something So Right

It's been a few weeks. I turned 33, the spotting finally, mercifully stopped, my in-laws were in town and we went to my husband's family reunion in upstate New York together (note to self: next time you're pregnant, if there is a next time, don't go to the middle of nowhere at the end of the first trimester. Hungry – no, starving – every hour is not a good state to be when the only food to be found is greasy, made of refined flour or artificial meat products). I've been living my life, trying to go about my business and keep on top of the worry. I'd say I've done an adequate, if not respectable job.

I know I sound ridiculous – I even bore myself – still sounding alarms when I've finally crossed into the second trimester and nothing about this pregnancy, not even the spotting, has concerned my doctors (or anyone else). But there's a reason for the term "battle scars." A war – no matter if it's fought on a battlefield or in a doctor's office – doesn't simply disappear, even if the ultimate result is victory. You remember how it felt to fight so hard, all the sacrifices that were made along the way. All the things you lost. And freedom, the more you taste it, becomes that much more difficult to imagine giving up again. You think, What if I had to fight that war again?

I remember this one time, a few years ago, I was shopping with a good friend of mine at a thrift store when a shady looking man started edging toward us. He was making a strange gesture so I glanced down and saw that he was, quite unfortunately, flashing us. Seeing a penis in a public store seemed so out of place it took me more than a second to realize what it was. Naturally horror was my first and most intense emotion, but there was little time to be horrified. I suppose at some instinctive level I felt it was important to get him to back away rather than letting him intimidate us. "No!" I said to him, wagging my finger. "Stop – you stop that right now. Leave us alone." He immediately recoiled and left the store. My friend applauded my bravery. I just sprang into action, she said, where she would've freaked and ran. I told her I wasn't willing to forfeit the bargains I'd found for some pervert. Later, once it stopped being scary, we laughed so hard about it that tears ran down our faces.

You see, I'm good in a crisis. And I'd gotten really good at crisis management over the past couple of years. What I'm having a hard time figuring out is how to turn off all that adrenaline and just enjoy the fruits of my struggle, without questioning what can go wrong and when. As Paul Simon sang so true, I can't get used to something so right. But I'm trying, and I'm learning even though it's slow (the nurse who has seen me three times now for extra doppler heartbeat listens can attest to that). It's new territory that I couldn't be more grateful to be exploring.