Monday, 19 February 2018

Microblog Monday: accomplishment

Today I finished a task I’ve been procrastinating for more than a year: updating the photos in our dining room display frames. The photos there previously were all from AJ’s first year of life, not even including her first birthday. They’ve been feeling out of date for a long time. The goal is to highlight good photos of our family and also extended family.

This project involved:
  • Going through hundreds of digital photos that are not really organized, and copying photos to print into a file. The photos were on phones, email, computer and hard drive
  • As I went through them I made sure all the photos were saved to the hard drive
  • Uploading to website to print
  • Processing the order
  • While I was at it I made two poster collages for the girls’ rooms
  • Taking all the old prints out, putting them into photo albums, plus the other ~400 prints that I had just put in a box. We took an awful lot of photos of our firstborn.
  • Cleaning the picture frames 
  • Going through the ~120 new pictures I printed, choosing which to put in the frames, and putting the rest on the albums
See why this job gets done maybe once every two years?

Nevertheless it feels very good to have updated pictures.




Something else that’s cool: I am writing this on my phone with a blogging app! Maybe this means I will write more frequently.

Thursday, 15 February 2018

Two weeks baby/post partum

We've been taking it pretty easy the past two weeks. Considering January was packed full of appointments, decisions, schedules, plans and finally our date with destiny, it's been a huge relief to hibernate for a while....particularly since our city was buried in snow the week after Dani was born. What a relief to not need to leave the house or do very much at all!

Dani's two week update:
  • increasing awake/alert times
  • Lots of smiles, which are so adorable. People say newborns don't smile....they're just wrong.  Not only does Dani smile but her face blooms with personality when she does. I've even seen her chuckle to herself.
  • Like her sister, she appears very observant, even at a young age. She watches what we do and responds to voices.
  • Pretty good sleeper for a newborn. She does 2-3 hour stretches, maybe up to 4 hours occasionally. Nighttime feedings/diaper changes/rock and soothe still takes at least an hour though....longer if she decides to make a few more dirty diapers while she's awake.
  • She did seem to get the cold Mr. Turtle and I both caught around the time she was born. It hasn't interfered with her appetite but has made her fussier especially at night. Nasal drops and occasionally the nasal aspirator have helped.
  • Eats very well, has easily learned how to breastfeed. It came back to me too. If you had asked me last month to explain how to breastfeed, I'm not sure I could have done so but when I had to do it I had little difficulty. I had sore nipples for a few days after Dani was cluster feeding but careful attention to her latch has allowed them to heal and so far so good. She does get some pretty major spit up though. It doesnt seem to bother her but  it sure is messy. And I thought I had a ton of laundry before....
  • Dani feels very strong. She can already lift up her head and move it around. It seems to me that AJ did not have the same tone. Who knows, but this one may not be a late crawler/walker like her sister

Me, physically:
  • Post partum bleeding is light, with occasional gushes. I had an episode of bleeding yesterday that freaked me out and had me calling the health hotline....but everything was fine. Apparently it's quite common to have a sudden increase in bleeding a couple of weeks after giving birth.
  • Mostly healed up down below...occasional pain from coughing or sneezing. I didn't know I sneeze with my pelvic floor but there you are
  • My boobs are now in competition with Pluto for small planet status. They can cause me a bit of discomfort especially at night: they flop around at odd angles and can even make my back hurt.
  • Big appetite; not monitoring my weight but my little pooch in front has noticeably shrunk: I can even wear jeans (the bigger sizes I own). That's pretty awesome. It took weeks after AJ's birth for me to want to wear real clothes. 
Mental me:

Mostly I feel great. I had a wonderful birth experience, and since it was low intervention I have had a faster recovery time. We have gone to the zoo and out for breakfast a few times. I love being able to relax and focus on family. The last few weeks, especially at work, I was pushed to my limit time and attention-wise and I am not at all sorry to let that go. I'm enjoying doing domestic tasks like baking (and blogging!) I've kind of gone to the other extreme now where I will procrastinate anything I don't feel like doing: I'll have to find a happy medium in the next few weeks.

Post-partum is also a time for up and down emotions so I guess I shouldn't be surprised I have had some of those too. I have been thinking a lot about how Dani is likely my last pregnancy/child and I have ambivalent feelings about that. When I was pregnant I felt quite OK with it being the last time but now that she's born it feels more complicated. Since I know my pregnancy ended happily it's easier to view the whole process in a positive light and feel nostalgic about it and/or sad that my child bearing days might be at an end.  I feel like I need to add the qualifier....we probably won't have any more children, but I can't say so with finality just yet.

It's been a smooth transition so far to a four person family but still momentous. I'm giving myself some time to process it, and it's both happy and poignant.  We wanted this life change, no doubt about it but our previous life was very good too, and now that there is no going back it's both sweet and sad to remember it. The fact that I spent a long time not knowing if we could expand our family, and actively cultivating an appreciation for our three person family has probably increased these emotions.

As I mentioned previously, AJ looks like such a big girl beside Dani. After holding a tiny newborn all day, I go to give her a hug when she comes back from daycare and she feels huge. (We've left her in her daycare program for now, and will make decisions about her attendance in a few weeks). I still call her Baby but she is growing up and (mostly) embracing her big kid/sister role. And I just realized that AJ will be starting kindergarten in the fall of next year. When I realized this I started looking up schools and programs near us and freaking out as I thought about all the decisions to make: we have an elementary school a five minute walk away but it's a alternative program: would that be right for us? How do we apply? Does our daycare do transportation to kindergarten? Bloody hell, do I even want to go back to work if I have a child in kindergarten. Maybe I'd rather be walking her to school and volunteering in her class rather than being with other people's children. Argh, the school open house was in January. Why didn't we  think to go?

Okay, breathe. We have a year to think about that and there will be another open house.

Anyway. The future is exciting, and as we start to live it I do think I will embrace it. Whatever it looks like.

Wednesday, 7 February 2018

Night of the full moon: Sprite's breech birth story.

She is here!


Sprite, who in real life shares a name with this race car driver  and this tree arrived safely and swiftly on her due date, January 31st. Here is our story.

First of all, a recap of a few details:

  • Healthy pregnancy, with only issues being severe nausea in the first trimester, gestational diabetes diagnosed in second trimester (diet controlled). Compared to first pregnancy, I had much less anxiety.
  • At 37 weeks, an ultrasound showed Sprite footling breech.
  • Shortly after we started a variety of things to encourage Sprite to turn. Chiropractic work (Webster protocol), moxibustion, inversions, acupuncture and external cephalic version (ECV). First ECV, unmedicated, at Designated Hospital failed to get Sprite head down.
  • After ECV failed, we asked for a consult with the breech delivery team at New Hospital. Ultrasound showed Sprite still footling breech. We were given two options: 1) continue to monitor her position and 2) try the ECV again with spinal block. We decided to try both
  • During 2nd ECV Sprite was successfully turned twice, and turned back to breech, twice. I struggled with the spinal block and the operating room atmosphere. I really wasn't looking forward to a c-Section now, but we went ahead with scheduling a c-section at Designated Hospital and discussing gentle Caesarian birth with our doula.
  • At 39 weeks, however, another ultrasound showed Sprite in the frank breech position (bum down, feet up). We also met the other criteria for a breech birth at New Hospital: not too large baby, amniotic fluid good, no cord issues, healthy baby. The fact that I had had a previous vaginal birth also improved our chances. We rescheduled our c-section for a few days after the due date in hopes that it wouldn't be needed (but I wasn't willing to go a long way past due date to meet our baby, either).
 Week 39, and the consult with the doctors at New Hospital marked at turning point in my mental state. I felt very ready to have this baby, one way or another! I felt quite good about our decision to attempt a breech birth, but also a little anxious. There is a bit of history (and politics) around breech birth and why it is not widely available, but I won't get into that (this will be a long enough entry without). Speaking for myself, I know people who have had a cephalic vaginal birth (including me), and I know people who have a had c-sections, but I don't know anybody who has had a breech vaginal birth. Knowing that we were taking "the road less traveled" caused some trepidation and self-doubt.

There also wasn't a lot online or in my birth books to give me confidence. Most websites talk in general terms about why breech births are no longer common (OBs have lost the skills over a generation or two, and/or breech birth is considered riskier, if not by doctors then by their insurance companies). I did find and watch some videos of breech birth, but while fascinating these were either home births or happened in different countries: they didn't show the way our birth was supposed to take place. My "Birthing From Within" book only included one breech birth story, and it happened in a hospital and was a negative experience, unfortunately.  The literature that would usually give me confidence was almost all about cephalic birth, which didn't exactly erode my confidence, but didn't help it much either.

Ina May's Guide to Childbirth did include one breech birth story, and I found it helpful. In this story Ina May talks to a first time mother who is carrying a breech baby and is worried that it is too big to get out of her. "You're going to get HUUUUUUGE" Ina May assures her, and forms her hands to the size of a grapefruit. During her birth, the mother repeats "I'm going to get HUUUUUUGE" to herself as a mantra, and she does, delivering without issue.  Ina May also shares other images of the female body getting huuuuuuuge, including one of my favourites, the Sheela-Na-Gig. With this in mind I came up with an inspiring image for myself: a grapefruit with a Sheela-Na-Gig drawn on it.


As it turned out, I never got around to drawing on my grapefruit and taking it with me to the hospital (I drew this one after the fact). But the mental image of it did help give me confidence.

So what was our plan? We discussed the following at our consult with Dr. W at New Hospital:

  1. If my water broke, we would go immediately to New Hospital
  2. If I started contractions, I could labour at home for a while, but not as long as one would for a cephalic birth (maybe a couple of hours at most), then I would go to the hospital
  3. At the hospital, baby and I would be assessed and another ultrasound performed to check baby's position
  4. There would be constant fetal monitoring. However, other than that, no interventions such as pitocin. The idea is that, if it is going to happen, a breech birth will happen on its own.
  5. Time limits on transition (90 minutes) and pushing (60 minutes). Dr. W reassured me that for second time moms in particular, those are very generous limits. However, going over those limits and/or fetal distress would be reason to have a c-section. 
  6. The birth, or "pushing" phase would happen in the operating room with a full team standing by in case c-section was needed
  7. I asked about epidural. Dr. W. said it was mostly patient choice. It is easier to push without an epidural. However, that was more for first time moms: he didn't think it would make much difference for second time moms. In the case that forceps or an emergency c-section needed to be done, it helped to have an epidural placed in advance, otherwise they might have to use forceps without anaesthetic (ouch) or use general anaesthetic for surgery. I leaned toward no epidural as I knew it had limited my movement with AJ and I felt that if I was going to have a successful breech birth, I needed to be able to move my body.
  8. Dr. W went over worst case scenarios. The head might get stuck, leading to asphyxiation or spinal damage. If they couldn't get baby out, there was a "hail Mary" operation where they cut open the mother's pelvis, which has a high chance of maternal death. He added that nobody in the hospital had ever done such an operation and it was very unlikely, and I was a good candidate for breech birth. I listened to the reassurance but of course it was scary to contemplate these possibilities. 
After the consult, Dr W did the membrane sweep. He was able to open the cervix a couple of centimetres.  I went home feeling like I could go into labour anytime now, the sooner the better. I thought that once I was in labour I could cope with it, but it was uncomfortable to be waiting to see what would happen. But other than an increase in Braxton Hicks and some spotting, the next days were quiet.

Over the weekend I finally finished packing the hospital bags. I kept busy with various chores and other procrastinated tasks. I grocery shopped and cooked and  baked. Mr Turtle was at home with a bad cold. Tuesday January 30th, I talked about possibilities for labour induction with our doula. I had an appointment on the 31st to have the membranes swept again. Our doula, Joanna, also suggested acupuncture to encourage a strong labour.  I scheduled the appointment.  But then we started to have doubts. Joanna had another client who was very overdue. She was concerned that we might go into labour at the same time. Mr Turtle went to see his doctor who sent him to be tested for influenza. He raised concerns about a newborn being exposed to flu, if he had it. So by Tuesday evening I was leaning toward not inducing the next day.  I picked AJ up from daycare and as we were driving home I pointed out the big, full moon in the sky. It was of course the super blue blood moon. We had a nice dinner and I had a snack around 8:30 pm and went to bed.

Credit: Neight Elder

I woke a few minutes after midnight on the 31st with liquid pooling between my legs. I registered "water break!' and jumped out of bed fast enough to save the sheets and mattress. It was a very weird sensation. I threw on a pad and went to find Mr. Turtle, who hadn't gone to bed: he was playing video games. Mentally we found the right place on our "flow chart" of possible events (water break=>hospital!) and went into action. Phone calls were made to my FIL to come pick up AJ, who would spend the night with them then go to my mom's. Our doula was notified and asked us to let her know when we were checked into the hospital. I got sort of dressed. My pad had already soaked through. No contractions. The in-laws had arrived and we were ready to go by about twenty to one. I tried to tell AJ what was happening but she seemed too sleepy to respond. However, according to FIL she knew exactly what was going on and told them on the car ride over.

It was a quiet night and we had about a 15 minute drive to New Hospital. I was mostly calm but also had some anxiety. When had I last felt the baby move? There was no discernible movement at the moment. What would they find at the hospital? what would happen next? The radio played mellow Celtic music...such as the song "Both Sides the Tweed." I sang along quietly. I thought I felt some gentle contractions: little more than Braxton Hicks.

We arrived at the hospital. I was having more noticeable contractions as we walked in, but nothing painful and I had no trouble walking and talking. I started paying some attention to my breath, but more to practice than out of necessity. We checked in and went to triage. I was hooked up to monitors which found a strong steady heartbeat (phew). An IV was placed as this was standard for breech deliveries. I sat on the bed with the back up high as that was most comfortable. My contractions were getting stronger, and I felt them mainly in my lower back. I started to cope by sitting up straight and digging my fists into the mattress. As they became more intense I would also press my fists into my lower back. Despite the IV I still felt thirsty and sipped water regularly.

When the triage nurse heard we had a breech baby, she said "Breech births are so cool!" I found this statement reassuring. "Oh, so you've seen some?" "Oh yes!" she said enthusiastically. This helped me to feel like I had come to the right place. The resident I saw next did not inspire the same confidence somehow. Although she said and did all the typical things she did not seem very sure of herself. She asked if I have been told the risks of breech birth. This brought to mind asphyxiated babies and pelvises sawed open: images I didn't need at the moment. I said yes, I was aware of the general risks but with regards to my particular case, I was relying on their expertise to stay informed. Dr. Resident then did an ultrasound. She took a long time to locate both legs but was finally satisfied that they were up and no feet were presenting. She also did an internal check and said I was dilated 4 centimetres. This was encouraging and I continued to visualize grapefruit. (For comparison, I was only 2 centimetres dilated after 24 hours when I was in labour with AJ).

Next the OB on call, Dr. Z came in. She said we were good to do "trial of labour."  There was some uncertainty if I'd signed the consent form for breech birth because I didn't remember doing so, but I must have because I didn't hear about it again. She said that the plan was for me to labour mostly "hands off". Because my waters had broken, they would avoid doing many internal checks. I believe she said they wouldn't bother again until I was "quite uncomfortable".  Dr. Z went over mostly the same information I had discussed with Dr. W earlier. The ward was quite busy so we stayed another 30 or 40 minutes in the triage room. I went to the bathroom. I was starting to cope more actively with labour and the contractions were about 5 minutes apart. I tried not to think too much about them and when Mr. Turtle timed them and told me, I said that was nice but I didn't really care.

Finally, a birthing room was open (around 3am, I think) and another cheerful nurse came to show us there. I walked on my own. I had to stop a few times on the way to the room to lean on the wall and breath through the contractions. Cheerful Nurse sang the praises of the labour nurse assigned to me: her name was Janet and she had been a midwife in England. As we walked to the room Mr. Turtle and I joked about  my butt hanging out of my hospital gown, the fact it was a full moon and how we hoped to see another "full moon" tonight as our baby would be born butt first.

In the birth room, I climbed back on the bed with one foot curled up, one foot down. I was slightly annoyed that the bed was too high for my dangling foot to reach the floor. The contractions were increasing in intensity and frequency and I started to vocalize through them, mostly low hums and grunts. Janet was very steady and helpful. At one point I stood during a contraction and leaned on her. She definitely helped me feel safe and calm. I asked for a hot pack and Mr. Turtle put it on my lower back during contractions. My attention was starting to move inward and the other people in the room felt like they were at a distance from me. I was still hooked up to the heartbeat monitors but I wasn't paying too much attention. The monitors needed frequent readjustment because true to my intentions I was not sitting still. There was not much of a break between contractions anymore, and I was starting to feel them in front as well as in my back.  Janet kept trying to take my blood pressure between contractions but there was some kind of problem with the cuff: it wasn't getting an accurate reading. She finally gave up. But all this contributed to a fuzzy sense that baby and I were on one timeline and everybody else was on another.

After I had been in the birth room for a while I felt like I really had to pee, so I went to the bathroom. Nothing happened though, and I rode out about 3 contractions on the toilet before giving up. Janet asked if I would like a birth ball, and I said yes. I sat on it and leaned on the bed, which was where I stayed for the rest of labour. I came out of my daze long enough to ask Mr. Turtle if he'd called Joanna to update her. He said no, he'd better do that. In the back of my mind I thought we should have called her a while ago but I wasn't able to focus on the thought.  My labour continued to get stronger and I started to vocalize very loud. I was staying ahead of the contractions mentally and with my breath but it was getting very challenging. Joanna heard me groaning over the phone and was a bit shocked, realizing that things had progressed quite far. She started on her way.  My body temperature was fluctuating. In between contractions I felt hot and threw off my skimpy hospital gown. But during contractions I felt cold. I managed to communicate (with difficulty) that I wanted the gown off between contractions and over my shoulders during contractions.

Sometime around 4am (I'm estimating) Janet went on her tea break, and Michelle came in to cover for her. I vaguely heard Janet updating Michelle, telling her that I had started off coping easily but that it was getting more difficult. I continued to sit on the ball and lean into the bed, and was beginning to feel a bit frantic. Michelle asked if I wanted laughing gas. I said OK. The gas canister arrived and I felt like I was watching everyone move in slow motion, trying to get it set up. I had the impression the hose on the tank was all tangled up and they couldn't untangle it. This was probably not true but in any case the gas never made it to me.

The contractions were incredibly intense now and I felt like I was right at my limit, maybe over it. I started to howl and yell in a less mindful way during contractions. I felt like they were overtaking me and I was losing my ability to cope.  Michelle asked me at one point if I felt the urge to push. I said yes, a bit. She asked if I felt that only during contractions or also in between. I said only during contractions, but I was not really sure. Despite my intention to labour without an epidural, I thought an epidural sounded awfully good right now. But before I could find the words to vocalize this thought, I had the most irresistible urge to push.  It is hard to describe as I have never felt anything like that. Ina May Gaskin gives this advice to women who are afraid of what happens in labour: "Let your monkey do it." Meaning, don't try to intellectualize or control what is happening: labour as if you are an animal. My monkey was now 100% in control. I could only holler: "I need to push! I need to push!" while my body bore down madly. It would have been about 4:15 or 4:20 now (I was not looking at the clock, obviously).

I think Michelle said: "If you are feeling that way, you need to get back on the bed!" but she might as well have told me to hang upside down from the ceiling: I had no idea how to do that. I squatted over the ball and pushed with every piece of my being. Strangely, there was no pain anymore, just the feeling that I was about to take the biggest dump of my life. Suddenly, I was startled to feel something globular and wet between my legs....not a poop! I began bellowing "The baby is coming! The baby is coming!" The evidence of this very thing was plain through my mesh hospital underwear. I rather regret not having the presence of mind to notice Mr. Turtle and Michelle's expressions at that moment. Michelle now insisted I get back into the bed, which was not at all easy to do, considering my urge to bear down and the fact that a baby was falling out of me. Left to my own devices, I probably would have spread my legs and said "Ready....set....catch!" As it was Mr. Turtle and Michelle somehow got me onto the bed: I have no idea how but I guess they each grabbed a leg and hauled. The hospital underwear also disappeared at some point.

Every bright blazing light in the room was turned on, and people began pouring in. I continued to yell that the baby was coming and who knows what other nonsense. Everyone kept paging for a doctor, and it seemed to take forever for Dr. Z to arrive, although it was probably only a few minutes. I was vaguely aware that we were supposed to be doing this in the operating room and that it was not going to happen that way: was that bad? But mostly I was in the moment, and not focused on "should have beens." My feet were put in stirrups and Mr. Turtle and Michelle were holding my hands since apparently I kept reaching down to the baby (but I have no memory of this).

Finally Dr. Z and Dr. Resident were both in the room and everybody seemed organized. Someone told me the baby was peeing. This humourous and prosaic detail was reassuring (she also pooped, as breech babies usually do). With everyone in position, I got instructions to take a breath, hold it, and count to 10 as I bore down. This was briefly confusing to me because I did not feel like my conscious mind was in charge of pushing: it just happened. But I managed to reconnect with my body and bore down on cue.  Again there was no pain: just a burning sensation as the perineum stretched. It was simply a physiological urge on a magnitude I had never experienced. But it didn't matter what I knew or didn't know. Let your monkey do it. 

One push, another push...or two...I knew she was coming but I could not see her.  The last was the head. This is of course the critical part in a breech birth, but I was not worried: this baby was greased lightning and she was not going to get stuck now. Dr. Resident was pressing on my lower abdomen as I pushed out the head. Suddenly - plop! I see a baby. She is grey and purple looking but has a human face and open eyes.  It is 4:29am. They put her on my abdomen. Mr. Turtle gets to cut the cord. I was apparently laughing and cheering madly....in an ecstasy Mr. Turtle said. All I remember is being astonished at what I have just done.


Sprite was put on my chest and was immediately alert and active. She was crawling around on my chest looking for a nipple, and somebody helped her to latch. She remained at my breast for the next hour, nursing on both sides. Joanna arrived shortly after the birth. It is too bad she missed it but it was great to have her there to assist me and talk to me after the birth. It also allowed Mr. Turtle to go take a nap, since of course he hadn't slept all night and was sick. One great thing about New Hospital is all the birth rooms have a bed for the support person to sleep in. 

I had some difficulty delivering the placenta as my bladder was very full. They had to put a catheter in to empty it, and then I pushed the placenta out. I also had a second degree tear which required some freezing and stitching. All the mucking about in my nether regions was uncomfortable but at least I had Sprite to distract me.

The high I had from the birth lasted all day and I felt very peaceful and blissed out.  In the pictures from after the labour I notice how healthy I look, compared with after AJ's birth. I bounced back quite quickly: it was much easier to go to the bathroom and regain normal functions without the after effects of anesthetic or major tears. We left the hospital a bit over 24 hours later with a healthy baby and happy mom and dad. Breastfeeding has continued to go well. I had a couple of hairy nights when Sprite was cluster feeding, but it served to bring my milk in and she is quite a chill baby so far. As of this writing Sprite....hereafter Dani....is a week old, alert and responsive, a great feeder and a decent sleeper for a newborn. Mr. Turtle was able to take a couple of weeks off work so we have been relaxing and settling into our new life as a family of four.

AJ has been doing really well, too, I think. She talks lovingly of her "baby sister" and likes to give her gentle pats and kisses. She is working through the idea of an expanded family in her own way: For example she likes to count us: "One....two....three....four!" and give us titles: King Daddy, Queen Mommy, Princess AJ......and Princess Dani. But I feel like I have lost my oldest baby. AJ was always little to me, and now she looks huge by comparison. She is indeed the Big Sister, and although I love her to pieces just as she is I feel like she has grown up even more since Dani was born.  The contrast is just too obvious.


I look forward to writing more as we embrace our new reality, both joyful and poignant. Thank you to everyone who reads and I wish you many blessings on your path.




Friday, 26 January 2018

Breech baby birth preparations

I start posts and then don't finish them and they feel out of date after a few days. I finally have a slack day, and can't concentrate on anything else, so here goes, I'm going to start and finish a post.

We've done our best to keep our options open with Sprite and she is happy to keep us guessing! I think we have a plan now....and I'm ready for her to be here. I hope my body gets the message my mind and emotions are sending.

Update:

  • Last week (just last week??) I met with the breech birth team at New Hospital. They did a detailed ultrasound that showed Sprite still footling breech. That meant we were not candidates for breech birth, but they offered to 1) continue to monitor with weekly ultrasounds 2) attempt a 2nd ECV with spinal anesthetic. We decided to try the 2nd ECV. (We'd already tried ECV without anesthetic at my regular hospital and the OB was not able to turn Sprite all the way). I was super busy that week finishing up at work, and the decision was made quickly. I am not sure what I expected, but generally I thought this ECV would  be easier. Yes....and no. I did not feel pain but the procedure was both physically and emotionally intense and I struggled with the spinal anesthetic: I positively hated the feeling of being paralyzed and not feeling my body.  I was fighting panic throughout it. I had an epidural when AJ was born and I do not recall having that overpowering icky feeling, but an epidural is not quite as strong I suppose. Mr. Turtle observed that I handled the pain and discomfort of the first ECV much better than being anesthetized. As for Sprite, they turned her head down successfully....twice. And she turned herself right back to breech....twice. So that was that. However, it provided some information: 1) Sprite isn't keen to turn for whatever reason, and 2) I know what I have to prepare for if I do end up in a c-section with another spinal.
  • Sprite continues to be breech at 39+ weeks, BUT an ultrasound yesterday showed she has moved into frank breech position (bum down feet up). She is around 7 pounds, healthy, has a normal amount of amniotic fluid, and chin is tucked in (flexed). So that made us a candidate for vaginal breech birth at the newest hospital in our city. At present that is plan A. 
  • I had a c-section scheduled  for the due date mid next week, but after breech birth became an option, we decided to put that off a few more days.  I could schedule as late as 10 days after due date but I'd rather not: I don't want to rush this birth but don't want to wait a really long time either. Personal preference/gut there.
  • I continued chiro/acupuncture this week. We have an active, mobile baby but she doesn't want to go head down. However, my pelvis is nice and mobile apparently!
Heh, so how am I feeling? I really feel ready to have this baby one way or another. I am a bit sorry it is not a conventional vanilla birth. When it comes to this baby stuff, boring is better in my view. But we have been getting great support from everyone and I feel good about the decisions we are making. I am glad we have actually been given options. It is not super common to try a breech birth, but it is good to have an option other than surgical. They are very strict about whom they allow to try and under what circumstances, so we are in good hands. If there are issues we can still have a c-section (in a nicer hospital environment, so that's another plus).  Of the people whom attempt a breech birth at New Hospital, overall 50% have a vaginal birth and 50% have a c-section. However, with second time moms it's more like 70% have a vaginal birth and 30% have c-section. So, the odds are it can happen.

The hospital bags are packed...mostly, finally. The laundry is all done. We're ready! (Except Mr. Turtle has another cold/sinus thing going on. Bleah.) I'm not totally freaking out. I had a lot of braxton-hicks today and they did a membrane sweep at New Hospital. Not sure if that will do anything but I'm ready for action and ready to be done speculating. And ready to meet someone very special!  Fingers crossed.

Sunday, 14 January 2018

What am I doing

I keep updating the blog in my mind, but actually finding the time to put mind data into actual words....it's just hard!

I am almost at the end of this pregnancy. The really important part: baby is healthy, far as anyone can tell.

The curveballs:


  • I've mentioned the gestational diabetes. I am diet-controlled, and lately, I seem pretty good at it. No sweets, no sugar (that was sad over Christmas, but bearable), no fruit juice and no fruit with meals though I can have fruit after meals. Lots of protein and fiber and vegetables. Basically, when Mr. Turtle cooks good news, because he does lots of protein and we use whole wheat pasta and have found a quinoa recipe or two that is not too boring. When I cook, bad news because I like comfort food and my instinct is to make everything carb-a-licious. Eating out is generally bad news too, even if I try to get the healthy, protein-heavy option. But my two ultrasounds since diagnosis show Sprite growing just fine so I guess I get a B+ or something on this.
  • At 36 weeks I went for my regular appointment at the maternity clinic. Dr. VE (same who delivered AJ, coincidentally, or I guess  tried because she was actually delivered in OR) measured my belly, palpitated and did brief internal exam. She said she'd like to send me for an ultrasound, because I was measuring a centimetre small (and AJ was small for gestational age so I have a "history" of smaller babies), and when I asked her if the head was down she said, "I think so" but then she hemmed and hawed and said it was unclear and she "doesn't like surprises." Still, I didn't read much into that so it was a surprise when the ultrasound (@ 37 weeks) showed Sprite as incomplete breech: head up, one leg curled under and the other up by her nose and arms doing God knows what.
The ultrasound threw us into a "what the hell to do about breech baby" frenzy. That's been what the last few days have been about. I'm over 37 weeks, so the likely answer to the question is we can't do much and will end up with scheduled C-Section. However, we've decided to try some other things first and see if they help.
  • regular inversions (anytime I can find time and a couch to turn upside down)
  • Breech tilt once a day (I find this so comfortable and easily stay upside down for 20 minutes or more)
  • External cephalic version last weekend, which failed (They got Sprite about 3/4 of the way, but could not get her head into pelvis). I got lots of compliments on my ability to endure pain however.
  • Webster protocol (chiropractor) several times in the next few weeks: the idea behind this is the back part of the pelvis can get out of line and twists the uterus, causing less room for baby, so they avoid going head down.  Webster attempts to correct this by re-aligning the SI joints
  • Acupuncture...haven't done yet but scheduled.
  • Possible consult with the breech delivery team. There is one hospital in my city that will attempt a breech vaginal delivery if certain conditions are met. I don't know if we meet those conditions (probably not with incomplete breech) but I said I'd still like to know for sure, and my maternity clinic has been supportive of this.
This is, obviously, making the weeks leading up to the birth rather more stressful than they could have been in an ideal scenario, and I am disappointed in that I would prefer a birth with as few interventions as possible. Also, all through the pregnancy people have been telling me that the second child is easier to birth and obviously I hoped that was true or that I would at least have the chance to find out. Plus I have that great pain endurance and labouring technique! All for naught? But on the other hand we have been approaching the matter quite logically and I think I'm comfortable with trying All the Things to turn baby and if it doesn't work, accepting that we did our best and so did the people supporting us, including medical team.

Next week is my last week at work.  I am mostly confident I will  get all the stuff done there too, though it's a bit insane. I am taking some time off for appointments but will also be trying to get work done when I'm off. Yep, taking time off work to do work. Whatever. Dr. Clarissa Estes tells a story of a woman who made sure she scrubbed the kitchen spotless before she blew her brains out with a shotgun. Gruesome, and I'm not comparing mat leave to violent suicide, truly I'm not, but I am definitely the type that scrubs the floor before blowing my brains out. Nobody's going to come in and say I left a mess, whatever happens.

Preparations at home: going pretty well! AJ now has her big girl room, and we have a nursery with baby clothes and diapers and furniture in it. It's a real thing not a room full of junk. Not a Pinterest nursery by any means but it was never going to be, even AJ didn't get that FFS. We got this. In an alternate universe I would include some pictures but in this universe I have to get to bed.

Have a beautiful week!


Sunday, 3 December 2017

Getting ready/Not ready

One of the things I struggled with in my pregnancy with AJ, even after reaching third trimester, was having the confidence to get ready for an actual baby. A month or so from delivery, I needed a push from my mom to go buy baby clothes.

With regards to clothes at least, I've gotten over this aversion. I have organized AJ's tiny stuff with the intention that Sprite will wear lots of hand me downs, but I want her to have things of her own, too. So I took a few minutes one day and bought some "going home outfits:

Kitty cat ears are a thing...and yes those are AJ's toes...


We are also on a schedule, and (were) mostly sticking to it, to get the house ready for a second baby. We already have all the major baby items (furniture, stroller, bassinet, highchair etc.) so not much needs to be done there. Most of the work involves tidying and reorganizing the house to free up the extra bedroom. AJ's baby furniture will move into her sister's bedroom and she will get big girl furniture. Mr. Turtle and I will get a new item or two as well as we move clothes and other possessions into our master bedroom.  Sounds simple, in reality it's actually a lot of work.

I was anxious to have these steps done as I wanted to focus on nesting in December, and Christmas stuff, not on house jobs. But seeing as it is December already, this is not likely going to happen. My visions of peacefully making batches of Christmas cookies with AJ and adding sentimental touches to Sprite's room on peaceful weekend afternoons as the Christmas music plays and snow falls softly outside.....natch. For one thing, we keep getting sick. Weekends arrive and one or more is down for the count and the other staggers around in a daze trying to get enough done to survive and be sort of ready for Monday. My Christmas hat and apron is lost somewhere at school, misplaced on an afternoon when things went south (see below for more on that). Hopefully not irretrievably lost.  I've also been diagnosed with gestational diabetes and not sure anymore if I'm managing it well enough through diet.  I'm still hoping to make some cookies, but I bowed out of a cookie exchange with a friend and her friends. I'm sorry about that because I'm really trying to do more play dates and social things. But it just ain't gonna happen. Also, immersing myself in sugar and baking is probably not the best thing for the GD.

I also need some time to be mentally ready for a baby.  I had a reminder of that a couple of Fridays ago, when I had some unusual symptoms, possibly related to the gestational diabetes. I had an ultrasound at 30 weeks that showed Sprite exactly on the 50th percentile, healthy and practicing breathing.  Also, my initial tracking of the GD showed it under control. So that was all positive.

Usually the GD is symptomless, but this particular Friday I drank part of a juice box (not my usual behaviour: long-ish story involving various events at work leading to self-neglect and dehydration). A few minutes later, after the students had left for their gym class, I found I was having trouble seeing the words on my phone and computer screen. After 10 minutes of shaking my head and squinting, I realized something was kinda wrong. A google search revealed that blurry vision can be a symptom of high blood sugar. I didn't take a blood sugar reading (why not? No idea. I'm not always logical).  I went to the office so I would be around people if I passed out or something. I ate protein and the blurriness eventually went away...but then I developed a headache. After a few phone calls, I ended up in labour and delivery to be "checked out." I think this was mainly because my regular doctors were not in the office to see me (being Friday afternoon and all) and the nurses on the health help line almost ALWAYS tell you to go to emergency or the hospital.....sigh.

So, I spend several boring hours in L&D. I was hooked up to a heartbeat monitor. Sprite kept moving around which didn't make it easy to get the readings. I was also tracking movement with a button. I had blood and urine tests. It all checked out fine, other than showing I was dehydrated. My blood sugar was fine by the time I got to the hospital. I think the  reason they kept me so long was my symptoms were similar to those of serious conditions like high blood pressure (which I didn't have) or pre-eclampsia (nobody mentioned that but I googled it, ha).

I consider it a good sign of my mental health that I was not freaking out about being in L&D. I can imagine if this happened during my first pregnancy I would have been terrified. But mainly I felt bored and wished I could get out of there already. I also saw women in labour coming in and others leaving with new babies. I definitely do not feel ready for that! Maybe in a month, maybe after meeting with out doula....not now!  I was so desperate to be OUT OF THERE.  Luckily we had a date to go to a long time friend's open house (they are moving out of town). Albeit arriving late we had a good time there, played silly games and enjoyed some laughter therapy.

So, overall things are fine. My early Christmas wishes are for 1) better health in general for our family and 2) time and energy to accomplish things. It's frustrating to feel stagnant and like things are piling up around me, while I drag my butt around.  It remains to be seen what happens with the GD, but I hope I can keep my good attitude.

On a positive note we went for maternity photos a few weeks ago, and they turned out lovely. Since we had these beautiful photos, I did something I have not done before and officially announced the pregnancy on Facebook. The wave of support and happiness resulting has cheered up a dreary weekend. And it was nice to see what a few hundred dollars to professional photographers/hairdressers could do for our image. It's worth it.  A few examples that are sufficiently anonymous for the blog follow:





Sunday, 12 November 2017

A few words about how we got pregnant (and at least as many in caveat)

Sprite and I are entering the third trimester, with no known complications so far other than mild gestational diabetes (I might write about that in another post, although there's not much to tell). So I feel mostly OK about writing a post about our success getting pregnant.

A few things you won't find in this post:

  • Advice on how to get pregnant unassisted. I'll say what worked for us, but I'm not claiming it will work for anyone else.
  • New scientific information. I wish I could give you the science of why conception happened this time, because that might be useful, but I don't know unfortunately, and neither does anyone else.
  • Trying to conceive woo (I don't believe in it, and I don't practice it.)
  • Lifestyle advice (again, I'll say what worked for me, but it isn't anything special)
So what's the point? Well, first I assume people are curious. I'm curious about other people. Secondly, there might be readers out there in similar circumstances who will find this information useful, anecdotal as it is. Lastly, perhaps it would be helpful to read someone be very matter of fact about how they beat the odds of infertility, which is what I intend to be. Don't get me wrong, Sprite and her older sister, AJ, are miracles that rock my world and my whole perspective on the universe. But that's a topic for another post, or several over a lifetime.  Lastly, as I move through this pregnancy, I'm thinking about ceasing to try to conceive, permanently. Part of this involves revisiting pieces of the odyssey, honouring them, and hopefully giving them their permanent place in the past.

Here is the summary of our fertility status. According to the doctors, both Mr. Turtle and I are infertile, but having achieved two pregnancies after our diagnosis, I think subfertile is more accurate. It's the word I use however, not the one our doctors use.

  • I was diagnosed with severe premature ovarian failure by our fertility doctor, Dr. Cotter. In her words, at age 33 my ovaries were functioning "like those of a 45 year old woman." The implication being that things would only get worse with age. After we had AJ however, she added "Clearly there are some young eggs in there."
  • Mr. Turtle has sperm counts that fluctuate from very bad to not so bad. He has Crohn's disease (currently in remission) and takes an immuno-suppressant medication. Either the disease or the medication or something about his current health causes a genital lymphedema that flares up periodically especially when he is sick. He has observed a drop in sperm count/quality when the lymphedema is bad, although Dr. Cotter said it shouldn't affect the sperm until 3 months later.
  • We have been trying to have children since the fall of 2011. There were periodic breaks, particularly right after Mr. Turtle was diagnosed with male infertility (which happened before my diagnosis) and for about 6 months after AJ was born. Other than that we've been trying pretty continuously on or own or with treatments (IVF in January 2014, and Clomid from September-December 2016). We haven't undergone that many treatments because Dr. Cotter did not see promise in many of the options. IUI was not initially recommended because of poor sperm count. IVF was tried once, but without great hopes, because my high FSH/low follicle count meant that my ovaries wouldn't stimulate (and they didn't).
So, with that information, what did I do?

  • I trusted my instincts. More or less. Even without the results of the medical tests, I could see that I did not ovulate all the time. My cycles tend to be around 24 days, and they can go as short as 15 days or more rarely, drag on for two months or more. However, I'm still more regular than not, and I have fertile signs such as stretchy mucous and ovulation pain maybe 60% of the time. When I temped, I got a rise in BBT on probably 2/3 cycles. I did get positive OPKs.  I'm definitely not optimally fertile. But I couldn't quite believe that I was completely infertile, either. It felt like my body was trying to do the right thing; it just didn't succeed a lot of the time.
  • I have used the OvaCue fertility monitor periodically, although I've found it less useful in the past couple years, for whatever reason. The OvaCue was how we timed sex to conceive AJ. But more recently I found I was getting very wonky readings and they were not so useful. So I did not use it for the cycle where we conceived Sprite or several of the ones preceding it. 
  • OPKs. I had the most success  with the non-digital kind. I liked to see the lines getting slowly darker as the fertile window approached. I would usually continue testing a few days after seeing the first positive, to see how long it stayed positive and when it went back to negative. Usually the test would stay positive for 2-3 days. I tested around noon. There were many days at school I'd go around with an OPK hidden in my pocket, trying to find a convenient time to sneak a peak. I dreaded leaving it somewhere accidentally and people starting rumours (because they couldn't tell the difference between it and a positive pregnancy test).
  • I took a daily prenatal. I've been on those things for most of the past 3 years. Prior to conceiving AJ I took only folic acid. Sometimes I'd get tired of them and go back to only folic acid.
  • In the summer of 2016, I started DHEA supplements and CO Q10 again, with Dr. Cotter's agreement. I took 75mcg of DHEA and 300 of CO Q10 until I think about January of 2017. At some point, I forget exactly when, I decided to reduce the dose. I had no very logical reason for doing so; I was just tired of taking pills three times a day. I went down to 25mcg of DHEA and I think 30mg of COQ10.
  • I took baby aspirin off and on. I did this because it was prescribed for our IVF cycle and I figured if it helped with implantation during IVF, it might help with natural implantation too. Sometimes I took if for the whole cycle, sometimes I only started after I confirmed ovulation. Sometimes not at all. I did take it for the cycle we conceived Sprite, but I forget when I started exactly. I stopped a few days after the first pregnancy test, on the recommendation of my family doctor who said he saw no point in continuing it.
  • I would usually take my BBT until I confirmed ovulation. For a few cycles I took it the whole time, but I found I was getting stressed about it particularly after confirming ovulation when I would start obsessing over the temperatures wondering if they showed conception or not. It started interfering with my sleep patterns. So I stopped taking it after 2-3 days of a confirmed rise.
  • I tracked changes in cervical mucous, as I found this a pretty consistent indicator of fertility, though not 100% consistent, of course.
I haven't found a way to put a picture of my chart to the blog, but here is a link where you can see it (sorry, doesn't work, stumped again).
 

Summary in words:
  • Positive OPKs on days 10 through 12
  • Sex on days 7, 9 and 11
  • Temperature rise on day 10, with a dip on day 11, then another rise on day 12 and a fairly constant slow rise to day 17 when I stopped temping
  • Tender breasts days 11 through 18 (at least that's when I remembered to chart it)
  • High temperature recorded on day 29, when I figured I was a few days late. This followed by the first positive pregnancy test.
On Mr. Turtle's side, he had had one test in the fall of 2016 showing very low sperm count. Due to gaps in our appointments, we didn't know the results of this test  till January, but the sperm situation may have had something to do with why we didn't conceive on Clomid, as my ovulation was confirmed 3/4 times. However, I also had a very short luteal phase on Clomid, for whatever reason. In the spring Mr. Turtle re-tested and the sperm counts were much better, good enough for Dr. Cotter to recommend IUI as the next step. We were supposed to start that in June. I conceived Sprite in May.

And that's about it. We did much the same things on this cycle that we did on a dozen other cycles. But this time, it worked for some reason.

Lifestyle:

I was average weight, on the slender side. I generally eat a healthy and balanced diet, but I'm pretty relaxed about it too. There are no foods I avoid and no foods I eat especially for fertility. Stress affects my eating habits (I eat less). My job is fairly stressful, though usually manageable. I don't recall having high stress when we conceived Sprite. My stress was definitely much lower, for example, than when I was trying to adjust to my new job and being a working parent, and dealing with my dad's illness and death, etc. Our outlook toward trying to conceive was more positive then than it had been in a while, due to hearing about Mr. Turtle's improved sperm counts and having a treatment plan again.

I did not completely avoid caffeine, though never imbibed excessively. I had one cup of instant coffee most mornings (anything more made me feel sick).  I drank alcohol, mainly wine, periodically, once a week at most, often less. I generally avoided drinking when I figured I was in my luteal phase, but there were certainly days when I was like, screw it, a little bit won't hurt. Everybody has their limits, and one of mine is alterations in my diet. Trying to conceive means performing a lot of ritualized behaviours. Some of these I was OK with (to a point): Charting, taking pills, taking BBT, etc. Allowing ritualized behaviour to infringe on my food and drink choices, including my small pleasures such as a cup of coffee or a glass of wine, felt like a bridge too far. When I looked at it analytically, I felt there was no hard evidence it made any difference at all, at least not to me. So since I didn't want to change my diet anyway, I didn't. I share this in part to validate that it's OK to have boundaries around what you are willing to do when trying to conceive. Everybody has different ones, but whatever they are, my advice is to know and respect them. This shit can take over your life and drive you crazy. Don't let it.

That's about all. Why were we able to conceive? Here's my theory of subfertility:

  1. some people are fertile all or most of the time
  2. some people are infertile all or most of the time
  3. some people are infertile much of the time, but are occasionally fertile
I think we fall into group 3. Most fertility tests would put people in either group 1 or 2. Group 3 is hard to diagnose because they would have to be retested constantly to find the "fertile windows." The only way to know if you are in group 3 is by experience. Two pregnancies in 6 years does not = great fertility, but qualitatively and quantitatively, it's a helluva lot more than zero.  We are extremely lucky.

As always, love and light to all who stop by to read.