Monday, March 31, 2008

Back to the nethers

Five-minute OB visit for me this morning (not including the hour wait). I told Dr. Pro I'd been having contractions on and off for a week, and she made the frowny face at me, but reminded me there's nothing to be done about uterine irritability at this point. We discussed 17-hydroxyprogesterone shots down the road, but those aren't even an option for another four weeks.

I'm not actually all that panicked about it yet. I'm expecting to experience at least one bout of preterm labor -- I think contracting is just what I do -- and to spend some time on bedrest and perhaps in the hospital. It'll be scary and un-fun when it happens, but I also expect that they'll be able to shut it down, as they did last time. With just one baby, it may not even happen until I'm far enough along that labor wouldn't be stopped. While it would be nice to take home a full-term baby, I've had near-term babies before, so it's maybe not quite as frightening a prospect as last time.

I do worry about not going to L&D until it's too late, because I'm so used to ignoring contractions. If I called my doctor every time I had four contractions in an hour, I'd be in her office every single day of my third trimester. Last time, my personal rule was that we went to L&D when they'd been five minutes apart for two hours, and the first-line remedies like drinking water hadn't worked. Since you dilate quicker in second pregnancies, I'm mildly concerned that I will cross the threshold of "active labor" before going in, and wind up having to have the baby. We'll see what my doctor sets her threshold as later on in the pregnancy.


In other news, we bought potties for the girls on Saturday. We're doing more potty familiarization than potty training at this point -- we sit them on the potties before baths, and if they should happen to use it, wonderful. They seem to get a big kick out of sitting on the potties, and both girls have peed in them. It's coincidental at this point, but that's how it starts.

I don't expect them to be fully potty-trained any time soon. I think they'll get that potties are for peeing and pooping pretty quickly, but I expect they'll be slower to catch on that we *only* pee and poop in the potty. In my ideal world, I'll have them day-trained by the time the new baby gets here, with pull-ups for naps and bedtime and maybe outings. I don't think that's completely unreasonable, and every diaper I don't have to change will be a win.

Sunday, March 30, 2008

In which I talk about things unrelated to my offspring

I don't really consider myself "creative", although I suspect anyone who knows me might disagree with that assessment, given the amount of time I spend doing handwork. I started cross-stitching at six, did various forms of embroidery in high school, picked up crochet a few years ago, and have knitted enthusiastically for two years. I've been sewing a good bit lately, with my beautiful and wondrous new Janome, and started learning to spin a month ago. I do some form of fiber work nearly every night, and almost always have a project within arm's reach.

Yesterday, "fiber creep" took a whole new direction. I signed up for a beginning quilting class, and started cutting and piecing some fabric left over from a tote I made last week. I'm assembling a stacked coin pattern, although I haven't much idea what I will do with it once the piecing is done. I want to make a quilt and bumper set for the Lagniappe's crib, but I can't use this fabric (hot pink floral and stripes, although I'm going to add some brown and either lime or blue) unless it proves to be a girl in a few weeks. Possibly I'll make doll quilts for the girls instead, or pillowcases.

Quilting is an odd thing for me to pick up, in some ways. My personal style, such as it is, trends to the minimalist, not "rustic" in any way. I'm terribly perfectionistic, and I don't like for my finished pieces to look charmingly handmade. Nor am I an art quilter in the making -- I am good at adapting and executing rather than conception, engineering rather than design. Other than the impulse to decorate for the new baby, I'm not sure why I feel like I need to learn to do it. But clearly, I do, so there's nothing for it but to sign up for classes and start fiddling around at home.

If you should be wondering how I'm going to find the time to knit or crochet a blanket and some hats for the Lagniappe, make a quilt and bumper set for it, decorate its nursery, sew myself the maternity skirt I bought fabric for, do a couple A-line dresses for the girls, finish the two pairs of socks and the shawl I'm currently making, and progress on the Christmas knitting (set to include a beaded lace shaw for my MIL), LA LA LA NOT LISTENING.

Tuesday, March 25, 2008

Latest stunts of my monkey children

  • [Claire] Said "bye-bye!" and opened Grandmama's back door
  • [Claire] Jumped up and down on the foot petal of the baby gate until it popped open
  • [Claire] Learned to unzip her PJs and take her diaper off
  • [Claire] Learned to wiggle her arms out of her backwardly-zipped PJs and push her diaper down inside them
  • [both] Learned to stick their fingers through the baby gate on the gas fireplace and pull out the lava rocks
  • [Claire] Spat milk all over my laptop keyboard and shorted out the question mark
  • [Claire] Learned to pull the outlet covers out of the outlets
  • [Claire] Learned to unplug network cables
  • [Katherine] Learned to bite when her will is thwarted
  • [Lagniappe] Moved
  • [Lagniappe] Caused the onset of uterine irritability by moving
  • [Lagniappe] Made me leave church in the middle of the Easter sermon to go throw up
  • [Lagniappe] Made me throw up in a Wal-Mart bathroom -- with twins and a cart full of groceries in tow
  • [dogs] Pulled two bags of Easter candy out of a bag on the counter, ripped them open, and ate the contents, including the wrappers

It's pretty obvious who is the monkey-in-chief...

Monday, March 17, 2008

Tentative improvement

On another note, I think I may be through the worst of the hyperemesis. With my Reglan pump, I've been increasingly well-controlled, and the ratio of good days to bad has been increasing. I have not thrown up very much at all over the last week, except under extreme provocation, such as when Katherine threw up in the hospital. I've felt very nearly normal, and have even gained a couple pounds back.

My pump went haywire on Sunday, just as we were preparing to be discharged, so I just yanked it out and decided to fool with it at home. I left it out for a shower and a nap, and since I was still feeling okay, decided to live dangerously and see if I could get by without it for a bit. I needed a Phenergan by the evening, but I was able to take it and keep it down, and it worked.

I popped a Zofran this morning, got my OB to call in a prescription for oral Reglan, and seem to be doing well enough so far. Late afternoons and evenings are my bad time, and I'm starting to feel a little queasy, but not enough that I think I'm in danger of vomiting. I wouldn't want to go completely unmedicated just yet, but at twelve weeks, it's a good time to try tapering down to oral meds.

I can always go back to the pump if I get in trouble, but I'm hopeful I can go un-tethered!

Sunday, March 16, 2008

Heading home

Katherine's platelets were up to 62,000 this morning, so we'll be discharged in the next little while.

Needless to say, we are all thrilled to be going home. It'll be great for her to be at home and free, not stuck in a hospital room and tethered to an IV pole. It'll be great for me to have a shower and a nap -- I didn't get much sleep last night, since she threw up four times. It'll be great for G, who won't have to alternate between taking care of Claire and being with us here. It'll even be great for Claire, who has been rather subdued without her sister (and her parents, and her normal routine).

We will be watching to see, over the weeks and months to come, whether her platelets stay up or continue to drop back down. The IVIG she received raises the platelets in almost all kids with ITP, but when it works out of her system in three to four weeks, her levels may go back down. It's possible we may have to repeat the IVIG treatment again; she will probably recover within the next six months, but she may have relapses during that time which require treatment.

I hope we're done with this, though!

Saturday, March 15, 2008

My brave little soldier

Katherine has been such a trouper about this. There were lots of tears, from her and a few from me, yesterday when her IV was getting placed and her CBCs drawn, but other than that, she's been as good as can be. Today she has been happy -- right this minute, she's amusing herself by throwing her toys around the room -- and didn't even cry at yet another finger-stick. She slept through the night last night, despite the constant parade of nurses, and showed no signs of vomiting or headache.

Her platelet count this morning was 26,000, a slight increase from yesterday's count of 21,000. The doctor says that's an okay improvement for this point, although we will expect to see a bigger increase tomorrow. We'll do another round of IVIG tonight, and if her platelets are up more tomorrow, we'll go home. If they're not, it may be another round of IVIG, or they may just send us home and check up on her.

Most kids, 80% or so, go into spontaneous remission within six months, so we'll check her CBC frequently for the next several months. I'm really hoping we'll be in that category. Of course, 2% of kids die, and that's when I wish I didn't have a good understanding of statistics. Katherine is one of 3750 children in the US who will be diagnosed with it this year, 75 of whom will die. I am praying we come back out on the large end of the odds, and indeed there is excellent reason to think we will.

I am also thankful that it's ITP, rather than any of the other things it could be. Cancer is a major cause of low platelets, and here in the cancer hospital, I can't help thinking of the other mothers like me who took their children to the doctor for something or nothing, only to get the worst news a mother can hear. I am so grateful she "just" has ITP. It could be a lot worse.

Friday, March 14, 2008

Scary medical term of the day

Idiopathic thrombocytopenia purpura. Go on, I'll wait while you google.

I thought Katherine might have a UTI, so I took her to the doctor this morning. The CBC showed no UTI, but it showed a platelet count of 30,000. We thought it was a machine error, until the second CBC showed 34,000. That was good enough to earn us a trip to the pediatric hematologist.

The good news is that she doesn't have cancer, and ITP usually resolves. However, because of her age, they've admitted her for IVIG therapy, and we'll be here until at least Sunday.

The incidence of ITP is 50-100 per million. I am so very tired of being on the small end of the statistics.

Friday, March 07, 2008

Diet for a healthy pregnancy

Breakfast: eat handful of dry cereal, because milk is vomit-inducing
Mid-morning snack: heave up handful of formerly dry cereal
Lunch: eat brownie and a few Pringles.
Afternoon snack: attempt more Pringles. Fail.
Supper: ZOMG husband brought home french fries must have NOW nom nom nom.
Bedtime snack: another brownie. Retain brownie, after some debate.

Total: two brownies, 1 oz pringles, french fries

And that was an OK day around here -- on the bad days, the failure rate is substantially higher. Alternately, I just quit eating altogether to save myself the trouble, because I don't throw up as much if there is no food to begin with.

Today's sorta-amusing discovery is that I can spin my wedding rings around my finger. At this point in the last pregnancy, I'd already quit wearing them, after my fingers swelled up during the OHSS misery. Today, I put them on my middle finger, where they fits quite well.

Eight pounds down in a month, with probably another month to go.

Tuesday, March 04, 2008

Does this make my belly look big?

By this point in my last pregnancy, I'd purchased and begun to wear maternity clothes. I quit being able to button my regular pants even before the beta, thanks to the joys of OHSS; rubber bands and a Bella Band got me through to about ten weeks, but after that, it was time to break out the shirts with the stupid ties on the back.
I wasn't really measuring more than a couple weeks ahead, but I have such a short torso that the belly popped right out front from the get-go.

Obviously, it's different this time. (I think that is my tagline for this pregnancy.) I've lost enough weight to have gone down almost a full clothes size, but in the last week, I've started to think my waist has been thickening up. Why, I might even start to look pregnant soon!

Then I saw Amalah's belly shot at ~7 weeks, and I wondered who I'm kidding. If current trends continue, I'll start wearing maternity clothes sometime in July. I have a formal event to go to, nausea permitting, in a couple weeks -- my little brother the almost-doctor's Match Day banquet, when they announce where the students will do their residencies -- and I don't feel the slightest need to drag down the maternity formal I wore to a wedding at twelve weeks with the girls. Instead, I'm wondering if I can fit into the dress I wore on our honeymoon cruise.

I actually bought a couple maternity tops the day of our first ultrasound, on the principle that the good stuff goes fast in the size you want. I was smaller going into this pregnancy than my last one, so all of my old stuff is between one and three sizes too big, depending on when it was bought. I'm mostly going to have to buy new stuff when the time comes, and until then, I don't have much in the way of spring clothes which fit. I'm ready to go ahead and have a visible belly and dress like it, instead of being stuck in this weird HG-weight-loss-bumpless-limbo.

This is an uncomfortable stage of pregnancy anyway, when you know you're pregnant but nobody else can tell yet, and maybe you've just got the worst case of stomach flu in the history of ever. Awkward clothing just makes it that much less pleasant.

Monday, March 03, 2008

The body knows

One piece of natural-childbirth "wisdom" I purely loathe is the bit that goes "your body knows what it's supposed to do." The list of things my body hasn't managed to do right over the last five years is as long as my arm, from hypothyroidism to infertility to preterm labor to two knee surgeries.

I did manage to get close to term, to breastfeed, and to spontaneously get pregnant, but then my body forgot how to eat and retain food, and it still hasn't figured it out. I have good days, but they're usually followed by bad days. Today was a good day for the most part, until I decided I was starving and desperate for protein. Unfortunately, just like my husband told me, the particular protein I picked is not sitting well, and now I'm wondering if I'm going to hang onto it or not. I do that on a regular basis, eat exactly the thing I crave desperately and later regret it.

There's a theory of morning sickness that postulates it evolved to keep pregnant women from eating potentially-toxic foods, and another that you crave the nutrients that your body needs most. In my case, I'm pretty sure it's not true, unless I'm really deficient in the bagel vitamins. I know I really need protein -- I'm eating a quasi-vegan diet at the moment, not from choice -- but it's the hardest food to keep down.

The good news is that the pregnancy itself continues to flourish. The Lagniappe itself had a nice strong Doppler-able heartbeat at this morning's OB appointment, and Dr. Pro even thought she could hear it moving a bit. I expect I'll feel it before much longer -- I felt the girls early, at 13 weeks, and they say you feel it earlier in second pregnancies. Other than the HG, I have no complications so far, no spotting or cramping. I'm down another two pounds in two weeks, still spilling ketones, but on the good side, I am generally managing to stay hydrated and haven't needed any more IVs.

Ten weeks tomorrow. Every time I have a good day, I think maybe the HG is tapering off, and then I'm disappointed when it comes right back the next day. One of these days, though, it will go away for real. I can't wait.