July 30, 2010

27+ weeks

Total weight gain/loss: 16 lbs

Maternity clothes? mostly, but I do have a skirt and a couple tank tops that aren't maternity but are stretchy and comfortable

Best moment this week: Washing the baby clothes and sheets, organizing some in the baby's room. And I love feeling him move around, it's the greatest feeling.

Movement: All the time! It's fun to watch my stomach move with his movements.

Food cravings: ice cream and cool whip

Labor Signs: mild contractions all the time, sometimes more frequently and more painful than others, but no true "labor" contractions.

Belly Button in or out? still in, it's never been an "outie" even at the very end of pregnancy (it's a pretty deep cavern apparently!), belly ring still in but starting to be more prominent through the shirts, so it looks like I have an outie.

Stretchmarks? nope. Got great genes that way!

How are you feeling? Today's not such a good day, pretty achy, tired, back hurts, fairly frequent contractions, well, probably more irritability than contractions, I'm crabby and I'm thinking maybe I have some adhesions as I've been having some pulling/pain off and on around c-section scar the last couple days.

What I am looking forward to: being able to sleep and being able to go more than 2-3 hours without peeing, hitting that third trimester mark in a few days!

What I miss: Sleep, being able to do things I just can't physically do right now.

July 21, 2010

What I Wouldn't Give...

I see the slender, in-shape runner, in her early 20's or even early 30's and I think "Man, I used to have a body like that and I used to be able to go run whenever I want. No worries about how long I was gone, no worries about the chores that won't get done while I'm out". I look down at my gravid belly and wonder if my body will ever be slender again, I know it will never be the way it was before after 4 babies...I remember when my hips were lean(er) before they expanded to allow a child to be birthed, my feet were a half size smaller, my legs weren't covered in spider veins and were tone and muscular. I could easily run 7 miles. I remember when my body was my own, before the skin was stretched beyond belief, before my breasts had nursed 3 children, before a cesearean and episiotomy scar left their marks, when I never worried about whether or not my bladder control would be strong enough to withstand a good sneeze. That thin woman running probably never thinks about that. But then I think "She may be in shape, but maybe she won't return home to children waiting with excited faces, waiting to show her their race track they built. She may not have the scars of childbirth, but maybe she wants to more than anything in this world. She may see me outside with my belly full of baby and my 3 children running wild around the yard and think "Man, I wish I had that". My hips may be wider, but they hold a child well. My abdomen will never be quite the same, but it grew to allow a child to develop. I may not have run a marathon, but I have finished the marathon of labor to bring my first child into the world. I successfully completed 3 rounds of pregnancy from start to finish. My breasts may never stand at attention like in my pre-child days, but they nourished 3 children and will do the same for the 4th. I may have scars from childbirth, but I wear those scars with pride...the reminders of what a wonder the womans body is.

After a long night of up and down, little sleep and coaxing a 2 year old back to bed, I long to be able to sleep all night long until I wake up on my own...something I haven't done in years. I wish I could sit on my deck, enjoy my morning Diet Coke before jumping into the day instead of getting up and jumping right into starting breakfast and answering the endless questions that start as soon as my eyes flutter open. I am awakened each morning by little fingers on my face and a small voice saying "Mommy, mommy" and oh!, how I long to be able to sleep in like some of my childless friends and have a full night of blissful sleep without disturbances. But, they wake up to quiet all the time, and they don't know what it's like comfort a scared child in a storm as they snuggle up to you and fall asleep in your arms, or to have 3 little ones climb in bed with you on a cold morning to watch cartoons.

In my shower, what I wouldnt give to be able to stand in the hot water for a long time, take my time, and shower in peace. And to be able to style my hair just right, apply make-up and leave the bathroom ready to go out. Instead, I take the world's fastest shower and still I have to holler at the kids to stop jumping on the bed, to stop hitting each other. I'd love to be able to shower, with the bathroom door closed. Frequently, I am scalded with hot water as one of the kids will sneak into the bathroom and flush the toilet before it's too late for me to realize. But, then again, I could take a long shower without interruption...but then what would I do? No, my hair isn't styled perfectly and my make-up is pretty minimal, my wardrobe, well, lets just say I'm not exactly in style and I usually have stains from little fingers on them by the end of the day. But I have a almost 6 year old that watches me as I get ready and says "Ooo, Mommy, you look so pretty!" and then I realize I don't need all that to be beautiful in my children's eyes.

I also remember the days of shopping for myself, by myself. I could browse the racks, make trips to different stores looking for just the right outfit, or pair of shoes. My underwear and bras matched. My selection of shoes was awesome, and I could peruse at my leisure. These days, my best white bra is an odd shade of gray, thanks to being washed with dark colors. I can't remember the last time my undergarments matched, or when I last cared. I may not have an awesome wardrobe, but my children have a great one. My trips to the store are rushed with children begging for this and that, fighting and running down the aisles. I see that woman about my age, looking at purses and shoes and I think "Man, I wish I could just go shopping alone again, and buy stuff for myself". But then again, that woman may look at my brood and wish she had what I have, that she had other things, like diapers and small clothes to buy.

I haven't read a great book for quite awhile...but I have read the journal of a 6 year old boy, who wrote "Me and Mommy played catch in the yard and then went to the park and it was fun". I may not have great pieces of art or sculptures, but I have crayon colored pictures on my refridgerator that say "Mommy I luv U" and a popsicle tower. My house isn't spotless, in fact, the floors need to be mopped, there are dirty dishes in the sink, laundry to be done, toys everywhere, but what good is a clean house if it is an empty one? While I would LOVE to have a cleaner house, I'd rather play a game with my children than have a spotless house that could pass the white glove test if it was empty. I don't have a flower bed with all kinds of exotic flowers or a vegetable garden with a large variety of plump, juicy produce. But I have a flower pot with a bean plant that we grew from a seed and a pot with a geranium that has a small handprint on the outside, given to me for mother's day. I haven't been to a musical in the city or in a big opera house for a long time, but I have seen some great talent at the 1st grade dinosaur play and spring concert. I haven't been out on the town for drinks at a bar, or to a movie theater or even out to eat at a nice restaurant. But I have snuggled on the couch to watch the latest Disney movie with a bowl of popcorn after a fine meal of pizza with my family.

Every day, I may have moments when I think "Man, I used to be able to do this before I was a mother", but then I look around and you know what? I wouldn't trade this for the world.

July 20, 2010

Work and pregnancy update

What a night! Busy, busy, busy! Thankfully, we are starting to pick up in the baby department after several months of s-l-o-w. Summer is usually pretty busy and business has been booming. Of course, it's never a even level of busy. It's either dead or we've filled every labor and post-partum room. No happy mediums for very long anyway. This weekend was no exception. Saturday was pretty slow, which ended up being a good thing for me, which I'll get into later. Sunday night we were pretty busy but nothing crazy. Last night, we were busy from the start: short-staffed for what we had and quite a few patients. I was in charge and if things went as they were "supposed" to, it would have been fine. But, we all know that's not how life is in healthcare. About 5am, when I need to start calling people to see if they would work dayshift (who was also short) a labor was very close to delivery, we were expecting 2 people at any moment for 5AM for scheduled procedures, and we had 2 pretermers down in the ER. No one from nursery was available to attend the baby at delivery so I planned on doing it...until I realized I would need to admit one of the new patients. Thankfully, both people we were expecting at 5am were late. Tthe laboring patient wasn't completely ready to deliver until the dayshift charge nurses had arrived at about 6am and she ended up getting quick trip to the OR, which bumped our scheduled 7am c/s and the to-follow c/s. It was just crazy! But, we managed and I got to bed about 8:30.

I saw Doc today and talked about some of the preterm contractions/irritability I've been having. In the last 3 weeks, I've had 3 episodes of contractions and irritability that were frequent, consistant, and painful. I won't go into too much detail, but the last episode was Saturday night and I ended up going home early...with the promise to come back as a patient if things picked up or didn't slow down. Thankfully they did eventually slow down. Now I will say that I was fairly certain they weren't doing anything to my cervix - they were just very uncomfortable and miserable, and I have no intention of letting things get out of hand. I have no intention on having a preterm baby if I can help it. So at my appt today I talked with Doc about these issues. I had mentioned what was going on 2 weeks ago when she came in for a delivery so she kinda knew things were happening. She did a fetal fibronectin swab and I should have the results of that tomorrow. My cervix is closed, but she thought it was thinning a bit, but wasn't too concerned at this point. The fetal fibronectin is a substance that is like a glue that holds the amniotic membranes to the uterine lining. It's normally not detectable between 24-34 weeks. If it is detected in the secretions, or positive, then it indicates that the glue is breaking down and that there is a high risk of preterm delivery in the next 2 weeks. If it's negative, or not detected, then there is (I think this is the correct percentage) a less than 5% chance of delivery within 2 weeks. It's just a way to keep from intervening with bedrest and such for preterm contractions if it isn't necessary. So if it's negative, then I can continue like I am, but if I have another bout of painful contractions, then I earn myself some brethine, procardia or hydroxy-progesterone injections to calm my angry uterus. If it's positive, well, that changes things, and we'll see what my future holds.

July 13, 2010

Fun Conversation

Actual conversation I had with a patients mother Friday evening. My patient was changing in the bathroom and missed out on most of this lovely conversation I had with her mother. For reference, I was in the usual scrubs with a scrub jacket on...usually that covers the belly fairly well.



Rude mother of patient: Wow, so how much longer do you have? (referring to my ever expanding abdomen)

Nurse Lochia: "About 15 weeks...I'm not due until October"


RMofP: (makes face that suggests she thought I was due any day). "Wow, you got big, huh?"


NL: (trying to hide my annoyance, feeling like I should further explain) "It's my 4th baby, and yes, I got big pretty quick. It happens."

RMofP: "Oh, my daughter is having her 4th baby too, but she's not nearly as big as you and she's due in 6 weeks!"


NL: (speechless, contemplating giving her the finger or commenting on the size of her waistline, but realize that may be a bit unprofessional, so I just smile.)


*patient walks out of bathroom*


RMofP: (to patient) "Hey, guess what? Your nurse here is bigger than you and she's not due until October!"

patient looks apologetically at me , embarrassed by her mother's comments.



It's never the patient that says anything to me about being pregnant...no one so far has ever been bold enough to ask me how far along I am. They all go about it in a round-about way, asking if I have children, etc. But the patients' mothers? They don't hold back. It's actually pretty funny because the poor patient and her husband/boyfriend/FOB always look at each other, sometimes horrified that their mother had the nerve to go ahead and assume I'm pregnant. Now, it is fairly obvious in street clothes, but in scrubs, especially with a jacket on, the belly is covered pretty well at this point. The first time a patient's mother made a comment, I was only 18 weeks - she asked me how far along I was. A bold move. I think I may start answering "Oh, I'm not pregnant", feign indignation and offense, and say no more. Just to see what people do. I know, I know, mean, but you have to admit, it'd be pretty funny. Hey, I gotta have fun somehow!

July 12, 2010

I hate my uterus

I'm really not a big whiny pregnant woman usually. OK, I think everyone deserves to complain about the peeing every 2 hours, the backache and general discomfort that goes along with pregnancy. So I did my share of that with my first 3 kids. It feels good and relieves stress. But man, the last couple weeks have been unpleasant. I have a long way to go to be this uncomfortable. And really, I understand that being pregnant isn't a comfortable state to be in. But my back aches all the time, I contract all the time, every time I walk my uterus contracts into a tight little ball, I pee constantly, I still vomit daily and I can't sleep. My 12 hour shifts are killing me. It's all I've been able to do the last two weekends to keep my composure until I'm in the van - then the tears from the severe discomfort just come and keep coming. Baby Cletus is doing just fine, practicing acrobatics in my uterus and gently nudging me pretty regularly, which I love. But the bad thing? I feel like I'm supposed to be "tough", after all, I'm a labor and delivery nurse and I should know that it's not easy being pregnant, and I'm having my 4th kid and all so I am going to feel like hell. But I've been pregnant before...I felt GREAT until 32-33 weeks with Isaiah, felt great the whole time with Clara and honestly, with Jacob, I had no idea what to expect but I worked up until delivery day so that doesn't count. This time I'm miserable after any amount activity. My cervix isn't changing and I'm pretty certain he's going to stay put until October, thankfully. But I've got a long way to go. Being off work won't do much good because I work just as hard at home as I do at work. And I don't do well being told I can't do something. Not being able to run OR go on walks is driving me nuts! Can you imagine me on bedrest? Ugh, I really hope he's just positioned in there funky and that's causing all of this because it did come on suddenly the night I ended up as a patient at work. I'm trying to stay positive and deal with it because I know how blessed I am to have this healthy little boy growing...I just am angry with my uterus right now. I hope it gets better, or I figure out a way to deal with this irritable uterus of mine for the next 15 weeks.

July 7, 2010

Viability!!

WooHoo! Today I am 24 weeks - Viability! This is probably the biggest milestone, right up there with 38 weeks. That means, God forbid, should this little guy decide to be born he would have a chance at survival. Not a great one by any means, and the chance of long term health problems would be pretty high, but there is a chance. I think 24 weeks deserves a party of some sort. Things are going pretty well. I'm still contracting more than a 24 weeker should be, but they aren't increasing in frequency and they aren't painful like they were last week. The pelvic pressure is pretty intense, but part of it I'm sure is it is my 4th baby and my poor ligaments and pelvic floor have taken a beating and are giving up! I chatted with my doc the other night, told her that when I walk my uterus tightens up in a ball, and that I was still contracting, probably more like irritability than contractions, had pelvic pressure, etc. She said as long as nothing gets worse, and my cervix doesn't start changing, it may just be that I have an irritable uterus and I'll be fine, and that I need to take it easy when I can. But if they increase in intensity or frequency, then I need to be checked out. Fine by me. But 16 more weeks of contracting all day everyday is going to get old. Plus I'm *trying* to take it easy...I don't like not being able to do all the things I want to do. My initial plan was to run the majority of my pregnancy, to take longish walks at the end, keep up with my kids and their activities, paint the kids rooms, rearrange things, etc. It drives me crazy that I just can't do it. I can't even go for a walk without getting uncomfortable. But I'm going to be good and not push it...I would not do well on bedrest. But I will do whatever it takes to keep little man in there until October.

July 3, 2010

Not a good sign

If anyone who has read my mind ramblings from the beginning may remember that I had preterm contractions at 34 weeks with Isaiah. They subsided, never did anything except for the one night that I started hurting with them and bleeding. I had hoped to avoid that this time around. Not going to happen I guess. I'll admit that I have contractions from very early on - nothing painful or too frequent, but they are there and have never led to a preterm delivery for me. With the first 3 kids I noticed them from about 22-25 weeks. This time I noticed them about 18 weeks. I figured "hey, it's my 4th pregnancy, I'm more tuned into things this time". Or at least that what I told myself. I had to stop running weeks ago because it wasn't pleasurable and the last time I tried, it hurt. I can't walk too far either, because my uterus tightens up - something that didn't happen until 30+ weeks in the past. But I can do small things, like being able to play kickball with Jacob, etc. I again tried to explain it away as being just part of what comes with a 4th baby/5th pregnancy. Wednesday night, I had picked up an extra shift. Husband was home, so I had an easy day. I napped with Isaiah in the afternoon, and laid down at 7pm like I do before a 11-7 shift. About 8pm, I woke up with pretty severe cramping, and it hurt to move. I figured it was round ligament pain, which I think was part of the problem and tried to go back to sleep. Didn't work. I got up, drank 1liter+ of water, went to the bathroom hoping that would help, but I found it didn't. I had a lot of pelvic pain/pressure, and my whole abdomen was really tight, and not relaxing. I kept trying different things, hoping it was gas, etc. but about 9:30 I realized that maybe something was wrong. I called the charge nurse and told her I needed someone else to be a labor nurse and me be the patient. I told her what was going on and she said I needed to come in. Damn. I checked my own cervix, because I knew they'd be doing it and I wanted to know myself, and it was long, closed and high. A good sign. I was just sure I would get to L&D, rip a great big fart, and be fine, or it had to be a UTI. I just couldn't be contracting at 23 weeks. Well, I was, every 2-3 minutes. After about 30 or so minutes, they started to really hurt, and I got really worried. I didn't have a UTI, baby looked fantastic for a 23 weeker, and I got several shots of terbutaline. That eventually knocked out the contractions, but the pelvic pressure didn't go away, and it still hurt to move. It's better now, but I still have some pressure. I'm able to work - for now. I know if it happens much more, that I will be done. I don't need to be off work this early, but I also don't need a micropreemie, and 23 weeks isn't viable. I have been taking it easy, and I've really limited my activity. It drives me crazy that my body won't allow me to do the things I want to do. What worries me is the day I had this, I hadn't done much of anything. I hadn't been running around, cleaning, or anything. I napped, cooked supper, gave the kids a bath, napped again, and Husband was home all day. And the pain started as I was sleeping and I was very well hydrated. So we'll see how it goes. Maybe it was just an isolated incident and not an indication of how the rest of this pregnancy is going to go. And maybe that's just how I'm going to feel and it won't make a difference in my cervix or timing of delivery. We're keeping our fingers crossed - this little guy needs to stay put until at the very least October, preferably the end of October.