Monday, September 24, 2007

The Triple-Screen Test

It's about that time when we have to figure out our feelings about the Triple Screen (aka AFP) test. This test screens for abnormalities that may indicate Down's Syndrome, spina bifida, or trisomy-18 (see more here). This has not been an easy decision, but we have ultimately decided not to do the test. This is especially interesting because in our previous pregnancy we were all for it.

Here's how it works: if you have the screen, you'll get a result which will indicate whether your child has a higher than expected risk of having one of the three defects mentioned above. The test for this first stage of screening is a simple blood draw - fairly uninvasive, no huge discomfort, no risk to mother or baby. If that test comes back "negative" - meaning, the baby's chance of having one of those defects is lower than expected - you're done. If, however, it comes back "positive", further testing is recommended. Further testing is an amniocentesis, which carries a 1 in 200 chance of miscarriage.

After a "positive" result, which I might reiterate does not prove the existence of any defect - merely that your baby has a higher than expected risk - you get the amnio and then wait a few weeks for the result. Presumably, stressing out the entire time. The results of the amnio will definitively tell you whether the baby has one of the defects or not, and which one it is. At which point, you can decide to terminate your pregnancy - or spend the remainder of it preparing to birth a child who is quite different from what you previously planned for.

After going through a miscarriage, I am more sure than ever that I would not choose to voluntarily end a pregnancy. After our loss, Chris and I both agreed that although it was a painful experience, we were glad to have had the pregnancy at all. Carrying that logic through, I believe at this stage of my life that I have to be grateful for whatever child God sees fit to give me - whether it's one who abruptly dies as an 11-week-old fetus, or one who doesn't survive his first year of life due to trisomy-18, or one who is born with Down's or spina bifida, or one who - can I dare to hope - is born perfect, healthy, and normal in every way. I have to believe that whatever happens in our family, happens for a reason.

Lest you think that I've gone completely off the deep end, let me temper my faith-based statements with a little scientific reality. I do believe in God, and believe that he looks after me and the tiny being in my body. However, that doesn't mean I step off a curb without looking, blindly trusting that God will stop all the cars on the highway and offer me His divine protection. I look after myself as best I can, and I take advantage of what science has to offer me in the way of testing, information, health care, and life-saving procedures. But what I've come to believe in terms of this particular triple-screen test is that it cannot offer me anything positive.

What would a positive screening indicate? A possible problem. Would I be brave enough to get the amnio, knowing it could well mean the loss of my pregnancy? If I did get it, and the baby survived, and the result was positive again - could I terminate? Would I use the information to do anything differently for the remainder of my pregnancy - other than worry endlessly and thus damage my own health and the baby's?

What good could this test possibly do for me?

The only answer is that it could come back negative, and offer Chris and I some peace of mind, knowing that (as far as we can tell) everything is just fine. But I already trust that it is - or that, if it isn't, there's a reason and a plan and that in this case, my version of "just fine" and the Universe's definition of same just don't mesh. In my book, that's no reason to put ourselves through any more stress than necessary.

Thursday, September 20, 2007

Taking a Rest

On Tuesday I called in sick to work, feeling far too exhausted to get out of bed at my wake-up time of 7:30. In fact, I went back to sleep until about 10:30, then still felt a little too tired to do anything much in my first 30 minutes of wakefulness - including checking email, putting on a movie, reading a book, or procuring breakfast. No, all I was able to do before needing a rest was use the washroom, brush my teeth, and make my way downstairs to the couch.

This is no way to live.

I talked to my supervisor on Wednesday, finally confessing that I am 7 weeks pregnant and having a really hard time. She suggested reducing my hours until the end of the first trimester. At first, I felt guilty and selfish and nervous about doing so. Millions of women get through pregnancy without needing time off work, don't they? What's wrong with me? Why am I such a wimp? I need to suck it up. But the more I thought about it - and with some supportive advice from my best friend - I realized, it made sense. At least half of my work day is spent doing nothing, anyway - the workload isn't enough to fill forty hours a week. And hadn't I been commenting that I was finding it harder and harder to sit at my desk, doing nothing, with my body aching and my stomach churning and my head throbbing and every sinew in my being yearning for rest, real rest? Why continue to put myself through this?

The fact that my supervisor suggested it had a lot to do with me being able to put aside my stupid Protestant work ethic and let go of the guilt. If work was okay with me taking a rest, why couldn't I be okay with it? It's only temporary, after all - someday, although it's hard to believe right now, the first trimester *will* end. I *will* start to feel better.

By coincidence, I had an appointment with my naturopath this morning anyway, and I told her about the conversation with my supervisor. She thought it was an excellent idea and was happy to hear that work was so supportive of my health and well-being. She happily wrote the doctor's note I needed, and an hour later I was in my supervisor's office figuring out logistics. Starting tomorrow, and for the next four weeks, I'll be working 4 hours a day, 5 days a week. I'm still kind of stunned at how easy it was. I'm so grateful to my supervisor for suggesting this, and guiding me through it.

Yes, there is a price to pay. I'll be losing about $50/week of take-home pay, which will have an impact. Chris and I are already constantly worrying about money as it is, and I know this decision hasn't helped his state of mind. But I keep reminding myself - and him - it's only temporary.

It's a funny feeling, willingly taking time away from work. I've never in my life accepted - and then insisted - that I needed, or deserved, a rest. I feel a little disoriented, to be honest.

Monday, September 17, 2007

More Ups than Downs

Pregnancy continues to be full of ups and downs, but more ups than downs right now I think.

Last week - week 6 - wasn't any easier physically, but I feel like I am getting used to the level of discomfort and finding a few ways to deal with it. There is still a lot left to do - for example, a friend suggested steeping ginger tea and adding just a touch to my water bottle to make hydrating easier throughout the day - but I'm getting there. I took some positive steps last week to help me feel more connected to this pregnancy, as well:

- Went to see my midwife
- Discussed my feelings with a friend who is also a midwife, who tells me everything I'm feeling is quite normal
- Bought a "Fit Pregnancy" magazine
- Took a belly picture

It may seem strange, but one of the things that is helping me feel better is looking at "The Amazing Floating Baby" and how much bigger and closer to human it looks this week. Arm and leg buds are growing, and you can see where the baby's eyes are going to be. Yesterday Chris kissed my belly and said, "I love you, Bean." That made me feel good.

Today is my birthday: I'm 32 years old. By my next birthday, I'll be a mom. Another positive thought: I'm just over 7 weeks today, which means the first trimester is halfway over.

Monday, September 10, 2007

Working Moms and Ginger Root

The nausea is so horrible I had to call Chris from work this morning and beg him to do me a favour. "Just find a health food store, tell them your wife is pregnant and nauseous like she wants to die, and she needs ginger candies or ginger ale or something. I'm desperate - I won't make it through the day without help." Because he is awesome, he was at my office 20 minutes later with ginger root capsules.

Many websites say that ginger can be of great help in reducing nausea and vomiting caused by pregnancy, but then they also say this: "Although a trial of Ginger in 27 pregnant women with persistent vomiting revealed no harmful effects, it is still not recommended during pregnancy." Ugh. I'm taking it anyway, for the time being, and when I see my midwife on Wednesday we'll see what she thinks.

I got to see Greg and Sue and their daughter Teagan on the weekend. She's now 7 weeks old and they took her to a camping event - an impressive precedent, and one I'm not sure I can live up to! Sue and I got to talking about pregnancy and motherhood and babies in general, and the need for genuine help in the form of a nanny. I never thought I'd be pro-nanny, but then my image of a nanny has changed drastically from the post-War concept of someone who lives in your house and raises your kids while you're off travelling the world with your husband. I now look at Greg and Sue and their utter sleep deprivation and see how a live-in nanny could help bridge the gap so that they could be more present and capable in their waking, with-child hours. Furthermore, the question of what happens next year - when Sue goes back to work - is another one that could be handily answered with a nanny. It's nearly impossible to find child care for kids under 3, so where does that leave the working moms?

As for money, I've never done the math on this, but I suspect that for most people, daycare is a losing proposition. I know my sister recently went back to work for one day a week, and barely breaks even on her paychecks after paying for daycare for her two sons. For me personally - in a job that barely keeps me busy for 10 hours a week - I couldn't stomach paying someone else to look after my child while I sit at work and surf the web, itching to get back home. I've already spoken to my managers about working part time in the future (i.e., after my maternity leave) and they are very agreeable. That's a huge stroke of luck for me, and one that not many mothers get. Again, the cut in pay will be difficult, but I'm sure we'd weather that better than me working full time and paying out full-time daycare - assuming I could even find such a thing.

By the time Sue needs to go back to work - next July - I'll be off on my maternity leave. It would be neat and tidy for me to offer my assistance in bridging the gap for her, but at the same time I will be at home with a newborn and adjusting to life as a mom. Do I really need to make my life twice as hard?

Friday, September 7, 2007


Dear Stomach,
What do you want from me, exactly? You gag at the smell or sight of food – sometimes even the thought of it – but I need to feed you, there’s a baby inside me and we all need the nutrients. When you don’t let me eat, I’m even more tired and draggy than necessary, and if my stomach is empty for the nausea-induced heaving, it’s even more painful. If you’d let me eat something, there’d be something in there for you to purge. I don’t think that’s an ideal situation for either of us, but maybe we could compromise, okay?

Dear Couch,
I love you so much. I love how you’re soft and pillowy and let me press my whole body against you whenever I want. I love how you’re located right next to my lappy and the TV and my DVD collection. I love how I can lie on you and pretend I’m still part of the World of the Living when in fact, I probably couldn’t get off you if the house was burning down. Let’s never end this affair, some days you are all that matters to me.

Dear Bed,
We really need to spend more time together. I really love being with you, on you, in you – my time there is always so satisfying. But there’s something between us, Bed. It makes me uncomfortable to talk about, but I feel I owe to you to come clean. It’s the stairs. I just can’t manage them until I’ve napped on the couch for an hour or two first. And once I’m on the couch, well, you know how it goes. I have a hard time leaving. Just like I have a hard time leaving you in the mornings.

Dear Headache,
Fuck off. Seriously. I hate you.

Dear Energy, I miss you. I’m getting fat over here. Please come back and at least visit once in a while, okay? I know sometimes I took you for granted but now … I’ve come to understand, I need you. I’m nothing without you. Please take pity on me and come back.

Dear Breasts,
I’m sorry for what you’re going through. I really am. When they say, “It hurts me as much as it hurts you,” well, that’s how I feel. It really, really hurts me to go through this with you. The only comfort I can offer is that it will all be over soon. Well, if by “soon” you mean “in 8 months”, and if by “over” you mean that you’ll be full of milk and getting chewed on by a newborn. Sorry about that. I’m afraid life is going to suck (heh) from here on in. It's true, things will never be the same, but I hope someday you’ll forgive me.

Thursday, September 6, 2007

Ah, the joy of mood swings.

Last night and today have been easier than yesterday. Perhaps I'm on an upswing - I can't dare to hope that the worst is over, because the second trimester is a very long way away. But I can be grateful for the good times, or to be more honest the Less Awful Times, when they are here.

Chris called me at work to discuss our plans for the evening, including the usual "What are we doing for dinner?" conversation. I was pleased that I could actually think about food at 2pm, as the last two days would have seen me turn green at even the thought. We decided hamburgers, as Protein is Fun. Sounds great to me - no dishes to do, no cooking on my part, very little prep for me and he does the actual work of cooking. Fast and easy and Bursting with Protein.

Anyway, he also mentioned that Greg was planning to stop by after work and that Chris might ask him to hold a couple fence panels in place while he attaches them. A pause, then "I can hold fence panels up too, you know." Chris agreed in principle that I am capable of this skill, but "for the past three days you're having trouble holding up yourself." "I know," I said, "But I don't like to be reminded of that! I like to believe that I could hold up fence panels if you needed me to! Why do you have to rub it in?"

I was kind of fake-crying but in reality making a bit of a joke of it. It's true, when I got home from work yesterday I confessed that all I'd thought about all day was lying on the couch. Does that sound like your dream partner for a fence project? We had a laugh about it and I agreed that if he had asked me to help him, I would have been rude and sarcastic and "up in his face" (his words) about how could you possibly expect me to help with this, I AM PREGNANT AND MUST BE HORIZONTAL AT ALL TIMES!

So yes, I am incredibly difficult to please. But at least I have a sense of humour about it, which I hope Chris sees as a benefit.

Wednesday, September 5, 2007

Hitting Bottom

All day, all I think about is going back home and curling up in bed. On my right side, naturally, because lying on my left side for some reason makes me incredibly nauseous. I'm at work right now, and I just got caught with my head down on my desk. Fortunately, this isn't the kind of thing I'll get in trouble for - just get asked questions that I'm not ready to deal with yet. Last time - yes, here I go again talking about "last time", I'm like some awful company transfer who can't get through the office orientation without saying "At my last office, we did things this way" - well, last time I managed not to tell my co-workers until I was 11 weeks along. They were shocked and amazed that I'd gotten through all the rough parts of the first trimester without them noticing anything, because another co-worker had gone through pregnancy recently too, and had called in sick at least one day a week for the entire nine months. I was really proud of myself for being able to hold it together. Well, guess what? It's 9am, I'm 5.5 weeks pregnant, and I was pseudo-napping at my desk. Guess I'm not holding it together quite as well this time.

But what I really want to talk about today is this couple I know who have a 7-week old baby. They seem, by all appearances and from their own admittance, to be having a really rough time. The baby isn't sleeping much, and when she does it's only for a few minutes at a time. For example, this past weekend, she decided to get into a charming little pattern of nursing for a minute, sleeping for 2 minutes, and then screaming until she was fed again. All day and all night long - no rest for anyone. Mom and Dad look really exhausted and fairly unhealthy, and there's just so little anyone can really do to help. They came over on Saturday and Mom took a brief nap upstairs while we looked after the baby, but to really get back on top of her sleep deprivation she'd have to do something like that every day, and that's just not possible. I'm really starting to see the value of nannies.

What bothers me about this situation is that I can't look at it and point to what this family is doing wrong, or what they need to fix in order for everyone to be functioning better. They are having a really rough time, and there isn't really a solution - it's just something to be endured. That's pretty scary to me, as I can see myself completely falling apart in the same situation. And let's face it, it's likely I will find myself in that same situation, and I won't know what to do! There is no prospect more frightening to me than the blank terror of "not knowing what to do". If I know what to do, I can usually do it (or work towards it), even if it's hard. But to have no solution at hand? To be barely functioning and feeling trapped and lonely and exhausted and maybe resentful and to see no end in sight?

As I re-read that, I see the parallels to how I feel right now.

It's similar - there's nothing I'm doing wrong, nothing I can fix - I just feel lousy, and I'm going to continue feeling lousy for (at least) nine more weeks. That thought just deflates me. There's no solution to this problem, either. There's not even the imagined deus ex machina of a nanny to come rescue me, because who ever heard of a nanny for a woman who hasn't given birth yet? It would sure be nice, though. She could make meals (not for me, since I can't stand to eat anything, but for my husband), tidy the house, do the laundry, maybe rub my feet and encourage me to get my vitamins down despite the nausea. Maybe she could even come to work for me and nap at my desk while I stayed home and zonked out in bed, too. Know anyone who's interested in such a job?

Tuesday, September 4, 2007

Symptom Festival

I mentioned to Chris a couple of nights ago that it was weird I had no pregnancy symptoms other than the fatigue/exhaustion. This was obviously a dumb thing to say, because I actually had about half-a-dozen symptoms at that time; they were just so insidious that I was taking them for granted and not connecting them to pregnancy. Moreover, within the next 24 hours, the two most horrific symptoms - the ones I remembered from last time - had reared their ugly heads.

I already had the exhaustion, the absent-mindedness, the lack of appetite (still! so weird), the sore breasts, the "full bladder" feeling, the mood swings, and the lovely warm glow that progesterone provides (aka "Get those fucking blankets off me right now"). Add to that the nasty tension headache, which affects either the back of my skull or the area right between my eyes, and today - drumroll please - Houston, we have nausea. As if I wasn't already disinterested in food.

This is where pregnancy really starts to kick my ass. I've got no appetite, and besides I'm exhausted, so I'd much rather lie on the couch than get myself something to eat. And if I am going to eat, it's going to be whatever I can grab instead of taking the time to make something healthy, because Hello - I could be lying down! All other considerations are secondary to the horizontal position of my body at any given time. Of course, not fuelling my body properly doesn't help me get any less tired. And I know that, but oh man, I just don't care right now.

I'm feeling pretty moody, too, and have a really short fuse. At any time I have a tendency to give up on things if they are difficult or complicated (whether tasks or relationships) and though I've done a lot of work to try and improve this habit, these days all that work seems to be out the window. In the past few days, I have given more than cursory thought to quitting/giving up on the following things: my choir, a friendship, my gym membership. It's like I don't have the reserves of patience and energy to work on finding a solution to problems; I'd rather just say "fuck it" and throw it out the window so I don't have to deal with it anymore. Fortunately, I have not had this temptation with my marriage or my job (knock on wood!).

The moodiness is quite out of hand, and seems a lot worse than last time. I really think that the physical symptoms are just bringing me down a lot more this time. Last time, I remember having the attitude, "Yes, I feel like crap, but it's all for a good cause," and could even summon a bit of excitement and pride in the symptoms I was having. Yes, I know it sounds insane, but I actually felt a thrill of pride the first time I threw up in the morning. This time, I don't have that joy or the feeling that it's all a new exciting adventure. I'd like to, but I can't figure out how to summon it. So the physical symptoms don't seem to have an upside for me, and I just can't seem to take a positive "glass is half-full" view.

If my last pregnancy is anything to go on, there are still symptoms I haven't got, bound to show up in the next few weeks. For example, I haven't had any food cravings to speak of, nor food aversions (last time, I lost interest in chocolate, which is downright bizarre). I haven't yet lost my sex drive. Sure, I'd rather be sleeping (10 hours or more a night sounds like a good start), but my body hasn't actually switched off. And another one I remember is weeping at the drop of a hat. Right now I feel more likely to strangle someone than cry, but that may change. Stay tuned.

I'm 5 weeks and 3 days today, 9 weeks until the second trimester starts.


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