Self-Care

In this time of relishing my last weeks of being able to be selfish, and yet my body feeling like it's at war with itself, these are the ways that I have taken care of myself:

• I purchased a pregnancy body pillow. I am not going to say it's a miracle cure like some of the Amazon reviews make it out to be, but I have definitely noticed an improvement in my sleep. I am waking up less, sleeping a little more soundly, and able to fall asleep a little easier when I do wake up, at least for the reasons of discomfort. Unfortunately, it doesn't solve the heartburn or leg cramping issues... 
• Regular chiropractor appointments. I am lucky that my insurance will cover a fairly generous amount of chiropractor appointments per year and also that these appointments include a targeted deep tissue massage of the offending areas. I wish that massages could be covered alone and then I would get these weekly, maybe daily if I could find the time. I walk into the appointments feeling stiff and walk out feeling like mush. 
• Prenatal yoga. I have only done this handful of times because it hard to work it into my schedule, but on the days that I go I have really enjoyed it. I am not normally a "yoga person." In the past when I have tried yoga, I usually have found myself being bored, agitated, and too self critical. Somehow, this prenatal yoga class is different. I end up feeling relaxed, stretched, and energized. 
• Sleeping in and taking naps. Part of my brain tells me I need to be more productive, but I am have been ignoring this part rather effectively and allowing myself to get extra sleep in the morning, or the afternoon, without guilt. 
• Occasional spa treatments. As someone who has always struggled a little with my weight, my body image has been difficult to manage these past several months. I have managed this by focusing on aspects that are not related to my weight and shape. I have gotten a few more pedicures than I would have normally and have had two facials so far in this pregnancy. Pampering my skin and focusing on these aspects of my body has helped to minimize my overall dissatisfaction. 

How do you take care of yourself?

11 Weeks... to go.

I had lunch with a colleague this week who is 36 weeks pregnant. She reports that her OB has begun doing internal checks and she is already showing some effacement and dilation. She told me that this made her feel a little sad, as she's not sure she's "ready to not be pregnant" yet. She likes being pregnant.

I am not one of those people.

My goal of infertility treatments was never to be pregnant, it was to have a baby. From the stories I've heard, I have not had a very difficult pregnancy by far. But I wouldn't go so far as to call it enjoyable.

I think I was secretly hoping that what they say about the second trimester being so much better than the other two wouldn't apply to me. It turns out that I am very stereotypical. Up until a last week, my "bad hours/days" were far outnumbered by the "good days/hours." Now, my sleep is disrupted significantly nearly every night, making my days a constant fight against ever-increasing fatigue in an effort to continue being a productive working member of society. Interestingly, the disruption is different every night. It's like trying to plug a water leak with your finger - every time I figure out how to manage one set of symptoms, another pop up.

I had several nights of not being able to get comfortable and find a good position, but getting a pregnancy body pillow has helped with that overall. Intermittently, the heartburn still takes over and will keep me sitting vertically for half the night. Then there was the night that I felt itchy all over and started feeling a little psychotic that there were bed bugs biting me. When I do fall asleep easily, I find myself waking up in the middle of the night with horrible leg cramps. And finally, I am still prone to getting pretty nasty bloody noses right before bed, which requires a good half-hour of care to keep it at bay.

I know, cognitively, that the best place for our baby to be right now is in my body. She is not ready to be born and will be much better off with some more time to grow in this nurturing environment. I truly want was is best for her. However, if some new science came out to convince me that she would be considered full-term by next week, her birth weight would be six pounds, and she would be fully developed enough to not require any medical intervention... heck yes I would want this pregnancy to be over!

Balance

Yesterday, I woke up still exhausted after a night of disturbing dreams, cramping legs, and an inability to get comfortable. I had great expectations for accomplishing things, but felt too tired and crabby to begin any tasks. As I was sitting there in a funk, C reminded asked me how many Saturdays we had left before a newborn would be relying on us for every. single. need. The answer (assuming baby comes exactly as planned...): Eleven.

Two of those Saturdays will be consumed with baby showers, one with a wedding, and another one I will be out of town at a conference. So, in reality, the number of Saturdays that I have to wake up when I want to, sip my coffee in silence, and enjoy mindlessly watching HGTV until I am fully awake and alert: Seven. And then my life will be forever changed and my Saturday mornings will probably never look the same again.

With his unspoken encouragement, I allowed myself to be a little crabby. I turned on the TV to a home-remodeling show and enjoyed sipping my coffee. I enjoyed the silence and I enjoyed the selfishness in my Saturday morning routine with a greater appreciation.

We wanted this for a long time. We spent many years and thousands of dollars working towards this goal. There were many days that my life was consumed by the task of having a baby. But this was a different type of consumed then actually having a baby. Entering the third trimester, I find myself becoming more anxious and apprehensive. Not that I will be a bad mother or that our little girl will be healthy and happy, although those worries definitely creep in also. I find myself anxious about losing my sense of me. Losing my own goals and aspirations, losing my hobbies and my friends, losing my ability to be introspective because I am too wrapped up in caring for someone.

When I first went away to college, I remember having similar fears. I knew I could do well academically, but I was not confident that I could be both a good student and have fun. I was worried that I would have too much fun that then suffer academically. Or that I would be too focused on my grades and then be miserable. It turns out that these fears were mostly unfounded. I ended up doing a good job of managing a social existence and still thriving academically, with only the occasional exception. I had achieved a sense of balance that I didn't know was possible.

I hope I am able to find this same sense of balance with motherhood.

Third Trimester: Ready or Not

Today I enter week 28, the third trimester. In 12 weeks, give or take, our little girl is expected to arrive.

The day started off well with my return OB appointment. My blood work came back well, so we can officially cross gestational diabetes off the list! My blood pressure was super low at the appointment and he was satisfied with the fluctuations from our monitoring over the past week. Current concerns of preeclampsia are also on hold and, overall, he was very pleased and relieved with my current health. I spent the rest of day convincing myself to also be relieved and get over my worked-up state I had put myself in over the past week.

My weight is up 22 pounds based on the official office weight, which is actually pretty consistent with my weights at home. This is more than I would have liked, but not too excessive so I'm mostly just accepting it. My hands, feet, and ankles are swollen according to my standards, but not enough to be medically concerned. My back and neck still ache at times, but last night I actually slept entirely through the night! Previously I had been waking up 3-4 times out of discomfort. The heartburn is mostly controlled with daily medication, but I do still get occasional breakthrough heartburn episodes. I still get tired more often, but it's not unbearable. The heart palpitations are currently my biggest issue, although my doctor said that occasional palpitations were normal and not concerning.

Baby "Beuhla", as we have officially nick-named her, is quite active these days. It is still rare for me to feel her from the outside, and I haven't felt her for long enough to get C involved, but I feel her internally at least several times per day. Personally, it seems like every time I put my hand on my abdomen to feel her, she stops moving. C told me that she's probably stubborn like her mother.

C officially graduated from nursing school last week and I couldn't be more proud of him. And also more relieved. It was a rough road. He's now in limbo while the state processes his background checks and applications so that he can eventually sign up to take the licensure exam. It it said to take up to 8-10 weeks at times, and my fingers are crossed that he'll be able to take the exam before Beuhla arrives. The thought of him trying to study and take the test with an infant who's awake every two hours does not sound like a good idea!

I have been having daily conversations with patients about my maternity plans and how this will affect them. I have several lists that I'm generating: discharged, "on-hold" during my leave, or transferred to a colleague. There are still a lot of patients between specific lists at the point, waiting to see how they do with the transition back to school. As long as the timing stays relatively on track, I'm hopeful that I will be able to have solid plans for all of the patients.

We still have not bought anything else for the baby, but have procured a jogging stroller and Boppy from his sister, so there is currently a pile of baby gear in the office. I may have had a minor freak-out last week about the fact that the nursery is still very much an office and that it needs to be painted and emptied by the shower date so that we can start filling it back up with baby stuff. Since then, we've begun to empty out some of the office stuff and have worked on figuring out exactly what colors we wanted to paint the room. We're settling on gray and yellow - gray walls with yellow accents. I think the first thing I might actually buy for the baby is paint! Writing this out loud sounds a little ridiculous. Oh well.

On the one hand, twelve weeks does not sound like very much time at all. I have a feeling it is going to fly by with everything that I want/need to get done. On the other hand, bringing home a baby still feels like and incredibly surreal idea. It was a muggy 80 degrees out today and November seems a far ways off. At least at this point, I am feeling optimistic about my health and our ability to get everything in order in time.  Ready or not, here we go!

The Dust Settles and Worry Begins

I've realized over the past few days that I know a lot about infertility, but much less about actual pregnancy, or more specifically, pregnancy complications. Ask me about the most common infertility medications, general statistics on success rates of various procedures, and costs associated with each option, and I can rattle off the answers without much thought. But then knowing the standard treatment options for gestational diabetes and I start to get confused. I don't know the statistics associated with preeclampsia and premature birth or the usual blood pressure readings and trends in your 27th week of pregnancy. It's funny how I could tell you "good" and "bad" beta numbers for each of the first few weeks of pregnancy, but the blood pressure readings seem so "grey" to me.

Since the initial shock of walking into an appointment expecting only the usual routine and then walking out with concerns of two different significant complications, I have had a lot to learn and absorb. Remember when I said that I wasn't nervous two days ago? Well, I take that back.

Now, every symptom that I experience is no longer interpreted as normal, but instead evaluated with caution and concern. I have had two nosebleeds, one of which was pretty significant with big, gross clots. My feet and hands continue to look swollen. Most concerning to me, is that I have been having a racing heart rate at various, random times throughout the day. I used to have a racing heart after doing activities that otherwise wouldn't have had big impact, like climbing a flight of stairs, but were otherwise understandable. Now my heart will race when I am driving, or sitting down for dinner, or rolling over in bed. It's hard not to feel panicky when my physiological signs are definitely those of panic!

I also haven't been sleeping well because I can't get into a comfortable position. I am exhausted and try to nap but then my heart races again. My muscles ache because they are so tired. I generally feel unhealthy and sickly. There is likely some somatisizing going on...

I started panicking about the lack of preparedness for a baby. The office/nursery is still 99% office. We still have no place for the baby to sleep. There is not a single outfit to be warn. C tried reassuring me that if she born now, or soon after, that she won't being coming home for a while anyways, but I didn't find this reassuring at all.

I also get worried about work. I have put forth great effort and thought into a maternity plan that has me working until at least the beginning of November. This didn't account for a potential bed-rest situation, or a reduced hours situation, or a "take-it-easy" situation. I've had a hard enough time getting my one (fake) boss accepting my current plan that the thought of adjusting this plan is nothing I am looking forward to. I know, I know, this should be the least of my concerns right now. The thing is, as a psychologist, I do feel an ethical and personal obligation to the patients that I care for. I appreciate that I am no good to them if I'm not taking care of myself first, but they still deserve consistent care and a reasonable transition plan if necessary.

27 Week Reality Check

My sister (AE) was visiting from out of town and wanted to attend my regularly scheduled OB appointment. I warned her that it is usually a little boring, but that she would be able to hear the heartbeat.

It turns out the appointment was a little more eventful than I had anticipated. My ankles and feet are more swollen than he would like, especially given a morning appointment. My weight had increased a too much over the past month. My blood pressure was "trending up" at 140/80. There was sugar in my urine (1000 mg/dl).

That's right... he is worried about both preeclampsia and gestational diabetes. I got an order for five vials of blood and instructions to check and record my blood pressure twice per day. While I had been  having monthly appointments, he now wants to see me back in a week for closer monitoring.

At this point, I'm not scared or anxious. I feel that I am good hands and he is on top of my health. I also live with two nurses who can monitor me daily if needed. No, I am not nervous; I am frustrated and disappointed.

I think I started taking a healthy, uncomplicated pregnancy for granted. It was as if I had paid my dues with the infertility, and felt like the universe owed me this. I knew in the back of my mind that PCOS puts me at a much greater risk of developing gestational diabetes, but I didn't let this knowledge significantly influence my lifestyle. I could have eaten healthier. I should have exercised more. On the flip side, I shouldn't have pushed myself so hard at work and entertaining guests.

There isn't a clear diagnosis of either condition at this point, but I do feel a significantly increased urge to make my health, and the health of our daughter, a much greater priority.

Trial Run: Hosting the Niece

The last few days, C and I were hosting one of his nieces. She is eleven years old and his God-daughter. He had brought up several times over the past year how he would like to host her and do something special, given their special relationship, and we finally made it work.

She came up with her family for C's graduation party and stayed out late with us on Saturday. Sunday began by Cand her running a 4-mile race through Cleveland, which ended in the baseball stadium. C said he could have done better himself, but their 5K time was about 35 minutes, and he was really proud of her. Later that day we went swimming for a few hours in my parents pool. She left her swim-suit in her parents' car, so we had to make an emergency run to the store. Trying to find a swimsuit at the end of the season, that is appropriate for a girl just entering Middle School, who is going through a slightly awkward phase of pudginess and is in-between kid and adult sizes, was slightly stressful to say the least. After the pool, we made dinner and she helped with the cutting and putting together kabobs. It turns out she is not a fan of most of the usual vegetables that go on kabobs, but did make an attempt at mushrooms and a red onion. She also attempted to put on a slice of cucumber and a strawberry... We finished the night with a campfire and s'mores.

On Monday, we started off the day with a kayak trip. She has previously gone canoeing, but only in a canoe with her parents. I remember kayaking being so much cooler because you were in complete control of your own boat. I was right. She was in heaven. Her skills were actually pretty good and she enjoyed exploring the river. We only had one dramatic incident of a "bug" falling into kayak, prompting her to try to stand up to shake it off (for non-kayakers - NEVER stand up in a boat!), then ended up jumping out to bathe herself in the river-water, then refusing to get back in her boat but agreeing to stitch boats with me. C responded very well - calm yet empathetic. I was just trying not to laugh at her drama.

We also watched a few classic movies, Jaws and My Girl, and had pizza dinner in Little Italy at an authentic Italian restaurant. The following day, we went to a famous pancake diner for breakfast, one of largest candy stores in the world to pick out some good-bye goodies, and then drove her to the meeting point two-hours away and half-way between our home and her parents'.

She was superbly behaved and one of the most well-mannered kids I've ever seen. The visit was exhausting. At one point on her last night here, C was in a bathroom and I was enjoying a moment of piece and quiet, when she appeared and said, "What are we going to do now?" in her sweet little voice. I wanted to laugh and cry.

At one point, C gave her a choice when I would have just given her one option instead. I pointed this out and he became concerned and asked, "Was that bad parenting?" I laughed and responded that it was just different approaches. I think he was genuinely concerned, but he was so sweet with her. He woke her up in the morning, got her breakfast, dried her wet swimsuit, and made sure she had everything packed up on her last day. He was exactly the kind of uncle/father I would expect from him.

After she left, we both commented how well it went. She seemed to really enjoy herself and we successfully tired her (and us) out. Before climbing into bed, at the end of our long day of transporting her back, C remarked, "Being a parent for two-and-a-half days in exhausting."

In all fairness, it was more difficult because she is not our child and we didn't know all of her likes/dislikes/etc. and also this wasn't her house so she couldn't just entertain herself at any time. On the flip side, she was eleven and relatively self-sufficient. We got her food ready, but didn't have to feed her. She bathed and dressed herself. She got herself in and out of the car and generally packed up her own clothes. So yes, being a parent for two-and-a-half days was exhausting, and fun, and exhausting.

I Haven't Forgotten the Blog

I read my subscribed blogs daily, get inspiring thoughts, and then flag them to return later and comment. I never do. I have random flashes of blog ideas and thoughts I want to share, making mental notes to express this later. Then 10 days go by and I realize that I've been essentially been off the grid. When did that happen? I've been here, thinking and reading, but there is no evidence of any of it. What have I been doing?

I think I've actually been doing less introspection and more living. In the practice of mindfulness, we learn that there are two states of living - thinking and being. I've been heavy on the doing, on the being.

I spent much of the weekend helping my mom re-organize the house and tackle the "have a place for everything, and everything in it's place." We now have a place for everything in the dinning room, kitchen, living room, hallway/closets, and laundry room. The family room and foyer are still works-in-progress, as are C's and my bedroom, office/eventual-nursery, and den.

We then went outside to tackle some of the flower beds; weeding and mulching and planting. Yes, this is late in the season, but having the baby shower at their house has lit a new fire under my parents to re-invest in their home.

All this work upset my back (still guilty of occasionally forgetting I am pregnant) and I spent the evening soaking in the tub.

The other weekend day, I went to work to get caught up on paperwork and also to work on some big projects. I was in the office for about four hours and got half of everything I wanted to accomplish finished, but it still felt good to cross things off my list and be productive in the quiet of the hospital when no one else is around.

We then went shopping for supplies to entertain C's nieces who will be visiting with us next week and also stuff for the home, to assist with the organizing and decorating.

C was busy studying for his very last final of nursing school. It was stressful and he was on the verge of the failing, and the stress was felt throughout the house. We found out on Tuesday that he passed the test, and therefore the class, and will now officially be graduating in just over a week!

I spent a lot of time on the phone with my best friend from graduate school who had her IVF transfer. Then there was the waiting. Then there were the results. She is pregnant! Two positive betas and an ultra-sound scheduled in a week. I am so so so happy for her, I can't even begin to express it.

I also spent a lot of time on the phone with my sisters. My cousin broke up with his live-in girlfriend. My sister is trying to hook him up with her friend. My other sister is planning to come visit in a few weeks and trying to plan the trip. There is always some sort of family drama.

At work, I became involved in several big projects. I started a new practicum student working under my supervision and oriented her. I interviewed potential candidates to be hired as my assistant, with goal to expand the practice significantly. I met with my boss and my administrator on beginning the process of an internship program and submitting for a grant, which was very highly received. These are all exciting endeavors, but also overwhelming and very time intensive. Sometimes I question my motives for signing up for these things at this point in time, as if I am trying to prove something: Having a child does not change my career ambitions.

I caught up with some old friends and colleagues. On three different nights after work I had dinners/happy hours planned with work colleagues. It was nice to be connected to people outside the office environment.

We were also working on finishing up the baby registry, finalizing and ordering the baby shower invitations, and beginning to work on addressing all the envelopes.

Yes, I have been living. It's been good, but exhausting. At times it feels like avoidance. Avoidance of introspection. Avoidance of the huge life change that will be occurring in about 14 weeks. In the practice of mindfulness, they talk about the necessary balance between thinking and being. I'm not great at balance, but being has been a lovely reprieve from mourning.