Posts tagged ‘health’

On Breastfeeding

I was lucky to have a book on breastfeeding on loan from the midwives when J happened to be born, and it was awfully handy as a reference during those first few difficult days. My midwives are very well informed on lactation, and the hospital where J was born is “baby friendly”, meaning all the nurses have basic training on feeding babies.

It took till the fourth day after J’s birth for my milk to really come in, and he was pretty dehydrated and down 9.5% of his body weight at that time. He ate pretty much continuously for about 36 hours, and was obviously getting more and more dehydrated, as his wet diapers were increasingly pitiful. I was pretty much convinced he wasn’t getting anything at all and was pretty worried. Z thought I was insane. J finally spat up some colostrum which made me very happy; if he spat something up that meant he was eating something! And then my milk showed up and everything got so much better – immediately, and over the next days.

If we hadn’t had such great information and caregivers, the first few days would have been much harder.  Even though my milk showed up a little later than average, I think our experience was about as stressful as average, because J was a pretty skilled and enthusiastic eater from day 1 and lots of babies aren’t. Thank goodness my kid loves to eat.

J asleep in his favourite spot in the whole world - draped over my boob and using it as a pillow.

We still have ongoing challenges of supply and demand, which I might get into another day (stay tuned for a fascinating potential post about green poop and sleeping on towels) but things are so much better. J is thriving, and I benefit from the inspiration of friends with older babies who breastfeed them effortlessly, often while multitasking. One day, I hope to be able to feed J in the carrier while also doing laundry. But for now, I’m getting to watch a lot of TV, and J is getting nice and plump, and my boobs don’t hurt (much anymore) so all is well.

So come all ye pregnant ladies: take out a book on breastfeeding from the library, read some stuff online, or talk to someone about their experience.  There was about 10 minutes about breastfeeding in my prenatal class, which is not nearly enough. Also, get a spill-proof cup with a built-in straw so you can drink water with one or no hands while nursing a little tiny baby. And maybe some trail mix which you can eat with one or no hands…

That part where you first learn to feed the baby is really hard! Then it gets easier.

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Perspective

Now that life is back to normal and I’m all done hyperventilating, here is the update to our 20-week ultrasound that showed a dialated renal pelvis (fancy medical term: pelvicaliectasis)

After the 20-week ultrasound, we were asked to return in three weeks for a second ultrasound to see if anything had changed. Last week, that ultrasound revealed that the renal pelvis continued to be abnormal.

As at the previous ultrasound, the technician wouldn’t give me any information. So, when he left the room to show the measurements to the doctor and get further instructions, I lept off the examination table and recorded a voice memo of all the measurements and notes that were left visible on the computer screen. For the first few days until they had written up my results and sent them to my midwives, who then delivered them to me by phone, that was all the information I had.

I plugged those measurements into Google and found a few medical journal articles and the like suggesting that this was fairly a mild case of pelvicaliectasis, which might resolve on its own after birth. It could also lead to kidney infections and other no-fun complications in affected newborns who might, at worst, need antibiotics and corrective surgery. Not great news, but not the worst either.

The most awesome medical journal article ever, covering this very topic, is entitled “Mild fetal renal pelvis dilatation: much ado about nothing?” The authors can’t stop making Shakespeare references:

To screen, or not to screen, that is the question:
Whether ’tis nobler in the nephron to suffer
The slings and arrows of outrageous infection,
Or to weight obstruction against a sea of refluxes,
And, by meds or surgery end them?
To flow, to reflux no more,
and by clinical trial to say we end the loin-ache
and thousand p-values that medicine is heir to,
‘tis evidence-based practice devoutly to be wish’d.

Extreme dorkiness aside, assuming that I understand it correctly and it is actually relevant in this case, the article suggests that relatively mild cases of prenatal renal pelvic dialation aren’t necessarily that big a deal. So we felt a little better.

But then!

The hospital’s very sympathetic Medical Genetics people called last Friday to explain that sometimes renal pelvis abnormalities are also markers for a genetic disorder, which can be life-limiting or maybe even “incompatible with life”.

Angst!

On Monday, we were given the option to have an amniocentesis to find out for sure. Amnio is pretty high risk at this point in pregnancy, as it can cause premature labour, which would really, really suck at 23 weeks, as the fetus is just barely, maybe viable. But since the fetus’ risk of a genetic disorder was estimated to be much higher than the risk of an amnio, we decided to go with the test, and at least have our answer.

I didn't look, but believe the needle used for amniocentesis was about this size.

After the needle in the belly, I went on bed rest for 24 hours and restricted movement for another day to reduce the risk of early labour. (Due to cramps that have scared the crap out of me as recently as yesterday, I’m still walking like a really old person and avoiding exercise even more diligently than usual.)

The hospital ordered FISH results, which are an early response to the part of the amnio that tests for the most common genetic disorders, the same ones that babies with pelvicaliectasis are at elevated risk for. They called yesterday to say that the baby does NOT have one of those genetic disorders. ( \Thank you, hospital, because I would have lost my mind spending two weeks waiting for those results. We’ll get the complete results in another 10 days, but since there is no elevated risk for those other disorders, we are not worried.)

So, it’s “only” a kidney problem. Even if the kid ends up with malfunctioning kidneys, infections, and needs surgery as a newborn, he does not have a systemic, life-threatening or life-limiting genetic disorder.

In a month or so, we get to go see a pediatrician who will hopefully have some more information about post-natal prognosis and possible treatment options. But, as the geneticist told me over the phone, whatever it ends up being, it’s just plumbing. It can be fixed with medicine and surgery.

Perspective: hooray!

After a few days of serious anxiety and feeling like maybe we should stop hoping for, looking forward to, and bonding with this kid, we are now back to contentedly considering names, getting ready to build the crib, and buying postpartum cloth pads on the Internet. (OK, maybe that last one is just me.)

Graceful Moments from a Day in the Life

I would like to take this opportunity to share a verbose montage of graceful moments from my evening. They involve two basic themes: my clothes don’t fit, and I am taking a shitload of vitamins.

My Work Clothes Don’t Fit

First of all, I learned yesterday that tomorrow I must attend a fancy-ass meeting – like seriously fancy, might be broadcast on community television that a whole 5 people might watch – and my “weddings and funerals” blazer is looking hilarious. It fit OK when I was interviewing for my first secretary job in 2005, but I’ve gotten a little plumper and a whole lot more boobalicious since then, and then I got 18 weeks 6 days pregnant. It’s not like the fetus is to blame for this entire fashion crisis, but it is not helping either.

So I spent the evening shopping for a maternity blazer. Of my two local maternity stores, one had a ton of blazers for approximately $200 each, so fuck that. The other one had a single, solitary black polyester blazer, which was only slightly too small, but was also the ugliest thing you have ever laid eyes on.

In a desperate stop at the discount department store, I found a non-maternity, cheap-ass, cotton-and-polyester half-blazer, half-sweater that fits over (nay, disguises) the belly and looks mostly acceptable, when seen from a great distance of course. So I called it a day, and headed home to make some last-minute alternations on the damn thing (i.e. cutting off the ruffles).

The adequate blazer. The ruffles have since been excised with scissors.

Vitamins

The fish oil which my midwives say will make the baby smart come in capsules approximately the size of my little finger. I am not kidding. They are enormous, and I don’t know how anybody ever swallows them. (And no, they’re not suppositories. But man would that be a whole new level of gross if they were.)

The bottle says to take 4-6 a day, but I draw the line at 3. I bite little holes in them and squeeze the oil into a spoon, before making a face and taking it with a glass of water. Sometimes the process goes awry and a little oil spills into the sink, or perhaps onto the floor where the cats can come and sniff at it excitedly.

This evening, I managed to not only miss the spoon, but squirt fish oil at high velocity all over every single thing I was wearing, except the socks. It even soaked through to my undershirt. Amazing!

My whole outfit is now in the wash. Thank the goddess it wasn’t my hard won fancy-meeting outfit for tomorrow. And I only have 2 more vitamins to take before bedtime.

***

On the upside, I am feeling all kinds of mysterious discomforts in my abdomen that are probably fetus aerobics, at least some of the time.

We got to hear the heartbeat again today at the midwife’s, which is always pretty awesome.

Next week I get to overfill my bladder and go for the big “anatomy ultrasound”, where we’ll get what is probably our last glimpse at the fetus before its birth. With any luck, we’ll find out the sex, and get to SEE him or her squirming around in real time. That will be pretty awesome, and I’ll forgive it the fish oil.

This kid better turn out really smart, though.

17 weeks: Belly (and Renovations) Update

Wow, I suck at this blogging thing. I blame my house.

The little 85-year-old house we recently moved into is completely charming, and also kind of falling apart. You know the type. We’ve just finished paying for some emergency plumbing repairs and asbestos removal in the attic, and the next little while will be all about fun stuff like insulation and possibly removing the cracked chimney. Which runs directly through the middle of the entire house. It’s going to be a blast.

The ever-growing fetus lends a sense of urgency to the house-fixing proceedings. Our goal is that by December, all the changes involving power tools and plaster dust will be over with, and we’ll be at the fun (?) part of crib assembly and washing and sorting secondhand baby clothes.

Recent developments in pregnant-lady land are as follows:

  • My pregnancy is finally public knowledge at work. Thank the Goddess. I wore a golf shirt to the office this morning and found it very liberating after 2 entire months of baggy shirts, shawls and sweaters in summer.
  • Today was my first prenatal yoga class at the neighbourhood community centre. I have been so physically exhausted lately that I was worried that an entire hour and a half of deliberate movement would be torture. But it was great. Yoga kicks ass, and it’s great to now have some pregnancy-approved moves to try at home when my back gets sore and needs a stretch.
  • All the ladies in my online due-date community are feeling fetus pokes and flips, but I haven’t felt anything definitive yet. I do feel lots of very odd sensations in the belly region though. Some of these are almost certainly fetus aerobics, while others are probably less interesting sources like stretching muscles. I look forward to being able to discern which are which.

That’s about all the news for today. I just made some delicious-looking granola and it’s time to eat some. So here, have a belly picture!

This is from 16 weeks (a week and a half ago, ahem) but I have rationalized my laziness by deciding that this series, with me in the same clothes all the time, is a monthly series, so the next picture isn’t due until 20 weeks or so.

I’ll write before then, but it might be about insulation.

Indignities

We’ve not even trying to get pregnant and I’m already enduring digestive indignities.

That multivitamin I photographed so eagerly two weeks ago is a rat-bastard motherfucker.

My all-Canadian pregnancy book says to take your prenatal vitamin with meals to prevent stomach upset, and it isn’t kidding. Once I figured out the culprit of my distress, I realized I have to completely stuff myself with a heavy dinner to minimize the damage from one of those nasty pills. And there are still… indignities. I can’t even imagine trying to take them on top of morning sickness, with nothing but a few crackers in your belly.

The bike ride home from this evening’s rehearsal passed the yuppie natural foods store, wherein the vitamin guru, glowing with virtue and health, suggested a new brand. It’s called “Multi for Two” and comes with this completely awesome warning not to take it while pregnant without the advice of a doctor.

That is a little worrisome. Why the hell else would you take a prenatal vitamin? (Well, some people on the internet who are not planning to get pregnant take it for nice hair. Those people are crazy.)

I’ll start taking the hippie horse pill multivitamins tomorrow, 3x a day (yikes), and will run them by my doctor at the next visit. Here’s hoping they are better than the last vitamins.

The mind and the body are one long braid

Today I feel all fragile. I would have made a great Victorian lady, and when not fainting could have spent my time lobbying for women’s cycling attire.

I want to take action, preventative measures that will help me be able to control my sympathetic nervous system so I can manage to finish my gigs. Linda Stone’s writing about breathing is inspiring to me, and I might just try to have a regular meditation/breathing exercise. Z thinks I might be further expressing my paranoia by obsessing about breathing, but… I don’t know. I want to take control.

Aaaand, in other news, people are so kind to me. My bandmate’s sister-in-law has offered to put in a good word for me in a starter job I want in the local government here. I am overcome with gratitude.

Privacy for my Cervix

I once stage managed a production of the Vagina Monologues. That volunteer activity has since been judiciously removed from my job-seeking CV, along with childcare at the local hippie/activist music festival and selling Keepers and cloth pads at cost  at a womens’ centre that also distributed stickers of the image below.

One of the Vagina Monologues is about pap smears and decries the “mean cold duck lips” of a speculum wielded by a brusque, officious stranger. I remembered it today!  The good (?) news is that apparently I don’t need to go back for another two years. If I decide to get pregnant before then, all I have to do is take folic acid a few months before trying.

Hooray! Cervix, you can have some privacy.

Speculum_1973

I love our Canadian system of health care for all, but there are some flaws in the overall Western medical approach on which it is based. I’d like to be empowered to take care of my own health more. To an extent, I can take responsibility for this myself, through independent research. Charting my fertility cycles is one way that I feel like a conscious steward of my own body. I learned to do BSE out of a book – no-one ever showed me. But I wish that doctors had a little more time to educate us regular folks about our own health and prevention, and to help us to look after ourselves in addition to measuring things and prescribing pills.

My doctor is a perfectly polite person and a competent physician, but she does not engage me in my own health. In my experience, this is typical. I can imagine how the cat feels at the vet. Unless there is a pathology, I do not learn anything about my body or functions. I’d rather hear about what she is looking out for, and why. Is my blood pressure normal? Are my boobs unusually bumpy? Should I eat differently?

My limited experience with midwives, having accompanied pregnant friends to their appointments, is that they are more likely to share this kind of information with the women in their care. The legitimizing of midwives as part of the medical system here is relatively recent, and I’m optimistic that other changes are imminent.

Here’s to a future of medical care where patient empowerment for self-care and prevention is a priority!