Tuesday, May 31, 2011

Our Story (5) : Specialists and Arguments

The week following my first trip to the hospital, I had an appointment with a Maternal Fetal Specialist that my doctor had recommended. She had been suggesting I see him for some time, but I had put it off because, as much as I liked her, I didn't trust that another doctor would be as supportive of my choices. I had finally decided to see him because of her recommendation thinking that perhaps one more person in my corner might help especially since I was now "high risk." I thought maybe he might have some additional ideas about ways to keep my blood pressure down. Thankfully, the medication I had just started taking was working at this point and my blood pressure was ok that day. But, that meant that we didn't spend much time discussing what was important to me, keeping me healthy, and instead focused on my request for a vbac. He came at me guns blazing telling me all the reasons why I shouldn't try for a vbac. I was so shocked. I had come in to discuss hypertension not vbac. I had read A LOT on vaginal birth after multiple c-sections. This was something that was extremely important to me...something I had discussed at length with my own doctor. I knew that most doctors and some states won't allow a woman to try for a vbac if they've never had a vaginal birth and more than one c-section. But, the research just doesn't support that kind of restrictions. In fact, the problem with vbamc (vaginal birth after multiple c-sections) is that there isn't much research on it at all. Here was my standard answer to anyone questioning my decision,
I've read up on the stats as much as I can. I feel strongly that my risk is with any kind of birth after having three c-sections. Whether I choose vbac or repeat c-section, I'm at a higher risk. Because of that, I'd rather go the natural route especially since I know that I have healed well from my other c-sections based on the assessment done by my doctor during my last Cesarean. I will have the highest chance of success with the least amount of interventions. If I need interventions, I'll have to weigh the pros and cons of continuing with a vbac. 
There actually was one recent study that showed that the risks of a vbac after three or more c-sections was the same as someone with only one c-section or with the risks of having a repeat c-section. (I emailed this to the doctor after my visit.) Anyway, this doctor visit was incredibly frustrating especially since it ended up being about something I wasn't expecting. He even left me in the exam room to go get the head of the department to try to convince me I shouldn't vbac. (This was in a state with very low c-section rates.) I think his intentions were good, but his method was everything I hated about the western medicine model of care. Thankfully, the head of the department was a pretty mellow guy and saw that I wasn't budging on this issue. Through the whole pregnancy, I said that if I needed interventions, I would reconsider vbac. But, I wasn't signing up for a repeat c-section unless it became obvious that I needed one. I was actually nervous about going back to my doctor, but again she was wonderful. She was not happy about how I described the appointment and reassured me that it was my right at anytime to refuse a c-section. The ironic thing about the visit with the specialist was that it shouldn't have been about vbac or hypertension. It should have been about pre-eclampsia. The lab had messed up my 24 hour urine test so we didn't have the results at the time of the appointment.  Had we had the results (which I found out a couple of weeks later), it would have shown that my protein levels were increasing. Pre-eclampsia was probably going to rule out the possibility of vbac for me. Maybe it was a good thing that I didn't know yet. Maybe just talking it over with me gave some doctors a different perspective? Doubtful, but I still hope so.

Saturday, May 28, 2011

Our Story (4) : Hypertension

Ugh. This is a tough topic for me. It's one of the areas of my life that I've tried to ignore over the last ten years. Not a good thing to ignore. I was diagnosed with PCOS when I was in college. It is one of those conditions that make life frustrating - weight gain, infertility, and a host of things like Type 2 diabetes, hypertension and high cholesterol that I'm now at an increased risk to develop. I stayed fairly healthy but gained weight after getting married. When I was pregnant with Boog, I had my first high blood pressure reading. It continued to rise while I was pregnant, and I was diagnosed with chronic hypertension brought on by pregnancy. I never showed any signs of pre-eclampsia - just really high blood pressure. Well, after he was born it did go back down. But when I got pregnant with Roni, the high blood pressure returned and never went away again. For that pregnancy, I was immediately put on medication. It did marginally well in controlling my blood pressure but I felt like a zombie. When pregnant with Pixie, my ob/gyn suggested we try a different med, something stronger that she liked. She made me feel a bit silly questioning it. A quick google search of Atenolol and pregnancy will show how dangerous this drug really is to developing babies. I have very strong regrets about allowing her to be exposed to this drug. My pediatrician at the time even asked me to switch to something else while breastfeeding. Thank God I listened. Since she hadn't nursed in quite awhile and we weren't planning any other children, I had just switched to yet another medication to try and control my blood pressure. I felt like it was my dirty little secret -- allopathic drugs for hypertension. I had tried some natural ways to treat it in the past but never had much luck.

We had the news that I was pregnant and I knew the medication I was taking at that time was not safe for pregnancy. I immediately stopped taking it. There was enough medicine in my body that it took several weeks before I started to see it rising again. Here's the decision I most question about how I approached this pregnancy. I don't question my motives at all, but I wonder if the outcome would have been different if I had made different choices. I read up on blood pressure drugs and decided that I wanted to avoid them as long as possible. I knew that I would probably need them eventually, but my goal was 6 months. My blood pressure was already going up at 6 weeks though. First I tried herbs to control it. I think they would have worked, but I couldn't keep them down. I typically don't have bad morning sickness, but this tincture made me vomit. Then I tried supplements, specifically magnesium, and exercise, walking. This did a pretty good job keeping it below stroke levels, but it was by no means "good." Generally it hung in the 140/95 range. My blood pressure monitor and I became buds. I took my pressure all the time keeping a meticulous record to show my doctor. I needed it because every time I went in for an appointment, it was high. Really high. But she believed my record and let me make the choice to stay off the meds. Right around 6 months, I started feeling awful. I got some really high readings and I tried to get a hold of my doctor but she was out of town and it was a Friday. I wish I could remember the exact reading. I think it was like. 160/110. The staff told me that I had to go down to the hospital to get it checked. Grr. I was so mad. I'd been through this before. I just needed a prescription for the drug that my doctor and I had decided on and that was it. It was hypertension NOT pre-eclampsia.

The doctors and residents freaked out a bit when I came in. But, my blood pressure did start to come down a little after I'd been there for a couple of hours. I finally got a doctor to give me my prescription but also made me do a 24 hour urine test. This was really the beginning of the end. I just couldn't see it at the time. I was heading into the medical monster called "high risk pregnancy." Heading straight for everything I wanted to avoid and my head was still firmly planted in the sand regarding pre-eclampsia.

Thursday, May 26, 2011

Favorite Things :: 6 year old Prayers

I've decided to start a new feature (not sure what to call it) on my blog called Favorite Things. It will be something fun or funny that's making me happy right now. I thought about making it Friday Favorite Things, but I know that if I do that, I'll rebel against myself at having to post something on a specific day. LOL It's bad when you like to be a rebel against yourself...you should see the drama surrounding my menu plans. :P Anyway, today I start with something sweet...

Every time my 6 year old says her bedtime prayers, this phrase is tucked in there somewhere.
"...and help all the people in the hospital, especially those with babies, so they can go home soon..."

Wednesday, May 25, 2011

Bye to My Baby

Ok, so he gets really mad at me when I call him my baby, but you know it's a mother's prerogative. My 10 year old left for a week long adventure with his best buddy in the world. He is going to have so much fun. It culminates in a solo airplane flight home at the end of the week. Mom, Dad and his 6 year old sister really miss him. I bet his brother does too, but he's too cool at 8 years old to admit it. ;)

Our Story (3) : Bittersweet Beginnings

I was pregnant. So what did I do for the first month? I hate to admit this, but I cried. It was hitting hard that we were going back to sleepless nights, changing diapers and a crying baby. Thank God that I have the most level-headed husband. He calmly reassured me every time that this really wasn't such a bad thing. We knew how to love a baby...all the rest wasn't a big deal. Of course he was right. Then I started bleeding. A lot and frequently. I thought for sure I was losing this baby. I felt so guilty for all of my complaining and fit-throwing. I really did want this baby. I had a miscarriage before becoming pregnant with my oldest. I knew how heartbreaking it is to go through that. I tried to tell myself that I couldn't care about this baby because there was no way we could avoid what I thought was surely a miscarriage. But then I would stop bleeding and think that everything was ok and then it would start again. What a roller coaster of emotion! It went on for most of the first trimester.

In the midst of the crazy emotional ups and downs, I started talking to the one midwife I thought might take me (and was covered by our insurance.) But, I had major obstacles. I have struggled with hypertension since my first pregnancy. Because of the hypertension and the type of care I was receiving at the time, I had had c-sections with all three of my children. Over the past ten years, I became more and more drawn to a more natural way of living, a more holistic model of care. I became more and more frustrated looking back at those births because I felt cheated out of something so powerful for me and more gentle and natural for my babies. My dream was a home birth, but I knew that would be a tough sell with my history. I had to try. New Mexico has such a wonderful home birth community. If there was ever a chance of my dream coming true, it would be here. I started to plead my case. The midwife was wonderful and encouraged me to pursue a natural birth, but I could feel her apprehension regarding a home birth for me. She asked me to contact an ob/gyn to discuss the possibility of a natural birth in the hospital. I was so scared. I still felt like doctors were bullies and I didn't want to be bullied anymore. I brought Brad with me to have my back. We sat in the exam room and waited to meet the doctor. I had just started Hypnobabies meditations so I put myself in my "bubble of peace." ;) In walked the doctor in jeans and a sweater with long straight hair. She introduced herself by her first name. And we talked. I swear she sounded more like a midwife than a doctor. I could feel that she wanted me to have a voice in my care. She wanted me to choose the kind of birth I wanted. The only thing she brought up was the possibility of pre-eclampsia. She said that if I showed signs of it, she would need to talk about a repeat c-section. That wasn't a problem for me. I told her I was a reasonable person and would of course be interested in discussing a different approach if any serious condition arose. Honestly, I wasn't worried about pre-eclampsia. I had three full term births all with hypertension. I just didn't think it was a risk for me. I knew it would be the first question anyone would ask because of my risk factors and my previous hypertension issues. My head was really in the sand on this illness. But, I left her office encouraged that I might actually get a chance at a natural birth. It wouldn't be at home like I wanted, but I guessed it would be the best I could get. As Brad said to me after we left, "You didn't even need me there. She's perfect for us!" I thought maybe he was right.

Monday, May 23, 2011

Our Story (2) : New Year's Surprises

I was thinking about where to start this story and I felt really strongly that I had to start it at the beginning -- when the news that Baby #4 was on the way rocked our world. We had just returned from Colorado after spending the 2009 holidays with my husband's family. We went to a New Year's Eve party at my wonderful friend's house to welcome 2010. It was one of those parties that just makes you happy. Good friends, good margaritas, good food and happy kids running around the house. Over the last year or so, I had been heard saying (several times actually) that I really wish we had had just one more child. But, with job loss and our three kids getting older and easier, Brad and I had pretty much decided that we were done. I remember thinking that maybe it didn't matter when I stopped having kids...I'd always wish we had just one more.

At that party my friend shocked me. She told me that she saw us with another child and when she did our numerology for the coming year, it foretold a possible child. Well, I thought that there might be a possibility that I was pregnant. But, I had tested a few days before and it was negative. (Thus the heavy consumption of margaritas.) You can imagine that that freaked me out a little. How did she know?! I continue to tease her that she scares me just a little with her psychic abilities. On January 2nd, I took another pregnancy test to make sure and it was positive. I was floored. It really wasn't probable that I could have been pregnant, if you know what I mean. I have said that this baby had to work really hard to come into this world. I was really shocked and unsure about having four kids. I mean, who has four kids??? We would be one step away from denim jumpers! But, as much as I was freaked out, I was also really excited. A new baby...my fourth. The one that I could finally bring into this world the way I wanted. We were finally confident about how we wanted to parent. So many hopes and dreams for this little one.

ETA: I just wanted to say that we have friends with 4 (or more) kids that have amazing families. I've never even thought twice about the size of their families. It was when we were faced with the reality of four kids that I took on what I believe is the prevalent attitude in our culture which is that that's too many. I think even my friends with one child would agree that there is this attitude that two children is best. Three is ok especially if your first two are the same gender. But only one or four or more? Not so accepted. I actually had a dentist say to me after finding out I was pregnant with number four, "Where I come from, we call that a litter." I didn't respond then so here's what I wanted to say, "Where I come from we learned not to say rude things to people." Ahh, that feels better. I've been holding that in for a year. :P

Sunday, May 22, 2011

Our Story (1) : I'm Back!

I had kind of written off this blog. I didn't feel like I had the energy or material to keep it up. It's still up because I was too lazy to actually discontinue it. ;) But, the other day I was thinking about everything we've been through in the last year and a half and thought that maybe it would be cathartic to tell our story. Those of you who know me personally, know that it's been an incredibly difficult time for us. And quite a bit of it, I wasn't ready to talk about until recently. The other night when I couldn't sleep, I was writing blog posts in my mind and I realized that perhaps it was time. I thought about just journaling it, but then I thought that maybe someday, maybe someone might stumble on this little blog and find some comfort if they need it. Maybe they could see themselves in the struggles we've had and might be encouraged to keep going and not give up. So, I've decided to tell our story. But, I think I'll start tomorrow....
But there is one thing I wanted to announce since the last blog post was about the daughter we were expecting. She was born last July and is a complete joy to our family...but that's part of the story too so more on that later. She's now 10 months old! I can't believe it! Here's a picture I took this past Easter. She's such a cutie!