37w0d - A Loss

Growing up, I lost a lot of people I love. I had five grandparents in the world when I was born (one divorce and remarriage), and by my preteen years I only had one. I lost my beloved uncle in that interim, too. With each of those deaths, there was time. They were struck down by cruel cancer, Alzheimer's in one case, things you expect in old age. Watching a loved one suffer isn't easy - much harder than my parents, I was the kid, I kept on going to school and seeing my friends, normal life for most of my day - but by the time they pass, you've known. You've maybe prayed for the end. 

My grandparents were old. Or, they felt old to me. My dad's parents were Holocaust survivors. They were of such a different generation. I look at my parents and in-laws and they seem so young, active, capable. Not the image of a grandparent I grew up with. 

Yesterday, early afternoon, my husband called me sobbing. His dad died. Massive heart attack. Gone in an instant. He was in northern Wisconsin at his cabin, celebrating his 22nd anniversary with J's step-mom. They were snowmobiling. He turned, grimaced, and that was it. It was immediate. His step-mom and neighbor did CPR but it was too late. I don't think he could have known what was happening, or felt much pain. The suddenness and the fact that he was in a place he loved, doing what he loved, with a person he loved, are the blessings in this horrible situation. 

J is lost, he's distraught. He wanted to see his dad hold his grandson. God knows we tried to make this happen sooner but now, 1-3 weeks before our boy is born, his grandfather is dead. What was such an exciting, anxiety ridden time is now so heart breaking. My husband hurts so badly and I can't make that go away. All I can do is hold him while cries, reassure him that no major decisions have to be made now. It sounds selfish, perhaps, but I hate the shadow of grief that is now hanging over the birth of our son. Of course we will be overjoyed, but J will be torn apart by love and longing for what absolutely should have been. 

J's dad and I did not always see eye to eye. I don't think that changes anything. I loved him because J loved him so fiercely. He was his parent, his teacher, and his boss for many years. Their relationship was more complex than most father-son relationships. I wish J would have his dad around to look to while he navigated parenting. J deserves that. He doesn't deserve this horribly-timed heartache. 

It's been less than 24 hours but it feels like it's been days. I am finding myself, at 9 months pregnant, more capable than I thought I was. While J has sweetly waited on me like an invalid in the past month or so, I have found the energy to take care of him. I am not worried about the activity, the hours, the throngs of family and friends descending. I welcome that for J. I dread the continued sadness. I didn't think we were there yet, the time where you start losing parents. We are becoming parents. Too much cycle of life. 

35w5d - Sonographer Makes Mistake, Hilarity Ensues

Yesterday was my first appointment with my regular OB since the "holy-shit-he's-tiny" ultrasound. The tone was decidedly less peppy than in my previous checkups. I got tested for Group B Strep a week early just in case they made the call for baby boy to make a slightly premature exit. We went over worst case scenarios and just "ok" case scenarios which, from my doc's perspective, seemed to be middle path we were headed down. No induction next week unless absolutely necessary but induction likely in the 38-39 week range. Basically normal except he'd be a small guy.

After we somewhat somberly went through everything, I asked to review the individual measurements taken at the ultrasound two weeks ago. Every time the sonographer took a measurement that afternoon - circumference of the head, abdomen and length of the femur - a corresponding gestational average would come up. I saw immediately that his abdomen circumference was lagging behind. The measurements for his head and femur, however, produced dates that were pretty much right on par with my dates. While lying on the ultrasound table with warm jelly smeared across my belly, I was reassured that at least those things were measuring at about average. When we met with an OB afterwards, she told us that his head had measured 6th percentile, his femur at 8th and his abdomen at 3rd. Somehow with the weight calculation he averaged to 17th percentile.  I expressed my confusion, first on how 3, 6 and 8 average to 17 (I mean, I'm no math genius but still) and then as to why the head and femur measurements on the screen would show him to be at least close to average and then come back in the single digits. She explained that the algorithm used to determine the average percentile was complex and took into account many other measurements. I was too sad and worried to push the issue any farther. Usually, I'll press on until I fully understand but in this case, I felt that I just needed to go home and sit with my news. Or lie on my bed and groan feeling generally horrible which is what I actually did.

Yesterday, I had the wherewithal to dig into it more. I didn't want to perseverate on numbers, I explained to my regular OB, but I did want to understand and not feel like a passive patient. I told her what I had seen on the screen and that the numbers didn't make sense to me. She started to spout the same answer about the complex nature of the algorithm but I could see her questioning her words as she said them. Then she stopped and carefully re-read the chart. "Well, this is a potential game changer," she said. "The sonographer entered your due date as 4/02. Your actual due date is 4/12. I'm having them rerun these calcs immediately." Ten days is a big difference in fetal development. Three quarters of a pound, lots of lung development. Depending on where that delivery date falls, ten days can be the difference between going home the next day and a week in the NICU.

THIRTY EIGHTH PERCENTILE, bitches. That's where he's averaging right now. Not 17th. Not a belly at the 3rd percentile. He falls well within the "normal" range for fetal development. His abdomen is still a little small but not to the extent that they're concerned. My follow-up ultrasound was cancelled. I'm back on track to deliver when he's fully cooked, no more talk of early induction.

So that was a fun two weeks. We scrambled to get the nursery done for a potentially early arrival from our long-awaited roommate. I ate too much ice cream in an ill-advised attempt to force him to grow with the gentle coaxing of Ben & Jerry. Guess what? Still kinda lactose intolerant. It took a lot not to wallow in feeling like I was failing Parenting 101 by neglecting to feed my fetus. Oh, they need to eat? Like every day? Shoot. I was constantly kinda stressed, kinda sad, but still very hopeful. I felt in my bones that things would be ok, I just didn't know what our version of ok would look like. And now, total and utter relief. I should be more angry at the ultrasound tech but honestly, she made a really basic, human mistake. She entered "0" instead of "1." I'm pretty sure I do things like that on a daily basis. Now, my job doesn't have quite the stakes that hers has but I am understanding. Things could have spiraled into a lot of very unnecessary interventions but fortunately that didn't happen. I'm the one that insisted  on human caregivers.

35w2d - Of Growth and Uncertainty

Oh ladies, it's been a little roller-coaster-y for the past two weeks. Things are still good but I'm facing my first hiccup of pregnancy. Ok, more than a hiccup potentially. I'll explain.

For those of you who are still in the trenches or haven't reached 20+ weeks, during the second half of your pregnancy your OB or midwife starts a highly technical measurement procedure where she takes a cloth measuring tape and, starting at the top of your pubic bone, stretches it over your bump to the top of your uterus. Supposedly, your measurement in centimeters should be approximately equivalent to your gestational week. As in, when you're 25 weeks, the measurement is 25 cm; 30 weeks, 30 cm. Give or take a couple of centimeters on either side. This is not hard science. I mean, it's done with sewing equipment for chrissakes. It does sorta-kinda-accurately give an idea of your rate of growth. In my case, it raised a flag.

At around 28+ weeks, I went from spot on measurements to lagging behind. My doc kept an eye on it for another appointment or two and then requested a fetal growth scan. Last week at the scan we found out that our kiddo is measuring at a measly 17th percentile. This was the second round of ultrasound measurements, this time by a supervisor. Our first round of measurements put him at 11th percentile, only 2 notches away from a diagnosis of IUGR (intrauterine growth restriction). We're taking 17th percentile and running with it. His abdomen measured particularly small which translates to him not getting all the nutrients he needs in utero. Fetuses, geniuses that they are, will funnel all of the nutrients to the brain and heart at the expense of building fat reserves if they need to. Why is this happening? They don't really know. Typically it's because the placenta stops working as efficiently as it should for this stage of pregnancy. The placenta slows its roll toward the end of the third trimester. Sometimes it doesn't make it quite so far. That could be happening with me. Not sure.  Here's the plan: 3 weeks after the initial scan, I'll go in for another ultrasound. If baby boy has grown leaps and bounds, well then, aces. Let him keep cooking. If he hasn't grown sufficiently and there's more evidence that he's not getting enough nutrition from my placenta, then they may decide to induce with the thought that he'll be better off outside than in. At the point of that scan, I'll be close to 37 weeks. Almost full term, not quite. I hope that I'm able to cook him to term. If not, it will be because we're doing the best thing for him. Upside being I'll get to see that sweet face just a little sooner. However it needs to happen so that he comes into this world healthy is fine by me. The evening of the ultrasound I was a sad mess. I felt like I was failing my boy way too early. Now, bolstered by my incredible doula, a particularly therapeutic trip to the acupuncturist (approaching this from all side - western meds and eastern crunch), and the kind words of friends and family, I'm feeling very confident. No matter what happens, things are going to be ok. I have an awesome team taking care of me from OB, to doula, to a stellar NICU if, god forbid, it's necessary. Also on my side, I feel him moving all the time. He feels enormous. I know he's just a little guy but my god I feel like I'm going to explode. I've gone from ribs that, as of this Saturday evening, felt as though they were going to snap into crumbled bits. I think that wonder boy is starting to settle in lower as the rib pain, while not gone, is subsiding and has been replaced by near constant bladder pressure. For now, I prefer the latter.

That's the Six Flags part of the post. In utterly lovely news, I had my baby shower. It was so, so nice. Everything I wanted. No games, fabulous food, lots of friends and family. I woke up the morning of my shower and, on cue, baby boy was squirming around. "They're throwing a party for us today!" I told him, because I am a nerd and was overwhelmed. It occurred to me that morning how long I've waited, even within this pregnancy, to just celebrate the fact that our son is well on his way. It was so joyous. I loved it. I got some good loot too, I cannot lie. Baby gear is expensive. I am grateful for every scrap gifted to us. With the influx of stuff, J and I were forced to make some serious headway on the nursery. As of yesterday evening, we are nearly done with the exception of getting the artwork on the walls (on its way from Etsy) and getting a little bookshelf. We have a crib with clean sheets, a dresser filled with clean clothes, a changing table and a bassinet that, while still in its box, can be erected at absolutely any time. My mom herded me around Target and pointed out what I might need immediately to help him survive/stay clean/save upholstery. I'm stocked up newborn size diapers, wipes, gentle baby shampoo and wash, and am the proud owner of a breast pump. Everything is ready, you know, whenever.

The follow-up growth scan takes place a week from tomorrow and then we'll know a lot more. We'll either get an induction date or the thumbs up to keep cooking. Or, something in between. Shit is getting very real and I am getting impatient. I don't want to under-cook my baby boy but I am so anxious to meet him. The time span of when that meeting may occur is preposterously large right now: between 1 week+ and 7 weeks. So much for a cozy 4 week span of possibility.