Friday, October 31, 2008

Musings

Before I went to Cambridge University, I did realise that the chances were that I would come into contact with people who would do really important things and possibly a few who would be famous in the general scheme of things.

This has turned out to be true, I was at college with http://en.wikipedia.org/wiki/Hattie_Morahan. Rather ironically, I had loved the drama she starred in in 1996 and not known it was her when I met her at college, to be fair she was someone I barely knew, but I think she was part of the same group of friends as my room mate in the first year.

A good friend of my husband's father had won the Nobel Peace Prize the year before and was considered some kind of security risk.

There were many people we knew who were so friendly and level headed that you'd never know of their great acheivements, it took me years to realise the connection between and algorithm I'd learnt and a lovely old man I'd chat with at coffee.

For quite a while I had an office across the corridor from the guy who invented iris recognition and who was also some kind of advisor to my husband for his final year project. Again, you'd never have known from him what he'd acheived, nor by how he lived.

Somehow at Christmas 1999 one of the easier versions of the eternity puzzle http://en.wikipedia.org/wiki/Eternity_puzzle appeared at our house and we all found it rather tricky and pretty much laughed at the idea that anyone would solve the full puzzle and win the million pound prize. Turned out that the solver, only a few months later had been a fellow of my college and supervised me for two years, he'd left a few months previously "to do other things" it seemed he had no real plans and this piqued his interest. How quite such an intelligent guy could appear to be quite so scared of a group of 18 year old girls, I don't know!

Tuesday, October 28, 2008

Sickness

I spoke too soon about not feeling sick last week, in the past few days I'm not only feeling sick, but actually being sick too, not my idea of fun, there was one day last week where I only kept down popcorn! Not exactly the ideal diet, but not really any worse than any of the other dry easy to swallow options I could think of!

I had breakfast with my dance partner on Sunday morning, I had to ask where the nearest restroom was, then run!

Dancing

I love to dance. As a child I was sent to dance class age 4 and just kept doing more and more until I went to college. I went to college in the UK, unlike in the US you can't get credits from multiple departments and even if you could only a few places have anything in the performing arts. When I got there I took up Scottish country dancing and occasionally some other folk dancing. I also did a 4 week crash course in ballroom dancing. I intended to audition for shows, but lacking confidence in singing, I only got round to doing one, which I didn't get through. Gradually I threw my energy into other things, mostly rowing and I got unlucky picking up injuries and mostly couldn't dance anyway.

But dancing is in my blood, I was destined to come back to it and finally last year I did, I took up ballroom dancing at a studio close to our home and I'm loving it. I've even started competing! I do International Style - what the rest of the world would know as ballroom dancing it's only in the US they have to distinguish between International and American style. It's split into two style "Standard", which includes Waltz, Foxtrot etc. and Latin American i.e. cha cha, jive etc. Of the two I prefer standard, though ironically at the moment I seem to be much better at Latin, standard is all completely knew to me, I have to relearn how to use my body. Latin is different, but a lot of techniques from Ballet and Modern are useful.

The problem is, at some point I have to tell my dance partner that I'm pregnant and this is going to muck the partnership up, but right now I'm attempting to live in a dream world where at dancing I'm not pregnant!

I've also been taking some ballet classes recently, which I'm loving, I hope I can carry on with them for quite a way through pregnancy.

Tuesday, October 21, 2008

 


I'm going to try and remember to take pictures right through this pregnancy. Previously I've only managed it once or twice. I'm already feeling self concious about my tummy, this is silly, but it is losing some tone, but it was pretty well toned for a mother of two, particularly with the amount of stretch marks I have, my skin isn't doing me any favours, it's all genuine tone!

Andrew took this picture on Sunday night, so 6 weeks precisely, I'll probably try and settle for multiples of 4 from now on!

I had a random thought tonight, assuming delivery occurs by 40+3, that would mean from finding out to delivery is 36 weeks. Tomorrow we'll have known about it for two weeks, meaning 1/18 of the way! Fractions help me, it's like ticking something off, it feels like acheiving something.

I've not felt as sick today, I hope this doesn't mean anything, I'm crossing my fingers it's more of a sign that I know what to do, so instead of waiting and seeing how I feel, I eat at certain times because I know what will happen if I don't!

I have an appointment with my physical therapist (physiotherapist in English!) tomorrow, it will probably be the last one, I saw a physiatrist last week, they are doctors that specialise in management and rehabilitation of musculoskeletal issues, mostly back problems. As well as everything else I've had two severe impact injuries to the same spot in my mid back, the 2nd was 6 weeks after Banana Girl was born and it's possible that time actually included a break of one of the vertabrae, with all that going on, it's hardly surprising it's a long term on off struggle with pain in that area, this PT has worked wonders with my neck and other bits of me, but the mid back pain hasn't changed. The physiatrist thinks it's time to try something else and has suggested another PT who specialised in a particular type of massage which might help me. I think I'm a difficult case as my spine is very mobile, so one joint being slightly stiff is a big contrast which causes muscle spasm and tension, when the same injury in someone else wouldn't be such a contrast with normal. Treatment has to attempt to get things moving at my normal range not average normal range, which is also tricky. Obviously I'll also be telling her I'm pregnant - this is a topic that has come up in conversation, so it will be interesting to see how she reacts, bizarrely it's not that long ago since she actually did ask if I was pregnant as it seemed like everyone around her was!
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Saturday, October 18, 2008

yuck, sickness

This sickness is hard - though I'd exchange nausea for some of the pain I experienced last pregnancy any day, but even so it's still hard, the worst bit is the feeling that you might actually lose it an throw up simply via gravity, bending over to fold laundry was not good!

The lack of control isn't great either, as well as nausea, I seem to have lost control of my body temperature, this has happened in my other pregnancies too. This afternoon at dance class, I came over all funny, like a hot flush and feeling nauseous too, I chose to try and cover it up and push through it, when really I wanted to go and stand outside. Given it was a joke at the studio that made me realise getting a pregnancy test was a good idea, I wasn't risking another potential "well you know what causes sickness....".

Sausage Boy has been doing a good job at keeping quiet, though apparently one of the older girls at dancing asked him something about did he have a baby in his family and he didn't know what to say as he seemed to feel neither yes or no was correct and he said something about her having to ask his mummy if there was a baby in her tummy, I wasn't there, but the next class he pointed her out to me and thankfully it isn't any of the girls that I know or would cross paths with, or as far as I know someone who's friendly with anyone who knows me as anything more than a random face. There are a few girls there who do know me as not just Sausage Boy's mum, but as a dancer and might put two and two together.

Banana Girl doesn't have the conversational skills to share the information, though she's clear on the fact there is a baby in my tummy, however she seems to think there is one in hers too, so how much she really understands is hard to tell!

I'm trying hard not to think about the birth too much, there is a heck of a lot of fear in my head surrounding that and I think in part how the pregnancy goes will effect a lot how the birth unfolds, but there is still a lot more information that I could find out, but it's hard to draw out the facts, Ehlers Danlos Syndrome does have an effect on expected outcomes, premature rupture or membranes is more common for example, as is damage to the pelvic floor and related structures. Most current medical advice is that if you have anything more than minor damage down there to have a c-section anyway, because their is a risk of making things worse, particularly if it turns out to be a difficult second stage, but it's still fairly small and as far as I can tell it's only details about actual tears that have been studies rather than longer term functional consequences, I had a neat 2nd degree tear, but have damage and function more comparable to a 3rd or even 4th degree tear, as I understand it, because the tissue underneath was torn but the outer skin mostly stretched, so it wasn't connected to the surface and thus not diagnosed, or repaired at the time - repair or 3rd and 4th deg tears is about long term function as much as it's about short term wound healing or infection control.

But given a c-section would be recommended anyway, it's hard to tease out if based on the Ehlers Danlos Syndrome that would be a stronger or lesser recommendation and there are a heck of a lot of factors to consider. I know that if it were only this type of damage to consider, that without EDS, on the information available to me, I'd not choose to have a c-section, which would be atypical, but as others who've made the same decision have said, they'd rather take the 10-20% risk of things getting worse than the guaranteed major surgery - but I might make a different decision if 10-20% was 50% or another number.

I don't even know who can really help me with this area, I had seen a physical therapist who worked with me on these issues, even before I got pregnant I'd been wondering about going back to her as I had felt things were worsening, she might be able to help me wade through things. I also saw a reconstructive gynaecologist to get a full diagnosis of what was going on, even though I didn't mention more children she said I should have a c-section, but because I wasn't thinking of having more I didn't quiz her much, so I don't know if based on exactly what she saw that was a very conventional medical view, or whether she thought my current damage was bad, or risk higher or anything. I could go back to her, but I don't really know if she could tell me anything more.

I also don't want to make any decisions early as I want to be open minded about this and be able to stay with my midwives, I think they are going to be a lot better for me for pregnancy care than an obstetrician, but if I decide early on we're going the c-section route, it would be hard for them to keep me, they know already that I probably wouldn't risk going into labour with a baby anything but perfectly positioned and have access to doctors for if that situation occurs, but want to work with me right through the 3rd trimester to make sure that doesn't happen.

Friday, October 17, 2008

Still not telling!

I'm not sure that should really be "still" as it's normal not to tell at this stage, I'm not even 6 weeks along yet. However I feel so sick, it feels really wierd attempting to go about normal life with no one around you knowing what is going on inside you!

I already feel enormous, though whether my slightly rounded tummy is due to baby, or simply my increased appetite is debatable. What is very clear though is the increased size of my breasts!

The midwife called yesterday to say my vitamin D was extremely low, which is a surprise as though the PNW isn't out of the zone of concern, it gets a lot more sunlight than the UK and I'm fairly sure I've been tested and just not shown a concerning result. I think it was tested around March time, when a test showed I was mildly anemic. I looked up vit D deficiency and there is some kind of loop with iron and zinc, but my brain wasn't working enough to work it out!

I have a vague recollection that vit D supplementation has been suggested for chronic pain, so I need to track those references down. I've been feeling so tired I haven't called the midwife back to get the exact numbers, she wants me on supplements which I am fine with, just curious as to how I got to this point - vit D comes from sunlight (well it's rather more complex than that, but getting out in the sun will make your body produce more) and I've not been out in the sun less than usual, I'm not a big sun person and I do protect myself. It's also in milk, fortified rather than naturally, I barely consume any, but that isn't a change from usual either.

I'll probably just pass it off as one of those things.

I've been feeling twinges in my symphysis pubis (where the bones join at the front of your pelvis), which worry me, I'd hoped to get to the 2nd trimester before that becomes a problem, but it also reminds me what a horrible pain it is and I know realistically I will suffer with it for a good portion of this pregnancy and that is scary.

Friday, October 10, 2008

Reassuring chat

I took the plunge and called a local midwife, I'd had this horrid fear that I'd somehow be ineligble for midwife care, there isn't so much a notion of shared care as there is in the UK and there are circumstances where a midwife pretty much has her hands tied over consulting a doctor and that can be troublesome.

In the UK a midwife has what is known as "duty of care", they have to care for whatever they are presented with, even if that person is completely non compliant, so someone could present with a situation that clearly needed more intervention than a midwife could give but refuse to transfer to the hospital, the midwife would probably inform someone to make sure her views were recorded independently and probably a few other things too, but ultimately regardless of when the situation presented, they'd still have to give care.

In the US a doctor can "drop" a patient - it's sadly not that uncommon to hear of a variation from normal, such as a prior c-section, being promised they could try for a VBAC with a particular doctor or group of doctors, only for them in late pregnancy to told the doctor was no longer willing to let them to that and in some states it would be illegal for a midwife to offer care, so it's possible to be left with no care.

There is a midwife in the UK, Mary Cronk, who is highly respected both by mothers and midwives (and hopefully doctors too!), she has several handy phrases to be used to point out to a doctor (she calls him Mr Hi-and-Mi-ti) that it's not his position to allow or not allow a woman to do anything - sadly that fundamental truth doesn't apply in the US, if the doctor says get induced and you say no, you could find yourself in a bit of a fix, there are some requirements in the law to care for a labouring woman as part of the requirement to provide emergency care, but it would be definitely suboptimal and you'd have to go to an emergency room and take pot luck.

All this was causing me some distress, the chances of me agreeing with a doctor are fairly slim, I don't respond at all well to orders, I want to know what each and every blood test is for (and if I remember rightly, last time I concluded that two blood draws with very basic tests was useful, but I'd do nothing more unless medically indicated) etc. and I need to be respected if I say no to things - especially anomoly screening type things, but there is other stuff that is routinely tested for that when you dig deeper the benefits of testing are unclear.

These things are all reasons that scream "find a midwife", but I'm not a trivial case, I'm not high risk, but not clear cut low risk either and there is stuff that will need management through pregnancy and getting to the end of pregnancy and deciding a c-section is the best option isn't an unlikely scenario and I didn't think it would be possible to go into midwifery care with that as a possible outcome. But I had a long conversation with a midwife today and it appears that it is, that at the end of a pregnancy the doctors they have relationships with will accept patients for elective section. Another thing that helps this particular midwife pairing is that one is also a natropath - which means they can fulfil some of the requirements to consult a doctor on certain issues without going outside.

It's such a weight off my mind, the only thing that does concern me is that having researched a bit into how to have the best c-section for both mum and baby there are a few things that I consider very important that aren't routine practice currently. Hopefully as the pregnancy goes on I'll have a better idea of the chances of me going that route and thus how much thought I need to put into it, or if it's a bridge I can cross when I get to it.

Where I'm at

Physically I'm sat on my bed, fairly wide awake at 2:49am. I'm a night owl anyway, but this is crazy, I'd like to be asleep, but sleeping tablets at this stage of pregnancy are a no no. Narcolepsy is a funny thing, people have usually heard of it in that context, a medical reason why some people fall asleep in odd places at odd times. But the truth is, that's not a true representation of how narcolepsy effects people, even a lot of doctors don't realise that a significant proportion of people with narcolepsy have problems sleeping at night time, I'm often asked why I take sleeping tablets by doctors other than my primary doctor and sleep specialist. I take them because if I don't, I don't get much sleep and since I started meds to combat the day time sleepiness, I've needed them even more.

So now I can take neither, which means I don't have many weapons against the tiredness I'll feel tomorrow (or today, in fact!), particularly as I'll try and avoid caffeine to give myself a fighting chance of sleeping tomorrow night.

The worst thing is, when I'm tired, I'm irritable, I become the world's worst mum, I try and get them to stop talking even when they are talking quite pleasantly simply because I can't process all that information coming at me! Then I hate myself for it.

I do have an idea, I realised I don't allocate time just to listen, I'm listening as a drive, or as I make lunch, I really ought to be able to figure out time to just listen, I'd also like to carve out time for individual time with each child. I naturally get it with Banana Girl because she's only in two day preschool, but given she has a tendancy to dedicate some of our mornings to screaming because she's not at preschool it rather spoils it, but I'm finally noticing that since Sausage Boy has started kindergarten, we're not getting much of that, I think I need to arrange a date with him!

Thursday, October 9, 2008

Why mumprime?

How do you choose a name for a blog? Do you concatenate a few words about your life and hope people will remember exactly the order, spelling and where the underscores are? Possibly, it's not a bad way to choose a name - but the blogs you remember are often the ones with snappy names, but of course all the snappy names around common subjects are taken!

I'm a Brit living in the UK, so my kids call me Mummy, but they haven't quite realised the difference and at preschool tend to produce works of art with me labelled by a kindly teacher as Mommy.

When my husband realised "Mummy" was free as a license plate number, he pretty much insisted we got it when he discovered how cheap it was - you'd think people would get the idea, but apparently the general opinion is that I'm some kind of Egyptian fanatic!

So why mumprime? Well, I have to confess, I'm a bit of a geek, though I've kept out of the loop for the past few year, but prime in my head will never mean anything but an indicator that differentiation has occurred. Being philosphical I could say that represents my acknowledgement that motherhood is something that changes through time and those changes are probably rather more interesting than a chronical of the day to day existance of being a mum.

Prime can also imply "prime number", so it acknowledges that things being as they are I have a prime number of children, both now and hopefully in nine months time (so can you work out how many I have now)? That all sounds a bit reminisant of the BBC Radio 4 program (oft repeated on BBC7) "The Consultants".

Then there is the obvious, prime meaning first or best - I don't think I'm number one mum, a long way from it in fact, but I do happen to believe that God is in control of my life and my kids life and that for know that means I am the best mum for them and will be as long as I live and they live.