Monday, November 19, 2012

9 more weeks. I can do it. I think.

So. Because the FFN is still negative and cervix is still closed there is really no reason to subject myself to bed rest. I can go to work as long as I feel like it, which is really just incredibly frustrating because I just don't know what each day will bring. If I go on family leave now I can get sick leave donated. Chances are I'm not going to get 9 weeks worth, let alone what I would need after the baby is born. But, if I keep trying to go to work and ending up at home or the hospital in the middle of the day, it will just be missed work and I won't get paid. I guess I'm just going to have to play it by ear and hope I can ignore these effing contractions for a few more weeks. I keep joking that when I want to go into labor I will certainly know what I need to do.

In other news, the holidays are becoming increasingly difficult. Flower of course wants to spend them with her bio-mom, which is so not happening, for a variety of reasons. I think we are also dealing with some trauma anniversary of hers because some of her behavior just seems like she is in pure survival mode. We ended up inviting some family friends with a large family (5 kids ages 10-22) to come have dinner at our house because their stove is broken and I am unable to cook anything more strenuous than boxed mac and cheese. The problem with that plan is that Flower recently stole a cell phone from one of the kids and they are feuding over it. I hated to put her in a position where she would feel judged and uncomfortable, but we aren't going to stop being friends and she will have to deal with it at some point. Usually when they are together they manage to get along so I'm hoping we can distract everyone with some fun outdoor games and we can avoid a major explosion. I guess we will see.

The other issue is that Sunshine, the 6 year old, is beginning to mimic almost all of Flower's worst behaviors. The last two days in a row she has been a screaming, raging mess. This is really, really unlike her. I don't know if she is just internalizing the stress of having a sick mom and hurting older sister, or if something worse is going on.

*Edited to add*

I had to stop typing because Flower came in from the backyard and then the Professor brought sunshine home from daycare. Sunshine seems much better today and was pretty well behaved for her, just some whining and enough defiance to cause some raised voices. Flower asked again about seeing her bio-mom today (I had already told her no) and fell apart when I said it wasn't happening. For a moment there I thought we were going to have a repeat of the night she was Baker Acted, but she managed to calm down and fell asleep. I have a feeling the holidays are going to be very, very rough. Poor Sunshine. I didn't realize that adopting a child with a traumatic background might very well ruin the holidays for her for life. I don't know that it would have changed my mind, but I feel really bad about taking that from her.

Friday, November 16, 2012

Bed Rest, again.

Yesterday I was sure I was just overreacting, but at the same time was convinced something was wrong. I've been having mild period-like cramps for about 3 days. Since that is one of the common warning signs of pre-term labor in women without an irritable uterus, I was making note of it. Yesterday I started feeling more consistently crampy, along with the feeling that the baby had dropped and was pushing against my cervix. I wasn't having more contractions than usual but felt "off" enough that I decided to go to the hospital.

The nurse at labor and delivery who answered the phone was not willing to entertain the idea that I knew what I was talking about and insisted I follow the stupid protocol of drinking a ton of water and laying down for an hour. This may work with a normal pregnancy with early contractions, but with an irritable uterus drinking a lot of water is guaranteed to speed up and intensify the contractions. I didn't argue, though, because I was worried if I showed up not having frequent contractions they would just send me home without checking my cervix or fetal fibronectin. So I pretty much intentionally made the contractions worse. Stupid, I know, but that seems to be the price of dealing with the high risk hospital here. They are still entrenched in the idea that pregnant women are clueless about their bodies and must be guided to do the right thing. It aggravates the shit out of me and makes me long for a midwife and home birth.

So I waddled to the L&D triage with a very full bladder and one pissed off uterus. Because of this the contractions, which were disorganized, weak, and 7 minutes or more apart, became very regular, very strong, and 3 minutes apart. I didn't have the pills I was given to slow contractions with me at work so they gave me the first one at the hospital (vistril). After an hour with no change they gave me a shot of terbutaline and checked the cervix (still long and closed) and fetal fibronectin (still negative). Those last two were really what I wanted to know so I was happy that they were comfortable sending me home to rest after the terbutaline shot.

Unfortunately, because this was the third and worst episode at the hospital, I am now on bed rest until I see my doctor again. I'm not sure what she will want to do because I still have the cramps and my uterus is back to being easily irritated into contractions. I had a couple of weeks there where I was even able to run without setting them off, but now just standing will do it.

The only bright spot is that I am now at 30 weeks so the danger to the baby is not as great (still significant, though) and I only have a few more weeks of worrying about it. I am kind of hoping they tell me to stay home because I can now get sick leave donated, but only for extended absences. This pattern of missing a day of work every other week is wreaking havoc on my budget. I need to be all the way on or all the way off.

I do believe someone, somewhere, has cursed me that I may live in interesting times. Never a dull moment.

Saturday, November 3, 2012

Post adoption services

First of all - it is high time that I came up with pseudonyms for everyone. I have always had trouble coming up with clever nick names so I've been using initials, but I find that to be pretty annoying and it's not very anonymous. So, I've given it some more thought and here is what I came up with.

Our Family:

K, age 6, AKA Sunshine

M, age 15, AKA Flower (Rose was a bad choice, I can't say why)

S, Hubby, AKA Professor (this is a joke on his personality, poor guy)

Dragon - currently a very feisty bump.

Ok - so now that I have that - and will probably change it again, back to my post.


I can't say enough good things about the post adoption support we have found. The original agency we adopted through, the one contracted with the state that handles all the adoptions, is absolutely horrible. It took over a year just to get a home study. Matching didn't take a crazy amount of time but the support and information we were promised never appeared. We were given lots of inaccurate information about Flower, we were promised records and explanations we never got, and we were promised tons of services that we never received. We went through 4 case workers in the 7 months it took to adopt her, 2 of those months were without any case worker at all. The therapist that was supposed to keep seeing her at home for 6 months after placement never showed up. We never got her records from California or got to talk to previous caregivers. I never complained because things were going pretty well and we just didn't think we needed all those things.

Now that the honeymoon period is over and we are in crisis, I am incredibly grateful that yet another agency is sub-contracted to handle post adoption support. They have been amazing. We now have an in home family therapist who can come to the house, a referral for a full psychological evaluation - which I have asked for repeatedly and never gotten, we are in the process of getting a different individual therapist for Flower that also comes to the house, and she will be able to see an actual psychiatrist instead of an nurse practitioner. We also have a case manager who can take Flower out to do things she enjoys and is willing to set up supervised visits with her biomom, taking me and the Professor out of that equation. I think that will make a huge difference because we can avoid the whole battle over when and how she sees her mom and siblings. I'm sure Flower will still argue that she should see her mom whenever she wants, but it will take a great deal of strain off of us, and if biomom is not being reliable the visits won't interfere with our plans. I'm not 100% sure the visiting thing will work out, but it gives me a lot more hope. Professor has only taken Flower on one visit and pretty much refuses to do it again, so all of the burden is on me, which right now is just not sustainable. I'm much less stressed knowing there are alternatives.

Things are looking hopeful. I'm sure we will still have lots of hurdles to overcome. The family therapist has mentioned residential treatment more than once. I'm really hoping it won't come to that because Flower doesn't need more separation, but at least there are now several more people in her corner, trying to get some workable solutions. School is becoming a big issue so the timing for intervention is very good. She came within a hair of being suspended and put on probation the other day. Once she starts down that road it's a pretty quick trip to an alternative school (basically reform school), and I just don't see that going well.

I really appreciate all the support and sympathy, please keep you fingers crossed that things will continue to improve.

Thursday, November 1, 2012

Some things are better, some things are worse

Baby is still good. The fetal fibronectin came back negative again and last cervix check was good. I am limited to light office work but not on bed rest. The instructions I have are for "irritable contractions" and say to take the meds, lay down and wait 40 minutes. If they get worse I get another trip to L&D but we are mostly sure the baby will not be coming early. Mom will just be really uncomfortable and constantly freaked out. Very restful, no?

The situation with M (lets call her Rose) has gotten worse. Last Friday she got really angry so she broke a mug and cut her foot with the shards. Hubby (aka Baldy) got the shards away from her and told me to call the new therapist, who had wanted to know if she did any more self-injury. The therapist told us that we had to take her to the ER for evaluation. I REALLY did not want to resort to hospitalization. The last time she was hospitalized she lost her adoptive home (the people that kept all of her sisters). I think she went straight from inpatient back into foster care. She sees the hospital as the place where people send their kids when they are too much trouble and the parents don't want them anymore. But the therapist was right, we could not let her hurt herself. Baldy (I know, I'll come up with something better) took her to the hospital and after talking to her the staff admitted her to the behavioral health unit under a Baker act. For those not in my state that is a 72 hour involuntary commitment for psychiatric evaluation. We spent almost all day Saturday with her and was told she could go home Saturday night. The doctor got her confused with someone else and thought he had to get DCF clearance to release her, so she didn't actually get to go home until Sunday afternoon. Since then she has been pretty manic, pretty angry, and very defiant, but she hasn't hurt herself. We have a bunch of appointments to try to get to the bottom of this but I'm seeing a pretty rough road ahead.

Work is the only thing that is actually good news right now, surprisingly. 25 people lost their jobs yesterday in my division. I was not one of them. Not only did I not lose my job, I was given a permanent, benefited position!!!!!!!!!! I have sick leave!!!! And vacation!!!!!!! And healthcare if my husband loses his!!!!!!!! Best of all, I am now eligible to receive sick leave donations!!!!!! I won't be able to accrue enough leave to have any maternity leave, but if I get enough donations I can have 6 weeks paid leave. I won't have to wipe out my savings account. We may even be able to buy a new car.

What a crazy week this has been and it is far from over. I have some more to say about Rose but I'm not going to have time to finish this post so I'll update again when I get a chance.

Wednesday, October 24, 2012

Baby is fine, mom could be better

Good news: Fetal fibronectin is negative, cervix is still long and closed.

Bad news: The UTI is not to blame for the contractions. They are continuing and get worse the more I do. Sometimes just walking through the grocery store causes them to get 3 minutes apart and they won't stop until I lay down. I have a medication to take that calms contractions, it is actually an antihistamine, but it really only works if I am also laying down. This means I am mostly likely headed to bed rest or at least restrictions on work. There are several reasons this is a very bad thing.

A rundown of last week: After another trip to labor and delivery and a shot of terbutaline I am now at weekly visits to the OB. Ultrasounds to check my cervix have been good so far. I'm told to take it easy and rest (ha ha hahahaha). Thursday night our teenager, who you will remember is fairly recently adopted from foster care, absolutely fell apart. She lost it over some minor argument and repeatedly hit her wrist on the wall or a tree outside until she had a large contusion.

The following day she left school early, supposedly because her wrist was hurting, but really to get out of a biology test. While at my friends house, who picked her up from school because I was out in the field, she poured perfume on her hand and set it on fire, burning two of her fingers but not badly.

On the way to work the check engine light came on in my 15 year old car with 200,000 miles. We have already put in almost 3K in the last year and a half, we just can't put in any more. On the other hand, we can't really afford a car payment and the additional daycare for the baby. Because I don't get paid leave we won't have enough cash to buy even a clunker. I'm not sure what we are going to do yet. The problem is reading as a misfiring cylinder and something that is blocked (I forgot what it was called).

When I got back from the field I was in a meeting in which everyone in my division was told that we would all be moving sections and therefore supervisors, and that 40 positions were being cut. An unknown number of those are vacant but at least 20 people are being laid off. I've been told my job "should" be safe but I am losing the best supervisor I've ever had and I don't know if the new will be willing to work with my restrictions. They will tell us on the 30th who is staying.

Friday night M was much calmer and really helpful and I made the mistake of rewarding her by letting her go to a teen hangout for a couple of hours. I was tired and stressed and should have said no, but I was also looking forward to a couple of hours of peace. As I was going to pick her up the off-duty police officer who watches the place called me to tell me she was kicked out for smoking. Fortunately he didn't give her the $50 citation that I would have had to pay.

Saturday was our Halloween party and although I did way too much and M was in a bad mood some of the time because her friends didn't come, the party went pretty well and everyone had a good time. Sunday morning I quickly realized I would be doing absolutely nothing the entire day. I ended up laying down for four hours because I was within minutes of hitting the point the doctor told me to go to labor and delivery. It was obvious I overdid things. I am very frustrated that it didn't show until the next day. How am I going to tell when I do too much?

I missed most of Monday and all of Tuesday at work so now I'm really behind and my check will be really short. Again.

So, now I am a high risk OB patient under an enormous amount of stress. We are now getting post-adoption services from an agency here that is not the useless one we adopted through. While this is a good thing for M, it is more scheduling and appointments for me. I was already overwhelmed, I'm not sure how I'm going to manage.

My husband has mostly taken over the housework and will take over the kids if I can't do stuff, but he is still arguing constantly with M and making that situation harder.

Losing my job now will not be nearly as devastating as it was before, but it won't be fun or easy. At least I wouldn't need a car! I don't know if the timing could have possibly been worse with this pregnancy. I should look on the bright side, though - at least we are not in a zombie apocalypse (how I love netflix).

Well off to a warm bath and more timing contractions. If I end up on bed rest you will be hearing a lot more from me!

Saturday, October 13, 2012

I may actually have a diagnosis for once

With my history I was sure they would find nothing to explain why I keep having contractions. For once I am happy to be wrong. I don't know why the hospital didn't mention this when I was there, but my urine had some leukocytes in it. That is usually caused by a urinary tract infection. UTI's are well known for irritating a pregnant uterus and causing contractions. The nurses always ask about difficulty peeing when you go in for contractions. I kind of wondered last time if that might be the problem but that time my urine was clear. Of course I had been drinking gallons of water to try to stop the contractions, so maybe it was just too diluted. Anyway, I am on antibiotics and awaiting the culture results. Normally I refuse to take antibiotics "just in case" but those contractions are scary. I think the risk of antibiotic resistance is worth not having a baby born at 25 weeks.

I'm hoping that a UTI is really what caused all this and once it gets cleared up I'll go back to the normal braxton-hicks. I'm not holding my breath because I had so many contractions with my first baby. I suspect they will get better for a couple of weeks and then get worse again, but at least by then we will be in safer territory for a preemie.

The good news is that my cervix is nice and long and closed up tight. Baby already has her head well down in my pelvis, right up against my cervix. That made me nervous. I would have preferred she hung out higher for now. It is weird to me to have a large baby in my pelvis. My first was very high and breech until right near the end and the second never made it to that size. When she wiggles around (which she does a lot, good baby) it feels like she is trying to break out.

I am trying very hard not to be resentful of how hard this is for me. Everyone around me has had or is having really easy pregnancies after getting pregnant within a few months of trying. I'm glad none of them know how painful a loss is but it is hard to listen to how naive they are and not be angry. I keep wondering why just one thing can't go smoothly for me. Then I feel guilty for complaining when I have a healthy six year old and a baby I thought we would never get on the way.

I told the doctor and the ultrasound tech that my uterus and I have a mutual hate-hate relationship and all this drama is it getting back at me for all the times I said I hated it. Stupid body.

Well, I am resting this week and I will make an effort to be grateful for a healthy baby and maybe try to make peace with my body.

Friday, October 12, 2012

Ok. So I really do suck at this pregnancy thing

Last night was my second trip to labor and delivery for uncontrollable contractions less than five minutes apart. Both times I was sure they would stop on their own but both times the doctor's office told me to not take the chance. Last night the nurse I spoke to very nearly yelled at me and she had me in tears. She wasn't being mean, she was just alarmed that I wasn't taking my contractions seriously. She lectured me on how much harder it would be to raise the children I have with a baby in the high level NICU for months, assuming she survived. I was in hysterical tears, which really didn't help the contractions any.

I just don't know what to do about this. I had it with my first pregnancy but it wasn't nearly as scary because they didn't get bad until after 30 weeks (I'm 25 today). I could never tell if I was actually in labor or not so I made endless trips to the hospital until I was nearly full term and then I ignored the contractions as best I could. Back then I was not working and didn't have other children to worry about. If I started contracting I could lay down. Now I can't. My income makes up most of our living expenses. My husband makes so little all it really covers is daycare and my commute. The only reason he works is because his job is the one with benefits. Since I don't have any kind of leave being on bed rest will be devastating.

Well, to back up, this is how yesterday went:

I went to work early to try to make up some hours for stupidly taking a day for myself last Friday and hanging out with my best friend. I had planned to go out in the field and do a couple of inspections but it was hotter than I expected and I was feeling out of sorts so I decided to put it off (thank god). I couldn't really pin point why I didn't feel good, I was just cranky and uncomfortable, which in hindsight is kind of alarming. I did notice more than the average number of contractions but they weren't less than 10 minutes apart and they were only intense when I was aggravating my uterus by letting my bladder get full or climbing stairs.

I got home and was still cranky so even though I didn't feel like it, I took M to her friend's house to get her out of my hair and then came back to start dinner. As soon as I started cooking the contractions intensified. I kept ignoring it because I was only making spaghetti and I figured I would lay down once I got to eat. By the time dinner was ready and we were sitting down to eat I was starting to think the hospital might be on the agenda. I started timing the contractions and didn't make it past 3 minutes the whole time. I was determined to finish dinner because I knew they wouldn't let me eat at the hospital and going that long without food would make me miserable. I know, great thing to be worried about, right? My husband knew I wasn't feeling well and had offered to help or take over but he was exhausted from working outside all day and I was being stubborn.

I called my sister (she is a family doctor who specializes in OB) and she lectured me about not taking it easy but didn't seem overly concerned about me not going to the hospital right away. I told her I was going to drink some water and lay down so when I was done eating that is what I did. By then the contractions were right on top of each other. It was getting hard to tell when one would end the next would begin. I was starting to worry, not that the baby would actually come, but that I would have to go get checked just in case. I called the after hours line at my doctors to tell them what was going on and ask how long I should wait to see if they stopped on their own. That's when the nurse almost yelled at me. When I told her that they were 2-3 minutes apart her voice got high and stern and she said "you are past the point of laying down, you need to go to the hospital now!" I started bawling and she was understanding but at the same time was clearly trying to scare me into being reasonable. We left my little one at the neighbors and went. The contractions did stop on their own after 2 hours at the hospital but they still gave me two meds to relax my uterus and told me to stay in bed until I saw my doctor. They did the fetal fibronectin test and it came back negative, which means there is a very good chance I won't go into labor in the next two weeks. That was reassuring but in hindsight the contractions yesterday were very different from what I'm used to. There was a lot more pressure and discomfort than I usually get and my overall feeling of something wrong persisted all day. Even when they stopped it was weird. They went from 3 minutes apart to nothing. It was another 30 minutes before they gave me the meds so it wasn't that. I've never had them just stop like that.

I already had an ultrasound scheduled today because of my last visit to l&d, so at least I will be reasonable certain the baby isn't coming any day if that goes well. In the meantime I am on bed rest. I know I'll get yelled at when S gets home for lunch because I had to get up to get something to eat and get the computer so I can do some work. Nobody really thinks about how impossible bed rest is when you have no one to stay with you. At least the kids are at school. I've known people that were told to be on bed rest with a toddler in the house. Talk about impossible.

So, wish me luck at the ultrasound today. I have a sinking feeling that the rest of this pregnancy is going to be a constant battle against my body to get anything done. I can probably work from home, and even from bed if I have to, but it won't be easy. I hope my boss will stay as understanding and helpful as he has been because he doesn't need a reason to fire me. Someone above him could decide I'm not being productive enough and force him to let me go. And I just don't do resting well. It will drive me insane knowing there is so much to get done and I can't do anything. My husband may have to tie me to the bed.

Any advice on coping with severe restrictions would be appreciated - also gentle reminders that this is about a healthy baby - not me being comfortable!