Grayson Muses

Back in Black

2008-12-07T21:20:00.004+01:00

(Okay, no black. Blame the title on Guitar Hero III, one of our Saint Nick Eve family gifts. It rocks. I was doing my Angus impression earlier--not that I had an Angus impression before GHIII, mind you.)

Anyhoo, I took the blog out of circulation for a while because I just didn't have much more to say. Turns out a lot of folks missed it. Moreover, silly Google told people they needed to be invited, which was not so. I had it set to allow no one access. So if you sent a request, my apologies that Google gave you the impression I was dissing you. Google never let me in on the fact people were requesting access.

A Year Tomorrow

2008-10-20T23:17:00.003+02:00

I've been dragging my feet toward this day for weeks. As it nears, I spend more and more time reliving the same days a year ago. On one hand, that's good; therapeutic, appropriate, and it reassures me that I haven't forgotten. On the other hand--well, I'm sure it's as obvious as a magenta cow in a snowy field. It sucks. Sucks like the mother of all Hoovers.

After lots of not wanting to think about it, turned into thinking about it for seconds at a time, turned into audible discussions, I've decided we'll commemorate her death by lighting a candle all day and observing two minutes of silence at dinner (by which time the baby should be asleep). I can't bear to do more, but I'll regret doing nothing.

Strangely enough, I'm afraid it will get harder as the years go by. She wouldn't be that different now if she had lived; in ten years, we'll be commemorating someone she would no longer be. It feels like holding her back, which I know is silly. And it's all we have, so we'll make do with it.

Movin' On Up

2008-10-02T14:31:00.006+02:00

To the west side (of the Netherlands). (Anyone else remember The Jeffersons?) After six years in the Dutch south, two of them spent wondering "should we stay or should we go?" (anyone remember The Clash?), we've taken the plunge and are moving back to my husband's roots next March.

By American standards it's just a nice, ordinary house; by Dutch standards it's to drool over. First of all, it's detached, not sandwiched between two other homes like 80% of all Dutch houses. Second, it's got a whopping 205 square meters (about 2230 sq. ft.) of floor space, compared to less than 1500 in an average Dutch home. And after we enclose the second-floor terrace, we'll have another 60 m2 (650 sq. ft.). Third, it has a huge yard (460 m2, or 1/9 acre) compared to our current, average-sized 190 m2.

This is why all our Dutch friends thought we were living the high life in our very-average-middle-class, $ 125,000 home in Durham. That house had 2300 sq. ft. and was, of course, detached. It had way more land (1/3 acre, or 1375 m2) than our new home. All at a mere fraction of the price we're paying for this luxury in the Randstad.

So much for the US perspective: we're delighted with our new home and feeling very much like We've Made It.

Aside from the better digs, this move brings us closer to Oma and Opa, Schiphol airport, and the North Sea. Several major plusses. But no transition is without drawbacks; the kids are sad to be moving, and we're leaving behind a rich social network, nurtured for six years. Yes, yes, we can always visit, but that isn't the same as living right around the corner.

Our eldest son is particularly bummed by the move. He alternates between being angry at us and feeling inconsolably sad. He's leaving behind his very best friend in the universe, the boy he saw on day one of kindergarten and knew was the one for him. (I do not exaggerate; that's exactly how it happened.) We've reassured him that true friendship doesn't die when the friends are apart--witness how close we've stayed with my husband's friends from high school--and listed a dozen ways they can stay in daily communication. He's getting used to the idea, which is not to say he's accepting it, exactly. He refuses to acknowledge even the smallest positive point about the move, to the point of hilarity (for us, anyway).

Our daughter, equally sad to be leaving, has a different approach. She figures it's going to happen, so she'll deal with it when it does. She can see the benefits of a bigger room, bigger yard, shorter distance to Oma and Opa. She knows she'll make new friends. In the meantime she just doesn't think about it. Certainly a more comfortable approach for her than our son's constant lamenting is for him--as long as she isn't stuffing her feelings under a rock, where she'll have to deal with them in therapy years later.

9/11

2008-09-11T21:38:00.005+02:00

For thousands, this was a day of mourning in 2001. For me, ten years earlier, it was a day of incredible joy. It was the day I first became a mother, the day I completed a rite of passage I had both feared and anticipated, the day I welcomed my firstborn to the world and marveled over her tiny perfect body as she nursed.

Today, nearly a year after her death, we celebrated her entrance into the world seventeen years ago by making fuse bead creations and playing 10,000 as we ate jellybeans and listened to her favorite music. We dined on steak and salad followed by ice cream. I think she'd be pleased with our activities.

In the days leading up to her birthday, I thought about her more and more often. Yesterday, the day labor began seventeen years ago, and today I thought about her constantly. Now I lost the mucus plug. Now we went out to lunch. Now contractions were so strong we drove to the hospital. Now I peed all over the nurse and doctor with my first push. And more times than I can count, I thanked the universe that I didn't know then all that would later come to pass.

I meant to celebrate her life today, but I couldn't fend off a deep sense of mourning. I remember so clearly how overjoyed I was with her, how happy to be a mother, how much I had looked forward to meeting her. She was as perfect a baby as any other, as perfect as Tilo, and I think his presence brings her babyhood back into focus at moments like these. I mourn the beautiful little life that was born that day, now gone for good.

Babybug

2008-06-12T11:07:00.005+02:00

Two weeks ago I took some plant clippings from the yard to root in containers in the window. Yesterday my seven year old cried, "Look! Baby ladybugs are all over these plants!" Sure enough, I spotted five ladybug larvae crawling around on the windowsill and the leaves.

(Click to see a larger version; the ladybug is in the center of the photo.)

Ladybug, ladybug

2008-06-04T10:05:00.004+02:00

This year we have an abundance of ladybugs in the yard, so many I find them by the fives and tens without searching on every plant I touch. Red ones with black spots, black ones with red spots, and scads of armadillo-like larvae. I'm happy about this, as they eat the aphids on the rosebushes. As of this morning, I'm also moved to tears by it. Because in an e-mail conversation about something else, my daughter's stepmother commented that Meghan chose the ladybug as her sign to let them know she was around.

Seven Months

2008-05-21T11:32:00.005+02:00

The enormity of what happened takes my breath away. Literally. Sometimes I cannot breathe, thinking about the daughter that was, the baby so full of life, the shy young girl terrified to speak up in class, the older girl with such a forceful, even destructive, lust for living; and then the frightened girl in a hospital bed, sick beyond relief from drugs and radiation, and later the passive, paralyzed, bald girl who seemed to have made peace with this turn in her life. Those months were good ones, healing for me, and I hope for her, after years of difficulty. But after them came the weeks of rapid decline, the confused girl, childlike, worn out, increasingly unable to understand or, eventually, make herself understood, who dribbled when she drank and didn't know when she had to pee. Now I see my youngest child making the strides forward that every baby makes, and I think of my firstborn, who made those same strides forward sixteen years ago, and then in reverse sixteen years later.

I suppose it's normal, seven months after her death, to still feel the wound so deeply. This kind of thing is unnatural, is not supposed to happen; just the thought of a sixteen year old--any sixteen year old--dying causes us all to shake our heads in sorrow. And this was my child. Yet when she died it was also welcome. We knew it was coming, and her year of struggle, extreme suffering, and then heart-wrenching decline made her death a relief. Though I knew to be prepared for the feelings I'm having, I thought with the optimistic naïvete of the uninitiated that I'd dealt with her death already, that knowing it was coming and living through her illness so intimately had prepared me. That the worst of the blow had already been processed.

But it stays with me, its power to make me burst into tears undiminished. It hits me when I hear certain songs, see certain photographs, watch Tilo reach baby milestones. Sometimes it hits me without any trigger at all. It feels like it felt when, running to jump my grandmother's ditch, I fell flat, hard, and the wind was knocked completely out of me.

I hope the pain will fade as the years pass, but then I'm terrified that that means I won't remember the details anymore.

Time Flies

2008-05-16T16:15:00.010+02:00

The Baby
Little Tilo will be two months old tomorrow. Like all babies, he's changing daily. He's an avid nurser and is gaining well; at 6 weeks he weighed 4030 grams, more than a kilo over his birth weight. His little legs have plumped right up. We saw his first smile on my birthday (strategic move, Tilo). All my babies were easy, but he's topped the list by being the first to sleep for 6 hours at a stretch so early in the game. His gas pains seem to be easing, he spits up much less frequently, and he's starting to coo. Can it get any cuter?

I've been remiss on posting photos, so here are a few to catch up. Here, angelic at 9 days old:

Doing the electric boogie at 12 days old:

Not too happy (either of them), 17 days:

He often dreams of winning, though we don't know what (6 weeks old):

First and second bottle practice runs at 7 weeks (note to my crunchier friends: don't freak, it's expressed milk):

Enjoying a bath in the Tummy Tub, 7 weeks:

Surf Safari
We spent the Whit Monday holiday weekend in Zeeland, this time in a ground-floor apartment right smack dab on the waterfront. The view from our living room:

It was heavenly, especially since the weather was fantastic and the days are already gloriously long, sunrise around 6 AM and sunset around 9:20 PM, with illuminated skies for a good half-hour or more beyond.

Some things don't change--remember last year's Zeeland trip? Sophie poses, Ben jumps.

The apartment was fantastic. The kids played by the lake shore whenever we were home, and there were lots of other kids (mostly German; Sophie acquired an arsenal of playmate-finding phrases) and the open grassy area between the individual yards and the lake was often filled with soccer balls (many of which ended up in the lake; thank goodness for long-handled nets). The shore was lined with smooth pebbles, and skipping stones was also a favorite pastime.

Ben was having too much fun to object to his picture being taken, giving us a rare treat.

(That's our apartment, and me, in the background.)

Marco and the kids spent three days surfing at Brouwersdam while Tilo and I camped out in the grass beside the surfing cove. We got smart the second day and took the parasol and a lawn chair from the apartment with us. The weather was phenomenal all weekend, truly marvelous by Dutch standards--by any standards, actually: high 70s to low 80s with a constant breeze.

Ben didn't make as much progress as he'd hoped, but Sophie improved in leaps and bounds. Last year she was too scared to do more than hold the cord between the board and sail; this year--well, have a look:

She was totally psyched.

Seeing the camera trained on her, she went into supermodel mode, naturally.

We also took a gentle 3-hour sail in a Centaur, Tilo in his Maxi Cosi (carseat). Ben was very nervous at first, as was his mother (who, despite her childhood on the water, only managed to retain one thing: one should keep one's head down when the boat comes about). Fearless Sophie had a blast manning the rudder. Ben was in charge of turning Tilo's carseat around to keep him out of the sun. After a while he warmed up and took a turn at the rudder. No photos, alas; we didn't want to risk a waterlogged Pentax.

Remembrance

2008-05-02T13:26:00.002+02:00

Meghan's tulips, blooming by the front door.

Home and Happy

2008-03-25T11:54:00.005+01:00

Tilo (say "TEA-low") and I came home on Thursday. We're both doing beautifully. He's an absolute angel, hardly ever cries (only when he's hungry or having his diaper changed), nurses like a champ, sleeps through all kinds of noise (which his siblings provide in abundance), and makes all those cute little half-asleep baby faces and noises. His father and I are, naturally, over the moon.

The C-Section
The c-section was far better than I'd feared, better even than my best case. I knew exactly what to expect, and even so there were a few good surprises. I'd expected to have to remind everyone Dr. Dietz had said the catheter could be inserted after the spinal, but they all knew. I'd been told the OR is cold, so I expected to be shivering there on the table in my hospital gown, but the staff had heated blankets ready for me and so I was warm throughout. No one talked about shopping or movies or anything other than the operation. One of the staff was present purely to take photos for us from the business side of the curtain, so we've got great shots of Tilo being born.

Tilo cried (best sound in the world) right away. Good lungs! His Apgars were 9, 10, and 10. 2910 grams (6 lbs 6 oz) and 50 cm long (19.5 inches) *. Marco was by him, touching him, as they checked him over, and he got to make the final, symbolic cord cut (the doctor made the "real" cut in the sterile field). Then Marco brought Tilo to me, and I got to touch him and kiss him for several minutes before they had to leave.

The sewing up took an eternity. I started feeling the afterpains (contractions of the uterus) during that time, but didn't feel anything else, thank goodness. Finally they wheeled me into the recovery room, where my temperature and blood pressure were a little low. Staff put an industrial-looking hair dryer under the top layer of blankets to warm me up, and asked if I wanted my husband sent down. Fifteen minutes later he and Tilo came walking in. Another pleasant surprise, as I hadn't expected to be able to see them until I left recovery.

In the meantime upstairs, Tilo had been weighed and Marco had held him against his bare chest, both of them wrapped in heated blankets. Marco opted not to dress Tilo yet, so I could hold him skin to skin when I got to see him again.

Once my temperature and blood pressure were back to normal and I started tingling in my toes, they wheeled me from recovery back up to the maternity ward. Around noon Oma, Opa, and Tilo's big brother and sister got to see him for the first time.

Tilo was grunty and showed no interest in nursing, which had me a little worried. I was reassured that c-section babies often do this (no pressure from contractions and squeezing through the birth canal to press the last amniotic fluid out of their lungs) and that both would resolve within 24 hours. And indeed, by late Monday evening he was breathing without grunting; by Tuesday morning he was rooting for the nipple.

At one hour old he was finger-fed 10 mL of formula because his blood glucose level was too low (another factor that can contribute to grunty babies). That did the trick and though he had to have four more heel pricks to test his glucose level, it stayed high enough and all were content to let him discover the joys of nursing in his own time.

I had no side effects from the c-section: no spinal headache, no nausea, and the incision is healing nicely. Seen purely as a method of giving birth, it was easy--I didn't have to do any work at all and had no pain. Of course, it's not just a method of giving birth; it's also a major operation, and the recovery is much slower and much harder than with my vaginal births. Eight days later I still move slowly; turning over in bed, sitting up, standing and walking all take time and effort, and if I move too quickly I pay for it in searing pain.

It's hard to be so dependent on others. I can do extremely little myself. Fortunately, each day brings a new little milestone: yesterday, for example, I managed to put on my own socks for the first time in a contorted pose not unlike the late-pregnancy sock-putting-on pose. Today I gave Tilo his bath for the first time, and walked down the stairs alternating feet instead of always leading with one foot. Woo hoo!

Mixed Emotions
Throughout the pregnancy people said so often, "You must have such mixed feelings, life and death so close together." I've felt that more strongly since Tilo's birth than at any point before. Sixteen years ago the nursing baby at whom I stared in rapture was my eldest child. All the feelings I have for Tilo, I had for her then. And she's gone.

The hardest thing is my lack of confidence. Before her illness and death, I always assumed things would work out well. They always had. Bad things happened, and of course I knew they could happen to me, but they never did. Now I can't shake a fear that some new catastrophe is lurking around the corner. I fervently hope this doom-and-gloom feeling will pass.

Bliss
I hate to end this post on a blue note, because most of the day is quite sunny. So let me share a feeling I had just before my eldest came back to live with us last April. We knew we were in for a heavy time full of chemotherapy with little chance of success. We knew the physical and mental workload caring for a half-paralyzed, wheelchair-bound cancer patient would take a toll. And yet I had a moment of clarity, one of three or four I've had in my life, when I knew that her coming back would usher in a period of great happiness for us. I didn't know what that meant and I definitely didn't see how that could possibly be so at the time, but now I do.

Sometimes I imagine her standing next to his cradle by the living room window, her blonde hair shining in the filtered sun, one angel smiling at another.

* The first nurse measured him at 46 cm; two days later another nurse measured 50 cm. We had a suspicion, as he barely fit into the preemie size his 47-cm brother wore for weeks.

Tilo in Pictures

2008-03-18T23:31:00.004+01:00

Earthside

2008-03-17T22:42:00.002+01:00

This is Grayson's husband. I am happy to report that everything went even better than expected this morning. Tilo Morris Jacobs was born at 9.38am, weighing 2910 grams. Tilo did not have to go to the NICU. He's a little grunty and hasn't yet shown any interest in eating, but the doctors say it will resolve itself in the course of the day. More news will follow later.

Counting Down . . .

2008-03-16T14:28:00.002+01:00

Friday's checkup was business as usual, cervix 3.5 cm. Nice to enter the last weekend on that note. And now it's Sunday afternoon, and in 17 hours we'll be at the hospital. In less than 20 hours we'll have a baby!

Excitement at meeting our new son is slowly gaining ground on my dread of the operation, for which I'm thankful.

I'll be in the hospital for several days, no Internet connection, but Marco will post a blog entry for me as soon as we're up to it.

Thanks to everyone who's been reading along and living vicariously with us! I'll take all your good thoughts and wishes to the hospital with me.

Checkup: 35 weeks 2 days

2008-03-11T15:56:00.003+01:00

All quiet on the Western front. Cervix 3.6 cm. One more checkup on Friday before the c-section on Monday. We're expected at 7:30 AM on March 17 and are second in line for the OR, so we'll probably be out of surgery and recovery and holding our baby before noon. Funny, despite all the attention the pregnancy has demanded, it still seems so abstract. Well, that'll change for sure on Monday ;).

Now that things have been steady so long and we're so close, most of my thoughts are for the impending c-section. I dread it like a student dreads a major exam, like an introvert dreads giving a speech. It keeps me awake at bedtime and occupies many of my dreams. I will be totally delighted to be on the other side of this major abdominal surgery. On the healing side. Moving forward instead of counting down.

Checkup: 34 weeks 5 days

2008-03-07T16:17:00.003+01:00

Business as usual again today. Cervix 3.0 cm, no contractions, nice heartbeat. Weighed in at 66.5 kilos (146 lbs), pee looked good, blood pressure 110/75. Just ten more days to go!

Checkup: 34 weeks 2 days

2008-03-04T21:37:00.003+01:00

Another uneventful checkup. Cervix 3.6 cm, CTG great, healthy heartbeat, no contractions. They didn't weigh me this time (or last time) and were unconcerned that I forgot to pee in a cup before I came. With twice-weekly checkups, I guess we can afford to miss a urine check or two.

The ultrasound technician who caught the vasa previa on our 20-week ultrasound (at a different facility) is now employed by our hospital, so we were able to thank her today for being so observant.

I'm feeling ever more confident that this may just work out all right. Still feeling mostly like a normal pregnant person (well, this weekend I was feeling like a zombie raised from the dead by Christopher Walken to perform nefarious deeds in service of his plot to rule the world, but fortunately that's cleared out, leaving only a slight cough in its wake).

Buy Stickers, Save the World

2008-02-29T13:09:00.006+01:00

Okay, that's perhaps a little over the top. But my sticker store is donating all profits for 2008 to charities. Help us have some profits to donate--buy yourself some stickers, or pass our name along to (Dutch-speaking, EU-resident) friends and family who might be interested. If you're a journalist, blogger, or other media-maker for a Dutch-speaking public, write about us.

Our slogablurb:

Butterwing Stickers
mooie stickers waarmee je de wereld ook nog een handje helpt
kinderstickers * knutselstickers * hobbystickers

As seen in our website logo:

Checkup: 33 weeks 5 days

2008-02-29T13:06:00.004+01:00

Everything still looks great. Cervix 3.3 cm, fundal height 34 cm (right on target), CTG with a beautiful heartbeat and no contractions. I'm still feeling more like a relatively normal pregnant person, less like a walking time bomb.

Four more appointments, and then he'll be here. Just 17 days to go!

Happy Birthday

2008-02-27T23:50:00.002+01:00

Our son turned 9 today. Serendipitously, his school had a study day, so he was free to party all day long. Best friend Ivar slept over on Tuesday night and both boys were quite excited. And up early this morning.

He was ambivalent about his birthday over the past few days. Part of that was worry that his father and I might not be able to be there (if we had an emergency situation with the pregnancy); part of it was the associated thought of possibly having to share his birthday with his little brother. But mostly, it turns out, it was something his sister said. She told him we didn't have any presents for him. And he believed it!

But presents he received in abundance, and many visitors, and good weather. He went to bed quite satisfied, feeling very much the birthday boy.

Checkup: 33 weeks 2 days

2008-02-26T22:13:00.002+01:00

We had a little more excitement yesterday, culminating in another visit to the hospital just to be sure. The CTG didn't pick up any contractions, cervical length via ultrasound was 4.1 cm, and manual examination of the cervix showed it to be tightly closed and moderately firm. I came home feeling like a normal person instead of a walking time bomb, if only for a little while.

The entire staff reminded us to call again no matter how wispy the symptom: better that we call 100 times for nothing, said Dr. Dietz, than that we don't call and that nothing turns out to be something after all.

Today's regular checkup went very well. Weight 66.25 kilos (146 lbs), up a whopping 1.25 kilos (3 lbs) in 4 days. Surely some of that was my sweater. Cervix is 3.2 cm, CTG was lovely (the baby slept through it this time around), no contractions. New was the abdominal ultrasound to check on the baby's growth. All his parts look wonderful (and boy did we get to see male genitalia up close and personal, no mistaking the sex) and he measures just under average by Dutch standards (remember, these are the tallest people in the world). That puts him at an estimated 3.5 kilos (7 lbs 12 oz) at full term, and just over 2 kilos (4 lbs 8 oz) now.

We asked about the back-and-forth cervical length measurements, which have ranged from 4.6 cm to 2.7 cm in the past 3 weeks. Dr. Dietz said anything more than 1.5 cm is "long," but you can't glean much more information than that from the numbers. They'll vary from day to day, even moment to moment, based not only on the angle and person involved in the measurement, but also because the cervix itself changes length for non-labor reasons--if the baby shifts position and puts more or less pressure on the cervix, for example. We're just happy that what looked like a downward trend hasn't continued.

Checkup: 32 Weeks 5 Days

2008-02-22T11:47:00.006+01:00

[Note: This post generated a lively discussion in the comments, which may be of interest to you if you're grappling with vasa previa. Click on the post title to read the post with all comments.]

The already well-informed Dr. Kuppens had printed out the latest recommendations from Up To Date, an independent informational clearinghouse for physicians, to ensure that her team is aware of the most recent guidelines. Trouble is, there is no recommended optimal management of vasa previa; it's too rare, and there are no large or controlled studies that demonstrate the most effective protocol.

In that light, said Dr. Kuppens, we have room to continually revise our plan. Catharina Hospital will admit me for the duration at any point if that's what we want, and we can even pull the c-section date forward--as early as 34 weeks--if we feel that would be best. If I have contractions again like those Monday, we'll call enough enough and go ahead with steroid shots and a c-section 48 hours later. She even said that if we--or she--just have a gut feeling, we'll go ahead with the c-section. It was refreshing to hear a doctor acknowledge that gut feelings can be valuable sources of information. I certainly believe they can--not because of some voodoo psychic whatever, but because those intimate with and experienced in a situation can pick up on subtle clues that don't quite make it into the conscious light of day.

The hard thing is to know what's best, of course. Boys in particular have the most trouble with prematurity, trouble that can extend into their school years and affect their fine motor skills. But every day he stays in the womb is a day the fetal blood vessels could rupture, and at this gestational point being on the outside will always give a better outcome than total rupture. If we knew when that would happen, we'd wait till the day before and get him out. But, of course, we don't know.

For now my husband and I have opted that I stay home. Despite the panicky rhetoric peppering the Web, we feel that being in the hopsital gives a false sense of security. I've read over a hundred real-life stories and distilled the facts into the following conclusion. In diagnosed vasa previa, there are really only two basic scenarios: either you have some warning before massive rupture (water breaking but vessels still intact, contractions that change the cervix, or simply reaching 36 weeks) or you don't. If we have warning, then the fifteen minutes it will take to get me on the operating table, even coming from home, are more than enough. If we don't have warning, then even three minutes will be too long.

From here on out, we'll also check the baby's growth and have a CTG at our biweekly visits (in addition to the transvaginal cervical length check). The CTG is to check that the baby, ever heavier, isn't compressing the blood vessels over the cervix. My husband and I were worried about that, but Dr. Kuppens reassured us that it's unlikely; the amniotic fluid provides a cushion and buffers the baby's full weight. I sat up as straight as I could during today's CTG, though, to let the baby put as much pressure on the cervix as I could. The results were great; the baby was active and his heartrate was strong, and there were no significant contractions. My blood pressure and pee were perfect; I weighed in at 65.0 kg (143 lbs), up half a kilo (just over a pound) since last Friday.

My cervical length was 2.7 cm, which is less than the most recent 3.2 cm and bears watching but is not yet cause for concern. Dr. Kuppens showed us in detail during Monday evening's ultrasound how they measure the cervical length; depending on the angle (and the person doing the check), readings can vary by a centimeter or so (the shortest number wins). She also showed us what 1.5 cm (50% effaced) would look like. That evening she measured 4.1 cm and 3.2 cm back to back, demonstrating that it isn't down-to-the-millimeter accuracy even though it's expressed as such. That said, today's reading and the reading from a week ago (also 3.2 cm) were made by the same ultrasound technician, who takes three measurements each time. So I'd bet the drop to 2.7 reflects a real change, even if not a full half-centimeter.

My next checkup is Tuesday.

Four Months

2008-02-21T13:17:00.002+01:00

Hard to believe it's already been 123 days since my eldest died. Seventeen and a half weeks. A third of a year.

A Little 32-Week Excitement

2008-02-20T10:15:00.003+01:00

Thirty-two weeks and two days (the day my water broke with #2) has come and gone and the baby's still safely inside. But this milestone didn't pass completely without incident.

On Monday (32 weeks 1 day) I had mild contractions all day. So mild I'd have ignored them completely if this weren't a vasa previa pregnancy. But they were similar enough to very very early labor (when you think "hmmm, maybe in a couple of days this could become something") and they went on long enough that we decided to have them checked out at the hospital.

They hooked me up to a CTG (cardiotocograph) and measured the baby's heartrate and my contractions for about an hour and a half. The heartrate was beautiful; the contractions were mild but real. A cervical length check late that evening showed my cervix to be unchanged at 3.2 cm, which was delightful news. They kept me overnight for safety's sake, and sometime while I was sleeping the contractions stopped. A second CTG the next morning confirmed a restful uterus. I was sent home with instructions to come right back in if it happened again, however mild.

My husband and I were elated to hear from practically every nurse, resident, and doctor who came by that a big old sheet of paper with my name and instructions written in large, bold letters is hanging in the staff room. This time they all knew who I was!

I slept terribly, but had good company. My roommate, Sylvie, had come in early Monday morning for contractions in week 31 of her twin pregnancy. Hers were significant enough to merit steroid shots and a two-day IV drip to try to stop them. We chatted non-stop for several hours that evening and started back up early the next morning (her IV started pinging just before 7:00 AM, waking us both). Poor Sylvie had to stay at least one more night, but the contraction-stopping drug seemed to be taking effect; I hope she's able to go home today.

My next checkup is Friday morning.

Checkup

2008-02-15T14:51:00.006+01:00

We saw Dr. Kuppens today at the hospital. The transvaginal ultrasound showed my cervix is 3.2 cm long, down 1.4 cm from Feb 4 but still not a cause for concern. If it starts heading for 2 cm (1.5 cm is the 'start thinking labor' point) then they'll admit me, give me steroid shots for the baby's lungs (which need 48 hours to work), and operate. From now on I'll be going in twice a week for cervical checks.

Dr. Kuppens also took a quick look at the baby via abdominal ultrasound. Everything looks fine and we heard a solid, steady heartbeat. He's certainly been kicking and pushing around in there enough lately to keep me from worrying about him.

My pee, collected at home this morning, was lovely, no protein or sugar or anything else off kilter. In a charmingly ecological departure from US protocols, the nurse rinsed out my sturdy, lidded plastic pee cup and gave it back to me to use for next time.

I weighed in at 64.5 kg (142 lbs), down 0.2 kg (almost half a pound) from two weeks ago. In total I'm up 7.5 kg (17 lbs) this pregnancy.

On an ironic but positive note, I don't have gestational diabetes this time. (I've been checking my blood sugar at home regularly since 20 weeks.) In fact, everything else about this pregnancy is perfect: blood pressure, blood sugar, weight gain, how I'm feeling. Textbook. If it weren't for that technician at the 20-week ultrasound, we'd be blissfully heading for catastrophe. Intervention-wary though I am, I'm now an ardent supporter of the 20-week ultrasound.

I asked about having my tubes tied as long as they're in the area, and Dr. Kuppens said it was less than two minutes' extra work, but perhaps it's better not to do it right away in case something goes wrong with the baby. My husband is also reluctant for me to do it.

Right now I feel like this decision doesn't hinge on what happens with the baby; we didn't plan this pregnancy, I'm 40, and we've been looking for a permanent birth control solution for a while. I've probably got another 10 fertile years to go. Since condoms clearly aren't foolproof, we need something else. This pregnancy was enough of a shock; I won't be happy at all if it happens again at, say, 45. But I concede that I might feel differently if things go wrong now.

It's not an operation I'd have on its own, so if we don't do it during the c-section, then we'll have to find some other solution. Vasectomy is on the table, but understandably not very appealing to my husband. We'll see.

After speaking with Dr. Kuppens, we headed up to the maternity ward on the 12th floor. We wanted to see if they are indeed prepared for us if we call suddenly and need a rush c-section. They weren't, but now they will be: Dr. Dietz (the obstetrician who explained exactly what we were dealing with two weeks ago at the 30-week ultrasound) will hang up a sign with my name, birthdate, patient number and staff instructions for if we call. She'll also send an e-mail to every nurse on staff so all are aware.

It was a frustrating 45 minutes, and I cried through about ten of them, but I'm glad we did it. The last thing we need is a nurse who answers the phone and thinks, "Yeah, right, you say we need to call in an OR team, but I think I'll just see what the doctor has to say about that." Not that this is an unreasonable response--we completely understand it. And we understand a nurse who thinks, "Poor dear, this must be her first, she's so panicked" and waits ten minutes for the doctor to finish checking someone's dilation before she informs him. But we can't afford any misinterpretations of our situation. We can't afford for someone to wait for my file to be brought up from the second floor before calling in the OR team*.

With every visit we get closer to making conditions ideal in an emergency. With luck, we won't have to find out just how well we've done.

* unbelievably enough, Catharina Hospital still works exclusively with paper files; no electronic patient records.

35 Days to Go

2008-02-12T17:40:00.000+01:00

We don't have an exact date for the c-section yet, but I'm 36 weeks on Sunday, March 16. Splitting the difference between March 17 (my choice) and March 19 (when I'm 36.5 weeks as the doctor specified) gives us March 18: thirty-five more days in the best-case scenario.

Now that I've exhausted all I could find to read on vasa previa and torn myself from the computer, the worst of the panic has subsided. It is what it is, and we don't have much to say about how it's going to go. There's only one scenario that can really go badly, and that's if the baby's blood vessels spontaneously rupture with no warning sign. In that case there won't be anything we can do to save the baby, even if the OR team are standing beside my bed, knives in hand.

Fortunately other scenarios are much more likely, such as my water leaking or breaking with no immediate vessel rupture, or changes to my cervix, or contractions. Or reaching 36 weeks without incident. In all these cases they'll be cutting me open within fifteen minutes (perhaps slightly more leisurely in the last case) and the baby should be just fine. He'll be early, but our 33-weeker was fantastically healthy, so that doesn't worry me much.

I've ordered four preemie outfits and five boxes of pantyliners that can detect amniotic fluid leaks. My hospital bag is packed, the maternity ward phone number is posted on the fridge, and we've practiced the route to the hospital during rush hour (also under 9 minutes). I walk slower than a Sunday driver and spend a lot of time resting on the couch. I don't go anywhere farther from the hospital than our home and I've always got a driver with me. This week that's my father-in-law; my husband is in Barcelona for a long-planned and important business trip. His employer was incredibly wonderful to us during our daughter's illness and death--which all began less than three weeks after he was hired--so I'm glad we don't have to ask for special treatment again quite yet.

My in-laws are a real blessing. Always there for us, fun to be with, enthusiastic about the kids and never imposing. My father-in-law is telecommuting to work from my husband's attic office and my mother-in-law cancelled the week's agenda to come stay with me. He's glued to a 50-meter circle of which I am the center; she brings the kids to and from school and has taken over several household tasks. Everyone should be so lucky. My in-laws make up for a lot.