Pioneer Women

Piper spiked an inexplicable fever on Saturday. Nothing else, no complaints about hurting ears or throat, just a restless night followed by a temp that started at 100.6 and climbed to 102.5 by lunchtime. I let her drink about 5 of the tiny, watered-down apple juice boxes she loves so much, in quick succession.  We bought a box of popsicles and let her go to town. I pressed water on her, and, once the fever climbed, gave her medicine and packed her off for a nap.

We made calls, of course, to the pediatrician's office that wasn't open at 12:30 on Saturday afternoon. To the Urgent Care centers in our area, asking for hours and procedures for getting seen. To the insurance company, trying to get authorization to take her to an Urgent Care center or, failing that, the ER. We were advised that we could do that, but since our ped "doesn't do" the sort of referrals we needed, we'd be paying out of pocket. That is, if any place would see us without the referral in the first place. The very nice nurse on the help-line at the pediatrician's office told us that we were doing all the right things and that, unless the fever didn't respond to the medicine or got to 104, it probably wouldn't help to take her in anyway.

As I sat there pouring out cups of water and apple juice, unwrapping popsicles, and making our temporal-artery thermometer work overtime, I stewed in my feelings of fear and rage and helplessness. Once we'd determined that there was nothing to do but wait it out, and Piper was snoozing away in her room, I snuck in to feel her forehead again. This symbolic gesture, not capable of easing her illness or of providing any accurate information about it, served only to comfort myself. I looked at her sweet little face, curls spilling over her forehead and her cheeks flushed. I sat down on the floor beside her bed and watched her for a moment, taking in the steady rise and fall of her breathing.

I thought of all the other mothers who have sat beside the bed of a sick child. Women who held small hands and willed that tiny form to keep breathing, keep breathing, please just be okay. Thirty minutes before I had been cursing the few options available to get my child to a doctor, raging at this ridiculous healthcare system that would make us choose between health and poverty, drowning in bitter resentment of all the circumstances in my life that had brought me to a point where I could not just truck off to the ER with my insurance card. Now I thought all we have to do is get to Monday. The pediatrician's phones would turn on at 8:00 Monday morning; all we had to do was keep the fever at bay until then. Then there would be an office visit, antibiotics, an explanation. This will end, and she will be okay.

I thought of so many other women before me, my ancestors. Women who journeyed with their families from the interior of Germany, to the Volga plains of Russia, and then on across an ocean to America. Women who came from England and Ireland and Wales, who left everything they knew and bore children in a strange and wild country. Women who watched those children sicken and die, who lost them to accidents or coal mines or farm equipment or the filth of cities, and could not do a damned thing about it. These women held the hands of their children in tenement apartments, in sod houses, on crowded passenger ships. They prayed and sobbed under cover of temporary shelters, the canvas of wagon-hoods or in farm houses surrounded by rolling acres of wheat. They prayed and sobbed and hoped, because that was all they could do.

As much as I joke about moving into a mud hut and leaving civilization behind, as much chatter as there always is about "the good old days" and going "back to basics," I don't envy those women. I wouldn't want to live in a time where an ear infection or a broken arm could kill my child. I live here, now, in this turbulent and fearful world, where there is so much to be angry about and so much to inspire despair. But it's also a time where I can soothe a fever with popsicles and apple juice, where a $4.99 bottle of bubblegum-flavored ibuprofen can knock out symptoms, and where the promise of a waiting room and white coats means that everything will be okay, and for that I am grateful.

Almost-Alone Time

Ryan is at a conference in Washington all week, so it's just Piper & me until Friday. That's a loooong time with nobody else around. I may or may not survive.

At least she's feeling better. She spiked a temp late Thursday night that continued to climb so we took her to the doctor on Friday. The nurse chastised me for not giving her any medicine that morning. Apparently I should've given her Tylenol for the fever and thereby eliminated her one quantifiable symptom thus far. Then the doctor told me to only give her something if it was above 101, which it was in the office, but it had only been 99.8 that morning. Sigh. Anyway, they took some throat & nose swabs, which caused Piper to scream so loud she could be heard in the parking lot. The verdict was "a virus, probably of the 48-hour variety." So all weekend she moaned and whined and refused to sleep. She kept running around, even though her eyes were so droopy and puffy it looked like she'd been hanging out with Cheech & Chong. You'd think that this would exhaust her and she would crash out for numerous hours of sleep, like the doctor encouraged us to let her do, but no. She woke up every 35 minutes all night, both nights, until I gave up and let her get in bed with us. Then she woke up every 90 minutes.

It was a miserable time, made more so by the fact that we actually had plans this weekend. Ryan asked a friend to babysit and was going to take me to see The Goods so I could indulge my Jeremy Piven crush. We had to cancel. I couldn't even call anyone to hang out for coffee on Sunday, because the alleged 48-hour virus was allegedly contagious. Having a kid means you will always be a plague carrier of one sort or another. Sometimes it's toys that spark another kid's cartoon obsession. Sometimes it's craft projects that shed glitter all over everything they encounter. Sometimes it's 48-hour viruses that make a whiny 2-year-old's parents feel simultaneously guilty and pissed off that she will not sleep when they are dropping in their tracks.

An Inside Perspective

Well, I went to the doctor today and he said there's not much happening, I have "at least" a few more days. The baby has not fully dropped, and my first thought after he said this was oh, fabulous, it gets WORSE?! How much more uncomfortable do I have to be?!. But I consoled myself by thinking that maybe as the baby gets lower, the weight won't be hanging off the front of me, forcing bits of my tailbone to rub together, but rather in the middle, putting enough pressure on everything to keep the bones apart.

He also said I'm not dilated much at all. Now, logically I knew that there's really only one way doctors check this sort of thing, and this is why I have been refusing internal exams up to this point. I figured there will be enough people sticking their hands and whatnot up there before this is over with, so there's no need to seek it out. I tried to get out of it this time, too, but they wouldn't let me. And logically I knew that having someone reach up there and poke around would not be comfortable. "Uncomfortable" is not quite the word for it. When he did this, he was also pushing the baby down so he could make sure her head was in the right spot. I think that was the worst part - my entire midsection felt squeezed like the filling of a Baby Sandwich.

My husband was with me, and afterwards he said the exam looked really uncomfortable. "It did not look like fun," he said. "Your eyes sort of bugged out."

Then I showed him just how much of the doctor's hand had been prodding around in there, and his eyes bugged out.

New Doctor, Same Old Tricks

So I managed to switch doctors and have had 2 visits with the new practice. I am unimpressed. The new guy is younger and more hippie-ish than the old one, but he annoyed me by trying to make me feel stupid every time I asked a question or voiced a concern. I told him I was a little tiny bit concerned about pre-eclampsia, since my mom had it with me. He blew me off saying that it was nothing to worry about and "just because your mom had it doesn't mean you will." Well, yes, I know that part, but my mom having it with me does mean I'm at a higher risk, as does the fact that this is my first pregnancy. But he didn't mention that. His tone indicated that I was wasting his time by even saying anything because of course I could not possibly have it. He could've just said "well, everything's fine so far, but we'll keep an eye out" but no, he had to treat me like a moron.

I asked about the call rotations, trying to get an idea of how many doctors there are in the practice and how often they rotate, since I could potentially end up with any one of them. I'm not bothered by this, I was just curious. He responded by telling me that they have on-call doctors because he cannot be expected to just leave in the middle of a surgery or procedure. Um, no kidding? Wow, I thought you'd just ditch that emergency c-section to come running every time I feel a twinge! All I wanted was some useful information, and again got treated like an idiot for even asking.

Questions about monitoring were handled in a similar fashion. I was told that "it will be a few minutes every hour until your water breaks, but after that you shouldn't be out of bed anyway." To which I later told my husband: to Hell with that. I will get up if I bloody well feel like it and am able. Part of the reason we went through this pain-in-the ass 3-rd Trimester game of doctor-hopping was because of Old Doc's monitorning policies (all internal, all the time) and his accompanying hospital's "no getting out of bed EVER for any reason after your water breaks" policy. After Old Doc's internal monitoring policy, I wanted to make sure this guy wasn't in the same camp, so I asked. New Doc looked at me like I had two heads and said external. I tried to explain that our last doctor had been a superfreak about internal monitoring, but New Doc really didn't care. I'm not even sure he listened long enough for me to finish my sentence.

New Doc did mention this no-out-of-bed thing is to prevent cord prolapse, which blindsided me. I mean, I know what it is (umbilical cord comes out ahead of baby) but not a single one of the dozen books we have laying around the apartment have mentioned that Southern California doctors are apparently hysterically paranoid about it. None of the books, or my friends, or the half-dozen websites, or the multiple baby blogs I read have even mentioned that a doctor could try and force me to stay in bed to prevent it. I have to say, I feel a little betrayed that The Books have let me down. They could've at least warned me.

My husband, my mother, my aunt, my best friend, my sister, and practically everyone else around me are always nagging at me to tell my doctor every little thing. I usually respond with "he won't care, and he won't do anything." And they never believe me, until I am at the appointment begging for some sleep medicine and my husband watches the doctor totally blow me off for the third time in a row. I'm not sure if it's that nobody believes me that my doctors are so indifferent, or that nobody believes me when I say I research things like a mofo and I'm pretty sure I'll know when something is seriously wrong. We got into a car accident and smashed up the front end of our beloved little car at the beginning of the month, and my husband was freaking out about the fact that I refused to call the doctor afterwards. I think he would've been happy to trot me down to the ER and get checked out, but I said no. My best friend and my mom were horrified that I didn't even call the doctor's office and let them know. "Why would I do that?" I asked. "They'll just get mad and ask me why I'm even calling." There was no bleeding, I felt fine (I helped push the car out of the road because it wouldn't start, actually), and the baby was moving just like normal. I had my first appointment with New Doc coming up a week after the accident, so at the urging of about 15 people, I told him we were in an accident. As I expected, I got almost no response. Baby still moving? No bleeding? You're fine, end of story ok gotta go. Once again, I got the impression that he thought I was dumb for even mentioning it.

Most of the time, my doctors make me feel like I am wasting their time for even being there. So when my friends and family pester me to tell the doctor that I have a stuffy nose or describe how my hips hurt or make sure they write down in my chart that I was born 10 weeks early by emergency C-section, I roll my eyes and say I'll mention it, but I almost never do. My husband has been with me at every appointment up 'til now, and sometimes he'll say something if I don't, but he always gets blown off too. It took him a lot longer to accept that the doctors just don't give a shit - it's only been since the car accident mention that he's started to agree with me. Long ago I stopped seeing these "healthcare providers" as my first and best resource during this pregnancy. Whenever one of my books says "check with your healthcare provider" or "talk to your doctor," I roll my eyes and snort "yeah, right." I view the doctors as a necessary...not evil, that's not the world I want...more like obligation. I have to go, so I'll go. They're there to point out any huge red flags, but other than that it's all me. If I have a problem or a question, I have to find my own solution/answer/consultant, because "consulting my healthcare provider" usually results in no answer to my query and being made to feel stupid for even asking.

After my last appointment, during which the nurse-practitioner (New Doc was out of town) wouldn't give me a straight answer when I asked if it was okay to take Pepto-Bismol, all I could think was thank God everything's been going fine so far. I can't even imagine the uphill battle I'd have getting these turkeys to pay attention to me if I had an actual problem.

OB woes

I am starting to understand why someone would opt for an unassisted homebirth.

Two nights ago, I sat in my living room with a heating pad tied around my head. I turned it on high, draped it over my head, and then used a long tiki-print scarf to tie it in place. I sat like that for over two hours, while the pain in my head subsided a little, until I could finish my homework without having to stop and massage my skull every thirty seconds to dull the throbbing.

I'm sure I looked entirely stupid - in spite of (or perhaps because of) the small bow I'd tied in the scarf. I probably gave myself some sort of brain tumor, or my child will be born with two heads now. At this point, I don't really care, because when the baby is born I expect the headaches to cease immediately. At least the ones caused by pregnancy.

They started when I was less than a week pregnant, if you do the math. Blinding, pounding pain, usually in the front or top of my head. If the headache went on for long enough, eventually I'd get nauseous and sometimes sparkling flashes of light would dance at the edges of my vision. I tried chugging water, I tried peppermint tea, I tried laying in a dark, quiet room. I tried having a caffeinated beverage or two, I tried hot washcloths and hot showers. The only thing that helped even a little was VERY hot steam - I'd hold my head over a hot of boiling water with a towel over my head and inhale, my nasal passages searing and my face turning lobster-red. It usually provided enough relief for me to fall asleep and hope it would be gone in the morning.

When I started regular visits with my OB, I told him about the headaches. He said there was nothing to be done for it. Drink lots of water, take only regular-strength Tylenol for the pain. I just had to put up with it. I followed his advice, I drank lots of water. The two times I cracked and broke my oath to keep this pregnancy as chemical-free as possible, I immediately puked my guts out. Not so much with the Tylenol, then. Meanwhile, the headaches increased in frequency and duration, the average number climing to two or three per week. Sometimes they lasted for days. I told my doctor at every visit and asked over and over if there was something he could do, something I could take, anything. I got the same response every time: drink lots of water, take Tylenol.

I got the same response from him when I told him about my insomnia, another symptom that started after less than a week of pregnancy. I can't sleep. I can't fall asleep, I can't stay asleep. I have rarely slept more than four hours at a stretch since mid-August. I have asked about it at every visit, and again got "nope, nothing can be done." I specifically asked if there's anything I can take, because although I wanted to stay chemical-free, exhaustion is not healthy for me or the baby. A friend's midwife gave her Ambien during her pregnancy, and both she and the baby were fine. But he blew me off. One time he said "maybe try walking more during the day," but that's all I got. Not even "try yoga" or a handout with stretches and relaxation exercises or anything.

My husband has tried to step in and press the issue, and been similarly blown off. My best friend has advised me to get bitchy with the doctor, to just say "Look. I know I can have Ambien, it's perfectly safe, so just write me a damn scrip already." But I don't feel comfortable doing that. Truth is, I don't feel comfortable with my doctor at all. We barely speak at my visits, which are usually very short (less than seven minutes). The two times he's done ultrasounds, they were also pretty short - "okay, there it is, everything's fine, okay bye." If we hadn't pinned him down and asked him a bunch of questions at the first visit, we never would've known about the internal monitoring issue, or anything else about his regular practices.

I wanted to switch right away after that first visit, because neither I nor my husband was cool with the internal monitoring thing. I was bothered that the history they took was only about three questions long, with nothing about my own birth. But I thought I'd give it a few more visits with this guy, because when my primary care office referred me, the girl on the phone said he was well-liked, and he seemed personable enough. Switching meant picking another random name off the insurance company's list, so what if I wound up with somebody worse? I didn't want to be hasty. I figured I'd give it another visit or two and see how it went. If we liked everything else with this doc and I developed a rapport with him, we could deal with the internal monitoring thing one way or another.

But things have gotten worse, not better. I feel less confident in this doctor now than I did after that first visit. My mom told me that she also had headaches when she was pregnant with me, and was also blown off by her doctors. It's nothing, they told her. It happens. Then, whoops, sorry, ma'am, you have preeclampsia, we're going to to do an emergency c-section 10 weeks early. And that's how I was born. This means that my risk of developing preeclampsia is much higher than normal - four times higher, according to some studies. It's also my first pregnancy, which is when most cases appear. But my doctor has no idea my risk is higher, because he's never asked. And I never get a chance to volunteer the information - our visits are so short and I don't feel comfortable bringing it up. I don't feel comfortable bringing anything up, in fact. At the last visit I didn't even bother telling him the headaches were worse. My husband did tell him, and pointedly asked if there was anything that could be done about that or the insomnia. And again got blown off, the same "there's nothing to be done for it" as the doctor was on his way out the door.

I just feel so helpless and angry. I don't want this man delivering my baby. I want to switch to a midwife, but our insurance doesn't cover either the traveling midwives or the nice birth center nearby and there are no others in the area.

I called another OB to try and switch, except this time I was going to to do like the books advise, and interview them first. I called a clinic with three doctors listed, two of whom were female. I wanted a woman this time, to see if that would make me feel more comfortable. I was going to do things right and do my homework before I came in as a patient. I was going to be prepared.

Except those doctors don't do that, apparently. I called and asked if I could come in and talk to the doctors before making an appointment, but was told that I need to drop off the records from my current doctor for their doctor to review, and then he will decide if he wants to take me as a patient. The girl who answered the phone kept saying "he," and I gathered that it was the male doctor I'd be seeing if I'd even be accepted as a patient. One of the female doctors, although listed with this clinic's name and phone number, doesn't work there, she only works at their office in another city. The girl also seemed incredulous that a) I wanted to switch doctors at 22 weeks along, b) I wanted to switch just because I was unhappy with the care I'm currently getting, and c) I'd called up wanting to talk to the doctor at all.

So, basically, I'm screwed.

The message board I hang out on has members in other countries. The women on there who live in places with universal healthcare make it seem so effortless - they just ring up whoever they want and make an appointment. If they want a homebirth with a water tub and a crunchy-granola midwife, they get it. If they want the most sterile hospital environment possible, they can have it. Meanwhile I am stuck with no way to get what I want, no control over how this is going to go. My hopes for a nice, friendly midwife-attended birth are just silly fantasies. It's enough to make a person go buy obstetrics textbooks and take a crash-course in baby delivering.

Baby-shaped

Had my 16-week appointment yesterday. I still have not switched OB's, although I want to. I like this guy, he's very nice and personable and all, but he insists on internal monitoring from the second I get to the hospital. If my water hasn't broken, he'll break it, and then they'll poke an electrode into the baby's scalp to measure heart rate and very probably stick a probe into my uterine wall to measure contractions. None of which I am cool with. So now I have to go through the pain-in-the-ass process of switching doctors. Sigh.

Anyway, yesterday the doctor couldn't find the heartbeat with the doppler. I was unconcerned; I've heard from a couple people that sometimes they're just hard to find. I had felt sick when I woke up in the morning, which meant my hormones were probably still working, and the doctor said he wasn't worried. My husband sure was, though. Max grew more tense with every minute that slipped by, every pass of the doppler wand across my exposed stomach. I could feel his anxiety as he stood next to the exam table; he was frowning and his jaw was clenched. Finally the doctor said "oh, it's just easier to see it, let's go into the next room and just do an ultrasound."

So he did, and the baby appeared right away. The first things I saw were legs. Two skinny little legs with feet, kicking around in the grainy grey window. The wand moved across my belly, and a head appeared. "See?" said the doctor. "Still there, everything's fine. It's perfect." He started to point out the various parts, but I blurted out, "Is it sucking its thumb?!"

It was. Not only was there a recognizable head, but there were arms and hands, one of which kept flying up to the mouth.

For the first time, I felt a little awww feeling. I have been pretty "meh" about this whole deal so far, even though it was a (meticulously) planned pregnancy and very much wanted, etc. I'm not overly sentimental about stuff like this by nature, and pregnancy is not very fun, so I have not been much for teary-eyed moments. But this was different; this was a person-shaped thing, not just blobs, and it was sucking its thumb. It was doing a thing that babies do all the time. So I felt a little "awww" and I felt a little "wow." It made it seem much more real; that grainy image of thumb-sucking sank in more deeply than all the barfing, all the insomnia and aches and strange feelings have.

Holy crap, we're having a baby.