Juliet Martinez

Thu, Oct 30 2003

I almost forgot...

The doctor who looked at my ultrasound yesterday is the guy who does the really tricky amniocentesis and CVS tests. He confirmed what I had suspected, that the CVS, which samples fluid from the placenta, is out of the question because my placenta is positioned at the back of my uterus. He asked if I wanted to have amniocentesis yesterday, and I brought up the risk of early delivery and my desire to postpone the test until delivery would be safer for the baby. The doctor gave me a surprising response:

"That's reasonable."

I don't think I've ever had a doctor respond like that before, but I liked it. So we'll probably wait another 9 weeks or so to do amnio, and if it's not possible then, we'll skip it.

This doctor said my amniotic fluid seems to have reached a steady state that it may just stay at. The amniotic fluid index has been at six for three weeks, so he said when we do amniocentesis the uterus will almost definitely make up for the fluid they take and go back to an AFI of six. Needless to say, the very idea that my uterus has mysteriously set its preferred level of amniotic fluid just above the danger zone (Normal AFIs range from 8-24, while 5 and below are considered dangerous) is somewhat comforting. I think my uterus may regret that move as the baby gets bigger and, uncushioned by amniotic fluid, gives it more of a daily beating. Or maybe I'll be the one regretting that.
by Juliet Email me!

Wed, Oct 29 2003

Here's the "hard news" lead on my ultrasound results:

My ultrasound this morning showed that my amniotic fluid level has remained steady at a below-normal level that my doctors said is still adequate for proper lung development and fetal movement. The prognosis remains positive as long as my fluid levels don't go lower, but apparently as the baby gets bigger it may face a higher risk of fetal distress because of constricting blood flow in the umbilical cord.

Needless to say, Mom, Joel and I are very happy with this news. Of course, we would be happier if my amniotic fluid level were higher, but this is just fine. It's funny how every time we see the same amniotic fluid index (or AFI - because they can't give you an absolute volume of fluid, just a score based on ultrasound measurements), the doctors give me better news. Three weeks ago when my ultrasound at Northwestern Memorial showed an AFI of six, the doctors there told us we should think seriously about terminating the pregnancy. Two weeks ago at UIC I got another AFI of six, and doctors said the baby has a chance of developing normally and making it to term as long as the level doesn't go any lower. Today the prognosis seems even a little better.

I guess it just goes to show what Nilufar's dad said the other day: In medicine, 2+2 never equals 4. You never really know how things are going to go, and we still don't. We just have to play it by ear for the next 10 to 15 weeks and see how things will go. Will I be able to give birth in a low-intervention setting at West Suburban Medical Center, or will I have to give birth in the high-tech environment at UIC? Right now there's no way to tell.

The other good news I have today is that after consulting with Joel and me last night, my mother has decided to stay in Chicago until after the baby is born. It is a huge relief to me that she'll be here, reminding me to rest and exercise, helping with all the things that need to be done on a daily basis at home, just hanging out and having fun. I've definitely had some dark moments in the last three weeks, and my mom's presence is just very reassuring. Besides, she brings her knowledge of midwifery and maternal-child health, which is coming in very handy. For my part, I'm trying to help her as a technical advisor of sorts as she develops her Maternity Fitness Spa (R). I know I'm getting the better deal, though.

by Juliet Email me!

Tue, Oct 28 2003

Close call... This morning for about an hour I couldn't access my site and realized how attached I am to it. I'm so glad it's okay! As the mothers of lost-then-found children say, "Oh, my precious baby! NEVER DO THAT TO ME AGAIN!"
by Juliet Email me!

The frog and the pomegranate

On Saturday night Mom and I went to Walgreen's to buy one or two little things we needed, and of course left there with more than we had planned on buying. It's very dangerous to go shopping late at night, especially in a drug store. You never know what they'll have, and some of it is bound to call out to you.

Mom and I wandered through the aisles making jokes about the embarrassing personal care products and dancing to the piped-in soft rock (Hey, it was Van Morrison, so be quiet). We chatted with the sales person whose job it was to check on us while we shopped. We told her she was welcome to just wander around with us, we'd enjoy the company. She laughed like we'd spoilt her attempts to be casual about following us, but didn't take us up on our offer.

On an impulse, Mom bought the baby a little bright green stuffed frog that makes a "ribbit-ribbit" sound when you squeeze it. It also rattles when you shake it. The darn thing is so cute that we're both quite taken with it. I have taken to squeezing it and holding it to my belly so the baby can hear it go, "ribbit-ribbit... ribbit-ribbit... ribbit-ribbit." And I tell the baby, "That's the toy your Grammy Dee bought for you." Sometimes I hug the little frog.

Yesterday I spent most of the day in bed, feeling tired and crampy and not knowing quite why. Actually it wasn't that much of a stretch to figure that the stress of the last few days, combined with not drinking enough water had taken a toll on my bod.

The baby was really active all day yesterday, and my uterus felt very tender, so every kick was uncomfortable. I took a hot bath and went back to bed. Mom read to me and made me soup. I even took the first (and so far only) Tylenol of my pregnancy. Then I remembered what my midwife had told me about feeling crampy. It was very likely a bladder infection. Just what I've always wanted.

By last night Mom was wiped out from bringing me tea and food all day, so I made a little trip to the store for cranberry juice (and to get some new videos). At the store I found pomegranates, which I had been thinking I'd like to eat. At $1.29 each, I decided to get only one. But when I got home I looked in my big book of Chinese nutritional healing and found that pomegranates are used in Chinese medicine for treating bladder problems. I guess your body really does tell you what you need to eat, huh? At least while you're pregnant, and at least when it's not telling you to eat large quantities of ice cream, Lemonheads and guacamole Doritos. Not that anyone I know has eaten those lately...

Well, I ate my pomegranate, drank my cranberry juice, and this morning I'm feeling much improved. I have to stay really rested and hydrated so I can keep my amniotic fluid up and get good news at tomorrow's ultrasound appointment. I'll let you know how it goes.

by Juliet Email me!

Mon, Oct 27 2003

Goodbye, Cleo

Yesterday Joel and I did something very difficult, but unfortunately necessary. Cleo's anxiety and Joel's and my stress from trying to take care of her had begun feeding off of each other. Joel got less and less sleep because Cleo whined and cried in the night. Joel and I argued about the best way to handle Cleo's whining, and Cleo responded to the tension between Joel and I by crying more and peeing in her crate.

After coming home from any of his three jobs to a house only moderately unpacked and the needs of a pregnant wife, Joel needed to be able to rest and unwind for a while if he was going to remain sane. Instead he was greeted with an anxious and energetic puppy who demanded attention even when she was in her crate. As Joel's needs went unmet, his, then my stress levels escalated, and Cleo became even more agitated. The situation became untenable, and absolutely not what the doctor ordered for me and the baby.

So yesterday, with heavy hearts, we returned Cleo to the Anti-Cruelty Society. We filled out a personality profile on her, describing what an affectionate, smart and family-oriented dog she is. We emphasized that she is wonderful with children and easy to train. We also described her anxiety problems and occasional nervous habits. They told us she will be checked out by the vets tomorrow and probably up for adoption tomorrow or Wednesday. We're praying she will be adopted quickly into a family with children who are eager to play with and love a wonderful dog.

I'll be calling this week to find out if she's been adopted and will let you know what I find out. Keep her in your thoughts in the next few days. I know this is not easy for her either.
by Juliet Email me!

Sat, Oct 25 2003

Boloney

Joel and I never anticipated that a lunch meat would become such a big part of our lives. Yesterday Cleo apparently decided she wasn't hungry for her regular food, only the boloney we give her when she goes into her crate. On Annie's advice, we had used lunch meat to train her to go into the crate because literally nothing else (short of force) would get her into it. This worked great, especially once we realized we needed to get her to repeat the task a bunch of times in a row and give her boloney each time. So great is her love of boloney that she quickly overcame her fear of the crate and now enters it voluntarily when we give the command, "Crate!" She knows a fatty, salty, meaty lunch-meat treat is soon to follow.

And now it seems like she is trying to hold out for some kind of mother lode of boloney. She went all day yesterday without eating more than a few pieces of her regular kibble, which I of course fed her by hand. It kills me for someone in my care to not eat, so I did everything I could to make her eat, to no avail. She repeatedly sniffed her bowl of food and turned up her nose to it.

But she hadn't lost her appetite completely, because every time I gave the command, she went right into her crate and devoured her quarter-slice of boloney. She is not interested in the biscuits we give her as treats outside the crate, although she will take them into her mouth before dropping them to the floor. I guess she has intuited that once it's covered with drool we're not likely to put in back into a pocket for later.

I was worried that maybe her anxiety was getting worse and ruining her appetite, so I called the behavioral specialist at Anti-Cruelty. She reassured me that since Cleo has not lost her appetite completely, she is probably just seeing how far she can go on quarter-slices of boloney. Or, the doggy shrink said, she might be fasting voluntarily for a few days, something dogs do occasionally.

She did eat some kibble last night after Joel gave her a bath. Maybe having lost the smell of baloney drool on her front paws, she gave in to hunger and saw the light.
by Juliet Email me!

Thu, Oct 23 2003

What can I say about today?

Mom and I went to the genetic counseling appointment this morning. Let me summarize it by saying that the amount of time we spent on a topic was inversely proportional to its likelihood of ever becoming reality. So even though so far the high-risk doctors have not been able to see anything that would indicate a serious genetic abnormality of the type that would cause me to have low amniotic fluid, those abnormalities were almost all that we spoke about.

The two available suspects are conditions known as trisomy 13 and trisomy 18. Trisomy means three copies of a chromosome instead of the usual two (one from mama and one from daddy), and 13 and 18 refer to the specific chromosomes involved. Another kind of trisomy with a different chromosome causes Down's Syndrome. Anyway, both of the conditions the genetic counselor discussed with me are lethal genetic abnormalities - a baby with these conditions cannot survive outside the womb.

But babies with these abnormalities usually show pronounced physical differences from genetically normal babies, and these are usually visible on ultrasound. None of these problems - heart and other major organ defects - is visible in our baby. But the low amniotic fluid interferes with the accuracy of the ultrasound images, so there is a slight chance that the problems could be present but not visible. One of the high-risk OBs even suggested that the odds of either of those trisomies are so low that testing for them would be a waste of time.

Regardless, the genetic counselor spent most of our appointment discussing these possible causes, the tests that could detect them, and the risks and benefits of those tests. It's her job to prepare patients for the worst. In spite of her caveat about the very low probability that either of these abnormalities is present in my baby, spending so much time talking about our baby's possible death was super depressing.

Mom and I came home and I went back to bed.

Joel also had a rough day and when he got home from work, also went back to bed. I was up by that time so I tucked him in and let him get some much-needed sleep. We called in sick to our childbirth preparation classes. Sue us; we had a bad day.

This evening after I watched a movie with Mom (Sliding Doors), Joel got up and let me spend an hour or so crying in his arms as the baby reassured me from within doing somersaults. I still feel the urge to pig out on cookie dough and cheetos, but may be able to wait till tomorrow for that. Or maybe tomorrow I'll just feel better.
by Juliet Email me!

Wed, Oct 22 2003

"Managed Care" is neither

Today Mom and I have to get on the phone and make sure all of my referrals are in place so that I can go back to UIC tomorrow for my genetic counseling appointment. Next week I'll go for the first of five planned ultrasounds that will take me through my 34th week of pregnancy. The doctors want to monitor my amniotic fluid every two weeks, and I will probably have other appointments with them as they take over my routine prenatal care.

All of this requires authorization from my HMO, and I shudder to think that every visit could be like my last two. The insurance person at my primary car provider's (PCP's) office had sworn to me she would get the referrals to UIC before my visit, but of course they were not there when we checked in. I called her but she was away from her desk, so I called my midwife, who also tried to reach the PCP's office and finally called the HMO directly to get the appropriate code. The following day we thought the referral was in place, but it turned out we needed yet more approval (even though the previous day's referral covered three visits). It's all been a huge headache.

So today we're going to get on the horn and try to get all the referral numbers ourselves before my appointment tomorrow. Wish us luck - we'll need it.
by Juliet Email me!

Tue, Oct 21 2003

Just for fun

Here are some of the Mad Libs Joel and I did on Sunday. The words we supplied are in bold.

How to Use a Defibrillator

If you're a fan of those Emergency Room TV shows, then you've probably seen actors portraying a garbage collector screaming "jinkies!" as they use those silly paddles to creep a flatlining patient. That hard machine is called a defibrillator. A defibrillator works by sending a tender electrical shock to a person's neck. The shock is so strong that the person's asophagus spastically starts sputtering again. To use a defibrillator, first press the black "on" button, then remove the patient's tie. Place one pad on the patient's toe and one on the lower left of the septum. The machine will then tell you if the patient needs a go-kart; if so, press the orange button and clap. Sometimes a person needs more than nine shocks. Once the heartbeat is restored, check the patient's ants and see if they are pounding.

(Blanks filled in by Joel)

How to Treat Frostbite

With the ever-rising popularity of sports like skiing and snow-boogying, it's important to be aware of frostbite. Frostbite occurs when a person is exposed to cold temperatures for too long, causing parts of their twig to freeze. Skin affected by frostbite often has a puce, smelly appearance, and in extreme cases, the skin can turn avocado green and require amputation. Frostbite most often affects the pubic bone, the fingers, and the big toe, but can really damage any exposed skin. To treat frostbite, first remove any morbid clothing. Next soak the frozen area in warm Mike's Hard Lemonade (approximately forty-leven degrees Fahrenheit is ideal) or wrap the area in a warm razor. Then, very heavily, apply sterile jimmies all around the affected area and go see a manicurist as soon as possible. The best way to prevent frostbite is to always wear a sock and a bra and to keep your boobs covered any time you are going out in the cold.

(Blanks filled in by Juliet - blame where blame is due)

****

Yesterday we watched our movies and LOVED them. I think "Holes" was the favorite, although "Punch Drunk Love" did not disappoint. I liked "Bend it like Beckham," but I felt it gave the message that it is impossible for a woman to be liberated in a Western sense while remaining integrated in a traditional setting. Maybe that's true, but I dislike the idea that one has to throw out all of one's traditional values (like multigenerational partying, modesty and respect for elders) in order to embrace the opportunities available to a woman in the modern West. Anywho, today we're going to get more movies and I'll let you know how those go.

Cleo also came home yesterday afternoon and it is so great to have her back with us. We have instituted a new regimen to help her with her anxiety and get her used to Joel taking care of her. Per the advice of the behavioral specialist at Anti-Cruelty, we are to keep Cleo in her kennel whenever she is not being taken out for walks or focused attention on her. We're also using Rescue Remedy to help her feel more calm. The crating was rough on her last night, but she seems to be calming down now. Joel took her out early this morning (Cleo may be the answer to his sleepy mornings and arriving late to school) and Mom and I walked her later in the morning. I think she's doing okay now, especially since her crate is stocked with a raw hide, squeaky toy and treat-filled chew-toy. All she needs now is Playstation.
by Juliet Email me!

Mon, Oct 20 2003

When this old world keeps a-getting me down...

Mom and I are determined to stay home today and take it easy after my very active day yesterday. Joel and I exchanged Cleo's cage for a plastic crate that will feel more secure for her, then visited a forest preserve we like. This is a place in the southwest suburbs that I love to go when I get stressed out. I ask Joel to drive me out there either just to drive or to lay our blanket in a clearing, look up at the sky and talk. Yesterday we made a minimalist picnic of it with sunflower seeds and chamomile tea, and did a couple of very funny Mad Libs out of the booklet of them I keep in the car (it's the "Worst Case Scenario" Mad Libs book).

The leaves are changing and we have been blessed with some gorgeously warm and clear fall weather. Once we got away from the alien ladybugs and other swarming beetles that were mysteriously attracted to our white van and my white shirt, we spread our designated car blanket on the grass so we could look up at the high blue sky. Joel and I talked about stuff we want to work on in the house, talked about the baby, joked about the less glamorous aspects of pregnancy.

And sure enough, the place worked its magic. By the time a couple of hours had passed, the restlessness and fidgety energy I had in the morning had left me. I felt relaxed and good humored, ready for another week of taking it easy.

***

On the way home we stopped at Blockbuster and signed up for the thing where you can check out unlimited videos for a month. So last night we watched Bend It Like Beckham, and today we'll watch Punch-Drunk Love and Holes. Let me know what you think we should watch next!
by Juliet Email me!

Sun, Oct 19 2003

Normal? I don't know what I was thinking

We got to the ballet and watched the gorgeous first act, but by then I was visibly tired and Mom suggested we go home and get me a nap before company came over. Well, the first act was good.

We are getting into a kind of holding pattern, though. I try to go out once a day, get a nap every day, or, in the tradition of naughty children everywhere, an hour or so to lie on the bed awake. That's when I talk to my baby. Mom makes great zone-inspired meals of a protein surrounded by green and yellow vegetables. It's very healthy eating, and I hope I'll be able to keep it up at least sometimes once she goes back to Puerto Rico.

I talked on the phone yesterday with my friend Laura about our upcoming decision to get amniocentesis or not. She raised what I consider to be the ultimate argument against it: I already have low amniotic fluid, so why would I want to remove any? Her excellent suggestion was that we wait until the baby's lungs will have already developed (around 34 weeks), then get it. This week I will meet with the genetic counselor, and probably after that Joel and I will call one of the high-risk OBs with more questions before making our final decision.

Whatever we decide, we're trying to stay focused on this baby as a baby, not as a medical issue. I know the doctors at UIC are experts in their field, and I will certainly pay attention to their advice, but I want to approach the proposed tests with caution, making sure that they will render useful information before we do them.
by Juliet Email me!

Sat, Oct 18 2003

Getting away from it all and getting back to normal

Today Mom and I are going to see the Joffrey Ballet's "Romeo and Juliet" with free tickets Joel got for us from his school. I guess that even with no contract and a threatened strike, teaching for CPS still has its perks.

Joel is staying home this afternoon to get the house in better shape for when my sister comes this afternoon with my niece and nephew. Marilu said she'll bring her kids by so they can meet Ashley and Brandon. Maybe tomorrow we'll bring Cleo home from the Anti-Cruelty vet, where she has been staying since my emergency room visit 10 days ago. We wanted to bring her home sooner, but there's just been a lot to figure out. Poor thing. I hope she's not too freaked out.
by Juliet Email me!

Thu, Oct 16 2003

Coming through, cautiously

The initial thrill of finding out our baby's probably okay is giving way now to anticipation of the next steps in what is now a high-risk pregnancy.

I went to see the maternal-fetal medicine (MFM) doctors at UIC today, and the wonderfully personable Dr. Bird told me the effort to find out the cause of my low fluid will now look at possible genetic problems. It's not exciting to know there might be more bad news to come, but Joel and I are starting to just enjoy my pregnancy.

We attended our first childbirth preparation class this evening, learning pain management techniques and watching a doll be born from a knitted uterus. We drew pictures of what we think birth will feel like, and Joel's was an olive-green rendition of my disturbed face screaming "OUCH!" I like how he doesn't sugar coat things. We're rubbing and talking to my growing belly (yes, it has continued to expand!), and joking about the baby's favorite game, "kick the bladder."

But we also realize that if bad news does come, such as learning of a genetic problem that could mean developmental delays or physical disability for the baby, we will stick to our belief that being healthy isn't everything in life. I guess we have both spent enough time with our own and other people's health problems to know that love, relationships, personality and character are what matter in life.

My mom asked what if we ended up caring for a child who cannot interact with anyone else or control his body. I have no idea how I would handle that, and anyone who says they do is lying. But we've got to go on our beliefs and hope for the best.

The blessings of this experience so far aren't lost on us, either. We've bonded much more with our baby in a way we hadn't before, and our identities as mommy and daddy are growing inside us, too. Joel has become super protective of me and the baby, and I have begun talking to my belly enough to make people think I'm mental. We have grown closer to family and friends who have supported us with prayers and food; we've become closer to each other as we've cried, prayed, worried and celebrated together. We have no way of knowing what the future holds, but we continue to hope that whatever happens, we will still count those blessings.
by Juliet Email me!

Wed, Oct 15 2003

Sweet, sweet, sweet

I had my ultrasound and the news was GOOD!

The level two ultrasound showed that the pockets of amniotic fluid are bigger this week than last, though the fluid is still considered low. But the high-risk OB assured me that the baby is NOT at risk as long as it has those pockets of amniotic fluid to drink and swim in. She said that since I don't have any of the normal causes of low amniotic fluid (high blood pressure, diabetes, other serious health problem), they want to monitor me with ultrasound scans every two weeks, but the baby is not currently at risk of premature birth and is very likely to be born at full term with fully developed lungs.

YAAAAAAAAAAAAAAAAAAAAAYYYYYYYYYY!!!!!!!!!!!!!!

On top of that, the doctor said the baby's heart, kidneys and bladder are all fine; the baby is growing well and its frequent movements indicate that it is strong and healthy. I can vouch for its vigorous kicks that can sometimes be seen on the surface of my abdomen.

The doctor said I should keep taking it easy but I don't need to continue on bed rest - very welcome news. She said I should avoid any strenuous activity, stay hydrated, spend my time sitting down and avoid stress. Well, there goes my big maternity-bodybuilding idea.

All this begs the question of why the doctors at Northwestern painted such a grim picture of my baby's prospects. They were offering us the option of terminating what we now believe to be the life of a healthy baby. Yikes! Fortunately we were never interested in that option, but if I were a doctor I'd hate to be wrong about something like that. Thank goodness we trusted our instincts and didn't do anything hasty. Instincts good. Hasty bad.
by Juliet Email me!

Short, not sweet

Last night and this morning I feel that the baby is more cramped in my uterus. My belly has lost a little of its size and the squishiness is down. I don't know what changed, but something has and I don't think it's good. This morning Mom and I spent hours on the phone trying to get my level two ultrasound lined up for today and an appointment with the maternal-fetal medicine (MFM)/high-risk obstetricians at UIC (where my insurance will cover it). Mom has been after me to be more assertive, more urgent, less conversational when I talk to the people who can get things done. I think it was mainly the persistence and pestering that finally got me the ultrasound appointment today and the MFM appointment tomorrow.

A bright spot was that I called my friend Nilufar's dad, Parto, who I have loved dearly since I first ate at his table as a teenager. He is an obstetrician and happens to be resting at home following a pacemaker replacement last week. I told him about my situation and he said what my midwives have so far failed to say: I need to see an MFM doctor right away, as soon as humanly possible. This was the fuel I needed to start the pestering of my midwife and get things going. Partow also reminded me that in medicine, as he put it, "two times two is never four - you can never predict exactly what the outcome will be. You just need to get the best care possible." He said to keep him informed.

Please keep up the prayers and thoughts of health and healing for my baby. Thanks.
by Juliet Email me!

Tue, Oct 14 2003

Egg whites are basic How do I know? In my never-ending quest to eat lots of fruits and veggies, the final course to my big breakfast this morning was some steamed red cabbage. Actually it wasn't too bad, or at least I'm getting used to eating it. The juice of the red cabbage is an acid-base indicator, and the little fragments of egg white left on my plate all got stained blue. If they were acidic they would turn red. Well look at that - my sheets are basic, too.
by Juliet Email me!

Ack.

I think I'm starting down the road that begins at restless and ends at cantankerous. Days of lying in bed and having to ask others to do for me are making me less fun to be around, especially to myself.

This morning I was hungry and waiting for Mom to fix me breakfast - or second breakfast in this case - but I wanted to go online while I waited for breakfast, so she had to get me my computer first, which made me irritable because I had already been waiting a long time to eat. Then my keyboard started acting up, which freaked me out because if my computer breaks now I'll go completely mental. While Mom rebooted my computer (and fixed the problem), I ate my eggs and toast, but now I'm still hungry and the cereal I want is on top of the fridge where Mom can't reach it. Why isn't the cereal on the counter? Why???? Make... Hulk... ANGRY!!!!

Okay, Mom has gotten the cereal down and soon I should stop feeling so damn hungry. I know I'm just lying in bed all day (or on the sofa, if anyone cares), but my appetite is still keeping pace for what I hope are a growing uterus and baby. On top of that, days of following doctor CJ's orders to the T (bed rest, no spicy food, no dairy, nothing cold, gallons of water, heaps of fruits and veggies) are making being good get old fast. I want so badly to get out of the house, go for a walk in the crisp fall air (okay, rainy fall air today) and then bury myself in a swimming pool full of Flaming Hot Cheetos. The closest I've been able to come to that was eating a banana nut muffin last night and a cinnamon sticky bun this morning. Big FREAKING whoop. As for my belly, so far it has kept its new, larger size and I'm keeping all fingers and toes crossed that Thursday's ultrasound will show that my uterus has gotten larger (not just my butt).
by Juliet Email me!

Mon, Oct 13 2003

Moving out of the shadow and into the sun

This morning my mom and I both see that my belly is bigger than it was, and it feels squishier. The baby is still moving around, but I don't feel every single movement the way I did before yesterday. We think this means we are doing something right. My mom says on her way here Thursday she kept thinking of the 23rd Psalm and feeling like we were in the valley of the shadow of death. We feel that shadow lifting.

The improvements have inspired my mom to give me permission to walk between the rooms of the house - my knuckles and knees were beginning to get calloused - and sit upright. She and Joel are still adamant that this does not mean I can resume normal activities, but need to stay mostly on bed rest at least until we get another ultrasound.

It's not that I want to go out and run a marathon - I never did before, so why now? - I'm just my old compulsive self once the soles of my feet hit the floor. I start to think about unpacking something, arranging something, making little side trips to another room to pick up a book. I'm supposed to be asking for help, not doing those things myself, but it's difficult. Still, between my mother and Joel, they've got the market cornered on graciousness and are equally insistent. Thank goodness for them, and for me not having to do this on my own.

Speaking of not doing it on my own, I just want to say another heartfelt thank you to all the people who have added us to your prayer lists, started prayer chains, and asked family and friends to pray for us, too. I know these prayers are having an effect, at the very least helping Mom, Joel and I to keep functioning and not become discouraged. And it seems like a dramatic shift is taking place inside my body, one that could mean my baby has a future. Your prayers are making a difference.

By the way, because I am still on bed rest, at least for a few more days, if you are in the Chicago area and would like to pitch in with a dinner or visit, please drop us an email so we can expect you. Joel and Mom are doing so much, and a little extra help means a lot of relief for both of them. Thanks.

by Juliet Email me!

Sun, Oct 12 2003

Knuckle walker

I don't know if I had mentioned that in an effort to avoid being vertical at all I now crawl when I need to go from room to room. Even though at this point I really don't think I'm leaking amniotic fluid, I'm still too leery of standing upright to walk normally around the house. My big treats are the times when I'm in the front of the house and I go to the bathroom in the actual bathroom (we have improvised another system for when I'm in the bedroom). That's when I get to actually stand on my feet for a moment like a normal person.

My feet have become like the hands of a delicate princess in that they now never do any useful work. My mother even massaged my feet with lotion last night so in addition to being clean and unused, they are soft and scented. My hands, on the other, um, hand, are getting more use than they're accustomed to. I crawl on them and have to eat with them, which kind of grosses me out because my main way of washing them is with wet-wipes. Fortunately the carpets were recently steam cleaned, but if I had my way I would mop the kitchen floor. A lot. In an attempt to segregate the walking parts of my hands from the eating parts of my hands, I've taken to walking on my knuckles, which brings home to me even more that this pregnancy crisis is an animal one. I'm trying to succeed in reproducing as a mammal, and in the process am getting down to the level of most of the rest of the mammals.

I woke up this morning feeling a renewed sense of optimism in my pregnancy and my baby. I felt my belly and it feels more squishy, maybe more full of fluid... My mom agrees and says I even look bigger to her. I pray that everything we're doing is working, and I rub the baby through my tummy, but today I don't feel an outline.
by Juliet Email me!

Sat, Oct 11 2003

Rock Against Oligohydramniosis

The musical offerings for the baby have started to roll in, and the two of us are listening to beautiful Andean music right now. It is by a friend's band, delivered in person by his little daughter and (and her aunt Annie) today. My brother and my best friend from college have both put cd's in the mail, and some other friends have mentioned they are doing the same. The music provides a comforting backdrop as Joel, my mom and I go through the day, alternately taking care of business and letting the daunting reality of our situation sink in.

Thanks again to everyone for all the warm wishes.

by Juliet Email me!

Day three

This morning I woke up feeling the baby's back pressed against the front of my uterus and the baby was not moving. I kept rubbing the baby's back, trying to get it to wake up and kick me, let me know it was alive and okay. I was scared and woke Joel up. We huddled together, praying and rubbing my tummy until the baby delivered a solid "Why do you keep bugging me?" kick to my left side.

I know that at five months I shouldn't be able to feel the baby's body pressed against my uterine wall. The amniotic fluid should cushion the baby enough that it can't get the traction to push against me that way. It's not reassuring to feel the baby's outline - especially after two days on my back and endless gallons of water - but I'll take whatever joy I can in rubbing the baby's head and back and telling it how much I love it. Joel has been talking to the baby and playing Beatles songs on guitar for it, which relaxes me and has probably contributed to my lack of contractions since yesterday morning.

Yesterday and this morning we've been trying to find out what we need to know to deal with all the different eventualities we may face in the weeks to come. We're going to try to get a level two ultrasound (better than the level one that we've already had) as soon as possible, on Thursday at the latest. We have to decide if we want amniocentesis, which, if it indicates a genetic problem, could prepare us for what to expect and what kinds of questions to ask if the baby is born after 24 weeks.

If the baby is born before 24 weeks (or in the next 11 days), we will go to our regular hospital where I will try to deliver the baby normally and hold it in my arms before it dies. Babies born before 24 weeks just do not have the lung development to live outside the womb. If the baby is born between 24 and 34 weeks, we will go to Northwestern Memorial, where they offer kangaroo care for preemies. Kangaroo care is where the premature baby is held on its mother's or father's bare chest to keep it warm, instead of in an incubator. This facilitates bonding and is shown to be better for the baby. Joel and I do not want the baby isolated from us and surrounded by well-meaning strangers.

If we can make it to 35 weeks we'll go back to our regular hospital to give birth. The baby could still have serious problems, either genetic abnormalities or developmental problems resulting from the low amniotic fluid. But all else being equal, the odds are more in the baby's favor by that time and our regular hospital has the facilities to care for it.

And we're still not ruling out that this may turn out to be a passing glitch in an otherwise normal pregnancy. That is our best possible outcome and our eyes are still on that prize.

P.S. For those of you who are wondering, the Depends strategy didn't exactly work. Most grown people won't have a chance to willfully violate the inhibition against peeing in one's pants or bed, but I have now been to that mountain and I don't want to go back. On top of that, I am proud to divulge, my bladder capacity cannot be matched by a mere diaper. We've had to find other alternatives for me, and describing them is too picturesque for this web log.
by Juliet Email me!

Fri, Oct 10 2003

Good morning It's day two in bed - I'm already counting - and Joel and I want to thank everyone for their prayers, warm wishes and letters. If we can't write back right away we hope you'll understand, but we are getting the emails. This is a rough morning because I keep getting these mild contractions that scare me. The good news is that the contractions are not painful, which probably means I'm not in labor, and the baby's still moving. It's just a waiting game, and I'm no damn good at it.
by Juliet Email me!

I need a young priest and an old priest

Okay, I don't need a priest at all, but it's 3:55 a.m. and I'm having contractions that come on when I move around (like getting up to use the washroom), and that so far are alleviated by booze. That's right, booze.

We got this from a couple of different midwives and midwifery books. Drinking alcohol when you're having pre-term contractions helps relax the uterus and the bed-ridden mom. My midwife recommended Mike's Hard Lemonade, and of course I wondered if there was an endorsement deal in the making.

So I'm drinking alcohol for the first time in my life, and what do you know? I don't like the taste or how it makes me feel, but I sure do get laffy. (In case you're wondering, the alcohol only hurts the baby if I drink a whole lot of it, like a six pack of beer in a day. Not likely to happen.) Since I don't like even the mostly inoffensive tasting MHL, my mom is suggesting I go the hard liquor route and just take it like medicine. I can't help but think, "eew."

And since moving around tends to bring on the contractions, Joel and my mom have come up with an ingenious way for me to avoid having to use the toilet at all. It's called "Depends." Super eew! Am I really going along with this? Mom called after Joel as he pulled on his jacket, "Get the kind that wrap and unwrap like a diaper, not the pull-up kind!" So no big-girl pants for me, I guess.

But as much as I pity the collapse of my dignity, I really feel sorry for Joel, who is about to walk into a Dominick's or Walgreens at 4 in the morning, sporting his rocker goatee and black leather jacket, asking for a pint of whiskey and a box of Depends.
by Juliet Email me!

Thu, Oct 09 2003

Oh won't you stay, just a little bit longer...

Sorry I've been out of touch for so long. We moved on Sunday and in the middle of unpacking Joel and I went Tuesday to have my routine ultrasound. After the test was over the technician told us to wait for a little bit, so we waited. We thought maybe there was a further hang-up with the referral from our insurance. Finally, after waiting for what seemed like hours, I got to talk my midwife.

She said the ultrasound showed that my amniotic fluid was "low." I didn't know what that meant, and Joel and I were scared but not too badly shaken. We were told to go into the midwife's office Thursday (today), and that I would have another, more detailed ultrasound at Northwestern Hospital. The midwife told me that this could be caused by simple dehydration or a problem with the baby or placenta.

So Joel and I went to clean up the old apartment and I put away about a gallon of water in a few hours. Yesterday I got up, finished unpacking the kitchen, ate a bowl of lamb and bean stew (high protein

AND fiber!), and shlepped Cleo to the vet to get her some cough medicine.

Standing in the vet's office something started to feel strange, though. I had been drinking a lot of water but my bladder wasn't full, so the little trickle I felt between my legs gave me pause. Some clear liquid was trickling out of me and it wasn't urine. It seemed I was leaking some of my already precious amniotic fluid.

The vet and her staff called an ambulance - it was almost funny how little they knew what to do about a human pregnant woman, but they were very helpful. The ambulance took me to Northwestern, which fortunately is the closest hospital to the Anti-cruelty Society shelter (and veterinary clinic). I called Joel and he arrived soon after I did.

After numerous wheelchair rides, a fun speculum exam (not) and a very thorough ultrasound, the high-risk obstetrician told us that a 22-week fetus with so little amniotic fluid has a very poor prognosis. I may be leaking fluid, which would likely cause me to miscarry within the week. Or my placenta may not be working right, but they don't know what to do about that, and it can still cause pre-term labor, failure of the lungs to develop, or physical deformity. The doctors offered to do amniocentesis, which would help illuminate what the possible problems might be (chromosomal abnormalities, leakage or poor placenta).

But even if they know more, our options remain the same. I can come home, rest and wait, or terminate the pregnancy. Needless to say, I'm resting and waiting. I'll go back for another ultrasound next week.

My mom is flying in today to help me stay in bed as much as possible (with doctor's admonitions about keeping active enough to prevent blood clots in the legs). I have to take my temperature every four hours to make sure I'm not getting some kind of infection (if my membranes have ruptured, the baby and I are both at risk for infection).

After leaving the hospital last night I called my midwife with the update, and she sounded so much more upbeat than the doctors at Northwestern. "Listen," she said, "I wouldn't put it past the Mother of the Universe to do anything She wants to do. This baby can still be fine, and you deserve to have hope for it and continue to nurture it." Boy, did we need to hear that.

We don't know how long this baby will be with us, but we've decide to try to give it the best possible time it can have in my womb. We're going to talk to it, read it our favorite poems, play music for it, and tell it over and over how much we love it. We have cried already, and will probably cry more, but we're finding things to laugh about, too. We want to make a convincing case for this baby to make it into the world outside the womb, and stay for a while here with us. For now the baby continues to kick in my belly, letting me know it is hanging in there. I'm already getting to hear other people's stories of making it through crises like this with a healthy baby, so there is definitely hope.

If you feel moved to write the baby a letter or send us some music to play for it, we would love to share them with him or her. Whatever you do, please pray for us and the baby. I'll keep you posted from here in my bed.
by Juliet Email me!

Fri, Oct 03 2003

Moving closer to motherhood

My sister-in-law Adele sent me an email yesterday with a link the earthbaby.com, a site that features a lot of great natural products for babies and new mommies. She sent it to me so I could see what the Chinese Birth Chart says about the probable sex of my baby (it predicts I have a girl), but when I started browsing I was happy to find a lot of the things I want to get for the baby but didn't know where to look. I checked out a lot of the products in their catalog and then came to the bottom of the homepage and the link that said simply, Motherhood. I clicked, read and cried.

Here is what the page says:

MOTHERHOOD: IT WILL CHANGE YOUR LIFE

Author unknown

Time is running out for my friend. We are sitting at lunch when she casually mentions that she and her husband are thinking of "starting a family". What she means is that her biological clock is ticking and has begun its final countdown. "We're taking a survey," she says, half joking. "Do you think I should have a baby?" "It will change your life," I say carefully, keeping my tone neutral. "I know," she says, "no more sleeping in on the weekend, no more spontaneous vacations..." But that is not what I meant at all. I look at my friend, trying to decide what to tell her. I want her to know what she will never learn in childbirth classes. I want to tell her that the physical wounds of childbearing heal, but that becoming a mother will leave her with an emotional wound so raw that she will be forever vulnerable. I consider warning her that she will never read a newspaper again without asking "What if that had been MY child?" That every plane crash, every fire will haunt her. That when she sees pictures of starving children, she will wonder if anything could be worse than watching your child die. I look at her carefully manicured nails and stylish suit and think that no matter how sophisticated she is, becoming a mother will reduce her to the primitive level of a bear protecting her cub. That an urgent call of "Mom!" will cause her to drop a souffle or her best crystal without a moment's hesitation. I feel I should warn her that no matter how many years she has invested in her career, she will be professionally derailed by motherhood. She might arrange for child care, but one day she will be going into an important business meeting and she will think about her baby's sweet smell. She will have to use every ounce of her discipline to keep from running home, just to make sure her baby is all right.

I want my friend to know that everyday decisions will no longer be routine. That a five year old boy's desire to go to the men's room rather than the women's at McDonald's will become a major dilemma. That right there, in the midst of clattering trays and screaming children, issues of independence and gender identity will be weighed against the prospect that a child molester may be lurking in that restroom.

However decisive she may be at the office, she will second-guess herself constantly as a mother. Looking at my attractive friend, I want to assure her that eventually she will shed the pounds of pregnancy, but she will never feel the same about herself. That her life, now so important, will be of less value to her once she has a child. That she would give it up in a moment to save her offspring, but will also begin to hope for more years - not to accomplish her own dreams, but to watch her child accomplish theirs. I want her to know that a caesarean scar or shiny stretch marks will become badges of honor.

My friend's relationship with her husband will change, but not in the ways she thinks. I wish she could understand how much more you can love a man who is always careful to powder the baby or never hesitates to play with his child. I think she should know that she will fall in love with him again for reasons she would now find very unromantic. I wish my friend could sense the bond she'll feel with women throughout history who have tried desperately to stop war and prejudice and drunk driving. I hope she will understand why I can think rationally about most issues, but become temporarily insane when I discuss the threat of nuclear war to my children's future. I want to describe to my friend the exhilaration of seeing your child learn to ride a bike. I want to capture for her the belly laugh of a baby who is touching the soft fur of a dog or cat for the first time. I want her to taste the joy that is so real, it actually hurts. My friend's quizzical look makes me realize that tears have formed in my eyes. "You'll never regret it," I say finally. Then I reach across the table, squeeze my friend's hand, and offer a silent prayer for her, and for me, and for all of the mere mortal women who stumble their way into this most wonderful of callings.

God bless you all.

****'

If you are interested, I have also registered at Earthbaby. To find my registry, simply enter my name in the search field.
by Juliet Email me!

Thu, Oct 02 2003

Doggy world

I took the day off from babysitting today - also talked to Marylu about cutting back - and am spending some quality time with my beautiful Cleo. I love this dog.

We walked to the Walgreen's and back so that I could get some groceries (vanilla yogurt, kidney beans and cold cereal provide only so many meal options). It was so much fun watching my doggy take in her new surroundings. Nose to the ground, Cleo inhaled the sidewalk residues of the dogs, cats, squirrels and other fauna and seemed to take note of places where something good may be buried, or an old but fragrant piece of gum on the sidewalk. She whined when we saw the neighbor's teeny shitsu (sic?) and then was briefly mesmerized by the window of a kitchen supply store we passed. Dried cat poop seems to hold a strange fascination for her.

I imagined as we walked that she was absorbing multiple layers of information about our neighborhood the way I would absorb information about a person. I look at a person and notice her facial expressions and body language, how she presents herself in terms of appearance, the contexts in which she seems comfortable or uneasy. It only takes a minute, but I get a lot of information and it all means something to me. Cleo couldn't tell me anything about what she learned on our walk, but I'm sure it all meant something to her.

Now we're back at home and Cleo is passed out on the dining room carpet (yes, the gold tortoise-shell-pattern carpet) right next to the kitchen door. I can see from her feet that she has stretched out for serious napping. I ought to do the same, but my pot pie (not related to the pot brownie) will soon be out of the oven and I'll have enough Walgreen's comfort food in my stomach to knock me out.

by Juliet Email me!