herveryown

That Must Be Some Powerful Wang

There seems to be a flaw in the current system of feeding infants.  No matter how often you feed them, they just want to eat again in (insert any random number from zero to eleventy billion) (nanoseconds/minutes/hours).  They never just stay fed.

Because of this, I had to leave the cozy confines of my home to obtain more formula yesterday.   My mother was home with the girls, and as they tend to gang up on single caregivers, I was attempting to make my formula pilgrimage as quickly as possible.  Naturally, I ran into an elderly acquaintance on the way to the car.

"Oh, Akeeyu, how are you doing?  How are the babies?"
"Fine, fine," I said, apologizing for not having any pictures on me when she asked to see one.
"Did you see that magazine?  That cover with the, ah, the Jo Lo?"
I told her that I did indeed see The Jo Lo.
"You know what I think?"
I wondered if she thought what everybody else in the known universe was thinking, but said nothing.
"I think those babies were gifts from God."
"Oh?" I said politely, fervently hoping for Jennifer Lopez's sake that they were not gifts from God.  The gods, after all, have a long history of giving pretty questionable gifts.
"She waited so long, you know.  I think those babies were her reward because of everything she had to go through."
"Hmm," I said.
"Because of what that Ben Affleck did to her."
"Oh?" I said again, wondering what she meant specifically, but more than a little afraid to ask.  Did she mean That Ben Affleck dating her?  That Ben Affleck dumping her?  That Ben Affleck costarring with her in Gigli?  That Ben Affleck committing some other unspecified evil my elderly acquaintance was privy to?
"It was just awful.  Poor girl."
"Mmm," I said, nodding sympathetically.
"But now she has twins!"
"Yes."
"Just like you!"
"Yes," I said, thinking '...Just like me in more ways than one.'
"Isn't it wonderful?"
"It is," I said, and we exchanged pleasantries before going our separate ways.

So here's my new theory, courtesy of my somewhat nutty elderly acquaintance: Ben Affleck, or the lack thereof, must be the new cure for infertility.  I'm not sure how much time you have to spend with him or what exactly you have to do with him, for him, or more specifically to him before you start popping out boy/girl twins left and right, but clearly The Jo Lo is evidence of some sort of Ben Affleck Infertility Cure. 

I think that somebody should probably apply for some sort of government grant to further study this phenomenon.

It's for the greater good.

Best

At least six times a day, one or both of the girls roots enthusiastically against my breasts before I can cram a bottle into their gaping maw.  "Sorry, kids," I say breezily. "No milk in there.  Well, okay, there's still kind of milk in there, but it's poison milk.  Here, have some formula, instead.  According to the Internet, formula is poison, too.  Mmmm, good, huh?  Sweet, sweeeeet poison."

Yes, I really do talk to my children that way.  Why?  Well, mostly because they're about a month old and don't speak English yet (although their Esperanto is coming right along), but also because I've been thwapped in the face so many times by the Breastfeeding Is Best brigade that I've moved from 'shame' to 'envy' to 'wistfulness' and straight into 'Yeah, whatever'.

The other night I dreamed that because I wasn't breastfeeding, men from the government declared me to be of no further benefit to society at large, took Fitz-Hume and Millbarge away from me and then had me killed for my tasty veal-like meat.  Yes, I dreamed that I was Soylent Akeeyu.  Clearly, I still have issues with the breastfeeding thing, don't you think?

I think it was the formula cans that pushed me over the edge. 

I love how it says "Breastfeeding is best" right on the fucking can of formula, don't you?   

Yes, I get that breastfeeding is best.  I've read the articles, I subscribe to your ideals, I totally wanted to do it, but cut me a goddamned break, okay?  I don't think there's a person in the world whose life was ever changed by such a simplistic message. 

"Gee, I'm at a crazy high risk for postpartum psychosis and the medications needed to lower that risk are so dangerous in breast milk that my children would  have to have weekly blood draws and frequent EKGs and might still end up with idiopathic brain, thyroid and liver changes, but wait!  This can of formula says that breastfeeding is best!  Oh, in that case..."

"Well, I have to go back to work pretty soon because my company/government doesn't offer a real maternity leave package, and there are no laws in my state protecting my right to pump or breastfeed at work, so breastfeeding exclusively for six months is just not going to happen, but wait!  This can of formula says that breastfeeding is best!  Oh, in that case..."

Fuck you, can of formula.  Fuck you right in your big powdery ass, because by the time I'm buying formula in cans the size of a Rottweiler's head, that ship has kind of sailed, don't you think?  While we're on the subject, why not put preachy warning labels on all baby related products?

Disposable diapers: Cloth is best.
Thermometers: The care of a registered nurse is best.
Baby food: Homemade baby food prepared by a registered dietician is best.
First Aid kits: Having an EMT on hand is best.
Your paycheck: Staying at home with your baby is best.
Cribs: Co-sleeping is best.
Your bed: No, wait, maybe a crib is best.
Bassinets: Dudes, don't look at me; I'm staying out of this one.  Maybe you should just carry your baby around until they're three.  Yeah, that's it.  Carrying your baby everywhere is best.
Baby Bjorn: No, you're doing it wrong.  That strap should be...no, not there.  Higher.  Lower.  Look, have you even carried a baby before?  I really think that an Au Pair would be best.

And Go Put On A Sweater

I've read blogs where new parents said things like "My God, this whole parenting thing isn't what I expected at all!"

Well...not so much.  Last night Fitz-Hume managed to soil seven diapers in a thirty minute stretch and one of my first thoughts was "This is exactly what I expected parenting would be like."

Millbarge has finally grown into the fifth percentile.  We call her our Big Fat Baby, mostly because she completely dwarfs Fitz-Hume.  Continuing her uterine trend, she eats like a fucking champion, as if she's still under the impression that she has to snorf up all the available resources before her sister gets a turn.  I keep telling her that the Wicked Formula Syndicate will keep making cans of Powdered Evil for her eating pleasure, but she doesn't really listen to me.  At this stage, babies are not all that bright.

Fitz-Hume has acquired some minor digestive issues that cause her a lot of pain, but she's still gaining weight, so her pediatrician isn't too concerned.  According to the doctor, it's just because she's so small.  When she said that, I was a little alarmed.  Small?  Fitz-Hume?  But she's over her birth weight by 50%!  She's not small, she's just the right size!  And then I looked at the charts, the ones that Fitz-Hume, even a month after birth, is still not on, and thought "Oh, riiiiiight." 

So, okay, she's still kind of small.  Whatever.  This, like the diapers, is to be expected.

What I did not expect was to ever have to say the words "Oh, for God's sake, please don't eat your sister."

Approval

Millbarge's trip to the specialist was largely uneventful.

The issue that had been the subject of many bedside visits by somber toned Pediatricians, the one that had been called a Congenital Whatsit of the Doohickey and scared us all to death, is now considered insignificant.  Eventually, it will just be a few lines buried in her medical record and a few pictures that we'll have to explain to her.  The bandages are off and we've been assured that they won't be going back on.

What was slightly more eventful (and in retrospect, hilarious) was Evil Insurance Company, Inc.'s fumbling efforts to approve the trip to the specialist, no, wait, deny it, hang on a minute, approve or maybe deny it, or...uh, we're all confused, can we sit down for a minute?

The Big Fancy Perinatologist Place arranged for Millbarge to see the specialist before we were released from the hospital, even contacting Evil Insurance Company, Inc.'s referral department to ensure that EIC, Inc. would give their official blessing.  You'd think this would be enough, but I've found that there is nothing so simple that it can't be effortlessly fucked up by massive layers of bureaucracy.

Four days before Millbarge's appointment, the specialist's office called to advise us that the referral had not gone through and EIC, Inc. was currently denying the appointment.  I was sure this was a mistake, so I called EIC, Inc., where a minion informed me that no referral had ever been submitted, that Millbarge did not have permission to go to the appointment, and that if we took her against their wishes, the appointment would not be paid for, not even retroactively if the referral was eventually approved.  I took a deep breath.  "The Pediatricians at TBFPP told us that our daughter has a birth defect," I said quietly.  "She needs to be seen by the specialist this week.  How can we make that happen?"  The minion was unmoved.  "TBFPP doesn't have any authorization to make a referral.  You'll have to take her back to her EIC, Inc. Pediatrician.  They can submit the referral, then it will go to a committee, and if the committee approves it, they'll send you a letter." 

A letter. 

Here is what I did not say: "Is this really what you want to do today?  Do you really want to be a party to denying healthcare to a potentially sick newborn and sound like you don't give a shit while you do it?  Are you prepared to answer to your supervisor over this issue?  Aw, fuck your supervisor, are you prepared to answer to your God?  Are you?"

Clearly, I was feeling a wee bit brittle.

Here is what I did say: "Yes, but the appointment is in four days."  The minion was still unmoved.  I was clearly wasting my breath and patience.  "You know...nevermind," I said, silently offering up my standard curse for the unmoved minion: "May you someday be the recipient of the same caliber of care you currently provide to others."  I began calling the Pediatrician's office every hour on the hour, talking to the receptionists and the nurses and explaining the situation a dozen different ways.  Within six hours, a representative from EIC, Inc. had called me at home to apologize and explain that the referral had already been submitted and approved (not once but twice) and ask if I would I like to take down the referral number for my records?

We went to the appointment, where the specialist declared Millbarge's problem to be a result of simple uterine crowding that was unlikely to have any long term impact, and there was much rejoicing.

Then the letters started arriving:

"Dear Millbarge Buttmansion,
Your referral to The Specialist Hospital has been approved.  This referral is active from (birth until one day before the date of the appointment) and covers initial evaluation and treatment."

"Dear Millbarge Buttmansion,
Your referral to The Specialist Hospital has been approved.  This referral is active from (the day of the appointment until August) and covers six appointments, treatment, and surgery if needed."

"Dear Millbarge Buttmansion,
We are writing to let you know that the service specified below (The Specialist Hospital, office visit) is not covered.  Patient does not have active Evil Insurance Company, Inc. coverage.  EIC, Inc. will not pay for these unauthorized services.  You will be billed for these services.  You have the right to appeal this decision, although it might be a tad bit difficult for you to read the directions for filing an appeal, since you are in fact a tiny little baby and communicate mostly through grunting and the expulsion of bodily wastes."

As tempting as it is, I have decided not to smear the denial of service letter with Millbarge's chief means of communication and return it in the enclosed envelope.

"I Feel Like This Is Happening To Someone Else."

"This can't be right," I kept thinking as they were arranging my body on the operating table.  "I think this is a mistake.  This sounds like someone else's story.  I feel like this is happening to someone else."  I simultaneously couldn't believe several things: that I was being prepped for major surgery, that we would see Fitz-Hume and Millbarge soon, and that so many improbable events had led up to this.

When we went in for a routine growth ultrasound, we were told that Fitz-Hume and Millbarge were both very small.  They had dropped from 'average' to 'acceptable' to 'much too small for gestational age' (think fifth percentile).  I mentally added IUGR to my list of "Sure, what the hell else can go wrong during this gestation?"  I was blissfully unaware that this list was about to get very long very fast.

While going over the results of the ultrasound and casually discussing induction plans with the doctor ("How's next week for you?  What about this weekend?") the nurse bustled in with a detailed follow up ultrasound report that changed the doctor's demeanor entirely.  "I believe they'll have a room ready for you in an hour."  The report indicated a possible problem with Fitz-Hume's placental blood supply.  I didn't entirely understand it, but it apparently wasn't urgent enough to warrant any sort of whisking away or immediate cutting, so we went out to grab a bite to eat while they prepared our room upstairs.  Nobody could believe that after almost 90 days on bed rest, I was about to be induced, but since my body specializes in the ridiculous, we weren't exactly speechless, either.

After dinner, we checked into The Big Fancy Perinatologist Place and started making plans for the staff to induce labor in a way that seemed acceptable for everybody involved.  Things were casual and laid back.  All parties were concerned, but not overly so.  We were asked if we were excited, if we knew the sexes, if we had names picked out.  Everything was going along swimmingly, and then a word popped up:

Preeclampsia.

Sure, why the hell not?  It was considered early or mild or 'lite' or 'fat free' or something like that, but it was still worrisome.

My blood pressure hit about 150/97, a number that sounded bad until it was followed by 155/101, 160/111, Holy Crap/WTF?, bla bla bla, plus my lab work came back indicating some sort of organ distress, and I got put on Mag Sulfate and Pitocin simultaneously.  "This seems...dumb," I remember saying.  "Don't those drugs pretty much counteract each other?  How can this possibly work?"  "Well, if we don't give you mag, you'll probably start having seizures pretty soon."  We inquired about other options, but none of them were good fits for the situation, so I consented to the mag.

We were collectively bundled into the care of an L&D nurse so pushy and dismissive that I began to openly ignore her and play computer solitaire between contractions.  She heartily returned my lack of regard.  Sam just shook his head and asked for the doctor every time she opened her mouth, a decision that turned out to be wise, as every piece of advice she dispensed was simultaneously stupid, inaccurate, and medically unsound.  I was beginning to wonder if Nurse GateKeeper had a sister, and then her shift ended and she was followed by a blur of pleasantly competent nurses who seemed to have everybody's best interest at heart.

Things I hated about Nurse GateKeeper's Clone, the short list:

1. She seemed passionate about the idea of keeping me immobilized in bed, even while all the doctors were encouraging me to (carefully) move around a bit to keep labor progressing.
2. I started to suspect that she earned a free toaster oven for every fifth epidural she talked somebody into after she woke me up to ask me if I was ready for an epidural not once or twice, but three goddamned times.  I'm no medical professional, but it seems to me that if your patient is sleeping through the motherfucking contractions, maybe suggesting an epidural is jumping the gun just a bit, yes?
3. Her choice of language was poor and aggressively unsupportive.  Instead of asking me how the contractions were going, or inquiring as to how I was feeling, she would ask "How is The Pain?  We'll want to do an epidural when The Pain is like this, and before The Pain is like that."  Way to set up labor as a hideously wretched process to be feared and medicated, yes?  I'm surprised she didn't offer me Twilight Sleep, for fuck's sake.

My blood pressure continued to rise, but labor seemed to be progressing at a reasonable pace and the mag wasn't totally kicking my ass, so things seemed tolerable.  All involved parties were optimistic about a successful and probably not-too-unpleasant delivery.  Things were going surprisingly well.

Sort of. 

Over the course of a day, my cervix dilated from three to five and then stalled out completely.  Walking didn't help.  Bouncing on the birthing ball was fun, but didn't help.  Increasing the Pitocin was not fun, and also didn't help.  My uterus, ever the irritable little twit, would immediately go from 'promising looking contractions' to 'one big long motherfucking unending contraction that put Fitz-Hume and Mllbarge into distress and had to be stopped'.  This happened several times.  I was not amused. 

After several bouts of this, I consented to have Millbarge's amniotic sac broken to see if this would generate productive contractions.  Not only did it fail to do so, it also moved the contractions from the 'not so bad' category into 'perhaps an epidural is not entirely unwarranted'.  I requested and received a walking epidural, which was actually quite lovely except for the part about throwing up violently and repeatedly.  The medication required to stop the constant hurling made me extremely drowsy, which made it impossible for me to take advantage of the 'walking' aspect of the walking epidural, as I went out cold for almost an hour.  During this time, my labor appeared to be progressing nicely without me, or at least the tocolytic monitor seemed to think it was, but repeated cervix checks indicated no change.

I woke up and threw up a few more times for good measure.

At this point my cervix had dilated a whopping two centimeters in almost 36 hours and wasn't giving any signs of dilating any further than five centimeters total in the near (or distant) future.  My contractions were frequent, but internal monitoring showed them to be completely ineffective. 

A doctor arrived to discuss the option of a c-section.  She was polite and respectful and answered all of our questions.  The most important questions were "What more can be done?" and "What haven't we tried yet?"  The all important answer to both of those questions was "Nothing."  Even so, she wasn't pushy about it.  "Take your time.  Think about what you want us to do.  I'll be back in a bit to see if you have any questions."  There was no impatient foot tapping or conspicuous checking of watches.  Nobody was in a hurry to make a golf game.

The Preeclampsia wasn't considered life threatening for anybody involved, but it also wasn't going anywhere and its presence was effectively cutting off almost all available routes of accelerating labor.  They couldn't stop the mag.  They couldn't increase the pitocin.  Every time I tried to get up or head in the direction of the exercise ball, my blood pressure shot up.  Neither Fitz-Hume nor Millbarge appeared to be in distress as long as my uterus continued to loll about pretending to be on a lovely tropical vacation, so we still had time but had run out of options. 

The going theory was that my uterus was just overstretched and either unable or unwilling to bring its A game to the table.  I had heard of this, mostly in connection with complications following delivery.  I didn't like it.  When the doctor left the room, I grabbed Sam by the collar and whispered "Sometimes women bleed a lot after.  If they have to do a hysterectomy to stop the bleeding, you tell them it's okay.  I won't be mad if you tell them it's okay."

And then I burst into tears.

I no longer had any fantasies about an empowering or granola-tastic birth at this point, but I had wanted to give Fitz-Hume and Millbarge a good squeeze on the way out, just to give their lungs one last boost and ensure that I was in the best possible shape to assist in their care post-partum.  It became very apparent that this was not going to happen.

Scenarios and risks were discussed, consent forms carefully gone over and signed, and I was gently (both physically and mentally) prepared for a c-section.  I have to admit, I always imagined the process to be much colder and more clinical, but everyone who came to see me was very considerate of my feelings, caring and upbeat.  I didn't feel rushed or pressured, instead I felt welcomed into competent and reassuring hands.

Even so, I felt very discouraged.  It had taken science to get me pregnant, science to keep me pregnant, and now it would take another enormous helping of science to get me un-pregnant.  I felt like an observer of this pregnancy, rather than a participant.  All I could think about was how I had repeatedly failed, how my body had to be bludgeoned into doing what everybody else's body seemed to do with ease, how incredibly unwomanly I felt. 

I did not feel great.

When they led me into the operating room, one of the Bee Gees was cheerfully squeaking out "More than a woman to meeee..." on the radio, which seemed both spot on and miles from the reality of how I felt.

The anesthesiologist and surrounding nurses began to go over how things were going to occur, what I would feel and hear, where everyone would be, and offered to answer any last minute questions I might have.  I didn't have any, having frozen in place both emotionally and physically.  One of the nurses who helped me onto the table said "It's okay to be scared, hon, but we're going to take good care of you.  We do this all the time."  I nodded.  "I know."  My legs were buckled in, my arms were strapped down and the epidural was converted from 'walking' to 'not so much'.  I was disturbed at the amount of pressure I could still feel.  I could also wiggle my toes for quite a while and kept doing that as vigorously as possible for as long as I could, just to helpfully point out that perhaps they should not start with the cutting just yet. 

I began to shake uncontrollably.  The anesthesiologist assured me that this was a normal reaction to the epidural.  I pictured the doctors trying to cut a vibrating target and tried really really hard to stop shaking.  For the record, this does not actually work.

Sam was brought in, looking quite dashing in a papery yellow gown and all the snazzy accessories.  The leader of our multiple pregnancy classes (also known as The OMGTwins! classes) had warned us that everybody tends to look the same in a paper mask, so I had bummed a thick black marker from a nurse while being shaved in my room and hastily scribbled Sam's most identifying facial features onto his mask to make him easier to locate, just in case.

I felt wretched.  My mouth was still dry from the mag, I couldn't stop shaking for love or money, and although I could see Sam out of the corner of my eye and hear the voice of the anesthesiologist (who helpfully doubled as an announcer throughout the procedure) just past my eyebrows, most of my field of vision was dominated by a big blue drape and most of what came out of my mouth was hoarse, incoherent, and largely unintelligible.

At one point I decided to display my iron resolve and plucky can-do attitude by humming a cheerful tune while being sliced and diced.  When I reminded Sam of that later, he said "Oh, is that what you were doing?  It just sounded like moaning to everyone else."

Millbarge came out first.  "It's a girl!"  She cried loudly enough that we could track her progress across the room while Sam and I stared at eachother and said profound things like "Holy crap," and "It's a baby,"  She was briefly mobbed by a pediatrician, a nurse and a respiratory therapist, then washed, waxed, fluffed, detailed and handed to Sam, who held her in my field of vision. 

I was skeptical.  "She's really pretty," I mumbled.  "I thought babies were supposed to be ugly.  Do you think she's ours?"  Sam said she probably was in spite of the prettiness, and in any event, we were keeping her.  I promised not to tell anybody that he cried like a big titty baby.

In the meantime, Fitz-Hume had been scooped out and whisked away.  "It's another girl!"  She did not cry, which alarmed me.  She was also mobbed, tidied up and handed to Sam.  He showed her to me, and I tenderly whispered "Please move her.  I am going to throw up."  It was a magical moment.

The anesthesiologist graciously held a little pink bowl for me to dry heave into and offered me a Whitman's Sampler of anti-emetics.  I felt like I was choking and kept thinking that I had to try harder to breathe so that Fitz-Hume and Millbarge would get enough oxygen.  It hadn't quite occurred to me that they were no longer plugged into the main generator, so to speak.

Fitz-Hume was quite a bit smaller and less robust than Millbarge, so she was taken on a detour to the nursery after her brief showing.

"We're going to give you something to help your uterus contract," the anesthesiologist said, and did so.  There were two injections into my shoulder.  I wasn't sure what they were, but the anesthesiologist sounded very calm and pleasant, so I wasn't too worried.  There seemed to be an awful lot of yanking and shoving going on below decks, but nobody was yelling or flinging instruments or dashing around like they do on television, so I continued to hum.  I think I slept.

Sam later told me that two surgeons appeared to be vigorously bouncing up and down on my uterus, as if they were enthusiastically giving my crotch some mutant form of CPR.  One of the nurses eventually told me that they'd done all sorts of massage and squeezing to try to force my uterus to contract after delivery, but my body wasn't having any of it, thank you very much.  In the end, they ended up putting a stitch around my uterus to stop the bleeding.  I had never heard of this, but naturally Dr. Google had.  Consider yourself warned: If you are squeamish or are overly fond of (or currently eating) cured ham, you may not want to click on the explanation of the uterine stitch.  Following the stitch, they 'administered something internally' for good measure.  Ever the delicate flower, when I was informed of this 'something internally' business in recovery, I immediately said "Like what, up my ass?"  After the repeated cervix checks and the urinary catheter, the Pestering My Unmentionables Trifecta was now complete.

Fitz-Hume was still in the nursery and doing well, although she was even smaller than the earlier ultrasound had indicated, the one that told the doctors to urgently pull the ripcord on this pregnancy.  She was about the size that a thirty two week old fetus should be and was all dark eyes and wrinkles when Sam went to check on her.

Millbarge was stable enough to stay with me.  She latched onto a breast larger than her own head for the first and last time in recovery and then stared at me for a very long time.  "I remember you," I whispered. "I think I saw you before, and I remember you.  Do you remember me?"

I thought that she might.

Many Thanks, No Sleep

I would like to thank Boulder for hosting my shower, Libby for sending the Amazon certificate, and everybody for offering help and support, or just keeping us in your thoughts.  It's appreciated more than I can fully express right now, especially with the awesome stupid-making powers of my current exhausted state.

Luckily, I started writing the girls' birth story before they stopped sleeping, and will post it on Monday.

Their Pediatrician assures us that they will sleep when they need to, but we have grown skeptical of this claim.  The new theory is that the Buttmansion girls do not sleep, they merely lie in wait.