Everyday Life

Categories Everyday Life, Pregnancy

Our newest addition

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We had hoped to keep Baby Garcia in the womb as long as possible – but really only had educated guesses as to how long that may be.

Turns out, that was 32 weeks.

On Thursday the 30th, my platelets dropped, causing our consulting physician to recommend induction. Even before we began that process, my blood pressure started to rise again (and wasn’t responding well to drugs) and my swelling had increased dramatically.

I had lots of side effects of the induction drug and/or the magnesium sulfate I was back on to prevent seizures – and by the time the day was done, I was physically and mentally exhausted. I couldn’t stand on my own feet between dizziness from the magnesium and swelling in my feet. I couldn’t grasp a spoon to feed myself ice chips since my hands were so swollen. I couldn’t see thanks to an unrecognizably swollen face, along with the characteristic “visual disturbances” associated with pre-eclampsia. And my oxygen saturations were dropping.

By midnight, I realized that I would not have the physical or emotional strength to attempt a vaginal delivery (at least another 12-24 hours on Pitocin) with the restrictions my condition placed on me. I requested a Caesarean section.

At 3:32 Friday morning, Tirzah Mae Eloise Garcia was born at 32 weeks 1 day of gestation. She was 17.5 inches long and weighed 3 lbs, 5 oz. She was born with her umbilical cord tightly wrapped around her neck twice.

In retrospect, Tirzah Mae’s cord plus my own health status could easily have necessitated an emergency c-section had we proceeded with an oxytocin-induced vaginal delivery, and I could have then needed general anesthesia so Daniel couldn’t be there and potentially would have ended up with an incision that would make VBAC less likely.

As it is, God in His mercy gave us an uncomplicated c-section with ample chance for VBAC and beautiful, healthy baby born at 32 weeks, 1 day.

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We’re still in the hospital – I will probably be here just one more day but we’re still working on getting my blood pressure under control. Tirzah Mae will be here longer, not because she isn’t doing well, but simply because she still has weeks of maturing to do before she’s ready to face the outside world on her own. For now, she’s breathing under her own power and starting to get tiny feedings of her mama’s breast milk. We treasure every moment we get to spend with our precious Tirzah Mae.

Thank you all for loving us and praying for us – and please continue to pray for us as we continue this joyful and challenging journey as parents of a preemie.

Categories Pregnancy

Life goes on…for everyone except me

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The oddest part of being on hospitalized bedrest is the realization that life goes on…for everyone except me.

People get up and go to work and come home and make dinner and watch the World Series and update Facebook with the goings on of their day.

I lie in bed and try to occupy the time between every-four-hour vitals and daily nonstress tests and couple time a week sonograms. I call the nurse to let her know how much I voided. I call room service for a meal and sit up in bed for one hour afterwards to avoid heartburn before lowering the head of the bed to keep my blood pressure lower.

My day is wrapped around baby’s health and my own.

Baby’s still kicking. Biophysical profile is good. Heart rate is great. No contractions. Baby’s doing fine.

My health is harder to assess and more tenuous. Is this headache a sign of disease progression or is it my normal morning sinus headache prolonged because I’m not getting up to clear my head? I’m struggling to breathe – how far do I press the residents to do something about it when my O2 saturations are staying okay? I’m retaining tons of fluid – the doctors haven’t recommended anything but the nurse suggested restricting my fluids a bit to try to stave off some of it. Should I follow her advice? My blood pressure fluctuates, never quite high enough to need an oral antihypertensive – but high enough to make me worry.

People ask me what they can do to help and I have no idea what to tell them. I know what I’d be doing at home if everything were fine and I was getting prepared for my expected home delivery – but my life is on hold now and I have no idea how to carry on.

Do I need preemie clothing? Will I need to be prepared to take baby home right after we deliver? Or will there be weeks in the NICU before that happens? How important is it that my dishes be done, that the nursery be prepared, that the freezer has meals in it? I don’t know.

I can only think for the present day, because everything could change in an instant.

And I open Facebook and see all the kids in their new Halloween costumes and pregnant mommas wearing clever little mom and baby costumes – and I am baffled that life goes on…for everyone except me.

Categories Pregnancy

Quick update from the hospital

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I saw our backup OB yesterday due to the blood pressure / protein spilling issues and my blood pressure had spiked to the point that he admitted me to consult with a maternal fetal specialist at one of our local hospitals. I’m currently getting at least 24 hours of observation as well as IV magnesium to reduce risk of seizures and steroid shots to help mature baby’s lungs for a sooner entry into the outside world. Right now, we don’t know when that might be, but this particular specialist (versus his counterpart in the hospital down the street) tends to like to keep babies in the womb if at all possible – which is very encouraging to me. We’ll have a better idea of what treatment will look like and whether I’ll be hospitalized for the duration of the pregnancy tomorrow after labs are complete. Either way, we’ll likely be spending quite a bit of time in the hospital in the next several weeks, whether in treatment for me or in the NICU with baby.

Good news is baby is healthy – growth is right on track, amniotic sac has just the right amount of fluid, heartbeat and fetal movements are great.

God has also been gracious to give me supernatural peace about this rather enormous departure from our planned home birth. The nurses and doctors have mentioned how remarkably calm I have been regarding the change – and how well I’ve tolerated the procedures so far (the IV and shot of steroids and the Foley catheter). I have to admit that’s not my strength at all – God has been gracious to grant peace and rest. (That said, I’ll be pleased as punch when the 24 hour sample is up and they hopefully let me start peeing on my own power again.)

Thank you all for praying and for continuing to pray. I know that God answers prayer according to the wisdom of His providence – and that He accomplishes all things for His glory and His people’s ultimate joy. I am currently resting in that sweet assurance – and praying that I would continue to rest in God’s good sovereignty.

Categories Pregnancy

Third Trimester Tales: In which I develop preeclampsia

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My second trimester was relatively uneventful. I felt great, had plenty of energy, and was eating well. The only cause for concern in trimester 2 was my weight gain – which was taking place more rapidly than hoped for – and the swelling in my legs – which started during a hot stretch of summer during which I was also training the county WIC staff in Baby Behavior (thus standing for longer lengths of time than usual.)

Apart from my pride (which really wanted to have perfect weight gain – I am a dietitian after all!), no harm was done, I figured. Excess weight gain is normal (even if not always healthy) in the second trimester, when feeling better leads to eating more – and when I’m pretty sure a fair bit of the gain is fluid? Well, fluid gain is also normal during the second half of pregnancy – especially for first time moms and those who are working on their feet or in a chair all day long. I checked my blood pressure a few times with my handy sphygmomanometer and didn’t worry too much – blood pressure was normal.

I was a day short of 27 weeks when I wrote of my dream of owning a pig. At that point, I had no expectation that a pig would be anywhere in the near future. Daniel had been looking around for land for a while, but I wasn’t in any hurry – and we’d resolved that unless a property was just right (and had the potential for a pig), we wouldn’t be really seriously looking until sometime next year.

At 27 weeks, 1 day Daniel found a piece of land he thought showed promise. He’d called the county and was reasonably sure we could put a pig on it. Would I be okay with taking a look that evening? The realtor told us to go right ahead and explore the property – and so we did.

At 27 weeks, 3 days we made an offer on the land.

At 28 weeks – the official start of my third trimester – we wrote a large check and bought ourselves a 2.4 acre lot outside of town.

At 28 weeks, 2 days I walked to the library and picked up a couple dozen books about evaluating builders, building houses, and running a homestead. That same day, the swelling in my legs went from nonpitting (not leaving a hole when I pressed on it) to pitting edema (leaving a hole when I pressed on it.) I knew that I needed to take it easy.

I woke up Sunday, at 28 weeks 3 days with a splitting headache and already sore, swollen feet. I really needed to take it easy. But it was a Sunday and we help out in the Preschool Sunday School classes on Sundays – and then there was the worship service – and the parade of homes just happened to be that weekend and what better chance to start to evaluate the builders in our area? We tromped through a dozen houses, taking notes on the quality of the construction. My legs were crying out by halfway through, so Daniel forbade me to climb stairs after that point. The headache continued. I stepped on the scale at the end of the day (not my usual pattern) and discovered that I’d gained 7 pounds from my morning weight.

Monday morning (28 weeks 4 days), I woke up with the same headache and knew I needed to call my midwife. Headache, pitting edema, very rapid weight gain. Those were symptoms of preeclampsia. I took the day off work and left a message with my midwife to call me. By the time she called back, the headache was gone but I’d already told her enough for her to be concerned. I didn’t have another appointment scheduled before our family trip to Williamsburg, but she wanted me to come in anyway.

At 29 weeks, we went in for a quick visit – which confirmed that I’d had a lot of weight gain and that my blood pressure was high (and not responding to positional changes, even more scary). But so far, I wasn’t spilling any protein in my urine. My midwife gave me some dietary suggestions, some supplements to start, and orders to spend as much time as possible resting during our vacation. She also told me she didn’t think I should plan on going back to work full-time after vacation. We scheduled a follow up for as soon as possible after my return from vacation – and I scheduled an appointment with my OB right after that.

We had a lovely vacation with Daniel’s family. I rested a lot, rode a wheelchair around historic places (now THAT’S an adventure), and ate absolutely nothing fun (pretty much just meat and nuts and fruits and vegetables – with no added sugar or salt). At the beginning, I was optimistic. I was doing everything right and I actually ended the day without any pitting one day.

At 30 weeks, we went about to all the drugstores in town to check my blood pressure – and couldn’t find a single store with an in-store automated blood pressure machine. So we bought ourselves an automatic cuff (much easier to push a button and let it check, rather than using the manual cuff and stethoscope that was still in Wichita) and I checked my blood pressure. It was high, still quite high. What’s more, my urine had started frothing – which could mean something as simple as dehydration, but could also mean protein in the urine.

This morning – 30 weeks, 5 days – we went in for our follow-up prenatal visit. I peed in the cup, ran the dipstick myself and confirmed my fears. I was spilling protein, majorly. Furthermore, I’d gained 9 lbs by my midwife’s scale in the 12 days since I’d last seen her. We still had a while to wait before we saw her, so I sat with Daniel in the waiting room, grieving over the homebirth I knew I had little hope of anymore.

Preeclampsia. The diagnosis I was afraid of, now the reality I must cope with.

I couldn’t sing it but my mouth could still say it, whispering hoarsely through the tears into Daniel’s chest:

“Whatever may pass and whatever lies before me
Let me be singing when the evening comes:

Bless the Lord, O my soul,
O my soul, worship His holy name
Sing like never before, O my soul
Worship His holy name”

~From Matt Redman’s “Ten Thousand Reasons”

Categories Following Christ, Pregnancy, Thankful Thursday

Thankful Thursday: Truth in Song

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As we showered this morning, I began to sing “It is Well with My Soul” (secretly enjoying the allergy-deepened sound of my own voice.)

“When peace like a river
attendeth my way
When sorrows like sea billows roll
Whatever the cost
Thou hast taught me to say
“It is well, it is well with my soul.”

It is well (It is well)
With my soul (With my soul)
It is well, it is well with my soul.”

I began on the second verse

“Though Satan should buffet
Though trials shall come…

And I stopped, searching my mental song bank for the rest of the verse. Where was the promise of deliverance, the reassurance that everything would be all right, the reminder that the trials would not overwhelm?

I gave up my quest and sang what came to mind.

“Let this blest assurance control
That God hath regarded my sinful estate
and hath shed His own blood for my soul.”

It was only after I’d finished the third verse that I realized the truth.

“My sin, O the bliss of this glorious thought
My sin, not in part but the whole,
was nailed to the cross
And I bear it no more.
Praise the Lord! Praise the Lord, O my soul!”

That had been the second part of the second verse. This song offers no blest assurance of some future event in this life. Instead, it harkens back to a blest assurance already completed: “That God hath regarded my sinful estate and hath shed his own blood for my soul.”

Yes, the looming threat of preeclampsia, of having to have a hospital birth, of maybe having to quit my job early and be on bed rest, of not being able to fully participate in our upcoming family vacation, of maybe going into premature labor – all those are trials that may come.

But my greatest problem has already been solved. My sin has been paid for, my soul secure. This is where my hope lies, not in happy outcomes on this earth, but in a blood-purchased ransom already accomplished.

So I will sing again through the tears.

“It is well (It is well)
With my soul (With my soul)
It is well, it is well with my soul.”

Categories Health, Pregnancy

Desperate women will do anything

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Ask any healthcare professional what causes pre-eclampsia and they’ll tell you that we honestly don’t know. We suspect that there’s a nutritional component, but clinical studies have been unsuccessful at isolating a root cause or identifying beneficial nutritional practices.

I know this. I try to stay up on the research, on the recommendations. I counsel pregnant women on nutrition for a living.

But when I start gaining fluid rapidly and my blood pressure starts creeping up and I’m afraid I’m going to risk out of home birth?

I’m willing to do anything, research be darned.

Up my protein from 80 grams per day to 100? Sure.

Cut out sugar? Sure.

Eat apples and beets for liver function? Why not.

So what if we don’t have any proof that any of those things will do any good – if there’s any chance that they will, I’ll do it.

It gives me a new compassion for the moms of kids with autism who desperately try eliminating artificial colors, and then gluten, and then dairy. So a professional (like me) tells them that there is no evidence that any of those are associated with autism or decrease in autistic behaviors.

They’re desperate and feel powerless – they’ll do anything, however bizarre to try to maintain some level of control.

As do I – putting my feet up on every occasion, lying down on my left side as soon as I get home from work, avoiding processed foods and sugar, loading up on protein.

Meanwhile, the clinician and evidence-based practitioner in me frets over the fact that I really have no idea if any of this will do any good. None of it is based on good science. It’s all just guesses.

So I do the one thing that will definitely not help my blood pressure stay low. I fret. I worry. I am anxious.

I resist the one thing I have been commanded to do by the One who made my body and who knows exactly what is best for it.

He says to be anxious for nothing, to lift everything to Him in prayers and supplications with thanksgiving. He promises peace that will guard my heart and mind.

Yet I fret, I resist, I try to do something myself, not willing to trust God with my body and my baby’s.

Lord, forgive me. I come to You desperate – able to do nothing. Take my fears, I choose to entrust them to You.

Categories Everyday Life

In which I receive my summons

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The envelope wafted in front of my face as I scrolled through the messages on my phone, obscuring my vision of the happy announcement (the youngest Miss Menter has arrived!)

“Are you doing relaxation exercises?” my husband asked me.

I averred that I had been, but was now catching up on family news.

“Well you’ve been summoned for jury duty.”

My eyes focused on the envelope from the jury clerk. He was right, I was receiving my first summons for jury duty. I was thrilled. Being on a jury has been on my life list for years. I’ve been eligible for 11 years, but never once summoned.

I slit open the envelope and my face fell.

The date I was scheduled to report was during our family trip to Williamsburg.

I read through the summons carefully until I got to the bottom section titled “Excuses from Jury Service”:

“Under the law, the judge is permitted to excuse you only if your presence is required elsewhere for public welfare, health or safety; if you are physically or mentally infirm that you are not up to the task of jury duty; if you have served on jury within the last year; or, if jury service would cause you extraordinary or compelling personal hardship.”

My only hope was “extraordinary or compelling personal hardship”. We’d have to cancel or change travel arrangements, be out several hundred or thousands of dollars (depending on whether Daniel went without me or if I tried to join the family for just part of the vacation). It’d be a horrid inconvenience, but was it “extraordinary or compelling personal hardship”?

I called the Jury Clerk the next day to explain.

She explained to me that she could not excuse me in advance, as I was only a stand by juror anyway. Instead, she would make a note on my file that I would be out of state for the dates of my trip. She then instructed me to call the day I returned from my trip to learn whether my jury group had been chosen and to serve (or be dismissed) at that time.

So I will be able to travel with the family – and maybe, just maybe, I could still sit on a jury before my years of breastfeeding (and therefore automatic excusal from jury service) begin.

Categories Parenting

No children, lots of theories

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You know that old saying about no children, lots of theories, and vice versa?

Well, with one in the hopper but none in hand, I’ve definitely got plenty of theories.

For kicks and giggles, I thought it would be fun to make a list of some of the many things parents take “sides” over – and declare my side.

You know, that way I can look back years from now and shake my head at how naive and idealistic I was back before I had children.

So, without further ado:

The first days:

Delayed cord clamping?
Wait until it’s stopped pulsing

Skin to skin?
One hour minimum right after birth

Vitamin K?
Yep

Eye drops?
Nope

Circumcision?
I don’t think it’s immoral, I probably think it’s on the smart side in our culture with increasing promiscuity (even if your son doesn’t engage in sexual relations outside of marriage, there’s no guarantee his future wife will be a virgin at marriage – and circumcision does reduce transmission of STIs). That said, I’ll defer to my husband’s judgment on that one. I really don’t have any strong opinions on the subject (believe it or not!)

Diapering

Disposable or cloth?
Prefolds with old-fashioned plastic pants (I’m cheap, but I plan to have some newer covers for when my kids are in the church nursery)

Pins or snappies?
Both

Feeding

Breast or bottle?
I hate that question. It should be “breastmilk or formula”, since women can still provide breastmilk in a bottle. But, I intend to breastfeed-that is, provide breastmilk “straight from the tap.” Pumping doesn’t appeal to me and if I’m going to be away from baby I plan on hand expressing and having him fed with a spoon or a cup.

Scheduled feedings or “on demand”?
I prefer to call it “per infant hunger/fullness cues”. I’ll breastfeed baby when she’s hungry and we’ll stop when she’s full. When she starts eating with the family around six months, we’ll work towards more of a schedule.

Vitamin D or no?
I’m deficient, so there’s no way my breastmilk will be sufficient (BTW, even in women with poor nutritional status themselves, breastmilk is generally a complete source of nutrition for a baby – except for Vitamin D.) I’ll be giving drops.

Nursing cover, blanket, or nothing at all?
Nothing at all

Introducing solids?
When baby shows signs of developmental readiness, no sooner than 6 months.

First foods?
Iron fortified infant cereal mixed with breastmilk. Which will be the only “baby foods” I’ll buy. Otherwise, we’ll be going straight to soft table foods mashed with a fork (but still introduced one food at a time with a new food every 3-5 days to watch for potential reactions).

Weaning from the breast?
No sooner than 1 year, probably no later than 2 years

Weaning from the bottle?
If I never use one, I’ll never need to wean from it. My kids can drink from cups

Pacifier?
Not for the first few weeks or until breastfeeding is well established. Beyond that, I probably prefer not but I’m not dogmatic about it.

Potential allergens?
Introduce them along with all the rest of the foods we eat as a family starting at 6 months. If we eat it frequently, we’ll probably be more likely to introduce it “early”. We will hold off on cow’s milk (for drinking) or honey (by itself or in anything) until 1 year.

Sleep

Cosleeping?
Baby in bassinet in our room no longer than 4-6 months. Never in our bed.

Back or front?
Back to sleep saves babies’ lives. Once they’re rolling, though, it makes absolutely no difference.

Nursing to sleep?
Can’t really stop it at the beginning – but once that first tooth emerges, nurse and brush or wipe before bed.

Rocking to sleep?
I’m generally a fan of laying baby down to sleep when he’s awake but showing signs of sleepiness.

Swaddling?
If baby tends to get overstimulated easily. But I don’t intend to rely on it as a regular means of getting baby to sleep.

Sleep training/Crying it out?
Yes, but not for newborns (or really even in the first 4 months or so.)

Miscellany

Babywearing?
Yep. But not all the time. It’s okay for baby to hang out in a crib or on the floor, with or without direct supervision.

Tummy Time?
Any time baby’s not sleeping or being held.

Car seats?
In the car, properly secured, and rear facing as long as possible. Baby will NOT hang out in the car seat outside of the car.

Church nursery?
Probably not until a breastfeeding routine is established, since I’ll want to be near enough to feed on cue – but once baby’s older and a schedule is established? Probably. I’m not opposed to having babies in the service so long as I’m still able to participate in worship with the rest of the congregation.

Of course, I haven’t covered everything here – far from it. In fact, I chose to focus on the first year and the controversies of that year. I have also not chosen to flesh out my positions on any of these. I’m not really intending to open up a debate here. I recognize that having a child of your own changes all sorts of things – and that different things work for different families. We’ll see what happens when baby comes and theory has to turn to action :-)

Categories Pregnancy, Work

You don’t LOOK pregnant

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I hear it often enough that I sometimes feel like yelling.

“You’re not even showing,” they tell me – and I know they mean well. When the time comes that I look like I’ve swallowed a beach ball, I’ll be glad for the days when I “wasn’t even showing.”

Truth is, I weigh more than I’ve ever weighed in my life. My belly has definitely expanded. Baby jabs at me day in and day out. What do you mean I’m not even showing?

What makes it even odder is how those who know me well are absolutely certain that I AM showing. My sister tells me “Anyone who knows how stable your weight is has to know that you’ve been gaining.”

Which is probably what explains things. Those who know me and have seen me regularly know that this current weight, this current distribution of weight is far from normal for me – those who don’t see just an average looking woman (not necessarily a pregnant one.)

As frustrating as it can be to be disbelieved when I announce that I’m due in December, it really came in handy with one client I saw last week.

Now, I generally don’t discuss my own pregnancy with clients. They’re in my office to discuss their pregnancies – and while my own pregnancy can help me empathize, that doesn’t mean that they need to (or want to) know the details of my pregnancy.

But this young woman was in the first trimester of her first pregnancy and was nearly thrown into a panic when her friend told her she didn’t look pregnant.

I tried to reassure her that every woman is different and shows at different times – but that many women don’t show until the fourth month or so, especially in their first pregnancy.

My client tried to believe me, I could tell, but she was still worried.

I stood up and smoothed my skirt over my bump.

“I don’t know if you could tell,” I told her, “but I’m in my fifth month.”

Her jaw dropped open and she gasped. “You don’t LOOK pregnant,” she said.

Exactly my point.

She got it – and told me before she left that she’s looking forward to seeing me again once I do start showing.

Categories Everyday Life, Reflections

Am I becoming boring?

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Blogging becomes increasingly hard – not because I don’t have anything to say, but because I fear I don’t have anything to say that anyone wants to read.

My days feel one dimensional – all caught up in pregnancy and work, work and pregnancy.

I go to work – where I talk to pregnant women, breastfeeding women, mothers of young children. I teach them how to be healthy during pregnancy, breastfeeding, feeding a family. I come home from work – where I try to be healthy during my own pregnancy. I retreat to the basement where it’s cooler for my evening workout. I grab a book and read more about healthy pregnancy, healthy delivery. I talk to my husband and fear I’m becoming a broken record, telling yet another story about how the book I’m reading is wrong about pregnancy nutrition or about how the clients I see don’t get it until I explain it to them a different way or how frustrated I am that I’m not the superwoman I wish I was.

Even the non-pregnancy related stuff finds a way to revolve around pregnancy.

Getting laundry done becomes all about making sure there are enough underwear that fit (I’ve graduated to men’s boxer briefs – which are much more comfortable than ladies underthings). It’s all about which dresses still fit my figure.

Cooking revolves around pregnancy – both my energy levels related to pregnancy and alternately trying and not trying to fit my intake into the ridiculous “Brewer diet” encouraged by the Bradley method. I spend way too much of my days internally grumbling about the diet, about how I’m going to gain too much weight because of it, and how it’s so darn much work. And I grumble more because even though I’m not a preschooler, I still want stickers for a job well done – even when I know as a dietitian that the Bradley prescribed diet is far from healthy for pregnancy.

Reading is all about pregnancy, childbirth, baby care. Crafting is preparing baby stuff.

And I wonder – if I’m already becoming this boring *before* the baby comes and I’ve quit my job, what will I be like as a housewife?

I fear more than just boring others. What if I become so myopic that I bore even myself?

It’s exciting and it’s scary, this new season we’re entering into.