33w0d: Belly Pics

12/31/08 Here I'm posting something I wrote in early December, but never got around to posting because I didn't "finish" the entry. Now I need to write another one!

OK, OK... I took belly pics. I have been meaning to do so for a long time, so I'm glad that you spurred me into action. Looking at these later, I think it shows how very deceptive these types of photos can be.

These photos were each taken within a few moments of each other at 32w2d (Thanksgiving Day):

It almost seems like in the group shot (3rd), you can't even tell that I'm pregnant. But in real life, there is no denying it!

Today, at 33w0d, I have gained about 26 lbs! I'm still hoping to stay under 35 overall, but I may not make it.

I'm really feeling pretty good. Some days my back hurts, like on Thanksgiving, when I spent much of the day standing and then was leaning over to get stuff from low shelves, etc, throughout the day. I do pee more often, and today it feels like my belly is about to meet my breasts in the middle of my torso.

32w0d: Blogiversary!

I keep putting off my blog entries as I keep waiting for "something worth blogging about." But meanwhile the time is slipping by and I don't have very many entries to document this pregnancy.

I can't believe it, but today is my Blogiversary! When I started this blog 1 year ago today, I was just gearing up for my first IUI and googling like mad to read the real-life experiences of women who were going through the same things that I was. The women whose blogs really inspired me to create my own blog (mostly because I wanted to leave comments on theirs!) were Cindy (who was also doing a first IUI) and Hilary (who was doing an IVF). Thank you both for your very honest and often poignant blogs!

Also today, I am thrilled to reach the 32 week milestone. At a work event (new faculty welcome reception) about 3 weeks ago, a man came up to S and me (quite randomly) and introduced himself as the head of the NICU. I kinda drew back, looked down at my belly, and said, "Ooooh, I'm not sure that I want to meet you!" (or something like that). He then asked me how far along I was. I told him (29w3d at the time) and he said, "oh, it doesn't sound like you'll need to meet me in the hospital. Really, we think of preemies in different categories: the 23 and 24 weekers, the 25 weekers, the 26 weekers, the 27s, and then 28-32... 28 and above is pretty good. 32 weeks and above, everything is usually just fine." Well, I was only 29 and a half at that point, but I did appreciate his reassuring words.

Which is not to say that I don't occasionally have waves of fear when I feel like she's moving a bit less or something like that. But all in all, it's starting to sink in that this is happening, and then everything is going to be OK. I have a lot more to say, but I promised S that I was going to come to bed earlier tonight. So I will. Hopefully I'll get back here in the next day or two!

28w1d: Bye bye, Second Tri...

... and hello to the third trimester! I can't believe that I've made it here. Every day, this is getting more and more real to me. I am truly grateful.

After Thumper, and then Thumperina, I have yet another new nickname for the BabyGirl. Kixie...Kicksy...or something like that. (I don't actually use these nicknames in front of other people, except maybe S, sometimes.) She is getting stronger by the day. I love her little movements, even though they still sometimes make me feel like maybe I just ate something that is causing my intestines to do flip-flops.

S and I went shopping for baby furniture last weekend. We checked out two stores: Babies R Us, and USA Ba.by. I realize that this sort of info is pretty boring if you're not currently in baby-furniture shopping mode right this very moment, but I will share a few details for anyone who actually is interested in this stuff. We ended up buying at USA Ba.by and we chose this convertible crib and combo dresser by Mu.nire. Yes, in white. I realize after shopping for baby furniture that the current trend is more along the lines of black and dark espresso-colored woods, but S and I were both a bit hesitant about this look for a baby girl (or any baby, really). I know a few of you have gotten these darker sets, and I'm sure that it will look great, but for us, white or natural wood seemed to fit our vision of a baby nursery. And natural is apparently so out of style that they won't even be carrying it anymore (who knew?), so we went ahead with white. I was almost tempted (by feeling unstylish) into considering a rich medium chestnut finish, but really, the bedding and everything else looked cuter with white, so we stuck with that. We splurged a bit on the furniture, but then got a glider that was on the cheap side (but still comfy). Hopefully we won't regret that decision!

Of course after I got home, I googled Mun.ire furniture and read tons of horror stories about delayed shipments which meant no crib for 4 months, etc. However, our items were in stock and were actually delivered today (about 72 hours after purchase). Now we just have to open the giant boxes and make sure that nothing is missing, scratched, or chipped!

As far as bedding (still boring, I know!...) I have just attempted to purchase the Lambs and Ivy Bright Butterfly set off of EBay. Just the quilt, sheet, crib skirt, and valence for now. We'll probably do a few other accessories, but I am officially Too Scared to buy a bumper since some organizations have recommended against it. Also, I had not used my Ebay or PayPal account for several years, so I had to update my current address, credit card info, etc. Ultimately, I need to wait a few days for PayPal to verify something, so hopefully the EBay seller won't be mad at me for the slow payment.

At Babies R Us, we came across a stoller that was the exact model and color that I had been considering. They normally carry these only on their website, but it had been returned by someone who had ordered it online. This meant that it was marked down by $94 off the usual price! Yay!! It's the Bob Sport Utility Stroller in blue. (The other choice was red, so blue seemed fine...plus, we wanted gender neutral.) For the little baby phase, we haven't yet decided whether to get an infant carseat + an adapter for this stroller, or an infant carseat + one of those stroller frames, or whether to get a travel system. I also need to make sure that the stroller we bought actually fits into the trunk of my car (a Civic).

Physically, I have been feeling pretty well except for occasional Braxton-Hicks type contractions that occur a few times a day. Also, I have noticed that my abdomen is getting a suspicious vertical ridge above my belly button when I try to sit up. I'm afraid that I might be developing an early case of either a ventral hernia or diastasis recti (separation of the rectus abdominus muscles). I suspect the latter, because I don't think that it's too bad, yet. Since I noticed it, I have been sitting up in a different way (rolling to the side, and then using my elbow to push up) to try not to exacerbate it. Some websites that I consulted suggested doing this during the rest of pregnancy, and then doing certain exercises (or even seeing a physical therapist) after birth. Of course, by doing that, my abs are probably losing even more strength, so I don't know if I'm doing the right thing or not. But I really hope that this goes away once there is less internal pressure.

My weight continues to rise steadily. I was up about 18.6 lbs as of this morning, and as much as 20.4 lbs the day before that. I'm hoping to come in under +35 for the pregnancy, but at this rate, I'm not so sure about that. Most of my weight is in the belly, but there is definitely a fair amount elsewhere, too. Last Friday, I tried on a pair of pre-weight loss (2003) pants -- 1 or 2 sizes above my more recent size -- and found that the 2003 pants fit perfectly. I have been keeping about 4 pairs of these pre-weight loss pants specifcially with the thought, "maybe I can wear them when I'm pregnant or post-partum," but about 2 months ago I tried then and thought, "No way! Way too big in the butt and hips, even if my belly grows." Well, apparently, all of me has grown and they fit well. However, I think I'll probably grow out of them, too, in the not-so-distant future. I am already bored with all of my maternity wear, but it seems like a waste to buy much more of it.

I'm going to do my glucose tolerance test tomorrow AM. My fingers are crossed. Hopefully my polycystic appearing ovaries (and possible PCOS) will not cause me to fail! I don't think I have any blood sugar issues, and there is no diabetes or gestational diabetes in my family, but you never know!

In other news, I completed my Medical Oncology board certification exam yesterday. It was a pretty difficult test, so I can only hope that I passed. The results will be available in 3 months... around the same time that Kixie makes her appearance, I guess. I'm sure I won't care much at that point!

25-26 weeks

Something really stressful happened at my last prenatal appointment (October 8, at 25w1d). It started out routine -- pee in a cup, blood pressure, weight...

My doctor came in and asked me about any symptoms. I told her that I still had the occasional tightening of my uterus, but nothing consistent and no vaginal bleeding to go along with it. I mentioned how it had been worse while riding the aforementioned bike in San Francisco (see below). She said that in general, she does not advocate bike riding during pregnancy as "you could get hit by a car" and because she's had a previous patient "flip over the handlebars and get hurt" while mountain biking. Well, OK... S and I don't even own our own bikes, and we have rented bikes exactly 2 times since we met 3.5 years ago, so I guess it won't be too hard for me to follow her advice.

Next, she proceeded to place the Doppler on my belly. Whoosh...whoosh...whoosh... a nice strong heartbeat.
But then: whoosh...whoosh.........whoosh.........whoosh.........whoosh.........whoosh..............whoosh............whoosh..................whoosh...whoosh...whoosh...whoosh
I could see wave of concern cross Dr. K's face. "Let's listen a little longer," she said.
Me: "The heartbeat showed down for a few seconds, didn't it?"
Dr. K: "Yes, but now it seems fine. It went into the 90s for a few seconds, and then came back up."
whoosh..whoosh..whoosh..whoosh....whoosh....whoosh..whoosh..whoosh
(It slows down a tiny bit, but not nearly as much as before.)
Whoosh..whoosh..whoosh..whoosh.. (for about 2 or 3 minutes)
Dr. K: "Well, everything seems OK. I think the baby probably just pinched her umbilical cord for a few seconds." (My face, I'm assuming, looks terrified.) "If you're really concerned, you could always go to Labor & Delivery and get monitored for a couple of hours."

At this point, I start to basically panic. As bad luck would have it, I have two patients scheduled for appointments that morning, starting in about 30 minutes. And afterwards, I am the consult attending at the VA, so I need to round on the inpatient service. Obviously, I could go to L&D if it's recommended or necessary, but it will require some major stress and inconvenience to others to make arrangements for someone else to cover these things for me.

I explain this to Dr. K, and she quickly back-pedals.
"I don't recommend that you go there; I think that everything is fine."
I try to negotiate a return to her office later for another heartbeat check... or maybe I'll go to L&D in the evening. My eyes fill with tears.
"No, I don't think you should. I wouldn't go there if it were me. Everything is fine. Let me get the ultrasound machine and let's take a look."

So, she got the ultrasound machine and we saw BabyGirl inside, head down for once, squirming and moving normally, heart appearing nice and fast and rhythmic, doing practice breathing with her diaphragm moving up and down.

And so I decided to NOT go to L&D. I wish Dr. K had never mentioned the words. My own rationale was somewhat like: 25w1d is way too early. If I got there, who knows, they might end up panicking and doing a C-section or something crazy. What else could they do if there really was a problem? Alternatively, they might order a bajillion more tests for me and BabyGirl. I know that would be SO scary. Somehow, I did believe that it was just a fluke and I didn't really want to be monitored and hear that again and just get more and more scared and worried. Did I spend the evening reading about decelerations and fetal heart monitoring?: ummmm, yes. But almost all of the info I could find referred to the perinatal period (ie during labor). And a decel lasts for minutes, not seconds. There's very little written, as far as I can find, about blips in heartrate that last for only a few seconds and which are noted at a random prenatal visit.

So, I've decided to trust Dr. K and trust BabyGirl and not worry about it. BabyGirl has been helping me out by being increasingly active over past week, so I know that she's OK in there. Just felt a kick, in fact! I know that Dr. K truly wasn't worried because our next visit is in November, at 29 weeks... 4 weeks from our last visit.

Between now and then, the only thing I need to do is take the 1 hour glucose tolerance test. I picked up the bottle of the orange stuff from the lab. For some reason, I was thinking it would be a small bottle, but that thing is pretty big! I guess I'll do it sometime next week.

I told a friend at work about the Scary Prenatal Visit, and she offered to bring me her "Doppler". It took her over a week to find it, and it's actually not a Doppler, but something called the "BebeSounds Prenatal Gift Set." As far as I can tell, this was probably popular right before people started buying and renting their own Dopplers for home use. It is basically a battery powered microphone that you put against your belly, and then you turn up the volume and listen with headphones. Honestly, I can't hear the baby's heart yet. However, the placenta (anterior) sounds like an approaching freight train. The instruction manual says that this machine works best in the 3rd trimester, so I'm not quite there yet anyway, and who knows if I'll ever be able to hear anything over the placenta. Also, it is highly dependent on the baby's position. BabyGirl gives me a lot of reassuring kicks while I try to listen, too. I love her so much already!! Today she is 26w4d old!

24weeks: Anniversary and San Francisco excursion

Oh wow, I can't believe how behind I am getting. I wanted to record every detail of this pregnancy, and I just keep putting it off. And the longer I wait, the more I have to write, which makes me feel like I don't have time to write a catch up message. I guess I'll write part of it now, and part later!

First of all, S felt the baby kick for the first time at 24 weeks! Very cool!

S and I celebrated our 2nd wedding anniversary on October 1st. Even though it was a Wednesday night, we went for a walk on the beach followed by dinner at a yummy Italian restaurant. Here's a 24w1d belly shot from our walk on the beach. As you can see, I've grown a lot lately!

Afterwards, our waiter at the Italian restaurant offered me wine, which I politely declined. As we were leaving, he said, "OH!!" and pointed at my belly. "Congratulations!!" This was actually the first time that a complete stranger had said anything to me (although people who know me have been commenting for weeks now.) And the very next day a random woman in the elevator at work also made a comment. So far, I haven't minded at all.

S and I went to San Francisco for the weekend of October 4-6th to celebrate the wedding of my very special friend K's little sister, R. It was a beautiful ceremony in an open field with a spectacular view of the Golden Gate bridge. I believe there were FOUR adorable little boys in the 10 months to 2 year age range, and it was great to see how well they did all evening, despite the unfamiliar faces and the noise.

Other highlights of the weekend included:

- catching up with an old ex-bf of mine (known him since '94 but only dated him in 2000-2001, so we are really more like old friends), and getting a chance to get to know his girlfriend a bit better. The only other time I had met her was at my own wedding, so you can imagine that I hadn't gotten much of a chance to talk to her then

- going to Golden Gate Park to check out the new California Academy of Sciences museum. Unfortunately, they had opened only 1 week before, so the line was way too long... Well, we saw it from the outside and had an opportunity to stroll around the park at least.

- being on a crazy crowded Muni train with hundreds of teens/early 20-somethings headed to some crazy event called the Love Fest. It looked like it would have been really fun -- if I wanted a chance to wear fish nets, boots, a pink wig, fairy wings, and a feather boa with thousands of my friends, and if I were about 20 years old. And then the Muni train in front of us apparently derailed... So we got to figure out how to get over to the BART train, rush back to our hotel, change clothes, and get to the wedding. Of course, our cab driver had never heard of the wedding location and was generally clueless, so we had to suggest that perhaps he should input the destination's address into his dashboard-mounted GPS. Amazingly, we made it to the wedding with about 5 minutes to spare!

- naively thinking that maybe we could just hop on a ferry to Alcatraz. No, apparently you need reservations weeks in advance!

- renting bikes instead. This actually made me kinda crampy and the (early maternity tight lycra waisted) cropped pants I had on are now way too small for my current belly. I guess I won't be wearing those again until the post-partum period!

23w4d: Thumper

I've been quiet again, I know. Part of it is simply being busy, and part of it is feeling guilty about talking about pregnancy stuff while several of my favorite bloggers are having Bad Things happen to them. :( Another part is having just a bunch of random observations, rather than a cohesive theme, for this post. But, the weeks are passing, so here they go!

Thanks to several readers with their concerns about my "contractions." To be clear, I think they were Braxton-Hicks contractions, nothing more serious than that. On line, some websites suggest that BH contractions can start in the first trimester, and others seem to say that they occur at 30 weeks plus. I haven't felt any generalized contractions lately, though, so I'm not thinking too much about it. I do, however, sometimes notice that the L side of my uterus seems to contract on its own, while the rest stays pretty soft or contracts just a little bit. It almost feels like a hard ball on that side only. Very very odd! I have not heard anyone else mention this kind of sensation, so perhaps I need to do a little research and ask my doctor about it.

It reminds of me of how, during med school, I did the requisite OB/GYN rotation, and a lot of the pregnant women would come in to clinic or labor & delivery, saying that their baby was "ballin' up". This was an inner city population in Baltimore. In retrospect, I think it is really interesting to think about how these patients perceived the contractions (generally what they meant by "the baby is balling up") were caused by the baby itself, rather than the uterus squeezing down on the baby. I had almost forgotten about this term until I experienced it for myself. Now, over 9 years later, I can at least understand what they meant by that. Have you all ever heard that term, and if so, where do you live? I haven't heard it here in San Diego, but I don't work in OB/GYN anymore, so who knows?

For the past two Sundays (21w5d and 22w5d) I did some moderate exercise - gym and swimming one the first occasion, a hike in our neighborhood canyon on the second. Keep in mind, pre-pregnancy I was running about 2.5 miles several times per week. I was no iron woman by a longshot, but I was at least in decent cardiovascular shape. These days, not so much. My exercise has really dropped off, partially due to the early OHSS, and then just due to lack of discipline and a busier schedule.

I didn't feel like I strained myself with the exercise, but OMG I did not feel good on either Monday thereafter. On the first Monday I had pretty bad back pain, and I really do think that I must have strained something at the gym. It went away by Tuesday/Wednesday, luckily. And last Monday (22w6d), I had really uncomfortable anterior pelvis and round ligament/ovary-area pain all day. Now, Mondays are my full clinic day, so I am up and down between a central work area and 2 exam rooms all day long. That day, I was needing to literally scoot to the edge of my seat and prepare myself before standing, for fear of getting a really bad pain and doubling over or wincing in agony if I moved too quickly. (I don't really want my patients, most of whom are meeting me for the first time, to see me do that.) I took Tylenol, which helped a LOT, but it wore off after 6 hrs or so. Monday night, I remember that it was even kinda challenging to get in and out of bed. My biggest fear was that this was how it would be (and worse) for the remaining 17 weeks of pregnancy. Argh!

The discomfort was still there, albeit improved, last Tuesday. This time, I took the Tylenol and it pretty much disappeared and hasn't been back since! I am SO relieved but still kinda mystified about whether just hiking a little bit could have set that off. Meanwhile, I am determined to stay active!

Jen has a very timely post about weight gain. I am so grateful to be pregnant that it feels weird to complain about ANYTHING, especially something cosmetic. And objectively, I'm up about 13 lbs, which is pretty much average for this point in pregnancy. I'm actually not worried about how I look NOW. It's the future that scares me. I'm guessing that I'll gain at least a pound a week from here on out, putting me at probably 30-35 lbs gained by the end of the 3rd trimester. I started this process at 132 lbs, so right away that means that I'll be at about the same weight as S! I'm guessing that I'll end up about 145-150 lbs immediately post-partum. Now, I have been around that weight or even a little more in the past (1998-2003 or so), and I know I can lose it, but it is NOT fun. I know that breast-feeding will help, and I plan to do that for as long as I can, but I'm still afraid. I'm afraid that it's going to be harder now that I'm in my 30s, now that I'm married and can't just eat Lean Cuisine for dinner, and now that I'll be worried about whether I'm eating enough to produce good, healthy breast milk. At the same time, I want my little girl to grow up with a great body image and confidence and healthy eating habits... ah, the challenges of womanhood!

As for BabyGirl, we still don't have a name picked out, and we haven't even been talking about it much lately. No new ideas, either. I think we're both trying to figure out whether we can learn to love each other's favorites. His favorite is growing on me, but I'm not entirely convinced yet.

I'm also thinking of her as "Thumper" at times... remember Bambi's little rabbit friend?? Her movements are definite little thumps. Some of them I can feel from the outside, and some only from the inside. S still hasn't felt one, but I know that he'll be able to soon. I was trying to look at my belly last night and I could kinda see some of them (jolt-like, rather than a hand or foot sticking out), but it is difficult with the movements from breathing and my own pulse kinda obscuring things.

We haven't bought anything at all yet. We still have a bedroom set (bed and vanity) in the nursery-to-be, and we need to move it out of there. My aunt feels that she must have it (it used to belong to my great-grandparents, and it's old, but not valuable). However, my aunt will be moving it into my grandfather's garage as she doesn't have space for it. Also, none of us own a truck, so she needs to hire someone to come and get it. It is frustrating because she is trying to get a neighbor of hers to do it, but he is being flaky. I think she should go on Craigslist and just hire someone, but she hasn't done that yet. And so we have no space! S is kinda annoyed about the whole thing so he wants the items gone before venturing with me to BabiesRUs, etc. I've been OK with that plan so far... although I've looked a little bit on-line. I'm not really the type to get super invested in a certain theme or brand or decor, so it will probably be a bit of a hodge-podge anyway. I may or may not have a hand-me-down crib (need to look it over) from my parents, and a high chair and pack-and-play from my co-worker. And we're not going to paint; the room is sort of a warm neutral/cream color, and I think that with some nice wall hangings or other art it should look fine! I think that both S and I are most excited about getting some sort of stroller that will allow us to take the baby on our favorite local hikes/canyon walks. I think we'll be checking out REI for that one.

S is away at a conference this weekend, so I'm all by myself for only the second time since we've been married! I'm fine, but I do miss him! Next week we'll be attending the wedding of my dear friend (and reader) K's little sister in San Francisco. Very very exciting. But in the meantime I need to find a dress to wear. Tomorrow, I'm going to try to hit an outlet mall with a Motherhood/Mimi/Pea in the Pod outlet and hope that I can find something. :)

21w2d: Quickening

Quickening. I love that word. It reminds me of stories that I've read at some point through the years (although I can't recall a specific book), in which the female character feels "a quickening in her womb," and this feeling confirms that indeed, she is pregnant.

I've been thinking about the fact that I would be writing one of my blog entries with the title "Quickening" for weeks. Thus, I've had plenty of time to think about the curiosity of this particular word and some of the different meanings of quick. Fast or rapid is the obvious one. But it also has an archaic meaning: alive, and that is certainly what fetal "quickening" must refer to. On the other hand, quicksilver refers to the actual metal mercury, or the "mercurial tendency" of being impulsive. And the quick of your fingernail is that sensitive part underneath that can bleed...in other words, the part that is "alive." The term quicksand, according to various online dictionaries that I just consulted, literally comes from the meaning, "living sand." It's such a rich and evocative term; I hope that "quickening" does not completely disappear from our lexicon.

As I described in a previous post, I felt the first definite movements in the middle part of week 19, and then only with intense concentration, when I was lying down flat with my hand on my belly. However, it was really this Monday (20w6d) when I felt BabyGirl flip-flop around when I was just casually sitting at work in clinic, typing at a computer, and with my hand nowhere near my belly. And since that day she has been doing it in little bursts on and off for 5 minutes here and there. It is a truly wonderful (but somewhat odd!) feeling. I fall in love a little more every time I feel it.

I've been trying to call BabyGirl by all 3 of our top names to see if one feels right and natural. Let me clarify: these are not really either of our individual absolute favorites, but ones that we both like enough to agree to put on a short list. Of these three, S likes them in the order: 1) E, 2) A, 3) N. And I like 1) N, 2) A, 3) E.

S's favorite of the bunch, E, feels the "easiest" of the three right now, but I'm still not ready to commit to that one. It is cute, but too common. This feels like such a big decision. I would even consider waiting until the birth, and deciding when we finally meet her, but S feels that it will help us bond even more if we start calling BabyGirl by her name now. I think I could get him to agree to N if I really insist, but I'm not sure if I want to do that, either. My fantasy is that we'll somehow magically find a name that we both LOVE and that becomes both of our instant favorites, pushing all others aside. I'm not sure that any of the names that we've considered so far is the right name. It would probably be most "fair" to use A, which may be both of our #2 picks from the short list, but that one doesn't work well with the middle name that I'm currently favoring.

In other news, I had a doctor's appointment on Wednesday at 21w1d. Strangely, the Women's Health office had moved from the second floor to the basement of the same building on the day before my appointment, so it felt kind of odd to be in that new location. The appointment was again really quick and anticlimactic. Pee in a cup, blood pressure, doctor enters and I ask my 2 questions, listen to BabyGirl's heartbeat (well, I love that part!) and then the doctor rushes away. She wasn't very impressed with my description of occasional contractions on-and-off for several weeks. She says, "oh, that's not Braxton-Hicks, it sounds more like growing pains in your uterus." However, trust me, these were true very intense contractions that made my uterus really, really hard for about 1 minutes, and then it relaxed again. I think they were contractions no matter what she says, and Dr Google and a few books I've consulted agree with me: they could be considered early Braxton-Hicks. But it doesn't really matter what she wants to call them, because as long as they're not regular or associated with pressure down below or fluid leakage, they're perfectly benign. So that part was reassuring, at least.

I still sometimes wonder if I would prefer a midwife. I mean, everything is OK with this doctor, but it's not like anyone has ever asked me to describe what kind of birth I imagine, how much I want to be monitored, whether I will want an epidural, a tub birth, a birthing ball, to be in a homey environment or in an OR. Whether I want the baby to be put on my belly afterwards or whisked off to be cleaned and weighed. I don't even know that I will do anything "alternative" but I wish that someone would at least ask me those questions and talk about various options with me. It would at least make me feel like more of a human being, a woman, going through this wonderful experience or pregnancy and preparing for birth. Right now I kinda feel like I'm just a quick-15-minute-appointment every-4-weeks person, and they are probably just relieved that I am such an easy, non-demanding patient with no complications so far and not many questions.

I hope you all are doing well out there... :) There has been a lot of excitement on my blogroll recently, and I'm really enjoying all of your posts.

20w2d: Developments

The biggest news is that I have felt BabyGirl move a bit. (I've been thinking of her more as BabyGirl now, instead of Blueberry, now that we know her gender). I think I first really knew last Friday night (19w3d) and then again a few times over the next few days. I'm not sure if it's the anterior placenta or what, but these movements are kinda subtle flip-flops rather than true jabs. The other weird thing it that I can only feel them when I am lying down flat, and when I have my hand on my belly. I feel like I am feeling it from both the inside and the outside. I know that you're "supposed" to feel it inside, first, but to me it is easier to feel them both together. S has tried on several occasions, but he only has the patience to hold his hand still there for about a minute. And again, I don't feel "sure" that I'm feeling movement unless my hand is there. So, I imagine that it will be another week or more before he gets to feel it from the outside.

And now, let the whine-fest begin... after a very harmonious first trimester after the OHSS fiasco, I now have some various complaints to share!

Last Saturday, around mid-day, I started feeling a pain in my chest, on both sides, whenever I took a deep breath. A bit later, my entire throat felt "gripped" by pain. It wasn't a burning sensation, but at that point I figured out that I was dealing with heartburn. I can't figure out what triggered it; I hadn't eaten anything unusual before it started. I know that heartburn is common in the third trimester, but 19w4d seemed a bit early. It got a tiny bit better, but didn't resolve with Tums, Maalox, or Pepcid. To be honest, the stupid pain lasted all day and I went to sleep that night propped up on 3 pillows and fearful that I would be spending the enitre next several months in this kind of discomfort. It was almost gone by morning, though, and went away entirely soon thereafter. It hasn't been back since. :)

On Sunday, I think I was feeling pretty good. In the heat of the day, S & I climbed a local mountain (site of our first meeting and our engagement) with our friend J. It's only 3 miles round trip, but pretty steep, so I was initially a bit wary of doing it given the heat. However, we took a rather moderate pace and I did just fine.

On Monday (Labor Day), we went over to my parents' for a little family get-together. My aunt proceeded to start talking about names. Every name she suggested sounded like it came from the 1950s, 60s, or 70s, and she came up with a lot of others that were purposely dumb or sound ridiculous with our last name. It was truly aggravating. Honestly, my sister (age 9.5) has taste much closer to ours. I think I'll probably end up talking to my mom and a few friends about possible names, but definitely not everyone else.

By Monday night and Tuesday morning (20w0d), I started having my usual GI issue (ahem...constipation) and developed what I believe is round ligament pain in my left lower quadrant. I'm saying round ligament pain because sometimes I stand up suddenly and it definitely hurts in that exact spot. However, on Monday/Tuesday this pain hit me every few minutes, lasting only a few seconds each time, and was there regardless of whether I was moving or perfectly still. Fortunately, it is gone now, but that sort of thing creeps me out. It does seem strange that round ligament pain would be so perfectly correlated with episodes of constipation. Sometimes I wonder whether if I should be paranoid and demand a scan and/or colonoscopy after BabyGirl is born... I don't want to be a hypochondriac, though, so I'll probably only do that if it persists or gets worse. I was also sorta freaking out on Tuesday during the day that I wasn't feeling much movement, but when I finally got home and had a chance to lay flat for a few minutes, I felt some reassuring flip-flops from BabyGirl.

I think another source of general discomfort this week is that my old pants are fitting worse and worse, but I only have one pair of maternity pants that I like. The maternity jean-capris with a lycra band around the top are actually less comfy that a lot of my regular pants. I did a pretty exhaustive search of Target, Old Navy, and a Pea in the Pod last Saturday and came up empty handed. It is hard to find pants that are not designed for women who are 5'10". It bothers me to be 5'5" (perfectly average, I think) and I always have to buy short or petite lengths. What about the people who are 5'1" or so? They have to buy short length and then get those hemmed. It really annoys me. Men's pants make much more sense in this regard. I guess I will have to go to an online site and buy some pants because in another week or two, I'm sure that nothing else will fit. I also have pants from my pre-weight loss days, but those don't fit either (too big in the hips/butt).

I've been debating about posting a belly shot, but I still feel a bit shy about showing my entire face online. I probably will someday, but I'll at least wait for a photo that I like better than this one. In the meantime, I will go ahead and crop it to give you some idea. Here I am at 19w6d:

Definitely a rounded belly, but not 100% obvious to a casual observer who doesn't know me. This is a maternity shirt and non-maternity shorts (old shorts in a size above my now-usual size.) I'm still up 7-8 lbs, but feel increasingly awkward when standing up from a chair, grabbing something off the floor, etc etc.

In other interesting/TMI news, my breasts remain much larger than usual, but they are now back to a medium firmness. In contrast, a few weeks ago, they felt like mega-firm bad implants ready to burst through my skin. :) No hint of colostrum yet, though...

I know that this post has been pretty whiny, but please believe me when I say that I am absolutely 100% grateful to be pregnant! I am thankful every single day!!

19w5d: Backtrack to 19w2d...Ultrasound Report

Actually the ultrasound was several days ago at 19w2d, but I'm finally posting now...

The most important news is that everything with the baby looks fine! Honestly, I think I was still anxious going into the appointment. In fact, I woke up at about 4:45 AM that morning, and I couldn't go back to sleep. Our appointment was at 7:30 AM, so it really was only about an hour early, but still... So I logged onto this website as well as Ovusoft and was thrilled to see that one of my IVF cycle buddies (Poppy at Forcing Seeds here on blogspot) got her first ever BFP from a FET cycle! Somehow this news felt like a good omen and made me feel a little bit more relaxed.

S and I had to drive in separate cars to the appointment as we both had to go to work afterwards. We met in the parking lot and headed into the Genetics and Fetal Diagnostics clinic area. We waited only about 5 minutes before we were called into the exam room. The ultrasound technician first asked us whether we both wanted to find out the gender today. We replied with a definitive "yes," so she got started right away and I was immediately relieved to see that Blueberry was there and moving around.

The exam itself was head-to-toe. Actually, first the technician looked at my cervix (4.0 cm, which she said was fine) and ovaries (one not easily visualized, one about 4 cm -- possibly still enlarged from IVF/OHSS.) She told us that the baby was in the breech position...not a concern at this point.

Next, she moved onto the head and brain, and spent a bit more time than I would have liked measuring the ventricles, etc. (Turned out it was fine, but it made me nervous.) I tried to kinda watch her face and attitude, and she seemed relaxed, so I tried to calm down and enjoy everything. She then looked at the palate and lips, abdomen, kidneys, cord insertion, etc.

Finally, she started looking a bit lower. I tried to figure out what I was seeing based on some of the internet pictures I've seen, but really... I had no idea.

She snapped a few pictures and said, "I see three lines." I understood what this meant immediately and looked over at S, who had no idea of the significance of those words. The technician then clarified: "You're having a baby girl!"

It was a big rush of emotion and I was surprised that I didn't start crying. (I certainly did at most of our previous ultrasounds.) I think that both of us were pretty surprised... maybe even stunned. I had thought for weeks that we were having a boy, and I think that some of that assuredness had rubbed off onto S. Not withstanding our surprise, we are thrilled!

The tech then moved onto look at the femur length, and then the ankles and feet. She then had me go to the bathroom to see if the baby might get into a more favorable position to looking at the heart anatomy. Before she started on that, she told us, "I am going to take a lot of pictures of the heart, and that doesn't mean that there is a problem. We are required to get a lot of detailed pictures." After that, she did a few 3-D images, but couldn't get a great face shot due to movement and the baby keeping her hands near her face. In fact, throughout the exam the tech kept commenting on how very active the baby was. We never did get a great view of the hands in the open position, but at one point she did seem to be pointing at something... I love these pics!

After this, the tech left the exam room to present her findings to the radiologist. After 5-10 minutes, the radiologist and tech returned to the room. The radiologist took one look at me, and said, "Oh, I think we've met before." I actually have no recollection of this, but later I figured out that he must be a resident and I've probably met him looking at a patient's chest CT or brain MRI or something like that. He said that everything looked fine but he wanted to get one more glance at the cord insertion and the kidneys. We did that, and he pronounced that everything looked fine. S and I both breathed a big sigh of relief! It looks like everything is OK!

Afterwards, S walked across the parking lot to my work building and we had breakfast in the little cafe there. Next, he came and saw my new office for the first time, and then headed off to work. At this point I spent a while phoning my mom, my friend K, and my dad and sister with the big news. I also told a few people around my workplace... A couple of them didn't actually know that I was pregnant, so that was kinda fun.

I also later spoke with my Grandpa. At age 93, he has 2 daughters (my mom and my aunt) and 2 granddaughters (me and my sister), but no male descendents. I thought he might be a little disappointed, but he was absolutely thrilled. I love my Grandpa!

I have a bit more to say, but it'll have to wait for later... :)

19w0d

I am still here!! Sorry for my long silence. After I returned from that conference I had to work as the inpatient attending for hematology/oncology consults at the VA hospital. That is a 7 day a week job, for 2 weeks straight. And of course I am still working this week, too, so I am currently on day 16 out of 19 in a row!! That is probably one of my longest stretches ever, but I have to admit that the weekends weren't too bad...I only went in for a few hours each day. Being the attending is a lot less busy than being the fellow, resident, or intern!! However, it comes with a different stress: that of being the final decision maker and the responsible party. I was lucky to be working with a responsible and attentive fellow, though, so I really can't complain at all.

Anyway, let's see... On August 13 (17w1d), I had a regular doctor's appointment and finally met "my" OB, Dr. K. I saw her once for a Pap smear... in 2006, I believe, and to be honest, I had completely forgotten what she looked like. I'm sure she didn't remember me, either. The appointment was really too quick for me to form much of an opinion of her. It was really just a "pee in a cup, blood pressure, weigh in, check baby heartbeat, any questions?" kind of appointment which lasted about 10 minutes total. She didn't even palpate my uterus! Oh well, she was nice enough, and I don't think she'll be doing the actual delivery anyway.

In other news, I still haven't felt any fetal movements, and I have been spending several minutes each day in intense concentration, trying to feel something, anything. My stomach is fairly active in general, and I haven't felt anything that strikes me as different than the usual digestive sensations. I have read about a lot of people on line who are feeling definite movement already (even first-time moms), but I'm trying not to stress about it. ("Anterior placenta!" is one of my mantras.) During the aforementioned 17w1d appointment, I mentioned it to Dr. K, and while she was listening to the heartbeat, there were several "thumps" that she said were fetal movements (and I felt nothing), so that was reassuring. Also, I am definitely expanding in the baby bump department, so I think that somebody must be growing in there! Suddenly I find myself up 8.6 lbs total. I feel like I am gaining too fast right now, so I probably need to watch out.

A couple of funny anecdotes from yesterday:
1) Most the time at work, I have been shielding my changing midsection with my white coat. Yesterday, however, I was wearing a very loose, maternity-ish (but not really) short sleeved sweater. I hadn't put on the coat yet when I walked into a morning conference. A little while later, one of the surgeons came up to me and said, "I didn't know that you were pregnant!" Well, I'm not sure whether she had the opportunity to confirm what she saw with someone else, or whether she was merely being observant, but she IF she made the observation on her own without confirmation, she may have been the first person brave enough to say anything to me! Yippee! On the other hand, my aunt saw me on Saturday in (non-maternity) running shorts and shirt and said, "Oh, I can't tell you're pregnant at ALL!" Ah well.

2) Also yesterday, I was seeing a particular breast cancer patient for the second time ever. I sat down and talked with her for a while, then stood to examine her. I think I might have gotten up awkwardly or something because she said, "Oh, are you OK??" I said, "Yes, I'm fine. Why do you ask?" She said, "I don't really know... you just look tired... maybe like you're pregnant or something..." I then confirmed her guess and then said, "It sounds like you're pretty intuitive about this stuff. Any guess about whether it's a boy or a girl?" She immediately reached out for my belly (through the white coat) and proclaimed "Boy!"

So, what gender is our baby? I'm at 19 weeks... we should know by now, right? Well, we have another 33+ hours to wait... our big ultrasound is scheduled for Thursday at 7:30 AM. Honestly, S and I don't care. We just want a healthy baby. I will be absolutely thrilled either way. I have to say that I am guessing "boy" too, though. I don't really know why, but that's my guess based on a non-scientific observation about my complete lack of morning sickness. Apparently my mom and my aunt are guessing "boy," too. Another person recently guessed "Boy...because your arms and face are staying skinny," (not sure if I agree with that). On the other hand, one woman at my work has guessed, "Girl...because your face doesn't look drawn and tired like it would if you were carrying a boy." A four year old that I consulted said, "Boy" one week, but changed her mind to "girl" a few weeks later.

Pink or blue... either one will be incredibly loved. I just can't wait to see our little one again on Thursday morning!

A big joyous congrats to Hilary and D in Vancouver! (http://tryingwithpcos.blogspot.com/). 41 weeks, baby Maya is here! Yay for IVF success stories!

16w3d

Backdated post from last Friday:

Now I’m in the airport, waiting for my plane to board to go back home. The conference was actually a very educational experience. It was aimed at helping the next generation of cancer clinical researchers develop their careers. Vail was beautiful, but we spent most of the time in the hotel because there lectures every morning (and sometimes into the afternoon) and there were huge assignments due almost every day. I am happy with the end product, though – a completed clinical trial protocol, ready for submission. First, though, I must see if the pharmaceutical company is interested in sponsoring it.

I did manage to sneak in 2 quick hikes, so at least I got a taste of the great outdoors. Unfortunately, almost every meal for the entire week was a giant (and pretty tasty) buffet, so I am going to be afraid to step on the scale tomorrow.

At this particular conference, almost everyone was married (or engaged, or had a long-term relationship) and a LOT of people either had young children, were pregnant, or (in the case of the men), their wives are pregnant. I happened to be roommates with a woman who is 36 and isn’t sure if she eve.r wants to have kids. She is pretty happy living with her husband and her dogs, she’s “afraid of being pregnant.” However, her husband wants kids, so she may need to make up her mind pretty soon. I told her all about IVF, etc, and she said that if she had problems, she would “never go through all of that.” I wonder what she will decide.

Last night we had a dinner/dance to wrap up the conference, and I was seated next to a woman who was exactly 5 days ahead of me in her pregnancy. I definitely looked chunkier than she did! It was interesting to talk to her for a while. She is a gynec.ological oncologist, so she specializes in endometrial cancer, ovarian cancer, cervical cancer, etc. She had to go through a general Gyn/Onc residency before starting her Gyn/Onc fell.owship. She said that while she is extremely excited about her own pregnancy and upcoming birth, she actually delivered so many babies during residency that she doesn’t care if she ever sees another birth (except her own). She said that after several hundred births, it became very routine and almost boring. My response was that I considered Ob/Gyn briefly during med school, but I quickly realized that I hated the surgical aspects and was only interested in the delivery itself. And for that, I don’t necessarily feel that a medical degree is necessary; women have been doing this for millions of years, so I am comfortable with the idea of midwives attending to many routine births.

In other news, I still haven’t felt any movement or anything like that. I know it’s still early (especially for a first baby and an anterior placenta), but I’m really looking forward to feeling something… even a hint.

My next doctor’s appointment is this upcoming Thursday. I hope that at that point, we’ll get to schedule the big ultrasound. I can’t wait!

But before that, I can’t wait to get home and see S! <3

15w4d: On The Road Again...

I’m writing this message on an flight from San Diego to Denver (will get online and post it later, obviously). For the next week, I’ll be attending the ASCO/AACR Meth.ods in Clinical Cancer Research workshop in Vail, Colorado. S, unfortunately, is staying home to work, etc. There is almost no free time at this conference, so we didn’t think it would be worth it for him to come along. I hope we can do some small trips together sometime soon, though. On the other hand, I’m trying to save up any vacation time that I may earn for maternity leave. Did I just say that? Wow!!

In my last real entry, I mentioned my nervousness about telling my boss, Dr. P, about the pregnancy. After all, I just started this job on July 1st . (On the other hand, when I interviewed an got hired, I hadn’t started the IVF process yet, although I knew we were going to do it, and soon.) Anyway, last Friday (July 25th), I asked if I could meet with her for a few minutes after weekly conference. I said something like, “I know the timing is not optimal since I just started working here. I would have liked to have a baby last year during fellowship, but it didn’t work out that way.” I didn’t mention IVF, though, because it seems to make the timing a bit more deliberate on my part. I mean, it was deliberate, but we had no idea whether it was going to work on the first try, or whether it would take a year or more.

Well, I am happy to report that the conversation actually went very well! She even made some coments along the lines of “Well, we as a society need to find ways to make these situations work if we want to have women in the workplace.” Yay, Dr P!! She may try to see if Dr. C (who just retired) would return for a short stint, or she may divide up my patients among several people to distribute the load during that period. I told her that I would like to take a 3 month maternity leave. I don’t know if I will be paid for the entire thing, but we’ll deal with it either way. I also told her that I wanted to work up until the end, if possible (to use all of my time with the baby), and that there was no chance of me leaving the job entirely to be a stay-at-home mom. I could tell that she was definitely relieved to hear that! Considering that I had heard that a previous (also female) director had said, "Everyone needs to get sterilized," when someone announced their pregnancy a few years ago, I feel very lucky to have my boss's support.

In other news, I am definitely getting pudgier, mostly in the belly. I still wear “normal” clothes to work and its not obvious, but on weekends I am wearing flow-y shirts and a lot of people (who know about the pregnancy) are commenting that they can see a little something there! Last night we hung out with some friends with daughters aged 2 and 5, and the 5-year-old was hugging me and even gave my tummy a few kisses! It was very sweet. As of yesterday, I was up by 3 lbs total, but for some reason this morning I jumped to 5.6 lbs gained. I am fine with gaining, but I better not start gaining too quickly!!

I have read about a lot of you wearing Bella Bands, etc. I don’t need those at all, but I think it is due to my general shape. I carry weight mostly in my hips, butt, and thighs, so most of my pants have a lot of extra room in the waist. Thus, I am stil wearing my normal pants, although I haven’t tried my “tight jeans” since before IVF. It also happens that I own a lot of clothes that are 1-2 sizes up from the time period before I lost weight in 2003-2004. So…who knows, I may be able to wear ‘non-maternity’ pants for a long time still. I knew I kept those clothes for something! On the other hand, they may just look stupid through the butt area, so who knows.

Yesterday, I had to go to the OB/GYN’s office for my AFP blood test. It is usually done duirng week 16, but in my case I will be away (or it will be the weekend) until 16w6d, so they told me that it was OK to get it drawn at 15w3d. Plus, I figured that maybe the results will be back in time for my next OB appointment (August 14th). Anyway, the appointment yesterday was a “nurses’ visit” in which the nurse merely filled out paperwork for the blood test (confirming my due date, smoking status, that it is a singleton pregnancy, etc). Yesterday morning (before the appointment), it suddenly occurred to me that since I would be right there in the office, maybe I could ask them to check the baby’s heartbeat with a Doppler… Well, my sneaky plan worked perfectly!! I went into an exam room with the nurse to fill out the paperwork, and the handheld Doppler was sitting right there on the desk. So I was able to casually say, "Oooh, any chance that I could hear the baby's heartbeat today??" She sounded a little unsure, but she asked another nurse if we could, and that one said that we could go ahead, and that she would help out. Nurse #2 said that she usually works with women in their 3rd trimester, so she would need a minute or two to find the heartbeat. At first we heard a slower heart beat (mine, I guess) that she said was coming from the placenta. She then moved around a bit until we heard the baby’s heartbeat. It was pretty muffled, (due to the positioning, I think), but it was there. So now I have a fresh the-baby-is-still-OK fix that has to last until my next appointment!

I still haven’t felt any movements, but I’m guessing that it will still be 4-6 more weeks until I do. Well, my plane is now about to land, so I gotta go! I hope you all are doing well.

15w1d: Book List

I snagged this from Poppy's blog.

"Here's how it works:
1) Look at the list and bold those you have read.
2) Italicize those you intend to read.
3) Underline (or mark in a different color) the books you LOVE
4) Reprint this list in your blog.

The premise of this exercise is that the National Endowment for the Arts apparently believes that the average American has only read 6 books from the list below."

Sadly, I used to be of voracious reader, but work has taken over my life for years now, and I rarely read books anymore. I spend too much damn time on the internet: either infertility stufff, and now pregnancy stuff, and of course my daily fix of New York Times, LA Times, San Diego Union, and CNN... Besides that I read magazines and medical journals, pretty much. Besides, I go into bookstores and feel overwhelmed by the sheer number of books, and too afraid to buy something for fear that I'll read a few pages and decide that I don't want to finish it. For that reason, I think I'd be better off going to the library. What I really like is for someone to tell me, "Hey, you should read this; you'd really like it."

I don't feel like putting the ones I intend to read in italics, so I'm not going to! Don't wanna see this list in 5 years and feel like a failure!

1 Pride and Prejudice - Jane Austen
2 The Lord of the Rings - JRR Tolkien - no, but I have read The Hobbit (didn't care for it much, and that's why I never read the rest.) Ironically, my middle name is a character in the Lord of the Rings Trilogy, but I have never read the books...or seen the movies!
3 Jane Eyre - Charlotte Bronte
4 Harry Potter series - JK Rowling - no, and I haven't seen the movies, either. I guess I'm just not a fan of the fantasy genre.
5 To Kill a Mockingbird - Harper Lee
6 The Bible - parts of it... for a college class, actually.
7 Wuthering Heights - Emily Bronte
8 Nineteen Eighty Four - George Orwell
9 His Dark Materials - Philip Pullman (I have to admit, I've never even heard of it).
10 Great Expectations - Charles Dickens
11. Little Women - Louisa M Alcott
12 Tess of the D’Urbervilles - Thomas Hardy
13 Catch 22 - Joseph Heller
14 Complete Works of Shakespeare- some of them, certainly not all.
15 Rebecca - Daphne Du Maurier (I don't actually remember anything about it.)
16 The Hobbit - JRR Tolkien
17 Birdsong - Sebastian Faulks (Never heard of this one, either.)
18 Catcher in the Rye - JD Salinger
19 The Time Traveller’s Wife - Audrey Niffenegger (??? I am starting to feel illiterate.)
20 Middlemarch - George Eliot
21 Gone With The Wind - Margaret Mitchell
22 The Great Gatsby - F Scott Fitzgerald
23 Bleak House - Charles Dickens
24 War and Peace - Leo Tolstoy
25 The Hitch Hiker’s Guide to the Galaxy
26 Brideshead Revisited - Evelyn Waugh (Again, ???)
27 Crime and Punishment - Fyodor Dostoyevsky
28 Grapes of Wrath - John Steinbeck
29 Alice in Wonderland - Lewis Carroll
30 The Wind in the Willows - Kenneth Grahame
31 Anna Karenina - Leo Tolstoy (I quit somewhere along the way.)
32 David Copperfield - Charles Dickens
33 Chronicles of Narnia - CS Lewis
34 Emma - Jane Austen
35 Persuasion - Jane Austen - (In fact, I have read everything and own everything by Jane Austen, including her short stories.)
36 The Lion, The Witch and The Wardrobe - CS Lewis
37 The Kite Runner - Khaled Hosseini - saw (& really enjoyed) the movie, and now not motivated to read the book
38 Captain Corelli’s Mandolin - Louis De Bernieres
39 Memoirs of a Geisha - Arthur Golden - read the book, and now not motivated to watch the movie.
40 Winnie the Pooh - AA Milne - Uh... unless there's some fancy adult version that I'm not aware of...
41 Animal Farm - George Orwell
42 The Da Vinci Code - Dan Brown - Read first chapter and got distracted thereafter.
43 One Hundred Years of Solitude - Gabriel Garcia Marquez
44 A Prayer for Owen Meany - John Irving
45 The Woman in White - Wilkie Collins
46 Anne of Green Gables - LM Montgomery
47 Far From The Madding Crowd - Thomas Hardy
48 The Handmaid’s Tale - Margaret Atwood
49 Lord of the Flies - William Golding
50 Atonement - Ian McEwan - Saw movie, and now not motivated to read the book.
51 Life of Pi - Yann Martel
52 Dune - Frank Herbert
53 Cold Comfort Farm - Stella Gibbons
54 Sense and Sensibility - Jane Austen
55 A Suitable Boy - Vikram Seth
56 The Shadow of the Wind - Carlos Ruiz Zafon
57 A Tale Of Two Cities - Charles Dickens
58 Brave New World - Aldous Huxley
59 The Curious Incident of the Dog in the Night-time - Mark Haddon (???)
60 Love In The Time Of Cholera - Gabriel Garcia Marquez
61 Of Mice and Men - John Steinbeck
62 Lolita - Vladimir Nabokov
63 The Secret History - Donna Tartt (???)
64 The Lovely Bones - Alice Sebold
65 Count of Monte Cristo - Alexandre Dumas
66 On The Road - Jack Kerouac
67 Jude the Obscure - Thomas Hardy
68 Bridget Jones’s Diary - Helen Fielding
69 Midnight’s Children - Salman Rushdie
70 Moby Dick - Herman Melville - most of it, but not every last bit.
71 Oliver Twist - Charles Dickens
72 Dracula - Bram Stoker
73 The Secret Garden - Frances Hodgson Burnett - I think I liked The Little Princess even more!
74 Notes From A Small Island - Bill Bryson
75 Ulysses - James Joyce
76 The Bell Jar - Sylvia Plath
77 Swallows and Amazons - Arthur Ransome (???)
78 Germinal - Emile Zola
79 Vanity Fair - William Makepeace Thackeray
80 Possession - AS Byatt (???)
81 A Christmas Carol - Charles Dickens
82 Cloud Atlas - David Mitchell (???)
83 The Color Purple - Alice Walker
84 The Remains of the Day - Kazuo Ishiguro
85 Madame Bovary - Gustave Flaubert
86 A Fine Balance - Rohinton Mistry
87 Charlotte’s Web - EB White
88 The Five People You Meet In Heaven - Mitch Albom (???)
89 Adventures of Sherlock Holmes - Sir Arthur Conan Doyle
90 The Faraway Tree Collection (???)
91 Heart of Darkness - Joseph Conrad
92 The Little Prince - Antoine De Saint-Exupery
93 The Wasp Factory - Iain Banks (???)
94 Watership Down - Richard Adams
95 A Confederacy of Dunces - John Kennedy Toole
96 A Town Like Alice - Nevil Shute (???)
97 The Three Musketeers - Alexandre Dumas
98 Hamlet - William Shakespeare
99 Charlie and the Chocolate Factory - Roald Dahl
100 Les Miserables - Victor Hugo - Yes, in junior high, but I think it was an "abridged" version (still several hundred pages, though), so I won't count it.

Bedtime; I guess I'll have to update on pregnancy stuff later!

14w1d: All is Well

I have been away for far too long. One problem is, I'd rather catch up on all of your blogs rather than write my own. Still, I want to keep this blog as a pregnancy journal, too, so I need to get back to it.

Today was 14w1d and I had my second "normal" OB appointment. My regular OB was booked, so I saw a second nurse midwife. It was a quick appointment in which they basically took my vitals (BP 90-something/50-something), had me pee in a cup, and weighed me (up 3.6 lbs by my home digital scale, essentially the same on their scale). The midwife then came in and answered a few questions that I had. I then asked her to show me how to palpate the uterus at this stage. As she explained it, I'm not supposed to be feeling for a firm edge, but rather for something soft, almost like a loaf of bread. My fingertips should really only be pressing in an inch or so. It is pretty subtle, and I'm not sure that I can find it again. She said that the size of my uterus is appropriate for 14 weeks.

My favorite part of the appointment was hearing the heartbeat again. I love that sound! She used an external Doppler and found it easily. I was slightly distracted because she kept asking me questions about my job during that part, and it felt kinda rude to say, "Um, can we just be quiet and listen for a minute, please..." She didn't actually measure the heart rate, but it definitely sounded nice and fast.

I confessed to her that I have cheated a bit on the deli meat restriction in that I have eaten a few turkey sandwiches here and there. She said it should be fine, and that the real prohibition is going to a deli where the meat sits out and they carve it in front of you. Still, the sandwiches I have eaten are usually from an internal catering team, so who knows how safe they really are. I'm feeling pretty relaxed about it, though. I have never gotten food poisoning from a sandwich, as far as I know. I did ask her to order a CMV antibody test on me. I will feel a lot more relaxed running around the hospital next month if I know for sure that I have a pre-exisiting immunity to CMV. It's the primary infection that can be most dangerous to a fetus, so I hope to be IgG positive (ie already immune) so that I won't have to worry about it. I will get this drawn on the same day as my AFP test. I have to do it a few days earlier than normal (a week from Friday at 15w3d) because I will be out of town thereafter for about a week.

My new job is going well. My main complaint is that I have an office but NO COMPUTER!! It was ordered July 1st or so (why not earlier, I don't know -- I reminded several people about it many times during the month of June) but then it was ordered via an incorrect mechanism and it still hasn't arrived. It is driving me insane to work at borrowed desks, etc. Half the time some aspect of the system is not set up on that computer, there is no printer connected, etc etc.

I still need to tell our breast oncology group's leader (Dr. P) about the pregnancy. I decided to wait until today's appointment, but now that it is done and all is well, I am eager to tell her. Otherwise, I'm afraid that I will leave for my week-long conference on August 2nd and return on August 11th looking really obviously pregnant (17 weeks). To my eyes, I am already getting pretty thick through the waist, but it is not an obvious "baby bump" quite yet. I still wear my normal clothes, and I think it just looks like I have gained some weight. I bought several of those juniors-style flow-y shirts that will help me look more pregnant than chubby, but I don't want to wear them to work until I tell Dr. P first. I just need to decide if I want to set up a formal meeting, or just hope to pull her aside in the hallway at some point. A formal meeting seems a bit awkward, but she's not the type of person to ever be just sitting alone in her office and available to chat for a few minutes (my preferred way of dealing with it).

I'm not sure whether my colleagues will merely divide up my patients during maternity leave, or whether they will hire back the temporary physician who just left when I started (a 70+ year old retired oncologist who had filled in for an entire year.) I feel bad for making the patients see so many different doctors, so in some ways he would be the ideal person to see the again.

Anyway...must go to bed. I am actually driving my parents and sister to the airport in the morning before work, so I will be up nice and early!

12w1d: Nuchal Translucency Screen

I feel bad for not posting more often, but I've been pretty busy lately with the new job. I hope that I still have some readers out there!

The good news is that I was able to move Blueberry's nuchal translucency screen from next week to today. The wonderful news is that everything looks great!

The baby was measuring on-target at 54.5 mm CRL, corresponding to 12w0d; that is just one day off... great! The heart rate was either 151 or 161 (too hard for me to see clearly). The nuchal translucency itself was 1.4 mm. Before screening, my age-related risk of Down Syndrome was 1 in 301, and this decreased to 1 in 1359 with the NT and bloodwork results. Before screening, my age-related risk of Trisomy 13/18 was 1 in 645, and this decreased to 1 in 5858 with the NT and bloodwork results. Needless to say, we are thrilled.

S was able to rush over from his work for the second half of the ultrasound, and it was fun to see the baby again with him. I got to see a few kicks and waves before S arrived, but the baby seemed to quiet down a bit after he got there. (Sleeping, maybe?)

And now for some pictures:

The first one shows the baby in profile, head on the right side.

The next one is a more magnified view of the head and neck, with the top of the head on the left side. This is the view from which they measured the nuchal translucency.

This one is my favorite and shows a tiny bent leg and foot. I wonder if the bright white areas in the spine, femur, shin, and foot are the beginning of ossification of the bones?

In other news, the cervix looks nice and long (over 5 cm), and the placenta is in an anterior location, which means that I may not feel kicks and other movement quite as early as some people. Oh well, at least I'll have a reason not to worry if that happens.

I started feeling a bit pudgy through the waist area over the weekend. I have gained somewhere between 0.6 and 1.8 lbs (my digital scale fluctuates from day to day). I don't think that anyone else can see a major change, but I can notice a difference. It's not a baby bump, yet, though. My guess is that the uterus is probably starting to fill the pelvis, pushing my intestines, etc upward, maybe?

Oh! This Monday I had lunch with a colleague of mine. She is a year ahead of me in terms of training, but is actually 40 years old. She got married about 2 months after me (12/06). Well, I had heard last week that she is pregnant, and I congratulated her. Eventually the conversation got around to the fact that I am pregnant, too, and that both of us did IVF! One really stressful thing about her experience is that her original IVF cycle was cancelled... due to egg retrieval being scheduled at the same time as last fall's massive San Diego wildfires!! OMG, I cannot imagine being all the way stimmed and then having to completely cancel the cycle due to a natural distaster like that. I bet it was a staffing issue at the RE's office (and this RE's office was actually in an area near the evacuation zone), but she was told that "they had poor results during previous San Diego wildfires" (2003). Yikes! I forgot to ask her whether she was able to get any reimbursement for the cost of all those wasted meds. Anyway, she cycled again in February and is currently at 20 weeks with a little girl! Congrats to her!

S's birthday is tomorrow. I hope he likes his present! I think I still need to get something else, too. I always feel bad because I have a hard time choosing gifts, but in the end it usually turns out OK.

11w1d: New Job

I don't have any signficant news on the Blueberry front. No new pictures or symptoms. I thought I had gained 1.4 lbs, but today I was back to -0.2 from baseline again. I'm sure that I'll be going up any day now, though. I don't feel a difference in my usual clothes, but there is a form-fitting dress that I'd like to wear to a party Friday night (someone's birthday celebration with a black and white them), and I'm not so sure that the dress is going to work...

I do now admit that my breasts have grown a bit (1.5", I think), but I don't need new bras or anything, and they have still never been sore. Although, thinking about the bra issue, the bras were probably a bit too big before I started, so now they fit just right. I guess I'm technically a real A cup now instead of something unmeasurable. (ha!) Seriously, I once used an online calculator to try to figure my ideal bra size, and it kept giving me an error because when I took [(bust measurement in inches) - (band size + 5")], the result was a negative number. Thus, the error message; you had to have a difference of at least 1" to qualify as an A cup. Other websites would claim that I was a AA, which I have never worn. I tried a professional "bra fitter" at Macy's and she claimed that I was a 32-something, but that made zero sense because I would never be able to fit into a 32-anything. (I'm a 34/36 girl.) Oh well, the change is kinda interesting. I know it is not permanent!

I had bloodwork drawn on Monday. This included both blood for the "Ultrascreen" (nuchal translucency test) as well as routine labs such as a blood count, hepatitis serologies, HIV serology, etc etc. I also got my insurance info today, so I was able to schedule the nuchal translucency ultrasound for Wednesday, July 16th....2 whole weeks away...argh! Unfortunately, the ultrasound clinic only had 2 slots available, and the other is not at all feasible for me (during one of my clinics). If I have to keep the 7/16 appointment, S will not be able to attend. Well, I guess I will just call them every day or two in hopes that they have a cancellation that works better for us.

Well, I always do check my own labs after I have bloodwork drawn. (Shhh! Not to worry; I'm not going to sue myself for breach of privacy.) The labs were mildly interesting because it showed that I have a mild anemia (hemoglobin 11.6; hematocrit 33.0%, but normal sized blood cells (MCV=92)). I know for a fact that back in April and May, my blood counts were completely normal. With this in mind, I suspected that this is the "physiological anemia of pregnancy," which occurs when a pregnant person has an increase in plasma volume, but a proportionally lesser increase in red blood cells. The consequence is that there are fewer red blood cells per given volume of blood, and you appear anemic by labs. Iron deficiency is pretty much ruled out given that the red blood cells are normal in size; iron deficient red blood cells are small.

Well, of course today I got an answering machine message from the OB/GYN nurse practicioner informing me that I am anemic and that I need to start iron supplements. Ummmm, no I don't. Granted, I could become iron deficient at some point in the future, and the iron probably wouldn't hurt me (other than causing constipation), but it's pretty surprising that the OB/GYN people aren't familiar with the physiological anemia of pregnancy.

Working in hematology, we get referrals all the time about people who are anemic and whose doctors just reflexively put them on iron and were confused when the anemia didn't improve. Iron deficiency is a common cause of anemia, but there are dozens of causes, and iron won't help anemia unless you are running low to begin with. So, I am not sure if I should just do what they say, or gently inform them that as a hematologist I disagree with their recommendation. I will probably just ignore it for now and mention it at a future appointment. See what a pain it must be to have me as a patient!

Monday (June 30th) was my last day as a fellow, and Tuesday (July 1) was my first day in my "real job." It was somewhat easy in that it is at the same locations where I have already been working (a VA hospital and a university cancer center), but of course nothing was quite ready for me to start. For example, the computer system needs to be changed so that I no longer need someone to co-sign my notes, and so that I can co-sign other people's notes. Also, today at the university cancer center, I had the opportunity to check out my new (sadly, windowless) office. There's a desk and a phone and... no computer. I've been asking about this for weeks, but nothing has happened yet. Supposedly, "a computer is being ordered today." In the meantime, I am using the desk of a woman who is out on vacation. Lots and lots of stuff to organize, but none of it interesting enough to share with you all here.

Has anyone seen the television show "Hopk.ins" on ABC? I was watching the first episode on the DVR, and was surprised to see that a resident that I used to work with (I was a 4th year med student, he was a second year surgery resident) is one of the featured doctors. He has a wife and 3 young daughters but he is now apparently having serious marital problems and he and his wife are contemplating divorce. It was kinda depressing to see that part. Also scary that I worked with him in September 2000 and he is STILL a resident (PGY 9, I think... in Cardiot.horacic surgery.) I looked in my Palm P.ilot, and yep, I still have his pager number in there from when we worked together. How random. I remember the other two doctors, too, but I never worked with either one of them directly.

I hope everyone out there is doing well. La la, I'd love to check out your blog but it looks like you've moved it(??).

10W0d: Colorado and 1st prenatal visit

We're back! We've been back since Sunday, actually. S and I had a wonderful time in Colorado. Last Wednesday night, we flew into Denver and picked up our rental car. We had reserved a "compact," but ended up with a Hummer(!) instead. Apparently this particular car rental place has a lot of very large vehicles (for skiers, I suppose), and few compacts. With today's gas prices, the compacts and even the full-size vehicles are being snatched up immediately. So, yes, we ended up with a Hummer for only $18/day (the compact rate). Even the gas didn't end up being too bad ($70 or so) since we used only 3/4 of a tank over the course of 4 days.

Wednesday night, we stayed at a semi-sketchy airport hotel that we had reserved via hotw.ire. Hotw.ire claimed that it was 3 stars, but failed to mention that it was undergoing major construction (especially outside) and overlooked the freeway. Oh well, it certainly beat our next accomodations...

In Estes Park, we stayed at a place called the "Tin.y To.wn Cabins," part of a larger enterprise called the "Tro.ut Have.n Lodge." We knew it would be cheezy based on the website pictures, but there was really no choice since literally everything else under $250/night was booked over the weekend. Our little cabin (nestled between a miniature golf place and a bunch of brush which hid the river, and overlooking an RV park) had very dated furniture and carpet, but we can handle that. The bad parts were: 1) we returned to the cabin on Friday to find a horrible smell. At first we thought it was a dead animal. We opened all the windows and doors immediately. Next, we noticed that we had zero hot water. Well, it turned out that the bad smell was an overwhelming amount of natural gas from a two dead pilot lights (water heater and stove). Good thing we didn't light a match or something! 2) Saturday AM, we heard the scratching sounds of what seemed to be a rather large animal in our wall, and then under the bathroom floor. Don't know what it was, but creepy.

Now that I have finished with the amusing parts, I will say that Rocky Mountain National Park is really beautiful. We saw everything from meadows with aspen and elk, rushing streams and waterfalls, high mountain lakes, snow-capped peaks, and tundra above the treeline, blooming for the few weeks of summer. We hiked every day (Thursday thru Sunday). At first I was concerned about the altitude, my personal fitness or lack thereof, and potential stress on Blueberry, but everything seemed to be OK in the end. I had a slight headache on Thursday and Friday morning, but that went away with some Tylenol and acclimation to the altitude.

S and I started an open-ended discussion about baby names. We have fairly similar tastes, but he is a bit less open to uncommon names than I am. Unfortunately the names that we both like are not favorites for either one of us. This may be difficult, but luckily we have about 7 months to figure it all out.

On our way back to the airport on Sunday, we stopped by to see my old friend and former med school classmate, R, her husband J, and their 3 children, ages 5.5, 2.5, and a 6 week old newborn. It was a lot of fun to see their home and to see how they deal with parenting 3 little ones at once. They are pretty relaxed and seem to do a great job.

Yesterday, I had my first "normal" OB appointment at 10w0d. They told me to arrive "1/2 hour early to complete paperwork." I chose to get there 15 minutes early, and completed the forms within 10 minutes. The medical assistant called me in to the exam room a few minutes later. I found it a little strange that she just asked me my weight rather than measuring it, even though there was a scale 2 feet away. I wonder if it will be that way throughout pregnancy. So far, I haven't gained anything, BTW. It's amazing, because I have been eating pretty heartily, and I usually gain very easily. I had initially gained due to fluid weight from OHSS, but I lost that plus 0.4 lbs more by late May, and the scale hasn't budged since.

My appointment yesterday was with a nurse practicioner. She does the initial visit, but then sets you up for the remainder of the visits with an OB physician. They do have nurse-midwives, but they are located at a different office, and I didn't consider that option. She had read the aforementioned paperwork and therefore knew about the fact that I had IVF. She didn't really ask me anything much about it (ie whether it was my first cycle, how many eggs, how many transferred, or anything like that). I also mentioned the OHSS and she wrote that down, but didn't have any further questions.

She then did a brief heart, lungs, and breast exam. She asked if I was sore ("no") but then said, "well you definitely have pregnancy changes in your breasts." Hmmmm... She next did my annual Pap smear (I was due) and confirmed what I already could feel -- my tiny cervical polyp has returned. I think this is the 4th time it has appeared since I was 25 years old. They won't remove it until sometime after Blueberry's appearance. Luckily, it has never bled, so I don't think it will cause any problems. As she finished the Pap, she said something like, "your pelvic outlet is nice and round, a typical female shape, and it should not be a problem to deliver vaginally." Interesting...

Next, she wanted to do the ultrasound. She said, "let's try the abdominal approach first." (To me this implied that we would eventually do both the abdominal and the vaginal approach, but that was not the case.) She said that it was fine that I had an empty bladder. She placed the probe on my suprapubic area and after just a moment of searching, Blueberry popped into view. It was definitely blurrier than the pictures at the RE's office. I'm not sure if that was due to the abdominal approach or whether it was simply a poorer-quality machine. Anyway, I was thrilled to see Blueberry again at any angle, and he/she gave a few waves and kicks to say hello. I could see the flicker of the heartbeat, but the NP said, "we don't measure that anymore because it doesn't matter what the heartrate is in the first trimester." I don't really buy that explanation, but I'll just assume that it was still OK. She did give me a bunch of printouts, but most are very blobby-looking. The best one is this:


I think you'll agree that the 9w0d ultrasound is easier to make out that this one. Oh well! The important part was that Blueberry had grown from 23 to 33 mm in just 1 week, and actually measured 2 days ahead at 10w2d. She didn't measure the sac, and honestly, I don't want to know anyway.

After the ultrasound, she let me get dressed again, and returned to the room with a packet of information. She then spent about 10 minutes showing me the various materials and brochures in the folder; it contained info about contact numbers for about childbirth and breast feeding classes, pamphlets about what not to eat, and brochures about first trimester screening and other upcoming tests. She asked if I had any questions, but really, I couldn't think of any. I guess I am hoping for someone to be really interested in chatting with me and getting to know me as a person, asking me about what kind of birth I want, etc, but I'm probably being unrealistic.

After that, the appointment was over. Oh, Dr. A from the RE office was standing there in the back hallway. He works at both offices (university clinic and private RE office), apparently. He said, "Hi, Sarah." It was nice to see a familiar face and I told him that all was well. I next chose my OB/GYN for the remainder of my prenatal visits. (I chose a woman, Dr. K, who I have seen once before in 2006. It's been a while, and I can't even remember what she looks like. However, I know I prefer her to my 2007 OB/GYN, Dr. V, who was the one who didn't know to draw CD3 labs -- like FSH -- on CD3.) However, for my next visit, Dr. K is already full and I will see an NP one more time. Other than that, I was scheduled with appointments every 4 weeks until early December. After that it will be every 2 weeks, but the schedule is not yet open that far out into the future.

I want to do the first trimester screen (bloodwork and nuchal translucency test), and they have in fact already scheduled me for the bloodwork part next Monday (June 30th), with the nuchal translucency scan to be done around July 7th. However, this stresses me out because I am starting my new job on July 1st, and I will therefore be changing insurance plans in the middle of the test. Thus, I'm afraid that neither insurance plan will want to pay for a screening test that was done half during my enrollment in their plan, and half either before or after my enrollment. I tried to sort this out today, but it seems that the majority of human resources / benefits type people on our campus are out of vacation this week, or leave their desks by about 4 PM. Argh... I could wait until after July 1 to start the screen, but it is a time sensitive test and I will be pushing the limits a bit. Also, I may not have a new insurance number for a week or so. I think it will turn out OK, but I can just foresee that I will have to make a lot of phone calls to try to sort this one out...

Anyway, I've certainly blabbed enough for now. I'm thrilled to see a few new pregnancies among the women on my blogroll recently (Alison! Jen!) and I hope that those will keep coming in the next few weeks!!

9w1d: Graduation

Yesterday was my last visit to the RE's office. S came along for this ultrasound, and it was truly magical.

Blueberry at 9w0d:

The head is toward the right, and you can see little arms and at least one of the legs. The "ball" at 9 o'clock in the top picture is the yolk sac.

The heartbeat sounded strong and fast again. The most amazing thing, though, was that he/she was actually squirming around! So cute!! The RE (Dr W) said, "Wow, I could watch this ultrasound all day long!"

I think I can finally come back to reality and not worry about the small gestational sac issue anymore. Blueberry's crown-rump length was 22.3 mm and the mean gestational sac diameter was 32 mm. (This time, Dr W checked 2 diameters -- 40 mm and 24 mm -- and averaged them, which is apparently the correct way. I'm kinda glad she didn't do that at prior visits because my numbers would have been even worse!) Anyway, there is now more than 8 mm between the size of Blueberry and the size of the sac, which is normal. This is such a huge relief.

After I got dressed and we walked out of the ultrasound room, Dr. W and several of the nurses presented us with a rolled up paper tied with a purple bow. It turns was a "Certificate of Graduation." Below that phrase it said our names, and then "Dreams Can Come True," and was signed by the entire staff. It is cheezy, I suppose, but of course I started crying and hugging everyone there. I felt a little bad because there was one patient in that area who was getting her blood drawn. Well, hopefully she got some hope or inspiration from seeing us "graduate."

They told me to come back and visit with a big belly and/or with a baby in tow. I just might do that, but I'll be sure to do it at a slow time of day so that there won't be other patients around. In any case, I didn't say goodbye because I hope that we'll be back in a couple years for baby #2!

Next Tuesday, I go to the regular OB/GYN's office. Yay!

We are going on a short mini-trip to Colorado tonight. This is our attempt to salvage a bit of real vacation before I start my new job on July 1st (as opposed to just sitting around the house during our ill-fated May vacation when I was sick with the OHSS). We are flying into Denver, and then we'll be staying in Est.es Park and spending a few days in Rocky Mou.ntain Nat.ional Park.

I'll check in with you all when we get back!