Sunday, August 14, 2016

Week 24: Vacation

We were on vacation last week in the north woods of Wisconsin, which is why I did not post anything. But, since pregnancy has been happily boring lately, there wasn't a lot to say.

During the first few days of the trip I did have another few days of really high highs, similar to the problem I had when my husband and I went away for our anniversary at the end of June. I remembered the lessons of the last episode and increased basal rates rather than bolus ratios. This worked beautifully, though I tweaked the bolus ratios a tiny bit, too, and had to work out a few kinks for a few days in the basal rates.  In fact, I've been adjusting basal rates pretty much since then. I should probably admit that I'm adjusting my basal rates slightly all the time, really. But some adjustments are more dramatic, and that's what happened a couple of weeks ago.

My current basal rate regimen has a moderate rate (0.75 per hour) for the early morning hours, beginning at the early time of 3:00a. This basal rate remains until dinner time, at which point it increases to 1.10 per hour. It drops to 0.45 in the late evening, about bed time, and stays there for the earliest part of the night, until the regular day time rate begins in what seems the middle of the night (3:00a).

I went to visit my doctors this week, too. My OB is - somewhat surprisingly - a little concerned about my weight gain. I gained 6 pounds this month, bringing me to 21 pounds of weight gain and exceeding the normal pace of weight gain throughout pregnancy. I blamed it on vacation. Since the recommended level of weight gain is 25-35 pounds, she's worried I'll exceed 35 in the next 15 weeks of pregnancy. I get it. I've written about weight gain before, especially the benefits of not gaining too much, and I can certainly imagine that excess weight gain for mom could lead to an LGA baby. I've written about this before. But I honestly don't know what more I can do. I'm eating as little as it feels is humanly possible during pregnancy, and will continue to do so, but I've also got blood sugars to maintain.

So she wants to make sure I am walking every day. I, um, kind of am, but I don't actually leave the house very often. So I was trying to explain to her how infrequently I actually sit down during the day, what with taking care of four boys and all, making sure that the crayons are staying on the paper rather than the wall and hanging diapers and helping a pre-schooler figure out which bin is the right one for the Matchbox cars and turning on videos and turning on videos and turning off videos and coming downstairs to see if anyone is bleeding and so forth. I'm not sure she entirely understood, and she just repeated her question about walking for at least 30 minutes every day. I'm also not sure she entirely understood that leaving the house when your blood sugar is hanging out between 70 and 80, with three children who don't understand traffic signs, to go out on a walk in 90 degree heat, is actually probably not very healthy. She did tell me that I was the first person she'd ever known with more than three male children, so perhaps that accounts for the lack of comprehension about my daily life. I'm just going to keep answering in the affirmative, because I am certain that I spend at least 30 minutes walking around my house during the day, and probably more like 2 hours. I might be fudging it a little, but I think it's close enough to the truth to say it honestly!

I also visited the maternal-fetal specialist this week, and he said he was perfectly happy with baby's growth. Baby is right in the 50th percentile, moving like a champ, no problems to speak of. And the placenta previa is gone. Didn't I always say that was probably a problem no one ever needed to know about? Knowledge is not always power. Just ask Eve.

Sunday, July 31, 2016

Week 22: When Pregnancy Is Boring

I am just going to note that some weeks, especially in the second trimester, can be pretty boring. And I don't mind that one bit! I am accustomed now to the idea of having another little person in the house in a few months, which always takes about the first trimester plus a few more weeks. None of the testing has revealed any significant problems with baby's health. I remember the pain of childbirth and the fatigue of recovery, but because they are not imminent, I'm not feeling it very viscerally. I worry a little bit about preterm labor, because it's hard not to think about it at all, but I'm also pretty fortunate that it's never happened to me. My blood sugars are pretty good and pretty stable, after a rough, early second-trimester ride that I've experienced before. And the counseling. It's really helped with the depression that I've truly been feeling for a while now.

So that's it. There's just not a lot to say right now, and I'm pretty happy about that.

Thursday, July 28, 2016

NFP Awareness Week!

I don't have a lot to say about NFP, mostly because, in spite of giving it a good go, we haven't found a method that can reliably help us prevent conception in the 12-18 months after a baby is born. It worked before we had a baby, but then we got the continuous mucus thing. It might work again after a few years' worth of continuous mucus observations, but we've had babies instead. That is, perhaps, its own post.

So for us to be faithful to the Church's teaching on integral sexuality, it's either have another baby (I am now 22 weeks pregnant), or avoid relations entirely for months (which is why this baby and the Scholar will be the furthest apart we've ever had at a whopping 2.5 years). That is probably also its own post that I haven't been able to bring myself to write, for reasons which have also had me seeing a counselor. Perhaps soon...

But let me tell you that there is someone who is writing very intelligently about this topic, and if you are interested to learn more about NFP or if you are struggling with it and you didn't expect to, you should check out Simcha Fisher. She was the first person I saw writing about grave reasons to prevent pregnancy that included mental health and poverty and didn't necessarily include an imminent threat to a woman's health. She was also the first person I saw who wrote honestly about what it was like to be poor and practicing NFP and relying on government programs for help. She writes about NFP with a lovely sense of humor. She was the very first one to open up the conversation about how hard it can be after the Catholic community had spent many years discovering its benefitsLots of other people have added their two cents to that conversation, because there's lots that can be said.

But I have found that Simcha Fisher is the one who has most reliably moved the conversation about NFP in the Catholic Church in America forward, and she is honestly striving to practice obedience and fidelity to the Church's teaching on this point. And she has particularly moved that conversation forward during this NFP Awareness Week with several excellent posts. Consider today's:

"Hello, elephant in the room! I see you, and I'm ready to talk about you.
 "The NFP community is full of large families like mine. What the heck? How can we say that NFP is effective, and then show up with ten kids in tow? If a told you I had a really great system for losing weight, but I weighed 400 pounds, wouldn’t you snicker and look elsewhere for advice?"

This post is so good I'm going to quote it twice.
"NFP is easier to mess up than artificial birth control. There, I said it. If couples with normal fertility want to use NFP to avoid getting pregnant, they have to stay on their toes and be committed, and there’s no such thing as 'set it and forget it.' If you make a mistake in charting, or if you know you’re probably fertile and decide to have sex anyway, you can get pregnant when you really didn’t want to. And there are occasional head-scratchers, where you follow all the rules to avoid, and you get pregnant anyway. It does happen.
"Of course, these things happen to couples using contraception, too. Raise your hand if you know someone who conceived despite using condoms, or the Pill, or an IUD, or even some combination, or someone who trusts the Pill but skipped a day because life is hectic. Heck, I know couples who conceived even after a tubal or a vasectomy. Life is so life-y."
She also has an interview with America magazine, published this week, because lots of people recognize that she's an expert on NFP. She does speaking tours, for example, and she's written a book about it. Here's my favorite question and answer from that interview:
"How is N.F.P. similar to and different from artificial birth control?
"It’s similar in that it can be used to avoid pregnancy; but it’s different in the same way that eating a sensible diet is different from sticking your finger down your throat! Not a pretty picture, but you see the point.
"The thing about N.F.P. is that it’s just information. It doesn’t do anything to your body or to sex. It simply gives us the choice to work with our bodies as they already are. Every form of contraception adds something artificial to our bodies, or removes or alters something; and every form of contraception changes the character of sexual union—and sex is so strange and so beautiful and so powerful, it’s something that you really don’t want to mess around with.
"What you want is important, but how you achieve it is equally important. Another way to look at it: Say I desperately want to inherit my grandmother’s jewels. I could either smother the old bat with a pillow and forge her name on her will, or I could care for her until she dies, and then enjoy my inheritance. Same goal, same desire, radically different approach!"
She's also giving away a fertility monitor that she has found helps her space pregnancies this week, with the help of several donors. It's an expensive contraption and might help some couples find their available, infertile days during times when they need to prevent pregnancy. I still think that a discussion of a more total abstinence is necessary for some couples - not just 7-10 days during a menstrual cycle, but for many months when the need to prevent is real and the risks of conception while using NFP simply can't be tolerated - but her work has created the space for women and men and families and the Church to have that conversation, and for that I'm very grateful. Check it out!

Sunday, July 24, 2016

Week 21: Managing Fatigue

The more babies I have, the more I understand my mother, and this includes beginning to understand why she always seemed so tired. Practically the only crime in my family was waking up someone else who was sleeping, and that someone often happened to be my mother. She was an ER doctor, and her shifts would keep her awake at times when most people would sleep, so she needed quiet time to rest at home. When we went on family hikes, it seemed like we were always waiting for her to catch up with the rest of us. I have a distinct memory, as a teenager, of being kind of annoyed with her for walking so slowly when we got stuck on an unexpectedly long trail in the mountains of Argentina. When we visited my grandparents for Christmas vacation, it baffled me that no one else wanted to spend 20 minutes putting their snow clothes on to work up a sweat moving snow around in the yard before coming back inside, spending another 20 minutes removing said clothing to hang and dry. How could the adults just sit around playing bridge and reading all day long?

But of course, as is so often the case, I totally get it now that I have my own kids. And I totally understand why my own children have no idea what I am going through and why I seem so crazy tired all the time. I actually had the experience of hiking with my husband a few weeks ago, and I was almost appalled at how slow I was. I immediately recognized what my mother went through more than 15 years ago when we dragged her through the mountains of Argentina for nearly 10 miles. (I also felt an appropriate amount of shame for assuming my mother was...what? Lazy? How could I ever have thought an ER doctor with four children was lazy?).

I have found, this pregnancy, that I am more fatigued than during others. Taking care of the kids takes it out of me, so that's one part, but by no means unique to this pregnancy. Eating less takes it out of me too, but that is also not unique to this pregnancy. The summer heat takes it out of me, so maybe that's it. Or perhaps I'm just getting a little worn-out at the ripe age of 32.

Unfortunately, in addition to being tired a lot this time around, I am not very good at resting. When I do manage to sit down, the incessant call of chores, the nagging anxiety of things left undone, my husband's high expectations, and the never-ending needs and desires of my children don't truly let me rest. When I was pregnant with my very first son, my OB had to tell me to tell my boss that I was starting my maternity leave "early"...when I was 41 weeks pregnant. I tried to resume a regimen of walking for exercise, to train for a half marathon!, when I was 3 weeks postpartum. As a result, my postpartum bleeding went on far longer than it should have (9-10 weeks), because I refused to rest.

This has also been a persistent theme that has come up in counseling in at least half the sessions I've been to. It came up the night my first son was born, when I knew that I physically couldn't lift myself out of bed and needed to rest but felt so guilty for asking someone else to help. When I recalled this memory in a counseling session, my counselor asked me if I could perceive where Our Lord might have been with us on that night. At first I scoffed, and said, no, that was just the problem. He wasn't there. No one was there to to help. Wasn't that obvious? But then she asked me to sit with the memory for just a little while longer, and suddenly, he was there. And do you know where he showed up? He was speaking to the baby, whispering words of comfort to my son. (When I told my seven-year-old about this later, he said, excitedly, "Yeah, and maybe my crying was the only way I had of talking back to him!" That made me cry all over again for a very different reason.) Then my counselor asked me, "And what is he telling you there in your hospital room?" I don't know, he's not talking to me. I just told you, he's talking to the baby. Then, with almost a dismissive brush of his hand..."To rest. He's telling me to lie down and rest."

So I'm working to find appropriate ways and times to rest. Leaving the kids to fend for themselves a bit more is part of it. Simply telling the children that I'm too tired (and letting them live with that fact, even if they don't understand it yet!) is another part of it. Giving the kids verbal instructions more than physical help is another part of it. Often it's not running toward the crying and screaming right away, but waiting to see how the boys handle it on their own (usually pretty well!). When the kids ask to do something special or out of the ordinary, I try to get them involved in thinking through the problems of the new activity. As Christians, we reserve Sunday for rest, and my husband has always been particularly good about finding ways to keep the Sabbath in the modern world. And sometimes it's just a matter of saying a prayer, going to my bedroom and shutting the door for 15-20 minutes...