juliloquy

tell me how socialized medicine would be worse?

So I have excellent health insurance. Seriously. Our hospital bill from Shmooie's delivery? $0. It will be the same for Polly-roo's, I believe. (We got one of those panic-inducing "explanation of benefits" saying we're responsible in full for the $47,000 6-day NICU bill, but that's being resolved.) So I know I'm lucky.

But the primary-care, referral stuff is bureaucratic bullshit. My 6-week postpartum OB appointment is tomorrow, and I got it in my head that I might be able to get an IUD inserted at the same time. So I called the OB clinic. They told me my insurance doesn't cover IUDs and that it would be $700ish. (And I think to myself: would my insurance company rather I get pregnant again? I don't think so.) I shelved that idea, but then was perusing my coverage paperwork, which said IUDs are covered, but under the prescription drug plan. So I called the prescription drug plan folks. The customer service woman asked me for the "name of the medication" and whether I'd ever been on it before. I went round and round to get her to understand what an IUD is. She then told me that it's covered, but that I'd have to check with the pharmacy for specific coverage and to see which ones are available.

So I called the OB office again and the billing woman told me that I will have to get the IUD at the pharmacy, bring it to the appointment, and then pay a $213 insertion fee. None of this sounded right to me, but I went ahead and called the pharmacy.

Sure enough, the pharmacy said they don't do it that way. That the doctor's office arranges for it. I briefly considered calling the OB office again, but I doubt I'd be able to get a straight answer over the phone. So I'll just have to go to the appointment tomorrow, talk to the doctor, probably set up another appointment (after getting a referral from my primary care physician), and pay $213 (which is not so bad since the IUD is effective for 10 years).

Thank god I'm on leave and have copious free time for phone calls. All this has me feeling a bit nostalgic for the Bulgarian medical system.

On a related note, I'm reading Catch-22 for NaNoReMo 2007.

gory, continued

Before I return to our harrowing tale, gentle readers, I must announce Polly's name.

Joni.

She is named after my mom, Joan. We are still fine-tuning the middle name: a version of Mary after HPR's Nana and also one of my mom's sisters. I think I will continue calling her Polly on my blog.

Also, congratulations are in order to the winner of the Polly due date pool, the kilowatthour. K, how do you do it? She was also the winner of family isoglossia's baby pool back in January. Perhaps it is somehow linked to gestating and giving birth to an amazingly cute son. For birth weight, it was my sister, although, zoicks, her guess is still 2 pounds over. Two pounds. It's still sinking in to me what a tiny, tiny baby my girl is.

Anyway, back to my story. 

We sat in the ER in frustration. It was obvious where we needed to go. The refrain of my thoughts: Get me up there. They're going to have to cut this baby out of me. I'm down with that, just so she's OK. Please just let us go up to the labor floor.

Seriously. Why did it take 15 minutes of waiting?

At labor triage they put a fetal monitor on my abdomen right away and - to our huge relief - Polly's heart beat was fine. They did an ultrasound to check that the placenta was in place and not blocking the cervix. They checked me and determined I was 4 cm dilated and 90% effaced. Therefore labor could proceed w/o need of an emergency c-section. They would watch me and Polly extra carefully, because the blood was probably an indication that the placenta was pulling away from the uterine lining a bit.

We were cleared for transfer into a delivery room, and found out we were bumped ahead of 8 others. (We found out later that a woman gave birth right in labor triage that night.) At first, there was no bed in the delivery room, but they rounded one up quickly. I think this was around 1:15. Contractions were coming frequently and HPR was at my side through each one, letting me squeeze his hand. We met our awesome labor/delivery nurse, Elizabeth. We briefly met a resident and the on-call doctor from my OB practice.

At around 2:00 (I think? Details are already starting to fuzzify.) I inquired about an epidural. Elizabeth left to try to round up the anesthesiologist. It was a busy night, so she was gone a long time. She would pop back in and leave again. (The entire experience was so different from Shmooie's delivery, where at least 5 people were in the room at all times.) By 3:00 I pushed the nurse call button and asked whether I could see the anesthesiologist. I think they assembled and we got it put in by 3:30.

But I could still feel contractions on my right side. Elizabeth tried to get the anesthesiologist back in, which took a while. When he came back in he pulled the catheter back a bit to see whether that would help distribute the lovely numbness. It never really did. And the down side to the epidural taking the edge off some of the pain was that it also blotted out my adrenaline from dealing with the pain. As a result, it really hit me how exhausted I was. Jury's still out whether a half-assed (ha - literally?) epidural is better than no epidural at all.

I labored away. HPR tried to rest a bit, since the epidural was helping somewhat. The plan was for the resident to break my water now that I was (mostly) numbed. She did so. There wasn't a lot of fluid, so we think my water had indeed broken back at home. She checked my dilation, and I was up to a 7 or an 8.

At about 5:00 I started to feel a really sharp pain in my right side. I started moaning. Elizabeth wondered whether that meant it was time to push. She said: "Don't push. I'm going to get the doctor." Everything happened quickly from this point. The doctor checked me and determined I was ready. Elizabeth and the doctor pulled apart the bed and put my feet in the stirrups. I got the go-ahead to bear down.

With the first push HPR, Elizabeth, and the doctor declared in unison "We can see her! She's right there!" I asked if I should keep pushing and Elizabeth said "with the next contraction." (One upside of the half-assed epidural was I could still feel the contractions, which I couldn't with Shmooie's epidural.) One more push and she was out. They put her on me right away. Back to giddy: I stared in disbelief. Here was our daughter.

Postlog

A routine blood draw yesterday determined that Polly's red blood cell level was much higher than normal, so they had to do a saline transfusion - where they take out some of her blood and replace it with saline to get the levels down to normal. This means that there was probably something minor wrong with the placenta - not enough to be detected during my prenatal care, but enough so that her body made the extra red blood cells for extra oxygen absorption (this probably also explains why she's so little). The transfusion was last night and she is in the NICU. She's also under the strong lights for biliruben to prevent jaundice, her platelets were low so they've given her some blood product (mine were low, too, although I guess they're not worried about me) and they gave her an antibiotic. She can't eat for 48 hours after the transfusion, so she is on an IV and I am pumping/expressing. She will have to stay a bit longer: I leave tomorrow; she'll probably be discharged sometime between Wednesday and Friday.

So, not exactly the way we wanted things to go. But they have stressed to us that this is just a short-term issue, that she is healthy. It's also encouraging that she nursed, peed, and pooped like a champ during the first day of her life, before she had to go into the NICU.

She seems very strong. I can't wait to get her home for major snuggling, feeding, love, and settling in.

HPR and I are feeling well. Just tired and emotionally drained. . . . Shmoo came to the hospital today, but isn't allowed in the NICU. He is home with HPR now and will have his normal daycare routine this week.

 

Details: the good, the bad, and the gory

When we left off (before the cute newborn photo), HPR and I were alone in our house, the on-call Shmoo tamers had just left. We turned in at about 10 p.m. I was still having contractions, some of which woke me up.

At 11:45, I was awakened by a contraction, then I felt a gush of fluid. I woke up HPR and told him that my water had just broken. I was giddy - this meant we got to go to the hospital - things were truly underway, not just a false start.

I grabbed up the beach towel from beneath me on the bed and ran to the toilet . . . where I discovered it was blood, not amniotic fluid, flooding out of me. (After the fact, I believe it was in fact both mixed.) HPR had noticed, too, and called to me from the hall that we had to go NOW. I wasn't operating well with the quick succession of my feelings from giddy to surprise to shock, but HPR really kept it together. He asked me what clothes I could put on and I didn't know. I knew I couldn't just walk into the hospital with a beach towel scrunched against my crotch. I told him to get the skirt I had worn earlier that day, which I pulled over my head and partway down over my hips. I had the presence of mind to grab a grungy blanket to sit on in the car. We took off right away.

HPR told me to call my doctor from the car. I had a number in my cell phone that I had called earlier that day. I got through, but didn't really know what to say other than blood was gushing and we were on our way in.

We arrived at the ER at midnight. Urban ER at midnight on a just-past-full-moon Friday. Yeah.

We waited a 15-minute eternity for someone to take me in a wheelchair up to labor triage.

Ay - I didn't mean to hit "publish" yet. But I can't hit "unpublish." So I'll edit this later. Right now I'm going to try to catch a cat nap.

She's heeere.

She's heeere., originally uploaded by juliloquy.

She arrived at 5:34 a.m. after a roller-coaster night. We are all well. Here's the big surprise: whereas her brother weighed in at 9 lb 5 oz, this peanut weighs only 5 lb 9 oz. 18.5 inches long. Perfect.

(And nearly named. Stay tuned.)

teaser

We were ready, this morning. We could drop off da Shmoo at daycare and I'd promptly go into real labor. I was pleased that I'd probably just labor during daylight hours, as I did with da Shmoo. No bleary overnight pain under fluorescent hospital lights, and one of HPR's parents could pick up da Shmoo at daycare at the end of the day. . . .

I've been having contractions since last night. Painful, but only coming 2-3 times an hour. They continued through the morning, then eased up around noon. I walked in to work. Started timing contractions at 3:30. They were coming every 7-10 minutes, then every 5-8.

We called all the on-call folks. HPR's step-brother and his girlfriend came from across town in case we had to make our getaway before HPR's mom could get here. Contractions continued, but didn't get more frequent. I took a shower; HPR's mom and sister arrived and whisked away da Shmoo. I am now drinking wine to see if it changes anything. I think we'll try to get some rest.

The midwife who examined me yesterday said I'm 3 cm dilated and that "the baby is right there" (in the correct position).

Aaaand over to you, Polly . . .

I will try to post here if there's hospital-ish news.

The week in pictures

How HPR spent last week:

With Dr. Loki, Attending Puddin'. Here's another angle:

Then, thanks to penicillin (All hail ye penicillin; O Bread Mold, I sing of Thee!) he rallied by the weekend and, among other things put up the sidecar crib. For Stella.

IM IN UR KO-SLEEPR . . .

Stella had the co-sleeper to herself for most of the week, but last night Loki joined her. (Apologies to HPR for the flash photography at 4 a.m.)

WE CAN HAS OFFSPRNGS BRETH?

Now just to figure out where to put the baby.

She'll be comin' round the Schuylkill when she comes

I gave birth to Shmooie at Hahnemann Hospital. Labor & delivery is on the 16th floor and we had a terrific view North on Broad Street to the glorious Inky building.

Image by XOZ.

My experience there was fine, but the only reason I went to that hospital was because that was where my OB clinic admitted. After Shmoo was born, the clinic changed staff and I wasn't crazy about the new folks. So I decided to switch my care to the hospital on the same campus as my office. It has been convenient to get there for appointments during the work day. My boss and I joke about calling security for a golf cart ride across campus if I go into labor while at work.

The maternity wing where I'll deliver Polly is on the 7th floor, so I don't know what the view will be. Campus or the Schuylkill River or the new construction for the Children's Hospital.

It's still a bit surprising to me that I will birth both of my children in Philadelphia. (And you may ask yourself-well . . . how did I get here?) Growing up, I thought of Philadelphia as a sort of legendary city. My family visited on our Great East Coast Trip of 1977, with just enough time to take in Independence Hall, the Liberty Bell, and the Betsy Ross House. I never would have guessed that those would be the very streets my future husband would walk every day for his work.

I have planned my life about as much as a dandelion seed charts its course on the wind. Tried out a few majors before settling on English, scrambled in my last year of college to get a minor in Publishing & Printing Arts since it was doable. My adviser set up an internship for me after graduation and voila, I was lucky enough to work in book publishing in the Twin Cities for 9 years.

I let Peace Corps decide where to send me, which took me to Bulgaria, where I met Handsome Ponytail Pennsylvanian. After Peace Corps we looked for work near our families both on the East Coast and the Midwest. East Coast won. Here we are. (For now.)

I don't know that I had a major point in all this, but I'll bet others of you had similar experiences. As a child, when you imagined your future life, did you have any expectation that it would unfold the way it has?

Let's get this bloody show on the road  - or - more cooking time, Polly?!

On Wednesday I had an OB apt. I asked about timing contractions and at what point I should call/come in. She gave me the usual "don't come in too soon, blah blah blah" talk.

[On that tangent, I have to reproduce the fabulous words of finslippy: You know this part if you've had a baby already: everything you read, every doctor you speak to, every hospital orientation you attend, every labor preparation course you take, they all tell you the same thing: don’t go to the hospital right away. We won’t admit you until you’re four centimeters dilated! they say. You’ll probably panic at those first contractions and think you need to go to the hospital! But you won’t! Stay at home and be comfortable and don’t bother the hospital until you’re absolutely certain! Maybe then you can come. Maybe. But until then we don’t want you. So don’t go to the hospital! Did you hear us? Were you listening carefully, when we said the part about waiting? Please sign this form that tells us you understood that part, because Jesus we don’t want you. Until, you know, such time as you’re truly, absolutely ready. But at that point when you think you should come, it will probably be even a few hours later than that. P.S.: Don’t come here.]

OK, back to me. Then came the internal exam. After some uncomfortable probing and prodding, the OB discovered that I was 2 cm dilated and my cervix, according to her, was "so, so anterior." She changed her tune from "don't come in too soon" to "you should be sure to come in right when you go into labor." She held up her glove after the exam and said "bloody show." (And I'm thinking: well, what do you expect with all the rummaging around you were doing in there?) She said "make an appointment for next week, but I doubt you'll last that long." [My sister, who chose an early date in the pool, is gloating.]

Meanwhile, HPR (back from his weeklong trip to Denver) had been sick as a dog on the couch since early Tuesday. Upon hearing that labor might be right around the corner, I immediately felt a bit panicked and teary. HPR found out Thursday that it was strep throat. Thank God for antibiotics; he's much better now.

And Polly has stayed put. I have felt some twinges here and there, but I remind myself that I was 2 cm dilated with Shmooie 3 weeks before he arrived, and 4 cm 4 days before I delivered. These kids do what they want, when they want. Here I am again, a dandelion seed on the wind. (Although perhaps "walrus on a rip tide" is a more apt metaphor these days.)

HPR's mom has Shmoo for an overnight tonight, so HPR and I can alternately relax and turbo nest. Maybe we'll even go on a real date! Maybe we'll walk the cobblestone streets of Old City, admiring the buildings in this legendary city where our children are beginning their life journeys.

the bets are in

It started out as a nice bell curve, but now it's looking more like a foppish hat. Here are the results so far. Feel free to keep them coming in (get info to help you decide here). And wish me luck in delivering what consensus says will be a big girl!

25 September, MonkeyHateClean (aka my sister), 7 lb 9 oz
26 September, SupaMB, 8 lb
27 September, El-e-e, 8 lb 10 oz
28 September, Swistle, 8 lb 6 oz
29 September, kilowatthour, 8 lb 8 oz
30 September, HPR, 8 lb 14 oz
1 October, Jennifer, 9 lb 2 oz
1 October, Lori, 8 lb 8 oz
2 October, Brian, 8 lb 14 oz
3 October, Night Editor, 8 lb 7 oz
3 October, Robyn & Mark, 8 lb 1 oz
3 October, Rachel E (by email), 8 lb 4 oz
4 October, Courtney, 8 lb 9 oz
4 October, Niki, 8 lb 4 oz
5 October, SteveO (my brother), 3.8 kg (= 8.36 lb = what, like 8 lb 5 oz?)
6 October, ratphooey, 7 pounds 15 oz
8 October, me, 9 lb even
8 October, ThomasT, 8 lb 10 oz
8 October, Erin, 8 lb 1 oz, 20 inches long
8 October, Auntie M, 8 lb
9 October, sgazzetti, 8 lb
10 October, LetterB

everybody in the pool!

You know you're getting close to your due date when you start to notice that it coincides with dairy expiration dates in the supermarket. So it's time for you to guess Polly's birth date and size. Here is some information to (possibly) help you decide:

My official due date from the medical establishment (LMP) is September 27, but early ultrasounds indicated due dates of October 4 or 7. Basically, anything between September 15 and October 15 could be considered normal.

Shmooie was born November 8 at 9:40 pm, which was 3 days after his due date. With him, I gained a total of about 40 pounds. He was 9 lb, 5 oz and 20.5 inches at birth. (I love the labor & delivery nurse’s quote: “He has Saint Bernard paws!”) My labor was about 10 hours and pushing was about 30 minutes.

This time I gained about 33 pounds but then have lost about 3 in the last week or two. I don't know how that happened; girl child is very hungry these days (I have to get up to eat in the middle of the night or I can’t sleep). I wouldn’t doubt it if I pack on a few more pounds in the coming weeks.

HPR thinks the new kid will arrive Sept. 30 and will be 8 lb 14 oz. I have no idea, but I’m leaning more toward the October dates. Maybe October 8? And I'll say 9 lbs even.

Comment with your guesses. Since I'm making the rules I'll say that it’s OK if folks duplicate. Will there be a prize? That's a very good question. I'll do a subsequent post where I'll log in everyone's guesses. Oh! And the hospital has wi-fi. I told HPR we have to bring the laptop to the hospital. He thinks I'm crazy.

Apologies to Isoglossia for ripping off his post title (from back in December). Image from here.

 

Talking about music . . .

(You know the rest of the quote. If you don't, I'm sure someone [Steve?] will be happy to leave it in the comments :)

I'm trying to come up with a descriptive phrase for our neighbor's band's music. Surf metal on speed? Power punk wah-wah metal? Give it a listen and tell me how you'd classify it. Either way, it makes for a rad blend with my milquetoast* classical background music when Stinking Lizaveta rehearses on the days I work from home. Polly likes it, too.

This article from JamBase declares that the band members themselves call it "doom jazz," which is kind of fun, but to me doesn't quite tell the whole story (leaving out, for example, the maniacal pulse of most of the songs). There are a lot of good descriptors in this paragraph:

Their newest long player, Scream of the Iron Iconoclast is their most exhilarating smorgasbord of heavy jazz transgressions and psychedelic wipeouts yet, with raids of metal menace, jagged post rock, mutated blues riffs and drummer Cheshire Agusta's esoterically woven, technically crunchy drum patterns that signal a sonic clutter in the middle of a black hole. Joined by Yanni's brother Alexi Papadopoulos - whose rapid fire upright electric bass lines force out the soul of Stinking Lizaveta's rhythmic bedlam - their live shows induce a lumbering hypnosis to the eyes, ears and minds of the crowd, especially when Yanni howls into his pickups and grinds his teeth against them.

*HPR's description of WRTI's classical playlist. We love the station and are members, but it's mostly for the evening jazz.