American Mother's Guilt 6-28-11

It starts early. Already I feel it at 10 weeks. All the things you can't do as a pregnant woman. No booze. That's not a big loss to me. I do enjoy the occasional glass of wine with a nice meal to relax. That's out for a good year. I've seen too many little ones with fetal alcohol syndrome and the less serious fetal alcohol effects. The problem is that people don't really know the threshold. I was a little surprised when my Irish friend said that pregnant women should drink Guinness, I believe, for the potassium. I'm sure there are lots of European folks who would advocate for the prenatal benefits of imbibing various local tipple.

Then, there's smoking. That's not good for anyone. (Well, except there was some hint a few years back that smoking may be beneficial for BRCA carriers??) Pregnant smokers are more likely to have low birthrate babies. I wonder what the story is with second and third-hand smoke. Our town just went smoke free, BTW. Great news! Smoking is no loss to me.

Then, there's all of the other things you have to avoid. Lunch meat! Apparently, lunch meat is prone to listeria and is verboten. This was a shock to me when I went to my PCP, as I had just had a yummy Cold Cut Combo from Subway a week ago :( So there's one more thing to feel bad about. My cardiologist had recommended lunch meat to me to help control my vasovagal syncope because it's high in sodium-but I'll have to look elsewhere. I read somewhere that if you douse lunch meat with mustard, it can kill most listeria, or there's the option of cooking the lunchmeat, I guess. I can't say I'm excited about either option.

Sushi, also out, or at least the uncooked fish variety. There's all of the various organisms in raw meat, but there's also the mercury contamination. Oh, I mourn the loss of spicy tuna rolls. I wonder if Japanese mothers have the same worries? Do their OB's forbid sushi? I did have a veggie avocado roll a few days ago. And I've been eating cooked shrimp. It's just a matter of picking fish lower in mercury, I guess.

Another thing I feel guilty about: taking meds. I pretty much just quit taking everything, but severe morning sickness had me a bit desperate. Baby's gotta eat! I tried to use the Pregnancy Class A meds, which are considered safe, but they just didn't do much at all. I moved on the Class B meds, which are thought to be safe, but they haven't done in randomized trials in pregnant humans. So, I resorted to Zofran and already feel guilty. There's also the issue that: Momma's gotta make money! And even with Zofran, I'm not completely there. So, at least I'm somewhat tortured and don't feel quite as guilty.

Pretty much everything I do, I wonder, "Will this hurt the baby?" There's always something to worry about, and it won't end at pregnancy. The fun is just beginning :)

For a nice website that covers many of these topics, you may want to look at this from the CDC.

Morning sickness 6-28-11

The first 4 weeks of pregnancy. I thought I had it licked. I couldn't figure what all of the fuss was about being pregnant. Just women wanting sympathy... like making their husbands make a midnight run for hot fudge cake and pickles. But then, the weekend I got back from a conference in Baltimore, it hit me. Yargh! So this is morning sickness.

At my 6 weeks, my RE showed me this article from 2010 New England Journal of Medicine, listing the various treatments for pregnancy nausea. It's actually a summary of an earlier, more thorough Cochrane Review, but the NEJM article is much easier to use. First recommendation was B6 at a certain dose 3 times a day. Threw that up. Second suggestion was ginger. Ooo, disgusting eructations (yep, that's a nasty burp) and threw that up. Third recommendation was Unisom, of all of the crazy things. Did okay with some, but yep I threw many of them up. Plus, it's Unisom. It's a SLEEP medication. Can't exactly take it before I go to work. And it makes me groggy. Talk to the hand! Another suggestion I've read is that you should never let yourself have an empty stomach. So, explain this to me: how do you keep your stomach from getting empty if you're not able to keep anything on your stomach?

So, I was pretty green the next time I went to the RE. I was sipping water, and the nurse said that the doctor didn't want me to have a full bladder. Nope, not an issue here. The ultrasound. I heard Boop's heart beat for the very first time. It really puts things into perspective. It was racing--the ultrasound print out said 178 beats per minute (which is a bit fast). Boop is pretty fantastic and BIG as in my Dad's side of the family. Hopefully, big and healthy! It was a momentary distraction for the constant nausea and the debate about whether and when to run to the bath--speaking of which, I just lost my last Unisom, just as an FYI--room. Afterwards, in the consultation room, the RE wrote "hyperemesis gravidarum" on my clinic chart, which means horrible, horrible morning sickness! He wrote me a script for Zofran. It's one of those unknown drugs as to the impact on pregnancy, but it helps me make it through the day. I'm somewhat functional at work, if not a little agitated from the meds. It is a med used for chemo patients.

I remember telling my primary care MD, "You know, at least this gives me a little bit of empathy for what chemo patients go through." She responded, "But at least they TREAT those people. They don't do anything for pregnant women. That's what really gets me!!" It's true: pharmaceutical companies do not want to touch pregnant women with a 10 foot pole. In Canada, they have a version of Unisom that has a longer, sustained dose with less of the sleepy side-effects, but they won't even put it on the market in the US.

I was a bit disheartened to read more about hyperemesis gravidarum. For most women, morning sickness usually wraps up by 14 wks., for those with HG, it is more like 20 wks, if it resolves at all! Keep your fingers crossed for 14 wks.

A little background...

"Are you in there little fetus? In 9 months you'll come to greet us!"--Phoebe on Friends.

Tomorrow, I believe will be 10 wks LMP (or about 8 wks GA). So, Boop will officially be a fetus, as opposed to an embryo. I was looking around online at some of the freaky images. The feti? fetuses? look like little alien creatures. And then there are photos of expectant moms with their bumps. It's a little frightening, too. Fortunately, I guess, I don't look quite as extreme as those women. My bump is quite small, and I don't think I look that big. Folks who see me may say otherwise...

It was a hard road to get to this place. I tried to meet the right guy, but I guess it just wasn't meant to be. And then there were all of the health problems. I'm not a young woman and got some pretty scary results from some blood tests ran by my GYN the end of last year, and I learned that I had POF (Premature Ovarian Failure, sometimes known by a kinder term: Premature Ovarian Insufficiency), which is a medical term for early menopause. My RE (reproductive endocrinologist) looked up at me, and said, "If you want to have children, you better start SOON." So, I tried to quickly get myself in gear. I had talked to a friend from grad school who became a Single Mother by Choice, and I joined their support group. Then, I prepared myself for the hard road ahead.

People often think, 'you should just adopt.' Well, unfortunately, it's not that easy, especially for a single woman. It's really expensive and takes a long time, if you ever succeed. Along with being single, with my health history, I don't know if I would have much luck. And there was the other bigger picture issue. I'm the only child of an only child; the last one left in my grandfather's line. Granted I have a wonderful extended family--lots of cousins and adopted grandparents, but part of me feels a bit like the Last of the Mohicans: Natty Bumppo or is it Chingachook?

So, I had tried to think of how far I would go. There are all of the celebrity women in their 40's and 50's getting pregnant. It's not a very realistic picture. Some women in their 40's are using donor eggs to get pregnant, a very expensive prospect. In my mind, I tried to figure what I would do to be a mom. Fortunately, I never had to get that far. I got pregnant on my second try! I was totally shocked. I never imagined it would happen this quickly.

I'm sitting here writing this for a few reasons. First of all, I'm not doing this for exhibitionistic motives. Those who know me well know that I am a very private person. And I hope that little Boop won't be too embarrassed by my efforts (well, except as a teen, where my every action will undoubtedly be a source of embarrassment). Mainly, I hope that at some point, Boop will find some humor in the postings and know how much s/he (I'm actually pretty sure Boop is a girl) is loved. Another major reason is for connection both for Boop and me with my family who is far away. In spite of her valiant efforts, my mom can at times be an unreliable messenger. Now you can get the scoop straight from the horse's mouth! And I appreciate hearing from you: getting your thoughts on my reflections and getting your advice. SO, PLEASE COMMENT <see comment area below>! Again, those who know me well will know that I will listen, consider your suggestions, and then do pretty much whatever I want ;) I guess that's a mother's prerogative...