Saturday, July 30, 2011

Countdown: 11

A few weeks ago I woke up to find that I was cuddling with a pregnant cat.  I could feel the little unborn kittens squirming around (each one seemed about the size of half a hot dog).  And I thought it was so cool. 

That feeling does not extend to human unborn.

I poked it.  The belly.  I didn't give it a good solid grope.  I poked it.  Tip of the finger.  That was plenty.  I was told after that it was a foot.  I poked at a foot.  Through the thin layer of another person.  Creepy.

At Sara's request, I'd just savoured a bottle of Reisling.  She didn't exactly request that I drink a bottle (rather than a couple of glasses) but it was a tasty bottle.  I don't usually like reisling - too sweet - but it was what Sara said she would be drinking on a lovely summer night if she could - so I did.  It was perky.

I've been drinking a little bit so I probably wouldn't make much sense if I spell out the details of our converation up until the point I poked the belly.  Somehow we ended up talking about death and dying and ghosts and whether we were afraid of dying and our experiences with dying people and how most marriages split up with the death of a child.  Morbid, I know.  I also freely admit that one of the reasons I'm reluctant to have kids is the possibility that they might die and I would be inconsolable.  I decided ong ago that if I have kids I want two, the second as a back-up, in case one of them dies.  Morbid, I know.

It makes some amount of sense to be thinking about mortality in the face of new life.  Which is, in effect, your replacement.  Which makes me sad.  That's all for now.

Friday, July 29, 2011

Countdown: 12

Sara tells me that she Homer Simpsoned a scale this morning.  Her belly rested against something that gave the illusion of much lower weight, and every time she shifted, her poundage yo-yoed out of control. 

I find it both hilarious and horrifying that her body has gone so far that she doesn't realize when she's touching something and when she isn't.  I choose to find it hilarious because how can you not know that you're touching something.  Horrifying because I'm not comfortable with reaching a point where my body is, quite literally, not my own.  Elaborating on this would depress me, so I won't... much.  I'll only say that one of the things that really turns me off about pregnancy is the objectification.  Being reduced to a vessel.  When was the last time an acquaintance asked Sara if she's read any good books lately?

The weather report for this Friday suggests that it will be too cool for an effective vodka-dousing.  I've requested alternate drinking arrangements.

Wednesday, July 27, 2011

Countdown: 13 Days

Not including today, or the day of the births, there are merely 13 days left before the minions are removed and all of our lives change forever. 

Now that her ordeal is drawing to a close, I asked Sara to create a list of the most inappropriate and/or offensive things that have been said to her over the last 8.5ish months, as a record of some of the more annoying moments of the pregnancy.  A list I hope that she will refer to as a method of birth control, the stinging memory of each comment preventing her from turning into one of those women who have vowed never to go through this again, and then after a couple of years have gone by, announce happily to family and friends that she's expecting again.  Her pregnancy has been largely free of fits of hormonal rage, so sadly, everything on her list is understandable rather than random. 

"You're expecting twins, oh my god I'm so sorry." 
"You know your belly is so big right now that I doubt a police officer would issue you a ticket if you were driving without a seat belt."
"Oh, you're having twins, that explains it." - what I don't know.
"Would you like those for here or to go." about the 7 giant cupcakes I ordered from The Second Cup to bring into work for my co-workers on my last day before maternity leave.
"Oh my god Sara, are you lactating already?" comment from a coworker at 8 months about water that I dribbled on my shirt. 

And my favourites:

"You must be so sad that you don't get to experience real, natural child birth."
"Oh, look you're so swollen you have cankles now"

and

"I am a twin too, but my sister died because she was the weak one."

I really thought that "you're slowing up the line, prego" would have made the cut, but I guess not.

As back up birth control, I encourage her to also compile a list offensive things that people say to her in the months following the births, when she is struggling with post partum hormones and sleep deprivation and will likely be very sensitive to perceived criticisms and/or completely redundant remarks.  I imagine that "you must be exhausted" will get annoying really fast.  Here's hoping she is not one of the unfortunate souls whose bellies stay swollen and rounded for a few months and she is repeatedly asked "when are you due?"  Probably effective birth control, though.

Tuesday, July 26, 2011

Vaginas (Still) On My Mind

I've been spending way too much time thinking about vaginas lately.  I had a dream last night that I looked at mine and discovered that it had transformed into the face of a star-nosed mole.  I woke up in a cold sweat, of course. Look below and imagine my horror.  Feel free to do a Google image search of "star-nosed mole" if this isn't enough eye candy for you.  Interestingly, if you Google "star face mole", you will be treated to many more pictures like this one, as well as a selection of photos of Sarah Jessica Parker. 















So, enough with vaginas.  Back to Sara's pregnancy.  It seems the twins haven't been up to much lately.  Just sort of hanging around waiting.  The ultrasound tech asked Sara this morning if they'd been doing a lot of fighting, as sometimes twins start punching and kicking each other during these late stages in a battle for space, but nothing like that.  Apart from the head kicking incident of several weeks ago, Jack and Molly have been surprisingly peaceful. In fact, last week's ultrasound showed that the gaylords-to-be were spooning each other lovingly.  Jack was the spoon.

Perhaps a drinking update is in order as well.  My drinking challenges of late have included a self-imposed weekend of drinking responsibly and in moderation, so not much to tell there, and a night involving a box of wine and a story that cannot yet be told.  That evening was also supposed to involve margarita popsicles but somehow we never got around to those.  A shame, because I was kind of excited to critique.

In more recent news, I was mostly well behaved at a hometown wedding this past weekend.  The end of the evening found me sitting on the sidewalk outside the hall, giggling hysterically with the matron-of-honour, for reasons I don't remember.  For other reasons I don't remember, I gave the deejay a big hug before leaving.  And I crawled into bed with my mom when I got home and had a little nap.  She didn't seem much disturbed, but quite groggy, so perhaps she didn't notice.  Thankfully I woke up after about an hour, and retired sensibly to the guest room where I belonged.

As for the upcoming weekend, it has been discovered that pouring alcohol on the top of one's head may be an effective way to reduce body temperature in excessive heat, so this Friday night will find me in Chris and Sara's backyard while they douse my head with vodka to see if it works.  Needless to say, I will also drink some of the vodka.

Thursday, July 21, 2011

it is much, much hotter than balls

Hotter than Mumbai.  Hotter than Al'Azizyah.  Hotter than Dallal.  Hotter than Bangkok.  Hotter than Death Valley.

I'm factoring in the humidity, of course, but when I left work today, it was 49 degrees Celsius.  To put that into perspective, it was hotter here today than it was in all of the above places, all known to be the hottest places on earth.

We didn't reach the disputed world record of 57 or 58 degrees, but at 49 not really that far off. 

To put it into further perspective, you will likely die if your body temperature reaches 44 degrees.  Yipes.

To think that I complained when it was a lovely and temperate 32.  32 would feel like a cold shower.  It's past 11 p.m. and still 42 with humidity.

None of this, of course, has anything to do with drinking and pregnancy, but the weather kind of has me preoccupied.  There is a candle lantern on my balcony.  The candle has melted.

Courtesy Stitch*

The third and final stage of my research involved leaving voicemails/messages at the offices of ten randomly chosen OB-GYNs, indicating that I was a "writer" doing an article on the pros and cons of different modes of delivery and would like to interview them.

I received no return calls.

Maybe something in the tone of my voice suggested that my final question was going to be "Courtesy stitch:  fact or fiction?"  It really was.  But I thought that maybe I'd get a few of them talking before things degenerated to that level.

*I have spoken to an alarming number of people in the last few months who are unfamiliar with this term.  I assumed that even if you hadn't heard it before, it was kind of self-explanatory.  I was wrong.  Click this link for enlightenment.  http://www.urbandictionary.com/define.php?term=courtesy%20stitches

Wednesday, July 20, 2011

And now... after a short delay... Science!

Or lack of science, as the case may be.  The second stage of my research into the C vs. V childbirth situation involved an attempt at an actual review of clinical findings.  I forewarn that I am not a trained medical researcher nor a gifted statistician (plus I have no intention of citing my sources), so you'll have to trust that I was thorough.  I should also point out that I should have known better than to use the internet to try to find legitimate information on this topic.  It was like expecting the people of Fox News to report on anything in an accurate and objective way.  Shudder.

Anyway, the internet is replete with webpages, most of which pass themselves off  as scientific articles, that offer virtually nothing in the way of actual data to back up their claims.  Or the actual data they refer to is misrepresented.  Need I say that these articles all assert that natural childbirth is the best and healthiest way of bringing children into the world and that a caesarean poses very significant risks both to the mother and child.  Also that caesareans are neither natural nor normal and the women who request them are so lazy and self-obsessed that they are willing to put their babies' very lives at risk in order to have things done according to silly and selfish whims. 

Whoever was responsible for the wikipedia entry on this subject very aptly put that "childbirth is an inherently dangerous and risky activity".  No argument there.

I'm listing the possible complications to mother and child in both vaginal and abdominal delivery below.  Just for fun, I'm going to spell out what can be done after the fact to resolve each of these pesky problems, as well.

Natural Birth:

From what I could determine, the risks to the baby in a vaginal delivery include breech, failure of descent of head into the pelvic rim, and a variety of dystocias (loosely defined as obstructed or difficult birth) which can include the head and/or the shoulders being too big to navigate the mother's birth canal, poor uterine contraction strength (the mother is simply incapable of pushing hard enough), and the umbicial cord being wrapped around the neck.  These can all lead to amazing things like fetal death, baby brain damage from lack of oxygen during delivery, and trachial nerve damage.  Oh, and about 1 of every 5 births has some kind of complication or another.  Oh, and they inevitably lead to emergency c-sections, otherwise, somebody's gonna die.

I am not a physician but I know for a fact that there's not really any recovery from brain damage, nerve damage, or death.

The risks to the mother include tears or epistiomies (stem to stern, ahem), prolapse (uterus falls down/slips out of place), post birthing incontinence of stool, urine, or both (urinary incontinence follows about 15% of births), sexual dysfunction, nerve damage, hemorrhage and infection.

Tears or epistiomies obviously are stitched up.  Prolapse can be corrected surgically.  Hemorrhage - blood transfusion, infection - antibiotics.  There's unfortunately not a lot of help for the incontinence, nerve damage or sexual dysfunction.

This might sound a little crazy, but I think I would have a hard time convincing myself I'd made the right decision in going natural if afterward I peed myself constantly and couldn't feel my clitoris anymore.  Or my bouncing baby had brain damage.  Or both.

Caesarean:

Complications to a baby in a caesarean birth include wet lung (retention of fluid in the lungs that would ordinarily be squeezed out when eking their way through the birth canal), the potential of premature delivery in the case the date of conception has been miscalculated, and higher infant mortality rate, at 1.77 of every 1000 births, as opposed to 0.62 of every 1000.

Fluid retention is dealt with upon birth with some manner of suctioning device.  I really did try, but couldn't find any info on long term complications of wet lung. 

While you can't reverse premature delivery, I find it a little hard to believe that the fetus age could be so far miscalculated that the delivery would be dangerously early.  Blood tests and ultrasounds have been used with reasonable accuracy to determine the stage of fetal development for decades. 

I am in no position to argue the statistic regarding mortality rate, and I can't deny that there's no reversing death, however, a little detail into the causes of death may have been helpful.  None was offered.

Complications to the mother are basically the same risks inherent to any abdominal surgery, which can include hemorrhage, infection (have I seen those words somewhere before?), internal or external scar tissue, and incisional hernia.  The recovery period following surgery is reported to be longer than with a vaginal delivery as well, which interferes with the mom's ability to care for the newborn.

See above re hemmhorage and infection.  Scar tissue and hernia can be surgically revised.  The recovery period varies person by person.  I won't deny that caesarean recovery does typically take longer.  However, I would guess that Stem to Stern wasn't exactly ready to jump into baby care action within hours of the birth, either.

And now, the wrench.

There has been virtually no research into the risks of elective c-sections.  All of the stats involving the risks of c-sections include those that have been scheduled on purpose for or have been performed as an emergency due to some kind of medical complication.  There's no real way to determine which of the C complications arose out of the pre-existing complications and which arose from the c-section alone.

I found one, and only one, scholarly article that seemed at all non-biased and acknowledged the flaws in what we believe to be the risks of the big C.  For one, it quoted a statement from the American College of Obstetricians and Gynecologists which suggests that maybe the autonomy of the mother should be a factor in how a baby is delivered, which sort of blew my mind because nothing else that I read factored in what a mother may want for herself at all.  Except, of course, for the endless stream of propaganda preaching that of course what a proper woman wants is to give birth naturally.

The article also goes on to refer to one of the only studies which compares elective c-sections to vaginal births, as follows:

"risk of perinatal or neonatal death or of serious neonatal morbidity was significantly lower in the planned caesarean group, with no significant increase in the risk of maternal death or serious maternal morbidity".

http://ecmaj.ca/content/170/5/813.full

I will not go on a full rant, but it sort of makes me spit with rage to know that your learned physician is giving you advice on which birthing method to choose, or flatly refusing to give you the c-section you request, based on statistical information which they know cannot possibly be accurate.

We have accepted that modern medical advances are safer than previous methods in almost all other areas.  For example, our hospitals are shockingly leech-free.

Before I shut this down for the day, just one message towards everyone who insists that natural childbirth is superior just because it's natural.  Think of all of the other medical advances that wouldn't be considered "natural" in a strict sense but improves our health and prevents early death.  Penecillin, tonsillectomies, insulin and dialysis?  Unless you are a devout Christian Scientist or similar and don't believe in medical treatment of illnesses, Shut the Fuck Up.  (Poor Jean Harlow).*

*Jean Harlow, of course, is the starlet of the 1930's who died of renal failure at the age of 26.  Ultimately she died in hospital, but not before spending some time ill and at home with her mother barring physicians from entering because they were Christian Scientists.

Friday, July 15, 2011

The great debate. For some reason.

I've been reminded that it's only 27 days until the birthing.  I'm running out of time. May as well share what I've learned re caesarean vs. vaginal delivery now before it's too late.

I conducted my research in 3 phases, not unlike the 3 phases of labour.* Except that the phases of labour are progressional and my phases of research are not like that at all.  What I discovered is that this is a really big subject and summarizing it all into one concise blog post is pretty much impossible, assuming I am reluctant to skip over some of my hard-earned information, which I am.  It's too bad about the limited attention spans of the modern age.  Try not to drift off.

I'll caution by saying that I'm really not trying to be preachy in anything that follows.  I have enough faith in modern medicine to believe that regardless of how they get the babies out, there's very little risk of actual death or serious injury either to mother or child.  Of course, that all depends on what you consider serious injury.  I think that things like the shredding of one's vaginal wall and incontinence are pretty serious, but what do I know. 

My bottom line is that I think that a woman should have control over her body and the method employed to get things out of it - and so, yes, I won't deny being a little ranty in reaction to the very real bias out there as to which way to go, and, for lack of anything else to base an opinion on, a little focussed on the long term consequences to one's body post-delivery.

My first phase of research involved trying to work the topics of birth and post-birth experiences into casual conversation with friends and acquaintances.  I don't know that many people with kids.  Of those that do, my questions were typically met by vacant blinking and what I presume was an assumption that I wasn't really expecting an answer to anything so personal.  I will not draw any conclusions from my limited data.  That would be biased.  But here's what I got from the eight people willing to talk.

Question 1 - how did the birth go?

One had a scheduled c-section (twins) and things pretty much went according to plan.

Four had vaginal deliveries.  One of them has done it four different times so for statistical purposes I should count this as seven different births.  The news there, no surprise, is that the process is excruciatingly painful and very undignified.  Only one very candid source volunteered further information, which was that she required so many stitches that they lost count, and the nurses of the ward all came to visit her after just to marvel at what she had endured.  Part of the reason for the unheard number of stitches was recounted to me in rhyme:  "from stem to stern is the splittage term."**

The remaining three had planned vaginal deliveries gone wrong.  All three, coincidentally, encountered the same problem, which was that each of their trusted OB-GYNs inaccurately measured the size of the fetus in proportion to their physical ability to pass them through their hips/birth canal.  After going through all of the torture of the first two stages of labour, they underwent emergency c-sections because their babies were too big for them to handle, and if not for the caesarean, both of them would have died.  In terms of how the procedure went from that point, I know that one of them had planned a natural delivery, and so was under no anaesthetic when they sliced open her abdomen and placed her internal organs on her belly so that they could access the uterus.  She could feel everything.  EVERYTHING.

Question 2:  What were the after-effects?

All eleven children are healthy and devloping normally.

One of the emergen-c ladies in question was really intent on the experience of the vaginal delivery, and was quite traumatized that it didn't go that way.  She's not morbidly depressed about it or anything, but it still upsets her 18 months later.

One of the others suffered damage to her abdominal wall during the surgery and is now incapable of crunches or sit ups. 

All women who had c-sections have surgical scars.  The incision is just under the top of the pubic hair line, so unless they're fully waxed, no one sees it.  Even if they are fully waxed, it's not as though their husbands are surprised or repulsed.  They know where it came from.

For the women who delivered via birth canal, one of them admitted to me sadly that her vagina just isn't the same.  She did not elaborate.  Another reported that it took some time, but eventually things tightened back up.  I only spoke to the husband of the woman who has had four vaginal deliveries.  He said that things were never the same after the first kid.  No significant change with subsequent.  He also mentioned that it's so long since he's experienced any other vagina that he doesn't really remember what they feel like pre-birthing and so no real loss there.  For him. We don't know what she's feeling.

Stem to Stern acknowledged that were she to have another baby, she would request a caesarean.

I tried to speak to many, many more than eight people about this when I began the interview process.  The trouble was that I unwisely jumped right into the question of whether the vag was ever the same after, and as previously mentioned, I typically didn't get a response at all.  Of those that did reply, I soon ascertained that I could not trust any of the information I was given.  Was anyone going to readily admit to me that ever since the birth it's like a hotdog down a hallway down there?  I suspect not.  I also suspect that it's physically impossible to do the number of Kegel exercises that would be required to restore things, but again, what do I know.

My next phase of research involved an attempt to find objective scientific data.  This proved difficult.  It turns out that my own attention span is a little lacking and so I'll save that for tomorrow.  Stay tuned for Science!

*For those that require the education, the three phases of labour are as follows.  1.  Early Labour.  onset of contractions that cause progressive changes in the cervix:  it effaces (thins out) and dilates.  2.  Transition.  The cervix dilates more rapidly and the contractions are longer, stronger and more frequent.   Transition ends with full dilation, also known as 10 cm.  3.  Pushing.  Expulsion.  I think self-explanatory.

**I know that's not really a rhyme in the strict sense of rhyming.  However, it contains both asonance and consonance, and that's good enough for me.

Wednesday, July 13, 2011

Hot as Balls

Everyone feels sorry for pregnant ladies during the summer.  What with all the extra weight they're carrying, plus oppressive high temperatures and poor air quality.  I thought of this earlier this evening as I hauled various heavy things around in 32 degree heat, imagining, of course, that I was sharing in their discomfort, in a manner of speaking.

This first crossed my mind as I made my way to the Beer Store to return some empties, which I towed behind me in a wheeled cart, like a hobo.  I should clarify that my thoughts were considerably more hobo-oriented than pregnant lady-oriented at this point.  I didn't go full hobo - it wasn't a grocery cart - but all the same.  I took my net profit of $5.60 and then empty wheeled cart down to the strip for some shopping, and returned home with a cart containing several amazing finds from Value Village, as well as a carton of some of the cheapest wine available at the Wine Store.  Hobo what?

Later on, the Chinese purveyor of my nearest laundromat ran out into traffic to help me with the startling amount of laundry I was carrying.  I told him I was okay, but he insisted.  There was a pregnant lady sitting on the doorstep who looked at me and said "looks like you're carrying quite a load there" as I followed my soiled clothing inside.  Huh.

When I sent Sara a text after to see how she was faring in the heatwave, her response was that indeed it was hot and that my apartment must be stifling, and did I want a window unit air conditioner that she and Chris had to spare.**

I may have to reconsider a number of aspects of my life in light of this evening.  If I can be compared to a hobo, and pregnant ladies are sorry for me both because of the weight of my laundry and because of the heat in my ghetto apartment, I am definitely making some bad choices.

*Hot as balls is an expression I'm fond of, but it makes no sense.  The whole point of dangling testicles is to ensure the lower than regular body temperature required for the production of sperm.

**The twins are still unevenly sized, and Sara is understandably preoccupied by the resulting back pain and the fact that she is being fitted for a specialized pregnancy belt tomorrow, which hopefully will take some of the pressure off.  Also, she has air conditioning.

Friday, July 8, 2011

Mythical Creatures

When I've had a few too many I develop what is known as "pirate eye", because I seem to lose all visual acuity in my right eye.  Which results, of course, in me squinting my right eye shut because it's useless anyway, and staring at things crazily with my left eye only.    In fairness to myself, I know that the vision in my right eye is significantly worse than the left, and neither are so good to begin with.  It stands to reason that the blurred vision associated with excessive drinking could render me effectively blind in my bad eye, hence, pirate eye.

I agreed to drink "The Kraken" spiced rum last weekend in order to amuse a number of people who felt it fitting because it somewhat resembles the name I am commonly known by ("The Granken", if that's not obvious).  Also, because the kraken are mythical scandivian sea creatures of monstrous size*, and I have, on occasion, also been referred to as a mythical creature.  When I got to the liquor store, however, and learned that The Kraken contains 47% alcohol, my mind travelled.  Rum?  Pirates?** Pirate eye?  I of course assumed that I was being set up for a very messy evening.  I am told I was being paranoid and pirate eye had not entered anyone's mind.*** Even so, I have to admit that I was apprehensive about the strength of the liquor and agreed to follow through only with a number of stipulations, as follows:

1.  Chris/Sara provide me with some mix.  I suggested coke (zero), ginger ale and ginger beer.  I encouraged Sara to be creative and throw in something else as she saw fit.

2.  Sara had to make my drinks as I tend to get more and more generous with my pours as things progress.  No one likes to slip into an alcoholic coma.

3.  At least one other person try some, too.

4.  Ensure that there was beer available so I could downshift in alcoholic content if I felt things starting to spin out of control.

5.  I leave any remaining rum at their house.  Having anything so toxic in my place could be dangerous, because I might get bored and drink it.

This is how it worked out:

1.  Sara's secret ingredient was Sunny Delight.  Which wasn't all bad.  I admit to a love of Sunny Delight.  Up until just now a secret love.  It's delicious!

2.  Sara made my drinks with glee.  No alcoholic coma for me.

3.  No one else tried The Kraken but I wasn't drinking alone, which is always a plus.

4. Sara's responsible service made the beer unnecessary.  I was in fine form - up until it was time to go home, when:

5.  I tried to take the bottle with me.  I was shut down.  To pacify me, I was sent away with a few ounces in an empty 7-Up bottle.  I freely admit that one of my favourite things to do when I get home after a night of drinking is to have one last drink to unwind.  And watch music videos on Youtube, which apparently is my new hobby.

*As it turns out, Chris and Sara's daughter is proving herself to be a sea creature of monstrous size.  She is a full half pound bigger than her brother, which may not seem like a lot, but when you're four and a quarter pounds and your brother is a mere three and three quarters, the half-pound difference is, well, monstrous.  I am not troubled by the sea creature comparison either, considering she is currently suspended in a pocket of salty amniotic fluid.  I know that Chris and Sara are fixed on her name being Molly.  I propose her middle name be Kraken in light of this situation.

**The birth certificate of the boy child will sooner than later prove his name to be Jack.  I have decided to make a personal project of teaching him to say "Why is the rum bottle always empty", in honour, of course, of Captain Jack Sparrow. If that phrase could be among his first words I would consider my time on this earth worthwhile.  It even makes sense considering fetus Jack was referred to as Johnny Depp long before his parents knew whether he was a boy or girl. 

***Sara suggested that I need not be worried about the strength of the liquor because I, myself, was already 47% alcohol.  Ahem.