Thursday, April 13, 2017

An Rh Sensitized Pregnancy (Part 4)

Just the other day, my baby received what will hopefully be her/his final blood transfusion before birth.

So. Worn. Out.

By now, you'd think I'd be an old hand at this. This was transfusion number three, after all. Five days after another procedure day, although that one was just a cordocentesis. Just. I swear, I could draw constellations on my belly and arms from all the needle marks right now. My poor arms, in particular, seem to finally be getting visibly tired of being pincushions; the blood draws from both of these most recent procedures have left bruises, and that's unusual for me. Bruises that are still faintly visible a week later. Normally, I handle blood draws like a champ. I've had a lot of them this pregnancy, after all.

Each one of these procedures is an all-day affair, with me arriving early for my ultrasound and blood draw #1 (there are always at least 2 blood draws, and 3 this time around), then spending hours waiting for the actual transfusion procedure. The wait usually has more to do with the blood bank than anything; when providing blood for an intrauterine transfusion, blood for a baby still in the womb, they do their homework and make sure the blood is the best possible match, the purest and cleanest available. Most days, as a result, the transfusion doesn't happen until after lunch.

In the meantime, I get to have an IV inserted (honestly, one of the worst parts; I cry every time) and spend some time on the fetal monitors. When I'm lucky, I only get monitored for 20 minutes. The last few appointments, I've been apparently having hardcore Braxton Hicks contractions. As in, very frequent, apparently pretty intense, although I have yet to actually feel a single one. Consequently, I've had the non-pleasure of spending hours on the fetal monitors. I've gone through several books, wasted more time scrolling Facebook than I care to admit, and played a ridiculous amount of phone games. All the while stuck in bed (is this what a standard hospital birth feels like?!?), wearing my hospital gowns (I always demand two, one for the front and one for the back), requiring permission for even the simple need to get up and go use the bathroom.

Oh, and because of those contractions, they've put me on magnesium sulfate for an hour or two leading up to the procedure, in the hopes of reducing the duration and frequency of them. Woooo, something else in the IV.

I really, really hate IVs.

Apparently, magnesium sulfate has no effect on me though. Because the contractions didn't stop, or even slow at all. It didn't make me sleepy, or light-headed, or overheated, or physically unstable; the nurses were quite surprised that I was, in fact, still capable of walking to the bathroom on my own (although they insisted someone accompany me). The only side effect I noticed was that my vein up above the IV kind of hurt while the magnesium was going in.

Also because of those contractions, I've had to consent to several cervical exams. They don't hurt so much as they're just awkward and uncomfortable, but I do understand their need to verify that I was not, in fact, in labor. Because I totally wasn't. Yes, I am ever so slightly dilated (good to know? Except I don't care, because cervical exams prior to labor tell me absolutely nothing about when labor will actually start, assuming it gets to start on its own. As the natural birth community reminds me, my cervix is not a crystal ball), but that's absolutely normal for being in my third trimester. I'm only half effaced, and baby is still very high up.

No other real signs of labor, anyway. Baby shows no more reaction to my Braxton Hicks contractions than I do. No decels. No discharge, no fluids leaking. Definitely not in labor, but I consented to the exams anyway. Like a number of other things in a high risk pregnancy like mine, this wasn't worth fighting about. I've got other, more important areas where I need to stand my ground.

And have I mentioned yet in this post that I'm not allowed to eat or drink in the hours leading up to the procedures? Yep, our old friend nil per os rears its ugly head. Sure, I can sneak a bit of water when nobody is looking, but once my water bottle is empty, I'm stuck. Sure, I can sneak a mid-morning snack (and yes, I totally usually do; research shows that aspiration during/after general anesthesia is relatively rare, and rarer still is it actually life-threatening... I'll take my chances, thank you very much), but there's no way I could get away with a full lunch. Even if I wanted to.

Anyway. The procedure itself usually takes about an hour. An hour on the table, being poked in the abdomen with needles. An hour of listening to the medical speak surrounding me. An hour of yoga breathing. An hour of keeping my eyes closed, even though the room is kept relatively dim so that the doctor can see the ultrasound screen. An hour of keeping the tension confined to my hands so that the rest of my body can stay loose. An hour of breathing in the essential oils I rubbed into my hands prior to the procedure (a blend of geranium, lavender, Roman chamomile, ylang ylang, and lemon, in case you're wondering), letting their scents keep me calm.

Then I get to spend a few hours in recovery, monitoring the baby's heartbeat as well as watching me for signs of premature labor. (After all, these procedures necessitate puncturing my uterus with a needle! No one would blame it for getting irritable.) Because my baby is so wiggly, they've had to give medicine to sedate her/him these last few times, which means that part of recovery is waiting for baby to wake up and start moving again. We already know by heartbeat that baby is fine, but the doctors want to know that there's movement, too. As do I, of course!

It's all for this little squish!

But now, hopefully, the transfusions are over. Done. Baby is tanked up with fresh blood and hopefully good to go for a few more weeks. We're down to the waiting game now. Soon enough, this baby will be earthside and all of this--the stress, the appointments, the blood work, the unpleasant procedures--will have been worth it. We're counting down the days.

No one is counting down more fervently than I.

***

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Wednesday, April 12, 2017

Review: The 4X4 Diet

Personal trainer Erin Oprea never set out to create a “diet” program or write a book, and she certainly never thought she’d have devoted celebrity clients.

But there’s a reason for her popularity. She helps clients–and now readers–develop a clean eating style using just four principles, and her simple workouts make exercise both fun and effective.

In The 4X4 Diet, Oprea lays out the basic principles that she uses to keep herself and her family fit, and which also keep her clients coming back for more. The book is separated into four sections. The first is a part introduction, part motivation. The second details Oprea’s rules for eating clean: no starchy carbs at night, less sugar, less salt, and less alcohol. These four rules are accompanied by explanations of why they’re necessary, and readers will appreciate Oprea’s straightforward and simple reasoning. She also provides a list of necessary kitchen items and a number of recipes that will help readers get started with healthier eating right away.

The third part focuses on the workouts. Oprea’s workout of choice is the tabata, which is essentially a mini-workout made up high-intensity exercises alternated with short rest periods. String a few of these together and the result is a workout that is still relatively short (following her advice means working out for less than 30 minutes) but surprisingly effective. Oprea provides three levels of tabatas, with numerous examples of each level; there are detailed instructions on how to do the moves, making them accessible even to fitness newbies, and there are plenty of pictures.

Part four puts it all together into an actual diet plan, although Oprea is quick to remind readers that this is a lifestyle change, not a temporary “diet.”
“All of this can be done in just four weeks. Each week, you’ll incorporate a new clean eating habit and slightly more challenging tabatas. And each week, you’ll feel cleaner, leaner, healthier, and stronger. That momentum will keep you going not just for four weeks straight but for the rest of your life.”
There are pros and cons to this book. Readers will love her simple rules, as well as the fact that she embraces “cheat” meals. At the same time, the meal ideas she offers are pretty heavy on eggs and meat, so readers who dislike those foods, or who choose not to eat them for other reasons, may find themselves struggling with how to make it work for them. Her rules are good ones, though, and a clean diet like hers could very well aid in weight loss, so long as readers actually stick with it over time (and minimize those “cheat” meals). The workouts are extremely challenging, and some readers will love jumping right in, while others might have a hard time staying motivated. It’s wonderful that she only uses very basic equipment; readers can either work out at home and have to buy only a few things, or do the workouts at their nearest gym.

Overall, the book is quite short, which will help those interested get started with their new lifestyle right away; a large chunk is devoted to the individual tabatas, which don’t all need to be read through before beginning the program.

For those who need help improving their diet in small ways and who want a simple–but challenging–workout plan to get started with, The 4X4 Diet is a great resource.

*****

I received this book from Blogging for Books in exchange for an honest review. The opinions expressed within are completely my own.

Thursday, April 6, 2017

Review: Boobin' All Day... Boobin' All Night

Every new mom has been there.

Baby sleep. That thorny, difficult issue.

We all want to know how to help our babies sleep longer. More. We want to know the best ways to soothe. We want to know the best place for baby to sleep. We want reassurance that nighttime waking is okay, and that we’re handling it correctly. Should we be night weaning? Sleep training? How much sleep is enough?

We want to know that our baby is, in fact, normal.

Meg Nagle, renowned IBCLC (lactation consultant) and blogger at The Milk Meg, is here to provide that much-needed reassurance. Her book, Boobin’ All Day… Boobin’ All Night is a short, sweet bit of sanity in a world that has way too many sleep trainers and baby whisperers.

This is not the bestest, most complete book on baby sleep ever. (My suggestion for that would be The Gentle Sleep Book by Sarah Ockwell-Smith. More complete, yes, but also a much longer read. It’s worth it, but don’t say you weren’t warned.)

Boobin’ All Day… Boobin’ All Night is a relatively short book, ideal for the sleep-deprived parent who just needs help NOW. Meg covers the essentials. She helps parents understand why it’s completely normal for breastfed babies and toddlers to wake up so much. She talks about why breastfeeding–or boobin’, as she prefers to call it–is often the most surefire way to soothe said baby or toddler, and how breastfeeding to sleep is absolutely not a bad habit. She talks about co-sleeping and bedsharing, and offers guidelines on how to bring baby into your bed–safely–so that everyone can get more sleep. She talks about how routines can work while nursing on-demand, caffeine, the breastfeeding-at-night-causes-cavities myth, and more. She has a relatively in-depth chapter all about night-weaning, for when it’s truly the best option or when it’s simply the right time. She provides all kinds of ideas and methods, tips and tricks that might help parents out with whatever challenge they happen to be facing at any given moment.

Through it all, Meg offers personal anecdotes, warmth, humor, adorable pictures, and plenty of encouragement, which we all need sometimes. Meg has a lot of experience with breastfeeding, both as a lactation consultant and as a mother, and her experience shines through in this lovely little book.
Feel confident in mothering through breastfeeding and cuddling during the day and at night, just as nature intended.

*****

I have been in no way compensated for this review. The opinions expressed within are completely my own.

Tuesday, March 21, 2017

Review: Birth Work As Care Work

These days, more and more pregnant people are starting to spend time researching birth before actually giving birth. They’re researching where they’ll give birth, who their care providers will be, who their support team will consist of.

And yet, as a society we still have a long way to go. A long, long way.

It’s easy for those of us who benefit from societal privileges to be completely blind to the advantages we have. It’s easy to forget that some birth givers don’t have access to the “good” hospitals because of location, insurance, or financial means. For some pregnant people, a higher risk of unwanted interventions or unnecessary surgery is unavoidable. For some, home birth is not an option. For some, hiring a doula is either impractical or impossible. For some, prejudice is faced at every turn due to skin color or gender identity.

For some, it’s a blessing simply to be able to give birth without being chained to the bed.

There are many issues that those who perform birth work need to be concerned with. Midwives, doulas, and childbirth educators are always learning, always reading. A new book to add to the “to read” pile is Alana Apfel‘s Birth Work as Care Work: Stories from Activist Birth Communities.
This anthology delves into a lot of sensitive ideas that are not often discussed in more mainstream birth communities, although there are certainly individuals and groups out there that are working in these areas.
“Ultimately the anthology is conceived as a platform through which to honor birth–in all its forms–as itself a profoundly radical act that holds the potential for deep transformative change.”
For example, many sections discuss the idea of white privilege with regards to birth, although those aren’t the exact words used. But there are discussions about how birth is experienced by racial minorities, and how marginalized groups have less options and less choice, and often face a certain amount of judgment simply for who they are. In addition, these people must sometimes deal with more affluent birth workers–because birth work often tends to draw in white, wealthier women–and the stigma of being “saved.”
“One such problematic narrative relates to the language of ‘choice’ within modern maternity care. The danger of celebrating the rise of choice within transactional birthing environments lies in masking ongoing forms of coercion that result in a denial of choice for marginalized communities and those with less access to the kinds of choice-making power enjoyed by more privileged counterparts.”
Also discussed is how birth is shaped by a person’s gender identity. Sure, plenty of white, hetero, cisgendered women give birth every day, but that doesn’t mean that birth is restricted only to straight women or even to those who identify as women. This book is sure to get readers thinking about ideas that some may have never encountered before.

And of course, Birth Work as Care Work talks about some of the issues that are widely known about among birth workers of all stripes, such as how the institutionalized medical model of care affects birth outcomes, the value of midwives, our society’s implicit (but not always well-deserved) trust in medical professionals.
“People see their doctors as authorities with complete control over their bodies and their babies–to the extent that they expect to be raped. The word rape might sound extreme, but I am quick to point out that when someone does something to your genitals without your consent, that is rape.”
Readers will get an overview of some basic herbal medicine–just a discussion of herbs, but no recipes–because of the importance of reclaiming medicine for ourselves. There is also a wonderful, straightforward glossary: the “Political Dictionary.” This gives readers an easy understanding of some terms they may be less familiar with, which makes this book even more accessible to everyone.

There are discussions of how doulas can serve different kinds of pregnant people, and readers will learn about groups they may not have heard about before: volunteer doulas, prison doulas, doula training programs, doulas that work in areas of reproductive health not normally associated with doulas at all (like abortion or adoption).

There are also a number of birth stories, which readers will love. Birth is beautiful, and these stories celebrate it in all of its messy, myriad forms. This is the kind of birth the author and others are fighting for, and readers will enjoy getting to experience it up close.

Overall, Birth Work as Care Work is a book that will leave readers thinking and questioning, and perhaps wanting to get involved (if they’re not already). This is a fascinating and thoughtful collection of stories, questions, and essays, and a book that any birth worker would benefit from picking up.
“Transformation happens when we come together and meet each other where we actually are, not where others perceive us to be.”

*****

I received this book from the publisher, PM Press, in exchange for an honest review. The opinions expressed within are completely my own.