21w 4d

I've always maintained that some people have friends and some people have blogs. Very few are able to combine those two factors of a life, unless they have online friends like I'm blessed to have.

I try to shower every day and get out of the house at least once, but I'm struggling to find free activities and I'm trying not to spend any money. I thought I had an intake appointment at an intensive outpatient therapy program tomorrow, but they moved it back a week because the program is full. So I have all these spaced out appointments for the next two weeks that leads to a series of other appointments every two weeks from here until birth.

My Dad has been retired for two years and he keeps telling me that it gets better: you can transition to being at home and find reasons to get out of bed every day. I have good days and not-so-good days. On the good days this feels relaxing and I feel productive. I clean and cook and manage to keep enough food in my stomach so I don't get sick. On the not-so-good-days, the anxiety I feel about walking away from my career is overwhelming. Rationally, I know there is a long history of women (and even men) that have taken medical leaves to take care of themselves and have gone back to their careers to be successful and fulfilled. These people probably weren't financial advisors. I've spent months building relationships with people and I just walked away. People in the office are covering for me and that helps ease the anxiety, but it also adds to the guilt because it just adds to their workload while I'm at home going to medical appointments.

What's been the most surprising about this pregnancy is how much pain and discomfort I have. I'm only in my second trimester and according to pregnancy books, I should be feeling great. Morning sickness to my back and cankles to look forward to. I have round ligament pain down low in my uterus and sharp, stabbing pain in my port. I'm supposed to see a neurologist soon regarding the day/week long headaches that I can't seem to get a handle on. I don't know. I just feel sick. Then I get sad. Then I don't want to leave my bed. Then I feel worse. It's just a cycle. Every day, I try and break the cycle. Every day, I try to drink water and eat a piece of fruit.

I don't have a pithy conclusion. I'm just struggling and I know that some days are better than others.

21w 2d (Medical Leave)

I'm on Day 5 of medical leave and I think I'm failing horribly at it. My one job in this world during the day (assuming the big one is at school and the dog and cats are self-sufficient) is to take care of myself and stay healthy and that's just a big task. I decided on Friday to stop taking Adderoll. I started taking it, I don't know, maybe four years ago when I was falling asleep while driving to work and then falling asleep at work and I maybe (just maybe) falling asleep while doing something productive human beings do - like raise their kids or get out of bed. My shrink told me it was a wee little dose, just 20 mg of amphetamine salt. Turns out others don't think that's such a small dose and assured me that Adderoll would surely start riddling my brains with holes.

Then I got pregnant and every, single, medical professional I talked to would start out the conversation on medication with something along the lines of, "Oh, but you've already started getting off Adderoll, right?" or my favorite presumptive question, "When did you stop taking Adderoll? I see it still listed on your chart." I would sigh and say that I hadn't stopped taking it because going to work without it made me tired, listless, and generally unfocused. I had to work. I had to make money. Hence, I took the Adderoll.

Then suddenly my world turned upside down and now my need to work has been trumped by my need to stay out of the hospital (which I failed on Sunday. Three day headache, hysterical crying, vomiting - four hour stay in the ER. The Emergency Doc took one look at me and decided that clearly I needed sleep - it was 4am - more than I needed to participate in an anatomy ultrasound. He prescribed IV Bendryl, which might as well be called "Look, I'm going to need you to go to sleep now and stop crying. You're scaring the homeless guy. Also, if you could stop vomiting, that would be great. We're running out of bags"). I stopped taking Adderoll the first day I didn't go into work and I remembered all the side effects of amphetamines. The primary one is euphoria. The secondary one is...I don't know...the ability to stay awake for more than 20 minutes at a time?

Suddenly I feel like those stories you hear about people retiring at age 70 and then dying three months later because they couldn't get out of bed. I bet they were taking Adderoll. I'm sad, apathetic, I don't want to take care of myself, and all I want to do is sleep, which I do in great, unproductive quantities. I just want to lie in bed and feel the baby move (20w 5d - that's how long it took before I finally felt this kid) and sleep.

I saw the Maternal Fetal Psychiatrist yesterday and she said something along the lines of, "Are you sure that Adderoll wasn't helping you manage your depression?" and I was like, "Um, I don't think so. I know it was inhibiting my ability to nap, but now that you mention it, I could use a little euphoria." She generally supports me getting off of it, but it's like jumping off a cliff. Also since I can't get within 20ft of a doctor without them prescribing me something, she prescribed two other depression meds. I haven't started them yet because of some problem at the pharmacy. That's something I'll have to figure out after my next nap. I did like that one of my drugs is folate for my brain. Apparently folate doesn't usually cross the body/brain barrier and she thinks my brain could use a little folate. That's sweet, right? I feel like that's up there with the theory that massive quantities of Vitamin C can cure depression. I have done every other synthetic, I might as well go all homeopathic now.

My main problem is that I don't want to feed myself three - or five - times a day. That seems like a lot of work. Then I don't eat and I get sick, which kind of defeats the purpose of being on medical leave. Short of keeping a refrigerator next to my bed, does anyone have any suggestions on creative ways to ingest food that I can work around my napping schedule?

20w 5d (Not that Kind of Hospitalization)

So I was hospitalized, but not for what you might be thinking. KGII and I went to my Ob Gyn appointment and on the way there, I started experience severe abdominal pain. Seriously, if someone told me that preterm labor felt like that, I would have understood. I had to take breaks walking into the doctor's office and breathe through my mouth. My Ob Gyn looked at me, felt around my uterus, and immediately sent me upstairs to the triage area of the hospital.

Everything hurt, but one spot in particular was hurting more than the others. It happens to be exactly where my appendix is. It also happens to be the exact spot that lap band port rests under my skin. Unfortunately, to rule out appendicitis, I had to fast for hours on end in case I needed surgery. They hooked me up to an IV of saline so I didn't die, but making a pregnant woman fast is just asking for nausea and morning sickness. They finally got me in for a CT scan. When I told my sister that (Aunt Jen, soon to be Dr. Jen) she immediately asked, "How did they shield the baby?" and I was like, "Um, they didn't". So yeah. I irradiated the baby after being pumped with contrast fluid in three different places (don't ask, you don't want to know, but I felt violated afterwards). Good news - I wasn't constipated when they finished that bullshit.

My scan came back and showed no inflammation and no fluid build up. The on call Ob Gyn called my bariatric surgeon and asked about symptoms of a gastric band port infection and it didn't look like I had that either. The pain had started receding in other areas of my uterus and just localized on the port. Finally, I was given some food and some pain medication. That was the best damn hospital food I've ever eaten after fasting allllllll day. The narcotics were nice as well.

The on call doc talked to my regular Ob Gyn and I was deemed "Not a physical pain complainer" ( !!!which made me laugh because I have been hospitalized three times in two weeks due to pain and/or inability to keep down liquids) and was told that since I was still in pain that they wanted to keep me overnight for observation. I was moved, finally, out of the triage room with the very uncomfortable gurney to the Woman's Suite with the Temperpedic mattress. So nice.

KGII got his futon cushions all ready and we settled down to sleep at 8:30pm after asking for my night medication at 8pm. You know - the medication I take every night to keep me sane and help me fall asleep. The medication that I'm addicted to and could no way fall asleep in a hospital without. I was told that the pharmacy didn't have my medication, but they were working on it.  The hospital I go to is brand new, state-of-the-art facility that is managed by a children's hospital. The children's hospital doesn't stock all the adult medication, particularly for depression and anxiety, particularly if it doesn't relate to labor or fetal care. At 11:30pm, I started begging them to just give me anything they had so I could fall asleep. I'm not proud, but I threw a hissy fit and asked to speak to the on-call doctor. I wanted to leave, so I could go home and take my medication, and fall asleep. She convinced me to stay since I didn't want to leave against medical advice and 20 minutes later my exact medication showed up.

The next morning, I felt fine. No more pain and I asked to speak to the Maternal Fetal Psychiatrist before I was discharged. She came into my room and we had a good talk. I had planned to go on medical leave in a couple of weeks, but after this recent hospitalization, both she and my Ob Gyn requested that I go on immediate leave. I went into work the next day and gave them the news. It was an incredibly stressful, overwhelming, and panicked day. I have one day on medical leave (Friday) under my belt and I can honestly say I have no idea what to do with myself besides go to medical appointments. That's not hard to do since I have So Many Appointments.

The Maternal Fetal Psychiatrist wants me to go to an Intensive Outpatient Program and I'm looking around for the right one. I've also started cooking and even cleaned a little on Friday. It was a big day. More to come.

20w 0d (Ante Partum)

It's very hard to tell the difference between depression and pregnancy hormones. Both can make you cry hysterically and both makes me not want to get out of bed for days on end. It's just something has changed recently. Ever since I started thinking about taking medical leave, I've realized how truly depressed I am.

I thought it was because I was so sick in my first trimester. I would go to work, come home, clutch my stomach, lie in bed, and go to sleep. Rinse and repeat. Then my first trimester turned into my second trimester and things got a little better, even as the nausea turned into morning vomit sessions. I'm 20 weeks and I still take Zofran on a regular basis. It's just...I don't get out of bed. I'm as close to being on bed rest as someone who holds down a full time job can be. When I get home from work, the first thing I do is get into bed (sometimes after taking a bath). I parent from bed, I eat in bed, I fall asleep insanely early in bed. If Zac wants to spend time with me, he comes into my bed room and I feel unbelievably guilty about that.

I've completely isolated myself from anyone who doesn't want to text with me from my bed. Even on days when I don't feel like complete crap, I stay in bed. KGII asks if I want to go out on a Friday or Saturday night and I can feel myself looking at him like he was just taken over by a band of roving aliens. I'd rather be eaten by cockroaches than to be outside of the house and get sick, especially if I'm sick and can't leave. It's created this kind of social anxiety. It's so much easier to stay in my nice, safe bed where I have cats for company and endless paper back novels to read.

I reached out for help today and the hard part about having my history is that you can never encounter just a little bit of help. The first two things that were suggested to me were partial or full hospitalization. Only when I balked at that did they talk about finding a therapist. The hardest part, for me, about starting with a new therapist is having to cover all the crap that came before. The previous hospitalizations and the times when I felt I didn't matter. It's so much crap that it keeps me from getting the help I need, plus I have an inherent distrust of strangers that ask a lot of questions. Bonding with therapists has been a definite issue within the past two years.

So I'm back in bed. This time my adopted (gassy) cat is here with me and I'm praying he doesn't start pooping under the bed again. I see my Ob Gyn and a Maternal Fetal Psychiatrist tomorrow. If you don't hear from me for a little while, just know that I lost the hospitalization debate and I'll be back soon. I've been sicker before and I've survived more. This is just a hard patch and eventually it will get better. That's what I tell myself when the crying jags start. It will get better. It just takes time.

19w 5d

I'm not sure where to start this blog post. I made a commitment to blog my way through this pregnancy so I could look back on these posts and remember what I was thinking and going through at the time, like I can with Zac's pregnancy now. It's just...I'm so scared and defensive about my decisions that's it's hard to write about.

One of the things that some people find difficult about my job is that I can't tell them what's right and wrong. I joke that if I had a crystal ball, Warren Buffet would be calling me for advice from my beach island. So since I don't have a crystal ball, I have to try and explain all the risks to my clients about their investments without scaring the crap out of them. I had a high risk Maternal and Fetal Medicine (MFM) Specialist on Monday try and explain all the risks of my conditions to me and, unlike finance, doctors don't really care if they scare the crap out of you. I think that's part of their job description to avoid malpractice law suits.

I had just had my 20 week anatomy ultrasound, where I found out that I'm having a boy.

I'll devote another whole post to my feelings about being a Mom to two boys (especially after I convinced myself that I was having a girl), but back to the MFM doc. After my 24-hour urine collection, they found 150 something something something of protein in my urine. That indicates high kidney function, which MFM speculates that when I was obese I damaged my kidneys a bit, but that's just a working theory. I also have blood pressure in the 135/90 - 145/95 range, which is considered hypertension. You put those two factors together: hypertension and protein in the urine and you get preeclampsia. According to the doc, conservative care for preeclampsia involves bed rest. Aggressive care involves taking the baby out early. Suddenly I went from having a 40-week pregnancy to a, "We'll let you know when the baby presents too much danger to your health and take him them" pregnancy, hopefully that's somewhere between 34-37 weeks.

Then there was the whole, "We don't think your depression and anxiety are being adequately controlled and you are extremely high risk for post parturm depression" discussion that doesn't seem to ever go anywhere. I already go to 2-3 doctor appointments a week, and I was trying at least to maintain and grow my business, but now I'm supposed to go see a therapist once a week and see my shrink once a month (I currently only see him every three months)?

I'm just overwhelmed and beaten down. I felt numb when the MFM doc was throwing everything at me and about two hours (and two meetings later) I just started to sob. Take my baby early? Premature baby in NICU? I can't even feel the baby move yet. It's not time. Cue ridiculous pregnancy hormones that allow me to escalate every fear into a full blown panic attack and you have the perfect storm for me sobbing while trying to drive home.

A mere three days later, I go to the eye doctor. They wanted me to follow up with her after the headaches from the hospital and it turned out that I needed a new prescription. I'm nearsighted and my prescription was -3.75, but every time my eye doc kept holding one of those glass pieces up in front of me, it was so strong that I felt sick to my stomach. She finally settled on a prescription of -2.25. She kindly took the eye thingy away from my face and had a said that only two things can cause such a dramatic shift (for the better no less) in a prescription in someone my age: cataracts and diabetes. She said I didn't have cataracts and she wanted me to be tested immediately for gestational diabetes.

Cue more sobbing. I managed to get into see my Ob-Gyn that afternoon and held down that glucose drink for exactly 61 minutes (did I mention that sugar makes me throw up?). I lost the contents of my stomach at the exact moment that they were withdrawing the vial of blood from my arm. Score! I didn't have to retake the test. I just felt like crap for the rest of the night. The results came back the next day. My glucose level was 121 and anything over 130 is diabetic. Doc said I was fine and that we'd retest between 24 and 28 weeks. The problem is that I don't feel fine. The symptoms for diabetes help explain a lot of my previously unexplained symptoms: fatigue, uncontrolled infections, headaches, increased urination, and thirst, but I'm not actually considered diabetic at this very moment.

I'm completely overwhelmed and I feel like my coping mechanisms are starting to fail. I cry a lot. I'm scared a lot. I try to be very still to see if I can feel any movement inside me (I can't) and I take a lot of naps and try not to think about the future.

18w 6d

Pregnancy is just weird. Weird things happen to your body and you end up having weird medical treatment for weird symptoms.

On Monday, I went to the ER because I was thirsty and couldn't keep down liquids. Two IVs full of fluid, one blessed dose of IV Zofran (why do they not sell that stuff in IV form??), and five hours later, I was feeling much better. Except...a headache started the next day...and every day after that. It would hurt extremely bad right when I woke up, hurt even more when I stood up or sat up, and then felt better when I lied down. By Thursday, I was remembering that my blood pressure at the ER had spiked to 138/90 and now I was on day 3 1/2 of a brutal headache. I called my Ob Gyn's nurse and she consulted with my Ob Gyn and recommended that I come in immediately for admitting to check on the baby.

Here's the wrinkle. I go to a brand new, state-of-the art maternal fetal center with a hospital attached. A hospital that exclusively serves women and their babies. That's great if you are having a pregnancy problem or are ready to give birth. It's particularly awful if you are, instead, having a pregnancy - INDUCED problem that has nothing to do with a uterus.

KGII and I got the hospital around 6pm on Thursday and were whisked away into triage. There my blood pressure was taken and it was 116/60, no joke. They checked the baby's heart tones and they were beating away at a perfectly normal 150-160/beats per minute. I seemed to be perfectly healthy, except for the excruciating head ache.

I was asked if I got migraines (no), if I had changed any of my medication (no) or if I had been particularly stressed at work (always a little stressed, not really a lot of stress..so no). I was seen by a very soft-spoken Maternal and Fetal specialist and she ordered a MRI/MRA/MRB for my head and a Neurology consult. The problem was...I wasn't in a multi-speciality hospital that could do that at night. I had to wait until the morning, which is how I ended up spending the night at the hospital, even though I had reasonable blood pressure, good baby heart sounds, and no IV. They gave me Tylenol with caffeine every four hours, which was actually helping my headache.

The next day, my regular Ob Gyn came to visit me, which is why I love going to her practice that is connected to the hospital, and I had my MRI tests. They all came back normal. No problems, no blood clots in my brain, no enlarged retinas, nothing of any sort. Then around 2pm, the Neurology team came in and said rather than having a high spinal pressure headache (like I had with pseudo tumor cerebri) it sounded like I was having a LOW pressure headache. The only way to be sure was to do a lumbar punch, which could actually make the problem worse. The one catch? The team didn't know who or where would do the lumbar punch in the maternal hospital.

Finally, since they didn't know what to do with me, they sent me home with the Tylenol/Caffeine medication, told me to lie down as much as possible, drink fluids, and hope to god I didn't have a leak in my spinal cord. Maybe the problem would resolve itself they reasoned? (Caffeine actually increases spinal fluid pressure, which is why people who suddenly stop drinking caffeine will get headaches because of a drop in pressure). I was also sent home a large jug, a plastic cup that fits on the toilet, and a bucket. I was told to collect my urine for 24 hours and bring back the jug o' urine on Monday when I go in for my 20 week ultrasound and a second Maternal and Fetal Medicine consult.

So that's been my weekend. I lie down, I collect my urine, I try not to get sick to my stomach. It's loads of fun over here

17w 3d

It's weird that this time around I can tell you almost to the day when I became visibly pregnant. It was right at the cusp of 16/17 weeks. I thought I had been doing a fairly decent job of not growing an enormous belly and I remember thinking that I was small last time in comparison to the other belly shots I saw, then I just popped out. Of the last three prospect meetings I've had, all of the people sitting across the table from me have asked me if I was pregnant. I don't try and deny it (because that would be silly in maternity clothes and dishonest) so instead I launch into a monologue about what will happen to my accounts when I'm out on maternity leave and the great support I have.

Now, I'm strictly forbidden to talk about the securities industry or divulge any proprietary secrets about my work life, but I think it's reasonable to talk about how I feel about my work (something that I've done very little of on here or in any other social media).

Basically, my job is to contact people, get meetings with people, and close accounts. The more people I talk to in one day, the better. Like today, I called 300 people and spoke to 100 of them. My voice was literally raw at the end of the day from talking so much. Fortunately, my voice does not give away my pregnancy, which is why I see a look of surprise lately in people's eyes when they meet me for the first time. And this is Texas. Everyone wants to know intimate details of my pregnancy, including how I handled my first trimester, what the future big brother thinks of my pregnancy, and if I'm currently too tired to meet with them. All this at barely 4.5 months pregnant.

My pregnancy feels like a distraction for people. Like, "How can we talk about money when you are gestating a human being in front of me?!?" Sometimes I can overcome the questions and manage to pull the topic back to where it needs to be and I like to think that we both blissfully forget I'm pregnant for an hour. Those are the good meetings. The not-so-good meetings are the ones where the women want to commiserate with me and their husbands look bored.

I'm just so scared about how I will handle my job as I get bigger and my pregnancy becomes more pronounced. Well, not so much scared about how I'll handle the job, but more scared about how people will handle me trying to do my job. I've tried to talk to some male coworkers in the office that I'm close to, but they've never been pregnant themselves. They think it's no big deal and I'm making a mountain out of a molehill. I'm a natural introvert (hello writing instead of, I don't know, actually talking to someone) so it's challenging for me on the best days to engage with strangers. Now imagine being X months pregnant, feeling huge in your own body, and trying to meet the same strangers. What's even more challenging is there are no female role models for me to talk to. Most of the female advisors I know in other offices either don't have children or had already had them when they started their career.

What's hard is that I can't predict the future. I can't know how big I'll get or if my blood pressure will spike, leaving me on bed rest. I can only remember the past. I remember how distracting it was for me to be in a meeting with baby Zac kicking the crap out of me, even though I was in a completely different industry. I remember how much I waddled and how I got so big that people on the street would say things, "Any day now Mama!" and "Not too much longer now" when I was only seven months pregnant. Some days I'm just scared.