Breakdown

It happened. I had my first official breakdown this morning, in my OBs office. Yup. That was me. The crazy lady crying in front of a stunned OB. This breakdown was several days in the making, and as KG said when I called him after the appointment, "It just sounds like you had a cry inside you needed to let out." Apparently so. This is a long one, so get comfortable.

Let's back up.

Over the last week, I have been feeling tremendous pressure about finding child care for The Nugget. I had 3 people in the span of as many days ask me the dreaded question, "Have you looked into child care yet?" Cue. Panic. Even though, to me, it sounds totally insane to look at day care when you are 15 weeks pregnant, apparently in Boston it is totally necessary. I started googling, talking to friends, and making some phone calls. Indeed, several places said that now is the time to look for September 2013. Yup, over a year in advance. So, I made some appointments to visit a few places in our area. Oh, and guess what else? You need to be ready to cough up nearly as much money per month as our rent for full time infant care. Again, cue panic. Since staying home is not an option for me (or KG) this is the reality. We'll just have to suck it up and eat ramen for a while.

So there's that.

I'll preface the next bit by saying I am a person who likes direct instruction. Don't make me guess what I should do. Just tell me exactly the right thing to do and when to do it. I follow directions like a champ. Teachers tended to love me for this reason. I generally did exactly what they asked, in order to get a good grade. Open ended assignments? That's another story.

On to today's appointment.

I saw the OB we met last month. Again, she was a bit late (30 mins) but was warm and friendly. All started well, with my uterus measuring just right and The Nugget's heartbeat sounding loud and strong. She said my blood pressure was "on the high end of normal" but that might have been from feeling annoyed that she ran 30 minutes late. Anyway, she told me not to worry about it (then why tell me?). Then, she asked if I had questions. She didn't know what she was in for.

I started off by asking about why my ovaries are still quite large from IVF (they mentioned it at the NT Scan). She kind of brushed it off saying it would go away after the baby and they wouldn't do anything about it now. I'm okay with that I guess, but it did leave me wondering.

Then I asked about exercise. How much should I be doing? For how long? Again, I felt like I got vague answers. It started out okay. She said I should be exercising every day (holy shit!). Then, I got the standard, "Don't do anything that makes you uncomfortable, breathless, too hot, etc." Okay, that's all fine. But, when I pushed her to tell me how long each day, etc. I got, "Whatever feels right." If I knew what felt right, I wouldn't be asking. It feels awfully right to sit and watch Real Housewives instead of going to the gym.

Next, was the heaviest topic. I've written before about the fact that I am on prescription medication for anxiety and depression. I am on very low doses and have consulted my psychiatrist and two years ago (when we began TTC) I even went to a special clinic that deals exclusively with pregnancy and psychiatric medication. At the time, everyone recommended I stay on my medication, even though they are Class C, because the risk of having a depressive or panic episode was overwhelmingly likely, especially postpartum. The research generally shows that the risk to me outweighs the risk to the baby and that the chemicals that the body of a depressed mother releases can be more damaging to the baby than the meds. They also said the amount passed through breastmilk is less than through the placenta, so it shouldn't be a problem. But, I wanted to make sure this OB is on board and that breastfeeding will not be an issue at the hospital. Now, I know this is a complicated issue and honestly the research sucks in this area because they aren't randomized studies. It may not be a clear cut issue at all. But again, instead of giving me a straight recommendation, she wants me to meet again with the clinic. I asked if she has other patients with this issue (she does - many) but she said it is all dependent on individual circumstances, etc. This is all true. But FUCK, I just wanted her opinion and she just wouldn't give it to me.

Then, it happened. I broke down in tears. I didn't see it coming and still don't really know why I went over the edge. She was stunned and thrown by my reaction, as was I. She babbled a bit and I agreed to make the call to the clinic.

Lastly, I decided to press my luck and ask about nutrition advice. Are there specific food groups I should be focusing on more than others? Protein? Calcium? I have all the books with some of this info, but I wanted to know from her experience if she considers some things more important than others. What did she say? I should go see the nutritionist. Another appointment. Another question unanswered. I think I'll just make a greater effort with leafy greens.

Did I mention I am meeting tomorrow with an endocrinologist because she didn't want to tell me when to go off Metformin (for PCOS, not insulin issues) without his opinion?

No one tells you how scary all this pregnancy stuff is. The thing is, I am petrified that I'll do something wrong with this pregnancy, that I'll personally make a choice that will harm this baby. And it seems that with so many of these pregnancy-related things, there is no one right answer. There is only making "comfortable" choices or doing what "feels right." Apparently this is true from everything from choosing a car seat to the question of getting an epidural. For someone like me, that is just about the worst thing I can hear. How the hell do I know what's right if I've never done this before?

Are all OBs like this? Do they all refer you out for tough questions? Are they only good for listening to a doppler and measuring your uterus?

Hell, I have a doppler at home...

By the way, today didn't start off like this. It's actually a really happy day: KG and I have been married for 7 years as of noon today. We are going to a fab restaurant to celebrate later and shake off this mood. Happy Anniversary, KG. You are the best partner to this batshit crazy lady I could ever ask for.

Waiting Room

Apparently, I'm going to be spending a lot of time in my OB's waiting room.

First, the good news: Overall, I liked the doctor. She was warm and friendly. We got to hear the heartbeat on a doppler at 10 weeks 3 days. 155 bpm. She warned us it might take a while to find it, but then it was there right away. Music to our ears. Now of course I want to get a doppler for home use. I'm still debating about that. KG is convinced I'll use it every day if we get one. But, I think I could agree to only do it with him once or twice per week. Thoughts on home doppler use anyone?

We also scheduled the early and second semester integrated screening (NT Scan and the 18w scan). I see the doctor again in a month.We went over a lot of my records, talked about some vaccines His Royal Fabulousness and I need, got a breast exam and a vaginal culture, checked my cervix and uterus, tested protein and sugar in my urine, and discussed some additional genetic testing for Ashkenazi Jewish background that I haven't had. I only had the basic 4 tests for that, and now there are like 20. I need to call my medical insurance to see if those tests are covered. We also talked about my risk for PPD (higher because of my history of depression and anxiety). She supported the rec to stay on my medications for that and said overall everything looked perfect.

The bad news: It was quite the ordeal in the OB's office yesterday. We had a 3:00 appointment and she didn't walk in the room until 3:45. She also quickly saw another patient (one who had come late because she got her appt. time wrong) in the middle of our appointment. She seemed a bit scattered, but I think that might have been because she was running so, so late. I didn't end up getting out of there until 5. I was a little pissed off and even more so when she failed to call me last night with instructions about stopping my progesterone and Metformin. She said she wanted a bit of time to review my chart more before giving me instructions and that she would call after office hours. No call. Sigh. I guess I'll call Monday morning. Do you think this is a bad sign about her reliability, or just a bad day? She comes SO HIGHLY RECOMMENDED.

So, I guess this baby is deciding to stick. KG said I looked genuinely shocked when we heard the heartbeat. That's both amusing and sad to me. I'm still working on my promise to think positively, but I'm making headway. My mom and I have been discussing timing for a baby shower in Los Angeles, which makes me happy. I've started to allow myself to look ahead, make plans, and get a little excited. Bit by bit.

This week was a good one: I turned 32, went to a Red Sox game on free tickets, said goodbye to my students for the summer, and heard the sweet sound of my baby's ticker. All in all, not bad.

Enjoy listening to Fugazi's "Waiting Room." Bonus points to anyone who can sing along.