Back to the Grind

The second year of medical school has arrived, and I am currently being slapped across the brain by something called “The Bug Parade.” This is the part of our training that involves learning 30,000 pathogens, what they look like, the diseases they cause, the antibiotics that kill them, and how they avoid being killed. We’re getting to see pictures of diseases that are branded, BRANDED into my memory.

I am now 38 weeks and 3 days pregnant. The house is filled with adult incontinence paraphernalia just in case my water breaks in our bed/couch/car. One of the challenges of going to school in Philly is that, while my husband and I strive to have nothing in our car that might look tempting to steal, we also have a hatchback with no way of concealing the highly desirable extra-long maxi pads, sitz bath, and underpads that I now carry with me everywhere I go. If you’re interested in gaining 30 pounds and spending your Friday nights in the ‘Adult Undergarments’ section of Walgreens, may I suggest pregnancy?

Brandon and I are so looking forward to welcoming our baby. And while we don’t yet have a crib in the nursery, we have done as much mental preparing for birth and life with a newborn as possible. My self-hypnosis skills have really developed over the past month. I feel physically fit and surprisingly comfortable. We have also prepared our home for the baby by getting our landlord to cap a porch roof that was sprinkling chips of lead paint down with every wind gust. Parenthood has changed our priorities already.

At this stage of pregnancy most women know where they are going to have their baby. I wish I were one of them. I risked out of the Bryn Mawr Birth Center due to my low platelet count (I will write more about this later) and now I have switched care to another midwife working out of Einstein Montgomery hospital, but who largely does homebirths. I still don’t know if I want a homebirth? Hospital birth? My husband reads all the studies to identify where the best outcomes are to be had. I’m aware of the statistics and now I am waiting to have a strong feeling one way or another. It’s strange not knowing, because so many women have really strong preferences when it comes to where they want to give birth. I shall have to see…

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35 Weeks, Low Platelets, HOT Summer

There should be a statue of me, 8 months pregnant, just quietly enduring this July heatwave. Because I could be doing a lot more complaining. It’s been in the mid to high nineties for the past week. Summers in the Northeast are humid and oppressive. I remember being a kid in our house pre-central air, just lying in a daze on the scratchy wall-to-wall carpet in the living room, sweating, too listless to play in the lawn sprinkler.

20 years later I am watching the local news because I am too listless to switch out the connection to the Netflix box. I can tell the newscasters are in a well air-conditioned building because they are wearing suits and three-quarter length blouses. I hate them for looking crisp and cheerful while the rest of us are lolling on our couches, stupid from the heat. How DARE they express any emotion unrelated to sympathy for those with no central air. The poor window unit in the living room managed to lower the temp to 85 degrees at 11:30 pm. Pathetic.

Yes, an in focus shot is too much to ask in this heat.

Yes, an in focus shot is too much to ask in this heat.

Here I am at 35 weeks, almost a month from my due date. I still feel really good, but sleep is not coming easily.

At my last midwifery appointment I had my blood drawn to check on my platelet count. It started out on the low side in the first trimester, then dropped to 120,000, and as of the last draw they were down to 88,000. Since they were below 100,000 I was referred to a hematologist. And I only found out that I would need to see a specialist at 5 pm on a Friday. What with the heat and being so late in my pregnancy, any extra things I have to do make me feel like everything is the worst. So on the one hand I’m annoyed and on the other hand I’m wondering if there is some other weird thing I don’t know about causing my platelets to be low that I should actually be worried about. I often feel conflicted in this way about healthcare providers: to what extent are these protocols necessary and to what extent are they there purely to cover the provider’s ass. I just got a bill from my 1.5 hour stay in the ER, and my insurance company was billed over $4,000. The 12 lead EKG was invoiced at $766. All for a vasovagal reaction that required no treatment. They gave me a cup of water, some juice and a cookie.

So now a hematologist is going to count the platelets in my blood by hand. This service sounds expensive, like all things that are done by hand. (I also wonder how manual this process is. I picture a doctor in a green visor with a dixon ticonderoga number 2 pencil behind his ear, counting out 100,000 cells.) I will learn more about how this will impact my birth next week. It’s hard to wait on information like this.

 

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It’s O.K., You’re Going to be a Doctor

My husband and my mother have a an atypical in-law relationship – that is to say they get along and enjoy each other’s company. I’ve tried to figure out why it works so well, since both of them are strong-willed, opinionated, and deeply principled – not a classically simpatico pairing. In a showdown of wills I’m not sure who would win. I’d probably place my money on my mother, but it would be close. All I can come up with is that they get along so well out of mutual respect for each other’s honesty. My mom is not shy about dolling out the following harsh truths: you need to get angry more, your bra doesn’t fit, your boyfriend is not good for you… etc. Likewise my husband has assured me he will be the first to let me know if I gain too much baby weight.

Brandon is so comfortable with himself and with the other women in my life that they have eerily started to discuss private bodily functions, meant to be shared only with me, in his presence. He’s impressively cool with it. You must be crying for anonymous examples:

-You’re going to be a doctor, so I can tell you that my daughter had labial adhesions and the pediatrician had to pull her vagina open.

-You’re going to be a doctor, so I can tell you that ever since menopause my pee comes out in all these weird streams going in different directions.

-Husband walks past open bathroom door whilst woman inside is peeing, he sees and then hears, “It’s O.K., you’re going to be a doctor.”

-“When I was pushing the baby out it felt like my ass was falling out of my body… It’s O.K., you’re going to be a doctor.”

-“Coffee gives me cystic breasts…It’s O.K., you’re going to be a doctor.”

The list is growing by the day.

 

 

 

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This Moving Day is as Welcome as Lebron James is Humble

I haven’t had time to update this blog in the last couple of days because we have been moving house. Almost everything is moved, but there are still many rooms left to unpack.

Moving is always fairly horrible. You’d think I’d be a pro after moving 12 times in as many years (2 of them international), but each move gets worse as I accumulate more things. This move was particularly bad @31 weeks pregnant. So bad I cried. Multiple times over the course of yesterday. I was hungry, which at this stage of pregnancy is horrible enough on its own to produce tears. I couldn’t help with the move as much as I wanted to. Out of nowhere I developed sciatica, so I was hobbling all over the place. For the first time in my pregnancy I craved hard liquor.

The day got better though – first with a smoothie from the Farmer’s Market and a panini from DiBruno Brothers. Brandon thought I was going to go into labor eating that panini because I was going at it like it was giving me a religious experience. Imagine the best sandwich you’ve ever eaten, then multiply the pleasure sense by 1000 and you arrive at the amount of pleasure a woman in her third trimester experiences eating her moving day DiBruno Brothers panini.

There is this one clerk at the DiBruno Brothers deli who took an interest in my pregnancy. Is it all Italian men who love pregnant women and babies? This guy was all “when’s the baby due? August? You’re almost theeah… Are smells botherin’ ya?” So cute. One positive thing I can say about the third trimester is the outpouring of positive attention, politeness and favors that I’m getting from complete strangers.

When my husband and I were at the State Farm office signing our insurance policies the women in the office were acting as excited about our baby as if it was going to be their grandchild. When I told them I was using midwives who don’t offer epidurals they reacted you would have thought I just told them I was going to raise the baby gender neutral or something. They kept saying things like, “Well I am sure you can just go over to the hospital across the street and get the epidural. They must be able to do that for you at least…” The thought of experiencing childbirth without an epidural was so foreign to them they could not compute it as even a possibility. I don’t have anything against epidurals. I’m just hoping to avoid as many medical interventions as possible for this birth.

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On a real woman?

Overheard in workshop:

Med student A: So, they had me manipulate the cervix…

Med student B: Like, on a real WOMAN?!

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Sangria and Lyme Disease

Since we are spending a lot of time stay-cationing in Bucks County this summer, B has unofficially themed this the summer of “sangria and lyme disease.” Sangria because it is delicious to drink in the hot summer, and lyme disease because we live in an area of the country with one of the highest incidences of lyme disease.

Last week I woke up twice to the feeling of a tick crawling up my thigh. They weren’t deer ticks, which are the ones that carry lyme, but they were still gross and unwelcome on my body. I love both Marley and Steven, the dogs we were taking care of this past week, but I have no love for the ticks they bring with them everywhere they go.

We are back in Ardmore now preparing to move into our new house. I am trying to be helpful, but I feel way too pregnant for this shit. Luckily I have the kind of husband who says things like, “go lie down on the couch and watch TV. I can pack up the entire house.” And he means it. And in no way is he going to resent me for the time I was not helpful when we moved for the second time in 2 years, while I was 7 months pregnant.

I nearly fainted today at my midwifery appointment. We got to see a wonderfully experienced and talkative midwife, who like me, spent some time working in London’s East End. Though she was having her ‘Call the Midwife’ experience, while I was having my ‘Wall Street/Lost in translation’ experience. Usually these appointments are a whopping 15 minutes long. How much do you weigh (we weigh ourselves)? Have you chosen a pediatrician? Then there’s a little measuring of the fundal height (that’s using a tape measure in centimeters from the pubic bone to the top of the belly), palpating the baby’s position, and finally a quick listen to the baby’s heartbeat. Sometimes we get a little attitude for being medical students. But not today.

Today’s appointment lasted an hour and a half. We discussed breastfeeding, my plans for the birthing, recommendations for pediatricians were made, mutual friends were discussed. This is the first time I’ve felt like I really had an experienced midwife looking after me. There was chemistry. I don’t necessarily look for chemistry with a health care provider, but damn it’s sure nice when it happens. I even teared up a little when she was telling my husband how the baby will know our voices once she is born, and she will look up at us as if she was waiting all this time to meet us too.

Yay I passed my 1 hour glucose test! My platelets were somewhat low still. If they go below 100 I’m going to have to give birth at the hospital. I get them checked in another 4 weeks so fingers crossed. For the fundal height measurement and the the heartbeat check I was lying on my back on the examination table, but my back was elevated and there was a pillow for support. The midwife was teaching my husband Leopold’s maneuvers, the ones used to determine the baby’s position, and then she moved on to find the heartbeat. First we heard the beat in the cord, then we heard my circulation, then there was searching for the tinny sound of the baby’s heartbeat. I started to feel like I was going to vomit, and I saw spots. I had to sit up or I was going to pass out. I couldn’t really stand. The midwife and my husband helped me onto my side and got me a basin for puking. It was a combination of the exam lasting longer than usual, the uterus weighing more than it ever has, and my blood pressure being naturally low (90/58) that drained the blood from my brain/heart. I am told I looked pale. I have had an aversion to lying on my back the entire pregnancy because it makes me feel like crap. The inferior vena cava being squished is not what it likes. I am completely recovered and fine, but I was just thinking how pathetic I would be if I were forced to labor on my back. Hopefully my blood pressure will be up for the excitement of childbirth.

I’ve never heard any stories of fainting on the exam table, so I imagine it’s pretty rare. But I start to feel lightheaded even if I’m slightly reclined.

Ah well, may the sangria flow and the lyme disease be quashed by antibiotic prophylaxis. Happy summer everyone.

 

lymedisease

Easing our way through tall grasses in lyme disease country.

7 months pregnant.

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On our 5 mile hike through Tyler State Park.

We were warned.

We were warned.

steven

I’m going to miss this knucklehead.

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Baking for a Rainy Day Cuppa

Another rainy June day is here. It’s been grey and wet; not raining very hard, but enough that the dogs have not stopped barking at the sky.  Today reminds me of summer in England, where a warm, clear day is more exception than rule. I can probably count on my hands the number of times I wore sandals in the 4 years I lived in London.

A friend recently asked me what counts as cake you’d eat with a cuppa tea. My favorite was Victoria Sponge with second favorite going to fruitcake, aka Christmas Cake. But this is not the hideous imposter American fruitcake you are thinking of that is the subject of so many jokes. The real fruitcake is soaked in brandy and topped with a layer of marzipan and royal icing and it is divine.

It’s hard to conjure a cake or cookie that doesn’t go well with tea, but for a perfect summer rain I think it’s best to keep things light and citrusy. Enter the Oatmeal Almond Crisp topped with Lime-Mascarpone frosting.

teacake4

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I used this recipe from Martha Stewart for the cookie. The baking time is only 14 minutes so no extended hot oven use necessary! I made up my own recipe for the frosting:

1 lime (zest and juice)

3/4 cup mascarpone

1/2 cup powdered sugar

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Just combine these ingredients with a wooden spoon. A lot of recipes I looked at called for butter in the frosting. I find you don’t need butter because the mascarpone is rich enough on its own. Make sure you let the cookies cool completely before frosting them.

Usually Earl Grey tea is not my favorite, but the bergamot notes go really well these frosted cookies. I’m no expert on brewing the perfect pot of tea, but I have learned a few things. Be generous with your tea; always throw in another spoon or teabag for the pot. Let it brew for a few minutes. Drink it while it’s hot!

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Here I am breaking out the secret stash of Fortnum & Mason teabags that I picked up on one of my many duty-free sprees on my way back to the States.

Enjoy the rain!

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