November

November has been a slow month for Mom and Thriller. We've been putting the house together (slowly) and relishing the moments when Morgan has been in town. We went to Vienna to have Thanksgiving with Morgan's family and had an amazing feast! While there we also went to Four Sun's Farm (where Morgan and I were married) as well as taking a Ray Vickery tour of historical sites and wineries around Fauquier County, Virginia.

59 days and counting ... Bradley Class No 4

Wow. It is 58 days until my due date. Almost all of my friends have delivered early, so I hope to be ready by Christmas! I am getting VERY anxious about being prepared.

Tonight Morgan and I went to the 4th Bradley class in our series. This weeks session was entitled "The Coach's Role" and we were very excited about the material as it was mainly geared towards Morgan.

Part of the coach's role is to be an educated participant in making decisions in the moment about medications and procedures.

I have to admit, that while I have been certain that I wanted to go natural since the beginning, I have even more resolve after tonight's class. We talked a lot about Analgesia (opium based narcotics) and Anesthesia (epidurals - which are cocaine based).

I was already sure that even in the worst case scenario we would opt out of the narcotics. However, I did not know that the narcotics are most likely to cause respiratory problems in the baby, which in turn means that it is taken away for observation until the breathing settles and you do not get to nurse or hold the baby, that they have to give the baby narcan (spelling? something like that) which is an anti-narcotic used to bring drug addicts back to consciousness to make the baby alert - NOR did I know, more importantly (almost, it is all pretty important) that it takes 2 WEEKS for the narcotics to get out of the baby's system. Not the way we are going to bring Thriller into the world ... even if I have to have a C-section I am opting out of any narcotics.

However, I have been more conflicted about the epidural. If I needed it, I was going to be open to it. In class, from the doctors, as well as through the stories and experiences of those I love there is no question that there is a place for the epidural in birthing, especially if it can lead to preventing further intervention (which would be very rare, but possible) or if you are having a c-section. I had heard rumors about chronic back pain being a side effect of the epidural, but I was still keeping a pretty open mind with very strong hopes that we made it through all the way without one.

And my new reason for not wanting an epidural or spinal is completely focused on me and preventing pain. Which may sound strange.

Apparently Epidurals and Spinals can cause migraines, and if you are already a migraine sufferer it is most likely that you will have the worst migraine pain of your life. This is because of a change in spinal fluid pressure on your brain stem. Okay people, I've already had what I thought was the worst migraine pain of my life. No way in hell I am doing ANYTHING that will most likely cause me to be in worse migraine pain that I have already experienced. I can't imagine that the most painful constant back labor and/or un-medicated episiotamy could be more painful.

In addition, immediately following the birth I would have to lie on my back to balance out the spinal fluid pressure and potentially the doctors would have to add more fluid back into my spine to get the migraine to stop ... I'm sure there is a more medically correct way to explain all this but this is the gist.

Not only would all of this be incredibly painful, but it would render me completely unable to nurse right away, hold the baby or do any of the things that I want to be able to do right after the baby is born. All of this would prevent me from being able to take the best care of Thriller possible.

My fear of the worst migraine of my life is much for extreme than my fear of labor. If there is a 2% chance it is too high, and it is much higher than 2%. The only way I will have an epidural is if I have a c-section - which god willing won't happen.

We can do this! And I have the best coach in the world.

Dr. V

Friday was, in the world of a pregnant woman, a very exciting day. I had a doctor's appointment at Triangle OBGYN with Dr. V.

Due to Morgan's travel and work, he hasn't been able to make it to a doctor's appointment since my 20 week appointment, so I was really excited to have him with me to introduce him to the new practice and sort of re-engage him with the process of preparing for Thriller. He met me head on and had a list of as many questions for the doctor as I did.

Triangle offers a nurse midwife delivery as long as the delivery is vaginal and has OBs on call in the event of major intervention, such as a c-section. And, fundamentally, if the midwife has a question or approvals are needed, she has to check in with the doctor.

(Note: OK, this is more of a conservative approach than Morgan and I wanted to take to birthing, but as this is where we are I feel that it is a very good compromise. We found a practice and a hospital that will let us has a natural, midwife delivery and respects the methods we believe in.)

I have met 3 of the midwives, all of which I really liked, but meeting "Dr. V" was a big deal - sort of like meeting the man behind the curtain, and also the man who might have to cut me open if things go that way. Meeting with him gave us a chance to ask the hard questions to the decision maker to be clear about the theory behind the practice and what we can expect in delivery.

Dr. V could not have made a better impression on us.

(SWEET! YES! THINGS ARE GOING TO BE OKAY!)

He is super mellow. He told us to go read up on Ina May. He answered all our questions honestly talking about the best and worst case. And he had actually really reviewed the chart enough to know that Morgan works in solar and know about our travels, etc which I honestly did not expect him to have done.

Induction: Will go 10 days past due date with new mother - really like to avoid induction especially with first time moms.

Early Discharge: No problem, if everyone looks good.

IV Port: Only required if you have B-Strep. However, if you're looking tired at 5 centimeters then its going in so they are ready (reasonable).

Food/Drink During Labor: Anesthesia at the hospital says NO - but if you need to munch under the radar they don't really care as long as you are not preparing for a C-section.

Labor: Tub, Ball, Move Around - whatever works for you. He did say not to be afraid to lie down especially as you go into the 3rd phase to preserve your strength.

Narcotics/Epidural: If it is in your birth plan to go natural, they will not offer, you ask for it.

Intermittent Fetal Heart Monitoring: As long as there are no interventions or irregularities, preferred method.

And many other points .... most importantly he said that he trusts the midwives 100% and clearly thinks of them as equals as medical professionals. That seriously made a positive impression on me!

His obvious intelligence coupled with his very honest and mellow attitude made me feel so secure.

Some people might want someone who seems very engaged or enthusiastic and been turned off by Dr. V. Not me. Not Morgan. I can't think of anyone I would rather have in charge of taking care of me and Thriller should our natural birth plan not work. (God willing this won't happen!)

Part of what we have learned over the pregnancy is that at lot of unnecessary procedures happen because of overeager doctors (Wolfe may call them "Masters of the Universe") and I am certain that Dr. V is just not that kind of doctor. Whew.

Slow House

Okay, so I am a slow un-packer. We are slowly acquiring furniture and other items to fill on our house, and honestly it has not be as much fun as it could be without having Morgan here all the time. As he is home all this weekend I hope that we will knock out a lot of the remaining unpacking and do something with the yard. The grass is tall, the leaves have fallen, and the plants need to be cut back. I think I might have to make a trip to Lowe's today to get a rake and some other supplies to make our weekend productive. Of course, I have no idea what to do with the yard - at least Morgan had landscaping experience after college, but I honestly don't think he really has that much of a clue either :)

Anyway. Things are, however, slowly coming together. I knocked out the kitchen the first day - thank GOD. Mom came up and brought more furniture and some family heirlooms to fill in our home as well as treating us to new Italian leather couches, chairs for the living room (which haven't arrived yet), bookcases and among other things.

The bookcases required assembly and I was damned determined to do it on Monday. Putting one together took me 4 hours, several power tools and now the whole neighborhood knows I can have a mouth like a sailor. At least it was sunny and I was outside. Luckily later that afternoon Amy Vaden came into town and the next day she was able to put the second one together in an hour, without the use of power tools until the very end. Apparently I kept stripping the screws because the bit on the drill was the wrong size. Who knew?

I swear I used to be more self sufficient.

Anyway. The bookcases are complete! And the library/music room is almost perfect! We still need to get the guitars on the wall, figure out what wall art we want to go with, and source a nice desk chair as well as a second reading area chair ... so maybe it isn't that complete, but it sure feels a lot more full! And it looks great! Thank you MOM and AMY! So it is the smallest room in the house. Plenty to go. But we'll get there -

It takes time to figure out the best place for everything. And better to take it than rush through the process, don't you think?

I am feeling a little pressure from being 8 weeks out. I would like to have it done by December 10. This is my goal! Wish me luck!

Bradley Class 3 & The Circumcision Decision

I really enjoyed our Bradley Class on Monday. There are a wide range of topics that we cover in each class, but this is the first class that started to bring people out of there shell a little. We did a foot to head relaxation technique as well as talking a bit about our personal experiences so far. We talked about pregnancy - the physiology of what is happening, etc some. Morgan could identify all of the organs on the diagram in our workbook, which was much better than I did. And then we talked about controversial issues in pregnancy. These included circumcision, b-strep/antibiotics, episiotomy, perineal massage, vaccines, etc.

The only one of these that Morgan and I had not already really figured out what we think/want to do is circumcision. I don't think either of us really knows what to think on this topic. On the one hand, we are the ONLY country in the world that has this debate - other countries (including Canada and all of Europe) ONLY circumcise for religious reasons. Insurance companies do not all necessarily cover the procedure as it is considered cosmetic and has no medical purpose.

But that is how his daddy is. And what all our parents did. So here we are, with all of our forward thinking still trapped by the construct of a social norm that makes us uncomfortable to think about being different.

In the Raleigh area there is a 60/40 split on circumcision vs. no circumcision - a common divide for educated, urban areas. The national average is like 55/45. Rural areas tend to see higher rates of circumcision. There are a lot of myths about why circumcision became the norm as far as the spread of diseases and cleanliness - and there are some truths. The most notable immediate development factor is that circumcised boys experience a drop in appetite and do not eat as much following the procedure for a while due to the trauma.

But this is one of those topics where you can find ANYTHING online to justify WHATEVER you want it to.

The American Medical Association states: All current policy statements from specialty societies and medical organizations do not recommend routine neonatal circumcision, and support the provision of accurate and unbiased information to parents to inform their choice.

Where does one begin? We have to have a plan in case Thriller is a boy.

For me the idea of having my (potential) baby boy taken away in the second day of life and put into a room where they go around snipping baby's foreskins in mass is relatively upsetting. I like the idea of having Morgan go with him so he wouldn't be so alone - but then I think that that would probably be pretty upsetting for Morgan. I have an image of the doctors approaching Thriller and Morgan snatching him off the table and running out of the hospital before the procedure could start - the Vickery men can't even face the idea of fixing their dogs!

And then there are other factors as well. Morgan and I have been hoping to have an early discharge so we can leave the hospital possibly 12-14 hours after delivery. However, if I have drugs, B-Strep or other complications then we have to stay the whole 2 days. If there are no problems and we can leave early then we would leave before it is okay to do the procedure. So then we would have to go to a doctor and do the circumcision in a Bris like fashion in the first week of life.

And then there is the insurance coverage issue...

And then there is the fact that men who are not circumcised experience a greater sensation in their adult lives when doing adult activities. Okay ... I can't really consider Thriller at this level at ALL.

And then there is the feminist prospective ...

I am very impressed that Morgan read through all the material and literature on this topic we were provided and is very thoughtfully considering what is best for Thriller. I think he will continue to do so, which is good because I don't want to look at the pictures of the procedure ever again. The slightest glance was too much for me.

My gut instinct is not to do it. However, it still makes me squeamish to think about either way.

I think Morgan may have to make the call on this one.

The Hallways Inside My Mind

Everyday in pregnancy has presented new, often juxtaposed, series of experiences ... weather it is an urge to get organized or a desire to do nothing but sleep, insatiable hunger or finding food revolting, energy to walk miles or an inability to consider walking to check the mail ... it always seems new, unexpected and different due to the rapid way my body and needs are changing.

One of the most dramatically different internal emotional dialogues is the back and forth between feeling incredibly lonely or realizing that I am never alone ... little Thriller is with me all the time. The moments of loneliness are accompanied by a sense of loss and confusion whereas the Thriller oriented times have pride, focus and purpose. Unfortunately I haven't gotten those good vibes in a few days.

I am sure that the loneliness is intensified by the fact that my husband has been out of town for weeks for work and I am no longer in San Francisco. But nonetheless I think that there is something more there - some sort of feeling of loss of a part of my life that will never be the same. I guess if you plan a pregnancy and decide it is your time it is a little different because you consciously say that you are ready to move on. And honestly, I have been totally ready to move on for some time. I was feeling a lot of disenchantment and frustration in the often self indulgent nature of our San Francisco lifestyle. That all being said - as I talked to Morgan over the course of this week and he was in San Francisco with all of our dear friends doing all of the things that we love to do I dug myself into a deep dark hole of discontent. I would also like the blame it on the bad weather - maybe the lack of vitamin D can be blamed for my selfishness?

And that is ultimately how I feel, petty and selfish. I have the most amazing thing in the world happening inside of me - I'm growing our child. And there is nothing with greater responsibility or purpose. I know every moment with Thriller will be more wonderful than every night out in my whole life! But I hope that at some point things will calm down and I do get a few more nights or cocoon days with Morgan before the baby comes. Moments that are really ours, our adventure, before the two of us become three. Those moments renew me.

Dance Party with Thriller

I have been able to feel Thriller move around for a few months now. First there were flutters, then sharper movements, then clearing some pounding or kicking from the inside. As previously mentioned, the baby obviously responds to music (specifically the bass) and I have recently noticed that Thriller also responds and starts moving a lot whenever we are in a setting where lots of people are talking.

But last night, we had a new series of rapid movements while I was being totally boring - watching movies and making giant floor pillows for the nursery (yes, that is right, I went to the fabric store and am hand sewing something). Thriller just started going NUTS at about 1 am. Moving around like crazy - this kid has some rhythm.

My only explanation for the stimulus for this movement is that somehow maybe Thriller knew his daddy was dancing away across the country at a Widespread Panic concert at the Fox Theater in Oakland. I know, its a long shot, but the baby hasn't moved this much since we went to go see Panic in Raleigh ... so I wonder if somehow the inspiration was a connection to Morgan. Is that possible? Probably not, but with as much as Morgan has been traveling these past few weeks, I'd sort of like to think so.

Pediatrician Search

I have been so focused on finding the right doctors for my prenatal care and delivery in Raleigh, that I honestly had not even thought about the importance of finding a pediatrician. At my first appointment with Triangle OB/GYN they could not stress enough how important it was that I start the interview process immediately and I then learned that in order to registered with the Wake Med Birthing Center I also had to have one lined up! And I was already 10 weeks late registering with Wake Med!

And then I learn that the doctors fill up, only taking so many new patients a year, and as I was so behind it might be hard for me to get into anyone good!

I immediately got a stack of business cards from Triangle and started setting up appointments, asking around and checking out online reviews. I was only told by practices that they were not taking patients so that gave me a place to start. I seriously miss Yelp in San Francisco when it comes to times like these! Although there are some pretty decent local resources with reviews, etc. I scheduled my first interview appointment and then realized that I had NO IDEA what to ask about or look for. Luckily Jane (oldest, dearest friend and mother of 2 ... or is it 5?) called me back immediately and started going over the list of interview questions and things to watch out for as I was driving to the interview.

It is a different experience to be in a new town on a doctor search. When I was a child in Tennessee I think that I went to the only pediatrician in Gatlinburg, or at least the one that everyone we knew went to ... and then when we moved to Alabama I never really established a pediatrician. Quite honestly, I wasn't sure what all the fuss was about.

But then I started paying a little more attention and realized the complexity of the pediatric relationship. We are luckily on a PPO so most of the concerns of many parents do not apply to us directly, but if we were on an HMO it would be very different.

Then things started to click ... such as the fact that we want a doctor owned practice as opposed to a practice owned by a large medical network that has really been created to operate within the HMO system. So then even if you have a PPO you are only referred to their internal HMO specialists etc. Wow. This whole conversation about health care is suddenly effecting my life in a different way. I've been lucky enough since we were married to be able to go to any doctor I wanted and not really needed anything special. But when you are thinking about being able to provide the best health care for your child with OPTIONS it is a whole different story.

I am an avid supporter of Health Care reform and a Public Health Care System (the result of being uninsured most of my life and afraid to go to the doctor due to the cost) and I know things are going to be changing. But for now I have to make decisions based on the existing system.

So there is the canvas where we start our search, and I haven't even added the questions or concerns yet! I generally asked about walk in hours, on call systems, specialties, labs, vaccination schedules, use of antibiotics, developmental testing, alternative treatments, etc. Some of the interviews are done in a group whereas other interviews are individual, depending on the practice.

In my first group interview I felt like such the California mom - really I did. The other mothers to be (all first timers) were on an entirely different page. I was a little bit shocked at the lack of concern about the questions I had vs. "Does it cost extra to call in after hours." (Which of course it does not!) One mother to be looked at me and said "Why wouldn't you want to give your child antibiotics whenever it would make them feel better? If your insurance covers it?" and I just wanted to SCREAM "So they will work when the child actually NEEDS THEM for something that won't heal in two days!" Has this woman not read a single article about antibiotics or watched the news over the past 10-15 years? Really?

Luckily the doctor helped me out quickly and explained that it isn't prudent to get antibiotics for ever ear infection as they usually just take a day longer to heal on their own, etc. Needless to say I immediately started liking this doctor, Dr. Erin Wooten of Oberlin Road Pediatrics.

She continued to answer all of my questions in an educated and genuine manner (and with answers that I agreed with, which always helps!). I think I found the right place and at least plan to start at Oberlin Road.

I wonder what this experience would have been like in a small town? Without 2 medical schools and other various medical facilities in the immediate area? Or if I was in Huntsville, would I have just gone with the doctor that all my friends were using? Would I have known to ask these questions? Would it have mattered? Will health care change so much in the next few years that this interview and research process will have been pointless for Thriller's long term care?

It is a strange and ongoing process, getting ready for a baby. Lots to do, lots to learn.

Getting Ready for Thriller ...

It is common knowledge that the wedding industry has control of whims and wants of brides to be and their families around the world. I did not know, prior to getting pregnant, that the baby industry is in fact as intense if not worse than the wedding industry! And they have a much more serious value proposition: Buy this OR be a bad parent.

Seriously, it has taken me months of virtual nesting, shopping, reading, talking to friends, etc to even begin to get an idea of what is really needed for a newborn. Everyone has a different impression of what works best for them - and there are SO MANY OPTIONS. Every time Morgan and I came to Raleigh to look for houses or for him to work over the summer I would search for the actual store where I could find some answers! Touch, hold, examine and consider. Online shopping has its merits, but it is just not the same.

I went to Baby's R Us. That was disastrous. I was terrified and totally overwhelmed by how much plastic CRAP you "must have" for your baby. (Note all of the plastic crap can be color or patterned coordinated!) The item that struck me the most was the series of plug in or battery powered vibrating chairs or "bouncers." I was told that if you do not have a vibrating chair, your baby will never sleep. You just must have it. WHAT? I walked out of the store totally convinced that if an item was in Baby's R Us, the baby didn't really need it because it all seemed so gross. This was obviously not true, they have some great items at Baby's R Us that are essential and will benefit your child, and a good online selection - but I just can't ever have a reason to go back into that store. Or on their website. I'm afraid.

I went to several local shops in Raleigh, Huntsville and Madison, searching for some clarity on the situation and was continuously turned off by the rude staff, the prices and the stuff ... just stuff ... where is the utility? The necessity? I want Thriller to have everything he/she needs and could even want - but I needed someplace to start that made sense.

Family, friends, articles, online resources and most recently our Bradley class started to tie things together. Morgan and I decided to go with a quality over quantity approach. Research clearly indicates that having an organic sleeping environment is better for the baby, so that gave us a place to start. Similarly we know that avoiding BPA and or PVC is beneficial for the baby - so we have tried to find feeding and other options that are free of these toxins. There are a LOT of online resources that meet our criteria and I feel that we have become educated baby consumers.

There is an online store that is local to Raleigh, called growgreenbaby.com. Finding this resource was nice because it met our criteria for organics and non-toxic AND is locally based. However, I have still been searching for a local shop - a storefront - where I could talk to a person. Where just maybe I could touch something in my hands to see if it felt right - or if the color was actually what it looked like online.

And alas, yesterday I finally found my spot.

GreenPea Nursery (greenpeanursery.com)

Where have you been all my pregnancy?

I had a staff person listen to me, give me options, show me a selection, let me touch things, talk to me about my needs and how to make solutions in the most cost effective manner. I love this store! NOT ONLY does it have an awesome, educated "green" selection of baby products, tons of information about making the healthiest environment for your child, but they actually also offer SERVICE (something that we know is rare). They are online and in person and I love them.

They do not offer everything I need - and I will still rely on our online resources for a great deal - but I feel so confident in what they do have! And in their answers! It is local, tangible, real, and genuine.

Finally, someplace that makes some sense to this consumer. I guess we all have different wants needs and having so many options has totally changed our retail economy. But I was really beginning to feel like the odd mama to be out here - no place to feel good about getting ready for the baby. I just felt guilty for wanting "stuff" and like the entire industry was trying to trick me. I had no confidence in making the right decisions. But no more!

Thriller's 29 1/2 Week Ultrasound

Today I went to Duke's specialty OB/GYN consultant office to have a "Level Two" ultrasound. Okay, doesn't that just sound scary?

After 20 weeks you generally do not have another ultrasound. However, Triangle OB/GYN (new doctors and midwives) wanted to follow up on a calcium deposit noted on the baby's heart at 20 weeks. Our doctor in Virginia assured us it would not be an issue and did not see the need for the "Level Two" but my new doctor just wanted to be sure.

I was very nervous going in and was alone. There might be something wrong. Probably not, but there might be ... this mantra was going through my head for the past week.

Luckily the baby looks totally normal. YAY!

The calcium deposit in the heart has dissipated (just like Dr. George said it would).

Thriller is a whopping 2 pounds and 14 oz. Man do we have a way to go! In the next 73 days Thriller will more than double in size (which I think means I will too).

Currently the baby is still turned in the right direction ... fingers crossed that he/she will stay that way.

And, the specialist doctor who came in to meet with me after the ultrasound not only has wonderful things to say about the doctors at Triangle OB/GYN, but the midwives (who he knew by name) too. It made me feel so good to know that they ALL have such positive reputations in the community.

Bradley Classes 1 & 2

The past two Mondays Morgan and I have headed out to our Bradley classes with notebooks, workbooks, pillows and such in arms ... I love our teacher, and literally everyone at my doctors office says she is the best Bradley teacher in the area. The class is an interesting mix of people and I hope that Morgan and I do find some community there.

The first class was very basic, and we learned exercises, etc. It was good to walk through it all in that setting with Morgan as generally it has just been me reading and telling him about what I should be doing. The main focus at the end of the class was to begin our relaxation exercises so we will be able to use the technique when I am in labor. On Sunday Morgan proved, without a doubt, that he will be able to be calm and master any personal stress to help me relax. We were watching the Redskins play the Falcons for what was a pretty terrible football game and I was sitting on the floor in the "tailor position" (yet another politically correct way of saying "Indian style") and he sat behind me and started going through the relaxation exercise and rubbing my back. He made me so calm and meditative that I didn't even know what was going on in the game. When I opened my eyes I realized that we missed another touchdown and there was a fight on the field, all of which would make Morgan crazy generally, but he overcame it to focus on me. Granted, the birth of our child will be more important than the Redskins, but I think the timing made the exercise very effective for both of us.

Last night a massage therapist came to the class and taught our husbands how to massage us during pregnancy and during labor. It was awesome! I've asked for a prenatal massage from her for Christmas ... we will see how that request goes with all of the other expenses we have right now :) And then there was MORE INFORMATION ON BREAST FEEDING. Can't seem to get away from that one. I want to breast feed for as long as possible. God willing, Thriller will never have formula. But I really don't like watching other people do it. I know, I'm supposed to be all open minded and liberal and I am - I just think that a boob and latch close up ... again ... isn't really necessary in my life. I know it'll be different once I meet Thriller and we bond and grow together through the process - but for now, can we please keep the nipple close ups at a minimum? Apparently not. Okay, time to master my fears.