December | 2011 | life and puppies

Archive for December, 2011

Back to the lab

Published December 30, 2011 baby stuff 8 Comments
Tags: gestational diabetes, three-hour glucose test

I’m up early (for me) this morning because I failed – or, rather, had abnormal results from – the one-hour glucose test I did last week. This failure on my part has sent me to the lab for a three-hour glucose test to determine whether I have gestational diabetes. From what I have read, gestational diabetes is both common and uncommon. Risk factors include being over 25 or 35, having a family history of diabetes and being overweight or obese before beginning pregnancy. Other risk factors appear to be being pregnant. Hmm. So here I sit waiting for the next blood draw…

Let me pause here to weigh in on a topic of semi-interest to me. It seems every profession has its own lexicon and its way of communicating with lay people. I am a lawyer and, while my work is not very complicated, it does have its own terminology and sometimes those terms can be non-self-evident to non-lawyers and require some explanation. For example, when I use the word ‘moot’ to describe a case, I mean that the case is no longer in controversy. The judicial branch can decide only cases or controversies, so if there is no more controversy between the parties, the case is moot and will not be decided by a court. The most common example of this is when there has been some sort of pretrial resolution to the matter at hand. As much as you or I may have wished to see how a judge or jury would decide a case, if there is no longer an actual conflict between the parties, the case is moot and is over as far as the law is concerned. Imagine my surprise then when I looked up ‘moot’ in a regular old dictionary the other day and found its meaning described as ‘open for debate.’ Well! Although this definition is not exactly the opposite of the legal one, it comes close. Anyway, the medical profession, not surprisingly, seems to have an entirely different language from my own, such that I sometimes wonder if we can ever be friends. Dr. Heather is particularly skilled at explaining things, but I have found her to be more of the exception than the rule. I do take some responsibility, though, as I’m sure I often ask the wrong questions. Awhile ago, when I lived in Richmond, I asked my doctor to take a look at a large mole I had had forever on my left leg, but which I felt had grown a little in the last year or so. She scrutinized the mole, scrunched up her face and said, “Well, it’s not symmetrical.” I said, “What does that mean?” She said, “It’s not the same on one side as it is on the other. If you folded it in half, it wouldn’t match up.” Uh, thanks. I guess what I should have said is something more like, “Does that mean it’s more or less likely to be cancer?”

This sort of thing happened to me again this week when I spoke to the nurse who told me that I had failed the one-hour glucose test. I asked her if she had any statistics for me, such as the percentage of women who fail the one-hour who are then diagnosed with gestational diabetes. She answered, “A lot of women fail the one-hour but pass the three-hour.” Very scientific. She then proceeded to tell me what the three-hour test would entail. She said there would be four blood draws and if I fail two of the four, I have gestational diabetes; if I do not fail two of the four, I definitely do not have gestational diabetes. I don’t know about you, Dear Reader, but this explanation made about zero sense to me and sounded a wee too close to junk science for my taste. So, I quickly took action and scoured the omniscient World Wide Web for information on this three-hour test. I soon realized that the explanation the nurse gave me, while technically true, was overly simplistic and, consequently, head-scratching. I am sure she was trying to conform her vocabulary to something I could understand, but her explanation had me only baffled. What I have learned since then, and what my basic brain has come to understand, is the following: gestational diabetes occurs when hormones from the placenta interfere with the pancreas’ ability to produce enough insulin to combat the glucose a pregnant woman ingests. For whatever reason, the condition usually sets in between 24-28 weeks of pregnancy. Because there isn’t enough insulin, extra glucose passes through the placenta to the fetus and that glucose is stored as fat in the fetus. The fetus can then become too big, which can lead to labor problems. Although there appear to be other complications with gestational diabetes, the major one is babies that are too large, which increases risk to the mother and ups the likelihood of a c-section. So, the test. Passing the one-hour test means there’s no need to do the three-hour (I passed the one-hour test I took at around 12 weeks). The three-hour, on the other hand, is considered diagnostic (though I read a bit about how some docs think it’s not very reliable) and it goes like this: the preggers lady (me, in case you got lost) fasts for 12 hours and then comes into the lab to have some blood taken. The glucose level in the blood is tested. If this number is too high, the woman immediately *fails* the test because, obviously, there is a problem: her glucose level is too high when she hasn’t had glucose in 12 hours. Ok, so assuming that test comes back in the normal range (the nurse told me she had had only one person fail blood test #1 in her nine years of lab work), the woman is given The Orange Drink. The Orange Drink is about eight ounces of sickly sweet Gatorade-like fluid that must be consumed in three hours. Women complain about the orange drink they consume for the one-hour test, but let me tell you that it is nothing compared to The Orange Drink I just drank an hour and a half ago. The drink for the three-hour test is twice as sweet as the other one; it’s just loaded with sugar. Note the capital letters to emphasize the difference. Anyway, ok, so the drink is consumed, the time the woman finished it is noted and blood draw #2 comes one hour later. So, I had my second poke about 30 minutes ago. This blood is then tested. Another draw is done an hour after that and that blood is tested and then there is the final blood poke, #4, which comes yet another hour later. The results of the blood test are then examined and if the woman has acceptable levels of two of the three, she is considered to be in the clear. On the other hand, if her glucose levels are still too high in two or three of the tests, she is diagnosed with gestational diabetes and the fun diet begins. So, basically, the test just measures how the pregnant body deals over time with a lot of glucose. The “if you fail two, you’re done” explanation is, as I said, true, and also now makes sense to me. I assume the most likely blood test to fail, for women who still go on to pass the test, is the blood draw at the one-hour mark; perhaps her body deals well with the glucose, but it takes just a little longer.

So, here I sit waiting for two more draws. It’s not so bad. I have wireless, a new laptop (MacBook Pro! Hallelujah!), Baby Bargains, The Botany of Desire, and some water — thank goodness the lab tech gave me a little bottle of water because I am still trying to get the artificial orange taste out of my mouth. And Doc Heather just stepped away from her hospital patients to check in on me and chat for a bit before she had to go because some loud alarm on her hip went ballistic!

I’m incredibly nervous as I really do not want to have gestational diabetes. Gestational diabetes can be an indicator that the baby will develop diabetes at some point in her life.* I know lots of women have dealt with it, it’s not the end of the world, the chances are the baby will still be really healthy and fine and that soon this will be a distant memory. I know all of that, but I still don’t want it. I worry I’ve already put my baby at risk for all sorts of physical shortcomings and mental problems, just by virtue of her coming from my womb. I don’t want to her to have to start off with one more.

*Since writing this, and while waiting for Blood Poke Four: The Final Chapter (for today), I read gestational diabetes is not an indicator for a baby’s future in the land of diabetes. Obviously, I need to do more research.

Buying the nursery chair

Published December 26, 2011 baby stuff 11 Comments

I’m breaking my own rule here by writing a new post before any one has commented on the last boring one, but I think it’s time to move on. As I’m now in the midst of week 29 (or, I suppose, really week 30 because I have completed 29 weeks, just as I have completed 36 years — zoinks!), I’m starting to get a little panicky about all of the things that we have to do and would like to get done before Baby Girl Sweet Potato arrives. We are really not ready. I know a lot of people say that — and I have even heard more experienced parents talk with pride about how the crib wasn’t put together until mom’s water broke — but I am pretty serious about it and starting to get stressed. I would like the crib together well before I am calling triage at the hospital to tell them I’m on my way. I would like the changing table/dresser ready to go before I’m making sure the camera battery is charged. So, this week is a big week for us. AO has taken the week off (because he always seems to have more vacation time than I) and is going to put together a bunch of things we bought at Ikea a few weeks ago. Among these items are the crib and aforementioned changing table/dresser but are also two bookshelves we hope are going to work magic in our living room. You see, Dear Reader, we live in a one-bedroom condo. So, and I’ll do the math for you here, we are soon going to have three humans and a dog in a one-bedroom condo. I’m really not too worried about this — we have plenty of space — but it’s going to take some creativity and — and I’m mentally preparing for this — some serious trial and error.

Ok, that aside, this week I’m also trying to focus on a chair for our nursery-area. For the most part, I am convinced that we would really like a glider chair. I have read a bit of info suggesting a glider isn’t really necessary and instead we can just rock the baby in our arms in a regular chair, but I think a glider — I’ll take the extra help with rocking, thank you — is the way to go for us. I started my search weeks ago, but have amped up my efforts in the last week. I have looked at Overstock.com, Target, Ikea, Room & Board, Land of Nod, Pottery Barn Kids, Rosenberry Rooms, Babies ‘R’ Us, Hayneedle, and more. I have even looked into how to add a glider mechanism to any old chair and emailed a local upholster to ask him if he could do that for us. I have alternated between the mindset that I am willing to spend a lot of money (telling myself chairs are expensive and it will nicely balance out the frugality we exhibited when we bought our $99 crib) and heeding the call of the thrifty siren (telling myself there are a million other things we need to buy and a chair is not the place to spend any extra dough). There is also the issue of space and design. I would like something fairly compact — nothing oversized — and with simple lines; something upholstered without any bells and whistles. I’m drawn to designs like this chair from West Elm (priced at $599, but 20% off for the next few days):

Ryder Rocking Chair

I also very much like this more expensive sweetheart from Room & Board ($999):

An example of one that I am not at all interested in? This chair from Babies ‘R’ Us looks quite comfortable and is nicely affordable at $199, but is a bit too busy for my eye:

There is an additional issue. I would really like to buy something made in the US or, at least, Canada. But I have not decided how committed I am to this. What I mean is, I have not ruled out buying something made elsewhere. I recognize I have already bought a million things that are made in countries other than ours, so why put my foot down on this one? On the other hand, furniture — and good furniture — is something that is still made here in this country and perhaps I should have the moral and ethical code to insist that at least something in the nursery is made in these parts. And if not the chair, then what? Narrowing my purchase choice down to one made in the USA has the added advantage of, well, narrowing my choices down.

Hmm. Ok, this has been helpful. Writing things down really helps me make decisions! Thank you, Dear Reader, for I think I will indeed refocus my glider search on a made-in-this-country option. Any suggestions you have, though, would be more than appreciated.

Elderly multigravida with a side of antepartum condition

Published December 23, 2011 baby stuff 5 Comments

The title of this post is composed of words that were used on the “after visit summary” I received at the doctor’s office yesterday. I believe multigravida means there is more than one baby inside that uterus of mine, which I’m pretty sure is 100% false.* I don’t know what my “antepartum condition” is, other than my elderly gravida, but I thought I should share this enigmatic summary with you.

Given my abnormal results from the first-trimester screening (my hormone levels weren’t what the medical establishment would like them to be), we had yet another ultrasound yesterday! This time, we were told, the tech was looking for growth and not so much, say, multiple heads or not enough kidneys. I was a little nervous before hand because, as much as it is wonderful to get another look at the little sweet potato, I was scared that something would be wrong. Alas, we are again blessed and lucky because Little Girl appears to be coming along just fine. She weighs just under three pounds, has an adequate amount of amniotic fluid to move around in, and even looked as though she were sucking her thumb. This time, the 3D image the tech created looked a lot less like an extra from the C-horror film Baby Aliens from the Womb and more like a little munchkin you’d love to cuddle with. I breathed another deep sigh of relief.

After the appointment, we returned to the lab so that I could have my blood drawn. I had ingested a lovely cocktail that tastes nostalgically reminiscent of McDonald’s Orange Drink (what a clever name!) before the doctor’s appointment and had to wait an hour before the blood could be taken. Fingers crossed that gestational diabetes is not an issue.

*UPDATE (April 2013): I guess I was mistaken and misinformed. Multigravida means the woman has been pregnant before, so this is her second or third or fourth, etc., pregnancy. This, too, was not a correct diagnosis for me, as this was my first – and only – pregger-nancy.

Ca va sans dire

Published December 16, 2011 life and pups 4 Comments

A few days ago, I started Christopher Hitchens’ latest essay in Vanity Fair. I put it down before I had finished it, wanting to save it, wondering how many days he had left with us and, selfishly, wondering how many future articles of his to which I could look forward.

I cried a little this morning when I heard the news that he is gone. The world has lost an incredible writer, observer and a very brave soul. I have long admired his sharp intellect and courageous attacks. I have, like everyone, disagreed with him from time to time (I know many of his fans would choose the war with Iraq as their evidence of his fallibility, but instead I point to his silly essay about women comedians to state emphatically that women are funny; to wit: Tina Fey), but more often than not, I have finished a Hitchens article in awe of his biting intolerance for corruption, his confidence in his moral compass and his capacity for knowledge and truth. Mr. Hitchens, you will be missed by so many. Thank you for all of the gifts you gave us.

Descending and ascending

Published December 8, 2011 movies 2 Comments

AO and I recently saw The Descendants. I had heard mixed things – well, actually, I had heard two very curt reviews: one labeled it close to excellent and the other deemed it so-so. I knew Aaron wasn’t psyched to see it, but he didn’t put up much of a fight so off we went! I’m still processing my thoughts and feelings on the film so please forgive me if this post is un peu disjointed.

Let me start by stating that if I had put it together that The Descendants was from the same man, Alexander Payne, responsible for Sideways, I’m not sure I would have even entered the theater. I found Sideways to be full of whiny, humorless middle-aged male crap for which I have almost no tolerance. Not to mention that I happen to like Merlot. Anyway, Payne’s resume also includes Election, not one of my favorite flicks, as well as a couple of Playboy videos. Had I known all this, I don’t know if I would have seen the movie at all, but if I had, I know I would have anticipated, at a minimum, a sexist or misogynistic vibe emanating from the screen. So, it’s probably a good thing I didn’t know anything about Payne, instead thinking only that the movie would probably strike me as being somewhere between excellent and so-so.

If I had to rate it as one of those two, I would smack it with the label ‘excellent.’ But let me back up. We settled into the theater with a bag of pregnant-lady popcorn (previously dubbed just ‘popcorn’) and a tasty cold Diet Coke (caffeine!). Gotta love Sundance for many reasons, not least of which are the real butter and Coke products the concessions stand offers. This movie snuck up on me, in the way that life tends to, I suppose. One minute I was munching happily away on my popcorn and then next I was weeping quietly, thinking about how hard life can be. Anyway, without any spoiling I think I can safely say the narrative of the film is as follows: George Clooney plays Matt King, a real estate attorney in Hawaii, who is married with two daughters, Alexandra, 17, and Scottie, 10. His somewhat estranged wife, Elizabeth, has recently been in a boating accident and is in a severe coma. Instead of tending to his wife and children for the last who-knows-how-many-years, Matt has buried himself in work. He became, or always was (we don’t know), the back-up parent (his term). Because of Elizabeth’s coma, Matt must become the primary caregiver. But this isn’t a Mr. Mom tale (love that movie, though!) or a How Will a Man Raise Daughters Alone? movie or even a Regarding Henry-type Work-Isn’t-As-Important-As-Family story. In fact, it’s nothing close to any of those paradigms for formerly absentee father films. This movie, instead, is about love and marriage and relationships and forgiveness and frailty and humanity and weakness and responsibility. It’s about care-taking in the truly best possible way. But let me back up.

While Elizabeth is literally comatose, Matt learns she had been cheating on him. The news floors him, but he is clearly more surprised, angry and resentful than heartbroken or sad. Matt copes with the news by trying to learn as much as possible about the man with whom his wife cheated, deciding he must confront the interloper in person, if only to relay to him the fact his lover is in a coma. This MacGuffin device is useful and relatable and, like most MacGuffins, ultimately quite irrelevant. It is what Matt learns about himself, his daughters and life while in search of his wife’s paramour that is the point of The Descendants.

Overlaying all of this, though, is Matt’s obligation as sole executor of a trust that holds an inordinate amount of beautiful, pristine land on Kauai. The beneficiaries of the trust are about a dozen or so of Matt’s cousins; the trust contains the family’s significant land ownings. The trust is in a precarious position as it may not hold the land in perpetuity, so Matt and his cousins are considering selling the land to comply with the law and, as luck would have it, to make them all very wealthy. The problem is, of course, the land is supremely beautiful, untouched and, well, paradise. Through his cinematography, Payne does an excellent job of driving home the point he had Matt extol at the beginning of the movie: Hawaii is beautiful, but it is inhabited by humans; no matter where humans are, life will be complicated and ugly, painful and hard. The land held by the trust is remarkable in its stark contrast to the other Hawaii Payne shows us, the one that looks more like something we’d recognize around us on the mainland: Matt’s dirty pool & his cluttered office, Alexandra’s utilitarian boarding school dorm, Scottie’s classmate’s house or Elizabeth’s stale hospital room. The Kings’ Hawaii is both beautiful and messy. And like all of us, Hawaii needs someone to tend to it, to care for it, or at least to look in on it, once in a while.

To me, The Descendants resonated as a tale of love and loss, reminding me that to love and to hurt, to cause pain and to mend, are innately part of our collective human life. As I continue to struggle with my own guilt at having hurt others and with the pain I hold at having been hurt, I appreciated and relished the movie’s reminder that we all hurt the ones we love, whether intentionally or callously, but that we all have the power to forgive, to heal and the obligation to wrap those closest to us in a blanket of safety and love.

life and puppies