Archive for Health

Week 28: GBS Positive

My Group B Strep test came back positive. So, of course, as with everything else, I go into full research mode.

For the most part, Group B Strep does not pass from mother to child, especially in the absence of other risk factors.

Usually, the treatment is to administer penicillin to the mother during labor at least four hours prior to birth.

Fairly straightforward except for a couple of things:

1. I’m concerned about extended labor post-rupture, which is what happened last time. And the hospital has a policy of administering post-natal antibiotics in the NICU, instead of in the room. My intention is to room-in with my baby, barring actual medical emergency.

2. There are also concerns about potential negative effects from penicillin antibiotics used during birth to combat Group B Strep.

I contacted my favorite gentle parenting blogger and asked if she had any information, resources, or advice. She forwarded some information from a midwife friend of hers who also recommended this article: The War on Group B Strep.

What I’m doing right now is using some herbal supplements to boost my immune system. I checked these with my midwife and she said they would not harm me or the baby and would not interfere with the antibiotics assuming I choose to take them.

If I either do not arrive at the hospital in time, have extended rupture, or refuse antibiotics, she said they would watch the baby carefully and possibly do a blood test in case of any concerns.

Although I feel the risk of a Group B Strep infection is very small, and there are risks from the antibiotics, right now, I am planning on taking the antibiotics assuming there is time.

Life Line or Pipe Dream?

Parenting involves tough decisions, and here’s one:

Should we bank our son’s cord blood?

Our daughter has a congenital heart defect (Tetralogy of Fallot) and received an open heart surgery repair when she was three months’ old. She’s doing great, but will eventually need a valve. Some recent studies and trials show that it may be possible to grow a transplant valve from stem cells that would grow with the recipient–in fact, researchers have grown a heart valve from bone marrow cells.

At the end, I’ll explain why I hope you’ll consider donating cord blood if you are expecting a baby soon.

But this post is about our decision about whether or not to use a private bank to store our son’s cord blood.

Here’s where it gets complicated.

I was pulling my hair out weighing the options with little information, pouring through academic papers that were way out of my field. Finally, I found this really helpful article about whether or not to bank cord blood, that gave me some more information so I could make up my mind.

Will the technology work?
This, of course, is just speculation. Who knows what they will be using ten or twenty years from now. So, no real answers there. If your child has a disease that is currently treatable with cord blood, you can apply for Sibling Donor Programs that will cover the costs for you. Since this is still experimental for heart valves, our daughter would not qualify–but it is good to know about these programs other parents are able to use.

If they do build a transplant valve, will it be more likely that they will use her bone marrow cells or cells from cord blood?

Hard to say. In many children currently being treated with stem cells, their own cells contain the genetic markers for the disease and is therefore unusable. However, that is not an issue when growing a replacement valve. Therefore, our daughter’s bone marrow would provide an exact genetic match without the issues involved in treating children with other diseases. Also, a single cord blood unit often does not contain enough cells to treat the patient. If my daughter is ultimately treated with cord blood, there is a possibility the surgeons will need multiple units, anyway.

Are we more likely to find a match from her brother’s cord blood or from a public bank?

If we do use cord blood at some point for her, it seems likely we would have to turn to a public bank. Although the chances of finding tissue matches among family is higher than finding tissue matches in a group of strangers, the odds are only 25% that any one sibling is a tissue match. On the other hand, it appears that the numbers game changes the odds. If thousands of samples are available in public banks, the odds are much better that one of these will be a match than the blood banked from one sibling. And, as I mentioned above, many treatments require multiple units anyway.

When will she need it?

We’ve gotten different answers from different doctors. Some say in her early teens, while others believe she will be able to wait until her early 20s. This matters, because we’re not sure about the length of storage possible for cord blood. Some studies suggest it may last up to fifteen years or more…or it may not. So, even assuming we bank her brother’s blood and it is a match and the technology is there and it is enough to grow her a valve, the blood may no longer be usable when we need it.

So, what does this all mean?

To bank privately or not is a hard decision. I would spend any amount of money to give my daughter the best shot at a healthy life. Many patients with valve replacements live long, full lives. At the same time, it seems foolish to throw thousands of dollars at a pipe dream–money that could be spent giving her and her brother other opportunities.

Current transplant valve materials all have issues and all require replacement approximately every 15-20 years. Heart surgery is growing by leaps and bounds, however, and it is entirely possible that a valve grown from stem cells (or made out of another material, like the super-elastic, shape-memory metal alloy called “thin film nitinol”) may be a real option for my daughter.

So, that doesn’t let any of us off the hook!!! Please donate cord blood!

Public banks of cord blood will be the source of stem cells for many potentially life-saving treatments for leukemia, lymphoma, sickle-cell anemia, immune deficiency diseases, aplastic anemia, thalassemia and probably more in the future. If you give birth at a qualifying hospital, without any charge you can donate cord blood, which contains stem cells that may save a child’s life.

Mama Called the Doctor and the Doctor Said…

Since her operation, my daughter has had an increasing fear of doctors, not that I blame her. Doctor visit phobias are fairly common in children, and she certainly comes by it honestly.

And perhaps it is hereditary as well, along with her unusually strong legs. When I was a child, two nurses and my mother had to hold me down for shots and I still managed to kick the stool and send it flying across the room at the pediatrician.

Last time we visited my daughter’s cardiologist, he said he needed a clear picture from the echocardiogram. If we could not keep her calm, they would have to sedate her.

So, since our last appointment, we’ve been reading about doctor’s visits and practicing with our doctor puppet and kit to alleviate doctor fears.

When I called up to schedule, the doctor told me to make an 8am appointment and to give nothing but clear liquids.

Of course, this makes total sense in case she needs sedation, but I was concerned that it also makes sedation more likely. Two year old, plus no food, plus doctor’s office, equals cranky.

When we arrived, they said, “We need to get you registered.” But…we’re already registered. “Okay, let me call registration.”

Apparently, one supervisor was on vacation and the other was in another building so the woman at the desk just disappeared.

Over the course of the next hour and fifteen minutes, the waiting room filled with other patients who also either needed to be registered or have their information sent over to the office.

And, of course, my daughter started to grow hungrier, and more impatient. She was so very good, coloring, reading, playing, but I could see her attention span growing shorter, and I knew what was coming. My daughter is sweet as molasses 95% of the time, but her tantrums go from 0 to 60 in a millisecond and, once we’ve reached the edge, there is no turning back.

FINALLY, we go into the room. I convinced them to delay taking vitals so we would be fresh, but the hour wait had already sabotaged that. The doctor made a remark that if I was concerned about the vitals, he thought that sedation would need to happen. I think the doctor believe sedation to be a foregone conclusion.

The technician points to the television, “Who is that?” Unfortunately, my daughter doesn’t know big bird from, well, a big, scary, yellow bird. At that moment, I start to see the advantages of introducing television earlier.

We get her up on the examination table with her pillow, Cat-Cat, and Yorick the Duck (my husband named him). For some reason, she kept wanting to grab her legs. Finally, we figured out that we had told her she would be lying down, just like a diaper change. So, she was holding her legs up in the air, like she does for a diaper change.

Two year olds are logical, we’re the ones who don’t make sense.

She was a little calmer, but still cried when the technician touched her with the “tickle wand.” Maybe, I asked, I could give her just a little banana?

Uh-oh, bad question. The technician looked nervous and got up to ask the doctor.

The situation was getting desparate, so I climbed up on the table (35 weeks pregnant) and held her. I asked my mom to call the technician back in.

We were so close, and yet not quite there.

Finally, the technician asked, “What colors do you see?”

Baby answered, in a voice approaching awe, “Blue and orange.”

“Good job!”

“Good job,” baby repeated.

“You’re making those colors,” the technician told her.

Bless her.

From there, it was a quick snack and smooth sailing through another hour and a half of tests.

Jessica Alba’s Natural Birth

It is so wonderful to hear a celebrity like Jessica Alba talking about a natural, peaceful birth:

“I didn’t scream,” Jessica tells OK! in an exclusive interview and photoshoot. “It was really Zen.” And Cash could only marvel at his wife’s quiet strength when she gave birth. “She didn’t make a sound,” he says. “It was amazing.”

The Love Guru star tells OK! that she had natural birth. “The labor was more like meditation,” she says. “I did yoga breathing. I was focused.”

Go Ahead, Make My Day (34 Weeks Prenatal Visit)

We went to the 34 Week Prenatal Visit last night. Yes, it was the same midwife from last time, though she seemed to have relaxed and there were no more awkward non-joke jokes.

We have decided to have a hospital birth because my first child was born with a complex heart condition and my husband was deployed during the last birth. We considered a home birth, but decided that wasn’t the best option this time for our family as a whole. Although I wish we had the “middle ground” option of a birthing center, that isn’t available in our area.

So, at this visit, I brought a draft of the birth plan to get an idea of what to emphasize. Our hospital is actually the best in our area both as a medical facility and in terms of what I want for the birth–the midwife practice has a very low c-section rate, less than half the national average, and the other area hospitals do not offer rooming in. So, all was going relatively well until we got to the part about allowing labor to progress naturally even after the membranes release.

Although she said they are willing to let things take their natural course, she casually mentioned that if I develop a fever during labor, my son will be brought to the NICU for antibiotics until he is cleared to go.

“The WHAT?”

Last time I did in fact develop a fever, which no one noticed until my mom said, “She’s burning up.” The wait for antibiotics stalled the labor but in the end, everything worked out fine. After she was born, my daughter was given antibiotics in an IV drip in our room. After 24 hours, she checked out fine and, if it weren’t for the heart murmur, we would have been able to leave.

So, explain to me why my son would need to go to a NICU to receive antibiotics?

According to the midwife: “That was Texas. I don’t know of any hospital in New York that does that. That’s the policy.”

Hopefully this won’t be an issue. But what bothers me the most is the pressure it puts on once the membranes release–the threat of separation hanging over you, pressuring you to make decisions you don’t want to make. If labor isn’t progressing, then here comes the suggestion of pictocin (don’t want to get an infection and be separated), and then the increased risk of a c-section. Last time I had pit but no c-section (thankfully), but that’s a fairly typical downward spiral of how a mama who wants to have a natural or vaginal birth can lose control of her own labor. To me this is not allowing things to take their course.

Later on, I find out that they have a “non-separation bonus” which means that, if requested in advance, the standard heel-pricking, etc. are done in the room with you unless they don’t have enough staffing.

Would I have found out about this if I hadn’t strongly expressed the desire to not be separated from my newborn son?

And, sorry…we’ll wait until staffing is available for non-urgent medical procedures. Unless someone’s life is in danger, no one is taking my newborn son from me.

Out in the parking lot, I turned to my husband and said, “You know, I can refuse consent…if there’s a problem, we may find out how security reacts to a postpartum mama who refuses to hand over her baby.”

He gave me that look you give the strange guy on the street who mutters to himself.

“Will you back me up?”

He still looked a bit anxious, but to his credit the man said yes.

Toddlerism: Kids DO Say the Darndest Things

My Two Year Old, pointing to my belly, very serious: Little Baby Brother inside.

Me: Yes.

Toddler: Sleeping.

Me: Maybe, Sweetie.

Toddler: Dark inside.

Me: Yes, love.

Toddler, making finger-wiggling motion: Little crib inside.

Me: Side-splitting laughter at the image of a little micro-universe inside my womb.

Baby CyberShower for Junior

Some of my FABULOUS online friends are throwing me a baby cybershower on Mamanista. Pamela Kramer of Happy Panda Baby, who also blogs at PMKU, is my hostess with the mostess and our three shower game guest judges are the marvelous: Amy from Crunchy Domestic Goddess, Kristen from Mod*Mom and Christine from Dates to Diapers!

Whether or not you are a blogger, please go join in the fun (play games, say “hi,” and enter to win great prizes), because the guests make a party!

My hostess informs me that people like to see “bump” pics of the mama, so I am going to reveal my HUGE bump (as of this past Friday, 33.5 weeks along). Why do people think it is cute to ask, “Are you carrying twins?” Yes, this second go around I am much larger (and way more swollen) than last time. But still cute, right? ‘Cause pregnant women glow, right?

And to get a little bit of a soundtrack going for the party, during both pregnancies, I had “These Are Days” repeating over and over in my head. Because truly, these are days I’ll remember and carrying a baby is a blessing. Music always sets the mood for me. I actually made different mixes (slow rock, fast rock, slow classical, fast classical, and world music) to bring to my labor so I’d have something that suited my taste at the moment.

Now, let’s play some shower games!

Over at Mamanista, you’ll have an opportunity to play some games and win some prizes, too. Even though of course I’m not entering for prizes (I already got such gorgeous gifts), I will play along right here.

The first is the Most Inspirational Story. My last labor was difficult, and I’m am certainly hoping this next one is easier and more natural…which is part of why I want you all to inspire me with your tales! Maybe some of you will find my labor story inspiring:

My daughter arrived a week and a half early and her father was on his way home for leave from Iraq. In the preceding week, we had discovered she was in the transverse position. So, I started doing handstands in the pool to get her to reposition. Perhaps this led to my water breaking in the early hours of the following morning, or maybe not, but either way she was head down!

The following 24 hours were amazing. Although labor stalled, I accepted pictocin, at about hour 10 I went for the epidural, and I contracted an infection that stalled my contractions, those 24 hours were some of the most empowering of my life.

Each step of the way, I questioned each procedure and made the decision that I believed to be right. I refused the IV when I came in and I fought to keep trying hours after everyone else seemed to have given up. As we started getting closer to 24 hours, I could feel the epidural wearing off and I insisted they let me stand (holding onto the bar) so I could let gravity help.

And then I pushed my beautiful baby into the world and was placed on my chest, making the whole labor more than worth the effort. Her body was the exact temperature of mine and she just felt perfect.

The next game is Most Fabulous Nest. I chose a jungle theme for our last nursery. Although I don’t think it would win most fabulous nest, it was a serene place for me and my first baby. This time, we’re holding off on designing Junior’s space because my little girl didn’t use her room much until she was older. We’ll start him off in the co-sleeper each night and then he can join us in bed if he likes. Once he’s too old for the co-sleeper, he’ll move into his sister’s crib and inherit her room…and she’ll get to choose her own decorations.



The final game is the best/worst/funniest advice for new parents. I think that “nap while the baby sleeps” may qualify for all three. Certainly it is a great idea because new mamas need lots of rest. But who are all these moms who manage to nap with the baby all the time? And how much hired (or family) help do they have?

I think the best advice I’ve heard is to not take everything personally with the baby. You just do your best and then if the baby still cries, you just know that you did what your instincts said was right. That, and get a sling.

Now you go head on over to the CyberShower, play along, and don’t forget to leave a comment!

How Do You Respond to That?

Last night we went to the midwife appointment. There are six midwives in the practice, so last night we saw one we hadn’t seen before and she had a strange sense of humor.

In she walks, full of nervous energy. She says hello and then poses near the calendar on the wall:

“I like to pose near the calendar so people can see…” She’s one of those people who laughs at her own jokes.

Hubby and I laugh, too. Not because that was particularly funny, but because she’s obviously making a good natured attempt to help us feel more comfortable.

While we’re still laughing, she adds, “Because I’m the dark one.” Then, as our laughter starts to become less comfortable. “Most people don’t believe I work here so I show them the calendar.”

HUH?

Did our (African American) midwife just make a racist joke? About herself? And or the bigotry of her patients?

And how does one react to that? If we keep laughing, do we approve of the joke? And if we stop laughing, what does that signal?

Leaving aside the race issue, it isn’t really even a joke–lacking any comedic structure or timing.

Throughout the appointment, she was friendly and professional and thorough…but she definitely had one of those odd senses of humor. The type that is not particularly funny, so she just tells the jokes really quickly and then laughs loudly. Later in the appointment, she compared my two year-old’s typical toddler speech patterns to Tarzan/caveman speak. Not really offensive…just strange and not especially well-delivered.

I really hope she isn’t the one on for the delivery…I don’t think I’d find her brand of humor especially relaxing.

False Alarm

I already wrote my somewhat angsty, confused thoughts about my 10 Year College Reunion. I wanted to share this anecdote but it didn’t fit with the tone of the rest of my post.

My feet were the size of waterlogged bath towels as we headed back to our beds. As I am walking, I feel something wet down the back of my legs.

Maybe it is air conditioning, I figure, and keep walking.

Again, drip drop…I look up. No A/C units. Maybe moisture from the trees?

Drip drop. Not under any trees this time.

Now I’m starting to panic. I’m 30 weeks along…I can’t have this baby yet! And I have no time for bed rest!!!

Maybe you’re sweating, suggests the husband.

No, I don’t sweat that much.

I take a few steps, splitter splatter.

Then I realize…my daughter had put her still open sippy cup of water in my bag. And the sippy was leaking…down the back of my leg.

So, I’m still pregnant…and everything is fine, as far as I know.

Week 20: You Gotta Have Heart

Skipping way ahead to current day. I’m in week 20 and I just had the fetal echo cardiogram. Because my daughter was born with Tetralogy of Fallot, they wanted to check out Junior (oh, yeah, BTW–IT’S A BOY!).

All looks well and I’ve been cleared to proceed as “normal.”

Which begs the question for me, what is normal? I had a midwife last time in Texas, and I’ve found a good midwife practice here in New York. However, I didn’t have the most pleasant labor experience last time around. How much of that was exacerbated or alleviated by being in a hospital, it is hard to say.

Part of me is really starting to feel like hospitals are great–for sick people. But a normal pregnant woman with a normal baby isn’t sick. And it isn’t just the horror stories of healthy pregnant women catching rare awful things from other patients…I’m also just really thinking about why hospitals are necessary for birth.

I’m a fan of Hathor and Crunchy Domestic Goddess, and I’ve been listening and reflecting on what they have to say about home births and the importance of feeling comfortable in your birthing place.

The benefits (in my mind) of a home birth is that it feels more natural and normal to me and I’ll have privacy and can birth the way I wish. The barriers to a home birth include the limited number of nurse-midwives in my area who will attend, the comfort level of other essential participants, and inertia. After all, the path of least resistance is to just go to the hospital. Which is strange, isn’t it? You would think that the easiest thing to do would be to just stay put, but somehow decades of pop culture have made it seem far more normal to rush into a speeding car, climb into a wheel chair, and be propped up in an unfamiliar bed.

My husband missed the birth last time (he was in Iraq), and he is looking forward to it. But I think he would feel more confident having his first time (and yes, his opinion does count here) in a hospital. I can’t forget that although I have a previous experience, this is all fairly new to him.

So, if anyone is actually out there reading…I’d love to hear your experiences with home birth. And I would REALLY love some words of wisdom from your partners. How did they feel about the home birth, before, during and after? Did they need convincing? What made them go for it? How was it? Would they want to do it again?