I believe at my last post, I was freaking out about what it meant to be on "light activity" and feeling guilty for everything I did and didn't do. Recently, I've just decided that being a mom means feeling guilty no matter what you do. There are always choices to be made, always something you are leaving left undone or someone left unattended to. For example, John was supposed to have a meeting last night, but it got cancelled. So I suggested that we go on a date. Called the babysitter and confirmed that she was up for staying late. Easy peasy. But I immediately felt guilty that I was going to choose to spend time with my dear husband instead of rushing home to see the girl child, whom I had seen for all of 10 minutes that morning. So there's the dilemma. John and I need time to relax together, and Becca was in more than capable and loving hands, but I still felt like I was choosing John over Becca - and had we chosen to skip the date and go home, I would have felt guilty about choosing Becca over time with John. Such is life as a mother. And it's really similar to life as a pastor. So we clergy moms (who often have an overdeveloped sense of guilt to begin with) are really good at wallowing. I'm open to advice on this issue, by the way. I'd like to think it doesn't *have* to feel that way.
But I digress...back to the pregnancy. So, I wasn't clear what I was expected to do/not do. I hit up Dr. Google for a little advice and came across a patient education handout from THE Ohio State University Medical Center that outlined "light activity" in pregnancy thusly:
- [Light Activity] is the least restrictive [prescribed level of activity modification]. You can do some activities, like walking, but not others, such as playing sports. Balance each activity with time for rest.
- Get 8 to 10 hours sleep a day.
- Rest one hour in the morning and one hour in the afternoon. Lie down on your left side while you rest.
- Do light household chores only for 15 or 20 minutes at a time. Get help for heavy cleaning or activities that involve bending, stretching, lifting, pushing, pulling or standing on your feet for any length of time
- Take short walks (2 to 3 blocks) if desired. Talk to your doctor about other light exercises you can do.
- Go on short errands or shopping trips, but pay attention to the amount of movement for the activity. Use an elevator or escalator instead of the stairs. Find activities that involve sitting, such as going to a movie or dinner, instead of walking.
- If you work outside of the home, talk with your employer if you doctor recommends decreasing your hours or working part-time.
I showed it to the good doc and he agreed that this is about where I needed to be. Once the expectations were more clearly defined, I could relax and live into the plan a bit more. I don't follow the above 100% - I usually don't get to rest an hour in the morning AND an hour in the afternoon, but have been known to take a quick nap in the youth room at church, and heaven knows I don't get 8-10 hours of sleep a day, mostly because it is taking me, on average this week, about 3.5 hours TO FALL ASLEEP after going to bed. (Not that I'm *complaining complaining* - it is lovely to have a third trimester, even with its discomforts, but, wow, it would be nice to get some sleep.) I am still working full-time (and the doc is good with that), but, thankfully, church life (at least for everyone except the youth ministers) slows down a good bit in the summer. Definitely no 12-hour days lately. I have learned that I can basically work a full day and come home and have to crash for the rest of the evening or I can work a shorter day and have some energy to take care of things (like, oh, Becca and prepping baby's room) when I get home - so I'm doing a mix of both. And I will say that until a few weeks ago, I was not aware just how physically demanding one of my massively famous Target shopping trips can be; I'm usually so caught up in the bliss of the bullseye that I don't notice how it wears me out.
My blood pressure has still been bouncing around a bit, but it has never stabilized at pre-eclamptic levels, thank goodness. I take it every morning and try to forget about it the rest of the day, unless I'm feeling particularly gross, then I watch it more closely. It is interesting how just a somewhat small difference in blood pressure can be reflected in how I feel - I can definitely sense a difference between something like 128/78 vs. 135/85. I don't know if the numbers go up because I feel gross for some other pregnancy-related reason (there are lots of them, I'm learning :) ) or if I feel gross because the BP is up, but whatever. When I feel gross, I watch it more closely, but so far it's always gone back down by the next day or after a nap or something. I am certainly tired and achy. Any of you who have been this pregnant before can probably understand why I've been posting less frequently - both because I'm exhausted and there's a lot to do, but also because we moved the computer upstairs to the play room, so posting means walking up a flight of stairs, which suuuucks these days (and since everything else is on the first level, I can avoid it otherwise). Like I said before...I hurt in places I didn't realize I had bones...bones that are now separating and painful. Also, it turns out that while he appears human on ultrasound, this baby is actually made of flames. Even though it's hot as the dickens out there, Becca requested today that I not turn on the "air 'ditioning" in the car because it makes her ears cold...because apparently I blast it in order for me to stay moderately comfortable. But again, I'm happy to have an uncomfortable third trimester.
Now that we are well into the third trimester, we are starting to make plans for the end of the pregnancy. As in, the birth of the babe. At this point, if I were to go into pre-term labor, they wouldn't do anything to stop it. (I'm not particularly at risk for pre-term labor, any more than anyone else is.) If I develop pre-e (still a distinct possibility - in fact, most people who do get it, develop in in the 30's, week-wise), we will try to manage it with bedrest (the hospital version, likely), but once we hit 34 weeks (on Monday), we're clear to deliver at Williamson Medical Center (the local hospital where normal women have their kids :) ), so as much as I love our Vandy folks, I think we'll be missing out on sharing this moment with them. I'm getting steroid shots on Monday and Tuesday (the last possible chance to have them) just to help the little Booger's lungs should he need to come early (before 37 weeks), but it's just a precautionary measure due to my history, nothing he's shown us he necessarily needs.
We're also working on dropping some of my medicines in anticipation of delivery (that is hopefully still 5+ weeks away). I've been on 100 mg of Zoloft for anxiety and depression for the duration of the pregnancy (down a bit from my non-pregnant dose), but I recently dropped to 50 mg, with hopes of dropping another 25 mg in a couple of weeks. Zoloft (despite the scary lawyer commercials you see) is a pretty safe drug in pregnancy, but the babies do tend to become dependent on it, so it's best to be at as low a dose as possible at the time of delivery, just to save the kiddo some withdrawal symptoms (nothing that really affects their health, per se, but it can make the restless, jittery, irritable, etc...much like the drop in dosage is making me this week). Sometime over the next few weeks (week 37, perhaps?), I'll stop giving myself the Lovenox shots, since it's a blood thinner and, well, you don't want your blood excessively thin whilst delivering a baby, whether it's a vaginal delivery or a c-section. And Dr. Sizemore told us yesterday that if you have taken Lovenox in the past 48 hours when you go into labor, you can't have an epidural...which makes me want to stop taking it, like, yesterday, just in case. Bring on the drugs.
Assuming I don't get sick, I am a candidate for a VBAC (a vaginal birth after Cesarean section). Even though they often have to do what's called a "classical" (or vertical) incision in an emergency c-section (like Becca's), one benefit of her being so darn small and sitting so low was that they were able to do a transverse incision, which qualifies for a VBAC attempt (unlike the classical incision, which indicates a repeat c-section before mom goes into labor because of the high risk of uterine rupture). I can definitely see pros and cons to attempting a VBAC vs. scheduling a c-section, and I don't really have a strong opinion one way or the other, so we've decided to wait and see what my body does leading up to delivery. Dr. Sizemore will let me go one day past my due date (and only because my due date is Labor Day), but no further. So, thinking backwards, the last possible day this kiddo will come into this world is September 4. We've tentatively scheduled a c-section for August 31, the Friday before Labor Day. If I haven't gone into labor (or developed pre-e and been delivered by c-section already), we'll go in the day before for a cervix check. If there are no signs of progress, we'll go ahead with the c-section the next day, since it's unlikely that I'd go into labor that weekend without any signs of being ready by Thursday. If I'm starting to dilate, etc., we'll hold off and see if I do go into labor and attempt a VBAC; if not, he'll slice me open on Tuesday. If I were queen of the world, or at least queen of my body, I'd stay the heck away from pre-e and go into spontaneous labor sometime in week 38, when little man's lungs should be good to go and our dear Miss Becca (the older, not the young miss she watches) goes back to college. But Lord knows I am NOT the queen of my body. :)
I think that about catches you up on the little guy, who, by the way, should be just over 4 pounds now and nearly as big as Becca was when we brought her home from the NICU 5 and a half weeks after her due date. Crazy. We're not scheduled to check his growth again because he's been tracking so darn perfectly - 50th percentile again at last check - but sometime in week 37 or so, we'll measure him just to make sure he hasn't turned into a real gigantic baby, which would point us toward a c-section rather than a VBAC attempt. (Not because I'm skeeered, but because once a baby is over about 8.5 pounds, the success rate for a VBAC drops significantly, making a scheduled section safer...but who am I kidding? I am skeeeered of labor. Who wouldn't be?) Oh, and I guess you can start calling the booger by his name...James Douglas. That's right; he's our sweet baby James! Becca has even (usually) taken to calling him that instead of Nemo...except that her J's sound a little funny, so it's usually "baby Dames," which is, of course, even cuter. Love that girl. Love that boy.