Saturday, May 31, 2008

P.T.A. - W.T.F.?

Edited to note that the complete incoherence of this post accurately reflects my confusion in regard to the purpose and/or mission of every PTA/PTO I've been exposed to.

Since the Sprouts entered school, Nigel and I have made efforts to be involved in their education. This was much easier at first than it is now, because the kids had I.E.P.'s due to developmental issues that may or may not have been caused by their prematurity.

Here in Israel, the kids attend a very, very small private school. I found out yesterday that there will be ONE child in the 6th grade class next year - that's how small this school is.

My current level of involvement has been to meet regularly with the kids' teacher, to be present at various school activities, and to volunteer at various school functions. I have never been interested in actually joining a PTA or PTO, and have a visceral distaste for being an officer. In other words, I will do anything they ask me to do and anything I feel will be beneficial to my kids, but I do not have any desire or need to be in a position of power.

When the kids were in preschool, I actually attended several PTO meetings. These meetings rarely had agendas and generally devolved into complaint sessions that, IMO, would have been better handled through regular channels of discussion with teachers and then, if necessary, discussion with the principal. Little of import was discussed and even less of import was actually decided and implemented by this particular PTO.

Twice, in these particular PTO meetings, a call for volunteers was made by the president. Both times, I and others expressed willingness to help. Both times, however, our offers were rebuffed and the president ended up doing everything she had asked us to help with all by herself. Then at future meetings, this president would take up an inordinate amount of time whining about how she never gets any rest and has to do everything herself. After the second whine-session, I quit attending the PTO meetings, but continued to volunteer in the kids' classrooms and to attend school functions.

I am a lazy person, admittedly, but my reasoning for not wanting to participate in PTAs is more of a desire to stay out of unproductive complaint sessions, to avoid ridiculous political maneuvering (I've already been hearing about the various cliques within this tiny school's parent community), and to keep my time my own (and my family's).

At this school, I have worked hard to try to get to know other parents, generally moms, and generally by talking before the gate opens and when waiting for the kids to exit after school. There are several moms I really like and with whom I would not mind spending time. HOWEVER, a couple of these moms are now pressuring me to get more involved with their PTA, even suggesting I run for office.

AUGH! I can only say this: If nominated, I will not run. If elected, I will not serve. Does this make me a bad mom? I don't think so. Does it make others think I'm a bad mom? Maybe. Do I care? Not at all.

The Birth of the Sprouts Part Four

Following the travails of Part Three, on October 3rd, the same guys who flew me to Hospital D back on July 27th came and flew the kids back Hospital A. Nigel was there waiting for them, and my mom and I cleaned up our room at Ronald McDonald House (with the help of the wonderful people there) and left early the next morning. We arrived at the hospital with two ice chests full of frozen breast milk, which drove everyone crazy, since they only had the small fridges. I ended up taking one chest home with me. We also had a carload of supplies the nurses smuggled to our car – bottles, diapers, wipes, alcohol wipes, formula, all kinds of things that came in very handy and would have cost an arm and a leg. We were there so long, that they all felt like we are family. I still keep in touch with many of them.

Shortly thereafter, The Princess came home. We had actually had trouble keeping her IN Hospital D. She was doing so well that I had to work hard to convince them of the wisdom of sending them to Hospital A together. Hospital A made us to a "sleeping-in" with her, which is just putting Nigel and I and The Princess in a room to be sure we aren't going to kill her or something. Her sleeping-in was uneventful.

A few days before Halloween, The Starving Child came home, over my objections. He didn’t seem right to me. His sleeping-in was horrible, none of us slept and he cried and had reflux all night long. But they insisted he was ready to go. Two days later, the home-health nurse checked his O2 sat and it was 88. So here we went, back to the hospital. Turned out he had bacterial pneumonia. I wrote a very scathing letter to the hospital administrator naming names. He stayed on the pediatric ward there for two days and nights until I realized that he would get better care at home with three adults and two babies, instead of with 2 nurses and 20 kids. They never brought his meds on time, and I always ended up giving him the stuff I brought from home. If I hadn’t been there the entire time, I don’t know if they would have even fed him. Imagine the fun if Nigel hadn’t had time off and if my mom weren’t there to help! So I signed the DAMA (discharged against medical advice form) and took him home, where he recovered in short order and I got lots more sleep in a real bed. He also had a hemangioma (strawberry birthmark that grows) on the back of his head and we had to keep it covered with Duoderm to keep it from rubbing and getting infected. It finally shrank down to almost nothing by the time he was 2. My oldest nephew asked me once if The Starving Child had an extra brain. Naturally, I said YES. We scared the hell out of a babysitter once, when we forgot to show it to her and she paged Nigel during the movie to tell us about this head injury and how she didn’t know how it happened.

The Lottery Winner had reflux so severely that he ended up getting a g-tube and fundoplication surgery. The drs thought he was having seizures at one point, and he got a full whachamacallit (EEG?) on his head, but no signs of seizures. We have since found out that he is one of 5% of kids who are able to stop breathing until they pass out. He did this when he was in severe pain and when he was in severe fury. He would just stop breathing, turn blue, then gray, then stiffen up and pass out. He’d wake up just a few seconds later and be tired and scared as though he had had a seizure, but it wasn’t one. No fits since he turned 4, though, fortunately. He also had casts on both legs for bilateral clubfeet (inherited from my grandfather). We fed him through the tube for a year, and he’s had two surgeries to correct his feet. He didn’t get to come home until two days before Thanksgiving. Both boys came home on oxygen and all three had apnea monitors, which we took off after the 50th false alarm at 3am, except for The Lottery Winner, who really did turn blue a time or two, just to scare the shit out of grandma. We even had a pulse oxymeter at home to check their sats regularly! I sometimes think I could be a NICU nurse.

After all that fun, having three babies at home was a piece of cake. My mom stayed for a month, then Nigel’s mom stayed for 6 weeks. By then, they were 6 months old, were sleeping through the night, (except we actually had to wake them up to eat once during the night – drs orders) and were on a strict schedule designed by Nigel and I based on the schedule at the NICU. We had to write everything down – BM’s, wets, how many cc’s they drank, what we put in it, which meds and when, etc. I look back in the notebook and can’t believe we lived through it! Some of it is funny: “The Starving Child didn’t eat for shit.” Or “The Lottery Winner took 30 cc’s by tube, then pushed it all back up.” Or “The Princess ate 30 cc’s, then barfed about 15.”

I look at them now, and can hardly believe how close they were to not coming home at all, especially the boys. People say to me, “Aren’t they just little miracles?” And I say, “Yes, miracles of modern medicine from conception to 1st grade!” It often annoys me when people who hear our story talk about how I should be thankful to a god, most likely the god they worship. I prefer to praise and thank the doctors and nurses, without whom neither I nor the kids would be here today.

The Birth of the Sprouts Part Three

After all the excitement of Part Two,, they got a suite ready and dragged all the neonatologists out of the NICU to attend, got Nigel suited up, and here we went. I was freezing to death (what a change) and terrified. Nigel was trying so hard to remain calm. He doesn’t like anything to do with blood or any other bodily functions, so I give him ten stars for his wonderful strength. They told us that since the babies were 28 weeks and 4 days, they probably wouldn’t breathe on their own at birth and we wouldn’t hear them cry. They told us that we couldn’t see or touch any of them because they would be rushed to radiant heater beds scattered about the room to be worked on by the neonatologists and nurses. They really prepared us for a great crisis.

The delivery was fast. I got the lovely vertical cut, which didn’t matter to me, since I already had one from the ’88 surgery. I kind of hoped they would go horizontal so I could show off my + sign, but speed was more important. They pulled The Princess out first, at 8:32pm. She cried!!!!! I started crying, too. The nurse taking her to her radiant heat bed held her up high, and I saw her!!! She was terribly ugly and extremely beautiful! Just tiny! The Starving Child came next at 8:33. He didn’t cry, but Nigel saw them taking him to his bed and says he saw him moving his tiny arms. The Lottery Winner arrived at 8:34, and he cried, too!! The Lottery Winner weighed 2 lbs. 2 oz., The Starving Child, 2 lbs. 3 oz., and The Princess, 2 lbs. 4 oz. They were each a little over a foot long.

I didn’t get to see them for two and a half days. That was the absolute worst part. My parents got to see them. Nigel got to see them. One of his FRIENDS got to see them. My f*&^ing in-laws got to see them. But not me. They kept telling me they wanted my lungs and heart to straighten out first and that it would be hard to go into the NICU with my oxygen tank. So I finally went on a 10 hour crying and screaming jag and threatened to drag myself there on the floor if they wouldn’t take me. I got to go.

They were absolutely adorable. The tiniest things I’ve ever seen. The no nipples thing got me a bit perturbed until they explained it. By the time I got there, The Princess was already using a nasal cannula and was in an isolette (the things they used to call incubators). The boys were not doing as well. The NICU nurses said that there is a common saying, “Girls rule; boys drool,” as far as preemies go. It turned out to be pretty true. Just about everything curable that they could have had, the boys had. Fortunately, all curable! My brother, an LPN, came down to visit us and was astounded by the strength of the antibiotics they were giving the boys. They both had bilateral inguinal hernias that required surgery. They both had patent ductus arteriosis that responded to medication, so didn’t require surgery. It took forever to get them from intubation to CPAP to cannula and there were lots of steps backward before they went forward. They both got just about every infection possible: Pneumonia, gram negative sepsis, meningitis. I didn’t get to hold The Lottery Winner until he was almost a month old, and The Starving Child took even longer than that.

Since I wasn’t able to see them for so long, and since they were getting sugar water with electrolytes for food through a nasogastric tube, I started pumping even before I got to see them. Pumping sucks. I pumped for six months, then had to either give it up or give up going to see The Lottery Winner after the other two came home. There just wasn’t enough time in the day. Fortunately, I had pumped enough to keep frozen for another two months after I stopped.

Part Four to follow.

The Birth of the Sprouts Part Two

Following all the excitement of Part One, we arrived at the airport in about an hour and 45 minutes and went by ambulance to the Maternal/Fetal ICU area, where I was unhooked and hooked up to monitors etc. again. They had us in a room designed for delivery with one of those two-piece beds and it was seriously uncomfortable. There was a constant hammering noise in the vents, apparently due to the cooling system trying to keep up with the late July heat. The doctors at Hospital D had a field day with me. It is a teaching hospital, so we had doctors and doctors and doctors, all looking up me every five minutes. They decided to just try to stop any contractions with continued Mag Sulfate and keep an eye on The Princess to be sure she wasn't getting distressed. They said it was possible that we could just leave things as they were for several more weeks, as long as the babies didn't start showing signs of distress. That was fine with me, since I had done my research and knew that the longer they could stay inside, the better chances they had, both for good health and for normal development later.

It was burning hot in there (to me) so I kept making Nigel turn down the thermostat. He was freezing his ass off the whole time. One of the nurses, feeling sorry for him, brought down some scrubs to use as another layer of clothing. He called my mom, who was leaving her house to drive to Hospital D first thing in the morning with my dad. She agreed to bring him some of my step-dad's sweats to wear while I froze him to death. We tried to sleep, but with the uncomfortable bed, the three monitors on my belly, the gnomes in the vents hammering away, and poor Nigel exhibiting signs of frostbite, it wasn't easy.

The next morning, Sat. the 28th, they moved me into another room with a regular bed, which was much more comfortable. However, I began to feel lots of pain. The contractions were back with a vengeance and were getting worse. I had had a cerclage placed at about 20 weeks, and they decided it would have to come out in case my cervix opened up and tore the stitches. They called the anesthesiologist, who wouldn’t be able to come until late afternoon. I got the two other steroid shots that morning and later that afternoon as well. Nigel called his best friend whose sister was attending the nearby university to get her phone number and she picked him up and took him to a local store to get him toiletries and some clothes.

My mom and dad showed up around noon, and we all talked with the attending drs. about what our options were. If The Princess started to look bad, they could try to deliver her and leave the boys. It might work or might not. We thought this sounded like the best option, since if it worked, the boys would stay inside longer. Still, we were holding out to see if the contractions would stop with the epidural later that day.

The anesthesiologist showed up around 6pm and we got the epidural set up and the cerclage removed. I inadvertently insulted the anesthesiologist by asking if his accent was German, when he really came from Russia. Oops. Later that night, I started feeling terrible pain again and nobody could figure out why. They kept increasing the dose into the epidural. By the next morning, I was crying constantly and they finally had me sit up and found that the epidural had fallen OUT! The bed was soaked with anesthetic. Coincidence? Or did I piss him off that badly? Maybe he had family members in Stalingrad during WWII. I’ll never know. Another dr. had to replace the epidural.

Sunday, the 29th, as far as the kids went, was just more of the same, except they wanted to know more about a surgery I had had back in 1988 for an ectopic pregnancy. I was able to tell them the doctor’s name and the hospital where it was performed and the date, then they faxed the hospital for the records. Everything seemed to be going well. They weren’t able to stop the contractions, and I eventually dilated to 4, but they weren’t concerned, since we were going to go ahead with our plan to deliver The Princess and keep the boys in. I, however, started to develop pulmonary edema – fluid was building up around my lungs, making it very difficult for me to breathe. I started getting oxygen and breathing treatments from an R.T. every two hours. It didn’t really help. I swelled up like a balloon, and they had to put these cool thingies on my legs that puffed up and massaged my legs automatically to keep the circulation going. If I still had those things, I'd be wearing them right now.

Monday, the 30th, it hit the fan. They did an ultrasound on my heart, and found that I had a problem there, too. Apparently, when the volume of blood increases with any pregnancy, but especially with multiples, there is the possibility that the heart can’t handle the volume. Lucky me, mine wasn’t able to handle it. The freaking-out began. They got a fax back from the hospital where I'd had surgery and freaked out even more. Now, I had been told by the surgeon in ’88 that there would be absolutely no problem with any future pregnancies. But, apparently, multiples were a different matter altogether. All my doctors knew of the surgery, even before we started fertility treatments, so it never dawned on me that it would cause any problems. The attending was freaking out all over the place telling us that they would have to do a c-section right away and not risk anymore contractions, because I could rupture my uterus and bleed to death in 5 minutes. It was pretty exciting, in hindsight. I was so doped and swollen and uncomfortable, that I would probably have agreed to just about anything.

Part Three to follow.

Monday, May 26, 2008

The Birth of the Sprouts Part One

We got pregnant by in-vitro fertilization in early 2001. The dr. got four fertilized eggs to put back, but told us they were “low-quality” whatever that means, and didn’t hold out much hope that they would implant. 3 out of 4 did! I went on bed-rest in mid-May, just after I received my bachelor's degree – wasn’t going to miss out on the ceremony, since I was 36 years old and had waited that long to finish college! I had contraction monitoring equipment that I had to use twice a day and send the data by phone to a company called Matria. The whole thing was going just great! No excess contractions, no diabetes, no high-blood pressure. The babies were all growing fine, had no life-threatening chromosomal defects, and no apparent other problems. My perinatologist was going to schedule a c-section around the middle of October at 36 weeks.

On Friday, July 27, 2001, Nigel had left to go to a "team-building" exercise at the Zoo. We had just had a checkup that morning with our perinatal specialist and everything was looking terrific. All the kids were measuring over 2 lbs, which was great for triplets just at 28 weeks.

I had been laying on the bed, just resting after the gigantic lunch we ate after our appointment, when I decided to get some more ice water -which I craved like I now crave chocolate and Bugles and Cheez-Its. I heaved my legs over the side of the bed and felt a small *pop* and felt wetness. I threw myself into the floor to avoid getting the bed all wet (stupid priorities!) and felt it running down my leg. I grabbed the phone and went to the bathroom.

While sitting there, I first called my dr., who told me to get to her affiliated hospital as quickly as I could so they could test the fluid and see if it was amniotic (like there was a chance it wasn't - :roll: ). I told her about Nigel and where he was and that we couldn't be there for at least an hour. She said fine. I then called my mom. Bad girl! I still haven't told Nigel that I called my mom before I called him. My mom started packing. Then I paged Nigel and he called me back right away on the cell phone of a woman in his group. I told him to come home right now and what had happened.

He arrived in about 20 minutes, probably lucky he didn't get a ticket, since it normally takes about 35 minutes to get to the zoo. I had packed a small bag, just in case, and we took off.

We got to the hospital in another 25 minutes and found our way to where my dr. was waiting. They tested the fluid and found that it was amniotic. They did ultrasounds and found that The Princess's sac had ruptured, but the boys were still enclosed. They hooked me up to three fetal monitors (external) and told me to stay calm. As if!!!

An hour or so later, my dr. came to tell us that since there were not three beds available in the NICU, we would have to be sent elsewhere in case delivery was unavoidable, but that they were going to try everything they could to prevent delivery. The monitors were showing occasional contractions, but nothing big - I had had a couple of contractions per hour for a few weeks. They wanted to make sure The Princess's sac was refilling itself as it leaked and to try to find where the rupture was - the closer to the cervix, the more likelihood of infection for her. They gave me Magnesium Sulfate, which gave me horrendous hot flashes for hours, but would hopefully stop any contracting. They also gave me a steroid shot to develop the babies' lungs more quickly in case we had to deliver. Two more steroid shots would be required, but they didn't know where I'd be by then. My dr. drew little marks with "A", "B", and "C" on my belly where the babies were located so that her records would make sense when she had to fax them to another facility.

My dr. came back about another hour later and told me that Hospital B was full and Hospital C was full, so they would be flying me to Hospital D. Nigel could go to, as long as he didn't take anything. Within minutes, we were being unhooked from this and that and being rehooked up to this and that and were whisked by ambulance to the airport for a LifeFlight to Hospital D. It was one of the most terrible things I've ever experienced. Besides being frightened out of my mind, I was nauseated and contracting. Poor Nigel was just sitting in the tail of the plane wringing his hands and trying to smile at me a lot. He had called our families before we left. The plane was hot and the Mag Sulfate didn't help that at all. They had to inject Phenergan to keep me from barfing all over their pretty plane.

Good Times!

Part Two to follow

Maleficent's Consumer Report: The Diva Cup

When we were preparing to move to Israel, one of the things people told us was that paper products are expensive and not what we are used to in the States. Now, while I am a Charmin and Bounty woman (who doesn't like squeezable softness on one's hiney or the joys of the "quicker picker-upper"?), I have been conscientiously trying to limit the use of paper products in general around the house. This is made more difficult by Nigel's upbringing in Wisconsin, where paper reigns supreme and half of any town was employed by some paper mill during his childhood. He just HAS to have his paper products. Still, I figured that if I kept my own and the kids' use to a minimum, we could make a small difference. My determination may have something to do with the fact that I did use disposable diapers when the kids were babies and I'm still experiencing a bit of guilt. Our diapers (triplets times at least 6 changes per 24 hr. period) probably made a land-fill of their own.

Now, on to the products in question: Feminine hygiene products; pads and poons; plugs and mattresses. I have always hated pads. Bulky, uncomfortable, smelly, no matter how "soft" the cover, no matter how frequent the change, no matter how mom-ish the pants, pads have been my bane. They are also hard to transport without taking up needed room in the tiny purse, and all purses end up being too tiny, no matter how big they actually are. Like George Carlin's "Stuff," things just multiply until there is no more room. Poons (a euphemism stolen from my best friend from high school, along with the name "Charlie" for our periods, as in "Aw, crap, Charlie's here for the week!" or "Chuck got to my house yesterday.") are much better, but still a pain to transport without getting purse-dirt all over them when the packages open. Subject for another post: my first tampon use, complete with lesson from above-mentioned friend, in a "not for customers' use" bathroom, on Bourbon Street, during a choir trip to New Orleans my sophomore year of H.S. Good times!

At any rate, someone on a forum I frequent had mentioned a Diva Cup in response to a complaint from another forum member. In researching this interesting item, I found that there is also a Moon Cup, which is very similar. I chose the Diva Cup because of its availability in an actual store, so I didn't have to mail order.

TESTIMONIAL: I love this thing. I've been using it for four cycles now, and I can say that I do not ever want to go back to sticking paper inside me or in my underwear.

That said, this product is not for everyone. It does put you in close contact with your menstrual blood, and it takes some practice and some getting used to. It took me a cycle and a half to get the hang of insertion and removal, but I only made a mess one time, so not that big a deal. The sight of blood doesn't bother me, unless I can see tendons or bones through it, so that wasn't a problem either. I don't have any issues with having to put my fingers into my vagina to adjust things if necessary, so no problem there.

There are only two sizes of Diva Cups. The small size is recommended for women under 30 who have never given birth. The large size is for women over 30 OR women who have given birth. According to this formula, I should be a size large. However, I find that the large size is a bit too large for me, even though I am both over 30 AND have given birth. When I replace my cup, I will be getting the small size to try. Their reasoning for my use of the large size is that vaginal muscles get looser with age and with childbirth, and my hips are wider than they were prior to childbirth and maturity (physical maturity, that is!). Still, I have done my Kegel's, and I am a very small person to start with, so I don't think these rules apply to me.

I highly recommend this product. Here are a couple of helpful hints for beginners if you should choose to buy a Diva Cup:

1) When you are first learning to use the cup, run your finger around it after insertion to be sure it is all the way open. I found that when mine was new, it sometimes remained partially folded, causing leaks. I could correct this by gently pulling it down until it fully opened up and then gently pushing it back into place.

2) When you are first learning to use the cup, be sure you are gentle when removing it and that you are holding it upright. My first removal was a little too quick and that's when I made the mess.

If I remember correctly, my Diva Cup cost me $35.00. This is pretty pricey, considering my flow is not too heavy and I didn't go through poons like more heavy-flow women do. Still, I like it so much better than other products, and I will no longer be contributing used pads and poons to the landfill, so I think it is worth it.