Tuesday, March 16, 2010

All She Wants for Christmas...

. . . is her four front teeth!

Nearly two weeks ago Adah lost two teeth in three days. One was pretty loose and fell right out as she was eating some soup. The second tooth--not as loose--was reportedly "knocked out by Maggie" two nights later. I wasn't home at the time and apparently the girls were goofing around/rough housing and an otherwise mild collision popped Adah's tooth right out! Two tooth fairy visits in one week was quite a cause for excitement in our house and Adah's first grade classroom.

Now, why did I say that Adah wanted her four front teeth? Well, two of Adah's baby teeth never came in! So, now she has a roomy front gap (and "vampire fangs") that will hopefully be filled by 4 permanent teeth. We're actually not sure whether or not there are 4 teeth waiting to come down. Adah is a little overdue for a dentist appointment (I swear, I'll call this week), but previously our dentist basically said, "There's nothing we can do about it yet, so I'm not going to make you pay for an x-ray you don't really need right now." I actually liked that conservative view of matters and decided to just worry about permanent teeth later. Now that she's got some space, we'll see about those x-rays.

Meanwhile...Adah seems to be enjoying her gappy grin.

Wednesday, March 3, 2010

And it came to pass. . . or not

Disclaimer: This post documents a painful medical condition I suffered and includes my own memories of the unpleasant details. It's also very long. I couldn't help it.

Two weeks ago, when I was 26 weeks pregnant, Damon took me into the hospital at about 8:00pm after I'd been suffering with severe back pain and some Braxton-Hicks (i.e. fake) contractions since the late afternoon. When the back pain started I figured I must have just picked up Gunnar wrong that day and tweaked my back a little. I'm pregnant. A backache comes with the territory. However, the tightening in my tummy became worrisome as the back pain didn't let up with heat or any new positioning of a pillow.

In the tiny OB ward of our local hospital, the nurse initially suspected I had a UTI. (I'd also been visiting the bathroom like every 10 minutes with nothing much to show for it.) She immediately put me on a fetal monitor. I had been feeling the baby move around a lot, so I wasn't too concerned about her. Her wiggling made it a little difficult to find her heart rate on the monitor, which just meant I had to sit there in pain wishing we could skip the monitoring and go right to relieving me. Eventually the nurse decided she'd had enough and we moved on.

I can't remember all the details of what happened after that. There was some vomiting and the nurse conferring with the doctor on call (who I never actually saw in person), and the bottom line was that the doctor and the nurse both suspected I might have a KIDNEY STONE. We were sent home with an antibiotic prescription (in case of the UTI) and the okay to take acetaminophen (Tylenol), from which I normally abstain during pregnancy.

We returned home where a kind and worried ward member had put the girls in bed (Gunnar went to bed before we went to the hospital). I went straight to bed and proceeded to have one of the worst nights of my life. I was awake every couple of hours throwing up into a bowl on my nightstand, using the bathroom (where I was supposed to dutifully strain my urine for possible stones), and then trying to get back to sleep despite the horrible pain in my right flank (basically my right side, towards my back).

I finally got a bit more sleep in the 5:30-8:30 time range and woke up able to eat some toast, applesauce, and peppermint tea before we headed across the river for an ultrasound at a neighboring hospital. (The ultrasound tech at our hospital was apparently out of town. "There's only one?" you ask. So did we.) One of their techs had gone home sick and they had squeezed me in at the last minute anyway, so we ended up having a really long wait--during which time I was supposed to have had a lot to drink and then not use the bathroom. Come on, people. I'm pregnant! I had a little outburst after being told it would just be a few more minutes and then having another patient called in ahead of me (granted, they were also doing MRIs, CT scans, and X-rays through that door) and the receptionists took pity on me and let me "go." Then I totally chugged 20 oz. in about 3 minutes and the tech never suspected a thing when I was called back about 2 minutes after that.

The ultrasound showed that my right kidney was totally full of fluid, a pretty strong indication that a kidney stone was lodged in my ureter and preventing the fluid in the kidney from being released into my bladder. We waited a little longer hoping to hear from the in-house urologist, however he was in surgery so we were sent back across the river to the doctor's appointment at my home clinic (but not with my usual doc, who was not working that day).

During all this waiting I was in continual pain and by the time we headed back to White Salmon it was time for another Tylenol dose (Damon had to buy some in the gift shop since we hadn't brought any with us) and I was getting seriously nauseous again. Back at home I was able to get a nap and have a little snack before the doctor's appointment. The doc prescribed a stronger pain med and said he was still waiting to hear from the urologist. He was also very sympathetic, having suffered from kidney stones himself.

Eventually, in the late afternoon at home, I got a call from a different urologist's office. This doctor prescribed another pill (read: Jillaire makes a 3rd trip to the pharmacy in as many hours) which was supposed to dilate my ureter and hopefully help the kidney stone to pass. They also made me an appointment for the following Monday. Now, keep in mind, it was Wednesday at this point. Inside I was yelling, "Monday?! Monday?! I'm supposed to wait until Monday?!" but instead I politely asked, "Why not until Monday?" The receptionist said he [the doctor] wanted to wait and see if the drug would work and I'd pass the stone on my own. Sigh.

Thus started the waiting game. Damon read up on the Internet and started plying me with distilled water (of no worth) and oranges (we're not sure--lemon juice/lemonade is a good stone preventer, though). Otherwise it was just a matter of coping with the pain, eating when I had an appetite, and trying to get a good night's sleep. There were times when the pain was definitely more intense than usual and I couldn't do much other than lie on the couch and moan. Other times I was able to be up and around, taking a shower (the heat felt great on my back) and getting my own food. Picking up Gunnar was pretty much out of the question, though. Damon worked a few hours here and there while the girls were in school and I put Gunnar in front of the TV, but mostly Damon just tried to work from home and take care of everyone.

By the time we went into the urologist's office on late Monday morning, I was pretty much ready to beg them to just go in and remove my entire kidney. "Just pull it out!" I thought. However, I was also resigning myself to having the doctor say, "You're pregnant. There's not much we can do," and then just have him tell me about possible ways of helping the stone to pass (like drinking distilled water and eating oranges?). Most of what we'd heard and read was that they can't really do anything for pregnant women with kidney stones.

Gratefully, we--and everything we'd heard and read--were wrong! The doctor wanted to do a few X-rays utilizing a kind of dye so that they could see the path through my kidney, ureter, etc. He said that the guideline for radiation with pregnant women is "as little as possible." He felt that I was far enough along in my pregnancy to do these quick images and we agreed. (Usually they do CT scans for kidney stones, so this was definitely the more conservative route.) So, across the street we went to yet another hospital in the Gorge, and then back to the urologist's office for consultation.

After looking at my 3 images, he informed us that my right kidney was completely blocked. NO fluid was getting through on that side. He recommended a procedure for the next day: ureteroscopy laser ablation of the kidney stone. Essentially, he'd put a scope up through my urethra and bladder and then into the ureter where he'd blast the stone with a laser and scoop it all out with a tiny little basket that would also prevent the stone from going back up into my kidney. The risk: possible premature labor. The doctor left the decision up to us. He said that if I thought I could handle a few more days of the pain, he thought I would probably pass the stone. But, if I had had enough, we could do the surgery. Hmmm....while earlier in the day I'd been ready for them to just amputate below the waist, now the possible reality of a very premature baby definitely gave us pause.

At this point it was past 5:00. Damon had dropped off Gunnar and Maggie with a friend around 8:30 a.m. so he could go to work for a couple of hours before my appointment. Adah had gone to their house after school when things went long. Needless to say, we were feeling a lot of stress about picking up the kids, getting them in bed, and then making this big decision. And, of course, I was at the end of my 6th day in constant pain.

Back at home, we talked to a retired urologist friend of my dad's who recommended a different procedure which he felt was less risky for a pregnant woman. It might not remove the stone, but it would relieve the pressure of the blocked fluid and the risk of infection that is the ultimate danger of a kidney stone. This procedure, however, required an invasive radiologist, a specialist that we weren't sure was practicing at any of the Gorge hospitals.

Side note: Most people think the pain of a kidney stone is from the sharp little "rock" poking the tubes in your body and scraping you up as it moves along and eventually out. That's not true. The pain is from the swollen/blocked kidney. Once the stone passes out of your ureter and the fluid can go into the bladder and out your body, the pain is relieved. The other "passages" are plenty large enough to accommodate the stone and so the passing itself is pretty much a non-event--except that you're supposed to catch it for analysis. It is true what they say about kidney stones being worse than childbirth. It was seriously like being in labor for a week, without breaks in between contractions, and without the reward of a baby at the end.

Monday evening we also got ahold of my own doctor who put me at ease about the risks of premature labor (she felt they were very small) and also expressed her extreme trust in the urologist. In regards to the alternative procedure, she said that there were no invasive radiologists in the Gorge and that a referral to a doctor in Portland would probably result in a delay of several more days. She also indicated that this urologist was not a "surgery-happy" surgeon. She said that if he felt it was safe and necessary, she would trust him. Damon and I went to bed resolved to ask the urologist about this other procedure in the morning, so that we had really explored all our options.

Before the doctor's office opened in the morning, I left a message with his answering service. However, before they got the message, the doc called his office from the operating room (it must have been his surgery day; I was 5th in line for that afternoon). He had looked at my 4th and final x-ray--taken after we'd left his office the evening before--and was now strongly advising me to go ahead with the surgery. The receptionist said she'd ask him about the other procedure, and we eventually got a callback about that, indicating that it really wasn't a good option given the situation. (At this point, I was feeling very good about having the surgery and really ready to go with whatever he recommended.)

I spent the morning making phone calls and figuring out the logistics of childcare, including getting the girls to their piano and dance lessons. (I was pretty proud that I was able to work that in--and so grateful for willing friends.) I think Damon went to work briefly. I can't really remember. In the midst of all this, Damon was up against an important deadline at work that had him going in after the kids were in bed and coming back home after midnight. His boss was very understanding and the deadline got pushed back. Nevertheless, it was a stressful week for Damon and he handled it all very well.

We reported to the OB ward of the hospital for some pre-op fetal monitoring, where we were visited by the urologist and anesthesiologist. The urologist talked to us a little more about the other procedure and why he felt the ureteroscopy was the best choice. The anesthesiologist informed us that general anesthesia would not be necessary and that he would be doing a spinal block instead. This was good for the baby, but freaked me out a little at first. I was kind of looking forward to the nap and wasn't sure I wanted to know what was going on.

In the end, I got to see the whole surgery on a screen and it was pretty cool! It was like Star Wars, watching them blast away at that stone with a laser. That stone, which the doctor estimated at 5 mm, ended up being 15 mm!! (That's 1.5 centimeters, in case you're a little rusty on your metric.) When he saw it, he said, "Jillaire, there's no way you were going to pass this. It's a good thing we're here."

The surgery lasted about an hour--I think--and after a short time in a recovery room right by the operating room, I was wheeled back to my room in OB for further baby monitoring and wearing off of the anesthesia before being released to go home. At least, that was the plan. The numbness took forever to wear off--about 7 hours after the surgery, to be more precise. And, as Damon put it, they wouldn't let me go until I could "go," so I ended up spending the night in the hospital. At 10:00pm Damon finally went home, leaving me until the next morning when he, Gunnar, and Maggie came to pick me up.

I was definitely worn out after a week of coping with pain and not getting good sleep, but the pain was immediately relieved after the surgery and it was remarkable how much better I felt. After about 2 nights back in my own bed where I could sleep 5-6 hours at a time (instead of 2), I was back to myself--more or less. I did find that during a week of being doped up on Tylenol every 4 hours, my basic pregnancy aches and pains were gone. Now that I was off pain meds, my hips were sore and my back (not at the site of my kidney) got stiff much more easily. No matter. I'm happy to trade in the kidney stones for maternity discomfort.

So, to any of you who actually made it all the way through this post and are wondering what's next: I return to the urologist next Monday for a follow-up. Hopefully we'll be able to get to the bottom of what caused my kidney stone. There is more than one type, so analyzing it can help determine what you need to do (usually diet-wise) to prevent them. I'm actually just hoping this had something to do with my pregnancy. I've never had a problem before, but since I don't plan to be pregnant again, I'm hoping this was a one-time ailment.

Saturday, February 13, 2010

The Best Way to "Have" a Pet

I think I may have discovered the secret to satisfying my children's yearning for a pet. (Yeah, I'm that mean mom who won't really allow animals in the house. Really, I am allergic to cats and dogs.) Anyway, the secret: a couple of weekends ago we babysat Adah's class pet Fluffy the Hamster, aptly nicknamed "Hamsty."

This was the perfect arrangement. On Friday afternoon we picked up Hamsty's cage from the classroom and were informed that he had clean wood shavings. All we had to do was feed him and give him water, and return him Monday morning! No cleaning the cage. No cleaning the pet. No vet trips (hopefully). No expense. No time to smell. Perfect.

My biggest worry the whole weekend was Gunnar. As I told Damon, "I don't trust him any further than he can throw Hamsty." Fortunately, there were no incidents. We did catch Gunnar trying to get the lid off the cage a few times, but someone was always ready to intervene.

The kids were delighted and enchanted with our weekend visitor. They had plenty of opportunities to hold him, let him out onto a towel for playtime, and generally show him off to anyone who happened to come to our front door.

It was a complete success and Hamsty was happily returned to the classroom Monday morning. We may even have him over again. (I hear there's a line-up, though--other parents must know "the secret.")

Epilogue: Sadly, Hamsty died about two weeks ago during lunchtime. Cause of death: suspected hamstercide by a fellow classmate who reportedly was squeezing Hamsty earlier in the day. Adah's teacher had all of the children paint a rock to place over the grave under a tree near the school where they had a small service. The class voted to have everyone donate 50 cents each to go towards purchasing a new class hamster.

Fun Times, or "Cabin Fever"

Here's just a little bit of what's kept us occupied during these rainy and gray days of late winter.

When Gunnar fell asleep in the car, Damon brought him in and ended up falling asleep holding him on the couch. That was a signal to Maggie to pull out her hair accessories:
Here's what happens when you let your children help you shred documents:
Note: I thought, "Sure, I'll be the fun mom and let them play with all the shredded paper." Next time, NO WAY. There was a huge fight when it came to clean-up, even though they were forewarned it would be their responsibility.

Finally, just this morning I woke up to find a pirate ship, Dash, in the family room. Here are two of the crew:

Aaaargh!

Monday, February 1, 2010

Adah's Reports

I wanted to show off some of Adah's recent school work. The first is from a little booklet she made, titled Bee Facts. The book begins [with Adah's original spelling], "Bees make nectar in to honey. Bees sting there enemys, but when they sting they die. Bees dance to show other bees where flowers are."

Page 2 is our favorite:

This second report was written just last week in her reading class. Each student had a library book on a different animal. They took notes and then had to write it all out in sentences. I was impressed with the complex structure of her first sentence, and then got a chuckle by her matter-of-fact statement/question later on. Enjoy:

We are very proud of Adah. She has a bright, curious mind. We're glad she has a teacher who really knows how to engage and challenge her. Keep up the good work, Adah!

Friday, January 22, 2010

Maggie Mermaid Turns Five

Maggie celebrated her fifth birthday this month in underwater style. She has been really into mermaids lately, so her birthday had an aquatic theme this year. She got a mermaid sandbox playset from Mom & Dad. It's a small box full of blue sand with rocks, seashells, a mermaid, fish, and other fun stuff for digging about. She and Gunnar both really enjoyed playing with it before the afternoon birthday party.
We had a fun after-(elementary)-school party with some very well-behaved, quiet young ladies--excepting our own Adah and Maggie who were bouncing off the walls in excitement. (Seriously, some of these guests hardly said a word!) The girls--and Gunnar--began the party by making seashell and jewel crowns.
Next they had a treasure hunt through the house, looking for marine items such as swim goggles, seashells, a toy whale, and flip-flops. The final prize was a treasure chest full of bubble bath, candy, pens, and other prizes buried under pasta shells.

After that, the real excitement began as each party-goer was equipped with their own mermaid tail. We had them step into garbage bags which we cinched and duct taped around their waists. Another, not-so-tight, strip of duct tape went around their knees. Then the kids had races across the family room to retrieve their crowns. It was so fun to watch them hop, squirm, and flip their way back-and-forth, giggling and bumping into each other. After the races, some of the girls were ready to be set free, but others--Gunnar included--kept their tails on for the duration of the party. Gunnar even requested another "mermay tay" later in the evening when the party was over, coming up to me with a new trash bag and the tape.

After opening gifts, we returned to the kitchen table for mermaid cake!
I am proud of this latest birthday cake creation, although I can't take creative credit for it. It was courtesy of Family Fun magazine. We did exercise some artistic license to cover the mermaid's top with Necco wafers, instead of strictly using them as tail scales. (For me, the frosting was a real hit. I get bored with plain old buttercream, but can't use yummy chocolate when colors are required. This frosting was a basic buttercream with cinnamon added. On top of chocolate cake: yummo! And it resulted in a nice skin tone for our mermaid, along with being easily dyed for the tail.) There is one warning that comes with this cake: it is HUGE!! It took me 2 trips to the shed to find a piece of wood large enough for laying out the entire cake.
It was all worth it, though. As you can see, Maggie Mermaid had a great time at her party:

Monday, January 18, 2010

95% Chance of Baby Girl

100% chance of baby

I think that most of my readers (3 or 4 of you?) already know about baby number four's expected arrival at the end of May. Perhaps you have not yet heard that now we're expecting a girl!

I had an ultrasound on January 6 that gave us the good news that baby is alone in there, growing at just the right rate, and has all the correct body parts looking as they should. Damon and the kids joined us in the tiny (and warm) room, but after pestering the doctor too much, they (the kids) had to be removed. Adah was very interested in knowing what every little image was, while Maggie was just confused. (Aren't we all, when we look at those things?)

The doctor tried for a long time to get a good shot of the baby's face to print for me. The circle at the top right is the head, with the two little circles below (and to the side) being the hands. That was the best he could do. I told him not to worry about it too much. I don't have ultrasound images of any of the other kids, so I knew I wouldn't feel a great sense of loss if I didn't have one of this baby either. With Adah, they forgot to print any for us. Maggie's got left at the hospital in Bedford when I went in with false labor (and never returned, since she was born at home). I had an image of Gunnar, but it was only of his private parts confirming he was a boy, and I figured we didn't really need to preserve that in the baby book. (I don't know why that's the only image the doctor printed for me.)

After looking for a long time, the doctor gave us a 95% confident prediction that the baby will be a girl. Of course, that 5% has left me a little anxious about totally throwing out the blue in favor of pink at our house, but we think the odds are in her favor, so that's what we're planning for.