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Friday, December 31, 2010

I love my crappy dog.

Monday morning, Kronk was fine. He ate his breakfast, was playing with Anna, and barked at the neighbor’s dog. But that night we went out to dinner and when we got back home, Kronk was most definitely not fine. He was obviously in a lot of pain, wouldn’t eat or even walk. Because things had gone downhill so quickly for him, we decided to take him in to the emergency vet clinic. Tests done there revealed a mass in his abdomen. The vet told me that it could be a cancerous tumor, a benign tumor, or a mass of cells caused by a perforated intestine. We wouldn’t know which until she could perform an exploratory surgery.

I decided to go ahead with the surgery because in two of those three possible scenarios, full recovery was likely after the mass had been removed. So Kronk went into surgery at 1:30am on Tuesday morning and wasn’t out until after 5am. The surgery was long and complicated.

There were actually 3 masses that they removed. The masses were not touching and didn’t look uniform, so they weren’t sure what they were, but there were two smaller ones and one large one. The big one was the trouble-maker, a tumor 3 inches in diameter. It had grown into a section of the intestine and a corner of the pancreas. To remove the tumor, the vet had to cut away part of the intestine and part of the pancreas, then resect the intestine to repair it. Kronk had to spend a couple days in ICU because of the severity of the surgery.

Kronk came home from ICU two nights ago and for now he is doing fine. He is continuing to recover at home. His pain is well managed, and though he’s reluctant to eat, he will swallow food when it’s force-fed via syringe. But his energy is coming up, he’s responding well, and we have confidence that soon he’ll be back to feeding himself.

Samples from all 3 of Kronk’s masses were sent for analysis by a pathologist. We were all hoping to hear that the tumor was benign, because that might mean a full recovery for Kronk. However, that was not the case. All 3 masses were related, 3 tumors from the same cancer: a leiomyosarcoma. The vet is going to consult with some oncologists and then get back to me about Kronk’s long term prognosis. His cancer is likely to recur, we just don’t know when or how. Hopefully, the vet will give us some idea of what to watch him for and how to know when it’s his time.

We’ve pretty much decided that we’re not going to do any more treatments. The two main possibilities are 1) chemotherapy very soon or 2) another surgery when the cancer grows back. We feel like, in either case, it’d just be putting Kronk through more sickness/pain than it’s worth. Putting a dog through chemotherapy seems questionable to me, and sarcoma has a reputation for not responding well to chemo, anyway. And more surgery would just be more than Kronk’s old body could take, I fear. So we’re trying our best to accept what will likely be inevitable. Hopefully, we’ve bought Kronk a decent amount of time, but really time will only tell.

This whole process has been a huge drain on me, both emotionally and physically. Physically, there are vet visits every day, sometimes twice a day, I have to help him and coax him when I need him to move around, I have to pill him and force feed him three times a day, and between the middle-of-the-night care and the worrying constantly going on in my head, I’m sleeping terribly. Emotionally, there’s the obvious struggle of knowing you’re slowly losing your dog. And I know, he’s just a dog, but I love him a lot, even though he’s just a crappy dog who doesn’t get along with other dogs and howls at kites and rolls in dead things. He’s also the dog who I trained to lay on my feet to keep them warm and who protects me when he perceives danger and who loves nothing more in the world than for me to hug him tight around his neck. Who wouldn’t love a crappy dog like that? But the other emotionally difficult thing about this has been that I’m second guessing every decision that I’ve made. Knowing now that he has a cancerous sarcoma, I wish that I’d not put him through the surgery. If we’d known then what we know now, I’d have had him euthanized that first night. How long will he have? How much pain will he be in? When the cancer comes back, how bad will that be for him? I just don’t feel like I’ve made the right choices for him and it hurts me to know that.

And on top of all this, there’s the constant threat of labor. I’m to the point of begging Ellowyn to stay in: I’ll walk around pleading to my belly, “Just one more week, ok? I just need you to stay in there for one more week.” Because hopefully by then Kronk will be better and I can’t fathom having to do all this care for Kronk and also have Mira AND ALSO have a newborn. Not to mention during labor. Kronk needs attention every two hours right now. Who will care for him if I go into labor right now? And then once we get home, will I be stuck in a perpetual rut of taking turns between caring for the baby and caring for the dog? And where does Mira come in to that? And it’s terrible that now the imminent arrival of my baby, something that should be exciting and that I should be overjoyed about and that I should be anxiously looking forward to, now that’s all turned into some lurking impending doom and just that fact makes my heart hurt a little more.

I guess you could say this has been a rough week for me. I hope you were all prepared to hear me pour my heart out.

Thursday, December 30, 2010

Pregnancy update - 37 weeks

Well, the pre-labor is going on and off and on.  Nothing as intense as that first night, where the contractions were coming on at least every 10 minutes for over 12 hours, but still having contractions pretty frequently, though they're also not as painful intense.  They'll start up, usually when I'm walking around, go every 8 minutes or so for maybe an hour, and then quit again.  I saw my midwife again on Tuesday (I'm going weekly now), and after a pelvic exam, she told me that I was still dilated to 1cm, as I was last week before all the pre-labor.  But now my cervix has moved around from a posterior position (where the cervix exists normally in most non-laboring women) to a more front-and-center position, the position needed for labor.  Also, Ellowyn's head is down low, at a -2 station now.  So all those contractions are moving things around, getting things lined up, softening the cervix, and bringing the baby into position.  So really, this could happen any day.  And now that I'm "full-term" at 37 weeks, I'd be comfortable delivering any time.  So now for the waiting...

Tuesday, December 21, 2010

Pregnancy update - 36 weeks (also, I talk too much)

My last pregnancy update was at 34 weeks, and I’ve actually had 2 prenatal appointments since then. And a lot has been going on with my body. Changes are definitely happening and I feel my body working up to labor.

Starting around the end of week 34, my Braxton-Hicks  contractions really amped up the volume. They were really strong, very uncomfortable, and mildly crampy. I also started having them very frequently, several times in an hour. It was a few days after that, I was in the beginning of my 35th week, when I started having what I can only describe as sharp, popping pain... down there. These pains started worrying me because I remember having something similar a couple hours before going into labor with Mira. So I went ahead and scheduled an impromptu appointment with one of my midwives.

After the routine checks and a pelvic exam, the midwife informed me that my uterus was “stressed”, her words. It’s normal for women to have BH contractions, but not with the intensity and frequency that I was experiencing. (I had several during the appointment, so she got to witness them first hand.) And the sharp pains that I was having, she called “cervical twinges”. She said it was basically the cervix starting to loosen up, and could feel quite sharp and painful. The pelvic exam revealed that, at that time, I was not yet starting to dilate, but my cervix was softening in preparation for labor. Of course, that can happen minutes before labor or weeks before labor, but either way that’s what was causing my discomfort. She said that she didn’t see any signs that I was going into labor immediately though, so she sent me home with directions to get as much rest as possible, drink lots of water, take hot baths often, and come back in 1 week.

Well, de-stressing a uterus is not an easy thing when there’s a toddler involved but luckily I have family and friends to help me. I’ve had meals prepared for me, several times someone has come and taken Mira for me, and Brian has really stepped up on a lot of the chores that I normally would do. But despite all the help, the BH contractions continued to be pretty frequent and fairly intense. They were uncomfortable enough that if I was walking when I had one then I would have to stop and stand still. And when I had them while driving, I was always very tempted to pull over.

After that week, I went back in yesterday morning for my next checkup. The midwife made sure that the baby was still head down, took a swab to test for GBS, and did a pelvic exam. I had told her that I was planning to travel to Dallas for Christmas this coming weekend and asked her if she saw anything to indicate that I should do otherwise. Essentially, her response was that I should stay home, though she didn’t say it quite that directly. My blood pressure was slightly elevated above my normal (though still in a healthy range), probably from holiday stress. And in the past week I had dilated to 1 cm, probably as a result of all the BH contractions. The midwife told me that she would advise me to do whatever I could to make this holiday a restful one... which sounded a whole lot to me like “Don’t go to Dallas.”

So that was yesterday and I went about making all the calls and cancellations so that we could stay in Austin for the holidays. And it’s looking like it’s a good thing that I did...

Because last night my body decided to give this whole labor thing a test drive.

I started having contractions that felt a whole lot more like actual labor contractions, starting at about 4:30pm yesterday. They were very crampy and much stronger than the BH I was having, and while they didn’t seem to have a steady rhythm, they were coming on about every 5-10 minutes. I called Brian and let him know what was going on, but that I wasn’t sure it was labor, and we decided that he would finish out his work day and then come home. So Mira and I sat down in front of Sesame Street and I relaxed and drank water while Mira was entranced by puppets. By the time Brian got home, the contractions were still going and becoming more intense, but still no steady rhythm. So we ate dinner and I called my mom to give her an early warning that we might maybe possibly be starting labor or maybe it was nothing. She said she’d go ahead and come get Mira to spend the night at her house just in case it was labor and I needed to go to the birth center in the middle of the night. Which was great because it really let Brian and I focus on what was going on with me, and on getting ready in case it was the real deal. (I had so convinced myself that the baby wouldn’t come till after Christmas that I didn’t have a bag packed for the labor yet or even have the baby’s carseat installed in the car.) So while I was taking a bath, Brian packed a bag and got the car ready. I was still having contractions at least every 10 minutes, sometimes they’d come much faster (every 3 minutes) and sometimes they’d slow way down again. Brian took great care of me the whole evening. At about midnight, we decided that we’d both try to sleep. I was still having frequent contractions, but they were feeling milder now, so I was hopeful that I’d be able to sleep through them. And I did... some. I slept for one 2-hour stretch and then for little 30-minute snoozes for the rest of the night. Brian slept a little better because we agreed that he should sleep in a different room so that I wouldn’t disturb him unless I needed to. But by this morning, the contractions had pretty much stopped... when I was sitting or laying still. The minute I would get up onto my feet they would start up again and walking would lead to basically one continuous contraction that just came in waves, with no defined start or stop, just an ebbing and flowing.

So that’s where I am right now. Brian has decided to work from home today so that he can be close to me and help me when I need it. Mom brought Mira back home for her nap, but can take her back at a moment’s notice, since she’s off work till after Christmas. I’ve given up on actually being in real labor for right now (though I was never convinced that all those contractions were labor, since they never became steady and organized). And still now, if I’m sitting or laying, the contractions go away, but if I stand or walk they come on immediately and pretty strong. So we’re sort of in a play-it-by-ear situation.

The good news is that, being 36 weeks along, my midwives could deliver me at the birth center now. (Any earlier than 36 weeks and I would have had to go to the hospital because of the risks associated with babies born prematurely.) But still, I hope that Ellowyn manages to stay put a little bit longer. Mostly because the closer I am to full term when she is born, the healthier she is likely to be. But also because we didn’t really plan to have a newborn at Christmas, and I’m not sure how it would effect our celebration plans. Do I really want to take a days-old baby to a huge gathering of people? I dunno...  We'll cross that bridge if we get there.

Monday, December 20, 2010

Mira counts

About a month ago, Mira began to obsess... with counting.  But she would only count to two.  She would count everything... balls, toys, people, shoes, bubbles, cars... everything... in twos.  "One, two," she would point and say.  And if there were more than two of whatever she was counting, then she would just keep on pointing and repeat, "One, two, one, two, one, two..." until she had counted them all.

Well one day maybe about a week ago, she was counting something and... she just kept going.  She counted right up to 10.  Now she can count all the way up to 12, though she sometimes skips 9 or gets hung up and needs reminding of what comes next.

And it's not like it's just a series of things to say.  Like three is just what you say after you say two.  No.  For her, there is meaning to counting.  She knows that the numbers are an answer to the question "how many".  What a smart little gal!  

So here are some videos of her counting.  I love the way she says "seven", especially.  Also, "six" sounds rather vulgar, which I find pretty amusing.  

In this one, she's counting while she spins.

In this one, she is counting her "guys" (that's what she calls her stuffed animals).  She keeps coming back to the camera because she has learned that she can watch the videos of herself right after I record them, so she's a little anxious to see the recording.

And as you might expect with a toddler, not all videos go according to plan.  In this one, I was trying to get her to count to 10 for the camera, but she was more interested in goofing off.  I call this one the blooper scene.

Tuesday, December 7, 2010

Goodbye Mimic

Yesterday afternoon, our cat (or really Brian's cat) Mimic passed away.  We had noticed that he wasn't looking so good over the weekend: he was walking funny, had lost a lot of weight very rapidly, smelled funny, and just didn't look right (though we couldn't exactly pinpoint what was off about him, we just knew he didn't look good).  So we watched him over the weekend and then first thing Monday morning I called the vet and made an appointment for that afternoon.

Mira and I took him in, and Mira was very interested in the whole process.  She knew that there was a doctor for her and a doctor for Mommy, but now she was discovering that there was also a doctor for pets.  On the way to the vet, with Mimic meowing from the carrier in the back, Mira kept saying "key ca" (kitty cat) and "dah ter" (doctor) and "moww" (meow).  And when we got there, she insisted on being held up to the examination table so that she could see what was being done to Mimic and I explained everything as the nurse listened to Mimic's heart with a stethoscope and took his temperature and looked in his mouth.  She was really interested in the whole process.  

Well, anyway,  then the vet came in and asked me to tell her what had been going on to prompt our visit and I tried to explain that Mimic just didn't look right, without really being able to pinpoint what didn't look right about him.  He was still drinking and being affectionate, but he seemed to have lost interest in food, though he did keep approaching the food bowl, he would just sit there next to it instead of actually eating anything.  After she got my version of what was wrong, she said that we were right to bring him in, he's very sick.  She then pointed out what exactly looked wrong with him, which I had been unable to put words to: his eyes were sunken and his skin was pulled in to his bones because of dehydration.  I told her that he has constant access to water and he was still drinking, so I didn't know how he would have become so dehydrated.  She then told me that it could be kidney failure causing the dehydration.

As soon as she mentioned kidney failure I knew...

She felt around on his abdomen and said that she could feel that the kidneys were inflamed.  She then said she'd like to do a quick blood test to confirm her suspicion.  While we were waiting for the blood test results, I called Brian and warned him that it was not looking good.  I asked him if he wanted to be present if it turned out that Mimic needed to be euthanized, and he said yes, so I told him he'd better come on in.  

The test results came back and all confirmed renal failure.  Mimic was rapidly building up toxins in his system as his kidneys shut down and failed to process them out through his urine.  The vet explained that the toxins were probably causing him to feel pain and depression, that there was nothing we could have done to prevent this, and that there was no treatment that would help.  I understood exactly what she was trying to gently get at and let her know that we would like to humanely end his suffering but asked if we could wait till Brian arrived so that he could say goodbye.  They were very accommodating.  

Brian arrived and he had some time with Mimic before he was euthanized.  I thought about taking Mira out to the waiting room, but Brian asked that I stay with him, so Mira just played with the cat carrier in the corner while the procedure was done.  It was very calm and serene.  Brian was petting Mimic as he passed away and Mimic was purring right up to the end, because that's the kind of cat Mimic was.

Well, as we were leaving, Mira noticed that we weren't leaving with a cat.  So she asked "key ca?"  I had been so focused on Brian that I was a little caught off guard by the sudden realization that I now had to explain what was going on to Mira.  As we were getting into the car, I told her, "Mira, the cat was old and sick.  The doctor couldn't help him get better.  He's gone now, he died."  She immediately looked right at me and said, "Dead.  Bye bye."  And it absolutely broke my heart.  That my not-even-two-year-old daughter, who still didn't even get the concept of when to say "me" versus when to say "you", whose spoken vocabulary didn't even yet include words like "fun" and "sing", who seems still so little and vulnerable to me... already she knew all about "dead".  In that moment, I just wanted to hug her close to me and protect her from everything bad that would ever happen to her and never ever let her go.

And I did just that.  For an entire, all-too-brief minute.

Monday, December 6, 2010

Pregnancy update - 34 weeks

I've now hit the point that my midwives want to see me every two weeks instead of just once a month.  So this morning I was back in their office.  This time, Brian came along, which was really nice.  He can't always make the appointments because he's busy at work, but I sure am glad when he can.  Not only is he helpful in watching Mira while I'm talking to the midwife or getting examined, but also it's just nice to not be the only pregnant lady in the waiting room with a toddler instead of a husband sitting next to her.  Something about the demographic of women who have chosen this birth center, they all seem to have husbands who are very involved, which is pretty cool.  Probably has something to do with the fact that Bradley courses (husband-coached childbirth classes) are so strongly recommended by the midwives...

Anyway, so speaking of our Bradley course... We just have two weeks left in the course and now that we've been through a majority of it, we know a lot more about what we're going to need in our birth room, having done so much relaxation practice and labor rehearsal.  So we wanted to revisit the birth rooms to remind ourselves what we would have available versus what we would need to bring (the main reason Brian came along for this appointment).  As we were checking out the rooms again, I was reminded of one of the reasons I chose this birth center over a hospital.  The rooms are so homey and relaxing compared to a hospital setting.  There is no nursery, so the baby never leaves the room where you are.  Everything that the midwives will need is right in the room.  They assume that the laboring woman will be unmedicated and therefore provide certain tools (such as a birth ball and squatting stool) that are not provided by most hospitals, where a majority of women are immobilized by an epidural.  Anyway, it's a really positive, supportive, relaxing environment and I'm happy to be delivering there.  

So then after that it was the usual prenatal appointment: weight, blood pressure, urine, belly measurements, fetal heartbeat, etc.  My blood pressure is staying good and low, right around 115/70.  Baby's heartbeat was about 140 bpm, which is great.  I actually lost weight again: in the two weeks since my last appointment, I lost one pound.  (Making total weight gain this pregnancy 4 pounds, so far.)  This actually makes sense to me, since I'm eating a lot less because it just won't fit in my tummy anymore.  I feel full after just a few bites.  Also, my reflux keeps me from eating normal sized portions; now that my stomach is so compressed, I start getting reflux not just after meals, but during.  Which is not appetizing.  And despite the fact that I'm eating so much less, I'm still just as physically active, since there's not much of a choice when there's a toddler involved.  Plus also, we've been working on getting the nursery ready, and that's a lot of moving around.  But the midwife seemed unconcerned that I'd lost more weight.  She said she was happy with my weight and the way I was looking, especially since my belly grew 4 centimeters in the last 2 weeks (!!!).  So that means the baby is growing and getting bigger, despite my weight loss.

By palpating my belly, she was able to tell me that the baby's head is down, as it was last time.  She also said that the baby would almost certainly stay head down for the rest of the pregnancy.  Especially since her head seemed to be jammed down into my pelvis.  The midwife said that there wasn't much give down there because Ellowyn's head was so firmly settled into my pelvis.  She said that happens sometimes with second pregnancies because everything is already loosened up for the baby's passage, especially when the pregnancies are close together as mine have been.  Well, that totally explains all the pain I've been experiencing over the last week or more.  My stomach and pelvis have been in almost constant pain, with certain activities making it worse.  My stomach muscles have been really sore and I'll get sharp muscle pain; I think somewhat because of this cough that I've had for about 2 weeks as I'm getting over a cold.  But also, my pelvis has been achy, like all the joints down there are painful and loose.  I never hurt this much in my first pregnancy, so what the midwife said makes sense to me that it's because Ellowyn's head is so wedged in there.  

Ellowyn is still just as active as ever, but the quality of her movements is changing as her space diminishes.  It's much less like "banging around" and much more stretching and pushing.  It's also getting much more uncomfortable when she moves, as something of mine is always stretched or squished.

I did end up talking to an eye doctor about my ocular migraines, as one midwife had recommended.  She said exactly what I thought she would, that the ocular migraines I was having were due to hormones and stress and that I would likely continue to have them throughout the pregnancy but that they would likely stop after the baby was born.  One thing she did say that I found kind of interesting: in addition to avoiding stress, I could help control them by drinking a little caffeine.  She said that caffeine stimulates the "blood vessel wall" (whatever that means), and will help prevent or lessen the severity of the ocular migraines.  She said to take in about 65mg per day of caffeine (about the amount in one soda or one small coffee), and to really maximize the effect, to nurse one caffeinated beverage over a long span of time.  Like caffeine on continuous drip.  I hadn't been drinking any caffeine really at all, so drinking one a day is kind of hard for me.  But I have found that since I've started doing this I haven't had another ocular migraine (I've been at it for maybe a week).  So maybe it's helping, which would be good news. 

So there.  Despite all the complaining, I managed to end the blog post on a positive note at least.  Can you tell that I'm done with being pregnant?  ;-P