Echogenic Intracardiac Focus

I didn't think it was possible to have too many ultrasounds but today I reached my limit. Ultrasounds are so advanced nowadays that they're finding things that I just don't want to know about! This morning the tech spent an unusual amount of time looking at the baby's heart- in particular, a small white spot on the left ventricle. When I asked her about it, she clammed up and told me that I had to talk to the doctor. So I left her office in tears and waited to see the doctor. I cried while they drew my blood, while they weighed me, while they took my blood pressure... I couldn't keep it together, imagining life with a sick child. 

Well, word must have spread around the office that I was an emotional wreck because the doctor came breezing in and immediately assured that I had nothing to worry about. Its called an echogenic intracardiac focus and its found in roughly 3-5% of pregnancies. Its like a cyst or calcium deposit, they're almost always benign and usually disappear eventually. 

Now, why couldn't the tech tell me that instead of letting me wait and worry!!! Ugh. I'd be much happier in my ignorance. I don't want another ultrasound for a long time. 

My Uterus, My Choice

I generally don't like to use my blog as a soap box, but there's an issue dear to my heart (and my growing uterus) that I feel like hashing out- the oh-so-controversial VBAC (or Vaginal Birth After Cesarean). I'm almost embarrassed to bring it up in such a public forum. I still get nervous and sweaty when I talk to my own doctor about having one, like I'm asking permission to poop my baby out in the bathtub by myself in the middle of the night. And that's exactly how it feels... like I need permission to do what most other women do all the time- have a baby the good old fashioned way (not in a bathtub, but vaginally). A little background...

Its estimated that 1 in 4 hospital births will be via c-section (in 2003, 27.6% of women gave birth by cesarean). The reasons for a c-section are vast. I liked this quote, "In the US, a woman is likely to have a cesarean is she's too big or too small; too early or too late; too old or too fearful; too tired of being pregnant or too tired of being in labor; if she's having twins, if she's breech, if she's previously had a cesarean; or if she's due and so is the weekend, Christmas, Thanksgiving, or New Year's Eve. Then again, she's also at risk if her doctor is in doubt, scared of a lawsuit, too busy, going out of town, or convinced that a cesarean is always safer... the reasons go on." (See this article for the source). And on top of it all, c-sections are "cool" nowadays... you've got Victoria Beckham telling us she's "too posh to push." Its out of control.

Don't get me wrong, I thank Heavenly Father on a regular basis for c-sections- without them, either Booker or I would probably be dead. I wasn't about to deliver a breech baby, in fact I've heard the only place that will is called The Farm in Tennessee and it involves something called spiritual midwifery- yeah, totally not for me. My point is that a c-section is MAJOR abdominal surgery and its a procedure that's being performed left and right at the drop of a hat and unfortunately sometimes unnecessarily.

Anyways, what's done is done. I had a c-section and I can't change that. It was in fact, a pretty decent experience. I've never felt such pain in my life, but then again percoset and morphine are kinda fun drugs to try. I had no complications and I recovered in the usual six weeks. But now as I consider my upcoming labor and childbirth, I have a decision to make- a decision that some women aren't even afforded thanks to the growing number of hospitals and doctors that flat out ban VBACs. Repeat c-section or VBAC?

You see, the big hullabaloo about VBACs involves something called Uterine Rupture. Basically, with a prior uterine scar you face a small (about 1 in 500) risk of having your uterus rupture at the site of the scar and having the baby come out into your abdomen (awful, I know). At worst, the baby and/or mom could die. More likely though would be damage to the uterus (resulting in no more children). Doctors and hospitals just don't want to deal with the lawsuits/malpractice insurance and so they refuse to do them. Finding a pro-VBAC doctor these days is nearly impossible. Once a c-section, always a c-section. But VBACs are possible, yet only 13% of women who have had a previous c/s will attempt one. As of now, I'm hoping to fall into that small percentage. 

Here are some of the reasons I want to attempt a VBAC:

• I want a big family but I don't want to have multiple major surgeries to do so.
  
• I want to be able to care for my child right away. Things like changing diapers, nursing and holding my child up will be possible immediately instead of a few days later. 
  
• I want to be able to care for Booker right away. For the first few weeks after your c-section, you can't drive, vacuum, go up and down stairs, pick up heavy objects, etc. There's no way I'm keeping up with Booker with an incision like that. 
  
• A small (very small) part of me has this crazy desire to experience labor. Icky, I know. It must be instinctive.
  
• Babies born vaginally have higher Apgar scores and are more likely to be breast fed. 

Here are some reasons why I'm a good VBAC candidate:

• The reason for my previous c/s is no longer present (well, actually it is at the moment but hopefully this baby will decide to turn sometime in the next 12 weeks). 
  
• I have a horizontal scar and not the vertical one which increases the risk of uterine rupture.
  
• I am in good health and currently face no complications such as preeclampsia or placenta previa. 

Here are some of the small roadblocks I've run into as I "fight" for my VBAC:

• My Mesa doctor does not perform a lot of VBACs, maybe 5 or 6 a year.
  
• My Mesa doctor has to be at the hospital with me the entire time I'm in labor. Neither of us are too happy about that. 
  
• My Mesa doctor would prefer it if I had a c-section and wants me to have an epidural in place in case they have to wheel me off to the OR. I'm ALL for epidurals, but it kinda feels like admitting defeat before the battle starts. There is also some evidence that epidurals slow labor and increase your c/s odds. 
  
• My Mesa doctor will not allow any type of labor augmentation or induction such as pitocin. That means its all up to me to get this baby out. That's a lot of pressure on me, quite literally. However, he has agreed to stripping my membranes and breaking my water if the conditions are right.  
  
• I will have to have continuous internal fetal monitoring to make sure the baby is doing alright. I'm fine with this, but I do worry a little bit because I'll be confined to a bed which might be annoying.
  
• My Tucson doctor (although they advertise on their website as being pro-VBAC) has given me an "expiration date." Meaning, she won't let me go past 40 weeks. If this little guy doesn't make an appearance before that, then they'll come in after him with a scalpel. Normally 40 weeks is considered full term, but some women can go as long as 42. Not me apparently. Again, that's a lot of pressure to deliver on time.
  
• I think I'm the type of woman to have big babies. Booker was early and he weighed 8 lbs 1 oz. My mom had large babies- my brother Danny was 11 lbs. The bigger the baby, the more stress on the scar site and higher risk of rupture.

Overall, I've haven't had a lot of positive support from friends, family and even medical professionals about having a VBAC. Its makes me feel self-indulgent. Why not just take the "safe" route with the known outcome? What if I somehow hurt the baby by attempting a VBAC? But there are risks for both c-sections and for VBACs. The truth is that there's a chance that I'll end up with another c-section anyways. The VBAC success rate is only somewhere around 60 to 80%. But if I don't even try, I'll never know. And the chances of having a VBAC after TWO c-sections are slim to none. So this is my one shot. I'm going in with my eyes wide open and well educated on the matter, happy with either result as long as I have a healthy baby and I don't have to list The Farm, Tennessee as the birth place. 

Toddlers

Here are some observations I've had lately about toddlers... I'm sure they're completely obvious to anyone who's ever spent five minutes with one, but its been fun for Clark and I to experience Booker at this age.

1. Toddlers like options. If I tell Booker he's having Mac & Cheese for lunch, then a tantrum will most definitely ensue. If I ask Booker if he wants Mac & Cheese or a hot dog, then he'll happily eat one or the other.

2. Toddlers react strongly to small levels of respect. At least mine does. Booker gets tired of being told what to do all the time. If we use "please" when we ask him to take a bath or go to bed, he's much, much happier. He's still trying to learn "thank you" but somehow he says "come" all the time for "you're welcome."

3. Toddlers are independent. When we get together with Clark's family and there are 30 other kids around, we usually say goodbye to Booker as he runs off with his pack of cousins and see him two hours later when its time to go. If we happen to bump into him and try to say "hi" or "we love you," we get an emphatic "NO!" He then runs in the opposite direction as fast as he can.

4, Toddlers are like sheep. Especially with their pack of cousins. Booker isn't a great eater but when he's sitting at a table with his buddies then he'll eat as long as they do. Its been especially fun observing Booker as he interacts with his older, cooler cousin Seaver. Booker adores Seaver. When Seaver does cartwheels down the driveway, Booker puts his hands on the pavement and tries to lift his feet. When Seaver climbs a tree, Booker holds the trunk and smiles up at him. When Seaver plays out in the freezing cold rain, Booker is two steps behind him shivering and shaking but having the time of his life. This level of respect is also reserved for cousins Dax and Jarem.

5. Toddlers can do the same thing for hours. For Booker, this is puzzles. He probably spends a total of two hours a day doing puzzles. We line up his puzzles and he goes down the line putting them back together. Of course, this level of attention quickly disappears as soon as we walk into the chapel for Church.

6. Toddlers are sticklers for rules and routine. We live in a gated community and I like to take Booker's car seat buckles off once we're through the gate so he can just hop out of the car once we're home. He absolutely hates sitting in his car seat, but if I try and take his buckles off a moment too soon he freaks out.
Now that Booker is in a big boy bed, our night time routine involves shutting him in his room and walking away. He yells, cries and bangs on the door but will not, under any circumstances, read his books or play with his toys. Once he decides to go to bed, he must slide his bathroom door closed, crawl under his covers and keep his sippy cup in one arm and Dora in the other. We find him asleep this way every single night.

7. Toddlers hate rules/routine and will flout them at every opportunity. No example necessary.

8. Toddlers are peculiar about their appearances. Lately Booker refuses to take off his plastic gym band (the one that identifies him at the gym's daycare). He wears them in the shower and to bed- day and night. I have to sneak in when he's sleeping and carefully remove it from his arm. As a result, we've worn through several bands in the past few months. Another example, Booker has several pairs of cute Old Navy flip-flops- perfect for hot Arizona summers. But the kid refuses to wear them or even acknowledge them as shoes. Sometimes I'll casually pull them out and try to place them on his feet. Its useless- he freaks out. No flip-flop style shoes period.

9. Toddlers have an exaggerated sense of achievement (and defeat). You should see Booker when he completes a puzzle. His face lights up, he starts clapping and then he has to run around getting a high-five from every person in the house. Every puzzle. Every time. Its quite tiresome for everyone, him included. On the other hand, when Booker has a poopy diaper he becomes sullen and withdrawn. I'm not sure what Clark and I have done to make him feel so ashamed of being poopy, but I feel terrible because of it. We're trying to teach him that EVERYBODY POOPS! But still, its always his darkest moment of the day. I can't wait until he learns how to poop in the potty. His sense of accomplishment on that one will be a thrill to witness.

10. Toddlers are power hungry little tyrants. Ask Booker any question and his immediate answer is "NO." This is usually followed by a well-thought out, "OK" once he processes the question. "Booker, do you want some fruit snacks?" "NO!!! OK." This takes some patience on my part. I've also learned to pick my battles. I never thought I'd be the mom who lets her kid run around the chapel without shoes on. But if his bare feet mean he won't be throwing his grapes at the family behind us, then I'm happy and he's happy. Won the battle, not the war.

11. Toddlers may be completely self-involved and manipulative, but they're also incredibly sweet and sensitive. Booker's sweetest moment of the day always comes as we're carrying him off to bed. He desperately tries to charm us into keeping him up later. He starts pointing out body parts, animals noises, colors, numbers... anything he's learned and thinks might impress us. Its always so hard to part with him after that. I also love his hugs and kisses, even when he's coerced into them (which he usually is). And even though I hate it when he somehow sneaks out of his bed and crawls into ours at night, I love cuddling with him and he's the best alarm clock to wake up to ever.

New Used Car

At 9 o' clock last night I bought a car in my pajamas. It sounds terribly irresponsible, so let me explain. As you know, Clark and I have been shopping around for a second vehicle. We're in no hurry (we need a second car by mid-July) so its been nice walking in (and then out) of dealerships after a lot of wheeling and dealing without any skin off our noses.
We test drove a TON of vehicles and decided that the Hyundai Santa Fe would be the best fit for our family (thanks for voting, btw). Once that was decided, I spent a lot of time searching through internet classifieds and craigslist for the perfect car.
Last night I found a promising listing that was super close at a Superstition Springs dealership. Without our usual Thursday line-up of shows to watch, we loaded Booker into the car and headed out thinking we'd be gone for 45 minutes tops.
Long story short, if it hadn't been for the receptionist with whom Booker became enamored we might not be the proud owners of a 2004 Santa Fe. She gave him balloons, goldfish, crayons and she even let him sit in her lap while they watched Dora on her computer. It made the whole experience a MILLION times easier.
But it wasn't just the receptionist. I feel like we got a pretty good deal. I won't say exactly how much we paid, but after tax, title, registration, blah, blah, blah we ended up paying just a little bit more than we had originally planned AND the car only has 36 k miles on it. My Aunt Diane always says that things are cheap for a reason, so while we wanted the best deal we could find, I also didn't want to end up with a lemon of a car.
I had a lot of fun driving it home in the rain... its seems so big and clean and eager to be filled with two little boys, strollers, and groceries. I'm excited. In all honesty, I don't think I've ever driven a car with so few miles on it, much less owned one. Its a strange feeling. I wanted to inform all the salesmen that they shouldn't be selling us a car... only real-life adults buy cars, and they usually do it in normal clothes and during business hours.
I know it seems terribly reckless to buy a car all of a sudden, but I promise that this was a well-considered decision. Plus, I feel like I'm so overwhelmed with major life changes lately that I'm glad to have one out of the way. In May, I'll buy a car. In June, I'll find a house to live in. In July, I'll move into that house and cheer Clark on as he passes the bar. In August, I'll have a baby. I can't wait for September when things are normal again, and hopefully we'll have good, reliable car to get us there.

Deep Car Thoughts

So with baby bringing our family total to 4 and Clark's mom coming home from her mission and needing her car back, we are in the market for a new vehicle. We think we want something on the big side so it can hold all four of us and all of our junk on a trip somewhere, but not something absurdly large that gets 12 miles per gallon. We also want something with less than 85,000 miles and costs less than $10,000. We have narrowed it down to four finalists that you can vote on below. Any comments/suggestions/horror stories/advice will be appreciated.

Lost Toenail

I thought my crazy pregnancy mood swings were all but gone, until last night when Booker's toenail came off. Booker was playing around with his feet, when I noticed that he was quietly saying "Owie, feet, owie, feet" over and over. A few months ago someone opened a door on Booker's toe and ever since the nail hasn't been the same. I should have seen this coming, but for some reason I was REALLY upset by the actual falling off of the nail. I cried and cried and cried... and then cried some more. Booker gets especially concerned when I cry, and kept hugging me and saying, "Mommy?" It was sweet, but every time I thought of him as an old man with only one toenail the tears came rushing back. Has anyone ever lost an entire nail? Will it grow back? Will my baby go through life as a one-toenailed-freak?!?!

Fetus Footage... Feetage?

Another ultrasound yesterday confirmed that we are still having a healthy baby boy. He is quite the little acrobat... babies usually are. In fact, when I saw Booker for the very first time I didn't comment on how beautiful he was, instead all I wanted to know was "Why is his foot up there?!?" His leg was behind his arm and his foot was right next to his ear. He had been curled up in my womb that way for quite some time and wouldn't budge- not even when they came in after him.

Anyways, this little guy likes his foot near his face as well... just check out the feetage. My doctor assured me that everything looks great but ordered yet another ultrasound in 4 weeks, which makes me a little nervous. I shouldn't complain though, most women just get one ultrasound per pregnancy and have to shell out hundreds of dollars if they want another one. I love every chance I get to see this little guy.