Under the weather...

I am, typically, able to boast a pretty hardy immune system. Observing regular health-ensuring activities such as hand washing, exercise, and basic cleanliness have helped me avoid most viruses passed around. This kid apparently has something to say about that truth as well.

I have had TWO stomach bugs since my second trimester. TWO!! I haven't had a stomach bug in I can't remember how long before then. But, I have had TWO. I don't even know how to ensure I get to the potty on time when I have to wretch, because I've never been afforded the opportunity to learn (with the exception of that one weekend in college, Heather). Since being pregnant, however, I have had 2 predictable 24-48 hour stomach bugs that wreaked havoc on my body and then moved on to the next victim.

Now, I am fallen to my annual go around with the ear/nose/throat issues. I should have seen it coming: when I went into my office on Thursday, it was a Michael Jackson convention, with numerous coworkers sporting the face masks that are purported to stop the release and reception of disease-spreading germs. At least one of those sneaky little buggers got through, though. And for the entirety of the weekend, I felt winded and steadily developed a heavy cough to go along with ear and throat tenderness. Last night it culminated in one of those sort of coughing fits that wakes you up in a panicky fear as you try to clear your throat so you can breathe in a way that is even partially acceptable.

Some of you may remember the great surgery-a-thon that was my early 20s. I had routine surgeries December 2001, January 2002, and February 2003. During the first of these surgeries, I shed my massive tonsils that set a record at Pitt Memorial Hospital for amount of infection and size. I have not been this sick since before that surgery. To return to that pre-tonsilectomy state is not a favorable turn of events in my opinion.

Thankfully, I was able to accelerate my regular OB appointment from Wednesday to today. My doctor checked me out, declared there was very good reason for my discomfort and sent me home for at least today, and tomorrow if we can afford it. She listened to the baby's 148 beats per minute heartbeat and was satisfied with his movement and vitality. She provided me with several prescriptions and sent me on my way to recover.

The good news is many fold: the insulin at night is regulating my fasting blood sugar readings well now. Diet and exercise is controlling the rest well. I have not gained any weight since my last doctor's appointment over 2 weeks ago and, therefore, I am holding fast at just 10 pounds gained. The baby's activity is regular and in good keeping with developmental expectations. I am measuring well within normal limits. My blood pressure continues to be that of a much younger woman. There is no sign of swelling anywhere that indicates a cause for concern. Overall, I have many many reasons to be happy for the general health I have been experiencing during this pregnancy.

As for today, though, I am DEFINITELY under the weather and just going to cuddle up with my little acrobat as he keeps his fetal kick count way up... Hector is fine with that arrangement, too.

(P.S. Happy Birthday, Uncle Jimmy Maher! Love, Baby Boy Eschler)

Is this really normal?

The lore of the bladder woes experienced by pregnant women is not foreign to me. The constancy of a rounded belly making a well-beaten path to a potty is an icon of American pregnancy. So, I am not taking lightly the stage wherein I am currently living out that stereotype. At this point, however, I have to ask with a sincere heart: Is this REALLY normal?

I CONSTANTLY have to tinkle.

I have attempted to abstain from describing those bodily functions I usually do not discuss. But, I am kind of in awe of my bladder's recent requirements of me and must now engage in a slightly more public forum about this topic.

Take this scenario, for example:

Yesterday, we ate dinner. About an hour and a half after that, Nathaniel and I decided to go to the gym. I changed my clothes, bound my chest, and emptied my bladder. By the time we got to the Y off of Hillsborough St. (a 3.6 mile trek according to Google maps), I had to relieve myself again. After washing my dried-out hands, I joined my husband in a warm up by power walking around the indoor track. After no more than 10 laps, I had to go again. I missed 2 laps as I excused myself to the bathroom. I rejoined my husband and, 3 laps later, felt the urge again. I could not find a cardio activity wherein the pressure on my bladder was relieved enough for me to fully engage, gave up and moved to weight lifting instead.

I am not required by my bladder's expulsions to remain a long time in the potty, but I am there so frequently that I'm starting to think of it as a second office. Today as I walked around my office and the grocery store, the bouncing of the activity made me feel that oh-too-familiar urge yet again. Is it possible that I will feel that pang relatively continuously for the next 11 weeks?

Is this REALLY really normal?

I am now in the third trimester. The final stretch. The long road home. 29 weeks today. I am getting the nursery painted, the bedding stitched, the clothing gathered, the classes registered, and the other endless details attended to. I am getting together a guest list for a baby shower (I PROMISE I am, Mary and Heather!). I am poking my finger no less than 4 times daily and, in a new development, administering 8 units of insulin overnight to address my liver's sleeplessness. I may never go through this stage again. Feeling strongly about adoption, I may stick to the original plan of grafting in our next children instead of popping them out. I am savoring these moments whether they be painful, stressful, delightful, or peaceful.

But, really... in this whole bladder scenario, I have got to ask: IS THIS REALLY NORMAL?

Making the most of the time...

Time is relentless. Time is a force which strips us bare and exposes our vulnerabilities in brazen demonstrations. Before time, we are truly helpless and victims in the truest sense of the word.

I sense this relentlessness in the way time repeatedly tramples the same date year after year. For instance, December 31 was a day of tears for me in 2009. It was the day my Nani passed. As we rang in 2010, I wept on Nathaniel's shoulder and planned which black dress would be lowest maintenance for the week ahead. December 31, 2010 however, was a different day. Without even the benefit of a year to adjust, New Year's Eve became the day my sister in law joined herself to a wonderful man, Josh, in marriage. The pain of the loss still lingered, even as the excitement and happiness for the new day emerged.

Other days are similar in reminding me of relentlessness of time, creating emotional and mental paradoxes in my heart and head. These special days always serve as reminders of the fact that we, as people, can rage and administer anti-wrinkle creams and plan and prepare, but time will always emerge victorious in whatever war we wage against him.

Because of this awareness that has been growing in my estimation, I often challenge myself to enjoy and savor the special moments in my own life and the lives of those I love. I make sure to celebrate events like weddings and babies well with my friends and family. I try to make time for simple enjoyments, like dinners and movies. I travel to be with those I love at important times. Knowing that I am powerless against time, I have repeatedly seized upon moments and events, attempting to savor the moment with abandon that would leave me with only the fondest memories and minimal regret.

I fear for this ability in the face of parenthood, though.

I often read status updates that say things like "Can't believe my baby is already x months old... where did the time go?" and "Time is moving too quickly - X is already Xing..." As a woman who generally has worked at least one job (if not 2), I detect the passing of these children's first months with the pain of recurring deadlines and stresses that keep me from marveling as the child's parents do. I very infrequently share the amazement of those status updates.

I am now at the brink of the third trimester. If Nathaniel and I stick to our original plan, this is the last trimester I will ever be pregnant. I will never feel the gentle pokes of my 7 month gestated son again. Comprehending that it has been 23 weeks since I cried in the tiny bathroom in our 2 bedroom apartment as I sit on the couch in our newly furnished living room in our 3 bedroom house is a stark realization of how quickly "it" has moved and how quickly "it" is apt to continue moving.

I am well versed in human life span development. I know (and have witnessed in the lives of children I love) that the first 3 years of a person's life contain more developmental milestones and events than any other time in human development. I am preparing myself for the rapid progression Nathaniel and I now face as we witness our son's development, in light of the terrifying persistence of time with which we are already familiar.

I fear my only tool is resolve. I resolve to feel and savor everything I can. To be saddened when baby boy leaves behind those endearing baby qualities for a more mature behavior. To be glad when milestones occur at the intervals which indicate development is typical and positive. To be anxious when I feel inadequate towards the task which I must now face. To be frustrated when I feel I don't have the time to prepare for the next step. To feel relieved when a stage passes with which I am not particularly enamored. To feel fully. To feel productively. And to feel without regret when I reflect on the tasks to which I am regularly matched.

I know these next few weeks will pass as though they are nothing. I know the years and months thereafter will maintain that pace. I know that the requirements of me are not likely to diminish and may, in fact, increase. I know that I may not feel adequate to the job, but will still be required to rise to the occasion.

I hope I never mourn the passing of time. I hope I celebrate it.

However, I hope I never forget to remain humble in the face of the foe I will never be able to match: time. I hope I respect it appropriately, while always managing to steal any and all available moments.

Most of all, I hope I never regret.

How should I feel?

Should I be concerned or comforted by the fact that the baby LOVES it when I eat?

While I am happy for his predictable movement and assurances that the energy is getting to him, I am TERRIBLY nervous about what this means for our future grocery bills...

Prepartum Blues...

As a case manager, I am CONTINUOUSLY assisting my clients in "reframing" thoughts. I work with them to reshape something that is a negative into a positive, or at least a neutral. Without bragging, I can say I am good at my job. And, I practice what I preach.

As everyone knows well by now, this pregnancy was NOT a planned event. Originally, we were going to wait five years before evaluating if we wanted to pursue this path or not. The birth control pill I took each morning was evidence of my commitment to that plan. However, when the life was discovered, I was able to reframe my thinking relatively quickly.

I quickly began to admire the little creature inside of me for his tenacity and fortitude. I began to anticipate the opportunity to meet this little being and be motivated by his presence to create a more perfect family future. I began to more carefully guard my own plans so as to ensure no unnecessary compromise and eventual frustrations. I began to understand the value of quiet moments and the urgency of developing the sort of relationship habits with my husband to ensure the 50 weeks we have been given as an independent couple have not been wasted. All in all, I became very positive very quickly. Even Nathaniel jumped on board relatively quickly, which is not a character trait for which he is known - reinforcing the miraculous nature of this child.

That's not to say we have not had our share of truly frustrating moments and stresses. Even families who embark on this journey after much psychological and personal preparation admit that it is a stressful change of familial circumstances. Nothing was ready for this child - not our bank accounts, our employment statuses, our housing situation, our academic plans, our psychologies... NOTHING. Some things rectified quickly. We now have a beautiful home with an amply sized room for the baby. Nathaniel was able to add some time to his work schedule, increasing income.

Some things, however, remain obstinate barriers.

One such barrier is our insurance. The thought of having EVEN MORE MONEY withheld from my primary, monthly paycheck to pay for the pitiful coverage I am afforded to be generalized to our firstborn is a stressor that I cannot confront at this time. I have to identify a more feasible strategy to cover the inevitable bills. Also, apparently, circumcision is considered cosmetic and won't be covered, no matter what insurance we choose.

Other concerns are the usual suspects: How do I go about picking a Pediatrician? What criteria should I even use? What do I do with the fact that I want to decorate the nursery in Yankees pinstripe, but my husband isn't buying it? How do I find out if the convertible car seat I registered for will be ok with the hospital or if I need to get one of those infant seats I find reprehensible? Will the arrangement with work actually pan out so I don't need to find additional child care? What if I don't care if the study has been debunked, I don't want our son to be given rapid-fire bundled immunizations? And the list continues on, usually long into the night, when I should be sleeping.

All in all, I am proud of the way I approach and handle these things, whether truly stressful or easily malleable. I've been able to maintain great physical health, as well as mental health. Until yesterday, that is.

Finally, I had enough. Reframing suddenly seemed like the biggest load of hogwash. I had no capacity for turning a negative to a positive. I also had no desire to do so.

The straw which broke this camel's back is the seemingly ridiculousness of the magnitude of planning that goes into ensuring blood sugar readings that will prevent my child from growing to gargantuan proportions. Facing the protein/starch abyss that had become my existence, with an eye toward keeping portions correct and refrigerated, yet readily available during the unpredictable work day I anticipated was a task to which I was not well matched. I spent an hour - sixty minutes... 3,600 seconds... 1/24 of my day - looking at the shelves and recesses of my kitchen trying to plan the next 12 hours of food consumption that would take place outside the walls of my home.

Do you know where I didn't spend that hour? In the bathroom. So, I left the house WITHOUT hair well styled or makeup done, with a satchel of snacks that were neither cohesive nor appealing to me. The simple act of eating and feeding became so overwhelming to me that it superseded any other function, and left me feeling deflated and frustrated as I handled the rest of my day.

Topping it all off was the fact that I went to a job where clients regularly assert their senses of entitlement. And I certainly felt no sympathy for anyone else's sense of entitlement yesterday.

I my perception, one truly "off" day in the 22 weeks we've known about the baby is not a bad average. However, it did not feel so good to have to deal with work and the frustrations of everything becoming increasingly difficult to address. I still have to address those stressors which are plaguing me in the middle of the night. And, I have little confidence that raging hormones, fluctuating sugar, and an encroaching due date will alleviate any of the stress I am feeling.

However, the deadline approaches no less rapidly or forcefully. And, I realize that perhaps this is the first great lesson of adulthood: the world is not going to stop for my inability to adjust. Our child will not stop developing and needing. Our deadlines will continue to approach. It is truly time to put up or shut up.

I woke up and decided to make today better. I marginally succeeded. Let's hope that putting up or shutting up are skills that are sharpened with practice. That may be our only hope for ultimate success in this parenting scheme.

Just like coming home...

I went to the endocrinologist today. One of the few silver linings to this gray day of ice was the abundance of cancellations at the doctor's office, which allowed me to float freely between the Diabetic counselor and my long-trusted Dr. Weir. With my husband in tow (and leading the way for a substantial portion of the conversation when my emotions kept me from speaking clearly), we were able to review our dietetic plan for the next 13 weeks.

Surprisingly, they want me to INCREASE my carbohydrates - which baffles the mind! Once we fully engaged in the numbers, needs, and options we settled on a proactive, yet reasonable plan. Her careful consideration and moderation in character are the reasons I have loved working with Dr. Weir for the past decade. She considered and consulted with her colleagues about a non-traditional gestational diabetes treatment suggested by Dr. Babyface at my last appointment. Once she had troubled herself to gather as much information as possible, Dr. Weir presented us with our options: 1. Use the medicine my OBGYN suggested, which only is endorsed as a level C intervention for pregnancy by the FDA; 2. Return to Metformin, which regulated me so well before pregnancy, and carries an FDA level B endorsement; or 3. Insulin, which is easier to regulate and requires the least risk and guess work.

After thoroughly engaging around these issues, unhurried as there was a deficit of patients to rush us, we decided to spend the week tightening up my diet, in accordance with the information presented at our consultation. In addition, Nathaniel and I will be walking at least 30 minutes first thing each morning and we are going to increase our priority in getting to the gym regularly. We are going to try implementing these measures for the next few days, until my appointment on December 19. At that appointment, we will reevaluate the numbers I am going to carefully monitor and record until then and decide whether to "encourage" my sugars to remain in normal limits (Metformin) or if I require actual regulation (Insulin).

I am still plagued by the frustration that is the Diabetes monster that devours my family's metabolism throughout life. However, today I am thankful for so many things.

I am thankful for the doctor who unraveled my metabolic concerns as a college student and continues to remember me without her chart and takes time and energy to carefully consider my needs. I am thankful for an ice storm which kept other people away from their appointments and afforded us plenty of time and attention. I am thankful for the sweet, maternal Diabetic consultant who sympathized and showed concern and compassion. I am thankful for a husband who went with me, considered the options, and helped formulate a reasonable plan for addressing this issue in a way that is sensitive to me and the baby. I am thankful that the baby, by all indications, is healthy and happy and a normal size. I am thankful my office was closed today so I could devote all my time and energy to this task. I am thankful.

As I said before, I am willing to do what is necessary to ensure baby boy is healthy. Also, I am becoming more and more committed to attempting a natural childbirth and do not want to compromise the possibility with high birth weight. But, for today, I am thrilled with the chance to manage these problems with careful consideration and strategic implementation.

Sugar and spice... no longer so nice...

I have very keen memories of my grandmother pulling up her shirt to expose her bare abdomen and inserting a scary looking syringe full of a clear liquid, which she would empty into her gut. Invariably, this medical ritual would be followed by indulgence in some treat from either Pepperidge Farms or Godiva. Once I got old enough to understand what I witnessed as a child, these images became more disturbing - one of the few instances that education led to MORE fear about a given circumstance.

My mother has since lived by a philosophy of improving each generation. My mother is more vigilant about her blood sugar, but struggles with it. We found my PCOS and insulin resistance early on and have endeavored to make exercise (once a dirty word to our family) a regular part of our life, with improved eating habits as an earmark of our daily routines. I will not lie, I still love a good pastry. An Italian girl without a cannoli or a Hispanic girl without a flan is a terribly sad figure. However, I have learned the importance of proteins, complex carbs, pairing foods, regular meals, and sustained raised heart rates. While my energy on an eliptical is impressive, my ability to outrun the DNA in my grandmother's bathroom is, apparently, not necessarily within my control.

I have been identified from the beginning of the pregnancy as a slightly elevated risk due to my insulin resistance. With my dependence on Metformin well documented and fear of PCOS symptoms apparent, the pregnancy began with a plan for vigilance and attention. And, the results have been pretty admirable. The doctor I work for has repeated checked in and praised my regular readings, which fall WELL within what is normal. Sadly, we had a holiday season.

Travel, emotional stress, holiday mania, and the increasing power of placental regulation led to readings that were not within the range with which I feel comfortable. The numbers were still numbers that most people sharing my struggle long to see. For those of you who are familiar with monitoring blood sugar, the highest number I have seen 1 hour after a meal (wherein my hunger and inattention led me to a meal devoid of significant protein) is 165. Typically, I am below 120. My fasting sugars are rarely at 90 anymore, with 98 being more average and 123 being the highest fasting reading since my December checkup.

These readings are not devastating at all. However, I am TERRIFIED of child birth involving a child over 7 pounds. The idea of a C-Section makes me shiver from the tips of my toes to the crown of my head. And, while I am mentally preparing myself to sacrifice my body in whatever way is required to ensure this baby boy is healthy and safe, I am also preparing myself to avoid extreme measures if at all in my control. Thus, I resolved to admit to my doctor the concerns and elevations I am seeing in order to head this problem off at the pass.

Resolving to do what is needed and relinquishing myself to the idea of no pasta or sweets for the next 14 weeks are 2 different things. On Friday morning, with a fasting sugar reading at 99, I was unable to shake the sad image of my grandmother in that bathroom those many years ago. And I cried. A lot.

I am going to depart from the narrative for a moment to do something I usually do not do and had relatively designed never to do: I am going to publicly and effusively sing my husband's praises. I usually reserve this sort of talk for the quiet of our home and the sanctity of our bedroom - those moments seem to be the most meaningful. However, Nathaniel needs to be recognized for his role in assuaging the morning drama.

One of the hardest parts of marriage for Nathaniel has been learning when to stop talking and when just to hug me. When to abstain from fixing and just support. When to stop feeling bound to making me a better person and when to provide me a place of repose in my shortcomings. On Friday morning, as I battled my own demons and fears of 14 weeks of insulin injections, Nathaniel hugged me. For a long while. While I cried warm, large tears on his t shirt.

The comfort of a partner who may not feel comfortable with his understanding of the situation, but is committed to supporting even the most irrational emotional outbursts is a comfort beyond measure. I am so thankful for my husband who has used the past 8.5 months to learn to love me better and shows it in such significant, tender ways. I can truly say that I enjoy being married to Nathaniel more each day we are married than the day before - and, we're coming up on a whopping 300 days here... Impressive, no? Back to the narrative.

In the privacy of the nurse's inquisition/confessional, I admitted my fears about the blood sugar readings and the increases I am noticing. She made note of my fears and took my other vitals. Thankfully, my blood pressure is still that of a 17 year old (knock on wood). I only gained 3 pounds over the past month, bringing my total weight gain to under 10 pounds at 26 weeks!!! Every indication aside from my pancreatic failures seem to say that I am a picture of gestational health. Had it not been for the sugar concerns, I would have faced the January appointment with confidence and pride.

When the doctor, who was my age at best, entered the room, he engaged me in the discussion I feared most. Armed with my mother and the generations of sugar-laden concerns, we heard his recommendations, concerns, and suggestions.

First, he told me that my numbers, if I were not pregnant, would be great news. The readings I am currently seeing are not terrible. However, being pregnant, Doctor Babyface told me doctors are extra vigilant and want to ensure regular birth weight as well as avoid possible hypoglycemia for baby boy. So, we were told that a gestational consultation with an endocrinologist is now appropriate and would be beneficial. Thankfully, I have a long history with an AMAZING endocrinologist, who was the doctor who initially solved the puzzle of my PCOS. After much voicemail self advocacy, I was able to secure an appointment to see her and to work for a solution that may still avoid insulin, although require additional medicinal assistance.

My mother and I adjourned to an early lunch of high protein with complex carbohydrates as we mourned our metabolism and genetics, and praised the circle of medical professionals with whom we have involved ourselves. While I was able to calm and bought my husband a 6 pack of fermented delights as a thank you for his understanding, the sugary monster continues to loom large. Our commitment to protein has never been greater, nor has our love of the local Y.

The rest of the weekend has moved along successfully. Our bodies are still on Utah time - those 2 hours can be killer! We are awake until midnight and cannot move at 7 am. That MUST change. We went for our tour at WakeMed on Saturday. Oddly, that tour caused me anxiety rather than bringing the calm of effective preparation. I think the reality of the room in which I will go through the most enormous pain imaginable was a little overwhelming. Also, questions of epidurals, birth plans, circumcisions, and all other eventualities reified. I am hoping that the hormones and nesting reflexes are the cause of this most recent round of anxiety. I will be taking advantage of the therapists with whom I work to identify some new coping techniques!

Last night, I went out with my parents looking for cribs. I believe we have found the set we want and, in keeping with the tradition of amazing men in my family's past, my father will be providing our child with the place to rest his head. My next step is to go fabric shopping. The concept for the nursery is beginning to come together in my head, but is all contingent upon a series of endlessly-shifting variables. I believe we may be closing in on something we can love, but nothing about our concept is concrete at this point.

We've eaten lots of protein, returned to the Diabetic's best sweet friend, unsweetened baker's chocolate, to satisfy sweet teeth, and returned to planning and scheming about colors and nurseries. The weekend has been successful and calming. This week, I have a consultation at my endocrinologist's office to start us off on that newest bunny trail and I am hoping that the snow and ice do not interfere with my billable quota!

I'm assuming that I am typical for this stage of pregnancy. My email newsletters seem to indicate I am. I am definitely experiencing more anxiety about the tasks which need to get done before this baby emerges. However, I am feeling more at peace about our combined ability to parent and make it through the rest of the process of becoming parents.

Baby boy is as active as ever and can now make the laptop move when I rest it on my stomach. He has definitely "popped" and there is no denying his presence. He loves food and responds so well to food. We have begun exposing him to 20th century music - we are SO excited about the possibility of a baby who hears nothing different in music that has no common practice tonal center. Most of all, the recent past has made me so anxious to hold him in my arms and see what color his hair will be and if the process of birth will calm down his seemingly endless movement. It's so strange to already love someone I only know in shadows.

I'm off to make some more chicken. And then to the gym. For the rest of our lives!

Rocky Mountain high... again...

Nathaniel and I are back in the land of elevation. His second youngest sister, Becky, married a wonderful man, Josh, on New Year's Eve. So, we boarded a plane at an ungodly hour on New Year's Eve and headed on a journey that, although didn't take a lifetime and cost lives as it once did it in our country's heritage, was REALLY, REALLY long.

We joined the family for a wedding celebration wherein Becky looked beautiful, soup was delicious, and our son gained a fantastic new uncle. Sadly, the tediousness of the travel and the excitement of a family wedding made it so that I saw an east coast new year, but not a Utah new year. In my defense, even those NOT gestating went to sleep before seeing the clocks roll over to a new day and year.

Since then, we have been running like Wiley Coyote is chasing us. I am not too humble to say that not only did I party like a rock star, but I also kept up like a woman who does not have a mostly-gestated child depending on her for life and energy. In any case, being with the Eschler/Nesbitt families has made me even more excited for our next trip out here, when Little Boy Eschler will be able to be held and adored from the outside by his myriad aunts, uncles, grandparents and friends.

We've found out another close friend is pregnant with us. We've processed the loss of another. We've laughed over the genetic possibilities that exist after reflecting on Nathaniel's baby pictures and my anecdotes. We've frozen our bodies posing for family pictures on the snowy shores of the Great Salt Lake. All in all, a prefect familial repose at the end of a hectic, emotional holiday season.

On Tuesday, we return to Raleigh, which is rumored to have raised temperatures above that of frozen wasteland, which is where they were dwelling when we left. Hopefully, Nathaniel will be on the downhill slope to dissertation completion and increased freedom from academic stresses. I have another doctor's appointment wherein I have to further discuss the issue of blood sugar. Also, we're touring the hospital and learning where Little Boy Eschler will make his debut. It's also about time to start making some decisions about the crib and fabric and nursery. Additionally, I have to identify and determine how we are going to handle the issue of health insurance for the baby. It feels as though we've come so far and gotten so much done, but the reality is still so terribly large as it looms before us.

For now, Nathaniel and I will just enjoy our repose in this rocky mountain high retreat!