Saturday, October 29, 2011

This is what's up with you right now.

I am rapidly becoming a freaking viking when it comes to managing medical appointments. Earlier this week, I had three appointments back-to-back AND managed to cram in a visit to the (almost palatial) NICU where you will be spending a chunk of your first few days of life. Seriously: it's one of the nicest hospital facilities I've ever been in, and because of my father's many health problems, I have seen some hospitals. It's becoming old hat. I walk in, do my best to make nice with the receptionist (hopefully not going on red alert because of a full waiting room or snippy attitude, both of which bode ill), wait, be super polite to the nurse who brings me in, and then just get business done with the doctor. It's easy. Sometimes I get poked: sometimes I don't. Sometimes there are new questions: sometimes I just hear the same thing I've heard before and we laugh about how this will all seem so silly in hindsight.

That's what I need to do now. I just soldier through, making nice and absorbing medical information more complex and important than anything I've ever really had to process before. Everything I've endured - for myself - up to this point has been maintenance or a minor fix. Tension headaches? Drink a little less caffeine, cut back on sugar, try to relax more. Rash? Use some ointment. Legitimately sick? Chill out, drink tea, maybe take some Tylenol, and call back if things don't improve. Now, it's a whole new ballgame. Even the fourth or fifth appointment with the same doctor requires careful attention, since he or she might tell me something about your care that I actually have never heard before. I've started to use a calendar to track all the different appointments, since I think I'm averaging about three per week, give or take a few, and they are massively inconsistent.

I'm getting tired, to be sure, and it's more than a little overwhelming to juggle being an actually good teacher with giving you and me the best care we can get. There's been a lot of driving, a lot of emergency granola bars, and a lot of sitting and basically staring off into space in offices. You, on the other hand, seem to be gearing up for action. You are kicking around like crazy, and I'm only just starting to figure out what sets you off. Here are a few things that you either love or hate, but which you react to pretty consistently:
  • Me tossing and turning in bed.
  • Your Dad poking you.
  • Bagels.
  • Stew and/or soup.
  • "Invader Zim"
  • Back massages (for me, not you, since I'm never entirely sure where any part of you other than your feet are, and those aren't always in a consistent place relative to the rest of you). 
  • Dave Matthews Band
I must admit, it is massively comforting feeling you kick around, even when you kick so hard (or against bone) that it makes me nauseous. It's totally worth it to know you're strong enough to do that. At our last ultrasound this past week, you weighed in at about two pounds, which (according to your Dad) is about as much sliced deli meat as the average large family purchases on a Sunday afternoon. Seriously, though: that's pretty substantial! An online size tracker puts you at about the size of a full-sized eggplant. Granted, it's a little creepy to think of you in terms of food, especially considering how much you've been moving around, but you are in my belly...

Thursday, October 13, 2011

Nosy Nellie has a strong opinion about EVERYTHING!!!

Oh, Batman. I love - and I mean LOVE - the fact that we just moved into a real neighborhood. Not only are your Dad's parents (your paternal grandparents, whatever their monikers might turn out to be) directly across the street, but our landlords - who live directly below us in the giant three-family house that we now inhabit - have known his family for decades, and most of the surrounding neighbors are either friendly and familiar faces, or the kinds of people who move to a quiet, residential suburban neighborhood because that is what they want, not just where finances and logistics dictate they settle. The upside: we're surrounded by people who, even if they aren't always like-minded, have the same standards for quiet, friendliness, and community that we do. The downside: we know everyone, everyone knows us (initially by proxy, because your Dad's mom is a voracious social butterfly, but now with the same background knowledge as people we've known for years), and everyone is in everyone's business. This is what we signed up for, and we both actually love having these kinds of relationships to delve into, but there are definite downsides.

One such neighbor has always been something of a Nosy Nellie. She is a rare and unique variant on the theme, in that she frequently enjoys stuffing her life in your face rather than just trying to stick her nose into yours, but the latter clearly offers her great pleasure as well. I worry that this Nosy Nellie may have tricked your Dad and I into a thorough run-down of all the baby- and parenting-related things we need to be careful of, scared of, aware of, and otherwise prepared for. She called (thanks a lot, Dad-in-Law for sharing my phone number!) and invited us over to look at a crib she had gotten for free from an online bulletin board. Thinking "aww, neighborly kindness!" we trotted over to her house...and were cornered for close to an hour while she thrust utterly inappropriate and personal advice upon us.

Word to the wise, Batman: when someone whose eccentricity rating surpasses "pretty darn weird" invites you into their house to look at something they got for free that they want to give you for free, think twice. It may - just possibly - be a ruse.


We entered Nellie's house, and immediately the red flags went flying. First, she wants to give us a tour of all her recent renovations. Okay...cool...she's a friend of the family, and we haven't seen her house in years (your Dad) or ever (me). Still, a little odd. Second, she escorts us upstairs - through a door at the base of the stairs that she closes and latches behind us - and into a bedroom where we see the most potentially death-inducing crib mankind has ever engineered. This thing looked like it had all the structural integrity of a pile of chopsticks held together with paper clips. The sides consisted of round poles that are roughly a baby head's width apart, and one of the sides (the one that is meant to drop down, a feature determined to be massively dangerous and now not allowed on any new cribs) was so wiggly that it looked more or less like it was going to slam down if bumped against by a sleeping baby. Basically, it looked like a device that a serial killer might use to kill only the babies he really didn't like.

Your father and I made immediate and definitive eye contact that said "this is absolutely not an option, and we need to get out before this crib jumps out and tries to kill us." By then, it was too late. I politely mumbled something about the crib being too big (to which she responded that it was the same size as every other crib), then about not even being sure that we want a crib (which she thought was just ridiculous), then about how we probably just want to put a mattress on the floor so that you can chill out in your room if you wake up on your own some time, and so you never fall out of a high bed (which she, mysteriously, thought was a great idea). She let us off the hook: we didn't NEED to take the crib, but by that point, we were a captive audience. We did need to listen to her lecture us on the following:
  • Breastfeeding, and how I would have major challenges with it having a baby who receives surgery so early on (duh).
  • Breastfeeding, and how it is a miserable and oftentimes impossible process (thanks for that encouragement).
  • Breasts, and how they suffer from breastfeeding (yeah, I get it).
  • Sleep, and how we will never do it ever again. Ever.
  • Free time, and how we will never have it ever again. Ever.
  • A sense of personal freedom from the crippling obligation of parenthood, and how this destroys every other aspect of your life, making even the simplest pleasures (like pooping uninterrupted) practically worthy of a parade.
  • Her children's struggles with a baby who wouldn't latch, wouldn't sleep, and couldn't be left alone, and how they basically had to practice deliberate abandonment in order to wean her off of their anal-retentive attention.
  • The fact that her children's experiences with their offspring, and her experience with hers decades earlier, are all COMPLETELY RELEVANT AND WORTHY OF OUR EVERY MOTE OF ATTENTION AND CONSIDERATION.
Right. After making the entirely legitimate excuse of "er...we really need to go grocery shopping..." and waiting out about half an hour of additional advice-pushing, we managed to flee. Lesson learned, Batman: there's no such thing as a free crib.

Friday, October 7, 2011

Ode to our apartment

Batman, one of the most obnoxious features of being me is that when I am motivated - and I mean gung-ho, all engines firing on full blast, ready for anything, piss-and-vinegar motivated - pretty much the only thing that can really stop me is myself...and I am REALLY good at stopping myself. We're in the process of moving out of an apartment full of pretty major events, and while I am truly thrilled, I'm left with enough philosophical musing (and laziness, stress, and no small factor of fighting a head cold) to distract me from the full-throttle packing I really should be continuing.

This old apartment has some serious flaws. To start, the unit itself is on the third floor, making both moving and getting in and out with anything even vaguely heavy a truly unpleasant task. Hell, it frankly sucks at the end of a long day...and first thing in the morning, when legs aren't quite awake yet. Batman, never get an apartment above the second floor if there isn't an elevator. The bathroom is kind of tiny, which is okay, but the lighting fixtures give off this godawful yellow haze, and the ventilation fan sounds roughly like an idling, poorly repaired Soviet-era rocket. The toilet has been a source of constant adventure: it periodically half-flushes itself, which is not only noisy but terrifying if you happen to be sitting on it at the time, and has several times started gushing water for no reason whatsoever. There is a pretty huge mirror, which is nice, and this weird mirrored box-thing that serves in place of a medicine cabinet, which is kind of neat, but the cabinet under the sink is particle board that looks like someone (or something) chewed on it.

Speaking of which, let me move on to the kitchen. The cabinets might have cost someone a few shiny pennies sometime in the 80's, as they regularly shed particle board fragments, and are of such questionable structural integrity that I am left wondering how our dishes and glasses are still intact. We got a brand-new stove and fridge within the first year and a half that we lived here because the previous ones were so trashed from over/misuse, which was nice, but of course the nine hundred year old dishwasher remained. The kitchen sink periodically took a cue from the toilet and just gushed water everywhere, and the overhead lights basically stopped responding to a switch sometime about a year ago. The ceiling above the stove leaks in the rain, and fruit flies seem to love our drainage system, making them year-round accessories.

The bedrooms are really okay, except for the fact that black mold seems to love to collect around the edges of the windows. The closet space is awesome: I will legitimately miss having four MASSIVE closets that were not only deep, but tall and wide. The new place also has four closets, total, but I think all three of them could fit into two of the closets in the old place, probably with room to spare. There was a little deck-thing off the "dining area" (read: "space too small and awkward to use for anything but a pretty small dining table, but even that is pushing it,"), but it was small enough - and frequently enough clouded with a neighbor's cigarette smoke - that we basically never used it. Your father will push for wall-to-wall carpeting anywhere we live, but so help me, this place has turned me off forever. The carpet held on to a funk like nobody's business, and it is this awful tannish-grey that never looks clean, even after repeated vigorous vacuumings.

Oh, and the neighbors. Let me try to sum up each in a single sentence. There was the lady across the hall when we moved in who chain-smoked in the hallway, possibly blowing smoke under our door, just to piss us off after we asked her to stop, then spent the next three years sneering at us any time we passed one another. There was the dude downstairs who broke up with his sensible girlfriend a few months after we moved in, then started loudly discussing on his cell phone the pharmaceutical drugs he was trying to cell while chain-smoking on the porch at odd hours of the night. There was the next dude downstairs who (like his predecessor) broke up with his sensible girlfriend, then started bringing underage chicks home from where he worked (which was the only strip club in Portland) to have mind-blowingly loud, ungodly late-at-night drinking parties. There was also the really nice single mom with a young, polite daughter who lived on the second floor not below us, and we were really sad when they moved out, but it was to live with the mom's nice new boyfriend, so that was cool. They were replaced by a quiet Indian couple who are completely innocuous except for occasionally leaving piles of shoes in the hallway. On the bottom floor, we started with a guy who must have been some kind of diagnosably crazy, because he SCREAMED profanity at his two Golden Retrievers while they were running around off-leash, pooping everywhere, and they weren't even allowed in the building. There was then a young-ish guy who was nice enough, but who regularly set off the smoke alarm with his idiotic cooking. After him has been a quiet older woman who has something like a jillion cats. On the other side of the bottom floor is a family from Rwanda who literally let their children (aged 4-ish and 6-ish) run rampant through the apartment complex, hurling sticks at each other and leaving a trail of garbage and toys wherever they go. Right below us now is the complex's head of maintenance, who we really like now that his ex-con son has moved out and they no longer have screaming fights at 4:00AM. Other people in the complex range from quiet families and working folks to more unsupervised, rude children and jackholes who go through the parking lot at forty miles per hour.

Moving to a building that is clean, well-maintained, and in the middle of a residential neighborhood with a quiet older couple below us and a quiet single guy above us - and quiet families who we know all around us - is worth potentially losing a month's security deposit.

While some might call this place a crap-hole (which, by the standards of many, it is), I feel like we're leaving a lot behind. It's where your father pulled his head out of his...I mean...er...where your father decided to give in to my year of not-even-vaguely subtle hinting at the fact that we were already a couple to admit that yes, we were a couple, and a damn good one at that. It's also where we discovered uncountable wonderful movies, books, TV shows, dumb internet memes, and other glorious tidbits of media. It's where we suffered through grad school together, then spent the next year dragging each other through the mud of unemployment and a really damn hard first job. It's where we first put all our books on the same shelves, mixed together in alphabetical order so that we really couldn't have extricated our individual collections without some serious debate and probably hair-pulling. It's where we made you (and by that, I mean we placed an order online with the stork, and icky grown-up stuff has NOTHING to do with it). It's where we nursed each other through finding out about your heart. It's where we've spent countless hours complaining about work, celebrating those few tiny successes teachers get to claim, mourning losses and victoriously lauding accomplishments.

It's where we've lived for over four years. It's surreal to think that this morning was the last morning I will leave this building to drive to work. After this weekend, it's down a different flight of stairs to a different driveway. I'll write all about the new place as soon as we're actually in there, but for now, Batman, just think: when you live somewhere, it may just be a place, but it's impossible for it not to become part of you in a way.

Sunday, October 2, 2011

...and then I called him a fuckhead.

Batman, sometimes you just need to call people on it when they are being inappropriately crappy. This week, I had the (hopefully rare, ideally one-time) experience of calling a doctor a truly naughty name. Now, as you will soon know, and as my friends and family can surely attest, I am neither an angry nor an aggressive person. In fact, I tend to try to avoid confrontations at all costs, often to a point of accidentally letting myself become a victim because I just hate, hate, hate it when people are upset with me.

This neuroses is especially profound when it comes to anyone in the customer service industry; if it is someone's job to provide me some kind of care or support, I tend to go out of my way to be nice to him or her almost regardless of how poorly that individual is treating me, or how poorly they are doing their job. Receptionists, flight attendants, nurses, and doctors have always been a source of particular anxiety for me, as they legitimately hold a fragment of my fate in their hands. In my head, it is virtually required for me to do anything I can to make any person in one of these positions feel favorably towards me, if not to flat-out like me. This week proved for me that not everyone in these noble and not always appreciated fields is deserving of such esteem. (Don't worry about the flight attendants. They're still cool.)

This Tuesday, I left school about an hour early to make the drive from work back to Portland. Now, most people can leave work an hour early with minimal crisis; my leaving work is a far more complicated endeavor. I need to secure coverage for my end-of-day responsibilities, which effectively boil down to outrageously carefully choreographed cat-herding. Thankfully I was able to do so, and (still stressed about creating any change in routine for my kiddos) I scooted my way to the doctor's office. This was my first appointment with the "high risk" OB/GYN practice that I was told (by the head doctor there, hearafter referred to as Dr. D-Bag) I had to - HAD TO - work with for the remainder of my pregnancy.

Batman, I'm sure you recall earlier posts in which I all but damned the medical institution surrounding maternal care. From all I have read, heard, and seen, there is essentially no consideration for patient needs in this system; doctors do whatever fits their schedule and their (or their practice's) financial desires. Drugs and often superfluous medical interventions are all but forced, and patients are backed into every possible corner with nothing more than the excuse of "this is for the good of your baby" to explain their (often mis-)treatment. Naturally, when you showed up I went running to the most holistic practice I could find. As soon as the diagnosis about your heart came about, Dr. D-Bag told me that I could not - under any circumstances - continue to work with a practice that didn't have as explicit a relationship with "the hospital" as his does. To be fair, this hospital does have a regionally award-winning NICU, and we will be working with a truly exceptional cardiologist based there, but...did I really need to work with a terrifyingly restrictive, conservative, and medicine- (not patient-) oriented practice in order to take advantage of all of these resources? My gut said no.

I showed up at my appointment a responsible fifteen minutes early. Even not being a new patient, I like to show up early to appointments just to show that I am respectful of the practice's time. (Some little part of me wants a receptionist to someday either compliment my timeliness, or better yet, give me some sort of gold star. Maybe they make notes in their records of who shows up early and who doesn't...See? Neuroses!) At 2:30, when my appointment was scheduled, several patients had already been called in. I had not. At 2:45, people who had arrived well after me had been called in. I had not. Come 3:00, I meekly approached the receptionist and asked if she had any idea how much longer I would be waiting. I was told in no uncertain terms that I would be called when it was my turn, and that they were very short-staffed, so she could make no accurate predictions. I muttered something about having come early just to be sure I was ready when it was my time, and was thanked for my patience and asked to continue waiting. In the meantime, several people who had showed up after 2:30 had already been called in to their appointments, and a few of them were already checking out and leaving, having FINISHED their appointments. Still, I was not called in.

Come 3:30, an hour after my scheduled time, my desire to please the receptionist had disintegrated into more or less red-hot rage. I could have not only left school at a normal time, but I could have carpooled that day, saving myself dollars in gas money and however much carbon emission that a second car created. While silently stewing (and watching more and more patients be called in for their appointments, then checking out and leaving), I tried to center myself. Sure, I didn't want to be working with this practice, but it wasn't their fault that I needed their services. Even though I was livid at having so much of my time wasted, I had to walk into this with a positive attitude. Finally, over an hour past my scheduled appointment, the waiting room otherwise completely empty, I was called in by a nurse who immediately set my teeth on edge.

Now, here's some simple advice for all medical professionals: when you first meet a patient, ask "how are you today?" or something of the like. This shows that you are a human being, not some sort of soulless demon with a name tag. This nurse immediately started lecturing me about the need to work with her practice, citing all of my risk factors (which were described so obliquely as to leave me more confused than when I started) and, once she got my chart in front of her, berating me for not seeking their highly-medicalized care the second I got pregnant. I seem to have forgotten many of the details of our conversation in a rage-induced fugue, but here are a few highlights:

Nurse: "I see you were working with a midwife practice. Now, since they aren't really doctors, and really aren't qualified to give you prenatal care, I hope you can appreciate that we need to redo their records."
Me: ...annoyed silence...

Me: "I'm hoping to get a better explanation for why you want to induce me at 39 weeks instead of 40, given that my child's lungs may not be fully developed at that point...also, especially since the doctors I've spoken to want me to have as natural a birth as possible, it seems strange to me to introduce chemicals into my system that will almost definitely require more chemicals being introduced, and increases my chance of a c-section dramatically. Is there any more information you can give me about why this is an appropriate choice for my baby's health?"
Nurse: "I don't appreciate your getting irrational about this."

Nurse: "Our practice has twelve attending physicians or residents, and works with several other practices to cover nights at the hospitals, because our doctors are only available until 5:00PM. Your baby will be delivered by whoever is on call when you go into labor."
Me: "What are the chances of me meeting the doctor who does the delivery?"
Nurse: "In the thirty years I've been a nurse working with maternal-fetal medicine, I've never seen a case of a woman knowing the doctor who delivers her child in advance."
*Note: I actually don't know a single woman who DIDN'T know the doctor who delivered her child in advance, and I've known more than a few families who used this hospital.

Me: "I am really not comfortable having a man deliver my baby. Is there any way to ensure that I work with a female OB?"
Nurse: "That is a completely irrational request, and one that is frankly closed-minded. Again, you don't get any say in or control over who delivers your baby. This is just part of how we guarantee that you receive the best possible care."
*Note: WTF?

After about twenty minutes of this sort of round-about bullshit, and four separate occasions of being called irrational, this nurse clearly realized that I was too irrational for her to handle on her own. I was proud of myself: I stayed calm, collected, and focused on the needs and concerns that your father and I had deliberated and discussed in advance. This nurse left me waiting for almost another half an hour while she got the doctor to "discuss my concerns" with me. It was at this point that I realized that she had only weighed me, taken my blood pressure, and listened to your heartbeat; no actual examination had taken place, and there had been zero conversation about how I have been feeling, whether you were moving around much, if I had been, I dunno, pooping normally...nothing.

Dr. D-Bag comes in and immediately goes on the defensive. I am told - flat-out told - that I am making irrational requests, and that what I "have to understand" is that this is a situation in which I have no control, no choices, and should have no expectation of having any input about my treatment. In the roughly five minutes of face-time he gave me, I was told (again) that no woman he works with ever knows the doctor who delivers her baby, that being induced early is non-negotiable, and that wanting a female obstetrician is a hurtful and irrational desire. It was at this point that I called him a fuckhead.

Now, profanity has a magical influence on people. For some, it is a catalyst for further rage, beginning an escalating spiral of violent language, and often violent behavior. For others, it is a neutralizer, negating any potential further action and stunning the recipient into stunned silence or complacency. For people like me who just flat-out hate confrontation, it typically sways me - usually instantly - towards acquiescing to the profanity-wielder's will.

Apparently for Dr. D-Bag, profanity is some sort of secret key code that releases his patients' true desires from the clutches of his fuckheadedness. The second I showed him just how much he didn't want to deal with me any more, he immediately offered to transfer me to a holistic practice of six women, all of whom I would meet during my pre-natal care, and none of whom "pass off" patients to other practices if one of them isn't available. Turns out that getting exactly what I wanted - what I knew from the beginning to be right for all of our family - was completely an option from the beginning.

Not only was I kept waiting (which is mostly annoying, but ultimately disrespectful of my time, as well), but I was spoken to rudely and condescendingly, lied to, and I would have been denied my rights as a patient had I not acted against my gut instinct and called this guy what he really is. I can't believe I let this wacko perform my amniocentesis, but at that point, I didn't realize just how bad he was. Batman, I hope you can take this as a mark of several important things. First, your mother will kick anyone's ass who stands between her and the best care for her family. Second, there is no such thing as "no choices." There are always choices. Third, and perhaps most importantly, I have one hell of a gut instinct.

Turns out that this fuckhead...I mean douchebag...I mean *ahem* "medical professional" is a lapdog to our insane, scary, dumb-as-toast governor. He (Dr. D-Bag) and his uber-conservative doctor wife have both worked to limit the rights of GLBT patients, from campaigning to allow practices to deny medical care based on sexual orientation, to working to flat-out deny lesbian mothers pre-natal care. I might still technically have to deal with this dude sometimes until you pop out, but I've got another practice full of women who buy in to the same philosophy that I do to back me up, and there will be one hell of an angry letter going to his supervisor as soon as I don't need to deal with him again.

Batman, I've got your back, and anyone who tries to stand in my way is going to see a very ugly side of me.