Saturday, 28 March 2015


As my 20% coupon had an expiry date, I went back to the baby supply store to purchase an infant car seat/stroller combination set. This time Husband joined me. It was a rare weekend when he didn't have to umpire any hockey matches, and as our garage project is on hold pending some issues that need HOA approval and City inspections, he probably didn't have anything better to do. Reflecting on my previous trip that reminded me of the first shopping scene in Pretty Woman, I commented that his presence followed how Edward Lewis accompanied Vivian the second time she went shopping. Husband was quite confused as he has never seen the movie, but I think he appreciated the comparison to Richard Gere.

I found the display model for the pram I had selected based on my research. We took turns pushing it around and then attempted to practise folding it. A sales woman spotted the clueless couple and probably feared that we would break something. "Can I help you?" she called from a distance and quickly started walking over to us. She gave us a demonstration and answered a few questions. "Is this something you'll want to add to your registry?" she asked in earnest. Husband let out a deep sigh as I launched into my spiel about being anti-registry and anti-baby shower. I even added how hard it was just for me to be in the store after my experience with infertility and pregnancy loss. The sales woman just returned a look that I'm pretty sure conveyed; listen lady, I really don't care about your back story. It was a yes or no answer... Then she informed us "Well you may want to create a registry for some items, even if you purchase them yourselves. You'll get coupons and it will help you organise and keep track of what you need."

Okay, I could go along with that logic. I also thought about Edward Lewis's explanation of customer service and capitalism. "Stores aren't nice to people. They're nice to money." Of course, he skips over the next sequence, which is that stores are nice to people with money. No one in the store would throw me out claiming that I didn't belong in there. I could be one of those crazy women who is faking a pregnancy and they would be all too willing to sell me the gear needed to support my delusion. (NB: Unfortunately this scenario does sometimes happen. Be sure to ask about Nursery security during your hospital tour.) I began to relax a little as we waited for the 'Registry Consultant' to meet with us. It helped that couple sitting next to us barely looked out of the first trimester. "Hi," she greeted. "I understand that this is a little difficult for you, so we'll try to make this as comfortable as possible for you." Oh good. She was just like Bridgette. "Barney said you would be nice to me..."

She took us around the store and we had our own little spree with the scanning gun. Much to my chagrin, I actually enjoyed it. When we first learned about my placenta issues, Husband didn't want us to purchase a single item until the baby was actually born and definitely coming home. "Um, I'm going to be recovering from major surgery and we'll be caring for a newborn in the ICU... not really ideal to be running in and out of stores..." No problem. He answered as he proclaimed that he would take care of it all. My parents also offered to take on this task when they arrive. I quickly thought back to how they wanted to redecorate our living room with new chairs. I may not recognise my own house any more. I reminded them both that I'm suppose to want to do this nesting thing... it may actually be instinctual. I feel that I've already been denied so many pregnancy experiences, damned if I'm going to deprive myself any further!

My mind oscillated between thoughts of NMG! I can't believe I'm doing this! How could I just abandon all my principles! to echoes of actually... this is pretty practical... Myrtle and Mrs Myrtle would send us a gift from a registry, as would our ex-pat friends. My mother's middle sister probably would as well. I'm sure that would be fun for her. When my mother told her the news, she issued her congratulations and then commented on how it seems that everyone around her is expecting grandchildren and how jealous she was. Her 34 year old daughter is recently divorced and her 32 year old son is dating a fourth grader (she's 22). What about my mother's youngest sister? Well that will depend on if my mother gave anything to Sid and Nancy and their methadone weaning baby. Don't you love how this game is played?

I made Husband promise that we would keep the details of our registry secret, and only share the information with anyone who specifically asks. I did have Co-worker take a look at it, only to act as a second registry consultant. She recently shared with me that our practice manager approached her about arranging a shower at the office. Her idea was to have people contribute to a gift card, which I could use toward my registry. I could actually go along with that. No one would be pressured or obligated. I wouldn't have to endure the awkward present opening scene and no one would be singled out for not giving a gift. Yet, keeping with my Pretty Woman theme, I still feel a bit whorish.

Saturday, 21 March 2015

"You Work on Commission, Don't You?"

Like many women in my age group, I probably have seen the movie Pretty Woman a few hundred times. One of my favourite scenes is when Julia Roberts returns to the snooty Rodeo Drive dress shop all dolled up in the posh threads purchased by her [ahem] employer. "Hi, I was here yesterday and you wouldn't wait on me," she reminds the saleswomen. "Big Mistake." she announces as she holds up all her shopping bags "Huge!" she adds for extra emphasis as she makes her grand exit. Yet, to appreciate that scene, one has to remember the earlier scene when she walks in wearing her hooker clothes.

"Oh, I don't think we have anything in your size..." The first sales woman subtly tries to discourage her.
"It's very expensive!" The second one tries harder to make her feel uncomfortable
Finally they take the direct approach. "We don't have anything for you. You're obviously in the wrong place. Please leave."

I recently purchased a baby shower gift for my friend in LA who is due in a few more weeks. She was registered at a popular baby supply store and upon completing my order, I was asked if I wanted to sign up for email notifications, and if so, I could receive a 20% off any one item coupon. Well, hell yeah! About 80% of my in-box gets deleted anyway, so why not delete some more for a 20% discount. However, the devil is always in the details. The offer excluded almost every major brand name baby retailer and would expire in just over a week. Although we had decided not to purchase any items until reaching viability, exceptions could be made when we're talking about potential savings. I had Co-worker take a look at the details to help me determine how I could best stretch my dollar given the limitations. "Hmm... well, this excludes just about everything." She deduced. "How about a Sophie doll? They're pretty expensive." I enquired about how much. "Twenty dollars." she replied. I silently sighed. That would only save four dollars. I don't think she quite grasped the purpose of my mission. I decided I would go to the store and just ask a salesperson how I can best use the coupon. I may try to keep my pride intact in front of my family and friends, but I have no qualms about looking like a chav in front of a complete stranger.

I entered the address to the store into my car's navigation system. It was actually right next to a Best.Buy that we've frequented many times over the past seven years and I never noticed the baby supply store next door. I walked through the front entrance and I froze. Yes, I expected the store to be full of baby related products, but it felt so overwhelming at that moment. There was a long queue of mostly very pregnant woman at the Customer Service desk. I felt as if they were staring at me. Suddenly I felt very self conscious. I was still in my gym clothes, but that wasn't the reason. My bump felt invisible at that moment. Despite the fact that my bump was first noticed and is most evident in my workout attire, I still have people telling me, "You're five months pregnant! You can barely tell!" It is much to my delight, but at that moment, I really wished I looked more pregnant than fat. As I watched the sales team helping other pregnant women, I started to feel singled out. Suddenly, I became terrified that I would be approached by a manger who would tell me that I didn't belong here and that I needed to leave.

I wanted to walk out of the store right then and there, but I really needed to pee, so I headed to the bathroom. As soon as I entered the stall, the tears started to fall. Then I started sobbing. "Are you all right?" the woman in the next stall enquired. That was my cue to pull myself together. "Yes, I am." I lied. I couldn't expect a complete stranger to understand why it was so hard for me to be in a baby supply store. Deep breath Jane... C'mon. You can do this! 

Fortunately, my meltdown consumed enough time to allow the queue to dissipate. I showed the agent my coupon and basically asked what was the most expensive item that would be eligible for the discount.  The girl just looked back at me "Well, what do you need?" she asked, probably thinking O-M-G, How tacky! and she's not even pregnant! "Everything." I replied, which most likely confirmed her thoughts. "Well, it just applies to these brands. There are other brands. You may want to check out the car seat or strollers" she suggested. Maybe a stroller would be a good place to start. I went to that section of the store and took some pictures of a few models so I could research them when I got home.

Then I looked around the store again. Next to me was a woman with her toddler looking for tandem strollers. One woman brought a doll so that she could try on baby carriers. Another couple was walking around the the scanning gun. There was a woman who kept her hand on her bump, it made me wonder if it were glued to her shirt. Once again, I felt as if I didn't belong. I've seen enough, it's time to get the fuck out of here... I thought to myself. Then I received a swift kick from Jate. As daft as it sounds, I felt as if he or she were echoing my thoughts, Hell yeah! We need to get the fuck out of here! While I can't say I approve of the language, I couldn't help to think that my kid understands me! More so, it was the validation that I needed. I only needed one person to recognise me as a mother. I may never be welcomed by the Mommy and Me crowd. I may never feel like I fit in with the other Soccer Moms. I just need to feel that I belong to Jate.

Saturday, 14 March 2015

First World Problems

When I was in my early to mid twenties, I read an article in Glamour magazine entitled 'Throw Me a Shower!'. The author was a successful single woman in her late thirties soon to be 4-0. She reflected upon the number of expensive items she had given her friends as wedding or baby shower gifts over the past twenty years, but because after many blind dates, set-ups and failed dating site memberships, she wouldn't receive anything in return as she hadn't found a soul mate. She even seemed to be a little critical of some friends who were on husband #2 after falling for Mr Wrong the first time around. When one friend admitted that she started having an affair a few months after her wedding, the author went to her house and took back the wine rack she gave as a wedding gift, in a move that I thought was awesome. The article struck a chord with me. After landing my first real job, I furnished my own apartment. Albeit, it was through consignment stores, IKEA and taking advantage of extended interest free credit card offers. Then boyfriend-now-Husband and I were talking about getting married in a few years and it insulted the feminist in me that I could be eligible to receive a new toaster from someone just for getting married.

I could follow that the tradition of giving flatware or a crock-pot made more sense when couples married at a much younger age. "People will want to give you wedding gifts." my Maid of Honour Myrtle tried to convince me. Um, that is some serious bullshit. When have you ever heard someone exclaim 'Oh, I am so stoked! I have to go shopping for a wedding present this weekend!' Of course, internet shopping has made this chore so much more pleasant. You can be sitting in your pajamas and slippers, click*click*gift wrap*send to their address*...and done! All before finishing your first cup of coffee. We had some practical considerations against setting up a wedding registry. Our wedding was in England, but we were living in Connecticut and preparing to move to California within a few months. Instead, we suggested guests could contribute to our honeymoon through Australia and New Zealand, and we labelled the tables at our reception based on our intended destinations. Some even gave us Australian currency.

I decided that I could accept the notion of wedding gifts on a few grounds. As many other friends were also getting hitched at this time, it had become a mutual exchange. Even for those who weren't recently married, our guests were treated to cocktails and appetizers in a beautiful English garden, a nice meal, an open bar and a live band for entertainment. They were getting something in return. Although I felt a little guilty exploiting this concept when a someone told me that she brings a blank cheque to weddings and estimates what she needs to give in order to cover the cost of her plate. Wedding gift giving should be a reflection of your relationship and what you can appropriately afford. The couple who goes over the top and splurges shouldn't receive more in gifts, as it is those who can only manage a backyard reception who probably need more help starting out.

I struggle even more with the idea of a baby gift registry. My inner conservative Republican insists that if we're making the decision to have a baby, we should be able to provide for it ourselves. That we shouldn't expect anyone else to furnish our nursery. I had these feelings long before we even started trying to conceive and the pricetag of our infertility treatments only makes my feelings more salient. My pride fears that I'll come off as a charity case. Oh look at her! Spent all their money trying to have a baby and had nothing left when it finally arrived... I'm just so uncomfortable with the thought of putting a gift list together and distributing it. When one of my high school friends sent a bridal shower invite to a girl who had moved out of state, the recipient sent the invite back with a note that read, 'I haven't heard from you in nearly two years. How nice that the first correspondence I receive is a list of gifts that I can send you.' It just feels very gauche.  Or perhaps, I don't want to be so presumptive to think that anyone will purchase anything from our registry

Once again, one can argue that it's part of a mutual obligation in our society. I think back to the Sex and the City episode, where the girls convince Miranda to have a baby shower. "Who would I invite?" she asks. "All the bitches you made you go to theirs!" Samantha wisely answers. Yet, there are other consequences of being the last of your friends to have a baby. When our friends in England started breeding like rabbits, Husband and I were very generous with both the first and second child. The couples who had a third baby received condoms as a gift. (Oh, yes. I did.) One even sent me a note, "Thank you for the year's supply of Johnnies [it was a pack of 3]. I opened it in front of my mother-in-law, who was most approving of your gift!" Again, long before my IUD-ectomy, I warned Husband that even if we did procreate, our friends would be too poor for any reciprocity. Unfortunately, my premonition came to fruition. During his recent trip to his homeland, he observed that most of our friends are living hand to mouth. It doesn't seem right to ask anything of them. I attended many baby showers for my friends on the east coast, but the years and distance have eroded our friendship to an occasional Facebook message and Christmas cards. I can't be like my high school friend and deliver a gift list out of the blue, just because it's now my turn.

So, I really shouldn't complain that I've already had a few offers for a baby shower, but it has become a source of stress for me. My mother revealed that my aunt wants to throw a shower for me. I guess she feels inclined as my mother isn't nearby and she actually won't see me again before the baby is born. The difficult aspect is that I feel as if I'm in a transitional state with my friends. About this time last year, our 'friends' H+B stopped hanging out with us. We're not sure why. We know they don't want to have kids and always felt the friendship would change if we ever did have a baby, so maybe it was better to part ways now. However, they were our connection to a few other couples, who we would enjoy their company when we would get together, but we didn't have enough of a bond or enough in common to go out with them on our own. As I've been swimming at nights and missed our last two meets, I feel I've pulled away from my swim teammates. I haven't played much in the past two seasons, so I'm out of the loop with my hockey friends. It's also awkward as I waited so long to tell people about my pregnancy and may have to prepare for an early arrival. It doesn't feel right to spring such a short notice request on anyone. We've started hanging out with some people from our gym, but it's too soon to estrange them with an baby shower invite.

Co-worker warned, "you know they will throw you a shower at the office." It's become a bit of a ritual, our practice manager will announce a fake staff meeting that is really a surprise shower whenever there is an expecting team member. She even goes as far as to create a false agenda. At one event, the intended guest of honour actually submitted some topics for the agenda, and while touched by everyone's generosity, she was disappointed that her concerns didn't get addressed. I've had to endure seven office baby showers since trying to conceive. I think about Betty and Veronica who experienced infertility, but never went through treatments. I know there are some staff members who are trying to conceive and aren't having much luck. I hate to think about subjecting them to the bitter feelings I had during baby showers. As our office has grown so much, I have to admit that I don't even know the names of some new faces. Why should they be expected to give me a gift when we don't even really know each other? Additionally, and I know this sounds really elitist, as I am among the higher earners in our group, I don't feel comfortable accepting offerings from those who make much less than me, especially as some live paycheque to paycheque.

I can't say that I resist being at the centre of attention. I enjoy teaching and I deliver a lot of professional lectures. I'm very comfortable with public speaking. When Myrtle asked if I would be okay with her having another friend (Helen) serve as her Maid of Honour, I was actually happy to be relieved of the extra responsibility, but I asked if I could give the toast. I knew that Helen would be nervous about speaking in front of a large crowd, and it would irk me to watch her stumble through it. My content was heartfelt and my delivery was flawless. I knocked it out of the park and I knew it. Many guests approached me to comment on how impressive my speech was, and two members of the band told me it was among the best they had heard. I was gloating inside. Yet, the thought of being in the spotlight at a even a small baby shower terrifies me. I expressed that I didn't want a shower during the ten minute duration of my spontaneous pregnancy, and now I am even more resistant. It's hard to celebrate this pregnancy without reflecting on the painful road we travelled and as potential complications are lurking, I still feel that I am tempting fate.

Please note, I don't project these throughts or feelings on to anyone else to has a baby shower or does a gift registry. I've attended many showers and purchased gifts from registeries without thinking that the couple can't provide for their own baby and are expecting others to fill their nursery. Although I thought it was very tactless when Mryrtle finished opening her gifts and announced, "So, no one wanted to go for the breast pump?" I've been trying to figure out why I'm wired this way. (Husband notes that I mispelled wired and meant to use the word weird) The only thing I can identify is that as an only child I grew up fighting the sterotype that I was spolit and it has stuck with me through adulthood. Then again, I also lack the girlie gene that makes me want to buy fancy shoes and expensive purses. I didn't have a bridal shower or bachlerette party. This is just not my scene.

Yet, I'm still faced with many awkward realities. We used a 21 month interest free credit card for all our IVF expenses, which ironically ends on my intended due date. When we submitted the application, our goal was to have a baby before the interest free time expired. Now it is Husband's goal to have all the IVF expenses paid before Jate's arrival. The inconveniently timed garage renovation is getting more expensive as we get deeper into the project. Fortunately, our tax return was much more than we were expecting, which definately provides some breathing room. Yet I know babies are really expensive. As proud as I am, I'm also pragmatic. I have moments when I'm tempted to say 'oh, fuck it!' and just yield to social convention. But, I.just.can'

Anything that anyone offers us will be most deeply appreciated. However, if anyone were to give us some gesture toward our baby, I would want it to be on his or her own volition. Without streamers and finger sandwiches and not being able to ever eat a candy bar ever again because you're thinking about baby poop. Without someone thinking, 'fuck, this is more than I wanted to spend on her, but all the items in my intended price range have already been purchased.' Is it too uncouth to ask for a gift card if anyone inquires about our registery? How can I politely tell my aunt, 'thanks, but no thanks.' Maybe I can suggest having a family brunch at my cousin's house and while they're loading the basinette and crib into my car, I can ransack her bookcase and help myself to her baby and child care books claiming, "you don't need this anymore do you?"

Aww, poor little infertile, now pregnant girl. Finally expecting a baby and has family and friends who may try to give her things she needs. It's the ultimate in first world problems.

Sunday, 8 March 2015

Preparing for the Worst Case Scenario

It is often estimated that patients only absorb a small amount of the spoken transaction with their health care providers. When I met with the perinatologist to discuss my placenta, I felt that I was not an exception. Although I am fluent in his language, I was a bit overwhelmed at that moment and I left the office with the feeling that I didn't have the full picture on our situation. Acknowledging that I have a lot of unfair advantages, I would wait until I had access to read my own report. This perinatology office is generally pretty slow to return normal reports. The turn-around time is about 1-2 weeks and I've come to accept that the longer it takes them to send a report, the more likely it is to be normal. The day after my scan, I received an email message confirming that my report was received and scanned into my electronic health record.

I had Co-worker print a copy for me. The details of my placenta read: anterior, total previa, grade 1, with placental lake. A placenta lake (also called lacunae) is a black sonolucent space within the placeta and can give the placenta a Swiss cheese like appearance. It indicates that there is a loss of placental homogeneity. The final comments noted; There is a COMPLETE ANTERIOR PLACENTA PREVIA. There are lacunae noted within the placenta, but without turbulent flow. A retroplacental clear space is visualised. Placental lacunae with placenta previa is associated with an increased risk of placenta accreta, but there is no definite evidence of placenta accreta on today's ultrasound. As I reviewed the report, my gut instinct told me that my previa was probably not going to resolve and the possibility of an accreta was more of a threat than I had previously anticipated. I showed the report to a colleague ,"Ugh" she reacted while making a face. Then she realised it was mine. "Oh, I'm so sorry!" she quickly recovered. No need. I wanted an honest response. She agreed it is a bit of an ominous prognosis.

I had my first visit with my Lead Physician where I was her patient and she was my Obstetrician. She had called to the perinatologist to discuss my case. Firstly, they both observed the irony and noted that Ob/Gyn providers just seem to be at a higher risk for weird and unusual complications. He really identified two separate concerns, the location of the placenta and the potential for an accreta. Even if my placenta moves, I could still have an accreta. He admitted that he has seen cases where previously noted lacunae or lakes resolve, but it didn't seem to be too often. The take home message was clear; I should prepare for the possibility and consequences of a placenta accreta. Something I more or less had already been doing.

As I've described the situation with a few non-medical people, I've been asked, "So what does that mean? You'll have to have a C/section?" The little voice inside my head wants to laugh a little and respond with oh, if only it were just a routine Caesarean delivery... The management for a placenta accreta is to perform a Caesarean hysterectomy. As the placenta is completely adherent to the uterine muscular wall, it can not be easily removed without risking massive hemorrhaging, so it is best just to remove the entire uterus. It is a very intricate and risky surgical procedure. My birth plan would look like this:
  • A course of bethmethasone steroids 48 hours before scheduled delivery at 34 weeks gestation
  • Pre-operative discussion of the potential intraoperative complications, including hemorrhage, need for transfusion, injury to bladder or bowel. Some of which may be life-threatening.
  • Delivery in the Main Operating Room where fluroscopy is available.
  • Two large bore IV catheters in place
  • 3-way Foley Catheter and ureteral stents to help assess the integrity of the urinary tract as needed
  • A sheath in the femoral artery to allow for interventional radiology to perform uterine artery embolisation to control bleeding during surgery
  • Type specific blood products and clotting factors available at the time of delivery
  • Experienced anesthesiologists and nursing staff. 
  • A Gyn-Oncologist is often called to assist, not because of any cancerous potential, but for their excellent surgical skills
  • Neonatology attendance
  • An ICU bed should be available for postoperative care
  • A scheduled delivery is optimal in order to coordinate all necessary personnel and equipment, and it is associated with less intraoperative blood loss. However, many patients will have a bleeding episode or go into preterm labour, necessitating an emergency delivery. 
I'm choosing not to focus on some of the life threatening consequences until I actually have to cross that bridge if I come to it. Rather, I'm preparing myself for the possibility of losing my uterus. In a way, it's even slightly ironic as I only wanted to have one child. All my reasons for only wanting one child are still intact. It just would be frustrating not to have that option any more. Medically, I know it's a straight forward decision. I reviewed the literature; in cases where a placenta accreta has been disturbed and is hemorrhaging, conservative measures are rarely effective and endanger the patient by delaying a hysterectomy. During the delay, massive hemorrhage can lead to a downward spiral of hypoperfusion of all organ systems, hypothermia, disseminated intravascular coagulopathy and metabolic acidosis... I already know that my uterus is useless. Even when uterine conservation can be preserved, reproductive outcomes are poor. Many patients have residual intrauterine synechiae leading to Asherman's Syndrome and they are at a very high risk of a repeat placenta accreta in the even of a subsequent pregnancy. I can't imagine that Dr Somebody that I Used to Know would even recommend transferring any embryos into a surviving uterus. Quite honestly, I would question him ethically if he did. It took us six embryos just to get a good one to stick and that was before we knew my uterus is shit. Perhaps I have found ultimate silver lining to our infertility journey. As we have three remaining embryos, we at least theoretically have the opportunity to try for a second child with a surrogate, even if we don't have the financial resources.

I've been clinging to a few positive aspects that I have in my favour. My placenta is anterior, and anterior previas are more likely to move and less likely to bleed. Cervical shortening is associated with an increased risk for bleeding and mine is a solid 43 mm. So far, my haemoglobin and haemotocrit are in a normal range and I plan to follow closely and proactively correct against anaemia. I have been allowed to exercise with modifications. I stopped running, but have continued swimming and going to Cross-Fit (although I'm not lifting).  Although the threat of pre-eclampsia is still present, my blood pressure has been within normal range. I feel great and I look great, even if the situation with my placenta is not great.

In such a strange way, I feel so fortunate to have this information now. A placenta accreta is most dangerous when it is undiagnosed. I have a lot of time to process the possibility losing my uterus. I've had two patients who needed an emergency postpartum hysterectomy and I can't imagine receiving that news just after giving birth. I was planning to resume using a Mir.ena IUD, not only for contraception so that we wouldn't have the post infertility surprise baby, but for menstrual suppression. After coordinating so many appointments and treatments around my cycle, I don't want to see AF for a long time. I was also considering Nex.planon so that I wouldn't even ovulate and be aware of luteal phase symptoms. As my pregnancy was dated based on my embryo transfer, I can't actually remember the day of my last menstrual period, which may actually be my last menstrual period.

My follow up scan was moved up one week, so I'll know a little sooner if this scenario will become my reality. At this point in time, if we have a take home mom and take home baby, we'll score it as a win. Anything else will be a bonus.

Wednesday, 4 March 2015

Living Dolls

While she's not nearly as insuffrable and obnoxious as Isabelle's Pregnant Co-Worker, I do have my own version of one. Our phlebotomist is pregnant. I saw her exactly a year ago for her yearly Gynae visit. She was excited as she had been dating a new guy for a few months and they would be spending the President's Day Holiday weekend in Monetary as their first romantic get away. Birth control method? My notes read 'using condoms, happy with this method, does not want to re-start Ring at this time.' My experience knows this translates to: will become pregnant soon. Sure enough in early March, she asked me to order a beta HCG for her. It was negative and I let her know my door was open if she wanted to talk any further. Later during the summer months, she asked me to "test her hormones". I explained that we couldn't just run them on the spot and reviewed testing FSH and Estradiol on Day 2 or 3 and checking a mid luteal progesterone. I realised that I was also outing the reason why I kept asking her to draw a progesterone level on me. She tried using Ovulation Predictor Kits, but was concerned as she kept getting a negative result. I enquired a little further and discovered she was only testing on one day per cycle. I suggested she test daily until she gets a positive response. You know, like they tell you when you read the instructions. About a month ago, a medical assistant asked if I would order her a beta as she just had a positive test in the office. "She's really nervous." the medical assistant informed me. "She's been trying for such a long time." I resisted rolling my eyes. When we reached the one year mark, it felt like it was a long time. I didn't know that it would take hitting the three year mark for one year to seem like nothing.

As soon as her second beta confirmed a decent rise, (although it was a little less than I would expect for four days) our entire department, and perhaps the entire office, knew she was pregnant. Of course, she wasn't using the OPKs at the time of her conception, which led her to conclude that they don't work and are a waste of money. I resisted explaining that when used correctly, in theory they do work, but the blind pig finds an acorn method sometimes works as well. Her mother came to her New OB appointment and she invited two medical assistants to stay in the room during her ultrasound, because that didn't put any additional pressure on her uterus. Fortunately, I would find she had a viable single intrauterine pregnancy at 6 weeks and 3 days (which she immediately posted as her profile picture). The next day, she announced that she went shopping for maternity scrubs that night. Yeah, I'm in my second trimester and I still am wearing my normal clothes... I thought to myself. Admittedly, I do sound smug, but I'll own it. This conversation was taking place inside my head as I still hadnt told my entire staff yet. Earlier, I took my designated medical assistant out to lunch to celebrate our anniversary together and I shared the news with her. I also disclosed to our office manager, especially to give her the heads up that I may need to go out early. Anyway, Pregnant Phlebotomist also revealed that she bought a special food processor that allows you to make organic baby food. Um, you do know that you're not going to need such an appliance until the baby is 6-8 months... It's going to occupy space in your kitchen for over a year. During that time, you could have someone give it as a gift for your baby shower, your birthday or Christmas... Or you could also realise that you can accomplish the same objective with an ordinary blender.

When she was only 7 weeks, she told my medical assistant, "I can't wait to find out if I'm having a boy or a girl! That is what is really important. Then, I can start shopping accordingly." Yes, she really said those words, and ironically it was on the same day as my anatomy scan. [At press time, she is 9 weeks plus a few days and she has asked Co-worker 3 or 4 times when she can learn gender, but she has already started buying girl clothes.] Co-worker and I privately expressed our concerns. "It seems as if she just views the baby as a living doll to dress up..." I observed. Co-worker was privy to some background information. "She's still living at home with her parents. The guy is a few years older than her and he already has three kids with three different women. She's Baby Mama #4. Why does she think that she and her baby are going to be any different? I think she just figured that she'll be turning 34 this year and now it's her time to have a baby." We collectively agreed that we hope she starts to appreciate all that is really involved with having a baby and raising a child. I thought back to my first visit with Myrtle after little Myrtle was born. We went out shopping and ran into a girl from our high school class, who is a relapsing alcoholic. "Aww, is she your little Angel?" she asked while cooing over little Myrtle in a way that made me wonder if she were drunk at that moment. "No." Myrtle replied firmly "She's a huge responsibility."

A few weeks ago, in what I warned will be the first of many Holy shit! I have no idea what the fuck I'm doing! freak-outs, Myrtle sent me a copy of the book, The Baby Gizmo buying guide. It's perfect for a novice like me. The opening chapter discusses activity mats and centres, some things I never knew even existed. Reading the chapter about baby bathtubs and accessories gave me some insight on how to bathe an infant. Then the book started to scare the shit out of me. Apparently, 12,000 children are treated for crib related injuries and an approximately 35 die each year. Most occur in second hand and hand-me-down cribs. My cousin offered us her crib as her youngest is transitioning to a big boy bed. Her son used it for two years and managed not to die. What is the expiration on a crib? How many families use the same crib for all their children? [I re-read that section of the book to verify my statistics, and they note that ten years is the approximate life span for a crib as long as it is in good condition. However, they do only recommend only accepting a crib from a family member, so you can verify its history.] I then became even more terrified while reading the chapter on car seats. Infant car seats cause 13,000 injuries and 5 deaths each year outside of the car. Am I going to kill my baby if I purchase the wrong product? I finished the book and felt more informed and organised, yet still completely overwhelmed. It has completely sucked any fun out of nesting.

I shared these thoughts with Husband in what I warned will be the first of many What the fuck did we get ourselves into? freak-outs. He quickly reminded me that I wasn't alone in this. I had someone by my side who would help with these decisions and manage our new responsibility. I acknowledged that I had been jealous of her unbridled enthusiasm and seemingly fearless approach about her pregnancy and it never dawned on me that it could be a coping mechanism. Perhaps she is just as scared and freaked out as I am, maybe even more as she'll likely be taking care of the baby on her own.