Wednesday, February 28, 2007

Week 35 1/2 Update

Thanks, everyone, for your kind thoughts and good wishes!

I'm still carrying the babies, although I saw my doctor yesterday and they could come at any time. If they don't come within the next few days, I'm due to be induced, as the risks of the liver complications for the babies start to outweigh the benefits of extra time in the womb.

I apologize for not having written more during this time, for not responding promptly to email, and for not having made my regular blog visits. I'm extremely huge and uncomfortable; I never thought I would make it this far into the pregnancy. Additionally, one of my medications has a sedative effect, and even though I spend a great deal of time thinking of writing topics, even the act of actually sitting at the computer and blogging is very tiring for me right now.

Hopefully, my next update will come soon, will involve me feeling more like my old self, and will happily announce the arrival of the babies. I'm very much looking forward to getting back to blogging. In the meantime, thanks so much for your patience. Please keep reading!

Friday, February 16, 2007

Surprise! A debate unrelated to being knocked up!

I haven't given birth yet. Tomorrow I'll reach the 34-week mark, which is pretty good, in the world of twin pregnancies. I'm still itchy and resting and miserable, but feeling better about having gotten this far, and able to think a bit more clearly about something other than my own disheveled internal organs, in spite of the fact that pregnant women's brains supposedly shrink during the third trimester, which I find really scary! So, I am drinking a lot of water to combat this phenomenon. I assure you, this makes perfect sense to me.

The governor of Texas recently ordered that schoolgirls aged 11 or 12 within his state be vaccinated against HPV, the virus that causes cervical cancer. The vaccine, Gardasil, has received FDA approval and is relatively new to the market. The Texas order, naturally, has sparked tremendous debate. Some see it as essentially condoning sex among teenagers. Some see it as a huge life-saver and want all girls and women within the effective age range to be vaccinated.

In general, I'm pretty much in favor of vaccinations. I think they've enabled us to make tremendous strides towards eliminating childhood illnesses that used to be crippling and/or fatal, and eliminated a great deal of misery for children and parents. I'm also very much in favor of taking an active role in one's healthcare, though, and not blindly following advice that may not affect you, or that tramples all over your personal decisionmaking without a compelling justification. And I tend to exercise caution when deciding whether to use relatively new medications or vaccinations, regardless of whether they are rigorously tested and found to be safe and effective.

I have several problems with the Texas order. Not because I see it as condoning sex, but because I see it as a restriction on personal freedom in the absence of a compelling justification.

HPV is not like polio or whooping cough--one is not at risk of catching it through casual contact, which is the general justification for schools requiring vaccinations so as to prevent epidemics. HPV is a sexually transmitted infection. Even assuming that a significant number of young teenagers are sexually active, I highly doubt that a significant number of young teenagers are sexually active within the four walls of their schools--certainly not enough to reach epidemic proportions. Yes, I realize that schools often assume the role of looking out for the interests of their students in all aspects of their lives--in my opinion, at increasingly intrusive and uncomfortable levels--but I think that mandating a new vaccination that is not required to prevent an epidemic of illness at school is carrying this a bit too far. There are teenagers who aren't sexually active. There are also responsible parents who discuss such issues with their children, and help them to make informed decisions. Virtually all medications and vaccinations have benefits and risks. A non-sexually active teenage girl who takes an active role in her healthcare, assesses the benefits and risks, and has frank and open discussions with her parents may very reasonably decide not to partake of the HPV vaccination at this point. Do we really want to trample on the personal healthcare decisionmaking of such a person by virtue of the fact that she attends public school?

My other issue with this situation is that the vaccine is only approved--and would only be mandated--for girls. While only females can get cervical cancer, the HPV virus, in males, also causes penile and anal cancer--these cancers are less common than cervical cancer, but I imagine they also aren't fun. Plus, males can certainly carry and transmit HPV to women. Why make women bear the whole burden, yet again, of this sexual risk? And why deny males who wish to protect themselves through vaccination the opportunity to do so? The manufacturer of the vaccination is currently studying use of the vaccination in males to determine whether it would be safe and effective for them; it bothers me that this study did not take place at the same time as the studies on females.

Ok, my brain hurts. Back to the couch. Respectful comments on either side of the debate are welcome.

Sunday, February 11, 2007

Madam Dignity

Ok, here's what happened...

By the time last weekend rolled around, I had been feeling a bit itchy for a few days. I chalked it up to general pregnancy discomfort, water retention, etc., resigned myself to my fate, and scratched.

And scratched. And scratched. And scratched and scratched and scratched. At some point, Ty turned to me and said, "Maybe you should check the pregnancy book. This itching can't be normal," which, of course, is Nice Husband-speak for "Please stop covering me with your shed skin cells, as it is simultaneously disgusting and unnerving."

I got out the pregnancy book, turned to the index, and looked up "itching." I located the page--right smack in the middle of the section on Serious Pregnancy Complications. The advice was essentially, "if you feel itchy, call your doctor immediately." It turns out that itching can be a sign of liver complications.

Naturally, it was a weekend: I called my doctor's answering service for the first time. He called me back promptly, and told me to go to the hospital to have the babies checked out and to have some tests run.

As Ty and I prepared to go to the hospital, it occurred to us simultaneously that I might not come back for a long time. So, I grabbed my partially-packed suitcase that I'd planned to take with me when I went into labor.

Pregnant women out there: if ever you have such an instinct, I suggest you heed it. If you are pregnant with twins, I also suggest that you fill out a little card and tape it to your forehead. On it, write the answers to the following questions, because you meet approximately 24 people per day in a hospital, and every single one of them will ask you: 1) Identical or fraternal? 2) Was this through IVF? 3) Are they boys or girls? 4) Do they run in your family? and 5) Do you have any names picked out yet? I also recommend making up fake names for your answer to #5, or simply saying "No," because 90% of the time the person doing the asking will only throw cold water on your chosen names and upset you. If you make up fake names, make them really ridiculous, because your only hope of getting some peace is stunning your questioner into silence.

At the hospital, the itching played second fiddle when they discovered that I was having contractions and was dilated. They admitted me; I had to stay for three days.

I was coping okay with the giant plastic IV embedded in my wrist for 36 hours, the two enormous shots (one in each buttcheek), the looming prospect of emergency surgery, the complete and total lack of privacy, the monitoring of the outrageous quantities of urine coming out of my body every 20-30 minutes 24/7 (YOU try peeing for three), and the one-volume television, but what really sent me over the edge was the hospital beef stew.

Well, that, and learning that the babies have pushed my liver to a location that is essentially underneath my breast. The ultrasound technician who pointed this out to me also asked me, upon learning that I was having twins, whether I planned a "normal" delivery. One would think that a medical professional would be a bit more sensitive to terminology--as far as I know, there are essentially two ways to deliver a baby, and both of them are pretty common and therefore "normal." Had I been in a better mood, I would have responded, "Well, maybe the first one, but the second one I plan to shoot out of my left eye socket and into a basket across the room." Instead, I conjured up my last few CC's of cheer and responded, "We'll see." Repeatedly jamming the ultrasound wand against my breast and insisting that I breathe through my nose (virtually impossible these days) must not have fulfilled her sadism quotient for the day, because she responded, "Oh, you'll probably have to have a C-section," before she abandoned me on a stretcher in the hallway to wait for someone to take me back upstairs. I used the twenty-or-thirty-minute wait to will her five consecutive patients with simultaneous halitosis, B.O., and nasty, infectious rashes.

I was finally discharged, with the official diagnosis of uterine irritability. My uterus apparently takes after my personality.

After being discharged, I went for followup with my doctor, who comforted me greatly. He also told me to buy a maternity-support belt and sent me to a medical-supply store that apparently only hires hot young guys to work there, yet sells belts that, for example, hold fallen balls in place, or products that bear names like "Sir Dignity."

After buying the maternity belt, I went for another follow-up ultrasound. I was pulling my pants up when a woman in a white lab coat knocked at the door and immediately entered. She wasn't the woman who had performed my ultrasound, and apologized profusely for walking in on me while I was dressing.

"It's ok," I replied. "I have no shame."

She smiled. "Then this must be your second."

"Yes," I said. "I'm having twins. It's my first and my second all rolled into one."