Cease fire?

Firstly, thoughts and love to Belle on the Scrambled Eggs blog, who lost her little Pip  after a long wait to fall pregnant,  at 7 weeks gestation. Thinking of you. Visit and send her your love, say a prayer, send a thought. My little trifling concerns are nothing, and blog silence for a while seems appropriate somehow.

But despite this wish, I have a noisy brain, so I’ll hold off on the bump photo related post I was doing to do, out of respect, dump some mundane stuff on the page, and assure her many of us in the blogosphere are thinking of her.

And a big shoutout to Captain Complicated, who’s off for some vaginal embroidery this week (ie cerclage). Hope the recovery is smooth, your cervix behaves, and you get a nice satin stitch or french knot that you can make a real feature out of.

It’s a busy week in fucked up pregnancy land.

Today, ah today. We managed to confuse ourselves more. I went back on a solo mission to Dr South Korea, just the follow up appointment after the scan.

A land of smiles and choices. I was 20 minutes early. He looked up as he walked into reception, remembered me, said hello, then asked was it ok if we went in early?

Ummm, yeah.

He is so warm. Just easy to be around. Calm. Yet still thorough. He asked had we decided what we were doing today about obs, and I said I didn’t know, because we were virtually ready to switch when North Korea sent out the peace treaty to the UN and apologised.  He emphasised there was no pressure, he was there if we needed him.

He told me about the recommended screenings coming up at 28 weeks. I thought 27 weeks was third trimester, but apparently 28 is. Whatever. We’re nearly there. He wrote down the tests he’d recommend so I knew what would happen next. He explained about Strep B swabs, and the antibiotics you’d get if this was positive to protect bub against pneumonia. Never heard of that one. Oh good, just when you thought it was boring, there’s more vag action.

He was pleased with my blood glucose levels and my new 30 minute daily walk around the neighbourhood. (Yes people, I’m moving my ass. With doctor’s permission. Finally. Those three blocks perambulated twice a day are a glorious release).

We talked about labour scenarios, about not wanting to go past term due to the diabetes, inducement, c-sections, possibilities of natural labour (which he basically views as a trial at my age, or at least wants me to see it’s a “let’s see how it goes” thing).

He even recommended whoever I go with to pay the big fee before 30 June so we get a bigger tax deduction as they’ve changed the medical expense rules in the federal budget. Geez. Talk about practical. And thoughtful.

The receptionist tried to bill me for a gynecological appointment. She didn’t realise I was pregnant. Apparently even in an obstetrician’s office, I can still hide it sometimes! We chatted after the Doctor had gone about why I was there for a second opinion (I believe I used the words “prick of a doctor” and she laughed. And said Dr South Korea is not only lovely but brilliant….).

He really does talk to me like I’m a person.

And I walked out really relaxed, but confused.

Again.

There is something in my head that says to be “good” it has to be “hard”. As though with a more abrupt doctor, you’re somehow getting “better judgement” or more of a “clinician” that might be better in an emergency situation. Rationally, I can’t seem to get through my thick skull that someone could be “good” and “nice”. That I could both be cared for with a great deal of medical ability, and a great deal of bedside manner. My heart feels like there must be some “cost” to this being treated like a human being palaver. I try to picture the labour ward with one, then the other. And I’m just confuzzled. (confused, and puzzled at the same time).

This kind of mental process could possibly explain some of the men I’ve dated in the past………..(not you, hub-in-boots).

I then proceeded to spend three hours thinking I’d lost my Iphone and retracing my steps through the local shops I’d stopped at on the way home, finding it IN MY CAR (oh god you should have seen me trying to ring myself on the cordless house phone from where it would not drop out in the front yard, dumping it on the ground, then running to the car to rummage for the mobile, then running back to dial myself again.). I found the mobile. It would have made a “funniest home video” had I not been in such a ridiculous kerfuffle. I needed the Benny Hill soundtrack.

THREE HOURS later when I went for my walk, after my first circuit of the neighbourhood, I found I had LEFT THE BACK CAR DOOR WIDE OPEN.

Because everyone is completely mad in this neighbourhood, no one even noticed anything out of the ordinary about a wide open car door. Or tried to steal the car. Or anything in it.

One saving grace was I managed NOT to flatten the battery.

Talk to me about baby brain.

We probably need to decide on a doctor before the decision flow chart in my head gets so busy that I accidentally walk in front of a bus.

Gumby is 27 weeks 2 days, rolling over and doing weird shudders more than absolutely belting me all the time now, he weighs 1.3kg, He wakes me up several times a night and my ‘sleep all night’ routine is now punctuated by being kicked awake and near constant peeing.

Given his 5am gymnastics, I think he might be a morning person. So I’m not sure we’ll get along, but I’ll do my best.

I leave you with this book, which summarises our parenting aims. I borrowed it from our local library. I’ll report back on it’s usefulness shortly. The title comes from the poem below, which you may have seen before, but is, nevertheless, a laugh.

 

Parenting reading

This Be The Verse

by Philip Larkin

They fuck you up, your mum and dad.
  They may not mean to, but they do.
They fill you with the faults they had
  And add some extra, just for you.

But they were fucked up in their turn
  By fools in old-style hats and coats,
Who half the time were soppy-stern
  And half at one another's throats.

Man hands on misery to man.
  It deepens like a coastal shelf.
Get out as early as you can,
  And don't have any kids yourself
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Toot toot chugga chugga big red car

The Wiggles announced their retirement yesterday. All except the Blue wiggle, Anthony, who clearly must have gambling debts and crack whores to support. Anthony admits he’s suffered with depression, just like many parents subjected to hourly reruns of Wiggles DVDs. They could replace the Dorothy song previously used at Guantanamo with a wiggles number, if the American military is running out of ways to breach human rights.

In other news, the Aussie champion Moto Gp rider Casey Stoner is retiring for family reasons. (Perhaps he’s had second thoughts about ending up in a mangled wreck of twisted metal like his Italian and Japanese friends, now that he has a kid. Who can blame the man). I thought perhaps for a new family friendly job he could become the Red Wiggle, but as my friend suggested he’d probably want to drive the big red car pretty damn fast. And if Casey was driving it’d probably be a two wheeled Honda, and it wouldn’t go chugga chugga.**

If only Jeff had got treatment for his narcolepsy, the group might have lasted. **

So I guess a Wiggles concert is not something I’ll get to experience with Gumby. And you say this like it’s a bad thing….

In yet other news, we visited North Korea yesterday. Dr North Korea to you.

I had been on the phone to the counsellor about our decision prior to the appointment. I THINK i was 95% in favour of a change. Unclear at the start of the conversation, everything I was saying to the counsellor led me to changing doctors, to the land of choice and progress that is Dr South Korea. Listening to the conversation, I think hub-in-boots began to understand my reasoning.

And then we dodged the snipers and visited his dictatorship. To find it a changed place.

There was a tacit decision by both of us not to look towards the large oak door as he swept into the room before the waiting minions. He seated himself closer to the giant desk, and we sort of continued our conversation about the retirement of decommissioned cruise ships to Russia (seriously). We were seated back from the desk, and towards each other.

He looked different. The air was kind of charged. He talked briefly through the scan report, not mentioning the other doctor’s name at the top of the referral. He expressed pleasure at the absence of the clot. He didn’t know I’d called it after him (BASTARD). He mentioned the “echogenic area” in the baby’s bowel was resolved. He spoke more slowly.

Any questions ?

I felt myself folding my arms. Tried to stop. Couldn’t stop it. “nope”

What about you, Stewart? Any questions?

Stew met my eyes. Deadpan. “nope”. There was silence. Dr North Korea looked from hub-in-boots to me. And back to hub-in-boots. Hub in boots went on.

“Actually, I wondered if you could run us through the scenario you see unfolding now that we’re in this different position, without the clot.”

Dr North Korea went on to talk about how at 16 weeks he did not think we’d make 24. At 24, he didn’t think we’d make 26. And yet here we were. He spoke some of the magic words “39 weeks”. He used the N word “essentially, everything’s NORMAL”. He went very slowly through the diabetes, looked at my blood sugar diary, complemented me on progress, asked for my endo’s feedback. He said some doctors would have me on insulin now, because any change takes two weeks to filter through to the baby& we don’t want a disproportionate abdomen as it shows Gumby is being affected by my sugars. But he did not query the other doctor’s choices on this. For once.

We resisted the urge to woop, holler and hi five. The dynamic of the visit was weird. The central focus was with us. We didn’t feel rushed, or trapped, we were nonchalant. We out nonchalanted him, and we were not relying on him for ‘salvation’. The power sat quite clearly with us. It was palpable.

As he helped me up onto the bed for the ultrasound, he looked me in the eye and said “would you like to attempt a natural labour?”

What the hell?

“it will depend on the position of the baby of course, and his size, and the diabetes, but you may be able to. At 26 + 5 it may be hard to predict at this stage. But it is certainly something to consider as things unfold.”

Yet again I was speechless. This felt like treatment with choices. We’re we still in north Korea? Toto, I don’t think we’re in Kansas anymore.

We went through the usual measurements, Gumby had a bit of a kick which I saw on screen. He was hard for me to see again, head down, up to 1.2kg (so how the hell am I losing /maintaining weight?).

As we went back to the desk, Dr North Korea paused, and then launched into an apology.

Hub-in-boots and I did not make eye contact, but I could hear the intake of breath at my side. You could have heard a pin drop.

“I understand you rang and spoke to B and were very unhappy after the last visit which you came to with your sister. I think we all had different purposes on that day. I wanted to apologise for that. I understand, as a woman, that you come in here wanting the most natural labour and birth possible, regardless of the kind of pregnancy you’ve had.”

“yes I do. And I understand that we are an unusual case, and it is not easy to predict. However I feel that I need to know if certain things are possible in the birth we end up having, like skin to skin contact, like early bonding, and breast feeding, that it will be actively facilitated, not discouraged. I understand everything is if the circumstances allow it.

He went on, I forget the exact words, but he basically admitted he had been out of line. He talked us through what would influence the caesarean v natural decision as events unfolded closer to full term, he never mentioned any dates other than full term ones. He explained the choice of anaesthesia would most likely be driven by who the anaesthetist was on the day & when they were educated. He did mention special care nurseries if there’s blood sugar issues for baby, but we knew that.

There was lots of content. But it was clearer, slower, full of choices.

We left, and hub-in-boots shut the door, and said
“THAT BASTARD! He’s made it such a hard decision now! It was so clear before we walked in there. It was like it was a different doctor! That must be the doctor that other people get.”

So we were confused, but walking taller. So much dark cloud lifted off our heads. So much anxiety we could let go of, at least partly.

We went and signed a one year lease for our place. Then we went to vinnies to find an outfit for Eurovision. Because, shit, when you’ve had all your worries lifted, and you’ve sorted out where you’re living, and you have a baby on the way, what you need is a bad eastern European styled outfit. They are gorgeous. Shiny. Hideous in their beauty. We can’t reveal it ahead of the party. But stay tuned for the photos. We are gonna be beautiful.

And I know if we decide to stay in North Korea, people will think we’re mad. There’s two people to care for here: Gumby, and me. This makes it a complex decision. I know in my heart that with many other doctors, I would have stayed on at work. I would have continued normal life. And the clot would have won. The extremely conservative way I’ve been managed by this doctor who was, more often than not, a complete ass, may have saved our son’s life. may have turned this from the hair’s breadth that separated the two scenarios, from horrible tragedy to miracle story with happy lively ending.

Am I prepared to suck up some personality issues for that outcome? You bet I am.

Would I prefer someone I clicked with a bit more reliably with?
Yes

Is it important that Dr North Korea is on staff at the public hospital with the best neonatal intensive care, just in case?
Yes.

Did the simple act of getting another opinion change the trapped feeling and bad dynamics for you, permanently?
Yes.

Would you go back to North Korea for a second pregnancy?
Probably not. But ask me later.

Are we living in a cartoon world where one doctor is all bad, and one is a shining light?
Yeah, probably not.

Does he really really realise you are not doormats and he is not god now?
Yes. Unequivocally.

Would he make a good member of the new Wiggles?
Yes. And if he ever pisses me off again, I’m just going to imagine him singing “hot potato, hot potato”, complete with gestures. In a yellow skivvy.

Knowing all this, and after yesterday, the decision is not easy. It is strange to have absolute faith in someone’s abilities, be willing to put yourself in their hands, and still not be sure if you like them very much.

We see Dr South Korea next Tuesday. I still feel like he is there for us if we need him, willing to step in at any stage. Perhaps this is the best of both worlds.

But no one’s getting their $4k bill paid, just yet. Not til after Eurovision.

** the Wiggles are an Aussie kids entertainment group with such songs as “big red car” and “hot potato”. They wear skivvies . They were previously an ordinary adults rock band when I was a teenager; they’ve made lots more money this way. For the record I don’t like captain feathersword, and felt their early work without the other characters had more artistic integrity. Jeff is my favourite. Like me, Jeff has trouble waking up. Once, my niece was making a wiggles big red car cake, and I kept eating Jeff’s icing head. Three times. Poor Jeff.

The glory that is Eurovision

Russia’s 2012 entry. I love them.

Ah Eurovision. It’s my favourite time of year. A time to celebrate all that is tasteless, kitsch, and blue eyeshadow about the world. A time to revel in dodgy voting systems and bad accents. A time strip off velcro attached clothing mid phrase, to drink on every key change, every peasant instrument, every dancer dressed only in white, every giant Maltese woman wailing in a flowing mumu. Take it to the bridge.

For several years now, wherever I’ve been, Eurovision has been a serious business. First inspired, perhaps, by the sardonic commentary of English footy presenter Terry Wogan, and later just for its sheer piss-weak-worldness, Eurovision is a time for celebrating mediocrity. The worse the song, the more we want it to win. The bigger the hair, the bigger the fan base. If you’re thinking “but it’s just plain weird” then you don’t get it, and you need to work harder at embracing your inner eastern European; which is like you in 1982, minus the money or taste.

Last year, the outfits were easy. Germany was the host country, and we lederhosened up, drank beer, and ate sausages und sauerkraut. Other years, in Russia, we made Moscow mules and wore giant fluffy muffs. Hub-in-Boots in Lycra tights and a bandanna almost put people off their food.

What the hell do you do for Azerbaijan ????

Our ‘party’ is essentially a gathering of tastelessly attired adults, sampling the drinks and food of Europe, shouting at the television, occasionally trying to learn the dances and playing Eurovision bingo and/ or drinking games. It is about as hip as Eurovision itself. This year, I have the added glory of dressing Eurotrash AND maternity. That should be special, but at 6 months pregnant w diabetes, it may cut into my beer smorgasbord and sausage fest a tad. It is important that Gumby is introduced to this cultural revolution in the womb, because his parents’ Eurovision parties may well become a staple childhood memory.

Just as some parents believe in the Mozart effect, we believe in the Eurovision effect. The ability of introducing bad synthesisers and back up vocals to encourage a lifelong tolerance of 80s music, rigged democracies and tragically time warped cultural stereotypes.

10 sleeps to go til the semi finals.
Happy first Eurovision, Gumby. Mummy and Daddy have no taste. Get used to it.

Hub in boots – Eurovision 2011. Out of a sense of respect for the good people of the internet, I left out the photo where you could see his chicken legs.

Mothers day

Well at 26 weeks, today is my first Mother’s day. It’s pretty special to turn 26 weeks today, when I know two grown ups who are alive and kicking who were born at 26 weeks.

For a long while, I didn’t think we’d get here. Since January 22nd, there have been a lot of times where I had no idea which side of the coin our fortunes would land on.

I know it’s not mothers day everywhere, but I’d like today to think of all those women who struggle, often silently, to become mums. Who, like me, just got caught up in life and almost left it too late, because of the stupid disparity between nature and culture that exists for many women now. Or who have unexplained infertility, or other problems. Who would make great mums, but don’t know at this point if they will ever get there.

I know for many of these women, mothers day is not an easy time. Some of them have suffered multiple losses: miscarriage, stillbirth, complications.

Some never got there at all. Some just try and try, and don’t choose to go on to some of the more extreme measures like ivf for many reasons.

For some, infertility becomes a relationship/life nuclear bomb, for others, it’s a quiet hollow ache. I could have been you, and I’m wishing you a happy mothers day. I think you’re more a mother than many women out there. I hope you find somewhere to give the world the benefit of those instincts, or that you find a way through.

Me, I feel like I’m going to be a mum now. Sure, something could still go wrong. But Gumby’s here kicking me in the guts, so I’m a mum already. I have a son. Which is weird. Next year, he’ll probably wake me at 5am, and dribble on me, and at about nine months old crawl all over the bed. He’ll probably smoosh my toast into the sheets. Also weird.

My very nice nieces bought me rattle toe socks for Gumby, and a gown with a hoodie. I think the hoodie is so if Gumby is a monkey baby I can go and steal someone else’s in hospital. Good planning.

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Hub in boots at least didn’t buy me a sympathy card, like he did one valentines day. He did find a mothers day card with a dog drinking out of the toilet. So romantic. And some cd’s…we’ve been rocking out to Jack White (of The White Stripes fame) new solo album in our pj’s this morning. Talking about bad Mother’s day stalls at primary school full of hideous craft, remembering picking out a ceramic ash tray for my mum, who never smoked.

Poor mum. I got her a good present this year though. At 82, her sixth grandchild!

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N n n n normal

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Yesterday, we had the ultrasound Dr south Korea ordered. Took mum along for the ride.

No freakin clot. None. Two people looking. Nada.

Big bugger of a gumby (91st percentile for gestational age weighing in at 1011g or 2lb 4oz . Oops).

No problems with the placenta, though the specialist found it has an annexe.

I’ve built a mezzanine level. Although I liked the placenta I had, we needed more space. As the extra piece of placenta, the annexe, is on the right hand side where we kick a lot, I think this is where gumby has set up his pool room. I wonder if I was supposed to lodge a DA with the council for it? (DA =Development Application). On the technicalities the flow etc is fine

I have a cervix that knows when to keep its mouth closed. Sadly, they decided to use the magic wand to find this bit of info out. Ta da! Say hello to my little friend. I’ll leave out the comments about its the most action i’ve seen in months. But it’s long and closed.

Good cervix. Nice cervix. It’s a shame you can’t pat them like a dog.

No cute baby pictures though. His head (with its 24cm circumference) was right under my belly button (which woke me at 3am. Ouch!), facing my spine, his face resting on his arms just like his dad, knees and 4.8cm legs tucked up around his chin ( dad can’t do that). Impossible to see. Apparently, most of what I’ve been feeling is getting kneed in the gut, judging by what he did during the scan.

The ultrasound specialist, let’s call him dr united nations, said both my docs are very good, he knows them both very well. He also said, in the absence of clot land, he doesn’t see why a natural labour couldn’t be attempted. Woah! Let’s just ponder that one for a while.

A freaky thing happened two hours later. MY DOCTOR PHONED ME.

Wtf?? Dr South Korea PHONED ME. I was gobsmacked. I couldn’t speak. Not since the days of the ivf clinic has a doctor actually phoned. He relayed the report contents…. All good . Then he said a weird thing:

“you’re normal. Really, after this scan, you’re normal. ”

I’m what?

“But still, don’t do anymore than you’re doing. Let’s play it safe, you’ve come this far. Don’t do anymore. But it’s a great outcome. Absolutely nothing to worry about. Of course, you’re having a big baby, but you knew that.”

I’m normal. Normal. I’m just a pregnant chick, 25 weeks 5 days. A pregnant chick, hanging around waiting patiently for a normal baby.

P.S. the people have spoken on the obstetrician, 94% voting for a move to South Korea. We’ll keep you posted.

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Crossing the border to South Korea

Well we’ve done it. Yesterday, unbeknownst to Dr Kim Jong Un’s Obstetric Dictatorship, we dodged the snipers and crossed the border to South Korea. A land of relaxed receptionists with big hair that don’t look like they work in a modelling agency, a land of a small simple office without as many machines that go ping, a land where, to some extent, you can choose your own adventure.

Instead of waiting, silently, in the office to see the obstetric god arrive, and sit across from us at a huge desk, the doctor met us in reception, introduced himself, and shook both our hands. He smiled.

I didn’t know whether to laugh or cry. The office was really small, and simple. It was like comparing the Wizard of oz with the booming voice and the big green screen to the simple little man behind the curtain. My knees stopped knocking.

“firstly, let me say Dr North Korea is a very good doctor. However people have many reasons for wanting to change or get another opinion,”.

Ok. So a) in South Korea they are still professional enough to be loyal to their countrymen . That’s good. I have used these lines many many times in the face of complaints about fellow lecturers. It’s appropriate. And b) our South Korean doc has rung the hospital and spoken to the head nurse who recommended him to me, because I never said who my doctor is. Interesting. He’s a fact finding do-er.

“Absolutely” I replied, noting the absence of nuclear weapons and people marching like Hitler’s Ss on cans of redbull,  “we’ve never had any reservations about him as a doctor. Never. For us, it’s the communication & feeling of involvement that is the issue”.

Involvement in your own birth experience? Crazy talk.

“Firstly, I’m going to ask a lot of questions this visit. We’ll start at the beginning. Because I want a complete picture before we start. Is that ok?”

Nodding, smiling. Hub in boots, did you see him look me in the eye just then? Wasn’t that cool ?  My mind wandered back to the first visit to North Korea. The massive kerfuffle because I asked the receptionist to photocopy all my originals of test reports. what, all of them? Big sigh. Really. There were so many clean surfaces in reception that she was concerned about opening a cupboard to reveal equipment  and use paper that might mess up the feng shui. That should have been a SIGN.

So the Dr South Korea with the nice bedside manner went through our little journey , and stopped to sniff the flowers on the way.

“You’ve done really well to make it this far. Your case has clearly been well managed , but YOU have done very very well to be here. What can happen with a haematoma is….insert details of certain death & placental abruption here with my brain going la la la la laaaaaaa…. The prognosis for a 60ml haematoma is VERY BAD. Very bad. So to be here still going at 25 weeks is excellent. It looks like the worst of it may be behind you”

I snap out of my la la laaaa land. Did you hear that, hub-in-boots? Part of the success is US! We’ve done something right! And it might get better! I’m like a kid that went to the principal’s office expecting a detention, and instead got a most improved award.

“Now at your age, there is a higher risk of preterm birth. And this also goes for an ivf pregnancy, and diabetes. But this is a higher risk than the general population. It’s not a fait accomplis. It means your risk may be 1 in 10 instead of 1 in 20. And I’m assuming here that the clot is no longer an active issue when I say this.”

One in ten? One in freakin’ ten?? The government of North Korea had me believing it was a 50/50 proposition we’d make 32 weeks. I felt the bricks I’d been carrying in the gulag instantly lift off my head. But I’m mixing up my contemporary dictatorships with my Stalinist states here.

We went on to discuss caesareans.

“So the thing with the Caesaerean is, at 40, you only have a 50 percent chance of a natural birth, at best. And that is before any complications. At 40, your body is not as good at reacting to what is required of it in labour. It doesn’t respond as well as, say, you at 20 or even 30.”

Oh! Hub in boots and I exchange glances. This is INFORMATION. This is what it looks like.  We never had this before.

“so many women who start to labour will end up, after a long and difficult time, having a caesarean anyway. Which is sort of the worst outcome for mother and baby in terms of breastfeeding and bonding. So we’d already be thinking about a caesarean for you. Add to that the large baby issue, which may or may not be an issue with the diabetes, issues with blood sugar and the haematoma, and it seems silly to take the risk on what is likely to end up being a caesarean anyway. We tend to treat IVF pregnancies with kid gloves also. They are very precious. This is a very precious baby we have here.  The planned c-section gives us more control. We could induce you early, but inducted labours tend to not proceed as smoothly, and we run into the problems again.”

I still don’t want one, my inner 3 year old stamps her foot. I could do it!!!!

But my outer 40 year old says it kind of sounds sensible.

“Now with the diabetes, we normally look at a 38+3  delivery. You may be able to go to 39 weeks, depending on this next scan. If the scans showed isuses, we may be talking 38, 37. But I’d be looking at the 5 days around August 11. I think Dr North Korea is talking and planning around the clot being an issue in labour, but I really don’t think this is going to be an issue. And there are difficulties using steroids for lung maturation if you have sugar problems. It stuffs you up.”

39 weeks.

Oh. My. God.

Hub-in-boots looks like he’s about to cry.

This is the FIRST time anyone has mentioned to us numbers that look even vaguely like full term numbers. You can hear us both start to breathe more deeply. It is palpable.

The visit goes on. And on. We are not rushed. We are asked “any questions”, but not in the usual stacatto standing -at- the- door- with- his- hand- on- our- back- reading- from -a- script- waiting- to- shove- us- out way. This is a genuine invitation. With answers that follow.

He thinks a spinal block in a casesarean will be the best for mum and bub. We weren’t allowed to talk about these options with Dr North Korea. Apparently the spinal is less invasive. Dr South Korea thinks I’ve been managed very very conservatively, but it’s worked, so keep doing it.

I ask about the need for further formal scans, not scans in the ob’s office.

“Yes. Definitely. I’d like you to get one straight away, and check your cervical length, the whereabouts of the clot, and the bright bowel on the baby. That bowel needs follow up. I’ll see you in two weeks, and we’ll review it.  Your cervical length was good last time, but it should be checked. We’re looking for shortening, or funnelling, and anything under 2.2 might signal a problem for us. (He draws what he means on a piece of paper). Then I’d like a scan at 28-30, 32 and 36 weeks. Minimum”

“Right. Because we asked Dr M this, and he said no.”

“Yes, but obstetricians are not trained ultrasound specialists. You want the specialist on the job for this. It’s important.”

Yes. This is what I thought. This is what the ultrasound doc said to us would happen, as soon as the baby was viable. And Dr North Korea dismissed this question, just last week, out of hand. Yes, it’s another airfare to Venice on scans, no, I don’t care about the money.

I asked about emergency labour situations prior to 32 weeks. We are in agreement which hospital has the best neo natal intensive care unit.

One downside is the new doctor is not currently on staff in that public hospital. The old doctor is. Dr South Korea openly states this is a possible advantage in sticking with Dr North Korea But he also says he wouldn’t send us to the inferior NICU where he is. He’d ring colleagues, and get us in to the good one, and get us delivered there.

We talk about vacancies, we talk about money. We talk about the pros and cons of switching, and when it is possible to switch. He even suggests I ring back the head nurse of maternity and ask for her input on the decision. He waits for a fax on my 12 week scan, to check the PAPP-A levels that may indicate more risk of stillbirth or preterm delivery. They are fine. He is so open. I want to hug him.

“I’d LOVE to know what he charges” says Dr South Korea. We laugh. And tell him. I realise I’ve missed something in the North Korean fee schedule, Dr South Korea can’t possibly be dearer. I look into it later and I have missed the delivery fee. With that, there’s not much difference. In fact Dr South Korea may be cheaper after Medicare refunds.

Dr South Korea is happy, impressed even, with my blood glucose management. He thinks the treatment path is fine. He trusts my endocrinologist.

Dr North Korea basically said it was out of control and I was damaging the baby through my choice of endocrinologist and not going on insulin. He’s like the big bully in the playground that doesn’t want to share his patients with doctors that won’t do what he says.

Back in South Korea, he’s happy with the use of oral tablets not insulin. He’s happy with my endocrinologist. He thinks the endo is the best person to talk about breastfeeding, but he can’t understand why it would be a problem. Difficult? Maybe. Impossible? No. 

He talked about skin to skin contact ALL THROUGH the operation after initial checking of Gumby by a midwife. He said the post natal support in our hospital is SECOND TO NONE. He swept away the thick cobwebs of worry with a simple flick of his informative wrist.

It’s possible Dr  North Korea is also Captain High Risk pregnancy. It’s possible we only made it this far because he was ultra conservative in his management of my pregnancy. I respect him for that. I thank him for it.

But I also have to be in the ultimate out of control situation, major surgery numb from the waist down, and put this person in charge of the birth of our child. I have to be in the same room as him. I have to be comfortable he is giving us the best advice, and I have to feel intellectually and emotionally satisfied that there are good reasons behind that advice, as we get to the pointy end of proceedings. I have to feel I could be in the room with him, and let him have that level of control over me, and over my baby.

So it’s a sitting with it decision. We are both unsure. We are not rushing it. Tomorrow, I have the scan that was ordered in South Korea, land of choice and information.  Next Thursday, cross the border back into North Korea, waiting to see the reaction of the dictatorship to news of a second opinion.

Then Tuesday week, we brave the snipers and head to South Korea again. Possibly to stay.

For a bit of a laugh, I’ve added a poll so the silent majority out there can air their views on our little saga. I can’t promise we’ll listen as we decide whether or not to change doctors, but I’m interested in your thoughts. 

After meeting Dr North Korea last week, I have a feeling my sister will vote 10,000 times for option b. This may skew the results slightly.

Hell hath no fury

Hell hath no fury like a mother-to-be scorned. Especially a mother to be finding herself trapped in north Korea, with Dr Kim Jong Un’s obstetric dictatorship again.

Another horrid visit to the horrid obstetrician yesterday. I took my sister along for the ride this time, because she has balls, and you don’t mess with her.

Yesterday I had my usual list of questions. Most of those were not answered. Not adequately anyway. My sister was disgusted by his arrogance & dismissiveness.

I wanted mainly to find out more about why we needed a caesarean, why it was the best course of action, how it would be done, and whether there would be any way of making it our birth still; such as immediate skin to skin contact, the need for gumby to go to a special care nursery, the possibility of having gumby with me in recovery, the likelihood of separation, the type of sedation , the effects of each type on me and on bub.

Instead, I got the scenario list: another bleed (emergency c section under general) if there’s active bleeding , placental abruption (depends on degree but prob the same), waters breaking prematurely (immediate delivery, epidural), intrauterine growth restriction ( immediate delivery, epidural), other problems with my health or gumby’s health ( immediate delivery& epidural), some lighter bleeding (extended hospital stay , delivery later) or scheduled delivery by c section (spinal block,) he doesn’t think now that I will make 38 weeks. He’s aiming for after 32. The funny thing is, I don’t know what’s changed?

When I asked about breast feeding, he just said ‘oh you won’t be able to breast feed. Special care nurseries, baby too premmie to suckle, your (gestational) diabetes means you might be on high insulin doses so you won’t be able to feed’. This was my breaking point this visit. He basically implied that I am being unreasonable having any questions / expectations a normal mother would have, worshipping at the altar of the GREAT OBSTETRICIAN, I should consider myself lucky if I get to take home a healthy baby. The rest is what ifs I shouldn’t even think about in our situation.

What ifs that plague me , 24/7. What ifs that I would like plans in place for, and forewarning, and preparation.

I’m not even clear which hospital I should head for in case of emergency: the public system with its NICU, or my private one ? Even that answer was unclear.

Gumby is looking ok. He is very big for his gestational age (24weeks 4 days)…he’s in the 97th percentile of babies, which may be the diabetes affecting him. But they are always big in our family. Not one under 8lb, (if you exclude Simon , who was born at 26 weeks, just under 1kg, and is now 21). I’m confused, because seeing the endocrinologist on wednesday, he was really happy with my levels and doesn’t yet see a need for insulin! So the two doctors agree to disagree. And my baby suffers from their lack of cooperation.

There is a bit too much amniotic fluid. Just a bit. This may also be the diabetes, and may also be a problem, later.

The placental flow is showing some resistance. This could be a problem measuring this this early, or it could signal the placenta is starting to not do its job, and we could be facing intrauterine growth restriction (& immediate delivery) down the track.

My sister asked him twice “don’t you have anything positive to say?”. He looked surprised. I think he has aspergers. Or maybe a degree of asshole that is somewhere on the autism spectrum. Or his own special spectrum. His reply was “I just did say something positive!” ( after the scenario list). “I think you’re doing really well.”

No “great control on your diet and blood glucose in such a tough situation” (which is what my dietician said, the day before), no “bloody hell I can’t believe you’re 24 weeks and haven’t put on any weight, you’re really getting there”, no “how are you feeling with being stuck at home for 3+ months”…no “hey look here’s your baby and he’s doing well”… He actually didn’t even remember he’d told me not to go back to work. Seriously. Couldn’t I at least qualify as “that bleeding diabetic lecturer old blonde chick whose baby isn’t dead who I’ve told to stay at home”. Couldn’t he even remember that much about me?

I was ok in the office, crying in the coffee shop on the phone to hub-in-boots at 10am, crying in the car park at 10:15, semi holding it together during the day w my sister at home & out at target and the deli , and finally just CRACKED IT at 4pm. I was at cath’s house, and I rang and spoke to one of his midwives.

I told her how unhappy I was, not with his judgements, not with his management, but in his bedside manner. His dismissiveness of my questions, my feeling that I am in a situation without ‘informed consent’ , his lack of understanding of my desire to breast feed, even the comments last visit about pelvic floor exercises. I didn’t swear, I didn’t shout, and I didn’t call him a c—, even though that’s exactly what he is.

She was understanding, said she appreciated me raising the issues with them, said she would tactfully speak to him, and suggested an appointment with their new lactation specialist to get an early breast feeding plan in place. (ummm, why couldn’t he have mentioned that they had a lactation specialist)? She said I may be able to express colustrum before the birth, to give us a head start with tube feeding a premmie gumby. She also said I can lean on the midwives more after each visit, for clarification and explanation. I feel a bit better for having been heard, but still a bit stuck. I feel no one else would touch my case now with a ten foot pole. I told her I’d considered switching to the public system to get away from him , and that I’d experienced better care in public hospitals. She also said I’d be welcome to get a second opinion. I made my dissatisfaction pretty damn clear.

Today I am just tired. Drained. Haven’t even made it out of bed to get breaky, and it’s 10:30. I’m going to do some information gathering. I am ringing the hospital we are booked into. I am ringing the Australian breast feeding association . I am ringing my friend’s wife who is a lactation consultant for advice. I may ring another obstetrician and think about appointments for second opinions, and I may ring the psychologist that’s been recommended in the area, as the stakes are really ratcheting up now, and with them, my anxiety. I am very under control…but I also feel I could spew vitriol for hours about this doctor and this pregnancy. Along with a growing gumby who is just under 1kg, it’s a lot to carry. One comfort I have thought of is that decisions about the care of a premmie gumby will not be his. Decisions about breast feeding will not be his. Once the birth is done , this dickhead is OFF THE TEAM. I can handle (just) him being there and stitching me up. I even trust he’ll do that well. He’s not fucking touching my son. Not once he’s born.

I’m not going to let this bastard get me down . What is important now is staying healthy , staying relaxed, and keeping baby on board for at least six more five more weeks and two days. I will breast feed. I will make it to 30 weeks. I will continue to eat well, and maintain my glucose . And god help any fuckwit doctor who stands in my way.

Ps the next post will be a happy clothing post, about the enormous haul of clothes we bought off ‘gumtree’, a second hand listing site, which has given us all many hours of fun going through it all. My mum just rang me, buzzing, because just this morning she’s been buying nana knits from the red cross street stall (as if this kid needs more clothes!!). After the docs visit she’s shifted into premmi sized wear. It’s nice to know all of this crap we wade through day after day can also bring with it a lit up joy.