"Pain with a purpose"

After seeing our midwife for the 33 week appointment today, Russ and I ran into another young pregnant woman in the waiting area, who has been a part of the childbirth classes we have been attending this month. As I stood in line to set up the next appointment, I caught pieces of the conversation Russ was having with her. At some point, I overheard her say, "Pain with a purpose." I looked over at her and we exchanged smiles. Was she quoting what I had shared weeks prior in childbirth class?

During the first class, our instructor was asking us about pain. She first asked us to share the worst pain we've ever felt. Our quiet classroom of couples remained quiet. I personally couldn't think of any significant or interesting pain story other than the occasional charlie horse. A husband behind me shared his pain from herniated discs. We all winced, made groaning noises, and empathized with him.

The instructor then asked us what the difference was with labor pain. While our quiet class continued to remain quiet, I couldn't help but share what I had read about labor pain. Quiet me spoke up and said, "It's pain with a purpose." I don't remember how exactly I built on that, but I remember talking about how the baby is the source of that pain, as he makes his way down the birth canal with each contraction. How can we think that's a bad thing? It's part of the birthing process.

Our instructor clicked on the next Powerpoint slide to show what each letter in the word PAIN represents:

P--Purposeful
A--Anticipated
I--Intermittent
N--Normal

These four words certainly capture and summarize what labor pain will be like for us pregnant women, or so I've read. A number of women who I have spoken with fear labor pain, imagining it as intolerable and/or torturous. Some believe an epidural is a necessity so as to avoid this normal, expected pain. Then an obstetrician may throw in some Pitocin to get the job done quicker. But do we question the side effects to these drugs that are often played down by healthcare providers? To each his own. I am clearly hoping and praying for a natural childbirth, knowing that in the worst case scenario, I may end up with a cesarean section.

What surprised me the most as I did my own reading about childbirth, is that the pain is not constant, but intermittent. When you break it down and reflect on what's really happening during childbirth, the process becomes so much more meaningful and beautiful. While we may fear the pain that we anticipate during labor, we can be comforted in knowing the essence of the pain is this precious tiny human trying to make his way out into the world. It will certainly be pain with a purpose.

Grateful

I am just floored, overwhelmed might be the better word by the myriads of gifts for this tiny human being residing in my womb. It began with a set of diapers from my favorite secretary at work during the first trimester down to an elderly woman who we have never even met. She gave us a check for the baby during our shower this past weekend. While the expected due date is exactly two months from today, she wrote in her card that she hopes the baby will be born on her birthday, April 13th. From gently used gifts to brand spankin' new ones, I am grateful beyond words for the generosity and kindness of so many in our lives.

Baby movement and appointments

I never thought I would want to know the gender of the baby before the little one was born, but my husband wanted to know. So if he knows, I couldn’t be kept in the dark.

At 20 weeks, Russ and I went in early on Monday morning for our baby’s first ultrasound. The sonographer started scanning my belly, telling us that she would do the so-called “boring” pictures first, ie the placenta. Our baby was actively moving to and fro in the womb. I reveled in our little one’s quick movements, which I attribute to morning oatmeal. The sonographer showed us the bladder, kidneys, stomach, spine, the flickering heart. The heart rate was found to be at 160. We watched in amazement. She then pointed out the little feet, the hands, our baby’s profile shot. All was looking good.

When it got to the part of revealing whether it was a boy or girl, our little one seemed to want to keep the gender a secret. The sonographer guessed almost certainly that it is a girl and that the baby was just being modest in not parting her little legs. Afterwards, Russ and I went upstairs to my floor to share the news and show our baby’s first pictures to my co-workers.

Later that week, I had my 20 week appointment with a different OB. I was starting to question why wait for 45 minutes for a 5 minute appointment to find out that everything was just fine? I was clearly not impressed with this OB. In trying to be a compliant patient, I show up for these appointments and also to hear our baby’s heart rate once more, which ticked at 155. I reminded myself that I need to be grateful for these quick uneventful appointments and the good health of our baby.

At 21 weeks, we took our first family photo by the Christmas tree and shared our latest joy on facebook.

At 23 weeks, my fellow pregnant friend and I had our picture taken together, proudly revealing our baby bumps.

At 24 weeks, I am happy to report that the little one has been super active in the womb. A couple weeks ago, I was playing the “push” game with her. Whenever I would feel her kick or punch, I would push back and wait to see if she would react. She often would push back and it would bring the greatest joy to me. Now, I have been pulling up my shirt at home and watching her powerful kicks come to the surface of my abdomen. She has me grinning more often than not. I guess I could also credit her active movements to my husband’s healthy and delicious cooking.

Yesterday, I had my 25 week appointment with an OB I had heard good things about. She lived up to what I had heard. She had a good sense of humor and actually asked me with genuine concern how I was feeling. If I wasn’t set on having the midwife walk with me through the rest of the pregnancy, I would certainly choose this OB. It was the first time anyone measured the fundal height, which was at 25, where it should be. Her heart rate was ranging from 151 to 160. In the middle of the heart rate check, she gave a swift kick or punch at the Doppler wand. The OB said, “I just got kicked!” The babe likes her morning oatmeal.

Christmas letter 2011

(This letter, which is copied and pasted here, was sent to family and friends. I hope to better keep this blog updated by next month.)

Happy Advent and Merry Christmas! As we aren’t always the best people in the world to keep in touch with loved ones, we thought that we would share the blessings in our lives from the past year through this Christmas letter.

In about two and a half years, Russ finished his accounting degree at Fairmont State University this past May. Then he studied for the next six months sitting for the CPA Exam, and we just found out that he passed! He’s looking forward to not having to study so much and to enjoying the opportunity to relax a bit on weekends.

Also in May, we finally took our honeymoon after two years of being married. We stayed at a cabin in the mountains of the Shenandoah Valley in Virginia for some rest and relaxation. We enjoyed the quiet and each other, whether we were sitting outside on the porch enjoying the beauty or watching our favorite movies on the rainy days. In the evenings, we would try a local restaurant in town and take evening walks, when the weather allowed it.

In the spring time, we moved from Fairmont to Bridgeport. We are grateful that the commute to work has been shorter for the both of us. Since graduating, Russ has started working full-time for T & B, a local accounting firm, doing taxes and auditing for health care organizations, non-profits, and other local businesses. Rochelle continues to work full-time as well, but as of recent, as the weekend charge nurse on one of the cardiac floors at UHC.

Also in the spring, we started a garden on our patio, which produced tomatoes, basil, and rosemary. Our rosemary plants are still going strong indoors. We continue to buy local produce and meat and support our farmers. Russ still enjoys cooking and finding new ways to make nutritious meals, because….

About five months ago, we found out with joy that we are pregnant! While Rochelle felt nauseated and exhausted all through the first trimester, she has regained her energy back and her baby bump is now evident. Recently, we had an ultrasound which the sonographer said with confidence that she was almost positive that our little one is a girl. We have since referred to our baby with female pronouns, though our modest little one never revealed her gender for certain. Our baby is kicking, punching, or head butting Rochelle daily. Russ has been lucky enough to feel her movements every now and again.

We hope this letter finds you doing well and enjoying the blessings of the Christmas season. Please know that while both time and distance may not allow us to see each other as often as we would like, you are often in our thoughts and prayers. Have a Merry Christmas!

With love,

Rochelle, Russ, and Baby P.

Second trimester

Last week, our 17 week appointment went much better than 4 weeks prior. I had lowered my expectations as a result of the last experience. We were fortunately greeted by a kind obstetrician who actually made us feel like we were worth his time. He walked in with the Doppler and my chart, which was the first promising sign. He took the time to answer questions. He gave us the shpeel of why an appointment is scheduled with each of the five WVU providers, as you never know which one would be there for the birthday party. I'm sure it wasn't the first time he has used that line, but what a joyful thought. His statement recognizes the literal birthday of our babe.

That day, Russ and I heard our baby's heartbeat for the first time together, going strong at 155. I was speechless once more, caught up in awe at this living being inside me. The obstetrician mentioned that it seemed as though the baby was doing back flips. Yet another pleasant thought of an active baby!

The obstetrician had asked me if I had felt the baby move. I told him I was uncertain if you could call what I was feeling the baby or my gut. When I was walking down the hall at work the week before, I did feel what I would call fluttering in my lower abdomen. I wanted to feel the baby. At times I am not sure when I am actually feeling the little one nor do I want to falsely tell people that I am feeling the babe when I am not. Toward the end of last week, I was feeling as though the baby was gently tapping my belly in sets of twos and threes. I mentioned it to Russ. He asked if he could feel it, but I didn't feel as though he could at that point.

Last night however, I could actively feel the baby kicking or punching. When I told Russ, he said it was because I just had coffee ice cream. Perhaps, but heck, I could feel the baby in action! I knew Russ was studying hard for the last part of the CPA exam, but I didn't want him to miss the obvious movement of our baby. He left his desk for a little while and sat next to me. I positioned his hand over my right lower abdomen, where I was feeling the baby kick pretty well. We waited for a couple minutes, then Russ felt the baby! I was so excited that he was able to feel what I was feeling! I think he was, too.

The heartbeat

During our first baby appointment at 9 weeks, our midwife attempted to hear the heartbeat in my lower abdomen with a Doppler, though unsuccessful. She told us not to worry, assuring me and my husband that by the next appointment in 4 weeks, we will definitely hear it. Because we chose to go with a group of OB providers, I would be scheduled with a different provider each time, even though I already made it clear that I preferred midwifery, as long as I remained at low risk. The midwife said she would note my preference in my chart.

Our 13 week appointment started out as expected: check my weight, leave a urine sample, take my blood pressure. But Russ and I were most looking forward to hearing the heartbeat. The OB, who I had heard good things about, said that we probably wouldn't hear the heartbeat, that it's too early. I sat there surprised and in silent shock. I didn't buy his words. He seemed to be in a rush. I left the appointment feeling disappointed and bitter. I felt like it was a waste of time for all. I forget how different the outlook of each provider can and will be.

That following weekend, I shared my experience with my co-workers. Stephanie, one of the nurses, volunteered to use the Doppler to hear the baby's heartbeat for ourselves. She, Elizabeth, also in the pregnancy club, and myself snuck discreetly into our last empty room. We collectively guessed at placing the Doppler in the general abdominal area that the midwife tried weeks prior. We heard my own strong heartbeat pretty easily.

But within minutes, I listened in awe as the faster heartbeat was detected. The baby's heartbeat. I only wish that Russ could have heard.

Charge nursing, bedside nursing, and meralgia paresthetica

Prior to becoming pregnant, my husband and I had discussed the necessity of childcare as we were and still are both planning on working either part or full-time. Now, with Russ working Monday to Friday, I jumped at the opportunity to leave my Monday to Thursday afternoon shifts as charge nurse and work on weekends from Friday to Sunday on the floor as a staff nurse. Working the afternoon shift, I was unable to have quality time and conversation with my love, as I didn’t come home until midnight, at which time he should already be fast asleep. It has been nice to share dinner daily with Russ. I am looking forward to spending four days a week with the baby and husband versus at work. It may sound crazy to anyone who enjoys their weekends off, but in terms of childcare, the only day we would need someone to care for the little one would be Fridays as of right now. Not to mention, working as a weekend premium nurse earns a few bucks more an hour.

Others may question, why would I want to leave my position as charge nurse? I had become jaded with my position as the job priorities are discharge planning, auditing, and of course maintaining order on the floor. While I have been honored to be in this position, I didn’t become a nurse to be a “desk” nurse. I became a nurse to care for those who are sick. I was enthusiastic when my new manager officially offered the job as a weekend premium nurse to me. Dave mentioned that our weekend charge nurse might be leaving to work on another floor soon. He asked me if I would be interested in still being charge. I told him no pretty quickly and easily because I miss bedside nursing.

But perhaps a week or two later, our day charge nurse, our clinical supervisor, and myself requested a meeting with Dave to discuss challenging issues on our floor. I remember becoming almost tearful as he discussed his plans for 6 North and for resolving these issues. It’s been a long time since I had been so encouraged by management. I believe that he will bring positive change to the floor. As I left that meeting, I began to ponder, maybe I should stay as charge nurse on the weekends? That night, I went to bed prayerfully discerning over how I could best be utilized on the floor. In what way was I being called?

A couple days later, Jodi, the main preceptor for the graduate nurses, came to me and questioned why I suddenly decided to go from charge to bedside nursing with this being my first pregnancy. She called me “frail.” I rebutted that label in a good-natured way. She was concerned about the health of the baby and me. I told her the reasons why I didn’t care to be charge anymore, but maybe I should reconsider? Perhaps this was a nudge from the Holy Spirit? I talked to Dave later that afternoon and told him about this conversation I had with Jodi. I had a minor breakdown in his office. I told him the reasons why I did and didn’t want to be a charge nurse. He has told me before that I am management material, not that I care to be in his role at all. He said that if I wanted the weekend charge position that I could have it. This time around, I told him yes pretty easily and quickly. I feel privileged to still be a part of the leadership team.

Weeks go by and I just finished working my first weekend as a staff nurse for now. Thankfully, I was blessed with a good set of patients and their families. On my first 12 hour day shift last week, my right leg started to bother me, but I knew it was because I had spent the majority of those 12 hours either standing or walking. As charge nurse, you do spend a lot of time at the desk, keeping the floor organized and communicating with physicians. If I would stand or take a walk, it would be a short one! But as I played staff nurse that day, I was feeling the pain!

I went home that night, fearing the worst. The pain was in my right thigh. As a cardiac nurse, I feared a blood clot, even though I knew it normally starts in the lower leg. They surely couldn’t do a CT to rule out a pulmonary embolism with iodine in pregnant women? Could they? Do they give heparin to pregnant women? Should I go to the ER that night? Would they have an ultrasound tech available to scan my leg? I couldn’t remember what the midwife told me to do if I had any problems. Maybe call the OB office the next morning? Maybe call my primary physician? I don't like seeing doctors unless absolutely necessary. Could this be one of those times? I didn’t want to tell Russ because I didn’t want him to worry for now. Behind my husband’s back, I immediately began googling what this could possibly be, other than a clot. When I found enough links of pregnant who complained of leg pain problems, I was able to sleep for a few hours.

When I woke up the next morning, my outer right thigh felt numb. Great. Now it's neurological. Could this be an MS flare-up? My gut told me it wasn’t, but I still questioned what it could be. When I googled the problem that morning, I found more promising links of what the numbness could be. I had officially diagnosed myself with meralgia paresthetica, which can be caused by all that walking and standing I was doing as a pregnant staff nurse the previous day. I read that it could best be relieved by rest and certain exercises.

When I saw my primary physician on the floor, I told her about my latest affliction. She listened thoroughly and patiently. She told me that it is something called meralgia paresthetica, that it was normal during pregnancy, and that it would go away eventually. I was so excited that I assumed the correct diagnosis, you know, being only a nurse. As my physician agreed on the diagnosis, I was fully reassured. Not a clot. Not MS. Just another pregnancy symptom.