Just when I was thinking I couldn't possibly handle any more stress I am handed some more! We moved the furniture this Tuesday. In addition to being up at the old place and instructing the movers I also had to be at the new place waiting for the landlady to come by for the walk-through. She was also having the plumber come to fix the bad leak under the sink. I told her that Tuesday was really bad because we had the movers coming, but she insisted it was the only day she could come so I had to figure out a way to be in two places at once! Tom was gone this past weekend in San Diego at a Knights of Columbus State Convention which left the last of the packing up to my mom, dad and I. Tom worked all day Monday and had was planning on working all day Tuesday as well, but with the landlady requiring someone to be at the house we begged him to take a half day off. The plan was for my father to stay inside the house and instruct the movers on what to take and what not to take (we didn't want to pay them their hourly fee to take light stuff that we could handle, and we needed certain things left behind to clean with), Tom was to hang out downstairs watching the truck to make sure no one stole anything while the movers were going back up for another load, and my mom and I were staying at the house. I was there to deal with the landlady and Mom was there to keep Tommy out of my way so I could focus on what needed to be done with the landlady without being distracted by him.
The landlady was supposed to be here between eight and nine am. Eight came and went with no landlord. Nine came and went. Ten came and went and Tom called with an update that the movers were making great progress and they all decided that they didn't need him, nothing would get stolen and he was going in to work. Eleven came and went and I got a phone call from Tom asking if we needed more help at the old or the new place because he was coming back. That confused me until he said that he had just been laid off! Even though the company he worked for had just gotten their second round of funding they still decided to go through with some budget cuts. They fired over a dozen employees that day. They now are down to 160 in the company and they will be at 100 by the end of the summer he was told. Tom was told in his small department there would be another person most likely laid off in a few weeks. Tom is a very high middle level UNIX systems administrator or a low Senior level administrator. They have one true senior admin, two low to mid level admins (who Tom has spent the last year training up from junior level admins so they are far underpaid for how quickly they have learned) and one fresh new junior level admin and one database guy. Unfortunately it made the most sense to fire Tom because he is paid more than the lower level guys and doesn't have all the skills of the senior guy. He's also the only one married and with a family, but that doesn't matter much these days I suppose.
I was beyond a state of shock at this point. I'm not too worried about him finding something else as in the past he contracted and he was never between jobs for more than two months, but with as many layoffs as there have been lately I fear it might take him a bit longer considering there must be more people out there looking at the fewer jobs that are available. There are fortunately still many jobs in his field in this area. Unfortunately the high cost of living here and the very low unemployment pay rate means we have about two and a half months worth of money before we'll be unable to pay rent and monthly bills. The other thought that entered my mind was that I wouldn't be able to see the midwife! I had planned to switch from the HMO to the PPO plan during open enrollment next month. I didn't think that you could still do this on COBRA, but I have now been informed that indeed I can. I spoke with Tom's HR administrator today and she is just confused. She said because I'm pregnant she doesn't think I can, but she did say that during open enrollment we are still eligible to switch. My being pregnant shouldn't have anything to do with that because there are no pre-existing conditions on the insurance plans. I think what she was saying is that the switch might mean a time consuming paperwork trail and perhaps the insurance company might not show that I'm covered in time for the birth or something. I don't care, I'll deal with that mess, just get me set on the right path for the PPO so that I can see the midwife!
When I didn't realize I could still switch I did some research and found that there is only one OB that delivers at the hospital I want to deliver at who is also on the plan. My midwife had been willing to work out a very reasonable payment plan with me should I be forced to stay on the HMO, but since the hospital is contracted with the HMO I wouldn't qualify for their special uninsured patient package and the out of pocket expenses without that special program are insane! The only way the HMO will pay for the hospital is if my care provider is also contracted with the hospital and fills out the referral paperwork and is the person who handles the birth. So basically there would be no way for me to use this midwife. The one OB on the plan is a high risk OB, that instantly sent up a red flag in my head. Very often high risk means high intervention. I spoke with someone in her office and this person claims she has a "very low" c-section rate and a "very good" vbac rate. She couldn't give me any numbers though. I set up a free interview for June 5. At this point I now know I will be able to start seeing the midwife again in July, but in the meantime I'd rather have an OB closer to where I live now. I saw my old OB at the end of the week and he knows I have moved and will eventually be leaving him. I didn't tell him the real reason, as I like to avoid conflict. After the birth I plan on writing to the medical group about my treatment though! He also knows about the lack of job and insurance situation and he said it is fine if I continue to see him until everything gets worked out. At least this way I am at least getting regular medical care. If this other OB seems decent I will switch my primary care to someone in her medical group so that I can have her as my OB should there be an emergency in the month of June. This is all such a mess!
The baby is hanging in there despite having such a frazzled mother right now! The heartbeat sounded strong and everything looks good with me. No protein or sugar in my urine and my blood pressure was surprisingly low (110/70) considering how stressed I am. My blood pressure is usually around 110-120/70-80, but it can go up to 140/90 on some days, usually when I've been running around franticly. My weight alone is probably the biggest cause of it being higher sometimes, but my doctor has never been worried and I don't have any signs of pre-eclampsia like spilling protein or swelling. In fact I haven't had any swelling at all this pregnancy and I didn't during Tommy's until the last few weeks. I lost another seven pounds this month to make my total weight loss 19 pounds! The doctor questioned it for the first time this appointment. By this time I had been gaining weight back with Tommy. He asked if I attributed this weight loss to eating healthier during pregnancy and I had to laugh! I can't tell you how many fast food stops we've made over the last several weeks during this move. I told him that I attribute the weight loss to having so many food aversions and to an increased metabolism. I have no idea why, but my metabolism seems to kick in when I'm pregnant! This past month I also attribute it to all the extra exercise I've done. Carrying boxes (don't worry, I don't lift the really heavy ones) and pushing around a steam cleaner and scrubbing walls and floor adds up to a lot of exercise when you do it all day every day for a few weeks straight! This is the first time he's seemed a little worried about the weight loss, but he shrugged if off and said that it's obvious I still grow a good sized baby and he left it at that.
On that note I'm also not measuring large, but then I didn't measure large with Tommy either. By feeling around he doesn't think this baby is bigger than average (unlike Tommy), but he also said that I'm the kind of woman that can hide a big baby well. I have a large bone structure with an hourglass figure so where I normally have a small waist I just fill up with baby and my roomy hips hide a lot down low. It was humorous to hear him say I had roomy hips after the times he has doubted the ability of my pelvis to birth a baby vaginally! I also got the let's-scare-the-heck-out-of-the-mother legal form at this appointment. It's the form I need to sign which says I realize the risks of a VBAC. Of course the part about possible uterine rupture is in caps and bolded, but the parts that say 70% of VBACs are successful and the part that says a VBAC carries less risk than a planned repeat cesarean are not emphasized at all! I just love how they don't mention any of the specific more common risks that go along with any cesarean, emergency or planned! The average person who had never heard of a VBAC before would most likely choose a planned repeat cesarean after seeing this form! The OB surprised me at this appointment though. He didn't try to discourage me from a VBAC like he has in the past. I guess he has resigned to the fact that he isn't going to convince me to not give a VBAC a shot. He actually changed his tune and said that I could probably birth a nine-pound baby relatively easily, but he's not sure I can handle another ten-pounder. He also said should I continue to see him he'll keep tabs on the growth of this baby as we get closer. I'm assuming he means another ultrasound.
A few days before this OB appointment I had my second dietician appointment. This other dietician is much better! She agreed with every change my midwife made and she didn't make assumptions about me based on my weight. She told me I was doing an excellent job. She was a bit concerned about my weight loss though, but she looked at the foods I had been eating and said that it must just be me because I certainly wasn't eating low fat or low calorie! My food records have actually been pretty horrible lately because I am on the go so much. I am following the diet, I'm just not writing down exactly what I was eating at each meal and snack. Well I shouldn't say I'm following the diet because several times I've gone well over four hours without eating which does seem to have a small effect on my sugars. My morning fasting sugar is still higher than 90 on most days. 60-90 is the standard they want me to fit. The first dietician said if I stay over 90 she will refer me on for insulin, but this one says that at the levels I'm at (almost always under 95) she considers this controlled. There were two readings in the high 90s and a few post meal readings that were over 120 that she was concerned about. All three days of higher readings were the first three days after I had sprained my ankle. I told her I had stopped basically all activity because I sprained my ankle and she said that not only was it probably due in part to less activity, but that any time your body is under stress (including illness or injury) your sugar will go up. I did know that, but I hadn't thought that injury is actually a stress to the body. She wasn't worried at all after that! She had me make another appointment for one to two weeks away. I did two weeks again because of the time and gas involved in driving back up there. I wonder what she will have to say about these last two days of higher sugars. My fasting was 100 this morning, the highest it has been yet, and my post breakfast was 130. I also am finally getting hit with this cold that Tom, my dad and Tommy have all had, so most likely the higher sugars can be attributed to that.
We've had another non-baby related adventure this week. Tommy has been sleeping poorly due to this cold. Two nights ago he was up most of the night screaming and nursing wouldn't console him. Usually when he acts this way he is teething or his ears are bothering him. I was considering taking him to urgent care the next day (Memorial Day), but after he woke I definitely was taking him. We noticed he wasn't using his right arm at all. It was just hanging limp by his side. No matter how we tried he would not lift it or use any part of the arm. I even let him have my car keys to see if he'd use his right hand in the car. When we go outside he turns and says "key" and then unlocks my door and climbs in then puts the key in the ignition and fiddles with the lights and wipers and turn signal until I kick him out into the back seat. Then he insists on strapping himself into his carseat (which he has also learned how to unbuckle now!). Yesterday he would do none of this with his right hand. He opened the car with his left and tried to use his left to put the key in the ignition. In the back seat he didn't even attempt to fight me to fasten his carseat belt himself!
At urgent care we were sent to another floor to pediatric urgent care. They do all their visits by appointment though so they set us up for a 12:30 appointment. We went back to the old place and cleaned for a while until our appointment. The doctor first checked him for his cold. I was a bit worried that somehow the two things were related. I said I wasn't worried about the cold at all until he stopped using his arm. She assured me that if it were an infection causing this that he would have a high fever and his temperature was normal. He had had a slight fever for a few days before though. The doctor said his cold was just a simple cold that was on the way out as I had suspected, and that his ears were fine. She then looked at his arm. She thinks it is "nurse-maid's elbow" or a dislocated elbow. She manipulated it and Tommy didn't flinch at all. She said it wasn't out of joint, but that he could have popped it out and back in and still be experiencing some pain and thus not using it. This sounded a little strange, as he had not once screamed in pain the entire morning no matter how much I moved his arm. He also seemed to be pretty happy and it didn't seem to bother him. He just didn't use it! She said if he wasn't better by the next morning to see his regular doctor.
My mom and I returned to the apartment and finished almost all the cleaning. The entire time Tommy was very clingy and nursed his arm even more than he had before. He also now seemed to be in pain. All night long he screamed again. He had an extra hard time falling asleep. He really wanted to nurse, but he also needs to twirl his hair to comfort himself. He started nursing on his left side, but that meant he needed to twirl with his right hand. He would start to do that and then stop, unlatch, scream and hold his arm! So I switched him to his right side and he couldn't get comfortable on that side because that meant he had to lie on his sore arm. He also insisted on having no clothing on that elbow so I had to let him take his one arm out of his sleeper. He scratched and rubbed at his elbow for a while until Tom got up and gave him some Tylenol. I rocked him for a while and he dozed off finally when the Tylenol must have kicked in. He woke just about every hour though and snuggled up to me whimpering and clinging tightly to fall asleep again so I got virtually no sleep (another reason my sugar might have been high).
I woke before him and called the doctor this morning. Unfortunately his doctor wasn't in and the other doctors were all booked up (typical). I was told to wait for a callback. Just as I was getting worked up about how my son's arm might have something seriously wrong with it, he woke and toddled into the kitchen. He was still nursing his arm, but he did reach for a few things with his right hand. By the time the doctor called back he was doing even more. He still was obviously nursing it, but it was better. The doctor sounded surprised. He said the recovery should have been much quicker, in fact it should have been almost immediate after it popped back into place which the other doctor said he had done on his own long before she saw him. He was also concerned that he wasn't using his hand, as a dislocated elbow shouldn't affect that. He said to watch him closely one more day then call again the next day if he was still nursing it. Fortunately he has gotten better all day long and now late at night (I cannot get him to sleep!) he is hardly nursing it at all. When he thinks about it he doesn't use his arm, but when he acts before thinking he uses it and sometimes pulls back some, but his motion is much better now than it was earlier.
The only thing I can guess is that when the doctor manipulated it to make sure it was back in place she caused further irritation and inflammation that just took longer than usual to go away? I was also stumped as to what caused this and when it happened, but Tom filled me in on that. While I was steam cleaning the old apartment's carpets Sunday Tommy really wanted to get to me and Tom was trying to keep him entertained. Tom had Tommy's right hand in his and he was walking him to the bedroom when Tommy decided that he did not want to leave. He started throwing a tantrum that involved dropping on the floor while Tom still had a grip on his arm. This is a typical Tommy tantrum and he has just dropped to the floor many times like this when I'm trying to lead him somewhere he doesn't want to go! He's been doing this since he learned to walk at 10 months of age. Tom said he heard a pop, but since Tommy stopped the tantrum soon after and continued to use both arms he wasn't worried. Tom didn't think the sound was all that remarkable. Tommy has a back and ankles and other joints that crack often. Tom and I are the same way. The doctor did say that it sometimes takes very little for a child to dislocate a joint, elbows in particular. They can even do it to themselves while hanging from a monkey bar or pulling too hard on something. I remember that Tommy was still using that arm hours later that night when we were eating dinner. I guess the pain just took a while to bother him, or maybe it swelled during the night or something. Whatever it was it seems that this ordeal is over and I am very relieved! I was so scared that something serious was wrong with him, especially with the coincidence of having that cold as well! I am so relieved that he is returning to his happy normal self. Even if that means I have a little boy still fighting sleep at 1 am!
