29 Months Old

1. Ian really has caught on to the concept of saying "no, thank you" instead of just "no." Kathy taught him this in terms of turning down extra food (after the timer goes off it's his choice if he continues eating or not), but he now says "no, thank you" in all different situations throughout the day. I love hearing the kids use good manners!

2. His breakfast these days consists of cream of wheat (I mix some syrup in to make the flavor  more interesting and boost the calories), cookies, and EleCare. After he takes two bites of cereal, he says "I need a tissue." I had been wiping his tongue with a Kleenex before he ate his cookie, but then this week I decided to switch the order and give him the EleCare after the cream of wheat (before the cookie) instead of after the cookie. This brought an end to wiping his tongue with a tissue.

3. His other three to four meals consist of yogurt (or pumpkin or applesauce if I'm out of coconut milk yogurt), a challenging food, cookies (or Froot Loops), and EleCare. Lately the "challenging foods" have consisted of small pieces of banana, creamed corn, fork mashed beef stew, or small pieces of hot dog. I have gradually been increasing the size of the pieces of hot dog and banana in part in an attempt to make sure he chews the pieces rather than just swallows them. Some meals go very peacefully, and others involve a lot of screaming.

4. Ever since he got home from the feeding clinic he's been putting "Miss" in front of everyone's name (ex. Miss Nadia, Miss Daddy, Miss Mommy, Miss Grandma, etc.).

5. Many times a day he asks Nadia the same questions, "Do you like Cars?" and "Do you like princesses?". Surprisingly Nadia hasn't become annoyed with answering those same questions umpteen times. She always says "no" to the first and "yes" to the second.

6. One of his favorite songs to sing lately is from Snow White ("Hi ho, hi ho, it's off to work we go").

7. The last few weeks the only places he's had an accident has been in his crib (while napping) and at church. He's currently gone 13 days without an accident. We shall see how long this streak lasts! Now that he's not drinking as much he only goes to the bathroom a few times a day. Earlier this week he had me concerned as he didn't go At All from the time he got up (7:30am) until 3:00pm.

8. Sometimes his naps are still only 30 minutes long, but most days they are 45-60 minutes long.

9. Every once in a blue moon he still wakes up too early (ex. 5:30am), but his average wake up time is 7:30. A few days he's slept until 8:00, which meant he slept 12 hours straight. When he wakes up prior to 7:00, I bring him into our bed and usually he falls back asleep on me. Cuddling first thing in the morning is very important to Ian. He needs some snuggle time before I change his clothes, etc.

10. Daddy puts him to bed every night (per Ian's request).

11. He's really been into playing in the ball pit (in our jacuzzi tub) lately. This comes in handy while I'm taking a shower.

12. Last week he finally got over his obsession with wearing a jacket all the time. Thank goodness. Now he sheds the jacket as soon as we come in the house. He still wants to wear a jacket every time we go outside though. Hopefully that habit will disappear as the temperatures rise.

13. He's very particular about keeping his clothes clean and dry. If just a little water gets on him, he will keep saying over and over, "I need clean socks (or shirt or pants)" until I change his clothes.
14. He learned many animals over the past month. If you show him a picture of a gnu, meerkat, capybara, koala bear, sloth, etc., he will be able to tell you what it is.

Shrinking List

I love seeing my to do list get shorter and shorter. It's such a great feeling to cross something off the list, particularly when it's something like "grade final exams." I finished all my grading this morning, and I've posted all the semester grades. WOOHOO! I'm hooding a student at the commencement tonight, and then the spring semester will officially be over for me. To celebrate the end of the semester, I'm going to stop at Panera on the way to commencement and buy a strawberry poppyseed salad, which I think is one of the best salads EVER, and since I'll be using a gift card it won't really cost us anything.

Yesterday I brought home the books that some textbook companies had sent me (unsolicited) over the last semseter that I don't want. I boxed them up and printed shipping labels this morning, and after they are processed, I should be getting $362 for them. That wasn't on the written to do list, but it was on the one in my head. Similarly, I signed Nadia up for swimming lessons today. I decided to sign her up for the ones that start June 18, even though she'll miss one morning (the day we go to Lancaster to see "Jonah") because I figured it would be better for her to have the lessons earlier in the summer than to wait until July 9. Ian is only eligible for the "water baby" classes so I'm going to hold off on formal lessons for him until 2013.  In between doing things on my list I get to play with the kids (this morning it was Mr. Potato Head and also building with blocks).

Paul tried to fill the P17 prescription yesterday, but PSU said it would take one week for it to come in. I called the OB office this morning and asked if #1 I could have a shot at my appointment next Thursday and #2 if they could give me one syringe to take on our vacation. Paul won't be on campus the next two weeks because he'll be in Philadelphia next Monday-Friday at a conference, and then we leave for Grand Cayman next Saturday (I'm going to start packing this weekend!). The nurse said that was fine as they have a supply of them at the clinic. Paul can pick up the prescription on May 29.

Flowers and Bears

This morning I bought some flowers, and Nadia wanted to help me plant them. She wasn't interested in helping me weed, and she only helped remove clippings from the mulch (I also trimmed the shrubs) for a few minutes, but she was definitely interested in digging in the dirt and planting the flowers. I let her pick where we put them (pink, purple, and white). It was a special moment. Her attention span didn't last as long as mine, but still it was fun to do it together for a little while. This was her first experience. I'm sure in future years her attention for the activity will last longer than it did today. This was one of the experiences I dreamed about before I became a mom. It's so wonderful to experience a dream coming true.
Paul's office (which is the room that will become the baby's room) has been decorated in Giants decor (lightswitch, curtain, floor mat, chair, keyboard, mouse and trash can). My first thought was to leave the lightswitch, curtain, and trash can and go with a NY Giants theme for his bedroom. I remember seeing NFL crib mobiles in 2008. Well it turns out they don't make those any more, and also Paul wasn't as keen on the idea as I assumed he would be. His thinking has always been that our children can root for whatever teams they want to (although I think he'd die if they picked the Cowboys, Eagles, or Redskins). Well I love decorating a baby nursery so it didn't bother me one iota to give up the Giants idea. Maybe some day one of them will want a Giants themed bedroom, but for now Mommy gets to pick. In 2002 I had purchased a Boyd's Bear crib set. I painted a bedroom yellow and put up a cute teddy bear wallpaper border. I picked this in part because it was gender neutral. When we moved in 2004, I gave the crib set to a thrift store. Time has passed, and I am ready for a teddy bear themed nursery again. I figure if the next FET results in a pregnancy, this baby I'm carrying now can move into Ian's bedroom, and I could use the teddy bear themed nursery for the fourth child whether that baby is a girl or a boy.

Part of the reason I was hesitating in going all out with decorating the nursery is because we're most likely moving next summer (2013), but the walls in Paul's office are pretty scuffed up (that one and our bedroom were in the worst condition when we moved into this house in 2008). I had actually planned to ask him to repaint them white before the baby arrived, if we were going with the Giants theme. He painted our bedroom blue and Ian's walls light green. Nadia's walls were pink when we moved into the house. I'm planning on asking Paul to paint the baby's room light yellow. After looking at various options online (Babies R Us, Target, and Walmart), I picked this set. I've never purchased a quilt before, but it was the only way to get the crib sheet and crib skirt. I'll have Paul hang it on the wall, especially as I've decided to forego the wallpaper border (even though it's really cute) since we're moving in about a year. I put up a wallpaper border in Nadia and Ian's rooms. I'm going to need to buy one more crib sheet (maybe yellow?) because I can't buy a second fitted honey bear sheet separately, and I know from experience it would be very unwise to only have one crib sheet! I bought matching lamps, bookshelves, and tissue covers for Ian and Nadia's rooms, but instead of those three items I'm planning to buy some teddy bear bookends, and I'll put some baby books on top of the nightstand in his room (it's a small room). I also got Nadia and Ian coordinating mobiles, trash cans, lightswitch covers, and hampers. I will need to buy the baby a hamper. We shall see about the other items. Shopping for a baby is FUN!

19 Week OB Appointment

The OB and MFM offices only seem to be able to calculate EDD's based on LMP, which is not how an EDD should be calculated with IVF. So they keep saying my EDD is 10/5/12 (versus 10/3/12). In their minds I'm 18w5d today, but I know I'm 19w. It's all irrelevant since my c-section has been scheduled for 9-24. I definitely won't be pregnant on 10-3 or 10-5. The OB today said she hopes I make it at least to 37w (September 12). Given the contractions I had last week I think that's dubious, but it would be awesome as that should mean no NICU stay for this little guy. I was at the OB office for 1hr 50 minutes today. Unfortunately I didn't bring my laptop or a book. I admit sitting in a doctor's office is one of my least favorite activities in life. I was there 90 minutes before the doctor walked into the exam room I was in (and I arrived right on time for my 1:45 appointment). I am going to try to stick to morning appointments in the future in the hopes that they will go more quickly (I figure they can't be really backed up at say 9am). I really got spoiled at the OB office I went to while I was pregnant with Nadia. I was in the clinic for an average of 15 minutes total. Today the nurse weighed me, took my BP, and did the urine check. She was going to have the OB do a pap smear and cervical cultures, but I said NO as I knew I had those done at the RE a few months ago. The doctor looked at my chart and listened to the baby's heartbeat (altogether that took about 5 minutes). Since I had an ultrasound last week and have felt stronger and more frequent movements from the baby the last few days, having the heartbeat checked wasn't a big deal to me.

I would have viewed the entire appointment as a complete waste of time except for the fact that the nurse gave me my first P17 shot, the doctor gave me an Rx for the rest of the P17 shots (she said almost all the patients choose to have it at the office instead of doing it at home, but I think having it at home is far more convenient), and the doctor wrote a little note explaining why I had the GD test in the first trimester. They scheduled my next appointment to be with a midwife in 4 weeks. In 3 weeks I plan on asking if I can be weighed, have my bp checked, and urine specimen done at the MFM appointment so I can cancel that OB appointment. If I'm seeing a MFM doctor every other week, why do I need to see a midwife every four weeks? Hopefully, they'll agree to my suggestion.

When I got home I looked up all the other procedure codes to see what tests the insurance declined the first time around. I have typed a list and am going to bring that to the office next week and ask if someone will write an explanation to the insurance why the other seven tests were medically necessary. I am not sure if they'll agree to help me out, but I hope so because the total came to $1,073.98 that we owe, and the glucose test was only $49.63 of that total. The most expensive test was the blood typing ($486), which was actually not needed since I've had that done in the past, but I'm not going to mention that to the insurance company! Maybe at least this will give the OB office a reason to pause the next time they automatically order all these tests. I certainly am going to decline as many tests from now on in light of this hassle (and potential expense). Regina, thanks for the tip about contacting the hosptial. If the appeal process doesn't work, I will definitely do that. I know that if Blue Shield was paying these bills they would NEVER pay the entire amount that was claimed. They always pay a heavily discounted amount. Why should someone paying cash have to pay more than an insurance company would pay?

I am not sure if Paul will have trouble filling the Rx tomorrow. The OB office said it might be difficult. If so, I'll have the P17 shot at their office next week (MFM appointment) and then I'd have to skip a week as we'll be on vacation, and then I have another MFM appointment in 3 weeks. Hopefully by that point PSU could get this Rx filled. Paul won't be on campus this week due to attending a conference in Philadelphia, so I'll have him take it in tomorrow morning, and hopefully they can fill it by Friday afternoon.

Whenever I started feeling annoyed at the OB office today I kept reminding myself that the reason I was there is a VERY happy reason, and that this too shall pass (as far as the frequency of needing to be at a doctor's office). Next time I'll definitely bring a book. That will help. I was very grateful that the kids were with a babysitter. The almost two hours would have seemed MUCH longer if they had been with me that whole time (there aren't any toys there).

Home Stretch

This morning I finally finished grading those lesson plans that had been hanging over my head. I only had a few left to grade when I went to bed at 9pm last night. This evening I'm giving a final exam, and I'm giving another on Thursday night. After I grade Thursday night's exams I'll get a couple of weeks off from grading (I already graded the exams I gave this evening). YAY! Friday night I'm hooding a graduate student at commencement, and then the spring semester will be done for me! I've had this student in several classes. She's forty-one years old and is currently eight months pregnant with her first baby (a girl).

Up until 5:30pm (when I had to leave to go proctor my exam), I had been home all day. The novelty of being home for that many hours in a row hasn't worn off yet. I still feel this smile coming over my face as I empty the dishwasher and sweep the kitchen floor. It feels SO good to be home! In addition to grading, I also spent a couple more hours straightening up and organizing today (our bedroom closet, emptying a drawer in a dresser so I have a place to put my maternity clothes, working some more on transforming the office into a nursery, etc.). I also ordered some materials for homeschooling next year from Sonlight, Handwriting without Tears, and My Father's World. I want to get organized ahead of time in light of the baby being due in September.

Sooner each time

When I was pregnant with Nadia, I didn't have contractions that concerned me until I was 34 weeks, and I had her at 36 weeks. With Ian I had them sporadically starting at 23 weeks, and they were happening quite regularly by 32 weeks, and I had him at 34 weeks. I admit I'm concerned that they started at 18 weeks this time around. They might have started sooner than 34 weeks with Nadia, but since I wasn't nervous about having a preemie that first time around, I didn't take them seriously until 34 weeks. They're definitely starting even earlier this time. The good news is that I'm going to start having weekly P17 shots on Wednesday, which are supposed to calm the uterus. Also, I'm going to be far more cautious this time and try to avoid doing things that seem to trigger the cramps and contractions. I had hoped to be able to keep getting some exercise for at least 10 more weeks, in part because of my desire to keep my weight in check, but unless things go differently the next time I walk the kids to the park, my exercise will be coming to an end at 19 weeks. I'm going to try it one more time, and I'm going to drink lots of water that morning as I know dehydration can also cause contractions. I want to make sure that wasn't the problem before I declare exercise as taboo for the rest of the pregnancy.

Ironically, getting more exercise this  past week and not eating any desserts at home didn't help me with my weight. I was not a happy camper when I weighed myself this morning and discovered I gained another 2 lbs in the past 7 days. I didn't gain any weight during the first almost 13 weeks, but now in the past 6 weeks I've gained 10 pounds (8 of those in the past 4 weeks). I definitely was eating more at the RMH and getting less exercise. As I reflected though I did probably eat too much for dinner on our date on Saturday night, and I did get ice cream treats when we were out and about two other days. The only thing I think I ate more of than usual at home were some chips. Gaining 10 pounds total by 19 weeks isn't so bad. What concerns me is that I don't want to continue gaining 2 pounds a week. I really, really want to average 1 pound a week from here on out. Hopefully I'll have more success this week with gaining at most one pound. Of course preventing preterm labor is FAR more important than how much weight I gain. I'd much rather gain some extra weight than have my third NICU experience.

On Saturday we got a bill in the mail for $1,077 from the bloodwork I had done on March 12. The EOB showed the total was a little over $1,500, and the insurance paid $400. They said the rest were for things not included in our maternity benefits. I called the insurance today as one of the things they wouldn't pay for was the glucose test because they only pay for it in the 2nd or 3rd trimester (and I had it done in the 1st trimester). The woman I spoke with said the doctor can send an appeal explaining why it was medically necessary (since I had GD in my last pregnancy). I have an appointment on Wednesday. I hope the office is cooperative with helping us appeal this bill. I'm not sure if she'll be able to justify all the tests (ex. they won't pay for the CBC either), but any that they can appeal would be appreciated. I had assumed that we'd owe some toward the RE appointments earlier in the pregnancy because those were at a hospital that doesn't work with our current insurance, but I had thought everything would be covered at the clinic I'm going to now since it's "in the network". They did completely pay for my first OB appt, my bloodwork on March 20, and Paul's bloodwork in April. We shall see what they pay toward the MFM appointment I had last week. Hopefully they'll pay for that as well. I can't wait for July 1 (when we're back on Blue Shield). It's nerve wracking to receive unexpected bills in the mail that exceed $1,000. I keep reminding myself that the baby is worth it, and as long as the bills stay under $3K, we still made the right choice. Last summer we received a $4K bill and after an appeal they paid the whole thing. I'd love for that to happen again, but I'm less hopeful since they are restrictive with the maternity benefits. I also have to say I can't believe bloodwork could cost $1,500! Paul's bloodwork last month cost the insurance $44 total. That sounds more like what it should cost to have bloodwork done.

Shopping and Nesting

The last two days I spent quite a few hours shopping at yard sales. The town where our church is located was having a community yard sale, which means MANY yard sales taking place at the same time. I had looked at the listings online and picked about 25 homes to visit over the two days. I tried to be as prepared as possible by having a list of some things I was hoping to find as well as printing out maps and figuring out the order in which I'd visit the sales. Friday morning I took the kids with me. They watched DVDs while I drove from house to house and did my shopping. Nadia was especially cooperative because many times I came back into the car with something she loved (ex. a Cinderella puzzle I got for 25 cents). The most expensive thing I bought that first day was a boppy with a slipcover for $8. Then when I got home I focused on cleaning for a few hours. I hadn't done much cleaning at our house during April in light of spending 20 days at the Ronald McDonald House. I straightened up Nadia's room, Nadia's closet, the family room, living room, and kitchen (mostly putting away toys but also doing things like sweeping and mopping). Karen (OT) and Kathy (EI) came at 2:30, and after they left we headed for the playground. It was really hot on Friday. Thankfully we had mild (spring like) weather yesterday and today. I have a feeling my days of walking to the park are coming to an end to prevent preterm labor. I knew I wasn't going to be walking to the park in August, but I think I'm going to have to give it up MUCH sooner than that.

I was a bit frustrated during the OT session becaues Karen said she didn't think she had anything more to offer to help with his feeding issues. I agree that he's come along way in the past several weeks, but he is by NO means "normal" yet. It takes about 8 meals for him to eat one banana. I've seen 12 month olds hold a banana and eat the whole thing themselves. The only things he can feed himself are crunchy foods (Froot Loops, pieces of cookies, Teddy Grahams, etc.). There are also still meals where he fights and screams over every single bite (Paul had to help me hold him down this morning for breakfast - he wouldn't even calm down to eat a cookie). He also hasn't achieved normalcy with drinking yet. We hold the shot glass for him. I'd like to see him move to a more normal size cup for a toddler and for him to be able to hold it himself. We finally agreed to go down to every other week. Of course, if she's not going to give me helpful advice in how to get him from where he is now to where a typical toddler is, then I guess there's no point in continuing the bi-weekly visits. We'll see.

Saturday morning I continued to visit the yard sales. This time the kids stayed home with Paul. I spent about $100 over the two days on a wide range of things for the three kids. For the baby I bought 2 boppy pillows, 1 gym, and some 3 month size clothing. Girl's clothing is MUCH cuter and fun to purchase most of the time, but some baby boy clothing is cute also (like the Steeler outfits I got him!). Ian wanted to wear some of the outfits I bought for the baby (especially one with cement trucks on it). He approved! I didn't buy very much for Ian. The toy I got him that he likes the best is the Elefun game I got for $1. Nadia made out like a bandit. I got her some new shoes (three of the pairs still had the tags on them!), a Bob (VeggieTale) Bible cover (also still had the tags on it), books, puzzles, and a Princess chair. They both love the small suitcase I got them for $1.00. We'll use on our upcoming trip! It's small enough that the kids can pull it around (it has wheels). My biggest splurge for Nadia was $8.00 for a princess dress (Ariel). The seller paid $65 for it at Disney World. It's very well made. Nadia loves to wear princess dresses!

I didn't get a few items I was really hoping to find - like some sandals for Ian because the size 7 sandals I had gotten for him to wear this summer are still a bit big on him, but overall I was pleased that I was able to cross a few things off my list such as a belt positioning booster seat for Nadia (she can switch to that from the carseat in June). It never ceases to amaze me of the WIDE variety in how people price very similar items at yard sales. Some people price things very low (10 cents or 25 cents each for clothing, books, etc.), and others list prices that are barely lower than what you'd pay at the store. Probably my best bargain (in terms of % off) was a hardback Fancy Nancy book (in like new condition) that retails for $17.99 that I got for 10 cents.

Last night Paul and I went out for an early Mother's Day date because next weekend is already pretty booked. Our first stop was to meet someone who was selling a double jogging stroller on Craigslist. I had bought one at a yard sale for $5 in September 2010, and it was very used when I bought it. It has served us well, but the last few months the tires can't hold the air. They have to be pumped EVERY time I use the stroller. So I had been looking for another one, but they cost a fortune if you buy them brand new ($200-$500). I was happy to see this one listed for $40. It's MUCH nicer than our old one. It's so much easier to push since the tires aren't flat, and it can be folded (our old one can't be folded). I'm hoping to give the old one away at our neighbor's next yard sale. My plan (after the baby is born) is to carry the baby in a Snugli and push Ian and Nadia in the stroller. I'm hoping that by the time the baby is too big for me to carry that Nadia will be big enough to walk (she'll be about 5 years old at that point I figure). After buying the stroller we had dinner and then did a little shopping at Target. It was a very full day!

I mentioned the word "nesting" in the title because in addition to feeling the urge to clean and straighten up the whole house (not that I achieved that goal in light of all the yard sales I visited), I've really had the urge to start working on the baby's room. I spent a lot of time organizing the basement this weekend because I was picking out what to donate for the church's upcoming yard sale (the proceeds go to folks in the church who are going on missions trips this summer). I did discover a few more boxes/bags of baby clothing that I had to sort through to separate by gender. All the girl clothing is now in the basement (in boxes up on the shelves in case the basement floods again), and all the boy clothing (that Ian has outgrown that I didn't sell or give away) is now up in what will be the baby's bedroom. In order to get those boxes in that closet, we had to carry some boxes (of things like scrapbooks and such) down to the shelves in the basement. I am determined to have the room ready before he's born (which didn't happen with Ian), and since I am prone to preterm labor, I want it ready within the next 3 months. There's a lot of work that still needs to be done like selling the dining room table and chairs, painting the room, buying a mattress and box springs for Ian so the crib can be moved to the baby's room, etc. The item on the to do list that Nadia is most excited about is buying a minivan. All this shopping and cleaning meant I didn't get any grading done this weekend so I am really going to need to buckle down and grade lesson plans tomorrow.

Thankful Thursday

AWANA Grand Prix

1. I am so very thankful that our (yet unamed son) is doing well thus far! What a relief!

2. I'm so thankful I was able to find out his gender before the community yard sales (in the town where we go to church) that are taking place tomorrow and Saturday! This evening I need to go through the boxes and make a wish list of what I would like to get (ex. Boppy pillows, Snugli, "big brother" shirt for Ian, etc.).

3. The last two mornings Ian has slept until 8am!! WOW! It was a big blessing this morning because I got up at 7am and wrote a tenure report before he woke up. I had inteded to do it yesterday, but I wasn't expecting the ultrasound to consume 6 hours of my day. Nadia woke up before he did, but she played quietly in her room until I came up to get them at 8:00.

4. I am ever so glad to be at home. I am SO much more relaxed than I was the past four weeks!!!

5. Tuesday was my last night of classes for the spring semester! I'll be giving exams two nights next week plus participating in the graduate commencement next Friday, and then I get a break from going on campus as I'm teaching online courses this summer. Tonight was supposed to be my last night of classes, but at 2:50 they sent an email cancelling classes for the rest of the day because of a power outage, and then the power came back on at 3:00! I wasn't on my computer at 2:50 so I was very surprised when I arrived on campus. My advisees still showed up for their appointments so my trip wasn't in vain. Then I did a little grading before coming home. I have really gotten caught up on grading the past few days. I only have one assignment left to grade (about 90 lesson plans). I want to finish grading those by Monday as I'll be grading final exams next week.

6. I'm grateful that (thus far) the heartburn has been far more manageable than in the last two pregnancies. As long as I am very careful about what I eat, the heartburn usually stays at bay.

7. My car passed the annual inspection today. The inspection and car wash were free, which was nice! I always expect them to find something wrong, but they didn't today. Yay!

8. The last night of AWANA was yesterday. I'm excited because starting next Wednesday she'll be participating in a choir. They're going to put on a musical later this summer. They will rehearse from 6:30-8:00 on Wednesday nights (the same time that AWANA met). It will be Nadia's first experience with any sort of choir, and she loves music! I think she's going to love it! I can't wait to see their production later this summer.

9. The specialist called me this afternoon and said the titer level went from 1:8 (March 20) to 1:32 (April 25); anything over 1:16 is considered "critical." He said there is no point in having any more titers drawn the rest of the pregnancy because the number is already a bad one, and it's not going to get better over time. He asked what we had decided about the amnio. I told him that my husband didn't want me to have it done due to the potential risk. He said to let him know if we change our minds, but until we do it means I need an ultrasound every week. I asked him if it was okay if we started out just having them every other week. He said that was fine for now. I already have ones scheduled in two and four weeks. I'm hoping they can also give me the P17 shots when I'm there for the ultrasounds, and maybe they can also do the weight/urine sample checks at those appointments (in other words skip the regular prenatal visits in light of all these ultrasounds). I'm going to ask about that when I see the OB next Wednesday. Please keep praying that the antibodies don't affect our son. If he doesn't have the Fya protein, he'll be fine. I'm thankful that so far he's doing fine, and I'm also thankful that I don't need to drive to Harrisburg again any time in the next few weeks.

Another boy!

After gymnastics and story time at the library, we came for lunch. After lunch, Paul's parents arrived, and I then left for Harrisburg at 12:30pm. My appointment was at 2:30pm. I arrived in the waiting room 15 minutes early. At 3:00pm I was called back for my ultrasound. With Nadia the tech told us in the beginning of the ultrasound that she was a girl, but with Ian I didn't learn until near the end of the ultrasound (because he wasn't cooperating most of the time with making it possible to see).

This time I also had to wait until the end to find out that baby is a BOY. The ultrasound took about 20 minutes, and then she talked with the doctor. She came back to check the cervical length in light of me giving birth prematurely twice. About 30 minutes later the doctor came back and took another quick peek at the baby. Then he talked to me for almost 30 minutes about #1 how to try to prevent preterm labor and #2 the antibody titer issue. The tech said I had placenta previa (which I had with Nadia but not with Ian), but the doctor said it was too early to make that diagnosis. Hopefully the placenta will move to a better location like it did with Nadia. The doctor said the two things to do to try to prevent preterm labor (because he said the odds have gone up a lot that it will happen again since it already happened twice) are #1 to do frequent checks on the length of the cervix (and there are steps that can be taken to prevent preterm labor if the cervix is the culprit) and #2 to have the P17 shot once a week until 36 weeks. My OB had said I'd start the shots at 20w. He said it would be better to start them this week. I told him my next OB appt is next week (at 19w), and he agreed it was fine to wait one more week to start the shots.

The OB office hadn't sent down my records, and when he asked for them at 4:15pm, the office had already closed. He'll be in that office tomorrow and said he'll check on my levels and call me with the information because he said 42 didn't make any sense. He said my first number made sense (1:8). He said the numbers are multiples of 2 (ex 16, 32, etc.). If my number is still at 1:8, then I only need a monthly ultrasound and titer level check. If my number is higher than 1:16, I need a weekly ultrasound and titer level check if I don't have an amniocentesis. If I have an amnio, they can check the baby's blood type, and if the baby doesn't have the Fya antigen (protein), then NO more monitoring is needed. It wouldn't matter what my titer levels were if the baby doesn't have that type of blood. If I had the amnio and the baby did have that protein, we'd be back to the weekly ultrasound and bloodwork. He said if the baby starts to show signs of anemia, they would give the baby a transfusion through my belly button to the baby's umbilical cord. He said based on the location of the placenta it wouldn't be an easy task. I asked what the risk was for an amnio, and he said there's 1 chance in 500 that it will cause a miscarriage. I was okay with that number, but in talking to Paul this evening, he said he doesn't want me to have it done. So I'm really praying that the titer level is low enough that I don't need weekly monitoring because they only come up to my OB's office every other week. I was at the MFM office for 2 hours and 20 minutes, but including driving time I was gone for 5 hours and 45 minutes for an ultrasound.

The differences I noticed between this clinic and the MFM clinic I went to for Nadia and Ian (which is much closer but our current insurance doesn't work with that hosptial) were as follows: the other clinic was much more efficient - a visit didn't take anywhere near 2+ hours, the other clinic weighed me, took my blood pressure, etc. (this one didn't do any of that), the other clinic had me meet with a genetic counselor (or something like that) at first who went through all the odds of the baby having Down's etc based on my age (I was very happy to skip that speech this time!), and this clinic gave me a complimentary DVD (I never received one of those in my previous pregnancies). If I had my ultrasound at the OB office (by this MFM clinic) as scheduled in 2 weeks, I wouldn't have gotten a DVD. At least there was one perk for having driven to Harrisburg, although if I had the choice I would have skipped the DVD in favor of far less driving time. They scheduled me to have ultrasounds at the OB's office at 20w and 22w. If the titer level is high, I think I'm going to ask if monitoring every other week would suffice at least until the end of June. He said usually a transfusion isn't necessary in the 2nd trimester. As of July 1 we'll be on the other insurance, and then I could switch back to the other MFM clinic if weekly monitoring is truly necessary.

I always am excited and nervous about this ultrasound. I know they can detect certain problems through this ultrasound. It's always a big relief when they say everything looks fine, especially since I'm 40 years old. I'm glad we know the gender of the baby. I had thought if I knew the FET was going to work, then my first choice would be to have this baby be a boy (because he'd be closer in age to Ian) and the fourth child be a girl. I also thought that if I knew this was our last baby, my first choice would be for this baby to be a girl because Nadia really wants a sister and I love baby girl clothing. When I told Nadia the news that she's getting another brother, she was NOT happy. She looked like she might cry or have a tantrum. I hope it doesn't lessen her excitement over the pregnancy, after she gets over the initial disappoinment of finding out her prayers for a sister weren't answered the way she wanted them to be. I told her we might have one more baby in a couple of years, and maybe that baby will be a sister, but that didn't cheer her up at all. Ian is oblivious now, but I think in a couple of years he will have fun with his baby brother. Sometimes Ian tries to play rough house with Nadia, and she doesn't really go for that. The two brothers can tackle each other and such. We only had a girl's name picked out. I don't like Paul's two favorite names (Gordon and Newton). I told him tonight that a boy's name would be the perfect Mother's Day gift for me this year. I love to refer to the baby by name while he's in the womb. At least now I can call him my son instead of just "baby." All through the ultrasound I kept silently offering thanks to the Lord for this miracle. It's just so amazing. I still say the sound of a baby's heartbeat in your womb is just one of the most beautiful sounds on the planet.

It's past my bedtime so I need to wrap this up (I had to leave for choir rehearsal shortly after I got home from the appointment), but I wanted to say that I emailed my department chair yesterday to tell him I was pregnant. I was excited to tell him the first two times, and I told him very early on both of those times. I had been dreading it this time. I actually was rather nervous about it. I emailed him on Tuesday shortly before I went to teach my 5pm class. He wrote back this morning and told me congratulations and that he had forwarded my email to the Dean. I feel a big sense of relief that thus far I am not being given any grief. Whew.

Antibodies are Rising

People must not realize that at least some (if not all) pregnant woman (including myself) want to look pregnant. I feel like I might scream the next time someone tells me (especially considering I'm about half-way through the pregnancy), "you don't even look pregnant." I said something to Paul this weekend about that comment, and he said, "I thought you'd consider that a compliment." Yes, it's true if someone isn't pregnant, they don't want to look pregnant (Nadia asked a lady at the feeding clinic if she was going to have a baby, and when the lady said "no" then Nadia asked "then why is your belly big?". I was dying of embarassment. Thankfully the lady handled it very well). Anyhow I want to look pregnant when I am pregnant. I know from experience I'm not one of those ladies who looks like she has a basketball under her shirt when she's pregnant. I thought it would be obvious a little earlier since this is the third time I've made it this far in a pregnancy, but I guess not. I definitely feel pregnant, especially by how the smallest tasks seem to knock the wind out of me.

As glad as I am to be at home, Nadia is really missing the RMH. She keeps asking me when we're going back. I'm glad it was a positive experience for her, but I'm hoping to never need to stay at a RMH again (although it was a very lovely place). One evidence that they missed being home as well is that whenever Daddy is home, they want HIM to do everything (brush their teeth, get them ready for bed, etc.). I keep hearing "I want Daddy" over and over and over again. I get enough snuggling time with them while Daddy is at school that it doesn't bother me too much. The only thing I can think of that I am missing from our time in Hershey would be the tempurpedic mattresses. They were very comfortable! I am at the stage where it's hard to sleep at night due to being pregnant.

I checked out a book from the library about 10 days ago. After reading a little of it, I decided I needed to buy it. Paul always feels that way. He doesn't borrow books and doesn't give away books that he's bought after he's read them. I rarely buy books for myself, but when I do, I rarely keep them. I say that just to emphasize how very impressed I am with the book, Give Them Grace: Dazzling Your Kids with the Love of Jesus. I believe I'll be reading and rereading this book in the years to come, and I've only read a couple of chapters thus far. I highly recommend it! The authors are Elyse Fitzpatrick and Jessica Thompson in case you're interested in reading it.

I don't like the way this OB office handles bloodwork results. They want you to call, and then they call you back. The problem is it's impossible for me to know when they'll have the results. It took more than a week to get the first titer results (in part because they lost the blood vials for 8 days), and it took one week for PSU to report Paul's results. Hershey faxed them the results on the very same day. I called yesterday to check on them as I figured Hershey was faster. Someone called me back at 5:30pm, but I was taking Ian to the bathroom, and I couldn't call back because the office was closed. I called back today. The nurse didn't want to give me the results at first because she said she didn't know anything about Anti Fya titer levels. I asked if she could just tell me the number (she wanted me to wait until my OB appt on May 9th). The number went from 8 (on March 20) to 42 (April 25). I have no idea what the critical level is as far as when an intrauterine transfusion is necessary. Shortly after I hung up with the nurse a midwife called me to say that she thought I needed to see a specialist asap.

She didn't think I should wait until May 17 to see the specialist. They will be at this clinic this Thursday, but they didn't have any openings. She asked if I was willing to drive to Harrisburg. I have an appointment tomorrow at 2:30. I wish I had thought of this 2 weeks ago when the OB suggested moving up the appointment. I would have saved myself a lot of driving if I had had this MFM appointment while we were in Hershey. Hindsight is 20/20. My in-laws offered to come up and watch the kids tomorrow as this clinic doesn't allow children under the age of 12 in the room during an ultrasound. The upside is that I'll get to learn TOMORROW if baby is a girl or a boy! This means I'll know before the big yard sales on Saturday!! The midwife said I'll need bloodwork and an ultrasound (with MFM) every 4 weeks for the rest of the pregnancy due to the titer levels rising. The Anti-Kell level fell to zero, but we already knew (based on Paul's blood type) that wasn't an issue. It's just the Duffy antigen (Fya) that's the problem. Please keep praying our little one won't develop fetal anemia!