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Internal (Medicine/Thoughts/Exams)

No baby yet.

I had a doctor appt. this morning with the Internal Medicine doc. I love her - I asked many nurses around the hospital who they would go to and she was always the one they said. She sits down, talks to me like a human being, shows me my chart and lab results, calls me by my first name, asks that I call her by hers and she kindly listens while remaining strong in her beliefs and recommendations.

I got a billion lab tests a few weeks ago and picked up those results today. It seems I am not doing so well with my cholesterol. My total cholesterol has climbed SIXTY POINTS in the last six months. Eek! Not so good. My Hemoglobin A1C is miraculously still under 6 (5.6), but that can't last with lipids the way they were. My triglycerides were still within normal range, but working towards the high side. I really can't add any statins (because of the liver damaging meds I am already on), so I have to do it with diet.

Speaking of...

I am FAT. (When I say it outloud, I say it just like that... "I am FAT"... with serious emphasis on the F-A-T.)

It is the most humiliating and depressing fact to admit I am fat again after a gastric bypass. I justify it with I am still 100 pounds down from where I started, but the reality is I am NINETY POUNDS higher than I was 3 years ago. This trend cannot continue because the gastric bypass was the Last Resort... and there is no other resort to vacation at besides that one.

Therefore, when I get home from New Orleans, I will be starting Opti-Fast - something I said I would never, ever, ever, ever do ever. But, I have got to de-tox from this sugar, Diet Coke, fake sugar, carb addiction shit I am living with and the only way I can see it is by going cold turkey on everything, including food. I will have a little time to consider it, but I think this might be the deal I need.

Believe me, I know all the arguments - it doesn't teach you to eat, etc. (I was going to write "blah blah blah," but reconsidered.) I know how to eat... the gastric bypass way - Protein First, No Snacking Between Meals, At Least 8 Eight Ounce Glasses a Day, and Exercising at Least 20-30 Minutes a Day. If I can do that, I can be healthy. laughing I'm sitting here thinking... if I can do it then, why can't I do it now? Because I need to be thinner first? Does that make sense? (Probably not.) Justification? (Probably.)

So, my liver panel was normal (yay!) - terrific considering all the meds I am on (mostly the fluconazole and acyclovir).

I'm just fat and eating like crapola. Sumpin's gotta change.

Okay, next!

I've gotten some really wonderful emails, phone calls and comments about my premonition post. Most feel I should 1. look at it and acknowledge it AND 2. circumvent it with information and changing what might have brought the vision on in the first place. Everyone has had really good things to say and they all helped tremendously.

An aside: I am PMS. Could have something to do with the incredibly vivid pictures I was seeing.

I went to her house again today to do an "NST" - sitting, listening to and charting FHTs for 10+ minutes, charting when the baby moved, having mom drink some juice to see how the baby reacted, charting what a contraction did to the heart tones... usual NST-type stuff. Talking with her, she shared that she feels she's been holding back some because of the memory of the pain from last time. We talked a lot about different fears and we all felt it was really productive. I felt SO much better after the talk, too, thinking perhaps they weren't all my issues that were coming up, but also hers.

She's had goodly contractions a couple of times - two to three hours at a time - bloody show and all - and then she would get scared and things would stop. If I didn't know the baby wasn't OA (more LOA than OA tonight) or know that she didn't have a pendulus belly, that is the type of labor it seems she is having. But, I will chalk it up to the fears and the baby not being quite ready yet.

I believe I am.

My apprentice went with me to help with the NST aspect and when mom wanted to be examined and stripped again, I asked if my apprentice might examine her also. She was more than happy to help educate her.

I talked my apprentice through the exam - letting her go first since I was going to strip the mom's membranes - and she had a fairly easy time of it. Much easier than my first 100 times doing a vaginal exam. She examines herself when pregnant (she's had several kidlets) and during labor, so she knew exactly what she was feeling for. Plus, it didn't hurt that the cervix was right inside the vagina, 4 centimeters open and 70% effaced. Also, that baby's head is so low! She was able to feel for the fontanelles and everything. I also talked her through pulling on the cervix slightly, fingers tucked under the lip of the cervix... she thought that was really cool, being so close to the baby's head and doing something (stripping) she never thought she'd do. But, mom really wants to have this baby, so we are helping to comply. She was 41.3 last night when we were there.

Before my apprentice did the exam, I talked her through examining the vulva in case we have to put it back together after the birth. (I really liked that one of the commenters said this because it isn't something I do often - see the vulva until very near birth - I thought I should make a point of doing this near the end of pregnancy instead.)

We talked about more induction options including acupuncture and castor oil. Last night, I said we could do castor oil today, but in the shower last night, I had a feeling acupuncture should come first, so I will call her today to suggest that instead.

Most people do 2 ounces of castor oil to induce, but I have had much better luck with 4 ounces and then 2 ounces three to four hours later if nothing is happening. The stuff is ghastly and I have a theory that the baby RUNS out of the vagina before the stuff hits the intestines because it is so awful.

My concoction for drinking castor oil: In a blender, put two scoops of frozen juice concentrate (something you never want to drink again), one scoop of vanilla ice cream, the castor oil and if the woman wants, a shot of vodka or rum or something. Blend furiously and slam it back as fast as you can. (20 years later, I can still taste that crap.)

I asked her if she'd like a soap suds enema instead. We don't use those as often as we used to back in the olden days. I loved them; they worked great. I'm not sure why we don't do those anymore. I'd take the 3 H enema (High, Hot and Hell of a Lot) over castor oil any day.

So, I started this piece last night - went to bed, had fevers all night long (with accompanying night sweats) - and here I am, 6am and still no baby. Not sure what this child is waiting for, but she does have a mind of her own, doesn't she. I continue not being impatient. We talked about another midwife taking over if I go, but I don't have this mom's records from the previous doc yet, so trying to go by any ultrasound that has a different date isn't going to happen until we have our hands on those. I might send her to the doctor today to go get them. Blessedly, she is very healthy and I know her history.

I leave for New Orleans in 3 more days.

Reader Comments (2)

I have you read Fat Doctor? She's honest--or blunt-- as you are about her weight. Has the same stresses and worries about it, too. I think you'd like her. She's survived two strokes, too.

I can't wait to hear about NoLa and your client's birth there. The trip I made last year to LA for a birth was precious. I _loved_ being there before and after in a way I usually don't get to do with clients.


Re: the Optifast.....NO! NO! NO!

If you want to detox and give your body a chance to heal itself from the addictions then something like the Hallelujah Diet is the way to go. You can lose lots of weight too, but it is healthy for you body, not just cosmetic. You can google Hallelujah Acres to find out more info. You don't need to buy any of their products (or follow their faith system) to do it. Although you might need to make some changes due to the gastric bypass issues.

I'm following it partially and my blood sugars have dropped, my insulin needs have been halved and when I go in for labs next month I'm expecting my cholesterol & A1C to be way down. And I just feel normal (the emotional, physical, and mental fog has lifted). I can actually jog now and before
(a month or so ago I felt fatigued just walking to the corner). I decided that my life and being here for my children is more important than any particular food I could enjoy for a few seconds (then suffer with long term).

I've been enjoying carrot juice (I didn't think I'd like it but it is delish!), green banana smoothies (I add about 1/2 tsp dried barley for the perfect flavor/color--the bananas are ripe, not green) and lots of fruits and salads.

We just got our first of the season CSA ( community supported agriculture) box of veggies...yummmy and I'm eagerly awaiting strawberry season...

June 10, 2006 | Unregistered CommenterAnonymous

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