Yesterday morning I woke with a poem on the brain.  And wanted to share it.

Suddenly Fall

The signs are small
In the land of sun.
Morning’s chill wind,
Fog’s shattered tears,
The angle of shadows.

Here, from my window
That does not open,
I see only the sun
Rising and setting.
As if the universe goes on.

Inside this room
My body heals
And my mind stalks my soul
Demanding why? why? why?

Ripped from me too soon
Was the sun.
Placed into a world of air
Where he flickered and dimmed
Unable to accept the wind.

Yet outside the seasons turned
Without my knowing.
Till finally I walked outside
Into the cold slap of Fall.
Alone.

(For my son William, born September 28, 2009 by emergency c-section, and died a few hours later due to under-development of the lungs.)

©2012 Norwitz Notions. All Rights Reserved.

This will be my last pregnancy update.

I was 36 weeks pregnant on Saturday, September 26, 2009.  40 weeks is the “due date” and 37 weeks is considered “full term.”  But 36 weeks is considered safe and close enough to full term.  It is the minimum gestation to have a home birth, which is what I was planning.

The pregnancy was very very hard on me with lots of fatigue and discomfort, but was going quite well from all other ways of looking at it.  The baby was growing at just the right rate.  He moved a lot and his heartbeat was always perfect.  I had an ultrasound at 20 weeks which showed he was a boy and that everything looked normal. My blood pressure was 110/60 or a bit less every time.  My last midwife appt was Wednesday before this all happened and my blood pressure was normal, along with everything else.

On Sunday, he only kicked and moved twice, at 11am and 6pm, no matter how much I poked and prodded.  And each of those times it was weak and short-lived.  When his position dropped a week and a half earlier (normal pre-birth occurrence), his movement also decreased but he checked out fine and started kicking at normal levels shortly afterward.  So I kept telling myself it was nothing.

Sunday night was the start of Yom Kippur services and we were at synagogue.  When services were over around 10pm, I went to one of the members who was a doctor and got her advice.  She said to call my midwife immediately.  I did and the midwife said to head directly to the ER.  The ER close to our house isn’t very home birth friendly and doesn’t have great OB services so we were going to go to my backup hospital way south of us.  But we already 10 mins north of our home and Michael was too tired to drive far, so we decided to go to Sutter Santa Rosa which our midwife often uses as a backup and where several doctor members of the synagogue happen to work.  The plan was to get monitored for an hour or two then go home.

We arrived about 11pm and were immediately sent up to labor and delivery and put on a monitor.  When I heard the perfect strong heartbeat I felt so relieved and thought that was it, we’d be sent home.  But the heartbeat was too perfect.  It’s supposed to go up and down with movement, only he didn’t move.

My blood pressure was high, in the 140′s to 160′s, with the bottom number in the 70′s I think (hard to remember) and there was protein in my urine.  I had had edema in my lower legs for ages.  Those three things together are not good though and I was diagnosed with pre-eclampsia.

They sent me for an ultrasound.  They do a rating out of 8 points.  He got a 2.  The heartbeat was strong but there was nothing but tiny movements and the blood flow through the cord was impaired.  One of his lungs was collapsed and they didn’t know why.  They told us he was better off outside of me than inside.  They thought his brain was probably not affected at this point and that he would probably be okay, though he’d need some intervention.  A c-section was the only possible choice.

They waited until my midwife Claudette arrived (once in the hospital she became my doula).  I am very anti-c-section except for medical emergencies but I knew this was the only option.  I chose my midwife precisely  because she does not follow mainstream thinking and has the skills and experience to safely help women choose to avoid interventions they are sometimes pushed into.  She told me to have the c-section.

I spoke with the surgeon and the anesthesiologist about my chemical sensitivities and drug reactions and they were very accommodating and worked with me well.  I was still scared to death and crying. But I would do anything to save my baby’s life and this seemed to be it.

At 2am they took me to the operating room.  The surgery was just awful.  No pain or anything but it felt just horrible all around. It was an emergency but not the full-out get the baby out right away kind so I had a spinal vs general anesthesia and they were able to take their time so my internal organs didn’t get too messed up.  Claudette held my hand the whole time and Michael stayed with Miriam in the room where she was sleeping on a mattress the staff set up.

William Gabriel Norwitz was born at 2:54am.

They wouldn’t let me see him.  I had almost no updates.  They had a team of doctors working on him.  He didn’t cry.  They intubated him but it took 3 tries.  I had to stay there for another long long while (I’m guessing half an hour but it felt much longer) to be sewn up.

I went to the recovery room but still didn’t know how my son was.  I knew he had been intubated and was in the NICU and that he had a cleft lip.  Post-surgery, my blood pressure went up.  And up.  At first they weren’t too worried and gave me meds.  But my pressure was more than 200/100 (dipping down to the 170′s or 180′s as well) for a couple of hours after several doses of a couple different meds.  I could tell how freaked out everyone was.  I knew I was in danger of a stroke or seizure or death.  I didn’t care.

They let Michael go see William and told him he was “probably not going to make it.”  I was shocked when I heard this.  I was worried about brain damage but thought he would survive.  We woke Miriam up.  A few minutes later, Michael and Miriam went to see him and Michael asked for some hard numbers.  What are his chances?  He was told “zero.”

I told them over and over again, do not let my son die before I can see him.  It took a very long time but they finally brought him into my room in an incubator.  I couldn’t move my lower body yet and could only reach his hand to hold it.  He looked so unhappy and uncomfortable.  I told them I wanted to hold him.  Our Rabbi was on her way and they were afraid of transferring him before she arrived.  I kept insisting but logistics kept it from happening.

When the Rabbi arrived it still took a while but they did give him to me.  I opened my gown and placed him skin to skin on my chest and arm, then we put a blanket over both of us.  He had the ventilator breathing for him and his eyes were gooey so I’m not sure he could see anything (I still don’t know what color his eyes were).  But he was awake.  Once on me he relaxed and seemed much more comfortable.

I held him for about half an hour while the Rabbi performed a naming ceremony for him.  Gabriel is his Hebrew name.  Michael held him for a little bit as well.  Miriam chose to stay in the room at times and to go out with Claudette at other times.  We gave her many chances to decide what she wanted to do.  She understood her brother was going to die and was very very upset about it.

This entire time was when my blood pressure was through the roof.  I had been getting over a cold and the crying and stress filled my sinuses and nose so I couldn’t breathe at all except through my mouth.  And then my throat started to swell up and I had trouble breathing.  I asked for oxygen and they said my sats (O2 saturation) were fine but I said give it to me anyway and they did.  It helped slightly.  The BP stuff didn’t scare me because I didn’t care at that point.  But my throat swelling did.  I did not want to not be able to say goodbye to my son.  The staff monitored me closely of course but they thought it was stress.

I did not find out until Thursday that my surgeon had given me an antibiotic during surgery that was a “cousin” to penicillin.  (I didn’t quite catch the name but it sounded like Ciprosporin.)  I told him about the throat swelling and how that is the reaction I got to amoxicillin (penicillin family) and his eyes got real big.  He said that was anaphylaxis and that I needed to add that class of antibiotics to the list of ones I couldn’t have.

When the 3 of us had said our goodbyes, we asked them to remove the ventilator.  They said we could have kept it in longer but we didn’t want William to suffer anymore and we knew there was no hope at all he would survive.  His lungs were hard and wouldn’t not inflate properly even though they were putting through pressures that were much higher than any newborn would get.  And his cord blood pH was so low that no baby ever survived it.  And the placenta was small with poor blood flow.

The neonatologist said he might live and gasp for a couple of hours, but he went in just 10 minutes.  Peacefully on my chest, in my arms.  He died with his little thumb in his mouth.  William died around 6:30am, after only 3 1/2 hours of life.

I held him for another hour or so.  My breathing improved and my blood pressure went down to insanely high but out of the danger zone (they’d cheer when it got down into the 170′s).  Michael held his body then and Claudette did briefly as well.  Miriam said goodbye but chose not to touch him.  Then they took him away and began the transfer to send me to my hospital room.

Although my doctors were still from Labor and Delivery, they put me one floor down, in Cardiac & Telemetry, in a private room.  Losing a baby is a rare occurrence in that hospital and they treated me with the utmost respect.  For my entire stay, every single person, from my nurses to the dietitian, was told what happened before meeting me.  Claudette had brought my birth plan (which had my chemical and medication restrictions listed) and my door sign, which they put up (asking perfumed people not to enter).  They also put a sign on the Purell dispenser outside my room asking people not to use before entering.

They took some care to get me unscented nurses though we had some laundry product issues.  Other staff with scent stayed away or worked with me by phone.  And the next morning Michael brought some safe liquid soap that staff used instead of the sink soap dispenser. With the door closed and the air conditioner on (the window didn’t open) my room wasn’t too bad.

I left for home Thursday late afternoon.  It’s been a difficult recovery, with lots of physical pain and a lot of work to find pain meds I tolerated that worked.  My blood pressure is still not normal but is mostly in the 140′s and 150′s now.  They gave me meds when it spiked to 161 and I spent the night feeling like half my head had been sawed off (this while being on heavy narcotics) so I know now that the recovery room migraine was caused by Labetalol (as opposed to any of the 100 other things it could have been caused by).  And I know I tolerate Toperol (anti-inflammatory) and Dilaudid (narcotic). My incision is healing well but I have welts and blisters and severe itching from the bandage adhesive.

My synagogue, Congregation Ner Shalom, was amazing and, between them and friends and family, I  had visitors and phone calls nearly around the clock, which comforted me to no end.  Being alone were the worst times, especially night and early morning. Although we had to delay the burial, we counted it as sitting Shiva.

As of Saturday afternoon.  I can get out of bed by myself (that feat took several days), use the computer, use the toilet, and stand for brief periods of time (a minute, maybe two).  I took a shower in the hospital which wiped me out and caused terrible pain.  I took one at home yesterday but needed much help with it.  Today I used a borrowed shower seat and was 95% independent.  I am eating and drinking normally.

We will meet with the neonatologist in a couple of weeks when all the test results are in.  They are waiting on some pathology slides and a chromosomal report.  But the diagnosis so far is pulmonary hypoplasia.  Or severe underdevelopment of the lungs, which were 1/10th the size they should have been.  This condition is usually secondary to other issues but, in this case, they think it is caused by a random genetic disorder, which also caused the other birth defects, and led to the failing placenta which led to my pre-eclampsia.  They say it is not related to my age or health but can happen to anyone, though it is rare.

The funeral was yesterday.  It was brutal but I needed to see him buried.  The cemetery is walking distance from our house with trees and grass.

That’s about all I have in me for now.  Thank you again to all who have visited, called, emailed, prayed, or otherwise supported us through this.  It means more than I can say.

William Gabriel Norwitz
Born and died September 28, 2009
10th of Tishrei, 5770

Goodbye my sweet boy.

©2012 Norwitz Notions. All Rights Reserved.

Miriam kisses her brother (22 weeks)

I had something similar during the second trimester when I was pregnant with Miriam, but this is worse.  And I’m well into the third trimester now.  Two huge increases/additions to my thyroid meds have helped, and so has being diligent about taking my supplements.  July was also a busy month, with preparations starting long before.  My brother Mike got married!  We took a trip to Los Angeles.  I helped plan the 2009 Festival of Fruit.  And California went through several heat waves.

Miriam as a flower girl at her Uncle Mike's wedding 7/19/09

So here I am, 31 weeks (7 months) into this pregnancy, and starting to feel a bit better.  Some news:  It’s a boy!!  We had an ultrasound at 20 weeks and the little sweetie was mooning us.  Even Miriam could tell his sex.  All the other measurements came out perfect too.

And, yes, we have a name picked out.  The first name comes from Michael’s family and the middle name/Hebrew name is just a name I’ve been drawn to for a long time, for unknown reasons.  We’ll announce them after he’s born.

So far, I’ve gained 20 lbs and have been craving fresh vegetables, fresh fruit, fish, and pickles (fermented/pickled anything really).  Miriam is still nursing, though usually not very much.  The house is a disaster because I haven’t been able to do any sorting and organizing like I was in the first trimester.  The plan is to get it all done before the birth (sure…).

Things are going well with our midwife and we’re still working towards a home birth with a hot tub in the living room.  I am getting backup care with the midwifery group that works at the hospital where Miriam was born.  And of course I’m getting endocrinological monitoring through-out.

Cyndi at 28 weeks

©2012 Norwitz Notions. All Rights Reserved.

Cyndi at 19 weeks (with Melanie in the background)

Things are going pretty well.  At 17 weeks I saw my wonderful family doctor for the last time (she’s switching to another practice, far away and doesn’t take my insurance).  I told her I was taking her up on her ultrasound offer.  I couldn’t stand it anymore, tell me how many babies are inside me!

Hooray! the answer is one.  One baby and one humongous placenta (which she said could very well account for why my uterus measures 3-4 weeks bigger than it should.  This was a low-level ultrasound with a dinky little screen so forget about finding out gender or anything else, aside from seeing that the heart was beating and the placenta was not over the cervix (very good).  We also saw little arms and legs kicking away.  We’ll have the full hospital clinic ultrasound next month.

I had mixed feelings about the idea of twins.  This is almost certainly my last pregnancy and so it’s my only chance to have 3 children.  But, really, all I felt was relief when I found out there was just one.  Much easier pregnancy and birth and not as difficult to take care of one baby as it is two.  Michael was freaking at the very idea of twins, so to say he’s relieved is an understatement.  Miriam says she would have loved twins (like some close friends of hers) but she wanted a boy and a girl.

I still get tired a lot but don’t have many full-out fatigue episodes.  I’m not able to exercise regularly again yet but I can do some.  I’ve been getting some edema (water retention) in my lower legs but my blood pressure is totally normal.  I had a lot of edema (and normal BP) with Miriam too. I’ve gained 5 lbs so far.

Below is Miriam’s favorite position, especially in the morning.  She comes and finds me on the computer, nurses in my lap, then insists on being carried to the couch.  Though between my growing belly and her growing body, I can’t really carry her much anymore.  And nursing is hurting more and more, especially after I shower, so I don’t do much beyond her morning snuggle time.  She says I still have milk though (that will likely change).

Miriam's favorite position

©2012 Norwitz Notions. All Rights Reserved.

I carry big and have looked seriously pregnant for a long time.  I look about 5 months now, not barely 3 months.  But I’m far enough along that I love it.  Aside from the obvious, that was my favorite thing about being pregnant last time: I actually look thinner.  I’m an “apple” so I have a ton of excess weight in my gut but, when I’m pregnant, it blends with the baby bump and all looks like part of the same thing.  I don’t look skinny or anything but I do look like I’ve dropped a couple of dress sizes.

Cyndi at 14 weeks

I chose a midwife and have seen her twice now as we plan for a home birth.  The only negative is she isn’t very scent-free, though she’s been trying.  I can’t be in her house at all because of new carpet and fragrances.  Fortunately, she lives in the same town as me and is willing to do the visits at my house, which I greatly appreciate.

She was here at 11 weeks and used the Doppler to try to hear the baby’s heartbeat and no luck.  But she heard “placental circulation” which was good enough for me.  Plus a couple days before that I saw my MD who did a quickie internal exam and said my uterus was big like it should be.

When the midwife was here last week (normally early visits are a month apart but we started late and she wanted to give me a chance early on to hear the heart) we did the Doppler again and got a heartbeat, which was really cool, though not a surprise   I got Michael on speaker phone and he was able to hear it too.

My uterus is measuring big (as it did a couple weeks ago).  About a centimeter higher than it “should” be.  With my last pregnancy I was carrying so big I was sure I must have twins but my uterus measurements were always dead on.  This time I’m even bigger (despite weighing slightly less) and my uterus is actually “too big.”  Coupled with the higher than average HCG doubling blood tests, the midwife confirmed my suspicion that this means an increased chance for twins.  I really had to push her though because she didn’t want to quantify it.  Finally I said, okay is my chance of having twins 25%, 50%, or 75%?  She said 25%.

This is my last pregnancy almost certainly so having twins would be great because it means I can have 3 kids.  But overall, neither Michael or I really want twins.  We have friends with them and, while they’re both amazing kids and they play with each other and all, we’ve seen first hand just how much work it is.  And they have 2 parents who work at home and no other child.  The very idea of twins freaks Michael out.  I would be okay either way I think but I’m still hoping for just one.  At least if it is twins I don’t have to worry about the birth.  My midwife will still do a home birth with twins, as long as they’re at least 36 weeks.  [As a side note, no you can't really tell from the heartbeat how many there are, not at this gestational age anyway.]

So far everything looks good.  I have a lot of sudden-onset bouts of tiredness, as well as milder longer ones, and haven’t been able to exercise for a while, but overall I’m decent (you know, the usual stuff).  My lower back and hips have been hating me for a while now and I have to be careful how I sleep.  I can’t be on my stomach anymore (I don’t sleep like that; I mean for anything) and being on my back is starting to get unpleasant (not from cutting off circulation, just uncomfortable).  Wish I could get weekly bodywork.

Miriam has just been thrilled and talks to the baby (“does it have ears yet?”) and kisses my belly regularly.  At 11 weeks, the midwife gave her a plastic doll that is the size and proportions of a 12 week fetus.  She played with it, pretending to carry it in her tummy.  I told her a bit what birth was like (contractions then pushing the baby out) and she loves to emulate the experience. I explained that the pushing was kind of like a difficult poop.  Michael chimed in with “but the poop is THIS BIG” and oh did Miriam’s eyes get wide.

She’s now decided she wants to be a midwife and she is going to deliver the baby herself (“me and you mommy”).  Though she agrees the actual midwife can be there too.  Michael said, you know, when the baby comes out it’s covered in blood and goo and stuff.  Miriam answered “that’s okay, I’ll wear short sleeves.”  She’s also requested birth videos.  The ones the midwife lent us either didn’t show the birth (personal DVD) or were scratched.  So we’ll be looking around (can’t do online video well on this computer).

It’s going to be an interesting ride…

©2012 Norwitz Notions. All Rights Reserved.

But then I was out of the habit of making regular posts.  It’s not for lack of material; I’ve got info for a good dozen posts, at least.  Just my own rhythms.

To get things going again, here’s an update.  This is what I look like now:

Cyndi at 11 weeks, with Miriam

What do I look…4? 5? months pregnant in that photo?  Actually, that’s all belly.  There is a baby but it’s neatly tucked away out of sight.  I’m an “apple” to begin with and then you add first trimester stomach discomfort so wearing tight clothes (like jeans with a belt) or even holding in my stomach is intensely unpleasant.  Upshot: I carry big.  With Miriam it was like a mountain, and she came out less than 6 lbs.

I am currently 11 weeks along (that’s nearly 3 months for you week-phobic folks) and due shortly before Halloween.  And, yes, I just had a birthday and turned 45.  No, that’s not a typo.

Miriam couldn’t be happier.  When we first told her she got all giddy, hugged me tight, and kissed me on the lips.  She insists it’s going to be a little sister, but of course we haven’t any idea at this point.

Stay tuned for updates as we have them.

©2012 Norwitz Notions. All Rights Reserved.