All About Babies, Part III Some More Things I Learned

Continued:

• Once a Cesarean doesn't mean always a Cesarean.

I feel there are two camps of moms-to-be. One group wants to have a Vaginal Birth After Cesarean because they didn't want surgery to get their baby out to being with. Another group enjoys the control and security that comes with a Cesarean. (There's a third group, a group that might want a VBAC but can't find a provider, but that is a whole separate issue. An issue of fear and malpractice insurance. :)

Whatever camp you fall into, it is clearer every day and with each new study that you don't have to have another Cesarean once you've had one. The risks of surgery are comparable to the risks of a VBAC, if you ask me.

The National Institutes of Health say that "...VBAC remains a safe alternative for the right candidates, and when those women try labor, between 60% and 80% of the time they do give birth vaginally...It urged that doctors offer mothers-to-be an unbiased look at the pros and cons, so they can decide for themselves...in 1980, government experts concluded that many mothers could safely deliver vaginally the next time, citing evidence that their risk of a uterine rupture was less than 1%."

One of my favorite bloggers, The Feminist Breeder, was featured in this article entitled Women Struggle to Avoid Repeat C-Sections: "...many women don’t know they have the option of fighting against the knife for a VBAC. Only about 11 percent of women in the United States had VBACs in 2003, down from about 28 percent in 1996, according to the National Center for Health Statistics."


But the illusion of being in control is powerful: " 'Our practice always offers the option [of repeat elective C-sections], and a lot of women choose to have another one,” she said. 'They like the idea that it’s scheduled. They go in and know what’s happening, avoiding any chance of an emergency'...C-sections have become such a common practice that 90 percent of women who give birth that way once will do so again, according to the Illinois Department of Public Health."

• There are risks to C-sections.

Risks for the mom with a c-section include: Infection of the bladder or uterus, injury to the urinary tract, and injury to the baby. For future pregnancies: Placenta previa, placenta growing into the muscle of the uterus and has trouble separating after the baby is born (placenta accreta), and uterine rupture. The New York Times article I pulled information from makes sure to say that the surgery is safe before it lists all the complications. :)

At least WebMD also specifies that c-sections are "major surgery". They also list a few more complications than the New York Times article: heavy blood loss, blood clots, nausea, vomiting, headache, bowel problems (!), oh, and rarely maternal death. Of course risks increase with each subsequent c-section.


There are potential risks for c-section children. Sections are being linked to obesity, possibly genetic issues, not to mention asthma because they didn't get their lungs squished through a birth canal. More interventions do not mean healthier children.

My takeaway is that a) elective repeat c-sections are definitely not 'safer' than VBACs and b) c-sections are major surgery. In every other discipline, great care is taken to be LESS invasive and avoid major surgery if possible. But with obstetrics, now we can just go cutting up the abdomen because the date works for everyone?

• It's NOT just about having a healthy baby.

It's about the whole experience. I keep hearing the refrain "but all that matters is a healthy baby", which translates to me as "your emotions and memories of birth really don't matter. Move on, be thankful, get over it." It's easier said than done, I suppose. There are some who believe that it's harder to bond with a c-section baby and to breast feed them successfully. Here is a link to The Feminist Breeder's 'lovely' c-section experience (here's the whole story). Also read the posted comments to hear other moms who wish it had happened differently. Here is a link to Q&A with an artist who had two Cesareans, one against her will! This is indeed how I felt:

Skeptical OB (Amy Tuteur) has a 'lovely' post about how this sort of thinking is just plain selfish. Labor and birth are all about a healthy baby, she says, no matter how you get there. She uses a horrible comparison--what if you had a wonderful vaginal delivery but your baby was dead? Would you be so happy that you had the birth of your dreams?!

Well, my husband pointed out to me that this is a logical fallacy. It's assuming that you can have one (lovely birth) OR a healthy, living baby. That's not true. What moms mourn is, I suppose, the whole package.

Despite Dr. Amy's opinion, I have to say that I don't think it's that simple. As my mom-in-law put it after my Cesarean, "Nicky, you were cut open. You need to take it easy." And that's how it felt. I wouldn't look down there, wouldn't touch my scar, wouldn't let my husband touch the scar all because it was a reminder of a cold room, helplessness, and someone cutting my baby out.

Well, those are some of the things I learned.

All About Babies, Part III Some Things I Learned

After my son's mostly wonderful birth followed closely by my daughter's not so great birth, I started reading more about the whole process. I am in a unique position to be able to compare the two and it's hard not to.

I haven't mentioned it anywhere else on this blog, but I'm a librarian. Already a slut for information, working as a librarian has just made me feel professionally obligated to seek it out and gleefully sort through it. Like a kid in a candy store! Except with facts and studies and....well, okay, I'm a really boring person.

I think that seeking out information about birth, labor, and how obstetrician's practice these days was/is a way for me to process my experiences and understand them. So this post is hopefully going to summarize some of the things I learned that made a difference to me and shaped what I want for myself in subsequent pregnancies, if we are blessed with them. I tried really hard to reference everything so you can see that I'm not a lunatic and research for yourself.

I also know that birth is really personal. However it might seem to you, I do not know your circumstances or the choices that you or your doctors made. What I believe is that we need to inform ourselves. We need to understand what is happening in pregnancy, labor, and delivery and we need to know what questions to ask to avoid unnecessary surgery. We need to be confident and less fearful of birth. 


Without further ado, here are the things I have learned:

• Sometimes c-sections are being done because they're the best thing for everyone. 

Sometimes everything goes wrong, even after the best efforts, and surgery is the only way out. I feel like it's important that you readers make the distinction with me between EMERGENCY situations and situations where everyone kind of gives up (or doesn't even attempt) vaginal birth. But how many Cesareans are actually necessary? That is the question.

For example, here is an article about a home birth family, in which the baby ultimately suffered because mom and dad a) had been previously traumatized by a c-section and b) refused all medical interventions upon arriving at a hospital. I think if the baby's heart rate is decelerating, it might be a good reason for a Cesarean.

• Sometimes c-sections are being done because it's the best thing for everyone else, i.e. your schedule, the hospital's bottom line, the OB's busy life...

When I was pregnant for the first time, I went to the first OB's office I found. My first appointment with her was nice. And then I started hearing all sorts of stories about how she was c-section happy. One woman was told her baby's heart rate was worrisome and rushed into surgery at 38 weeks. Her doula objected faintly that her strip (the strip of paper printing out baby's heart rate from the fetal monitor) was perfectly fine. Later she found out that the OB was going to go on vacation the following week. I switched to a practice that wasn't so OR-friendly.

But that's not okay. I think moms and doctors need to take a step back from putting our own schedules ahead of a physiological process, because it sure seems like circumventing that process hasn't done us any favors.

Ricki Lake's documentary The Business of Being Born talks about the 'conveyer belt' mentality in hospitals. You go to the hospital. You might be induced. If the induction doesn't work, then you get Pitocin. Because Pitocin is certifiably exhausting, you get an epidural. If the Pitocin doesn't kick-start things, you end up with a c-section because everyone is tired and eventually mom and baby start to show signs of duress. It doesn't take a genius to figure out that sometimes your body isn't ready to labor and then you're 'failing to progress'.

Some doctors are inducing women who are not physiologically ready to give birth so that they can get home on time, which is just plain bad medicine. Here's an article about cutting for convenience. In Pushed, doctors and nurses admitted that patients were induced all in one day just so the doctor on-call could try to get everything done in one day.

A woman I really admire, The Feminist Breeder, almost missed her VBAC because the hospital staff was tired of waiting for her to labor. The Doctor gave her the 'dead baby speech', but in this instance everything was actually fine and dandy. Feminist Breeder's husband was getting scared. He took the doc aside in the hallway and finally got the truth. The Doc admitted the baby's heart rate and the mom's heart rate/bp were fine and agreed to back off. THIS SHOULDN'T HAPPEN. If there's no concrete reason for surgery, it shouldn't be done. You should click on that particular link. I love that story. Anyway, the reason she got her VBAC is because she knew what was what. If baby had really been in distress, things might have ended differently.

• Some OBs use fear and crap reasoning to coerce women into getting c-sections. 

This article is about this very phenomenon. Some call this the 'dead baby card'. That's ultimately how I felt before my section. "Restricted growth! Low amniotic fluid! Breech baby!" In the end, I have good sources who tell me it was more about my OB not wanted to wait around for me to labor than any risk factors. I have heard lots of women say they got c-sections because their pelvis was too small, their baby was too big, or because they weren't progressing 'fast enough', Failure To Progress. From what I've read, it doesn't seem like these are always good reasons, they're more like excuses.

The link for 'small pelvis' includes a video full of women who were told that very thing and then proceeded to have babies out their 'too small' pelvis. Here's a link about what anti-intervention people call "Failure to Be Patient".

Then there are the out-and-out lies, like in the Feminist Breeder's VBAC story: “They kept trying to tell me that Julsies’ heartbeat was becoming [too fast]. Well, I knew what that was and I could see the fetal monitor and it wasn’t,” Crosley-Corcoran said. “To me, the most inappropriate behavior was the scare tactics.”


I have friends who have labored for hours and did discover they had a weirdo birth canal and had to have a c-section. By the same token, I have read story after story about women who were told their pelvis was small or their babies were big and would never have a baby vaginally but then went on to have their babies vaginally. What does that mean? You don't know if X, Y, or Z is the really and truly the case until you've labored.

• Speaking of fear, we need to be less fearful of childbirth.

We are scaring ourselves out of a positive birth experience. The End. Seriously, there is physiological evidence that the more anxious and fearful you get in labor, the more labor is inhibited. Then you get drugs and then maybe a c-section. The current medical climate isn't solely to blame for the insane rise in c-sections.

• Some OBs are terrified (with good reason) of being sued. 

The reason for all these c-sections? Doctors and hospitals get sued if they don't do c-sections fast enough these days. It looks like they've done 'everything' they could if they do a c-section. Here is an article about how there are actually fewer OBs because less people are willing to deal with the lawsuits and malpractice insurance, etc. etc. Dr. Amy Tuteur (a stanch opponent of home birth) posted about a lawsuit (Homebirth Ends Brain Damage, Parents Win 55 Million...From the Hospital) in which, after a failed homebirth, the hospital who tried to save the baby was successfully sued. WTF?

• Most OBs are less skilled at delivering babies and are more skilled at cutting.

Breech vaginal deliveries, twin deliveries, and all sorts of non-vertex positioned babies are routinely scheduled for c-sections. Part of the reason is because (besides being terrified of lawsuits) doctors don't know how to deliver these types of babies anymore. There are only two doctors in my town that will attend a vaginal breech delivery.

PubMed has an article entitled To Rescue A Vanishing Obstetric Skill--Vaginal Breech Delivery that explains this phenomenon. Another blogger at The Obstetrician's Lament has a post about this as well. A similar article, Vaginal Delivery of Vertex-Nonvertex Twins, discusses how nowadays instead of even attempting a twin birth, twin pregnancies are automatic c-sections.

Yes, some deliveries are higher risk. But I think that when we hear the phrase 'high-risk' we assume that 60% of vaginal breech babies WILL DIE, for example. Breech babies "Perinatal mortality is increased 2- to 4-fold with breech presentation, regardless of the mode of delivery. Deaths are most often associated with malformations, prematurity, and intrauterine fetal demise." So breech babies are at a higher risk for having something wrong with them already, regardless of the mode of delivery.

In Pregnancy Outcomes by Mode of Delivery Among Breech Births, the authors write that between women who had a vaginal breech birth and a c-section: "Neonatal complications did not differ between the group of women with term babies" and that "Vaginal delivery of 1,000-1,500 g babies presenting as breech is associated with the increased neonatal mortality compared with cesarean delivery. [Um, because they already have something wrong with them...] Cesarean delivery is associated with maternal morbidity compared with the vaginal delivery." 


Did you catch that? Cesarean is riskier for the mom. Huh, I thought they were just sunshine and roses.

This is the End of Part I. It's getting super long. See my next post for the continuation.

All About Babies, Part II Dear Daughter's Birth Story

I finally have Internet access again! I contemplated posting a blog from my cell phone, but that was a last resort and I don't love blogging enough to endure the frustration of trying to type on a virtual keyboard.

In any case, still in my effort to reach the blog where I try to tackle my personal feelings about childbirth, here is my daughter's birth story.

In my last post about my son's birth, I hope it was pretty clear that everything went extremely well. With my daughter's pregnancy it seemed like everything went extremely awry.

During the whole pregnancy, we were trying to move, find a new house to buy, and figure out everything financially. Oh, and we were moving into my in-laws basement in the interim between an old house and a new one. One contract on our house fell through and we had to kind of move back into our home and try to sell it again. All that = STRESS.

At about ten weeks pregnant, I developed some sort of infection (B.V. for those of you in the know...) and I could either let it be and risk a pre-term labor or I could try to treat it. After about four days of using what they gave me for that, I experienced that heart-stopping moment when you think you might lose your baby.

At about eleven weeks pregnant, I had a pretty substantial sub-chorionic hemorrhage, or BLEEDING. As most of you know, that early in pregnancy the baby docs are pretty clueless and hands off. There's really nothing they can do and nothing you can do but wait and see. The options were miscarriage or not.

This didn't help alleviate any of my stress.

Thanks be to God, when we went in the day of the hemorrhage, our baby girl was still there. After the bleeding stopped--still there. On the ultrasound you could see the blood. The tech estimated that it was about a cup of blood, just hanging out in there waiting to be reabsorbed. Because I am an information seeker (and probably very annoying) I asked and asked what could have caused it. One of the possibilities was that a small part of the placenta had detached, but not the whole thing.

The middle parts of the pregnancy were okay. I was again diagnosed with slight anemia (again), I was dehydrated, dizzy, I had some weird bouts of puking. It wasn't great. My daughter was also breech.

Near the end of her pregnancy, she was still breech. Not only that but they were concerned that she was too small. I was not concerned about a) trying for a breech birth because I was a vaginal breech birth, it can be done, and b) her size.

My son was basically a healthy eight pounds and they had also sounded the alarm with him because my stomach didn't stick far enough out. I had two or three extra ultra sounds to confirm that he was in proportion and wasn't suffering from a growth restriction. And in the end....EIGHT POUNDS!? Forgive me for not worrying about my daughter's size either.

Because they thought she was approximately four, maybe five, pounds, we started doing non-stress tests. We tried external version to turn her, but that failed pretty promptly because she suffered decelerations in heart rate every time the doctor got down to business.

Then came the last scare of all--low amniotic fluid. The doctor finally sat down with us to say that her presentation, her size, and my low amniotic fluid had prompted him to recommend a Cesarean. It was terrifying and I wasn't sure what to think. One of my nurse midwives agreed with his recommendation. I didn't really speak with anyone else before the surgery to get their opinion.

Comparing the craziness and thrill of a vaginal birth with a Cesarean is like comparing a roller coaster to being kidnapped by a maniac. For me, anyway. One is fun, exciting, and a little scary. The other made me feel vulnerable, unsure, and helpless.

I met with the Nurse Anesthetist before the surgery and he was very calming. Once I got into the O.R., I was shocked. It was terribly cold and filled with strangers. I had one close friend there who was a nurse and my nurse midwife, but even they had to wear the surgical gowns and masks. Right up to the end, I was asking my nurse midwife if she thought this was a good idea, if I would be a candidate for a VBAC (Vaginal Birth After Cesarean), etc.

I had a brief moment of panic when they put the mask over my face. It made me feel claustrophobic and I reached over to move it away. The Anesthesiologist gave me a patronizing glance and without a word, put it over my face again. It wasn't the worst thing in the world, it was just bad timing. I was already freaking out and it was just made worse. I said my peace and the mask was finally removed.

Sometime during or after the surgery, my midwife told me that my uterus was "beautiful". But now it had a massive scar on it?! Could I ever again rely on that uterus?

My daughter was pulled from me and appeared to be just fine. She was also two weeks early and a strong six pounds, ten ounces. Too small, my ass. Next time I'm pregnant and there are concerns about size, I am going to flip my shit. It's not worth worrying about.

After the surgery, I was nauseous and puked and so they gave me more drugs. I was stuck in bed with three or four different machines on me plus those damn compression socks. I argued with our nurses all the time. I was frustrated and unfamiliar with the whole surgery process.

Let me just remind you, after a vaginal birth you can go do aerobics for all they care. You're fine. You are not a floppy piece of woman to be poked, prodded, and continually drugged up.


When I finally went home, I was bloated, distended, and in pain. I couldn't pick up my toddler and every time I looked down I was reminded of my mutilation. This is what it seemed like to me. I didn't want a c-section, but I did it because I thought it was best for my daughter.

For whatever reason, the aftermath the surgery combined with some predispositions in me equalled crazy IBS and newly developing thyroid problems. I wasn't able to really enjoy my new daughter because I was totally distracted by my body rebelling.

I talked with a friend later who knew one of my other midwives. I guess this particular midwife (whom I did not speak with the day before my surgery was scheduled) was totally on board with me getting an induction and a trial of labor. She was also of the opinion that I wasn't low on amniotic fluid at all. This enraged me. I thought at the time that there was a consensus of medical opinion that a c-section was best for me.

My DH is very reassuring about all this. I will never know what would have happened if I had labored. Maybe she wasn't strong enough to withstand labor. Simply, we believe God does have a plan that is for the greater glory. Even though I wish it hadn't happened that way, somehow it will all work out for the best. And yes, I am very grateful that I have a daughter who is here and mostly healthy and mostly happy. :)

This is the way it happened. It's done, it's in the past, and it's definitely time to move on.

All About Babies, Part I Dear Son's Birth Story

I have been posting a lot on Facebook about birth in our world today. It's a seriously sensitive topic! I posted this article about apparent Systemic Failures in American Maternity Care without even noticing the comments afterwards. But then I read on and on and on....after the article, there is a heated debate in the comments section between a former OB who is staunchly against home birth and other women who are for less 'medicalized' hospital births.

In any case, I think that a) my daughter's birth is intricately tied into my weird postpartum health problems and b) it might be worth telling my birth stories to explain how I ended up where I did with my views on childbirth. Here goes.

With my DS, everything went as according to plan as it possibly could. The only problem was that later in the pregnancy, they were concerned I wasn't measuring big enough. I got extra ultrasounds as a bonus and they couldn't point to any major growth restrictions or disproportions.

My water broke at 3 a.m. on August 24th, 2008 and then there was that dreaded 'plug' business. (Let me just interject that my husband works with other people's mucous all day but when it came to this stuff, he couldn't stomach it! Pansy.)

I woke up my husband right away and we just walked around together. It wasn't until I started puking and needing the toilet simultaneously that we decided to go to the hospital. We could have waited longer.

Triage at the hospital was just annoying. I knew I was in labor, irrefutably. But it's not really labor until a stranger with the tools of the trade tells you so.

In our room, I was welcomed by a nurse who, while otherwise nice, would NOT get off of my back about laying down and getting drugs. She eventually just resorted to the same annoying phrase: "You'll eventually want to...." Fill in the blank with whatever she wanted me to do.

I spent the next few hours walking in our room and meditating on a medicine ball, which I adored. 

After who knows how many hours, my nurse midwife came in and asked if I wanted her to break the rest of my 'waters'. Because I was impatient, I said, "Yes." In retrospect, I definitely would have waited. It's like a children's story. Because she broke my water, then the contractions got tough. Because the contractions were tough, Nicky got tired. Because Nicky was tired, Nicky caved to the aforementioned-and-refused medication. Because she got some weird med, Nicky got dizzy. Because Nicky was dizzy, Nicky couldn't stand up. Because Nicky couldn't stand up, Nicky didn't progress. You get the picture. :)

The next time my midwife checked things out, I wasn't dilated as much as she was hoping. She was suggesting we try Pitocin, which I really didn't want. Because Pitocin can be horrible, she suggested we get an epidural first. I did. It was lovely. I slept. Despite having a "window of pain", I slept. On my left side, down into my leg, I could feel the contractions. I could still feel my legs. I think this was probably a blessing.

While I was sleeping, I relaxed and everything else relaxed and I dilated to a 10.

Me, before the epidural:

Almost 16 hours after my water broke, it was time to push. This part was the most frustrating to me because there was a bowling ball stuck in my nethers and I didn't really try to push because everyone was so encouraging. Their encouragement led me to believe that my son's head was just about to fall out! Surely I didn't need to try that hard! After some crazy acrobatics (here's where I'm grateful the epidural wasn't total) and two hours of pushing later:

Someone handed me my babe. Even though I'd paid lip service to the idea of skin contact right after birth, I was a little out of it and he was slimy. And purpley. So I sent him to get bathed. :) The first thing I asked for after he was born? A Coke.

My DS was 7 lbs, 15 ounces.

In Dedication to My Darling Daughter

So, my Facebook friends know that this week has been interesting. I'm going to tell the whole story here on my blog because this is what has consumed my week and because it does concern health issues. It's just I'm not the Guinea Pig, it's my Dear Daughter.

Two weeks ago Dear Daughter told us that her "ear hurt", so we took her to the pediatrician and sure enough, ear infection in the right ear. Since she'd had Amoxicillin in April for a double ear infection, the pediatrician put her on Augmentin this time. As I understand it, Augmentin is like Amoxicillin but augmented to be more effective.

After about five days on Augmentin, DD came down with a fever. I totally dismissed her fever and accompanying cough because our DS had just battled a fever and cough the previous four days. In any case, after a night and most of a day with a fever, DD woke up from nap time with what looked like hives:

Because neither of our kids had ever had a rash that looked like this, I took her to see her Doctor.

The diagnosis at this point was viral hives, presumably from the virus she caught from her brother. The pediatrician ruled out a reaction to Amoxicillin because she assumed that DD would have reaction the first time she'd been given the drug. I know now that this is not necessarily true. Our doctor told us to stop giving her Augmentin because, whatever was going on, it clearly wasn't helping her ear infection. Instead we were told to start her on a drug called Omnicef.

In any case, into the night and into the next day, DD started to get worse and worse:

Benadryl did nothing to ease the itching or the swelling. Oatmeal baths were nice temporarily, but ultimately annoyed her. Her skin turned fire engine red and raised up into welts. Her eyes gradually disappeared. She also had a high fever this whole time and we were giving Ibuprofen for that. She had no trouble breathing at all, fyi. Now, I was told she was having a "allergic" type reaction to a virus, so to my knowledge all of this was to be expected.

After nap time on this third day, DD woke up with bruises in amongst the rashes. Now, I've talked to my DH about this sort of thing before and I knew it wasn't good. So I called our pediatrician back and this is the conversation we had:

"Hi, this is Me, we saw you yesterday for a rash? It's gotten a lot worse and her face it totally swollen. But that isn't really what concerns me. She just woke up with what looks like bruises all over."

I was waiting for our Doc to reassure me and say that was what she expected to see. Instead she said, "Um, yeah....she could be going into blabbedy-blabbedy-septicemia. You need to get her to the ER now. If she needs something I can't provide, I'd rather she be there instead of here."

"Oh. Okay, well I'm going to go now." 

"How far away are you from the ER?"
 
"I'm going to take her to Children's, we're maybe half an hour away?" 

"Okay, that should be fine."

"Okay, thank you, will you call ahead?!"

"Yes, they'll know you're coming." 

"Bye."

So, even though DD was responsive, eating and drinking some, and breathing fine, now I'm terrified that she's going into septic shock and is going to die before the day is out.


My husband was in some inane (so it seemed at the time) Life Support Class for his job at the hospital and I couldn't get a hold of him. I called my Mother-In-Law instead, a saint in jeans and T-shirts, and she dropped everything to meet us at the hospital. I was bawling as I buckled the kids into their car seats. Every time I looked at DD's legs, all red, splotchy, and bruised, I was reminded that her little body might be giving up some invisible fight.

Through my tears, I called a number DH had given me for the department he usually works in at the hospital. Some poor Respiratory Therapist tried to understand me through my sniffling. She worked some magic and figured out where my husband was. I found out later I used the wrong acronym to describe what class he was in and there was a lot of confusion. So the message that "his wife is looking for him because she has to take their daughter to the ER" got sent through a lot of people before it made it to my husband. In real life, Telephone works pretty well!

In any case, I calmed down when we got to the Children's Hospital Colorado Urgent Care and was relieved to see that we weren't the foremost priority. That calmed me down because I know that they rush the most critical cases right in. Apparently our warning signs weren't that terrifying. My poor son was tired (nap time) and hungry. I had thrown an energy bar and chips at him for lunch before we ran into the truck.

My mom-in-law and Dear Husband arrived shortly after we were admitted into a room. People underestimate how nice it is just having someone there with you. They don't even have to anything, it's just nice that they're there, you know? So my mom-in-law brought comfort, reassurance, and love but also books, food, and cuddles. :) Priceless.

When DD saw her Grandma, she immediately asked for her, "Hold you, me! Hold you, Grandma!" DD gobbled down her first solid food for the whole day, Grandma-Approved Goldfish crackers.

Shortly after seeing my sick kiddo, the Physician's Assistant and the Doctor working agreed that she had something called Serum Sickness.

PubMed Health says that Serum Sickness is "a reaction similar to an allergy. Specifically, it is an immune system reaction to certain medications..." That's so much better than having blood poisoning and dying! Seriously, that's not sarcasm, that's a ton better.

Continuing on: "During serum sickness, the immune system falsely identifies a protein in antiserum as a potentially harmful substance...The result is a faulty immune system response that attacks the antiserum. Immune system elements and the antiserum combine to form immune complexes, which cause inflammation and other symptoms...Unlike other drug allergies, which occur very soon after receiving the medication again, serum sickness develops 7 - 21 days after the first exposure to a medication."

From what I was told, it's totally possible that her first exposure to Amoxicillin was when her body developed antibodies. This second round of Amoxicillin (Augmentin) triggered the immune response. I chafe at the description saying this is a "faulty" response. Honestly, we humans are so prideful. Amoxicillin is man-made and totally unnatural. Yes, it helps us and is an amazing drug, but it's not supposed to be in our bodies. I think DD's immune system is just better than normal at identifying invaders. :)

The super-nice staff answered all of my questions and reassured me over and over. The bruising was normal and caused by the severity of the rash. The rash was so harsh that it bruised itself! We were told to take her off of any drugs for her ear infection. The Physician's Assistant there said a) the infection didn't look horrible and b) it wasn't worth the potential complications if DD was still reactive. More variables, you know. Hopefully the ear infection would clear up on its own.

We were given steroids to put her on for four days to calm down her immune system. Steroids? My baby!? I repeatedly asked about the risks versus the benefits; so far the steroid has made a remarkable difference in her symptoms. After one dose of steroid at the hospital, you could kind of see her eyes again and the redness on her face started to recede. After three doses of steroid, she looks mostly like herself again and the itchiness has largely disappeared. This is after one dose of steroid:

Her hands and feet are swollen (it was difficult for her to walk) but she looks ten times better.

At our follow-up with someone in our pediatrician's office, I asked over and over whether they agreed with the diagnosis. This doctor did. I asked if we should get her tested for other drug allergies. The doctor shook his head. "Oh, no, she won't be allowed to have any of the drugs in that family. Penicillin, Augmentin, and the cephalosporins,Omnicef.."


I nodded my head, but I don't know what cephalosporins are. Google tells me that she can't have:

• Penicillin VK
• Penicillin G
• Dicloxacillin
• Oxacillin
• Nafcillin
• Amoxicillin
• Ampicillin
• Augmentin (amoxicillin/clavulanate)
• Unasyn (ampicillin/sulbactam)
• Zosyn (pipercillin/tazobactam)

• Keflex (cephalexin)
• Ancef (cefazolin)
• Ceftin (cefuroxime)
• Cefzil (cefprozil)
• Omnicef (cefdinir)
• Vantin (cefpodoxime)
• Many other antibiotics beginning with “cef-“ or “ceph-“

And if she does, "complications include: Anaphylactic shock, inflammation of the blood vessels, and swelling of the face, arms, and legs.


Today she looks better still, but she still has a ways to go before she's 100%. And come to think of it, my Dad has a similar penicillin-family-of-drugs allergic reaction. Genetics might have something to do with poor DD's reaction. Since this has happened, I've heard from several friends and acquaintances who have had or have children who had the same reaction. Not so uncommon. The wonderful woman who helped me get my library books today has a son who has had serum sickness and can no longer have these drugs.

Anyway, I'm going to stay home, breathe deep, and just thank God that both my kids are doing okay.

Updates & Insights

I went to see my Doctor of Osteopathy yesterday. It was a kind of check-up for my thyroid and to see how things were going. I just think she's the best. Here's the rundown:

*I was able to tell her that, for whatever reason, Tirosint treats me better than Nature Throid. I have less arthritis and all that.

*It's too soon to do a blood draw to see how my levels are, so I'll go back in a few weeks to check thyroid hormones, Iron levels, etc.

*I asked about my liver and kidney function tests and they're fine. If you recall, many were convinced I had autoimmune hepatitis, so this was very reassuring to me. :)

*I asked how she felt about someday trying again to wean off of thyroid medication and see if my ol' thyroid can pick up the slack. We checked my TPO antibodies from February (at 15, where above 34 is out of the lab range). It's a good sign to me that my antibodies keep dropping. Hopefully they'll be gone someday.

Anyway, I keep thinking of the stories I've heard where people did things to change their diets and lifestyles and were able to go off of thyroid medication. I'm also a little concerned because 18 months ago 100 mcg was WAY TOO MUCH medication for me because my "thyroid was still working", so a doctor said. Now, because of taking medication, my thyroid appears to be fully suppressed and taking a nice vacation from working so hard. ;)

I don't know, I just thought I'd ask.

Lo and behold, Doctor Awesome said she had another patient who presented with Hashimoto's Thyroiditis (antibodies present) at six months postpartum (exactly when I had major problems too). The patient was put on medication and after a month and a half decided to stop taking them. Somehow, her thyroid evened itself out and her levels are fine. Sigh. I so very wish things had gone differently when I went to the doctor that first time.

But they went the way they went. My point is, is that Doctor Awesome said she would be willing to try to do some other weaning experiment someday.

*Doctor Awesome also has a background in OB/GYN which is kind of awesome. She was going to be an OB but then realized how our medical system is kind of crazy right now. Those natural birthing books I keep reading that are angry about the formula every mom is inserted into (i.e., labor last this long, you will dilate this much, if you don't we will break your water, give you Drug A, then Drug B, then you are "failing to progress" so you get a C-Section...) are correct.

She said she left the OB field because she was getting frustrated that every night at 5 PM, the OB in charge would tell her to get every woman in labor moving along so he/she could go home. Waters were broken, Pitocin was given, just because of some dude's busy schedule. That's crap. And now I know that the complaints of natural birth people are not just sensationalism, they're real. Another friend in the baby field says she sees it all the time.

I like her. :)

Let's Review, Shall We?

Someone asked the other day how I felt now that I'd stuck with a med for awhile.

I feel like you, Dear Reader, need to know that they recommend taking a thyroid medicine for four to six weeks in order to let your thyroid levels even out and see where the drug gets you--high, perfect, or low. So, let's review:

• October-November 2010: 100 mcg of Synthroid (After two weeks I was super hyperthyroid, but the "Good" Doctor told me to keep taking the damn stuff. I lost 25 pounds in a month and had chest pain.)

• November 2010-January 2011: Nothing, because taking thyroid medicine when I was so hyper would have been even more detrimental.

• January 2011: Started on 25 mcg of Synthroid.

• February 2011 to May 2011ish: Gradually increasing dosages of Synthroid. At 75 mcg of Synthroid I had an allergic reaction and was put on 75 mcg of Tirosint.

• June 2011: Bumped up to 88 mcg of Tirosint because my endocrinologist thought my levels could be better. At the same time, I decided I wanted to give 'natural' stuff a try and attempted to level out my thyroid with acupuncture and herbal stuff, which I may try again someday.  

• July 2011-February 2012: Tried taking some herbs and Thyroxal from an herbalist. Thyroxal does have dessicated bovine thyroid in it, so it has at least a little bit of the main thyroid hormones, T3 and T4. (For one month I was on BOTH Tirosint and Thyroxal and ended up super hyperthyroid again. Hindsight is 20/20.)

• February 2012: Started taking 88 mcg of Tirosint again because something wasn't working and I felt like crap.

• March 2012: Still had arthritis, so talked with the Doc and decided to see if natural dessicated pig thyroid (Naturethroid) would help, 1 grain up to 1 1/4 grains. It didn't. I felt well besides the arthritis.

Today, June 2012, I am taking 100 mcg of Tirosint again and my arthritis has disappeared. I was holding out hope that the pig thyroid would work (because I really wanted the bone protecting hormone!) but the clincher was when raising the dose didn't make my arthritis go away, but it DID reduce my monthly cycle from about 26 days to a completely unacceptable 20 days. I had too much T3 coming in and not enough T4.

Looking at my history, I feel like I tried T4 therapy for ten months. Then I tried some herbal stuff for about seven months. People, that's enough time to see how a drug works for you. I also know that after TWO flipping weeks, I was hyper from taking too much T4. Not four to six, which would have made me positively anorexic, but two.

Because I need a mental break from figuring this out and I want to have a baby soon, I decided to go back to T4 therapy because it has honestly made me feel the best out of all the things I've tried.

Choices have to be made one way or another. I am choosing this right now and I still cling to the hope that my thyroid isn't all dead. I do know that the drug I'm taking has taken over any residual thyroid function I did have; that is, my thyroid isn't producing anything because it doesn't have to.

Other updates: I still don't eat wheat or milk and I do try to stay away from fiber-rich stuff. I take Selenium and some other good herbal things and I try to eat my veggies. :)

There will be a Pop Quiz later. :)