23 Weeks Pregnant: Daily Walks, My Husband Away During the Week, A Forced Visit to the Naturopath, Planning a "Babymoon," Ruminations, Worries About the Future, and Was That It Moving or Am I Having Weird Indigestion?

Current mood . . .

I honestly never thought I'd make it this far into the pregnancy. After years and years and years of trying to get pregnant, having a miscarriage, and then being told the mournful statistics of how unlikely it was for me to have  a live birth from each round of IVF at my age by my reproductive endocrinologist, Dr. Hudson (28% chance of a live birth at my age), I just kind of assumed I'd have to try several rounds of IVF or that I'd get pregnant and miscarry again or that I'd just never be pregnant again. Being already pessimistic, going to law school, practising law for years, and then having years of bad luck really did a number of me. But here I am, 23 weeks pregnant today from a single round of IVF at the Victoria Fertility Centre.

This week, I have been experiencing continuing ups and downs with sleep (including nightmares, trouble getting comfortable, having to go pee really often through the night, and sometimes waking from panic attacks). My ears keep plugging and unplugging. This seems to be an extension of my congested sinuses that couldn't be connected to those two colds anymore and must in fact be from all the increased blood flow that I'm experiencing because of pregnancy (congested sinuses and ears are common in the second and third trimester). My hands seem to be more swollen than they were and I'm wondering how long it will be before I have to take off my wedding ring and engagement ring. My shape is changing steadily with each passing week too. I've had a bit of eczema acting up this week (some women get eczema acting up, while others notice an improvement during pregnancy).

On the advice of my perinatal psychiatrist, who told me that I need to get out of my head and house more and walk every day, I have been walking every day (except for over last weekend when my husband was at home and I wanted to spend every precious moment with him before he left again for the week, plus I was exhausted). I must say that while it's been nerve racking leaving the house, on some days more so than others, it has felt good once I am out of the house. While I started with a few kilometers per walk, I went up almost immediately to 6.5 km most days and even did 9 km on Wednesday (but that was overdoing it, as I was even more sore and was so exhausted the next day that I could only walk a couple of kilometers).  My hips and legs have been sorer than they would usually be going for long and brisk walks (and it's hard to be as brisk as I used to be between hauling around extra weight and gasping for air while being pregnant), however, it seems to make me less uncomfortable at night in bed when I go for a walk that day.

With views like this a walk seems like a reward on a sunny day.

Another benefit to the regular walks is that I have been sleeping much better on days when I go on long walks than on days when I don't walk or go or a short walk (like last night when I slept just 4 hours). The beauty of the walks I can go on near to my house is breathtaking (and that's not just the breathlessness of pregnancy). I have been watching early spring come to Victoria, including spotting the first cherry blossoms in my area two days ago. I don't mind it when it rains much and I've been lucky lately (especially considering that I have no raincoat that fits). I would say that the daily "exposures" to my anxiety over leaving the house (exposure therapy is used to treat panic disorder and anxiety by forcing a patient to do exposures where they face their fears by doing what they're afraid of repeatedly until it becomes less scary and then hopefully not scary at all- this is one of the most effective treatments for panic disorder and one that I had do extensively a few years ago when I was first diagnosed with panic disorder) have been beneficial in more than one way (sleep, less restless uncomfortable feelings at night, a mood boost, and lower anxiety). I have also had a friend come on a couple of walks and having someone to talk to other than the cat has been a treat (since my husband is away all week for work).

There's a herd of deer that spends the spring and summer in the Ross Bay Cemetery.

They make themselves at home.

The first cherry blossoms that I spotted this year.

I would say that even having my husband away all week, every week, has been easier to deal with since I've been walking daily. My psychiatrist is right that getting out of my place and seeing something other than this place has been good for me. A man even stopped to tell me a joke in the graveyard when I was wandering through there the other day alone and this gave me a laugh and a brief fleeting moment of social interaction when I otherwise would have had none.

I've been craving fruit like crazy.

My husband made me delicious blueberry pancakes last weekend before he left again.

I received a message over the weekend from my old naturopath (the one that my husband and I went to for months and months and received supplements and acupuncture from in the hopes of avoiding IVF and conceiving "naturally," only to find that we had to get IVF after all). She said that in order to keep selling me the prenatal vitamins that I buy from her (and sometimes probiotics too), she would have to see me for a follow up visit, since it had been almost a year and "the college" requires naturopaths to do this (all I could think was what?! They require an annual visit to dispense multivitamins and yet they let all this other crazy stuff that we read about in the newspaper happen with naturopaths? Shouldn't they focus on making sure naturopaths advise people, including parents of seriously sick children to get medical advice when they need it, instead of giving them herbs or whatever and in some cases having tragic things occur?!). But I digress. Since I like the prenatal vitamins that she has there (they have real folate instead of folic acid and some people may have difficulty converting folic acid into folate and since she got me scared about this a year and a bit ago, I've only taken folate to be on the safe side- I can't help the risk aversion being a recovering lawyer), I scheduled a visit.

Having to go for an unnecessary visit made me grouchy.

I was told that my visit to the naturopath could be quick, but of course it ended up being not quick. I was there 45 minutes updating her on what medications I'm taking (still all the same) and how the pregnancy is going (normal, maternity doctor has no concerns at all). While she does have some interesting nutritional suggestions (she really got my husband and me onto turmeric last year), some things really annoy me. One example was when I told her that I had managed to get a few okay sleeps with daily walking and she said in that smug manner that all people who have had children before seem to use "well enjoy it while you can because you won't be resting for the next few years." (chuckle, chuckle). No, it's not funny, especially when you suffer from bipolar disorder and a series of bad sleeps can trigger an episode. I don't need to be any more terrified of being a parent than I already am. Anyone expecting a child, unless they are the calmest person in the world or delusional, is terrified about the future, they don't need your sanctimonious and smug laughter and stories to scare them more. It's not helpful, just leave out comments like that. Everyone knows that new parents don't sleep well. Sorry you didn't get a gold medal for your sleep deprivation, but there's no need to boast about it to me because I'm not going to give you an award either.

Another example of an annoying thing in my appointment with the naturopath was when she started in on breastfeeding counselling. I told her that because I'm on lithium carbonate for bipolar disorder (which she had just confirmed that I was still taking), unfortunately I will only be allowed to breastfeed for a couple of weeks to give the baby the colostrum and then I will have to feed the baby formula. She initially seemed to protest, until I reminded her that lithium carbonate can be toxic and that when we can't test the levels in an individual they are dangerous. Despite this, she prattled on and on about strategies for breastfeeding and co-sleeping. As if I don't feel bad enough that I won't be able to breastfeed my child when everyone in my family has harped on and on about it my whole life. I already feel like a failure (even though according to research, I shouldn't feel a failure, and this is more common of an issue than people talk about due to the militant breastfeeding shaming in our society that currently occurs).

She took my blood pressure and pulse and confirmed what my doctor always says that I do NOT have high blood pressure and that I seem perfectly healthy.

Quit prodding at me and give me my prenatal vitamins.

At the conclusion of the appointment, which I was trying to rush along, as I had really had enough, she gave me a packet of various articles on pregnancy and a recipe for an easy cereal to make ahead of time for eating while I'm trying to feed the baby in the morning and beseeched me to come back in my third trimester. She also tried more than once to tell me that I should have a doula present with me when I deliver despite the fact that I have a doctor and I'll be delivering in a hospital (years of law school and practising personal injury and medical malpractice ensured that I would choose this route for childbirth). The whole interview was kind of annoying, but at least it's over with and I have some articles to read and a couple of recipes I could try if I needed to. I'm not opposed to approaching health and pregnancy in as well rounded a way as possible, I just don't like it when I'm made to feel guilty for having an incurable mental disorder which requires me to be on a particular medication for life and that medication makes me unable to breastfeed. What am I supposed to do? Go off of my lithium and then destablize, get hospitalized in the psychiatric ward again (this time pregnant), and spend the remainder of my pregnancy there and get put back on psychotropic drugs, or worse yet, wander off, do harm to myself, and then have an even worse tragedy occur? No thanks, I'll stay on my prescribed psychotropic drug that is effective for treating my potentially lethal mental disorder and I will follow my specialist's advice. Yes, it's too bad I can't breastfeed, but that's life, and I might not have a life if I didn't take lithium carbonate (bipolar disorder has the highest suicide rate of any mental disorder).

I spent a good part of this week making lists for our trip, finalizing accommodations (quite difficult on some of the more remote islands in French Polynesia and requiring me to start polishing up my rusty French), communicating with various travel insurance providers over specifics of their travel insurance policies as related to pregnancy, and starting to make piles of stuff to bring (and trying on bathing suits- nope those won't work, I'll have to go shopping). I'm anxious to go on vacation while I'm pregnant, but I'm also excited. I think the time away and intensive time with my husband will be very good for me. I can't believe we're going back to French Polynesia, where we had our honeymoon nine years ago, to have our last vacation before the baby comes. Read more about the vacation (or "babymoon" as some people call it) on our travel blog, Two Restless Wanderers.

As beautiful as spring in Victoria is, I'm looking forward to French Polynesia.

I will miss him though.

But being in French Polynesia again will make up for missing my kitty.

I had a lot of trouble falling asleep last night. I couldn't get comfortable despite all the pillows (including the rip off defective maternity pillow from eBay that the crook seller refused to refund) and only sharing the bed with the cat (who takes up roughly 1/3 to 1/2 of the king size bed). I had a bit more caffeine than usual yesterday and a bit later than usual, so maybe that contributed, but I couldn't stop worrying about things that could go wrong on the trip, where we're going to live when we have the baby or what if we still have to keep living here, and thinking about my family. I don't think the pregnancy book that I was reading before bed helped, it was going on about preparing the baby's room in the part I was reading last night, letting your partner paint it, etc. The book also irritatingly keeps talking about how you should not be surprised when your mother is obsessed with your pregnancy and keeps talking to you about it, giving you suggestions, and talking about when she was pregnant with you or when you were a baby.

What if no one in your family talks to you or takes any interest in your pregnancy? What if your mother is dead, is a alcoholic or drug addict, is incapacitated by a mental disorder, or is generally absent from your life? Why do almost all the pregnancy books I've read keep going on and on and on and on about how your family will react and all saying the same thing? Not everyone comes from a functional family or a family at least that will take any interest in a pregnancy. Some of us either don't have one or more parents, have parents who are addicted to alcohol or drugs, have mental disorders, and/or can't or won't be actively involved in their pregnancy.

What the books are saying makes me feel even more alone, even though I know I'm not alone. Rates of drug and alcohol abuse in the world are extremely high (and this is with them being underreported) and mental disorders impact many families (and underdiagnosis means that more people are impacted by them than official numbers would indicate). Plus some families are just assholes. Not everyone is going to have someone asking them about their latest ultrasound (or any of them), wanting to know what the sex of the child is, giving helpful suggestions or commiserations over what's like to be pregnant and afraid of the future, or helping to pick out things for the nursery (if you happen to have one). Some of us will not have their family talking to them or wanting to know anything about the pregnancy or the future grandchild, nephew, or niece (or even wanting to know which it is) or even if the fetus is still alive or if you're still alive.

I lay awake thinking about how if I were to find a place to move to, unless I wrote about it on this blog, and someone in family happened to read this blog, they would not even know that I had moved. I thought about what it will be like having a child and my family not even knowing that I've had the child, what the child is, what the child's name is, what the child looks like, what it will be like not having any help at all. But my psychiatrist says that I can't allow myself to stay in the pattern I've been in with my family. I must set boundaries and keep away from abusive and unhealthy behaviours by them for my sanity and for the good of my future child. I can't allow myself to have family members hurling abuses at me (sometimes when drunk, sometimes when sober), then denying that they said these things (whether because of a blackout from alcohol, forgetfulness, or pride) or justifying why they said these monstrous things to me, never apologizing for hurting me, acting in an okay manner for a while, and then exploding again shaking my soul to its core and causing me further anxiety and depression.

This pattern that has been with me my whole life with my family cannot continue now that I have a dependent creature to think of that's not feline. It's excruciating to not have my family involved at all, but I can't risk the child being exposed to what I was (not that my family wants to be involved at present). My psychiatrist was unequivocal that unless things were to change drastically that I should not expose my child to my family and the chaos that surrounds it. I must think of what is best for the child even if it feels painful. I wish that people would stop saying how great it is that I live in the same town as my parents and sibling when it's really not and they have no idea what it's really like for me. Quit assuming everyone, it's making an ass out of u and me.

So, to the writers and editors of these lacklustre pregnancy books that I've been reading, not everyone is in the same boat and you shouldn't make it seem like they are. It hurts worse to hear about perfect, functional families when you are pregnant and hormonal than it would when you're not (even though it does then too). It wouldn't take much to add a couple of sentences to these books about how you can turn to a close or trusted friend(s) or to your in laws or even to just your partner if your family is not supportive (in my experience, people will come out of the woodwork or step up in ways you never imagined before and while it may not be the same as having your family involved in the pregnancy, it's your reality, it's different, but it's okay). Or perhaps just state that not everyone will experience support from their family, but that they will find a way to get through it. But all of these books are written in such a simplistic and summary manner, I doubt that they will ever add something as complex as this. It's out of their depth (especially since some of these books seem to spend inordinate amounts of time on frittering things like being bored of your limited wardrobe in pregnancy, being afraid of how your appearance has changed, and how to decorate a nursery- come on!).

I was feeling kind of worried at the end of last week, after having seen my doctor about the hemorrhoid (it's getting much better with the epsom salts baths and Proctol ointment and witch hazel by the way) and him asking me if I was feeling the thing move inside me. I hadn't really been feeling it move, or at least not what I could recognize as movement. I had in the past a bit (I think), but then I didn't for about a week. Last Friday night, I felt some twitching again. I felt more movement many of the days this week. The thing seems to like it when I'm in the bath and sometimes when I'm in bed.  It feels stronger than it did before, so I think it's not indigestion, gas, or a muscle twitch in my abdomen, it must be the thing! It's so strange. This morning when I was trying to fall asleep, I felt like I had a tiny eel thrashing around in my abdomen. My husband has tried putting his hands on my abdomen when I've told him I feel something strange (when he's around on the weekend), but he can't feel anything yet of course, it's too faint.

It must be really hard for the partner of a pregnant person to not be able to feel for quite a while what their pregnant partner is feeling. My husband is much more liberal with talking to my abdomen and stuff though than I am, so he is bonding in his own way. I still feel pretty scared to get attached in case it doesn't work out, but with each passing week, I have felt my fear falling away a little. I suppose it will just take time. And maybe seeing it in the flesh in about 17 weeks will be believing.

23 weeks pregnant.

22 Weeks Pregnant: Another Visit to the Maternity Doctor, Perinatal Psychiatrist, and Chiropractor, and Planning One Last Vacation as a Couple

Current mood . . .

Before my husband took off to go back east for work, we celebrated St. Valentine's Day early by going out for dinner. We went to our favourite Japanese restaurant in town, Sen Zushi. He also brought me home two beautiful bouquets since he wouldn't be here for the actual day.

We also discussed further one last vacation before we become parents or a "babymoon" as some people term it. We debated at length again various locales, the pros and cons of each, and finally decided we were going to go back to where we had our honeymoon, French Polynesia (but we're going to try some new islands on this trip as well as going back to a couple of the ones we visited before). We've always wanted to return to French Polynesia, it cast quite the spell on us, so it seemed fitting to have our one last hurrah before children there. A honeymoon and nine years later a babymoon in paradise. I researched extensively diseases and dangers and concluded that if we weren't idiots, it would be safe for a babymoon. Plus as a French Colony, part of the EU, and the recipient of lots of money from France, they have a higher standard of living that many tropical islands and a good medical system (they've been Zika free for 2 years, too). Yes, the main flight will be a bit long (8.5 hours from LA to Tahiti), but the prospect of spending three and a half weeks in the place we consider the most beautiful place in the world was too tantalizing. Plus we'll pace ourselves accordingly this time. Less tours, less long walks, and more relaxing. To read more about the vacation visit our travel blog, Two Restless Wanderers.

We've been waiting nine years to get back to French Polynesia.

I saw my perinatal psychiatrist on St. Valentine's Day. She was the only person I saw that day as my husband was back east for work. When she asked me how I had been feeling the past month and if things with my family were better, I burst into tears. I hadn't expected to cry in the appointment, but I just couldn't help it. I was overwhelmed by melancholy. I told her about my frequent panic attacks, high anxiety, and low moods and how I had tried two different courses of Loxapine to remedy my mixed state. She decided that I need to get out of the house more and not just for medical appointments. No matter how frightened I feel at being outside, she told me I should walk every day, even if it is only the two blocks down to the ocean and back to my place (in my panic attack group that I used to attend shortly after my diagnosis with bipolar disorder, we call facing a fear when you are anxious an "exposure" and this method is really quite effective for panic disorder). She said that I need to get out of my head more, as well as my house. She also said I'm far too isolated. My medication was left the same as my lithium level was good in the last lab test. I will retest my lithium level once more before I go on vacation and if the level is off or I'm feeling awful, I'll see her. If not then I'll see her when I return.

At VGH hospital for a visit to my perinatal psychiatrist.

My valentine was less than enthused.

One of the parts of pregnancy that a lot of people don't talk about, though many experience it, is problems with veins. This could be varicose veins, spider veins, or hemorrhoids. The latter two have flared up in me now. The spider veins are benign, but the hemorrhoids are really a pain in the . . .. I finally went to see my maternity doctor again this week as my soaks in the tub and witch hazel were not working. He prescribed a cortisone ointment with analgesic and antibiotics (mine is called Proctol). I didn't want to just start something like this without his advice, as the sources I've read say that one ought to weigh the benefit with the risk when pregnant. He says it's fine to use this ointment though and that this is a very, very common problem in pregnancy due to the increased blood flow, pressure, and weight, as well as constipation that many women experience. I have not been enjoying the experience, but I just remind myself that I'm lucky to be pregnant and I count it as a blessing every day after all the years we tried to get pregnant, the miscarriage, and having had to undergo IVF.

At the doctor's office.

The other part of my visit to Dr. Down was asking if it was alright for me to go on a vacation in the next few weeks. He has no concerns about my pregnancy, but warned that sometimes babies even come as early as 24 weeks and if they do they need hospital facilities as they are viable at this point (some survive, some don't). It's highly unlikely, but one should consider the possibility. He queried whether French Polynesia had adequate hospitals and if our travel insurance would cover the infant's medical bills as well as my own if I should labour early. Naturally, travel insurance is a very important thing to have when you travel and knowing the particulars of the policy is crucial. I used to practise in the area of insurance litigation, so I'm hyper aware of this issue (whether or not an insurance company will actually pay rightful claims is another matter altogether- we're still waiting for a response back to our latest letter to our insurer over the prescription drug costs from IVF that they refused to pay.) Each policy is different, so it's important to understand exactly what your policy covers.

Our cat will not be happy that we're going away, but I'm sure that with enough tuna he'll forgive us.

I was at the chiropractor today for another adjustment. He says that my back and neck are starting to settle down, but I'm still quite tense in the mid to upper back (this would explain the spasms in my right trapezius sometimes). I'll be back in about three weeks, just before I leave for my vacation for another adjustment.

I'm 22 weeks pregnant today. I must say that it's getting harder to deny that I'm pregnant when I look in the mirror. In less baggy clothes, my stomach is starting to become more and more obvious. I'm still monstrously uncomfortable in bed at night and not sleeping well. My stupid maternity pillow finally arrived from the crook I bought it from on eBay.  It was almost three weeks in coming from the U.S. to here in Canada. It was vacuum sealed and arrived flat as a pancake. Having read online that people put maternity pillows into the dryer for a few minutes on low to fluff them up when they arrive by mail and having no instructions to the contrary with the pillow or on the pillow's tag, I took of the zippered cover to wash it and put the pillow itself in the dryer. When I pulled it out a few minutes later, it was oozing fluff from several different areas as the cheap plasticy papery mesh covering had disintegrated. I struggled alone to stuff it into its zippered case and slept with this obese lumpy corpse alone that night. It was hideously uncomfortable and not at all as described ("This Total Body Pillow delivers the ultimate comfort and a restful sleep. Embrace your entire body in complete relaxation. This body pillow is an exceptionally comfortable addition to your bedroom, living room, college dorm. This pillow can provide relief from the discomforts of pregnancy and is perfect for side sleepers.") When I contacted the seller about this defective piece of junk, they wouldn't respond. The second time, they blamed it on the dryer and said I shouldn't have even used one. I have not heard from them since then. So, I guess the moral of the story is that sleeping when you're pregnant is hideously uncomfortable and nothing will help this problem and that there are many people waiting to profit from your misery and desperation for a good night's sleep. It seems in maternity there are countless people lined up and waiting to rip you off.

Yeah every pillow's supposed to look like this the first time you use it. What a rip off.

Since I saw the psychiatrist, I have been going for a walk every day. It has been scary getting outside, but when I'm actually out there, I've been enjoying watching spring progress into Victoria, even on the days when the weather is not so great. Since only a few of my wool coats fit and they're all too heavy for walking and my raincoat doesn't fit across the chest anymore, I've been layering a couple of old Addidas sweaters over my workout leggings and top. This is an economical solution, as I don't want to buy a coat just for the couple of months when I might need it in winter/spring in Victoria while pregnant.

Pictures from my various walks this week.

I'm still not really feeling any movements from the thing. The doctor doesn't seem particularly concerned. He says people feel it at different times ("quickening" as they call the first movements). I haven't been feeling any of the weird feelings like I was last week, so I don't know what's going on. But I guess I'll know when I know that it is actually the fetus moving and not just indigestion. In the mean time, since I have no indication that anything is wrong, I will continue to take this pregnancy one day at a time.

22 weeks pregnant.

21 Weeks Pregnant: Fears for the Future, Preparing to Be Almost Completely Alone for the Next Month, Sleep (and Other PregnancyRelated) Struggles, Blood Tests, and Acupuncture

Current mood . . .

Today, I'm 21 weeks pregnant. In the past, before I was jaded by years of trying to get pregnant, my infertility struggle including countess tests and different therapies attempted, the miscarriage, and the uncomfortable process of IVF, I used to believe that I would just easily become pregnant and sail through the pregnancy. Now, every day seems like a miracle and perhaps even borrowed time like someone will just seize it all away and I'll be left with nothing again, heartbroken, and unable to carry forward. It seems like I could end up having a baby now that I'm over halfway through the pregnancy, but we've all heard stories about late miscarriages (and if they happen this late they need to be aided by a D & C, they don't just happen all naturally like my miscarriage) and still births. I'm terrified to be excited or even to really prepare much for the future. But then I think about how if I actually do have a baby (the odds favour this reality), I'll have no time to prepare after it has arrived, so maybe I should be preparing now.

It all overwhelms me. I can barely cope right now. My bipolar disorder has stabilized somewhat, but I'm still suffering regular  panic attacks (usually in the middle of the night), higher anxiety, and a low mood and very low energy. Plus, every time I check the local renting or real estate listings, I'm filled with a deep feeling of gloom that doesn't lift sometimes for days. I've never felt so trapped in my life. I have no idea what we're going to do. With regard to preparing as in getting things for a baby, we have nowhere really to put them and would just have to move them if we ever found a place, I'm scared I won't need them if I don't actually have baby, and I have no idea where to start and in the absence of anyone to help, I'm overwhelmed and terrified. I had always pictured that when I finally was pregnant it would be a happy time and that I'd have family and friends around who were excited (and might ask about ultrasounds, etc.) and could perhaps lend me some wisdom, but by in large this has not happened.

And now I contemplate being even more alone as my husband prepares to leave this coming week. We'll revert back to the schedule of him being gone all week, flying back for a brief day or so here, and then leaving again to go back east for work. This will happen for the next month solid (he arrives back partway through my birthday). By the time he's done, I'll be just crossing over in my third trimester. As the days tick by, my panic and feelings of being trapped increase. I think about how all the people I've watched pregnant have bought stuff and starting nesting like something out of an extreme home makeover show on HGTV (complete with coming up with baffling themes for their baby's nursery), even when they were totally not like that at all before they became pregnant and then I think about how I can't even figure out where we're going to live and how I have no nursery so even if I wanted to decorate it, I wouldn't be able to (not that I think that I would be, except for maybe the last minute when it seemed like I was definitely going to have a baby, doing it earlier would feel like a jinx I think). It just all feels so hopeless. As the rain falls outside the window, melting the last of the freak snow storm in Victoria, the world feels utterly grey.

Winter actually visited Victoria.

The promise of spring.

Goodbye, snow.

I know it is not helping that I haven't had a decent sleep in months. My maternity sleeping pillow has still not arrived and with the lackluster tracking information available from the Global Shipping Program at eBay, all I know is that it's somewhere in Canada right now and that it should be here in the next week. My collection of pillows is not working out that well and trying to get comfortable in bed feels like an epic and never-ending struggle. And once I get comfortable I have to pee. And once I fall asleep, I have nightmares and sometimes wake up in a full panic attack which takes me an hour or more to settle out of and back into sleep.

I wish I could sleep like my cat.

My appointment with my perinatal psychiatrist was rescheduled from this Tuesday to next Tuesday. But I had to get my lithium levels done in advance and I had rescheduled my appointment at the lab once due to snow and couldn't do it again without risking not having lithium levels available for my psychiatrist since Monday is Family Day in BC (I'll be alone with the cat). I see my psychiatrist on St. Valentine's Day. I guess at least it will get me out of the house, since I'll be alone for that day as well, as my husband is working back east all week. Getting to the lab was a little anxiety provoking as our rear wheel drive car is more made for hurtling down a dry highway than sliding around in slushy west coast snow, but I made it. I walked to the post office from the lab and it was a really slippery walk. I find that I am slower and less steady on my feet than I used to be and I can't imagine what women feel like late in their third trimester.

At the lab.

My lithium levels have come up a bit from my last lithium level test a month ago and are almost into the range they have been historically when I've felt the best, so it looks like I won't need an increase in my dose of Lithium Carbonate this visit. My psychiatrist told me that pregnant women usually only get one to two dose increases of lithium during their pregnancy. I guess we'll see. I'm still feeling like I might have to go back on Loxapine again given that I don't feel that stable yet, but my psychiatrist has pointed out in the past that anyone in my shoes would probably be feeling pretty anxious and depressed, so a lot of what I'm feeling is probably situational and not chemical. I guess I'll wait and see what she thinks.

Just let me curl up and sleep until spring.

The other blood test that I had done at the same time as the lithium levels and kidney function test (normal), was a full blood panel and screening for anemia. My maternity doctor said that by the third trimester something like 80% of women had to be placed on iron supplements due to anemia and since I was feeling tired all the time and had been anemic in the past (I don't eat red meat), it was worth investigating if I was anemic. The blood tests were all normal. My anemia test was just on the border of being normal and thus was in the category of "probable anemia". I await instructions from my doctor over whether or not I should start iron supplements and if so, which type.

I went for my monthly continuing acupuncture appointment this week. Since I'm further along, acupuncture for the first time was not done on my back, but was done lying on my front, using special pregnancy bolsters (it is a two pillow system with indents for the breasts and a face area, and they pull apart to let the stomach fall through when you're bigger). Situating myself on these bolsters, on top of the acupuncture table felt precarious. It was not that comfortable, but then nothing is at this point. She said that since I'm not sticking out much in the stomach, the two bolsters could stay together instead of pulling apart to create the gap for the stomach to fall through. She put a variety of needles into my neck, shoulders, and back (I've been really tense and sore in the neck, shoulders, and back), as well as needles into the lower legs for the meridians that connect to the uterus to support the pregnancy. Then I lay there face down for what felt like an eternity. I tried to focus on my breath, counting my breath, meditating to try to calm myself, but all I could focus on was my mounting feelings of panic with regard to the approaching due date, not knowing where we're going to live, not knowing what I need to buy to prepare, feeling completely alone and overwhelmed, and my husband's impending departure from town. Having him around for the past month and a half lulled me into a false sense of security. Now that I'm faced with being even more alone and isolated, I feel completely overwhelmed. Getting a picture of needles sticking out of my back while I was face down was impossible, so I only have a before picture from acupuncture.

Before acupuncture.

After acupuncture, I went downtown to have my passport photos done and go straight to the passport office to renew my passport immediately (I'm so glad we have a 10 year option now, 5 years is too short a time for a passport). I need it to be valid by March (it expires this early March), because we'll be travelling somewhere for a vacation once my husband can take some time away from work in early to mid March. And it will definitely be international, unless something changes in my medical situation. And now Canada doesn't allow dual citizens to exit and enter Canada with their other passports, so my Irish one just won't do alone. We have had wild variations in thoughts of where we should go that change every week, so who knows where we'll go. But we know it's our one last hurrah before our lives might change forever. I discovered from googling places to travel when pregnant that people call it a "babymoon" when you travel somewhere while pregnant. This term kind of makes me want to retch.

So, other than the horrible sleep, sore neck, shoulders, and back, and continuing anxiety and depression and panic attacks, how am I feeling halfway through the pregnancy? I'm still having trouble with my sinuses following my second cold of the year and have had to continue with saline every morning and night to try to flush them out (I've been sick continuously for the last month and a half and no doubt that has not helped my sleep, mood, or energy levels). I've been skirting on the edge of a sinus infection for a while, but then I seem to fight it off, but then it seems to return. It is so annoying not really being able to take anything and not really wanting to go on antibiotics I have just left it. Moving down to my digestive tract, I only get occasional stomach upset (but I'm on Omeprazole, so this suppresses acid production), I definitely get gas pains, and I'm still having some constipation and this alternates sometimes with diarrhea (and guess what, any hemorrhoids or fissures that may occur in pregnancy can't really be treated with anything other than epsom salt baths and some Witch Hazel wipes). I started some probiotics that I used to be on before I was pregnant that are not only supposed to improve digestive tract function, but also help mental symptoms (my naturopath approved these for use during pregnancy). We'll see if these help. I've been using a combination of prune juice, daily Metamucil, and drinking lots of fluids (and I've found that my thirst is increasing). The other part that would help would be daily exercise, but other than short jaunts and housework, I haven't been really exercising much. I feel completely exhausted, plus I feel highly anxious about being out alone most days, so this combination is not really conducive for going out for walks or exercising. I've found that my hips seem to be feeling more sore and no doubt this is the change in the pelvis due to the increasing size of the uterus (on my left side this soreness is going down all the way to my left knee). Connected to that is pain in the round ligaments in the abdomen (they support the uterus normally and as it grows outwards they get stretched and sore in many women). I've noticed that the spider veins in my legs are getting more pronounced which often happens in pregnancy.  I have had a few days this week where I thought I felt something weird in  my abdomen, but then couldn't tell if it was just a twitch in my stomach or if it was the thing moving. Being pregnant is really, really weird.

I just can't picture making the transition from being alone with the cat all the time to having a baby with me all the time (and the cat is really going to be surprised by this transition). I think I've psyched myself out from all the years and years and years of trying to get pregnant, the miscarriage, having to go through IVF, and then having difficulties with pregnancy that I hadn't really contemplated years ago when I started trying, plus the complete lack of support from most people in my life. I keep thinking of all the things in my life that I've accomplished and thinking well,  if I can do that, surely I can do this. Or looking at other people who have children, well if they can do it, I should be able to. But comparing is the route the suffering according to a lot of psychiatrists. I just don't know what will happen and I guess that's what bothers me most. I can deal with almost anything other than uncertainty.

21 weeks pregnant.

20 Weeks Pregnant: Another Blood Test, Developmental Ultrasound, Visit to the Endocrinologist, Massage Therapy While Pregnant, Finishing Another Course of Loxapine, Chiropractor, Visit to Maternity Doctor to Review Ultrasound, and Thoughts on Reaching the Halfway Point

Current mood . . .

The weekend proved to be somewhat unenjoyable and stressful with two visits from one of the landladies (trying to figure out how to plug up the hole where the rat supposedly got through in our laundry room and then putting something over it) and finding out that my new laptop from Dell was a lemon and that while Dell could fix it remotely with software, they would not do it unless we paid for them to fix it even though the laptop was brand new. That's right, extortion and racketeering. After a further call and threats of litigation, my husband managed to get a packing label to send the laptop back. So now we have to send off the laptop, wait for a refund, then buy yet another laptop. It really pisses me off, especially since my current laptop has been on its last legs for a while and I was counting on this one. A laptop is the tool of my trade. The next laptop I buy certainly will not be a Dell computer. That's for sure.

Caturday fun taking selfies with the cat. He was not impressed.

Our walk on Sunday started at sunset.

Our walk Sunday evening revealed a sliver of moon and Venus.

Beautiful Gerbera daisies that my husband brought home for me.

Monday morning, I was in the lab first thing in the morning for my scheduled blood test for my thyroid levels. I had to get my levels done again as I had an appointment with my endocrinologist on Wednesday and he would need my levels to determine if my thyroid levels were optimal (if they are not optimal it can affect the fetus' IQ). If my levels were not optimal then he would have to raise my medication(s) again. The test results online showed that the my thyroid levels were not optimal with my T4 and T3 levels being off even though he raised my levothyroxine dosage last time he saw me a month ago.

Too early on Monday to be at the lab for yet another blood test.

Tuesday, my husband and I went to the Royal Jubilee Hospital for our schedule Developmental Ultrasound for the fetus (this is usually done between 18-20 weeks pregnancy, I was 19 weeks 4 days). The process was annoying with having to take a number, wait for it to be called, check in, then go to a second waiting room, then wait around there for the technician to fetch us (he was slightly late, but it's a hospital, so not a huge surprise), all while having a full bladder (required for imaging of the cervix and placenta).

Car selfie.

Before the ultrasound in awesome hospital lighting.

Hospital selfie.

My husband and I had both had this technician image us in the past when we had had imaging done to try to diagnose our fertility problems, so it was funny to have him now doing the fetal developmental ultrasound. I had been told by people and the pregnancy books I've been reading that this is the best ultrasound that one has during pregnancy. People say that it's longer, you get to see more details, and they go to various parts of the fetus and linger over it, so you can see the various parts in great detail. There was only one screen in the ultrasound room that we were in. The technician told us that he would have to view it head on and I wouldn't be able to see it until the end, as he had to do measurements. I had never had this experience before. In the private fertility clinic I was always shown the screen while the ultrasound was happening and they were very amenable to me taking photos for my blog too (photos are not allowed at the hospital at all in your ultrasound), no doubt because we were paying a fortune to be there. In my two other non-private ultrasounds I have had another screen to look at, so I've been able to see what's happening while the technician does measurements and images various areas. In the absence of this, I lay there nervously for what felt like forever while my husband stared at the screen that I couldn't see and didn't bother to reassure me that the fetus wasn't dead until after a few minutes (yes, I still feel worried about this every time I have an ultrasound- that miscarriage is still fresh in my mind).

Then when I couldn't hold it anymore, I asked to go to the washroom as the technician had told me that once he had the cervix and placenta imaged, I could go to the washroom, as the quality of the fetal imaging would not be impacted by an empty bladder. I went to the washroom and returned for another long stretch of staring at the hospital ceiling. Then he turned the screen towards me and proceeded with the most blurry and fast ultrasound session I had ever witnessed. I had maybe two minutes and then he was done. He said the heart rate was 152 bpm and that the fetus measures at maybe two days older than it's supposed to be (given that my husband is around 6 foot and I'm 5 foot 10, I'm not surprised). I was pretty disappointed and even more so when he handed us a few hastily printed photos of the fetus. They were badly printed and the least number of photos I've ever had from an ultrasound, other than the heart ECG ultrasound where one doesn't even usually get photos, but the technician there kindly printed them for me for my blog. The three photos we were given from the ultrasound are below. The fetus was facing down, so the full body shot is spine up. The other two are supposedly nose and lips and hands and arms.

The fetus is lying face down and spine up in this body shot.

Apparently the lips and nose.

Blurry renderings of each of the arms and hands.

Wednesday, I was subjected to the regular torture of being weighed and questioned by my endocrinologist who monitors my hypothyroidism (suspected Hashimoto's Disease). He commented that I had gained "a lot" of weight. Gee thanks. Then he said that my thyroid levels were not right (too low) and that he'd have to raise my dose of levothyroxine yet again (it's common in pregnancy to have medication dosages go up by a lot due to increased blood volume, weight, and metabolism). He said that my medication needs had increased due to my increased weight and the pregnancy (yeah, don't try to link those two items, whatever you do, and the falling thyroid levels couldn't have caused any weight gain!).

I'm perfect. Don't criticize me!

Thursday, I decided to go for massage therapy, as I was feeling very stiff and sore in the neck, back, and hips. Massage therapy when you're pregnant is more complicated. I still am not sticking out much in the stomach, so she was okay with having me on my stomach to begin with for a bit, but not as long as usual and I had to have pillows under my shoulders to help take pressure off my breasts and make it more bearable to lie on my stomach. When I was turned over it was onto my side instead of my back (the vena cava can compress when lying on the back, so this position is best avoided or done for short periods of time, so in pregnancy massage is usually done on the side and since left side is optimal for cardiac and digestive reasons, it's done on the left side). On my left side, I was given a pillow for my head, a pillow to hug to support my shoulders, and a pillow between my bent knees. Then to end, I was on my back for a short while, but she put pillows under my right hip to take pressure off the vena cava, so that it would not compress and I was told to tell her if I had any dizziness or strange feelings (an indication that the vena cava is being compressed). I was really stiff and sore, but felt better after the massage for sure. I was really impressed with how knowledgeable Ashleigh at Moss Street Health is with pregnancy massage. It was very reassuring.

And after my massage, I brushed the cat and fed him treats. We were both happy then.

I've been taking Loxapine to treat my mixed state from my bipolar disorder since last Thursday. How long the course of PRN medication is really depends on how bad the episode is, the season, and other factors that I don't really understand (and no one really understands, it is a very mysterious and not well understood disorder even to this day). What I have to look out for is when I start to become very oversedated the morning after my dose. In the beginning, no matter how high the dose, I will feel wakeful, energetic, and peppy the morning after taking Loxapine despite the fact that this drug is an antipsychotic with various off label uses including treating bipolar disorder without psychosis, a sleeping pill, etc.. However, there is that magic point at which I can't get out of bed the next day without great difficulty and I feel dozy all day. That's when I know to decrease my dose. Then I stay on that next lower dose until I'm oversedated the next day from that dose and so on until I'm off of it. Of course, the being off of it is not pleasant either, because then I have to suffer from withdrawal. This varies based on how high my dose was and how long I was on it for. For me, it always means sleep problems for at least a day or two or longer if my course has been several weeks, a month, or more (for more severe episodes). I had my first night off of Loxapine last night and I did not sleep well or much, but there's the promise that I'll feel better now that I've treated my mixed episode and have come off of this drug which quite frankly has some awful side effects (including increased stiffness in the joints and ligaments, constipation, a dozy feeling all the time, weight gain, increased hunger, etc.).

This morning, I went to the chiropractor for another adjustment. I've been getting the spasms in the my neck and shoulders still and felt stiff in my low back and hips too. But mostly, it was my neck that was bothering me this morning. It actually woke me up and kept me awake part of last night. It felt so tense that it was giving me an awful headache. My chiropractor put the electrotherapy on me with heat and then did adjustments to my neck and back. I'll be back in two weeks unless my neck is continuing to really bother me, then it will be earlier.

This afternoon, we had an appointment scheduled to see my maternity doctor, Dr. Down, about the ultrasound results. I had booked this due to wanting my husband to be able to be there (before he starts travelling across the country again) and because we were anxious to find out if everything was okay from the ultrasound (and we might find out the gender of the fetus too, but that's not of big concern to us, we just want to know that everything is okay). It certainly wasn't apparent to us from the ultrasound if the fetus was okay other than that its heart was apparently beating and apparently it was breathing, though I didn't get to see this part.

At Dr. Down's office, I, as usual, had to give a urine sample and I was weighed by his lovely MOA. Dr. Down reviewed the ultrasound results with us. He said that everything was found to be developmentally normal with the fetus in the ultrasound. He said that the growth and weight were measured to be normal. I told him that I had had some cramping type feelings in my abdomen the last few days and he suspected that this was ligamentous in origin and that the weird feelings I was feeling could even be "quickening" or the first movements of the fetus starting to be felt by me (women apparently usually start feeling some movement between 16 to 20 weeks time). He palpated my abdomen and said that the uterus seemed to be in a normal place for 20 weeks (with the fundus or top of the uterus being around my umbilicus). He also took out a tape measure and measured from my pubic bone to my belly button and said that my measurement was right on track for 20 weeks. He took my blood pressure and said that it was low normal (no surprises there, my blood pressure has always been on the low side). I told him that I was still feeling really exhausted and hadn't felt that energy that the pregnancy books talked about people feeling in the second trimester. He said that this is normal for some women, but gave me a lab test for anemia to check if this could be the cause (conveniently I'm already booked in with the lab on this coming Monday to have my monthly lithium levels done, so I can have this done at the same time). He said that he has absolutely no concerns about my pregnancy and that he will see me again in four weeks. We were very relieved to hear that everything was found to be normal and that he was not concerned about anything. After the journey we had trying to get pregnant, having the reassurance that this is a normal pregnancy (at least so far) is wonderful.

Car Selfie.

Awesome doctor's office lighting.

Yesterday, I was at day 141 of my "cycle" ie. since my last cycle started (the first day of my last period which is how pregnancy is calculated) and the book said I had 141 days to go until my due date, so I was at exactly the halfway point. Today, I'm 20 weeks pregnant, starting into the last half of the pregnancy. I honestly can't believe it. In some ways, it gets easier to believe that we might have a baby, but in other ways I'm still to afraid to "gloat" ie. be excited or happy, because I'm afraid I'll jinx it and have another miscarriage (totally irrational, I know, but I'm still traumatized my that miscarriage in June of last year). Plus, on top of not wanting to buy stuff (I did get a new sports bra and workout leggings this week, so I can start walking and exercising again now that my mixed episode seems to have passed) because I'm afraid the fetus will die, I don't know where we're going to live, so there's no point in buying stuff if we're going to move. But what if we can't move? I just don't know what we're going to do and with only half my pregnancy left, time is running out to either make a move or figure out if we could ever make this cramped duplex work with a baby.

20 weeks pregnant.

Halfway to my due date.

Hanging out in The Hudson's Bay before dinner out with friends tonight.