Wednesday, November 18, 2009

Frozen Dinners

One of the things on my long list of to dos has been to find a way to prepare six weeks of frozen dinners for after the babies are born. Basically, Trey only gets 5 days of paternity leave from school and gets no leave from work so we have been trying to figure out ways to streamline parts of life that are somewhat controllable.

Cooking here in general has been an adjustment. When a recipe calls for a stick of butter, I have to think: “let’s see… that’s half a cup, where’s my conversion chart… OK, half a cup of butter is 110 grams… butter here comes in a package of 250 grams… I guess I can just eyeball it… what is the next ingredient?” I know I could get a scale and if I didn’t have to share the kitchen with college students, I might invest in some more useful kitchen equipment. That is the case with a good recipe which contains items available in the grocery stores here. (For those interested in the conversion chart I have been using: http://www.veg-world.com/articles/cups.htm)

Finally, I had decided to start from scratch. It just seemed easier. Buy cooking magazines that actually call the ingredients by the names they use here and give measurements in metric units. That made life so much easier for a few weeks. Then I began hunting for cookbooks geared towards making dinners ready to freeze such as those featured on http://www.savingdinner.com/. I didn’t have much luck.

Finally, I figured I better just start asking because I, apparently, was not putting the ideal search terms into Google. First I tried the dietitian at the hospital. She said that sounded like a fabulous thing for them to know about and she would look into it. The next day we had a meeting with our Pastorate (what they call Sunday School here except it is more like what we call cell groups in the States.) There was a lady who had made a delicious key lime banana pie. The previous meeting she had made these cupcakes that I swear could have come from a store. I asked her if she liked to cook and we started talking. It turns out she had some American recipes which called for “a stick of butter” and was thrilled that I could reveal that a stick of butter was a half a cup. She said she had all of her recipes scanned in and would be happy to email me the ones which were her favorite for freezing. I could have hugged her but we’re in Brittan so I didn’t.

Finally, today I had coffee with two women from the twins club I joined. One was about to pop at 36 weeks pregnant and one was 20 weeks. One of them mentioned they had ordered homemade dinners which were ready to freeze from somewhere called Cooks. Everything went into slow motion. I turned to her and asked her to repeat that information. She said there was a shop where you could place your order online and either have meals delivered or run in and pick them up. They were made with fresh ingredients and you just popped them in the oven for 40 minutes. THIS was the answer. It had to be. We simply do not have the freezer space for six weeks worth of meals anyway. I immediately went home and looked it up and it looks perfect! The website is http://www.cookfood.net/ and it seems like my prayers are answered.

I can't help adding that after our coffee I walked out of the apartment and across the street to Harrods to drool over the handbags from Vogue in person. Even though a diaper bag is the only new handbag in my foreseeable future, a girl can still dream right?

Thursday, November 5, 2009

Ultrasound Update



Baby B (boy) who is sitting on top.



Baby A (girl) who is lying on bottom.)


If you have heard about our last ultrasound, you will understand why I was very wary of this scan. It was with the same consultant who had previously been so rough and hostile with me. I returned to her this week for my 25 week scan because she could not get the measurements of one of the babies’ face. I just hoped that last time she had been having a bad day and prepared myself to be stern if she did anything I was uncomfortable with.

When we were called into the room I immediately stated that we would like pictures of both of our babies this time. She said fine and we began the ultrasound. She was able to get all the measurements this time and still said she is almost 100 percent sure baby A is a girl but she is positive baby B is a boy. She actually told me a few things she was measuring and apologized when she had to push hard because one of the babies was turned away from her and there was no wand beating this time around. Overall, she was still pretty disconnected but she did seem to be in a better mood.

The babies were both moving around a lot (which I could have told you without the ultrasound) but they are again lying transverse (they are stacked horizontally across my midsection.) Baby A is very low and her head is about even with the sharp point of my hip bone. Baby B is floating around up under my rib cage. I also did not need the ultrasound to tell you they were stacked this way because it is a LOT harder to walk and move with them in that position. They feel a lot heavier than when they are side by side. Baby A started to slide up to my right side yesterday which made me very hopeful but Baby B did not get out of her way and after sitting cramped for a few hours she slid back down to her more spacious accommodations about four inches below him. We all need to pray they turn to a vertex vertex position (both head down) before it gets too crowded for an easy delivery. If they stay in this position I will have to have a c-section.

At the end of the ultrasound, the consultant asked us to step outside while she typed up her report. A few minutes later she entered the crowded waiting room and handed me the report and ONE picture of ONE of my babies. I just want to make it clear that these pictures are printed attached to one another in a minimum set of four. She literally had to tear off the picture and throw the rest in the trash. I looked at it for a minute then looked back at her and said “could I have a picture of my other baby also?” She said “I’m sorry, I only got this one.” I think everyone in the waiting room was looking at her and Trey and I looked so disappointed (I am literally thinking “and are you going to be there to explain when I have a 10 year old twin that asks ‘where are all the ultrasound pictures of me in my baby book’?”) She says hold on a second, turns, goes back into the room and returns with a lovely picture of our baby boy. VICTORY! Hopefully I never have to have a scan done by her again!

Third Trimester!

The home stretch! I can’t believe the babies will be here in about three months! I still feel totally unprepared. So far we have no way of getting them from point A to point B and we only have a place for one of them to sleep. Thanks to eBay they both now have lots of clothes up to three months. I did make one retail purchase of some baby blankets, receiving blankets, towels and washcloths. I need a lot more blankets, some bottles, hygiene things and a first aid kit and a ton of other little things but I have a list so that always makes me feel more in control of the situation. The one thing I haven’t been able to find here are the plain cloth diapers that everyone at home uses for burp rags.

Trey and I have attended a few things for the twins clubs we joined. We first went to a Halloween party with the social club. We decided to volunteer as we thought we would feel strange standing around while everyone was watching their kids. They put us in charge of serving drinks (which was mostly keeping the children out of the Winter Pimms punch as it looked so delicious with its cut up pieces of fruit and cinnamon sticks. It was a really nice idea of them because there was a constant flow of people we could talk to. I even met and exchanged numbers with a lady who has 9 month old twins that literally lives around the corner from me. She gave birth at the same hospital I am going to and had lots of reassuring information.

The next event we attended was a lecture from a local author on multiples. We were really excited about it but it was kind of a bust. The speaker’s strongest qualification was having three year old twins and most of the information we already had. It did succeed in making us feel quite overwhelmed as they talked about how you really need to lean on your family and ask them for help over the first few months and how to make the most of your government grants, neither of which we have access to. One thing that was quite helpful was when she talked about having to be assertive with your healthcare. She told a story about how after her c-section she had one baby laying beside her and the other in the nursery. She called the midwife to come help her lift her baby in the middle of the night and the midwife responded “I’m already busy with your baby in the nursery.” She responded “well, I have another one here beside me and would you have me let her lay there and cry all night or would you come lift her so I can feed her?” She also talked about having to break the rules. For instance, most of the children’s clinics do not allow you to bring prams in. She recounted an experience where she was asked to remove her pram and she told the receptionist “excuse me, I have two babies, would you like to hold one so I am not in need of a place to put one?”

Most recently, I attended a coffee break at one of the mom’s homes I me through the twins club. It was amazing to be around three other moms and get to pick their brains. The woman who set up the coffee invited two of her friends that had the two prams we had been interested in. With the limited space in London there aren’t many on display. I got to push them both around but ultimately still am torn. One also gave birth at the hospital I am at. It was just really refreshing… and interesting with three sets of twins.

Ill Fated Ultrasound and Midwife Visits

I wish I could make this shorter but, for all those interested in my experience with NHS care over here…

We had an ultrasound scheduled shortly after my 21st week of pregnancy. We had been disappointed at a previous scan because at 16 weeks many of my friends had been able to tell the sex of their baby and when I asked if we might be able to find out I was told the policy was the sex wasn’t divulged until the 20 week scan. (Note the difference between, no, we can’t tell but no we DON’T tell.)

The 21 week ultrasound was to be a bit different because it would be performed by a “fetal medicine specialist” due to a great deal of concern from the consultant (twin specialist) that I had missed the opportunity for Down syndrome screening during my move to the U.K. With a single pregnancy the screening can be done until 16 weeks but with twins the cutoff was 14. This did not particularly matter to me because all it would do is give you an idea of the odds and help you determine if you would warrant an amniocentesis which I had already decided I didn’t want. (In my totally nonmedical opinion, a twin pregnancy is high risk enough I didn’t want to throw a large needle into the mix.) We thought that having a doctor doing the scan was fantastic because it was going to be very thorough and they would be taking all kinds of measurements so SURLEY we would find out the sex of these babies.

We waited outside a scan room reserved for multiples and high risk pregnancies. Under NHS you are held to a strict time table. If you have one baby, you get a 15 minute ultrasound. If you have two babies you get a 30 minute ultrasound and if you are having a fetal monitoring scan you are given 45 minutes to an hour depending on how long it takes to take the babies measurements. The woman in the room before me looked very sick and was wheeled out of the room. When Trey and I were called in one of the first things I said was “we are so excited to hopefully get to find out the sex of the babies today!” The consultant (specialist) responded “Oh, I don’t think that’s very likely” in a cold disconnected manner. I just thought “well, I have been praying for these babies to be turned the right way for four weeks and I just drank the first Starbucks I have had since moving to the U.K. so we will just see how likely it is.” She then asked me why I was seeing her for a scan that day (you always have to tell the doctor why you are there… love the preparation.) I replied with the details about missing Down syndrome screening and she said again “so why are you here to see me?” I again said that my consultant had made the appointment and so I followed her instruction. She responded “And who is your consultant?” in a hostile tone. I told her to which she gave a humph and moved on. The whole conversation all I could think was “oh thank God my consultant it is not you.” I still have yet to actually lay eyes on my consultant. I see a doctor that works with her for my antenatal visits.

I lay down and she began looking at the babies without a word. I said, “I assume you see two heartbeats and both of the babies look OK.” She said “yes.” After a several moments of silence with her clicking around taking measurements I began to ask “…and what is that… and what is that… oh OK what is that…” expecting she would take the hint and eventually begin telling me what she was measuring. Instead after several exchanges like this she said “please don’t ask me any more questions.” Finally upon seeing what was clearly a girl on the monitor I said “can you at least tell me what I am looking at there?” No response. Towards the end of the ultrasound she announced in the most uninspired, disinterested tone I think the words have ever been uttered: “I think we have one boy one girl.” And that was that. After a lot of prodding she could not get the measurements of the boy’s face and proceeded to take both hands around the ultrasound wand, bang it onto my stomach and yell “I cannot get this baby to show me his face!” She hit me so hard I felt it for two days and had a cut next to my belly button. At the end of the ultrasound when I asked for pictures, she gave me one picture of one of my babies and threw the rest in the trash.

So that was bad and it completely freaked me out that she had banged on my stomach so hard but the whole time I was thinking, she is a doctor, she knows what she’s doing. I decided I would ask my midwife about it in the appointment I had with her the following week. I hadn’t actually been to the clinic where my midwife team practices so I set out early. I had a hard time finding it and was almost late which really gets me flustered. After I sat in the waiting room and was called back to my appointment I was surprised to see that the midwife I had spoken two twice was not who was assessing me at this appointment. I thought that the same midwife saw you through your prenatal care and came for the birth. The midwife took my notes (you keep your own medical records here and they call them notes) and began to look through them. She looked at the page from the previous midwife’s notes and said that they needed my blood type but the test the midwife took was inconclusive. If you have read my previous entry about the adventure to take my blood you already know what happened there. I explained that the midwife sent me to the phlebotomist and not to worry, the blood tests were performed. She said well, I don’t see your blood type here and if you are negative you will need the Rho- GAM shot. I explained that I was a negative blood type and would need that. She said she would go check the computer for my blood test results. When she came back she still could not find them (she was also very flustered.) I told her I had seen my blood type in my notes and could show it to her if she would just hand them to me. She said never mind, she would just take my blood and then she would know if I would need the shot or not. I replied “Listen, you aren’t going to be able to draw my blood so just trust me. My blood type is in my notes. It is negative. I only know about the Rho- GAM because when I met with the consultant three weeks ago, she explained… as she was looking at my labs… that because I was a negative blood type I would need to get it. Now, if you will just hand me my notes I can show you where it says…” she walks out of the room and goes to get the equipment to draw blood.

She comes back into the room, ties both my arms, unsuccessfully poking around for a vein, and then asks me where were they able to draw your blood last time. I pointed to a vein in my hand. She ties off my forearm and sticks the needle into the desired vein. Nothing comes out so she begins to prod and dig at it. She does this for quite a while until my skin begins to bubble up behind the needle and turn slightly blue. She is still digging away when I say “Um, that will be enough thank you.” She pulls the needle out, bandages me up and says “do you think you could get a copy of your labs when you go to hospital next?” At this point I am ready to scream. She then hands me a piece of paper and begins to go over the glucose test I will need to have performed. She tells me to come back to the clinic November 20th and we will do the test there. I read the sheet and it lays out a timeline, basically drink the liquid and in exactly one hour have your blood drawn. It specifically states that if you don’t have your blood drawn exactly one hour after drinking the drink the test is inconclusive. I take it upon myself to say to the midwife “don’t you think I should do this at the hospital?” She says that it is usually performed there. I reply “you just saw how well I give blood, don’t you think I should be at the hospital where I can go to the phlebotomist to have my blood drawn after the test so I don’t end up taking it twice?” She concedes and writes me orders. The whole time I am thinking “why am I the one telling you this?”

Now the appointment is winding up and I told her I had several questions. She literally says to me “we don’t have time for that.” I am fighting back tears at this point and say in a chocked voice “well there are some things I am concerned about and I don’t have anyone else to ask.” She allows me to ask one question where I asked about the consultant hitting me in the stomach during the ultrasound. She talked to me about my rights and when I started to ask one question she asked me to go take a urine test. I go to the bathroom and completely fall apart. I am sure she thinks I am taking forever and when I pull myself together and go back to the exam room, as she is testing my sample, I decide to ask my other questions. “We don’t have a car and the hospital requires you leave with the babies in car seats, can my husband push the babies home in the pram? Will someone going to talk to me about my options for the birthing process…?” She does not answer, tells me my test results then leaves the room. I sit, not knowing what is going on when in she comes pushing a pram and followed by a woman with a tiny baby. She is profusely apologizing to the woman saying “I’m so sorry, I know you have been waiting a long time, I am so very sorry, come in and have a seat.” She then looks at me and says “Sarah, I trust you can see yourself out.” I leave the office and again burst into tears (I have never cried so much in my life as I have during this pregnancy and I sincerely hope this persistent symptom resolves itself after the babies are settled into a routine.) I cried all the way home, even through the grocery store that I stopped at on the way.

By the time I got home I resolved the only way I was going to get through this was to take it upon myself to make sure Trey and I became educated. Within the week, I had enrolled us in two twin clubs; one called TAMBA, the Southwest London Twins Club, a parenting course at our church and scheduled a tour of the maternity ward and the NICU at our hospital. TAMBA is more educational and focuses on advocating the rights of parents of multiples within NHS. They also host classes around the city with guest speakers as well as a prenatal course specifically designed for twins and multiples which I dished out the £139 (OUCH) for. The Southwest London Twins Club is more social. The moms bring their babies for coffee breaks to each other’s houses and attend holiday parties as well as quarterly meetings. Hopefully, we will be able to build our confidence in ourselves enough to know what to expect and reduce the stress associated with the healthcare system here.