The Tree Fights Back

Jeff has been working on cutting down the maple tree in the back yard. It is really overgrown and is a pain. There is no grass on half of our back yard, just moss. Thanks to the shade from the giant tree. There is also not a lot of room in our backyard because we have two overgrown trees, a swing set, and a patio. We want to build a deck that will run the length of the house, so we need to clear some room.
So today he was cutting the tree. He used a pole saw and got all he could from the ground. Then he grabbed a ladder and started climbing. The ladder wasn't very stable against the tree, so he climbed onto some of the thick nubs of branches that were left and started cutting again. He was attempting to get back on the ladder to climb down when the smaller branch nub he put his foot on gave way. I was watching from the couch inside. He fell and his arms went up as he slid down against the tree. I though for sure he had broken his arm. Not so. He has nasty cuts (maybe gouges) on two fingers and his arms were pretty scraped. He is lucky he didn't get hurt worse!
Here is a picture of one arm:

OUCH!!!!!

Baby

I had my first doctor's appointment today. I got to hear the heartbeat! It was so fun to hear it. There is really a baby in there! Maybe now the sickness won't seem so horrible. And I only lost 3 lbs. I lost 7 lbs with Alona (which was my first pregnancy on Zofran) and only about 4 lbs with Natalie. I lost 25 with Ashley (no Zofran that time). I only gained 13 lbs with Alona, 20 lbs with Ashley and Natalie (that is from my pre-pregnancy weight, not from the lowest weight during pregnancy). So I am hoping this one is closer to the minimum 15 lbs they are requiring me to gain. I guess we'll see what happens. The hardest thing for me will be not gaining weight after the baby (postpartum depression is to blame for that)!
Anyway, we should find out the sex of the baby in July, so hang in there!

Hyperemesis Gravidarum

So there is a name for what I've got. Its Hyperemesis Gravidarum (HG). It is in the book Your Pregnancy week by week 6th Edition. Pages 88-89.
This is what is written about it:
"Nausea doesn't usually cause enough trouble to require medical attention. However, a condition called hyperemesis gravidarum (severe nausea and vomiting) causes a great deal of vomiting, which results in loss of nutrients and fluid. You have HG if you are unable to keep down 80 ounces of fluid in 24 hours, if you lose more than 2 lbs a week or 5% of you pre-pregnancy weight, or if you vomit blood or bile. Contact your doctor immediately!
Only 1 to 2% of all pregnant women experience HG. Very high levels of nausea-inducing hormones produced by the placenta may be one cause. Your sense of smell may also be more intense, which may make nausea more severe.
If symptoms are extreme, call your doctor's office as soon as possible. Even though your first prenatal appointment may not be scheduled for a while, there's no reason you should suffer. Your doctor will want to now about the problem. You may have to ask to be seen sooner than a normal first prenatal appointment so you can find some relief. If you experience severe nausea and vomiting, if you cannot eat or drink anything or if you feel so ill that you cannot carry on your daily activities, call your physician. Call if your urine is dark, you produce little urine, you feel dizzy when you stand up, your heart races or pounds, or you vomit blood or bile.
In severe cases, a pregnant woman may need to be treated in the hospital with intravenous fluids and medications. Hypnosis has also been used successfully in treating HG."

I don't know about the 80 ounces of fluids, that is quite a lot. I am lucky to get in 24 ounces of fluids per 24 hour period and I'm on ondansetron (zofran). I weighed 135 before my first pregnancy. I lost 25 lbs. That is 18.5%. That beats the 5% by quite a bit. As gross as it sounds, I have thrown up bile many, many times during pregnancy. Even while on medication. I pretty much fit right in with this condition. With Alona, I told my doctor at 5 weeks that I get extremely sick and she started meds immediately. I still lost 7 lbs and only gained 20 lbs from that point. She was shocked at the weight loss while on meds. With Natalie, we did the same thing, but I lost a little less and still only gained 20 lbs total. This time around, I tried to make it through without meds, but gave up at 8 weeks. I was already dehydrated and couldn't get up.

I also looked it up online. There was quite a bit out there about it. What I have read pretty much goes along with what I have experienced- it generally doesn't end at the beginning of the second trimester, but continues through 20 weeks and in some cases continues through the entire pregnancy. Basically they say that B6 and Unisom don't really work for HG, zofran (ondansetron) works well but is very expensive, phenergan (promethazine) works but is really and antihistamine and causes drowsiness. Zofran is a Pregnancy Class B drug (not expected to effect fetus) and Phenergan is a Pregnance Class C drug (not known if it effects fetus). The average trip to the ER to treat HG is $3300.

Here is my question:
Why does my insurance only allow 24 4mg pills of generic Zofran (ondansetron) every 25 days at a cost of $90 (I have a $15 copay, so it is $75 for them), or will allow as much Phenergan as I want?
With 4 mg of Zofran I am still feel really sick, can't do my daily activities, and throw up some of the time. With 8 mg of Zofran I feel a little sick, but can manage most of the time. With Phenergan, I don't know if it will effect my baby, and I fall asleep and am useless. I know, I've been on Phenergan plenty of times. If I run out of meds and have to go to the ER, I have to pay my $100 dollar ER copay and then 20% of the total bill (approx. $740 total) leaving the insurance to pay out $2560. This is far more expensive an option than just paying for the Zofran I need! Which would be under $1000 from week 6 to week 20 (a total of 15 weeks). So why does the stupid insurance company get to decide my treatment? Shouldn't that ultimately be up to my physician? Hmmm...

The Strangest Thing

Jeff said he needed my help with something today. I was thinking, "oh no, what am I gonna have to lift in my condition?" Turns out he wants me to make a list of all the things he needs to get done today so he can prioritize them! Who'd have ever thought!!!! So I guess I'd better get started on that list!

Swim Lessons

The girls had their first swim lessons today! I know, we are way behind. But we are trying to catch up. And I have to say, every single one of the girls got right in the water and were completely happy! They love the water and have definitely spent time in it during the summer. Now we are just gonna teach them to swim without any type of floating device. Ashley and Alona are quite capable of getting around in the water if they have something holding them up. So now they just need to learn to hold themselves up on their own! Here are some pictures.

Natalie was in the same class as her cousin Dylan. She had a blast!


Alona was in the same class as her cousin Ashten. She loved it!


Ashley has dance when the other kids are at swim lessons, so she goes later than the rest of them.


Front floats.

Jeff took the girls this morning. Photos are from his iPhone.

Nothin' but Nausea

It has been three weeks of sickness at my house. And it isn't just me.
On Monday, I broke down and called the doctor. They prescribed Zofran. It makes me not throw up. I still don't feel good, but at least I will survive. I didn't realize how dehydrated I was. I started the medicine Tuesday morning. Alona wanted hot dogs for lunch so we headed to the store. I almost passed out while there. There was a reason I was in bed or on the couch for the previous 2 weeks! I bought a SmartWater at the store (because it has electrolytes) and started working on restoring my hydration. Wednesday was Ashley's field trip to the University of Oregon Natural and Cultural History Museum. I went with her class. It was a little difficult as we were standing for 2 whole hours (although I did manage to sit down on the bench a couple of times and lean on the walls a lot). But I made it through. I didn't feel so well the rest of the day. I have continued to get through each day. I still feel a little nausea, but at least I keep food down. And I tried to do the dishes yesterday and the plates were SO heavy! I am pretty weak still, and still losing weight- which is both good and bad.
Yesterday morning Ashley ate a few bites of breakfast and got sick. She will throw up if she doesn't have enough food. She didn't eat enough dinner Thursday night because she doesn't like hamburgers. Who doesn't like hamburgers? It got worse and worse that evening and into Saturday morning. We were afraid we were going to end up in the ER again. That happened once before. If she gets a stomach bug, she ends up staying sick because she hasn't eaten. She was sick for 4 days once before the doctor gave her phenergen. We have found that if she can keep even the tiniest amount of liquid down, we can turn it around. So we started giving her a teaspoon of Gatorade every 15 minutes. It is turning around and we are up to 3 teaspoons every 15 minutes. She should be back to her normal self tomorrow!