Tuesday, September 05, 2006

Tipat Chalav

I went to my first official visit at "Tipat Chalav". These are nationally sponsored neighborhood health clinics devoted to pre and post natal care. They are considered supplementary to doctor care and they strike me as a darn good idea.
I should have started some time ago but my doctor never mentioned them, perhaps assuming that most Israeli women simply know about them. Then the war started and I went to one in Zichron but didn't open a tik, a file.
Conveniently located a few minutes walk from my house, the Tipat Chalav was clean and cheerful yet had clearly seen better days. Funky child-oriented paintings and pro-breast feeding posters in Hebrew, Arabic, Russian, and Amaharit (Ethiopian) decorated the walls. The waiting room chairs could have used a replacement.
But most importantly, nurse Ela was really nice. And she had all the time in the world for me. She patiently filled out my tik carefully copying down all the information from various tests I carry with me in a folder (this folder did not leave my sight during the war). She recorded additional information such as my parents birth years and birth countries, my husband's profession, and so on. I kept thinking what a boon this data would be to researchers interested in matching the quantity of protein in urine to grandparents place of birth. Or maybe even more useful things. But she assured me that the data was strictly private and that the tik would be a lovely momento. (With this in mind, I'm happy to note that Ela has exceptionally nice handwriting.)
By the end of our time together, I felt she was caught up on all the important details of my pregnancy so far: the scary bleeding and hospitalization at 13 weeks, the myomas, the nausea and vomiting that is mercifully past, the decision not to have amneo (so nice that it's not a big deal anymore!!). And she had nothing but good things to say about my Dr. which is always nice to hear.

What else happens there? She takes my blood pressure, checks my urine for protein and something else (sugar mabye) and weighs me. Mention of that last item caused my blood pressure to spike just a bit, so she did it twice and all was fine. Urine check involves peeing into a cup then dipping a little plastic strip into it. Colored squares either retain their yellow colors, turn green or red. Very exciting.
I have gained about 10 kilos so far. I asked Ela if that's OK. She reasuringly put her hand on my arm and looked into my eyes with her green eye-lined ones and said, "The way we see it is, it's all for a good cause."
So maybe it'a little freaky that most of that I gained after the first 3 months (during which my weight did not change despite FEELING much fatter) and that Cholent currently weighs only 800 g. But, whatever. It's not like I'm up to running marathons now. I'll try to eat more vegetables, really I will.
She went through a long list of unpleasant side-effects which I happily was able to answer "No" to. Even the swelling I'd been feeling in my extremities upon waking has disappeared for a week or so.


The main benefit of going to Tipat Chalav (in addition to doing those basic standard checks) is that you can feel free to ask all the questions you want without fear or embarassment. You could ask the doctor too but a) He's a boy. and b) He's a bit more busy. No particular questions for Ela today but it was good that she reminded me that it's totally normal to experience sadness and mood swings now.

Doctor


We saw the "real" doctor too in the evening. Everything OK there too. His ultrasounds are not nearly as exciting as Dr. Shapiro's, though it was nice to get a quick peek at Cholent who now moves often.
My myomas (fibroids) still there. They are not bothering Cholent, though they may be the reason she was lying transverse (horizontal relative to the floor) during our visit. A C-section therefore remains a likely outcome, not only because the myomas could be in the way but because they may make it more likely for her to be in a non head-down position (or impossible for her to get to a head-down position on her own).
Personally, I think it shows good sense to be transverse at least now - those head down pictures of babies always look uncomfortable to me.
For planning purposes you may find the following info useful:
(1)A final decision re: c-section will be made in week 36 of my pregnancy = Dec 19 - 4 weeks = ~ Nov 21
(2)C-section would be done Week 38 = Dec 19 - 2 weeks = ~ Dec 5.
(3)So.... while it is not 100% certain, I think it is very safe to say she will arrive sooner than Dec 19 at the very very very latest, with good money on a ~Dec 5 arrival.

Fear


I'm feeling less freaked out than last week about the actual birth. Talking to friends really helped. Particulary C. from work who had a baby last year, naturally. She said, "What, only now you're freaking out?"
That made me feel more normal about being afraid.
I also started reading up more on C-sections on the web and in a lovely little booklet my aunt wrote back in 1978.
I read about a woman in Mexico, Inés Ramírez Pérez who did a C-section ON HERSELF with a butcher's knife with only a few slugs of rubbing alcholol as anesthesia. She and baby Orlando survived. Her story made me think about how lucky I am and how no matter how bad it gets, it is extraordinarily unlikely that it will ever be as bad for me as it must have been for her!

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