We applied for a plan with Blue Cross/Blue Shield (who we were with previously). Because we had exhausted our COBRA options, we qualified for something called Guaranteed Issue. Very simply, that means that if we couldn’t be underwritten for a regular plan because of pre-existing conditions, they still had to offer us coverage. I filled out our family application online while I was on the phone with an agent. We discussed that my pre-existing conditions are all pregnancy-related, and decided it would be best to waive maternity coverage.

The decision came back a few days later. I had been denied underwritten coverage because of c-section rehab, postpartum depression, and gestational diabetes. Mike had been denied because of his hospitalization last year. We weren’t worried, though, because we still had the guaranteed issue option…at least, we weren’t worried until we saw what that plan entailed:

$1,266 monthly premium
$4,000 deductible per person or $8,000 maximum family deductible

I had to bust out my calculator, but I figured out we could potentially spend $23,192 out of pocket in the next 12 months. I don’t expect my health insurance to be cheap, but I don’t expect it to be out of reach, either. I believe that you get what you pay for, but for $23,192 I’d think we’d have the best insurance in the world.

It turns out that they have to insure you, but they can charge whatever they want. When I called to be like WTFBBQ you denied me for all pregnancy-related conditions even though I waived maternity coverage, I was told it didn’t matter – I showed a “pattern of health problems.”

The new health care reforms don’t kick in until January 2014. There is a “temporary high risk” pool for people like us, but unfortunately (at least as far as Mike and I understand it), you have to have been uninsured for six months to be considered – meaning, this isn’t even available to us for half a year.

It looks like we have two options: either go into debt to have insurance for all of us, or just insure Annie. We are leaning toward just insuring Annie, but that terrifies me. The last three years have shown us how important insurance is. Our health can turn in an instant.

We’re extremely frustrated. This is another example of just how broken the health care system is and how many people get left out in the cold. Hopefully, by 2014 this won’t be the case anymore. I’m worried though. There is still opposition to reform…could it be derailed by 2014? Also, as this “temporary high risk” pool exhibits, the reforms still aren’t perfect. People (like us) are slipping through the cracks.

I spent hours on the phone today exploring other options (and don’t even get me started on how Blue Cross took money from our bank account three days early). We’re afraid to make the wrong decision. I am so stressed out about this. GAH. And the fact that we are still better off than many only makes the entire situation more despicable.

I’m definitely happy that Annie’s bilirubin levels went down because her yellow skin tone was starting to make her act a little strange. Earlier today, for example, Mike turned the TV to an episode of MTV’s “Jersey Shore,” and Annie immediately locked her gaze on the screen. Mike and I joked that it must have been because she felt a connection to all the orange-skinned, overly tan guidos and guidettes on screen, then left the episode on as we went about our day. This was a mistake. Check out how I found her only a couple hours later:

I immediately took the weights away from Annie, I mean those things could really hurt a newborn! But she wasn’t done acting out. Not ten minutes later Mike found her like this:

Okay, so Annie’s tanning in indirect sunlight was actually a good thing considering her bilirubin levels, but where the heck did she get those sunglasses? Mike took the glasses away and told her she was too young for them (they were totally for 3-6 month olds (but of course they fit her giant Spohr Head)) and that she shouldn’t try to grow up so fast. Annie seemed to get what Mike was saying, but then, five minutes later, we found her like this:

What baby does their own laundry? Mike and I weren’t sure why Annie was acting so strange until it hit us… GTL! Gym, tan, laundry! Annie was only doing what ‘The Situation” taught her to do on “Jersey Shore!” Wow. I guess kids really shouldn’t watch TV. And those Jersey Shore people? Totally not role models. Thankfully, once we learned from Dr. Looove that Annie’s bilirubin number went down, Annie was less interested in imitating Snooki and the gang. Still, it’s cartoons only from here on out…although, I wouldn’t mind if she kept doing her own laundry.

A couple hours later we got a call from Dr. Looove’s office. The results came back at 13.9 mg, which isn’t great. (18 mg or above usually leads to being admitted to the hospital so the baby can be treated under the lights.) Dr. Looove suggested we have another blood test the next day (Tuesday), and if that test resulted in a lower number, that meant the jaundice had peaked and Annie should be fine. Unfortunately – after another heinously long wait at the hospital – Annie’s number came back at 15.1 mg which is a bit worrisome. Dr. Looove’s diagnosis is Annie is suffering from Breast Milk Jaundice, where the mother’s milk “produces an enzyme that interferes temporarily with the normal bilirubin elimination pathways of the liver.” (Thank you, Dr. Google!) The awesome part of this is that this only happens to less than 2% of all babies (sarcasm). The plan now is to suspend breast feeding for 24 hours, and then test her again. In most cases, babies with Breast Milk Jaundice will have their bilirubin numbers back down to normal levels after 24 hours without the breast milk. Interestingly, they then can resume breast feeding without the jaundice reoccurring. Here’s hoping this works…neither Annie or I want to make a habit of getting her cute little heel jabbed at with a needle.

Not to mention I loathe pumping.

In light of Annie’s Baby Pacman impersonation, I thought it might be as good a time as any to try out taking some black and white photos. She is so yummy, like a yellow M&M.

the first time I ever walked around holding my daughter

Maddie on the loose!

in the sun for the first time

our family

When you’re in the NICU for as long as we were, you learn that discharge days are arbitrary. We saw plenty of parents get disappointed and frustrated as their child’s discharge date would get delayed for one reason or another. We were told Madeline would come home that week, but we didn’t let our hopes get TOO high. But that morning, our phone rang, and it was the head of the NICU. “Hi Mr. and Mrs. Spohr! Your daughter is ready to come home!”

Magical, wonderful words.

Mike and I raced to the NICU, car seat installed and ready to be occupied. We practically ran into the NICU and I gleefully removed the last sensors that were stuck to her skin. I dressed her in the going home outfit we’d chosen, and then I picked her up and walked around with her – the first time I’d ever been able to do that. She’d always been tethered to a monitor, or a medicine drip, or a an oxygen tube. But she was finally unencumbered. Mike and I walked her through the NICU for a goodbye – her victory tour – and everyone remarked how big she was. She weighed six pounds two ounces, double her birth weight. We thanked and hugged all the people who saved Madeline’s life, and then we left. I remember feeling like we should run, like the doctors and nurses were going to tell us that a mistake had been made and she wasn’t REALLY allowed to leave.

Mike drove so slow on the way home I still can’t believe we made it back before the sun went down.

Those first few days with her home were amazing and scary and fantastic. We stared at her. We couldn’t believe we got to be with her all the time, that we didn’t have to drive to visit her anymore.

Even Rigby stared at her:

the beginning of a (beautiful) relationship

We were so grateful to have our family together.

It was the best of times.

I turned to twitter for advice and got TONS of ideas. I realized that a lot of what I brought when I was on hospital bed rest would still apply. One key difference this time is that I’ll be able to wear my own clothes (if I want) instead of hospital gowns. I can’t stress how awesome this is. I get weekly updates about my pregnancy from TheBump.com, so I skipped ahead a few weeks (ironically to week 35, where I am now) to see what they suggested for a hospital bag. Their list is great – they list by essentials, the stuff you don’t HAVE to have but might want, and the stuff to leave at home. It helped me whittle down a lot of my list.

So this is the final-ish list of what’s in my hospital bag:

Um. So. Yeah. What does Mike need? I don’t have any idea if he needs anything special. When I was on hospital bed rest, Mike came and went as necessary. This time he’ll stay with me and Binky the entire time, so I want to be sure to have everything he might need.

As is my way, I’m now wondering what else I’ve forgotten. I had a phone list packed, but then we signed up for this awesome service that will call all our friends and family for us. Instead of a notebook and pen and a separate DVD player, I’m bringing a laptop that functions as all those things.

What am I forgetting? Help a mama out!

Also, today is the 11th, which means 11% of all sales made today at Kinga’s Kreations will be donated to Friends of Maddie!

I honestly hadn’t been worried until the nurses seemed concerned. The nurse practitioner found Binky’s heart rate with the doppler, which immediately set my mind at ease. But the NP said that wasn’t enough, and she went off to report to Dr. Risky. A few minutes later a different nurse came in to say Dr. Risky wanted to perform an ultrasound. So off we went to the ultrasound room, where Dr. Risky spent the next ten minutes watching Binky. We could see that she was moving, although not big vigorous movements I could feel. I never have a great angle from the exam table, but it was pretty cool to see her floating around, a hand drifting up every now and then. We even got a good shot of her face. She looked like a little Frankenstein!

Cheat Sheet:

The gentle movements weren’t enough for Dr. Risky, so off to Labor and Delivery I went for monitoring.

In the meantime, Rigby had her follow-up vet appointment, so Mike left me to take her to get checked out. A quick exam lead the vet to conclude Rigby needed an ultrasound. Rigby and I both got pictures of our insides! After the ultrasound, the vet decided that her bladder wasn’t full enough, and told Mike that it would take three hours for it to fill to their liking. He told Mike to come back, but not before mentioning Rigby definitely had SOMETHING in her bladder, and it looked like kidney stones.

So there I am attached to monitors on the Labor and Delivery floor of the hospital, and I get a text that my dog might have kidney stones. It was then I realized sometimes my life is like an episode of Friends.

I was hooked to the machines for about 45 minutes. I couldn’t really relax because the nurses had me shifting into different positions to make sure Binky stayed on the monitors. It was cool to hear her heart pumping away, although it reminded me of the nights I was on hospital bed rest with Madeline. At one point, one of the nurses came over and told me they had enough and I could go. I asked how the baby looked, and they said everything looked fine. It was such a relief.

Mike arrived back at the hospital when I was done, so we had a quick tour of the maternity floor from my old college friend Staci, who is an L&D nurse. I’d been to some parts of the unit but Mike hadn’t been there at all, so it was nice to get acquainted. Then it was back to the vet’s office to check on Rigby.

I haven’t been to the vet’s office in a while. That task always fell to Mike. So I’d forgotten how sad the vet’s office is. All the animals are whimpering and the whole place smells like fear. I had to do some mouth breathing. The assistant brought Rigby out to us and I’m pretty sure she’s NEVER been so happy to see us. My face is raw from all the licking. We spoke to the vet, who said that Rigby’s bladder is FULL of crystals and possibly stones. While she was at the vet, she passed three crystals. The vet showed them to us – they were the size of rice grains. I wanted to cry just looking at them! Poor Rigby. We have to continue to treat her for the next two weeks with antibiotics, an anti-inflammatory, and special food. If those three things don’t improve the situation, Santa will be bringing the Spohr family Doggie Bladder Surgery for Christmas! Just what I always wanted.

Rigby’s anti-inflammatory is a pill. I have a hard enough time getting Mike to swallow pills, so I knew Rigby would be a challenge. Sure enough, she spit the pill out about five times before we finally found the one thing that tricked Rigby into swallowing her pill – a dollop of jam.

My dog really IS Joey Tribbiani.

How YOU doin’

17 weeks 2 days

24 weeks 3 days

Binky is moving along well, and it is such a comfort and relief. Things have been a little bit rougher for me but nothing awful. My sudden crazy upper back and neck pain has been super annoying but it all checks out OK and it’s nothing I can’t handle. My blood pressure has been kind of wild. High one day (132/83 is significantly above my baseline BP), and then extremely low the next day (83/40 is low for ANYONE). It makes taking my blood pressure every day feel like my own weigh-in scene on The Biggest Loser – I never know what the number is going to be.

I actually ended up calling Labor and Delivery over the weekend when my pressure stayed persistently low and I spoke with the on-call doctor. There was talk of me going int0 L&D for monitoring, but it was decided I’d stay home with clear instructions on when to come in and luckily I never got to that point. Two years ago I was admitted to the hospital with Madeline still in my belly. Walking into Labor and Delivery two years later (to the day) would have seriously tripped my brain.

I spend most of my days taking it easy. Dr. Risky wants me to be careful, but I’m not on bed rest so I can still go out, as long as I don’t over exert myself. Mike has been WONDERFUL picking up my slack, but sometimes I gotta get out of the house and grocery shop with him.

What, like Mike is going to let me walk through the store? I can’t get away with anything around here.

We walked through the medical plaza before we went into the hospital, and I pointed things out to them. The lab where I fainted, the hematology clinic, Dr. Blood’s office, where we saw Matthew Perry, Dr. Risky’s office, the cafeteria where the hot doctors eat, where the crowds gathered after Michael Jackson died. You know, the landmarks. It seemed like I’d really come to know the place since my weekly obstetric appointments had started.

Except, we’ve been keeping appointments in the medical plaza for over a year. Appointments for Madeline. The building houses Dr. Lung and the NICU follow-up clinic. It has the x-ray machine that took many images of Maddie’s lungs. It’s where we were told she was doing so well, developmentally right on target, sloooowly catching up in size.

In fact, we were there a year ago yesterday. I didn’t know that when we were there, but while I walked through the corridors of the medical plaza with my mom and friend I was hit with a lot of memories. I remembered when Maddie was smaller and Mike and I would push her in her stroller to her appointments. As she got bigger, I’d carry her on my hip and she’d make friends with everyone we passed. I remembered standing in the elevator lobby while four nurses went wild over Maddie, and she waved and said hi to all of them. I remembered the pride I felt that my daughter was so happy and charming despite her rough start in life. I remember sitting in the waiting room surrounded by “sick kids,” and longing for the day that Maddie wouldn’t need monthly check-ups. Now I’d do anything to be sitting in the waiting room with her again.

Mike usually drops me off in front of the medical plaza before my OB appointments. I go check in, and he parks the car. The first time I walked in alone, I automatically hit the elevator button for the second floor. The pediatrics doctors are on the second floor. I didn’t realize my mistake until I rounded the corner and saw the big fish tank in the waiting room. The kids’ fish tank. Maddie LOVED looking at those fish. I burst into tears.

Later today, I will take that elevator to the fourth floor, and see detailed images of my second child. I will leave my sadness on the lower floors. On the fourth floor, only cautious excitement is allowed.

Because my pregnancy had so many complications, Dr. Looove ordered more than the usual panel of tests. I had some major blood work – 14 vials of blood were taken that afternoon. Yeah, I practically needed a transfusion after the nurse was done. I will say, the nurse that took my blood was so amazingly gentle that I started to cry. I cried because she was always Maddie’s nurse. She didn’t hurt me, and I realized she never hurt Maddie. It was a relief.

I didn’t think much of the tests until Dr. Looove called me a few weeks later. Everything had come back normal except for one thing – I had an indicator in my blood that is common in clotting disorders. She’d run it because I’d had so many blood clots during Madeline’s pregnancy. Dr. Looove hypothesized that this could have been the reason Maddie was born eleven weeks early. She referred me to a hematologist, and that appointment was yesterday.

I was very nervous about the appointment, I barely slept the night before. Luckily, the hematologist immediately put us at ease. He went through my whole history and asked a zillion questions, examined me, and then poured over the test results. He was very interested in hearing all about my pregnancy with Maddie, and requested access to my pregnancy records. He is especially interested in the pathology results from Maddie’s placenta.

Dr. Blood (come on, you knew I was going to give him a nickname) doesn’t want to make a diagnosis until he reviews my pregnancy and gets new tests results (eight more vials of blood were taken, yay). But he said that I may have something called Antiphospholipid Antibody Syndrome. Basically, that means my body’s immune system “attacks” its own clotting mechanism.

Our biggest question after getting all this information was – should I have been tested for this when I was pregnant? My general practitioner thought to test for it, so it seems like something my obstetrician and THREE high-risk OBs would have thought to check for, too, right? Dr. Blood said, “well…” and his pause and the look on his face spoke volumes, “some doctors are not used to this sort of thing, and might not think that way…but with the presence of clots I would think that yes, you probably should have been tested.”

Oh good! I LOVE the Coulda/Woulda/Shoulda Game! Now with the exciting What If? Bonus Round!!!

So what does this mean? Well…there is still a lot of testing to be done. Like I mentioned, I had repeat labs run today, and they will be run again in eight weeks. Right now we just have to wait. My pregnancy records are being sent to Dr. Blood (my former OB is associated with a different hospital), and once he reviews them he’ll decide on the next step.

Until then, all we can do is wait and wonder.

From Thursday to Sunday morning, Mike and I were dog sitting for our friend Alison. This is her dog, Dignan.

Mike loves Dignan so much, that I swear when he reads this at work he will gasp and yell, “DIIIIIIIGNAAAAN!”

Dignan is a Yorkshire Terrier, and so well-trained and well-behaved that it shines a bright light on the terrible job I did training Rigby. Anyway, Dignan eats canned dog food. Rigby eats dry dog food. Dignan eats his food twice a day, Rigby free feeds (that is for her own good, trust me). On Thursday, Dignan had already had his breakfast, so I just had to give him a can of food for dinner. It had one of those ring-things, so I just had to pull on it, I didn’t need a can opener. I’m not entirely sure what happened…I know I was talking to Mike, tugging on the lid of the can. And the lid kind of got stuck, so I thought, “I should just get a spoon and scoop it out.” But then as I walked back to Dignan’s bowl I decided to give the lid one more tug…and the lid came off and sliced my pinkie finger from right below my nail bed all the way around to the middle of the tip.

I think I sort of blacked out in a haze of blood and curse words. I just remember being in the kitchen, yelling at two dogs to NOT lick my blood up off the floor. I rinsed my hand to ensure no dog food got in the cut (BARF) and then I wrapped it tightly. But before I wrapped it, I got a good look at the cut. Well, as good a look as one can get when blood is gushing out of a wound. I knew it was bad. If Mike had cut his finger this badly, I would have dragged him kicking and screaming to the hospital. But since I am a big hypocrite, I didn’t go.

The next morning my whole hand hurt so badly I couldn’t deny something was not right. I took the bandage off…and blood started gushing out of the cut. CRAP. So I called Dr. Looove’s office (she’s my doctor too!), because the idea of going to the ER in the middle of the day, with Maddie in tow, was NOT appealing. Luckily, Dr. Looove told me to come see her.

She looked at my cut and asked how long it had been since I’d cut my finger. It had been about, oh, sixteen hours at that point. She gave me A Look, then said it was too late for stitches. I’m not going to say I wasn’t immensely pleased when she said that, although I can honestly say that I didn’t know there was a window on when you can and can not get stitches. Dr. Looove admonished me for not going to the ER right after I hurt myself, telling me I needed “several” stitches, but she totally understood when I said I didn’t really feel like shelling out my $100 ER copay for a few finger stitches. I mean, really, I don’t care if I have a scar on my pinkie finger. I’ll tell everyone I got it in the gang wars.

Dr. Looove said she’d get a nurse to clean and repair my finger, but she couldn’t find one that was available so she decided to do it herself so I wouldn’t have to wait. This both pleased and terrified me. Doctors just…aren’t…gentle. They don’t have that magic way of making things not hurt the way nurses do. With the exception of the nurse I dubbed “Stabby” back in my hospital bed rest days, I’ve never had a nurse hurt me. I’ve had PLENTY of doctors hurt me. My OB did a blood draw once that made me cry. Man, I hated her.

Anyway, Dr. Loove was as gentle as she could be as she cleaned out my finger but it still STUNG TO HIGH HEAVEN, and then she had to push my wound closed while she glued it shut and applied Steri Strips. It took everything I had not to scream. It HURT. The whole process took a lot longer than I expected. Which meant Dr. Looove and I had a lot of one on one time. Sure, Maddie was there in her stroller, but she didn’t really add much to the conversation. Dr. Looove asked me a bunch of questions about how Maddie was doing, so I filled her in on the feeding specialist and she laughed. Then she asked how Mike and I were doing so I filled her in on us…and then there was silence. And for some reason I just couldn’t bide the silence. I couldn’t! I could feel this terrible bubble rising in me where I was about to admit that I stalk her on facebook (we’re not friends but we’re in the same network). I tried to push it down, but I opened my mouth to tell her how pretty she looked at her sister’s wedding…and then she interrupted me.

“Well, I just want to say that you and Mike are doing an amazing job with Madeline.”

“Oh. OH! Thank you! That’s very sweet of you!” (DON’T TELL HER YOU STALK HER FACEBOOK HEATHER!)

“I don’t have my own kids yet (I already knew that, she is Mike’s age and unmarried with no kids, thank you Facebook!), but I obviously see a lot of kids and their parents, and you two handle everything so well, and Maddie is just doing fantastic. You should be really proud.”

And then she gave me this really sincere look that made me want to cry a little.

“Oh! Well, thank you. We just do the best we can, we love her and we want her to be healthy, and you’re a great doctor and pretty and thanks and all that!”

Then she gave me a look like, “did you just call me pretty?” and said, “OK. Next time, don’t be such a chicken about stitches! You have to at least ACT tougher than Maddie!”

And then I almost said, “you should totally update your facebook status to ‘just busted a patient!’” but luckily she walked out of the exam room before anymore verbal diarrhea could escape past my lips.

So, see?! Someone was nice to me! Don’t worry, I’m sure the universe will right itself very soon.