Finally Back Home

Thank you so much to everyone in Anchorage who was so wonderful to us during our stay there- Marika, Marika's friends, Dr Ha, Dr McCleave, Dr Tulip, and everyone at the Providence Alaska Medical Center and the Hickel House. But on Tuesday, August 10, 2010, we were finally going home.

Jack with all our luggage (5 checked bags, a stroller and car seat that were gate checked, 3 carry-on bags and a boppy) at the Anchorage International Airport at 7 am on Aug 10


Jack and me on our flight from Anchorage to Minneapolis. He slept almost the entire 5 hours!


Chris and Jack at the Minneapolis Airport, waiting to board our flight to Boston.


Arriving in Boston at 11:15 pm!

The three of us at home in his nursery on Aug 11. His nursery was very nicely set up by his extended family while I was in Alaska.

And they all lived happily ever after. The end!

Meet Jack!

Sorry about the delay since the last posting, but we've been kind of busy. Just to warn you, there are A LOT of pictures in this posting...

On Tuesday July 27, we woke up at the crack of dawn, and by 5:15 am were walking across the SkyBridge at Providence Alaska Medical Center towards Ob Admitting. They quickly got me settled in and started an IV. Around 7:15 am, I was wheeled to the OR, where the very nice anesthesiologist started the spinal. I think I was more nervous about that than anything else! The spinal was pretty trippy, it was really weird having my legs and lower abdomen numb and paralyzed. Chris came back to the OR once the spinal was complete and I was prepped. It always amazes me how quickly it takes for the baby to come out during a c-section. At 8:01 am, Jack was born! The first thing I heard was Dr Ha say was a comment on how much hair he has, and he does have a lot! Apgars were 8 and 9- I didn't see the breakdown but I'm imaging 1 point lost for color at both times, and 1 point lost for some grunting at 1 minute (breathing difficulties, for you non-medical people out there). Chris got to see him get weighed (8 pounds 12 ounces) and measured (length 21.5 inches, head circumference 34.5 cm). They then brought him over to me, so I could be with him while they sewed and stapled me up.

Jack a few minutes after he was born

At some point, Chris took Jack out to meet my mom, dad, and step-mother, who were all waiting to meet him and for the big announcement of his name: John Francis Brigham. John was Chris' dad's name, and Francis was my maternal grandfather's name. Like Chris' dad, we will be calling him Jack.

Me, Chris, and Jack shortly after his birth

Because I had a c-section, we were in the hospital for 4 nights (through Saturday July 31).

Jack and my mom on 7/28

Jack on his belly on 7/30, slightly jaundiced. And look at all that hair!

I honestly don't know how women do it who go home after only 2 nights in the hospital. I really needed the support of the nurses and lactation consultants, and 2 days and nights certainly wouldn't have been enough to make me feel confident as to what I was doing. And the nurses there really were wonderful. Chris slept over in the room with me, and we kept Jack with us at all times, and one night we were really struggling- I was having trouble breast feeding and then even when that was over, we couldn't get Jack to settle. One nurse sat in the room with me for an hour, helping me feed him and then helping me get him to sleep. I couldn't believe that she was able to spend some much uninterrupted time with me!

Chris with Jack on 7/31

We came "home" to the Hickel House on the afternoon of Saturday July 31. It was nice to be back among familiar surroundings.

The three of us heading leaving the hospital!

My dad and step-mother flew home to Boston on Saturday, but my mom is still here, staying at Marika's house, until this coming Thursday, when she returns to Boston. It was been very nice to have that extra support! Jack is a really good baby, so happy during the day and a great napper! However, at night, for the first few nights, he did NOT want to sleep, and spent several hours crying, which was hard on all 3 of us. But last night, we had two 3 hour chunks of uninterrupted sleep, which makes such a difference!

Our first bath time experience with Jack on 8/1


Jack and me hanging out in our room at the Hickel House

We have had a relatively busy day today. Jack had his 1 week follow up appointment with his Alaskan pediatrician, Dr Tulip, who is so nice. He has gained 5 ounces since his discharge, and is doing really well. We then went up to the Chugatch Mountains, the same place that Chris and I went the first day with Marika, and then later went back with my mom. We went for a little walk with Jack, and then had a picnic lunch.

Chris, Jack, and me on the Anchorage Overlook Trail

Chris, Jack, and me on a bench with the Chugatch mountains in the background. This is the same bench (although slightly different angle) as earlier pictures of Chris and my mom. He is wearing a hat knit by Marika's mom and a sweater knit by my mom. Fortunately, this is summer wear in Alaska so he wasn't sweltering...

It is amazing how long everything takes now. We think we're ready to go out the door when he decides he's hungry, and then after I feed him, he needs a diaper change. I wanted to do a blog posting yesterday, but never had time to do it. I started this posting at 9:45 am, and 7 hours, I'm only this far.

It's actually pretty hard for me to believe that we are scheduled to go home in 1 week! I almost can't imagine being at home at this point. It's going to be weird not seeing Marika so frequently, I've gotten spoiled by seeing her so often again! But I am looking forward to returning home, having Jack meet his aunts, uncles, and paternal grandmother, as well as many friends and family in the Boston area.

Chris and I of course think that Jack is just about the most handsome, adorable baby ever, and feel very lucky that everything turned out so well in the end. And all that hair!! What has been somewhat of a surprise is that we have become some of those people, you know the ones, the ones who endlessly talk about how cute their baby is. This is somewhat surprising, given that neither one of us were particularly baby people, but I guess having one of your own really does change you!! And along those lines, here are a few short videos my mom took of Jack, videos that my mom would point out only a parent could love (specifically his parents), because otherwise they might be a bit boring. But I think they're awfully cute...

Jack wiggling and stretching

Jack discovering the joy of sucking his thumb for the first time

39 0/7

So today is my last posting before the baby is born! Last Thursday, my mom and I went to the Alaska Zoo. It was neat because it was mostly animals native to Alaska, such as black bears, brown bears, polar bears, moose, caribou etc. And the non-native animals were all from cold weather places elsewhere in the world, like tigers from Siberia. We also twice heard the wolves howling, which was pretty eerie. My mom took a short video of this, which you can see on YouTube if you click here.

Black Bear at the Alaska Zoo, similar to the one seen the next day in Anchorage!

Then on Friday, we were driving down Lake Otis Parkway, between 15th and 20th (for those of you who know where that is), and in the backyard of one of the developments there I saw a black bear moseying along! It was very exciting! But also a little scary, because that's just a few hundred yards from where Marika lives! But it was nice to check off "seeing an urban bear" from my list of things I wanted to do while in Anchorage. If only I could see Denali once before I go home, then I would feel that my trip was complete. :-)

On Saturday, Chris, my dad, and step-mother Joyce all arrived. It was so nice to see them! It had been 7 weeks since Chris had flown home, so I was pretty happy to have him back here, and before the baby was born too! Last evening, we tried to go for a walk on the Coastal Trail, but it started raining again, so we didn't get very far. But my mom was able to take this picture before the deluge.

This morning I went to the hospital for my pre-op blood work, and impressively the phlebotomist was able to get me on the 1st stick without even needing to use a butterfly needle! Later today, we're going to Babies R'Us to buy some more supplies off my registry- Babies R'Us gives a 10% discount 1 week before your due date, and since my due date is technically 8/2, today is 1 week before. Chris assembled our stroller yesterday, and I think we've mostly figured out the car seat, as we're feeling as prepared as I suppose we can, at this point. One sort of amusing thing that happened today is my watch died, and we've decided that this is symbolic of the fact that once the baby is born, I'm not going to have any control over my schedule anyway! Tomorrow, we have to be at the hospital at 5:30 am, and the c-section is scheduled for 7:30 am Alaska time (11:30 EST). We'll send out some sort of announcement as soon as we can afterwards...

38 1/7

The end is finally approaching! I had my last ob appointment this morning before my c-section next week. Everything continues to be fine. I got to sign the consent form, which listed the usual million and a half ways they could maim me and the baby- frankly, the list was so ridiculous, it almost makes it pointless because if you were really worried about all those things, there is no way you could go through with it. But that's out the medico-legal world rolls. I am beyond ready for this baby to be born. I remember my mom telling me a long while back that 9 months is a really long time, I had no idea...

We've had a relatively quiet week since my last posting. I have seen 3 movies in the theater though, that should hold me for the many months/years that I'm sure it will be before I am able to again see a movie in a theater. We have also been exploring the Tony Knowles Coastal Trail, which is a very nice paved path along Anchorage's coast. I think it's about 11 miles long, so we've tried starting at various parking spots and walk for about 30 min round trip. It's very pretty, I wish all cities had done as nice of a job of conserving it's coastline for everyone to use!

Along the Coastal Trail, looking back at downtown Anchorage with the tops of the Chugach Mountains peaking through the clouds

Our most exciting day was Saturday, when conveniently the weather was gorgeous. We went to the Fire Island Bakery for breakfast, home of the most delicious scones (they have to be about 25% butter), and brought breakfast to a picnic bench at one of the parking spots along the Coastal Trail. After breakfast, we took a walk. Later that day, we drove up to the Chugach Mountains to the Anchorage Overlook Trail, the same lookout that Marika took Chris and me to on our first day here, way back on May 22. Much less snow on the ground, the mountains were a lot greener, and there were a TON more cars in the parking lot than there was in May.

My mom in front of Flattop Mountin in the Chugach Mountains. If you go back to my 1st blog posting in May, you can see a picture of Chris sitting on this same bench.

Also on Saturday, we took a tour of the maternity ward at Providence Medical Center. My mom and I had very different reactions- she was impressed by how many delivery rooms there were, while I thought it seemed so small! But I am a bit biased, since my delivery room rotation as a pediatric resident was at Brigham and Women's Hospital, which I believe has the 2nd highest number of deliveries of any hospital in the country. But regardless of the number, it seemed very nice. They also gave me a booklet of all the various birthing and child care classes that they have. They have the typical classes that you would expect at any hospital, plus 2 that I am pretty certain you wouldn't see in Boston: Babes in the Snow ("designed to empower parents of infants and tots with the tools and confidence they need to embrace winter with their little ones") and Babes in the Woods: Hiking/Backpacking ("how to stay safe, sane, dry, and relatively bug free on the trails of Alaska's backcountry"). There were several other pregnant women on this tour, and it surprised me that quite a few of them who aren't due for weeks/months looked more pregnant that I do. While I feel a big as a house (and you can see this latest profile picture of me below), I guess I'm still not as large as I potentially could be. This is not something that concerns me though, because all my ultrasounds have confirmed that this baby will likely be on the large side (and given Chris and my heights, what else would you expect?), and certainly is appropriately developed for age.

The most recent of the many profile pictures my mom has insisted on taking, much to my chagrin.

The weather hasn't been very nice the last few days, so we haven't done much since then. Tomorrow, we will likely be having breakfast with the husband of my mom's best friend from when she grew up, who is arriving in Anchorage late tonight for a fishing trip. Then tomorrow night, Marika's parents are in town so we'll be getting together for them with dinner. It should be fun to see new people! Nothing big planned for Thurs or Fri, but on Sat, Chris, my dad, and step-mother all arrive. I'm just crossing all my fingers and toes that I don't go into labor before then. Their flight gets in at 2:18 pm, and frankly I'd be thrilled if I went into labor at 2:19 pm, but hopefully not before then!

37 0/7

Mom by the totem pole at the Alaska Native Heritage Center

I am now officially full term and it's time for my weekly post-ob appointment posting! I had my weekly visit this morning, everything continues to be fine. I am starting to feel more tired though, and I'm not sleeping as well as I had been before, mostly due to lots of kicking. I think either he's training for the World Cup in 2034 or is going to be a drummer, because the kicking is very rhythmic. His new favorite place to kick me is on the left side on the underside of my ribs, which is actually kind of painful. The nurse today asked me if I was counting the days, and I told her I'm counting the days to 3 different events: Chris coming out (13), the baby being born (16), and when we are heading back to Boston (30).

In the meantime, the time here is actually going by more quickly that I would have expected. Sleeping so much certainly takes up much of my day. But everyday we try to go for a walk and then do something else. On Friday, my mom and I went to the Alaska Native Heritage Center, which had really interesting exhibits about the various native cultures. It also happened to be a beautifully sunny day, which was nice because most of the exhibits were outside. We had lunch at their outside grill, and had native foods too: I had a reindeer burger (tasted pretty much like a hamburger) and mom got grilled salmon. We also got pedicures on Sat, which was pretty crucial for me, because it's getting harder and harder for me to touch my toes!

Today is another beautiful sunny day. I'm pretty tired this morning due to my lack of sleep last night, but hopefully if I feel a bit perkier later in the day, we'll go for a walk. The nice thing is that since the sun sets to late, we can take walks late in the afternoon/early evening and it's still broad daylight out there! Tonight is the season premiere of "The Closer," which I'm kind of pathetically excited about seeing. Then later this week, I'm going to be joining Marika and her friends for some get-togethers in the evenings, which should be fun too.

Thanks again to everyone who has emailed, written, and called me. It's nice to still feel connected to home!

36 1/7

I really don't have much to say since my last posting, it's been pretty quiet since Kristin and Chris left. But I did have my weekly ob visit this morning, and feel somewhat obligated to do a posting as a result. Everything continues to look fine. The baby is still growing and kicking. Now we're just waiting.

I suppose the big news is that Chris now has a ticket to come up Saturday July 24, the weekend before the c-section is scheduled. I'm just crossing my fingers that this baby doesn't decide to come early! And the perhaps bigger news is that we now have tickets to come home 2 weeks after the c-section, on Tuesday August 10. Somehow it makes it more bearable to be here, knowing that the end is in sight. My dad and step-mother are also coming up on July 24, and will be here for a week. My mom is scheduled to fly home on August 5, and Chris and I are hoping that we will be seasoned enough at that point to survive the last few days on our own!

The other thing I (re)learned yesterday is that it could always be worse! When we were having dinner at the Hickel House, another woman was saying that she was staying here because her daughter was having complications with her pregnancy. Her daughter was attending school in Fairbanks and developed some sort of complication (I didn't ask) and now she is on strict bed rest. I can't even imagine how miserable strict bed rest would be. But the real kicker is that this mother came all the way from Cameroon to be with her daughter! Kind of puts coming from Boston in perspective...

35 6/7

Since my last posting, we have been trying to get a bit more organized, since this baby will be here in a little over 3 weeks! We went to Babies R'Us and bought what hopefully will be enough clothing and supplies to get us through 2 weeks in Alaska without doing daily laundry yet without requiring us to pack 3 extra suitcases to get home to Boston. It's very hard to figure out what exactly I need here, and what can wait until I get home. Despite being a pediatrician, I feel very clueless about the whole situation. The other thing that I've decided is really stupid is the cut off between newborn items and size 1- it's around 8 pounds, and so many newborns are around 8 pounds. Why couldn't they have made it something that is more clearly an actual cut off for newborns, like 10 pounds?!?

I have also decided though that I want to go home all in 1 day, when it is time to for us to go home. While it will take over 12 hours door to door to go from Anchorage, AK, to Watertown, MA, and I'm sure I'll be exhausted and in some degree of pain at the end, I think that stopping off halfway, getting our luggage, checking into a hotel room, checking out the next morning, rechecking luggage, re-going through security etc would also be quite exhausting. The pediatrician side of me is also fairly convinced that he is going to catch a cold from all the lovely recirculated air on the plane, and any baby 28 days old or younger with a fever of 100.4 or higher essentially automatically gets a 2 day hospital admission, so if he does spike a fever, I'd rather have that happen in Boston than in Minneapolis, Salt Lake City, Seattle, Chicago, or wherever we'd end up having an overnight layover. At least in Boston, I could choose which hospital to go to (Newton Wellesley Hospital would be my hospital of choice, by the way, no offense to MGH or CHB, but MGH and CHB don't have single rooms and NWH does!) and would be surrounding by family and my things! Also since our last posting, my mom, sister and I took a drive up north, and walked to Thunderbird Falls, which was a pretty waterfall, but nothing spectacular like other sites I've seen here. But after that, we went to a really fascinating church in Eklutna. St Nicholas Orthodox Church is left over from the days when the Russians came to Alaska and converted the native Athabaskans. The church seemed quite traditional Russian Orthodox to me, with beautiful paintings of icons in the inside. But the church burial ground incorporated the native tradition of Spirit Boxes, which are still being used today. So that was really neat to see.

St. Nicholas Orthodox Church

The inside of the church.

Spirit Boxes.

Kristin and Chris (my brother-in-law, not husband) left last night. It's always sad for me to drop people off at the airport, both because I'm sorry they're leaving and I'm sorry I'm not going with them! But at least Chris (my husband) will probably be here in a little less than 3 weeks and then the baby should be here in a little more than 3 weeks! The big challenge between now and then is to keep both my mind and muscles from atrophying. My mom and I are going to try to go for at least a short walk everyday and then a car ride somewhere, just to keep from getting too stir crazy. Other goals for the next few weeks:

• read some more books, as I've been told I won't have time like this to read for about a decade or so
• finish seasons 4 and 5 of "The Wire"
• start reviewing my Spanish, thanks to some CDs that have been sent to me
• learn how to install a car seat
• organize all the baby stuff and figure out if I need to buy more stuff
  

That's about all I can think of for right now.

Happy 4th of July!

35 2/7

Since my doctor cleared me last week to drive a bit further, on Monday we drove to Girdwood, which is about 45 minutes south of Anchorage. We made a few stops along the way down, and then had lunch in Girdwood, which is a small town at the base of the Alyeska Ski resort. We took a tram up to the top of the mountain (2,300 feet). Unfortunately, it was kind of cloudy at the top, so we could only intermittently see all the way down to the bottom, but it was still pretty cool up top, with an impressive amount of snow given that it's almost July!

My mom on top of Mt Alyeska, with Kristin and Chris (my brother-in-law, not my husband) in the background.

Taking the tram down the mountain, with another tram coming on up.

On the way back to Anchorage, we again made several stops on the Seward Highway. If you want to see more pictures, I've posted them on flickr.

I had my weekly ob appt today. It was supposed to be with Dr Ha, but about 5 min before I saw her she had to run to the hospital to deliver a baby, so I ended up seeing Dr McCleave instead. Very different from my ob's office in Boston, in which each doctor has a day when they're on call and don't see any clinic visits on those days. But I guess in a practice with only 2 doctors, things like that would have to run a bit differently. Everything continues to be fine, and now I have a date for a c-section: Tues July 27. Now we just need to work on plane tickets to get Chris up here before then. Hopefully I won't go into labor early, because then they'd have to take me to c-section whenever that happens. But since I'll be 39 1/7 on July 27, hopefully that won't happen!

Several people have commented that I don't look all that pregnant in pictures I've posted on the blog. In order to prove that I am in fact quite pregnant and in Alaska, my mom took this profile picture of me, which will hopefully put all rumors to rest! And trust me, my diminished lung and bladder capacity continually remind me just how pregnant I am...

Me, 35 0/7 weeks pregnant

34 4/7

Me, my dad, and my sister grilling some hamburgers at the Hickel House.

It's been a while since my last posting, it's been a busy week! My dad, sister, and brother-in-law all arrived on Sat. On Sunday, we went out to brunch for father's day at a nice restaurant in Anchorage. Then on Monday, the weather was beautiful so we went for a drive down the Seward Highway. It was the same stretch of road I had been down with Eleanor and Marika last week, but was very different seeing it when it was sunny and no gale force winds. Then on Tuesday, we were going to go to the Anchorage Museum, but Kristin ate a nut and didn't feel well so we hung out at the Hickel House instead. But on Wednesday, we went for a little over an hour. They had some really interesting native Alaskan artifacts and exhibits on the history of the region. Kristin pushed me around in wheel chair, because I'm really not supposed to be on my feet all that much. On Wed night, my dad flew back to Boston but Kristin and Chris are staying until July 3.

The other big event was figuring out whether or not I could go home to Boston before or after I deliver. On Wed morning, I had a repeat ultrasound with Dr Richey, the perinatologist who consulted when I was hospitalized. She said everything looked good and thought that it would be okay for me to fly home; however, what she said to me verbally was not quite the same as what ended up in the final report. When I saw Dr McCleave, the regular ob/gyn on Thursday, she was less encouraging about my flying home, after reading Dr Richey's final report. She was concerned about what might happen if I started bleeding again halfway between here and Seattle, because I could be a good hour and a half to two hours away from medical care, since there isn't a whole lot between here and Seattle. And since we still don't know why I bled in the first place, going up to 30,000 feet and back down again, and experiencing depressurization and repressurization, I might be putting myself and the baby at risk. I told myself last week that I would only go home if all the doctors I've been consulting with agreed it was safe to go home, and since they didn't, I've decided to stay until I deliver. While it saddens me that I'll be here for another 7-8 weeks, a healthy baby is the most important thing at this point, so I'll just tough it out.

However, I have come up with a list of pros of staying in Alaska:
-A birth certificate from Anchorage is certainly more interesting than one from Boston
-Lots of vitamin D from all the sunlight!
-I didn't have a chance to say goodbye to Marika before she went "outside" to a wedding, and now I'll get to see her again
-I also didn't get a chance to say goodbye to Dakota before she went to Marika's friend's house, and now I'll get to hang out with her again
-I have a bit more time to see different sites around here (and Dr McCleave cleared me to go as far as Girdwood!)
-Maybe I'll actually get to see a bear before I leave, still haven't seen one of those...

-I saved my mom, sister, and brother-in-law major airline fees because now they don't have to reschedule their flights since I'm staying here too!

The other information that came from my repeat ultrasound with Dr Richey is that it looks like I will in fact need to have a c-section. The placenta is still pretty low, so there is a risk for major bleeding if I don't have a c-section. Frankly, I'm totally fine with having a c-section, and in some ways makes it a bit easier to plan as to when Chris should return to Alaska. So that will probably be the last week of July, and I've been told that I should fly until 2 weeks after a c-section, so I'll be home mid August. I put up a new poll question and would be very interested in the opinion of women who have had c-sections in the past (but please don't answer it if you haven't personally experienced a c-section yourself!).

33 5/7

Eleanor, Marika, and Dakota at a VERY windy pull off from the Seward Highway

Eagle River Nature Center

I just had an eventful (in a good way) few days. On Wed, I had my weekly ob appoinment with Dr Ha. Everything continues to look fine. This coming Wed I have my repeat ultrasound with Dr Richey to see if there have been any further issues. Dr Ha is unfortunately away next week, so on Thurs I'll have an appointment with her partner, Dr McCleave, who I also met while hospitalized. My impression from my hospitalization is that Dr McCleave is more conservative in her management than Dr Ha, so I think it's less likely that I will be cleared to fly home, but I'd actually have the more conservative doctor help me to make this major decision, because if Dr McCleave does think it's safe for me to fly home, that would reassure me that much more about the safety of flying home. But honestly, I'm trying to not think about this too much, because I won't have the information I need until next week, so no point in worrying or obsessing about it!

The other big event was that Marika's and my friend Eleanor came from DC for a whirlwind visit! Marika and Eleanor were actually supposed to be visiting me this weekend in Boston, but since I wasn't going to be in Boston, Eleanor decided to come up here instead! She arrived Wed around noon, and went home last night at 9 pm. Marika was fortunately able to take the day off on Thursday, and since I'm able to drive 30 min from the hospital in any direction, we went on some mini road-trips. We drove 30 minutes south on the Seward Highway, which was absolutely stunning! We then had lunch in Anchorage, and drove north 30 minutes on the Glenn Highway to the Eagle River Nature Center, which was also quite pretty. It is amazing how much you can see 30 minutes from Anchorage! Meanwhile, since I was occupied with my friends, my mom went on train trip down to Seward and then went on a sight seeing boat trip from Seward, and then took the train back to Anchorage. I was glad that she was finally able to see some of Alaska! On Friday, I was pretty tired from my big Thursday, so we took it easy. Marika had to work, so we went downtown and watched her in action in the court room, which was a lot of fun. We all had dinner together at a great Thai restaurant last night, and then Marika drove Eleanor to the airport.

This morning, I slept in, as I was still kind of beat. Today, my dad, sister, and brother-in-law all arrive, so it will be nice to see them all.

33 0/7

Beautiful birch forests at the gardens

A bee buzzing around the peonies.

Forget Me Nots, which I think are the state flower of Alaska.

A cat joining us on the patio.

Marika and me at the restaurant on Sunday night.

Since my doctor cleared me for more activity, we've been slowly doing a bit more and more. Initially, we just went for walks around the hospital (which is actually quite large!). But on Saturday, Marika was in a road race so she lent us her car for the day. First, we went out to breakfast at the Cafe Amsterdam and had a ridiculously large breakfast. We used the opportunity of having a car to go grocery shopping, and then in the afternoon, we went to Anchorage Markets and Festival, which is a 2 block open air market, full of all sorts of different things. We bought some appropriately themed Alaskan baby clothing and some absolutely beautiful photos of Alaskan wildlife that I'm planning on framing for the baby's room, whenever I do finally get home. One of the things that I found most interesting was the street food at the festival- lots of local items, such as lots of halibut and salmon, and most intriguing perhaps was the salmon and reindeer quesadilla.

Yesterday, we took a taxi to the Anchorage Botanical Gardens and took a nice 30 min stroll around the place. That's where all the pictures of nature at the top of this posting are from. I'm sorry, I haven't yet figured out how to embed pictures within the text of my blog posting! The weather yesterday afternoon was sunny and warm, so when we returned to the Hickel House we sat out on the patio, and were joined by a local cat. Then Marika drove us downtown and we all had dinner together at Simon and Seaforts, a great restaurant overlooking Cook Inlet. The food was excellent, particularly the mixed berry cobbler that I had for dessert. So all in all, an excellent weekend!

32 2/7

The view from the SkyBridge from the Hickel House to the hospital.

Me on the patio outside the Hickel House.

Common kitchen in the Hickel House

Dining and living rooms of the Hickel House.

Our room.

The Hickel House

Sorry about the lack of postings recently, but I haven't had much to say until today. Chris flew home on Sunday, which was sad. My mom arrived last night though. This morning, we called up the Hickel House at the Providence Alaska Medical Center, and they had a room for us. Marika has been a wonderful host, but we've been at her place for over 2 weeks, and if guests begin to smell after 3 days, I can only begin to imagine what it's like after 2 1/2 weeks! So my mom spent the morning packing up my stuff for me. It's very frustrating to not be able to do simple things like that for myself.

Then this afternoon, I had my weekly ob appointment. Everything continues to look fine. The good news is my doctor said that I can now liberalize my activity a little bit. I can go for car rides, we can go out to restaurants to eat or go to a movie! She also said that I can try walking a bit more, for up to an hour at a time. I'm probably going to take it slow at first, and slowly start walking more and more.

Later this afternoon, we moved our things over to the Hickel House. My mom had to lug all the luggage around and unpack all my things for me (again, very frustrating!). This is really a very nice place. Our room looks basically like any hotel room, but the common areas are really lovely.

Here is my new mailing address, in case anyone has any huge desire to write:

Walter J. & Ermalee Hickel House

ATTN: Kathryn Brigham, Room 207

3967 Piper St

Anchorage, AK 99508

We also have a direct line and voicemail in our room, and can be reached at 907-212-4207. But we also both have our cell phones and can be reached with those as well.

After we unpacked, we explored the area (which is when all the above pictures were taken). Since I'm now allowed to walk a bit more, we walked to the hospital via the SkyBridge and got a piece of chocolate pie for dessert later tonight.

31 4/7

No medical updates today. Things are still stable. I've had fun dealing with insurance stuff, getting referrals from my PMD's office and trying to explain why I need to be seen for routine ob visits out of network. By the way, AK is the state abbreviation for Alaska, not Arkansas...

I thought that, while this is a bit off topic, I would just mention a few differences I've noted about Alaska vs Massachusetts medical care. When I went to the outpatient ob/gyn office earlier this week, they gave me a sheet of paper listing the prices of various services, here are a few examples:

Initial office visit: $400 (est. patient), $500 (new patient)

subsequent office visit: $130-240 (depends on level of service and/or length of visit)

ultrasound: $600, twins $950

one hour glucose test: $75

cbc: $48

antibody screen: $75

vaginal delivery: $3,300

vaginal delivery, twins: $4,125

VBAC: $3,700

c-section: $4,500

c-section, twins: $5,625

c-section (attempted VBAC): $5,000

I wonder how much this compares to what Brigham and Women's Hospital charges insurance companies...

I thought it was very interesting, but didn't think too much of it, until I then went to the website of the pediatrician that we will be using temporarily, if I do end up delivering here, and they also discussed the high cost of health care and said that a fee schedule is available on request, although did not specifically mention prices on the web page.

I have never ever ever seen a price listed anywhere at any of my doctors' offices in Boston. I wonder how much of that has to do with the fact that MA essentially has universal health care coverage, so maybe people assume that no one in MA cares about prices or would bother to shop around? I know it never occurred to me to ask. I have only once had a parent comment to me about prices at the clinic where I work, and that was after I had ordered some expensive lab tests and they got a bill in the mail. Even if they had asked me beforehand, I wouldn't have known what those lab tests would have cost, and wouldn't have known how to find the answer for them either. Perhaps there are enough people in AK without insurance that people do shop around. I wonder if that keeps the prices of health care lower in AK, as a result...

Anyway, I hope everyone has a nice weekend. Chris flies home on Sunday, but my mom will be arriving on Tuesday. Thank you to everyone who has sent me cards, flowers, and packages, I really appreciate it!!

31 1/7

Today, I had my first appointment with my new ob/gyn, Dr Ha. I was a little disappointed that I didn't have any moose sightings on the drive, but given that it was only about a mile away, I suppose I shouldn't have gotten my hopes up too much. The office was very nice, and actually felt much less factory-like than my ob in Boston. Everything continues to look fine (fetal heart rate 156). I'm going to be seeing her weekly, and have a follow up ultrasound at 33-34 weeks to see what's happened to the small collection of blood. She said if I continue to have no further bleeding and the blood goes away, I could consider going home at 34 weeks! I'm not getting my hopes up too much about this one, but still it's nice to hear that all is well. I will be seeing her weekly, for the time being.

We had a fun evening yesterday. Marika had some of her friends over last night for a Memorial Day barbeque. Chris manned the grill, and grilled up some excellent burgers and veggies. Oddly enough, one of her friends grew up in my neighborhood in Concord, and his sister and my sister went to nursery school together and were good friends when they were little. A very small world...

Today, I'm going to attempt to see if my brain hasn't completely atrophied after a week of bed rest and try to work on a manuscript we are trying to get out the door at work. Hopefully my brain hasn't atrophied as much as my muscles, as I have actually lost a pound over the past 2 weeks, and that has to be due to muscle atrophy, given all I do is sit around and eat!

31 0/7

We have had a very nice Memorial Day weekend at Marika's place. We got to her place on Friday afternoon, I think that Chris and I were both a bit nervous that night. But everything has gone fine without any complications. I certainly am getting kicked all the time!

On Sat, Chris and Marika did fun housework around the house while I hung out. The weather both Sat and Sun was phenomenal- in the 80's in the sun! I'm glad that I had my sister mail me my few pairs of maternity shorts, it's hot here! We've spent much of the days on Marika's patio, soaking up the sun. We've also broken out the grill, and Chris grilled steaks and veggies on Sat, and Marika treated us to some Alaskan salmon on the grill, which her mom had caught.

I think I'm finally getting someone used to the sunlight here (today: daylight is 4:39 am until 11:18 pm). I am finally able to go to sleep in broad daylight and not wake up in the morning until it's been daylight for several hours. I haven't had a chance to see much wildlife yet, but I swear on Sat night I woke up to a clip clopping sound going down Marika's street, which was likely some moose roaming the neighborhood.

Tomorrow I have a follow up appointment with my new ob here in Alaska. While I did put in a referral to my PMD on Friday afternoon, I give it about a 75% of Blue Cross Blue Shield being annoying and sending me a bill for seeing someone out of network. Apparently with our health insurance, we're allowed to see people for emergencies out of state, but for routine things (like ob visits), I'm supposed to see someone in state. When I spoke with BCBS on Friday, they did admit that this was somewhat of an unusual situation (nice of them to concede that!), so I guess we'll wait and see.

30 4/7

The big news today is that I'm being discharged! I went for my 3 little walks yesterday without any incidents, and all the fetal heart tracings look fine, so they're springing me from the joint. When my doctor asked me this morning if I felt ready to go today vs Tues (the joys of the long weekend!), I started crying and couldn't decide, so she pow wowed with the perinatologist and reviewed my ultrasound. The residual small areas of blood are quite small (1-2 cm in size) so they feel like it's pretty low risk for me to go. My friend's house is just about 10 min from the hospital, so I can always come back over the weekend, if anything changes.

So I am very excited to get out of here, hang with Marika's dog, and sit on the patio and get some vitamin D.

Also, my sister made this webpage more fancy, so now you can subscribe to these blog postings, if you'd like. I know reading these postings is without a doubt the pinnacle of everyone's day. :-)

30 3/7

We had an uneventful night yesterday, with the exception making the mistake of watching the Celtics game. Chris and I got 2 exciting packages yesterday- we got our laptops mailed to us (yay!) and a care package from my sister, so that was a nice diversion.

I'm still struggling somewhat with the time zone change and incredible amount of sunlight, so my sleep is off. I woke up at 5 am Alaska time, but the nice thing was that I had about a million emails and facebook comments waiting for me, since most of you had been up for hours! I really do appreciate all the notes.

The covering ob came by, and it's still not clear as to whether I can leave the hospital tomorrow, possibly not until after the weekend. But I'm just trying to take it day by day. Sounds like when I do leave, I'll need to be on bed rest for several weeks. I know that there is very little evidence that bed rest actually changes outcomes, but when that's the advice I'm getting from my doctors, it's kind of hard to go against it, in case anything does go wrong.

Then the neonatologist stopped by to say hello. Apparently the NICU here is 48 beds with 7 NICU attendings, with one in house 24/7. So that was good to hear, although I'm still hoping that we can avoid using the NICU. Assuming I am able to go full term, I asked him when he thought it would be safe for me to fly home with a newborn. His feeling was that I could pretty much go home as soon as I wanted, which was nice to hear. I would like to hear from any other pediatricians out there reading this what their opinion is on this matter, as this not an issue I run into on a daily basis in Adolescent Medicine.

The best part of today was when Chris wheeled me over to the Hickel House which is for patients and familes from out of town. It seemed really nice, and might be a good option for a place to stay for the next few months to weeks, since it's looking pretty definite that I'm here until I deliver. The nice part was that I got to go outside for about 20 seconds, and it was sunny and warm! And the walk there was quite beautiful- he pushed me through the hospital's sky bridge, and I had a gorgeous view of the mountains. So it was nice to at least have that temporary change of scenery.

Also, Chris bought a connector cable for my camera to my computer (didn't bother to bring it with me to Alaska), so if you're really lucky, maybe I'll even upload the 3 pictures I took before getting hospitalized, and perhaps a nice shot of my hospital room as well. :-)

Seeing different sites of Alaska than we had anticipated...

Hi everyone,

I am starting this blog as a way to keep people updated. Not that people are so fascinated with my life, but it's hard for me to remember who I've told what, so thought this would be an easy way to do it.

First off, the important info is that I'm still pregnant (30 2/7 weeks today), the baby seems to be doing fine, and I'm doing fine.

Chris and I had planned to come visit my friend Marika in Alaska for vacation at the end of May. We made these plans before I knew I was pregnant, and once I knew I was pregnant, my ob said it should be fine anyway. We had planned a relatively tame vacation, just to be safe. Marika did a great job of putting together a fantastic itinerary, and I had actually checked to make sure that we didn't go anywhere too remote, and that there would always be a hospital nearby, in case anything did happen. But with the exception of some morning sickness and constipation, I had had an extremely uneventful pregnancy, and even had my routine ob appt 5 days before we left, and got the all clear to go.

We arrived in Anchorage on Sat. It was a beautiful sunny day, and the flights were completely uneventful. We went with Marika and her dog Dakota on a nice, non-strenuous walk through one of the beautiful parks in Anchorage, and then drove up into the Chugach Mountains (very close by!) and had an absolutely gorgeous view of downtown Anchorage and the surrounding water. Chris and I even made it up until 9 pm that night, and went to bed while it was still light.

I woke up in the middle of the night multiple times to use the bathroom, as I do these days, and at 2:30 am discovered I was bleeding. I called my ob in Boston, who told me to go to a hospital to be evaluated. Marika drove us to the Providence Alaska Medical Center, the biggest and best hospital in Anchorage. I was promptly admitted to the ob service for observation. That was probably one of the scarier mornings of my life. But the bleeding stopped quickly, and except for the annoyance of getting IVF @ 125 cc/hr so needing to get up to pee even more frequently and being hooked up to continuous fetal monitoring so not really able to move, it could have been much worse. This didn't happen while I was on a plane, this didn't happen in a remote area of Alaska, and everything seemed stable-ish. However, the big shock was the news that I might be hospitalized for weeks and then eventually be stuck in Alaska until after giving birth, which I am still hoping won't be until near my due date of Aug 2.

On Monday, I was evaluated by a perinatologist, who did a very thorough and fancy ultrasound. The good news was that I did not appear to have a partial abruption, which is what I was afraid of. The cause of the bleeding was not 100% clear. The perinatologist actually thought that the flight in might have had a role. Apparently commercial airlines do not pressurize their cabins as much as they used to- they used to pressurize to 5000 feet but some are more like 9000 feet, and that sudden change in pressure could potentially have made it more likely for me to have a small bleed. I only wish I had known that ahead of time! But at the same time, during this pregnancy, I have flown to CA, IL, FL, and Toronto, without any difficulties. The other theory as to why I might have bled is that I might have vasa previa, which is not something that you can tell on ultrasound, unfortunately. But Monday continued without any new bleeding, I was off IV fluids, and only being intermittently placed on the fetal monitor.

Tuesday more or less the same, but they did finally let me take a shower sitting down and walk out of my room, which was pretty exciting! And I was officially beta complete, as well.

Today, I was allowed to take a shower standing up and they want me to get up around the unit at least 3 times today, and see if I still don't have any further bleeding. If all continues to go well, there is a slight chance that I could be discharged home to Marika's place (not home to Boston!) on Friday, but it all depends on how the next few days go.

So that's the medical update.

Outstanding issues- will I be able to go home to Boston before I deliver? Unclear at this point. There is maybe a tiny chance that I could consider it at 34-36 weeks, if all continues to go well. I am at risk for premature rupture of membranes, due to the bleeding, but that wouldn't be quite as big of a deal at 36 weeks as it would be right now. But I think that's pretty unlikely at this point that I'll come home before I deliver. If it is vasa previa, I would not want to be on a plane if something bad started to happen.

What about Chris and my jobs? Chances are I wouldn't be able to go back to work, even if I were back in Boston. Since I'm technically on vacation this week, I've decided to not really let myself worry too much about this one until next week, when I would have gone back to work. My guess is that I'll probably have to go on disability and that my fellowship will be extended beyond July 2011 (ACGME rules are hard to get around!). But that certainly is not the worst thing in the world. Chris will likely return to Boston for a while, and then return to Anchorage when my due date approaches.

Where will I live for the next 10 weeks? Poor Marika got more than she bargained for when we decided to come and visit her! Although I could keep her dog Dakota company while Marika is at work... It sounds like my family though will play a bit of tag team and come up and visit me at various times, and try to rent an apt or something for the summer, so that way Marika doesn't have to put up with us for the whole time!

Aren't I worried about getting my healthcare in a location other than the Medical Mecca of Boston, MA?!? In a word, no. The doctors and nurses here have been absolutely wonderful. The hospital I'm at has a level 3 NICU, and they do everything except ECMO, and if we need ECMO, we're in trouble anyway... I was joking with my nurse that people in Boston would be concerned if I were getting my healthcare in NY, because clearly no place is as good as Boston! So I really have no worries about this. And it sounds like I lucked out with the ob that was on call when I came in, my friend's friend knows of her and says she's one of the best in Anchorage. But I have to say that it is a wee bit ironic, because I intentionally chose my ob in Boston because she delivers at Brigham and Women's Hospital, so much for my planning! When I was a resident, I rotated through the delivery room at Mt Auburn Hospital, which is a very nice hospital in Cambridge with a LOT of yuppie parents, most of whom have "birthing plans." We joked that having a birthing plan was a surefire way to guarantee that things would NOT go according to plan. I didn't have a birthing plan, but clearly even trying to choose with hospital/city/state I would deliver in was more than the gods were willing to let me do.

What about everything else that has to be done at home?!? I miss my kitty very much, and it makes me very sad that I might not see her until August. Fortunately, she is happily staying with Chris' mom, and probably doesn't miss me one iota! My family has been absolutely wonderful with dealing with outstanding stuff- my sister Kristin went to our place and got some things to my dad, who shipped them to us here. Kristin also went to Pottery Barn to pick up the rug for the nursery that we had ordered, and dropped off the glider rocking chair and other things that friends have loaned to us. But I'm learning to let go of some of the little details- if I don't get the pictures up on the wall before the baby is born, no big deal, because frankly he won't notice either way! And they've been helping out in a million other ways, too many to go through in this blog.

Anyway, that's the update. I am hoping that as time goes on, perhaps I'll have something interesting to say. Otherwise, it might degenerate into review of the Law and Order and Fresh Prince of Bel-Air re-runs that I've been watching on TV...

One last thing- I would just like to say how wonderfully nice everyone has been in Alaska. One of Marika's friends lent Chris their car, so he can drive to and from the hospital to visit me. The nurses and nursing aides here have all been so incredibly friendly and helpful. And even though we were beyond the cancelation policy for pretty much all our reservations here, almost everyone is giving us a full refund, once they heard our story.