Tuesday, May 24, 2011

30 weeks 1 day

I took two pics to show you what I look like from the front and the side. If you look close you can see my shirt is working so hard it's almost see through! Not to mention it barely covers my whole belly. I am loving being pregnant and can't believe what joy this whole experience has brought to my life. I love you Belle!

Tchau,
Sara

I love my concentrating face.... Cracks me up!

Monday, May 23, 2011

Glucose Tolerance- Round 2

This morning Nate and I finally crawled out of bed after snoozing for an hour to drive into centro for my labs. We tried to do this last week but neither one of us wanted to go and since we have both determined that Dr. J has a crazy streak we didn't think the labs we too pressing. Needless to say this morning we were both tempted to post-pone the test again.

Good thing we did snooze because the lab changed location. Luckily the website was finally updated and we got the new address but unfortunately they didn't update the hours. We arrived right at 7am for the doors to open and already four people deep in line. A woman starting telling me that I was in the wrong place in line to get my number and that this other guy should be in front of me.... uhhhh, ok. Could she not see that I was pregnant and I get to cut in front of all of them so it really doesn't matter. After I did what she said I talked to the lady and the front and was the first served :) I didn't make any friends this morning but who cares when you know you have to be there for two hours. Nate wants me to be pregnant forever while we are in Brazil for all the preferential treatment we receive which deserves a post on it's own.

Then it was time to pay but they take cash/check only now where they used to accept debit/credit. I talked to her to let me start the test that way Nate could run to the ATM.... simple right? Wrong. On the fourth ATM Nate attempted to withdrawal money from he finally found one that had money. I just don't get that three different ATM's throughout the city can just not have money? Even the ones at the bank! O'well, by the time he returned my test was done and we could go home. I doubt that Nate wanted to wait with me anyway and I don't want to wait with him while he continues to wake up.

The test itself suck as usual. The fasting is terrible by itself but then you drink an extremely disgusting sugar drink. After that Belle went crazy! I should have video taped my belly and all the weird things that were going on. About an hour into the test I started to get really dizzy and felt like I was going to pass out. I think that was the sugar crash. My body probably freaked out with all that sugar and dumped a large amount of insulin. Then tried to stabilize a little late. Either way this test does weird stuff to me. Same thing happened last time.

I just hope that since I have been such an ass about the whole test that it really does come back negative! I will find out in four days so I have a few days to feel good. Can't worry about something you don't know right? Well off to do some laundry and other things to keep me busy and useful.

Tchau,
Sara

International Insurance

Ever wonder how our medical experiences here go or how what's covered and how we even file claims?

When we moved down to Brazil the company switched us from a US plan to the International coverage from CIGNA. Basically we can go anywhere in the world, except the US, and we are 100% covered for all treatments including holistic approaches. When we enter the US the coverage switches to 80% covered when in network with 100% coverage on preventative tests. Not bad huh?

Once we have Belle, she will be 100% covered in the US and anywhere in the world. This means that I will not only have a pediatrician here in Brazil but I will also search for one in the US. Just to cover all of my bases. Of course this depends on how much I trust the medical advice I am receiving here in Brazil. If I don't agree or feel that procedures done are in Belle best interest I will consult with a pediatrician in the US. Why not? It's all free so who wouldn't if they could.

Anyway, back to the insurance part of the blog entry. Once Nate and I visit a doctor they ask us how we will be paying since we are not Brazilian. Most offices do not have credit card machines and therefore we are left paying with cash or check. Our ultrasound office does accept credit cards, thankfully, but the others don't. We then hand over our Brazilian version of a social security card, our cash and wait patiently for an official receipt.

The official receipt, nota fiscal, can then be used for reimbursement by our insurance company. Once we get home I scan the document, sign into the insurance website and submit the claim on-line. It takes about one week for us to receive our reimbursement via electronic transfer of funds. Here's the best part of it all- We pay up front for our services in Brazilian reais but we are reimbursed to our US bank account in US dollars. Great way to avoid money transfer fees and exchange rate fees!!

So far the process of it all proves to be very simple. The only thing I worry about is when we have to pay the hospital upfront the total amount for the big day.... That's going to be interesting! Right now we pleasantly surprised by how cheap services are down here.

Approximate pricing:

Doctor Visit (She's expensive from what I hear): R400 =  USD 248
Ultrasound: R 350 = USD 217
Labs (basic urine test): R 30 = USD 18.60
Lab (glucose tolerance): R 50 = USD 31
Lab (extensive blood): R 650 = USD 403

Not bad if you ask me. There are no hidden lab fees or cost to random people that you don't know about.  I think that overall though the cost to have a baby here is the same to have a baby in the US based on recent friends calculations. The only thing is that no matter the cost we get it all back :)

So that's our medical stuff in a nutshell.  Right now, I am in the process of determining if all of our massages can be reimbursed... to be continued.

Tchau,
Sara

Sunday, May 22, 2011

Belle's a Mover!

Just in case your wondering what the new addition's personality is like, I am going to tell you. I think we are in for some trouble. Constant movement at all hours so were not going to have an easy going kid or a lazy one. Recently she found my ribs and loves using my bladder for a trampoline. At any given hour you can find my stomach moving and Belle trying to find comfortable spot to run.

She starts out moving bright and early to wake me. Usually she does this by wedging herself under my ribs  and then stretching out to kick my full bladder. It feels that she knows exactly what she is doing. I can hear her say, "get up mom because I am hungry and this full bladder you have is really cramping my space." I then stumble awake to get some hot tea and breakfast which sends her into overdrive.

This goes on throughout the day. The only time she isn't moving is when I am moving or at least I cannot feel her. If I sit for too long she gets angry that she can't stretch so I end up walking around or clean when I am at home. Good thing I still don't have a car because she loves the daily walks to the fruit market and grocery store. This usually appeases her for a few hours before the cycle begins again for dinner.

The good thing about her moving around so much is that Nate really gets a chance to be a part of everything. At night after dinner we catch up on some DVR and play with Belle. Most of the time by finding out where she is laying. We have both determined we can feel her head or butt and not sure how to tell the difference. It feels sorta-of like two tennis balls spaced apart with random kicks and hits.

Recently the hiccups show up a regular intervals. At first I thought my heart beat was really strong or that she was compromised in some way which freak me out! Then I realized that the beating had an irregular pattern so either my heart is off or it's not my heart. I completely forgot about hiccups presenting around this gestational age but then quickly made the connection.

The hiccups used to be cute but now they happen so often that I almost get annoyed with the slightly off rhythmic movement. It does provide me reassurance that she growing and her lung/diaphragm muscles are working hard so that eases the annoyance. This muscle development means that not only will she be constantly moving but possibly being able to voice her opinion whether we want it or not. Of course these are all guesses but it's better to be prepared than underprepared! Thankfully from what we know she is healthy!

That's Belle in a nutshell :)

Tchau,
Sara

Thursday, May 19, 2011

Lucky Find

The past few night when I wake up I find my stomach rumbling. I usually try to just go back to bed but I am beginning to think that just walking my butt into the kitchen is a more practical idea. Yogurt happens to be the quickest snack plus I get the calcium. Today however, I did find these Ritz crackers! Oh Ritz, I didn't even know I missed you. I never thought to even look for them in Brazil and it's like they fell into my grocery basket.

I know what you are thinking. No, I won't stop eating the yogurt at night but maybe I can rotate in the crackers? Or possibly when heartburn erupts these can calm the fire.... Ever pregnant woman needs a good cracker right?

I am afraid now that I have found these they will soon disappear only to resurface at the most random of times. How I wish grocery stores here knew what inventory was. Owell. I have my Ritz for now!!!

Tchau,
Sara

Tuesday, May 17, 2011

No news = Good news

This morning we left the house around 8am and got to Rio at 12 just in time for the appointment which was less than impressive. I told Nate that I wish that I was ignorant and never went to pre-natal visits because they seem like a waste of time. Honestly I learn more from books and the internet than I do my doctor. Good thing we don't pay a dime but we do have to make an 8hr round trip to visit.

How the visit went:

Dr. J: How is everything going?
Me: Great no complaints
Dr. J: Ok let's check you out. You look like your gaining weight great just in the belly. Some people have such a hard time with eating right. You must be taking great care of yourself.
Me: Uh thanks. I try.
    I step on the scale.....
Dr. J: Wow you've gained too much weight too fast. I think we need to do a glucose test again for gestational diabetes.
Me: ???? Ok???

End of visit.

Ahhhh she kills me. I have no idea what to do with her but laugh. I gained 11 lbs in 9 weeks which is approximately 1.22 lbs a week. According to the books I should be gaining 1 lb a week. How in the heck did I gain too much and where is the line? It's almost like she has a number and if that number deviates then she freaks. I don't even thinks she takes me into consideration.

I really don't care what she says at this point about my weight. I will just do what she says to appease her even though I know that I am healthy. Next week I have to go in for another fasting glucose test, drink that terrible sugar drink and then wait so they can draw my blood again. I just don't understand why she doesn't talk about anything else other than my weight like is Belle moving and how often. You can't have it all I guess.

Nate said the perfect phrase to put life into perspective: "A crappy day but a healthy baby. You can't ask for more." It's so true and so I will end with that.

Tchau,
Sara

Monday, May 16, 2011

Rainy Day

The past week the rain can't decide if it wants to stay or go. On this particular afternoon the storms looked so amazing over the water that I had to grab my camera. Since my camera and I are still in the getting to know you phase I stuck to some of the preset settings to capture the images below. The key to learning is practice so that's what I am aiming for. 









I just can't wait for Belle to get here because if I can take pictures of clouds for an hour I can't imagine how fun it will be with her! Hopefully I will have all the settings down and some sort of style that way there isn't too much lag time in between photos.

Tchau,
Sara

Need sleep?

This weekend has worn me ragged! Tons of friends, golf, cookouts and home projects. Of course I lost some precious time by drinking this tea in the morning instead of the night. I slept for three solid hours two hours after waking from a full night sleep. Either the third trimester is getting to me or this stuff really works!

No new news on the home front. Today we were supposed to go to the doctor but had to cancel because she had to attend a delivery. I am just glad we didn't leave Macae yet! The appointment is rescheduled for tomorrow so I will definitely update on what she says!

Tchau,
Sara

Saturday, May 14, 2011

News to Me

Each day I feel like I have a new revelation about life, Brazil, pregnancy and simple tasks. Here are just a few of them.

1. Toilet paper does not work as a substitute for paper towels. Thought I would try since every store in Macae has been out of stock for a week. This is where 'buy it when you see it' comes into play. Unfortunately my stock was empty.

2.  The kitchen timer only works when you are close enough to hear it. Which means don't go upstairs close the door and turn on the tv expecting to remember the food downstairs.

3. Cheap hotdogs are a huge no no in pregnancy. I guess I should have known since they are really not good for you when your not pregnant. A little late in the pregnancy to find this out but the list of no no's is really long these days.

4. The brie cheese that I have been avoiding is actually pasteurized down here so I can eat it! So I was eating the bad and holding off on the good. You can't do everything right. It will give Belle character I think.

5. I can no longer get out of the shower by sliding opening one door. I have to open them both. Even then I think the bigger I get the harder it's going to be to get out both. Somebody get the baby oil. Gross- sorry.

6. My increasing tummy size makes a great folding table for clothes. It also makes a great food catcher. I now find stains on the middle of my shirt from some sauce that dripped.

7. I can play 18 holes of golf, walking the course, but I cannot sit in a restaurant for three hours without pain and getting cranky.

8. Ordering water while everyone else is ordering a beer causes confusion in the waiter who always forgets me. I have gotten used to asking twice and sometimes three.

9. Trying to do things for Nate makes him frustrated because I am pregnant and he should be doing them. We both feel bad. Me for not working all day and him because of the baby.

10. Men think that I will break just because I am pregnant. Sure there are some things that I can't do but for the most part I am fine! My golf caddie told me not to jump up and down when I made a great chip on the green. Then he told me not to run.... ??? Por que? This goes with my doctor too. She told me not to get my heart rate up- uhhh are you practicing in the 1950's? This is 2011 and pregnant women run marathons these days.

11. The pears, apples and plums never expire here in Brazil. I swear I have had a pear in my fruit basket weeks and it's still good.

12. The revelations are over. I probably should have saved the best for last but I just wrote them as they came to mind.

Have a great Saturday!

Tchau,
Sara

Friday, May 13, 2011

Preemie in Brazil

A question everyone asks is, "Are you going to have the baby in Brazil?" The next question asked is, "Are you scared?" To answer quick I say yes we are having the baby in Rio and yes I am scared.


It's very hard for me to distinguish normal pregnancy fears from ones that I am feeling by having the baby in another country. My field of work before moving here doesn't help the nightmares. I have images of past cuties that I have had the pleasure of taking care of. The fear isn't of having an extreme preemie, it's that if I were to go into labor right now my baby would not live. In the US I wouldn't have this fear. Here are a couple of my preemies.


Josh at 23wks gestational age weighing 245g = 0.5lb
(meaning that Belle currently is 6wks older than this little boy born already. Look at your hand- that's the size of this little one and the diaper he is wearing, which is too big, is the size of a maxi pad)




 Lauren at roughly 29wks she had a twin brother who was just as cute!! She was actually born at 25 wks  with her brother. (This is where Belle would more than likely be at. Those stickers on )



 Ellie somewhere in the 30's and probably 33wks??


You probably can't tell from the photos but the babies in each of the pictures the breathing support decrease with the increase in age. The first photo the infant was on full ventilatory support. Second by CPAP (continuous positive air pressure), which adults who have sleep apnea are sometime prescribed a BiPAP which is only worn at night. The third infant is on nasal cannula which most people are familiar with from tv. 

Anyway, the point of the mini lesson is that in Macae there isn't a NICU. Scare the hell out me, I just want to scream when I think about it. Rio on the other hand does have one. When I tried to open dialogue with my Dr. about NICU concerns she dismissed them telling me I had nothing to worry about. I then reached across the table and slapped her while screaming that I was a NICU RN!!! JUST KIDDING but that was the thought running through my head as I calmly told her what I did. I still don't think she heard a word I said and continues to think I have little to zero knowledge about babies. Sad to say that I probably know more than her in this area.

Of course these worries are completely outrageous because in my unit we only saw the 0.01% of the births in all of the US. The worst of the worst. I could tell you stories that would may you vomit and then pass out. I keep reminding myself that while premature birth does happen it doesn't happen to everyone. 

I just had to get that fear off of my chest. Now I can move forward and continue my healthy pregnancy. I really have to say that I have a whole new respect for those mothers and fathers of NICU babies. I honestly don't know how they do it.

Tchau,
Sara