Apparently Rebecca is our accident prone child these days.  About a year ago, she was climbing on boxes and fell and chipped her tooth.  If someone can fall and get her it'll be her.  Just this year at the beach she fell every day we were there at some point, somewhere.  She skint up a knee, took all the skin of of one arm, is constantly cut or bruised somewhere.  Today someone turned on the ceiling fan that we haven't yet replaced in the girls' room, and she climbed into it and cut her forehead. It was bound to happen, we have got to get that light changed out soon.  At least she's happy now, and we got some extra cuddle time out of the bargain.

When the captain got his first pirate hook, he had alot of trouble...

Captain  wanted to eat a cookie, to make him feel better, after his hand was cut off and ate by the Tick-Tock Croc.  So as he got down to the end of his cookie, he bit his hook, and all his teeth feel out.  After he glued his teeth back in his mouth, he decided to eat a banana to make his teeth feel better.  But, someone went over board, so he sent someone to save him.  As he went back to sit and eat his banana he slipped and broke his back.  When his back was almost healed, he could barely bend, and it was really hard to sit, but he decided to go for a walk.  He wanted to be sure everything on the ship was in tip-tip shape.  But as he walked through the kitchen he slipped on the banana peel again and broke his head.  So he wanted to lay down and take a little nap.  After his nap, he took a trip off the boat, to chop some wood.  When the tree fell, it squashed him flat like a pancake, and a stick poked out his eye, so he needed an eye patch.  Finally he was ready to chop up the tree into pieces, but while he was holding the ax with his hand and his hook, he dropped it and chopped off his leg, so that he needed a peg leg.  So, if you can help it, never get a pirate hook, or you might lose everything.

Captain Beard and his teddy bear.

My dentist appointment was great.  I had two cavities, so I can't have sugar for awhile.  They are in two of teeth that are grown up teeth.  Momma wasn't happy.  Momma said if I didn't take care of my teeth that they would all fall out.  If they all fall out all I can eat is jello and applesauce and drink water.  And I don't like any of those things.  I told myself I was sorry by deciing to try harder next time.  I'm going to brush my teeth three times a day until Momma says I can go back to two times.  And I am only going to drink unsweet tea, water, and sometimes milk.  That part is going to be hard.  I was really good, so I got a cool race car and a neon orange toothbrush.

So as I mentioned on facebook, we went to my Reproductive Endocrinologist appointment this morning.  I was wound up about it to say the least.  Optimistic that he would listen, take me seriously, and be proactive about my thyroid.  Concerned that I'd be told it wasn't an issue for an RE, that they wouldn't see me, to find a thyroid specialist.  Then I'd be out of reasonable options.  Pessimistic that it would just be another doctor, too arrogant to listen to me, so far above me that they can't be troubled to explain anything, and not concerned with my concerns.  I was afraid that this would be doctor number for in the, your numbers look fine, let's just wait and see crowd.

Eld. Adam Green was preaching this weekend at MacClenny.  On Saturday afternoon in a surprisingly compact sermon he preached from I Pet. 5:6-7 to cast all our cares on Him.  I've often heard it is a sin to worry and stress, but never really what to do instead.  I really struggle with overanalyzing everything, and I stress alot, and don't sleep well.  Trying to turn it off, is like trying to jump off the roof and expecting to fly.  Now, I know it can be done, or God wouldn't tell us to do it.  But in 31 years, I can not recall anyone from the pulpit explaining how to do it.  Bro. Adam went several places to show that we do it through communication and contemplation.  We communicate those concerns to God through prayer, and contemplate on who He is.  It helps us to put things in perspective and reminds us even if God does nothing about this situation right now that there is Heaven afterward.  And that He does care for us, so of course we should go to Him.

So back to this morning.  We are pulling into the parking garage at Tampa General for my 8 am appointment at 2 minutes till 8.  I'm keyed up beyond all belief.  Gary is on the phone with four different people at work trying to juggle things on the farm.  We get down to the hospital and I realize my medical records are still in the car.  Gary runs back to get them.  I find out where to go and I wait outside for him.  At 8:15 he is still missing, so I go up to the car thinking that he can't find where I stuck that folder, only to not be able to find him.  At this point I'm all but having an anxiety attack, and I head into the office.  They take me back at 8:25, and Gary is still nowhere to be seen.  I'm sitting in an exam room, waiting on the doctor, and I'm trying to think about that sermon, and pray, and calm down.  I'm feeling a little better when they then bring me into the doctor's office to talk with him, but Gary is still no where to be found.  A few minutes later, about half way through my medical history he shows up and I felt so much better.

After going through everything in about 30 minutes. The doctor was incredibly knowledgeable and incredibly nice. He asked a lot of questions and really listened. He treated our loss of Abigail as the real loss of a person. I can't tell you how much that meant.  I checked around before scheduling something all the way up in Tampa.  The report for Fort Myers was the guy knew alot, but he was a total jerk.  I wanted someone to explain something, I'm never again going to just trust that a medical professional knows what they are doing.  Besides after everything else we've gone through, I want some compassion not a jerk.

The RE said it could have been a tragic flux but was alarmed by what all they did not do. He ran all the blood work but went ahead and diagnosed me with sub-clinical hypothyroidism which he described in the same way as what I have read about masked hypothyroidism. I've done alot of reading and studying over the last few months.  25% of cases of hypothyroidism, shows up with "normal" labs.  I've also read enough to know that alot of women feel their best with the TSH levels in the upper 1/3 of the normal range.  I'm so glad that he is willing to look at our loss, how I'm feeling (which has gotten worse just in the last month) and really manage it.  He also said if I don't already have Hashimoto's it's a matter of time, given the family history, and the extremely high antibodies at the last few lab visits.  However, we want to delay the onset as long as possible by managing the hypothyroidism now.  He felt like this would be an easy fix, and I started back on 50 mcg of Levothyroxine tonight.  I'm hoping to hear back about what my levels are at in a few days.  We will go back in 6 weeks to recheck levels and see how I'm feeling.  Then we will go from there.

I've promised Gary that after that appointment I won't make him come all the way up to Tampa with me.  But the way I about had a panic attack that had my blood pressure through the roof when they checked it in the office, I'm not quite ready to see doctors without him.  It makes me so very panicky now, partly because I don't trust them, and partly because it puts me very vividly back in the room I sat in after we lost her with the worst OB ever.

Last week Rebecca had her first Dentist appointment.  She like the other two, was so excited they were all arguing about who got to go first.  She climbed up in the chair like she'd done it a 100 times before.  And sat there like such a big girl.  I went back and sat in the room with her, just to see how she would do.  She was no trouble at all, and the dental hygienist thought she was so cute, and couldn't get over how she did.  They are going to wait a while longer on fixing her front tooth, since she's so little they weren't sure if she could sit still long enough.  We are going to watch it though, since it is really close to the nerve and they don't want the tooth to die.

So on Friday, I mentioned that our final shot for figuring out what happened to Abigail was with the results of 4 vials of blood they drew.  Results that we expected to be completely unspectacular, and completely unhelpful.  The only reason that my doctor even did the autoimmune blood tests, was because I was once diagnosed with hypothyroidism.  Hypothyroidism is where you thyroid is underactive, and doesn't perform as it should.  It is mostly monitored by checking your thyroid stimulating hormone (TSH) levels.

The first of the test came back Friday afternoon.  First the TSH results were 1.75, well within normal range (higher than ever for me).  Next were the Thyroid antibodies.  They were high, incredibly high.  The nurse at the office couldn't tell me anything right away, and the doctor wanted to wait for the rest of the blood work before giving her opinion, but today they confirmed what I have read.  She will be referring me over to an endocrinologist if they have one in the system that accepts our insurance.  So, I did what you should never do.  I started searching the internet.  I quickly discovered that you can have thyroid problems even though you TSH levels appear normal, and that high thyroid antibodies can actually increase your risk of miscarriage 290% (follow the link for the article with the study).   Now I had never even heard of thyroid antibodies, but typically above average levels indicate that your immune system is systematically destroying your thyroid.  I also discovered that while the normal range for TSH is .27 to 4.2 that in the first trimester of pregnancy for women who have had hypothyroidism (that would be me) it shouldn't be higher than 2.5, and now looking back through the records at my initial appointment my TSH was at a 3.01.  In yet another study I read that high antibody levels can cause fetal tachycardia or thyroid problems in the baby.  A normal fetal heartbeat is 120 to 160, fetal tachycardia is 170 to 220.  A baby's heart rate is it's highest at 9-10 weeks, and it can get as high as 170 then.  That of course had me looking up Abigail's recorded heart rates.  Due to the new computer system there weren't any except what was saved on the ultrasound that we did at 9 weeks, 5 days.  Her heart rate was 181.  It is possible then that my dysfunctional thyroid caused my child to basically have a heart attack.  My body killed my baby.

On one hand this news is absolutely maddening.  I mean we KNEW I had hypothyroid issues in the past, and the midwife even told me it would need to be monitored.  But we weren't testing everything that needed to be tested and we weren't even measuring it on the right scale.  This could have been prevented.  My aunt and a Church member back in Indiana, suggested I find an actual thyroid specialist and not leave it up to the regular doctors.  I should have pursued that.  I feel STUPID for thinking oh it's back to "normal," no problem here.  I should have done more personal study, it's my health, my responsibility not just whatever-doctor-in-whatever-state-we-happen-to-be-in-at-the-moment's responsibility.  I mean do health problems ever just miraculously disappear?  On the other hand while this knowledge is now worthless for Abigail, it's good to know for the next pregnancy. Because next time, levothyroxine can be given which brings the rate of miscarriage back down to the same level as those without thyroid problems.  Also I need to have higher levels of iodine than usual in pregnancy, which might explain the salt cravings I was having.

As for me, that means I need to have more follow up work done with an endocrinologist, because high thyroid antibodies increases my risk of having masked hypothyroidism, most likely Hashimoto's Disease, or a slight possibility of thyroid cancer.  To be quite honest though, I could care less right now about what this means for me, because all it means to me is that my baby unnecessarily died.

The bracelet I made for Abigail.   I have it and my necklace on now, and feel much better.

Ashley sells Origami Owl Jewelry, and she made me a beautiful piece to remember Abigail.  With a little girl, a pair of angel wings, a ribbon for pregnancy loss awareness, an A for her name, her birthstone, and a rose gold cross.  Ashley didn't know but rose gold is something I've come to associate with Abigail.

Yesterday, I had my follow up with the doctor's office.  Now, I thought I had been keeping it together pretty well, since getting home.  I'm not crying every 15 seconds, I'm not even falling apart every day anymore.  I'm immeasurably sad, and if I am awake she is on my mind.  And despite being rather distracted, slow to focus, even slower to get things accomplished, I'm functioning.  Yesterday proved otherwise.

First I had to check-in, and apparently in the new system, they ask not for your name first but for your due date.  So I choked out that we had a stillbirth 3 weeks ago, and that I was here for my follow up.  For the next 20 minutes or so we sat in the waiting room.  Now seeing pregnant women or newborns hasn't bothered me so far.  After all I shouldn't have a newborn yet, and I hope no other pregnant woman goes through what I have.  I am a bit wistful when I see someone about half way along or so, where I should be.  I've even been able to listen to the pregnancy chit chat.  But, yesterday being in a room, where everyone had a baby but me, left me feeling like I had been gutted.  Like I am empty and defective somehow.  I sat in there with tears just streaming.  We finally went back, and the nurse had to ask a ton of questions, once again because of the new record keeping system.  When she laid out things for a physical exam, I just blurted out that I didn't want one, I needed some answers.  She went to get the doctor, and I just sat there crying hanging on to Gary's hand for dear life.

Even though they told me that half the time, there are no answers as to why a child dies in utero, I expected to get some answers.  I suppose on some level I was already telling myself that it was most likely a chromosomal issue (like the majority of first trimester losses are), that Abigail lived longer than most, that she couldn't have survived outside of me.  I could live with that, even if it hurt.  Instead I got to hear a list of what it wasn't.  There were no genetic anomalies.  There were no chromosomal defects.  There were no obvious cord problems.  The placenta had begun to break down after Abigail being gone for at least 2 weeks, but it was a good size and shape.  There were no signs of infection or anything else in my blood work.  Since I have had three textbook, boring pregnancies they could rule out any issues with my "hardware" (which accounts for most of second trimester losses).  Basically she was a perfectly healthy baby, who died for no apparent reason.  I just wanted to scream "THEN WHY did my baby die!" instead I just sat and cried and cried some more.

They could tell me nothing.

Oh she could speculate a bit.  She suggested that perhaps it was that the cord was pinched in some way, a freak accident that left no trace.  Maybe it was an infection that I contracted through something I ate or through my gums, something that didn't even give me the slightest cold, but crossed the placenta to her.  Neither of these help, they just make me feel more paranoid.  I wanted something I could fix, something I could prevent from happening next time. Not random guesses.

I asked about my hormone levels.  They never checked them, so they can't tell me anything about them.  But, they will monitor them next time, from the time we get a positive on an at home pregnancy test.  I asked if it could relate to my thyroid, but she felt it was a long shot since my TSH levels have been normal my entire pregnancy, however for my peace of mind, she ordered an autoimmune work up since sometimes that raises the risk of a miscarriage.  So after we finished the appointment with the physical exam, and after I apologized to the nurse for being so abrupt with her, we headed across the parking lot to the lab for some more specialized blood test.  After which I cried some more.

We will know more hopefully on Monday.

On the back she engraved something very special, a reminder that I find myself in need of hourly.

First we got pumpkins.  We got them and bring them home.  We got four mules at Walmart (that would be thermals for the rest of us).  Me put them on at home under my Belle dress.  They keep you warm, warm, warm.  Momma took three pictures and then we went to eat supper.  We eat pizza!  Daddy had pizza that was bread all around (a calzone).  I wanted purple pizza, but they didn't have it.  Then I wanted pink and purple pizza, but someone ate it all, because no one had it.  Then we went to Halloween to get candy.

















That picture of me trick or treating is a bad picture because me hurt my lip.  I fell down on the rocks, and me got hurt.  It bleed alot.  It very hurt.  It hurts when me do that (she's opening her mouth really wide to show me again).  My hands got dirty but not my dress.  That was really good.

I don't normally like to post more than once a day, but I have a funny story to share, that just can't wait.  Britt, as you might have gathered from his post earlier is crazy about Angry Birds.  Ahna found a couple of boxes of Angry Bird band aids while she had the kids, so she got him some.  Britt saw them last night, as we were unloading the car, and he wanted one before bed.  I told him he didn't need one and though he wasn't thrilled, he headed off to bed.  This morning, he tried to convince me that his week old scratch that is nearly gone needed one.  He also manufactured several "accidents" this morning, that left terribly painful, invisible cuts, in an attempt to get an "Angry Bird bandage."  He didn't get one.

We went off to conquer our day - speech therapy, doctor's appointments, lunch, landscaping appointment, scheduling other things for the next week.  This evening, Britt was playing outside with Kita.  He takes a stick and runs around the yard, dragging the tip.  Kita bounds along beside him, trying to catch the stick and then take it from him.  Sometimes she gets it and goes tearing off in the opposite direction for a game of keep away.  Sometimes she gets aholt of it, and they play tug a war.  Sometimes Britt throws it and she goes after it.  She will catch it, play a little keep away, and then drop it by him for another round.  Today, we had one of those moments, where I really wish I had my camera rolling.  Britt was running, and dragging the stick like usual when Kita dove for the stick and instead caught the hem of his bluejeans.  As always, she whirled around to take off with her stick, but instead Britt went down on his behind, and she went flying across the yard, with his pants flapping in the wind.  See he didn't have any shoes or socks on, and I suspect he hadn't even buttoned his pants from the last trip to the bathroom.  Kita got all the way across the yard, before realizing that she didn't have the stick after all.  She dropped the pants, came back and got her stick.  Britt meanwhile is laying on his back howling about how Kita tried to eat him, and how he is hurt.  For all of that, he had a small cut on his wrist.  So we went inside, I washed him off, got him dressed again, and let him pick out an Angry Bird band aid   He is really proud to be sporting it, and with in 5 mins, he was back out chasing Kita in the yard.

Ruth had her evaluation through First Steps last Thursday.  Several have asked about it, and it's really way too much to write on facebook, and it's a long conversation to have 45,000 times so I thought I would just blog about it, instead of Ruth posting today.  While we learned alot, we won't know her exact scores and what all she will or won't qualify for until March 1st.  At that time they are going to come back out and talk to us, and let us know what options we have, and possibly set up a game plan if she is considered delayed enough.
They tested 6 areas - fine motor skills, gross motor skills, adaptive, cognition, social-communication, and social skills.  They told us that she was far ahead of her age for fine motor skills.  Britt got to test a little with her, since he wanted to play too, and she far out ranked him on fine motor skills, some of what she's doing they told me was at a 4+ year level.  For example, she managed to almost completely cut out a shape, and I've never even let her attempt something with sissors.  I still think that was a fluke.  She is spot on with gross motor skills (this is what her funny gait falls under), she can jump, gallop, kick a ball, etc.  With her adaptive skills, they looked at things like how she eats, just generally works with her environment, once again that was at her age level.  With cognition they were looking for how quickly she processes and figures things out.  She was ahead in this area as well, though they didn't tell me what level she was at.  Ruth's problem areas are particularly in the social-communication area and as a result of communications issues also a few problems in the social skills area.

Sprawling out is ok, in fact, it's perfectly normal for her to look a little knock kneed up to around 4.

Ruth had several red flags in her social-communication.  The first is that she uses almost no consonant sounds.  At this age they don't expect them to use the right consonants, but they do expect them to be using some consonants.  For example, I know that "uh-ey" means monkey, "ah-ul" means apple, and "uh ou" means love you, but none of those "words" have consonant sounds in them.  Secondary concern is that while she has a large vocabulary it is primarily nouns, she uses almost no adjectives, and very few action words.  Additionally when she uses action words, she doesn't attempt tenses.  For example, she would say "I run" not "I running," "I ran," or "I runned" all of which would be normal at this age.  She also never says things like I eat, but rather things like I hungry.  Which of course sounds more like "I uh-ey", and we only know the difference between monkey and hungry because we figure out from how she acts, or from asking several different things.  She had one additional flag in the social skills area.  In everything else, she rated above her age level, but since she is a social butterfly who has never met a stranger we aren't surprised.  Her one flag is her frustration level at trying to communicate.  She attempts to carry on a conversation, and she understands everything that is said to her, BUT when you don't understand her (which happens alot) she gets frustrated, and rather than showing you, or trying to rephrase what she wants, she just repeats the same thing over and over and over, until she's pitching a fit or you figure it out.

Ruth W-sitting.

As for her walk, best they can tell, short of doing xrays to confirm, there is nothing wrong with her walk.  Most kids walk a little pigeon toed before three, and the only reason that she's not growing out of it faster is that she does W-sit alot.  I didn't realize what that meant when someone asked me about it last week.  They were impressed with her ability to quickly get up from a squat, which is her favorite way to sit and play in the floor, and said that she had good strength and muscle tone.  W-sitting means that over time as her pelvis matures, that it might not line up quite like it should.  It's ok for them to do that, but she is doing it too much.  Additionally for Ruth she is not pointing her toes straight behind her when she sits but the foot that turns in, she points out perpendicular to her body.  They could verify that she sits this way too often, because they checked her flexibility.  When they laid her on her back and had her butterfly her legs (feet together, knees out) she couldn't put her legs flat to the floor, like kids under 3 should be able to do.  Additionally when they put her knees together and her feet out to the sides, she could not only lay them completely flat but she could actually pull her feet all the way up to her sides, making a V shape.  She was more flexible than she should be.  What that told them is that she keeps her hamstrings in the shortened position most of the time, and she's not working them enough (she has a little bit low muscle tone as a result, not much just a little low).

Ruth squatting.

While they couldn't tell us her actual score yet, I did overhear them discussing that she was borderline, and that they would recommend her for speech therapy.  Even if she doesn't qualify for the program, they gave us some stuff to do help her.  For the gait, we just encourage her to "sit like a big girl" and they gave us several ways to have her sit instead.  We won't completely eliminate W-sitting that's just her preference, and there's nothing wrong with that, just encourage her to not sit that way as often.  For the speech, play lots of singing-finger play songs (like itty-bitsy spider).  Most kids learn through singing to speak clearer, and since she loves to sing and dance, this one will be great for her.  Also, to pick a sound to work on so that when she drops it, we repeat it back to her, emphasizing the missing sound.  The key here is to do this often enough, that she begins to hear what she is dropping, and to encourage her to add it on her own.  She won't start doing it right way, it will take time.  The next milestone we are to be looking for is using more consonant sounds at the beginning and ending of words.  If she has had no improvement in 6 months, they recommend having a full hearing check at 3, just to be sure that's not an issue (initial test, showed that it's not though).  All in all, we got alot of information, and I'm glad we went ahead and had her tested.

Ruth is a bit accident prone.  It's rare for more than two or three days to pass without her falling, tripping, running into something and having a knot, scrape, or black eye to show for it.  None have been so bad as her last ER trip, but it's becoming a joke just how ungraceful she is.  Britt hasn't even come close in 3 years to the damage she's done to herself since she started pulling up and walking.

He tried to make up for it this week though.  Tuesday night he was over at Memaw and Mister's house while Gary and I went to a Gator Networking dinner.  He was running around and playing with Lilli like usual and either tripped on something or ran into a wall.  Anyway, he fell on the floor and cracked his head on it pretty good.  He was crying and let Mister hold him, and ended up finally going to sleep, but he had a pretty good knot on his head after that.

The fun didn't end there though.  Wednesday, Gary was gone to an ag conference so to get all of us to Church we needed to split up.  The two kids rode with Mom, Dad and Lilli, and then Uncle Quintin and Aunt Joanna picked me up.  While everyone was in the lunchroom taking care of a few things before Church, the three kids were playing in the nursery and Britt came running, crying, and bleeding this time.  Britt says he hurt himself on a bench, Lilli says he ran into the wall.  In any event, he cut himself both under and above his eye.  He wouldn't let anyone clean it up with a wash rag or a bag of ice.  Last night he finally let me wash it up a little.  Britt may have a scar to match the one Ruth has now.

Believe or not the fun continued.  On Thursday, for the first time ever Ruth managed to fall off the hearth for the first time.  She landed flat on her face from the looks of it.  Britt wouldn't admit, it but I suspect they were fighting and pulling on a toy.  Britt probably succeeded in pulling it away from her, and she fell off.  I saw her run through the kitchen with Unca Matthew's old raccoon, then when I heard the crying and went back in the living room Britt was running off with it.  She's got a real bruise and a little cut on her forehead.  It's been the sort of week that keeps me hopping.  That's for sure!