Wasn’t I just saying that this new vitamin supplement spared me waking in the wee hours of the morning? Yes, but tonight it is not the queasiness that has roused me, it is the coughing, the coughing, the goddamned coughing. Every fall/winter I get these colds that lead to relentless coughing: it wakes me up, my ribs hurt from it, the tickle in my throat is unendurable if I try to talk or, you know, breathe.

As far as I can tell, none of the over-the-counter cough medicines work even a little tiny bit. A doctor once gave me a prescription for a cough syrup with codeine in it, and that did work a little—but only because it knocked me into a narcotic coma, not because it did anything about the cough. If you’ve found some sort of miracle product, please let me know.

When I’m pregnant, these coughs are so much worse: not only am I unable to induce coma via Nyquil, the coughing can trigger barfing. And when I’m pregnant, I’m already uncomfortable and sorry for myself, and adding illness seems so, so unfair. Paul said he’d read that a pregnant woman has lower immunity to illness because otherwise her body would think the baby was an intruder and get rid of it. This did make me feel a little less sorry for myself: illness = helping baby.

Tonight I finally gave up trying to sleep through it. It was 4:00 a.m., I’d been awake with the coughing every hour or so all night, and I was noticing that every time I coughed (every eight seconds), Paul moved around a little, so I must be messing with his sleep, too. I’m up having some graham crackers and water and some Tylenol for the rib pain.

Hey, have you been watching My Name Is Earl? I realize everyone else has been raving about this show and giving it awards and writing articles about the actors, but we only just noticed it. (I think a child puts its parents about 5 months behind, culturally-speaking. Add a second child? Now you’re 10 months behind.) We’re getting the first season on DVD from Netflix, and so far it’s bear-awesome.

The nurse at the OB office gave me a sample pack of a prescription medication I’d never heard of, which is supposed to help alleviate some of the nausea I’m about to go crazy from. The medication is called Premesis Rx, and it’s just a vitamin supplement: 75 mg of slow-release vitamin B6 (the normal daily amount is 2 mg), plus some B12, some calcium carbonate, and some folic acid. I gather that only the B6 reduces nausea. (The calcium carbonate is like nibbling 2/5ths of a Tums tablet: I guess it could help a little, but it’s not something you’d get a not-covered-by-your-insurance prescription for.)

I tried taking it last night, and although I am still queasy all the 24-hour-day long, I haven’t actually barfed, nor have I woken at 3:00 in the morning too nauseated to get back to sleep, nor have I felt as if I wished I myself had never been conceived. I wonder, could it be working? Has anyone else tried this, or known anyone who tried it, and did it work? The nurse at the OB office said she tried it for her own pregnancies but it was a complete bust for her.

She also said there’s something else they can prescribe if this doesn’t work. My question is, WHY HAS NO ONE MENTIONED THESE TWO PRESCRIPTIONS TO ME BEFORE, WHEN I HAVE BARFED MY WAY THROUGH THE FIRST TRIMESTER MORE THAN THREE TIMES NOW?? I think the reason is that I’m insufficiently whiny (in person, I mean). I say I’m having some trouble with morning sickness, and the OB says heartily that that’s perfectly normal, and I say “Oh” and thank him. Whereas what I should be doing is grabbing him by his collar and saying, “NO, I don’t think you UNDERSTAND. I can’t SWALLOW. I can’t SLEEP. I am BARFING INTO THE TOILET at 3:00 a.m., 7:30 a.m., and 2:30 p.m., and lying groaning on the recliner in between, and unless you do something about it, I will be doing this for EIGHT MISERABLE WEEKS you bastard, and my guess is that if you had this feeling for TWO DAYS you would be CRYING FOR YOUR MAMA.”

It’s 4:30 in the morning; I’ve been up since 3:30. This is happening almost every night: I wake up queasy and restless and uncomfortable and the wrong temperature, and can’t go back to sleep. This particular night, I have the additional keep-me-up of feeling like a prime idiot for once again practically kissing a doctor’s sandals for giving me what I think was a wrong and inappropriately dismissive diagnosis.

For the last few days, I’ve been running a fever on and off. The highest it’s been is 99.9, so I’m not exactly combusting here, but when the fever is “on” I feel so awful I can’t even describe it. I feel as if I’m dying, or as if I’d like to. I can barely walk or move, but sitting/lying still doesn’t help either. I feel like I can’t lift the babies, or change their diapers, or comb my hair, or swallow food. AWFUL, is what I’m saying here. Also, I have a gunky cough, and when I breathe in my lungs feel sore.

I went to my primary care physician’s office, confident I’d be walking away with an antibiotic. They made me see the nurse-practitioner, which is standard for this stupid office: the actual doctors have 3-month waits for appointments. His diagnosis? Probably a cold. Just keep taking Tylenol every six hours. His attitude was dismissive and amused, like I was some silly pregnant woman wasting his time. He noticed that Elizabeth was coughing, and I said, “Yes, we’ve had a cold going through our house,” and he said, “Well, guess what?”–meaning DUH, lady, you have that cold too, you didn’t need a DOCTOR VISIT to tell you that.

As I understand it, though, a CHILD might get a fever from a cold, but adults usually do not. In an adult, a fever is usually a good sign that something is wrong. And in a pregnant adult, I don’t think I’d take a chance on that, if I were a doctor: infections can be serious, serious things.

I can’t believe he sent me away as if I were just there for fun, maybe trying to score some “good stuff” antibiotics. It is no small feat for me to get to a doctor appointment: I have to schedule it around a 2nd grader and a kindergartner’s schedules, and I have to bring the twins with me in their ginormous stroller that barely wedges into the exam room, and the twins have to miss all or part of their nap. I don’t go in until I am so worried about my health, I’m starting to wring my hands and hyperventilate and imagine scenarios where the last-rites priest says, “But why didn’t you call the doctor sooner?” A brief glance at my medical records should show that almost every single time I come in, it’s something that requires medical attention–and on the few occasions I’ve gone out of there without medication, I’ve been back a week later and they’ve given it to me that time, finally willing to concede that I have, for one memorable example, pneumonia.

What I really can’t believe is that I said not one word of this to the nurse-practitioner. I said “okay.” I thanked him. I’m completely responsible for the well-being of a child living inside my own personal body, and I have a fever, and I feel so bad I have WISHED FOR DEATH, and I thanked him and paid my co-pay and didn’t even argue a little. Okay, I argued a teeny bit: I said I was worried about the fever, because I knew pregnant women shouldn’t have fevers. He gave another dismissive look/sound/gesture and said, “Well, sure, if you were running a constant 102 that would be another matter.” Me: “Okay! Thank you!”

In part, I blame my mother, who reared me with such a deeply respectful attitude toward authority, I have been unable to break that attitude even when a break is richly, richly called for. But in addition to the nurture, it is my own shy, fearful, confrontation-hating nature that turns against me. If only there were a medication for THAT.

I had my first OB appointment this morning. It was an “intake” appointment: I just saw the nurse and updated my family history, got my free tote bag and my lab paperwork and my sheet of which medications are approved to take during pregnancy and which aren’t (“DO take your prenatal vitamins! DON’T take crack!”).

Every time I’ve gone to the intake appointment before, they’ve asked if the pregnancy was planned, and I’d been debating what to say this time. Just “unplanned” and leave it at that? How should I do my tone of voice so that they don’t ask me any unpleasant questions? Luckily, the nurse didn’t ask this time. I suppose they assume that once you have four children, a pregnancy is either planned or you’re too dim to figure out how it keeps happening.

First barfing! 4:00 a.m.

So. queasy. I feel so awful, I don’t know how I can get through the next 2 months of it. (And I feel so, so, SO sorry for the women who have this the whole 9 months. I think sainthood isn’t too lofty a reward for those women.) This morning as soon as I got up, I ate saltines and ginger ale and banana, but I’m still on the verge of actual barfing. I feel tired and achy all over. Usually I get the twins dressed right after they have their breakfast, but today I barely felt like I could lift them from their high chairs into their play yard. Then I sat in the recliner for awhile, feeling yucky.

I don’t even want to read. I don’t want to go anywhere or do anything. I don’t want to pick up toddlers. All I want to do is WHINE.

I keep looking for more solutions to the problem, but my conclusion is that there is no solution. People mention ginger, and peppermint, and a whole bunch of other things, but the consensus seems to be that nothing really works on “morning sickness” except time: getting past it.

Here is what I am really wondering: Is this the usual nausea I have with every pregnancy? Or is this the more intense variety I had when I was expecting the twins?

Good pregnancy feelings:

• I am doing something important every second of every day, even if I am eating Dove chocolates and reading a People Magazine.
• I wonder if this baby will be a boy or a girl?
• I wonder what we should name the baby?
• I wonder if it will be twins again?
• I can eat well and exercise, for actual health reasons and not for “being healthier” in the sense of “I don’t care what I have to eat or not eat, I WILL hold up my ‘fat pants’ next to me and be dwarfed by them.”
• Oh my god, oh my god, oh my god, oh my god, oh my god, a BABY.

Bad pregnancy feelings:

• I think I’m going to barf.
• Nothing sounds good. What can I eat? Everything looks gross.
• That statistic my mom told me ten years ago about most families having one more child than they should have had. My mom, who makes up statistics. That I then believe, for some reason.
• I can’t believe I have to go through this physical misery again.
• Oh my god, the medication I took before I knew I was pregnant!
• Oh my god, I didn’t realize too much ginger was dangerous!
• Oh my god, now I have to be careful of AROMATHERAPEUTIC OILS??
• Definitely, I am going to barf.

Last night I woke up at about 3:00, and I couldn’t get back to sleep because I was too queasy. I finally got up and did a few chores: labeling photos (from July–I’m more than a little behind on this chore), emptying the dish rack, etc., while drinking tea and eating saltines. I tried going back to bed around 4:00, but felt so very, very queasy I had to get up again. At 5:30 I felt a little better, and very carefully lay back down, and felt well enough to drift off. At 6:15, William came in to tell me there was a spider in his room.

So, morning sickness again. One of the few reasons I was glad I was done having babies was that I was done with morning sickness. The weeks of it seem endless. I think some people think it’s just a little touch of wooziness, and of course that’s all some women get: one of my friends assured me that if I nibbled a saltine first thing in the morning and stopped lying around so much, I’d feel better—making it clear to me that she didn’t deal with the level of morning sickness I’m dealing with. Here is what it’s like: it’s like having stomach flu for nine weeks. Anyone could be excused for going INSANE in such a situation.

Oh, I could use a baby frontpack for the new baby. I’ll be a sight, won’t I? Two walking children, two children in a mammoth double stroller, one child strapped to me. But it solves the problem I seized up with yesterday, wondering how I would even transport this many babies.

I could also shop in the evenings, when Paul is home from work and the kids are asleep.

I just had my first big swoop of doubt. I was going through some photos from the summer, Robert and William at the pool having swimming lessons. I was thinking about how great that worked: I’d put the twins in their double stroller and we’d sit and watch Robert and William swim, and it was such a nice way to have some summer automatically at the beginning of each day.

I was thinking about how I’d definitely sign them up for lessons again this year. Then I realized that this year, I’ll have a new baby, just a month or two old. The twins will be in their double stroller–and where will the new baby be? In fact, where will the new baby be on any outing? Already I am out of room in the shopping cart.