Friday, April 21, 2017

The birth of Samuel Cary part 5 - the C section

I am writing this post to try to remember all the details of our son's birth - maybe too many details.  Feel free to read along or just scroll through and look at pictures.

I did not finish this post for a long time (like 10.5 months AFTER Samuel was born) so here are my foggy memories:

Once the forceps did not work, I knew that I was going to have a c section.  I pretty much just laid in there and cried and tried to not cry while people went into action.  Dr. Bozeman was really sweet and as I was signing my life away he told me, "You tried everything you could. You are not failing." My response was to cry harder and ask Ian to bring puke bags into the Operating Room with us.

Ian was getting scrubs on.  Dr. Bozeman was stitching me (becuase I pushed long enough/ hard enough / whatever enough to tear).  Even with an epidural it was not a pleasant experience.  I found out that Sara could not go with us into the operating room.  Only one person was allowed and we thought it would be good if Samuel's father was there for his birth.  I was nervous about Ian holding the puke bags.

They wheeled me into the operating room.  People kept walking up to me and introducing themselves and telling me their duties.  I did not care in the least at that moment, but I do remember thinking, "there are SO MANY people in here".  I had to be switched to a different bed and I was so impressed by how amazingly smooth the procedure went (I am guessing this is part of people's every day job, but for someone who has never stayed in the hospital for longer than a few hours, I was impressed!)

Dr. Bozeman had another doctor assisting him with the procedure.  It just so happened to be Dr. Jill Ingenito.  Dr. Ingenito just so happened to be the doctor who removed my arm stick 38 weeks and 5 days before Samuel was born.  She told me to start taking prenatal vitamins and to stop drinking alcohol (at that time).  I was all like, "Oh it is going to take us years to get pregnant.  I will think about possibly starting prenatals soon." Dr. Bozeman and Dr. Ingenito had a chuckle about it.  I was not chuckling.

Anyway, I do remember that there were two anesthesiologists or one anesthesiologist and one assistant to the anesthesiologist.  One was a man and one was a woman.  The woman anesthesiologist gave me the play by play of what was happening.  She stood above me and would hold my face in her hands and bend over and talk right into my face any time she wanted to tell me something.  At the time, it was reassuring and sweet.

Dr. B and Dr. I were going about the c section and shooting the breeze like it was no big deal.  I was crying, trying not throw up any more, and trying to process my life.  I did throw up once or twice in the operating room.  I can't remember if it was before or after Samuel was born.

They did announce, "Your son is about to be born.... He is here!" (I don't remember what they said but it was something along those lines.)  Soon, I could hear his cry.  I had not really stopped crying in the last 45 minutes, so I just kept crying.  

Ian went over to check on him and ended up cutting the umbilical cord (not by his consent, but it makes for a funny memory). Eventually they brought Samuel all swaddled up in a blanket over to let me see him and hold him.  The man anesthesiologist took a couple "first family pictures" I did not look at the camera.  I did not smile.  I laid there and cried.  I don't know if I even held Samuel.  Then they took Samuel and Ian off somewhere.  I can't remember when I stopped crying, but I was trying to pull myself together while they stitched me up.

I feel like it was half an hour later that I was wheeled into an alcove of a hallway with a chair for Ian.  Samuel was in his little plastic bed thing, just taking the world (I was surprised he was not crying). Ian and I tried to process our life and call people and send pictures etc.  We did it!  We had become parents.  Ian did not faint.  I did not make it anywhere close to having an unmedicated all natural birth, but a few months later I would finally accept it.  We did find out that Samuel had a slightly over 15 inch circumference of his head which is huge.  One nurse practitioner mentioned that I may have broken my pelvis or something if I had pushed him out (Lordhavemercy).  Samuel Cary weighed 8 pounds 7 ounces and was 21.5 inches long when he was born at 3:01pm. 

I could probably ramble on and on about our stay in the hospital but I will end here.  The adventure of parenting has just begun.  We are so thankful for our friends and family that supported us so much the first few weeks of Samuel's life.  We would not have made it without yall.  Much love and thanks.

The birth of Samuel Cary part 4 - the pushing

I am writing this post to try to remember all the details of our son's birth - maybe too many details.  Feel free to read along.

Once Casey came back she asked if Ian would like to cut the cord after the baby was born.  His reply was a solid, "NO!" Then she asked me if I wanted to cut the cord after the baby was born.  My reply was also a solid, "NO!" Our friend, Sara, was there and so Casey asked her and she was like, "Of course! That would be so cool!"

I told Casey that this was my first rodeo as far as giving birth and Ian and I had not attended any birthing classes or really had any idea what we were doing.  She assured us that this was okay and that she would just teach us her own method.

I was supposed to wait for a contraction (which I could not really feel all that much) and then hold my breathe and push. Casey would count to ten. I would exhale, inhale and repeat. And a third time. It sounded so easy.

On the second or third push Casey told us, "Your baby has hair!" I thought, "YES! This is working wootwoot!" and on the push after that, "He has long dark hair." I was encouraged.

Aunt Sara and Samuel
The story gets fairly boring for the next few hours.  I pushed and I pushed. I started throwing up about an hour or so into the pushing.  God Bless Sara and Ian.  Sara held the puke bag and helped me rinse me mouth out after I threw up each time.  Good thing the room was well stocked with puke bags. Ian was so great!  He held my leg and was so encouraging. (I kept waiting for him to pass out or something and he did not.  He hung in there for the entire process and was so great!) Actually everyone was encouraging.  I specifically remember asking Casey how I was doing at one point and she told me that 75 to 80% of my pushing was good.  The main thing I HATED was holding my breathe. I could rant about that for a long time. I don't think the person who proposed holding one's breathe while trying to push what feels like a bowling ball out of one's self did not had any experience in doing so.

Casey was SO GREAT! She was so encouraging and she did not give up on me. She was the slowest count-er to ten that I have ever met.  I would try to count to ten slowly in my mind and I would be at twenty and she would be at six.  One thing that I will always laugh about is my memory of pushing.  I told Ian later, "I know I pushed for three hours, but I was only pushing like every 10 or 15 minutes... so it wasn't really that much." He looked at me with a shocked face and said, "No. I was watching the monitor, you were pushing every 2 to 4 minutes." Hahaha - time can become a funny thing.

At one point after I had thrown up and was feeling exhausted, I pathetically asked Ian, "Once this is all done (and in my brain I added, "And I survive this ordeal alive...") can you please find me some Sprite." The only thing I want after throwing up is Sprite.  Of course I was restricted to ice chips. Ian agreed to find me some Sprite.

At one point I think they may have turned down my epidural so that I could feel the contractions so I would know when to push as it was not timing out correctly.  I can't really remember... it is part of the fog now.

I don't remember how far along we were, but at one point Casey asked me how much I had left in the tank.  I gave a pretty vague answer. I did not feel like I knew. At that point it felt like I was going to spend the rest of my life pushing as I was not really making any progress.  

Dr. Bozemann came in around the two and half or three hour mark of pushing.  He said that I had four options:
  1. Turn the epidural off and let nature take its course - Um, NO, I was not about to do that.
  2. Keep pushing - well I had not really progressed (in my opinion) in the last three hours, so I am not sure why this was an option
  3. Try forceps or vacuum - I was not crazy about this option.
  4. C-section - at that moment in time I thought, "I will do anything so that I do not have to have a c-section."
My only "birth plan" was: do whatever the trained people tell me to do. Unfortunately all the medically trained people were like, "What do you want to do?" and Ian and I were like, "Tell us what to do!" By order of elimination we decided to try forceps.

I don't remember a whole lot at this point - they had me put my legs in stirrups and my legs started shaking uncontrollably. They did a quick ultrasound to see what way the baby was facing.  A LOT of people started coming in the room. I think I tried to keep pushing through most of this because trying to breathe through a contraction and not push was WAY more painful than pushing.

Once everything was ready, they told me to push. Sweet Lord Jesus, Rapture Me Now. Pushing with forceps was hands down the most painful thing I have ever experienced in my life.  I was willing to do anything in that moment to not experience that pain again.  I screamed (from pain) and then started crying (because I knew I was going to have to have a c-section).  

The birth of Samuel Cary part 3 - the unnatural labor (aka magical unicorns, rainbows, and puppies)

I am writing this post to try to remember all the details of our son's birth - maybe too many details.  Feel free to read along.

At 7am Dr. Bailey, an anesthesiologists, came in and introduced herself.  Ali, our night nurse, was there too.  Ian was awake and hanging out.  I was scared to get the epidural and exhausted and discouraged.  Dr. Bailey was amazing! She was direct and quick.

I sat on the edge of the bed and hugged a pillow.  Ali directed Ian to sit on a little stool that had wheels on the bottom and be near me (I whispered in an angry voice for him to back up - sorry Love - I laugh now when I think back on it.) I don't remember all the directions, but at one point Dr. Bailey said that I would feel a sting in my back (a tiny bit painful, but nothing in comparison to contractions or other pain I have felt in my life). I cried during the procedure (spoiler alert: I cried a lot during the whole giving birth process).  Why did I cry? I am not 100% sure - I think I was disappointed in myself for getting an epidural.  Dr. Bailey said the whole procedure took about 17 minutes. 

Napping in his Baby Box
Once I got all hooked up and good to go, I was told to lay on my back for 20 minutes to let the medicine disperse correctly. Glory, glory, hallelujah - I got to lay on my back after months of being told not to. One thing I did not know was that once you have an epidural, you are not allowed to get out of bed and need to be catheterized (how did all of my friends leave this part out of their stories!?!).  I told myself that I did not really have a choice and to just get over it.  In case you are wondering the PRO of having an epidural far outweighs the CON of having a catheter put in.

Since it was coming up on shift change time, Dr. Webster and Ali came by.  Dr. Webster checked things out and told me I was 6 cm dilated (wootwoot!). Then she said that she was wrong and I was only 3 (bummer!). Dr. Webster (I think her name was Kelcey) told me that she was going off and Dr. Bozeman was coming on duty.  She mentioned that he had a lot of experience and if she ever had to deliver using forceps, he would be the person she would choose. (At the time, Ian and I found it to be a weird tidbit to share.) 

his favorite position to nap - being held
My new nurse, Casey, came on shift and introduced herself to me. I love Casey! She will forever be remembered as the best nurse that has ever lived and all future nurses will have to live up to her crazy awesomeness.  She told us a little bit about herself and that she was good with me hanging out for awhile.

After they left, Ian mentioned that he was tired and hungry (and I think I gave him the death stare) and he headed out to find some breakfast.  I told him, "Under no circumstances will you bring a cup of coffee into this room!" Clearly the epidural did not take all of my unkindness away. I drifted in and out of sleep for a little while.  At one point someone came in the room for me to sign some papers.  I think I would have signed anything at that point. I think one was for the hospital to take photos of the baby later (which we opted out of), one was for a hepatitis B vaccine, and one was something super crazy like "if you are about to die, can we try these things to keep you alive".

Once the epidural kicked in, my contractions slowed down so they put me on pitocin to keep things moving. I felt nothing! (and I was ecstatic about feeling nothing). I tried to get some rest as I knew we had a long day ahead of us.

I woke up around 9:30 or so and found our friend Sara chatting with Ian. We filled her in on what had happened and we were just shooting the breeze. We decided to take bets on when the baby would be born.  I remember that I thought 6pm. Ian said 3pm, Dan said 2pm, and Sara said 4pm.  I don't remember what anyone else guessed.  I do remember thinking, "TWO P.M.!?!? These people are crazy, I won't even be fully dilated by then."  I told Ian that he needed to tweet out, "Have a good day!" for me so the kids would know that I was in labor at the hospital.

Around 10:30 or so I felt "different" like I needed to pee (but I had an empty bladder). Casey came by (or we called her, I can't remember) and she checked - I was 10 cm and ready to push.  I was SHOCKED. (At pretty much every point in this story I was shocked and in denial but this was probably the most shocking part - I felt exactly the same at 10 cm as I did at 1 cm).

Casey told me that she needed to go pump for her 6 month old daughter and that she would be back in half hour and start pushing.  If you have been reading along on these pregnancy posts and labor posts than it will not be hard for you to believe that I was in disbelief and denial.  To help the thirty minutes pass we turned on the TV and watched some show on HGTV about people who win the lottery and then use the money to buy a house and furnish it.  I don't know if we really paid attention, but we all pretended to watch it.  (We never turned the TV off so I can remember throughout the next couple of hours seeing the TV still on and chuckling in my head.)

The birth of Samuel Cary part 2 - "The All Natural Labor"

The point of this post is so that I can remember what happened - feel free to read along.

While I was being admitted, hooked up to an IV, and monitored, Ian and I were having a full on conversation about what he needed to do - mainly run home for stuff and fill the car (with the car seat in it) up with gas.  Since I had not packed a bag for the hospital (it was on my to-do for that day) I was saying a lot of things like, "... in the bottom drawer of the dresser there are gray fleece sweatpants, get those..." Ian was googling, "What to pack in the hospital bag" and I am pretty sure our nurse, Ali, thought we were crazy.

The way our health insurance provider works is they have two OB/GYNs rotate through the labor and delivery unit at the hospital.  The first doctor was really nice - Dr. Webster - I think.  My blood pressure was a little bit elevated, so she gave me some possible scenarios that we would be facing and I expressed my desire to do whatever was best.  However I really, really, really wanted to go all natural.  Dr. Webster was so nice!  She let me get out of bed and do whatever for an hour and then I had to get in bed and be monitored for 20 minutes.

Once Ian left (around 1 am I think), Ali brought an exercise ball in for me. My contractions were really manageable at this point.  I knew that I should try to rest, but once someone told me that I was having a baby, I had way too much adrenaline in my system to try to sleep or be stationary.  I spent a lot of time walking with my IV cart (super annoying - you would think in 2017 they could invent an IV cart that would move easily), bouncing on the ball, and just trying to breathe through each contraction.  I can't really describe how a contraction feels - mine were all in my back - the main issue is I could not find a comfortable position (and I tried every position known to man) to be in.  Once the contraction would pass, I would be fine, but in the middle - oh man - they were not fun.

I think Ian got back to the hospital around 3 am and I was definitely feeling the contractions at that point (I was having contractions when we first arrived at the hospital - I just did not notice them).  There was a couch/bench in the room and Ian stretched out and went to sleep.  Before he drifted off, he reminded that we live in a day and age of epidurals and that I have choices.  I don't know what I replied, but it was not the kindest.

Around 4 or 5, Ali came in to hook me up for monitoring and the contractions were getting really unbearable while I was in bed.  I would just sit and watch the clock waiting for 20 minutes to pass and for Ali to come back and let me get up and move around again for 40-60 minutes.  This time, though, the baby's heart rate did not measure the way they wanted it to, so I had to stay in bed for more monitoring.  I was really discouraged in that moment.  Ian was asleep, I had just talked myself off the ledge for 20 minutes, and Ali did not know how much longer I had to stay in bed.  Thankfully, the baby's heart rate returned to normal in the next 10 minutes and I think I jumped out of bed.

I do not have a great memory of timing, but it was starting to feel like I was having three contractions back to back and then a break for 10 to 15 minutes.  I really wanted a tall (bar height?) counter to lean against during each contraction.  Yet, there was only a normal counter for the sink.  I was starting to have a hard time thinking during each contraction. 

I had a little conversation with myself that basically went like this, "Could I keep going all natural?" YES! "For how long?" I don't know.  "Will you be in any shape to push if you get no sleep tonight and labor takes 12 more hours and you are not allowed to eat?" Probably not. "Do you want to bite your husband's head off each time he tries to be nice to you?" No. "Can you continue to sit in bed and be monitored for 20 minutes at a time and not move around if the contractions get stronger?" Maybe, but it is torturous. 

So at 6am I told my nurse Ali that I would take an epidural. She said that two other people had just requested epidurals as well.  I told her I was not in a hurry and the other two could get theirs first.
how I felt during contractions
Other things I remember from this part:
  • Ali was a traveling nurse from the Dallas area.  Her accent was so cute!
  • I went to the bathroom several times.  Getting the IV cart in and out of the bathroom was not easy (did I mention that the person who designed the IV cart would not be rated (by me) as effective at their job?).
  • Our hospital room was near the helicopter landing pad - I would not have known this except there was a little blinking in our room ALL night.  I was so annoyed by it! (I was pretty much annoyed by everything to be honest).
  • At 3am (or so) I realized that I needed to put in for a sub on Monday so I bounced on the exercise ball and went online to put in for a sub for Monday and Tuesday. It took me awhile to get it done, but I did it!
  • Ian texted his parents and my parents around 2am to tell them we were at the hospital - I was not the happiest camper about this (I wanted to wait until 8 or 9).  I don't remember why it felt like such a big deal at the time but it did.

The birth of Samuel Cary part 1 - am I in labor?

I am going to guess that this will be a long post but the point is so that I can remember what happened.  I feel like some details are already fading or blurring together, so I want to try to write out as much of the story as I can remember.  I will intersperse cute pictures of my kid if you just want to see baby pictures.

Thursday, April 20th was a normal day - I got up, went to work, and came home.  The next day was a comp day for conferences, so I was looking forward to a three day weekend.  I stayed after school and made sure all my grading was done and my sub binder was ready to go.  I really believed that I would be back at school on Monday, but on the off chance that something happened, I wanted to leave everything in good shape.  *At this point, my first three subs had canceled on me so I did not know who would be my sub should I have the baby over the weekend.*  During 4th period Calc BC that day, the kids asked how they would know if I went into labor or not.  We decided on a secret code: I would tweet out "have a good day" whenever I was at the hospital having the baby.  A lot of the kiddos wanted me to give birth on 4/20 and I was bound and determined that it would not happen.

Easter Sunday - five days before Samuel arrived
Once I got home, I made a to-do list for the next day (run to Costco, pack a bag for the hospital, write thank you notes etc.) and then Ian and I worked on rearranging our bedroom.  I wanted to put the bed in a corner (really inconvenient for Ian to get in and out of bed now) but it was the only way to create more space in our bedroom.  We had been talking about rearranging our bedroom for a month or so and I was glad that we finally got it done.

I had had a cold for most of the week and my nurse practitioner suggested that I try some Tylenol PM if I could not sleep. Since I had a lot that I wanted to accomplish the next day, I decided to take a Tylenol PM and get a good night of sleep.  Ian went to hang out with his brother and some friends but had to work the next day so I knew that he would not be too late.  I think I went to bed around 8 pm and was out like a light.  I woke up at 11 and thought, "something is different".  I got up to use the restroom and realized that I had completely soaked myself.  I was definitely feeling the Tylenol PM at this point and drowsily told Ian that either my water had broke or I had slept so deeply that I had peed myself.

We tried to google the difference and that was not helpful.  I told him that we could call the hospital and check with them.  We did not get a direct answer from the hospital (due to our health insurance provider) but Ian stuck with it and kept finding numbers to call until he could talk to someone.  I had gone back to bed and was trying to fall back asleep.  The questions that we got asked were...interesting... "Are you having contractions? {No, if I was, I would be timing them and know when to go into the hospital} Is part of the baby exposed? {NO! If I had half a baby hanging out of me, I would not be talking to you.}" Even though we answered no to each question she asked us, we were still encouraged to go in and be evaluated.  She reminded us that if part of the baby became exposed on the ride to the hospital to pull over and call 911.

I grabbed my purse and Ian grabbed the camera (I rolled my eyes and told him to leave it at home) and we headed to the hospital.  The whole way there we laughed about being first-time parents and how we were going to get sent home.  I was hopeful that we would be back home and asleep by 1 am.

We did not really take into consideration that it was the middle of the night.  We parked where we had planned and went to enter the hospital only to realize all the doors were locked so we started walking in the street (there weren't any sidewalks) to another entrance.  At this point I was laughing out loud - it was freezing so Ian was walking fast but I couldn't keep up - and the whole scenario was hilarious to my sleep deprived mind.

We finally figured out how to get into the hospital. Ian was so great - he wanted to give anyone and everyone all the details as to why we were at the hospital.  I was like, "Cut the chase - it is a security guard, he does not want to know our whole life story - just show him your ID".  We headed up to the labor and delivery floor and were shown to triage (a room that is none too big with a bed, a baby bed and warmer, a bathroom, and a monitoring system... and a chair for Ian to sit in).

Our triage nurse's name was Jennifer and she was energetic! I got changed, she hooked me up for monitoring and then tested to see if my water had broken.  I had to chuckle because the way you find out is watching a small piece of paper - if there is one line your water has not broken, if there are two lines, then your water has broken (just like a pregnancy test).  Jennifer told us that it could take up to 10 minutes to get the results.  Ian and I watched the clock as it was 11:55 pm at this point.  I was pretty positive that I would not have a baby in the next five minutes, but we had nothing else to do, so watch the clock we did.  4/20 came to an end and April 21st began.  Jennifer came in to check the results.  I rambled on about how I could kinda see the second line but it was not super visible and yada, yada, yada.  She took one look and gave us a big smile and said, "There are two lines!  We are having a baby!"  

My first reaction (mentally) "Can we just freeze all of this and I can come back in a few days!?!?  I have stuff to do tomorrow (well now tomorrow was today). Can we just wait 24 hours?" I think I just stared at her.  She told us we were going to be moved into a labor and delivery room and she would be back in a moment.  Ian and I just stared at each other and laughed nervously as we waited.  And mentioned repeatedly how shocked we both were.

Jennifer came back pretty quickly and started to escort us to our new room.  Someone from admissions was waiting for us in the hallway and was asking for information and signatures - I will make the following statement several times - you could have asked me to sign anything at that moment and I would have been in so much shock that I would have signed my name to just about anything.

Monday, April 17, 2017

40 weeks

Well, here we are at 40 weeks pregnant.  I will say it is fun to have people ask, "When are you due?" and to be able to answer, "Monday" or "any day" and then see their expressions.

A recap of the past few weeks:
Week 36 - SPRING BREAK!  What a glorious week and by that I mean we worked our tails off but it was so nice to cross stuff off the list and get stuff done!  The weather was amazing so I tried to get out and walk each day.  I had a doctor's appointment and saw an actual doctor (usually I see a nurse practitioner).  We had a ten-second ultrasound to see if the baby's head was down - it is.  I was a little bit, like, "Hey!  Can we see something besides a circle that represents his head?"  "What about an arm or a leg or something!?!?".  I think I went to Target almost every day.  For what? You may ask...I don't remember but I found a reason to go and wander around.  I know one or two of the days it was for thank you notes.  I chopped about 10 inches of hair off and enjoyed getting my hair washed and head massaged.  
37 weeks 5 days
Week 37 - I can't remember anything interesting happening - school, school, and more school.  Ian finished up his oral antibiotics for impetigo and it finally looks like it is healing!  My first long term sub canceled on me.  So I started my search for another one.  The baby really likes to stick his butt out - several times a day my stomach will bulge on the right side near my belly button.  I have decided that it is his butt and I give him a few pats each time he sticks his derriere out.  

Week 38 - We were productive.  It finally seemed real enough that we are possibly having a baby so we installed the car seat bases, assembled the stroller, and put together a swing that some friends loaned us.  I washed a bunch of blankets, burp clothes, and one sleeper.  We went out to eat at some "nicer" restaurants that we had gift cards for (thank you Calc 3 students!).  We decided on a name (we think).  (And that was all basically in one afternoon).  My second long term sub canceled on me.  We had a doctor's appointment and my sugar was elevated (of course!) so they want me to come back in a week.

39 weeks 2 days
Week 39 - Long term sub #3 is the charm (finger crossed - she has not canceled yet).  It was a relaxed week at work in some ways.  There was a lot of state testing and so fewer classes to teach, but I did my best to crank out 6 weeks of sub plans and stay caught up.  I treated myself to a Starbucks and a pedicure.  My ankles and fingers just started to swell this week and they are not underachievers in the swelling department.  I am not ready for the baby to come yet, so I stopped exercising (which why I think the swelling came on so quickly).  The good news - it does not hurt at all.  

Waiting for my toes to dry and watching my belly physically move when the baby moves

I keep waiting to get to the stage of, "I am so big.  I can't sleep.  I am so uncomfortable.  Just come already, Baby!"  But it has not happened yet.  I feel pretty good and I once I fall asleep I am good for the rest of the night.  I had one poor night of sleep where I kept waking up with intense back pain and a horrible leg cramp.  I was concerned that I was maybe going into labor, but the next day everything was normal.  I mentioned to nurse practitioner that I hope to make it 41 weeks and 4 days and she told me that I was the first person she had ever heard that from.  We shall see.  {I would try to make it to 42 weeks, but the nurse practitioner has already said 41.5 weeks is the limit.}

At this point, I keep comparing my pregnancy to a marathon.  A marathon is 26.2 miles, which is 42.195 kilometers (and yes, they mark each and every km in Korea when you run a marathon). So I have told myself a week = a kilometer.  At this point, I am somewhere between 24.5-25 miles into my 26.2 miles analogy.  24.5 miles is not a fun spot to be and you are so close, yet so far.  At 24.5 miles, you just put your head down and get through it.  I would definitely take 40 weeks pregnant over hanging out at 24.8 miles of a marathon.  All of that to say, it gives me a good perspective and helps me stay patient.