Cleared for Launch (36w6d)

Today was my last prenatal appointment. Short and sweet.

  • BP: 154/97 both times
  • Fluid: 5.7 in only two pockets (dunno if that’s good that they were big, or bad that there were only two.)
  • Monitoring: Little man seemed content to kick at the monitors, so he didn’t need to be buzzed.
  • Group B Strep test was positive, so I’ll need 2-3 doses of antibiotics during the course of labor. No big deal, just one more thing going into the IV.
  • We chatted for a bit with our favorite nurse, Paula. She’s a neat lady. Hugs all around when we left.

    So we’re cleared to arrive at the hospital at 7:30 on Sunday. This is getting very real all of the sudden.

Still here (36w4d)

Quick & Dirty update:

  • BP was 155/99, so in the unhappy-ish range and up from Monday.
  • Monitoring went well (no buzzer needed)
  • Fluid is back up a bit to 5.7 (although Dr. Schwartz told us on Monday that he has a sneaking suspicion my fluid has always been a little higher than AFI readings are saying – just because on someone of my shape and size there’s more ‘nooks and crannies’ for fluid to hide in. Doesn’t make visualizing them or getting to them for an amnio any easier – but it does explain why he hasn’t been all Chicken Little like the nurses for the last two weeks.)
  • Gave blood and pee to re-check stuff and was sent home (as opposed to the hospital.)

If I wasn’t scheduled for induction on Sunday, they’d be having me do a 24-hour urine starting tomorrow. So thank God for small favors.

Worrisome upper belly pains + increasing headache + vision changes are making Dr. Schwartz look at me funny, but he let me go home today, so I consider that a victory. It’s possible the lab results will change that tomorrow, but we’re thinking positive. In the meantime, I’m trying to lay low – which is fairly easy today cuz I kinda feel like crap between an upset tummy, headache and the upper belly pains.

I guess I should clarify that the induction on Sunday isn’t something we’re expecting to go especially quickly. At not quite 37 weeks, I’m high and tight (not dilated or effaced at all) so I’m assuming it’s gonna take at least the full 12-hour cycle of the Cervidil to get things moving, if not a second round. (Our prepared childbirth instructors warned that it’s not at all uncommon for two rounds of Cervidil to be needed for induction before 38 weeks.) I’m not contracting anymore though, thank goodness. If the contractions from the amniocentesis had continued more than 8 hours or so, that would have been a problem. So while a shared birthday with Daddy is possible for June 30th, I’m not aiming for it. Personally, I think the little guy is gonna arrive on the 29th – but the 28th would be even better! As always – safe and healthy baby and Mama is all we’re after, however that comes about.

I’m back at Dr. Schwartz’s office on Friday for monitoring and possibly an amniocentesis if there’s a big fluid pocket that the doc of the day (not Dr. Schwartz) feels like trying to stab at. (Uug, that sounds gross, doesn’t it?) I’ll say goodbye to the girls in the office who we’ve gotten friendly with (I swear, it’s like Cheers when we come in now: a chorus of “Hi, Sarah” wafts out of the back.) If I end up with a Cesarean, I’ll be in the office for a follow-up at two weeks. If I manage to do a vaginal birth, I won’t see anyone in Dr. Schwartz’s office (including Dr. Schwartz) for six weeks. (He’ll still manage my insulin and meds during that time, but we’ll do that via email only.)

So, in the meantime I plug away at work stuff and Paul tries to keep me from working too hard. :)

Holding Pattern & Why I LOVE Dr. Schwartz (35w4d)

Fairly boring appointment today. Did the test for Group B Strep, the results of which should be back on Friday. (Most people carry Group B Strep on them with no worries, but if I’m currently carrying it, the baby can get REAL sick if exposed to it during a vaginal birth. Two doses of antibiotics via IV during labor will take care of it if I am positive.)

Amniotic fluid was back up to a 6 today, so that’s good. Little man was happy to show us how well he practices breathing, and had fun kicking the ultrasound transducer. Monitoring was the same as usual, requiring the buzzer to get things going. But once he woke up, he proceeded to kick the contraction monitor pad for about 5 minutes. His heartrate did a scary little deceleration thing a couple of times, but he bounced back quickly – so that’s OK.

Blood pressure was mixed: 164/97. So it was higher than it has been, but the diastolic was under 100, which is good. Dr. Schwartz said he was OK with my BP today, so yay.

Paul and I chatted with Dr. Schwartz about the plans for the rest of this week and next. (We also talked about developing an iPhone app vs a fee-for-service website…) But once we got home, Paul was explaining to his Dad what my status is and kinda had it all wrong. We talked, but Paul was still pretty convinced that he had it right and that the induction wasn’t happening unless it was an absolute emergency. So I e-mailed Dr. Schwartz. Below is the actual e-mail conversation (along with an explanation of what’s up for the next 5 days):

On Jun 16, 2010, at 8:10 PM, Sarah wrote:

Sorry to bug you, but Paul and I seem to have heard completely different things at today’s appointment and I’m hoping you can clear things up.

I’m under the impression that barring any significant change to my condition, you’ll do a Jedi-worthy amniocentesis on Monday morning which will confirm binary-style whether the little man’s lungs have matured enough to be on the outside. If the test comes back with a yes, you’ll have me report to the hospital Monday evening to start the induction. If the amnio comes back saying baby’s lungs aren’t mature yet, we’ll hang out and do another amnio a week later to check lung maturity then.

Paul is under the impression that I’m not being induced until the situation becomes an emergency, and that Monday’s scheduled amnio is just to give us an idea if the baby could handle being outside the womb when that crisis time comes, whenever that is.

So, who’s got it right?

Sarah
——-
Hi,

As is probably the case in any disagreements that you and Paul might have, YOU heard correctly and Paul is wrong. Please feel free to refer Paul to this email throughout the rest of your life.

JKS

Sent from my iPhone

I LOVE my OB so freaking much. So we’re just hanging out for monitoring on Friday and then the amniocentesis on Monday morning. We’ll have results that afternoon, and either we’ll be at the hospital that evening, or we won’t.

Updating from home… (35w3d)

I was totally expecting to get sent to the hospital today, but I got sent back home! Yay!

Dr. Schwartz re-did the fluid check and is confident he saw 5.5-6 worth of fluid in there. Heck, he even thinks there’s enough that he could do the amnio on Monday. He says he likes a challenge. My BP was fantastic today, with the diastolic under 90!! (I forget, it was 140-something/80-something.)

So I’m home now, gonna go take a nap. Monitoring and Group B Strep test tomorrow. We’ll see how it goes. I’ve got a monitoring appointment on Friday and the amnio scheduled for Monday morning.

Oh, and Dr. Schwartz obliged Paul while he was hunting for fluid and took some measurements. The little man is weighing in at just a tad over 5 pounds right now. Not sure about his length cuz the measurements were kinda all over the place, but the weight is a good estimate at least. Our little bag of sugar! :)

Set a Date (34w4d)

Good appointment today. Little man was lazy again and had to be buzzed several times to move while being monitored. His heartrate was in the 170’s for a while, but no one seemed to think anything about it.

My BP was in the same range of high, but not as scary as it has been. They always take it twice now, so today’s readings were 156/97 and 150/99. The response to this is: “meh”. Oh, and I lost three pounds since last week – that also didn’t really elicit a response. (But hey, my a1c is 5.7 – so HOORAY for excellent diabetes control!)

Amniotic fluid was even less today though. The nurse worked and worked to find pockets of fluid to measure, couldn’t find the required number of pockets for the full measurement, but calculated it at 6 based on the largest pocket she could find, down from 9.6 on Monday. And again, they wanna see 14. So yeah, I’ve been put on notice for that. I’m drinking. I really am. But now I’m chugging. If it’s lower on Friday, I get sent to the hospital for more intensive monitoring. I’m chugging, cuz I don’t want that. I want another weekend at home.

Dr. Schwartz entered the monitoring room asking “What are you doing still pregnant? I thought you weren’t gonna get this far!” So yay for levity. He’s impressed as hell that I’m still doing my Easy-Bake thing but thinks the end is getting close. My labs from Monday were all good, but things in general are just continuing on a not-good vector, so he wants to have a plan in place. To that end:

NEXT Monday (not this coming Monday, but the one after that) June 21 will put me at 36w2d. 36 weeks is the magic number for pulling the baby with essentially no guilt – the beginning of diminishing returns to my health for keeping the baby inside. On the morning of the 21st, Dr. Schwartz will do an amniocentesis to measure the maturity of the little man’s lungs. The results will be back that afternoon (fast, right?) and assuming everything looks good (which we expect it to because of the steroid injections I got last week) Paul and I will arrive at the hospital at 8:00pm that night to start the induction.

The induction process will take a while. Like overnight for sure. In the morning they’ll check me, hopefully find me 4cm dilated or better and they can start the pitocin. If I’m not dilated 4cm on Tuesday morning, they’ll give me a 2nd dose of Cervadil and let me go another 12 hours. So that part alone just to get me dilated a bit could take 24 hours. The pitocin could take 24 hours on it’s own too before things really get going – although we hope it won’t. (Cuz let’s not forget that I’m not allowed to have anything to eat or drink anything once I arrive at the hospital to start the induction. Ice chips: that’s it. Glucose and insulin IVs. yum.) I’m planning on getting an epidural, so there’s a hope that my being relaxed and pain-free will help the pitocin work quickly and get labor moving. Where it goes from there, we have no idea. Go with the flow will be the rule of the day.

So we’re looking at probably at June 22 or June 23 birthday for our little man. This of course assumes that things stay copacetic for another week. I’m still being monitored three times a week and at any time Dr. Schwartz says he could send me across the street to the hospital for more in-depth monitoring is something goes pear-shaped.

A bit of good news though: our little guy won’t be a preemie. Now that we’re past 34 weeks, he’ll be pre-term, but not a preemie. And at 36 weeks or later, there’s at least a chance that he won’t have to go to the NICU, meaning he can come home with us when I’m discharged! No way to know how things will go until he gets here, but we’re thrilled with our chances of our little guy not going to the NICU.

So that’s where we stand now. One more week of holding on, hoping to keep my BP where it is and keep my labs steady. But OMG, in like a week and a half, we’ll have a baby!!!

(NTS: figure out a dang name! and find a pediatrician!)

To recap BP over the last few weeks for perspective:

Date
BP
June-9b
150/99
June-9a
156/97
June-7b
162/103
June-7a
153/95
June-3
147/97
June-2
157/110
May-26
155/97
May-19
131/83
Apr-28
138/85