Tag Archives: development

Possible change in plans… (35w2d)

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Today’s appointment for monitoring was pretty darned good. I walked in feeling better than I have in a while. Excellent blood pressure again (147/90) and after some not-so-gentle prodding, good numbers from the kid on the monitoring strip. (He did not appreciate me chugging half a bottle of ice water to get him to move and getting my whole belly woggled by the nurse.) Trace amounts of protein in the urine (up from zero) but not OMG either.

The bad part comes during the ultrasound where they’re measuring the amniotic fluid around the boy. The levels should be around 14 on average, with 5-25 being the extreme low and high ends of the scale. Anything at or below 5 is cause for major concern. I’ve been sliding down that scale and was at a 6 on Wednesday and Friday last week. I forced fluids this weekend, making sure I was taking in well over 100 ounces a day in the hopes of bumping up that number.

Today all the head nurse could get was 4.8 – and that was after 20 minutes of looking and looking all over. So the oligohydramnios is very much in affect. What exactly this means, we’re not sure. We know it ain’t good, but the fact that this is happening towards the end of the pregnancy as opposed to towards the beginning is good. If it were at the beginning, it would be because of some abnormality with the baby. Now it’s just a culmination of my pre-existing medical conditions: hypothyroidism, hypertension & diabetes.

Dr. Schwartz is in his other office across town today and tomorrow, so they called him while we were at the office to see what he wanted to do. We were sure he was gonna send me over to the hospital. But he asked to see me in his other office tomorrow instead. So we’re taking that as a sign that there’s no need to totally freak out just yet. Mostly what oligohydramnios means at this point is that delivery is gonna be a bit more complicated and the chances of a cesarean are probably higher. There isn’t anything they can really do to reverse it – like putting me on a saline IV to pump me full of fluids or something. (There are some therapies that involve pumping fluid directly into the placenta, but those are mostly for use *during* labor.) There isn’t enough amniotic fluid around the baby to *do* an amniocentesis – so we don’t know how much that will blow out next week’s plans. With such decreased levels of fluid/cushioning around the baby right now, the chances of him laying on his umbilical cord and squashing his blood/oxygen/nutrient flow increase. This is where I am SO GLAD that I completely trust Dr. Schwartz and his knowledge/experience in treating high risk women like me. Whatever he says tomorrow is OK with us. If he still wants me to try for a regular birth, I’m all for it – but if this situation necessitates a cesarean from the get-go, we’re OK with that too. Whatever gets our little man out safely.

So this afternoon and this evening are final prep, just in case. All bags are being packed (we were doing laundry this morning already) and final arrangements are being made. I’m gonna try to go get my nails done. Gonna get the Ragu Bolognese made and in the freezer, along with the Creamy Italian Chicken. (There’s a lot of simmering involved there – I’m not gonna be slaving over a stove.) We’re hoping that Murphy’s Law will kick in if we get all this stuff done tonight. Paul is pretty anxious, but I’m doing pretty OK. I am keenly aware that I need to stay calm, and having tasks to focus on helps me greatly with that.

We’ll update tomorrow after the appointment here and on Facebook. (Facebook will probably get updated faster because it’s easier to do from our phones.) We’re halfway expecting to be told to go to the hospital from our 9:00am appointment. I’m all the more glad that we have a 7:45am appointment to meet the pediatrician tomorrow. Gonna be a busy day. Prayers would be appreciated.

Couple of Notes (34w5d)

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1) You may have noticed that the dates on the posts rolled back by two days. The actual count we’ve been using this whole time was based on an ultrasound dating from my 2nd ultrasound – way early on. My official due date never was changed from July 17th.

But now that the gestation date makes SO MUCH difference, I’m reverting back to the original count based strictly on the original due date. Mind you, the little man has measured all over the place based on ultrasounds – he was measuring more than 2 weeks ahead on length at one point. But Dr. Schwartz is going strictly by due date, so we are too.

2) Breastfeeding class was tonight, and it was fantastic!! I’ve been doing a lot of reading, research, and asking other mamas about BFing, but 3 hours with a lactation consultant that included a video of actual mothers breastfeeding their babies was SO helpful. The instructor sat with us after the class was over and answered our questions about how things will be different because our little guy is coming early. I learned that I do have the right to refuse formula at the hospital, no matter what the baby’s blood sugar is. No one is gonna be happy about it, but it’s my right. I’m not saying that I will refuse it absolutely, but I am SO glad to know that I can. If nursing and skin-to-skin contact doesn’t help his blood sugar, then *maybe* formula will be OK – but I want Paul and I to have the opportunity to try all other methods of helping our baby before resorting to something with 2-week repercussions, especially if he is stable enough to be nursing at all. (And to that end, if he’s not able to breastfeed for some reason, I can request he be fed through an NG tube or from a cup – he doesn’t *have* to get a bottle.)

2a) Dude, breastfeeding is freaking AMAZING. I am gonna be SUPERWOMAN – with the ability to give my baby EVERYTHING he needs. I am confident that my body will do what it’s supposed to do and that breastfeeding will go just great. I’m looking forward to it. Paul completely supports it.

2b) Melt-my-heart moment tonight: Paul asking the LC about how to do “Kangaroo Kare” with our little guy in case I have a cesarean or he ends up in the NICU. He’s planning on bringing button-down shirts to the hospital now so he can comfortably cuddle his son skin-to-skin.

3) I have a highly recommend pediatrician to call tomorrow to schedule an appointment with. I’ve been meaning to look for one, but just haven’t gotten around to it yet. Fixing that.

4) No, we still don’t have a name yet. We’re working on it. There’s a list. We’re not just holding out cuz we can. Really.

I think we’re both excited, but I know I’m a little freaked out. It’s not like there’s a ton of stuff to do still – but things just got REALLY real. There’s a date, and an appointment. Holy cats.

Set a Date (34w4d)

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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

Fetal Monitoring (32w4d)

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Today was my first experience with fetal monitoring. They did an ultrasound to see what position the baby was in and then took me to another room with a reclining chair for me to hang out in to be monitored. It took the nurse a minute or two to find his heart with the monitor, but once she got that thing strapped on, it was clear as a bell! (Actually, the baby started kicking the monitor which was funny to feel and hear!)

My blood sugar took a nosedive while we were there though. I’d had a super busy morning and a board meeting right before my appointment, so I just hadn’t eaten enough. I took my blood sugar and it was at 48, so I asked for and chugged some juice.

My blood pressure though… not good. It’s been 138/83 or lower this whole time. Today’s lowest was 155/96, and that was after I was done with the monitoring, so I’d been chilling out for a while. So they took some blood and another urine sample, and I’ve got the 24 hour urine collection to do tomorrow. (I did one when I was about 20 weeks or so as a baseline.) We’ll see. Dr. Schwartz says he’s not worrying about me yet so I’m not to worry either.

I feel the same though. Swelling hasn’t gotten any worse. No pain in my upper abdomen. I’ve had a twinge of a headache a time or two in the last week, but nothing severe or lasting at all. No weight gain since last week. (Shocking since I’ve been so dang hungry!) I’m trying to think positive and assume it was the busy/stressful day at work directly before the appointment or because my blood sugar was so low. We’ll see. If pre-eclampsia has started, we’ll figure out a way forward from there.

Unless something changes though, I’ve got an appointment for monitoring in a week, and then I go to twice weekly after that. FWIW, the baby monitored excellently today – Dr. Schwartz said he couldn’t be more pleased.

Tonight we went to our Baby Basics class, and were fairly disappointed. I didn’t learn anything at all. Paul at least got to change a diaper on a baby doll and we both burrito’d the doll and put a shirt on it. Some of the information presented directly contradicted what we’ve already learned in our Prepared Childbirth classes, and what we’ve read in books and online. So meh. Good to have the experience under our belts, but we’re both looking forward to the Breastfeeding class in two weeks much more. I figure between the couple of baby care books we have, my experience, and just fumbling along – we’ll be just fine.

Fetal Echocardiogram (31w4d)

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Today was a good appointment, if sightly underwhelming from what I was expecting.

I’m up three pounds over the last three weeks – continuing my steady single-pound-a-week trend. Dr. Schwartz is very happy with this.

Blood pressure was 131/83 when he nurse finally did as I said and took it on my bicep. She did it at first on my forearm (which I appreciate because it doesn’t hurt as much) and came up with 161/89. Nothing doing, says I. I know I can do better.

The fetal echocardiogram was basically a detailed ultrasound watched by the cardiologist and Dr. Schwartz, but mostly the cardiologist. The nurse worked hard to get weird angles – we didn’t recognize most of what was on the screen. Apparently they were getting a good look at various organs. Cool views of our little man’s heart, with all four chambers doing their thing. The cardiologist said that everything looks good at this point, no thickening of the muscle, and all the parts seem to be in the right place and hooked up correctly. They couldn’t get all the angles necessary to rule out a VSD (ventricular septal defect – the condition I was born with) but he said that’s very hard to do before birth anyway. The fact that our baby has had an echocardiogram now means that he’ll have one before we leave the hospital after he’s born: standard procedure.

After the echo, the nurse did a regular ultrasound, taking measurements of random stuff and trying to get measurements of the pockets of amniotic fluid. I wasn’t able to pay attention to the screen as much as I’d like because Dr. Schwartz was talking to me – but what I did see looked good. Our little guy is weighing in at 4 pounds exactly and is measuring 4-5 days ahead, which Dr. Schwartz says is just fine considering how tall Paul and I are. We didn’t get any pictures or anything, the nurse said he wasn’t cooperating at all and she never saw his face.

The pains I’ve been feeling along the bikini line are apparently my pelvic bones opening up and widening in preparation for labor. It’s the ligaments that hold those bones together stretching – which explains why things tighten up down there and then stretch out again. All normal parts of pregnancy. As are the pains I’ve been feeling at my waistline with hardly any exertion. I’m relieved to hear that it’s all normal – makes it easier to put up with for the next 4-6 weeks. And that’s how I look at all this – just stuff to get through for the next little while. And there’s really nothing I can’t put up with for that long.

It was funny how Dr. Schwartz asked about my swelling – he said “I can see by your new footwear that the swelling is continuing.” I’ve switched to Crocs sandals and flip flops, mostly because my hot feet are even hotter now. The swelling is as bad as it has been, but no worse. Again, Dr. Schwartz isn’t worried and neither am I.

Next week starts fetal monitoring and weekly visits. I’m hoping to keep the appointments at weekly, but I know they’ll go to twice-weekly fairly quickly. We’ll see how things go. We’re at the first of several milestones now: 32 weeks. It feels really good to have gotten this far. If the little guy came today, he’d have nearly the same chances as a 40-week baby. We’re hoping that things stay calm for the next four weeks – 36 weeks is our main goal. Anything past that is just gravy!