Tag Archives: Doctor Appts

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

Monday update and Office Cat (34w2d)

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Today’s appointment took freaking forever, and I’m not sure why because the place seemed deserted. But seriously, we were there for 2 hours!

Well, OK – some of it was our fault. And by ‘our’ I mean the baby’s. He was being a lazy little putz this afternoon and *refused* to move around to let the nurse measure the amniotic fluid. She jiggled the hell outta my belly with the ultrasound transducer and more roughly with her hands. She had me chug half my ice water to dump it on his head. She finally went and got the buzzer. Nothing helped. The little man was just firmly set in taking a nap and nothing was gonna budge him. She was *finally* able to maneuver around him enough to get a measurement – which wasn’t good anyway. The measurement was 9.68 – lowest I’ve been so far is 12.5. They wanna see around 14. I need to drink more, especially since it’s been so crazy hot.

Then on to the monitoring room. Got me hooked up and left the room for what seemed like a longer than normal time. Come back in, take my BP (153/95) and use the buzzer on my belly + jiggle things to try to get the little man to move around. Fetal monitoring requires the kid to move a couple times during the monitoring so they can track his heartrate at rest and activity. All resting doesn’t tell them what they need to know. So, once they got him to move a bit, they left me on the monitor for a while longer. It was a tad disconcerting that they were so concerned about baby not moving. The phrase “decreased fetal movement” was tossed around.

By the time the nurse came back, it had been 90 minutes since I’d last pee’d and things were getting desperate. I asked if anyone else wanted a sample since my last two appointments required secondary samples at the end and after WAY more hemming and hawing than I wanted while I tried not to wet my pants – they asked for a 2nd sample. I come back and they took my BP again since the first urine dip stick test found trace protein. Second BP of the afternoon is 162/103 which kinda sent the nurses into a tizzy. 10 minutes of squawking at the nurses station pass and the nurse comes back in with labs for me to have drawn. I’m used to this part, that’s why I asked about the 2nd urine sample. They asked if I had a headache or blurred vision, to which I truthfully responded that yes, I’d had a minor headache all weekend and today that tylenol wasn’t helping and a teeny bit of blurred vision. (But honestly, I think the blurred vision is the normal pregnancy vision weirdness, not BP.)

So more blood work drawn today that will presumably be back tomorrow or Wednesday for sure. I imagine that if something comes back really amiss, I’ll get a phone call. Otherwise, my next appointment is Wednesday at 2:30, with Dr. Schwartz. We’ll see what he has to say then. My bag will be packed by then, just in case.

In the meantime, I got a lot of work done today – my first day in my home office. Of course, the cable went out around lunchtime and has been intermittent ever since. Cox will be out tomorrow to check it out. Perfect timing. Thankfully, I can work offline on payroll and accounts payable, so it’s annoying, but not terribly problematic. I’ll get some more work done this evening to put me at full-time hours for today. My goal is to be as caught up as possible on payroll and accounts payable every day until the baby comes so that if my boss has to take over mid-stream, things are as complete as possible.

Good first day home. And yes, I have to say that having a cat and a dog in my home office while I’m plugging away at spreadsheets is pretty damned awesome. :) Oh, having Paul at the desk three feet away from me ain’t too shabby either

*To recap BP over the last few weeks for perspective:

Date
BP
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

LOLercoaster + Tilt-a-Whirl (33w5d)

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I feel like I’m getting jerked around and I don’t like it.

Today everything seems to be fine! No really. Like according to everything today I’m barely pre-eclamptic. Apparently once you’re in the pre-eclamptic zone you don’t get out, but you can vary within the zone from mild to moderate to severe. Today I’m at the mild end. Which is great. My blood pressure was 147/97 today, as compared with 157/110 yesterday.*

Except: if I’m barely worse off than I was two weeks ago (no protein showing up on today’s dip stick) then why am I being forced to modify my work schedule and burn my precious paid leave for nothing? Why can’t I work at least half days in the office? (I’m wanting to be in the office because there’s stuff I can do there that I can’t do at home – the amount of stuff I have to do at home is finite and will get burned through in this next week for sure in order for me to keep up full-time hours.)

YES, OF COURSE I’m happy that things look rosier today. Healthier Mama means baby stays put which is a good thing. OF COURSE. This is just all very hard to take on 3 hours of sleep (cried myself to sleep finally last night and was up at 4:30am this morning) with hormone overload raging. I feel so completely out of control and that scares me and makes me angry.

Yes, I’m a control freak – but it’s not that. I literally feel like I’m being told different things each time I go in now and it’s hard to assimilate them all together and find a way to waddle through the next day or three before the next appointment where I’ll be told who-knows-what. Going with the flow when your health, your baby’s health, and your family’s financial stability are all on the line is really very difficult to do. And being constantly told to calm down and relax and just let everything in the world go doesn’t help. (I appreciate everyone’s support, really I do…. it’s just hard advice to follow.)

So for now, we’re stable (?) in this mild pre-eclamptic state. I did get the 2nd steroid shot today, so at least those are doing their thing – with their peak of efficacy in about 7 days. I’m planning on going into the office again tomorrow for a half day because there’s stuff I need to wrap up there still. Depending on how things go at my monitoring appointment on Monday, I may go into the office for a half day or two next week as well. I don’t feel that I’m pushing it to do that, especially if my blood pressure is barely higher than it was two weeks ago. If BP readings are creeping up, I’ll stay home. I have monitoring appointments M-W-F next week, and I actually see Dr. Schwartz on Wednesday. They’ll do a urine dip-stick at each appointment which I guess is the starting point for worry if it comes up with anything.

*To recap BP over the last few weeks for perspective:

Date
BP
June-3
147/97
June-2
157/110
May-26
155/97
May-19
131/83
Apr-28
138/85

Pre-Eclampsia (33w4d)

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We knew this was a possibility. Just didn’t think it would actually happen so dang fast. (But to put it in perspective, Dr. Schwartz expected to see symptoms of pre-eclampsia in me by 28 weeks or so. It usually shows up in non-hypertensive, non-diabetic, non-obese, non-thyroid-challenged women between 32-37 weeks. So the fact that I got to nearly 34 weeks with my medical history is astounding.)

Fetal Monitoring appointment today went well. Baby was head down (again) and cooperating with holding still for the monitor. It wasn’t strapped so tightly to me this time, so he wasn’t kicking at it. I actually fell asleep for a little bit while being monitored.

But when they took my blood pressure, things got a little scary. 157/110, up from 138/83 two weeks ago. (It was ~150/97 last week) And that’s with hella medication. The results of my 24-hour urine test came back in the mid 300’s, which indicates mild/moderate (as opposed to severe) pre-eclampsia.

None of this is a surprise. What Dr. Schwartz told us about at the beginning of this 3rd trimester is coming true. The hope is that the creeping up of my blood pressure stays slow/moderate, and that the protein count doesn’t skyrocket. More labs were taken today and the results will be in tomorrow – which will give a more exact look at what the situation is. I’m not showing many other symptoms – and especially none of the symptoms of HELLP syndrome. But I’m up 2 pounds this week, so that’s a tad worrisome.

If things are getting worse quickly, Dr. Schwartz will have to hospitalize me for more intensive monitoring (BP readings every 15 minutes, IV therapy, fetal monitoring, etc.) Nobody wants that – cuz it would stress me right the hell out. Being in the hospital (by definition, uncomfortable) wasting paid leave with no baby, strapped to a bed would just suck SO bad. And it’s possible that I could be monitored for up to a week before things reach a critical point where the baby has to come out. So that would be a TON of paid leave down the drain. If I’m allowed to be at home, at least I can still do *some* work, and Paul is here to keep a close eye on me. We live like 7 minutes from the hospital if that becomes necessary.

In preparation of the baby coming much sooner than anticipated, I got the first of two steroid shots today. (Supposedly they burn like crazy, but I didn’t feel it at all!) For those who know or care, I’m being given Betamethasone.

So here we are. I’ve been told I can’t go into the office any longer. Dr. Schwartz didn’t get into specifics right yet, but basically I need to be off my feet as much as humanly possible, with feet elevated. And most importantly, I need to be in a calm environment, away from stress. I need to go into the office tomorrow to collect some things and wrap up some stuff, but I’ll be leaving at noon for my 1:00pm appointment. I might go in for a couple hours on Friday too. Cuz seriously, I wasn’t ready to not be in the office quite yet.

Dr. Schwartz is back at home in Denver until Monday, so he’ll call me during my appointment tomorrow to go over my lab results and answer whatever questions we come up with by then. He’ll be back in the office for a 9-day stretch starting on Monday, so I have a strong suspicion that he’ll deliver me during that time, assuming I don’t need to be delivered this weekend for some reason.

As far as baby goes: he’s doing OK at this point as far as we can tell. He was 4 pounds exactly two weeks ago, so we’re assuming he’s somewhere between 4.5-5lbs right now. Our concern for delivering him soon is his lung maturity. The steroids they gave me today (and tomorrow) are designed to kick his lungs into high gear to make surfactant to make it easier for him to breathe. He’ll have to spend some time in the NICU when he comes, but we don’t know how long – could be 2-4 days, could be 2 weeks or more. No way to know until he gets here. If we make it to 36 weeks (doubtful) they can use amniocentesis to check the development of his lungs, but prior to 36 weeks, there isn’t much they can do to check. If he comes sooner than that, it will be because my body just can’t take being pregnant anymore.

We’ll have a better idea of where we stand after tomorrow’s appointment. I already have appointments for Monday, Wednesday and Friday next week for fetal monitoring. Here’s hoping I can keep those.

I still need to pack my hospital bag. I need to wash some baby clothes and put things away in drawers and in his closet. I need to go out and buy some preemie-sized clothing and onesies. It never occurred to us that we could have a preemie. We knew the pregnancy would almost assuredly have a bumpy ending, but having a preemie never occurred to us. I can’t believe I’m typing that word.

I don’t know how to deal with this, really. I’m a planner, and I can’t plan anything right now. I don’t know how things are going to go or what my options are anymore. I don’t know how nursing/pumping gets dealt with in a NICU situation. What do we do with ourselves when we can’t be at the NICU? Does it make me a terrible parent that I’m still worrying about getting to work during all of this? I’m vacillating between abject terror and a preternatural calm, both stemming the knowledge that I am in control of absolutely none of this. I’m going with the flow, because I don’t have any other choice. I’m doing my best to stay calm because stress really doesn’t help the situation. Prayers would be appreciated though. An update will happen as soon as possible after the appointment tomorrow afternoon.

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.