Tag Archives: oligo

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.

Cleared for the Weekend (34w6d)

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Shortest appointment in the last two weeks! We were in and out in barely an hour!

Little man cooperated with monitoring and kicked and rolled over a couple of times. I gained back a half pound. So that puts me at 13.5 pounds total gained this pregnancy. I find it fascinating how these numbers bounce, since they seem to have no correlation with my actual size. But hey, I’m just happy I’ve managed to stay in a happy, healthy range. My blood pressure was better than it’s been in like two weeks: 147/90!!

Apparently, I have oligohydramnios or too little amniotic fluid. I’m drinking more, I swear I am. My fluid score was 6.7 today, so a teeny bit higher than it was on Wednesday, but still well under the 14 they wanna see at this point.

We were concerned because I’m feeling like ass about half the time, and my right and left feet/ankles were not equally swollen – which is something the lists of pre-eclampsia symptoms always point out, when one foot is markedly more swollen than the other. But the nurse said that as long as the edema wasn’t pitting and I could still move my feet, we didn’t need to be worried. That was nice to hear!

So I’m cleared for the weekend. Next appointment is on Monday. A week from then and we’re done!

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