Tag Archives: testing

Amniocentesis FAIL (36w2d)

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So my fluid was at an all-time low of 4.5 today, and even with Dr. Schwartz’s Jedi-like skills, the amniocentesis couldn’t be completed today. There was one tiny (1.2cm) pocket he was aiming for, but the kid kept putting his arm there when Dr. Schwartz got close with the needle. Paul watched on the monitor as they tried and tried to get into the pocket they were aiming at.

I got jabbed twice though. Not as bad as I thought it would be at all. The pressure was the worst part – until the contractions started. (It’s two hours later and they’re still happening…) It wasn’t pleasant by any means, but I’m not shaking in my boots at the prospect of another one.

So the plan is to wait another week. Since we can’t absolutely confirm that the little guy’s lungs are mature enough to be on the outside, we hang out. I’m still doing OK enough (surprisingly) that we have time before things get to a crisis point. So we’ll continue monitoring me this week, and on Friday I’ll be checked by one of the other doctors in the office. If he sees a big pocket of fluid, they’ll probably go ahead and attempt an amnio – but if not, it’s not a problem. I’m scheduled to arrive at the hospital at 7:30 on Sunday evening to start the induction. Dr. Schwartz will come straight from the airport on Monday morning to check on me, and we’ll take it from there. (Friday’s potential amnio would only be to tell us something wasn’t right – not to give us the go-ahead to induce. The default now has been flipped to induce, as opposed to waiting for confirmation.)

We were pretty disappointed. Paul and I had worked this weekend to get ourselves to a good head space for having the kid today. We felt ready. (well, as ready as one can feel…) So it was a pretty big let down today, and Dr. Schwartz recognized that. But we agree with him that discretion is the better part of valor and to err on the side of caution is a much better way to go right now. Paul is concerned for me having to stick it out another week, but I’m fine. Letting the little man have an extra week is all to the good for him, and I can put up with basically anything for another 6 days.

I’ll be going in to start the induction process at 7:30 on Sunday June 27. It’s entirely possible that the whole process will take 2-3 days. Paul’s birthday is Wednesday the 30th. Could be fun if his son shares his birthday. (Considering Paul was born on his parent’s 3rd anniversary.)

For now though, we’re finally back home. The appointment today was over three hours long with 30 minutes of monitoring before and after the amnio. We know what a contraction looks like on the monitor now! I’m dead on my feet and in a fair amount of pain in my upper-mid back and from the continuing contractions, so I’m gonna lay down for a nap. I’ll be working the rest of this week, so I will be staying busy between monitoring appointments on Wednesday and Friday afternoons.

Sorry for the big build up to nothing, folks.

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

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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.

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