Paul & Sarah

Great appointment today. Confirmed something important about our baby: it’s a little punk. Misty (Dr. Schwartz’s nurse) spent a good 15 minutes trying to coerce the little critter to show us the goods. We were looking up at it’s bum, like we were under the invisible little chair it was sitting on. But the baby just wasn’t about to open it’s legs and confirm what we thought we saw. The baby was flip flopping and bouncing around (maybe because of the two sips of OJ I had right before the ultrasound) but not about to show us what we wanted to see. DANGIT. Next time… (Misty and I both thought we saw something, but she wasn’t confident enough to call it.) It continues to seem odd to me to see the baby doing crazy acrobatics and I still can’t feel ANYTHING. Hopefully soon.

Dr. Schwartz was great about answering questions today, having been prepped by my e-mail last week. We covered a lot of things today:

• I only gained half a pound!! Holy cats! I was totally shocked. I was honestly expecting a gain of 4-6 pounds because my clothes are totally fitting different (way tighter) and well…. I’ve been eating more than I ever have cuz I’m starving all the time!! Dr. Schwartz was happy to see the small gain, but cautioned me that I need to make sure that I actually am eating enough since the baby does need a fair amount of nutrition for all the growth it’s doing these days. He totally gets that my brainmeats are making it hard for me to eat as much as I apparently need to. At my next appointment he’ll be checking to make sure that the baby is growing and gaining weight as expected. But he was supportive (as always) that I must be doing things pretty well as far as nutrition and calories because my blood sugars are consistently improving, and my a1c results (like a 3-month diabetes report card) were down to 6.0 (from 6.5 and 6.3 the last two times it was checked.)
• Speaking of proper nutrition, my Muscle Milks are TOTALLY FINE. Contrary to what the morons at GNC and Vitamin World yelled at me last week, there’s NOTHING of concern whatsoever for pregnant women to have protein shakes. The L-Arginine in the shakes (as a form of protein) is also found in most nuts. L-Arginine has been found to help with placental growth retardation, as well as preeclampsia: both of which I’m at risk for! (The lady at GNC was yelling at me that I was going to have a GIGANTIC, over-grown baby because of drinking protein shakes, and that my doctor was stupid for allowing them. Dr. Schwartz asked which GNC it was cuz he wants to have a word with them.) So I can happily keep drinking my yummy High-protein, Low-carb, vitamin-rich shakes. Hooray!!
• The swelling in my ankles/feet is nothing to worry about yet. Dr. Schwartz thinks I’m just prone to swelling. (I’m getting a fair amount of swelling in my wrists too.) He encouraged me to continue to keep my feet up as often as possible. He agreed that striving for good hydration is a good idea, but that it won’t help this kind of swelling as much as it does for regular hot-weather swelling. He cautioned that it’s not gonna be fun towards the end of my pregnancy when it’s hot, cuz then I’ll have both types of swelling working together. Oy. (Oh, and apparently a restless legs / ants under the skin feeling in the evenings is normal too. Wheeeee.)
• He also commented that towards the end of my pregnancy, he expects to see me twice a week for nonstress tests and whatnot. So I’m gonna have to work something out with him for scheduling, and work something out at work so that I burn as little of my paid leave as possible. (Maybe I can just not take a lunch EVER AGAIN.) I’m really concerned about my maternity leave. I’m taking as little leave as possible for my appointments, but any leave I take comes directly out of what I’ll be able to take when the baby is born. I have to take 8 weeks off because the daycare won’t take infants under 8 weeks – but there’s no way I’ll have that much paid leave saved up – especially if my appointments move to once a week or more. Unfortunately, we need both our salaries – so I’m not sure what we’re gonna do for several weeks that I’m gonna have to take off unpaid. I guess that’s what credit cards are for, right?
• So, because I’m doing so well (blood pressure was lowest it’s ever been, blood sugars are consistently lower, weight gain is very small) I’m cleared for another 3 week appointment. No changes to my insulin or blood pressure meds for the 2nd appointment in a row! So I’m set for Wednesday March 24th at 3:00pm. (Dr. Schwartz is taking me as his last appt from now on so I can burn as little paid leave as possible – he just has to leave by 4:00 to catch his flight home.) Edit: I changed my appointment to the first of the day at 8:00am, because I actually lose less work time by going in the morning. Those first-thing appointments go fast tho, so I can’t always get them. There will be a full ultrasound at the next appointment to check growth and (hopefully) confirm sex for us.
4 Comments | Tags: changes in me, clothes, development, Doctor Appts, testing, Ultrasounds

For those waiting with bated breath: WE DON’T REALLY KNOW. Sorry.

Our kid is a little stinker. The baby spent basically the entire time sitting on it’s butt, directly on top of my cervix. The tech tried and tried to jiggle it outta position, but nothing doing. (a couple of Andes mints didn’t help either.) She had a hard time even getting the measurements she needed for the anatomical ultrasound (femur, abdomen, head) because the little critter wouldn’t cooperate. And the couple of times it did move where we could get a look: it put it’s hand(s) between it’s legs.

But the good news is that Dr. Schwartz says everything looks fine. Some of the measurements are measuring “ahead” by nearly two weeks, but Dr. Schwartz says that’s because Paul and I are both tall, so we’re having a tall baby. It’s weight clocked in right at 8oz.

For those interested or who know what on earth this relates to:

• Head Circumference: 16.25cm (6.4″)
• Abdominal Circumference: 12.42cm (4.8″)
• Femur Length: 2.5cm (1″)

The heartrate came in at 161, so according to old wives – it’s a girl. Dr Schwartz and the tech gave us a guess, but they both strongly cautioned us not to paint anything yet. I tried to explain to Dr. Schwartz that I’m a planner and I really need to know… he chuckled, told me to deal, and then listed his favorite neutral nursery colors.

Paul’s mom Jeanne came along today and seemed to really enjoy herself, especially when the tech turned up the sound and the WHOOSH-WHOOSH-WHOOSH of the baby’s little galloping heart stopped our chatter for a moment. I wish the kid would have cooperated a bit more so she could have seen it wave and face us like Paul and I have seen before. I invited her to come to the next appointment if she wanted to, since we’ll try again then to get/confirm the sex.

In the meantime, there’s new pictures that I screen grabbed from the DVD we got today. (I’ll get a DVD of the next appointment too.) They’re mostly body parts, but there’s a couple cool profiles – and an awesome 3/4 full face image from the heartrate image. It’s small, but if you’re good at all for looking at ultrasounds, I think you’ll see it. It’s kinda like the face on the moon… the baby is looking to the left. You can see the chin, lips, nose, cheeks, forehead and a dark hollow where the left eye is.

The rest of the appointment was pretty ordinary. Insulin and one BP med were upped a tad. Weight is up .5lb for a total of 4.5lb in 18 weeks – just fine. My next appointment is in 3 weeks, which is great. The fewer appointments I have for a bit, the less paid leave I have to burn. (Last week’s illness cost me 3 days of maternity leave…) They drew blood for TSH, a1c, and the 2nd part of the quad screening. (Dr. Schwartz took a copy of a bill I got from the lab for $700 worth of “genetic” tests that my insurance is denying from my first visit in November… I LOVE that he’s willing to take on that kind of stuff for his patients.)

So for now I guess we’re looking at more gender neutral stuff, since we might not find out the sex of our little stinker until July!

Quickest appointment yet today. But I guess I’ll be having more like this for the next couple of months.

Took a quick look at the baby, mostly to check the heart rate (160, just like it has been.) Didn’t get a measurement, but the critter obviously bigger than it was two weeks ago! (According to the intertubes, it’s 3-3.5″ or roughly lemon-sized.) It was just kicking back, with it’s arms up, like laying in a hammock. The tech got two pictures, but they’re pretty fuzzy. It was bobbing it’s little head, but not dancing like last time. (This appointment was at 3:00pm, whereas my others have all been before 10:00am… so maybe afternoon is siesta time?)

Dr. Schwartz went over my 1st trimester screening results with me and things are looking great.
Downs Syndrome result is 1:4800 (chances of the baby having DS are one in 4800 similar births.) The baseline chances for someone of my age with my health profile was 1:320, so the actual test results tell a MUCH better story.
Trisomy 18 result is 1:2350, which I guess is very good. Dr. Schwartz says anything over 1:100 is fabulous.
Based on these numbers and the great results on the nuchal fold screening, there’s no need to seek further testing (like a CVS or amnio) at this time.

My a1c is down to 6.3 from 6.5 when I first got pregnant. (The a1c is like a 3 month report card on my blood sugar control. Anything below 6 is non-diabetic territory, so I’m doing fabulous in this regard which basically negates any diabetes-related risks to the baby.) Thyroid is creeping up a little, which is expected. My thyroid meds will prolly get adjusted at my next visit, if for nothing else than to negate the fact that I’ve got 30% more blood volume now. My blood pressure was lower than it has ever been – which means the new med (Methyldopa) that was added to my regimen last time is working. Still on the high side, but Dr. Schwartz was happy to see some movement on that, finally.

I e-mailed Dr. Schwartz yesterday with a couple of questions, so he’d be ready to be interrogated. Got some surprising answers, not what I was expecting from the reading I’d been doing in books and online.

Delivery: Currently Dr. Schwartz is planning on letting me go to 39 weeks – so delivering around 7/10/10. (If I went to 7/11, this would be the 3rd kid in my family with that birthday, which includes my brother!) He wants to avoid a C-section if at all possible. Vaginal delivery has a lot of benefits to the baby, but mostly he doesn’t want me to have to deal with recovery from abdominal surgery. He feels that at my current weight and as a diabetic, recovery would be less than optimal and that I would be in a lot more pain & have a longer recovery than average. He’s totally open to a C-section if it becomes necessary, but has every intention of inducing me first and letting me at least attempt to labor. He said that actually he expects me to do well with a vaginal birth. So YAY for that. I’m not all crunchy granola and ‘needing’ to try to push the kid out – but I’m totally open to the experience. I am also totally open to the epidural as soon as they’ll let me have it. :)

OMG pains: Apparently mostly what I’ve been experiencing in the last two weeks has been “low pelvic pain” as opposed to “round ligament pain” My pelvis is splitting apart and it’s totally normal. Hurts like hell and scares the crap outta me when it takes my breath away or wakes me up in the middle of the night, but it’s normal. So whee and hooray for being pregnant.

Bedrest: Currently not a big concern. Dr. Schwartz says I’m doing fine and that he avoids complete bed rest if at all possible. Apparently high risk pregnant women are at higher risk for DVT (blood clots) when on complete bed rest. He didn’t rule out modified bed rest for the last month or two though – which would mean that if I’m not at work, I’m home with my feet up. (Honestly other than the fact that modified bed rest would mean baby/house prep has to be done sooner, being ordered to go home and put my feet up sounds pretty good actually.)

Next appointment is first thing in the morning on Wednesday the 27th. Dr. Schwartz says we’ll try to figure out the sex at that appointment, but if we don’t get an answer then we will for sure at the next appointment which will be the “big” anatomical ultrasound. So hopefully we’ll know soon!

We have quite a little dancer on our hands. It was flipping and wiggling and kicking and WAVING at us. But it behaved just beautifully for the ultrasound tech – even flipping to the other side to give the tech a better angle for the Nuchal Fold screening.

Paul was just slack-jawed the whole time. I was pointing out what we were seeing on the screen and he was just amazed when he finally started to see the little critter on his own. It was pretty awesome! I was laughing and giggling like a loon every time it waved at us! I couldn’t believe how active the little shrimpy thing is!

There’s new pictures in the gallery, and we’re working on putting up the little movies they gave us. (The tech made us a DVD instead of printing out pictures this morning; how cool is that?) Just click the above picture to get to the gallery (or click the “Gallery” link at the top of the page.)

Nuchal Fold screening went just great. The tech & Dr. Schwartz discussed which picture/measurement to submit for review and the “official” measurement. They decided on the largest measurement she could get, which was 1.21mm. Anything under 3mm is just great, so we were very pleased with these results.

They took a bunch of blood for the 1st trimester screening panel, and gave me supplies to (ick) capture all my urine for 24 hours. So Sunday will be fun. But they gotta check for protein and something else, and this gives them a baseline.

Insulin got bumped up a little more (2 units) and Dr. Schwartz is adding another BP med since I don’t think the Labetelol is really doing anything. But he’s OK with my BP where it is, and is happy to see my blood sugars where they are. Nobody had mentioned my weight to me at any appointments so far, so I asked. Turns out I lost 2lb this time, which seems odd to me, cuz I feel puffier than ever and can’t fit into some of my jeans already.

All in all, great appointment. Paul and I are so stoked!!

Round and round. I think my scholarly tendencies to study everything to death are doing me a disservice at this point.

Wednesday’s appointment is supposed to get us some good profile pictures of the critter because they’re going to do the Nuchal Fold screening test. Presumably they’ll also do some bloodwork at the same time that has some chromosomal screening stuff in there too. The bloodwork screening stuff is done during late 1st trimester and early 2nd trimester.

Depending on what these tests say, we’ll be presented with other testing/screening options. First would be CVS (chorionic villus sampling) which is akin to amniocentesis, but is slightly less invasive and can be done sooner than an amnio. CVS & amniocentesis screen for chromosomal abnormalities like Downs Syndrome and other genetic conditions. Amniocentesis can also screen for neural tube defects like spina bifida as well. Both have the bonus of telling the sex of the baby with 100% accuracy.

There’s a decent chance I’ll need an amnio later in the pregnancy anyway, depending on when Dr. Schwartz determines the baby needs to come. Amniocentesis is commonly used late in pregnancy to determine how far along lung development is. (How they tell that from amniotic fluid is beyond me.)

But I just can’t stop thinking about these tests. Do we even want them? What about the slight elevation in risk of miscarriage? What would we do with the results? Does it make me a terrible person to even be wanting this screening done? A lot of women choose not to have these tests done at all because the results wouldn’t matter to them either way. What does that say about me that the results *would* matter? And lastly, what if – God forbid – the results came back in a not-good way? What would having to make that decision to to Paul and I?

Round and round. This is part of the training to become a parent, right?