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.

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.

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:

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:

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:

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.

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.

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.
]]> http://paulandsarah.org/pregnancy/good-appointment-20w6d/feed 4 http://paulandsarah.org/pregnancy/little-stinker-17w6d http://paulandsarah.org/pregnancy/little-stinker-17w6d#comments Thu, 11 Feb 2010 06:53:34 +0000 Sarah http://paulandsarah.org/?p=323 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!

]]> http://paulandsarah.org/pregnancy/little-stinker-17w6d/feed 2 http://paulandsarah.org/pregnancy/no-news-on-sex-but-good-info-13w6d http://paulandsarah.org/pregnancy/no-news-on-sex-but-good-info-13w6d#comments Thu, 14 Jan 2010 07:42:16 +0000 Sarah http://paulandsarah.org/?p=235 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!

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