Tag Archives: Ultrasounds

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.

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

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.

Good Enough? (32w1d)

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I’m beginning to stress a bit. The need to get everything bought and ready for when the baby gets here is getting a little overwhelming.

YES, I know that technically NOTHING has to be purchased and/or ready except a laundry basket and some towels for a makeshift bassinet. (And a properly-installed car seat.) But that answer doesn’t really cut it. It’s not like it’s going to be so much easier to go out and purchase stuff after the baby gets here. So please don’t tell me that I’m concerned for no reason.

I want to find the perfect bouncer and washcloths and diaper pad and wipes and wetbags and baby socks and onesies….. But there’s so many dang options for everything. I’m getting all wound up, and I know that this has to be pregnancy hormones talking – but it’s upsetting.

I just want to do right by my son. I have no way of knowing if he’ll hate a bouncer until we put him in it. Also, I would really love a clue as to how big he’ll be when he finally gets here because I don’t know what size onesies to buy him. (We’re totally set for rompers and outfits, but the undies part of the equation – the onesie – we’re seriously lacking in.)

Gah. How the hell do you ever know if you’re good enough?