Friday, August 20, 2010

When it rains, It pours

Chris and I had a good laugh last night.

We just can't believe that this whole pregnancy has gone by SO smoothly - barely a bump in the road - only to have this many issues crop up in the final weeks.

I had my growth ultrasound yesterday morning.
Chris called at 6 to let me know that he wouldn't be able to make it to the appointment. His other full timer called out and they were short staffed as is. It's the first appointment that he's missed and, looking back, one of the handful he REALLY should have been at. Bummer.

So I go in for the scan, it's just your basic ultrasound, and right away she's able to tell me that she's head down and facing my spine like a good girl - no more fears of delivering sunny side up - but because of that we probably won't be able to get any pictures. No biggie. At this point I know I'll be able to see her in a few weeks and really, I'm not that concerned about grainy ultrasound pictures anymore.

She starts looking things over. Checking kidneys (I ask if she has three like my great grandmother and unless it's hiding, she probably doesn't *wink*), looking at the bladder and spine, Checking the blood flow to the heart... etc etc.

All of the sudden I get tunnel vision, extremely nauseated, wicked lightheaded and feel like I'm going to pass out. I've never felt like that before. So I stop the scan and take a breather. She was sitting with all her weight on my artery and there was an issue with blood flow. The rest of the ultrasound is done with me laying on my side.
If we were in AP English, the teacher would point out that this was a foreshadow moment.

So the tech started taking measurements. For those that haven't had an ultrasound recently, when they measure... let's say the diameter of the head for example, the find a specific cross section by looking for anatomical landmarks, then they draw a circle around the skull's edge and as they size the circle to get it to fit perfectly, there is a number on the screen that gives you the measurement in centimeters as well as the corresponding gestational age. So she measures the diameter of the head (37 weeks) and the circumference of the head (39weeks 3 days), then she measures the femur (39weeks 3 days) Keep in mind that I turned 38 weeks yesterday so she's still tall! :)

She measures the amniotic fluid levels and tells me the placenta is about 4 cm thick. Good to know.

Then she measures the tummy.

She finds the correct cross section and starts drawing the circle. As she's sizing the circle, I'm watching the gestational age go up. 37 weeks, 38 weeks, 39 weeks, 40 weeks, 41 weeks, 42 weeks, and then. To my horror. It stops listing weeks and switches to just a centimeter reading. Oh My God.

So clearly, I'm thinking this chick SERIOUSLY screwed up with that measurement. Good thing they take 3 readings and average them.

The next one was 41 weeks 1 day.

The next was 42 weeks 0 days.

This is not comforting.

All of the sudden the ultrasound is over and she tells me the doctor will be in to go over the results in a few minutes.

I grab my clipboard and write down the recordings so I can tell Chris. The average tummy measurement was 41w 5d. Almost 4 weeks ahead of where she should be. I do a rough calculation, dividing the circumferce of her tummy by pi and realize that the diameter is greater than 10 cm.

All of a sudden I realize that she is really going to hurt me and rethink the epidural.

About 10 minutes later the doctor comes in. She's a woman and I recognize her name as a perinatologist my midwives referred me to. She said that the baby looks healthy and will probably be tall, which isn't surprising. She said the amniotic fluid level is normal, but at the high end of normal. Better than the low end I think and imagine a giant tidal wave when my water breaks.

Then she says that the concern is the weight.

Her tummy is measuring very large and they think she currently weighs 8lbs 11oz.

Wait a minute.
Wait just a minute there Missy.

In my head I freak out a little.
I'm thinking about how I weighed myself right before I came in for the appointment and I was only 8 pounds 14 oz above pre-pregnancy.

How can she weigh 8lbs 11oz if I've only gained 8lbs 14oz and I don't have gestational diabetes.

It's not like I've gained 50 pounds with this pregnancy.

My midwives joked on Monday that I should expect an 8.5 to 9 pound baby. When my eyes bugged a little she said "What do you expect a 5lb baby? You're 6', your husband is 6'2". Big people make big babies. Small people make small babies, that's just the way it works." Which is fine. Because that's based on the assumption that that's how much she'll weigh WHEN SHE'S BORN. Not 2 weeks before her due date with no labor signs anywhere on the horizon.

The doctor asks me to wait in the waiting room and another perinatologist will consult with me in a few minutes.

I go out into the empty room to tell Chris the 'good' news and imagine the doctors convening a huddle to talk about the giant baby with the ginormous tummy.

While I'm talking to Chris and my mom in the waiting room I try to rationalize the news in my head.

It'll be fine. They'll probably just induce me early. If she's this big already, and I have a clotting disorder, certainly they won't let me go past my due date and risk a c-section.

I'm called back by the nicest nurse ever named Malorie. Melody. Marjorie. Something. Nurse M.

She has me do the usual weigh in and pee in a cup routine. At this point, I'm a natural at this party trick. I don't even flinch at the thought of a public weigh-in anymore.

Then we go back into the room and she tells me she's going to take my blood pressure.
I remind her that I've just been told my 38 week fetus weighs almost 9 pounds and ask for a few minutes to calm down. She takes my medical history and a few minutes later, when she takes my BP it's 120/70. WAY lower than I thought it would be.

So the resident come in and starts talking to me about the Factor V leiden issue.
They must see this all the time because she's telling me that since I'm hetero vs homozygous (meaning I only inherited from one side of the family and not both) that they consider me a fairly low risk patient.

Instead of the 6 months of blood thinners, they'll probably only do 4-6 weeks. Which is fabulous because then she goes on to tell me that it's not a pill, it's a SubQ shot that I give myself once or twice a day depending on the dosage. ugh. shots.

I ask about side effects and whether it'll be a issue for breastfeeding. She says that bruising at the injection site (duh, it's a blood thinner) and platelet counts can be effected so I'll need to do weekly blood work for the first two weeks. Meh, no biggie. Apparently I'll start this regimen 12-24 hours after delivery.

Then we talk about the humongous baby I'm growing.

She asks about my weigh gain and seems surprised when I tell her the low number. She grabs my chart and I know she's looking at my glucose test results Which Are AMAZING. She's surprised to say the least. I can tell she's a resident. She hasn't developed her poker face yet.

I ask about inducing early. 'Oh no, we'll probably only discuss induction at 41 to 42 weeks.'

But I thought I wasn't going to go past 41 weeks because of concerns for the placenta?

'Well, obviously the placenta is functioning well because your baby is getting plenty of nutrients and you're getting weekly non stress tests, so we're not concerned'

Glad to hear you're not concerned.
Isn't she gaining a half a pound a week at this point?

'Yes, but the ultrasound could be off by 10% which is a pound."

So she weighs somewhere between 7lb 11oz and 9lb 11oz. And if she goes to 42 weeks she could weigh between 9lb 11oz and 11lb 11oz.

'That's possible'

And you're not concerned about that?

'We'll repeat the growth scan at 41 weeks if you're still pregnant. If she weighs 5000 grams, we'll offer an elective c-section.'

How many pounds is 5000 grams?

'... ugh, about 10 pounds' Oh nay nay, stupid resident. I googled. 5000grams is ELEVEN pounds.

*blank face* So. a c-section. With a clotting disorder.

This is where I start crying.

The doctor comes in and basically says the same crap.

They won't induce early unless my blood pressure goes up to 140/90 because if my cervix isn't favorable it will just lead to a c-section.

They told me they won't use forceps or a vacuum extractor. If her head won't fit, her shoulders won't fit and they'll do a c-section.

They also mentioned that the should issue, distocia, could be 'catastrophic'.

Bad choice of words. I had just stopped crying and then I started again.

If my labor isn't progressing, they don't want to risk a blood clot, so they'll do a c-section.

Basically, the perinatologists really like c-sections.

By the end of the appointment, besides crying, all I wanted to do was go to the midwives because I know their goal is NO c-section. I also wanted to go on a long walk, eat a lot of pineapple and spicy food, do jumping jacks, bounce on an exercise ball, schedule daily acupuncture sessions and just about anything else to GET HER OUT.

I'm not done being pregnant, but I'm done baking this little girl.

As far as I'm concerned, I'm issuing an eviction notice and operation 'Get the Eff Out' has begun.

Here's hoping for an August baby.

Wednesday, August 18, 2010

Non Stress Test #1

Because of the factor V diagnosis, I need to go in for weekly Non Stress Tests until I deliver. Since my midwife appointments are first thing Monday morning, I've been able to schedule the NST immediately afterward.

The NST monitors her heartbeat, movements and my contractions over 20 minutes. Since they need a 20 minute continuous strip and she is a diva, it took about an hour. Not bad for our first time.

I started out in a room with a reclining chair and had the sensors (1 for her HB, 1 for contractions) placed on my tummy and held in place by bands. It's the same setup you see in labor and delivery. She was good for about 10 minutes and then moved and we lost the HB. The nurse came back in and repositioned the sensor only for the baby to move the second the nurse walked out of the room. She came back in and spent a few minutes trying to find the HB, but our little girl has gotten REALLY good at hide n go seek.

So they moved me to a room with a bed and brought in a portable ultrasound. By laying flat, there were less places for her to hide. Turns out she's facing out instead of facing my spine so they were trying to listen to her HB through her chest instead of her back, which is apparently much harder. They had me roll over on my side (NOT comfy given my pelvis issues) in order to get a better angle, but she rolled over as well and foiled their attempts. So Chris had to come around and hold the sensor in place for 20 minutes. So much for him using this downtime to read the birthing book he needs to finish!

I had no contractions while we were there. Not even a blip. Which I expected.
I also felt vindicated because the readout showed that she was kicking NONstop during the NST (as she does all day long). This girl doesn't give me a break! (But I'm okay with that) Everytime she moved it put a little black dot on the screen. Chris was pretty impressed when instead of the random dot her and there, she was producing a solid line of neverending movement. :)

So the NST went fine. Her heartbeat was right where it should be and the nurse said that with a baby that active, we had no reason to worry. ... Not that we were.

Tuesday, August 17, 2010

37.5 Midwife Appt

Monday we had our week 37 midwife appointment and it went pretty well. My weight was down a pound from last week, the urine strip was negative for protein and sugar and my blood pressure was fine.

My fundal height was measuring at 40cm (or 40 weeks). I don't know what my fundal height was last week (I got a little preoccupied when they thought she was breech again - she's not), but I know I was 34cm and 34.5 weeks, so the discrepency happened over the last three weeks. Meh. No biggie.

We signed our release form for the Waterbirth tub, so now we just need to pay the fee. We also turned in the paperwork to donate her cord blood to the public blood bank.

The midwife showed me how to feel her head when I'm laying down, and her heartbeat was about 135.

We confirmed that I'm Group B Strep negative so I won't have to get antibiotics during labor and will be allowed to stay home longer before coming in to the hospital. I'll still need to have an IV, but that's for the clotting issue.

That's about it! The appointment went really well.

Friday, August 13, 2010

I'm Defective

After Monday's midwife appointment, I'm glad I live nowhere near Arkansas, or I'd be knocking on my Aunt's door and promptly screaming at her.

Apparently 3 years ago when my cousin (Dad's half-sister's daughter) went into labor with her daughter, there was a very serious complication and she almost died.

Fast forward three years and my aunt finally mentions to my dad that I should be tested to see if I have the same condition Shelly has since it's genetic.

So at my midwife appointment two weeks ago, I asked to have the blood test done and on Monday I got the results -

I'm positive for Factor V Leiden.

It's a rare blood clotting disorder that occurs in about 5% of the Caucasian population, but up to 15% of some Swedish communities. The midwives almost never deal with it and had we known about it before I had gotten pregnant, I would have been with a high risk doctor and VERY closely monitored throughout this whole pregnancy.

The concern is that I'm at much higher risk for blood clots - Deep venous thrombosis in my leg, Pulmonary Embolism in my lung, or an Ischemic Stroke caused by a blood clot in the brain.

If that wasn't fun enough, I'm also at risk for a blood clot in the placenta or cord which would probably be fatal for the baby.

I should have been on blood thinners for the duration of the pregnancy, I should have been getting weekly Non Stress Tests, I should have been meeting with a perinatologist and hematologist on a consistent basis. But none of that happened because my aunt failed to share this information with the rest of the family when they found out THREE YEARS AGO.

Can you tell I'm a little upset?
I'm not.

To say I was a little upset would be the understatement of the century.
I'm pissed.

This condition put me at extremely high risk for a miscarriage.
Stillbirth is still a huge concern.
and had I had a c-section without knowing about this condition, it could have had serious complications.

They probably won't let me go past 41 weeks, due to concern for the placenta.
I can't go on most birth control options because it raises my risk of blood clots 35 times.
and I'll be on blood thinners for 6 months after her birth.

Don't get me wrong. I'm thankful that I know NOW before anything bad happened, but I just find it hard to believe that they didn't think I should know about this family condition the second after they found out. Since I tested positive, that means my father also has it.

I'm upset that he had a heart attack and they still didn't mention it.
I'm upset that they put me at risk when I was on birth control before I got pregnant.
I'm upset that they let me go 8 months into my pregnancy without telling me.

But I find it unforgivable that they knowingly put my baby at risk.

I had a minimal relationship with them before,
but now I want nothing to do with them.

37 Weeks!

•Total weight gain/loss•
About 8 pounds above pre-pregnancy. As of Monday at my midwife appointment, I weighed 1/2 pound less than I did 2 weeks ago. I wish I could lose weight and still eat the way I do when I'm NOT pregnant. That would be awesome.

•Maternity clothes?•
I need to do laundry. Seriously. Last weekend was busy - I got my haircut and ran errands on Saturday, we went to the Bite of Oregon and the Trader Joe's Comopany party on Sunday, we had a LONG midwife appointment on Monday. I probably could have thrown in a few loads in between everything, but I didn't.

I'm still sleeping like a rock and hitting the snooze button WAY too many times each morning. I still only have 1 bathroom break in the middle of the night at about 3am which is amazing considering how much water I chug right before bed.

•Best moment this week•
This week wasn't this great, but the best 'moment' was probably on Wednesday. Chris felt awful so he called out sick for the first time in 6 years, and I wasn't feeling too hot either, so I called out sick as well. We slept in and laid around until almost noon. It was glorious.
and probably something we'll never be able to do again :)

When she was measuring my fundal height, my midwife got a little concerned that she might have flipped back to breech. She couldn't feel the head down low and there was a nice round mass high on my stomach. So she called for the ultrasound machine to verify the position. Turns out her head is so low that she was feeling the shoulders and that round mass was her booty. She's still head down and probably engaged. It makes sense I guess - she hasn't been as crammed up in my ribs lately and most of the kicks are lower than they were last week. I kept hearing horror stories about the 'lightening' pain I'd feel when she engaged. I guess compared to my pelvis pain, engaging is nothing.
ahhh, the bright side. :)

•Food cravings•
I haven't really been crazy about food this week. I eat when I'm hungry, that's about it.

I did have Chris buy some ambrosia salad while he was at the grocery store last night and promptly ate it for dinner when I got home.... But that's about the only ridiculous food stunt I pulled this week. Much better than my tirimisu frenzy of week 36.


•Labor Signs•
The midwives suggested that I start acupuncture again, now that I'm full term, to start thinning the cervix. I had my first induction appointment last night and, besides the needle she shoved just below my pinkie nail, it was awesome. By the time I paid my copay and walked out the front door, I had some serious menstrual type cramps. They faded sometime in the middle of the night, but at least it started doing something! (I told her to take it easy and not do TOO good of a job stimulating the points as Chris is going camping on the coast this weekend with Shakes and Sarah and I'll be home alone. Smart huh? *wink*)

•Belly Button in or out?•
Still an innie, but barely.

•What I miss•
Pepto Bismol.
Anyone that knows me knows that, besides loving anything pink, I keep pepto with me wherever I go - car, desk, bathrooms, luggage, etc. Inevitably the one time I don't have it will be the time I get a stomach ache.

BUT, pepto is not safe for use during pregnancy. So now on the rare occassion that I have a little heartburn or indigestion, I have to take tums instead. I seriously miss pepto.
Chris thinks I'm crazy for loving the pink chalk as much as I do.

•What I am looking forward to•
The weekend. I've got a few more projects to finish up in the nursery - finishing touches here and there - and then I'll be ready. I also need to do all the laundry from last week and this week, as well as sleep at least 8 hours per night, get some reading in and finish simplifying my Birth Plan for the hospital. I'm tempted to just write: "I'm with the midwives for a reason. Keep it calm and don't offer drugs. If I want to get in the pool, let me." But I feel like I should offer a few more details than that.

•Weekly Wisdom•
We took our Infant Safety and CPR class on Wednesday(No More Classes!!) and it was really quite informative. She went over the role of the local poison control (based out of OHSU and providing coverage for Oregon, Alaska and Guam. Random.), information about SIDS and the Back to Sleep and Feet to Foot Program - basically put the baby to sleep on its back and have the feet touching the foot of the bed so that they don't burrow under the blankets when they start the natural 'grounding' tendancy to find their boundary. She talked about Kangaroo Care and Carseat installation. We had just installed them earlier that day and really should have waited. We ended up putting them in correctly, but only after a lot of trial and error with the seat placement and leveling. We were sweating and feisty by the end of it, but at least we now know what works best for our cars. We still need to have them inspected however.

Then we did the CPR and Choking training.
I hope to never have to use that information though.

Full Term! 'nough said.

Thursday, August 5, 2010

36 Weeks!

•Total weight gain/loss•
8 pounds above pre pregnancy or down 2 from last week. Last week was hot and I was having issues with ... cankles. Yes I can admit it now. I had cankles. Some nights were so bad that I had creases in the front of my cankles. It was not pretty.
But the heat has backed off and I took it easy this weekend and now my feet are back to normal! Yay! I have indentations on my feet! I never thought I'd be so happy. So, anyway, I lost a couple pounds of water weight. Which means I need to eat more popsicles. At least that's what I'm taking away from this developement.

•Maternity clothes?•
This weekend we have the Trader Joe's company party. Finding a maternity dress that is flattering, befitting the dressy yet casual atmosphere of a TJ's party and doesn't cost a million bucks because it's maternity is a hard feat. Then finding one that fits a 6' tall chick is darn near impossible.

I settled on this number from Motherhood:

Basic black, not that fun, but it'll work. :)

*snooze* *snooze* *snooze*
I fall asleep in seconds and refuse to wake up.

•Best moment this week•
The best moment came as a result of the worst moment.
Chris was in a car accident on Thursday. A woman driving a Tahoe ran a stop sign and hit Chris at 4am while he was on his way to work. The car was totalled and the air bag deployed, but he walked away relatively unhurt. So on Saturday we went car shopping and it was fabulous to walk into a dealership and be so financially secure that no one batted an eyelash at selling us a car and giving us the lowest interest rate I have ever seen. Best of all, Christopher's car now has power doors and windows. and is clean. WOOT!

She was a wiggle worm on Tuesday, but was pretty quiet yesterday. I still have her little butt shoved out high on my right side. Chris keeps reminding me that although it feels huge, it's small compared to her head. Gee hun. Thanks.

•Food cravings•
popsicles. And sausage burritos from McDonalds. :)

I also had an insatiable hankerin' for Italian desserts yesterday. Canolli, Tirimisu, Gelato... It was a hard choice. Chris made this fabulous pasta dish: kale and fresh green beans with bacon over whole wheat angel hair pasta... OMG... and then we went to Pastini's (this local Italian chain) and ordered dessert. Yes, we went to a restaurant just for dessert. Chris wasn't complaining.
and it was delish.
I got the tiramisu and Chris got this amazing looking chocolate cake with ice cream.


•Labor Signs•
None. We'll know more on Monday, but I'm not expecting much progression yet.

•Belly Button in or out?•
Still an innie.

•What I miss•
Eh. This week was pretty good on the pregnancy front - I slept fine, my pelvis feels better now that I'm have chiro done 2x a week on it, I'm not swollen like a blimp.... I'm good. :)

It would be nice to wear my weddign ring though. It still fits in the morning, but I'm afraid it would become too tight while at work. And before you suggest it, my ring doesn't really look good when strung on a necklace.

•What I am looking forward to•
I'm looking forward to the midwife appt and seeing if anything is happening. It probably isn't, but I just can't believe we're already at the home stretch of the pregnancy.

•Weekly Wisdom•
We took the waterbirth class last night. We'll have to see if I'm able to take advantage of the opportunity on delivery day, but at least we know what to expect.
The instructor did a fabulous job of giving us a mental image of what to expect when labor starts and when we arrive at the hospital so I feel much more confident now and know that when things DO start that we should just sleep and eat and relax in order to conserve energy. She made a lot of sense. And now that I have a mental image of the intake process and possibly how water immersion would go, I am starting to be able to picture myself actually doing it. Which is nice.

Even if she's not born until I'm 42 weeks, she'll still be here in less than 45 days. That's SO soon! Also, there is now less than a month till her due date and only 1 week till she's considered full term! Amazing.



Related Posts Plugin for WordPress, Blogger...