Friday, September 28, 2012

9-28-12

It's hard to believe it's been three years. That we should have a three year old.

Happy birthday Olivia. We love you and miss you so very much.




Tuesday, September 25, 2012

Day to day.

Yesterday I had 3 appointments.

My OB was annoyingly calm about everything. She still thinks we can make it to 37 weeks (and even started lecturing me about some difficulties 36 weekers can have, like I'm just tired of being pregnant or something...) And then she mentioned she saw my protein level test results and called it "good" and nonchalantly mentioned I was spilling protein again on their diptest and didn't raise an eyebrow that I'd gained 4 lbs in a week and 10+ lbs in 2 weeks (that day when I gained 7 lbs between the two appointments? I really did gain 7 lbs between the two appointments. Yesterday my weight was exactly the same at my OB and MFM, so the difference was probably not their scales.)

She is so frustratingly calm that it makes me question why I'm even wasting the time and money to see her. And so calm it makes me again think back to three years ago and wonder if things would have been different at all if I had been seeing a different doctor, if I had asked to see a high risk doctor, etc. I mean, the Friday before I got sick, I called begging them to take me out of work and put me on bedrest. The nurse was going to call me back on Monday after talking to the doctor who was out of the office. Monday I went into the hospital at 3 am and came out almost a week later with a dead baby. The week before, I saw my OB for the extreme upper right quadrant pain I was having. She suggested I try prenatal yoga. Then we did the ultrasound and saw Olivia was extremely far behind in growth, so she saw me again, and said that I was probably developing preeclampsia. I was only 22 weeks with a severely growth restricted baby, in severe pain, and she sent me home because my blood pressure was normal and my urine was clear. She even mentioned that slow growing babies are at risk for being stillborn and that we may have to deliver as early as 24 weeks because even that early, some babies are better off outside where they can grow rather than in utero where something major is wrong. She didn't order bloodwork or a 24 hour urine. She didn't send me to a high risk doctor. She let me keep working. (In fact, I specifically asked about bedrest. She mentioned it wasn't proven to help...which is true...but it would have been better than doing nothing.) I was supposed to follow up in 4 weeks, and I was 22 weeks, so I was relieved because I thought that that at least meant we should make it to 24 weeks. I know she had no idea how bad it was or would get, and I do really ultimately think that *most* ob's would have done the same thing...my blood pressure was good and my urine was clear. And I don't think it ultimately would have made much of a difference, even if I had been put on bedrest then, we were in such bad shape, bedrest probably wouldn't have made a difference, or maybe just bought us a week, but even a week longer likely wouldn't have saved Olivia. But still...she disregarded some pretty serious stuff...stuff that could have ended up killing me before we ever even made it into the hospital. So it's not only frustrating that she seems to be on another planet at this point in this pregnancy, it's triggering some feelings I thought I had resolved a long time ago.

My high risk doctor is not nearly as relaxed. I asked if she thought we were still okay to deliver at 37 weeks and she stared at me like I was crazy and said, "I'm a realist. Let's just see how your monitoring goes downstairs."  I pressed her about it a little more and she elaborated that while she would LOVE for me to make it all the way to 37 weeks, she has no intention of walking on egg shells for an extra week unnecessarily and the best case we are probably looking at...if everything stays status quo and we can limp along a few more weeks...is delivering at 36 weeks with no amnio. Because at this point, I have steroids, and the baby's lung development is secondary to the risks of preeclampsia and/or HELLP...seizure, stroke, placental abruptions, etc., so if she decides it's time to deliver because of my symptoms getting worse or signs that the baby is starting to have issues, whether his lungs are completely ready just yet is irrelevant (they likely will be fine anyway) and we don't need the added risk of the amnio putting me in labor (again). She is also really nervous about my weight gain, which she said is definitely swelling, and was not happy to hear that I had protein again in my urine that morning. (Though I had a clear test there.) Luckily she decided not to do another 24 hour urine just yet, I think she doesn't really want to know if that's much worse yet, since there is no recommendation or guideline on delivering for protein levels alone and the baby is doing well and my blood pressure has been good and I haven't had any symptoms of HELLP, yet. And probably, if I'm able to have some clear tests at least, it isn't that much worse yet.  But still, she had pretty much the opposite attitude of my OB, which was actually kind of reassuring that I'm not crazy.

The baby keeps doing really well on his nonstress tests, except for the pesky fact that my amniotic fluid levels have gone from 18 to 15 to 13 to 11 over the last 4 times they were checked. A lot of things can affect measuring fluid levels, (especially the baby's position and the person who is doing the measuring) but they should stay relatively constant, generally speaking... (With Luke they were around 15-16, sometimes up a little from that, sometimes down a little from that, but right there in the middle with no pattern up or down, just some minor variation.) They want them a 10 or higher, so if this trend continues, on Thursday my high risk doctor is not going to be happy. I don't think they'll deliver at this point for fluid levels unless they get really bad, but I wouldn't be surprised if it earned me bedrest officially or even getting admitted with iv fluids to see if that might help. I distinctly remember one person on the Preeclampsia Foundation forums who was in the hospital because of low fluids and they were trying to get them up with IV's and drinking, when she had a placental abruption that her doctor happened to be right there in the room watching the baby's monitors and they managed to get the baby out just in time via emergency c-section and probably saved his life. In some cases, low fluid levels can proceed other things going haywire, so while this trend is still within a perfectly normal range, I'm not incredibly optimistic that I'm going to be leaving the hospital Thursday after my monitoring in lieu of everything else going on too.

On the bright side, we are really close to October, I'm really close to 33 weeks (Friday), and I'm still feeling pretty good, overall. Fingers crossed we can make it a few weeks more. Or at least till October.

Thursday, September 20, 2012

Lots of updates.

Today I was at the perinatal center for monitoring. I happened to glance up at the time the nurse stepped in the door to call someone back when I realized it was my favorite nurse from my pregnancy with Luke. She is mostly working at the perinatal near my house now (and I haven't done anything there except my second ultrasound), so I haven't seen her yet this pregnancy. She didn't even call my name, she smiled and motioned for me and I went back, and she told me she grabbed my file on purpose because she remembered my name. (I think Luke and his eventful monitoring sessions may have stressed her out as much as it stressed me out.) She was as awesome as ever. It's too bad they don't have doctors at the perinatal center by our house, because I'd love to get to see her for all my NST's again. (And not drive 30 to 45 minutes for them.) These days, though, I'm at the hospital for appointments weekly anyway so it actually is easier to have an appointment then monitoring right there in one chunk of time, it's just the second time of the week that it's a pain to drive out there only for that. Though with all of the drama and uncertainty, I feel better being by the hospital and with doctors there.

Baby boy looked good. And showed us he is a boy multiple times during my fluid checks, it was impossible to miss. I still don't understand how people with surprises can have monitoring and not see boy parts if they are having a boy unless they aren't watching a lot of the fluid check. Or maybe my boys are just super proud of their parts and like showing them off in ultrasounds. Anyway, while they were doing fluid checks, he was moving well, practicing breathing, fluid levels were normal, and he flipped back to head down again. He kept moving off the monitor for the NST so that was a little tricky, but eventually when I held it down where he was, he easily passed.

The only thing that has me wondering a little about how he's doing specifically, is that his/my amniotic fluid levels have gone from 18 to 15 to 13 in the last week and a half. They want it over 10, so at this trend, it could be at or below that next week. But there are a lot of explanations for the variance...like the fact that the measurements were done by 3 different people, or the fact that he was head down, then breech, then head down again. So it's not something I am super concerned with, knowing it could be right back up to 15 or more on Monday, but it's something I am "watching". Low fluid levels can be a sign of fetal distress--I had that with Olivia when things were bad--and that's why they check it with the NST every time.

I saw my high risk doctor briefly who was happy with how things looked, told me to start trying some stronger meds for the heartburn to see if that helps, and said she'll see me next week. So we are a couple hours away from 32 weeks and it is looking encouraging we may even make it to Oct. That's as much as I can dare to hope for just yet.

I am really looking forward to just vegging out around our house (hopefully getting some cleaning done...or SOMETHING constructive done...like laundry) tomorrow. Four appointments a week was time consuming enough when I was pregnant with Luke, now it's just a joke, it seems like there is no time for anything else. Next week I have 5 appointments between my OB, high risk doctor, 2x monitoring, and a dentist appointment...that's assuming I don't have to do any bloodwork or labs or a 24 hour urine, which I'm guessing is very likely in my future. Then Friday is Olivia's birthday (which I have hardly had time to think about while at the same time am thinking about it way too much.)

I half-heartedly packed a few things in a bag and threw it in the van today just in case I didn't get to leave the hospital. Important stuff like comfortable clothes, my Nook and charger, cell phone charger, toiletries, the camera, and an extra book. I think it's a pretty good prevention from getting admitted, because usually my hospital admissions have caught me unprepared...with Olivia I had my purse and a book and that was all. With my hand, nothing except my purse and my dad. (And Joe did a really bad job of packing clothes for me, thank goodness for my mom! He did get my Nook and chargers and laptop, but still, comfortable clothes are VERY important when you are stuck in the hospital.) Even with Luke, I had a bag mostly packed, but I was busy cleaning and planning to put a few more important things in it at the last minute when my water broke and that went out the window. (Important stuff like his baby book!) So still, we ended up calling my parents at some ungodly hour in the morning, I think like 2 or 3. And at first we just told them what happened but that they weren't planning on surgery till 7 so they could take their time. But then my contractions picked up and 7am turned into 4 am and suddenly we were calling them and asking them to go to our house ASAP to get the baby book so they could get his footprints/handprints done in it...they were literally wheeling me into surgery when someone in the room said, "Oh, here's the baby book!" So yeah, I'm thinking that as long as I keep a bag in the car on days I have appointments, maybe we can even make it to Oct.26th. I'll just have to try not to unpack it when I get low on laundry and stuff.

Our house is not so much a fun place to be at the moment. Luke is being very much a 1.5 year old, which at the moment is exhausting. Joe is stressed out about his work situation (contracts are still in limbo, he's had a few interviews, pretty certain he will have *a* job, not so sure it will be the same pay, etc.). And then there's me and this pregnancy and trying to keep up with Luke and also worrying about Joe's job and blech, blech, blech.

Luke is a little pistol, to put it mildly. I think his favorite thing in the universe is dogs, although he also really likes his cars and ride on toys and saying "beep beep" over and over. This morning my mom came over and watched him for a little bit while I had a new pediatrician "meet and greet", and when I got home, I managed to accidentally let our husky out. Luke got into the spirit of trying to catch him (holding my hand) by patting his legs and yelling "dog! dog!"  like he always tries to do to get the dogs-any dogs, anywhere- to come to him (which has never ever worked, but the poor kid sees it works for Joe and I, so he keeps trying and trying.) Luckily, Koda stopped at a fenced yard a few houses away that had a couple of dogs out, tried his best to get in a fight with a pit bull in the yard but luckily the fence between them prevented it (I was actually more worried about him hurting another dog vs. getting hurt, he's such a pain in the butt.)  My mom was still there and managed to grab our dog and drag him back to our house (and probably only bothered to try to catch him because she knew I would if she didn't). Ugh, dogs. But watching Luke hitting his leg and yelling "dog! dog!" so intently like it might just work, almost made "the chase" worth it. I could have done without having to carry him home kicking and screaming and trying to squirm out of my arms because he wanted to walk around the neighbors' yards (not people we know or have ever even seen before). So I'm not sure who actually had it worse, my mom dragging our 40+ lb husky by the collar while he tried to stop/pull away over and over (and FYI, huskies are pretty strong), or me carrying the 30 lb toddler trying to kick me in the face and jump out of my arms. Fun walk home.

Wednesday, September 19, 2012

HELLP

I almost made the title of this "the second worst outcome", and I wanted to, but given my current pregnancy drama, didn't want to stress anyone out unnecessarily. So you are welcome! :) As far as I know, I'm fine, baby is fine.Both rounds of steroids are in, 24 hours until they should be fully kicked in, so hopefully the baby's lungs should be good to go, whenever he is born. (Hopefully not until October!) Nothing really new to report except last night my heartburn was so bad it woke me up at 3 am and took a couple hours before I could go back to sleep, and dinner was nothing spicy, so that's erm, sucky, but could be normal. (It is NOT "upper right quadrant" pain, thankfully.)

Anyway. I remember someone, I think probably Brooke , talking with her doctor or someone medical not long after her daughter Eliza was born still, and them saying that losing the baby was the "second worst outcome". And when she questioned that, they either said that the worst outcome was losing the mom and the baby, or possibly just the mom. (Sorry to be vague, my brain isn't working so great at the moment.)

 Obviously, I think losing the baby AND the mom would definitely have to be the worst outcome, losing two lives with one pregnancy. Nobody goes into pregnancy expecting to die, or even thinking that women still die in pregnancy in this day and age, especially not in countries with medical care like we have in the United States. I can see how a doctor might think that losing a mom is the "worst outcome", but from a mom perspective, I'd say losing a baby is the "worst outcome".  I would have gladly traded places if we could. But then Luke wouldn't be here, so in that respect, I'm glad I didn't die.

But I still vividly recall a medical professional trying to comfort me in the hospital after they told me we had to deliver and Olivia was most likely not going to survive," You are young. You have family. You can go on and have other babies". Really, not that comforting or helpful in that particular moment, though I know they meant well and were trying to save my life at the time. But all I wanted in that moment was THAT baby, our baby girl, the one who was still inside me at that moment, moving around, but so small I couldn't yet even feel her, even if her survival meant I had to trade my life for hers. I knew even then that they couldn't promise I would ever get pregnant again, or that we would ever have a healthy living child, or that having a living child would just make up for the one that we lost. (It doesn't "make up for it", but I am glad, now, to still be alive so that he can be here.)

Anyway, apologies for rambling. What I am getting at that even as recently as this month, women in the United States are dying from HELLP syndrome and preeclampsia, sometimes their babies survive (usually, in these cases, it seems like the baby does survive), sometimes they are both lost. As sad as that idea is, for a baby to be motherless and a father widowed in what should be the happiest time of their lives, it's worse when you see the faces...the young, healthy women glowing with pregnancy and glowing holding their new baby, only to die soon after.

Even though we lost so, so much because of HELLP, it could have been even worse, which was impossible to think at the time, almost 3 years ago. But now, I know I am lucky to be here. These stories of women dying could have easily been me. If we hadn't gone to the hospital when we did. If they had sent me home when they initially found almost nothing wrong. (My initial labs showed my liver enzymes just "slightly elevated" with everything else totally normal. They thought my liver enzymes may have been elevated from gallstones...They kept me anyway. Six hours later, my liver enzymes more than doubled, and my platelets dropped by 100,000. I continued getting worse over the next two days before things finally started getting better. My platelets went from 250,000 upon admission (normal) to 40,000 at the worst (the worst category of HELLP, "class I", which is 50,000 and lower), in a matter of a couple days. Even as my labs got worse, I didn't feel any worse. These stories most certainly could have been me.

I am at higher risk than most to develop HELLP again. We can't say for certain that this is where it's going, yet, but a lot of the symptoms I am having are all too familiar. This is why I got the steroids now, in case we need to deliver soon.  And this is why I'm on a pretty short leash as far as how long this pregnancy will go. Since my blood pressure barely acted up last time, it may not act up again this time. (I suspect if I look at my records closely, it was only high when we were in conversations about Olivia dying, etc.) , there were one or two barely elevated readings over the entire week+ that I was hospitalized. I don't really like how my symptoms...the swelling, the heartburn, just feeling off, are seeming to be progressing and constant. It is impossible to predict though, how much longer we have left. On Friday, I will be 32 weeks. Just one day, one week, at a time, at this point.

I came across this video today from a friend on Facebook, it is not to ask for donations, but simply to put a face behind one of the stories and spread more information and awareness about HELLP syndrome. September seems like it is a bad month for HELLP especially, though maybe I'm biased because that's when I got sick and diagnosed with Olivia. At the beginning of the month, on the PreEclampsia Foundation, a bereaved mother wrote about her daughter who died from HELLP 4 days after delivering her baby boy a month early. (The video below is not the same story, it has been on YouTube for 3 years, but both women who died were young and healthy and in the hospital when they died.) Like preeclampsia, there is no "cure" for HELLP besides delivery, and often it gets worse after delivery before it gets better (it got worse in my case as well). Sometimes (usually) HELLP presents first as preeclampsia, with protein in the urine and elevated blood pressure, and as preeclampsia gets worse, it can develop into HELLP, with red blood cells breaking down (Hemolysis), elevated liver enzymes (EL), and lowered platelet count. (LP). It basically attacks the organs and blood of the woman.  Sometimes women are like me, and don't show they typical preeclampsia symptoms while going directly to HELLP. (In my case, swelling and severe upper right quadrant pain...around my rib cage/bra strap/back on my right side especially...pain that came and went for WEEKS...were my telltale symptoms.) It typically doesn't happen until the third trimester, but can happen (rarely) as early as 18+ weeks. It most commonly occurs in first pregnancies, when women are the most vulnerable because they don't know what is "normal" discomfort in pregnancy and what is not. (I even posted on internet pregnancy message boards about my rib cage pain, and was reassured it was normal by everyone.)

Here is someone else's HELLP story, with some good medical information in there as well.




Monday, September 17, 2012

31 weeks= drama

Some of you may remember back when I was pregnant with Luke, when I got admitted twice in the same week, back to back days, for different reasons. On that Friday, we went for monitoring, where Luke did HORRIBLY with some ugly decelerations (more than once) that were so bad that the nurse wanted to fax the test strip to my high risk doctor directly, followed up with a failing biophysical profile--he was too lazy to practice breathing and his movements were more sluggish than usual--my MFM had us head to the hospital, where they quickly hooked me up to monitors and watched him for a couple hours. He did perfectly, then they followed up with a biophysical profile again, where he passed easily in 5 minutes. All that drama for nothing.

The next day, I was laying on the couch watching tv when I started having contractions. I was told to call if I have more than 5 in an hour. I had more than that, called, they told me to go in. Same place, the very next day, more monitoring for both contractions and his heart rate. (He did perfectly.) I had an irritable uterus from a UTI, they sent me home with antibiotics after a few hours.

Silly me, thinking this pregnancy has been so mellow and drama free with the exception of the hand saga, I often almost forget I'm pregnant. Last week I was mildly alarmed when I was spilling a little protein at my OB, but then I wasn't spilling any at my high risk doctor, so it didn't seem too terribly alarming. Then I started feeling like I was getting swollen, especially in my face around my sinuses/the bridge of my nose, it felt like I was getting a sinus infection, but didn't. Which is kinda a big deal, because swelling in the feet during pregnancy is normal...the face, not so much. But swelling is tricky, I didn't think I looked more swollen, and maybe it was all in my head.And my blood pressure was really good.

My first appointment today went well, unlike his big brother, the little boy in utero is super cooperative and easily passed the nonstress test and my fluid levels were good. No drama there, at all, except he flipped from head down to breech which is a whole lot more comfortable for me, although it's surprising an almost 5 lb baby still has that much room in there. But no big deal, having a c-section, he can stay breech (and just might).

My second appointment...eh. My blood pressure was good. My 24 hour urine results, not so much.

The diagnostic criteria for preeclampsia is two blood pressure readings of 140/90 or higher, and 300 mg of protein in a 24 hour urine test. (The in office dip tests are supposed to give them a general idea. Last week my test was +1, which is supposed to be an estimate of 100 mg. +2 is a guess of 200, etc., and they only go up to +3. But they are notoriously inaccurate. One of my friends had a 24 hour urine test of 250 mg when her office test was completely clear. One sample at one random time doesn't mean that the kidneys aren't spilling protein, even with a completely clear test. Or someone can get a +3 test if they are dehydrated, but not actually be spilling 300 mg over 24 hours, so they can be inaccurate both ways, but a whole lot more convenient than saving your pee in an orange jug for 24 hours.)

 Anyway, last Monday, I had a +1 test in my OB's office, but a clear test in the afternoon at high risk. Wednesday through Thursday I did my 24 hour urine test and blood work. It came back at 700 mg of protein and my uric acid was "a little high" (something to do with the kidneys, not sure what, it's not super important in terms of preeclampsia). I am pretty sure my high risk doctor accidently muttered the 700 mg and could tell immediately I knew what that meant by the look on my face (BAD!) because we have spent a lot of time together and freaking out about it isn't going to help anything. She quickly said, "That's not bad enough to pull the trigger.  If you get to x000's then we probably will." (Can't remember if she said 2000 or 5000, either way, I'm going to be reluctant to deliver if I'm "only" spilling protein, though I'd rather not have kidney damage along the way so we'll have to weigh the options carefully if it comes to that. Spilling protein isn't good for *me*, but my understanding is that it isn't really putting the baby at risk, as long as my blood pressure and everything else stays normal.)

So, this changes things. It seems like she's now preparing for *when* trouble comes vs. *if* it is coming. Because there is not really a good reason to be spilling that much protein, when I never have spilled that much in pregnancy before. (With Olivia, we never had time for a 24 hour urine, my office dip tests were always completely clear, so who knows how bad my kidneys were doing or for how long.) I did "baseline" 24 hour urines before I got pregnant with Luke, and a baseline 24 hour urine early in my pregnancy with Luke, we didn't do one this time, but last time there wasn't any/much.

I'm now getting steroid shots to help develop the baby's lungs, tomorrow and Wednesday. (It is ideally 2 doses, 24 hours apart, as close to delivery as possible) She made a comment that she wanted them done by the time I go back for monitoring Thursday, which should probably have us all a little alarmed, because the unspoken meaning is, I want them done by Thursday so we can deliver then if we need to. I am only going back Thursday for an NST and fluid check, though they'll also check my blood pressure and she specifically said she'll "see me then", so we'll see how that goes. Then I go back again Monday, so I guess I am on weekly appointments now, plus she is sending the results "and a note" to my OB, so who knows what my next few weeks will look like. I don't think she is inclined to put me in the hospital or on full bedrest, if it gets that bad, they'll likely just deliver because of my extreme history and the fact that we are in the 30's weeks-wise with a nice sized baby.

Mostly, we are still in good shape. The baby is doing well. I'm only a few days away from 32 weeks and will have steroids for his lungs soon. They are watching everything closely. I don't think they'll let me go to 37 weeks anymore unless things take a drastic turn for the better. (Like if my next 24 hour urine test comes back under 300 and my swelling goes away, which is not very likely.) With the protein as high it is, most likely they will call it quits if we can make it to 36 weeks. I would love to make it 37, but I just don't know that it's very realistic anymore with the direction things have turned. Right now, I just want to make it to October with the baby still in utero and doing well. Bonus if we can make it to 35 weeks or more. (At 35 weeks, NICU time is 50/50 odds. Luke was born at 36 weeks and didn't need it but it happens sometimes.Before 35 weeks, he'd most likely need some NICU time to learn to eat and regulate his temp and stuff. So 35 weeks is a good "first" goal, but that's a month away and we may not get that lucky this time.) If I make it to 35 weeks, I'll probably still deliver at the non-baby factory hospital, but before then, baby factory it is because I don't want to risk the baby needed transferred to a higher NICU and us being in two different hospitals.

So blech. I'm not on bedrest but on "seriously, take it easy! No running around like crazy!"-rest. Which I think might mean that any trips to the zoo in the next few weeks are out of the question. (Not like we would have time for that anyway with all my appointments.)

Fingers crossed we can keep this baby baking for awhile longer, we have way too much still to do.

Tuesday, September 11, 2012

Maybe normal, maybe not.

Everything looked pretty good today.

The baby is still most definitely a boy (and I still can't fathom how anyone can have a boy and be surprised, we can always see he's a boy when they aren't even looking for parts. I guess my boys just like flaunting their stuff.)

He was really active the whole time, and is measuring big...like 4 lbs 9 oz (estimated) at 30.5 wks. I think he might be bigger than Luke was at this point but I'd have to look back. I have read that babies from women who have pre-e or a history of it tend to have either small babies or big babies, and not a lot in between, so I wonder if that has to do with it. Either way, I'll take a nice big baby over a small baby any day.

My fluid levels were good, and he *easily* passed his NST even though it was only 30 weeks. He even stayed on the monitors the whole time. Hopefully that's a good sign that this is kid is going to be way more cooperative than Luke was.

I haven't started my lab tests/24 hour urine yet. That will be a fun project for tomorrow when we don't really have to go anywhere.

My blood pressure has been good all day today. (I've been watching it.) But my feet got pretty huge and my sinuses around my forehead/nose/eyes started feeling tight/heavy/like it is getting swollen. Fingers crossed that it's just the start of a sinus infection or cold or something, but I'm not so sure. I had a few more contractions today, though I don't think I had any during monitoring. So, we'll see. Could be normal, could be not. As long as my blood pressure is okay and I'm not having other symptoms, I don't think they'll do anything like bedrest (bedrest is usually in hopes of keeping blood pressure under control.)

It is crazy how fast this pregnancy has gone. I can't believe I'm already doing NST's and that I only have one growth ultrasound left. With Luke, that pregnancy felt like it was 10 years. This is like I've blinked and here we are in the 3rd trimester.

Luke had a really good day today. He walked into my parents' house and immediately headed straight for the toys. My mom gave him a huge stack of dixie cups to play with as we were leaving (she went with me, my sister stayed with Luke), and he was so entranced with stacking and unstacking them and ruining the pyramid my sister was trying to build, he could have cared less when we left. And when we got back, he was pretty underwhelmed to see me and probably would have been fine if I left again, I practically had to drag him out the door to leave with me. I am glad, that will make it a lot easier to be in the hospital (hopefully just for delivery), knowing he isn't having separation anxiety the whole time. Though I suspect my hospital stay with the hand saga is what started that to begin with, so being gone again (overnight especially) could possibly re-trigger it.

Anyway, so far, things are still looking reasonably okay, so I've managed to chill out a bit. Friday is 31 weeks, I'm pretty certain we will make it at least that far.

Monday, September 10, 2012

Blech.

My normal pregnancy may have just went out the door. I feel like I totally jinxed it.

This morning I saw my OB. Everything looked good except she casually mentioned I had a little protein (+1) in my urine sample. Since my weight was the same as 4 weeks before, no troublesome symptoms, and my blood pressure was normal, she wasn't too worried about it.

Which didn't stop me from crying when she started talking about how we'd be to Oct.26th before I know it and then looked at me and asked if I was ok. Pregnancy hormones, the daunting prospect of going back to that hospital, the unexpected protein, Olivia's 3 year birthday coming up, and just being tired from Luke all kinda hit me I think.

Luckily my OB is fantastic and gave me a long hug and said, "You know there is nothing you could have done, right?" Which surprisingly is one thing she's never said before, but the ultrasound tech, for my last ultrasound with Olivia--at that hospital--before I was transferred in an ambulance, said something really similar way back then. So of course that made me cry even more. And before I knew it my OB was crying too.

So that was fantastic.(Actually, it means a lot that she cares.)

She reassured me that because of my weight and normal bp, she thought things were okay and we'd make it to the end goal again. But she was glad I was seeing my MFM in the afternoon and they could retest, etc.

So I got lunch, went shopping for a short time, and headed to my high risk doctor.

Except it was just one of those days...my high risk doctor was in emergency surgery, they had no idea when she'd be back, which sucked not only because of the protein thing, but because I wanted to talk to her about when and if we would do NST's, when I would get steroids, etc.  And I've only met the nurse practitioner once, I wasn't super impressed, and know others who have had a bad experience with her.

Luckily, even though my sample was clear of protein, she seemed suitably concerned about the protein from the morning, especially combined with the fact that I had gained 7 pounds from the morning and from my appointment 4 weeks ago. Sheesh. My blood pressure was borderline, 134/84, kinda high for me. But no other symptoms. They decided to order a 24 hour urine and bloodwork and went out to do the orders for it with my exam room door open, when my high risk doctor walked in, she still had those shoe covering things on from surgery. They told her about what was going on and she stopped briefly to talk to me, decided that the lab work and 24 hour urine was a good start, and that she wanted me to start monitoring this week and to go back next week. She asked if I was working and implied that if I had been, she would have pulled me out. Then she asked about my symptoms, etc.

So that mostly worked out. Got my NST's question answered (start them this week), and I'm fine with asking her about the steroids next week. I have a growth ultrasound and NST tomorrow and they'll check my blood pressure again there. I can't start my 24 hour urine test until tomorrow afternoon when I get home because I am NOT hauling a jug of pee to the perinatal center and considering I will probably be there AT LEAST 2 hours, there is no way that I can guarantee that I won't have to go to the bathroom. (For those of you who haven't had the pleasure of doing a 24 hour urine test, it works just like it sounds. For 24 hours exactly, you collect all of your urine in a jug. The jug has to be kept cold. So if I went somewhere else and had to use the restroom, I'd either have to figure out a way to "save" that urine for my jug...no thank you....or it would ruin the test if I'd already started it.)  So this fantastic fun time is gonna have to wait one more day. They won't deliver or do anything drastic even if I'm spilling a lot of protein (ie. means kidneys aren't working right and a symptom of pre-eclampsia), unless my blood pressure or other things are acting up.

I think mainly, they are wary that this could be the start of something. I'm not eating the best ever, but my weight jumped up like 14 lbs at my previous appointment, and then 7 more lbs this appointment...something really similar happened with Olivia, a month before I started getting sick. However, in neither of my previous pregnancies-including the entire time with Luke being seen every week from 28 weeks on- never did I spill any protein. Even when I was diagnosed with HELLP syndrome with Olivia, no protein. (This was part of the reason it took awhile to figure out what was going on.) So, it is concerning, a bit. I'm comfortable that I'm not in HELLP, or near HELLP, yet. I feel like this baby is growing JUST FINE. He's active. I'm not having the upper right quadrant pain that I had with Olivia. I am having heartburn though, a lot, pretty bad, and even when I eat stuff that should be relatively harmless...like a banana. My MFM wasn't thrilled about the heartburn, it does go away with Tums, but my upper right quadrant pain with Olivia started out as heartburn and would go away with Gaviscon/tums for awhile too.

So anyway, nothing ESPECIALLY concerning, but nothing exactly reassuring either. I am reassured that they will check on the baby even more tomorrow, I'll have my lab stuff turned in by the end of the day Wednesday and hopefully results Thursday, see my high risk doctor again on Monday, and my OB the following week with NST's in between as well. Their radar is up, my radar is up, maybe we are worrying unnecessarily, but we'll see. I'm a little nervous how the NST is going to go with a 30 weeker, Luke was notoriously bad with NST's this early. My sister works overnights as a manager and is going to watch Luke for me since she doesn't go to sleep till noon or so, but I hope that the baby cooperates so I can let her go sleep.

I am 30 weeks and 4 days...7 weeks further than we made it with Olivia...well past "viability" and even "micropreemie". I don't think it's very likely that I'll be delivering in the next 2 weeks, unless things get crazy ugly very quickly. Fingers crossed that this is just a fluke and we can return back to our uneventful, boring pregnancy.

Sunday, September 2, 2012

29 weeks

I am getting really bad at this. Every time I start to try to blog, Luke wakes up or something else comes up and I get interrupted and never finish and never go back to what I started. But this time I'm going to really try to finish!

29 weeks now (and 3 days). Kick counts are good, when I remember to do them, but usually when I lay on my side and start doing them I fall asleep. I can't do them when Luke is up because he takes me laying somewhere as an invitation to come over and climb all over me. As far as I know, everything is fine. The fabulous part of this is that I have hardly any time to think about all the things that could go wrong or to worry at all, unless I have a doctor's appointment that day or something. The only mildly warning sign I have is my feet keep swelling pretty bad by the end of the day, but I don't think I'm swelling anywhere else, so I'm going to chalk that up as normal. Even my heartburn has been behaving lately. And I don't remember if I mentioned that hallejulah, I passed the 1 hour glucose test so no gestational diabetes for me! I'm still trying to not go crazy on carbs (most of the time), but I'm pretty excited not to have to mess with that diabetes crap, it's such a pain to keep track of your blood sugar all the time and remember to test an hour after every meal, etc. etc.

One of my favorite moments possibly from this entire pregnancy happened last weekend. It was Luke's favorite witching hour, 4 am, and we were in our bed. (Joe got fed up with Luke's bed hogging ways and my paranoia "your blanket is too close to him, move your pillow higher, etc" and had moved to the couch.) I was TRYING my best to sleep while Luke watched Blue's Clues and flopped around everywhere. At one point, Luke was laying with his head at the foot of our bed and his feet resting on my belly. Almost immediately, as soon as he put his feet on my stomach, the baby kicked, right where Luke's feet were, and strong enough that Luke felt it and giggled. It was such a cool moment, even at 4 am. The brothers are already playing together.

We are getting really close to a name. Maybe by the end of the week, even.

We are not at all close to ready for this baby, house-wise. It seems like it shouldn't be "that bad" because we have a 16 month old and all of his baby stuff. It is "that bad" because our living room looks like a mini Toys R Us wannabe. Kangaroo climber? Check. Cozy Coupe? Check. (Yes, we have a cozy coupe in our living room. It was too hot outside for Luke to play with it there and now it's been raining for 3 straight days, the plan is to take it outside though, at least.) Two more ride on cars. Leapfrog table. And lately Luke has been pushing his baby walker around too, right around the time I was going to put it away figuring he'd outgrown it. I am dreading adding a baby swing and everything else to the chaos. We'll definitely have to limit the toys we keep in here, but Luke's room is really small, too. I'm probably going to have to start rotating his toys in and out so some seem "new".  And then there's the baby's room. Luke's room was supposed to be Olivia's room, and it was tough emotionally to get it ready, but it was already pretty much emptied out and not too hard to do. Well, our "spare room" is about to not be so spare. (Although I doubt we'll put the baby in there for awhile.) It's our office/ guest room/ exercise room- complete with a desk, desktop computer, two printers, file cabinet, 8 million books, elliptical, twin bed, wall to floor book shelf, and large dresser. Not to mention it's where we've been throwing all kinds of random crap over the past couple years. Anyway, it is going to be a ton of work. I have no idea where we are going to put all of that stuff (good thing we have a basement, and I'm trying to sell/get rid of a lot of it.) I think we are moving Luke to the twin bed (just going to throw the mattress which is pretty much brand new on the floor b/c otherwise it's too high for him.) He hasn't slept in his crib in a month, anyway. I am seriously contemplating moving Luke to that room and putting the baby in his room. Since the crib is already in Luke's room, it would be easier. Plus that room is a lot bigger than Luke's room, so there would be more room for his toys. The downsides are that I don't want Luke to feel like he's been displaced...I'm not sure how much he would or wouldn't feel displaced given that he's only 16 months and NEVER SLEEPS IN HIS OWN ROOM anyway. The other thing is the wall decals of the giant elephant and tiger and giraffe and monkey in the tree. Luke LOVES them, he goes in there all the time and points at the animals and likes to pat the wall where they are. I mean, he could still do that even if that is the baby's room. We can't move the decals to the other room because only 2 of them are reusable- the tiger and elephant- the tree and monkey, and giraffe, can only be applied once. (And no way will I be able to convince Joe to rebuy the same thing we already have on the wall..they weren't that cheap.) I'm not sure that's a good enough reason not to move him. For now, we just need to worry about getting the room cleared out, anyway.

It is going to be a busy couple of months!