29 Week Appointment

So after our appointment with the high risk doctor last week I was a bit worked up and paranoid. I should now apologize to all around me.

 

We had an appointment with our regular ob, who is a pretty straight shooter with loads of experience. I just think he is awesome.

 

So yeah, I have a bit of extra fluid and it is outside of 2 sigma. But according to Dr. M, high risk doc is a great guy, but it is his job to find little concerns and turn them into big ones. He also apparently thinks that everyone has gestational diabetes regardless of the test results. Dr. M on the other hand seems quite convinced that I do NOT have gestational diabetes and stated that the baby isn’t big – he is 63^rd percentile – with GD at this point, you see bigger babies. And the truth of the matter is that I passed my 1 hour screen with flying colors. He stated he was more inclined to say that the high fluid levels are either just a fluke (i.e., we don’t typically diagnose on one data point) or it just happens with some people and we don’t know why and should count our blessings given that I am 41. He says he too often sees the opposite problem with women over 35 where the placenta starts deteriorating, fluids become low, etc. Right now all signs are that we have a very healthy pregnancy with a healthy baby boy.

 

I complained a little about my heartburn – what should I take beyond the Zantac I am taking twice a day.

 

“Let’s switch you to Pepcid, it works better. And I am assuming you are avoiding high acid foods?”

 

Silence.

 

“You know like orange juice, citrus fruits, tomato based sauces. You know this NM.”

 

Then AB starts to laugh, “You just listed off her main diet right there!”

 

Bratty husband ratted me out.

 

Yes, I KNOW I shouldn’t eat that stuff. I know it isn’t good for my esophagus (or gums) to eat grapefruit, pineapple and tomato based sauces ALL the time. But finding something else that actually sounds good. Tis not easy.

 

Dr. M was still thrilled with weight and bp – 8 lbs total gained since beginning of the pregnancy (on track for 1 lb/week until delivery) and my bp was 111/70. No swelling or water retention and in fact my rings are feeling looser – though it has been cold out and that could be the reason. He asked if I was able to keep sugar and carbs at a minimum still and asked about diet in general. Then bratty husband had to go and rat me out for a second time.

 

“She never eats!” he proclaims.

 

“I do to eat,” I said.

 

“What’s going on with the diet?” Dr. M asks.

 

“Just nothing ever tastes or sounds good except for pineapple, grapefruit or pasta,” I told him, leaving out the latte and pastry part… because they sound really good, but I really don’t eat a pastry very often. “Or I eat a bit and get full after a few bites,” I told him.

 

Thankfully he didn’t get on me about that and told AB not to worry about it so much. (So HA!) It isn’t like I am only eating candy. (Which frankly makes me gag as bad as meat does half the time.)

 

In all honesty though, this pregnancy has been very weird with food. NOTHING, absolutely nothing sounded good for the first half. And then I couldn’t keep stuff down anyways. So why eat good food that I would only be turned off of? Then the second half a few things have worked their way back onto my “I could eat that” list, but my stomach has no capacity. Not to mention that half the time I get started on something only to be turned off of it a few minutes later. Pregnancy eating is NOT fun this time around. Food will be one thing I will be ready to jump back on after delivering.

 

Anyways… good appointment. Dr. M thinks I will deliver around 38 weeks if fluid levels stay high – not 32 that the high risk doc was concerned about. Another ultrasound scheduled for a couple weeks to check fluid levels and make sure they aren’t completely out of whack. Plan is to deliver at the hospital that I had the other kids at. I asked about this because my coworker delivered at the other larger hospital. Of course if I go into labor early, like at 32 weeks, we will go there for the higher end NICU instead of the smaller hospital.

 

Phew – I don’t need to go out and buy EVERYTHING right now. At least I don't think so!

High Risk Appointment #2, 29 weeks 1 day (according to them)

What exactly was I saying about wanting to go to the ob and NOT have some issue? I think this has happened exactly twice now.

We went to the high risk doc for ultrasound #6 to check the baby's heart. Happy to say that the baby's heart, anatomy and genetic profile are all looking super.

The space surrounding him though? Not so great.

The reason I am measuring large (at my last ob appt on 12-26) and that my back aches, my legs ache, I have shortness of breath, still throwing up on occasion and monstrous heartburn? I am polydyramnios.

My amniotic fluid is presently sitting at 26 and 24 is considered high end for 29 weeks (I think he said 12 was average?).

A bit of confusion surrounding all this. They reviewed the ultrasound results and none of the "observable on ultrasound" physical markers indicate a problem with the baby (i.e., no swallowing of amniotic fluid, blockages, etc.). And the genetic tests all came back clear.

About 2/3 of the cases of polyhydramnios don't have an apparent cause. They just happen and the doctors can't figure out why. 10% of them are caused by gestational diabetes and are therefore considered manageable. The remainder are typically a physical or genetic issue with the baby (which in my case have been ruled out as best as they can).

But I passed my gestational diabetes test just fine... Given my "advanced maternal age" the high risk doctor thinks I may be flying under the radar with GD. Apparently women in their 40's don't usually just pass the one hour test...

So his recommendation is that I go straight to glucose monitoring after seeing my ob on Tuesday morning, maintaining my same diet so as to not obscure the results, in an effort to identify GD as the cause of the polyhydramnios.

All of this got me thinking, "so I have a bit of extra fluid, so what's the big deal?"This is where I started looking up on the internet... which is not always a great idea. But anyways...

Apparently a large percentage of women diagnosed with polyhydramnios before 32 weeks end up with ruptured membranes (broken water) or preterm labor and if not stopped, deliver by 32 weeks. Of course in order to stop the preterm labor and keep it maintained, that means bed rest. Other complications include placental abruption, umbilical cord prolapse, hemmorhaging post delivery and the doctor may recommend a c-section delivery to avoid potential complications with a vaginal delivery.

Either way (GD or not) it probably means weekly non-stress tests and every other week ultrasounds (according to the high risk doctor). If it gets bad (according to the internet) they will drain off fluid through an amnio. Or there is a medication that can be used up to 31 weeks, but has some not so great side effects for the baby - so risk benefit needs to be assesed.

So hmmm. This is where we sit now.

I don't want this weekend to fly by exactly - I have loads of things to do (buy baby stuff, paint - provided we can decide on a color which isn't looking terribly likely, finish his quilt, and start washing baby boy clothes so I can assess what I have and what I need). But at the same time, I am really looking forward to Tuesday morning for my ob appointment, which AB will be attending with me.

Moving along...

Getting closer… (written before the high risk doctor exam on 1-18-13).

It’s been harder to maintain the blog as I must be nesting. Everything needs to get done… NOW!

The baby’s room is ready to paint. I still have bought next to nothing (hopefully will remedy that this weekend or next). The quilt is nearly half done. The kids are getting excited. And the house can’t get clean enough.

One of my good work friends just had his baby Monday night. I got his e-mail first thing Monday morning that they were headed to the hospital. It is hard to explain but it sent a wave of panic through me! I knew they would be fine. We have the same fabulous ob, she is a nurse, he’s an engineer. Under control. (At least from my far removed perspective.) But as a typical pregnant woman I have to make everything about me. Oh my goodness we are next! Oh my goodness I am not ready! Oh my goodness who is going to take care of the kids?! Oh my goodness how is this all going to go down? Oh my goodness in theory (though I never go into labor early and always go late) this could happen any day now and I don’t even have a carseat! Oh my goodness we haven’t visited daycares yet! PANIC!!

Pulling myself out of the “it’s all about me” mentality… They had a healthy 7 lb 14 oz baby boy and all is good.

29 weeks. 11 weeks to go (if I am lucky and not overdue). I am feeling good. Much better now that my anemia is under control actually. My typical cravings have set in – grapefruit and pineapple. I am trying to moderate myself so that my gums don’t completely freak out. Leif is helping with that because every time I grab a grapefruit he requests half. At least. This morning he requested my other half and then begged for another half on top of that. And then the little turkey didn’t even give me the remnants to squeeze the remaining juice out of… he squeezed it himself and drank it.

I feel as big as a house and AB laughs when I tell him this. “But you still have 11 weeks!”

My body is tired though. I have many more Braxton-Hicks contractions than I ever had with the other two. My back aches. My legs ache. I can’t eat much of anything without getting crazy heartburn. Ok, honestly I can’t eat much of anything because my stomach has shrunken or maybe disappeared altogether. Nothing sounds good to eat (except grapefruit, pineapple, lattes and pastries). Beer sounds good. Wine sounds good. Food, in general, sounds nasty. Meat? Blah. (Which doesn’t help the anemia issue…)

Names… we have one. Maybe we have two or three. AB prefers to see the baby before selecting a name – but the main problem with this comes about when we only REALLY have one name selected and we both like it. It is kind of hard not to think that we haven’t already named him. We actually do have a name #2 – but it isn’t Scandinavian (it’s Hebrew). And it is actually on the “popularity list”. And probably even worse yet is that it is on a major television series. Thus it breaks like every rule ever for a Carman baby. But it sounds great with our kids’ names and we like it. That one is our back up I guess.

As usual for us, we won’t be sharing the name beforehand. You could probably tease it out of the kids, though every time we bring it up they come up with other names. So I am not sure they are taking OUR selection terribly seriously. Last night Skadi came up with a new name – Brandon. “And we can call him Baby B or Baby Brandon”. It is one of the few “normal” names my kids have come up with. Cute, but no. I tried to explain that Leif, Skadi and Brandon just don’t go together very well… as opposed to Leif, Skadi and (insert other male Scandinavian name) goes a whole lot better. She wasn’t buying it. Brandon…

On finding out the gender

I don't think it is a secret that with my first two, we didn't find out the genders. With Leif it was something we thought we were supposed to do. AB and I were relatively indifferent to finding out the gender of the baby I was carrying, but so many people around us were anxious to find it out. And being that I was 32 and healthy, I got my one of two ultrasounds I had that pregnancy. So it wasn't like we were in having looks at the baby every few weeks. We finally made the decision to find out.

And that little baby was not cooperative. Then we enjoyed not knowing the gender! We drove our family and friends nuts.

Then the second time around with Skadi we decided not to find out. We loved not knowing!

It was a bit more difficult with decorating and maybe this is why Skadi is over the top girly is that she spent those first few years of her life in a gender neutral room. And clothing - well I had the logistics of having to buy two outfits to take to the hospital and return one. And then dealing with gender neutral stuff for those first few months with only a few gender specific clothes sprinkled in.

A friend of mine when I was pregnant with Leif said that she felt she bonded better with her baby after finding out the gender. She could assign a "her" (and therefore a name) to the baby and not a moniker. One of the guys I work with once told me that his wife HAD to find out. That they would be going back to the ultrasound tech and paying out of pocket to find out the genders of their babies had they not been cooperative. The reason? Because she was very organized and couldn't proceed with her planning without knowing the gender. Then there is my sister - who is just one of the most impatient people in the world and loves to know the surprises in life! She always has!

I do love how people are so different and I think it very important to emphasize that differences are good. I didn't fall into any of the above categories. I bonded just fine with the monikers we assigned to the first two babies. I am a huge planner, but I just planned not knowing the gender. And I love surprises. If I could I would just sit there with my Christmas presents in front of me for as long as possible without opening them and just admiring and considering the possibilities. I love the anticipation and upon finding out a gift, it isn't that I am let down or disappointed, but that rush of anticipation is gone and leaves a little bitty hole behind.

So as I told my husband this morning, "if we were to have another baby, which we aren't, I wouldn't find out the gender."

It isn't that I am disappointed. I guess it is hard to explain. Maybe it is that I feel that anticipation let down that I feel after opening my Christmas presents?

I do love being able to paint my last nursery gender specific and grab a few outfits on clearance. And the ability to chop our name list in half once we found out. I love hearing my kids talk about their baby brother. I enjoyed my daughter telling me that she really hopes that the new baby doesn't look JUST like Leif as she doesn't want to be surrounded by Leif's. I like all that.

But I REALLY love the surprise reveal after 40 (or 41) weeks and the labor!

No gestational diabetes!

What a huge relief!

It is amazing how we can convince ourselves that something is wrong. And that we know what it is. Blame the internet?

No, we don't all need bloodwork, we just need symptoms and access to the internet!

Even though websites said that most people with gestational diabetes don't have symptoms, I was positive I did. Lethargy, slight nausea = gestational diabetes. Has to right?

Wrong.

It also equals anemia. Turns out I am actually very iron deficient. Probably not terribly surprising now that I think about it. Meat products - not particularly my favorite right now. Even the, albeit very delicious, prime rib my husband cooked for Christmas? Ehhh.

And then last night I gave in and we went to Bob's Burgers and gasp, I actually ordered a burger and ate it. Then I woke up feeling actually pretty good comparatively to what I had been feeling the past week or so. I could get myself out of bed without a force of nature (i.e., my kids) pushing me out.

I stopped by the grocery store on my way home and stocked up on beef. My husband is in heaven. Fajitas tonight, short ribs tomorrow or Sunday, loads of spinach. And lots of citrus to help the absorption of that iron. That one I can buy into easily.

Hopefully I will start feeling better soon!

(AND I CAN STILL HAVE SWEETS!!)