34 Week Appointment

Pretty blah appointment actually. It was extremely fast. My ob looked like he had just been to the war and back and I really wanted to tell him to cancel the rest of the day and go home and sleep. Or hand him my latte and tell him he actually needed it a whole lot more than I do. Anyways, it was bad enough that I was glad he takes extensive notes because I am not sure he would remember seeing me, especially since at one point he called me by the wrong name. And we know each other – we run in similar social circles and when we see each other at the Court Club, he always remembers us by name.

Let’s see – baby is 50^th percentile. Great. Amniotic fluid is at a “normal” level – which he was skeptical about especially given that I am still measuring 2 weeks ahead. He thinks it was an artifact of not having a high res ultrasound. He explained how the measurements are taken in each of the four quadrants, but if you see cord in any of the three quadrants, you don’t use that quadrant’s measurement. Well you don’t have to be a statistician to see that can cause major problems in measurements. He suspects that my fluid is still high, but not crazy high. So for now we are just going to go forward calling everything normal.

Baby was head down, but not engaged, he is “floating”. I could have told him this. He swaps positions all the time. I usually wake up with him transverse and throughout the day he switches head down. The other night I swear he was doing somersaults while *I* was trying to sleep.

We talked about my crazy heartburn, but he felt that by the time we got me switched over to one of the other meds for that and it kicked in (since the drugs a step up are a more cumulative effect type of thing), I will have birthed. Talked about the contractions. I had one hefty one this morning that did the full on start in the back and radiate around my sides to my belly and lasted for 60 seconds while I gasped and tried not to make a huge deal out of it as I leaned on the counter in front of the kids. Only a few mild contractions after that and none but the usual Braxton Hicks on occasion since then.

I am under direct orders not to show my face at my next appointment until I have registered at the hospital. My day is open on Friday… maybe I will do lunch with my husband and run and do that then.

Heart rate was 130-140 bpm.

Weight gain – oh my. I am convinced it is a ton of water weight though. Suddenly my rings had to come off, my hands have swollen and my feet are swollen. But then again it may be indicative of my desire to actually eat again. Ok, the number. I am up a total of 16 lbs now. So I think that puts me at a weight gain of 5 lbs in TWO weeks!! ACK!

BP: 124/76

I think I am finally feeling like this IS going to happen soon. We talked to the kids about it the other night. Explaining that they will have to go and stay with our friends. If history holds true for me, it will be in the middle of the night. We will have a bag for the kids and their sleeping bags and drop them at one of our friends’ house. Leif’s big concern was what happens after 5am? Hans and I sat there and pondered what he was asking. Finally he explained that he was concerned about what happens if dad has already gone to work (at 5am) and mom goes into labor then. What is he supposed to do? I think we worked out that it won’t be a big deal, the baby doesn’t just come spraying out, there will be time for me to get them to a friend's house and dad to come get me or something. (I hope.)

I have some things to clear up at work. One report I need to get out the door. A few monthly and quarterly reports I need to write or at least outline for my replacements. Things should be pretty good there. I do have a delegate replacement and she cracked me up after one of our meetings yesterday. “You will be able to talk on the phone when we need, right?” she asked. “Of course!” I exclaimed. “Good,” she said, “because you might think everything is going to be easy and smooth, but he is going to flip out at least once without you here. You know he completely relies on you.”

Good to know I am needed.

I met with my HR department straight after my appointment today and all was as expected. No surprises there. I am hoping to be able to be out on leave through the end of the school year… though not sure that will actually happen for a few reasons (possibility of birthing well before due date, potential of husband on furlough – nice to have him there at home with us, not nice for both of us to not be receiving paycheck if I take unpaid FMLA to cover that time… ).

 

Update 33 weeks 5 days

I am closing in on the 34 week mark and looking forward to my next prenatal. The ultrasound last week went well, but it is always interesting how some techs inspire confidence and others… just don’t.

She was nice and all, but seemed more focused on getting us good pictures of the face and feet on her non-high res ultrasound machine (believe me I have good ultrasound pictures from a high res machine) then getting good measurements of fluid and baby. Anyways, that didn’t inspire confidence in the scientist side of me. She said fluid levels were “about normal” and baby was about 4 lbs 13 oz (I saw the four measurements - they oscillated between 3 lbs 12 oz and 5 lbs 4 oz - also little confidence there), which is almost a half-pound over normal for 33 weeks. At the ultrasound he was head down, but he seems to swing between transverse and head down pretty regularly. I routinely wake up in the morning with a VERY transverse baby sticking out on both sides and sometime during the day he switches to head down. So I don’t know if it is my sleeping position that is prompting the transverse swap or what. Either way, I am not terribly concerned about it, he seems to routinely go to that head down position, so I suspect at some point he will go there and stay.

 

The nursery is about 90% done. Painted, nearly set up except for the crib – which needs a bit of work. And I need to clear out the closet and the many Rubbermaid bins scattered all over the floor. I have washed 80% of the stuff that needs washed. Nearly everything 0-9 mos has been washed and sorted into dresser drawers. Everything 12 mos and up is sorted into Rubbermaid bins that will be labeled and stacked in his cleaned out closet.

 

There are only a couple things - small things - I need to buy still. Basically a new hand pump (my old Avent Isis just looks nasty) and replacement pump parts for my electric. Neither is high on the “must have now” list.

 

Names… oh my. I don’t even know what to say. We had it narrowed down to #1 and #2. Then AB decided he wasn’t that into #1. I liked the name, but it was probably in reality my #2 name. It is amazing what this admission did… that poor name is nearly off our list now. The #2 name (the uber-popular non-Scandinavian name – uber-popular, in our world at least, means it made the top 300 boys’ names in the US in 2011) is now about top of the list and we have a whole other list of possible contenders including a couple that are a bit out there (thanks AB...). And don’t even get me started on middle names.

 

I mentioned the other day in Leif’s presence to someone that we didn’t have a name yet. Leif said, “I thought it was (insert prior #1 name)?” So maybe he does listen?

 

I have had a few people recently ask how I feel. I think I must be looking huge or something as I have had a few people jump on me about my plans and setting things in motion for my leave. With the last two kids I was just a peon working on projects for the most part. Taking 8 weeks off had little impact on what I was working. Not so this time around. Though one of my good friends and coworkers put it to me this way, “honestly, it may seem like 8-10 weeks is a long time to you, but it is going to fly by in the blink of an eye to us. Seriously you will be gone and then you will be back. Just like that!”

 

My role has changed at work in the last 5 years to Project Manager from Scientist. Which means I have responsibility for scope, schedule and budget of presently 6-7 projects. Not to mention that I have 9 proposals/white papers currently pending responses from potential clients who are likely sitting on their hands while we push through the current budget crisis. Anyways, it hasn’t been easy to find another me. In my reviews at work I am routinely hearing how my work is diverse - at first that was bad, now it is good. I am experiencing that right now – I have a number of really great people to tap, but I can hit each one with only one of the many diverse areas I am working in.

 

The other new aspect for me is that I actually lost out on the lead of a major program because of my pregnancy. And the managers weren’t shy about telling me, “I am sorry, but we need someone who can over the next 6 months nurture and care for this client since this relationship is already on the rocks.” I totally get it – I would say the same thing in their shoes. They had come to me and when I went to the meeting I could see their eyes bulge when they realized just how far along I was. But at the same time it bums me out a teensy bit to miss out on a big opportunity. One of the managers has made a few concessions to me – I can tell he feels bad about it. He has two things ready for me to lead in FY14… provided they get funded.

 

It’s the tradeoff being a professional working mom. A tradeoff I will deal with because while I really enjoy what I am doing right now at work, I love my family so much more.

 

So anyways, I started this section with how I feel. Honestly cruddy. I try not to complain and I try to remind myself how this is the last time I will feel a baby move within me and what a wonderful joy that is (even if times it brings tears to my eyes as he is whipping my insides into scrambled eggs). My back aches. I am having Braxton-Hicks contractions regularly and real contractions on occasion as well that stop me in my tracks and make me want to squeal. I never had these with my other two until I was in active labor. My heartburn is out of control and I have quit the pineapple and grapefruit for the most part. (And yes, we actually SAW hair on the last ultrasound – so the old wives tale is holding for me with three kids.) I am tired and grumpy. My appetite is actually returning. AB commented last night when I ate an entire meatball sandwich. I have spent 7 months basically picking at my food. This last week, food actually looks good again. Huge accomplishment!

32 Week Appointment

I remember when I worked in the dermatologist’s office and we had those patients with everything in the world "wrong" with them and who whined and whined. I can only imagine that it is 1000x worse as an obstetrician. Plus, as an ob, you get the added bonus of seeing those patients every 1-2 weeks when they are wacky hormonal and ready to birth.

 

My ob admitted to AB and me the other day they call those women, “wimpy patients”.

 

Today there was a wimpy patient in the room next to me. She was young and there with her mom, who probably wasn’t much older than me. She sobbed and sobbed and cried out in pain on a regular basis. And since the walls are paper thin I got to hear all the details – she was tired of being pregnant and very sore all over. Dr. M had checked her cervix and she was not ready to delivery (as he used to state with me and my first two, “green as a gourd”). She begged and begged him to induce her. Over and over. About four times he told her that her body wasn’t ready, the baby isn’t ready just yet, you need to just sit tight, bad things can happen when you induce someone early for no reason. (She was almost 37 weeks.) He layed out the plan – about four times – she would come back in 10 days at which point he would check her again. If she was still insistent on being delivered he would plan to induce her at 39 weeks, but not a minute before then.

 

I really like my ob, if you haven’t picked that up before.

 

He came into my office looking haggard, breathed a deep sigh of relief and said, “it is so good to see you, you probably heard next door, you are a sight for sore eyes right now!” Throughout all of my pregnancies he has commended me on my strength, my willingness to roll with the punches and face things head on. (Not that I had much of that with the first two.)

 

“I don’t get it,” he says, “you have these girls who come in with beautifully normal, non-problematic pregnancies who just do not have the ability to deal. Then you get the women like yourself where there are actual issues to work through, and they do it with grace. You have grace.”

 

I know he was venting. But I was kind of sitting there going, “ne ner ne ner, our doctor said I have grace!”

 

Anyways, onto me.

 

Let’s see, BP = 112/78. Weight gain a total of 11 lbs for the pregnancy.

 

I went to L&D last Thursday. I was having very mild contractions. I knew they were mild. But they were sore and not going away when I layed down. I called the office and since my ob was still whopping it up in New Orleans for the Super Bowl, they sent me to the hospital for monitoring. Shortly after getting on the monitor they came back and told me I had a UTI and that was likely causing the contractions. After my full hour on the monitor (hello lovely reading time) and downing a huge glass of water, they sent me on my way with heavy duty antibiotics.

 

I told my ob I felt like a dork afterwards, in some ways I feel like I should have known that was what it was, except for the fact that I have actually never had a UTI! He was glad I had gone in and not waited till my appointment a few days later as these infections can easily spread to the kidneys and that is very bad.

 

So next he determines that the baby is actually transverse. He asked me how long he has been lying transverse?

 

“Umm, probably about 20-30 mins,” I told him honestly. Seriously this baby flips and flops and rotates. Position long term? I don’t think there has been one!

 

Dr. M chuckled and tried again.

 

“Seriously, he moves ALL over, I doubt he will stay that position for long,” I told him.

 

“Well we can hope that is the case,” Dr. M resigned, “but we do need a plan just in case.”

 

Part of the problem with a transverse baby is that it throws the measurements off. Where I have been measuring big for the last two appts and Ultrasound shows too much fluid being the source for that, now we have no idea where things are and the fact that I am measuring a tad small is indicative of this. And that is concerning. So the ultrasound is this Friday.

 

The plan:

 

Ultrasound for fluid levels and baby’s size

 

Appt in 2 weeks (34/35 weeks) – check position, if transverse consider version for week 37.

 

(I bet he flips… of course Dr. M’s snarky response was “well then which way does he flip?”)

 

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!