Life is full of surprises. From that unexpected gift under the stocking to the car battery that dies overnight with no symptoms to tell of. I woke this morning and was impressed with myself, having gotten both kids dressed, fed, and out the door by my 715 deadline, headed to drop them off. We didn't make it past the driveway.
The battery died. Some days, you just have to be thankful for all the moments you missed. Today, I missed my appointment for my ultrasound, but I caught up with a friend and enjoyed a long afternoon nap. All in all, a good day.
Appointment rescheduled for next Monday.
Monday, February 13, 2012
Saturday, February 11, 2012
Maternal Fetal Medicine: A Brief Overview of What to Expect
Monday is just around the corner....
Things they will check.
Nuchal translucency, this is the fluid at the back of the neck. If the NT number is high, it could mean a disorder of some sort.
They'll also take measurements of the baby's arm bones, femur, head circumference, distance across the head (biparietal diameter), circumference of the baby's abdomen. They'll measure fluid pockets around the baby. You hope for at least 10 ML of total amniotic fluid. My numbers usually are below that, which means the baby is at risk for complications later in pregnancy. They'll look for signs that the baby is swallowing fluid. This can be determined by looking at the kidneys. They'll check the four chambers of the heart, and the stomach.
They'll run a measurement of the blood flow through the umbilical cord and the placental pulse. These give an indication as to whether the baby is getting sufficient nutrients to sustain life and growth. I've run into problems here in the past as well. A decrease in blood flow can be dangerous, a reversal in blood flow is fatal in hours. With my oldest, her blood flow would stop intermittently near the end of pregnancy. They induced because the risk of it reversing once it stops is quite high.
They'll look at the placenta. In the past my placentas have been small, usually malformed. My youngest daughter's cord was too short. My oldest daughters placenta was over half dead at birth. This can be very dangerous. It's another factor that inhibits growth. When a placenta is too small or not functioning well, the baby's body will sometimes grow the vital organs at normal rates while the other organs suffer. The brain, heart, and lungs often develop faster than the kidneys, etc. This is why both my girls had trouble with blood sugar and body temperature after birth. It is also why my youngest had severe acid reflux at birth. Her body wasnt ready yet. Sometimes, in very sever cases, this kind of growth restriction can lead to multi-system organ failure.
After all that is done, they will watch for activity of the baby.
When you add all this up, calculate all the measurements. Assess all the risks, they will determine the following:
The gestation my baby measures at.
The likelihood of death in utero.
The overall health of my baby.
A treatment plan, if needed.
In the past, my babies have measured 2-6 weeks behind. Two weeks is not such a big deal, but as I get further along in the pregnancy, the numbers become more skewed. Six weeks is dangerous. To give an example, the difference in 6 weeks could be whether a baby can breathe on his own or not. Or whether he has a fully functioning brain or not. I've only lost two babies, and both were very early on, likely due to placenta problems. They weren't viable.
Even with all the risks, my babies generally do really well once they are born. It's the incubation inside my womb that seems to be the struggle.
Bedrest, lots of water, walking daily, and a balanced diet have always been the plan in the past. Oh yah, and no stress. Hahaha!
Nuchal translucency, this is the fluid at the back of the neck. If the NT number is high, it could mean a disorder of some sort.
They'll also take measurements of the baby's arm bones, femur, head circumference, distance across the head (biparietal diameter), circumference of the baby's abdomen. They'll measure fluid pockets around the baby. You hope for at least 10 ML of total amniotic fluid. My numbers usually are below that, which means the baby is at risk for complications later in pregnancy. They'll look for signs that the baby is swallowing fluid. This can be determined by looking at the kidneys. They'll check the four chambers of the heart, and the stomach.
They'll run a measurement of the blood flow through the umbilical cord and the placental pulse. These give an indication as to whether the baby is getting sufficient nutrients to sustain life and growth. I've run into problems here in the past as well. A decrease in blood flow can be dangerous, a reversal in blood flow is fatal in hours. With my oldest, her blood flow would stop intermittently near the end of pregnancy. They induced because the risk of it reversing once it stops is quite high.
They'll look at the placenta. In the past my placentas have been small, usually malformed. My youngest daughter's cord was too short. My oldest daughters placenta was over half dead at birth. This can be very dangerous. It's another factor that inhibits growth. When a placenta is too small or not functioning well, the baby's body will sometimes grow the vital organs at normal rates while the other organs suffer. The brain, heart, and lungs often develop faster than the kidneys, etc. This is why both my girls had trouble with blood sugar and body temperature after birth. It is also why my youngest had severe acid reflux at birth. Her body wasnt ready yet. Sometimes, in very sever cases, this kind of growth restriction can lead to multi-system organ failure.
After all that is done, they will watch for activity of the baby.
When you add all this up, calculate all the measurements. Assess all the risks, they will determine the following:
The gestation my baby measures at.
The likelihood of death in utero.
The overall health of my baby.
A treatment plan, if needed.
In the past, my babies have measured 2-6 weeks behind. Two weeks is not such a big deal, but as I get further along in the pregnancy, the numbers become more skewed. Six weeks is dangerous. To give an example, the difference in 6 weeks could be whether a baby can breathe on his own or not. Or whether he has a fully functioning brain or not. I've only lost two babies, and both were very early on, likely due to placenta problems. They weren't viable.
Even with all the risks, my babies generally do really well once they are born. It's the incubation inside my womb that seems to be the struggle.
Bedrest, lots of water, walking daily, and a balanced diet have always been the plan in the past. Oh yah, and no stress. Hahaha!
Friday, February 10, 2012
Sprouting Up!
Well, everything looked really good at my appointment on the 7th with my OB.
Blood pressure was good 122/82. Weight was 193.6, down a few pounds from my pre-pregnancy weight. Happy for that. Also received good news about all my labs. Everything came back clean. No Gall Bladder Disease. No thyroid problems. No pre-eclampsia. Yay!
We had a hard time getting the baby's heartbeat on the doppler, so the Nurse brought in a portable ultrasound and I saw the baby. Squirming around, that one is. Heartbeat was there, a little blink on the screen. So happy for that. Didn't get an actually heart beat per minute count, but I'm sure I'll get all those details on Monday.
Monday's the big ultrasound. They'll take all the measurements, check the fluid, analyze the placenta, measure the baby. It's going to be good, I hope. Can't wait to see how this one is growing. :)
All in all, a good appointment.
We are CONSTITUTIONALLY SMALL afterall!
So the girls had their 4 and 6 years well check ups, and once again I broached the issue of height/weight with our daughters' pediatrician. Dr. Ott is wonderful, and he sat down and explained to me why I don't have to be even a bit worried right now. The girls are both in the 3rd percentile for height. Hailey is also in the 3rd percentile for weight, and Clara is in the 25th for the same. However, when you factor in my height and my spouse's height, you come up with 5'3. Now, subtract 5 inches because they are girls and you get 4'10" as their GROWTH POTENTIAL. If you find 4'10" on the growth chart, it is the 3RD PERCENTILE for an adult female! How's that for special math! Yay! So, they'll monitor their growth and their weight and see what happens. More than likely, they will just be normally petite. But if they deviate below the 3rd percentile we may consider HGH supplements. But there's a good size window before we have to worry about that. So thankful for some relief in this realm of littleness.
Sunday, February 5, 2012
Baby Gear Dilemma
With each of our girls we were so blessed to receive all the items we needed, and as our children grew out of those things, we passed them on to others in need. Over the years I have been able to pass on cribs, bassinets, pack n plays, swings, high chairs, car seats, strollers, clothes, boxes of diapers, etc. It is a wonderful feeling to know they are going to a family welcoming a new child into the world, one who needs the kindness of strangers.
That leaves me in a pickle. With my youngest being four, I've passed forward all of our baby and toddler gear to people who could use it. So now, it's my turn to take a spin around the block again. Because we will be moving shortly before this baby is born, I hesitate to buy anything right now. But I am setting aside the funds to do so. At the same time, I don't want to wait til the last minute, have this little sprout early, and not have anything ready. What's an expectant mother to do?
Do I buy the stuff now and have it all shipped to the new house, or do I store it in the walk-in closet until we move? Or do I just wait until after we move? Oh the choices.
Saturday, February 4, 2012
Writings from Today
**These writing are not entirely true occurrences. They are part the rambling of my own conscience and part past experience, but very well depict how I feel and what I'm struggling with right now, for that, they are post-worthy**
A Mother's Worries
The day before Valentines Day, I will enter the office of a Maternal Fetal Medicine Specialist, for the second time in my life.
I will fill out pages of forms, sign my name a dozen times, and give my weight in blood. They will usher me into a room where I will wait, to speak to a Nurse about the possibilities awaiting me. And then, I will put on a gown and lie on a table, a cold, lifeless table. The Doctor will enter the room, almost cheery but more somber. She will spray blue gel on my flabby stomach and tell me two seconds too late that it might be cold. The screen above me will be on.
And for a second, I will see a whole life flashing before my eyes. It will be beautiful, precious, and scary. Because the moment I see this precious thing, this alien of my own blood and DNA, I will realize all my worst fears.
The news will filter through my ears like the teacher from Charlie Brown's cartoons. "Wah. Wah. Wah wah."
The gel will be wiped off, the screen turned away, and I will be left on the table to dress and wait some more. The Doctor will meet me in a sterile room with a desk, to talk about our "options" and "plan of treatment," as if there really were any other option than coming to grips with the reality that my perfect little creation is imperfect, and perhaps dangerously so.
The drive home will be a blur. I'll likely run a red light, or maybe only a yellow one, for the second time in my life.
But when I get home and all is quiet, the ache will begin in my heart. I will cry.
Not because I'm scared of the possibilities, but because sometimes loving hurts more than I can bare. Love is forever and unconditional.
So no matter what the ultrasound showed the morning before, on Valentine's Day I will get up and put on a smile. I will wear my heart on my sleeve and decorate Valentine's cards, for all of my children. The ones I've lost, the ones I've gained, and the ones I have yet to meet. Because love is forever, for me.
Stained Red by Life
Valentine's Day is fast approaching, and I'm dreading it. This year anyway. The truth is, it's mostly been a wonderful time in the past, but this year it feels tainted, somehow lost in the somberness of that appointment, in the reality that high risk is yet again the name for me and this child. That loving also means letting go, maybe sooner than you ever hoped. I love against all odds, and hope against all science that this baby will grow. That all the vital organs will be perfect. That small is the only problem we have. I hope against medicine and blood tests that chromosomal abnormalities will not happen to us. But the odds are stacked high, and not in our favor.
I've been through this before. I know how to navigate the appointments. I understand the risks. It's like a worn dirt road with familiar bends and pitfalls.
No one quite seems to understand it. My friends dismiss my worries, even the diagnosis from the Dr becomes some cute little reassurance in their ears, echoed back to me in my own. It hurts, a dull knowing ache for their ignorance. For them, it really is bliss. "Your babies are just small" they chime. It gives me migraines every time I hear the words. They seem to fail to understand the very definition of the diagnosis: Intrauterine Growth Restriction is the failure of a fetus to grow to its potential size, NOT excluding genetic factors.
Yes, we are small people, but the diagnosis takes that into account. And there are other markers, other complications, that we have to handle. It's not so cut-and-dry as my friends make it. "Your babies are just peanuts," they remind me when I tell them of my appointment at the specialist office. I just smile and walk away, thankful for their optimism, how ever unfounded it may be.
A Mother's Worries
The day before Valentines Day, I will enter the office of a Maternal Fetal Medicine Specialist, for the second time in my life.
I will fill out pages of forms, sign my name a dozen times, and give my weight in blood. They will usher me into a room where I will wait, to speak to a Nurse about the possibilities awaiting me. And then, I will put on a gown and lie on a table, a cold, lifeless table. The Doctor will enter the room, almost cheery but more somber. She will spray blue gel on my flabby stomach and tell me two seconds too late that it might be cold. The screen above me will be on.
And for a second, I will see a whole life flashing before my eyes. It will be beautiful, precious, and scary. Because the moment I see this precious thing, this alien of my own blood and DNA, I will realize all my worst fears.
The news will filter through my ears like the teacher from Charlie Brown's cartoons. "Wah. Wah. Wah wah."
The gel will be wiped off, the screen turned away, and I will be left on the table to dress and wait some more. The Doctor will meet me in a sterile room with a desk, to talk about our "options" and "plan of treatment," as if there really were any other option than coming to grips with the reality that my perfect little creation is imperfect, and perhaps dangerously so.
The drive home will be a blur. I'll likely run a red light, or maybe only a yellow one, for the second time in my life.
But when I get home and all is quiet, the ache will begin in my heart. I will cry.
Not because I'm scared of the possibilities, but because sometimes loving hurts more than I can bare. Love is forever and unconditional.
So no matter what the ultrasound showed the morning before, on Valentine's Day I will get up and put on a smile. I will wear my heart on my sleeve and decorate Valentine's cards, for all of my children. The ones I've lost, the ones I've gained, and the ones I have yet to meet. Because love is forever, for me.
Stained Red by Life
Valentine's Day is fast approaching, and I'm dreading it. This year anyway. The truth is, it's mostly been a wonderful time in the past, but this year it feels tainted, somehow lost in the somberness of that appointment, in the reality that high risk is yet again the name for me and this child. That loving also means letting go, maybe sooner than you ever hoped. I love against all odds, and hope against all science that this baby will grow. That all the vital organs will be perfect. That small is the only problem we have. I hope against medicine and blood tests that chromosomal abnormalities will not happen to us. But the odds are stacked high, and not in our favor.
I've been through this before. I know how to navigate the appointments. I understand the risks. It's like a worn dirt road with familiar bends and pitfalls.
No one quite seems to understand it. My friends dismiss my worries, even the diagnosis from the Dr becomes some cute little reassurance in their ears, echoed back to me in my own. It hurts, a dull knowing ache for their ignorance. For them, it really is bliss. "Your babies are just small" they chime. It gives me migraines every time I hear the words. They seem to fail to understand the very definition of the diagnosis: Intrauterine Growth Restriction is the failure of a fetus to grow to its potential size, NOT excluding genetic factors.
Yes, we are small people, but the diagnosis takes that into account. And there are other markers, other complications, that we have to handle. It's not so cut-and-dry as my friends make it. "Your babies are just peanuts," they remind me when I tell them of my appointment at the specialist office. I just smile and walk away, thankful for their optimism, how ever unfounded it may be.
Friday, February 3, 2012
Catching Up the First 10 Weeks
Week 7
Went to women's clinic at 7 weeks. Low level limited scan (just to confirm pregnancy dates). Ultrasound technology is not very good, but we see a sac with a bean in it. Measuring a bit behind, but with a good heartbeat of 126 bpm.
First OB appt on Jan 30th. Preparing for 1 healthy baby...
Week 10
Had my first routine OB appointment on Jan 30, 2011, and it was anything but routine.
My medical history was so long the nurse had to pull out another piece of paper. Laughing.
Then, she sends me for 6 vials of blood and orders a 24 hour urine. My blood pressure is high enough to warrant one.
Okay, fine, I can do this right?! Well, she talks to the Dr and they decide I need to come back in the afternoon to be seen by an actual physician. Okie dokie.
So I go get lunch and come back. They check my blood pressure a third time. It's still high. I'm now supposed to make a trip to CVS or somewhere and keep a journal three times a week of my blood pressure. Alright, easy enough.
They suspect I have gallbladder distress. That's what they think is causing the pain episodes I'm having. Yay. So they want a baseline test for that. Which I'm doing on Wednesday.
Oh yah, and by the time I finished my morning appointment, I had a referral in my hand for Maternal Fetal Specialists.
So much for hoping for normal. Next appointment is next Monday for a routine OB physical exam.
At some point soon I hope they will let me see my baby or hear the heartbeat. Going through all that I did today without either makes me kind of worried.
Breathe. In. Out. Smile. It's going to be okay, right?!
UPDATE FOR WEEK 10
Heard from the office Jan 31, 2011. Three nurses called me Feb 1, 2011 to make sure I had gotten the referral information.
I go to Wilmington Maternal Fetal Medicine on Monday Feb 13th for my first growth scan. Growth scans are done every 2 weeks.
I have appointments with my normal OB office on Mon Feb 7th.
Turned in my 24 hour urine today, and had a comprehensive baseline blood draw to check for gall bladder disease.
I imagine all those results will be in by Monday. At least, I hope they are.
So. Im trying to take it easy and rest. I am super tired all the time. Maybe I need some iron? It doesnt matter how much sleep I get, I still spend a good part of my day in bed.
Went to women's clinic at 7 weeks. Low level limited scan (just to confirm pregnancy dates). Ultrasound technology is not very good, but we see a sac with a bean in it. Measuring a bit behind, but with a good heartbeat of 126 bpm.
First OB appt on Jan 30th. Preparing for 1 healthy baby...
Week 10
Had my first routine OB appointment on Jan 30, 2011, and it was anything but routine.
My medical history was so long the nurse had to pull out another piece of paper. Laughing.
Then, she sends me for 6 vials of blood and orders a 24 hour urine. My blood pressure is high enough to warrant one.
Okay, fine, I can do this right?! Well, she talks to the Dr and they decide I need to come back in the afternoon to be seen by an actual physician. Okie dokie.
So I go get lunch and come back. They check my blood pressure a third time. It's still high. I'm now supposed to make a trip to CVS or somewhere and keep a journal three times a week of my blood pressure. Alright, easy enough.
They suspect I have gallbladder distress. That's what they think is causing the pain episodes I'm having. Yay. So they want a baseline test for that. Which I'm doing on Wednesday.
Oh yah, and by the time I finished my morning appointment, I had a referral in my hand for Maternal Fetal Specialists.
So much for hoping for normal. Next appointment is next Monday for a routine OB physical exam.
At some point soon I hope they will let me see my baby or hear the heartbeat. Going through all that I did today without either makes me kind of worried.
Breathe. In. Out. Smile. It's going to be okay, right?!
UPDATE FOR WEEK 10
Heard from the office Jan 31, 2011. Three nurses called me Feb 1, 2011 to make sure I had gotten the referral information.
I go to Wilmington Maternal Fetal Medicine on Monday Feb 13th for my first growth scan. Growth scans are done every 2 weeks.
I have appointments with my normal OB office on Mon Feb 7th.
Turned in my 24 hour urine today, and had a comprehensive baseline blood draw to check for gall bladder disease.
I imagine all those results will be in by Monday. At least, I hope they are.
So. Im trying to take it easy and rest. I am super tired all the time. Maybe I need some iron? It doesnt matter how much sleep I get, I still spend a good part of my day in bed.
Here We Grow Again!
In the last year, my family has undergone radical changes- both scary and wonderful. Evan and I have embarked on a new journey in our marriage, and it is honestly the most wonderful gift ever. We've finally come around the bend and we can see the light and joy we were missing for so long. I'm so thankful to have such an amazing husband. I feel truly blessed each and every day.
Clara and Hailey are quite a pair. They're four and six now, and their check ups are next week, so be sure to check back about that. We're hoping to get some answers about the girls' growth at this appointment, rather than them just being dismissed as little by proxy. More on that next time.
Hailey is the best big sister and the worst big sister ever. She goes from complete adoration to total frustration in a matter of seconds. I can catch her teaching her sister the alphabet, numbers, colors, days of the week, shapes. And then five minutes later, I find her with her arm mid-air about to hit her sweet sister. It's quite a challenge, this sibling gig. She's in first grade and is becoming quite the reader. Very proud of her for that. Her latest obsession in the book world: Fly Guy! When she's not in school, she likes to color, play dollhouses, chase her sister outside, and spend time with the token family furrball- Callie.
Clara is the ham of the house. She's got her daddy's sense of humor and her mama's giggle reflex. Everything is funny and happy in her world. She's in preschool, and has made quite the impression on the preschool director, Mrs. Patty. She is a little learner by heart, but she also is a mama's girl. She misses staying home with me all the time, and asks each morning if it's a stay home day, and pouts when I tell her it isn't. I still have her home two days a week, so we do have our special cuddle times, which makes me one well-loved mama.
As for me, I'm still in school, and struggling to get through my final semester. I've had a few set backs and quite a few accomplishments. And now the really big news, as the title suggests, we're growing again! That's right, Evan & Sarah, Hailey & Clara are welcoming Baby Sprout into our lives in August 2012. What a way to grow! Evan and I are quite excited, but we haven't told the girls yet. We will soon, so keep our secret for us just a little longer, will ya?!
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