Thursday, January 27, 2011

23+3, and high risk appointment (it's a long one)

Well, I've at least made it one extra day this time, hopefully with many more days to go.

So my high risk doctor appointment yesterday wasn't the greatest, mainly for a bunch of little reasons.(It wasn't especially bad, just annoying more than anything.)

First, she thinks that the dizziness is probably gestational diabetes- my blood sugar getting too high. (Funny because my ob thinks it's from my blood sugar being too low, which lines up more with what I've seen online.) I'm not a doctor, but I really don't think it has anything to do with food, because on Sunday I got dizzy and I'd barely eaten anything that day, every other day I've been sure to eat because that was my ob's advice, but my times of eating have varied, and it always starts at 2 - 3 pm regardless of what I have ate or haven't ate and what time. I'm not saying I don't have GD because with PCOS and a history of pre-eclampsia (well HELLP), I'm at higher risk for it, but I find it doubtful that's really causing the dizziness. (Dr.Google does not mention anything about dizziness being a sign of GD.) I was going to do my 1 hour glucose test at 26 weeks before my OB appointment, but if it's really GD and it's really so bad that it makes me dizzy for 8+ hours a day, we should probably know about that and try to fix it (argh) sooner than later. So I have the drink and the lab slip already so I'm going to go do it on Monday. I'm going to ask the lab tech how long the results take and call my ob's nurse and ask them to test my iron levels if I pass it, because I'm still not convinced it isn't anemia. (I take my prenatal vitamins at night around 11 pm, they have iron in them, and I never wake up dizzy in the morning and I feel fine every morning until around 2 pm to 3 pm. That might explain why it's an afternoon thing. Maybe I'll take them around noon tomorrow and see what happens.)

I can't remember what I weighed last time at the high risk doctor (it's kind of confusing because my ob's scale and high risk ob's scale give totally different numbers). In any case, I've either gained 4 lbs in 2 weeks or 7 lbs in 2 weeks, hopefully it's 4, I should have asked. My diet really hasn't changed and I'm not really doing a lot less than I was before, I wasn't doing much before. The first trimester, I actually lost 5+ pounds and I didn't start actually gaining weight until 20 weeks, so they aren't really concerned about my total gain, just that I put on so much pretty quickly. My ob checked for swelling last week and high risk ob checked me again today, no swelling. I think my belly is bigger than it was 2 weeks ago. But still, this happened about 3 weeks before I got sick and we (including my ob) didn't notice swelling then. So, it has me a little freaked out for impending doom.

And then there were a bunch of little things that got on my nerves, because some of the things she said the last time I saw her, she told me totally different things today.

Like the notching. It's bad. It means they have to watch me more closely. (That's not new/different.) But yesterday she tells me she's not that concerned with checking it again because even if it's gone away, they still need to watch me more closely. And she's more concerned with keeping an eye on the baby's growth than the notching because if the notching gets bad/worse, his growth will likely show it. Last appointment, she said to try not to freak out because the mild notching was our "baseline", which implied to me that they planned on looking at it again because what's the point of having a baseline if you don't check again later? My ob said last week that in the plan my high risk doctor wrote her, it included after my 20 week ultrasound to check the blood flow every ultrasound, and she said that if the notching gets worse she wants me on bedrest, for sure. I mentioned the part about bedrest to high risk ob and she said, "Eh, don't go looking for trouble. You'll be on bedrest soon enough."  Uh, I'd rather be on bedrest before the trouble starts to hopefully prolong it from starting as long as possible. Anyway, I plan on disregarding what my high risk doctor said (about not looking at the blood flow again) and if the tech doesn't automatically do a blood flow study (I'm pretty sure they should have a copy of "the plan" in my file somewhere so they might just do it), I'll mention what my ob said about wanting me to go on bedrest if notching is worse and hopefully they'll check it. But I'm not holding my breath on that. I'm not going to be a happy camper next week if they don't look at it at all. (My high risk doctor didn't say that they shouldn't/won't look at it for sure, she just isn't going to specifically tell them/ask them to look at it because she doesn't really think it matters, suddenly. There was notching, that is bad, the end, basically. My ob does want them looking at it, she wants to know if it's worse, so I'm just going to say that if I need to.)

And then! At my last appointment, I asked if we could do the amnio at 36 weeks exactly and deliver when the results were back (apparently they should be back within a few hours so we'd be set to go for 36+1.) She said she'd much rather do the amnio at 36+1 and have delivery at 36+2. Fine, so I talked to my ob about that last week and she said that works out perfectly because her surgery day is Wednesday anyway and that's when I'll be 36+2. So yesterday, when I told high risk ob that ob wants to put my c-section on her schedule now so tell her when we're doing the amnio for sure, she looked at the calendar and said, "So do you want to do it Monday (36 weeks?) or Tuesday (36+1)?" If I had known I could have done it on Monday, I would have asked my OB if she could schedule my surgery for Tuesday, but I didn't, so I didn't want to tell her let's do the amnio on Monday since that's suddenly now okay but wasn't okay a week ago. Anyway, it's just a day difference, so I just stuck with the original plan, amnio is scheduled for 36+1 on April 26th, and delivery will be 36+ 2 April 27th. (My friend was told by a different high risk doctor in the same practice that they actually just keep you after the amnio and only send you home if the lungs aren't mature, but she's getting induced so I don't know if they will keep me since I'm having a scheduled c-section and all.)

Anyway, the gist of the appointment was that she's not worried (and would tell me if she was worried), but watching me extra closely, and still concerned about the notching and a little about the weight gain, not really too concerned about the dizziness, and we'll see how the baby looks next week and if I pass the 1 hour test.  (I guess GD would explain the weight gain, at least.) I see her again in two weeks, so that keeps me covered with appointments for the next 4 weeks: 24 wks ultrasound, 25 wks high risk ob (and labs), 26 wks regular ob, 27 wks high risk ob (probably), 28 wks ultrasound (probably). It's going to make me crazy if she keeps changing what she says. (I can just see it for my appointment in 2 weeks, "of course you didn't have gd, that shouldn't make you dizzy, it's probably....") Anyway, I still like her, but some consistency would be nice and I think she's a little too cavalier about "oh I'm not worried yet"...luckily my OB IS consistent, I think she has my chart memorized, and she worries what I deem "enough" and not too much.

Helping out was a lot harder than I expected. I didn't realize that Maggie's office is on the labor and delivery floor, I mean, it makes sense that they would keep her there (she runs all of the support services for families who lose babies, stillbirths, miscarriages, NICU losses, the support group plus sort of acts as a grief counselor), but for some reason it didn't occur to me that's where they would put her. So yeah, that was a fun time walking through that floor yesterday with her. I sat in her office and cut bubble wrap for the Valentine's day thingies, and cut little stuffed animals out from their boxes, and labeled things with stickers, and then went to meet my friend and fellow pregnant again baby loss mom for dinner. Walking through L&D sucked again to get out, worse this time because there was a couple checking in, expecting their first, a little girl, and I was just hit with a moment of jealousy, not for their little girl but because I wish that's how it would have been for us, and just feeling sorry for myself. (And of course I got lost because when Maggie gave me directions to get out of the floor, I nodded but didn't really pay attention, so I got to stop at the nurse station because I didn't want to wander around on that particular floor a minute longer than necessary.) 

Dinner was good. Hope nobody was eavesdropping because they would have gotten an earful, not that we really cared (topics ranged from our babies dying, how the heck we're going to figure out breastfeeding, why our high risk doctors are getting on our nerves, etc.) I'm so lucky to have a friend who has been through this pregnant at the same time.

Then we went back to the hospital, but luckily just to the cafeteria and not Maggie's office, walking through the L&D floor four times in one day, on that day, would not have been my idea of a great time, two times was plenty. Too, too many babies have died in the last year. Maggie was saying they have someone new pretty much every day, some days more than one. Ugh. It was good to be around people who have been there, done that, and it felt good doing something for other people who have been through this, but it was depressing, too.

Anyway, that's all my rambling for now.


Kimberly said...

Angie, wonderful that you are, as you put it "more pregnant than you have ever been before." I am sending my most positive thoughts and hopes your way that your baby boy stays healthy and growing as long as possible! Love.

MrsH said...

My OB also changes his mind constantly, I think as long as things are not very clear they don't know what to do either. As for labour and delivery, I have to go on that floor at least 2-3 times a week as part of my job, and work with perfectly normal couples with perfectly healthy newborns. I can tell you that the key to survival is exposure, it only hurts the first hundred times.

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