Wednesday, October 17, 2012

Status: tentative

Still pregnant. Still very tentative on how long I'm staying pregnant. Over the weekend, my swelling got pretty bad. In my face, hands, feet. It was bad enough that Joe stopped at my sister's work and asked her to "check in on me" when she got off. (She is a manager working overnights at QT and is on Joe's way to work.) This freaked my parents out and when they saw me they were a little on the alarmed side. I managed to put them off making me call my doctor (because she already knew I was swollen on Thursday, and even though it was worse, nothing else was any worse.) and they helped with Luke a lot which was really nice.

Monday I saw my high risk doctor. She took one look at me and said, "Your face is really swollen." And then I showed her my feet which were really bad. (They do get better overnight, which is good, but get very swollen again quickly the next day, and each day it seems like they get a little worse than the day before, and a little faster.) But everything else is the same. My blood pressure is not fantastic but not bad (130/90, 130/67). He is still easily passing NST's and my fluid levels are great...around 15....not even almost borderline. He's active throughout the day. No upper right quadrant pain, no headaches, even the heartburn is mostly better. Last night I even ate lasagna and didn't have heartburn which would have never happened earlier. (Granted, I was smart and took a Pepcid a little bit before we ate.)+

So this makes things really tricky.

My MFM actually asked me what I wanted to do. That totally threw me off. I mean, I'm used to telling her what I want (no wonder she is ready for this baby to come out and be done with me!), I'm just not used to her asking.  She offered me an amnio Thursday and deliver Friday if the baby's lungs are ready. I made a face. She sighed back.

To me, the baby's lung maturity is really one of the least of my concerns. Luke's lungs were fine. More than likely, by now, this baby's will be fine too, considering I had steroid shots several weeks ago. But that's not a guarantee he wouldn't end up in the NICU anyway for trouble regulating temp, or jaundice, or feeding issues. Even if the amnio came back with his lungs mature, I would not be enthusiastic about delivering him this week at around 36 weeks exactly (Friday.) And I don't think the amnio is worth the risks this time, knowing what happened last time. Trust me, you only need to hear one story of a uterine rupture to realize how freaking lucky we got with Luke when my water broke and I went into labor the night of our amnio. It could have so easily ended tragically. If my uterus would rupture as a result of going into labor from the amnio, the baby would likely die. I could die or at the least need a hysterectomy. All to deliver him a week early? No thank you. Plus, if the amnio comes back with his lungs not mature yet, but my water breaks, we'd have to deliver him with immature lungs anyway. I've seen how the odds play out. I am in the under 1% of pregnant women who had HELLP (and an atypical case of it at that...even more rare.) I've also been told that it's pretty rare, like 1 in 100, to have your water break after an amnio. So anyway, after giving it a lot of thought, I am totally opposed to the amnio this time, in my case. Either things are bad enough to deliver regardless of if an amnio says his lungs are mature, or they aren't. Because even an amnio saying he has mature lungs is no guarantee he won't need the NICU, anyway.

Unfortunately, I keep riding this fine line of limbo, where things aren't really bad, but they aren't smooth sailing either. If I didn't have my history with Olivia, there is no question that they would not even consider delivering someone for swelling and slightly elevated blood pressures at only 36 weeks. (Some studies have found it to be the best outcome for baby and mom to deliver at 37 weeks, with a preeclampsia diagnosis or elevated blood pressure.) I don't think there's much doubt that this is headed towards trouble, I was never swollen like this with Luke, BUT we aren't there yet and there is no indication when we will get there. The baby is active and easily passing everything, I'm feeling pretty good except the swelling makes walking and everything uncomfortable, my blood pressure is still okay. No pressing reason to deliver this week except I'm swollen and we think trouble is coming, sometime, maybe. Blah blah blah, same old story.

So my MFM is going to go see me when I have monitoring Thursday early morning. If I look the same, we do this again for another week (I'll have monitoring again Monday and see her again Monday, then if we make it that far, monitoring again Thursday, deliver early Friday morning.) If I look worse, she's going to call my OB and tell her that this is it, we need to call it quits before things get bad. I see my OB a couple hours after my monitoring appointments and my MFM was really happy she "gets me" first. She had me make an appointment to see her on Monday but implied she doesn't expect that it's going to happen.

I am hoping that things stay the same, or get better (because who headaches got better, my heartburn has gotten better...), by Thursday and we can limp along a few more days at least. Even if I only make it to next Monday or Tuesday instead of Friday. (My babies really do not like to come on schedule. Just ask Luke.) I just want to get a little bit further than 36 weeks exactly or maybe not even really 36 weeks if my dates are off a day or two. But then that makes me nervous too. Because we can't really discount my history. (Although with Olivia, I had pain. And heartburn. And she had low fluid. No pain, no heartburn, great fluid levels as of now.)  And because I worry that maybe I'm being greedy, trying to push it too far, and I really do not want to lose another baby. I would also rather not spend a day or two on magnesium sulfate (ugh, awful stuff), either. I know if either doctor was truly worried or my health was currently at risk, (even spilling protein does not generally do longterm damage, even a lot of it, the kidneys typically go back to normal. And I may not be spilling protein at all..) they'd have had me in the OR already, no question about it. I have them uneasy and on edge, but not at "you NEED to deliver".  I have been in that place before, they wouldn't be shy about it, and they wouldn't be asking what I wanted to do. I want to keep this baby in as long as possible for his health, as long as we aren't putting his health or my health at risk by doing so. And it just sucks that this makes me feel guilty for being "greedy" by wanting an extra few days or a week if we're lucky. If I were an outsider on this, I would probably be screaming, "just get the baby OUT already before something horrible happens", yet here I am trying to push it a few more days.

(Joe is pretty much conflicted the same.)

On another note, we talked about future babies. Well, A future baby. My MFM said we could do this again, even with all of this latest lame drama. But this will be c-section number 3 and I think 4 c-sections will probably be as far as they want to push it. (Plus I think 3 living kids would definitely be our limit anyway.)  Instead of asking this time how long we HAD to wait, like I did after Luke was born and after Olivia died, I asked how long we could wait. Ideally 2 or 3 years, and before I'm 35. (I'm 28 till December... so we have awhile...though I will be careful not to wait too much longer beyond 30.) I don't know that we WILL have one more, even.  If we do, we want to keep our kids relatively close in age, ideally, but I do not want to be pregnant with a "pre-toddler" again if we can help it. (Pre-toddler is what we called the 12-23ish month olds when I worked in daycare, babies were under 1, toddlers were 2-3.) Luke is still so babyish and it is so hard right now to pick him up to change his diaper, wrestle him in his carseat, etc. He weighs 32 lbs and I have to carry him at least a few times a day, to say nothing of the chasing him around and trying to keep him entertained. It wasn't too bad when I got pregnant and he was only 9-10ish months old...not walking yet, not climbing yet, not running yet, not throwing his body on the floor for a tantrum, sleeping through the night, under 30 lbs. But now? Yeesh. So anyway, I guess we'll see. But I officially have the green light unless something happens.

I feel like I need to try to "enjoy" these last few days of this pregnancy just in case this is the last time we end up doing this. But it's hard because we still have so much to do, Luke is still SO.BUSY., and not knowing if I'm delivering this week or next week is really throwing me off too. More than I am enjoying being pregnant, I'm looking forward to holding a little newborn in my arms again.


Heather said...

Hello! You don't know me, but I came across your blog last week and I have been casually paying attention to see the news of your new little one arriving! I just wanted to tell you that I am NOT on the outside saying "just get that baby out!". In my opinion, you are doing the right thing by trying to keep baby in as long as possible (as long as your pregnancy is still healthy). I have had one baby at 39 weeks and one baby at 42 weeks and there was a drastic difference in their nursing abilities, tummy issues, and sleeping. The longer they can develop in the womb in a healthy way, the better! I find it the complete opposite of greedy-- you are putting your baby first by trying to give them the best start you can! So keep on keeping on-- I will be anxiously awaiting your news of a sweet little baby!

Kim said...

You are not being greedy at all! You are faced with tough decisions either way you go. It sounds like you are being watched very close and there won't be any hesitation to deliver when the time is right. Thinking of you:)

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