April 20, 2014

Viability

Yesterday was 24 weeks, which is technically the edge of viability.

From what I've read, Kiddo has a 50/50 chance of survival at this point, and every day during the 24th-25th weeks increases those odds by 3-4% per day, then 2-3% per day during the 26th and 27th weeks.

In my usual fashion of not counting my kiddos before they hatch, I am still holding my breath a bit and cheering for every extra added chance of survival that each day brings. But overall, I'm more calm this time around, as evidenced in part by my lack of constant "dear God, please let this end well" posts.

We had the fetal echocardiogram last week to get a better look at Kiddo's heart, since Miss A was born with a couple of cardiac issues and R has Brugada Syndrome. Everything looked as expected, so barring the perinatologist's ultrasound tech suddenly seeing something obvious and unexpected between now and birth, we don't have to visit the cardiologist for this Kiddo again until 2 weeks after birth. At that point, they will do an EKG to see if any abnormal rhythm pattern indicative of Brugada's is appearing. My guess is that it won't, and that will be just the first of many EKGs to come for Kiddo, as it has been for Miss A. She gets her next EKG in a few weeks.

Next up - This week will be the gestational diabetes test. Since I had it with Miss A, I asked to just do the 3-hour version of the test and save myself the trouble of having to chug down the stuff you have to drink for it twice.

I hope all of you are having a lovely spring!

March 17, 2014

Happy 2nd birthday, Miss A!

Two years ago today, this amazing little girl entered our lives, and our world will never be the same.

Happy birthday, Miss A!

March 16, 2014

Anatomy Scan

We had the Kiddo's anatomy scan recently. Overall, everything looked good.

There is a 4-chamber heart, 3 vessels in the cord, 2 kidneys, and the brain looked good. The only thing that was kind of unusual was the ultrasound tech couldn't get a clear picture of the stomach.

She is the opposite of an alarmist - in all of our scans with Miss A and up until this point with Kiddo, she had never given even the tiniest, slightest hint of any concern. So I started to get nervous when she kept fixating on it. But then the peri looked and felt like she saw it clearly, and while she was looking, the ultrasound tech left the room to go look at the images from our past ultrasounds. She came back and reported that she found very clear images of the stomach on a couple of recent ultrasounds, so then she was satisfied, and I breathed a little easier.

Since Miss A was born with pulmonary valve stenosis, we'll have a fetal echocardiogram to get a closer look at this Kiddo's heart in mid-April. After that, the gestational diabetes test is planned for the end of April, at 24 weeks. The peri is ordering it a little early since I had it with Miss A.

Once we have the GD results back, we'll pick a day to schedule the C-section. The peri and I have not had an in-depth conversation about this, but I did bring it up at a high level a few appointments ago.

I talked about my concern that my water breaking with Miss A was actually likely a minor placental abruption, and my concern about being at even higher risk for it this time because of that history and because of the large SCH in the first trimester. Because GD, high blood pressure (which was actually very good at the last appointment - 111/64), and advanced maternal age can also all cause the placenta to start breaking down early, she was receptive to my concerns.

She wants the GD results before we pick a date because she wants to know if that is going to be an additional risk factor, but she actually seemed open to delivering during the 37th week. She prefers her singleton patients to wait until 39 weeks, and in an ideal world, I'd be all for that. But given that Miss A came at 38w0d on her own and the risk factors that I have, 39 weeks feels a bit unlikely to both of us.

I'm all for going as far into the 37th week as possible, but I really don't want to push it beyond 38 weeks. Call it mommy instincts, call it fear, but whatever it is, there is something inside me that feels like the 37th week is the safest option, and anything beyond 38 weeks feels risky.

But at this point, even 37 weeks feels like forever away. I'm 19w1d today. How is it that I'm not even at 20 weeks yet? It feels like I should be in the third trimester by now. Not that I'm impatient or anything...

February 28, 2014

So This Was My Friday...

The perinatologist's office must be updating the patient portal they recently implemented, because I received about a dozen - literally - e-mails from them today.

Most of them were appointment reminders, with a few appointment cancellations thrown in for good measure, all related to past appointments. Then came an e-mail titled "Important Health Information Message". It sounded, well, important...so I clicked on the link.

It told me that based on my most recent appointment on Tuesday, I have high blood pressure.

First of all - um, yeah, no surprise there, I've been on medication for that for more than a year. Second of all - thank you for taking the wind out of my "yea, my blood pressure is doing well!" sails. I was actually quite pleased about my reading on Tuesday (122/64), particularly given that I had forgotten to take my medication that morning and because it was my first ever peri appointment without R there. (He was at home with Miss A, who somehow came down with scarlet fever on Sunday night. She is doing much better now and is mostly recovered.)

About 15 minutes later came another "Important Health Information Message" e-mail. Having not learned my lesson from the first one, I clicked again.

It told me I was fat.

Well, not in those words exactly, but something about a BMI above 30 and obesity, and well, you get the picture.

"But, wait!" I wanted to tell it. "You don't understand! I was wearing tennis shoes. And jeans. And I had just eaten lunch. And drank a lot of water. So my number isn't really quite as dire as you're making it out to be."

Except that e-mail messages about your BMI don't really care about what shoes or clothes you're wearing, and what you just ate. In reality, I know I need to lose a good bit of weight. And as much as I wish they did, the shoes and clothes and even the late lunch don't add up to enough to move me down to below 30, into the overweight category instead.

A couple of hours later, a nurse from my PCP's office called. She was calling to follow up on whether I had gone for an ultrasound on my leg.

It's a long story which I won't bore you with, completely unrelated to the bulge on my other leg that I mentioned in my last post, and nothing I was worried about. I had tried to get the ultrasound a couple days ago, but when I got to the imaging center there was a mix-up and they wound up not being able to do it, and I hadn't gotten around to rescheduling yet.

The nurse asked if I could drop everything and go get the ultrasound this afternoon.

So I did, and as soon as the ultrasound tech put the wand on the spot, she said, "Oh, look at that - you have a lovely varicose vein!"

Normally, my age doesn't bother me much. But today, after that little pronouncement, I'm feeling a bit middle-aged for the first time.

Then when we got home tonight after picking Miss A up from day care, I opened the mail. I had asked R last month if we had paid the December IVIG bill, and he said yes. It turned out we had paid the November one but not the December one. We owe more than $4,200.

So now I'm feeling middle-aged and financially broke.

But Kiddo's heart was still beating strong and he was wiggling around on Tuesday. And Miss A is on the mend, spends her weekdays in a wonderful day care where all the teachers truly care about her and where she loves hanging out with her little friends, and she continues to amaze us every day.

So overall, even middle-aged and financially in a major hole, life is still very, very good.

February 20, 2014

It Wasn't Amniotic Fluid

Thank you all for your comments and concern. Kiddo is doing well - he was moving around when we checked on him on Monday, and the ultrasound tech said there was plenty of amniotic fluid.

Apparently it really was just sweat. It didn't happen again to anything nearly that degree, so I wasn't too worried by Monday. I'm probably going to have to get used to it happening though, because I'm not due until August, and I live in a place where we're going to have 100-degree-plus temperatures long before then.

I apologize for the silence. I've gotten into my head again and gotten freaked out about something, so I've been ruminating on that for the past several days. I won't go into great detail, because I'm sick of me being in what seems to be a perpetually worried state about something, so I can't imagine how tired you guys are of hearing about it. I had been doing pretty well with the health anxiety, but it seems to have returned in full force lately.

Suffice it to say that I have what is best described as a bulge above my knee. (I'm not calling it a lump, because I can't feel a distinct mass - it feels more like the muscle is enlarged.) I've shown it to the perinatologist, and my PCP has ordered an MRI, which I will be getting on Wednesday. Odds, of course, are that it's nothing serious. However, I Googled "lump on quadriceps" and "bulge on thigh", and that was a mistake, because very scary things came up. Hence, the ruminating.

February 15, 2014

This is Hard (And, Gender Revealed)

The roller coaster continues.

Things looked great at our most recent appointment on Thursday afternoon. This afternoon, I wound up having to page the doctor on call because I'm concerned I may be leaking amniotic fluid. The doctor is concerned enough that she is having me come back in on Monday morning.

First, our Thursday appointment - Kiddo looked good, and was moving around and active. It is amazing how arms and legs go from being little stubs to looking like they are one long bone to two bones with a connecting joint in between, all in just a few brief weeks. The growth is amazing.

Arms and legs weren't the only thing we were able to see. Kiddo cooperated with giving us good views this week, and I was brave, so we found out.

We (ok, I) told a couple of people, but overall, we're still holding off on telling most people in our offline world, including our parents. But all of you have been so great at holding my hand, and I trust you to keep the secret, so:

Kiddo is a boy!

We knew that we had either 8 or 9 male embryos left, and only 3 or 4 females. So it wasn't really a surprise, more of a confirmation of what we expected.

If you're sensing a lack of enthusiasm in my words, please know that it has nothing to do with Kiddo himself. It's just that every time I start to let myself relax a little, things get scary again. And we still have a really long way to go since today is only 15 weeks. I'm just tired. Tired of this being so hard.

I finished weaning from progesterone last weekend. My levels had been in the upper 20s. It was rechecked on Thursday, and I got the results yesterday - 19.7. The clinic prefers it to be 20 or above, but the nurse said 19.7 was close enough and that I was officially released from their care.

With Miss A, my numbers were slightly lower and the reproductive immunologist had me go back on the suppositories for a few weeks. I decided that since I was close to 20, I would not freak out about it but would just ask the RI for an order to recheck the level again at the beginning of next week.

I don't think that progesterone necessarily has anything to do with the potential issue that arose today. It's just one more thing, and I'm really ready to be done with "one more thing".

This afternoon, I laid down to take a nap, and I realized my jeans were wet. Not so wet that liquid could be wrung out of them, but definitely far more than damp. And it wasn't just one small spot, it was a couple inches down both of the inner thigh areas, too.

I've read that amniotic fluid has an ammonia-like smell. Whatever the fluid is, it didn't seem to smell like that, but it also didn't smell like urine.

I've also read that a subchorionic hematoma, especially a large one which is what mine was, can cause water to leak or break early. The doctor on call, who is the other doctor in the practice, confirmed that is true. She said that odds are it's not amniotic fluid leaking, but it could be.

She also said that I could go to the ER if I wanted, but that they would keep me in the ER and not send me to L&D since I'm not yet 20 weeks. She also mentioned that an ER ultrasound tech is unlikely to be able to tell us anything other than whether there's a heartbeat, because they are not as likely to be well versed in what a normal vs. abnormal level of amniotic fluid looks like. So I don't think we'll go to the ER unless I start to leak heavily or gush.

I know there are still a lot of reasons to be positive. This may not even be amniotic fluid at all.

I just want it to be July already, for Kiddo to be here, safe and healthy, in our arms.

February 04, 2014

'Believe in Good Things to Come'

An IRL friend who has been through IF and IVF sent me a text with that message today. Even after having Miss A and several encouraging ultrasounds with this pregnancy, sometimes I still need the reminder that this has the possibility of turning out well.

Today's ultrasound went well. Kiddo is continuing to grow on track. I decided to be brave and go ahead and find out the gender, since R wants to and he was so patient with waiting until 30 weeks with Miss A.

Kiddo did not cooperate in that plan, so we'll have to wait until next time.