29 Week Check-up

I am exhausted.  I left the house this morning at 9:15am, drove 1.5 hours to the doctor, was there for four appointments and then drove another 1.5 hours, arriving home at 5:30pm.  And I have to do this twice next week, once on Tuesday for several appointments for Nora, and then again on Thursday for several more appointments for me.  And all without Eric.  Ugh.  I keep telling friends I will come see them on the weekends, but I’m just too worn out.  And add to that the fact that I’m getting an average of four hours of sleep a night.  Not enough, between Nora waking due to teething and me just not being able to sleep lately.

So a recap of today…  Tomorrow I will be 29 weeks, a new milestone for me, as Nora was born on 29w0d.

  • OB Check-up – My doctor still wants to keep seeing me weekly, so another check today to see how I was doing.  We chatted a little about my gestational diabetes diagnosis, but we left most of my questions for the dietitian.  We listened to baby’s heartbeat, which was around 130-140 bpm, she moves constantly, so hard to get a good reading.  My OB measured my tummy again…  Last week I was measuring two weeks ahead, today I was measuring three weeks ahead, so she wanted to get a growth scan to make sure all was on track, especially with the GD.  Oh, and she checked my cervix also, last week I was just a fingertip dilated and cervix was 50% effaced. Today I’m just a tad bit more dilated, but still less than 1cm and still 50% effaced, so she was happy.  I’m still having lots of tightening, but baby is still inside, so we’re counting this a win for another week.
  • Growth Scan – I got lots of cute pictures of baby, posted below, and happy to report she is measuring perfectly, head and femur were 28w5d and they estimate her weight to be about 3 lbs., so just a tad larger than Nora was born weighing.  Also, fluid around baby is good, apparently GD can cause extra fluid, but not the case right now for me.
  • Nurse Teaching – This was really pointless as Eric had already walked me through how to use the glucose monitor, and really, if you can read, the directions that came with it are pretty good.  I’ve been using the monitor for the past several days, so really no need to review this.  The nurse did give me another Makena injection though.  I’m still saving the two doses we have at home, as I assume it will still take another two weeks or more to get our new insurance to approve the drug and have it shipped to me.  More on insurance below 😉
  • Diabetic Teaching w/ Dietitian – This was a really good visit, the woman I met with was super helpful and answered a ton of my questions.  She laid out a sample meal plan, went over what’s good and not so good for eating, and reviewed when I need to check blood sugar levels and what they should be.  This probably deserves its own post, so I’ll make some time tomorrow to tell you all more about that!

Our insurance still isn’t figured out, basically we just aren’t in their system yet, even though our coverage is active, therefore I can’t get the information I need to give my doctor’s office or pharmacy.  In their eyes I’m uninsured.  And OMG, my doctor’s office is having a COMPLETE FIT.  My four appointments today, you check in and out of each, and at each check-in and check-out, so eight times, I was asked about my insurance, even though all of them said they would add notes to the system, that I should have the data soon.  Oh, and my doctor’s office called me yesterday to remind me I had an appointment but no insurance listed in the system.  And then, while I was meeting with the dietitian, she got a page that I was to go see a financial counselor before I left the office.  UGH.  He was like, so you know if you don’t pay in 120 days we send the balance to a collection agency.  So I was like, can I just pay cash for whatever our balance is right now, which would only be from my appointments last week and this week.  He was like, well, there isn’t a balance yet, billing period isn’t over yet, so nothing to pay.  I wanted to scream, then why did I have to talk to you???  I seriously feel harassed…  No really.  It was that bad.

Okay, I have lots more to say, but honestly, I’m just too tired.  More tomorrow, if Nora naps!

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Time Got Away From Me!

Seriously people, time got away from me.  I don’t even remember the last time I wrote…  But I’m back, to Iowa, back to my normal life, and thus, an update!  But where to start!

Materniti21 Results – Let’s start with the exciting stuff!  Last Thursday my doctor’s office called with my Materniti21 results.  And it was all good news!  Results were negative for any chromosome abnormalities, and…. it’s a girl!  I’d be thrilled with either a boy or girl, but I think two girls so close in age will be fun!  We had an ultrasound way back when my blood was drawn for that test, which I don’t think I ever posted.  A profile picture, and then a little foot, which was 1cm long at 12 weeks.

baby us        foot

Belly Pictures – I guess I need to start these again.  I personally hate them, but I kind of like looking back and comparing, so I guess I’ll do them again…  This was taken this morning, so a bit over 13 weeks.  Yes, I cut my head off on purpose 😉  And I think my behind is actually larger than my baby bump…  I better cut back on my McDonald’s runs.  I’m in maternity jeans but regular shirts still.

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Nora’s IgG Results – Finally got these back!  Last check was only 107, and it’s now 211, which is hugely encouraging.  I mean, it’s still a far cry from normal, which is around 650, but we’re getting closer.  And really, it’s just good to know it’s increasing.  They still want to check it every 4-6 weeks until it’s in the normal range.  Ugh.  But it could be worse.

Las Vegas – I got back last night from Las Vegas, a trip Eric purchased for my birthday, for just my mom and me.  I was seriously scared to leave Nora, but I have to say, Eric really impressed me.  Even if his parents were there to help.  My mom and I had a wonderful time, eating, shopping, sightseeing, etc.  It was just nice to get away, and get an actual night’s sleep, without peaking at the monitor every hour!  We stayed at the Venetian and even had a limo from and back to the airport!  I’m still exhausted today though, as I think we walked over 17 miles!  I took some random pictures, if you’re interested, click here.

Otherwise, I’m not sure what is new…  I lead a really boring life you know!  Nora was really cute this morning when she saw me…  Huge smile!  And she was super sweet all morning, didn’t seem to be as clingy as last week.  She played on the floor without needing me right there.  She even attempted to lay on Kona, and Kona’s bed, which is currently in the middle of our living room.  And, she took a two-hour morning nap!  That never happens!  So I was actually able to shower and relax!

Alright, until next time, I hope you’re all well!

Ultrasound ~ Recheck of Cervical Length

First, the good news!  Baby girl is looking great, and the ultrasound tech even made sure to get me a few pictures of her, despite the order for just a cervical length recheck today.  Her heart rate was 143 bpm, she was moving all around, and the amniotic fluid volume looked perfect.  My doctor was very pleased with my blood pressure and weight gain thus far too.  Baby is still head down right up against my cervix, and although they claim she still has enough space to change positions several times a day, somehow I doubt she has moved much in the past three weeks, as her position is identical to my last ultrasound.  Here is a picture of her cute little hand and fingers 🙂

162 Days ~ 23w1d
162 Days ~ 23w1d

So now the bad…  And there was far more bad than good news today 🙁  Three weeks ago at my last ultrasound my cervix measured 2 cm, too short since we’d expect it to be between 4 cm and 5 cm at this point.  Well, today it’s even shorter, only 1.4 cm now.  So again, my regular OB consulted with the high risk provider on call.  Really long story short, they are giving me one more week until I’m not sure what happens.  I’ll have another scan next Tuesday morning and if at that time my cervix is shorter I’ll receive steroids to mature baby’s lungs should I deliver soon.  They considered giving me steroids today, but there are risks to both me and baby, and since we don’t know when I’ll deliver, they would rather wait until we know more.  The risks of steroids to baby include stunting her growth, as studies have shown baby’s who received several doses of steroids in-utero were born with smaller than average heads.  Risks to me center around blood sugar and blood pressure issues.  So we decided to wait a week when we know.  For the time being I’ll continue on the progesterone and ‘take it easy’,  She didn’t specifically tell me certain activities were off-limits but she did stress I should pay attention to how I feel.  If I notice increased pelvic pressure or an increase in the frequency of tightening in my uterus, I’m to rest.  She also stressed not being afraid to call, for any reason, which was comforting.

I asked a lot of questions although for the life of me most of the appointment seems like a blur now.  I asked what happens if my cervix continues to shorten, or if it thins to nothing.  My doctor was honest and said the risk of me delivering early is high, although how early we don’t really know.  She said if my cervix gets much thinner the chances of my water breaking increases and thus baby would need to be delivered.  She did say they can keep you pregnant in the hospital after your water breaks, but I didn’t ask for how long.

I didn’t really get scared during the appointment until my doctor brought up viability and survival rates.  She wanted to be honest and make sure I understood what we’re dealing with…  She said the vast majority of hospitals will not resuscitate before 24 weeks, I am 23w1d today.  The good news, my hospital will resuscitate as early as 18 weeks, although regardless, outcomes aren’t promising, even at 23 weeks the mortality rates are high.  I wasn’t sure what to say or think at that point, other than I guess it’s best to know risks now rather than to be surprised later.  I think I’m still a little in denial though, not ready to believe this baby is anywhere near ready to be born.  There is a chance I’ll deliver at 40 weeks, so for now I’m living in that dream.

I’ll end this post here, as really I’m not sure what else to say at this point…  I have a lot of fear running through my head, how could I not?  I feel like we’ve been through so much during the past three years, trying on our own, the failed IUIs, a year of IVF, and now 23 weeks of thinking we are finally going to welcome a baby into our life.  I am not prepared for this to be taken away from me.

20w2d – Ultrasound Pictures

First, the ultrasound pictures, as promised.  These have also been uploaded to the scrapbook page 🙂

141 Days ~ 20w1d
141 Days ~ 20w1d
141 Days ~ 20w1d
141 Days ~ 20w1d
141 Days ~ 20w1d
141 Days ~ 20w1d
141 Days ~ 20w1d
141 Days ~ 20w1d

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141 days ~ 20w1d
141 days ~ 20w1d

I did a lot of thinking last night, and reading.  Reading seems to get me in trouble though.  The short of it is, it appears that progesterone is the only approved treatment for a shortened cervix during pregnancy, and it only works about 1/3 of the time.  That said though, I’m telling myself this can’t be that serious, as if it was, my doctor wouldn’t be waiting 3 weeks to recheck me.  Right??  I mean, for the most part, I’m going about my life as normal.  A small part of me does feel a bit like a ticking time bomb though.  After everything we’ve been through to get to this point, I honestly can’t imagine starting all over.  And perhaps I’m getting way ahead of myself, but those fears are obviously there.  I received a few clothing items for baby in the mail yesterday, and immediately wondered if they would need to be packed away, not to be used come June.

As for the progesterone, I’m waiting for the mess so many of you have mentioned 🙂  And why don’t they come with an applicator??  Is that really too much to ask for??  They are smaller than I imagined, they look like little round pearls, which just happen to be an unpleasant shade of pink/orange.  Directions are two each evening before bed, and of course, when I got up this morning I fully expected gravity to take over…  But nope, no mess yet.  Does it take a while??

I do want to thank everyone who commented yesterday.  One of the main reasons I’ve kept up with this blog this long is the constant support it provides.  Yes, each and every one of you is amazing, and I promise to respond to each of you later today.  Thank you so much for your kind words, prayers, and advice, for those of you with first hand knowledge.  It truly means the world to me 🙂

20 Week Anatomy Scan – Good & Bad

First the good…

Baby is perfect!  It was so fun to watch her wiggling around during the ultrasound, sticking out her tongue and swallowing some of the amniotic fluid.  She was sure busy!  The technician was very detailed, measuring each organ and body part and explaining all in detail.  She estimated baby’s weight at about 14 oz. today which is right on track developmentally for 20 weeks.  We received several cute pictures, but I’ll post those separately once I have a chance to upload them.

I did ask about movement, or rather my lack thereof, being it’s been on my mind so much.  The tech confirmed I have an anterior placenta, meaning it’s in front of the baby closest to the front of my abdomen and thus the reason I haven’t felt much movement yet.  My doctor confirmed that since I have an extra barrier between baby, I might not feel definite movement for a few more weeks, but that I shouldn’t worry.  The ultrasound confirmed baby is healthy and active.

So now the not so great…

One of the measurements the ultrasound tech needed was the length of my cervix and whether it was closed or open (dilated).  Thankfully it’s still closed, not dilated, but it is much shorter than it should be at this stage of pregnancy.  Basically the cervix should be about 4cm throughout pregnancy and shorten (efface) during labor.  Well, mine is already effaced to 2cm, which is apparently not good.  At first the tech thought maybe she just wasn’t getting a good view of it, so out came the dildo cam.  Yes, and here I thought I was finished with ‘those’ ultrasounds.  Oh the memories!  The second ultrasound showed the same though…

My doctor explained the risks of a shortened cervix at 20 weeks, mainly miscarriage and pre-term labor.  My regular OB contacted a high risk physician and it was decided that for the time being we’ll try progesterone suppositories, as they have been known to stop effacement (further shortening of the cervix).  The problem though is, nothing has been known to increase the length, so getting to 40 weeks could be problematic.  Side note, I’ve heard from fellow IVF bloggers that progesterone suppositories are nasty messy, but in this case going back to the injections isn’t an option, as we need the localized effect of the vaginal suppositories.  My directions are to use them nightly, beginning tonight.  I’m sure I’ll have some great stories for you all soon!

So going forward…  I pray the progesterone stops the shortening of my cervix.  In three weeks I’m to return for a repeat ultrasound to check my cervical length.  If it’s the same, I assume I’ll stay on the progesterone.  If it’s shorter we’ll have to be more aggressive.  My doctor mentioned perhaps bed rest, steroids, stronger medication to deter labor, etc.  I didn’t ask a lot of questions about what’s to come, maybe I should have.  For now, I’m going to focus on the next three weeks.

Eric was with me today during our ultrasound and appointment, and thank God, as he understands all this medical stuff so much better than me.  Problem with him sometimes though, is that nothing serious really seems to phase him, as serious to him is about dead.  He did seem worried today though…  As we walked out of the doctor’s office he said, “We just need to get to 30 weeks for baby to be healthy, that’s only 10 more weeks.”  Um, frankly, I’m still holding out for my 20 more weeks.  I am not about to assume at this point she’s coming early, nor am I ready, on any level, for her arrival in 10 weeks!