Tuesday, January 7, 2014

35 Week Update

Today marks 35 weeks with Claire. I had my OB appt. this morning and things have definitely changed. I'm starting to be taken a lot more seriously.

After Friday's appointment that put me in low spirits and tears (marginal NST, measuring small, bile acid levels high and no one who cared...), I called Saturday to request the nurse put in a requisition for another repeat bile acids test and to add a liver function test to that. The nurse was not the lead nurse and could not authorize it, but she did write me a requisition that day and told me to wait until the lead nurse okays it before I have it done on Monday morning. I was in tears talking to her about this and she told me to go with my gut and that I'm the only one who would know absolute best. Essentially, she was giving me permission to break the rules and get the blood test without the blessing of the lead nurse and overseeing MFM.

Monday (yesterday) marked 10 days since I had my first blood draw and levels at 132. I scheduled an appt. for 7:30, knowing the lead nurse wouldn't be able to get back to me in time before the test to authorize it. I was breaking the rules, I guess. My body, my baby. And who cares if I'm paying and it doesn't increase their workload at all, right? Two hours after I got the test done yesterday, I received a call from the lead nurse telling me she spoke with the MFM (who is clearly not someone I like) and he concluded that 10 days won't make a different in my levels and not to bother with the blood test. I told her I already had the blood draw and if the levels didn't matter, then we'll find out.

While I have no training as a nurse, doctor, or even phlebotomist (though I'm pretty sure I could be one having had so much blood taken in these three years of babymaking), I know that blood levels rise and fall rapidly. I remember getting beta levels tested for my last three pregnancies and getting blood draws in the hospital daily to see increase and decrease in other levels. I had blood tests every other day after my miscarriage to make sure my levels were decreasing. I know levels can rise and fall quickly, so to tell me 10 days doesn't matter... false.

I've been plugging along with my diet, taking the meds they prescribed and had a list of questions to ask at my OB appt. today. I've been anxiously awaiting this appt.

My ultrasound was first and she measured the fluid at 13cm, which is absolutely incredible for me. I had Polyhydramnios with both Benjamin and Andrew, so checking fluid for this baby has been really important. At this stage with Benjamin, I was well on my way to 28cm. That's a huge difference.

She also did a growth ultrasound since my NST and OB visit on Friday caused that OB (who I never see) to question why I was measuring behind. Turns out I'm not since Claire is measuring 5lb.15oz. and in the 62nd percentile. All measurements were in the 35th/36th week range. I know those measurements are usually padded and often babies are born smaller, but to be near the 6lb. estimated range is great. A sigh of relief on that one. No growth restriction like that OB had me worried about on Friday.

The same nurse who gave me the unauthorized requisition to get a blood test helped me today. And you know what? Before this week, I'd never seen her before. She set me up with my NST and we were in business. Despite the NST taking about 45 minutes until my OB was pleased with the number of accels, she did do fine. My babies are never rockstars on these, it seems. But, she did move and it was tracked and her heart rate did elevate accordingly.

We chatted about the itching and how I'm still up hours at night showering and trying to find relief any way I can. My OB told me she was surprised to see such high numbers in me but not jaundice. That she normally does not worry much about Cholestasis as it is more common than people realize, she wasn't taking any chances with me especially, knowing we lost Andrew. Music to my ears. I talked about my diet and she said that people with gallbladder issues are often encouraged to reduce fat intake, so it can't hurt.

Then I asked if she would consider moving my induction date up so I didn't have to endure a weekend and it would put me closer to 37w rather than the 38w mark. She said she was on board and would be in talks with the MFM (different!) and they might want me to come in for an amniocenteses on that Friday before they make the call to induce early... but if it were her, she'd just push for a Friday (1/24) induction. Still hooked to the NST at this point, she came back and said the MFM is concerned enough about my levels that they want me re-booked for more bloodwork, but this time both bile acids and liver function test. Hmm... my intuition is stellar.

I told her I already pushed for those and that I got the test yesterday (against the lousy MFM's orders). She wasn't pleased that the lab might take 7 days again at that particular lab, so she sent me over to the hospital next door for a rush of bloodwork with hopes to have the results by this Thursday or Friday, latest. We would discuss at my Friday NST. She even mentioned that if my levels are elevated more, they might be talking an induction in the 36th week instead.

Holy. Of course I don't want a 36-weeker, but if my levels are high, the baby is not safe inside me according to my fabulous OB and the new MFM who are taking this seriously. {Note: my fab OB did not know my high bile acid levels when she was nonchalant about my itching last week. Now that she knows, there's been a fire lit, it seems.} Yes, many outcomes around 37 weeks are positive with women who have Cholestasis. But my levels are high and I've been dealt the card once before. It appears now no one important is willing to take any chances.

They handed me a requisition sheet, booked my NST for Friday and said we'd discuss after my levels come in about my induction date. I was at the office for 2 hours. Oye.

As I was walking out, that unauthorized nurse who gave me that requisition sheet came in my room. I told her they were pushing for the exact same bloodwork I requested from her that the lead nurse and terrible MFM saw as irrelevant. I told her I guess my intuition was correct. She then told me again that I knew better than anyone and going with my gut was the smartest move. Smiles exchanged.

I went over to the hospital and repeated the bloodwork just an hour later. It wasn't 100% fasting like I'd done at the previous one (and yesterday's) and I had lots of sugar in my body from the NST, but hopefully we'll see some trends or a decrease. And bonus! While I was there, I was able to pick up Andrew's ornament from the SHARE tree we hung at the remembrance ceremony on December 10. Nothing says you're in this hospital way too much like killing two birds with one stone on a visit. It's not like the grocery store, and yet... feels so familiar. Cannot wait for that hospital to be a foreign place to me again. How's next month for a beginning?

All that to say... there's no definitive news, but bloodwork is in the works and an earlier induction is highly likely.

12 comments:

Party of Three Heads said... [Reply to comment]

and if I were you... I'd continue to put your foot down! Come on Claire! I know your more than ready to have her here alive and well! Xoxo

Molly said... [Reply to comment]

As you know, K was a 36-weeker and didn't spend one second in the nicu. Plus, I think I heard that girls' lungs develop faster than boys', so likely is that Claire would be great. Keep pushing. Such BS that you have to though.

Unexpected Delays said... [Reply to comment]

Keep pushing on!! Good for you to listening to your gut and doing what you feel is best for baby Claire! Thinking of you.

Melissa said... [Reply to comment]

You are incredible! You are doing everything you can. I love that the nurse validated you and that they are finally listening. I have been waiting all day, wondering how it went and hoping that you were heard. I know the feeling entirely, wishing to not have a familiarity with the hospital. It will happen. In the end of my pregnancy with Lil it was jarring not to be at the hospital constantly. Freeing but jarring. You will get there. You did amazing today! You did your girl proud.

Ben and Katie said... [Reply to comment]

gaw, doctors...cannot love with them and you cannot love without! no blood level changes in 10 days my ass!! as a nurse i know this to be untrue and with bens stuff i changing levels always! that makes me mad! sounds like that new nurse whom you'd never seen before was an angel, right there for you in the momens you needed her!
praying over you and claire!! xoxo

Caroline said... [Reply to comment]

Claire's mom is a rockstar.

You're getting there, hun.

Veronica said... [Reply to comment]

jeeezuz the run around doctors give us poor pregnant ladies. And when it's the wrong run around, or a bunch of down played BS from someone in a white coat who couldn't give a crap about you or your life...it's like a big eff you from the medical community. So glad you are getting the right care from SOMEONE who's looking after you and Claire.

I had an ultrasound with Theo that threw everything into high gear. The OB that analyzed the scan at 28 weeks total freaked me out and told me that my AFI was WAY too high, and that another scan should be done RIGHT AWAY. All this, and my OB was on vacation. Hands tied, and I had to wait to see ANOTHER OB to do the Very Important Scan to determine if my AFI was actually as bad as it was reported. And it was, but it then fluctuated, and Theo was breech and flipped and flopped until 34 weeks... and when I finally touched base with my OB, she took full control of all scans and monitoring because she didn't need me having a heart attack - wouldn't really go well with having the baby and all!

All that being said, I wanted to tell you about a success story regarding babies being born early. My SIL actually. She had her daughter at 33 weeks. She had full placenta previa.. and was on bed rest at 26 weeks. Well, long story short - she wasn't the best bed rester, and didn't have any REAL fear of losing the baby, so she went about life a little outside of doctors orders - but she was hospitalized at 24 weeks (admitted for 2 weeks) and then again at 28 and 31 weeks because her bleeding wouldn't stop. At 31 weeks they kept her admitted because releasing her once didn't fare well for anyone. Anyway!! She starting bleeding/hemorrhaging one night, and they rushed her into an emergency C-section. Good thing they kept her admitted at 31 weeks, because if she had been at home, her baby would not have made it. Her daughter was delivered 4lbs 2oz at 2 days shy of 33 weeks. She spent 2-3 weeks (I think?) in the NICU, and was sent home once she hit 5lbs. She's never had any respiratory problems, and is now almost 8 months old and adorable. It's very true that girls do better if born early. I am still bewildered by her existence (BLM trauma brain on that one) but she is here and healthy and I'm so thankful that my SIL was spared, and she somehow sidestepped the world of loss that so many of us find ourselves in after doing everything that was right/mindful/proactive/etc for our babies.

But I wanted to tell you about my niece to maybe give you some comfort in knowing that if Claire has to come a touch earlier than expected, she's most likely do better than B did in recovering from busting out prior to 37.5 weeks (Term).

Oh how I hope you could just hit >>FF on these next few weeks and you could just have her in your arms.

Counting down the days with you. Loving Claire, and holding you tight <3 Hugs

Addi's mom said... [Reply to comment]

So close and yet so far, I hate this part the most. So much at stake. Come on baby!

Anne said... [Reply to comment]

Hallelujah and go Mama! I had a whole email in my head to send you after your post the other day, and of course didn't find the time to actually sit down and write it....but wanted to tell you that you are doing the exact right thing. I am so, so glad you found the right person (people) to get you what you need- it makes a world of difference doesn't it? After we lost Rip and I got pregnant with Gracie, I was known to go sit my fat pregnant arse over at the doctor's office until they are forced to deal with me. Prayers for you and Claire.

Brooke said... [Reply to comment]

I'm so glad to read this and know that you're being taken seriously and that you pushed for what you felt you needed. I think too many women have their concerns dismissed. Here's hoping for an early-but-not-too-early induction and a healthy baby girl.

LookItsJessica said... [Reply to comment]

You're doing great under this crazy pressure and stress! I have also heard that girls lungs mature faster, so that would be great if you end up delivering at 36 weeks. Avy was born at 37+3 and was absolutely fine.

It must be so scary but thankfully the docs are finally paying attention to everything that is going on.

Her and Her and Him said... [Reply to comment]

I'm so sorry you're dealing with this scary complication. Praying for you and Claire.