Risky Business

We're down to the home stretch at just over 3 weeks before Claire's scheduled arrival. And yet, I'm terrified. Not in the normal babyloss mom kind of way, but something additional.

All was going pretty smug and well (honestly) until the end of my 32nd week.

The amazing husband gave me a hand and foot rub and all I had to complain about was a demanding toddler, lower back and hip pain. Typical pregnant girl problems. The day after that hand/foot rub, I complained they both itched a lot. Chalked it up to cheap lotion or whatever.

Fast forward a few days at my 33w appointment. I mentioned the extreme palm and foot itching to my OB. She also said itching was normal in pregnancy. Listen, I know. It's not my first rodeo. My belly itched like crazy with Andrew and now it doesn't because it's been down that road a few times. But this hand and foot itching? It seemed... abnormal. My urine was also getting progressively darker, despite the insane amounts of water I have been drinking to hopefully cleanse this away. It wasn't dehydration. I can't possibly be drinking more water. And I was spending 3-4 hours up in the middle of the night itching my skin to scabs. The only temporary relief was showering and I have been taking about 3-4 each day... mostly in the middle of the night when the itching was at its worst.

Two days later, I called back to ask if I could be tested for Cholestasis. It's a condition in which your liver does not process bile acids properly and could possibly leach these acids into your bloodstream which are toxic at high levels for the baby. It's a simple blood test that takes forever to get back. Seven days. That's a full-on eternity when you're in late pregnancy. It's also rare. When I went in for the blood test, neither of the ladies administering had ever done one or seen that test. Oh, to be in the 1% again. It's getting old.

At my non-stress test yesterday (going 2x/weekly), Claire was sleeping and performed crappy (to my standards since I've been through plenty of these) but the OB wasn't worried because there were a few good accels. Then she measured my belly and told me I was measuring 2.5 weeks behind. What? I just saw my regular OB on Tuesday and she mentioned no such thing with the same measuring device. I suppose I can chalk that up to being subjective, but it wasn't the best news to hear after the NST was just marginal. Add a growth ultrasound to my fluid check ultrasound on Tuesday.

Then she told me my levels were in. My bile acids as of 12/27 were 132. That was eight days ago and since I suspected the itching was not just a no big deal sort of thing, I took matters into my own hands and changed my diet. I'm eating very low fat and just started a hot water and lemon juice cleanse each morning. I've upped my vegetable and Vitamin K intake and I'm living on hope. When I tested, I had just eaten pizza the night before and was not on any sort of diet before then. Perhaps, perhaps, that could have contributed to such high numbers. The idea is that if I lower my fat, there will be fewer bile acids my liver has to process and fewer to enter the bloodstream. We'll see if my logic is helpful.

If you do any kind of research (in medical journals or even Google...), you'll note that bile acid levels of 132 are high. Anything above 40 is high and risky. As in, risk of meconium in fluid, stained placenta and stillbirth. Yep, stillbirth. Lucky ol' me gets to deal with that fear again in another form. Yet, my OB, another practice OB and the coordinating MFM I saw all through Benjamin's pregnancy don't seem to be worried. In fact, they've told me that they've seen elevated levels many times before and none of those cases have ever lead to a demise. Ah, see that's where I lose my mind. Because you've never seen one, it doesn't mean I can't be your first case. And to have already lost a baby and have everyone scratching their heads after as to why? Not exactly the game I want to play.

The one silver lining is that I was prescribed Ursodiol, which is meant to help break up those bile acids and hopefully lower that number to a more manageable and less risky territory. But there are no guarantees. I took my first dose about an hour ago and will take them 3x/daily until I deliver. Of course the risk of stillbirth increases exponentially after 37 weeks. And those bile acids can spike at any time with no way of knowing because the blood test takes a week to come back!

In the meantime, I will be hopefully going in for another blood test to see if the diet (and few doses of Ursodiol) are working. It will take another week for those results and put me just under 36 weeks. I just might lose my mind in that week. If you call, I probably won't answer (like I haven't been anyway).

This baby would live if delivered today. It terrifies me to play Russian Roulette again, despite knowing she needs more time for maturity, growth, and lung development. This is the last time I can do this. It's simply too hard.

Feel free to comment with success stories. You know, if you know someone as unlucky as me who has had just about all the issues under the sun in pregnancy.