Well, I'm back. Again. For the last time. I'm hooked up to monitors for Claire's heartbeat and contractions. No Cervidil. No IV. No Pitocin. Just monitors. I'm basically here for an overnight NST. At 6 a.m. tomorrow morning, I'll be given Pitcoin (which I had with Benjamin). Elliot will come about two hours later and be with me for the duration. They've already offered me an Ambien so I'll sleep before it all begins. It's weird being here alone, but I know it's really uneventful and quite uncomfortable for Elliot to be here. And honestly, I want Benjamin to have normalcy tonight with Dad at home before his world is given a spin.
Both of the weekend NSTs went great. She moved like a champ (go figure!) and I got 4 hours of monitoring to calm my nerves a bit. I still performed plenty of kick counts at home, but those NSTs were worth whatever they end up charging us.
I've been scurrying to get things ready for Benjamin, my parents, and my friend Danielle who will take over tomorrow until my parents arrive late Tuesday. The teacher in me got right to work on my "sub" notes, complete with addresses and phone numbers of places we often go with Benjamin. The fridge is stocked, the pantry was already stocked, and I cooked/baked things that my son might actually eat 4 bites of before giving up. I'm so thankful we have such good friends willing to fill in while we're not able and that my parents could make the trip out to spend a week with Benjamin.
We're hoping our family is not separated for over a week, but we have to be realistic about things. I'm being induced at exactly 36 weeks. That's considered pre-term. Which means Claire will be born a preemie. Not a super small one (hoping for 6lbs! Though, B was 7lb.6oz. and still earned himself 4 days in the NICU at just barely term), but premature nonetheless. Which means... we're sort of setting ourselves up for a NICU stay. It would be amazing if she did not need NICU time, but we just want her alive.
My mind and heart have been all over the place. Nervous. Anxious. Frustrated. Excited.
I'm nervous about being away from Benjamin. I already miss him and it hasn't even been 3 hours since I got hugs and kisses from him last. I'm nervous about choosing to induce our daughter this early. But, I'm more nervous about leaving her in with the uncertainty of Cholestasis that can strike at any time without much medical understanding. I'm nervous about another NICU stay. I'm nervous she will show distress. I'm nervous about the delivery and if that will go well and safely. I'm nervous about seeing her struggle. There are just so many uncertainties.
I'm anxious. We have gone back and forth about whether this is the right decision to induce. This condition is rare. And risky. Most people have happy and healthy inductions with this condition. But most is not good enough for us. The itching, even with 1200mg of the Ursodiol drug in me each day tells me that my levels are fluctuating and uncertain. That while she's in there each minute, she's growing and maturing as she should, but could also being exposed to something we're uncertain about with consequences I'm not willing to gamble.
I'm frustrated we are going through another strange induction. It's frustrating knowing that we didn't get to make it to 38 weeks and have a normal, happy induction with our daughter in mother-baby and going home 2 days later. Yes, it could happen, but I doubt it. I'm frustrated that I've been pregnant 4 times and none of them ended in the simple, happy, fairytale ending we imagined. Even if she doesn't have a NICU stay, this end is not something I desired for her.
I'm excited about having a living daughter. I'm excited Benjamin will likely have a little sister and grow up with someone else to interact with. I'm excited for our family to welcome another grandchild and niece. I'm excited I won't ever be pregnant again and this condition will go away!
Here we are again... updates to come tomorrow! Thanks for all the emails and comments of support. We appreciate them all.
Monday, January 13, 2014
Friday, January 10, 2014
The Saga Continues...
I was almost admitted tonight. My OB and the fab MFM were chatting FOUR times on the phone about me during my NST visit.
My appt. was at 2:30 and I just got home at 5:20 (but am just publishing this now because I have a demanding toddler whom I'm so freaking thankful for). I saw both the OB and drove to the hospital (next door), valeted my car and saw the MFM. I had three ultrasounds. Not exactly a simple NST.
First, there is some good news. Let's start with: SHE IS ALIVE. Also, my bile acid levels have lowered considerably (but are still considered high) to 55. From 132 to 55? I think the drug and my diet are both magic. I shall continue all of those until delivery. My liver panel was elevated but not with alarming numbers. My bilirubin came back in the red, but also mild.
Now here's the play-by-play:
On the way to the OB, she was moving decent. I was happy, but knew once they hooked up that stupid machine, it would lull her to sleep. And it did. She seriously moved like once in 30 minutes. I had juice and a lollipop and hoped that would make things happen. She ended up having 3-4 great accelerations in 10 minutes following. Not the best, but she's never been the best.
My OB did the Strep B and told me she wants me admitted Monday night and to deliver me Tuesday now at exactly 36w. Then she checked me to see if I was dilated and could not feel the baby at all. Her positioning was odd and she told me to get dressed and meet her in for an ultrasound.
Ultrasound time (#1) and she is still head-down, but not engaged. Fluid looked great and she was concerned about the cord blood flow because of how she was positioned in relation to the cord. Said she wanted to have the MFM ultrasound me and told me to sit tight.
Various calls with the MFM later (to which I heard much of these conversations) and my amazing OB told me that the MFM told her to just find a reason to admit me tonight and deliver because we just seem to be hitting so many issues. But, they couldn't find a clear reason unless there is a cord issue. Fluid is good, she is reactive, my numbers dropped considerably... so it's not good enough reason to induce earlier than 36w.
Before I left for the MFM, my phone kept updating me with scheduled appointments to Labor & Delivery for NSTs. I will be having an NST tomorrow (Saturday) at noon and Sunday at noon. On Monday night, I will be admitted at 6 p.m. to get some rest before my Tuesday induction. I was grateful to hear all of this, but a little nervous about not being admitted for round-the-clock monitoring until she is born. However, with the news that the numbers have improved, I was thankful for at least that.
I headed over to the MFM at this point and had an ultrasound with the technician and then another one when the MFM came in. She showed me cord blood flow and positioning of the cord no where near her head or neck-- near the placenta actually. Yes, there was a lot there, but the blood flow was good.
I'll be monitored every 24-30 hours until she is safely delivered. However she comes, let's just hope she's alive. Like so many of you wise and wonderful people have said, NICU is just a stepping stone. We'll get through this.
While I slept maybe 3 hours last night and will likely not sleep until Monday night when I'm admitted, I'm feeling more confident about the frequent monitoring. Of course I'll be doing kick counts in between these L&D visits, but at least we had some good news.
My appt. was at 2:30 and I just got home at 5:20 (but am just publishing this now because I have a demanding toddler whom I'm so freaking thankful for). I saw both the OB and drove to the hospital (next door), valeted my car and saw the MFM. I had three ultrasounds. Not exactly a simple NST.
First, there is some good news. Let's start with: SHE IS ALIVE. Also, my bile acid levels have lowered considerably (but are still considered high) to 55. From 132 to 55? I think the drug and my diet are both magic. I shall continue all of those until delivery. My liver panel was elevated but not with alarming numbers. My bilirubin came back in the red, but also mild.
Now here's the play-by-play:
On the way to the OB, she was moving decent. I was happy, but knew once they hooked up that stupid machine, it would lull her to sleep. And it did. She seriously moved like once in 30 minutes. I had juice and a lollipop and hoped that would make things happen. She ended up having 3-4 great accelerations in 10 minutes following. Not the best, but she's never been the best.
My OB did the Strep B and told me she wants me admitted Monday night and to deliver me Tuesday now at exactly 36w. Then she checked me to see if I was dilated and could not feel the baby at all. Her positioning was odd and she told me to get dressed and meet her in for an ultrasound.
Ultrasound time (#1) and she is still head-down, but not engaged. Fluid looked great and she was concerned about the cord blood flow because of how she was positioned in relation to the cord. Said she wanted to have the MFM ultrasound me and told me to sit tight.
Various calls with the MFM later (to which I heard much of these conversations) and my amazing OB told me that the MFM told her to just find a reason to admit me tonight and deliver because we just seem to be hitting so many issues. But, they couldn't find a clear reason unless there is a cord issue. Fluid is good, she is reactive, my numbers dropped considerably... so it's not good enough reason to induce earlier than 36w.
Before I left for the MFM, my phone kept updating me with scheduled appointments to Labor & Delivery for NSTs. I will be having an NST tomorrow (Saturday) at noon and Sunday at noon. On Monday night, I will be admitted at 6 p.m. to get some rest before my Tuesday induction. I was grateful to hear all of this, but a little nervous about not being admitted for round-the-clock monitoring until she is born. However, with the news that the numbers have improved, I was thankful for at least that.
I headed over to the MFM at this point and had an ultrasound with the technician and then another one when the MFM came in. She showed me cord blood flow and positioning of the cord no where near her head or neck-- near the placenta actually. Yes, there was a lot there, but the blood flow was good.
I'll be monitored every 24-30 hours until she is safely delivered. However she comes, let's just hope she's alive. Like so many of you wise and wonderful people have said, NICU is just a stepping stone. We'll get through this.
While I slept maybe 3 hours last night and will likely not sleep until Monday night when I'm admitted, I'm feeling more confident about the frequent monitoring. Of course I'll be doing kick counts in between these L&D visits, but at least we had some good news.
Thursday, January 9, 2014
You Can Handle Anything That Comes With Alive
That's what my friend and fellow babyloss mom, Melissa, has been emailing me over the last couple weeks.
This diagnosis is really throwing me some curveballs. Excuse me for posting exclusively about this scary pregnancy for the duration of it... because it is consuming every crevice of my mind.
My OB personally called me yesterday to tell me the liver function test was not good and my levels there were high, too. She was not surprised and I wasn't either. High bile acids indicate your liver is not working like it should. The bile acids test has not returned yet, but we can only assume it's not looking pretty. I will find out tomorrow at my NST appt.
Now that both overseeing MFMs are on board and clearly see the urgency in my case now, they specifically told my OB that we need to make it to 36 weeks (Tuesday) and then it's go-time.
I'm having this baby next week... if she makes it that long. The clause I never want to add, but reluctantly must. It's all that is going on in my brain right now. She had hiccups three times this morning. Does that mean she is in distress? Is there meconium in the fluid? These thoughts never rest.
My OB said we have a decision to make-- will it be next Wednesday at 36w1d, or next Friday at 36w3d? She also said I could come in for daily NSTs if that is what gets me through. I just might.
Will we have a living child? Hopefully.
Will we have a living child with potential NICU time for either choice? Probably.
Will the 36w3d choice be wiser to avoid NICU time? Likely.
Can we wait that long, knowing we are putting her in danger even longer inside my body? Unlikely.
We both agree that we'd LOVE to wait until 36w3d, but really, we'd love to wait until 40 weeks! That's just not happening. The difference of those two days seems harrowing. Knowing the anxiety that I am currently experiencing, we might just be scraping it to Wednesday. And honestly, if these bile acids come back astronomically higher than my 132 (already over 3x the severe mark), Wednesday isn't going to be a consideration, but a decision made.
On Tuesday at my 35w appointment, I went from an induction date of 37w6d (without Cholestasis) to possibly 37w3d (diagnosed with symptoms) to 36 weeks. These decisions all happened in 24-hours.
We can handle anything that comes with alive. Of course I don't want my daughter to deal with NICU time. But I feel like my body is slowly trying to kill her and I just can't take that chance. If we're lucky enough to see her born alive, we'll handle anything that comes with being alive.
Probably more updates tomorrow after my NST.
This diagnosis is really throwing me some curveballs. Excuse me for posting exclusively about this scary pregnancy for the duration of it... because it is consuming every crevice of my mind.
My OB personally called me yesterday to tell me the liver function test was not good and my levels there were high, too. She was not surprised and I wasn't either. High bile acids indicate your liver is not working like it should. The bile acids test has not returned yet, but we can only assume it's not looking pretty. I will find out tomorrow at my NST appt.
Now that both overseeing MFMs are on board and clearly see the urgency in my case now, they specifically told my OB that we need to make it to 36 weeks (Tuesday) and then it's go-time.
I'm having this baby next week... if she makes it that long. The clause I never want to add, but reluctantly must. It's all that is going on in my brain right now. She had hiccups three times this morning. Does that mean she is in distress? Is there meconium in the fluid? These thoughts never rest.
My OB said we have a decision to make-- will it be next Wednesday at 36w1d, or next Friday at 36w3d? She also said I could come in for daily NSTs if that is what gets me through. I just might.
Will we have a living child? Hopefully.
Will we have a living child with potential NICU time for either choice? Probably.
Will the 36w3d choice be wiser to avoid NICU time? Likely.
Can we wait that long, knowing we are putting her in danger even longer inside my body? Unlikely.
We both agree that we'd LOVE to wait until 36w3d, but really, we'd love to wait until 40 weeks! That's just not happening. The difference of those two days seems harrowing. Knowing the anxiety that I am currently experiencing, we might just be scraping it to Wednesday. And honestly, if these bile acids come back astronomically higher than my 132 (already over 3x the severe mark), Wednesday isn't going to be a consideration, but a decision made.
On Tuesday at my 35w appointment, I went from an induction date of 37w6d (without Cholestasis) to possibly 37w3d (diagnosed with symptoms) to 36 weeks. These decisions all happened in 24-hours.
We can handle anything that comes with alive. Of course I don't want my daughter to deal with NICU time. But I feel like my body is slowly trying to kill her and I just can't take that chance. If we're lucky enough to see her born alive, we'll handle anything that comes with being alive.
Probably more updates tomorrow after my NST.
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.
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.
Saturday, January 4, 2014
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.
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.
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