Friday, February 10, 2012

Week 25 Update: Fourth Prenatal Appointment

I can't believe how fast my belly is growing!

I swear that I am getting bigger by the day!  It is so crazy to me to look back at the photos that I have added here and see how my body has changed.  I am so glad that I have been letting Brian take photos so we will have the record of it.  Trust me, some days the very last thing I am interested in is letting someone take my picture.



Another angle of the bump.


My belly is big enough now that the "normal" pregnancy issues have either begun or intensified and the issues with my hip and leg seem to be worsening.  I don't mean to complain, I am thrilled to have our little Peanut cooking away in there, it is just where we are at now. 


Here I am.  Not enthused to have my photo taken, but I relented.


I am so very grateful to all of the wonderful family members who knew more than I did and went ahead and bought me maternity clothes even though I thought I wouldn't really need them.  Clearly, even the Bella Band wasn't going to help me fit in my pants at this point!


Punky has been my cuddle buddy.  She loves to lay on my belly, though she doesn't so much like getting kicked.


I have been home a lot lately.  My job consists of being on my feet for hours at a time with no breaks, so I haven't been able to tolerate working much and the issues with my hip make getting around difficult.  It is really frustrating to me; but, Punky is loving it!  She is getting spoiled spending all this time with me.   


Like the pout?  This is the look I get when I don't want to play. 


I hope that it doesn't cause us problems later when we bring Peanut home.  She is our first "baby" and I am sure that there will be some jealousy.  She has been extremely protective of me, even more so than she was before, and I imagine that might worsen.  She loves my niece and plays really well with her, but she has never been around an infant.


Ready to play with Peanut?

I am sure that it is going to be difficult for us all to adjust to the changes that will come once Peanut is here, but Brian and I are aware of that and committed to doing what we can to make things as smooth as possible.  Which will mean doing our best to each spend time with Punky without the baby and making sure that she isn't displaced.  Peanut will be our primary focus and responsibility, but we won't forget about our other baby.




We had our fourth appointment with the midwives on February 9th.  We got to see our favorite midwife, Patty, for this appointment.  I was so thrilled; I can't even explain how relieved I was!  This was the first time that I was nervous before a midwife appointment.  I was not sure what they were going to have to say about their communications with Dr. Nath and the other doctors.  I was also beginning to really worry and stress about some of the unresolved issues, like "How in the world am I going to deliver this baby with my hip and leg causing so much pain?!".  I felt like Martha was really dismissive when I would ask questions and as I get farther and farther along, it is more bothersome. 

I gained some weight finally, which I figured I would based on Peanut's growth alone.  My blood pressure is still in the normal range.  Peanut's heart rate was normal and she was extremely active, which made them happy despite it making it difficult to get a good heart tone with the Doppler.  They measured the size of my belly and that was normal. 

I asked Patty about what they felt about Dr. Nath's findings.  She went through the reports that he sent over to them with me.  He was much clearer in the reports than he was with me, which is no surprise.  Much of what was in there I already knew, but he was clearer about stating that the growth was normal and he was not concerned about further complications.  That being said, he told us at our last appointment that it was absolutely fine with me continuing my routine care with the midwives, but he clearly said in his report to them that he recommends that I see the high-risk doctors.  She was frustrated that he was being so unclear and plans on having a meeting with him and the rest of the team to clarify what is actually going on and what the best course is to take to provide me and Peanut with good care.  Her feeling about how worried to be is that the honest truth is that they don't know what is going on and even the ultrasounds are not going to really tell us very much.  She feels that, in her experience, fetal movement is a better indicator of fetal well-being than any of the tests or procedures that they have.  She felt really good about the amount, regularity, and strength of Peanut's movements.  She sure seems happy and healthy in there to me and Patty agrees. 

Patty doesn't want to wait anymore to see what this hip is going to do.  I have an appointment with a general practitioner on February 21st.  In addition to repeating the glucose tolerance test on that day, Patty wants to see what the doctor has to say about the issues I am having with my leg/hip/back and wants a referral to an orthopedic specialist to be made.  Finally!  Patty wants to know what the orthopedic doctor recommends for the pregnancy and for delivery.  She doesn't want to wait any longer to come up with a plan for delivery.  I am so glad someone was finally listening to my concerns.  The very last thing that I wanted to have happen was to continue to be put off and then go in to labor and have everyone be scrambling trying to figure out what is best to do. 

I left the appointment feeling much better, despite so much being unresolved, simply because I knew that I was heard.  I am a little nervous about the team meeting because I am not sure that I will be heard if my care is transferred to Maternal-Fetal Medicine.  For our next appointment at the Antenatal Testing Center on February 23rd, we will be seeing an associate of Dr. Nath's.  I can't remember the doctor's name, but we are hoping that maybe we will feel more comfortable with this doctor's manner and communication. 

We'll let you know how we make out!

Thanks again for checking in on us!

Wednesday, February 1, 2012

Week 24 Update: Second Maternal-Fetal Medicine Appointment

I guess I need not have worried about the bonding issues because at this point in the pregnancy everything is very real to me.  I haven't stopped feeling anxious about something going wrong, but that seems really normal given what complications we may potentially face.  I think that knowing who is in there has really helped and seeing Peanut looking healthy and very much like a baby on the Level II ultrasounds has helped dispel that feeling that somehow I was "making it all up".  I actually had a moment of true pride when I saw her move her hand and could see all the little tiny phalanges (finger bones) working as she made an itty-bitty fist.  I thought, with a sense of awe and amazement, "I made those hands!".  It is amazing to me!  I am sure the change also has some to do with the fact that I can feel her move all the time now and feel like I am getting bigger everyday.

Here we are at 24 weeks.  Obviously pregnant.  :)

You can see "the bump" better in this photo.  Strange how big I am considering I haven't gained any weight.  Peanut got bigger but not THAT big!
 We had a follow-up appointment with Dr. Nath at the Antenatal Testing Center on Thursday, January 26th.  They checked Peanut's spine again and it looks perfect.  Everything with my anatomy looked fine, including the amniotic fluid level.  They also checked on Peanut's growth.  She gained 5 ounces in the two weeks between appointments!  She is still pretty little; she averages in the 45th percentile for growth and weighs slightly less than most babies at this stage (1lb 2oz).  However, she did grow at a normal rate, she is just small.  (I guess her nickname winds up being apropos.)  They really tend to focus on the femoral length, or the length of the thigh bone, for checking growth, probably because it is the largest and longest bone in the body.  Her femur is small, but I did challenge the doctor a bit on how much to be worried about that issue.  After all, I have very short legs. (A 28" inseam!  LOL!)  But, he can be very dodgy and is extremely frustrating to talk to.  *Sigh*  Specialists are generally like that, in my experience.  He wouldn't say how worried we should be moving forward or how he felt things were progressing, but he didn't want to see us for four weeks, so I took that as a good sign and told him so.  We also have been given the go ahead to resume our routine care with the midwives, which is more evidence that I should probably relax more now.  I will have a regular prenatal appointment with the midwives on the Febrauary 9th and they will continue to stay in close contact with Dr. Nath.

        
This would have been another cute profile shot but then she moved.

We caught her yawning or drinking...well...we're not quite sure what she was doing!

So, to clarify for anyone who is concerned about how we are being cared for during the pregnancy...

As of right now, we will be seeing the midwives for our routine care.  The place that we go has three midwives and we have seen two of them so far.  One I really like and one I really don't, so I am guessing I will be ambivalent about the third when I finally see her.  The midwives are supervised by an ob/gyn that keeps track of everything that is going on in case there are complications during the pregnancy or delivery and are part of a practice that is based at Monmouth Medical Center.  Dr. K has been working with the midwives all along, and also with Dr. Nath, though I don't see him for my appointments.  He will continue to keep appraised as things progress and will be my doctor should I no longer qualify for midwife care or have an emergency during delivery.  He will defer to the Maternal-Fetal Medicine specialists should I develop complications from the abnormal placenta or if it seems like there are issues with Peanut, but until then there is no need for them to be involved daily or weekly.  Dr. Nath will continue to follow us as our perinatologist and will work with the midwives and Dr. K to ensure that they are taking the best care of both of us as is possible.  Due to the complications that could possibly arise, I will deliver at Monmouth Medical Center, which is where Dr. Nath practices and where the dotors that supervise the midwives are based.  We hope not to need it, but they have a Level III NICU should Peanut need any extra help.  One of my friends delivered there and was happy with her experience.  I am hoping we are as lucky. 

This could all change at any moment, but that it what is happening right now.

My hip and leg are still a really problem, but I have been blessed with a few good days and so I haven't gone over the deep end.  Yet...LOL!  I am still waiting to see if I can get a referral for the chiropractor or for the orthopedic specialist.  (Ugh! More specialists!)  I have had some days where my leg completely stops working, which is frustrating and scary.  Besides that and the normal pregnancy issues, I feel pretty good.  Just really, really, REALLY tired.  Which is totally normal in pregnancy, I am told, but I imagine the placental issues are also a factor in how ridiculously exhausted I have been feeling.

I have been spending lots of time lately chatting and reading to Peanut and just trying to enjoy her. She does seem to be happy in there...and for that I am truly grateful.  We've done some shopping, which has been fun since I was so unwilling for so long for fear of "jinxing" ourselves.  I can't seem to do as much as I would like to without causing my leg and hip to really start hurting, but our short excursions have been successful all the same.  Gotta love finding 40% off the lowest clearance price sales!  Unfortunately, we're not taking as many rides as we used to because sitting in and getting out of the car is something that hurts even on good days and I have had to miss visiting with folks for the same reason (Love you, Court!). 

Things are going really well right now and it is great to share good news with all of you!  Thanks for keeping us in your thoughts.