Tuesday, September 30, 2008

Labs Today

When I had my first trimester screening done by my local group back in August, I was given a lab slip for another blood draw to be completed between September 18 and October 2. The tech told me to do it closer to the 18th of September so I would get the results sooner. By the way, this test is for neural tube defects.

I marked my calendar and placed my prominently marked lab slip in my day book weeks ago, thinking, yep, I'll be there on the 18th. Well, here I am just two days before the test "expires" having my blood drawn.

Distractions, distractions. Such is life with a two year old. And it's even worse with a sick two year old who was born a micropreemie. By the way, she is back to her old happy self and thankfully, Hubby and I escaped getting sick ourselves. Oh, and flu shots are lined up...times three!

Thursday, September 25, 2008

17 Weeks!

Here I am at 17 weeks. There is really not much to report... I got my second Progesterone shot this morning, thank you, Kim! And like last week, it was a piece of cake. The shot was injected into my left side this week and I will say, I had some minor bleeding at the injection site but other than that, feel fine. I did spend some time sitting on the heating pad which I think is helpful in reducing any potential discomfort.

I created a little shot countdown that I posted on the right side of my blog. The first thing my husband said to me when he found out Kim came this morning was two down, 18 to go. It seems funny to me to count my shots down, for each week that passes, we are that much closer to meeting our little boy. And I know I've said it before, and I have no problem saying it again, I am in no rush for this pregnancy to be over!

Plans are all well and good, but as I realized with my first pregnancy experience, plans go out the window real fast. Nonetheless, I still can't help but play out in my mind the way things "should" go:

My hope is that I am still pregnant at 36 weeks, that PTL (pre-term labor) doesn't strike or that I don't fall victim to pPROM (pre-term, premature rupture of membranes). 37 weeks is considered term and I would feel more comfortable scheduling my c-section based on that milestone because of my own crazy fear of uterine rupture. But given the fact that we are expecting a baby boy, and boy lungs don't mature as quickly as girl lungs, I think it's best to plan on having an amnio to confirm his lung development is mature enough for delivery.

So what was the point of all this? Assuming I get to successfully cross off each one of those remaining 18 syringes, my next hurdle becomes dealing with an amnio... why does that cart always get in the way of that horse?

Wednesday, September 24, 2008

Catching Up and Hoping I Don't Get It!

My Sweet Little Miss came down with her first cold of the season on Sunday. It must have been brewing for a few days as the end of last week, I was mom to a very unhappy and miserable little girl. We thought it was just a phase but Sunday morning, she woke with a runny nose and by afternoon, she had a low-grade temp. By Sunday night we were on O2 and by Monday, sitting in the pulmonologist's office learning she had a raging ear infection. So much for the oozing that ear tubes are supposed to provide you with when an infection is running rampant. I have no idea how long the infection was brewing but it was long enough to wreck havoc on her respiratory status and her asthma flared up, requiring a couple days worth of oxygen therapy. We will probably continue it for the next couple of nights just to be on the safe side. Thankfully, her fever is gone and she is satting fine during the day.

Now I am fighting something as my throat is scratchy. I hope that's the extent of it.

Yesterday, Little Miss and I spent most of the day in bed, just hanging out and watching TV. Oh, how I hate to admit that but when you are a two-year old tethered to a tank, there are few options. Anyway, in the midst of checking my email, I noticed that something had leaked. It was clear fluid, no mucus or anything and no, I didn't cough or sneeze and nothing about caring for a sick child is funny. So as far as leaking pee, I don't think that was it. But there was something and that something remained unknown. I told my friend and ran it by my husband, who both insisted that I place a call to the doc. They were at lunch (a long one at that) and by the time I remembered to call back, the office had closed.

I knew there was absolutely nothing they could do if I was leaking amniotic fluid. I know if much of anything happens at this point, there is nothing that can be done. The baby is all of 6 oz (hard to believe Precious Miracle was just a whopping pound more at birth) and at almost 17 weeks, not yet viable. It breaks my heart to think that way but I have realized that I can control what I can and what I can't is really out of my hands. Why worry, why obsess? I have done absolutely everything I can to make sure this pregnancy goes to term. I cannot second-guess and question that nor can I spend my day thinking about everything that could go wrong. I chose to move on.

What made it easy to move on was knowing that I had an appointment to be seen by my local group this morning. I told the nurse what happened with the leakage of something and she said, we'll just do a quick test for amniotic fluid. Well, by the time the doc walked in, that was out the window, as he claimed if it was fluid, it would not have been a one-time thing. Back to that whole trust issue...

So why didn't I just demand the test, just to put my mind at ease? Perhaps because I just didn't want to know. Maybe that is my whole approach to this pregnancy. A do all you can, close your eyes and pray that everything works out okay approach? A don't go looking for issues if they can't be fixed approach? Denial? Detachment? Not yet sure.

Back to the appointment: all looks good! I gained two pounds, yippee! No more anorexic momma here! My cervix is measuring 3.3 cm and with fundal pressure, remains long and closed! And my uterus is right on target in terms of size and the baby had a good heart rate of 145. Oh, and he is very active!

I also asked Dr. G (as Dr. C requested) what his thoughts were about bed rest. He said nope, not necessary. Thank goodness! Now, there is always the caveat that if God-forbid, something should be identified, I will climb into bed in a heartbeat and stay there until this little guy is ready to be born.

Oh and the other difference between the two docs, Dr. G wants to start weekly checks now as opposed to week 20. I'm okay with that.

Finally, I just want to add that since Missy has been sick lately, she has been very clingy and needing lots of cuddles. We have spent the past few days practically attached to each other as Daddy can't even hold her nebulizer. Everything is, "No, Mommy do it!" Anyway, when she snuggles into my tummy, putting a little bit of pressure on my growing bump, the little guy gets all charged up, moving around and around. Now if he could only see the stickers that decorate my stomach from time to time, courtesy of Big Sissy... we'll just take a picture and show him in six months from now.

Saturday, September 20, 2008

Another Call to the Doc...

Okay, back to the spirit of honest reporting. This morning I passed some mucus - enough to show my husband and enough that led us both to decide it was worth a call to the doctor. Dr. C was on-call and offered to see me, but felt that as my pregnancy progresses and in light of my TAC, mucus-like discharge will only be on the rise.

It is hard not to reflect on my first pregnancy when on the Sunday prior to learning my membranes were bulging, I passed something that hindsight tells me was my mucus plug.

This time around many thoughts went through my head. If it was my mucus plug, would I be placed on bed rest, started on antibiotics and told to just wait? If I started contractions or active labor, or if infection were to occur, I would have no choice but to have a c-section and deliver. You see the TAC is so great, you can't deliver vaginally. There is enough room for an early miscarriage (up until about 14 weeks) to pass but beyond that, a Cesarean must be performed.

Dr. C is really starting to know me well. He said if I am going to obsess about what happened, then my peace of mind is his peace of mind and he would like me to come in to be evaluated. He also stated again that there is a very low threshold for admitting me this pregnancy. Then he brought up what I feel like is his favorite topic: bed rest. He admits he's very conservative and that the literature really doesn't support it as a prophylactic measure but still feels I should, perhaps at 20 weeks, go on limited activity.

Dr. Davis told me aside from bungee jumping and sky diving, I can carry on with life as usual. I told Dr. C that this bed rest issue seems to be the biggest discrepancy between the two practitioners. He wants me to run it by Dr. G who I plan on seeing Wednesday.

Getting another opinion from my perinatal group is not the same as getting another opinion from a TAC surgeon. They see these high-risk patients day in and day out. They know the limitations and successes of their work and I am positive they would not advocate for no bed rest if in reality all of us TAC mommies should be reclining for the remainder of our pregnancies.

This reminds me of something else Dr. C said today. He said he does NOT look at me as just a regular pregnant woman. I'm glad to know his opinion of me as a patient and truly appreciate the fact that he takes the time to have these conversations with me, especially on a Saturday morning. I also appreciate that he knows exactly who I am when I call and that I can be an active participant in my care, sharing my opinions with him. That whole relationship as equal partners in my care is working! I am very thrilled that this has been achieved!

The conversation ended with the plan that if anything changes, I will call. If I have any bleeding, watery discharge (leaking membranes), severe cramping or contractions I will go in to be evaluated.

In the mean time, I have been hydrating very well. And, in the spirit of confidence in my doctor and confidence in my intuition, walked around a tree house exhibit with the rest of my family. So far, so good... just don't share this with my doc!

No Words To Eat...

There is no change of heart for me regarding my first Progesterone shot. The crampy feeling I had in my muscle was virtually gone by the time I finished with the heating pad. Upon assessing my injection site later in the day, I could feel only the slightest little bump - about one-half the size of a pea - when I flexed my muscle. Not bad.

I will admit I am now wondering what other side-effects I may have developed as a result of the shot. I've been so focused on injection site issues, that I neglected to even ponder other consequences that could potentially cause trouble.

For example, late afternoon on Thursday, Missy and I met Daddy at a golf-outing dinner. I was so mentally out of it, I could hardly carry on a decent conversation let alone deal with the fussiness of my two-year old. Fatigue also set in pretty strong and I couldn't wait to get home to my bed. Thankfully I followed Hubby home but will admit, I was driving on reserves - no actually fumes. I was that tired.

Looks like the fatigue was not an isolated incident as that has been my M.O. for the past two days: tired, just plain tired.

Then yesterday, I felt a faint pressure across the lower part of my forehead. I showered before bed, thinking that would help eliminate an escalating headache. But I was wrong. I had a terrible night of sleep as my headache quickly moved across the entire back of my head. This is a very different type of headache than I usually experience with my migraines, which I am thankful to report, disappear when I am pregnant. I did break down and take a Tylenol this morning and went back to bed with the heating pad. My first Tylenol during this pregnancy.

It is hard to function in a mental fog. Pregnancy tends to bring on that mushy brain anyway, and now I feel as though I have been dumbed-down even more. With my Prometrium pills, I would sense a feeling of intoxication with my afternoon/early evening dose. It was very short-lived but intense. While this current feeling has less intensity, it is constant. I wonder how long it will take to get used to my new, yet temporary, mental state.

Wednesday, September 17, 2008

Welcome CarePage Readers!

It’s official, Little Miss is going to be a big sister to a very lucky little brother! We discovered on Saturday, June 21 that we are expecting our second child. I am 16 weeks today and I suppose you could say the cat is finally out of the bag.

We initially thought it was going to be a long, long road: a road filled with much nervousness and anxiety, but it is really amazing how quickly time has flown by. I can't believe I'm 16 weeks already. I realize I still have many weeks to go and I have not entered what I consider to be my "danger zone" yet. Thankfully, I have my darling daughter to keep me grounded and focused. Without her, I don’t know how I would make it through this high-risk pregnancy.

It was extremely important for us that Missy Girl not be an only child. We so desperately want her to share her life with a sibling. For those surprised that we might attempt another pregnancy, here is how we got to where we are today:

We (more I) did a tremendous amount of research into why our little girl arrived at 24 weeks. I met with many specialists, talked with numerous physicians, connected with other preemie parents and joined online support groups for women like me: women who suffer from cervical insufficiency. It turns out that I have an anatomically short cervix. Basically, I don’t have much of one.

There were a couple of opinions on how to handle a second pregnancy. Most physicians, even the group that followed my first pregnancy, suggested a transvaginal cerclage (TVC) be placed around 14 weeks. This is cervical stitch in which they “sew” your cervix closed through a vaginal approach. It is amazing to me the number of “experts” who recommended this course of treatment without even knowing if I had enough cervix to stitch. There is much risk of cervical tearing, funneling and other complications that would require bed rest. Prior to even knowing my cervical status, I knew in my heart this was NOT the prophylactic option for me. Not to mention the risk to our unborn baby as the doctors are “fooling around in there” possibly nicking the fetal membranes. By the way, I don't have enough cervix to stitch so had I gone with this option who knows what would have happened.

There IS another option out there that most physicians felt was too radical a step: the placement of a Transabdominal Cerclage (TAC). In fact, none of the physicians who suggested a TVC even mentioned the TAC. And when I did, the feedback we received was to try the TVC first and if that fails, then move on to something more aggressive.

We wanted to do all that we possibly could do to ensure a successful and healthy pregnancy from the start and were not prepared to lose a child just to prove to the doctors something more ambitious should have been done. There is a such thing as instinct and my heart was really pushing me on this one.

All the research and discussion ultimately led to my pre-pregnancy placement of a Transabdominal Cerclage (TAC) on March 10, 2008. I found a fabulous MFM (Maternal Fetal Medicine) in South Jersey who is the board doctor of an online group called “Abbyloopers”. This board advocates for TACs, and after reading how many women have lost babies due to failed TVCs, our decision was confirmed. By the way, of the three physicians that I spoke to about performing the TAC surgery, they all agreed that I was a candidate.

Essentially, Dr. Davis (MFM) went through my c-section and placed a mersilene band (polyester fiber) internally around my cervix just below the uterine artery. While mine was done pre-pregnancy, it can also be done in the first trimester. Hubby and I were not willing to add additional risks to our future baby and knew pre-pregnancy placement was the option for us.

I was in the hospital for two days and had to take it easy for a couple weeks after surgery. The success rate, when done properly, is extremely high, much higher than that of TVC. We absolutely lucked out. Not only did we come across a physician who is expert in the field of TACs (he performs at least three per week and women travel all the way from the west coast and internationally), but he is only 2 hours away and has agreed to monitor this pregnancy as much or as little as I would like.

I am also being followed locally by the same group that handled my first pregnancy. They are treating me with kid gloves this time around and I must say that I am much more educated in obstetrical care than I ever imagined I would be. It is fair to say that I am confident in my ability to not only direct my care but also demand or deny specific care and challenge anyone who disagrees with me. We are sticking with this group because they are the only suburban high-risk group and, in the event our baby needs NICU care, we want only the same fabulous physicians and nurses who took care of our baby girl to take care of our baby boy.

I started this blog back in January documenting our decision to grow our family, followed by my search for the best surgeon. From there I chronicle my journey through surgery, recovery and finally learning that we are expecting. (Previous posts are archived on the right side of the blog.)

This blog is public and my intention is to spread the word about pregnancy after prematurity and Transabdominal Cerclage. I have been brutally honest in my posts and hope to encourage other women suffering from cervical insufficiency to investigate Transabdominal Cerclage. As you can see, due to the public nature of this forum, I have elected to keep the names of my darling husband and daughter private.

I update this blog often as I chronicle the daily ups, downs and milestones of this pregnancy. I am not currently aware of a feature that notifies readers of updates (please, someone correct me if I'm wrong!) so I advise bookmarking this site or adding it to your favorites if you are interested in following our story. Also, please, please, please feel free to direct anyone to this blog who may benefit from reading our story.

One Shot Down at 16 Weeks

My neighbor Kim, who is a nurse, was kind enough to come over this morning at 9:00 A.M. to give me my first of twenty prescribed 17P shots. She could sense my nervousness through my emails alone as we went back and forth on timing. Initially we were going to do 11 but I thought Hubby should be here to help massage my injection site.

I am so glad we had a professional do this! Thank you, Kim! Just watching her draw up the solution into the syringe was enough to let me know we are not equipped to do this ourselves. I would be standing over my poor husband's shoulder second guessing if he did it right. Yes, second guessing him with all the medical training I've had which is zero.

My behind was iced to the point where it turned red. Kim had me lay on the couch to better relax my muscle. She gave me the necessary warning and I must admit, I was pleasantly surprised! The needle stick itself was just that, a slight stick. The solution didn't burn going in but towards the end of the shot, I could feel a "build-up" of sorts. I suppose that was the accumulation of the Progesterone in my muscle. I had slight cramping and tightening in my muscle but nothing major.

Missy had speech therapy in the basement playroom and was thankfully occupied while I warmed the injection site with a heating pad. Hubby didn't even have to massage anything!

I am so glad it's over with as the build-up and anxiety leading up to the shot was much worse than the actual experience. It was so nice to be pleasantly surprised.

So for all the women out there anticipating a painful Progesterone shot, it's really no big deal! Let's hope I don't eat my words later today. I'll let you know if I have a change of heart...

Getting a Little Nervous

My very first Progesterone shot is scheduled for tomorrow. I am getting nervous, especially after seeing the size of the needle. It's 21 or 22 gauge and it looks like a whopper! I keep reminding myself I would much rather endure a painful stick each week than be sitting with my baby in the NICU. My friend Wendy put it well. She said every shot I do is one less. That is so very true, there is an end in sight.

I have scoured the Internet looking for tips from other women on how best to prepare. My shots are ordered weekly so I will alternate sides each week. Otherwise, I think my plan is this: I will ice my behind (it's an intramuscular shot), warm the solution in the syringe (I read it doesn't change the makeup of the medication), bite the bullet and have it injected, then apply moist heat while my husband massages the injection site. I've decided to do it early in the day so I can use my muscle and hope it works the solution through better. I've read horror stories of women who have injected prior to bed only to wake up at 2:00 in the morning with terrible pain.

I go through all this strategizing and then I think of all that Missy endured through her 105 day hospitalization, her post NICU admissions for asthma and her two seasons of Synagis. I have absolutely no right to be such a wimp about this. Bring it on!

Tuesday, September 16, 2008

Enough Already!

I am two days away from 16 weeks and I had another round of vomiting this morning. What gives? Why is this pregnancy making me so sick? Typically morning sickness is over at this stage. But no, here I am feeling so sick to my stomach. I actually took my temperature to make sure it wasn't something else. I really shouldn't complain because in the end, all we want is a healthy baby and I will hang upside-down by my toe nails if that's what it takes. Believe me, I would. But when everyone I talk to says it should be over by now, I can't help but anticipate that good days are around the corner. It's one long block and the corner is nowhere in sight!

Monday, September 15, 2008


This week - week 15, marks the point at which the remainder of this pregnancy is exactly what my entire pregnancy was with Missy. Actually, at this point (15w 4d), assuming I get to term, I have 24w 3d left. A mere two days shy of the entire 24w 5d she got in the womb. And, technically, I am more than 1/3 of the way through this pregnancy. It is absolutely flying by - not something I really hoped for. Yes, it makes the worry less (I honestly could be much more of a wreck than I currently am) but the reality is, this baby boy will be here before we know it. Am I ready to be the mother of two??

I've said it before and I'll say it again, my pregnancy with Missy felt like every minute, every second was excruciating. Now, I blink and a whole week goes by. Did I somehow wish her early birth? Yes, we were anxious to meet her and I couldn't wait to hold her and I can only wonder if that contributed to things. That is my irrational brain at work. The reality is that no, it didn't. But I can't help but ponder...

My stomach is clearly upset. I would really like to settle for a happy medium. My previous issue is currently no longer as whatever I eat quickly ends up going through my entire system. I really have to be careful that this latest inconvenience doesn't end up interfering with what was starting to look the return of a semi-normal appetite.

Sunday, September 14, 2008

A Confusing Night

Before I get into the events of this evening which involved a phone call to my practitioner, I want to mention that we went shopping as a family for maternity clothes this afternoon. I ended up getting some fall/early winter staples that much resemble my usual wardrobe: ribbed turtlenecks. I tried to mix it up but that's just not possible. Additionally, I was afraid to purchase too much as Mimi has a "store credit only" return policy. And with my history I feel I never know when things could possibly change. My hope is that I have enough to get me comfortably through fall - if fall would ever arrive - it was 92 degrees today.

After my mini shopping spree, we went to my mom's for dinner. That's when the tightening in my pelvis/abdomen started. About every twenty minutes or so, I would feel this tightening/cramping sensation that would peak and then slowly dissipate. Both hubby and mom were feeling my stomach to see if they could sense the same tightening outside as I did somewhere on the inside. Nope, I felt the same. As one came on during dinner, it was determined that I needed to call the doctor.

So, on this Sunday evening, I learned Dr. G was on-call. He called me back and we had a nice conversation. Nice in the fact that he acknowledged that this pregnancy is going to be very stressful and that each twinge and pain will be assessed very critically. Nice in the fact that he encouraged me to call anytime something doesn't seem right - that they, my group, should be the ones to determine if it's worthy of concern or not.

The part that leaves me confused and troubled is this: Dr. G said what I described sounds like contractions. However, he also said that contractions don't start at this gestation 15.5-16 weeks of pregnancy. He claims I am having uterine cramping. I asked about Braxton Hicks and he said no, not Braxton Hicks either. This makes me wonder - last time I saw Dr. Davis, they saw Braxton Hicks during my scan. Dr. Davis also said that the uterus contracts from the very beginning of pregnancy. Perhaps I misunderstood contraction versus cramping. Who knows but it's moments like this that make me really question and that is not good. I need to have faith in my group. Faith in my local group.

We left for home and I had another episode in the car and then again about 30 minutes later at home as I was getting ready to read to my Little Nut. It took quite awhile longer but eventually my issue became clear. I must have some type of GI thing.

Hubby commented that I must have what he had on Friday night. Which at the time, I asked him if he thought it was something that was going to work through the household. Luckily his was a one-time trip to the bathroom. Thankfully, my cramping has stopped and I feel better. I can't help but think this could be the precursor to labor as the Tuesday night before I found out my membranes were bulging, I was so sick in the bathroom, cleaning the pipes from both ends. That was with Missy's pregnancy - my only other experience on which to draw from. Oh, and I hope this stops here. I cannot imagine an upset stomach while potty training. We've been three weeks diaper-free and I can only imagine an event like this would cause a dreaded setback.

Friday, September 12, 2008

No Infection!

My local group was able to squeeze me in for a quick check this morning at 9:00. I saw the same doctor who told me my membranes were bulging and that "you are not leaving the hospital until you deliver. Could be 12 hours, 12 days or 12 weeks". (By the way, it was a Friday that all this happened.) Needless to say, I was a little nervous about seeing him. I have friends who love him and I have friends who feel anything but love for him. Trying to make a positive relationship out of this, I tried to give him a new chance at becoming a doctor I like. Remember, he could very easily be the person who delivers me this time around.

Back to today. He was thorough, and I felt I was treated with kid gloves. Even though I was squeezed into the schedule, I didn't feel rushed as I asked him the outstanding question about prophylactic antibiotics. He took the time to give me an answer I felt satisfied with, especially after discussions with other physicians, that there is no evidence-based information that treating prophylactically does anything except create resistance to treatment in the future.

So back to my supposed infection. Turns out I have irritation and it is recommended that the next time I have an ultrasound we use a covering that does not contain latex. I never thought of myself as someone with a latex allergy but I will take this precaution in the future.

Thursday, September 11, 2008

15 Weeks!

Here I am at 15 weeks. There is not much to report from yesterday except that Daddy got to feel the little guy moving a tiny bit last night. No, it wasn't gas, it was clearly the baby moving around inside his warm and cozy quarters.

It looks like I am unsure if I have an infection so I am going to my local group to get checked. Initially, Nurse Barb said I didn't need to be seen, that something would just be prescribed. That was not okay with me. If I don't know for certain that something is going on, let alone what, if anything it is, then how will they know what to give me? If it isn't an infection, I think I am having a reaction to the covering or gel that is used for the transvaginal ultrasounds. Their coverings are different from the ones they use at Dr. Davis' office, which so far, haven't given me any issues. Yesterday was my first transvaginal scan with the local group this time around. I really hope it's nothing but I need to be 100% sure.

Wednesday, September 10, 2008

A View of My TAC

I had an appointment with Dr. C this morning. It was a regular appointment so I hopped on the scale - and according to their records, I have neither lost nor gained. My weight is exactly what it was on July 30th when I had my first appointment. I was happy to know that based on the same scale as six weeks prior, my weight did not go down. My blood pressure was taken and thankfully, it is where I am used to it hovering: 90/50. We also heard the baby's heartbeat on the doppler: 153 bpm. It was picked up very easily and there is no better sound in the world.

Dr. C then did a cervical scan. It was a landmark day as he saw my TAC for the very first time. He then went on to evaluate my cervix. He came up with over 3 cm of cervical length. I am not so sure how I feel about this as Dr. Davis claims that the cervix does not get longer but that the lower uterine segment can often be mistaken as cervix. Dr. Davis consistently measures my cervix at 2.5 cm with a functional length of 2.4.

The events of today took me back to my almost 18 week anatomy scan with Missy when I was told my cervical length was 2.5 cm and that it was the "low end of normal" but still "ok". If there is a tendency to overestimate, chances are it wasn't 2.5 cm. If a proper measurement was achieved, would other measures have been taken that could have prevented her premature birth? Thoughts such as these are a vicious cycle as I remind myself often that Missy is who she was destined to be. Perhaps had they been wise to my cervical issues and attempted a transvaginal cerclage, my membranes would have ruptured. When I look back at it all, especially considering just how well this child is doing, I can only feel blessed and thankful that everything went exactly as it did.

So the question becomes, why do I keep questioning this group? Is it because I blame them? Is it because the same room where my exam was held today was the exact same room where I was told my membranes were bulging? Is it because they were not advocates of the TAC? Is it because I trust Dr. Davis more?

I really like Dr. C. I do. He treats me with respect (now that we've moved past our differences in treatment options and I took charge of my care) and was very thorough prior to the start of today's exam asking very telling questions about discharge, fluid leakage, back pain, etc. I felt he was extremely methodical and cautious with my c-section the first time around, doing all he could to ensure I didn't have other issues down the road. I trust his skill in that fashion and would really prefer that he deliver this baby over anyone else.

My main concern is funnelling, which in my understanding, is easily identified. I am certain that this phenomenon would be picked up by anyone qualified to do a transvaginal ultrasound. I am really tempted to stop driving to see Dr. Davis and in fact am really close to canceling my appointment for Tuesday. Yes, it's nice to see the baby but the reality is he's moving and I feel it. Perhaps not everyday but just when I realize it has been a while, he gives me a nice nudge. And yes, it was confirmed that Missy is going to have a baby brother! We are excited to be expecting a baby boy for a number of reasons, one of which I already addressed (although the name thing is back in the air again). I'm sure I'll address the other reasons in later posts.

On another note, it looks like my placenta previa has reduced itself to "marginal" and Dr. C is confident it will continue to move away from my cervix. He too said not to be alarmed as I am having a c-section anyway. The good news he pointed out was that it's posterior, meaning the placenta is on the back of my uterus as opposed to the front of my uterus. Adhering to the front can cause a whole new set of issues which it looks like, thankfully, I'll be able to avoid.

All in all, today was a good visit. I got a call from the pharmacy that my progesterone was filled. Hubby just needs to stop by and pick it up along with my syringes. Then we need to submit for reimbursement - fun.

We are also debating whether or not to go back to the doctors office so hubby can learn how to inject my medication. That would entail going at 16 weeks for a lesson and then going back at 17 weeks to confirm he can administer the shot properly. I am really nervous about him doing it for some reason although there is absolutely no need to be.

My nausea returned for the better part of the morning as I hadn't felt as sick for a few days now. I'm hopeful this will pass very soon - why does it seem like I am always saying that?

Friday, September 5, 2008

Insurance Woes!

After spending over three hours on the phone with my insurance company over the past few weeks, I received conflicting information which basically made my visit to my primary care yesterday a waste of time. It turns out that BCBS changed their policy in the midst of my conversations about P17 and home health care coverage.

The same woman from Baby Blue Prints that I dealt with during my first pregnancy called me this morning (after I spent 1.5 hours on the phone with member services) to let me know that I must pay for the injectible out of pocket and have my husband, friend, neighbor, etc. learn how to inject this viscous solution into the muscle of my behind on a weekly basis. I was told this after reading a horror story of a woman who received her injections incorrectly and ended up with a terrible infection. Infections and pregnancy don't mix. Why chance it, or so I thought - give me a nurse to shoot me up with progesterone each week. My husband sure can't stomach that and I can't very well aim for my tush with any accuracy, especially as I get bigger and bigger.

My frustrations came out on this woman as I ranted and raved over the fact that my breast pump rental (a one year rental) was not covered by my insurance when in reality is should have been. Having a 24 weeker in the hospital for 105 days and then bringing home an oxygen-dependant baby who doesn't have the strength to breastfeed each feeding, is defined as a very legitimate reason to have a hospital-grade breast pump. Yes, I am proud to say, that Missy Girl got one year of breast milk and was eventually (with the help of a handy invention called a nipple shield) able to take some of her feedings each day at the breast.

The point of this whole tirade was to illustrate to the woman that I don't trust the insurance company to reimburse me.

It looks like all the work my new primary did was for naught. My visit yesterday was for nothing - although I have the wonderful knowledge that I'm anorexic - remember it's lack of appetite, not some purposeful avoidance of food.

I see Dr. C next week at which point I am going to request that they attempt to get me a home health nurse. Yes, come 20 weeks, I will be seen weekly, and could probably get my shots then. Yes, I have friends who are all too familiar with these injections who have offered to teach proper technique to hubby. And yes, I have two neighbors who are nurses and have offered to help me out. But really, how do you repay someone for coming over once a week (for what should be a 20 week treatment) to stick a needle in your bottom? Would it be more comfy to get my shot at home - absolutely! Abbyloopers members have given me the plan: warm the vial in my bra, try to find the smallest gauge needle that will work, ice my behind until numb, take the shot, massage with heat and just stay in bed! Oh, and alternate sides each week.

This is far from over!

Thursday, September 4, 2008

Second Trimester!!

I am officially in the second trimester and feel extremely hopeful that my sickness will go away once and for all!

My new primary care is in the process of working on ordering my progesterone shots and home health care nurse who will administer the shots each week. This new doctor, who is fresh out of med school, I might add, called me anorexic when I told her how sick I was and how it is very hard for me to eat as I have aversions to almost everything lately. She really made me mad! After doing some research, I discovered that she is correct. There are two different terms: anorexia nervosa which is a purposeful disorder and just plain anorexia which is defined as "a medical symptom of reduced appetite" http://en.wikipedia.org/wiki/Anorexia_nervosa.

So it looks like I have a clinical diagnosis of anorexia or reduced appetite. Why does is sound more terrible than that? Like I am a pregnant woman purposefully starving myself?

Moving along, I have started to develop what feels like carpel tunnel in my left wrist. I am not left handed and notice it mostly when I am driving. It's pretty uncomfortable but nothing major - just another difference between my two pregnancies.

Which by the way, assuming this child is a boy, I take back my previous comment about needing to come up with a name. You see, even before we knew that Precious Miracle was a girl, we decided that if she ended up being a boy, we would have named him after my deceased father, Karl John, calling him Jack after my husband's deceased maternal grandfather. Yes, I know Jack is a relatively common name and I personally prefer names that are less-common. But the family connection is so strong, in our opinion, it overrides the fact that more than likely, he won't be the only Jack in his class. We are feeling somewhat confident that Missy will be the only one with her name in school - at least that's how it is this year for two-year old preschool! But back to Jack - it's such a strong name. Missy actually says, "Baby Jack in tummy" and gives him kisses.

I suppose the reason for the comment in my previous post was because I just want to be sure that's the name we are going to go with. There are some other names we like, for example, Henry and no, we would NOT call him Hank. That's about as far as we've been able to get. We have a girl name all picked out but these boys names are tough! The other part of this is that it is very emotional to commemorate or memorialize two very important people in our lives. My father passed away when I was six and my husband never met his grandfather, someone, who if my husband had an opportunity to meet, would in a heartbeat. I know it will be just as emotional for my mother, my two brothers (both younger than I), my husband's mother and his grandmother.

The other thing that I'm sure my father-in-law is secretly wishing for, especially considering the baby is due right around his birthday, is for us to name the baby III. My husband (obviously a Jr.), has a unique name himself and found it difficult growing up with a name that people always did and continue to butcher. He is pretty adamant about NOT naming this baby III. The only proposal I have - a gamble of sorts, is that if this child happens to stay in until March 4th(Grandpa's birthday) then by all means, we should name him III. I say this knowing that in all likelihood, this child will be out around Groundhog Day. If he makes it to March 4th, that in itself, would be amazing!

Tuesday, September 2, 2008

High Risk Times Two??

No, not two babies but ANOTHER pregnancy complication has come up. Dr. Davis said not to worry about it, but it's hard not to. It turns out I have placenta previa, where the placenta has formed covering my cervix. It sounds like it could still move up but at almost 14 weeks, I am not really sure. The bottom line is that Dr. Davis feels my TAC is holding things together nicely. However, placenta previa can cause bleeding which would make me FREAK out! And it turns out this bleeding, heavy bleeding I might add, usually comes towards the end of the second trimester and into the third. My understanding (which could be wrong) is that it's best to deliver by c-section, which I have to do anyway.

I'm praying that all goes well! The baby is growing like a weed, measuring ahead of LMP gestational age. It is very active! Preferring to bounce around and suck his/her thumb. I'm gonna go with him because all signs with this pregnancy are pointing to a him. Now if we can just come up with a name...

Also, during my ultrasound today, braxton hicks contractions were very evident. Fabulous! Dr. Davis assured me, even prior to this confirmation, that uterine contractions begin very, very early in pregnancy. I am two weeks and just about a day away from getting my first P17 shot. Let's hope all goes well with that pharmacy order and that my new primary care gets it right.

And yes, I've lost about 4-6 lbs so far during this pregnancy. Not the case with Little Miss as I was getting quite plump all the way around with her. Again, I was told not to worry. It turns out sickness can cause weight loss in the first trimester. Let's hope I gain a healthy amount of weight for the remainder - 26 weeks - of the pregnancy. Dr. Davis equated the baby to a parasite - the best parasite - a parasite that will suck every last drop of whatever it needs out of me. I'm sure sucking the life out of a sauerkraut hot dog is extremely healthy, but since I really can't eat anything, my craving had to be satisfied - finally, tonight was the night. But I had two and now I feel sick so I doubt I'll crave another hot dog anytime soon.

Finally, did I mention that placenta previa by itself puts me at high risk? What does this make me, high-high risk??