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.

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.

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.

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?

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!

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!

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??