Pregnancy ups, emotional downs

This week, last month, summer and autumn have involved a LOT of traumatic events locally, which I haven’t gone into here, as they aren’t the focus of this blog. They have taken my attention, though, which is a lot of why I’ve written so little. I just haven’t had the mental energy to either fret about or enjoy this pregnancy.They also pulled me out of the running and other exercise I was doing in the first trimester (my DH felt it got dangerous to run alone late at night, and asked me not to, and it was too hot during the day, and although I joined the gym, I really didn’t enjoy exercising there very much), and it’s been really hard to keep up my energy levels ever since. I spend a lot of time feeling exhausted.

On the other hand, my medical test results have mostly been good. I did the follow-up ultrasound on the excess amniotic fluid yesterday, and while there is still a tiny bit too much, it’s nowhere near as bad, apparently. The doctor told me to go back in two months (ie right at the end of the pregnancy) so they can see how it looks before the birth. I had actually been wondering if there was an improvement in this, because I’ve been feeling more kicks and other movements, and feeling them more all over.

Also this week I started a series of dental hygiene appointments at the local dental school. A second (of two) year student on a local parenting group asked for patients, and it seems a very good deal – a single cheap price for multiple in depth appointments completely under supervision. I really haven’t had dental care since I moved here, so this would be a good thing. Both my (student) hygienist and her supervisor stressed how important tooth care in pregnancy is, because gingivitis can lead to low birth weight and premature labour. In the health questionnaire at the beginning I was asked about present or previous instances of high blood pressure or liver issues, so mentioned the last pregnancy. I very quickly gave up on trying to tell them about HELLP, and focussed on the pre-eclampsia having led to both, but being fine for now and carefully monitored. In the end they just accepted that and moved on, because it doesn’t seem like either should really be affected by this treatment. I was somewhat bemused that neither of them knew what pre-eclampsia is (let alone HELLP), and only the student (who has two daughters of her own) had even heard the term before. On the one hand, I’m delighted she didn’t need to know, for her sake, but in case she might want further children I hope she at least knows symptoms to get checked out, even if she doesn’t know what they might be from. I have no idea if her supervisor has children or wants to, but same for her if so.

I am here

I keep thinking I’m keeping this blog much more up to date than I am. Where are we? I’ve had a LOT more medical appointments, and mostly everything looks fine, although I’m being followed up for excess amniotic fluid. That meant lots of blood tests for nasty infections and things, none of which I seem to have so far, and going straight to the three hour test for gestational diabetes, rather than doing the usual one hour test first. I just did those this week, so I haven’t been back to the doctor after them yet, but from what I could see/look up online, I don’t appear to have GD or anything else. So still no idea why the extra fluid, but I’ll go back to the doctors next week, probably, and see what they think.

I’m assuming that’s why I don’t feel so very many kicks, even though at every ultrasound they’ve said baby is very active indeed. When I lie down I feel a lot, and those I do feel during the day are nearly all at the top or bottom, so I think there’s just a lot of room to swim in the middle, and baby’s not hitting the sides so much.

Apart from the amniotic fluid, and some weirdnesses with leucocytes and lymphocytes, that my GP had me check for a UTI with (negative), everything looks good. My monthly blood tests show my liver results staying normal, and the anatomy scan and foetal echo showed all of baby’s organs developing well, and on schedule. (I think on average we were two days from the expected developmental age, which is basically spot on.)

We do the echo because our eldest daughter has a ventricular septal defect (VSD), which doesn’t affect her at all (no treatment, therapy or restrictions) apart from going for a cardiology check-up every couple of years to see has she finally grown out of it. It does apparently very slightly raise our risk of having another child with a congenital heart defect (CHD), so we do the extra scan with a paediatric cardiologist. He said he can’t rule out a VSD as small as our eldest has at this stage, but he has no reason to suspect one, let alone anything worse, and we already know that a tiny VSD isn’t exactly a major problem.

Most of the time we forget the nearly four-year-old has it. Just when she gets examined by a new doctor we mention it, so they don’t get worried by her slight heart murmur. We do NOT mention it at her nursery, dance class, or any other programme she takes part in. There’s no need to, and from what we read online from other parents, it’s better not to, as occasionally people like to take it upon themselves to restrict the child’s activity, which is the last thing she needs! I saw advice that if a form asks specifically about heart issues, the thing to do is write, ‘normal’, (which it is), so that you’re neither lying nor causing uninformed people to panic.

None of which is to minimise in any way the seriousness of other CHDs. I have a couple of friends with children with very severe heart issues, who needed surgery within days of birth, and in some cases need ongoing surgeries as they grow. Thankfully for us, our experience just gives us a tiny amount of extra empathy for what they deal with.

Radio Silence

Very strange – I really thought I’d posted this update a couple of days ago, but there’s no sign of it at all. In short, it’s still too hot (that’ll probably be the case until November, so I’ll try not to complain about it too much) and there’s been local drama going on that has largely distracted me from the whole pregnancy issue, which in some ways is good, as long as I keep dealing with stuff.

I saw the gastroenterologist about 10 days ago, and he’s referred me on to a liver clinic at a local hospital, and told me to avoid paracetamol products and alcohol (neither of which I use even ‘normal’ amounts of anyway, so that’s no issue). He didn’t seem to know a whole lot about HELLP or pregnancy related liver conditions, which I think is why he wants me to go to the hospital, where it’s easier for the doctors to work in a more inter-disciplinary way. (I.e. they can talk to gynecology immediately.) He also had me do new, more specific, blood tests to take to the clinic. From what I can see the new ones look like I’m back in the normal range, but I haven’t been seen at the clinic yet. I went to my appointment on Wednesday last, but it was cancelled at the last minute. They made me a new one for this coming Wednesday, but told me to phone ahead and confirm the doctor is back from his urgent overseas travel, so we’ll see what happens.

In the meantime, my mother has also had some strange liver enzyme results (definitely not pregnancy related), and had to follow up with a specialist. Unfortunately the health service/her insurance where she lives doesn’t have as comprehensive financial coverage as we do here, so I’m thankful she can afford what she needs, even if it’ll potentially cramp other things. I’m even more thankful that our national system is as good as it is, so that my only financial consideration is the time I have to take off work for appointments (the wasted one last week was annoying). We do pay a nominal amount of co-pay for specialist visits, but they are truly nominal, and our basic coverage is entirely means tested/treated as tax, which is how I personally feel such things should be. It is very comprehensive, too. It doesn’t cover regular optometry or dentistry (at least for adults – it covers more for children) but does cover ophthalmology and anything referred by a doctor, pretty much. Only once has the basic package declined to cover something for us immediately, and that was literally a case of, “reapply nearer to the time,” and then they agreed to cover it.

This is awfully cutesy, but honestly I’m not keeping track of exactly where I’m up to (in weeks and days) in this pregnancy, so will let a tracker do it for me. Colours etc are no indication of anything – this was just the least ‘baby’ one I could see. I’m still not entirely adjusted to that idea. I’ll get there. I hope.
Pregnancy tracker.

Sick of the heat

My DH says he thinks the heat has been less the last few days, but I’m definitely feeling it more. Maybe the humidity is up? I’ve been feeling ill whenever I’m not in air conditioning (which we don’t have at home, although a fan directly pointed at my head from no more than two feet away does help).

I actually went to the office today, which does have a/c. The journeys either way were rather brutal, though. I and a colleague go in by taxi two days a week, and since the regular drivers are paid a flat rate per journey, they tend to go pretty fast. Between the heat, the humidity, and the motion, I was decidedly queasy by the time we arrived this morning, and then on the way home the walk was atrocious. (We get picked up and dropped off at a central point in walking distance from both my and my colleague’s homes.) Since the gym was barely out of my way home (the other side of the main road) I ended up going in, enjoying their *cold* a/c, and having a shower and changing into some of the clean clothes I’d left there. I didn’t feel up to actually exercising, but I felt so much better the rest of the way home that it was definitely worthwhile.

I’m lucky, I’ve always thought, that I really don’t get morning sickness (in both of the previous two pregnancies I’ve had one incident of real nausea, right at the end of the first trimester, so I suppose that’s due in the next fortnight or so), but as with seasickness, sometimes the queasiness can go on for ages, when a good vomit should clear the head, at least temporarily. Oh well, so long as I can keep cool I’m sure I’ll be fine.

I’m due to see the high-risk doctor tomorrow morning, so I might bring this up. I’ll be interested to see what this doctor says. I won’t be impressed if I get brushed off, certainly.

Saw the new Ob/gyn…

… and I think I like her. She took her time, and listened to me, and seemed interested, and actually wanted to follow up on things. She’s in walking distance of my home, too, which means less than half the travel time, and no annoying waiting for the bus.

She said everything else was fine, but my liver enzymes are high, so she’s referred me to a gastroenterologist to follow up on that, because they shouldn’t be, at this stage. She seemed very unimpressed that I hadn’t been referred to one as general follow up on HELLP, so I feel much more confident about sticking with her as my regular one after all this, too. She also spent time actually talking to me about the various optional tests that the insurance company subsidises but doesn’t fully cover, so I can make up my mind on those.

Too Hot!

This is my third pregnancy, but my first to have the first trimester in the summer, rather than the winter. In the first two I felt freezing in the first trimester (my DH called me Icefoot), and too hot in the second and third. Apparently it wasn’t really about being colder in the first trimester, it’s about reacting more strongly to whatever the ambient temperature is. Right now, that is definitely Too Hot, even with fans, at 11:17pm. Goodness knows what I’ll be like during a winter third trimester. (Although I do want to experience the whole thing, thanks!) Presumably I’ll need all new winter maternity clothes… (I hate shopping, especially for clothes.)

Birth Priorities

It’s a long way off, but here they are, definitely in descending order of importance.

  1. I don’t die.
  2. Baby doesn’t die.
  3. *Everything* gets fully explained to me at every point.
  4. We’re both healthy.
  5. Time to bond and initiate breastfeeding directly after birth.
  6. DH and doula with me as much as I want them.
  7. No-one takes offence if I want to be alone at any point.
  8. Avoid ICU.
  9. No separation between me and baby after birth.
  10. Avoid Caesarean section.
  11. Contact with my daughters during labour and any/all hospital time.
  12. *I* choose the position of the bed, however I’m using it. (Sitting/lying on it, or leaning against it.)
  13. No epidural.
  14. Avoid induction.
  15. Not stuck on bed during labour or birth.
  16. I choose my birth position.
  17. Mobility as I want it and feel up to.
  18. Allow labour to begin naturally.
  19. Food and drink I want, when I want them.
  20. Funny, light-hearted books with nothing to do with birth, motherhood, health, etc.

 

I would love a home birth, but it’s not something I feel safe enough to hope for, let alone organise. I can’t face the disappointment of things not going as I want, again. That’s why I’m making this priority list. I want everything on this list, and just because I don’t get something higher doesn’t mean everything else can be discounted, but it does give me various points to potentially count as success, even if I don’t get to have it all.

This list may well change over the next few months (I’m sure there are things I’ve left off), but here’s the starter version.