Pregnancy Week 24

It has been a crazy month since I last updated about my pregnancy. On the 22nd of January, I had the second anatomy scan to get a look at the parts that the tech couldn't get with the baby laying on her tummy. I was also meeting with main delivery dr for the hospital that I like. I invited my sister to come with me this time as I am allowed 1 guest and any child under 8 so my niece came as well.

Week 21 Day 4

We went into the ultrasound pretty quickly after getting there. The baby had been moving a lot the night before and was laying on her back this time. So the ultrasound tech could get the face, hands, feet, chest and heart. They also do 3-d scans of the face. The baby loves to have her hands by her face and suck on her thumbs, but luckily she was moving around enough to get a good shot of her close up.

After the ultrasound, we waited in the exam room for the OB and that took forever, maybe 45 minutes or an hour. We even thought they might have forgot about us. The appointments with the dr after the ultrasound are scheduled as a separate task so there was a little time between the ultrasound and the dr appointment, but also the dr was a little late. I was ok but Naomi was grumpy about being in the exam room for so long. 

My sister really didn't like my ob. She thinks that she was rude. I think she was a little short, but my sister kept interrupting her explanations to ask questions. So I think they were both being a little rude. My opinion is that the labor and delivery nurses do a lot of the work and I will interact with them the most so I just like a Dr that can handle anything crazy before or after delivery. 

There were a few concerning issues with the second exam. The first, was that the cord was inserted into the placenta at 1.9 cm and it should be at least 2 cm. Since 1.9 is so close it is not a big deal but something to monitor because the baby might not get as much nutrients.   

The second thing, was an EIF (echogenic intracardiac focus) which is a calcium deposit on the heard and shows up as a bright spot. It is a soft marker of down syndrome because EIFs show up more in babies with down syndrome, but EIFs are also seen in typical babies. Since, I already did the genetic screening for down syndrome then there is no concern about down syndrome. I could do a more invasive and risky test to be 100% sure instead of 99% sure, but I don't think the risk is enough for 1% difference. 

The final thing, which is the most concerning was that there was fluid on the heart. The doctor was concerned about this but she wouldn't speculate about what that would mean without sending me to a maternal fetal medicine doctor for a closer look. She said that she just wanted to "cross the t's and dot the i's" so I shouldn't lose sleep over it. Ha! Having less information proved is not very good for me in the coming weeks.

Other than those, I learned that because of my advanced age that the OB office I go to induces at 39 weeks even if everything looks good. I was not sure how I felt about that. I really wanted to at least get to 40 weeks May 31st even if I have to get induced at that time. I left feeling concerned about the baby's health but also contemplating switching obs if other options were available. Since my sister had a follow up the next week I asked her to talk to her doctor about what they do.

At home, I was at first ok with being patient and waiting for more information, but I decided I wanted some more information. So I requested my records from the anatomy scan appointment. On Monday I called my OB office and asked about the referral. They said that the referral wasn't marked 'stat' so they had a week to do the referral, but they would note that I called to see if they could get it done early. Hearing again that it wasn't urgent was a relief but I am glad I called because they texted me that night with the referral information. 

First thing on Tuesday, I called the perinatal office to make the appointment. They hadn't even opened the email yet about the referral, but they let me schedule. I was able to schedule for the following Tuesday. I think if I had waiting for the normal turn around time it could be another week before the appointment. It was nice to know that it wasn't a rush but regardless I was still thinking about it all the time.

Alongside of making the appointment, I was looking up fluid on the heart online. This resulted in two main outcomes. The first is Fetal pleural effusion. A fetal pleural effusion is when there is fluid around the heart greater than 2 mm. It can be concerning because it can take up room where the lungs need to develop and pushes them aside. However, from a few studies even at 7 mm of fluid the outcomes look good. They might need to insert a needle in to the uterus and drain the fluid from the heart if it was really keeping the lungs from developing or they might drain the fluid after birth. However, for many cases they don't do a lot of intervention. So this seemed like ok news and it also sounded most like what was going on with me.

The second result is about hydrops. It is much more concerning with worse outcomes. However, for hydrops to occur two or more areas in the baby need to have fluid, like the heart, kidneys, abdomen or near the lungs. It can happen for several reasons one is caused by an immune response if the mother lacks an RH factor. I have an RH factor so hydrops wouldn't be caused by an immune response. There are also non-immune factors the most common cause is parvovirus. My ob did ask if I had a cat and I said no and that I do have dogs but I used a claw to pick up the poop so I don't have direct contact. Actually I didn't even pick up the poop during the first trimester just in case! I had a lot to pick up in December however. It can be caused by other viruses as well as down syndrome, turner's syndrome and other chromosome abnormalities. So, because I already did the genetic screenings, I didn't have a cat, and the fluid was only in one spot I didn't think hydrops was likely but it was still a possibility. 

I also looked up inducing at 39 weeks for older mothers. I didn't find a ton of numbers for women over 35, but one UK study said that for 35-39 mothers who get induced at 39 weeks it prevents 17 stillbirths a year. There are more births in the US so I estimate maybe it would be about 100 stillbirths in the US. So there is a benefit but it is pretty low for an individual. 

On Friday the 29th, my sister had her follow up. She had a great appointment. The placenta had healed and the clot was gone. Hooray! Also, the baby was bigger again so her due date was changed again to August 27th. Which matches my sister's dates so it probably won't change again. She also asked about what their policy was for induction at 39 weeks. Her Ob says that week 39 births are less risky, but what they do is they have you go in during the 39th week. They do a ripening and that may put you into labor but it may not. She said if it doesn't happen that they wouldn't move on to full on induction.

I looked up ripening on Mayo clinic, it is considered a type of induction, but it is not like they are breaking the water or giving medication to induce. So I am tempted to change OBs.

That week, I also learned that my Aunt had colon cancer. She went into get a routine check and they found the cancer. Colon cancer can be very deadly but that is because by the time symptoms show up it is already 4th stage. So everyone is hopeful that because she didn't have symptoms yet that it was an earlier stage and easier to overcome. She was lucky to get in for a surgery on Wednesday the third. They would remove the cancer and some of the nodes.

So the first week of February, was just as eventful as the last week in January.  On Monday the appointment records arrived. I was able to see that the fluid was measured at 3.4 mm. That made me feel that the fluid was an effusion and not hydrops. Also, between 2 mm and 4 mm is considered a low amount of fluid (above normal). The results of low fluid gave me a lot of relief that no intervention would be needed. 

On Tuesday, I was able to bring one guest to the MFM. It was pretty far from my house but because of the freeways I was able to get there in 45 minutes. I met with my mom so that we could go the rest of the way together. She offered to drive which was nice because I was nervous. The MFM office was very nice and clean. I had filled out a lot of the forms online but there was an additional questionnaire that needed to be filled out. I also had to give a urine sample. 

Week 23 day 1

We went back to the ultrasound first. It was like another anatomy scan! The tech looked at everything again. Of course she took a lot of pictures of the heart and because of all the research I saw the fluid this time and saw when she measured. I also got more 3-d pictures of the face which is so clear. At the end of the ultrasound the tech told us that less than 3 mm was considered normal and that the fluid was measuring less than 3! So she was not concerned about the fluid!

I was so relieved to hear that news. It was great to know that the fluid levels were normal and everything was looking good. The tech led us to an exam room to meet with the MFM. While we were waiting a staff member came in to let us know that the appointment was booked for 10 so it might be a little bit of a wait, but as soon as the dr was done with the current patient he would be in. It was so nice that they came into the room to let us know that there would be a bit of a wait, even though it was only about 15 minutes. 

It was nice to decompress a bit and my mom and I discussed what questions we had. I wanted to ask about inducing and 39 weeks and my mom wanted to know about covid vaccine especially for my sister who cannot work from home. She also thought maybe I could switch my OB to that office even if I don't need to see the MFM in the office I could see an OB at the office.

The doctor came in. He went over all the results including the placenta cord (which I hadn't even told my mom about before that opps). He was not concerned because the baby was weight 1.8 lbs and that is considered in the top 91%! So the baby is getting all she needs otherwise she wouldn't be so big. He talked about the EIF but because I have the genetic screening and no other soft markers he is not concerned. Then he said the fluid looked good. There should be some fluid around the heart because it lubricates the heart as it pumps and the level of fluid is within normal.

Cushions for Window Seat, Nursery

Then, we asked out questions. He said that a baby doesn't get any more benefit being in the womb at 39 weeks vs 40 weeks and that there is a reduced risk of stillbirth, preeclampsia, and reduced c-sections. However, he said that it was my decision if everything looked good and I wanted to wait then they would wait. 

So we asked about switching obs. I don't think he wanted to steal business from my doctor, but of course I could do that. Also I could do a hybrid approach. Their office doesn't not have admitting privilege at the hospital I was thinking of, but the hospitals they admit too are great ones too. I like the first hospital because my brother and niece were born there. So I know that it is nice and it does have an NICU. However the one he admits to is one that my friend went to. I know it is nice too and the NICU is even better. I am still not sure if I will switch or not but I did like the MFM better than the OB at my office. I have a follow up appointment with them in a month. So I have time to decide.

As far as covid vaccine, he said that if it was him, he would get it when it was available to him because the risk of hospitalization, incubation and death are high for people with covid if they are also pregnant. I don't know when it will be offered to me and since I work from home right now I think I can make it to my due date before getting the vaccine. I do want to get it after I give birth even though I plan to breastfeed.

On Wednesday, my Aunt had her surgery. They removed the cancer and also a few nodes. The dr thought they looked like the cancer had spread to a few of them, but they will biopsy them. If it did spread that is considered stage 3 but it doesn't look like stage 4. Stage 3 survival rates look much better than stage 4. She is already scheduled to do chemo. 

After all the good news from earlier in the week. I woke up on Saturday and was relaxing with my coffee. I looked over at my 14 year old dog, Reggie's and I saw that the white parts of his eyes were yellow. I checked his ears and they were yellow too. I knew that was not good news. 

In the last few weeks, he had been declining. It was hard to get him to eat even if it was just liquid broth. He was wheezing a lot at night. He also had lost a lot of weight, but he started out overweight so he wasn't underweight for his breed. He still wanted to eat treats, or if I had yummy chicken he wanted to eat it. He was also still active. He would get up to the couch and bed. he would still bark at me if he wanted something or at the door if he heard amazon. So while he was declining he was still happy and not in pain. 

I called his vet but they were almost closed for the day and they couldn't take him until Thursday. So I thought maybe I could wait until Monday to bring him to Jojo's vet. Reggie's vet is near my parents house because he lived with them for most his life and Jojo's is near me but they allow walk ins. So I spent the afternoon painting the remaining walls of the nursery white. I probably could have spot painted but it was pretty quick with the roller and I had did the trim the Saturday before. Reggie stayed in the room with me or right by the door because he didn't like the tarp. He was annoyed that he couldn't be on the couch but he still was being active.

In evening I was concerned about waiting all the way until Monday to get him to the vet. Sunday was superbowl and I wouldn't be with him all day. So if something happened I wouldn't be able to take him to the vet. So I asked my sister where they brought their dog when she had a heartattack. She sent me back the vet and I called to ask if I could wait until Monday. They said I should bring him in.

I just knew then that it was not going to end well. So I put Jojo in my room in order to get Reggie in the car by himself. He was excited to get in the car. He was even more excited when I put the leash on him. He was very happy in the backseat, looking out the window and going for a ride. The vet was about 30 minutes from my house. I kept looking back at him and looking at him with the mirror. When I got to the doctors we waited in the car as I called from the parking lot. 

The tech came out to get him and have me sign some forms. He barked at her a little bit, but was nervous when she opened the door to get him out. I told him it was ok and watched him go. I wish I had hugged him once more and snuggled him when we waited. 

After about 20 minutes the vet called and said that Reggie was yellow and he wanted to blood work to

Reggie

look at his liver enzymes. That would take a few hours so I was able to go back home. I really didn't want to go home but I needed to because my phone battery was low. I was finishing dinner when the vet called again. He said that his one enzyme that normally would be under 400 was at 7,000. He thought he had an obstruction in his gallbladder but he would need an ultrasound. He was so surprised that his levels were that high especially because Reggie was so active even barking at people. He couldn't believe he was so active. Usually if he was that active he would sent him home until the ultrasound the next day but with the levels so high he thought the gallbladder might erupt at any time.

Anyway after a difficult conversation, I called my parents to let them know what was going on. I had texted them a few times that day but they had not responded. I knew it was bad and I needed to get a hold of them. They didn't answer but I left a tear ridden message and they called back. I explained what was going on. My mom said that she could be the one to get the information and make the decision. So after we hung up she called the vet and he explained everything to her.

My dad called after the conversation and said that after a long conversation the vet had said that it was either liver cancer which at his age would not be treatable or gallbladder obstruction (which was the most likely) he could have gallbladder surgery but it is a hard recovery for any dog especially one so old. He said if it was his dog he would put his dog down. He said there was also a risk of eruption of the gallbladder and that would be a very painful death. So we had to decide if we should put him down that night or in the morning. We, including my sister and brother, decided that it was better to do it that night. Reggie would be scared and uncomfortable all night being at a vet office. We just didn't think it was right to make him go through that. Luckily we were able to go see him one last time.

It was bittersweet though because they had to sedate him prior to the visit. He was awake but he was very out of it. Also we could only go in two at a time. So my sister and mom went in first, then my dad and I went it. It was decided that we would be in the room when they put him down. I went into the room by myself. Reggie was laying on the table in a blanket. He was really out of it. I put my hand by his nose and when my dad came in the room I saw him look over and his eyes did light up but it was just a barely. It was so hard to see him like that. It would have been nice if he was active like he had been that evening, especially for my family who hadn't seen him that day. 

I just wanted to pet Reggie for as long as I could, but I knew it was more for me than for him. I told him I was sorry and hugged and kissed him. After sometime my dad said he was ready when I was. I said I was ready. I wasn't ready, but I knew I wouldn't be ready. So I said ok. He got the vet who administered the drugs. It was very fast after that. I did see when the light left his eyes. It was a little after his breath stopped. While the drugs were being administered the baby was kicking me a lot! Maybe she knew I was upset and she was saying goodbye too. The vet checked his heart and said he passed. We were able to stay after that. We said some final goodbyes. He was still soft and warm, but it wasn't Reggie anymore.

After we went back to the car with my sister and mom. We spent some time in the car talking about Reggie. He had been in our lives for 14 years. We all had great stories about him like he brought a dead bird into my sister bed, he knew all of our names, and he was super smart. He learned to ring a bell to go outside and knew when you told him that you put leftovers in his bowl. He was young when my brother was in HS and he went to all the parties that my brother had in the yard, but when my brother went to college he was getting older. So he would just hang out with Dad and in his middle and late ages. 

It was hard to let him go. I think maybe if I had just waited until Monday I would have got one more day with him, but the results would have been the same. However, his gallbladder might have erupted and I'm glad he wasn't in pain. 

It is different without him in the house. He is more of a cuddler than Jojo is. Also I think Reggie and I had a strong bond. I usually could figure out what he wanted when he barked at me, and he is better at reading my body language. I woke up this morning and the blanket smelled like Reggie. It is an big feeling for sure. I know it was the right decision even though it was a hard one. I will miss and love him for the rest of my life. 

I am relieved about the good news about the baby and my aunt, but I am still feeling bummed about losing Reggie too. 

Week 23 Bump

I have still been having heartburn in the evening and at night. It doesn't happen every day, but a few times a week. It even makes me a little nauseous. I also have my hands are sometimes numb when I'm in bed and I have been trying to stretch my shoulder blades to help. I have had some round ligament pain but not as often or long.

The last thing is that I was touching my stomach on Saturday and I felt that it got hard! I couldn't feel
anything on the inside, but I think it still counts as a Braxton hicks. My sister was the 23 weeks and 5 days when she started getting contractions. Hers were not considered Braxton hicks but they were not labor contractions. Her contractions were more consistent and often also some of them were a little painful. I also felt a hard stomach once today, Monday the 8th! So I think that is a second one.

Pregnancy Week 21

 It has been so long since I have posted anything. It was hard to post during the holidays and there hasn't been a lot of new information to post. But I thought I would probably like to look back at this later so I should try to add a little more.

So last time I revealed the gender is a girl. I had thought that I was having a girl from the beginning, and I'm glad to have it confirmed. The first week of December I watched my niece so that my sister could go to dinner with her husband on her birthday. She had taken steps before that but that week she was really walking so she spent most of the night dragging me around the house showing me her toys and the dog water bowl. Running around with her wasn't the most comfortable on my back but other than that I haven't had too much back trouble.

I also started watching my parents dog while they moved into their new house. After a few weeks my mom asked if I he could stay with me indefinitely. They don't have a fenced in yard and she doesn't want to mess up their new house. I agreed to take him. He is almost 14, so he sleeps a lot and he doesn't hear and see as well as he used to. His breath was stinky so I gave him some denta sticks but they were making him sick. He used to be able to eat different treats and food easily but he is having more trouble now. I think that is another symptom of him aging. At least I'm got practice cleaning up puke.

On the 11th I had a doctor appointment. There wasn't an ultrasound so I went on my own. They used a doppler to listen to the heartbeat. I started to get a little nervous because it took the tech a little while to find it. But once I could hear it it was a relief. Since I wasn't having a lot of symptoms at that time it almost felt like I wasn't pregnant. So it was nice to hear. The beat was 154 which was very good. The PA came in after and said that I needed to gain more weight. My weight was the same as my first appointment. I think I was bloated during that appointment so I do think I gained weight based on my pre-pregnancy weight at home. She said that it was sometimes in the first trimester it was hard to gain weight but to try to gain some now. I also scheduled my 20 week anatomy scan for 4 weeks in the future. 

In the following weeks I got ready for the holidays by getting gifts, wrapping them, decorating a little bit. On December 20th I asked my sister if she needed to go to target because they were going snowboarding for the holidays and she usually has to get something, and I had to get new bras. Mine cups were getting too small. So we went to Big 5 so she could get a snowboard outfit, she usually would borrow from our parents. She did a lot of the shopping. I walked around with Naomi as she walked around the store and tried to put things in her mouth. But I was able to help her decide on a coat and pants. Then we went to target where we got some outfits for Naomi for the snow. We also got a lot of other clothes for her. Then we got two maternity bras that work for nursing too. We also got some stocking stuffers and household essentials. When I went home I was so exhausted. For the most part I don't get tired anymore but long days can make me tired even though I know I wouldn't be tired if I wasn't pregnant.

Month 4 Christmas Bump

I also started to notice some flutters but I wasn't sure if they were kicks or gas. They felt like little bubbles and sometimes I would have gas a little bit after. So I can't be sure when the first kick was but I felt some kicks on Christmas eve that I'm going to count as the first kick. During Christmas and New Years weekends I visited Mimi and Papa's new house every day. We did walks, ate Christmas dinner two days in a row, played pickleball and mahjong and watched Christmas movies. We would usually visit my G'ma as her birthday is the 26th and she turned 90. However, covid numbers were very high and none of us wanted to risk giving it to her. She is getting the first dose of the vaccine on January 21 and will plan a 90 year old birthday party for this spring. So it was a low key holidays but very relaxing.

I was starting to suspect that my sister was also pregnant around this time. I knew that she wanted to have a second baby soon so I knew she would be trying soon. She had her first period after giving birth a year after Naomi was born. She has irregular periods so they are hard to predict but I was thinking she should have a period by then but she hadn't. One day in mid-December she called me and asked what my earliest pregnancy symptom was. That made me think she was asking because she was trying to figure out if she was pregnant. Then I noticed when we met to exchange gifts she didn't have anything to drink! None of these are suspicious on their own but together they were. 

So on January 3rd, I went over to my parents house to watch the Cardinals game with my Dad. She and my mom had gone to walgreens when I arrived so I texted her and told her to get a pregnancy test. So she got one and took the test. After 3 minutes she didn't go straight in to look at the test so I did because I learned that if you don't look at the test at the right time there could be an evaporation line that makes the test look positive. I picked up the test and there were two lines! It was positive. Even though I had been suspicious I was shocked and I felt bad about seeing it first. So I walked out of the bathroom and said "you should look at the test." Then I walked away. 

My sister and mom called me back in the bedroom because of my reaction. Turns out that my sister already knew she was pregnant she knew since the day we went to target. Earlier that morning my Dad saw a bracelet on Naomi's wrist that said 'Big Sis' so they all knew already. Naomi had been napping the entire time I got there so I didn't see the bracelet. 

Since I knew so much about the tests because of my journey, I said something like the test line was light but it still counted as positive which got my sister worried because she didn't know it needed to be dark. So she called her doctor the next week to get her first appointment changed. They scheduled her for the 15th but since she was concerned she was moved to the 8th which w
as the same day as my anatomy scan!

Our OBs are on separate corners of the street with the Chandler hospital at the third corner between them. My OBs covid rules is that you can bring a guest and any child under 8 so I invited my mom to come to the scan. My sister's OB doesn't let guest or kids in right now. So we were going to bring Naomi to my appointment, but my brother in law ended up watching her. 

At my appointment the baby was laying on her stomach and her head was near my belly button on the right side and the legs were by my hip on the left. Because of he position the tech got to see the skull, kidneys and the potty shot, but she wasn't able to get her face, chest or heart. So I had to get rescheduled for Friday the 22nd. Her heartbeat was strong and the PA said that she was weighing around 11 oz but it is hard to tell that early. My mom asked about seeing the delivery doctor. So this coming appointment will be with the main doctor that delivers at the Chandler hospital. I don't mind seeing the PAs but it is nice to meet the doctor later this week.

There was one issue which was that the baby's placenta partially covering my cervix. It is called placenta previa. If the placenta is within 2.5 cm of the cervix that can cause bleeding and when giving birth it could mean that the placenta is born first which is bad because the baby can't get oxygen or anything if the placenta is detached. I have noticed a little bit of spotting, but only when wiping and sometimes it is hard to tell if it's blood or just dark urine. It wasn't really a concern because everything I read says that it should be more like period flow. Most of placenta previa will resolve later in pregnancy. The way it was explain is that if you imagine a balloon with words on it. The words might look like it is near the part you blow in, but when you blow up the balloon the words more out of the way. So as the uterus grows the placenta will move away from the cervix. Since mine is only partial previa it will probably go away and I will be able to have a vaginal birth. I was put on pelvic rest which means no sex and avoiding pelvic exercises. 

At my sister's appointment, she had a blood clot and the blood clot made the placenta tear a little bit from the wall. Usually that will have the symptom of bleeding, but my sister hadn't experienced any bleeding, but she had some more cramps than the first pregnancy and she felt hot in her uterus. The doctor was concerned he scheduled a follow up for a week, the 15th.

On the 15th appointment the doctor was much more optimistic. The baby's heart rate was up and it grew more than what is expected in 7 days. There was still some bleeding and a tear but it looked much better. She has a follow up in two weeks. So she is 8 weeks and 1 day along and I'm 21 weeks along. I think the baby is a boy, so I will use he to refer to him from now until we find out the gender. He is due August 29th. Since she hasn't told anyone but us and her husband I won't be posting this publicly until after other people know, but I wanted to write about it while it was fresh.

Nesting - Painting

Last week I had heartburn a few days in a row but by the time I bought tums I didn't really have any heartburn, but we will see if it returns. I have also been feeling the baby move a lot more. I don't have to think if it's gas or not. I have also been having round ligament pain. I went to my sister's no Tuesday and walked with my niece to the park twice. It isn't too far but it is hilly. The next morning I had pain. I think because of all of the activity the day before the ligament got tight over night so when I stood or turned it would be sore. 

Week 20 - Nesting

The other time I had the pain was today! Last week I kind of started nesting, so I decided I wanted to paint the nursery. I found an ombre wallpaper that looked so pretty and I found tutorials on how to paint it. Since I was so determined my parents came over to help. We only painted one accent wall that color. I might go back and paint the rest of the walls white since they are a little scuffed from over 10 years of living in the house. After we painted I made lunch and my dad fixed my pooper scooper and then picked up the poop. After lunch we went to look if we needed to do another coat. We decided the top white part was too big and created another transition color to make it fade a little more. Then gave the dogs baths. While they were drying we cleaned up the paint and put the crib together. Kelsi's son just grew out of the crib so she brought it over on Friday! After my parents left I did laundry all night and organized my drawers. So this morning I felt some round ligament pain too. It wasn't as bad as last week. I saw that Pidgeon pose is a good stretch for this pain and you can do it easily in bed on your back. It only takes about 20 seconds on each side and it feels much better. 

Today I also think I might have felt some hiccups. I have been feeling more movements, but these felt more consistent and in the same spot, but I also just read about feeling hiccups at this stage so I could just be kicks.