This has been an interesting week for me. It started off with us having a massive snow and rain storm that started Friday night into Saturday, dumping a solid 7 inches of extremely wet, heavy snow on us. It also caused the girls’ school to flood over last weekend and they were off with me Monday and Tuesday.
Monday, I took them to our local doughnut shop for a little indulgence, and Tuesday we met my parents for breakfast to kill some time.
My hips and pelvis have been gradually getting more painful and I have the worst sciatic pain in my left butt. It’s in both butt cheeks, but definitely more painful on the left, making walking near impossible.
So…I sit a lot.
But mentally, things have been weighing a lot heavier this week.
I was hospitalized with preeclampsia at 34 weeks and 3 days with Emelia, before finally delivering her at 35w1d.
Since 29 weeks, I feel like I’ve been living some sort of countdown, mentally calculating in my head how long the baby would be in the NICU if I delivered at certain weeks. I know, I think I’m going crazy too. But I’ve realized over the last months that all of this is a trauma response, with some weird way of thinking I have control over the situation if I just planned and expected it. And the weeks have gone by and now I’m 34 and hit the week that I had Emelia.
Emelia was a 10 day hospital stay, I’d tell myself, if I can make it to 35, that could be half that time, and if I make it to 35 and a half, there’s a chance Pokemon may not need any NICU time at all.
I know. I need to chill. But since I can’t take any CBD supplements for the long haul right now, I’m left to try to manage this anxiety on my own.
But I’ve made it now almost to 35 weeks and things are still looking good.
BPP and NST #1
My blood pressure is still holding steady at 136/84 and Pokemon passed his biophysical profile (BPP) with flying colors. She also did a growth scan on him and he measured about 6 lbs 2 oz in the 71st percentile. His tummy is still measuring in the 99th percentile, but Dr. C said at my appointment that everything was looking great with him.
All we were really able to get was a picture of both his feet. He still is pretty scrunched in there, lots of limbs up by his face, making it challenging to get a decent profile.
I remembered this time to bring a bottle of water and a protein bar, so I could eat and drink during the non-stress test (NST).
He also passed that with flying colors as well. The notes from the MFM consult are still missing from my records, so I reiterated again to her that someone should call to get those since they contain their recommendations if I were to get severe preeclampsia postpartum in the hospital.
It’s frustrating. I’ve been bringing this up to the various practitioners since I had the consult in January and everyone says how important it is to have those and that they’ll call to get the notes. Yet…the notes never come. I had actually asked about them last Tuesday, and then again with Dr. A on Thursday, and now this week, they still haven’t come. I think I’m just going to call over there myself and request the records be sent to me and I can bring them with me to the hospital in case we need them.
Dr. C. also brought up again the baby aspirin and how Dr. A put the note in my chart about not discontinuing it. She said she still didn’t agree and didn’t want to contradict him, but thought I still need to go off it. It was a bit awkward but…I’m still going to stay on it through birth and postpartum. The risks of preeclampsia and blood clots just aren’t worth it to me.
She also told me I might be too monitored with the preeclampsia labs and that we can go back to once a week, especially since I’m not having symptoms. Another thing I just didn’t feel comfortable with and planned on bringing up to Dr. A. when I saw him in two days.
The PA also told me Pokemon is sitting really low in my uterus. I don’t know how long for sure he’s been this way, but it has to be recent and probably explains why I’ve had such an increase in hip and pelvic pain, an increase in needing to pee constantly, and why I’m now up 3 times a night to pee.
BPP and NST #2
Thursday, my BP was still holding steady at 122/84. I had body work done with my doula earlier that morning, and always feel so much calmer after it. I’m 4 pounds less than my prepregnancy weight and everything was looking good with my glucose readings.
Pokemon passed his BPP again, actually very quickly because he was doing his practice breathing right away and wiggling around like crazy.
We couldn’t get a good 3D image because he always insists on stuffing his fists in front of his mouth and nose.
Unfortunately, my doctor had left for a birth, so I saw my PA who also had a student. I was disappointed, hoping to have this conversation with Dr. A, but knowing the gamble of him being on-call and how I may not get to see him.
It didn’t start out very well. First, she came in and introduced her student, and then proceeded to tell the student how high risk I was, how complicated my pregnancy was.
Which, fair enough. But as I sat there, a smile pasted on my face, I eventually found my voice and said, “Yes, but things have been going really great for a long time save for the weird blood pressure thing a few weeks ago.”
And it’s true. Yes, I have blood pressure issues. But they’ve been perfectly controlled 97% of the time and all my preeclampsia labs have been cleared.
Yes, I have gestational diabetes. And I’m fully controlled on diet alone and my blood sugars are almost all in normal range.
Yes, I have some funky liver thing going on. But it’s stable.
The baby? Looking absolutely perfect. Passing his NSTs and BPPs with flying colors except when he didn’t want to do his practice breathing (which he gets a pass on until 35 weeks anyway).
So yes, I have a lot going on. But I’m doing pretty fucking fantastic considering the odds. And I don’t really want to be used as fodder for the PA students.
We discussed the 37 week induction and basically, she explained that they’ve found the risk for severe preeclampsia after birth to be higher the further along you are. So basically, they would induce me at 37 weeks in order to hopefully prevent that. More thoughts on this later.
I can schedule the induction about a week in advance. If we use a balloon catheter (which was used successfully with Emelia’s birth), I would go in the night before to have it placed. If I’m dilated enough, we can skip it and I would go in that next morning for low-dose pitocin.
She agreed that I can do twice-a-week preeclampsia labs, instead of the once a week like Dr. C advised.
“I don’t think she knows you very well, and your history,” the PA told me, “But I agree twice a week monitoring is fair.” Unfortunately, with Good Friday, the clinic is closed and I won’t find out anything until Monday anyway. The nurse did recommend I log in to the website where they receive lab results early, Friday or the weekend, in order to view them early. There won’t be any comments from the medical staff, but I could at least see the results.
As far as I can see, there’s still no preeclampsia.
But I walked out of there knowing I needed to get home and do some Hynobabies to get myself back in a better, more positive, frame of mind. It just felt a bit defeating. Even talking about the induction, my PA was like, well when we said 38/39 weeks for an induction if BP and glucose were stable, we really meant, you’ve been stable the whole pregnancy. And when you needed a medication increase early in pregnancy, that counts as not being stable and we’d still want to induce at 37 weeks. Which, really?
And it sucks not having access to my actual OB to talk these things through with. True, I can refuse an induction unless I actually get to speak with him. I just want to make sure we’re doing these things for the right (read: medically necessary) reasons.
Induction thoughts
I talked to my doula this week when I saw her on Monday and we talked about a 37 week induction. It’s tough because I know every day the baby stays in on his own is further development he needs. At the same time, it feels like playing Russian Roulette. Preeclampsia can hit at any time. And even mild preeclampsia for me can change on a dime postpartum.
I think I had mild preeclampsia with Olivia, since my doctor said he was okay waiting until the next morning to go to the hospital as long as I wasn’t having symptoms. But after my C-section with her, things went haywire and I was hospitalized for 6 days. And with Emelia, I went from fine to severe preeclampsia just like that.
So is it better for me to induce after 37 weeks, the furthest I would have gotten with any pregnancy, when my BP is looking great and there’s zero signs of preeclampsia, or insist on waiting until 38 weeks and suddenly one night I have a massive headache and just royally fucked myself for a long hospital stay trying to control severe preeclampsia?
None of it is an easy decision. I mean, of course, in some ways it seems like a no-brainer. I’m the only one who can make this decision, since I’m the only one out of my medical team and support team that’s experienced severe preeclampsia twice now and had traumatic hospital stays because of it. Inducing at 37 weeks when baby is healthy and relatively ready to evacuate my uterus seems to be the best option. Sure, preeclampsia may never come. But the odds seem to be stacked against me.
So 37 weeks seems to be what I’m leaning toward and even if I insist on an induction mid week, it still gives Pokemon a bit more time to cook.
