Sunday, October 16, 2011

Misconceptions

Since I was sick on Monday, I had rescheduled my peri appointment for Friday. They did my weekly labs at the hospital on Monday (to rule out pre-e) and the nurse told me that she called my OB with the results "they were fine with them." so I figured that part was taken care of.

Thursday, my OB's office called and wondered if I'd gone in for labs. I explained about the hospital. She insisted I needed to have them drawn anyway. I was confused, but whatever. I had to go to the peri center on Friday anyway (which attaches to my OB's building by a walkway) so I'd just have them drawn on Friday while I was there.

My per appointment went fine, if slow. I swear they are the most inefficient office in history and since we're now adding weekly NSTs to my appointments, that meant 2.5 hours to get a growth check and NST. Growth looked good. Chello measured 49%, estimated weight 3lb 12 oz. She was active and moving around. My fluid was an 11. They checked my weight (down 5 pounds for the pregnancy), BP (122/72) and urine dip (trace). Then I had my first NST. Chello had the hiccups at the beginning, which was cute. She got what she needed and it was fine.

Dr. Bitchy was there that day and she was unusually chipper. She said I looked great on paper. She wants me to schedule my c-section. She said she wants me to have an amnio and deliver just before 37 weeks or in the 37th week w/o one. I explained that it doesn't seem to appear I'm going to make it that far, and she agreed, but wants it on the books anyway. I was a bit confused because Dr. Sunshine actually said he wouldn't bother with an amnio and just deliver anyway because he'd rather be a few days short of lung maturity than risk my uterus rupturing and that's why we'd planned on steroid shots at 34 weeks no matter what. I told her I already had steroids, she was pleased I'd had them, but still wants the amnio. She wrote a note to my OB to tell her as much.

Then I went off to my OB's office. I still wasn't sure why I even needed it, but whatever, it's just a blood draw. Thank goodness needles don't bother me. When I got there, the phlebotomist came to get me and as we were walking back, she asked one of the nurses to tell my OB I'd made it in, then explained that she'd been looking for me. Again, this struck me as odd because I already had labs this week, but whatever.

As we're back in the room, my OB wanders by, sees me and comes in, saying "Oh good! I was wondering where you were!" (Mind you, I didn't have an appointment with her, so she just meant for labs.) I expressed my dismay about doing them again and she said "well, they were so elevated at the hospital, we needed to check them again." Elevated? What happened to "fine?"

Apparently my AST was in the 50s, my ALT in the 90s and my protein was 2+. Not what most would call "fine." The hope was that it was because I was sick and dehydrated, but obviously it needed to be watched. Cue annoyance with the hospital. I wish I'd have insisted on the numbers when I was there, but frankly by that point I was just relieved to be able to sit upright and go home. I figured fine was fine and I'd get the details later.

In any case, my OB asked if the peri lab had checked my urine & BP and was happy to hear that everything had been normal. The phlebotomist had been attempting to get blood the whole time w/o success. She declared that I was still dehydrated despite the fact that I'd been drinking water even while in the peri lab. Because my checks that morning had been okay, Dr. G said we could just wait until Monday and do the whole workup (24 hour urine included) then if she couldn't get it.

She also looked at the note from my peri, also expressed dismay at the amnio recommendation and shook her head. The phlebotomist finally declared defeat to my veins (I now really look like a heroine addict) and said we'd do it all Monday.

It really only makes sense that being sick would have screwed with my labs on Monday.  I was super sick, for sure. I just really hope that next week's labs bear that out. I'm thrilled to be at 31 weeks at all, plus not in the hospital, but I still really have my heart set on November.






Now I'm going to vent a little.

A lot of people seem to be REALLY hung up on the whole 37 weeks delivery. I'm getting a lot of disapproving comments and looks about not being able to 1) delivery vaginally and 2) do so closer to 40 weeks. Truthfully, it's starting to get to me a bit.

I wish that those things were options as well, but unfortunately that's something that preeclampsia took from me. Robbie was born via classic c-section. That means my uterus was cut vertically instead of horizontally that way is normally done these days. That weakens the muscles of the uterus quite a bit leaving me at risk of rupture if I were to labor. As a matter of fact, Dr. G mentioned that part of her concern with the dehydration on Monday was that it could cause contractions which she does not want on my c-section scar.

When I was admitted to the hospital to have Robbie, Dr. G was very kind in explaining both how Robbie would have to be delivered and what it meant for the future. I had been hoping for a med-free delivery with him, so of course I was disappointed, but it meant less stress on Robbie and less risk of brain bleeding, so it was never in question that it needed to happen.

Then, there is also the fact that my organs are not happy. The longer I am pregnant, the more damage I am likely doing to them. My kidneys, in particular, concern me. When Robbie was born, my proteinuria was at 9,000. Remember that it only takes three HUNDRED to qualify as preeclampsia. Nine THOUSAND was my number. That's kidney failure level. Everyone was actually surprised they worked as well as they did after that kind of insult. Right now I'm living in the land of 300-400. That's not awful, but not great, either. And they really don't need any more damage.

And as I get more and more unhealthy, there are also risks to Chello as well. If she's not getting the blood flow she needs, her growth and development are at risk as well. This is why I'll be having an NST every week from here on out. If she starts to show signs of stress, she may well be better out than in.

Even if things don't get significantly worse in the next 6 weeks, my doctor has to balance the benefit of Chello in the womb for a few extra days vs extra stress on my organs. All of that combined means they're going to err on the side of caution when it comes to picking a time for Chello to come.

It isn't that I don't wish for more time. I'd love 38 weeks. I'd love 40 weeks. But most important is as healthy a mom and baby as possible. That's why Chello will be coming when she will. Not because I'm lazy or misinformed or my doctor is lazy or whatever it is that people seem to imply when they express their opinions on my birth plans.

I realize that there is a large contingent of people for whom things like "The Business of Being Born" is their bible. And good for them. I'm glad they have the luxury of that idealism. However, that is not my life.

I still think that pregnancy is amazing and miraculous. I still lay in bed and marvel at the alien kicks in my belly. I hear people blame lack of bonding on the fact that it took a half hour an hour to hold their babies after birth. But I'm quite well aware that I can bond with my baby even if he's in a plastic box for months, and I don't get to hold him until he's 5 days old, and then only for 30 minutes. What Robbie's birth taught me is that God laughs at plans.

I'm hoping for the best, but also knowing that whatever may come, we will roll with the punches. As amazing as pregnancy is, it's also terrifying and often dangerous. I'm confident in our choices and happy to explain them to most anyone with questions. The real rub comes when people don't ask questions, but just assume the worst- about me or my doctor(s) or the hospital or whoever they think doesn't agree with their picture of how things "should" be.


So right now, the plan is to deliver as close to 37 weeks as possible. I'm hoping to schedule my section for the day before Thanksgiving. That would be 36+6. I pray that my body and Chello both hold out that long. But if they don't, we'll handle that if it comes. For now, I'm still just looking at every Thursday as a new milestone. Come on 32!


--Trish

10 comments:

Bridie said...

blech. there's a big difference between your medical need to deliver via scheduled c at 37 weeks is much different than one scheduled for convenience and nothing more.

My friend had a fibroid tumor behnd her uterus, she basically had a c-section (classic cut) but through both walls. She is currently about to start her second round of IVF (first resulted in an 18 w loss) and will also have to deliver via a scheduled c at 37 weeks.

NoVaIrish said...

Oh Trish, I am so sorry. I had an encounter with someone last night that made me bristle on a different but related child birth/rearing topic. What I find amazing is that so often people who are passing judgement consider themselves experts but only really have an understanding of one side of the issue. You are a fantastic advocate for your kids health and your own which is equally as important to your kids well being.

Anonymous said...

hear hear! well said Trish. xx mel

S said...

You will do what you know will be best for you and your sweet baby. I was 37+1 with an induction for my second baby without an amnio b/c of the possibility of the quickly approaching full blown PE. At delivery she was termed a 36 weeker because obviously an unhealthy placenta doesn't grow the best baby. However, she did just fine and stayed with us in the room and left the hospital on schedule. I had lots of "you should really try to let her come on her own, the closer to 40 weeks the better, I can't believe they will actually induce you this early" speeches. Some people just don't know when to close their trap :):):). Keep us posted on the Monday results...

Monika said...

Ugh, people just need to butt out! What is wrong with them, that they think they can be judgy when they don't even know all the facts?!!? (((hugs))) Every week that goes by and you're still pregnant, I'm thrilled for you. And whenever Chello needs to come so that BOTH of you are healthy, that's the right thing!

Emily Gore said...

I'm sorry Trish :( Don't they know that 37 weeks is considered full term? Gah. Everyday is a gift for you and for Chello... I think your plan sounds perfect and can't wait to see pictures of your sweet baby ;) *hugs* Chin up - you are doing a GREAT job!!!

ggop said...

Gosh Trish, you wrote this post so well. I wish I could retort this well when I see doula-midwife-natural birth advocates post some inane update on Facebook. I take it personally because they never ever acknowledge the actual (maybe few and not vast majority, still that makes difference in infant mortality right?) cases where a surgeon is needed for the baby and mom to live.

Searching said...

Geeeez. SOme people are so ignorant and have no desire to actually hear the facts. Just tear down anyone who believes anything other than exactly what they believe, right or wrong. You KNOW you are doing what is best for you and your child. I would say life & health come first, screw the rest of the "perfect" birth plan. They don't want to know the real, scary side of pregnancy and birth, which is their life & right I suppose, but they should NOT belittle you for things they know nothing about. Hang in there! (& yay for making it to another lab draw! The weeks are slowly going by!)

Shannon said...

Goodness. Obviously those people just have no clue. They must not realize that sometimes, baby needs to come out ASAP...what good is a natural birth if baby or mom doesn't survive???? I would have loved to have a med-free birth with Ellie or Bea, but it wasn't in the cards. Do I get sad sometimes that I'll never have that experience, and jealous of those that do? Absolutely! But the fact that Ellie is a happy, healthy 2 year old reinforces every day that C-sections can be a saving grace. Ignorance like that just makes me so mad!

Heather said...

Sorry to hear if you are being given a hard time. I always say to do whatever you can to have a healthy baby and a healthy mom. If that means a C-section, so be it. The purpose of a pregnancy is to be able to enjoy a healthy baby. You know my story. My first was only a 36-weeker and the twins were 31 weeks. They are 11 and 2 years old now and we are all bonded and they are awesome! We don't get to decide some things, so we don't obsess on them and enjoy what we do have. Congratulations on making this far and I hope you all stay healthy and happy!