Saturday, September 18, 2010

The Current "Sitch"

So....this past Monday Chris and I headed in for a biophysical profile and growth ultrasound as a follow-up to the last OB appointment when I was measuring small. I didn't really think much of it as I was gaining weight and definitely getting bigger. However during the ultrasound, the technician didn't really say much and I couldn't see anything due to the angle of the screen. At one point during the intervaginal, she was really pushing and prodding at my belly as well, which was uncomfortable and disconcerting. Finally near the end, she confirmed that baby did indeed appear to be a girl (we wanted confirmation on this), but then she started asking me questions about whether I was feeling pelvic pressure, if I had to go to the bathroom, etc. I left to go pee & change, and when I came back I heard her on the phone and caught a few words including "shortened cervix". Hmm. I tried to ask her about it but she said she was "just the technician" and sent Chris and I right over to our OB.

Dr. Schnarr was out of town, so we met with her fill-in Pat (not sure whether she was a doctor, a nurse or what, but anyway) who gave us the low-down. The good news is that baby girl scored 8/8 which means *she* is currently doing well, however a couple other red flags turned up for Mom:

1) My amniotic fluid level is on the low side. It isn't at a dangerous level as there are adequate "pockets" of fluid for baby to breathe and move around in, but if it gets much lower it could cause stress for baby and possibly require induction of labour to get her out.

2) My cervix has shortened to about 2.5 cms (when it should be about 3-3.5 at this point). If it continues to shorten (and especially if it begins to dilate) I could go into pre-term labour.

Pat recommended that due to this, I take it very easy and that the doctor's order upon her return may be actual bed rest. She then sent us over to the hospital for a couple other tests/procedures:

1) A Celestone (steroid) shot - this can substantially help out baby's lungs if she is born early - especially before 34 weeks. I was told I'd need to come back in 24 hours for a follow-up shot.

2) A "fetal fibronectin" test - this can be an excellent predictor of pre-term delivery. A negative result indicates that there is a very low chance (5% or less) of going into spontaneous labour within about 2 weeks, whereas a positive test isn't as useful as it's inconclusive (about a 15-20% chance). Thankfully my test was negative so *chances are* baby will stay put for another couple weeks at least.

The Triage doctor (Potts) thought I could continue to work given I have a desk job and can work from home, however he suggested I confirm this with my OB.

During our 5-ish hours at the hospital, we also got the pleasure of listening to a woman in the early part of active labour pre-epidural. She was NOT having an easy time of it, vocalizing wildly and claiming that the pain was "a thousand million times worse" than her endometriosis. Noice. It was quite a vivid experience and made me question more than anything has previously whether I would actually be able to get through childbirth naturally as I'm hoping to do.

Following Monday afternoon's "adventure" we've had several more preggy-related happenings over the remainder of the week:

Monday night - Did some research on all the findings from the day - low amniotic fluid, shortened cevix, fetal fibronectin, celestone, etc. Found out that while Celestone / steroid shots are one of the most important and effective advances when it comes to the prognosis for pre-term babies, that there are some side effects and possible contraindications. For one thing, it can be very difficult to control diabetes (regular or gestational) while on the drug. Given I hadn't heard back on my follow-up glucose test, this was a concern so I decided I'd try to find out prior to getting the follow-up shot.

Tuesday - Spoke with Pat again at Schnarr's office. The results were in from my glucose tolerance test, and things looked fine. Whew - no gestational diabetes - one good result at least! Due to this, I felt OK to go in for the follow-up Celestone shot. That evening, we met with Beth Murch who was as wonderful in person as we imaged, so we decided to hire her as our labour doula.

Wednesday - 2nd prenatal class at the Childbirth Resource Room. Ever so appropriately, one of the topics was "pre-term labour". We filled our instructor and classmates in on our current situation.

Thursday - Appointment with Dr. Oliver, the other regular OB at Schnarr's office (she's still on vacation). She checked my cervix and said that it's definitely shorter/soft, and that baby's head was essentially "locked & loaded". She didn't give me a direct order (presumably because she's not my own OB) however her general demeanor and message was that I definitely should be taking it easy, and that Schnarr might be recommending full bed rest next week when she returns.

Following this, Chris and I decided to really buckle down, at least in the short term - no more physical exertion of any kind for me; off my feet and kicked back whenever possible. Chris rigged a little set up so I can work comfortably on my laptop in bed, and we moved my new glider into the living room so I can kick back and play video games :) In terms of work, still need to decide if, or to what extent, I'll be continuing forward since mental stress isn't really any better than physical. In terms of social activity, I suspect my aversion to the phone will diminish considerably :) Relationship-wise, Chris and I will be tested but I think this will just make us stronger. This is one of those times when it's so abundantly clear what a great person he is and I love him more every day :)

Long rambly entry, but that about sums things up. May write more about this later, or may not. Lots of other topics to tackle as well!


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