Saturday, June 25, 2011

22 weeks, 2 days

I am starting to really get anxious...and I don't mean all in the good way.

I had my 22 week appointment on Friday. I started the day off extremely nauseous. While I was getting ready to leave my house for the 45-50 minute drive to Ypsilanti to the doctor, my hair straightener was warming up in the bathroom and I was pouring my cereal for breakfast, I took one small bite and got this overwhelming feeling of YUCK! I was deep breathing to try to ward off the gag reflex as I made my way to the bathroom. It took me a few seconds to realize that I was getting hot and dizzy. I decided it was better for me to lay on the couch and remove some of my excess clothing -- it was a cool and misty day after all, so I was bundled with long jeans and a long sleeved shirt. As I lay there, breathing heavily and moaning, Shaun stared across the room at me in wonder. "Are you okay?"

"Um, no, I am gonna puke," I tell him.

"Do you want me to cancel the appointment? We are going to be late if we don't leave soon."

I thought about the anxiousness I had been feeling over the last week. I had been contracting a lot more than I thought I should, I had this scraping feeling near my pelvic area, and my friend's who work at St. Joe's just told me that the lead doctor in the practice was no longer apart of the practice and the helicopter service was being merged with another hospital. Plus, it had been a long 3 weeks since I had last seen the doctor. "No, don't cancel. If I am late and they don't let me in, then I will probably want to go to the hospital anyway, since I am feeling anxious about these contractions and excess movement I have been having. Give me a minute to sit up slowly and regain my composure and we can go."

The next few minutes I was certain that I wasn't going to be able to make the almost one hour drive without barfing, so I asked Shaun to find something to take with us for a vomit basin. He found a small waste basket from our computer room to lug along. Slowly, I got up, redressed myself and shut off my hair straightener before leaving.

I managed to will myself to drink the 16 ounces of water one hour before the appointment so the technologist could have a full bladder for my ultrasound. And luckily did not need to use the makeshift basin in the car. We arrived 7 minutes late, but the receptionist did not mention my tardiness, just signed me in as usual.

The ultrasound began and we saw once again our little boy who was growing as he should. The sonographer pointed out that he was a footling breech, which explained to me why it felt as though he was trying to dig his way out of my uterus. One of his feet are hanging down by my cervix and his head is up near my lungs.

Here are my notations for his growth at 22 weeks, 1 day:
Placenta: looking good along the back of the uterus
Heart Rate: 153 beats per minute
Cervical length: 3.1 mm (this is good as long as it is over 3 mm).
Head circumference: 19.55 cm
Head length (BPD): 5 cm
Femur length: 3.8 cm
Abdominal circumference: 16.9 cm
Amt. of amniotic fluid: plenty, we will begin measuring this starting the next ultrasound
Weight: 1 lb, 1 oz
Measuring due date: October 31, 2011 (within a week of the ovulation due date, so due date will remain the same -- October 27, 2011)
Mom weight: 139.8 (up 3.4 pounds from last visit...yuck, gotta get this under control)
Mom BP: 102/78
Mom Pulse: 90 (yep, still anxious and nauseous)
Mom O2: 99

I knew I was going to be meeting with Dr. K., the one doctor in the practice that I had not met with yet. She walked into the room with a bright smile on her face and introduced herself. She stated she had heard my name and knew about me but couldn't believe she had not met with me yet. I just started talking, telling her about my nausea and all the other things I had mentioned. Finally I slowed down and took a deep breath and asked her pointed questions.

Me: I have been contracting significantly these last few weeks, do you think I should be monitored?
Dr. K: Any time you want, call us and talk to us about your concerns, and we can send you to triage and have it checked out. It is okay to be anxious after your losses.
Me: Well, I live an hour away, so I don't want to come to triage for nothing. But, I felt my cervix a little lower this morning and it felt like it might have a fingertip opening to it.
Dr. K: Would you feel better if I checked you?
Me: Could you, please? Also, I heard that Dr. B. is gone. How will the office be restructured?
Dr. K: nothing you need to worry about. There will be a doctor on call and one in the office every week.
Me: So, you and Dr. W. will split the duties 50/50 now instead of 40/30/30 before?
Dr. K: yes, and we have a midwife you may see at your office visits sometimes, and we have another doctor in here who will work minimally, but you probably won't see him much.
Me: So, since you have heard about me, I guess you know my history pretty well.
Dr. K: Yes, I have read over everything you have provided to us, including your previous pregnancies and doctor reports regarding that, but don't want you to have to relive all the details of your losses by having to share it once again with me if you don't want to. But, if you want me to know anything more specific, I will let you share whatever it is you want to share with me.
Me: Good, and I don't need to share anything else right now, but may want to at future visits. If I have a bleeding emergency, will it be quicker to send a helicopter or for me to drive to St. Joe's.
Dr. K: Good question. But, you will need to go to your local hospital first even if you want a helicopter to pick you up, they won't pick you up at your home.
Me: I know, but my local hospital was not equipped to deal with my emergency even when I was admitted in the hospital the last time, so I would like to be transported somewhere I could get an anesthesiologist immediately.
Dr. K: Understandable, but think positively that you are not going to have an emergency this time. Do you think you need to take something for your anxiety? Like Zoloft?
Me: I have been doing okay with my anxiety and don't think I need meds. I just have been worried a little more this week.
Dr. K: well, let us know whatever we can do to help you get through this pregnancy. It is going to be okay and we are monitoring you so very closely and want you to be able to enjoy this time and feel okay about it. So, if you think you need meds, please let us know and tell us what you need to feel more comfortable. Speaking of which, have you talked with the other doctors about your delivery.
Me: Well, I was told I couldn't deliver until 39 weeks and that the safest way to do so was by c-section. What do you think?
Dr. K: I always think vaginal deliveries are best except when there is a possibility for uterine rupture from prior surgeries. Plus, you need to not go full term, so I would not recommend induction, but if you were to come in to the hospital at 5 cm dilated at say 35 weeks and you were strong into labor, then we would see how it goes and let you deliver, but at this point, I would suggest a c-section at 38 weeks. Is that ok?
Me: um...yes, ok by me.
Dr. K: good. Cause I just scheduled it for October 13, 2011 at 8am.
Me: um...hmmmmm....ok! Are you going to be the doctor on call that week and deliver me?
Dr. K: yes, that is me. And then you will see our new doctor on Friday morning rounds, but me for the most part. Is that ok?
Me: yep. Ok.
Dr. K: Now let's talk about the potential for gestational diabetes. What do you think about just taking a few random fasting blood sugars at home and a few random 1 hour after meals and tell me if you see any more than a couple highs or detect any patterns instead of having to drink the glucose and doing the 3 hour test again?
Me: Um...ok. But, my batteries in my glucometer are dead.
Dr. K: Well, get some new batteries, and we will give you a script for some test strips. Now, you don't have to do all the blood sugars, but just randomly test them and let us know at each visit what you did.
Me: Ok.
Dr. K: your ultrasound looks good, your cervix is high and closed tight, and I think you are doing great. Now, when would you like to come back again?
Me: When would you like me to?
Dr. K: Whenever will make you feel more confident and comfortable with this process and reduce your anxiety. Was 3-4 weeks too long between visits?
Me: yes.
Dr. K: Ok, then, what if we have you come in 2 weeks from now and do a nurse visit where she will check weight, blood pressure, baby's heart rate and answer any questions from you and if you need to see the doc, we will be right here. And then in 4 weeks you can come in and have a growth ultrasound and then see the doctor. You can alternate every 2 weeks between doc and nurse and then at 32 weeks we will be seeing you twice a week; one for ultrasound and one for NST. And we will deliver you at 38 weeks. But, if you say you can't stand it anymore at 36 weeks, then we will deliver you then, too. What do you think about that?
Me: Perfect.

The visit was over. I scheduled my nursing visit for July 7 and the next ultrasound for July 21. WOW!

I didn't tell the doctor this, but I had been secretly hoping that I would deliver on October 13. On that day, 11 years ago, was the day my mother died. Shaun thinks I am crazy superstitious, but whatever. I would like to honor my son by sharing with him that he was born on the day of his grandmother's death. I feel like this is a great thing as this would solidify this day as a day of happiness instead of a day of dread. However, when my mom died it was Friday the 13th, so I am ultimately glad that this year October 13th falls on a Thursday. :) Ok, Shaun, you are right. I have a little superstition. hehe. I do know that this is not a set in stone date. If for any health reason it is safer for baby boy to come sooner, I will not hesitate to have his birthday be in late September or before October 13. But, under no circumstances do I believe he will be born after this date. So, here it is. In 16 weeks or less, baby boy Plato #2 will arrive. And, I am anxiously awaiting his presence. Both nervously and courageously.

Father, I thank you so much for a very patient doctor who is willing to let me have a little sense of control over this pregnancy to feel confident in my ability to deal with it. I thank you for the changes that have been made in the office that at first seemed to be a burden on me, but has turned into a blessing. I thank you for giving me a glimpse of hope amidst the scariness of this pregnancy by infusing my mother's birth date to Heaven into the potential birth date of her grandson. I thank you that you are forever in control of all the circumstances and outcomes of this pregnancy and all the rest of everything.

I pray that you continue to provide solace and blessing to Shaun and me during the next 4 months and beyond and praise you for your provision with Shaun getting a job this week despite the threat of unemployment being depleted. I praise you that your perfect timing have been proven over and over again and I ask that you continue to astound me with your presence. I thank you and praise you every moment.

I pray Lord for my friend's babies that I blogged about earlier this month and ask that you continue to help them heal. But, praise you from the mountaintops that both of them are home and thriving!!! I pray that you continue to show yourself faithful and merciful to their families by giving them HOPE through your son Jesus and showing them miracles in their everyday advancements. Praise you for a job well done, once again, Great Physician.

I pray all this and much, much more in the mighty name of Jesus, AMEN!

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