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Baby Update

I’ve mentioned a couple of times that I’m under “couch arrest.”  Guess I ought to say something about that.  Where to start…  Middle of August, I suppose.

 

In the middle of August my pre-existing slightly high blood pressure finally caught up with me.  Apparently my wonderful blood pressure readings the last however many months are typical of pregnancy and are unrelated to anything I’ve been doing.  To which I say, “well, shit.”  So back on the 15th at my regular appointment Doctor Steadman decides that she doesn’t like my blood pressure (130/90.  Prior appointment had been 126/80.  Yes, I’ve been writing it down.) and decides to do a “non-stress test.”  This is where they strap a monitor onto your belly and look at the baby’s heartbeat.  My understanding is that they want to see the heart rate elevate subsequent to movement – a nurse explained it to me that if I jump up and down for five minutes, it will cause my heart rate to increase.  They want to see the baby do the same thing because it implies that all is well with her oxygen supply.  Okay, fine.  It took them a while, because she was taking a nap (the fact that I’d intended to grab lunch *after* the appointment and my blood sugar was in my socks probably didn’t help.  They did get me some crackers.)  So she started me on non-stress tests twice a week – Mondays and Thursdays, as it turned out.  Those happen downstairs, actually IN labor and delivery.  Which is nice.  All the other ladies in my office had to do them in their doctor’s offices on that sad little exam table.  I get a proper bed in a private room.  Or to put it another way, I get an afternoon nap twice a week.  I’m cool with naps.  It just wreaks holy havoc with my work schedule, because it’s an hour total transit time, and then anywhere from 30 minutes to multiple hours at the hospital for the test – I can’t leave until the nameless little girl performs, and apparently the hospital tends to put her to sleep.  But I digress.  She also wants me back the following week.  Oh yeah – and I get to do another one of those fun 24 hour “samples.”

The following week I see Doctor “no time for wimps” Walsh.  My blood pressure at that appointment is Just Fine (124/82 – I’m all over the map) and while he doesn’t discontinue the NST’s, he doesn’t think I need to come back for a doctor’s appointment for two weeks.  Somewhere in there, my feet and ankles finally start to swell.  That stinks, but I figure it’s to be expected.  What I didn’t expect was that my shins were going to swell quite so… dramatically.  You can press your thumb a half an inch into the flesh over what should be the bony part of my shin, and it takes the dent about three minutes to go away.  Kinda cool, in a distressing sort of way.  As I said, I hadn’t expected that, so I asked Dr. Alkass about it at the following appointment (which also included the group B strep screening.  What fun, but not actually as invasive as I had anticipated.)  He asked if I had shortness of breath, and I said that I did.  Someone has her feet planted in my diaphragm – what do you expect?  So he goes, looks at my chart, and says that we should talk about scheduling the induction.  EXCUSE ME?!!!  Which is about what I said.  In that tone.  Causing him to look at my chart again and ask who sent me for the NST’s.  That would be Doctor Steadman.  Why?  Because my blood pressure was up, and she wanted to be careful.  So you haven’t already been diagnosed with preeclampsia?  NO!!!!!!!!  Oops.  He’d misunderstood the notes in my chart.  So then he says that he wants me to get an EKG, and at that point I was so flustered that it didn’t occur to me to ask why.  Answer: to be sure that the swelling was entirely due to pregnancy, and not because of something underlying like say, congestive heart failure.  Apparently my swelling is REALLY impressive.  My EKG was normal, by the way.  Oh, and another damn 24 hour sample.  So far, they’re letting me do them over the weekends.  Let’s hope it stays that way.

That brings us to last Monday, and back to Doctor Steadman.  Now she’s talking about inducing.  The blood pressure is roaming the spectrum, but apparently for pregnancy they don’t like to see anything over 140/90 on either number, and I hit 134/92 at that appointment.  Of course, later on that morning at the NST it came up 133/82.  So who knows?  But for the first time, they asked me if I was “taking it easy.”  I said “not really.”  Hey – no one told me to.  I’ve been operating on doing as much as I’m comfortable with, trying not to push too hard and overdo it, and live life as close to normal as possible.  If they didn’t want me doing that, someone should have said something.  Unfortunately, my protein numbers are also up – her sample three weeks ago came back at 201.  Dr. Alkass’ sample last week was 300, and apparently the 300-500 range is considered mild preeclampsia.  So now we need to start being careful and watchful.

At work, I’m pretty much confined to my chair, which is annoying and uncomfortable.  I’ve nicked a recycling bin to put my feet up.  Problem is that your knees lock, your hips cramp, your butt goes numb… it stinks.  Not to mention that I can’t get to the ladies room without four people yelling at me.  One of the cures for edema is hydration, which means I’m gonna be making that trip people…  This weekend has been hard.  I’ve spent most of it on the couch, which is enormously out of character and is driving me nuts.  On the other hand, at the end of the day they still look like my ankles and not sausages, and the tops of my feet don’t hurt anymore from the pressure.  So I suppose there’s something to this “taking it easy” thing.

I don’t want an induction.  Really, really don’t.  BUT… I’m not going to play games with preeclampsia.  It’s dangerous, and the scary part about it from what I read is that you can walk around without being obviously symptomatic while it goes after your kidneys, your liver, etc.  The potential for uncontrollable placental bleeding is a nice touch too.  So there will be no stupid ego games there.  Again - BUT… I’m not interested in an induction “just in case.”  Nope.  We’ll be chatting about that if that’s what she’s thinking.  I’ll stay on my butt for a couple of weeks.  If necessary, I’ll see about half days at work.  I’ll come pee in a cup every damn day if they want.  But no one I know who has been induced has had any result other than a c-section, usually followed by a complication of some sort.  I’d like to avoid that.  Also, I just don’t like how much doctors seem to like to accelerate things.  I figure that if the little girl was done, I’d be in labor.  I’m not in labor, so she’s not done yet.  In a perfect world, I’d go a couple of weeks late because that would work out very nicely for maternity leave.  Very nicely.  I don’t think it’ll happen, but wow it would be great.  At this point though, I’m just hoping to make it to my due date.

So that’s where we are.  Being careful and playing it safe.  Next doctor’s appointment and non-stress test are tomorrow afternoon, and I’ll see what they have to say.  Now we just need a name (BOB.)


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Comments

( 12 comments — Leave a comment )
davidsmom1
Sep. 15th, 2008 02:06 am (UTC)
I had preeclampsia, was on bed rest and went into labor and had a natural delivery. Just so you know. Hang in there hon. I'll keep you and the little miss in my prayers.
kls_eloise
Sep. 15th, 2008 03:40 am (UTC)
Not an option at this point - last week I was officially full term. They only try bed rest if they're trying to *keep* you pregnant. At this point they'll induce in order to deliver (that being the only cure.) Best rest is actually worse - every day out of work before delivery is a day younger into day care.
kebbykate
Sep. 15th, 2008 04:21 am (UTC)
I was induced with M and we did a vaginal delivery--she was due December 20 and I had her on the 3rd. I won't deny that it was a very tough labor--much tougher than E's delivery, which was nine hours shorter after I spontaneously went into labor. I've also known lots of people who went into labor normally and ended up with a C-section. My sister for one, and she's still miserable over it three years later.

My gut take is that the older and more experienced your doctor, the more considered that they're going to be about the C-section. You got a resident handling you in a potentially complex situation, you're gonna get a C-section--it covers his or her ass.

One final tweak, especially if the docs get _very_ concerned about the pre-eclampsia, based on all the moms I've discussed this with, is that a scheduled C-section beats a C-section after many hours of non-productive or stalled labor. So if they are talking induction and she's up high and likely to take her time coming out, you _might_ want to press for the scheduled C-section rather than the scheduled induction if it looks like your medical status could turn it into an emergent C-section instead. Everybody I've known who had a late-delivery emergent C-section was simply wretched afterward while my friends who for a variety of medical considerations had scheduled C-sections all bounced back much faster and had fewer post-op complications and complaints.

I expect you'll have other people chiming in on this one...

kls_eloise
Sep. 15th, 2008 01:20 pm (UTC)
Good to know. I'm also already wandering around one and a half centimeters dilated, which Dr. Steadman finds very encouraging in case they do need to induce. I figure that we'll chat about things today and see where we are.

Luckily, I'm not emotionally invested in how we get to the end game - just as long as everyone gets there healthy and whole. I'd just preferred not to be sliced width-wise as a matter of policy. Narrow-minded, I know :-)

There are some aspects of this that are just not under my control, and I'm okay with that.
kebbykate
Sep. 15th, 2008 02:06 pm (UTC)
Yes, as a "high risk" mother I had nothing invested in how babies came as long as we were all safe and healthy at the end. I surrendered control and was much happier for it.
galingale
Sep. 16th, 2008 08:21 pm (UTC)
Hey, as far as I'm concerned that's promising! I ended up with the C-section because after about 11 hours of labor I wasn't dialated enough for them to even measure. (Well, that and they'd overestimated her weight by a bundle!)
kamau_d_lyon
Sep. 15th, 2008 12:29 pm (UTC)
It sounds like you're doing it right even though that might be uncomfortable and against your usual habits. It is hard to get the right balance between needs and doctor's advice but you seem to be looking at it in a very healthy way. I'll certainly continue to keep you in thought and prayer as the day draws near.
kls_eloise
Sep. 15th, 2008 01:15 pm (UTC)
Thank you - I'm trying to walk that line between "what I want," "what they want," and "what is medically appropriate." It's much easier to either just take orders or just be a willful brat. This whole being a grownup thing is a real drag sometimes.
lady_kathryn_r
Sep. 16th, 2008 02:34 am (UTC)
The inducing is not that bad... I was induced with Daniel, my youngest. And I would have to say that it was the easiest birth I had. And my most relaxing of the 3. Take it easy and ask to squat for delivery.
kls_eloise
Sep. 16th, 2008 02:38 am (UTC)
Well, that's good to hear. Although if I have an epidural there's no option other than flat on your back - they're terrified of a fall.

I'm really grumpy about the whole thing.
lady_kathryn_r
Sep. 16th, 2008 11:54 am (UTC)
The Dr turned off the epidural as soon as I hit 10 cm, that enabled me to use a squat bar attached to the bed... I did not use the bar with Matthew, my oldest and I was pushing forever. I used it for the other 2 and the longest that I pushed was 10 min. My daughter however was 2 min... When you are on your back you are fighting gravity and for every push you take the baby backs up so to speak a little bit. Can not wait to hear you have delivered and see the baby...
kls_eloise
Sep. 16th, 2008 11:50 pm (UTC)
Now that hadn't even occurred to me. Hopefully at that point my back won't be so far out that it won't matter. I'll just have to wait and see.
( 12 comments — Leave a comment )