Wednesday, July 15, 2009

The End is in Sight

It's been ages since my last blog post -- I know. I've been busy with life and appointments and kids on summer break, not to mention "The List" -- my insane compilation of pre-birth projects. Moreover, I've been struggling with swelling hands lately and find it very painful to type with numb fingertips. Numb fingertips or not, time is flying by and an update is long overdue.

I'm at 36 weeks and one day pregnant today, which is the exact gestational age I was when I gave birth to Gracie, though as far as I know, I'm physically no closer to giving birth to this baby than I was weeks ago. I took my last 17P Hydroxyprogesterone injection last week and have been having some contractions this week. The swelling, though, has been much more problematic than the contractions.

On Friday, I had to go in for a blood pressure check because my hands were so swollen I couldn't grip anything. My blood pressure was within a healthy range -- elevated, but not necessarily high enough to indicate pre-eclampsia. My pressures were elevated enough that the nurse told me to monitor for increased swelling or any abdominal pain and to go in to Labor and Delivery if other symptoms developed.

Saturday, after running errands, I noticed my right leg was very swollen. As time passed, I began having a constant pain in my left side. Abdominal pain associated with pre-eclampsia is normally on the right, still, we weren't taking any chances. We went to L&D where I was examined, had some lab tests, and spent some time on the monitor. Labs came back fine, but the exam and monitoring indicated that I could have been in the beginning stages of labor. My cervix seemed a bit shorter and I was contracting every three minutes or so. After a couple of hours of monitoring, the contractions began to fizzle out -- they weren't quite as intense and they weren't getting any closer together. Because I was beyond 35 weeks, contractions weren't going to be medically stopped. Because they weren't behaving appropriately, though, the doctor on-call didn't think it was necessary to keep me or to suggest delivery so prematurely. He sent me home on Ambien, saying that the relaxation of a deep sleep would allow my uterus to either work more effectively or calm down.

He was right -- by morning, everything was well rested. Sunday progressed normally, but as I slept Sunday night, I was shocked awake several times with hard, intense contractions. I wondered if we were going to have a "Honey, it's time" scenario, but just like the night before, the contractions never fell into a consistent pattern. I was sore and queasy Monday morning, but after a chiropractic adjustment and a massage, I've been fine and contraction-free.

Today, I had my regular appointment with my OB/GYN. The baby has been consistently measuring big: at 34 weeks, my uterus measured 38 weeks; at 35 weeks, baby appeared to weigh around 8 1/2 pounds; at 36 weeks (today), tummy measured 43 weeks. I've had my blood sugar tested three times and every test has come back with good results -- we've just made a big, tall girl! Big babies, though, produce lots of fluid, and all that weight on a transabdominal cerclage could prove to be heartbreaking (though it could also not become problematic at all -- it's hard to say for sure).

For some time now, my OB/GYN has held fast to the ACOG guidelines and planned to deliver after 39 weeks. With the current measurements, though, he's finally willing to concede that an earlier delivery is probably necessary. The plan at this point is to have my specialist perform an amniocentesis on Monday (when I'll be at 36+6) to determine lung development. The results will come back 24 hours later, and if the lungs appear to be fully developed, I'll likely deliver by the end of the week. I could potentially be without a cohabitant in ten very short days! If the lungs seem to need more time, I'll probably deliver by the end of the following week without a repeat amnio. I'd be at 38 1/2 weeks at that point, and in general, delivery is quite safe then.

At today's appointment, we discussed about the process of delivery -- what to expect, what to tell another doctor about my modified makeup if my OB/GYN does not deliver me, etc. He also told me that I can keep the baby with me in the OR after the c-section instead of sending her to the nursery and said that she can join me in the recovery room to begin nursing within the first hour. I have to say it is so surreal to be talking about delivery and nursing and the happy end of things. I still feel such a disconnect, like all this wonderful good fortune could not be ours. I know that we're not totally out of the woods yet, and I know there are still no guarantees, but I am beginning to feel the most remarkable glimmer of hope.


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