36 weeks 4 days

This will, most likely, be my last post here before our little runt arrives. That is his new nickname. Runt. I'll get to that, trust me.

My blood pressure is doing okay. I guess I would call it stable-ly elevated. I've pretty much stayed in the 149/90 range for the last few weeks without many problems. The persistent headaches continue, and swelling has increased drastically, but the perinatologist has assured me that it's fine.

My blood sugars, which have been elevated recently, have dipped back down to acceptable levels, which makes me wonder if the placenta's integrity isn't an issue now, but that doesn't even really matter now, because our baby will be here Tuesday. His eviction noticed was signed nearly a week and a half ago.

He's repositioned himself back head down, and I have dilated to 2cms thus far, so we are continuing with our induction, rather than a Cesarean at this point in time. However, given baby's current condition, that could still be our end result, unfortunately.

Amnio fluids are still measuring high. Higher, in fact, than they have been. Initial levels that I was aware of were 18cm. A week later, those levels were down to 16cm. They have since increased to 21cm. Too much further beyond where we are now is dangerous and calls for immediate delivery at this point in pregnancy, however, his eviction notice has already been singed, so it's moot at this point.

As of my last posting, at 34 weeks, our baby was measuring 4lbs 3oz and was just under the 10th percentile (9th) for his gestational age.

As of yesterday, 36 weeks 3 days, our baby's growth curve has dropped even further than where it was previously. His estimated weight is between 4lbs 8oz and 4lbs 11oz. His abdominal measuring puts him below the fifth percentile (4.85th percentile). His head measurement was in the 6th percentile and his femur measuring was just below the 3rd percentile. Overall, they consider the abdominal measurement the one to watch. At the 3rd percentile on an abdominal measurement, they would want to deliver immediately. At this point in time, our baby will most likely NOT be breaking the 5lb mark. He is truly the 'runt' of my children, who have all weighed in at greater than 8lbs 6oz.

This particular ultrasound was done in the OB's office, and in my experience, they have a tendency to give 'extra' and over project compared to the ultrasounds that I get at the peri's office. Anyway, after my OB got the report, she literally dropped everything and walked out to go do a phone consult with my perinatologist. He is going to see me tomorrow (Friday) for my regular visit, where I will have another growth ultrasound to basically do the BPP we always do, and to confirm the accuracy of the ultrasound that I had Wednesday with the OB. The perinatologist assured us that it was safe to wait until my already scheduled induction on Tuesday morning. He said he actually prefers to wait until 37 weeks gestation strictly for lung maturity's sake if at all possible. As long as I am stable, and baby is scoring 8/8 on his BPP's and NST's it's okay to wait. The OB said, she'd have LIKED to take him Wednesday, and absolutely would have, had the Peri not assured her that it was fine to let me go a few more days, at the very least, to my appointment with him Friday. At which point we will be re-evaluated with the new ultrasounds and tests, to make sure that we can make it through the weekend. He will let her know if someone needs to see me on Monday or not, or if my induction needs to be bumped up to Monday morning instead of Tuesday morning. Unfortunately, inductions are not done at hospitals around here on the weekends, otherwise I would be going in on Saturday night. My mom flies in from Seattle and arrives in Austin on Saturday at 4:30, so that is the earliest that I would be comfortable doing it, unless it was an emergency. Technically, it's not emergent, but it is a very fine line that we are walking right now....and dare I say, my balance is not that great!!!!

I think the only GOOD news we got this week was that my Group B Strep test came back negative, so I do not need to spend four hours hanging out getting IV antibiotics.

I have been advised, that in the event that my water breaks between now and Tuesday morning, at 5am, that I am to immediately go to the ER so they can take me up to labor and delivery. I am not allowed to wait around and see what happens due to the fact that baby is so small, that he could, quite literally, arrive in one unintentional push. Scary to think, due to the fact that if my water DOES break, I'm going to be pretty well dilated at that point, and without the epidural to slow my labor, and his size, I could very likely have a delivery even more rapid than my third was. From the time my water broke with him, until he was out, it was an hour and 46 minutes. I have to get down three flights of stairs and make it the 20 minute drive across town without delivering in the suburban LOL

Currently, we have about a 90% chance of needing to be transferred to another hospital upon delivery. Our hospital does not have a NICU, but they are equipped to care for babies at 35 weeks with no issues. The neonatal pediatricians and nurses that work in our hospital actually circulate between the local LEVEL 2 and LEVEL 3 NICUs in our area. With our hospital though babies having lung problems have to be transported. At 37 weeks, we won't know until he's here without an amniocentesis, what his lung development looks like. Also, babies having low blood sugar issues also have to be transported. Given my diabetes, he most likely WILL have blood sugar issues.

Babies needing transportation, go to one of two hospitals. Dell Children's, meaning he would have to go by himself until I'm discharged, due to the fact that they do not have maternity suites for moms, or Seton NW, meaning we BOTH would be transported together, because they DO have maternity suites for moms. My OB assured me that she would do everything in her power to have us sent to Seton NW in the event that we have to transport so that we can stay together. Especially since I breastfeed exclusively and we both agree that breastmilk for babies is THE BEST thing, especially in premature infants and infants with issues such as our baby has.

Overall, I'm absolutely terrified. I wish it was Tuesday evening already. That our baby was here. That all the hard decisions had already happened and we could just get the show on the road already. I have thrown myself into researching IUGR and have read everything that I possibly can so far, something that I continue to do. IUGR babies struggle for YEARS to catch up with their peers, which is discouraging. The only encouraging thing that I've read so far is that IUGR babies tend to thrive REALLY well once they are born. They are used to living in a hostile environment and once the strain is off of them, they just do really well!

We will not know until after delivery what the actual cause of the IUGR is, and we really might never know. The most targetable thing we can settle on right now is the fact that my diabetes and my pregnancy induced high blood pressure are both known causes of IUGR. Other possible causes in my case are thing like chromosomal abnormalities, something that we did not test for. Or placental abnormalities, something that we will not know until we see the placenta and possibly have it analyzed.

Anyhow, one way, or another, the newest addition to our family will arrive some time on Tuesday at the latest.

I'll leave you with this....it's a side by side picture of my youngest son, and the new baby. They look so much alike, at this point, that they could be twins! I can't wait to see how the runt compares to his brother once he's here.

31 weeks 4 days

Yesterday was a long day from the word go!

I had my second appointment with my OB scheduled for 11:10. They got me back in the room and I waited more than an HOUR for her to come in. I usually don't tolerate waiting well, but I did it because I 'get' the fact that she is an OB and delivers babies half her day in the hospital next door. And one day, she will be dropping everything to run down and deliver ME.

We went over my birth control issues again. I REALLY need to have a tubal ligation, however our hospital is owned by the catholic hospital and they are not allowed to do tubal ligations at this hospital. Without my being 110% positive in my desire to do the tubal, it's just something that we are not ready to do yet anyway. Also, with my being diabetic, the infection risk of having ANY type of implant or foreign object inside of my body is too great to make it a viable option. IUDs are out, the implant is out. The essure procedure is out, as is any clamping of my tubes with titanium, or silicone clamps or clips. Meaning when I DO have a tubal ligation, it has to be the old fashioned cut, tied in a knot and burned type of tubal, where no foreign objects are left in my body.

Due to my getting pregnant, consistently on the traditional hormonal birth control pills, I am not able to take them. I would literally just get pregnant again, even with my diligence of taking my pills on an alarm every single day. She refuses to do the DEPO shot on anyone who isn't a skinny 12-13 year old girl. I didn't get into it, I would really only have taken the DEPO shot as a LAST alternative. Due to allergies, latex, spermicides, foams and such are not something that I can use. I exceed the weight capacity on the patch.

That basically leaves me with three options. Abstinence. Which is NEVER going to happen in this lifetime, nor my virgin alter ego's lifetime. My partner getting a vasectomy....which goes back to the fact that we aren't 110% positive that we wouldn't change our minds later. And something called the NuvaRing. The NuvaRing is safe while breastfeeding, so the NuvaRing is it, and what I will be using post-partum.

After several other necessary discussions, including bruises and injuries that aren't healing, questions about who does the circumcisions and when, and some stuff about weaning off of my fasting insulin, and a few other things....I spent another 20 or so minutes making my appointments for the next six weeks, which include an NST, an ultrasound and an OB check at each visit. Then I literally had to RUN to my next appointment over at the hospital (at 12:45) so that I could make it in time. I didn't have a chance to eat lunch until almost 3pm, and was feeling seriously ill by that time because my sugars were so low. Anyway, I had my EKG and Echo cardiogram. According to the gal that did it, everything looked good, but we will still be waiting on a report from the radiologist.

Baby sounds good. Urine was fine, so no protein or sugar issues this week. Blood pressure was VERY good in the office too. My next appointment will be tomorrow, with the perinatologist in Austin.

30 weeks 3 days

I had another appointment with my perinatologist today.

Baby is doing GREAT. His weight on ultrasound was 3lbs 3oz, putting him in the 33rd percentile, which is up from the 26th percentile that he was two weeks ago. That news is such a relief!

He's moving lots, getting his practice breaths in, and his little bladder is full again too....thus all the hiccups I've been feeling from him (including right this minute LOL)

Thankfully, with the help of http://spinningbabies.com/ I was able to get him turned around again. He's no longer in the breech position and is now head down. Hopefully he stays that way, because I'm really tired of standing on my head. And I pulled my butt muscle doing it. Let me tell you though, I'd rather pull my gluteus maximus 10 times over, than have to go through an c-section ANY day!!

The peri wants me to be seen twice weekly now. I'll be seeing him once, and Dr Holley, my OB, for the other visit.

Starting tonight I have to increase my insulin by two more units. Not a big deal considering I'm going to be at 16 units and some women are at around 200 units for the entire DAY.

My blood pressure is up, but it is not at such a concerning level that he feels the need to increase my meds yet. They are going to set me up with someone that comes out to the house a couple times a week to take my blood pressure so I can be monitored more closely. For now, I just have to deal with the headaches and the swelling again for a little while.

My weight still looks great, I actually lost two pounds since my last visit. This puts me at a 13 pound baby gain, but I'm still at a 29lb loss for the entire pregnancy. Literally, my physical profile from week 22 compared to week 29, hasn't even changed. I don't look any more pregnant now, than I did then.



Both doctors now agree that a 37 week induction is the game plan with me having diabetes, high blood pressure and a history of large babies, even at 39 weeks. This means that I now have LESS THAN SEVEN WEEKS before baby will be here. And I'm ready. I've got everything I need now. The diaper bag is stocked, the diaper caddy is ready. He's got enough clothes washed, dried, folded and put away to last him the first three months, then I will have to pull some more boxes out and probably buy a few more things. But I am ready. Clear down to q-tips, gauze and vasoline.

I started taking my Evening Primrose Oil (EPO) last night orally. Hopefully I will be all ready to go cervically when induction time comes. In LESS THAN SEVEN WEEKS.

I started (and finished) baby's first blanket and layette set this last week. It's a soft blue color that daddy picked out. I picked up some white the other day and I completed the sweater for set number two and just started on the blanket for it last night.



Oh, and for the record, NO we have not officially decided on his name yet. But we do have a couple of serious options on the table and just need to nail down exact one we are going to use.

29 weeks 4 days

I had another ultrasound last week. Baby was measuring 2lbs 3oz at 28 weeks 4 days. He was head down and everything looked good.

Today I had an ultrasound with my new OB. Baby is now breech transverse again. His rump is in my pelvis, his head is on my left side and he's playing with his toes. Hopefully he gets back to where he's supposed to be soon.

I'm going to be tested for Group B Strep at my 34 week appointment, since the baby has to come out early. GBS testing is usually done around 36 weeks.

She wrote on my chart that I was to have a 37 week induction.

She also wanted to see me next week, but since I see my Perinatologist next week, she's going to wait to see me again in two weeks because she doesn't want me having too many appointments in a week LOL Which means I will actually be having Biophysical Profiles (BPPs) and Non-Stress Tests (NSTs) Every week, starting NOW.

I really love her. She is an awesome doctor. Her nurses are wonderful. The ladies at the front desk are great. It's a real classy facility and I feel much more comfortable there than I did at the last office which was like "public health" and left MUCH to be desired.

The blood pressure headache is starting to return between pills, and I woke up this morning with swollen lips again. We will see how many more mornings I can make that happen. My Perinatologist might have to up my BP meds again. My fasting numbers are also on the rise again, so my insulin will probably also have to go up soon.

Other than that, Baby is looking good. He's gained a little weight (but that's questionable given the fact that it's not the same ultrasound machine), and I have gained NO weight. Which actually makes me happy LOL

Oh, Dr Holley has also referred me for my EKG and Echocardiogram which the OTHER doctor was SUPPOSED to do WEEKS ago. They have to hunt down an opthamologist for my eye exam though. And I was supposed to do some labs today, but somehow they got forgotten as I was the LAST patient there today LOL

Kidney Stones and My New OB 27w6d

The last several days have been exciting, to say the very least.

From day one, I knew that my new OB's office in TX was NOT going to be a good fit for me. That point was taken to heart and well proven over the last few days. Several other choices I have made as a patient were also supported.

All day Wednesday I was feeling 'off' so to speak. I couldn't quite put my finger on it, but I knew that something wasn't right.

Wednesday evening the man went to softball practice. I didn't go, because I just wasn't feeling that good. Even though the temperatures outside had dropped about 10 degrees, I just couldn't bring myself to go anywhere. I opted to stay home with the kids. I'd taken a lengthy nap that afternoon and he actually had to wake me up before he left. About 15 minutes after he left, I got up to use the bathroom and was peeing straight blood. I knew then that I was having a kidney stone issue or a severe kidney infection. I wasn't in pain, but I knew it was serious. I tried to call him on his cell phone, but he didn't answer. I called out to my OB's office then. It was 7:30, and already after business hours. The on call OB, Dr Phelps called me back and he advised me to go to labor and delivery.

I spent the next hour and a half, calling the man, attempting to get him on the phone to come home and take me to the hospital. Bare in mind, I'm not in pain at this point, but in serious panic. I go ahead and send the kids to bed, knowing that I'm going to have to drive myself to the hospital, 40 minutes away, once he gets home. I drink 24 ounces of water, hoping it will help with the cramping that has started now.

Shortly after 9pm, he calls me and asks me what is going on. He had 27 missed calls from me. His phone was on the charger in the truck. He came home and then he told me to call him and let him know what was going on as I was leaving. I said "whatever" and left. Yes, I was pissed. I'm pregnant. Your phone should be on you. What if my water broke in the two hours you were gone and I delivered the baby and had to be taken to the hospital by ambulance. WHAT THEN? IDIOT.

I reach the hospital around 10pm. They call labor and delivery and I wait for someone to come and get me. I get a gown on, I leave a urine sample. The nurse asks me if I'm having any pains. I tell her that I'm having mild contractions, but I'm okay at this point minus a cramping feeling in my right side. I inform her that I've had kidney stones twice before, that I'm 99% positive that THAT is what this is and that I need some pyridium and probably an antibiotic at this point. They hook me up to the monitor to watch baby. I have a couple of contractions and then everything stops. Baby looks fine. I go through the registration process which takes nearly two hours. The nurse checks my urine and says I have trace protein, and that I've maxed out the blood on her dipstick. It stops at 250. She apparently speaks to the doctor, and comes back and says they are discharging me.

The guy did NOTHING for me. No IV fluids to help flush the stone out. No ultrasound to confirm the presence of a stone. No meds to soothe my urinary tract to help with the pain. No NOTHING. I was told to call my provider in the morning so that she could give me an ultrasound to check on the stone.

What the fuck ever. I leave to go home, and arrive there around 1am.

By 2am I am thriving in pain. Literally screaming in agony it is so bad. The man wanted to take me back to the hospital and I refused to go again. He was FURIOUS at the doctor for doing NOTHING. The doctor didn't even come and SEE me, even though he was at the hospital.

Around 4am, after 3-25mg benadryl's I finally fall asleep. I get up at 7:30 with a continuing dull ache in my right side.

I call the OB's office and tell them that I was at Labor and Delivery the night before and that I have to be seen. That I have a kidney stone, that I need meds and an ultrasound.

She gives me a 10:10 appointment. I wake everyone in the house up, so that we can go. The man refuses to get up. I have sat with him for HOURS ON END, TIME AND TIME AGAIN at doctor's appointments and hospitals, and his back hurts so he doesn't want to go. I was LIVID. I took the my oldest son with me, because he had an appointment with the orthodontist at 1:30 in Austin and I didn't know if I would make it back in time to pick him up.

I arrive at the clinic and then we wait in the waiting room for at least 30 minutes, then back in the office another 40 minutes or so before my OB finally comes in. She doesn't understand why the on-call OB didn't at least give me fluids. She gives me pyridium to help with the pain in the urinary tract and tells me that there is really nothing they can do but wait for the stone to pass. I get it, I'm pregnant. At least she gave me the perscription for the pyridium. She SHOULD have done an ultrasound, but didn't. She sent my urine off to the lab to see if I needed antibiotics, and sent me on my way.

The rest of the day, I spend in and out of random bathrooms because any urine in my bladder AT ALL is irritating. I get my son to the orthodontist. I get back into town and stop at Walmart to pick up my perscription. I stop at the dental office to see about them pulling one of my son's teeth that needs to be pulled before the braces can go on. They want to see him at 9am the next morning. Then we go home. Through all of this, I'm still angry at the man for not being with me when I needed him to be. I get home, I'm still hruting, but whatever, life goes on.

About 8pm, I'm DYING. Puking because the pain is so intense. I was ready to cut my bladder out with a steak knife. I felt like I was stabbed in the back on my right side. I was having hard contractions and screaming and crying again. I got up, got dressed and literally could not even stand upright I was in so much pain. I screamed and cried all the way down three flights of stairs. I don't waste time calling the piece of shit OB this time. The man takes me straight to the local hospital, which is eight minutes away comes back home with the kids after the ER staff gets me in the back and he's sure they are going to take care of me. I scream and cry for another hour before they finish with the ultrasound on my entire urinary tract and the baby. They were digging the damn probe into my kidney and making me hurt even worse. They admit me shortly midnight and give me a huge dose of morphine.

Within 10 minutes of being upstairs in labor and delivery, the on-call OB for the hospital is in my room. We go through my history, my high risk status, my previous pregnancy. There is a stone, right above my bladder, on my right side. It is still in the tube and that is why it's hurting so bad. It's having a hard time getting into my bladder. She is completely shocked that they did NOTHING for me at the visit the night before, because the other hospital is supposed to be a really good one. She's sorry I'm in pain, but she's glad I came back, and to a different hospital.

The severe pain fades overnight. She sends me home around lunch time with shit ton of narcotics. Enough to kill an elephant. I'm supposed to watch for the stone, and come in if the pain gets worse, of if I start to develope an infection. Burning urination etc. So far, I'm clean for an infection, which is great news. Baby still looks good. No contractions since the pain meds and pyridium are taking care of the irritation being caused to baby and my uterus.

Dr. Holley, the on-call OB who saw me, is now MY OB. I called yesterday afternoon when we got home and canceled my oppointment with the other OB clinic and let them know that I would NOT be returning. That they were completely incompetent. That Dr Phelp's bedside manner was SHIT and that I could have DIED because of his stupid mistakes and failure to give me an ultrasound to investigate where my stone was at. Had I had a full out blockage, I could have gotten sepsis and DIED! All the while they said there was 'nothing we can do'. I was severely dehydrated and that is what was causing the contractions. I could have lost my baby because of THEM. That I would NEVER recommend their practice to ANYONE I knew.

I'm still in a fair amount of pain. Still waiting for the stone to pass. Today pretty much went with me getting up around 8am, yelling at one of the kids for some reason I couldn't remember later, taking another round of pain meds, sitting at the computer for 30 minutes before the med kicked in, then crawling back in bed and sleeping until 2pm. I haven't taken more meds yet, and the pain is ever present, but I would really like to get some sleep tonight, at a normal time.

Overall, I'm really happy that I have a new OB. She is fantastic. She met all the kids and the man. They all liked her too. No more driving 40 minutes away to see a public health style doctor who doesn't really give a shit about their patients. No more wasted gas. No more wasted time. And our new hospital is better than the other one. The nurses are just as nice and everyone will be a lot happier in the end.

I also get to continue seeing my perinatologist, because Dr Holley refers ALL of her high risk patients to him. He is THAT GOOD. :)