24 weeks 4 days

24 weeks. Viability. We have achieved viability. It's a milestone that every expectant mother anticipates meeting. Some never achieve it, and many are born shortly after. Every day counts.

That is kind of where we are right now. Every single day matters.

This week my perinatologist increased my insulin dosage to 12 units of insulin per night. It has worked wonderfully, and I'm now within the acceptable range that they want me to be with my fasting numbers.

I was also put on a second medication for my blood pressure and taken off of the first medication due to an allergic reaction. The biggest side effect of this medication is the dizziness that it causes. I woke up this morning at 3AM to the WORST case of the spins that I have EVER experienced. Put yourself on the spaceship ride that is at the fair, called The Gravitron and ride it for several hours. I literally did not have the ability to roll over in bed and make it to the bathroom by myself it was so bad. Thankfully the intensity of the spins have worn off some and things are more or less just swaying back and forth now rather than full on spinning. Although, it did NOT help the nausea that I experienced this morning. I'm supposed to give it through the weekend, and if it doesn't go away, they are going to try me on a third medication.

I had an 'anatomy scan' today. Basically it's like a regular ultrasound, only a little more in-depth. The doctor wanted to look at each of baby's fingers and toes and do complete measurements again.

The BEST news we have, is that the baby's heart is still looking great.

The baby is still very tiny though. He is still measuring about two weeks behind. His weight is 1lb 5oz, which puts him in the 25th percentile. The largest we can hope for him to get is approximately 7 1/2 lbs, but probably closer to 6 1/2. This is a little unsettling for me, and I was worried that there was something that I had done, but the doctor just reassured me that he was still within normal range, even though he was tiny, and that nothing I have done, or haven't done, could have caused him to be so tiny. I have ALWAYS had big babies. My smallest baby was 8lbs 6ozs. Everyone else was bigger than that. It feels WRONG for him to be tiny.

We want to keep baby in the 25th percentile. If, during my next scan, he is at all below the 25th, we will worry about growth restriction and other things that could possibly be going on.

My target right now is 34 weeks. That is the point we would like to achieve at the least. Ideally, I will make it to 36 or 38 weeks.

The situation with my blood pressure right now is much more concerning than my diabetes. I was told, straight up, that I have about a 1 in 3 chance of developing pre-eclampsia due to my pre-existing conditions. Right now, my blood pressure can be stabilized with medication. The headaches are moderate, my swelling is minimal, and my 24 hour urine collection was 159 for protein and that doesn't get concerning until we are nearing the 300 level, which is grounds for an immediate c-section, no matter where you are in your pregnancy.

I'm currently seeing my perinatologist every two weeks, and my ob/gyn once a month. The further along I get, or however worse my condition becomes, I will be seeing doctors more and more regularly. Within the next month, I will be seeing someone once a week. Nearing the end of my pregnancy, I will be seeing someone probably 3 times a week.

Mentally, I am still pretty content with knowing all of this information. Knowing the statistics. Knowing the risk factors. Knowing the consequences of premature birth. It makes me sad knowing there is not much that I can do, but at the same time, I'm still really grateful that we have the best doctor that we could possibly have right now. And he's not afraid to answer the VERY tough questions that I sometimes present to him. I can be a difficult person to deal with, and it's hard to be put on the spot sometimes, especially when you are dealing with an emotional pregnant woman to boot and don't really know what to expect from her LOL

23 weeks 4 days

After a week's worth of home monitoring of my blood pressure, the doctor called me and has decided that my blood pressure is consistently elevated and that I needed to start taking medication. I will be taking a medication called Labetalol twice a day, starting tonight. Ultimately, I am thankful that we can go the medication route instead of going straight to bed rest like my OB/GYN suggested would happen. I cannot imagine being a full time mother of four and being on bed rest for the next 3 1/2 months or so.

I was also given a supply of insulin and syringes. I have to inject myself with insulin at bedtime to bring my fasting numbers down. At this point, it is highly likely that the dosage, which is currently 10 units, will have to be increased over the remainder of my pregnancy. Most pregnant women with gestational diabetes will generally have to have their insulin needs increased around their 30th week due to placenta and fetal grown, increased resistance hormones, and increased speed of insulin breakdown.

Currently, this particular insulin is one that works over a long period of time, basically an extended release. The nurse said it does NOT carry the same risk as the Glyburide does in the sense of sugars dropping too low in the middle of the night and possible death, which was a relief for my heart and mind!! She also said it will start working INSTANTLY. I won't have to wait 3 or more days to figure out if my body is going to have an issue with it, or if it's going to work at all.

I am confident that no matter what happens, that I am possibly in the best hands that I could EVER be in. I didn't know it at the time, but my doctor is basically the BEST doctor in this area for me. He was actually appointed Medical Director of High Risk Ultrasound and Fetal Testing for an entire group of hospitals in our area, which includes five hospitals. It goes a long ways, knowing that your doctor is competent.

My next baby appointment is with him on the second, for an ultrasound and followup. I'm sure there will be other tests done at that time too now, considering the medication addition and the fact that now I will need to be monitored even more closely.

Until then....one more day at a time.

22 weeks 4 days

I had my second visit with the perinatologist two days ago.

I stabilized my weight for two weeks, and actually gained one pound, but I'm really not going to count it, because I'm pretty sure that in two more weeks, it will be gone again LOL

All my lab work that the perinatologist had done, including my 24 hour urine, came back great.

My blood pressure is under observation now. Since the babydaddy has high blood pressure, we have a machine at the house. I will be taking my blood pressures twice a day for the next two weeks, and bringing the results in to the perinatologist when I go back in. When I was there, my BP was in the 140/95 range.  Some of my home tests have been SUBSTANTIALLY higher than that. 180/98 and even 191/101.

Today in the OB's office, it was 133/98 (any first number over 140 is suspect, and any second number 90 and above is suspect according to the standards for pregnancy). So even though my first number had dropped some, my second number was still considered high. I'm also dumping protien in my urine and have the accompanying headaches. Which basically signals pre-eclampsia, but they don't like to actually diagnose it until the third trimester. The third trimester technically begins at 26 weeks. Anything that begins between the 20th and 32nd week is considered 'early onset'. Most likely, they will not try and medicate me for the high blood pressure. They will put me on bedrest, monitor me more closely and make me do 24 hour urine's once a week or so to monitor the protien.

The perinatologists wants me to have another ultrasound in two weeks (June 2nd). I will have my first Non-stress test (NST) at 32 weeks. I also need to have an EKG done on my heart, and have an eye exam done to make sure that having diabetes hasn't damaged my heart or my eyes during my pregnancy.

I was also told that I will be induced some time between my 36th and 38th week, depending on when my cervix is ready. I walked around dialated to 4cms for a month prior to my induction with my last baby at 39 weeks, so most likely they will be taking the baby around my 36th week and he will end up in the NICU for a little while to make sure he's okay. Which means all the stuff that goes along with that. Like steroid injections for the baby to make sure his lungs are developed in utero before they deliver me.

If my blood pressure insists on continuing to be an issue, and I have to be on bedrest, and being on bedrest does not help my blood pressure levels, I could end up on hospital bedrest, or having an even earlier delivery than at 36weeks. Considering the fact that I've had four babies before this one, and as well versed as I am via experience and research, I am aware of most of the consequences this could have on our baby. The only cure for pregnancy related high blood pressure is DELIVERY. The survival rate for girls born premature is much better than for boys born premature, as well as the consequences. They can't quite explain it, but it's the way it is. I won't bore you with any more of the morbid details, it is what it is, but I have every intention on keeping this baby right where he belongs at least until that 36 week mark.

That is what is going on with baby and I right now. We are just taking it one day at a time.

Oh, and we have a name, but we aren't telling. :-p

20 weeks 3 days

I've started the 20th week of my pregnancy.

My blood pressure is high, but we've attributed that to the fact that I am in some pretty severe pain right now. Several years ago, I had several falls with knee impact type injuries. I saw a public health doctor at the time, who didn't really explain things to me, but put me in knee braces for three weeks. I never went back to the doctor. My bad, I know. The injury never healed right and is occasionally aggravated (say, by climbing up and down three flights of stairs five times in one day) and then I pay for it. At this point in time, I'm barely getting around. Every movement is painful. I can't roll over in bed without being in pain right now. Yes, it's that bad that I'm spending most of my time in bed anymore, and I have been going like this for more than two weeks. The problem is, is that I can't consistently stay off of my feet. There are four kids in my house and someone has to take care of them, including jumping up and down to get after a toddler every two to five minutes. Since I don't have insurance at this point in time, I'm really just struggling through it. Due to the fact that I'm pregnant, I can really only take Tylenol for the pain, and we all KNOW that stuff doesn't work when a person is at the level of pain that I am at now. Without seeing the doctor, we can't pinpoint EXACTLY what my problem is, which means it can't be solved. Right now, we are ALL in medical limbo though. My daughter needs to have her braces maintained, or removed, and needed to have it done about three weeks ago. One of my sons is supposed to be medicated for his ADHD and other issues, and ran out of medication three days ago. Apparently two of the kids need MORE immunizations for school because Texas has different immunization requirements than Washington does, so they might not be able to go to school soon. It's scary, and really difficult, to be a family, with children, especially children with medical or dental needs, and not have medical.

Anyway, back to me, and my pregnancy. I saw my new Perinatologiest yesterday. He is young. 35 years old. And has the most insanely beautiful blue eyes a girl has ever seen! We had a lengthy discussion about my diabetes. He feels, that it's highly probable that I am NOT diabetic. That I have something called "insulin resistance'. However, because I am pregnant, we have to treat me like I have gestational diabetes anyway. About three months after I have the baby, I will have to do another one hour glucose test and we will re-evaluate whether or not I am ACTUALLY diabetic.

I lost five more pounds in the last two weeks. That brings my total weight loss to 43lbs from my pre-pregnancy weight and puts me at 311lbs. Given my weight, he's still not concerned about the weight loss, but he WOULD like me to stop losing weight. Something that is really beyond my control right now. Given the fact that I can barely WALK right now, it's not like I'm exercising either. When you cut sugars and carbohydrates almost completely out of your diet though, you have to expect that to have some impact on your weight. It's not like I can just eat a bunch of fatty foods to prevent me from losing weight. Those fatty foods are mostly carbohydrate, sugar based, foods. It is literally impossible for me to GAIN and still follow the diabetic diet.

I had an ultrasound yesterday too. The baby is measuring small. I was 20.2 and baby was measuring 18.4-18.6. I have NEVER had a baby measure small. My babies have all measured bigger than their dates in the past.I suppose that is why I am five MONTHS pregnant and I don't look pregnant at ALL. I literally look exactly the same as I did before I was pregnant. Baby's heart looks good, which is really good considering my diabetes issue. Heart conditions in the baby are one of the big things that happen in babies with mothers that have diabetes. Our baby having a normal heart is comforting.

We also found out that we are having another boy. We have not broke the news to the kids yet, but have managed to tell most of the important people in our lives.

Emotionally, I'm feeling really mixed about this fact. This is my fifth, and final, baby. I really just is not possible for me to do this again. Not financially, and not physically. I wanted to be able to give the man I love a little girl of his own. I wanted more vag in this house and less penis. I didn't get the opportunity to enjoy my daughter when she was a baby because of the, less than healthy, situation I was in, and my severe depression because of it all. I wanted the chance to do it again. I wanted ruffly panties and cute little dresses. I wanted hair bows and barrettes. I'm upset because we don't get those things. And I have run out of boys names.

I do know that the primary focus should be that this baby is healthy and that is the only thing that should matter, but I can't help feeling sad. I feel like I have failed my partner by failing to provide him with a daughter, daddy's little girl. I have failed all the kids, who have wanted a little sister. I feel that it's all somehow less important, less special, that we are having a baby now, because it's just another boy. And I feel like I fail this child by even giving a damn. Believe me, the failure is present.

On top of all this, I really miss my home. I didn't spend as much time with friends or family as I would have liked and now it's impossible to change that. I am missing people. I am missing cool air. I am missing open minded people. I am missing my religious comfort zone and am now forced into a position in which myself and my family have to hide everything we believe in. Our views and values are being challenged at every crossroad in this alien territory. It's taking a long time for things to settle into place the way that we need them to, and that isn't helping the way that I am feeling. The way that my partner and I are both feeling. I think he is feeling the worst, because he is watching me struggle and knows that there is nothing that he can do, aside from taking us HOME. He wants to admit defeat, rent a u-haul and get out of here. I want the dream. I want our house. But I want to be comfortable in my community and not forced to hide everything about myself. I want to be in a place where people mind their own business and don't shove their shit down your throat. I want to not be suffocated by the people I'm forced to live around. Maybe I'm asking for too much, but at what cost? More than anything, I just feel really ALONE here. Alone and unwelcome. I've never felt that way before, and it's really not a good feeling. Like you are an outsider and do not belong somewhere, and probably never will. For as many hopes as we've had for this place, it's pretty devistating.

Following up on the sister drama, she has made her choice, and made her bed. Her children were placed with the family member she LEAST wanted them to be with. She has 30 days worth of U/A's to complete, then they say that she will be eligible for an 'in-home dependency'. However, because of her actions, she no longer has a home to go home TO. I made the offer for her to come here, and she chose not to. I hope she can get her shit together, but I'm not going to hold my breath about it. Sad but true.

Anyway, that's all I'm going to say for now. I need to lay down for a while and just rest. My body, my mind and my heart.

18 weeks already...

I have reached the 18 week mark now.

I also had another OB visit today with the new OB office.

Some things happened to change my perspective today and I am hopeful that things will be BETTER from this point forward.

Apparently nobody did their job informing me of the way that business is conducted in the office, and that was a FAIL on their part.

The nurse called me back to check my blood pressure and weight (For the record, I am currently stabilized at 316lbs, which is 38lbs below my pre-pregnancy weight.) and mentioned to me that I was there for a GYNO visit. I was like, 'uh, NO, I'm not. I'm 18 weeks pregnant, I have an OB visit. Nobody is gettin' up in my business today LOL' She sent me back out to the waiting room where I sat for another 10 minutes or so

The head RN came out and got me and took me into an actual office to find out what was going on. I let her know that I was NOT there for a GYNO exam, and would not be having one because I've already had the one necessary for my pregnancy. That I was not intending on staying with their practice because of the negative experience that I'd had during my first visit. She asked for more details, and I told her that I, and the father of my child, felt that this clinic lacked the experience and knowledge to properly care for a high risk patient. That we had certain expectations for my care, that included more frequent visits, close monitoring and managing my diabetes during my pregnancy. That during my first visit, the doctor had not gone over my sugars, or even asked about them, nor had she dopplered the baby until I ASKED her to. I felt that the clinic was incompetent of caring for us and we deserved better than sub-standard care.

She informed me of a LOT of things. Including the fact that the majority of their patients are high risk. That the clinic DOES KNOW how to manage me and my issues. She apologized that I was not informed prior to my first visit that the protocol for the clinic is that the first visit to the clinic is STRICTLY a pregnancy verification visit. The second visit is a GYNO appointment where they also do pregnancy related blood work. Visit number three is strictly genetic, Q&A related. From that point on, you have 'regular OB visits'. She also said that rather than seeing high risk patients every two weeks, high risk patients are seen on the regular OB schedule and alternate on the two week mark with a Maternal Fetal Medicine Specialist (ie a perinatologist. The MFMS is the one that gives you your ultrasound, and your NST's. She said that she hoped that, given all the information I NOW had, that I would reconsider changing doctors after that point. That she actually is also a patient at the clinic and the doctors are all really great. And that at ANY point in my pregnancy, if the physicians felt that my situation was beyond the scope of their experience, they WOULD refer me to someone else who would be able to care for me.

In the end, I was really relieved that my first impressions were wrong. I'd rather NOT change clinics again, even if I have to change doctors.

I got lots of paperwork today. A local resource list, a list of other services provided through Texas A&M, and among other things, a signing sheet that I have to have signed for every visit....if I don't skip any appointments, after 12 appointments, I will get a coupon for a free car seat. Which is awesome, because it means that I can pick out a GIRL car seat if we are having a girl :)

Baby's heart rate looked great. It was in the 150s.

She DID ask about my blood sugars and said that they ONLY way to bring down my fasting levels would be with medication. She said since my 2-hour levels were looking great that showed that I was really sticking to the diet. I told her it was all really about portion control and manipulation. That I was still eating cheesecake. She laughed and said that now she wanted to go to the cheesecake factory for dinner.

She put in my referral for the Austin Maternal Fetal Medicine. She said they would be doing my ultrasound (hopefully next week) and would be seeing me every two weeks, alternating from when she saw me. They would also be the ones that would go over my sugars and give me medication if I needed it.

I had to call and find out where my records were. Apparently my doctor's office mailed them out LAST Friday, but they still haven't arrived yet. Which tells me it's taking more than a week for mail to get from there to here.

Overall, I'm feeling better about the doctor situation. And it does help to know that I only owe $14 for my last visit. Which my medical insurance will pick up once it FINALLY goes through, which may still be a bit longer since they are asking for MORE information now and I have to go into the office again to drop it off. Monday morning. Hopefully that will square away everything and that will be the end of it.

Drama of the Sister variety.

More than a month ago I mentioned that a new breed of drama may be encroaching on my family bubble.

Let me explain.

Of all my siblings, I am the only one who has honestly ever been worth a shit. In their ONLY defense, they chose 'other' options in their lives. One choice in particular, that has lead to their ultimately unfortunate lives was their choice, as teenagers, to remain in the toxic environment that their father and his family created for them. They had the choice to be in a structured environment, the same one that I was raised in. A place with rules, regulations, chores, curfews and expectations....and they chose against that. They chose freedom. The freedom to do whatever they wanted, whenever they wanted, with whoever they wanted. In turn, they have both turned into the drug addicted, criminal types. One has been in and out of jail and prison, and the other in and out of rehab at various times over their 30 plus years of life.

I, on the other hand, while not perfect by any stretch of the imagination, have become a strong, independent, self-sufficient woman who has taken the completely opposite path that they have chosen.

At this current place in time, my step-sister has recently relapsed into her crack cocaine addition in the last four months and has basically brought the entire world that circulates within her range, down with her. Including her fiance and her children. She is set to lose her fiance, is facing an eviction from her home and will probably lose her children TOMORROW MORNING at the emergency meeting if she does not ACT NOW and get her shit together.

Two of these children have been through this before. They WILL NEVER return to her care if the state steps in to remove them. This also means that our family will probably never see these kids again. They are already disadvantaged because of their absent fathers and their mother's off and on relapse pattern. My heart aches to imagine the extremely hard road they would face were they placed into the foster care system, separated from each other, and bounced around from house to house and school to school for the next 5 to 16 years.

My parents cannot take them in again, for various reasons that are completely understandable. Nobody wants to further support her behavior, or be enabling of her. Absolutely people are done cleaning up her messes for her and helping her get her shit together.

That leaves me.

Unfortunately for the kids, my family just moved half a country away and I am not in a position to do very much.

After a lengthy discussion with my other half, I had the opportunity to speak with my step-sister on the telephone yesterday. I informed her that the ONLY option she had left to her was to go and pick up her children from our brother where they currently are, get in her truck, and drive her ass to Texas, to ME.

She didn't even know that I was pregnant. Or that we had already left for Texas yet.  I made her cry a lot, and hope that the words that I left with her were sincerely receieved. She is going to have a few obstacles in her trek to get here if she does decide to actually come, and either my partner or I might have to actually fly back to Washington and drive her here ourselves due to a licensing issue. Her ability to gather the funds it would cost for gas to get here is going to be a small hurdle.....but it is possible.

I feel helpless right now because there is nothing that I can do. I feel like an asshole for abandoning my family in a sense. I feel stuck because I cannot help MORE. I cannot save everyone, but given the opportunity, I would. I would absolutely save these kids. There is no question in my mind that they would already be WITH me if I was at home. I am, and this situation is, the ONLY option that these kids have left.

The last time this happened was in 2005. We had 9 people in a two bedroom mobile home with one bathroom. This time, we will have 10 people in a four bedroom two bath apartment. I think we can handle it. She just needs to GET here now.

Settling In

Today is the first day in nearly three full weeks that I have been able to sit down and write. We just got our internet, cable and phone service installed the day before yesterday...which was installed by a black man with a full on, top and bottom, gold grill. It took everything I had in me to not laugh. It was something that I had never seen in real life before and I honestly thought it was something that only rappers did. It still makes me laugh. He somehow managed to not do his job right, and we were still without telephone service more than 24 hours later. We were also told that we would be getting THREE cable boxes, and only ended up getting ONE. AND the internet was BASIC internet and not wireless, so we had to run out and buy a wireless router. Spending money we didn't really have didn't make me very happy, but at least I have my internet back. It has been a horribly long wait, that wasn't helped by the fact that the woman in the office didn't put the request in for us BEFORE WE GOT HERE like she was ASKED to do. Two weeks later, she still hadn't put the request in, and we had to go above her for it. I pretty much want to punch this broad in the face.

As far as me, baby and our medical state go, I'm struggling a little. Texas hospitals and physicians will not accept out of state medical programs. I went to the hospital to get a once over and a referral and they flat out refused to see me, because 'nothing was wrong' with me. I wasn't bleeding, cramping or contracting, so they couldn't do anything. Including get me a referral. I ended up eventually finding a resource that I could utilize, a sliding fee clinic at Texas A&M's Health Science division. They will basically hold my bill until my new insurance company kicks in and takes over.

Let me tell you though, I am LESS THAN SATISFIED with the level of care that I have received there. I've only had ONE visit and I already know that I hate the place. The doctor that I saw struck me as extremely incompetent. She's an OB/GYN with basically no concept of ANYTHING pregnancy related. It didn't matter to her at all that I am high risk. She didn't want to see my sugar levels for the previous weeks. She didn't ask how the trip had gone, or inquire to make sure that I had stopped often for bathroom breaks or to get out and walk. No questions about complications in prior pregnancies. Not a word about my medications. She didn't even DOPPLER THE BABY, until I straight up ASKED. Honestly, it SICKENS me to my very CORE that I have to go back and see her for at least one more visit before I can get myself a REAL doctor. The complete doctor/insurance situation has made me not seek medical attention for a few situations that I'm currently dealing with on my own right now, but really do need to see a doctor for. Particularly a cyst that has abscessed, and an infection.

In the middle of all this transition, I am now 17.2 weeks pregnant, and I should be worrying about and looking forward to my BIG ULTRASOUND where we find out the sex of the baby. Something that generally occurs between the 18th and 20th week. Yeah, I'm REALLY not happy about THAT one.

The baby is moving a bit now. We have felt some pretty good movement in the last couple of days. This baby is busy. I'm getting heartburn more often, which kinda makes me laugh because I don't feel like this baby has even GROWN. I haven't gained a pound of weight, only lost thus far.

The only real 'productive' thing that I've managed to do since we have been here, is get two of the kids set to start school on Monday morning. The third child that goes to school has special circumstances where we actually have to sit down with staff members and have a meeting before we can start him in school. We have to make sure he is in the appropriate program and that everything is going to be good from the get go.

The other half tore the ligaments in his hand and thumb while playing on the playground with the baby. On our way back from seeing the doctor, we stopped at McDonalds, where he got food poisioning from eating chicken that was either cooked inproperly or unsanitary conditions in the kitchen. BET I called the Health Inspector and ALSO mentioned that they had flies all over their dining area and that they probably have maggots in the back somewhere. Good times.

Ultimately, I am really missing Washington. There is a lot going on back home and people need me. CHILDREN need me and I should be there and I'm not. I feel guilty for that. I also really loathe change. The struggle to change schools, doctors, hospitals....find new grocery stores, restaurants, places to play.....really makes me sick and wears me down. For the most part, I just want to sit on the couch right now and not DO anything. I don't want to unpack a single box more and they are towering everywhere. I don't particularly feel like socializing with anyone aside from my immediate family either.

Don't get me wrong, we are GOOD right now, I'm just not real happy with a lot of things/situations that are ultimately out of my control at this point in time.

For now, I will stop there. I want to get to the stuff that is happening at home, but it really does need it's own blog.