26 weeks 3 days

I had my appointment with the perinatologist today.

They did an ultrasound to check baby's movement and his breathing. Baby is taking some regular practice breaths, which they can see with the rise and fall of the diaphram.

Baby looks good. Placenta looks good. Cord looks good.

I have to stop by the lab tomorrow after my OB appointment (I was exhausted today and it was too hot to stop again!) They are going to run some labs on me (CBC and Metabolic panel). We are also going to do another 24 hour urine collection to check for protein and creatinine.

He's upping my BP med to twice a day. That should help with the headaches. If I'm not feeling better in a week and the headaches and swelling are still going on, then I need to call and they will either up me again or we will try a new med.

He also wrote me out a prescription for a blood pressure cuff/machine since my old one is now fubar'ed. If my insurance happens to not cover it, they have a program where they can send a nurse out once a take to take my BP and do a urine collection daily so that I don't have to come in every day or be in the hospital.

I'm to continue to try my best to stay off my feet as much as possible, but I'm NOT on specific bed rest at this time. And NO HOSPITAL. YAY!!!!

He's not worried about the face swelling (weird) or the three week long headache (because it goes away when my BP is down).

We are going to watch me super close now, not that we weren't already though.

I will have another big ultrasound in two weeks to check out baby's size to see if he's growing more or not. Since there are some concerns about his size and possible IUGR (interuterine growth restriction). If his growth percentile starts to decrease, we could have a problem, but he looks good right now, even though he's tiny.

As far as my diabetes, my blood sugar looks FANTASTIC.

I did mention to him that I'm really not feeling good, and when I don't feel good, I tend to eat whatever I want to, even if I'm not supposed to. In a "Get the fuck away from me, I'm eating the damn brownies and I don't care what you have to say about it" kind of way. I only have SO MUCH self control and the more stressed or anxious I am right now, the less able I am to handle controlling what I put in my mouth. He didn't give me the green light to eat whatever I want, but he said my numbers look good and he's not worried if I have to eat some brownies LOL

As far as my weight gain goes, I'm up four pounds since my last visit two weeks ago. I had that massive weight loss, so I'm still down 37lbs, but I've gained 6lbs from my all time low. Which is really good. At least I'm not losing MORE. It's the brownies I tell you!!!! Six pounds of brownies, straight to my thighs and ass!!! LOL

Tomorrow's checkup with the Parinatologist.

Tomorrow is my 26 week checkup with the Perinatologist.

I have to say, I'm not super duper excited about this.

My blood presure has continued to rise back up to my normal levels since I initially started taking my BP medication (procardia) two weeks ago.

The pain in my head has increased to the extent that it continues for all but about two hours in the morning after I take my medication and basically throbs to the extent that this evening I can hear my heart beating within my head. There is no sleeping it off as I have often done with the headaches I got prior to pregnancy, it just continues on it's merry way without thinking twice about ME.

The swelling in my lip area is now starting to extend to the area round my mouth each morning and it is a nightmare to look in the mirror every morning not knowing what I might find 'this time'.

I have tried my damndest to stay in bed on my left side, or on the sofa with my feet as far up as I can get them. I have avoided leaving the house at nearly all costs, with few exceptions, particularly for financial reasons with the intent to secure my family prior to the impending doom of hospital bedrest that I know is on the horizon.

The man and I have had several very frank conversations and tend to agree that the best route, at this point, would probably be hospital bedrest, and while we are certainly not happy about it, we know that it's the right thing to do for baby and I. So if, or when, it needs to be done, it's something we wouldn't resist. Even if it's tomorrow. He is worried now. You can see it in his face. It breaks my heart and makes me cry to know how he is feeling. That there is NOTHING that he can do to fix it, or me, or make sure this baby is okay.

I have managed to get a few newborn and preemie items to start us off once baby finally comes home. We got the diaper bag, and the carseat.....the rest we will manage while baby is still in the NICU.



Mentally, I'm starting to crack. I know that baby will be okay, I'm just not sure that *I* will be okay. I'm scared. Genuinely. And I'm pretty much having an internal panic attack about it. And I feel pretty alone in all of this right now. I know there are a few people who are supportive from a distance, but physically, it is lonely here dealing with all of this.

We have been open and honest with the kids about the posibility of me being hospitalized and the fact that I am really sick. I'm not sure that they understand completely, but they do know that momma always does what is right and for the right reasons and that we will all manage to somehow get through this.

Today, the cuff on my blood pressure monitor burst on my arm. We went to Walgreens, unfortunately they do not sell replacement cuffs. We had a lengthy conversation with the pharmacist about my condition and she tended to agree, that were she my doctor, she'd admit me at this point.

Having someone agree, scares me. Knowing that my body is going to kill this baby, or it will kill me, is eating me up inside. I feel like my body is a failure. I feel like I have failed as a woman, to protect and carry this child. I felt quite similarly when I miscarried. And knowing that this is the LAST child, because my body can't do it anymore....while I'm not READY to be done, also eats me up inside. My body has taken the choices away from me. I want to kick, and scream, have a tantrum and cry. It's a lot to accept in one swallow.

Did I mention how bad my head hurts? And that pain won't go away until my blood pressure comes down, and even then, the reprieve will only last a few hours.

I desperately need to make it to the 32 week mark. 27 weeks is in sight.

After my ultrasound tomorrow, if baby hasn't grown, or something else happens, they might just take him out. Then we will shift on to new worries, I'm sure. We just don't know what is going to happen right now. Not knowing is the worst. Mommies shouldn't have to deal with this stuff. Ever. Their bodies should just do the right thing. And I have accepted enough of the UNKNOWN this year. In this lifetime. I'm not sure that I can cope with MORE right now.

26 weeks

Today marks 26 weeks for me, and I can assure you, I am mostly dreading my visit Wednesday morning with the perinatologist.

I'm pretty certain that based on my BP's this last week that the medication is failing to control my BP adaquitely enough. It makes me wonder exactly how high my BP would be WITHOUT the medication though.

I've awoken every single morning in the last week with swelling in my lips, along with a little numbness and tingling. Some days are substantially worse than others. Strangely enough, it seems to go away within a few hours of awakening. My entire face is not swelling, but my lips most certainly are.



The swelling in my hands is very minimal. Noticeable to me, but not outlandish. And the swelling in my ankles...or cankles as the man has referred to them now, is worst in the afternoon, even if I haven't been out in the heat or up and about.

I've also noted the onset of that throbbing headache that begins some time in the afternoon, doesn't go away with tylenol and continues until about an hour or so after I've taken my BP med again in the morning.

I've had some spotty disturbances with my vision in the afternoon to late evening but it is still going away within a few minutes. It's not hanging around, so that makes me feel better.

I know that it is definately time for another 24 hour urine collection. And probably for an increase in my BP meds. Beyond that, I'm not sure what is going to happen.

I certainly hate my body right now. It's doing everything that it can to reject this baby. And that's just not cool with me.

One thing rest very certainly in my heart right now though. That is the fact that I know, in the end, he will be JUST fine, no matter what happens to end this pregnancy. I know this, because every pregnancy I have carried a child, someone in the family has died, and my baby ends up fine. Just last night, that happened.

There is no sadness, no grief, no feeling of loss. The family drama was far too deep for that. I have learned one lesson, and that is that I will not do the same. I will stand by MY family, my children, my grandchildren, my great grandchildren and protect them when it is necessary for me to do so. Blood will always be thicker than water for me.

Were I able to travel the 2500 miles back to Washington right now, I would not. I do wish I was a fly on the wall right now though, to watch the fight that happens over her possessions. Her daughters at least, are petty, greedy and despicable. They have plotted for years about who would get what. Maybe I'm just in the mood for a little hair pulling, face slapping, nail scratching, bitch fight. LOL I'm glad my father will at least do the honorable thing, hold his head high and walk away.

25 weeks

Emotionally, I have somehow managed, thus far, to hold it all together. Maybe that is my way of inadvertently trying to reassure my partner that everything will be okay, when everything is going horribly wrong right now. He actually has no clue as to how serious things are. He knows what is going on, but he just doesn't grasp the depth. I'd rather keep him oblivious, for all of our sakes. LOL

I am, and have always been, a woman of strength. I vent a lot of things about the struggles that I am having after the strain of carrying it all has taken me over the limit. I vent it off, and somehow, beyond what I even knew I was capable of dealing with, I manage to carry on. I manage to keep calm during the daily challenges by setting everything aside. I set aside the emotions and basically do a mental 'check out' with whatever I had to set aside. THAT is how I have managed to survive.

As the days go by though, the gravity of the situation right now is really starting to clamp down harder on me.

I spoke with my mother on the phone last night. She has laryngitis. She's not in pain at all, but her voice sounds horrible. When I started talking to her about the baby and my condition right now, and she responded....her voice cracked and it almost sounded like she was speaking through tears and was in pain....not by the fact that her voice is messed up due to illness, but out of genuine worry, concern, and pain for me. In that moment, I couldn't hold back the tears that silently streamed down my cheeks.

In these moments, I'm glad that there is no one here, face to face, to speak with me about such things. I would not be able to keep myself together. I would much rather shed my tears alone, than further bear my soul for an audience. I would not want anyone to be burdened by such a situation either, so I'm kind of glad that there is no one close at hand.

I awoke this morning with a some swelling in my face. My lower lip in particular, was noticeably swollen when I glanced at my reflection in the mirror. While my blood pressure has been fine today, and only the most moderate of swelling is visible on my hands and feet...I still worry.

I spent most of my day in bed, which was strange, given the fact that I didn't even get out of bed until 10:30 this morning. I napped for about four hours, assisted with dinner, and have been lying on the couch ever since, watching movies. I drank as much water as I could, which was apparent enough by the 50 visits to the bathroom I made today. I'm certain that I over-exerted myself yesterday, but it was necessary that we spend three hours in Austin tying up some loose ends.

Two hours from now marks week 25 and baby's survival rate increases to 50%. That fact provides me with a small bit of comfort...but doesn't soothe the soul quite completely enough.

Beyond that, beyond baby, I am still struggling to accept the fact that this is the end. That the choice to have more children has been made for me. By my own body. It's kind of the enemy right now! LOL

In the coming weeks, I plan on venturing out to pick up a few preemie outfits and a few baby supplies that need to be replenished. Diaper cream, baby shampoo, some more lotion, cotton balls, vaseline...you know the things I mean....

The bassinette will be pulled out, the sheets washed, receiving blankets washed, burp rags located, washed and folded....I have to be prepared, because there will not be time later. Nesting will start early....even if he doesn't come home right away. He will come home. He will.

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