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Sunday, June 6, 2010

24 Week Update

Miss Beana has been dancing up a storm over the last few weeks.  She is on the move 24/7, which is more than I could ever say for Gracie, who slept for 6-8 hours a day with very little movement during those hours.  Some days I feel like she is literally sucking the life out of me; I am just absolutely exhausted.  I know that some of it is just because I have been going non-stop at work, which will be slowing to a normal pace by the end of this week; but I can't help but wonder if some of it is because Beana is actually growing as she should be and physically requiring more from me than Gracie did...since we now know that she was not really keeping up in terms of growth.  Regardless of the reason, it has forced me into taking weekend naps in an attempt to catch up with what I am not getting during the week.  I am loving the weekend naps on the weekend, but not so much during the week when I think about what I could/should have gotten done during the time that I was napping.

We had our 24 week appointment on Thursday, which included another level 2 ultrasound, a visit with one of the MFM docs and a visit with one of the midwives in our OB practice.  The ultrasound was, again, an amazing experience.  Beana was having a little dance party during the entire ultrasound - it was weird to feel her moving and watch it at the same time on the screen and see which body part it was that I was feeling.  She was in a head down position at 20 weeks and she was still that way on Thursday!  Yippee!!  The ultrasound wasn't quite as detailed as the 20 week ultrasound, but we still saw pretty much every structure of Beana's body.  We were also able to see the placenta pretty well, as well as blood flow through the umbilical cord.  Placental size and health and cord flow were two of the things that I was most concerned about (in addition to cardiac structure and function), and both looked really good on Thursday.  Heart structure and function is still looking good, too.

 Although you can't see her face, this is a shot of her arms up in front of her face.  It's similar to a few ultrasound photos that we have of Gracie.

You can see her heart with such clarity here...

Overall, Beana is measuring in the 39th percentile for growth - she was estimated to be 1 pound, 5 ounces.  I am not real crazy about the 39th percentile, since Gracie was only in the 30th percentile at 32 weeks, but as long as she holds steady in her growth and stays at or above the 39th percentile, all is well.  (I forgot to ask where she measured during the 20 week ultrasound.)  After our first go-round with IUGR not being diagnosed until postpartum, I am just a little nervous.   

The MFM doc basically came right out and said that everything looked good.  Jeff was surprised by this, because he was expecting him to give us the same line that the other doc gave us 4 weeks ago..."Nothing of concern seen at this point."  He said that if everything continues at it is now, we will have additional ultrasounds at 28 and 32 weeks, and then start weekly biophysical profiles (ultrasound and non-stress test combo).  We will also have a second NST each week since that information is considered to be valid only for 3-4 days. 

Nothing exciting during our midwife appointment.  My blood pressure was just a little higher than I hoped it would be, but it was certainly not high enough to cause concern.  I have gained a total of about 22-23 pounds so far, which is good.  Fundal height measurement was 24 cm...right where it should be.  Heart rate was 145 beats per minute.  We discussed a few other business matters...

The day of our next scheduled appointments will be quite eventful...I will be returning a 24-hour urine collection jug, doing the 1 hour glucose test, receiving my Rho.gam injection, having an ultrasound, seeing the MFM doc and seeing the midwife.  We decided to ask how much pressure we are likely to receive for induction as we get closer to our due date - in all honesty, if things are looking good, I have no desire at all to induce early.  Her response was that much of those recommendations would come from MFM, but as long as there were no concerns from us or from the medical team, it shouldn't be much of an issue.  But, she did say that it's not overly likely that they will 'let' me go past my EDD.

We also discussed with her that we feel like our medical team is getting a touch too big for our liking.  I am all about the 'two heads are better than one' thing, but I also believe that twenty heads are not necessarily better than two.  I'm not entirely sure that our midwife completely agreed or understood where we were coming from, but I explained that we sometimes wonder if Gracie's backslide in growth percentile would have drawn more attention if there had been less than 9 people (not including nurses) involved in our last 5 appointments before she died, which were a combo of NST, ultrasounds and office appointments.  Most of those 9 people were the result of circumstance and random luck, rather than intentional scheduling, but I still can't help but wonder if the drop from the 30th percentile to the 19th percentile in a 3 week period would have drawn more attention if it had instead been a consistent 3 or 4 or 5 sets of eyes reviewing my chart repeatedly.  (Our practice like to make sure that you see each midwife at least once for familiarity's sake, and that you see one of the docs at least once during each pregnancy...that is a potential of 7 people to see during each pregnancy, now that they have hired a 4th midwife.  I like the convenience of the MFM group coming to our OB's office, which saves us from travel and/or going to a hospital that we don't really want to go to - but because they rotate and we don't always see the same doc.  In addition to all of the docs and midwives, there will be a combination of at least 3 different people doing ultrasounds - 2 that travel with the MFM group and one that works in our OB's office.  Hence the feeling that our medical team is getting a little too large...)  Long story short, we will be working to limit the number of different providers that we see over the next couple of months in an attempt to maintain some continuity.  Although this might requires some repetitive travel to the hospital/office a few days a week instead of scheduling everything on one day, in the long run, I think it will be worth it in terms of my own sanity. For now, we will be sticking with docs who travel with the MFM group and the midwife pool from our OB's office.  Since we are seeing MFM on a regular basis, and we are already familiar with the docs in our OB group, there won't be a need to see any of our local OB docs for the 'obligatory' visit during this pregnancy.  Hopefully it works out when push comes to shove once we start scheduling weekly appointments beyond 32 weeks...

In closing, I want to send out my deepest sympathy to Courtney and her husband, who just sent a third angel to heaven. 

Sending out congratulations to Franchesca, Bree, Alison and Tina...who are all loving up their new rainbow babies!!

And last, but certainly not least, sending out warm, fuzzy thoughts to the other mamas out there walking this rainbow journey with me.... Dawn, Katy, Heather, Megan, Lareina, Holly, Lori and one last mommy who has not yet announced her new pregnancy in blogland.  Sending out the best vibes in the world to Kerry and her family who will hopefully welcome their rainbow on Wednesday, June 9th.