I can't believe that it's been almost 4 weeks since I last posted. Things have been super crazy here, and I was without my laptop for a while (which, I have sadly learned, has become a physical extension of my body). Consequently, I have become a bit of a cyberslacker. I have been neglectful of Bean's blog, as well as Gracie's blog and FB; I am hoping to get Gracie's blog updated by the end of the weekend, since I have had a post brewing in my head for quite some time.
Bean has been busy over the last couple of weeks getting her feet wet as a tiny little firefighter. We have been to three working fires in the last two weeks, which is actually a lot for a two week period of time in our little corner of the world. No, I am not doing any actual firefighting, but instead doing the 'boring' things that a deputy chief gets to stand around and do at large fires. Aside from all of this excitement, everything with Beana is moving forward pretty uneventfully. Here is a quick rundown since my last post.
Tuesday, August 17th was a three-appointment day....non-stress test, ultrasound and midwife appointment. The NST was again reactive within 20 minutes. The biophysical profile ultrasound was good, scoring 8/8. The ultrasound tech gave the very distinct impression that he was in quite a hurry to get us in and out; I was only on the table for about 3 minutes. I have confidence in his scoring/evaluation of everything except the amount of amniotic fluid, which he rated as normal (it had been high during the two preceding ultrasounds). After the ultrasound done yesterday (8/26) I am pretty sure that my assessment was correct in not trusting his 'normal' rating on the 17th. The midwife appointment on the 17th was uneventful. She reviewed the rest of my labs that were not back by the last time I was in to see her. There was very little protein (which is normal) in my 24 hour urine sample, which is what anyone with chronic hypertension wants to hear. The 1-hour glucose test that I did on Wednesday the 11th was also well within the normal range, so it means that the extra amniotic fluid that was seen was not the result of new onset gestational diabetes.
35 WEEKS
Friday, August 20th was another NST...again reactive within 20 minutes.
Monday, August 23rd was another NST...again reactive within 20 minutes. I am starting to love the quick reactivity that Jellybean is showing at this point, as Gracie was never this reactive.
36 WEEKS
Thursday, August 26th was a NST, a Maternal Fetal Medicine appointment (which included a level II ultrasound) and a midwife appointment. Bean was quite active during the NST, so I was again done within the 20 minute window.
The level II ultrasound was good. We didn't get any good pictures because she continued to be quite active right through the ultrasound. She was estimated to be 6 lbs, 4 oz, which puts her in the 50th percentile for size. Keep in mind that this is an estimate, and can be +/- one pound of the baby's actual weight, but it is encouraging. At 35 weeks Gracie was estimated to be 5 lbs on the nose, which put her in the 19th percentile; a week later she was born at 4 lbs, 3 oz, which put her in the 7th percentile...which is way to small for a fetus. So...at this point, Bean's estimated weight is about 50% more than Gracie's actual birth weight at 36 weeks. The ultrasound technician seems to think that Bean is going to have quite a bit of hair. She pointed out white spots around Bean's head on the ultrasound and said that it was hair (from her head) floating in the amniotic fluid. Given the hair history of Bean's parents, aunt and uncles, I won't really put too much faith into that prediction until she is born with a full head of hair!! :-)
I met with a MFM doc that has not been to my OB's office before...the assumption is that she usually doesn't travel and was just filling in for one of the regulars. Too bad if that is the case, because I liked her quite a bit more than the regulars. She had no concerns other than my amniotic fluid level, which is, in fact, still pretty high. Right now, there are two realistic explanations for the high fluid levels (there are many other things that can cause high fluid levels, but most of those have already been ruled out). It could be absolutely nothing - completely benign and insidious. It could also be the result of a chromosomal abnormality (i.e. Down Syndrome). If it is benign without substantial cause, it may go down between now and the end of the pregnancy, or it may not. If it is due to Down Syndrome, it will likely persist for the remainder of pregnancy with the possibility of increasing further.
The MFM doc offered me induction any time after 37 weeks (this coming Thursday). She offered this for two reasons, first and foremost being our emotional well-being in light of our history. The other reason was the fluid and the potential impact that it might have on my breathing. Luckily Bean has been very low during the entire pregnancy, and she's not yet dancing around under my ribs, so I am not having any breathing issues yet. At this point, we are not considering early induction, however she left the option open and on the table in the event that we change our minds. If I start having a hard time breathing, we will probably consider it, otherwise we are just going to wait things out and let her come on her own terms.
Thursday's midwife appointment was relatively uneventful. We did and discussed some end-of-pregnancy stuff. We discussed the fluid issue a little more and that was it. Bean and I coerced Jeff into helping with our belly cast on Sunday, August 29th. My midwife keeps telling me how lopsided my belly is...I just wish I could tote the cast in for her to see. It is one of the most lopsided things I have ever seen!!
37 weeks
Tuesday the 31st was a NST, BPP and midwife appointment. The ultrasound was uneventful, and amniotic fluid was measured around the same levels that it has been. The NST was unfortunately non-reactive and I had to go to L&D for additional NST. I was there for about 45 minutes, it was reactive, and I came home. Before I went to L&D, the midwife checked my cervix - 1 cm with no substantial effacement.
Friday, September 3rd was a NST and my hospital pre-admission visit. Both were uneventful.
38 weeks
I'm a little off at this point - I will be 38 weeks tomorrow, but you get the point. We had a NST, US and midwife appointment yesterday.
The ultrasound was good - 8/8 toward the BPP score. The amniotic fluid level was actually in the high end of the 'normal' range, so it's still coming down a bit. The NST was reactive, so the overall BPP score is still coming in at 10/10.
The appointment with my midwife was a bit more eventful than normal. She expressed concern about the shape of my pelvis. This is based on the last couple of exams, as well as the fact that it previously took me almost 90 minutes to push out a 4 pound baby. She had the high risk doc from the practice come in to do my internal exam, and he insisted that I have the room to push this baby out. The baby has also changed position a little bit and my cervix is now dilated to about 3 cm and about 50% effaced. He thinks that the position of the baby and the status of my cervix had a lot to do with how my pelvis was feeling to the midwife. Much to my dismay, my midwife did confirm that they are not going to allow me to carry to my E.D.D. because of my history of chronic hypertension (which as been completely under control for the entire pregnancy), the amniotic fluid level and our history of stillbirth. We discussed this at length. I really want to go into labor on my own, but at this point, I guess we are not in a position to argue. For now the plan is to see what my cervix is doing on Tuesday (9/14) and formulate a plan for possible induction if necessary.
I have a NST on Friday, and then Tuesday will be decision day. Who knows what will happen beyond that point. Until then, I am still trying to wrap my head around the fact that there will be a baby here within the next two weeks. Will hopefully keep you all posted on any further developments...
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