Almost there... 36-38 weeks

June 25 – 36w 2d

Another appointment marathon day.  First stop of the day à biophysical profile.  I’m confounded every time I deal with the ultrasonographer at this point.  When I was pregnant with Gracie, he remembered every time he saw me that I am a physical therapist and went to P.T. school with one of his wife’s colleagues.  He is the one that confirmed that Gracie had no heartbeat.  Yet, 6 months later, when we showed up pregnant with Jenna acted like he had never met me before.  Same deal with baby number 3; every time he sees me, it’s like he’s meeting me for the first time.  Anyway, as he got started with the ultrasound he asked “Has baby been breech?”  Of course, this almost brought me right up off the table.  I asked if he was telling me that she was breech and he asked again if she had been breech.  Long story short, our little bug had flipped herself over again and was back in a breech position.  Fantastic.  Just what we need at 36 weeks.  Aside from this wonderful news, all was well with the NST and the OB check.

June 28 – 36w 5d

NST and MFM appointment.  NST was appropriately reactive.  The very good news of the day was that our little bug had, yet again, flipped herself over and is again head down.  She was estimated to be 6 lbs 12 oz for overall growth, which put her in the 59^th percentile.  No more MFM appointments unless a problem develops between now and Bug’s birthday.

July 2 – 37w 2d

BPP, NST and OB check.  Ultrasound had to be done at the hospital instead of in the office this morning, as the sonographer is on vacation this week.  The hospital sonographer didn’t know that she had just been measured a few days before, so she measured her again.  Estimated to be 6 lbs 15 oz….  so we are thinking that she will likely be between 7 and 7.5 lbs when she finally makes her appearance.  Very reactive NST.  Met the new midwife in the practice today.  They haven’t turned her loose on the L&D floor yet, as she has only been there for a couple weeks, but it was nice to meet her.  I liked her immediately, which usually doesn’t happen with the midwives.  Since she is so new, it’s unlikely that she will be the one to deliver our little bug…but maybe next time.

July 5 – 37w 5d

NST only today.  Very reactive in a short period of time.  In and out quickly today!

July 6 – 37w 6d

Very distinct change in Bug’s movements today.  Everything seems very sluggish.  The amount of movement doesn’t compare to what it’s been in the last several weeks, and the intensity/velocity of the movement also doesn’t compare.  Thought that perhaps it was heat related, so I made a huge effort to drink even more than I normally do and make sure that it was all very cold, but it didn’t help much.  Finally decided to put a call in to the midwife on call and she had me come into L&D for a little monitoring.  As soon as I was hooked up, I could hear her moving all over the place, but I was just not feeling any of it.  I was  hooked up for just over an hour, and all looked well.  They sent me home with instructions to come back the next day if nothing changed.  Movement the next day wasn’t a whole lot better, but I waited it out until the following day (Sunday)  Things were better on Sunday, so I assume that all is well.  But… it was just one of those moments / experiences that made we want to crawl out of my skin.  If one more person tells me that she’s running out of room to move as we get closer to delivery, I might have to start clubbing people.  Yep.  I understand that.  However… it’s not something that changes overnight; it changes gradually.  I have also experienced sudden change…and it was because my baby was dead…not because she was out of room.  Sigh.

July 9 38w 2d

Appointment marathon Monday.  BPP was good; baby is still vertex.  NST was appropriately reactive without any issues.  Midwife checked me – 1 cm., 50% effaced, cervix pulled about half-way forward and very soft.  So…pretty much whenever she wants to make her appearance, it’s go time.  At this point, we are giving her the week to bake and then this weekend we will start the stuff that we did with Jenna to ‘self’ induce labor.  Next appointment is Friday, July 13 for NST.

Update... weeks 32-34

Thusday, May 31... 32w 5d
We had our 32 week visit with maternal fetal medicine on Thursday, May 31 (as well as a midwife check and NST that day).  All continues to look well with our little bug.  She was estimated to be 4 lbs, 14 oz, which put her in the 63rd percentile for overall growth.  Placenta health looking good, and blood flow through the umbilical cord still looking good.  Our little bug, however, continues to persist with her frank breech positioning, with her but down and her head and feet up.  I was very disappointed to hear this, as I was certain that she had turned based on the intensity and amount of movement earlier in the week.  At this point there is still plenty of time for her to turn, and the plan was to employ any method necessary to achieve such.  Tactics on the list included ice on my belly, playing music by my pubic bone, increasing the amount of child's pose and downward dog during yoga, bridging exercises, etc.  The possibility of visiting the chiropractor (gasp!) for the Webster technique has not been ruled out.  Moxibustion has also not been ruled out, but I cannot find anyone around here to does it... so it's either wing it and do it myself without the acupuncture component or skip it all together.  In the event that all of this is unsuccessful, we will try an external version with the OB doc.

Monday, June 4... 33w 2d
Biophysical profile (including non-stress test) day with a midwife check.  Too lazy over the weekend to implement much in the way of extra tactics to get bug to turn, so I was quite surprised to find that she was in a vertex position with her head down where it belonged.  YAY!!!  Everything else looking good.  Scored a 10/10 on the combined biophysical profile.  Hopefully she stays this way.

Thursday, June 7... 33w 5d
Non-stress test.  In and out quickly with a very reactive test.  Lots of movement in the lower part of my belly...hoping that Bug has not changed her mind and turned again.

Monday, June 11... 34w 2d
Biophysical profile day again, with another midwife check.  Still vertex (head down)!  Scored 10/10 on the biophysical profile again, and all looks well. I'd be lying if I said that any of this gave me any substantial amount of comfort at this point, though...

On a slightly different, non-medical note, we may have finally decided on a name.  Well, at least a first name.  Hubby is still up in the air about the middle name at this point, but a first name is a HUGE step.  With Gracie and Jenna, I had my hospital bag packed by 30 weeks.  I am 4 weeks behind that pace...and counting.  I had planned to do it two weekends ago, and then again this weekend, and then again tonight after work.  And...still not packed.  I am woefully behind on listening to my Hypnobabies tracks.  I have finally brought all of the newborn through 3 month supplies from the attic...clothing, swing, bassinet, baby tub, etc. Perhaps we will be ready by the time she makes her appearance...

The best part... we have come to the realization that we live in a 3200 sq. ft. house and have nowhere to put a second crib.  This is primarily due to the fact that our house was hit by a car 16 months ago.  At the time, we were in the process of renovating the entire second floor, with the expectation of having all bedrooms and upstairs bathrooms finished by the time Jenna's younger sibling arrived (she was only 5 months old at the time and I was not even close to being pregnant).  Our house is safe to live in, but our renovations can not continue until the damage caused by the impact is fixed.  Sadly, not a single repair has been made and our insurance claim remains unsettled and has now entered into litigation.  Consequently, our second floor remains torn apart and completely unlivable; we are situated on the first floor with no major problems...except the fact that there is not an appropriate place for a second crib.  The bassinet will get us through until about Thanksgiving, and then who knows what we will do.....

Being sure to not overshadow Jenna and her pure delight...  She is almost 21 months old.  She refuses to talk, but uses her signs pretty independently.  She has verbal approximations of mom, dad, Izzy, up, off, cat, Aflac (ha!), and a few other words, but for the most part there is nothing doing on the verbalization front.  She is climbing everything.  Yesterday she found a dime on the floor and climbed up onto the dining room table to get her piggy bank that was temporarily parked there.  She has figured out that she can use the dog as a step stool to climb up on our bed, although I'm not sure the dog appreciates this.  Luckily, she is not yet climbing out of her crib.  She loves to brush her teeth and retrieve her own food and drinks from the fridge.  She is loving her swimming time and demands to go outside every time she hears a train or fire truck.  I could go on and on, but suffice it to say that she is just pure joy...

28 Week Update on Our Little "Lady" Bug

Thursday was our 28 week appointment.  To be precise, I was 28w 5d on the day of the appointment.  Everything is looking great as this point.  Here are some details:

• I did my 1 hour glucose test two weeks ago.  Both the fasting blood glucose and 1-hour glucose levels were well within the range of normal.
• Hemoglobin level from 2 weeks ago were good, so no issues with iron.
• No protein detected in my urine dip in the office today, and the urinalysis from 2 weeks ago was good (and protein in the 24 hour collection that I did at the end of the first trimester was in the normal range). 
• Remainder of the blood work looked good - this included kidney panels, liver panels and some other random stuff that they look at a little later in pregnancy.
• Got my Rhogam shot two weeks ago.
• My blood pressure is still really good!
• Belly measurements were exactly where they should be for 28 weeks
• Bug's heart rate was measured in the 140s in the morning and 130s in the afternoon.
• Bug's estimated weight was 2 lbs, 15 oz...which puts her in the 62nd percentile for overall growth.  (Jenna was estimated to be 2 lbs, 11 oz. and in the 61st percentile at exactly 28 weeks, so I would say that we are right on target!) 
• Blood flow through the umbilical cord was "excellent", size and health of the placenta appeared to be "excellent" and the volume of amniotic fluid was "excellent".  Cord flow and placental size/health are again big things for us at this point. 
• The most disappointing news of the day is that Bug is still situated in a frank breech position with her butt snuggled down in my pelvis.  She was like this at 20 weeks and has not shown any desire to move or turn. 

Bug still does not have a name.  At the rate we're going on names, she might be 10 years old before we come up with something that we can agree on.  Other than that, things are going well overall, but this pregnancy has been a completely different experience that our pregnancy with Jenna.  The midwife that we more or less 'found a home with' during our pregnancy with Jenna left at the end of last summer to return to school for her PhD.  The midwife that delivered Jenna also left to take a job much closer to home.  A new physician also joined the practice after Jenna was born, and there are quite a few new nurses in the office.  We have been in the office for appointment 5 or 6 times now, and I've left feeling pretty frustrated after at least 4 of those appointments.  I'm back to feeling like we are just a number since most of the people we've encountered don't know us like the 2 midwives who left the practice knew us.  I have had to reiterate the 36 week stillbirth story to at least 3 different nurses who couldn't be bothered to read my chart. 

We met the second of the new midwives during our last appointment 4 weeks ago, and we weren't impressed.  She was more or less in and out before we could blink our eyes.  Our first appointment with the other new midwife was a while ago, and since then our encounters with her have not left me feeling overly warm or fuzzy.  And... there is apparently no communication or common opinion between the providers in our OB office and the MFM providers about when I am supposed to start NST and biophysical ultrasounds and how often they are supposed to be performed.  As a result, I had to schedule an extra appointment with my primary OB doc so he can make a decision about this.  With Gracie, we started NST twice each week with weekly biophysical ultrasounds (even though we tried to keep the ultrasounds limited to every two weeks, they turned out to be weekly) around 32 weeks due to my preexisting hypertension diagnosis.  With Jenna, we started the same routine around the same time, due to our history with Gracie and my history of hypertension.  So, when the midwife told me this week that we would be starting weekly NST, I was surprised.  As long as things continue to go well, I honestly don't care whether we do them once or twice a week; I just want to know for sure what the plan is...

After much discussion, we have decided that we will try to ride out the remainder of the pregnancy with the only midwife who has been in the practice for both of our previous pregnancies.  She is the midwife that we saw one week before Gracie died, and simply because of that there has been some negative association since then.  But she knows us and knows our history and we're not just a number to her.  Our next regular appointment is scheduled with her, so we'll see how it goes, I guess.

In the meantime, I am investigating various options for turning this little bug around and getting her head down where it belongs.  In addition to the 'basic' things like positioning, ice on my belly, music and warmth near my pelvis, I am looking at seeing an acupuncturist for moxibustion and/or seeing a chiropractor (gasp!) for the Webster technique.  If anyone reading here has had 'success' with any of these techniques, I would LOVE to hear about it!!!

Refiguring

I received a call from our Maternal Fetal Medicine group on Monday.  The woman I talked to was very nice, chipper, perky...the whole nine yards.  She called in reference to my first trimester screen.  Specifically, she called to verify whether or not we had a child with Down Syndrome.  I'm probably the only person who will answer that question with "we don't know for sure."  I mean, how many people don't know whether or not their kids have Down Syndrome.  I explained to her that Gracie was stillborn and that Down Syndrome was heavily suspected for multiple reasons by our OB doc, as well as by the MFM doc that I consulted with between pregnancies.  She asked if chomosomal analysis had been done, and I told her that it had not.  She, of course, asked why it had not been done.  I told her that, as much as we were able to determine with lots of backtracking, there was dropped communication between parties in the hospital regarding the fact that our insurance would pay for the analysis, and that my placental tissue was ultimately never sent out from the lab.  She sounded stunned by this information.

She then went on to say that she was calling my OB office to have them refigure the results of the first trimester screen since they apparently ran the screen with us listed as definitively having a child with Down Syndrome.  She stressed that they needed to have accurate screen results, and followed that up with "keep in mind that your blood work is still really abnormal."  I told her that she didn't really need to bother with refiguring the results, as we weren't going to do an amnio or CVS, regardless of the new results.  I told her that we were going to see them for a level 2 ultrasound at 20 weeks, regardless of the results of the first trimester screen, because of our history and that that had been decided before the first trimester screen was even done.  I emphasized that the results of the first trimester screen were not supposed to have even been forwarded to them, since it was a moot point.  The conversation went in circles from here for about 5 more minutes before she finally told me that we shouldn't bother doing the first trimester screen in subsequent pregnancies if we weren't planning to do an amnio or other definitive testing to diagnose abnormalities prenatally. 

The whole conversation left me scratching my head and feeling a little disconcerted.  I was kind of bothered by her final 'instruction' to not do the first trimester screen in the future if we weren't going to do any further diagnostics.  It is our right to do the screen, for whatever reasons we choose to do it.  It is our right to decline invasive diagnostic testing based on the results of the screen (which were, apparently, skewed in this particular case) for whatever reason we choose to decline them.  It is our right to have a level 2 ultrasound during subsequent pregnancies, based simply on the fact that we have a history of fatal placental insufficiency and IUGR.  It is our right to not really care about the refigured results of the screen.  Why can't they just leave well enough alone?

Hoping that the remainder of the pregnancy does not go this way.....

And Then There Was a Bug....

We are happy to announce, providing that all goes as expected between now and July, that we will welcome another baby into our family.  My official estimated due date is July 21, but if this baby is anything like Jenna, I expect to welcome it about a week early.

We have another month to wait to find out if this little bug is a boy or a girl, but my prediction is boy, as much of my early pregnancy 'symptoms' were much different than with both girls.  Other than my own illnesses over the last month, the pregnancy itself is going well so far.  Although we expected a 'concerning' result, we elected to do the first trimester screen again this time.  With Gracie, our predicted probability for Down Syndrome was 1:47, and with Jenna the probability increased to 1:39.  Since I am another 2 years older than I was during pregnancy with Jenna, I anticipated that the probability this time would come back around 1:20.  I was wrong.  Our probability for Down Syndrome with this baby is 1:11 - based on the screen.  We will not do an amnio, but we due to our history with Gracie and due to the results of the first trimester screen, we will have level 2 ultrasounds at least at 20 weeks and 30 weeks, with the possibility of additional ultrasounds in between.  The biggest concern going into the first ultrasound at 20 weeks is the baby's heart structure, as kiddos with Down Syndrome have a high incidence of structural heart defects.  If there are issues with the structure of the heart, we will assume that Bug has Down Syndrome; if there are no issues with the structure of the heart, we won't know for sure until birth.

In terms of our providers, this pregnancy has been a bit rough.  There has been a large change in staff at our OB office.  The midwife that we have worked closely with over the last two pregnancies left to go back to school, and the midwife that delivered Jenna left to take a job much closer to home.  They were our first and second choice for providers, hands down.  A third midwife that we are very familiar with, but didn't work much with, has also left the practice.  So, out of the 4 midwives that were there when Jenna was born, only 1 remains.  There are two new midwives, and also a new OB/GYN, who we have heard good things about.   (There are also a bunch of new, young nurses)  We have had 3 appointments so far... the first was with 'our' doctor, the second was with one of the new midwives, and the third was with the new doc.  The appointment with our doc, as expected, was fine.  The appointment with the new midwife was very, very positive.  She took quite a bit of time to review our history and talk with us about our expectations and anticipations for this pregnancy.  We got a basic plan laid, and we left feeling really good about things.  The appointment with the new doc kind of sucked.  She was running 45 minutes behind (at 8:30 in the morning), and was in and out in literally 2 minutes.  She very quickly told us the results of the first trimester screen, and when we mentioned that we had dealt with high probabilities before, she quit talking about it aside from saying that we would definitively stick with the plan for the level 2 ultrasound.  She listened to Bug's heartbeat (barely long enough to count it) and that was it.  We have heard lots of good things about her, so I was really disappointed with that.  Hopefully, it was only a matter of trying to get caught up, but still.....   I think that we will likely stick with the new midwife that we have already met for most of our care, going with the 'if it's not broken don't fix it' theory.  Overall, though, the experience with the providers' office has been much different.  When we got pregnant with Jenna, they fell over themselves trying to treat us as well as they possibly could because of our history.  Not this time.  Not even close.  I don't expect them to treat me like I write their paychecks, but it would be nice to not have to repeat for every nurse that checks me in (except for a few of the 'old faithfuls') that we have one live baby and one dead baby.  It's in my chart.... in plenty of locations... including the paper that I just filled out at the beginning of this pregnancy, which is in the front of my chart....

Aside from that, it's been pretty uneventful so far.  First couple rounds of blood are out of the way and the first 24 hour urine collection is underway...  Just counting down the days now until we find out if this little bug is a Mister Bug or a Lady Bug.

Keep reading below for an update on Jenna...

Catching Up...Almost 17 months

Man, it's been a looonnggg time since I posted here.  I came to the blog today to look up something from my pregnancy with Jenna and almost fell over when I saw that I hadn't posted anything since July.  I have been so busy that I haven't really had much time for reading other blogs, and my own have sadly been a bit neglected, but I figured that I better do a little updating here for those that still read and and are not FB friends. 

Jenna is almost 17 months old now!  She is a very, very busy girl.  It's been so long that it's hard to know what to write, but here is a fun list of facts...

• She started walking just a few days after the 11 month mark.  It's been all downhill from there!  
• She has 12 teeth now.
• There are a few words that she has used only one or two times (uh-oh, poop, mama, no), and one word that she uses all the time (up), but for the most part, she's not saying a whole lot yet.  She is using 11 signs spontaneously, though, which helps quite a bit with knowing what she wants.
• She loves music and loves to dance.
• Thankfully, she loves to eat.
• She loves bath time and will ask for a bath at random times during the day.

 \

Here are a few photos from the last 7 months.... 

 SUMMER TRIP TO LAKE ONTARIO

 Bath time at the camper  :-)

FIRST BIRTHDAY PARTY

ONE-YEAR PHOTO SESSION

 

 

PICKING OUR PUMPKINS

 OCTOBER FAMILY REUNION

Jenna and her cousin Lila, who is 18 hours younger

 

 Testing the water in the lake

OCTOBER SNOW!!!

HELPING AROUND THE HOUSE

CHRISTMAS!!!

 

 DOING CPR...

  Jenna accompanied us to CPR certification a couple weeks ago.  She watched with much interest for about an hour as we worked with the adult mannequins; when we got out the infants, she quickly stole one and carried it around like a doll.  Then she stole a mask, and before we knew it, she had done this all by herself!