31 weeks and going strong

Another 5 week gap between posts, whoops. I’ll bring you up to speed, shall I?

In my last post it was the day before the gestational diabetes test and I wasn’t looking forward to having to stomach that horrible sugary drink. I ended up feeling quite sick after it and it took about 24 hours for me to start to feel better again. Then at my OB appointment a few days later, I was told that I had failed the test (like really failed apparently ) and that I had gestational diabetes.

I can’t even begin to explain how ripped off I felt at being given that news. I already have my fair share of pregnancy worry to deal with, why do I now get this too? I was sent home with some dietary advice (goodbye white carbs) and to start testing my blood sugar 4 times a day – first thing when I wake up (fasting level), and then an hour after breakfast, lunch and dinner. All of my post meal levels have been perfect this whole time but my fasting levels have been consistently high. It’s been a bit stressful to see a high number flash on the screen every morning. I’ve had a whole heap of suggestions from people to eat a low GI snack right before bed and so far have tried at different times; an apple, a slice of multigrain bread, a glass of milk with milo, low GI crackers with cheese – none have worked. My OB explained that it’s not my fault and that my placenta is just making too much hormone that leads to a build up of glucose in the blood and my pancreas can’t deal with it.

She started me on Metformin (3 x 500mg) tablets each night for the diabetes. After more than a week of taking them and seeing no change at all, it was decided that I would also require insulin injections. I had to see an endocrinologist who started me on 14 units of insulin in addition to the 3 x Metformin tablets, all to be taken at night. Fast forward another week and I was still failing my fasting levels so as of yesterday I am now trialling 4 x Metformin tablets and 18 units of insulin. This morning my fasting level was 4.7 which is under so I’m hoping that this will be the turning point and that I can stay consistently under 5 from now on. If I have 3 fasting levels fail in a week then my dose will have to be upped again so fingers crossed that doesn’t happen.

In between all this, I had a brief hospital stay due to a change in amniotic fluid loss. As mentioned previously, I’ve been losing an increasing amount of fluid but was told that as long as it continued to be clear and I had no pain then it was ok. Well, I woke up to dark pink fluid on the morning of our 5 year wedding anniversary. I called the pregnancy assessment unit to check with them what I should do. They said to come straight in but not to panic so we organised for my Mum to come and stay with Oscar for a few hours while Candice and I headed into the hospital.

Once there, a midwife tried to find the baby’s heartbeat using a CTG monitor but was initially having trouble. She didn’t really say too much to us but then announced that she was going to “call in some friends” and pressed a buzzer on wall. All of a sudden things got real hectic. We went from having 1 midwife with us to about 7 people crowding around the bed, all seemingly with a job to do. The midwife explained to a doctor that she was having trouble finding the heartbeat and when she could, it kept dropping really low and then she would lose it again. There was a nurse putting an IV line into my hand and another nurse taking blood samples from the other arm. Another 2 were standing over my belly with dopplers, trying to locate the heartbeat while a doctor was setting up an ultrasound instrument to see the baby. Then the OB came in and she was the one that was finally able to find the heartbeat and show us the baby on the screen. I don’t know how Candice felt at that point but I could feel my own heartbeat thundering in my chest. It was a really intense moment and I actually thought at one point, am I about to be taken into surgery to have this baby now?

After I had been monitored for about 30 minutes, I was started on antibiotics and was given a steroid injection in my leg. The monitor was showing regular small contractions but I honestly couldn’t feel them at the time. We were told that I would have to be admitted and would be there for a few days. I was moved up to the pregnancy and maternity ward and given a room. By this time I could feel the tightening contractions which were happening every 10 minutes on the dot. I continued to time them but after an hour they started to become irregular and also hadn’t become painful. The last thing I wanted was to be going into labour so it was a relief to know they were false contractions. The nurses continued with the antibiotics every 6 hours and also gave me the second steroid injection the next day. On the Monday, I was expecting to be discharged so when my OB came to see me on Monday morning and told me that I would have to stay at least one more night, I begged and pleaded to be able to go home. The only reason she wanted me to stay was due to the huge spike in my blood glucose levels. She didn’t want me to go home until they had settled (the steroid injection was directly responsible for the increase). We made a deal that as long as I saw an endocrinologist that day and was shown how to start injecting insulin, my OB would allow me to go home.

I really feel for all the women who need to be on hospital bed rest as opposed to home bed rest. I have a lot to say about bed rest in general but will save that for another post as this one is already incredible long-winded. I’m back at home and taking it very easy, grateful to be back under the same roof as my family. There’s only 9 weeks until this baby is due and it feel like an eternity but also no time at all. Fingers crossed for an uneventful couple of months ahead.

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27 weeks and things looking good

It’s been 5 weeks since my last post so I have a bit of catching up to do. The scan we had at 24 weeks was really positive! All the bed rest and over the top water consumption had done the trick, with fluid levels increasing to a total of 7cm. They actually found 4 pockets of fluid to measure, compared to only 1 measurable pocket (1.6cm) at the 20 week scan, so it was great improvement. The size of baby’s chest was still smaller than average and the heart to lung ratio wasn’t great due to past compression but other than that, fetal growth was spot on!

Last week we had another scan at 26 weeks which showed that the levels were still sitting about the same which I’ll admit, I was a little disappointed with. Obviously I had hoped to see a big jump like the previous scan so I initially felt a bit disheartened. It didn’t take long for me to come around and appreciate that the fact the levels didn’t go down was the most important thing. As long as the levels are above 5cm, I can’t complain. Once again, fetal growth was perfect for that gestation and this time there was even an improvement in the heart to lung ratio, which shows her lungs are developing.

We are meant to go back again for another scan at 28 weeks but I’m hoping to stretch that appointment out closer to 29 weeks if my OB says it ok. Tomorrow I have the gestational diabetes test which I’m not looking forward to. Most mornings I feel quite queasy when I first wake up so the idea of having to fast for 10 hours and consume that disgustingly sweet drink isn’t something I’m overly keen on. Hopefully the test goes quickly.

I’m leaking more and more amniotic fluid which worries me but at the same time, the baby is clearly replacing the fluid quickly enough now that she is bigger. I can no longer get away with not needing to wear a sanitary pad at all times now. Every 4 hours or so, it fills enough to need replacing and a couple of times I’ve leaked so much that it has overflowed and soaked through my pants. It’s so stressful and leaves me feeling quite emotional. All I can do it drink even more water and try not to move too much which isn’t always easy.

I hate not knowing whether I’ll make it to full term or not. I’m told that the biggest concern is now infection. The amniotic sac is no longer a sterile environment due to the tear so there is a real risk of bacteria getting into the amniotic fluid. I’ve been taking pregnancy probiotics since 20 weeks in an attempt to flood my body with good bacteria but realise I have little control over what happens.

Some really good news – survival rate for premature babies born around 27 weeks is really good. Somewhere between 80% – 85% in fact. So I can definitely say that we are feeling much better about everything over all. Better yet, by 31 weeks the expected survival rate is 95% so these next few weeks will bring us a lot of relief. We are aware that the baby’s lungs would have likely suffered in their early development and as yet none of the specialists can tell us what affect that may have on her at birth but what we do know is that every week she stays in there the more time her lungs have to developmentally catch up.

That’s all I have for now!

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22 weeks

I don’t have all that much to update on here except that I am now 22 weeks. The next appointment we have isn’t until the 17th July when I’ll be just over 24 weeks along. We’re hoping to have a better idea of things after that scan. The last scan had shown the deepest pocket of amniotic fluid to be 1.6cm which was lower than the deepest pocket measured 5 days prior, at 2.56cm. We’re obviously hoping to see an increase, not a decrease, at the next scan. We also need to make sure she is still growing and that the limited space isn’t slowing her down too much.

I’ve been drinking so much water and getting as much rest as I can. I’ve been eating food that is high in water content and avoiding those that are known to dehydrate. I’ve cut out what little caffeine I was having, so it’s strictly decaf tea (limited to 2 cups a day as water is my main source of hydration) and goodbye to my beloved dark chocolate. Basically anything that can act as a diuretic is out of my life. I’m trying not to stand for periods longer than 15 minutes (although sometimes it’s hard to avoid) and I’m only sleeping on my left side in order to increase blood flow and circulation to the placenta. I’ve been put in contact with a few PPROM support groups which seem to have good advice on which foods are good/bad as well as some positive success stories from people who have gone on to have healthy babies. It’s been helping me to feel a bit more positive overall, though of course there is still a lot of fear.

I’ve been doing some research on the neonatal intensive acre unit and finding out a lot of really helpful information. If we’re going to have a premature baby, then I want to be as prepared as possible. We will also have the appointment at the NICU in a few weeks, where I’m sure our eyes will be opened. In the meantime, I’m collecting all the articles I can on how to handle NICU life, what questions to ask the nurses, resources on how to get the most out of pumping breast milk for tube fed infants, the benefits of music therapy on NICU babies, and even a diagram of an incubator with all the tubes, masks and monitors, labelled and explained. I’m trying to take some of the fear out of it, though I imagine that nothing could really prepare a parent for seeing their tiny baby attached to all that equipment.

Physically and emotionally, no two days seem to be the same lately. One day I feel positive and full of hope, the next day it’s a struggle to feel any happiness. Physically, it’s the same – one day I’m feeling really drained, queasy and dizzy but the next I feel like I suddenly have energy and strength again. One day I can feel strong kicks all day long but the next barely anything at all. It’s just confusing trying to work out which of these are normal pregnancy side effects and which might be a sign of impending labor.

I really want to make it to at least 28 weeks. But with how slow the days seem to drag on it feels so far away and an almost impossible goal at this point. But other people have done it, so why not me.

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Preterm Premature Rupture of the Membranes

Or PPROM for short.

On my last post here, I mentioned the unexplained bleeding I was having at around 15 weeks. It ended up continuing for another 14 days and then completely went away. Then late last week, we went along to the 20 week morphology scan.

Every single scan I’ve had during this pregnancy has begun with such a strong feeling of something wrong and this one felt no different. I walked in with my usual sweaty palms and fidgeting hands, just hoping that everything was going to be alright. I’ve been feeling movements and tiny little kicks now for weeks so my nervousness makes no sense. The screen flicked on and showed a strong heartbeat as always. As the sonographer checked over all the organs and confirmed the correct bone measurements, I started to relax. But I couldn’t help but notice how grainy and difficult it was to make out details in the images. Towards the end, I was finally asked if I has noticed any amniotic fluid leaking or if I’d had any bleeds. I mentioned my previous unexplained bleeding and that I hadn’t experienced any losses of amniotic fluid, at least nothing that I had noticed anyway. She measured the 4 quadrants of amniotic fluid and found they were well below the normal range for this age of gestation. The total average of all 4 pockets of fluid was 2.91cm. We found out the average for 20 weeks is meant to be 14cm, with anything below 6cm considered dangerously low. It indicated a huge problem.

The next few days were hard while we waited over the weekend for our appointment with our OB to find out what this all meant. Our OB is usually so positive so it was painfully clear to us when we walked in that something was wrong. She went on to explain that low levels of amniotic fluid at this point meant one of 3 things;

  • Either there was a problem with the baby –  such as an inability to swallow, kidney function or problems in the bladder. She explained that at around 20 weeks, it’s the baby that is responsible for replenishing and maintaining 90% of the amniotic fluid through swallowing and urinating so this could explain why levels were so low.
  • A production issue with the placenta
  • Or lastly, a tear or rupture in the amniotic membranes. This would usually be obvious, like a huge gush as if my waters had broken. I knew that hadn’t happened so we initially thought it must have been one of the other 2 options.

She booked me in for another scan, this time with an Associate Professor who she explained was an obstetrician who specialised in performing ultrasounds on pregnant women. He no longer delivered babies or worked in obstetrics – ultrasound diagnostics was his niche. We were still freaking out but this gave us peace of mind that we would soon know for sure, what the problem was.

The scan was early in the morning and quickly ruled out any problems with the baby’s kidneys and bladder. The bladder was full, in turn meaning the kidneys must be functioning and the baby was also seen to be swallowing throughout the scan. There was also no problem discovered with the placenta flow. This left only the third option – a rupture in the membranes. It was towards the end of the scan that he discovered a small separation on part of the uterus wall. He asked about the bleeding and quickly pieced together that this separation was the space that held the subchorionic hematoma that must have caused the unexplained bleeding. Subchorionic hematomas are pockets of blood that build up between the folds of the outer membrane and are usually fine and clear up without issue but it appears that mine was large enough that when it ruptured it actually made a small tear in the membrane and I’ve been very slowly leaking out amniotic fluid over the last 5 weeks.

The bad news is that there is nothing to be done. The tear can’t be repaired and as hard as the baby tries, she can’t refill it quickly enough to stay on top of the leaking. He told us that at this point of being only 20 weeks, some parents choose to terminate as the chance of a live baby if I go into labour now are zero. But he also said that sometimes the baby continues to grow and stays safe inside, just long enough to survive a premature birth. He pointed out that our baby is completely healthy, she’s measuring perfectly for her gestation but noted that it’s clear that the lack of fluid is starting to affect her. Her chest is slightly smaller due to the compression forming around her. He explained to us that her biggest hurdle if she initially survives once out of the womb, would be her underdeveloped lungs. Even if by a miracle, she stayed inside until 30 weeks, her lungs would only be developed to that stage of a 24 week old because without the fluid around her, she is running out of space to suck anything in to stretch and strengthen her lungs and practice breathing.

We left that appointment and went to see our OB straight after to discuss what options we had. We now knew that termination of the pregnancy was an option, though she didn’t mention it. She said all we can do for the next couple of weeks is take it one day at a time. There’s literally nothing else we can do at this point. She explained that the earliest a baby can be revived at birth is 22 weeks and 5 days but the survival rate is next to nothing. The next milestone would be 23 weeks and 4 days where survival rate is still less than 30%. After I reach 24 weeks, there are a few things that can be done such as giving me injections of steroids to help mature the lungs and magnesium sulfate by IV to delay labor when it starts. So that’s our goal for now. In 3 weeks and 3 days, I’ll be 24 weeks pregnant and at least then I will feel like we have some sort of control or plan in place. If I make it 24 weeks, our OB also wants to set us up with an appointment at the Neonatal Unit at the Mater Hospital. She said it’s important that we are aware of the harsh reality of having a micro premmie is actually like. The side effects of being born so early often result in life long disabilities and injuries such as cerebral palsy, brain damage etc which is why I suppose some people choose to terminate rather than go down that scary road. But there are also stories of babies fighting long and hard and ending up completely healthy children. I don’t want our baby to suffer but I don’t want to give up on her while she’s healthy either. This is the most terrified and unsure I’ve ever felt in my life.

I’m off work, resting and drinking lots of water. I’m trying to stay positive but I’m painfully aware of how bad things are. I’m hyper-aware of every little pain or ache I feel, worried it might be the beginning of labor. Every little wriggle or kick I feel, breaks my heart. It feels so cruel. Not knowing if we will still be feeling her kicks in a few weeks or whether we will be planning her funeral. This feeling of helplessness is so dark and so scary. We just have to keep reminding ourselves to take it day by day. If I don’t do that, I think I’ll sink. I’ve never been more thankful for Oscar, he is the only thing in this world that can take my mind off it and actually make me laugh and smile. That child is pure sunshine and we are so lucky to have him with us through this.

I’m not sure when I’ll update again, maybe in a few weeks.

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A little scare for Mother’s day

After the recent appointment with our obstetrician, we hadn’t planned to see her again until mid June which would be just after the 20 week morphology scan. Since I’ve been feeling the daily reminders that this pregnancy is indeed progressing normally – nausea, back pain etc – I felt confident that I could go 6 weeks before needing a check up. But then last Thursday night I had a little bleeding/spotting.

I’ve been having a difficult time at work, and last week I was particularly struggling with the graveyard hours of 10pm-6am and feeling so exhausted. I knew I was pushing myself too far physically as my lower back pain had become so awful that I was having to walk with a limp. Any pressure in the joints around my hips and tailbone made me flinch with each step. I work in a laboratory and in an effort to avoid all chemicals, I’m taking on a lot of tasks I usually wouldn’t. A rack of samples can weigh up to 6kgs each so bending and lifting these for analysis when you have back pain isn’t fun. Anyway, it was almost the end of my shift when I used the bathroom to find a small amount of blood. My heart immediately fell into the pit of my stomach. I never had anything like this during my pregnancy with Oscar so I went into panic mode. A quick search on google told me that spotting in pregnancy is actually quite common with about 20% of cases classified as unexplained. By the time I got home, the spotting had stopped. I called the obstetrician the next day and made an appointment for the following week.

The next day, Candice and I took Oscar camping/glamping for Mother’s Day weekend which was exactly what we needed! Sitting by a crackling fire helped to take our minds off everything. There was also very limited phone reception which I really appreciated. Being disconnected from the rest of the world made the whole weekend so much better.

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I was back at work on Monday and immediately started having trouble with my back again. I woke up today with more spotting so I was relieved to realise that today was the day of the OB appointment. The first thing she did was a quick scan which showed an active baby, a strong heartbeat and plenty of amniotic fluid. Next she did a speculum exam which showed that my cervix is completely closed and no signs of infection. She could see small traces of blood but nothing major. All good results. So I guess for the moment, I’m part of the 20% of women with unexplained bleeding during pregnancy. She gave me a medical certificate which states that I will need to be placed on light duties at work so I’m hoping that will help to lessen the back pain I’ve been having. In one month I’ll be at the halfway mark of 20 weeks. Although this pregnancy has felt far more stressful and harder than the one I had with Oscar, it’s going a LOT quicker.

15+ weeks already!

At this point, I’ve pretty much accepted that there is just no way I can update this blog as often as I managed to when pregnant with Oscar. I’m so much more tired this time around and I’m also still feeling waves of nausea. Between a really busy work schedule, being a parent to a 3 year old and sleeping every chance I get, it leaves very little time to come on here. Candice has taken on soooo much of the parenting but even so, I still wake up exhausted after a nap. While I’m waiting for some pasta to boil, here’s a run down of the last few weeks.

We had the Nuchal Translucency scan and everything looked perfect. The baby is very active which was awesome to see. I’ve been so lethargic and low on energy that it actually surprised me to see how much movement is going on in there. All the test results came back low risk which is excellent news. A healthy, bouncy baby which is more than we could have hoped for.

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Prior to the Nuchal Translucency scan we also had the harmony test (NIPT) as extra reassurance. Everything came back as low risk which meant walking into the NT scan, we felt a whole lot less anxious. We initially decided not to find out the fetal sex of the baby but then changed our minds. I’m really glad we did decide to find out as it has made this pregnancy feel a whole lot more real now.

We threw together a gathering of just immediate family to share the news that we are expecting a baby girl. To be honest, it was quite a shock to both of us. It’s been difficult to imagine having a daughter as all we’ve ever know is having a son. But we are beyond excited and can’t wait to meet her. Before we popped the balloon, someone asked Oscar if he wanted a baby brother or a baby sister. Lucky for us, he declared, “Baby sister!”.

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I have a few more updates but my pasta is done so I’ll finish up this post and hopefully jump back on in a couple of days.

First trimester down

My last update on here was 2 months ago. I did not intend to go that long between posts but the morning/all day sickness plus simply having no energy has meant it’s turned out that way. The good news is that as of today, I am 12 weeks, 2 days! I’m so excited to be entering the second trimester and hopefully start to get some energy back.

Once we got past the initial 6 weeks of waiting to know if it was going to be viable, this pregnancy has since been almost identical to the one I had with Oscar. Same level of nausea, same timing of the round ligament pain in my lower back, same lack of energy and fatigue. I would say that the only difference so far is that I’m showing a LOT earlier. At 12 weeks, my bump looks about the same as it did when I was 18 weeks pregnant with Oscar! I’m told that it’s normal for women to show earlier in their second pregnancy but I feel quite embarrassed about it. I’ve had one person assume I’m 20 weeks pregnant, I’ve had another say, “Are you sure it’s not twins?”I just feel uncomfortable all the time. When I’m wearing my normal clothes, everything feels tight and restrictive which adds to the nausea. I’ve partially given in and I’m now wearing maternity pants/shorts etc when I’m at home but still wearing my normal work clothing during office hours. Luckily while I’m at work, I’m hidden behind a lab coat most of the time so my bulging belly under my blouse can’t be really noticed.

Next week on Tuesday, we have the Nuchal Translucency scan. I’m looking forward to seeing how much the baby has grown and getting final confirmation that at this stage everything looks healthy. We also have a routine scan with our OB next Friday which means getting to see the baby twice in one week, yay. So far we have had 2 scans, one at 7 weeks and the second at just under 10 weeks.The last time one we had it was still looking quite blobby but measured perfectly with a strong heartbeat. Our OB was able to point out its head and also its legs/nubs wriggling about which was both awesome and weird.

Here is our 7 weeks scan.

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