Changes in routine pregnancy care

Baby sister,

Today was another unpredictable and eventful day, but it also brought me some peace of mind. Last night I was pretty itchy and was convinced again that I have cholestasis, but I feel asleep pretty quickly and didn’t wake up from the itchiness, which was great, but also made me question my thoughts from the previous evening. Around 11, Dr. G called to chat about yesterday. The official test for cholestasis will take several days to come back as they have to send it off somewhere. However, they did some other tests around my liver and both of them came back slightly elevated. For one test a normal was considered 40 and my number was 45 and another test the normal number was 32 and I came back as 72–which really means nothing to me, but just documenting for the sake of documenting. Dr. G. says given my history, my symptoms and these elevated numbers , it would indicate I have cholesstais. As a result, she wanted me to come into the office to get a steroid shot to help your lungs develop incase we need to deliver at any point. She also had me do an bio-physical ultrasound to check on baby.

The ultrasound tech was so awesome and really helped me relax and be at peace with everything. She explained just how serious cholestasis is and how they’re going to watch me closely for the rest of the pregnancy, and most importantly, what types of things I could expect based on how the tests go. If the blood work comes back positive, you will for sure be delivered at 36 weeks no questions asked. I was curious if things seem to be going fine and my levels are low, would they wait a little longer and she said no. It is too risky to wait and they want you out of there as soon as possible. I feel like for most people, that would probably be a pretty scary idea, which it is, but it honestly gave me more peace of mind as it helps me set expectations, prepare and just takes a lot of the unknown out of everything. I forgot to ask, if the blood work comes back negative, would they be as likely to induce given the rest of the symptoms or would they just play it by ear?

From this point moving forward, I’ll go into the office on Thursday mornings to have blood work done and then go in on Fridays for an ultrasound and a checkin with Dr. G or a nurse practitioner. During the ultrasound, they look for three main things: you taking practice breaths, movement, and monitoring my fluid levels as these three things are indications that you’re not doing super great inside. The practice breaths are really the most important. If they aren’t able to see those during the ultrasound, they’ll have me do a stress test. If things still aren’t looking great there, they’ll send me to the hospital for more monitoring and based on how those go, they may or may not deliver you. So we’re really taking it week by week knowing that you may come at any point now. Understanding this also made me decide that we for sure aren’t moving Lexi’s tonsil and ear tube surgery and we’re just going to have to wait until after the baby is born to do it. Not ideal, but again, I feel good knowing a decision has been made around that.

So onto the actual appointment. Blood pressure looked good, I got the steroid shot in my butt and will head to the Maple Grove Hospital tomorrow to get the second round as it is pretty important it is administered exactly 24 hours apart. The beginning of the ultrasound was a little rough as I nearly passed out 2 different time–like to the point, I needed to sit up and put my head between my legs. I can’t lay down on my back and the angle I was reclined at prevented me from breathing. Eventually, I rolled onto my side and was able to get comfortable.

One of your hands was by your mouth for almost the entire ultrasound, but she was able to watch your breathing and you passed with flying colors there. My fluid levels were a little high, which she said was good because they are much more concerned if they are too low. You also had lots of movement so you got a 8 out of 8 on your very first test! Again this made me feel really good. She confirmed that you are head down (you got extra credit from mom on that one). We also looked at many of your measurements. According to the machine, you weigh just over 6 lbs., which is equivalent to a 35 week baby! Way to go! I don’t think you actually are that big as the machine can be off, but still it is reassuring to hear. You’re also measuring at the 89.9% for your gestational age, and 90% is considered a big baby, so in my eyes, your a big baby. Again, all good reassuring signs that if you do come early, things will be ‘oh-tay’ as your big brother likes to say.

After my appointment, I swung into target to return some stuff and also picked up some essentials so I’m ready if you do come. I didn’t have any newborn clothes because your siblings were too big for them, so i picked up a couple of onesies, wipes, nursing materials like pumping bags, nursing pads, some nursing tanks and lounge/athletic shorts to wear after you are born.

To top the day off, Lexi learned how to ride a two-wheel bike this evening. She has been able to for awhile but was lacking the confidence to actually do it. A little bribery helped and she rocked it. She’s a little wobbly steering but can start and stop by herself–now we need to work on turning while riding!

As we head into memorial day weekend, I’m hoping for a relatively quiet and uneventful weekend. Don’t pull any funny stuff on your mom little one! I need a mental break!

Love,

Mama

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