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┬ácholestasis, 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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Baby #3 33 Weeks

Dear Sweet Pea,

Today started out with an unexpected visit to the Dr’s office. I woke up around 5 am this morning and was pretty itchy. I have been itchy in periodic spots for the past couple days but chalked it up to dry skin and didn’t think it could be cholestasis because the itchiness wasn’t concentrated to the soles of my feet or the palms of my hand and until last night, it didn’t seem worse at night. Given that I woke up from being itchy made me want to do a little bit of research on cholestasis to make sure I understood all of the symptoms. Sure enough, itchy hands and feet are the most common symptoms but you can also have itchiness all over. Part of this information went straight to my head and I think I started to think I was more itchy than prior to this information. Regardless, I decided I would call the Dr. to get their thoughts on it. The nurse on the phone said my symptoms sounded like┬ácholestasis and that they would want to do some blood work and check on me. After getting my blood drawn, I chatted with the nurse to get a better understanding of this condition. I was curious, ‘Are there varying levels of it and you have more intense symptoms if you have higher levels? ‘Can it go away?’ ‘If the medicine is working, would they still induce or can you go to full term?’ Unfortunately, this is a pretty rare condition so she didn’t know a ton about it and just had to google it, annoying because I had already done that. So basically, I need to wait until the blood work comes back to get more information and figure out a plan with Dr. G.

What I do know is that I had this same condition with Lexi, but it showed up closer to 37 weeks and I had the intense itching on my palms and soles. When the blood work came back positive, I was 39 weeks and was induced within 2 hours. Essentially,┬ácholestasis is a condition that prevents bile from flowing out of your liver. As a result, it builds up in your liver and the acids from the bile enter your bloodstream and cause your skin to itch. These acids are harmful to you and since we’re sharing bloodflow, it can cause babies to be stillborn. I’ve read there are medicines you can take to help ‘fix’ this if you aren’t full term yet.

I may be jumping the gun as it hasn’t even been confirmed that I have this yet, but emotionally I’m kind of all over the board. For the past 8 months, I’ve been mentally preparing to have a baby in mid-July and be on leave until October. We’ve made plans around this including Daddy’s transition plan, Lexi’s tonsil surgery, work transition plans, vacations, how I’ll use my PTO and I’m having a hard time realizing how none of what we had planned may work. I should know better than to make plans and anticipate because you little ones like to do everything to disrupt those plans but it is really hard not to. Overall, all of those things are trivial and what really matters is making sure you arrive as a healthy baby and I’m willing to do anything to make sure that happens. It would just be more convenient if we didn’t have to. Additionally, the thought of you arriving before 37 weeks is a pretty terrifying thought for me. Adding a 3rd munchkin to the mix will be challenging enough the way it is, BUT if you’re a premie and I have to figure out how to split my time between your big siblings and you at a hospital, I am really, really going to struggle. Your daddy and I are both praying for your safe arrival and any strength we’ll need to help us get through this unpredictable transition, whatever that may look like.

Aside from those major updates, many of my symptoms remain as they were last week. Lots of bathroom breaks, shortness of breath continues to get worse, heartburn, restless feet syndrome, difficulty sleeping at night and lots of braxton hicks contractions. Either they are getting stronger or are shifting to some real contractions as several of them have been somewhat painful. You continue to be very active and I can often feel a little foot or hand moving across my belly.

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I continue to get lots of questions at work, ‘when are you due again?’ ‘July’ ‘It’s coming up’ and have recently had several people tell me I look great for being so far along. They’re probably lying, but I’ll take a compliment when I can get one!

This past weekend was Lexi’s first dance recital and she rocked it! I was a little nervous as the dress rehearsal didn’t go great, but we practiced that evening and the next morning and she did so great! It was so fun to watch her and I was so proud to see her out there on the stage with the lights and all these people watching her, especially as she has been a pretty shy little girl.

More updates to come about my test results!

Love,

Mama

Baby #2 33 Weeks

Dear little babes,

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Another week is checked off the list. I can’t decide if time is going fast or slow. It is hard to believe it is the middle of January and I only have to wait 7 or 8 weeks to meet you. It feels like the last 30 weeks or so have gone by in a flash, yet when I think about last June when we found out we were expecting you, it feels like another lifetime.

In general, work is insanely busy right now so I’m hoping these last few weeks feel like they go fast. I’m excited to meet you and see how you blend into our family.

This past week, the weirdness in my hands and feet has gotten more intense. They feel very dry regardless of how much lotion I put on and like they need to be massaged. However, after I’m done rubbing them, they don’t feel better. It is very much like restless leg syndrome in my feet. Wearing socks to bed helps–specifically, ones that have compressed arch supports. I remember this same thing with Lexi–which ended up turning into ICP, we’ll see if the same thing happens this time, or it is just a weird side effect of pregnancy.

Overall, I continue to feel pretty good and fairly comfortable. I still have a limited range of positions I can sit or lay at to feel like I can breath normally, which isn’t a big deal. Sleep is still going well. Eating is kind of up in the air. I do eat, but don’t have a large appetite and get full pretty quickly. For the most part, nothing gets my mouth watering–just eating out of necessity. Heartburn has been fairly minimal as well as general hip pain and swelling that I was experiencing last time.

I don’t have the time to analyze and day dream like I did with Lexi, which I think made those last 8 weeks with her go by slowly. I’m hoping these next 7 to 8 weeks will be quickly.

Overall, i feel like your movements have become much more intense over the last week or two. Kicks, rolls and you stretching out are much stronger and felt more intensely than they used to. I can now also identify different body parts. You’re head down and can tell the difference between your feet stretching out and your hands.

Until next week…

Love, Mama