Tuesday, August 25, 2009

Update on Thumper and I

Only 2-4 weeks left. Only 2-4 weeks left. Only 2-4 weeks left.

If I keep repeating that it will make the time go quicker right? It'll make everything stay good and healthy right?

So far (knock on wood) everything is still going well. I had an appointment with my high risk OB last week. This was a follow up from a very irritating appointment with my regular maternity doctor. Here's the background on that...

At the beginning of this pregnancy my mat doctor had told me that I would have so many ultrasounds I would be sick of them by the end. That I would be sent for routine non-stress tests from around 32 weeks on. That I would do kick counts. And that at 36/37 weeks they would do an amnio to check the baby's lung maturity and then induce me. That all sounded good to me. I was sent to a high risk OB around 12 weeks just to make sure things were good. In this doctor's report back to my regular mat doctor he outlined that I would need more monitoring and more support since this would be such a difficult pregnancy, emotionally wise mostly.

At my appointment earlier this month I asked my regular mat doctor what our game plan was for the rest of the pregnancy. He said that I would be sent for one more ultrasound, I might be sent for a non-stress test, and at 36 weeks we would meet to discuss whether he would let me go past term or not. Ummm.... Past term?? As in past 40 weeks?? Are you kidding me? I almost started hyperventilating right then and there. He said that he didn't want to do too many tests because sometimes they can lead to 'off readings' that would rush people to make decisions and lead to an unecessary c-section. Fair enough. But they can also show problems that we wouldn't have known about. They can also do a lot to ease my anxiety.

I left that appointment feeling so many things. Dissapointment, anxiety, fear, sadness, and just a general sense of being let down and alone. I had a therapy appointment that Friday and talked about all of this with her. She helped me to see that I wasn't overreacting and that I should make another appointment to go in and talk about this with him. That I should demand the care that I feel I need. If I feel further tests would ease my anxiety then push for them. If I feel I cannot go past a certain week of this pregnancy then make sure he knows that. There is no reason for him to make me go to term, let alone past term. From everything I've read and every website I've seen there are not too many women who have had a subsequent pregnancy after stillbirth that are made to go to term. Most are induced between 36 and 38 weeks.

Brian and I went back to see him early the next week. He had already called the high risk OB and was setting up an appointment for me to go and see him to get some questions answered. In the meantime we asked him all of our questions. He told us that he didn't want to send us for frequent non-stress tests because they generally are only useful for pregnancies where there are issues concerning the oxygen flow to the baby. He said this was not the case in my pregnancy with Benjamin. For those of you that don't know what a NST (non-stress test) is, it is a test where you are hooked up to two monitors. One measures the baby's heart beat and the other measures your contractions. Then you are usually also given a little clicker that you press every time you feel a movement. They then can see how the baby's heart rate reacts to movement and to contractions, to see if it is in any sort of distress in the womb. You generaly are hooked up for about 15 minutes. So anyways, my doctor felt this was not going to be overly useful to us. I pointed out that we don't know why Benjamin's blood clotted. That for all we know it was a slow building clot. And if that was the case then a NST would have been useful because if his blood was clotting then it would have been flowing slower and therefore oxygen would not have been getting to him like it should have. A NST would have shown that. He agreed with that but then added that the blood clot could have been a sudden thing and a NST would not have been helpful. Whatever. He said that he would be sending me to the high risk OB who would decide the course of action. Basically the HR OB will make the decisions and my regular mat doctor will just follow through with his orders. So my mat doctor is the HR OB's bitch.

So last week I had my appointment with the high risk OB. It was a MUCH better appointment. I went in there with my list of what I wanted to happen.

1. I want routine NSTs.
2. I want at least one more ultrasound with the option of having more if they will give me some reassurance.
3. I want weekly visits with him.
4. I want an amnio at 36/37 weeks and to be induced as soon as the baby is ready.
5. When the induction is started I want to be admitted to the hospital until the baby is born (sometimes they start the process and send you home to do early labour at home).

I didn't even have to tell him my list. He was already planning to do almost all of that! He wants to see me weekly. He's scheduling me for weekly NSTs. I have an ultrasound tomorrow and possibly more after that.

As for the induction dates. He kept reminding me that we have to keep what happened with Benjamin fresh in our minds, but treat this pregnancy as what it is; a healthy uneventful pregnancy. So we have to do what is best for Thumper. I know all of this and obviously that is my first concern. But it's just so hard to truley believe that everything will work out well. To believe, without a doubt, that she will be born screaming. So he said that if any of the tests come back showing serious life-threatening concerns then we will get her out right away. If the tests all continue to be normal but I am having a really hard time (emotionally) then we can do an amnio around 36 weeks and induce if she is ready. Otherwise he will induce me around 37/38 weeks. He said that he will not make me go past 38 weeks. Phawoo!! That was such a relief to hear all of that. I just cannot imagine going much past 36 weeks. That is my breaking point I think.

Most people who have had a stillbirth or a pregnancy loss have that one special week. That week where it all went wrong. Through their pregnancy they aim for this week, thinking "if I can just get past xx week then it will all be okay". I've got the reverse. Everything was great until 36 weeks. So I feel more along the lines of "if I can just get to 36 weeks then it will be okay". After that week I feel like I am tempting fate. It's hard to think otherwise.

So last week I had my first NST of this pregnancy. Thumper wasn't cooperating very well and decided that was a great time to have a nap, lol! But her heart rate did fluctuate a lot. Apparently I didn't have any contractions the entire time I was hooked up to the monitors, which is odd because I have been having a lot of contractions the last few weeks. I go for another NST tomorrow so we'll see what happens at that one.

And that's my update.

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