Thursday, January 17, 2013

Everett's Story: Pregnancy

Well, not much crafting going on as of late. It is not the newborn, though. Everett is the model baby in terms of behavior -- still at 7 weeks sleeps large blocks of time, easily placated with nursing or holding different from big brother! Big brother has turned out to be the one who requires a lot of mama time (still -- after all these years). He is home with us 3 weekdays. There are some jealousy issues with little bro which necessitate making sure I spend adequate time with Hank to make sure he knows he is important as well. Hank still has a hard time playing by himself, and even a requested half hour playing Legos independently is punctuated with a constant volley of Mama, watch this. I am also seeing how important learning activities are to him, and that he actually does want to do things other than watch Power Rangers all day. Fancy that.

The other two weekdays with Hank back at pre-school were supposed to be my magic days through April when I was scheduled to go back to work. Since Rip Van Winkle spends most of the day off in dreamland, I was having dreams myself of finishing big projects like quilts and deep cleaning projects (I know how to dream big). But, work reared its ugly head. A project that was taking a nose dive back in November when I went out on leave was this month about to crash. I just couldn't sit idle and leave my team to fail, so I made the difficult decision to work on those two days. I work from home mostly, though I do meet up with the two supervisors I oversee weekly for lunch or ice cream. Two days has kinda spread over the whole week -- weekends included. Which causes even more issues occupying the big kid, and doesn't leave much time for anything fun or practical...

Pregnancy announcement to friends and family -- 21 weeks
I'll probably only have one crafty thing to show you this month, but thought I would tell you about some of the details about Everett's sorta dramatic entrance into this world. I will also share pics of the boys' shared room, though it is more for the element of how to fit two kids into a small space versus anything different with decor.

Reading Oh the Places You Will Go at the library -- amateur pregnancy photo shoot
So, yeah. This pregnancy, too, was very easy in the beginning. I had no nausea, and didn't even have any of the "normal, but less common" side effects I had with Hank, such as carpal tunnel and fallen arches. Later in the pregnancy, when the time came for the Gestational Diabetes glucose tolerance test, I was resolved that I had it again -- so much so that I bypassed the 3-hour test and asked my doctor just to put me in the system as having GD once I failed the 1-hour test. Now -- a couple of notes on the testing for GD. One, I have come to find out that my insurance provider is very stringent about the numbers they use in determining if a woman has GD. They allow higher fasting numbers, for example, for people who are not pregnant, and significantly higher numbers for people who have regular Type II diabetes. Along those lines, my insurance is rather militant about taking these tests. Discussing the test with my girlfriends, most of them were allowed to take the glucose drink home, drink it, and then drive in for the blood draw "about an hour" after that. With my insurance -- no go. They don't want you to interfere with how your body responds to burning sugar on its own without moving around putting laundry away, or driving, or whatever others would be doing before they came in for the draw, plus it has to be an hour on the dot. At our lab, I was told where to sit, watched to make sure I drank the test drink under 5 minutes, and then had the lab tech calling out for me before the one hour mark to ensure I was in the seat needle in vein at the proper time. My numbers never were all that bad, so I probably would have been considered borderline under other health care providers. Interesting.

Bonus points, Hank, for looking so enthralled!
Around this time, we were very busy at work with this project from hell. So much so that I didn't want to waste time taking the 3-hour glucose tolerance test. I got started right away with taking my blood sugar 4 times per day and eating the diabetes diet. I did find it a little more challenging to control my sugars associated with eating than with Hank, but overall my after meals numbers were ok. The other issue was that with the project we were working on, I wasn't cooking as much at night to bring leftovers, and I was out in the field a lot, which led to eating out more. I also rarely had time to walk at the right time in relation to a meal. So those things could have been the issues with the meal related numbers. My fasting numbers, though, were also off this time. They never went more than 8 points higher than they should have been (again, according to a fairly strict scale), but I couldn't reign them in no matter what I ate for my bedtime snack. So -- after a week or so, I was put on insulin. I had a small dose of 7 units one time of day with the bedtime snack. I didn't need an increase in the dosage which commonly does occur as the pregnancy progresses. I was actually GLAD to be on it, as it relieved the stress of having to figure out something I was doing wrong, and I din't need any more stress to compete with work stress. The insulin type I was on is designed to kick in during the early morning hours to keep my sugars from crashing, which had been leading to my helpful pancreas kicking out the wrong amount of sugar to combat the crash prior to taking the insulin. And yes -- the shots go in your belly. The needle is so tiny and doesn't hurt, but kind of unnerving to give yourself a shot when you know a baby is under the skin there. After a month or so I couldn't pinch off any extra skin in my mid-abdomen where the shot was supposed to go, so I admittedly did switch to doing it in my leg.

Looking for a pregnancy book -- should have learned the Dewey Decimal System
Now here's where the weirdness kicks in. Around 32 or 33 weeks, I started itching. Really badly. It was although a little itch bug was under my skin, and would travel around to different spots on my body. I would scratch my scalp, then my ankle, then my shoulder, an every other spot on my body. During the day time, I could sorta control the urge to itch (like in a meeting), but at night it was inescapable. It was noticeable to people around me, and was keeping me up at night. I don't normally have skin issues that lead to itching, and lotion wasn't doing anything if I had just had dry skin. I had stayed away from Dr. Google for the most part during this pregnancy, but consulted my favorite online doctor about extreme itching during pregnancy. I got back one of those "probably normal, but could be this" results. I showed my husband the info -- my husband who never buys any of my self-diagnosed hypochondria -- and he asked if he could take me to the emergency room. I was taken aback, but knew that if he was worried, I was probably on the right track.

I went in the next day, but unfortunately my Ob was on vacation. A nurse had deflected me to a general practitioner, as she felt the issue was unrelated to pregnancy -- eczema or something. The doctor I saw luckily was familiar with pregnancy related matters, and ordered a round of liver related tests, including one to measure bile salts. If I did have Cholestasis, the bile salts were accumulating under my skin and causing the itching. Unfortunately this test was done out of house, and took a week and a half to hear back on the results. The other tests took only a couple of hours. Most test results are emailed to us, so I logged on to find that my liver numbers were sky high. One liver enzyme test, abbreviated ALT, the normal results are supposed to be between 30 and 50. My number was 357 or something crazy. I was all worked up, but had to wait for the bile salts related test to come back. That number ended up being high, but still normal. My doctor didn't want to prescribe any unnecessary medication, so all he could do was keep redoing the tests and send me for twice per week non-stress tests.

So much for not wanting to spend extra time away from work doing tests, lol. I had to drive an hour round trip to the hospital two times per week that serves all the clinics in our area, plus go in for blood work every few days. I guess they find it easier to do the non-stress tests for all the pregnant women at the hospital's Labor & Delivery versus having a testing area set up at each location. I kind of enjoyed going there and hearing all the skippy heartbeats of multiple babies. We came in at slightly different times, so I never saw any of the other women in their little curtain rooms. But, you could overhear bits and pieces to know why they were there. An overdue baby. A few women with twins. One other with GD. I guess I could have received non-stress tests just because of that condition outside of the liver related matter, but my doctor is pretty laid back, so hadn't seen that as necessary until the other issue popped up.

Me and mom at the Aquarium Thanksgiving Day -- one day before delivery
My due date was December 9. My parents were scheduled to come out for Thanksgiving, and then my mom was going to stay with me until the baby came. We didn't want to cook for Thanksgiving. I found online that a local attraction, the Aquarium of the Pacific, had a Thanksgiving deal that allowed you to eat a full Thanksgiving meal for $10 above the regular admission price. I called and made sure it wasn't going to be too crowded, and made our reservations. It turned out to be very uncrowded, and the food was quite good. I was very tired by this point -- like fall asleep sitting tired -- another symptom of having a pregnancy related liver issue. But, I made it through the aquarium.

The next day, my mom came with me to the non-stress test. She sat in the lobby while I was in getting the test. Coincidentally, my doctor was at the hospital that day. I don't know how he does it, but somehow he works regular hours Monday through Thursday at the clinic, and then a 24 shift Fridays at the hospital (very grateful about that shift -- more in the next installment). He would perform C-Sections, D&Cs, or whatever else was needed surgery wise during that time. He came in and let me know that my liver tests were getting worse -- now the ALT test was in the 500 range. The numbers weren't being emailed to me anymore, btw -- I guess my doctor had shut off that feature to prevent freaking me out. He wanted one more round of blood work, and indicated I could get it right there at Labor & Delivery. I got done with the non-stress test, and went to find out about the blood work. The nurse said she thought she had seen that I had somebody with me. I said yes, my mom -- she is out in the waiting area. She asked if I wanted to go get her to wait with me. I said ok, but thought it was odd since it shouldn't take too long to get some blood -- especially since nobody else was in the L&D triage area. Well -- turns out I was being admitted. They were sending the blood down to be tested stat. Since most likely the tests were going to come back worse, I would already be checked in. To have a baby. Sometime in the next 48 hours. Two and a half weeks early. Glad my mom was there to help me process that one.

Dad comes to relieve Nana from baby watch -- luckily I had packed my bags the week before!
We waited in the little triage room. They came in to take no less then 10 vials of blood (may have been 12 -- I lost count). I don't know what all they tested me for, but they weren't taking any chances. About an hour later, another Ob came in. She said she had talked to my doctor between surgeries, and that that they concurred that I should be induced. I was actually already having contractions at the time. I hadn't told my mom until the whole oh-glad-you're-here-because-I'm-going-to-have-a-baby-now thing, but I had started feeling them that morning. Nothing big deal, and spread 10 or 15 minutes apart, but I guess maybe my body knew it was time to evacuate the precious cargo before my crazy pregnancy hormones went after another organ. The final diagnosis wasn't Cholestasis, but HELLP. Itching isn't associated with HELLP, but so glad I had it to clue me into the real problem. The other symptoms that were rearing their ugly heads around this time included high blood pressure and low platelet count in addition to the high liver enzyme result (they stopped telling me how high it was -- probably to assist me with trying to bring down my blood pressure). No doubt about -- it was go time!

No comments: