Friday, June 18, 2010

Less Than Two Weeks Til Showtime

My son celebrated his 5th birthday this week. We hit full-term (37 wks) on Tuesday. Good week all in all (with the exception of England's performance in the World Cup today and US getting robbed of a goal in a separate game. Husband is British so we all get into this :)

This week's bloodwork came back good. Everything stable. Platelets continue to creep down a tad and are at 161K this week from 166K last week.

We tentatively have a c-section planned in 13 days and if we go into labor naturally before that will attempt a VBAC. No really signs that tenant is ready to come out (Why would he? He's been getting ice cream sandwiches every night) Still trying to do daily walks - a bit uncomfortable at times with a head pressing down on the vag, but doin what I can :)

I will try this weekend to answer some of the questions I have been getting in the Comments. My son was off preschool this week so have had very little me time.

Monday, June 14, 2010

You Just Don't Know the Future


On this exact date 5 years ago, I was hospitalized with preeclampsia and rode in an ambulance for the first time ever. On this exact date 2 years ago, I did my first triathlon. Today, we are one day short of being full-term with this bean. You never know what is going to happen in life from year to year. Thus, you just gotta keep on truckin. I've had a rich life because of the good and the bad.

Friday, June 11, 2010

36.5 weeks


Jesus, I have the world's worst acid reflux tonight. Overall felt good this week. Had a burst of energy most of the week (well relatively. A burst being like 15 mins at a time). Today felt exhausted though. Latest weekly bloodwork looked fine though two markers were not ideal. Uric acid has been trending slightly upward each week (this represents kidney function) And platelets still falling (down to 166K). According to doc's email today, both still well within normal levels, just something they will keep an eye on. (I think uric acid falls mid-pregnancy and then rises back to normal by end so this rising may actually be perfectly normal) On the positive side the big markers for preeclampsia still look good. BP trending around 112 over 65, urine negative for protein. Creatinine looked fine (kidney function again) and hematocrit level where it should be (too high means not enough expanded blood volume and correlated with pre-e). Still little to no swelling. Did a mile or so walk this evening waddling around neighborhood, having a big craving for a trail run once I am back in the post-pregnancy saddle.

Cramping and some contractions but no really sign my tenant plans to come out anytime soon.

3 days til full-term. Holy shit we just might make it.

And June 14th will mark the 5 year anniversary since I was hospitalized with preeclampsia.

Monday, June 7, 2010

Thanks!

Just a quick note to say thanks for the comments I receive on this blog! And I haven't officially signed up as a "follower" but I do also follow the blogs of all the Moms leaving comments, and try to check in at least every couple days to see how everybody is. I'm just getting more and more limited on how long I can sit for before my butt goes numb so I don't always comment when I read a new post. And my wireless mouse is driving me nuts this past week making it hard to surf the Web. And I crave birthday cake -- like all the time! Couldn't say no to two pieces last weekend at a party :)

Sunday, June 6, 2010

Exercise, Healing and Preeclampsia

This isn't a post about the benefits of exercise in reducing preeclampsia risk or how exercise is beneficial in general before and during pregnancy. No, this is something I have wanted to write about for a long time - how exercise helped me heal in the years after a traumatic train-wreck of a pregnancy. And how it's saved my sanity the past year. I just hope I can put it into words well as it's 10pm and my butt hurts from sitting. Any position hurts lately.


When you have a pregnancy that is troubled, that ends in the worst way you ever imagined, or when things just basically go really really wrong, there is so much questioning afterwards. Anger, sadness, guilt, confusion, helplessness -- all of these feelings that many of my followers I know can relate to -- whether it was preeclampsia or something else that went wrong. You guys know what I'm saying. Especially when you thought you were doing the right things like taking your prenatals, avoiding alcohol, going to your appointments. So many of us end up with a feeling like our bodies failed us somehow. Failed us and failed the children we intended to carry for a full 40 weeks. Comments from folks who do not understand the complex physiological causes of preeclampsia usually don't help either! Some of us recover quickly physically, some of us are left with lingering health issues as a result of whatever developed in pregnancy. Not to mention the huge toll when one has a preemie and all that goes along with that (because prematurity does NOT end with the NICU). Anyway, everyone has their own way of coping. So here's my background:


I was into sports from an early age and in a Track and Field team by the time I was in elementary school. Ran cross-country later, did softball, volleyball, you name it. I did something every season. Got into cycling in high school and did that for quite a while. Went to university and was still a bit active but by my later twenties it was career, dating, other stuff that got in the way and made exercise less of a priority. I got back into running a bit before my wedding in 2002 but it was more to fit into the dress rather than as part of a lifestyle. Husband and I used to mountain bike some in our early years, but then homeownership and working long hours in high-tech sucked more and more time.


I certainly wasn't obese when I became pregnant but looking back wasn't where I had wanted to be. Add in a 1-1.5 hr job commute daily, with somewhat long hours. I think I've already blogged enough about early swelling in my last pregnancy and generally feeling unhealthy plus stress so let's just skip to the next chapter - After Preeclampsia.


In the two years after having my son in 2005, I kept wanting to get into shape but just never found my groove. Well for the first year my energy was focused on my son and his health, after a 76 day NICU stay - getting him to grow, worrying about his preemie lungs, devoting myself basically to helping him recover. My weight and physical fitness were secondary, and I was adjusting to being at home full-time. (I went back to working part-time after a year but from home, ie within 15 feet of the refrigerator).




Finally around October 2007 the stars aligned: a friend took me out on a trail run/walk and I was hooked instantly. She also got me to consider the crazy idea of doing my first triathlon. And another friend was just getting into running (she would go on to lose 100 pounds BTW). We started off with a mile, and tacked it on from there ever so slowly. And then the following June at exactly 3 years to the day I was hospitalized with preclampsia we completed the women's short (sprint) distance triathlon. By that October I ran my first Half Marathon and did two more in 2009 before getting pregnant last October. Attaching a photo from my first Tri and Half Marathon.


Every time I came back from a race, my darling son would see my finisher's medal or ribbon and excitedly ask me if I had won. Because to a 4 year old it's all about winning and being the fastest and nothing else matters. I try to explain to him I didn't, and I probably never will be on the award stand. I will probably never qualify for the Boston Marathon. Of course at 4 he doesn't realize what it's given me.




I don't know how to describe it. A feeling like well I can't control every aspect of my health and why my body developed this crappy syndrome, but I sure as hell can control my weight. I can control my fitness level. I can turn down the odds that say because I had pre-e that my risk of stroke and heart disease are greater. If I want to run 10 miles in one go, yes I have the power to do so if I work for it. If I want to reach the top of this 1,000 foot climb it may take me a year (it did) but each week I will run a bit farther before I stop panting. I cannot control my preemie son's growth nor how long it takes his prematurity issues to resolve but I am in control of my body. And this has given me a wonderful sense of accomplishment and a feeling of taking back what preeclampsia took from me.


I know not everyone gets the same desire, but I can only share what it did for me. Now on to this pregnancy, it has saved my sanity for close to 250 days now. Being in a high risk pregnancy and the worry over the what-ifs. All I can say is when the anxiety has gripped me, nothing has worked better than getting out with my iPod, listening to Desiree's "You Gotta Be" or another tune, getting out of the house, walking with the sun on my face. Putting one foot in front of the other and moving forward.

Friday, June 4, 2010

35 Weeks

Sometimes it's hard to believe the same body can be carrying two pregnancies so differently. As of 35.5 weeks I have yet to exhale completely but things are looking pretty darn good right now. On this date exactly 5 years ago, I was shuttling back and forth to the hospital not quite understanding what was happening and not knowing a heck of alot about preeclampsia. I hadn't a clue it would get as serious as it did and that I would be in ICU with organ failure in just 12 days with a 2 pounder in the NICU.

You can hypothesize about the many reasons why this pregnancy is (so far) preeclampsia free, and I have ideas as to what is helping, but at the end of the day it is a crapshoot and luck of the draw. Nothing, and I repeat nothing, has been proven to completely prevent preeclampsia from recurring. All you can do is reduce your risk through management of blood pressure, reduction of stress, good nutrition and being in optimal vascular health. And getting at a healthy weight if that is a risk factor for you. (Plenty of skinny people get preeclampsia but if you are obese, losing weight helps with blood pressure which is a known risk factor) I'm about to do a post on exercise later today BTW. Anyway I liken it to playing poker. You do what you can to hold the best hand and that's all you can do.

This week's labs looked great. Creatinine is at .58, platelets are back up to 180K from 170K last week.

Went in for appointment this morning and the BABY IS HEAD DOWN! Hooray for turning. Cervix is softening but no signs of effacement nor dilation. Not that surprising. VBAC would still be great if we go into labor and doc is hopeful but doesn't want a long inducement.

I also did confirm if the BP suddenly starts to rise we will indeed deliver the baby. We will not wait for full-blown preeclampsia to strike. Thank God. Pre-e can be deadliest post-partum so I'd rather play it conservative at this point.

Getting a bit better at controlling my nerves at each checkup but white coat syndrome continues to be the bane of my existence (see previous posts) Whereas I am running 110 over 65 at home I get 122 over 68 today in the office. Not bad for me as when I am really nervous it shoots MUCH higher and then we have to do a retest.

So from here on out, we have just 3 weeks and 6 days until the end point at which they will let me go. Continued home monitoring and weekly blood tests. Achy, crampy, and suffering from awful acid reflux but no swelling. Confession - sometimes I wake in the middle of the night to go pee and look down at my ankles for swelling. Hard to believe this was me exactly 5 yrs ago with preeclampsia. Couldn't get socks on, couldn't fit anything. If only we had the magic key to preventing preeclampsia every time.

Saturday, May 29, 2010

34 Weeks Plus a Few More Days


LOL my son took this and as usual cut off my head. And yeah I suppose I need to buy some shirts that cover my stomach. Sorry for the lack of updates. I have all sorts of weird symptoms these days, as I venture into new territory going this far in pregnancy. As I may have mentioned, it's hard sometimes deciphering what is normal pregnancy woes, what's a sign of problems. Overall I feel like I am doing very well. The last couple days I've had some mild cramping, which according to what I have read is normal. By the grace of God I seem to have little to no swelling which is just so bizarre when I look at pics from last time. How can two pregnancies (so far) be so different? The toughest complaint I have had is I tend to get this weird fatigue daily. I'll wake up and be fine for an hour and then a wave of fatigue will hit - not normal tiredness. This feels like weights and I can barely stand up and my pulse races. Lasts a couple hrs and then am fine usually. Hits in the afternoon as well. My perinatologist mentioned something about cortisol levels but didn't indicate it was serious enough to treat. Blood work from last week showed that I am now less anemic so doubt it is that (my anemia hit its highest level at the point where the blood volume had finished expanding) and is now stable.

Anyway I mentioned on a couple boards what the gameplan is now for the next 5 or so weeks:
- Weekly blood tests to check liver and kidney function (CBC, ALT, AST, creatinine, uric acid)
- Usual daily BP checks and urine checks I do myself at home
- Last ultrasound was at 33 wks. No more scheduled. Growth at 55% est 4lbs 12oz.
- Going in biweekly but suspect it will change to weekly after 35 weeks?

Right now the baby is breech and shows little signs of going head down. If things don't change and we don't go into labor the plan is to have a c-section at 39 weeks. However if we go into labor before that and the baby turns and no blood pressure problems then we will still hope to do a natural VBAC. Only time will tell. Just want a healthy baby - experiencing labor ideal but is secondary to our health.

Constantly adjusting exercise level to how I feel, try to get a mile walk in with the dog at least. It actually makes me feel better.

Other times, man, the tiredness is just overwhelming. Lots to do, not much time. Lucky if I scratch one thing off my list. Oh yeah and I have a cold this week. Wow, colds and pregnancy do not go together well. Especially coughing and being pregnant!

Monday, May 17, 2010

T Minus 49 Days

What's Going On:
I had a blood draw this morning which was actually the first since 27 weeks so seems like it was definitely due! My CBC already came back. Overall looks good, still borderline anemic but doesn't look severely so. Hematocrit is down to 34% which is the lowest range of normal, but as I mentioned it before represents hemodilution in pregnancy (in other words blood volume is expanding, which is a good thing. In pre-e it doesnt not expand to what it should and is overly concentrated). Here is a good article on hematocrit and hemodilution. So now I am waiting on the big tests for liver function and kidney function. I love Kaiser and I love getting the results by email but of course it is always a little anxiety-ridden when the results come in. Blood pressure today was still hovering at 107 over 65 with protein negative. So in terms of pre-e we still look good but the blood tests will give an indication of any signs of HELLP syndrome approaching. My platelets were down to 172K from 181K a month ago - so a bit on the low side but still in normal range. (I never run high - 220K at the max anyway). Little to no swelling.

Thursday is an ultrasound to check on growth and a regular Ob appointment.

Today I pre-registered at the hospital and got to see L&D (it's a new hospital). Two women in labor checking in as I was at the counter. I can't wait til this is me.

How I'm Feeling:
Not great but expect much of this is normal for 33 weeks. I've been getting some major Braxton Hicks contractions in the afternoons and evenings that don't stop til I lie flat. I have called the docs and am monitoring. Doesn't seem like a danger just have to take it easy. Also these come on regardless of whether I have walked that day or not. (It's more a case of them coming on when I am housecleaning - bending over, playing ball with my son, etc). Hmm what else: back aches, acid reflux, generally feeling like a whale. I've also had incidences where my heart races and I get very weak and my BP drops quite a bit (like too much). In this case, again not pre-e, but more likely part of all the blood circulating and being a bit anemic. Walking and stretching (ie light exercise) actually seem to be the best things to get the blood circulating and me feeling normal - I just have to time it right.

I'll update once the labs come back. Going to go for a slow 20 minute (1 mile) walk on the treadmill to stretch out my legs and see how I feel. And then a bath!

Thanks for reading. Two more weeks and we may just escape the NICU entirely this time. What a dream that would be.

UPDATE 5/18: Yes, all bloodwork looks fine: CBC, ALT, AST, creatinine, uric acid. Fingers crossed for good ultrasound Thursday

Tuesday, May 11, 2010

32 Weeks

OMG was my stomach really this flat last October? It feels like such a distant memory! 5 weeks pregnant



And 32 weeks...blimey.



More updates tomorrow. PS I had my 31 week appointment last week and my Ob Gyn says to me, "I hadn't scheduled any more appointments because I didn't think you were going to get past 32 weeks." (This was early on, she is more optimistic now). She didn't have to be quite so honest but the fact is she sees alot of recurrence when you get it as early as I did. Oh well. We're past 32 weeks, that's what matters.

Monday, May 3, 2010

Hello May, It's Nice to See You


Back in October I remember looking at the calendar and thinking about what each month meant in terms of the baby's birth. Feb meant no chance for the baby. March meant a 50-50 chance but a micropreemie no doubt. April meant some relief - an early preemie - but one that would have a fighting chance. And I remember thinking if we could just get to May (June of course would be even better). Especially May 6th which would be just two months left to D-Day. And May 11th marks 32 weeks exactly.

So here we are May. I'm glad to see you. The picture on the left is the urine dip sticks that I use to test my pee every day for signs of protein, a marker for pre-eclampsia. I reckon now since starting at Week 20, I have done this 70 times. The color that appears every morning is a relief but there's always trepidation that one morning is going to be the morning when I wake and it's a darker color, like the colors it was in 2005 when I was diagnosed and doing this at home. (So far it's negative as long as I am hydrated and I dip trace when I have not had enough fluids).

Similar to what I had at 20 weeks (see old post), I had a little bit of irrational anxiety since hitting Week 30. It must be something about hitting the number (10, 20 or 30). If I had known before conception how much better things would go this time, I would have jumped in even sooner. But I still get gripped occasionally with the fear of my body turning against me and the baby. Like I said before, 95% of the time I am fine and upbeat, it's only moments here and there. And I allow myself this. As my high-risk doctor has said it is completely normal to experience some anxiety in a high-risk pregnancy. Honestly to ignore the risks and not ever think about the what-if's would be a bit like sticking your head in the ground to me.

But I'll take a deep breath and head out soon for a short walk (my walks are indeed getting shorter!) and I will rejoice in the fact that this baby is now 50% bigger than Liam was at birth and in another week will probably be around 4 lbs, twice what he weighed.
Thanks again to everyone following our journey and prayers to all those facing similar journeys!