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Archive for July, 2009

29 Weeks & 6 Days

29 Weeks & 6 Days

Diet Restrictions

After one day of monitoring my sugar levels, the doctors decided to have a dietician talk to me and give me some dietary guidelines.  My sugar levels aren’t terrible:  the highest has been 147 and it should be under 140, but they prefer it to stay below 100.  The main thing they want me to do is count my carbs for each meal.  It’s going to be difficult because carbs are in mostly everything and I’m already somewhat limited in food choices due to a small menu of food.  However, I can still have food brought in from elsewhere.  I was given a handy guidebook that lists most of the mainstream restaurants plus store-bought foods and most food categories, and next to each item it gives the fat, calorie, and carb breakdown for that item.  So they aren’t putting me on a special menu or anything like that, but they are expecting me to take control of the situation and watch how many carbs I eat with each meal.  Hopefully doing so will get my post-meal sugar levels down below 100.

7/29 Ultrasound

I had an ultrasound to check the fluid, blood flow, and growth today.  The fluid hasn’t changed much – today they measured .68 cm.  My blood flows also looked good.  However, my baby is still very small for gestational age.  In fact, the baby was having a growth spurt, but it seems to have slowed down.  At my 19/20 week ultrasound, the baby was in the 2nd percentile for gestational age.  Then, after the growth spurt, the baby was in the 17th percentile, after that the baby was in the 16th percentile.  However, today the baby only measured in the 10th percentile.  I was told it isn’t anything to get too stressed about, because there isn’t a lot of difference, and the 10th percentile is still better than the 2nd percentile.  As of today the baby weighs 2 pounds and 1 ounce.   So the baby is growing, just not as much as he/she should be.  I’ll have another fluid check in a week and a growth check in 2 weeks.

Today’s ultrasound tech guessed girl, but she said she really didn’t know, it was only a guess.  It’s still too difficult to see much.  The baby had his/her hands up by his/her face again, but today also had the feet up there too.

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I spoke with the doctor and she said gestational diabetes is generally associated with too MUCH, not too little amniotic fluid.  Also, gestational diabetes can result in a very large baby.  So it wouldn’t explain any of the other things going on with my pregnancy if I have it.  Hopefully I don’t.  I’ll start the finger pricks after all meals tomorrow.

The results of my blood count test are in.  The numbers looked good and I’m not anemic, so that’s a good thing.  I’m not on an iron supplement, so they said I am getting enough of it through my diet.  I’m sure it’s due to all the milk I drink, because I don’t eat a lot of meat.

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Today I was screened for gestational diabetes.  It involves drinking an extremely high-sugar carbonated drink and then getting a blood draw an hour later.  If your blood sugar is over 130ish, they will do an extended 3-hour test to determine if you have gestational diabetes.  If your number is over 200, they usually assume you have gestational diabetes and don’t even bother with the 3-hour test.  Mine was over 180, which means I failed test #1.  I had a feeling I was going to because when they came in to take the blood, I was still feeling VERY shaky from the sugar drink, and they said my system should be back to normal by that time.  In fact, 4.5 hours later and after eating a high-protein breakfast, I still don’t feel quite right, but it’s getting better.

They were supposed to withdraw a 2nd vial of blood this morning for a complete blood count, which checks white blood cells for infection and red blood cells to be sure I’m not anemic.  They did this when I first checked in, and apparently it’s standard to do checks every once in a while when a person is in the hospital.  Unfortunately, they forgot to take the additional vial when they were drawing for the diabetes test, and they had to come back and take more blood.

Anyone who knows me knows my aversion to needles and those bands they use to squeeze the life out of your arm.  Even after all this time in the hospital and having blood pressure checks several times a day, getting my blood pressure taken still makes me uneasy.  So when they informed me they were back for more blood, it was very upsetting to me.  My veins ended up constricting to the point they couldn’t draw any blood from my arm the 2nd time, so they cut my finger and drained blood from it instead.

The 3-hour test involves drinking a drink that is even higher in sugar and getting blood drawn once every 3 hours.  Due to how badly I failed the first test, and after seeing my aversion to needles, they decided to give me another option besides the 3-hour test.  They said I could get my finger pricked before and after every meal for a few days, and they could also diagnose me that way.  They haven’t asked for my answer yet, but I will probably go with the finger pricks.

I also talked to the pediatric cardiologist today.  He decided to wait a few more weeks to do a check-in, but he will be in touch with the perinatologists and he will be close by when the baby is born.  The perinatologists are planning to let me go full-term unless an emergency occurs.

I thought I read somewhere that gestational diabetes can trigger low amniotic fluid, but I can’t remember for sure where I found that information.  I am going to ask the doctors more about it the next time I see one.

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I had my ultrasound to check the fluid today instead of tomorrow.  The ultrasound was very quick – much quicker than other ultrasounds I have had.  Unfortunately, no measurable fluid was found today.  There was fluid, but it was all around the umbilical cord and, as mentioned before, they can’t measure fluid with cord in it.  The other ultrasound techs took a little more time in trying to locate fluid, so there is always a chance she may have missed it.  However, I must admit I was a bit disappointed.  I had hoped things were starting to improve.  At least the cord is cushioned by fluid.  Maybe next week’s fluid check will show better results.

The baby continues to look good on the heart monitors and continues to move around.   In fact, the movements are getting stronger, and I assume it is because the baby is growing.

Tomorrow I have my gestational diabetes test in the morning.  I’m not looking forward to it at all.  I really hope I pass because I don’t want to have to take the 3-hour test!  I guess we shall see what happens.

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7/22 Ultrasound

I was taken in for another ultrasound this morning for a fluid check.  We have 1 cm of fluid!!!  It’s still not a lot, but it has increased a little since Monday (it was .82 cm), and that is a good thing!  We hope and pray it continues to increase, and are thankful to God for the increase we have seen.

I also saw the baby’s face today for the first time!  Usually the baby is turned the wrong way to see the face.  The baby was sucking on fingers from BOTH hands!  We were given a picture, but it’s a little fuzzy.

From now on, my ultrasounds will probably be on Mondays.  I also will be having another echogram later this week, so I’ll update afterwards.

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Today I had an ultrasound for the purpose of checking the blood flow from the placenta to the baby.  As mentioned in yesterday’s post, previous ultrasounds had shown the blood flow to be bordering between normal and too low.  Today, however, the blood flow was perfectly normal.  The doctor said blood flow levels can improve, and it seems that in my case they have.

They also saw some fluid, but none they could measure because the umbilical cord was in it.

The baby was moving around during the ultrasound which, as mentioned before, is a very good thing.  The baby kept rolling from side to side and also kicking like crazy.

That’s the only update I have for today.

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Tonight when the perinatologist was making his rounds, he mentioned that I was scheduled for another ultrasound either tomorrow or Monday to check the baby’s blood flow.  This, of course, puzzled me, as I have never been told anything about a problem with the baby’s blood flow.  Apparently the blood flow from the placenta to the baby is normal, but barely.  They want to check to make sure the baby is getting an appropriate level of blood.

The borderline blood flow problem may indicate a problem with the placenta.  If there is a problem with the placenta, it could explain the lack of amniotic fluid and the growth problems with the baby.  However, it would NOT explain the baby’s heart problem.  The perinatologist said taking all of the abnormalities together, a chromosomal problem comes up first on the list, but it is also possible that there is a placenta problem plus a heart condition, and they are 2 separate issues.  If we are dealing with a placenta problem, our baby would most likely be fine.  There would still be the heart condition and some lung issues from the baby being without fluid, and the worry of whether or not the baby would be able to breathe (due to being without fluid for so long) would still exist.  The perinatologist said this is the situation they are hoping for.  However, he said we have to be prepared for the possibility of chromosomal issues as well, as they are the primary concern.  Of course, we won’t know what is going on until the baby is born, but we were glad to hear that there are other non-devastating things on the doctors’ list of possibilities.

I also asked for more information about the plan for my pregnancy.  If my baby continues to do well on the monitor, they won’t necessarily take the baby at 34 weeks – they would probably let the baby go longer.  This means the possibility of a longer hospitalization period, but it also would be better for the baby.

It had never been explained to us what exactly they were looking for on the monitor – we had an idea, but not the specifics.  Apparently as long as the baby’s heart rate isn’t consistently above 160 or isn’t consistently taking dips below 120, then it is considered good.  We want the baby’s heart to go over 160 from time to time because that indicates movement.  However, remaining above that level isn’t healthy.

Finally, I asked again about what my chances of a c-section are.  He said there is an 80% chance I will have to have a c-section, but only 50% of that 80% would represent an emergency c-section.  If the baby continues to do well, they would probably schedule a c-section at some date they felt was appropriate.

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