June 15, 2016

Updates! (tl;dr: I am large and full of fluid. And baby.)

So! Brisk clap! I saw the high risk antenatal doctor yesterday, and have Many Updates.
  • Polyhydramnios (excess fluid) diagnosis was reconfirmed. Normal fluid level (amniotic fluid index, or AFI) is between 5-25cm. Between 25-30cm is mild polyhdramnios; between 30-35 is moderate; and 35+ is severe. I'm at 29.6cm, so hanging by my fingernails in the "mild" classification. 
  • Assuming I stay in the mild-to-moderate category, there's not much I can do or that the doctors will do, aside from monitor the bejeesus out of me. I'm now scheduled for weekly sonograms for the remainder of my pregnancy, to make sure I do in fact stay in this category. I don't need to go on bedrest or modify my exercise or anything at this juncture, which was a relief to hear. 
  • But since there is still a very real risk of scary stuff like preterm labor and placental abruption (and oh hey STILLBIRTH) as complications should fluid levels elevate more, those weekly sonograms are a nice reassuring way to make sure I haven't suddenly veered into "severe" territory and put myself and baby girl at risk. Should that happen, that's when I suspect there would be some more concrete intervention, although I do need to confirm what that might look like. 
  • But for now, they expect this to proceed normally and the mild polyhydramnios in and of itself should not prevent me from being allowed to go into labor naturally, have a vaginal birth, etc. 
  • There's still no official "cause" at this juncture. (Oh yeah! I passed the 3 hour glucose test with flying colors. No diabeetus for me! But also means they can't easily explain my big baby / high fluid.) The doctor did say that roughly 50% of the time, polyhydramnios ends up being idiopathic, but she has seen an anecdotal correlation between big babies and too much fluid. They can't entirely rule out other known causes like chromosomal issues or an infection, but since I scored well in the first trimester screenings it remains a decently low probability. Anatomical issues can also be to blame, and many of those have been ruled out via the anatomy scans, but if the baby has trouble swallowing, for example, that would be tough to identify on an ultrasound. 
  • (Did you know this?? That fetuses spend their days drinking the amniotic fluid to practice swallowing and digesting, then pee it right back out into more amniotic fluid? That is so cool / gross! So there's a chance baby girl is just, uh, an overabundant pee-er.)
  • Oh! And another thing they're checking for on these new weekly sonograms will be baby position. Apparently, babies with so much extra fluid to float around in are not always the best at getting and staying in a head down position toward the end, since they basically have their own built in kiddie pool that they can luxuriously somersault all around in, unlike normal, cramped babies who aren't being spoiled with an extra large 24/7 day spa. 
  • Speaking of all that space, the ultrasound technician did warn me to expect to get "very uncomfortable and distended" as the weeks go on. So that's super neat to look forward to! :-/ 
  • (I got lots of great info and comments from the tech actually! She was lovely, kept telling me how adorable my unborn baby was, asked how often people inquire if I'm having twins due to my size [me: "FREQUENTLY!"] and let me know baby girl has a full head of hair right now [!!])
  • And although on the Slightly Alarmingly Large side, right now baby girl is still well within predicted acceptable size ranges for squeezing out through my tortured lady bits ("You're looking at an 8- or 9-pounder, most likely," said the doc) so as long as she doesn't speed up her growth I can look forward to that.. uh..  exciting... experience. 
  • On the other hand, if this were not an IVF pregnancy, they would move my date up by about 2 weeks and assume the early scans or my period math was off. However, because Science, we know exactly how old lady baby is, and so her +2 week sized noggin is just because she's big boned, darn it. 
  • (Her head and her femur are measuring the SAME amount of ahead-edness at least, which is good, as it means she's proportionally large all over.)
  • They did ask if the father was "really big" to help explain her size. 
    • Me: he's like.. 6 feet-ish? 
    • Them: oh, no, that's pretty normal, nevermind. 
  • Basically they wanted to know if I'd copulated with Tormund Giantsbane. Obviously I would never do that, I don't want to mess up his budding relationship with Brienne of Tarth, duh.
The whole appointment was pretty interesting and informative overall, and it took place in the hospital where I'll be giving birth, so it's nice to get increasingly familiar with that complex. It more or less confirmed all the research I'd done on my own, and confirmed my (somewhat hopeful) suspicions that I was on the "milder" side of polyhydramnios for now, which I will happily take. 

Because my lands, I am already getting REALLY UNCOMFORTABLE. And large. 

31 weeks. Belly button popped around 29.5
Thank the tiny baby jesus that they are still fine with me doing some light exercise, because I feel like my twice weekly workouts ("workouts," honestly - there is not exactly a lot of sweating going on these days; it's more resistance training and some yoga and balance work and a lot of grunting from me as I try to get up and down from the floor) are one of the only things keeping things from getting unreasonable. My hips and lower back are still doing OK (again, I credit my trainer with this 100%) but I've started to really run out of space in the torso area. My RIBS hurt, and I think it's because the lower ones literally are being squished by my bulbous midsection. 

(Although to be fair, the last time I assumed I was in fairly severe pain due to the natural but unfortunately immutable rigors of pregnancy, it turns out my entire hip was completely out of alignment and THAT was why I was having excruciating pain shooting up my back any time I was seated. I mean, pregnancy probably contributed to my hip going out of alignment in the first place, since that is not exactly normal for me, but my chiropractor was like "um, next time you're in intense pain for three weeks, COME SEE ME, DUMMY." [The dummy part was not technically vocalized, but we can assume he was thinking it.] My lower ribs have started to enter the "fairly excruciating" band of pain on a daily basis, so I'm headed to the chiro today after work to try and be less of a dummy if it's fixable again this time.)

Did I mention before that I was getting Braxton-Hicks contractions? Right at 24 weeks almost to the day, I got my first nice strong one, which was a little alarming at the time because it was the Monday right after we moved into the new house, and while I'd been very careful not to move anything heavy, I found it difficult to literally not lift ANYTHING AT ALL, because.. moving. But then I started getting contractions, at exactly the same week that all my baby listserves sent out Serious Newsletters about the dangers of pre-term labor and how to recognize the signs, so of course I was like OH NO I OVERDID IT WITH THE MOVE I RUINED THE BABY HALP OH NOOO. But no, just harmless ol' Braxton-Hicks! And I've had them reliably nearly every single day since. Still nothing painful (usually.. this is starting to change) and they're certainly not regular or consistent, but definitely present multiple times throughout the day. 

(Oh! The high risk doc did also say she often finds big ol' babies in excess fluid to be extra active [check] and have more early contractions [check], so that story checks out.)

Kicks 2

(Other oh! Completely related to anything in the previous paragraphs, but I also learned from that doctor that the echogenic foci on the baby's heart - which they did another detailed examination of - while only found in 3-5% of pregnancies, within that range the percentage is much higher in babies of Asian descent, which obviously ours is. There is no real significance to this aside, I just found it interesting.)  

Meanwhile, the swelling of the lower extremities continues unabated. I am relieved on a daily basis that maxi dresses and flip flops are acceptable options, because a) I literally cannot fit into 95% of my shoes on any given day and b) maxi dresses are basically pajamas that have the added benefit of hiding the woeful state of my cantaloupes ankles. I've started to get what feel like killer shin splints, but googling informs me that no, it's likely just the constant pressure on my shin bone from the swelling as well that is making it sore. Which, frankly, makes far more sense than shin splints, since I would have had to participate in some sort of cardio activity to acquire those. 

I absolutely cannot complain about my skin and hair though. I will be so very, very sad to have to give them up after baby girl makes her exit. My hair looks about 20x better when I do LITERALLY NOTHING to it - I mean, seriously, I brush it after I get out of the shower, and then NOTHING ELSE - than it ever has pre-pregnancy, under any circumstance. It's glorious. It also never needs to be washed. As in, it starts to look greasy on day 6. DAY SIX OF NO WASHING IT. I mean. It's practically enough to make a gal find Jesus over here. 

8 comments:

  1. Oh, my. Thank you for posting the update. I've been thinking about you! Xoxoxo I'm gonna focus on what a good breather and eater your baby will be when she gets here cause she's so busy practicing. ;)

    I remember my midwife telling me this about Braxton-Hicks contractions. If you're questioning if you are labor, you aren't in labor yet. You will know. And I found that to be true.

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  2. First of all, I'm glad to hear everything is ok! Phew! Second, your belly doesn't look *that* big (to my uninformed, never been pregnant, has no idea what I'm talking about untrained eye). You can do this! Baby girl will be so worth it :)

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  3. I just tried to comment and I think it got eaten? But I was saying that you look GORGEOUS and I'm a little bit in love with your doctors for providing so much detailed information. So reassuring! Good job, doctors.

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  4. Yeah you better not mess things up between Tormund and Brienne! ;-)

    I think that you look great and I'm glad that while you still have excess fluid, you are on the mild side. It sounds like you are being well taken care of by your doctors and staff which is always a good thing. :-)

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  5. Fingers crossed the amniotic fluid doesn't change in amount! I just think baby girl is eager to grow and come out and play with little W. :) So glad your docs are doing what they are doing!

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  6. Whew! Lots going on. Keep on hanging in there!

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  7. P.S. Finally got a chance to watch that video and it is AWESOME!!!!!!

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  8. Oh. My. Word. SO MANY THINGS!

    xox

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