Saturday, 16 March 2013

Another scan...

With not so great results.

I'm up at 3am, can't sleep and am a nervous crying mess.  I'm going back next week for another, "otherwise unscheduled" scan.  Because of one thing.

My fluid levels increased severely over the past 4 weeks.  I'm now measuring at 30+ cm at 32 weeks, when 25 cm is considered the ceiling to "the higher end of normal".  I was 23.5cm at 28 weeks.  I knew something was up...but no one wanted to let me "go there" with the possibility that this could be an early sign of something being wrong.

I had a freak out after my last appointment with my OB at 30 weeks with that student by her side.  The next day at work, I felt like I didn't feel baby enough.  I felt tons of activity in the morning while laying in bed...but then an all too quiet baby while at work.  I took myself into triage.  They ran a strip, and did an ultrasound.  Baby was head down!  Flipped.  Yay!  That's why I couldn't feel baby as active during the day.  Just taking some down time after it's little adventure.  I went home feeling kicks and rolls in all the right places.  (I wrote a blog post about it all...never got around to finishing it, and/or posting it.  Boo for me.). A few days later, after stupidly spreading the news that baby is now head down...I was sure I felt another flip.  And all last week I couldn't tell what was what.

The ultrasound yesterday showed baby is breech.  Again.  Still?  Whatever.

They said this is why baby is still breech.  There's too much fluid to swim around in, and the excessive size of my uterus isn't encouraging a permanent lifestyle change.  The baby is now measuring at 4.4lbs, and I'm terrified that I'll have a malformed baby with defects in its skeletal structure.  The ultrasound showed it's bum right up against my cervix, legs curled up against my left side with kicks against my lower left half.  The back and spine seen arched along my right side... and head tucked under my right ribs.  Curled up like a giant "C" in there.  I guess when he turned down earlier this month, he easily bobbed back up as there's nothing keeping him restricted in one place. 

Of course I read on a million reasons why fluids can be high, and digestive system defects pop off the pages.  Fluid is building because of a possible blockage in the digestive tract.  Or maybe baby isn't able to take in any fluid at all, and is just continuously peeing with out cycling it.  I read about such things when I was 28 weeks, and measuring at the higher end of normal at 23.5 cm.  No one wanted to validate my concerns that maybe, just maybe, they shouldn't be so high.  When the ultrasound doctor told me that they had increased to a level that was now "questionable", I was so frustrated.  I knew it.  Fuck.  And a month has now gone by, and this baby has been bobbing around in what only seems to be increasing fluid levels.  And now, they want to do another scan to see if they can determine a cause.  Maybe baby isn't swallowing. 

I knew it.  I've felt it.

It's true...this baby does not hiccup.  Alexander got the hiccups all-the-time in the third trimester.  He was so perfectly perfect it breaks my heart. 

I tried to comfort myself in the early weeks of my third trimester in that the reason I couldn't feel hiccups was because of the babe's position.  But no - I cant feel them because they're not happening.  This babe hasn't swallowed an ounce for his own good health this entire time.

Yeah, it's a he.  I'm having another boy.  Might as well get it all out in the open now as I'm seriously doubting the overall health, and/or chances of living that he'll have.  My desires to keep it a surprise until the end are fading as it'll be pretty anticlimactic if his gender reveal is over casted by his death. 

And I cant help it.  I don't believe he'll live.  I don't believe that he'll be ok.  It's all happening.  It's all showing it's ugly dead baby truth.  If one can die, while perfectly healthy,... then they'll all die. In me.  Only in me.  Everyone else will have complicaitons leading to beautiful, healthy living children.  But not me. 

One of the worst parts of today (yesterday now) is that my doctor was on vacation.  It's "March Break" here where I am, and she took the week off.  She's got kids... they're out of school this week... so it's natural for parents to take this week off too. 

I had to see her substitute - or "partner" as she calls it.  But they are not equal in their practices.  Dr. C is knowledgeable and all, but couldn't hold a candle to Dr. W.  Dr. C was half there, half not there in all the questions I was asking.  Daniel got comfort from her answers, but I could tell she was giving text book "worst case scenario" and "safe" answers as any OB would.  She talked about draining the fluid with a needle through my belly (!!!), suggesting I take myself into triage if I feel shot of breath or if my contractions turn painful (no shit).  But she hasn't been with us, side by side, in this pregnancy as Dr. W has.  I kept pushing to see my doctor next week asap for another scan as the doctor who did the follow up after the scan told me that was the next step.  And Dr. C kept saying... "sure, and I'm here next week whatever works out with scheduling".  I thought, you're here now too! and not doing much for me!  get a clue!

Another stress.  The receptionist (who I love) is on vacation next week, and some girl down the hall is handling all of Dr. W's appointments next week.  So when I went to see her to book another appointment with Dr. W, she told me not to worry.  Told me Dr. C would fill in Dr. W first thing Monday, and Ashley would give me a call to tell me when my scan would be.  Ashley?  Who the fuck is Ashley, and what the fuck does she know about how important it is to make sure I get in again next week? 

Fuck.  This sucks. 

And I cant feel him as much as I used to.  There's a ton of fluid separating his jabs and pokes from the exterior of my belly... so it's like feeling someone giving you a high five while holding a water balloon.  Very wobbly and jiggly. 

I feel like I'm a ticking time bomb.  No.  A balloon really.  About to burst.  I'm a huge indoor pool with it's lid on... ready to down my child. 

Saturday, 2 March 2013

And this baby is...

I'll get to that in a minute. 

I had a scan 2 weeks ago to check in on everything, and this baby is measuring a week ahead.  It's in the 80th percentile.  At 28 weeks, babe was measuring at 28+6, and weighing in at almost 3lbs.  My fluid levels are "subjectively increased" with an AFI of 23.5 cm (and 25 cm is what is considered abnormally high).  The over all opinion given on the report was "Active and well grown fetus", and this little shrimp passed the BPP with an 8/8 in the first minute. 
But here's the kicker...
This baby is breech.
Not a big deal, as I was told by every technician, and doctor that saw me that day... "It's early.  Babies usually turn.  1 in 4 are breech at 28 weeks, and only 3% are breech at term.  Everything should be fine".  I knew something was up though. I felt jabs, and pokes in all the wrong places and movement, and kicks felt NOTHING like Alexander's.  And when they told me the babe's head was under my right ribcage, it made total sense. I've been feeling lots of thumping on my cervix (or err, bottom exit area?) and had a heavy suspicion they were coming from feet... not hands and elbows.
I know baby has time to move, and find it's way head down... but I checked back in my pregnancy records while pregnant with Alexander, and he was recorded as head down at 30 weeks, and stayed that way for all follow up appointments thereafter.
Well, today was another appointment for baby #2. 
I'm 30+1 weeks along, and I was anxious to talk to my doctor more in depth about the scan rather than the quick recap I was given at my last appointment.  I had a really bad cold last week, and was coughing up a storm... and I swear I felt the familiar feelings of little hands in my lower half.  I thought all the abdominal contractions the coughing and blowing of my nose brought along might have helped this babe turn.  However, I have felt a lot of pressure under my ribs, and some nights, even saw a huge hard mound push out, and thought "dammit, that's a head if I've ever seen one...". 
There was a resident doctor starting off with patients today... and I heard him in the room next to me getting all chatty with another couple.  My doctor told me that I'd be spared the resident rounds, so I was pretty confident that I'd only be seeing my doctor today.  Plus, the receptionist would have let me know Dr. W was with students ... ya know.. a bit of a heads up. 
Daniel and I talked a bit while eavesdropping on the couple next door.  Poor guy, we thought, he doesn't know a thing about a damn thing yet... yeesh.  
 A light knock on the door..and Doogie Hower walks in, so happy to be doing his job.  Dammit. 
I wasn't emotionally prepared for this.  I didn't want to have to tell yet another person about "my history", and get another taken aback response.  This past week has been hard... Alexander's birthday wasn't easy, and getting through the week almost felt harder than the day itself.  I felt myself becoming very emotional on my way to the appointment, and was actually afraid that I was going to cry when I got to the clinic.  I was just so tender.  Everything was on the surface.  Why is this baby not head down dammit?!? And why did my baby have to die just so I could do this all over again and have it be so-damn-hard?
He asked the typical starter questions... any bleeding?  No.  Vomiting?  No.  Leaking fluid?  No.  So this is your... *flips through pages* ... second baby? Yes. 
I could feel how uncomfortable we were making him feel.  He was on top of the world next door with Mr and Mrs perfectly pregnant... and now he's with the ice queen and her silent straight faced man.  He was probably thinking... what the hell am I doing wrong??  Why aren't they talking about the weather, or how fat she feels, or what the hell it's like to be pregnant??
He continued to flip through my file... and I could see the white pages at the back (Alexander's autopsy report) but he only went through the pink and yellow pages at the front.  He asked me if I knew I was GPS positive.  Yes, I did.  But he continued to tell me about the procedures of going into labour and getting antibiotics... Yes, once again, I know. 
He told me it was time for me to hop up on the table and check my blood pressure and baby's heart rate. 
After my blood pressure, he asked how old our first was. 
I said it fast, abruptly, and almost out of body.  He died at birth. 
I just couldn't cry in front of this student.  He wasn't even supposed to be seeing me.  He had NO IDEA that he was going to get this on his plate today.  And I just couldn't break down.  I didn't want to be a mess.  I didn't want to become a spectacle. 
And on top of that...I was proceeding to lay down.  I didn't want to cry while laying there.  I dunno...I just felt every guard go up, and I was holding back the urge to scream at him to get out and give me my space!  He did apologize, said "I'm so sorry".  But then asked, "Why are you in the low risk section of Dr. W's clinic?"  I felt my face get red, and I was now laying on the table, and he was leaning almost over me... I ummed, and ahh'ed, hearing my voice shake as I told him that things were so far so good in this pregnancy - just as they were with my first - so I'm in the best hands, and her high risk clinic mostly deals with premature labour candidates, and women who have trouble staying pregnant in the 2nd trimester.  So... here I am.  Pregnant... "low risk" as it gets when it comes to her high risk comparisons, I guess. 
He measured my uterus.. and said I was measuring at 31 weeks.  I told him about the scan, and that the baby was measuring big, and that the baby was also breech... ish.  He said it was "the time" during pregnancy that is common to check for baby's position, so he was going to see if he could pin point exactly where babe was.  He told me he couldn't seem to be able to locate the head.   I told him (once again!) that the scan 2 weeks prior showed the baby as breech, and I felt as if the babe was now more on the transverse angle of things as kicks and babe's bottom were more on the lower left quadrant.   He gently rubbed and pressed on my belly trying to see if he could tell me exactly where baby was... but he was already letting his nerves get to him.   He said he wanted to know exactly where the baby was so he could locate the body to get the heart rate.  He kept noting that the baby was "kicking" him when he was touching right under my right ribs.  I told him that he was probably feeling elbow's and hands... as that hard mound was most likely the head. 
*touch*touch*press*press* "oh, ohpphh! would you look at that!  you have a really active baby!  I can really feel it!" 
Yes surrey, that is indeed a baby in there, moving, punching, poking... still alive...get over it, and give me the freaking heart rate! 
Well... sheesh... he moved the little wand around for 5 minutes, and couldn't find anything but static.  I tried to direct him.. but he kept going up to the top of my uterus... under my breast bone, and picked up my heartbeat a few times.  Then, the placentas (according to him!  "that's your placenta" ... wwookkaaay.)  But my lack of patience was getting to me.  And the mad, aggravated, ragey side of me wasn't coming to the surface - but the sad, exhausted, get me the hell out of here or I'm going to start crying soon, I can't do this anymore side was.  I wasn't nervous that baby might be dead... as I felt kicking and squirming the entire time... but I was getting anxious.  Why wasn't the heartbeat pounding so healthily that the Doppler couldn't pick it up?
He did end up getting it... as he went down to the lower right side of my uterus (where I told him to go FIRST off!... but decided to search up near the top!) and he got a reading.   He told me it was 130bpm.  I was spent.  130?  He went on to explain that 130 was healthy... but I told him I don't care all that much about what's what these days... I want consistency.  Last time it was 145-150.  WHAT-THE-FUCK dude??  My doctor came in seconds later, and the look on her face was priceless.  I could tell she meant to tell him to skip this room, because holy shit, not just anyone wearing a name tag has the right to talk to us about the health and well being of this baby these days. 
I sat up, and started to wipe off the gel with my bare hands... I was frazzled...and told her that it took him forever to find the heartbeat.   She said she knew as she was next door with another patient, and could hear the static through the walls.  I assured her we got it...but still!  The resident asked me to lay back down so my doctor could check to make sure the position of the baby was what he thought... which he called "vertex".   I laid down and made eye contact with my doctor, and nearly lost it.  I just wanted this young kid out of the room so I could talk to her about everything that's been on my mind since the scan.   I laid down, and she touched lightly, and placed the Doppler on me and found a healthy 150bpm in a matter of seconds.   The student joked, "the babies always know when the boss is around!"  She took her index finger and thumb, and squeezed right above my pubic bone... "nope, nothing engaged".  She gently smiled at me, and I nodded back as if to tell her I already knew.  I know the baby is still breech. 
My doctor sent him out of the room, and I lost it.  LOST it.  And she knew I would.  She had Kleenex in hand, and was apologizing over and over.  She told me she knows I don't need that right now, and struggling through someone else's inexperience just isn't what I need to be enduring.
I cried for almost a minute straight.  I took my glasses off, and pressed tissue so hard into my eyes as the tears were pouring out.  I managed to choke out "I cant do this anymore".  And I didn't mean the pregnancy.  I haven't had any real scares (yet?  knocks wood).  This baby moves, and I'm not in that omg is this baby going to die any minute stage (yet? knocks wood).  I meant it in the sense that I cant face another innocent well meaning inexperienced person while pregnant.  I cant have another "doctor-like" person tell me the facts of what's good or bad, normal or statistically proven.  I just need to see her all the way to the end, and that's it. 
I did get to talk to her about the baby's position, and she talked about a new plan of action if the baby doesn't flip by 37 weeks.  And that's c-section (gulp).  I'm not a candidate for a version, and she's seen most versions fail anyhow.. and it's just not worth the risk or stress it could put on the baby.  That being said, she told me there's still lots of time for the baby to move.  She said it's 1-3% of babies that remain breech at term (those stats didn't make me feel better... I've been the less than 1% before in regards to something that NEVER HAPPENS these days.  Thank you stillbirth), so there's a good chance that the babe will turn.  And, she said it's usually first timers that stay breech because the uterus is tight, and restricts baby's movements.  And this being my second, babe should turn.  Should.  Hm, not the most comforting phrase.  Alexander should have lived.
But I know the health of the baby is the most important thing... but I was really hoping to have a vaginal birth.  For everyone's sake.  And, for the sake of my uterus for (hopefully) future pregnancies that turn into eventual living children.
I have another scan at 32 weeks... then at 34, 35, 36, and 37.  And these scans were all scheduled before any of this breech business was on the table.  But now, that's all I'll be thinking about.