‎Friday, ‎February ‎18, ‎2011

‎Friday, ‎February ‎18, ‎2011
What a day! I woke up this morning, sort of excited, sort of scared about the appointment. Jason made J and I breakfast, then we got ourselves ready, and out the door. We dropped J off with my Mom, who had all sorts of fun things planned for the two of them, and headed to the hospital. Jason dropped me off at the entrance, then parked the car where we didn't have to pay. After a week of coming to see me in the hospital, we've spent a LOT on parking!
So, I checked in with registration, and met Jason at the front entrance. We then checked in at the MFM desk, and were instructed to wait in waiting area A. We sat there for about ten minutes, then a nurse called my name, and I went in to pee in a cup, and get weighed. I'm up 10lbs now, which is good. I'm glad to see the numbers climbing. My belly sure has noticeably grown over the past two weeks.
After that, the nurse told me they'd call me when the room was ready. We waited, and waited and waited and waited. Finally, after over an hour and a quarter waiting, they led us to our room. I felt weird sitting on the exam table, so I sat next to Jason on the chairs. At first, a med student came in, talked to me about my symptoms, got my history and did the basics. He said "it's strange, you don't fit into a catagory". Meaning, I have had a post dates, no problems baby, and this time my cervix is presenting short, I've got tons of contractions and blood streaked mucous. Contractions aren't regular, they don't know what is going on with me. He said all that, then said he was going to go get Dr.M. She's a super nice French-Canadian perinatologist, and my first impression was a good one. She repeated most of the questions, and asked a few more about recent ultrasounds and tests I'd had done. She said that she wasn't overly concerned about my cervical length, especially given that my labour with J had to be induced. She said the short cervix does pose a risk of PTL, but my history decreases it. She said the SCH increases the risk of PTL due to placental abruption, and was JUST about to go into the details of that, when my sweet husband, who will probably die if he finds out I shared this, said "Um, excuse me, I think I'm going to pass out". I looked at him, and told him to put his head between his legs, three times, before he actually did. The doctor seemed concerned, and a little confused when he said "I'm okay" and I said "No you're not...oh look, he's out". GREAT. He totally lost consciousness, his face turned as white as is physiologically possible, his eyes rolled into the back of his face, and his tonge sort of stuck out. I wasn't sure what to do with him, the Dr. was on his right, I was on his left, and it was all we could do to make sure he didn't face plant into the floor. He got all rigid and sort of swooned upwards, if you can imagine it. Totally the opposite of what you would expect. I think he was out of it for about a minute, before he slowly came to, and snapped out of it. Dr. M kept asking him if he was with us, and on the fifth time he answered "Yep, totally fine" like nothing had happened. Meanwhile the med student disappeared trying to find someone to help, and suddenly the tiny office was packed with nurses. They moved my reluctant husband to the exam table, one had a cloth on his head, one took his blood pressure, another his heart rate, and yet another was making him drink a juice box. I was sitting in the corner trying not to pee my pants laughing at the ridiculousness of it all. Many suggestions were made "low hemoglobin, see doctor, etc..." and finally they all left, and we got back to the appointment, after Jason expressed his embarassment and apologies. Poor guy!
So, we got back to talking about my placenta, and the Dr. suggested he might want to leave. He declined, but did stay recumbant on the table. The SCH puts me at an increased risk of PTL, but then again, it's not a substantial risk. Their main concern, upon reviewing the ultrasound results from yesterday, is that Ellie is very small. At 19 weeks, her measurements were between 10th and 50th percentiles, last week her smallest measurement was the abdominal circumference, and it was just below the 10th percentile. Well, this week, her largest measurement, I believe, was her femur length, which came in at the 21st percentile. Her abdominal circumference was 8th percentile, her something was 10th and her bilateral pd? was 2nd percentile. All these measurements were based on an EDD one week LATER than what I've been going by, a date from my 7 week ultrasound, to give her the best possible benefit of the doubt. I don't even want to know what sort of difference it makes if they were to input those numbers with the June 8th EDD. It's scary.
In her opinion, this warrants serial ultrasounds, at least every 2 weeks, to monitor growth as well as cord blood flow. She asked who my care provider was, and I told her that I originally was with Jane, who I love, then got switched last week to Dr. K. I expressed my dislike for a system that pairs you with someone you haven't had the opportunity to choose yourself. Prenatal care is so important, and I strongly believe that the care provider you have should have similar if not the same beliefs regarding birth as you do. Otherwise, you have no guarantee whatsoever that you'll end up getting even a shot at the birth you envision. She agreed with me, and said it wasn't necessary for me to be seen by three practitioners/practices. Dr. M suggested I continue to see Jane/Courtney/Sandra for the duration of my pregnancy, but that the MFM clinic follow me for the growth issue as well as to monitor me for the threat of PTL. I was very happy with that.
Getting to the topic of bed rest, I explained that I'd spent the last 9 days on strict, doctor imposed hospital/home bed rest. Dr. M asked me what I did for work, and I explained to her the basics of SusieCues. She said that it was her recommendation that I get someone else to do the work for me (which I've already done) but that if I felt up to it, I could probably do some light sewing, provided I stop immediately, and rest if contractions or cramping occured. She said that she doesn't believe in the efficacy of bed rest, and believes that it can do more harm than good. She said that I should always listen to my body, and that it would probably be a good idea to spend most of my time on the couch/lying down, BUT, that I shouldn't let my body suffer from complete lack of exercise.
We talked briefly about delivering at Women's (which I am very open to, and would prefer over delivering in Richmond) and that if I made it to term - 37 weeks- my full care could be transfered back to Jane. She said the receptionist would call me with my next appointment time, and that I should call their emergency line in case things acted up again. After that we were done.
So, my strict bed rest sentence has been lifted, although for the sake of my sanity and the sanity of those around me, I'm going to be lying low for a while, probably as long as until my next MFM appointment.
We left the hospital in the glorious sunshine feeling moderately victorious, although quite concerned about our Peanut's lack of growth.
When i got back to my parents', I called the midwifery clinic to let them know my status. I didn't expect Sandra to call me, but she did, just wanting to know where I was. I am so impressed with their level of care. We talked about the MFM appointment, the bed rest, the cervical shortening, the contractions, the probability of IUGR. We talked about a lot. She said that if she could hope for the best possible care situation for me, it would be exactly what Dr. M suggested. It was nice knowing they felt that way too. She asked if they'd talked about what would happen if there was very little to no growth over the course of a month, which they hadn't. I said something along the lines of them probably waiting for me to hit viability before they discussed that. She agreed. She said she would talk to Jane about the possibility of my delivering at Women's over RIchmond, and she said that would have to be decided by Jane, as Women's is a case to case thing. (edit) She also said they would see if they could come to me for my appointments to limit the amount of traveling I have to do. She seemed happy with my decision to stay with my mom while Jason's working, and be at home when he's off work.
So, that's where I stand with that. A lot to think about, and a lot to worry about, especially that Ellie's not growing like we'd like to see. I think, that the type of IUGR that Ellie is possibly exhibiting is called symmetrical IUGR. Everything is growing small, not just the limbs, and sparing the head. I don't know what that means though. Lots more to learn, lots more to find out. For now, I need to sleep, it's been a long day. I miss my boys, DH is at work, J's with his grandparents in Delta. I'm here with Mom, but she's asleep already, and I want to make the most of the day tomorrow. I plan to reserve some books online, look up information about community center activities for J during the week, and read all I can about tiny babies.
Ah, I hope that she grows, faster than my cervix shrinks. That she continues to grow, that my placenta continues to nourish her, and that we have a healthy little girl. Please, let her be healthy.