Wednesday, September 3, 2008

My "halfway" Dr Appt Update and my Goodbye ...

I saw my OB! Finally! Every appointment has been the NP (which I don't mind since I do like them both) because my OB has gotten called out on emergencies each time. When he walked in I was all "oh, amazing to actually see you" and he said "Yeah, they've been keeping me away from you!".

My OB is so awesome, I love him so very much. I saw him ~every visit~ for the first two babies, so it's just strange not to see him. He's just so very popular now!

Anywho - Dr's appointment went swimmingly.

~ I've gained 2.5 lbs total. He started to tell me I need to gain more but I reminded him I was up 12 lbs from the fertility treatments so he agreed my body was using that extra weight up until now. So really, I'm up 14.5 lbs from normal pre-IVF, just only 2.5lbs from pregnancy. He wants to see some gaining now though, but at least he's counting the IF weight gain. He said a pound per week from now on would be perfect, but he knows my body gained 50lbs each time, so he'd allow more without being worried.

~ My ute is measuring 21cms, so for being 19w5d, I'm measuring a week ahead.

~ Peapod's heartrate was 152bpm

And now for the VCI (velamentous cord insertion) questions/answers (more for my info):

~ Peapod will be getting growth scans starting when?
--- I'm scheduled to start them at 24 weeks (oct 2nd). He'll decide how often after that appointment.

~What if the baby is on the small side due to VCI? Will the baby be taken early? What would be the earliest?
--- He said he's never seen this happen and doesn't even consider it to be worth thinking about right now. But if the baby is small, it'll be decided then, not now.

~ If the baby is taken early, will I be induced or will a c-section be necessary?
--- Depends how early. After 37 weeks, it would most likely be a vaginal induction.

~ During delivery, will I definitely be able to do a vaginal birth?
--- Yes.

~ Is there anything that would necessitate a c-section regarding VCI?
--- It would depend on how the baby tolerates the labor.

~ Due to the delivery of a placenta with VCI, what will happen if the cord does detach? Will we still try to manually extract it? Or will emergency surgery be necessary?
--- He would first try to manually extract. Surgery would be next step.

Cord Compression specific questions:

~ Will laying on left side help due to it being on the right side?
--- "Theoretically, no" was his answer. If there is a normal amount of fluid, the baby would be cushioned by the fluid and laying on either side wouldn't matter. If there is low fluid conditions, a different approach may be given.

~ What is the risk of stillbirth for general public?
--- He quoted a statistic from the March of Dimes which has a general number of "1 in 200 pregnancies results in stillbirth". That is .5% and with this VCI issue, I was given a 1% chance. Although it's double the general public, it's still very low.

~ Can I do anything to decrease this risk?
--- I will be starting weekly BPPs (biophysical profiles) starting at 24 weeks (Oct 2nd) and they will continue through delivery. This will keep a close eye on the heartrate of the baby to see if he is compressing his cord at all during normal conditions. This timing my increase based upon the results.

~ If the baby is showing signs of compressing his own cord, how early would he be taken?
--- He explained that the first thing he would do would be to put me in the hospital to monitor the baby 24 hours a day. He would then be able to come up with a plan based upon that. He would not simply just take the baby based upon a normal BPP.

Based on my OB's feedback, I feel so much better! He said the VCI wasn't that rare and due to the position of mine, he doesn't think there will be any problems. He seemed so blah about it, which really helped me relax. But then again, he is going to keep a close eye on it, just in case. It'll mean a lot of trips to the OB, but totally worth it to me. And I love the fact that blips on the regular BPPs would mean 24 hour monitoring. Whew. Okay, I'm not as terrified anymore.

I leave for Phoenix in the morning and I most likely won't have any internet access when I make it up to Pine. I'm not bringing my laptop and I'm sure the cabin won't have a computer available. So it's goodbye for the next week, BUT ... I'm going to change up the format of this blog while I'm gone. Number one, I'm taking ~off~ moderated comments, so they will appear immediately. Number two, I'm pre-scheduling 6 posts (one per day) in which a question will be asked. So there will be something to read each day while I'm gone.

(Also, I did update my belly picture early, so the new one is over to the right. Thanks to those who told me you did look for the new picture!)

I hope everyone has a wonderful week!

And a special note to miss soulbliss ... I hope you find some peace over the next few days. This baby in my belly measured 4 days behind, but I do understand your fears due to your past experiences. I've got my own little nickname for him ... Mirakel. It means miracle in Norwegian. And while I don't think he needs a miracle to keep on growing, I think he will simply be your little miracle. The miracle you'll need to rid yourself of the understandable fear you have in your heart. He's your miracle growing in your belly right now and soon enough you'll be able to let go and encompass him in love, no longer feeling encased in apprehension and dread. Mirakel is strong enough to take all that away from you, he just needs a little more time to show you just how strong he is.


Io said...

Dude, glad the baby is ok, but did you really just write *7* posts a *day*?! How am I supposed to keep up? My googlereader will go mad!

nancy said...

Whoops. Yeah, that did sound like I was writing multiple posts for each day. I changed it to say I'm writing 6 posts all together, which will publish ONE per day! Thanks Miss io!

JamieD said...

What great news! Your OB sounds awesome.

Have a good time in Phoenix! We'll be here when you get back.

Jennifer said...

Glad that the OB was able to reassure you. We worry about every thing and the Drs. have done it all and are so easy going. It's nice to know you're not a "risky" case.

I don't know if you could use this, but I just came across it.|0&ENDECA_SEARCH_INPUT%3C%3ENtt=&ENDECA_SEARCH_INPUT%3C%3Erecs=35&ENDECA_SEARCH_INPUT%3C%3EN=4294963616&ENDECA_SEARCH_INPUT%3C%3Etype=2&PRODUCT%3C%3Eprd_id=845524867564665&FOLDER%3C%3Efolder_id=2534374752618876&bmForm=guided_nav_search&bmFormID=1220470823546&bmUID=1220470823546]Kohls%20Maternity%20Clothes&prtID=pfx&src=k1971&cm_mmc=Performics-_-Affiliate-_-**Slick%20Deals**-_-120x30%20Kohl%27s%20w%2Fborder

The Captain's Wife said...

So glad you had a great appt!

Your boy's HR is so high for a boy...makes me think that there could still be a chance I have a little guy in my belly (!?)

Have a great trip, and thanks for thinking of us in advance...with the daily post and all.

Oh and since you will be away...congrats on making it to the half way mark!

Denise said...

Glad you had a good appointment and your OB was able to alleviate some of your worry. Have a good trip!

nancy said...

Thanks for the link Jennifer! And I have a question ... Are you Jen_1980?

nancy said...

The Captains Wife ...

Funny you mention the HB. For my girls, their HR was 168-169 at each and every appointment. So when peapod's HR was 169 at the 8w appointment, I thought for sure it would be another girl. BUT, by the time we got to our 12w appointments, it was down to the lower 150s. And that's where it has stayed. So for US, 152 ~is~ a low HR!

And .. my friend Katie is having a boy and his HR was 179 at 8w and 167 at 20w!!! He definitely has a penis!

Io said...

Dude! I'm sorry I'm so political! At least my liberal nutjobism is distracting me a bit from my infertility woes. Sigh.

Oh good - I'm glad you're not doing 7 posts a day! I would never be able to keep up on commenting!

Sarah R said...

Yay for your awesome doc...and great belly pic!!! You look gorgeous!

nancy said...

Aww Sarah, you are so nice!

Geohde said...

That's a lot of monitoring but far better safe than sorry- and the ressurance is always good to have.

But I hope the cord does not detach during delivery- a MROP always seems slightly vetinary to me- human limbs should not be able to reach all the way up there!!



chicklet said...

Your belly pics are awesome. Glad the baby's good.

nancy said...

J -

That reminds me of a very "still fresh in my mind" memory of a time about 3 years ago. 3 years ago exactly give or take a few weeks. That's not really exact now, is it?

Anywho, about 5 weeks post partum, I started bleeding like a stuck pig. Everytime I stood up, I would fill a huge hospital grade pad. Just like someone in the first 12 hours of a vaginal delivery. Well, I obviously know this isn't right. I drive myself to the ER while hubby is home with the baby girls.

I'm given an u/s and although the tech tells me she can't tell me diddly, she says "yeah, something is still in there." I'm given some meds to try to stop the bleeding (which does decrease it) and I'm sent home with instructions to see my OB first thing in the morning. My OB gives me another u/s and confirms there is "something" still in there. I'm given more of the anti-bleeding meds and scheduled for surgery.

It's supposed to be a quick D&C and while being prepped, the nurses argue with me about taking a pregnancy test. Um, JUST gave birth and haven't had sex since.

Hubby is waiting for the "20 minute" surgery to be complete in the waiting room. 2 1/2 VERY nervous hours later, my doc finally comes out to say there was complications, but I'm in recovery.

IN recovery, I wake up to see my OB there who looks at me and says "Whoa. I almost lost you in there." The "something" ended up being a piece of placenta that grew into my uterus (thank you placenta acretta) and when they went to pull it out, I bled and bled and bled. He goes on to tell me how they tried every option known to medicine to stop the bleeding and he literally had his hand closed on the bleed while they were prepping me for an emergency hystorectomy. They also had blood being delivered due to me losing a bit over 2 liters. (that sucked. I had to stay in recovery for ~hours~ until some blood count was up or something like that).

So, what do I say after learning of all that? Nothing about almost dying. Nothing about almost losing my girlie organs. Nothing about coming close to being told I could no longer have any more children. Instead, I look at him in ~horror~ and say "You had your entire arm up my vagina?"

So yes, I agree with you. Human limbs should ~not~ be able to reach all the way up there.

jenn said...

I am so glad you had such a good appointment! (Sorry I lost that $5- but I wouldn't have ever been able to be the first to remind you!)

I think you are the smllest in this one- it'll be excited to see if you really pop from now on with your weekly 'gain'! Of course- you think running around after 2 beautiful girls could have something to do wih not gaining that much ;o)

Have fun on your trip- I'll be trying to commen & post more... I know I am terrible right now!

Morgan said...

You are absolutely GLOWING in your new belly pic..yay!

Jendeis said...

So glad that the appointment went well. Loving the new belly pic - you look beautiful! Have a wonderful time in Phoenix.

calliope said...

so glad things went well. hope Phoenix is the wonderful for you.

(& you look so effing cute in your new photo!)

Liz said...

That's all great news, Nancy!

Jen said...

I am thrilled to hear that you and the little bub are doing well.

And I am glad I am not the only one who has worries about things going wrong (namely my placenta being in the wrong place)...

But I am still totally jealous of your perfectly shaped belly.

bleu said...

Thanks so very much Nancy, I am so truly moved to tears with your comments.

Have a wonderful trip.

Sara said...

Love the belly pic! You look beautiful. :)

Glad your appt went well. It is so reassuring to see the doc you are most comfy with!

Lisa said...


I am so happy to hear that all went well. And I love your name for your new little man!

Have a great trip!

docgrumbles said...

Glad things look good! Judging from you latest belly shot, I think you look large enough... a nice defined and growing bump.

sara said...

Thanks for explaining all of that in this post - it was cool to read and I felt like I learned a lot. Your OB sounds great, and I hope you have a good trip away. We'll see you when you get back! (I promise I won't get into any trouble in the meantime and I'll stay quiet until you return, LOL!)

Kaci said...

Sounds like things are going well. Your OB sounds like he's on top of things which is great. Love the belly shots - you look great!

Amanda said...

So I'm only almost two weeks late on this post...BUT

Just wanted to say hooray for such a great appointment!!!! I love it when the doc tells you what you want to hear and it's actually the truth!