31w2d

I am doing my first day of bed rest at home.  It is only ten in the morning, but I am soooo sleepy!  And I am trying to keep some regular nap time from 1-3 pm, so I am struggling to stay awake.  So far my BP has been 128/81, urine negative or trace, I cannot really tell, and the weight at 205 lb.  One whole day to lie here and worry, hurray!

home today

They let me go home because the blood pressure has stabilized below 140/90 and the proteinuria is stable, at the moment almost non existent.  It was +1 and now it is zero.  I know that this disease will come back, but hopefully as the one nurse said to me I can "sneak in the pregnancy" unnoticed.  I don't think anybody believes that I will make it to term, but then again everything is possible and why not let things be.

Wish me luck and I will keep updating.

update from the hospital

Yesterday I did not pee almost at all.  400 ml was all I made in almost 20 h.  So they threatened me with an IV, and I started drinking massive amounts of water, I drank about a litre per hour for three or four hours.  It took a while for things to start working, but they finally did, and towards evening I was putting out a normal amount of urine.  I was so dehydrated from the stress of admission that my sense of thirst had completely gone out the window.

I am doing much better, BP 130/80, has stabilized over the past day or so, and I have not gained any further edema.  The baby looks good, and if tomorrow's ultrasound shows good cord flow, then I might get to go home and continue on bed rest there.  I only have mild proteinuria, and mildly elevated BP, but I do feel that I was starting to turn sour, so it is a good thing that they admitted me and stabilized me.  I am a lot more relaxed when I am in the hospital and taken care of.  I have also had some time to think about my priorities right now:  this pregnancy is the first priority, it has to be.  It is a much more fragile situation than anything else going on, and it is only for a limited further six weeks or so.  Emma is very well looked after by my mother, so I can relax about mothering her right now and focus on myself and the gestation.

I am meditating for about half an hour twice a day, and hopefully that helps to keep the blood pressure down as well.  I don't get up that much, just for bathroom, and for about one hour per day total with walking to the water cooler, and stretching my legs.  I plan on continuing that as much as I can at home.

Every day that we gain is a bonus, but I feel that we will make it for a whole other week.  I have a good feeling about it.

I landed up in hospital

This was quite an eventful time for me.  I saw the OB on Wednesday, and my weight had increased 9 lb, blood pressure 140/92, no proteinuria.  I then went back to see him again on Friday, and I had gained a further 8 lb, with same BP readings, but +1 protein.  He sent me straight to the hospital for admission, and here I am, an inpatient again, sooner than I had expected.

The labs showed that my platelets decreased slightly from 164 to 146, and the uric acid went up from 345 to 370.  No protein was present on the urine PCR (yeah, they have urine PCR here, fancy stuff).  I am now doing a 24 hour urine to confirm, but the dipstick upon admission was also negative, so I am thinking that the OB's receptionist over interpreted it or something.

The BP in hospital ranged from 158/89 (when I just got into my room) to 135/90 most often.  I think that they will start me on labetalol.  The baby looks great, the NST was fabulous, and I am getting an ultrasound on Monday.  I did freak them out though because they gave me steroids, and I am now so full of beans that I am typing at 100 words per minute!!!  Mind you, I have only slept for three hours last night, so I am pretty sure I am typing nonsense.

I miss Emma so much...  My mom is bringing her tonight, and we talked about bringing her every evening for 1-2 hours.  I am going to read to her, and maybe draw/colour if mom brings some books. I got to sing her good night songs over the phone and she fell asleep, it was so sweet!  I don't think she can tolerate more than a relatively brief visit daily, she needs to be outside in fresh air, playing with the dog, not in a hospital room with me.  And seeing me every day should give her (and me) reassurance that we are alright.  Last night, when it was time to leave, she started pulling on my hand and saying "mommy let's go, let's go with the grey car to bua's house (bua is the name she gave my mom)".   I cried a bit thinking about this, how eager she was to direct me home with her... but I remembered that I am here in a big part to protect her from losing her mother.

I was going to fight this admission somewhat, because I saw no reason to manage me as an outpatient, except that of course with the labs being somewhat worse, I guess that I would have been wrong.  I need to be here for now, until we figure out what is going on.  HELLP kills, I am well aware of that, and I am fortunate enough to be under surveillance.

The care that I am getting here is excellent.  The OB's are taking things seriously, I am frequently monitored, and there is a tertiary NICU available if I should deliver right in the hospital.  I am in the best place possible.  Not to mention that they have free wireless internet :)

Will update when I have something new to say.  If you are so inclined, pray for me and for the baby.  Thank you!

30w3d update, Hypertension

My blood pressure was a lot higher today at the OB's office, 135/96 once, and 130/90 the second time.  Enough to buy me a blood test and a warning that I'd better rest in bed for the rest of the gestation.  It's not like I am a model of activity anyway, but it looks like I have to adopt the sick position for the next six weeks, if indeed I make it that far.  It would not be the first time, I say.

I have no proteinuria, and my bloodwork turned out fine (here in Vancouver you can find out the results at the same time as your doctor by checking online).  The swelling however is really noticeable, and I have gone up 9 lb in two weeks, which is about 7 lb more than usual so far.  I am seeing the OB again on Friday, and I am guessing that if the BP does not come down, I am going to end up on meds and with three times a week visits to the hospital for non stress tests.

In the meantime, I am trying to finish knitting a blanket made of white alpaca wool that I have started during Emma's gestation but only got to halfway.  Perhaps this baby will get to enjoy it.  Emma just came by as I was typing just now and pulled out one of the needles (losing about fifty stitches) and exclaiming "big crayon"!  Gotta love her.

swelling, swelling

Whoa, I have gained 6 lb this week, and yes, I am aware that the week is not even over yet.  In four days, I should specify, my weight has gone up by 6 lb.  I am now 200 lb, the weight I was aiming for at delivery.

I am very sure that it is all fluid.  I track my calories religiously on myfitnesspal and I have not gone over 2300 calories, in fact I have stayed around 1800 calories on most days, except on the days when I swim half an hour, then I add an extra 200-300 calories if I am very hungry.  Also, my carb intake is around 45%, which is very decent.

Today I woke up with my fingers the size of sausages.  I cannot make a fist at all.  I have not looked at my feet yet, but I can thankfully open my eyes, though I am puffy.  This weekend I am supposed to have my beautiful maternity photographs done, sigh...Hopefully she is decent with photoshop.

I have noticed that being in the water helps a lot, and I take Emma to the pool for two hours at a time, as well as swim for half an hour a few times a week.  I only do about 800 m front crawl, and have been planning to slowly increase by 50m per week until I reach 1 km, then perhaps stay there for the duration of the pregnancy. I really need to spend as much time as possible in the water, something about the hydrostatic pressure (and lack of gravity?) is very helpful with this swelling.  I now recall why I was such an avid swimmer during my last pregnancy :), then I had the time to do 1.5 to 2 km in a leisurely fashion almost every day.

My BP is still good, 110/84 or so.  I have an old dipstick and did a urine protein, but not having the box anymore I cannot really tell what the colour should be, I just watched the square that I know corresponds to the protein to see if there are any big changes.  There were no big changes, so I am not thinking that I am spilling massive amounts of protein.

Don't know what is happening with the fluid retention, but I am really hoping it will stabilize.  As it is, I am heading towards 210 lb at delivery if I don't gain any more fluid.  A lot more than I was hoping for, but so be it.  Healthy baby boy at the end, fingers crossed.

29 week update

I really need to post more often.  Too many things happen within one week to really be able to write about in just one post.  First of all, I got a call last week from the OB's office to go and repeat partially the ultrasound because they saw "some abnormality" on the fetal spine.  Gulp!  I called the receptionist back and made her read to me the ultrasound, she did not know where to start, but I realized it was a skin structure, probably a skin tag, that worried them.  I then went to see the OB as I had a scheduled appointment the next day anyway, and read the report myself, which said that on one of the views the skin tag looked like it was there, at the base of the spine, but on the other views it was not, so most likely it could be artefact (in other words, not real).  I was a bit stressed at that appointment, and my blood pressure was higher than normal, 110/85.  He repeated it a few times, and the diastolic (second number) stayed highish, at 85.  My prior BP measurements showed a diastolic of 70-75.  This is definitely not good news.

I have repeated my BP during the week with my home monitor, and it is around 79-88, most often around 82-84 during the day, and lower if I rest, especially lying down.  If it reaches 90 or over consistently I will have to be on medication.  I did not have proteinuria, and what makes this whole thing so bizarre is that this is my second pregnancy with the same partner, hence the risk of developing a hypertensive disorder is very low in general.  Apparently beware, when something rare can happen, it will happen to me.

I had the followup ultrasound today, and the neuro radiologist herself scanned me and showed me the whole spine.  There is no skin tag, no tethering, nothing to note other than a very normal looking baby. She did say that the anterior uterine wall looked very thin, but not in the lower segment, rather in the uterine body.  My prior tear due to the cerclage and the c section cut are both in the lower segment, and that is where the weak spot of the uterus is if anything should happen.  Hopefully there will never be any labour and hence no opportunity for a catastrophe like a uterine tear.

I am worried, of course, because I am now in the third trimester, and things can go more wrong around now.  I am worried about the blood pressure increase and the swelling of my hands and face that I woke up with today (swelling likely due to too much salt on Sunday at church lunch).  I am also worried about the uterine integrity and prior injury and hence relative weakness.  But despite this worry, I am also preparing for a baby.

I am getting my maternity photo session done this weekend, and also the baby shower is this weekend. I am so excited about seeing newborn cute clothes and having a newborn glued to me again.  It will be blissful.