Worst IVIG yet...treatment #5

Yesterday afternoon, I had IVIG infusion #5. I had really hoped that IVIG infusion #4, sucky as it was, would be the last, but my reproductive immunologist's blood work showed a spike in my TH1:TH2 levels...not just a little jump, but a good sized one, so I reluctantly opted for another treatment. I did refuse, after how dreadful the last infusion was, to do it in the office again. He must have heard in advance from the nurse that there was no way I would agree to that again, so he relented and let me have the treatment at home with a private nurse (I have to pay for her time if it's in the office too, so this was not an added expense).

If done at the usual speed, it's a four hour infusion. I usually feel "okayish" for the first half hour or so and then get clammy and cold and pale, then get a low-grade fever, which starts to lower by the time the infusion completes. They dose me up with two tylenol and two benadryl ahead of time, so I'm a bit groggy.

This time, I actually felt pretty good at first and opted to sit up on the couch and read for a bit...then all the sudden, I thought I should probably lie down. By the time the nurse got me into bed with the IV hung up, I was shaking violently. I couldn't tell if I was having chills or just tremors of some sort. It was a bit wild. I also felt very short of breath and was kind of panting. She wanted to turn off the infusion, and I wanted her to keep going (so we could finish and she could leave). We ended up turning it off until the shaking reduced some and then continuing. I spiked the usual 101 degree fever, but then was able to sleep through a couple of hours of it, which helped a lot.

So one more infusion behind me. But yuck!

The whole time I was shaking and feverish, I was worried about Ms. Magpie. If *I* was having this reaction, how was she doing? Was this hurting her in any way? She was very quiet last night and into this morning, which had me worried, but by mid-day today she was her usual kicky and squirmy self (much to my relief).

My reproductive immunologist is making noises about me continuing this treatment until I reach 34 weeks.

God, I hope not. Of course I would do anything to make this pregnancy a success. I just wish I believed in this treatment a bit more (at all?).

Mo

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Oh my! You're carrying so small! or...Not!

Two amusing exchanges in the past seven days:

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I am at the pharmacy to pick up a prescription for Will. The pharmacist asks, "Are you having a boy or a girl?"

Girl, I say.

"Oh, that's what I thought! Because you're carrying so small!"

(Puzzled look from me...since she's never seen me before).

"How far along are you? [...pause...] Seven months?"

Chuckle from me. Six, I tell her (and really, I'm just at the beginning of six).

"Oh!"

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I get into a taxi cab on my way to work (I am strongly supporting the taxi industry these days).

"I don't mean to be rude, ma'am, but are you pregnant?"

Yes.

Much information and excitement about this gentleman's eight grandchildren....the youngest of whom is three months.

"When are you due? [...pause...] Next month?"

October. (and really, the end of October).

Much excitement and talk ensues from taxi driver about pumpkins, which is perhaps what it looks like I am carrying.

-----

I will post a picture soon so you can draw your own conclusions about my potential hugeness.


Mo

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Viability?

We are 24 weeks, 0 days today. And I believe, if I understood my OB correctly, that today is the first day they would try to intervene if the baby made an early appearance.

I have no desires for her to come anytime soon, but it feels like a big milestone that they would even try to save her life at this point. I feel her moving around a lot these days and sometimes you can see her bulging through my stomach, like she's doing a dance in there or something. She is so obviously alive. And I am so definitely falling in love with her, that it helps to know that if she came now they wouldn't just say "Sorry," but would actually at least try to save her if she came.

It would be a very dire situation, as evidenced by this chart I found through the March of Dimes:

Length of Pregnancy	Likelihood of Survival
23 weeks	17%
24 weeks	39%
25 weeks	50%
26 weeks	80%
27 weeks	90%
28-31 weeks	90-95%
32-33 weeks	95%
34+ weeks	Almost as likely as a full-term baby
Sources: March of Dimes, Quint Boenker Preemie Survival Foundation

But still. There would be a chance. I have a section on my blog roll now linking to preemie blogs and there are a few folks with live babies born in the under 25 weeks gestation category. It's not an exhaustive list but lists some of my current favorites.

So, Ms. Magpie, if you came - please know we would now be able to try to save you! But please, please just stay in there. Stay healthy. Stay in there. We've got about three months to go, you and I. I want to meet you, but not until then!!

Mo

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"The next month is the most important of this pregnancy"

I saw my OB this morning - 23 weeks and 5 days - just shy of viability, which at my hospital is 24 weeks.

All is looking good. Blood pressure was fine 117/70, baby was heard promptly on the doppler (but I knew she was fine as she was kicking away all morning), cervix measured posterior, long and closed.

The OB told me that the next four weeks are the most important of the whole pregnancy. That it is critical to avoid preterm labor during the next month. She advised me to take special care of myself: watch the heat and try to stay out of it and that I need to take extra precautions to stay hydrated (2 liters of water daily with an extra liter with electrolytes if I'm going to be outside). If I'm not careful, she said I may experience contractions, which while she doubts will lead to full blown labor, will likely lead me to have lots of anxiety and necessitate extra monitoring.

So better safe than sorry. I will be very cautious.

Funny to hear that this four weeks is the most critical. Honestly, every week up to this point has felt so important and tenuous. And I am holding my breath a bit until Saturday, which is the first day they would try to save the life of this little girl if she did appear early.

So we are a few days from viability - unimaginable! And a month from hoping that this baby could be born without major complications.

One day at a time. Here we go...

Mo


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Home again, home again

  

Pahoehoe lava meets the ocean. View from helicopter 

We are back from our vacation! We had a very good time - and we are still pregnant (phew!).

The Big Island of Hawaii was beautiful and we had a very relaxing and stimulating vacation. Lots of exercise, which was good for me and made me want to try to fit in more regular exercise in my daily/weekly schedule. We snorkeled several times, which is something we love, and saw beautiful coral (some of the best I've seen anywhere), lots of turtles, and many fish.

Tide pools 

The second part of our trip we went to the other side of the island and stayed in a small cottage in the rainforest near the volcano.

The volcano crater was pretty amazing at night - glowing orange and beautiful. The beaches on this side of the island were beautiful - dark black sand and many swimmable tide pools filled with fish and coral. The hardened black lava that flows down to the beach was incredible as well - beautiful undulating black. We briefly considered a hike out on this old lava to see the fresh flowing lava, but ruled it out as too strenuous for me while pregnant. Maybe next time.

Kilauea crater after dark

Will did manage to talk me into a helicopter ride to see the volcano area and red flowing lava. I was pretty scared (I am not a fan of small aircraft), but it was beautiful.

"What have I gotten myself into?"

Throughout our trip, the little one obliged me by being very squirmy and kicky. I could feel her a few times a day, which would stop me no matter where I was or what I was doing and make me smile. I kept wondering if she could tell when I was swimming, if my being in water made things more weightless for her in any way. Probably. Throughout the trip, I was super grateful for all of her movement. I only used the doppler once when I became worried because I hadn't felt her in a bit and decided not to wait it out. She was right there and doing just fine.

The only rough part of the trip was the getting there and back. This was much tougher than anticipated. We flew out of JFK airport, which unfortunately was evacuated as we were waiting for our flight. So we had to leave the airport lounge and go outside and then with thousands of other people make our way back through security. This took hours, of course, and meant we missed our connection tin San Francisco. Then, when we arrived in San Francisco, there was a mechanical failure on the next aircraft that took several hours to try to fix, and then hours to get another plane when the first plane was deemed unfixable. All in all, getting to Hawaii door to door took approximately 24 hours. I was swollen and hurting pretty badly by that time. Getting home was simple - flights all on time, no delays. Still tough and pretty uncomfortable but not as bad. I think I underestimated though how much pregnancy impacts my stamina and comfort. And I think I struggled more (and am still struggling!) with the jet lag as a pregnant person than I would normally. 

Mo's feet at 22.5 weeks

So, all in all it was a lovely trip! It felt like we really got away and were able to enjoy each others' company in an idyllic setting. If only there were a way to teleport to Hawaii instead of fly!

Mo


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