Thursday, April 19, 2012

12 weeks 5 days ultrasound


Everything is still looking good!

The baby was kicking up a storm and waving its arms around. you could see it opening and closing its hands. it was quite something.

The OB didn't measure the heart rate or size this time - just showed me the baby moving around like crazy and answered my questions. She feels all is going well.

We asked about incompetent cervix. She said that she is not concerned by my history (four D&Cs after miscarriages and a cryosurgery in the 1990s) - that usually the women who have losses due to IC just have it happen out of the blue. "So I won't be considered high risk unless and until I lose this baby?" I asked. And she said, technically, yes. But that she would treat me as though I am high risk for incompetent cervix because she knows I am nervous about it. She said they would start monitoring me for it soon.

She also said that the cramping I'm experiencing is normal: the uterus is expanding. And that if I think I'm feeling cervical pain, I'm not, because the cervix doesn't have pain receptors. I didn't ask about rechecking my progesterone levels with her. I'll go back to my RE and have them draw it or have Will write me a prescription for the blood work tomorrow.

She asked what else I worry about with the pregnancy, and I told her my other concerns were potential cardiac issues (because they are relatively common), P-PROM, and pre-eclampsia (god, she must think I'm nuts). She said cardiac problems are not so common and that they will check everything thoroughly if we can get to 20 weeks (ok, she actually said "when we get to 20 weeks" but I can't bring myself to type it). She said  that in her experience, P-PROM is usually associated with second trimester bleeding, and is unusual and can't be prevented (so no use worrying). And she said that pre-eclampsia, while more common in older women and first-time pregnancies (me! me!), is something they'll be watching me for like a hawk. And she said there is some evidence that the lovenox I'm on may offer some protection against it. (Cool!)

I told her the reproductive immunologist is planning to take me off of the lovenox at 20 weeks, and she said that she will continue me on it (!) until 36 weeks and then switch me to sub-q heparin. I found this funny. I'm sure she would never have put me on it herself because I don't have clear indications I need it, but now that I'm on it, she doesn't want me off of it. That's fine with me.

She also told me that cooked sushi is fine to eat (I'd been wondering if it was safe or if it was a listeria risk). So things like California rolls and shrimp avocado rolls are back on the menu (with gluten-free soy sauce). Yay! I love those things. She said regular sushi should actually be fine too, because in NYC everything is flash frozen before serving, which kills any parasites. But she said I shouldn't eat it anyway, just out of an abundance of caution, given my history (bummer).

The OB shared at the end of the appointment that she was starting her day with me (six miscarriages, now pregnant at end of first trimester) and ending her day with a woman now 38 weeks pregnant after seven miscarriages. That she thought this was a great way to have a clinic day. That good things do happen sometimes. And that she looks forward to me being 38 weeks too.

Here's a picture of the yumster (that's what the OB calls him/her). Pic isn't very good quality, and the amniotic fluid looks really low in this shot, but believe me, this little one was doing the bicycle in there, waving its arms around like a maniac, and generally having a grand time.





Mo

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63 comments:

  1. Yay!!! What a lovely picture.

    (I hate to break it to you, but I'm fairly sure California rolls are made with fake crab, which is not gluten-free).

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  2. Yay! My high-risk OB had me on ASA from day 1 to reduce my risk of pre-e. My autoimmune shenanigans increase my risk. I believe he said blood thinners in general help reduce risk.

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  3. Beautiful beautiful picture!! Yay!

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  4. Loving to see this kind of updates!!!

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  5. Woohoo! I am SO glad you've made it this far and that things are going well.

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  6. alexicographer - I looked it up and you are right! Bummer!!! No California rolls for me! : (

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  7. So happy to read this! And overwhelmed w/joy for the EOD patient, whomever she might be!

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  8. I just love reading your updates...and I love your OB! I hope that you are gradually able enjoy (emphasis on "joy") your pregnancy as time passes....I feel like I hear little bits of it sneaking into your posts...

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  9. Seriously <3 it. I feel like I always say this to you, but it's how I feel after ready every single update post. It makes my hear full. Okay, I'm a bit of sap today. :)

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  10. Yay yay yay Mo! So happy for your continued good progress reports!

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  11. Yay for more good news; hello yumster! (What's your/Will's nickname for the baby?) Only 2 more days until you're in the 2nd trimester-- Pretty wonderful stuff, no? :-D

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  12. Looks like one beautiful and happy baby in there!!!!

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  13. Emily Erin - we don't have one yet...

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  14. I see a nose! Hooray! Good for you, little one. So nice to read this today, Mo.

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  15. Beautiful picture and I'm so glad to know your OB is taking everything so seriously.

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  16. YAH! So happy for you!!! Hugs!!

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  17. @Mo, I know, right?

    Though per this thread:
    http://www.celiac.com/gluten-free/topic/1882-california-rolls/ , if you can find them made with real crab, obviously, and perhaps from some other sources, there exist GF versions.

    I remember partaking of a very scrumptious egg version of a sushi roll that a local restaurant makes when I was pregnant. Maybe that would be an option? Though I cannot swear that I checked it was GF ... may be worth asking if you find such a thing, because who knows?

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  18. Great picture. How exciting to see so much activity.

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  19. Hurrah, hurrah, hurrah!
    Yay for someone who sounds like an EXCELLENT doctor for you right now. So very happy for you, you-almost-in-the-2nd-trimester-pregnant-lady,-you!

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  20. Yay!!! What a beautiful little baby! My OB kept me on Lovenox until 36 weeks as well, then switched me to Heparin at that point, and had me stay on it until a few weeks after the birth of my baby. I'm so excited for you!!

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  21. Absolutely beatiful! Congrats Mo! You made it another week! :)

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  22. Yumster is SO CUTE! Love your OB! I need a new gyno, would love her info. BTW, Sunshine was a maniac in utero, and still is.

    I would be so happy to deliver sushi to you in postpartum. (And hold Yumster while you eat!) xoxo

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  23. Im all smiles reading this! :) I am so happy for you!

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  24. Yay! So glad everything is continuing to go well. You know, the fact that you are now vitamin D replete helps reduce your risk for a LOT of those things you are worried out- preeclampsia and PPROM/abruption (because vitamin D repletion strongly reduces the risk of infection and inflammation).

    Of course, nothing can take it away 100 %, but as you get closer and closer, make sure you are getting regularly checked for bacterial and fungal infections (I have a post on this)- I've quoted a recent clinical trial where they showed that treating women for their fungal infections had a mild effect in reducing the incidence of adverse outcomes.

    After you do all this, you can just sit back knowing you've done all you can, with all the best information and resources of modern medicine. You are in a very good place:)

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  25. Hi Mo,

    I've never commented before but I felt the need to share... With my first pregnancy I developed PIH at 28 weeks and then by 33 weeks, I'd graduated into pre-e and HELPP and delivered our son at 33w1d. He weighed 3lbs 3ozs. Today he's 28 months old and weighs 33lbs. It turned out that I had a clotting factor (Factor V Leiden) which was diagnosed after I developed a DVT post delivery. For my 2nd pregnancy I was on lovenox from 4 weeks until my delivery. My bp stayed around 120/70 the entire pregnancy and I barely had any swelling. I had a scheduled repeat c/s at 39w2d. Additionally I was on low dose aspirin as there is some anecdotal evidence that this helps to prevent pre-e. I went from a 1st pregnancy where anything that could go wrong did to a text book pregnancy albeit high risk. Hang in there and know that I'm cheering for you!

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  26. so glad that everything is moving along smoothly. so much love and luck to you
    xoxo
    -c

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  27. Yay! I love these good reports!

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  28. jay - actually just found out today, i am STILL vitamin D deficient! despite my supplementation. so i'll be upping to a higher dose of D... more in a post soon.

    erika o - thanks for sharing your story and taking the time to comment. i'm so sorry for your loss.

    cgd - so glad to hear from you. i've been thinking about you - lots.

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  29. This makes my day. :) I am so happy for you two! I mean, THREE! :D

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  30. Hello Mo,

    I'm ashamed that I'm just commenting now. I've been reading along for, well years actually, and was SO EXCITED to see your success with this cycle. I'm just so thrilled that after so much pain and loss you finally seem to have your take home baby. I'm just thrilled for you.

    I wanted to finally comment and congratulate you. I hope all continues to go well. My heart bursts with happiness for you and Will.

    With you always on your journey,

    Esperanza

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  31. Mo, your vitamin D requirement goes up bigtime in pregnancy (because the baby uses up crazy amounts), so its very likely that you were replete when you started out with this pregnancy with the dose you were taking, but are deficient now.

    This is why I tell people to keep checking blood levels on not blindly supplement, I only wish I'd taken my own advice :))

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  32. That's a bonafide baby you got in there! :) It's so good to hear things are continuing to go well. I've been following for a long time and couldn't be happier for you!

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  33. Oh, what a beautiful baby picture! And your OB rocks!

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  34. Yay, hooray!

    FWIW, I found heparin to be MUCH more tolerable than lovenox (actually used it for my entire pregnancy with LG), based on needle gauge alone. You should be seen by a hematologist and/or have your platelets monitored, though.

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  35. What a perfect ultrasound! Almost to the second trimester... YAY!

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  36. Hey Mo,

    Following every post and thinking of you constantly. I know we are in very different places and that we don't know each other in person, but I 'heart' your journey as it has been chronicled and I am wishing you all the best!!!

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  37. Awww!! Already so cute! : ) I haven't commented much lately, but I am reading & cheering you on!

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  39. Thinking all sorts of positive thoughts for you, Mo!

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  40. so glad you are staying on the lovenox.
    you're OB is smart... treating with you exactly as you need to be- not as 'this is the way we do it', but as 'this is Mo, and this is what we are doing for her history, her peace of mind, and my peace of mind.'.

    your 12w5d baby looks so sweet... how incredible to be here now! cherish each day, come morning and night... each day is a gift.

    we never really did nicknames. it was either 'the baby', or the name we picked out when we found out the gender. nothing against nicknames, just saying that not everyone does this!

    ticker's saying plum. PLUM?! dang! plumbs are big.

    hope you have a great weekend and thanks for updating.

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  41. I find myself holding my breath each time I read a new post from you, so thank you for putting the happy news at the very top. Second trimester, here you come!

    For what it's worth, I was older than you for my first pregnancy and had no complications whatsoever (aside from GD, but that was really nothing and since you're already on such a controlled and restricted diet I doubt you'll have insulin troubles). Age does not necessarily lead directly to problems.

    Still thrilled for you. Again, congratulations!

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  42. I swear I can see a smile on Yumster's face! Love all of this great news for you guys! Did I miss an update on your mom's reaction?

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  43. Congratulations!! So happy for you!

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  44. Wow, Mo.
    Really, really fabulous:)

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  45. this is so great! I remember providers telling me to relax and just enjoy the first trimester, as if, i had three loses and could not and would not relax. take it one ultrasound at a time. so happy for you!

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  46. Such a fantastic post to read! :D I'm glad she was able to relax some of your fears on a few fronts.

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  47. :Yumster: made me laugh
    and BEAUTIFUL!!!!!!!!

    hot damn, I say, hot damn.

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  48. What a perfect little photo!!! I'm over the moon for you all. That's one beautiful yumster you have there!

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  49. wonderful news!! Congrats and wishing you well in the your 2nd trimester!!!

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  50. So glad everything is going well! CONGRATS on the second trimester...so happy for you!

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  51. So happy to read the good news!! :)

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  52. I'm sure I sound like a broken record...but I'm just SO happy for you and Will. I love seeing your updates...sending you lots of love and ((HUGS))

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  53. You know this makes me really happy, right? SO so pleased.

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  54. So wonderful! Have an awesome weekend!!!!

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  55. Erika O

    Not sure why I blundered and told you sorry for your loss - pregnancy brain is my only excuse. What I mean is, I'm sorry you had such a harrowing journey and am so so glad things turned out ok.

    Mo

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  56. So, so happy for you Mo! I was on Lov.nox until about 20 wks too (for no known blood clot disorder). I'm glad the OB is keeping you on it.

    Praying that things continue to go well for you guys!

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  57. HI, over from ICLW #90

    Congratulations!
    I relate to your nervousness, I'm currently 18 weeks pregnant after the stillbirth of my daughter, Charlotte last year.
    So lots of positive vibes and constant monitoring to us!

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  58. the little cyclist looks fantastic!

    i am a little skeptical about this "cervix has no pain receptors" idea. like, what part of the cervix? my two (yes) both hurt like blazes when they get touched by much of anything, and i certainly experienced what felt very much exactly like stabbing cervix pain during my pregnancy. (i was at high risk for IC, so it freaked me the hell out, but everything turned out just fine, for the record.)

    anyway, if you do know more about that and have any interest in writing about it, i'd be interested to know.

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  59. Just wanted to add a detail about cooked sushi. Most sushi is prepared on the same surface with the same utensils, so keep that in mind if you take that risk.

    Congrats on the Yumster! Super cute name.

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  60. Mo-
    I was never diagnosed with IC however, like you, I did have a procedure (LEAP) in my twenties along with a few D&Cs. My doctor wasn't taking any chances when I got pregnant (IVF). He put a cerclage in at 12 weeks. YES - 12 weeks. His thought was that I had worked hard to get pregnant (and was already 40 trying for my first) and by the time IC is diagnosed, it's often too late. PLEASE trust your gut on this and do what makes you comfortable.
    I am rooting for you over here in CT. I have been reading your blog since I first started trying to get pregnant!

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