Second Trimester Pregnancy Symptoms

As I've said before, I've been extremely fortunate to have had a relatively easy pregnancy up until this point. But that doesn't mean it's all been smooth sailing! Since I don't want to forget a moment of my pregnancy, good or bad, here's a list of the symptoms I've been experiencing lately:

Trouble sleeping: After sleeping really well during the first trimester (probably due to all the progesterone I was taking), my sleep has become a lot lighter, more restless, and more fragmented. Sometimes I wake up (usually because I have to pee) and then can't fall back asleep. This can happen at 2, 3, 4, or 5 am. I'll lie awake for hours, tossing and turning, trying to find a comfortable position (recently I've begun sleeping with a pillow between my knees, and this does seem to help). Usually I'll get up to eat once I start to get hungry. Sometimes I can fall asleep again after eating something and lying in bed reading.

Fatigue: I think this is mainly related to sleep-deprivation. On those days when I haven't had a good night's sleep, I hardly have any energy, and spend most of the day on the couch reading or watching tv/movies on my laptop.

Decreased stamina: Normally I can push my body pretty far, but now I find that I get tired a lot more easily. I can't work out as long or as hard as before I was pregnant. I am really trying to listen to my body now and rest when I feel like I've had enough.

Crazy, vivid dreams: Sometimes they're disturbing, sometimes weird. Recently I had another dream that I was having a baby boy. What's up with that? I'll know soon enough if it's prophetic :)

Frequent urination: I thought this had improved a bit as I entered the second trimester, but now it's getting worse again. In the first trimester I would wake up to pee, stumble to the bathroom half asleep, and then stumble back to bed and immediately return to slumber land. Now that my sleep is lighter, I'm more likely to stay awake after getting up to pee in the middle of the night. I've been trying to limit fluid intake after 6pm, which sometimes seems to work and sometimes doesn't. Sometimes I get really thirsty after dinner, especially if I had a high-sodium meal, and can't help drinking a lot of water.

Skin problems: This includes acne, dry, itchy red, irritated skin, spider veins, and breaking out in a heat rash (at least I think that's what it is) after walking outside in the heat. Basically my already sensitive skin is even more wacko than usual.

Skin pigmentation: Fortunately I haven't developed melasma/chloasma (I am hyper-vigilant about avoiding the sun, and wear sunscreen and a wide-brimmed hat when I am outside), however I do have a faint linea nigra, and my areola have become a lot darker and larger than they were before.

Sore nipples: Although my breasts aren't sore anymore, my nipples become extremely hard, sore, and painful when they're cold, especially after taking a shower. In the first trimester, they would burn really painfully when this happened, and it took a while for them to return to normal. Now the pain isn't quite so intense or long lasting, but I still have to remember to quickly put on some clothes as soon as I hop out of the shower and to always bring a sweatshirt or something warm when we're inside in case the air conditioning is too strong.

Increased hunger and thirst: This is to be expected of course. I'm especially hungry when I don't get enough sleep. When I'm sleep deprived I swear I get hungry almost every hour, and yet at the same time, I feel kind of full and slightly nauseated like I don't want to eat anything. I try to eat small frequent meals and snacks to keep my blood sugar stable, and it seems to help. It's funny but sometimes the same food tastes really good to me, better than it ever did before I was pregnant, and other times, it kind of repulses me.

Increased gas and stomach ache: Sometimes the gas pains were so bad in the first trimester that I would spend the whole day in bed, drinking peppermint tea, chewing gas-x tablets, and in general trying anything to make the pain go away. This has improved quite a bit as I've progressed into the second trimester, but it can still be an issue.

Occasional burping/heart burn: I wouldn't even mention this since it happens so rarely, except that it's unusual for me to experience it at all. Fortunately the heart burn lasts for only a second when it does happen, which is almost never.

Loose stool: I would much rather have this problem than the opposite one of constipation!

Occasional pains/twinges in lower abdomen: I have definitely experienced the infamous round ligament pain, especially when I cough or change position abruptly. In general I just feel more aware of my uterus, of its weight, and of a faint, almost crampy feeling sometimes.

Dry eyes: They feel especially dry and irritated when I wake up in the morning. I've completely given up wearing contacts. My vision also seems slightly blurrier. Supposedly it should return to normal soon after I give birth

Feeling more emotional: I get teary a lot more easily, especially when watching/reading about something that involves children. I am usually not the type who cries easily (except when I have PMS), so this is definitely new to me!

Increased stupidity/forgetfulness: My memory (which is normally pretty good) is definitely a lot worse. Basically I am just a space cadet these days! I've done some pretty stupid things, like forgetting to lock the car in a parking lot and even worse, leaving the keys in the car so anyone could have stolen it--thankfully that didn't happen!

Well, I'm probably forgetting something (see last symptom listed above!), but that's all I can think of for now. Overall I feel great and am so happy and grateful to be able to have this amazing experience of carrying my own child. Thinking of Ziggy, feeling him/her moving inside me, listening to his/her heart beat, and best of all, imagining what this little person will be like and who they will become makes every little discomfort so worth it.

No More Progesterone

Just wanted to share the highlight of my day so far. Dr. W's nurse called to say I should stop the progesterone suppositories since my level is so high (well above 90). So that's it, I'm done! And I just ran out yesterday and was about to go to the pharmacy to pick up the refill when she called, so the timing was perfect. I'm stopping one week earlier than Dr. M would have liked, but given my high numbers, this seems like the right course of action. Yay to no more leakage and having to change my underwear several times a day (sorry if TMI)!

Week 13: Pregnancy Quiz

So I finally caved and decided to do that pregnancy quiz I keep seeing floating around cyberspace. I think it would be a little repetitive to do it every week, but since this week marks the end of the first trimester, it seemed like a good time to do it.

How far along? 13 weeks
Total weight gain/loss: Don't actually know since I haven't been weighing myself, but I'm definitely gaining weight (will post belly pic soon).
Maternity clothes? No, not yet, but I have started wearing some of my larger/looser/more comfortable clothes. Will probably need to buy some maternity clothes soon though.
Stretch marks? None more than usual :)
Sleep: Somewhat restless, especially toward morning. Have lots of vivid dreams. Get up to pee a lot. The worst is when I wake up at 2 or 3 and can't fall back asleep :(

Best moment this week: Finding out that my progesterone is above 90!
Movement: I know Ziggy is bouncing around in there because I saw it on the last ultrasound, but unfortunately I can't feel it just yet.
Food cravings: Ok, these are all the cravings I've had since the beginning of my pregnancy: angel hair pasta with peas and parmesan cheese, smoothies, milk, hummus, avocado, cheese, cream of wheat with strawberries (used to eat it as a kid), toasted oats cereal (like cheerios) with milk and banana, mac and cheese, pizza, english muffin with fried egg, scrambled eggs...I'm sure I'm forgetting something.

Gender: I don't get how people can know one way or the other, aside from just guessing. My mother says boy since I had such mild morning sickness. I really have no idea, although I would be totally happy either way.
Labor Signs: No, hopefully not for a while.
Belly Button in or out? In
What I miss: Not much really. I guess I miss not having perpetually bad skin! And not being constantly gassy :P And not waking up to pee several times each night.
What I am looking forward to: Stopping the progesterone suppositories, getting my doppler fetal heart rate monitor in the mail so I can listen to Ziggy's heartbeat whenever I want to, feeling Ziggy move, seeing Ziggy on the next ultrasound with AC, finding out the sex, Mother's Day (yay!)
Weekly Wisdom: Don't rush the pregnancy

Milestones: This week is the dividing line between the first and second trimesters!

Week 11: In which I make the Acquantaince of Dr. W

A week ago today I had my first appointment with Dr. W, who seems really nice, knowledgeable, and pretty flexible. Even though he didn't agree that I needed to continue the progesterone suppositories and shots until 14 weeks (he says he usually discontinues progesterone supplementation at 10 weeks for his patients), he said I should continue whatever plan Dr. M laid out for me, since he was successful at getting and keeping me pregnant, and we don't want to mess with that. He also didn't agree with me being on Armour Thyroid, but again deferred to Dr. M on that. He did want to measure my level of TSH though, and when it came back low the next day, I was told to halve my dose from 90 mg to 45. I wonder what Dr. M would have to say about that! I'm sure he wouldn't be pleased, but at least they're letting me stay on the Armour Thyroid at all. I always felt like the dose was maybe a little high; plus, my plan is to taper the dose and get off the medication altogether by the time I give birth so I can safely breastfeed.

Hmmm, so what else happened at the visit? I urinated in a cup (not sure what they were measuring there), had my weight taken (up 4 lbs since the last time I was weighed at a doctor's office in November--I don't weight myself at home), had blood drawn, talked to Dr. W and his nurse about my Kartagener's Syndrome (they've actually had a patient like me before, and seem to know what it entails), and best of all, had an ultrasound. This was my first abdominal ultrasound, which was so much more comfortable than the vaginal ones. As soon as the ultrasound started, I saw little Ziggy jumping and bouncing around in my uterus! It was amazing! I didn't realize s/he was already moving so much--I wish I could feel it, but I guess that wont happen for a few more weeks at the earliest. I found the experience of seeing Ziggy moving a lot more powerful and emotional even than hearing the heart beat--it kind of hit me even harder that I really do have a baby inside me that's growing every day.

Anyway, Dr. W said it's a "beautiful baby," which I guess means everything looks good and is where it should be at this stage. He also said there's no sign of bleeding, so I guess it must have reabsorbed! Yay!!! He measured Ziggy three times to try to get a week 11 measurement (since I was exactly 11 weeks at the time), but kept coming up with 10w6d. So Ziggy was measuring a day behind, but Dr. W said it's not a big deal. Even so, I have been worrying about it a little and trying to make sure I eat every few hours. I read in one of my pregnancy books that babies get better nutrition and grow better when you eat frequently, rather than eating a few large meals a day. Plus, I find that I get hungry every few hours, so it seems to be working out.

Dr. W said I should return in 5 weeks when I'm 16 weeks, at which point we'll discuss doing a blood screen for chromosomal abnormalities, so my next appointment is on May 21. I really hope AC can make it, so he can see Ziggy dancing around too! I wanted him to be the there this time, but unfortunately he had a simulator :(

Before I end this post, I also want to update on the progesterone in oil situation. After stressing the whole weekend that I was going to miscarry because my progesterone would drop too low, on Monday I called to ask if they could measure my progesterone just to make sure the level wasn't dropping too low with me just being on the suppositories. The nurse told me that Dr. W didn't see the point in doing the blood test--basically what would we change if the numbers were low? I said I would go back on the shots if absolutely necessary. I also said that Dr. M had wanted my level measured a week after I stopped both forms of progesterone at week 14. She asked what the point of this was, and I told her that he would want me to continue the progesterone for the remainder of the pregnancy if my levels were below 20. This surprised her. She said they didn't have any patients on progesterone for the whole pregnancy, and that in general they no longer do progesterone monitoring since it had not proved clinically useful. She did say that Dr. W was willing to order the test for my peace of mind.

So I'm going in on Monday to have blood drawn, and they should have the results for me on Tuesday. I really hope my progesterone is at a decent level. I wonder if I can convince them to test me again at my next appointment after I discontinue the suppositories in two weeks. They probably already think I'm a difficult patient, but I don't care--better to be difficult than lose a baby, right? I tried to impress on his nurse how different it was to go from an infertility clinic, where you're seen every week and closely monitored, to a regular OB, where you're seen every 4-5 weeks, and they seem to take a much more blase attitude toward things. I also told her several times that the reason I was so insistent on careful monitoring is that if for some reason I lose this baby, I can't just get pregnant on my own in a few months like another women might. I'll have to do IVF all over again (well, fortunately the frozen embryos will make it easier), but it will still involve going back to NY and going through almost everything again. She seemed somewhat sympathetic, but I still got the sense that they view me as a drama queen or something.

Anyway, to end on a positive note, here are the week 12 sonogram pictures of Ziggy:

The Horror of Progesterone in Oil Injections

I've barely been able to walk for the past couple of days. Sitting down takes me about twice as long as it should, with me gingerly easing myself down onto the seat like an old lady (no offense to old ladies, of course, but at the age of 27, I don't really want to be moving like one!). Even lying down is painful, as I try to avoid the most tender spots on my backside, gently flipping from one side to the other to try to find any position that's remotely bearable.

So what exactly has gotten me in to such a pathetic state? It's those dang progesterone in oil shots that Andy has been injecting into my buttocks each evening. They have never been that pleasant, but at least in the beginning they were tolerable. At worse I would develop painful lumps on my butt, which are apparently either pockets of oil or scar tissue. But these past couple of weeks, the shots were getting increasingly uncomfortable with more blood, and it finally got to the point where my entire butt had become so swollen, painful, and slightly numb that I felt temporarily crippled.

Even though Dr. M wanted me to continue both the progesterone shots and suppositories until week 14, I couldn't stand it anymore, and when the nurse from my new doctor's office (Dr. W, who seems great, by the way--I'll post more about him and my first appointment later) called to report on my lab work, I begged her to let me stop the shots and just continue with the suppositories. She said she'd have to consult with someone on that and call me back. Thankfully, when she called, it was with good news--I could discontinue the shots!

My first reaction was relief, but then, being the obsessive worrier that I am, I started to wonder if maybe Dr. M had a good reason for keeping me on both forms of progesterone until week 14, and that maybe I was somehow putting myself at risk of miscarriage by stopping the shots so abruptly. From what I read online, the placenta takes over production of progesterone at about 10 weeks, and most doctors stop progesterone supplementation between 10-12 weeks (I'm 11.5 weeks now, so I fall safely into that range). Some stop it as early as 8, while others go for as long as 14. From my online research, it seems that a lot of women feel nervous about discontinuing the progesterone, and some continue to take it even after their doctor tells them to stop, often slowly tapering the dosage over several weeks. No one had lost a baby from coming off progesterone too soon, which was a relief. I started to calm down a bit, reasoning that I was still going to be on the suppositories until week 14.

But after going for one day without the shot, I started to feel panicky again and, can you believe it, voluntarily gave myself another shot, just to be safe! How crazy am I! I even had to stab myself twice because not all of the oil would go in the first time. AC had already told me the previous day that since I'd been given the okay to stop, he was done, he wasn't going to administer any more shots. Well, I can tell you, that is absolutely the last shot I am doing! After another day of hobbling around in horrible pain, I am done.

So, goodbye progesterone in oil! We'll probably meet again at some point (like when I have my next child), but that wont be for another few years, and hopefully by then my butt will have fully recovered from your pernicious attack!

Sick and Tired

Yesterday I had another scare at Dr. M's right before I was supposed to go for my ultrasound. I went to the bathroom to empty my bladder and some stuff fell out into the toilet. I wont go into the gross details of what it looked like, but suffice it to say that I thought this was it, the end, my baby was gone. I was unbelievably relieved when the ultrasound showed the baby completely healthy, heart beating away! It has started to separate from the yolk sac, and the sonographer said the umbilical cord will start forming this week. She said that the stuff that came out was a blood clot from the bleeding I had and probably some mucous as well. Dr. M said I should continue to take it easy but not be too concerned if I experience any more bleeding and only to call if the bleeding/cramping is worse or different than what I've experienced.

So I return in a week (Friday) for another ultrasound and blood test. It will be hard to wait a whole week to see my sweet little baby again. I'm just so scared that something will happen to Ziggy this week. Fortunately my bleeding has stopped, I have very little pain in my abdomen, and my progesterone is 38.4, so things are looking good. Unfortunately I seem to be getting sick; last night I was coughing more than usual and feeling especially tired and weak, and when I took my temperature, it was 100. After a rough night of shivering, sweating, coughing, and feeling in general sick, my temperature was 101.6 this morning. I don't know if I should take some Tylenol or just wait it out. From what I've read, it seems that a fever of 102 and above could possibly harm the baby. I guess I should probably call Dr. M's office just to be sure. Anyway, it seems like today will be a low-key day with lots of rest and fluids.

Week 7 Scare

On Tuesday I finally got to see Ziggy on the ultrasound! S/he look like a small bean curled around the round yolk sac. S/he's only 7.5 mm long, but already has a heart beat of 156 bpm! I could actually see the flickering/pulsing of the heart. My progesterone was measured at 37.7, so it's still increasing slightly. Dr. M said everything looked great and that I could stop taking the estrogen patches but should continue with the baby aspirin for another week. He also said that after seeing a good strong heartbeat, the miscarriage rate drops from 35% to just 5%. In another two weeks, it will drop to just 3%.

So I was really surprised and shocked when the next day things took a turn for the worse. I started to have some cramping really low in my belly. I also had pain that felt like hemorrhoid pain, so I thought maybe my hemorrhoid was acting up. Suddenly I felt some fluid gush out of my vagina, and when I looked in my underwear, I saw bright red blood! This completely freaked me out so I immediately called the nurses at Dr. M's office, who told me to come in immediately. Luckily my dad was staying with me in CT, so he could drive me into the city. The drive was excruciating! It helped to talk to AC, but I was still terrified the entire way there, imagining that I was miscarrying and that there wouldn't be any baby on the ultrasound this time.

The office was completely empty when I got there, which was a little eeire. They actually had to call the sonographer to come back because she'd already left for the day. She asked me what happened and then did the ultrasound, which to my immense relief showed little Ziggy and the heartbeat still there completely unharmed. She did find two small spots of bleeding in my uterus that fortunately were not close to the baby, and she said that this is relatively common in the first trimester. She did say it's possible I'll have some bleeding/spotting for the remainder of the first trimester. Dr. M came in looking very concerned and seemed greatly relieved to learn that the baby was fine. He said I should discontinue the baby aspirin. The sonographer told me to take it easy and rest with my feet up if I experienced any more cramping. I return tomorrow morning just to make sure everything is still ok.

Before I left the sonographer told me the baby is measuring at 6w4d and the due date is estimated to be November 7th, although yesterday I was really 6w6d (based on when fertilization took place). I was too overwhelmed by what had happened to ask what that meant, but maybe tomorrow I'll find out. I was planning on doing a week 7 post today, but now I'm not sure I really am at week 7. Anyway, I am still somewhat shaken by what happened. I dread going to the bathroom and seeing blood, and evey little pain or twinge in my abdomen makes me feel panicky. I can't wait till tomorrow to see that the baby is still ok. If they let me, I would probably go in everyday for an ultrasound! I know I need to relax and rest and just hope for the best. From what I've read, there's not much one can do to prevent a miscarriage, so there's really no need for me to obsess (although it's hard not to). I'm already doing everything I possibly can for the baby--taking my progesterone suppositiories three times a day, injecting myself with progesterone in oil every night, trying to stay off my feet and rest as much as possible--so I guess I should just calm down (easier said than done of course). I'll be back tomorrow with a (hopefullly) positive update.

PS: I've added week 7 ultrasound pics below.

More Good News

The cast is off! But more importantly the blood work today showed my progesterone level at 33.3 and my hCG at 6933! And best of all, I got to see the yolk sac on the ultrasound. It didn't look like much (just a black oval), but it was exactly where it's supposed to be in my uterus. Because of my increased risk of ectopic pregnancy (due to my PCD), Dr. M placed the embryo low in my uterus when he did the transfer so it wouldn't float back into the tubes. And it worked! Little Ziggy (that's what AC wants to call the baby until we know the gender :) is right where s/he's supposed to be! I return next Tuesday when we should be able to see the baby and hear the heartbeat! Dr. M says he'll release me in 3 weeks, maybe even sooner if everything looks good. The sonographer was surprised that my ovaries had already returned to their normal size, but I guess they bounced back fast because I didn't hyper-stimulate at all.

Even though originally I had planned on staying on the East Coast during the pregnancy because of the highly recommended MFM in New Haven, AC and I have decided that it's just too hard to be apart for so long, especially when I'm pregnant. So the new plan is for me join AC in Little Rock once Dr. M releases me and be followed by an MFM there. I've already started looking into some doctors there. Since AC's training has been delayed so much due to his eye, it looks like he'll be in Little Rock until July or August. Most likely I'll go with him to Albuquerque as well, where I'll deliver the baby in early November.

As for AC's eye, it's been acting up again (basically he's been on medical leave for over a month now), but at least the military doctors finally started to take it seriously and referred him to a corneal specialist. He's having eye surgery on Thursday and will be in pain (the same severity as when he first injured his eye) for about 5 days. At least he'll be given prescription pain killers. I wish I could be there to take care of him but Dr. M said definitely no flying until we see a good strong heartbeat.

Anyway, that's all the news for now. It's hard to believe I'm almost 6 weeks pregnant! Crazy!

Happy Update

Wonderful news! The blood test on Wednesday measured my Beta hCG at 1100 and my progesterone at 14! So it looks like I am out of the danger zone for now--phew, what a relief! Dr. M wants to see my progesterone go even higher so I started progesterone in oil shots on Thursday. They have to be injected into my gluteal muscle, which hurts a bit, but it's all worth it for baby :) While AC is here, he can administer the injections, but I'll have to do them myself once he leaves on Monday (that may be a bit tricky, especially with one arm in a cast!). My next appointment for both blood work and ultrasound is on Tuesday. I also get my cast off on that day. Yay! I also just wanted to mention that I am 5 weeks pregnant as of Thursday! Hard to believe, huh?! I will post pictures of my 5 week belly when I get a chance later this week. My plan is to take pictures and post them every week so we can all see how my belly grows.

Why Google Is Not Always a Good Thing

I had my followup blood test yesterday, and the good news is that my Beta hCG went from 165 on Saturday to 416 on Monday. The numbers are supposed to double every 48 hours or so, so this is a very good sign. Unfortunately my progesterone level is not so hot. It's still within normal limits, but it's on the low side; it dropped from 11 to 9.5 from Saturday to Monday. The lower end of normal is 9 but, according to the nurse, Dr. M likes to see at least 13 or 14 at this stage in the pregnancy. She said it was nothing to worry about, but that Dr. M wanted to switch me from Endometrin to regular progesterone suppositories, which are supposed to be stronger.

Despite the nurse's reassurance not to worry, being the worry wart that I am, I immediately started to google low and falling progesterone levels in pregnancy. Bad idea! From what I read, it seems that low (and especially falling) progesterone levels can be a sign that the pregnancy is doomed to miscarriage! :( Of course I also read some anecdotal stories of women who had had ridiculously low progesterone levels but went on to deliver healthy babies. I also read that vaginal progesterone like Endometrin usually doesn't show up in the blood tests as well as progesterone pills or shots because most of the progesterone is absorbed directly into the uterine lining where it needs to be rather than going into the blood stream. I really hope these new progesterone suppositories bring my level up. They're messier than the Endometrin, but if they work, it's all worth it. I go in tomorrow (Wednesday) for another blood test. Until then, I am going to try to relax and not stress too much (easier said than done, of course!). AC arrives tonight, and I can't wait to see him. I need him and his calming influence right now.