Week 25: Doctor Update

I'm officially 25 weeks today! It's been a week of doctor appointments for me. On Tuesday I saw my pulmonologist, who said everything continues to look good. However, she did mention that my last sputum culture grew MAC (along with the usual Pseudomonas aeruginosa), which I've heard is pretty hard to eradicate once it takes hold. She confirmed this when she said that treatment usually involves three different oral antibiotics taken for a year. Given the low number of bacteria in the culture and my lack of symptoms, she did not think I needed treatment just yet. However, she did say I should continue to monitor its progress with frequent cultures and had me leave another sputum sample with the lab before I left.

She also checked my ears out of curiosity (even though that's not really her domain) and said she could see the two tubes in the left ear, and that one definitely looked open, but that she couldn't tell what was going on with the right ear. So far, it hasn't been bothering me, so I'm hoping it's still open, although I haven't been able to blow air through it recently as I have with the left ear. She was also quite surprised that I'm still able to use the vest with my expanding tummy. I told her that I've just been pushing it up out of the way of the bump. She suggested that I switch to the Acapella device once I can no longer fit into the vest, but since I don't really know how to use it, she scheduled an appointment for me with a respiratory therapist to show me the ropes.

Other than that, I had my weight checked, and I was up a shocking 12.5 pounds since my last appointment with Dr. W 5 weeks ago! She said something about how I appeared to be gaining an appropriate amount of weight, and I said something along the lines of "It seems like a lot." Later I noticed in my chart that she had typed something like, "Worried about weight." You have to be careful about what you say around doctors I guess! Not that it was wrong of her to put it in, but it surprised me because I had thought of it as just an offhand comment, nothing to be taken seriously.

Anyway, today I had my glucose screen. I had already decided I was going to fast beforehand even though I didn't receive any specific instructions to do so. Unfortunately I woke up around 4:30 this morning and couldn't go back to sleep, which meant I had to fast for 5 hours before my appointment! It wasn't as bad as I thought it would be actually. Around 8:30 I was pretty tempted to eat something, but I managed to hold out.

When I arrived at Dr. W's office, the receptionist sent me down to the lab to drink the glucola, the sickeningly sweet orange soda flavored glucose drink they make you consume. At the the first sip, I thought it wasn't too bad, but by the end it was getting pretty disgusting. Luckily it didn't make me nauseous or feel sick. I did feel slightly light-headed, but that could have just been from the sleep deprivation. The lab tech instructed me to return in exactly an hour, so I headed back to Dr. W's office for my appointment, except that it turned out Dr. W had unexpectedly gone on vacation, so another doctor in the practice was covering for him. I had the option of seeing her, but they were so backed up because of his absence that I opted not to--seeing her would have meant going back to the lab for the blood draw and then returning to the office again to wait for who knows how long. So I was just seen by the nurses.

There was the usual drill with collecting the urine sample, measuring weight, blood pressure, and fundal height, and checking Ziggy's heart rate with the doppler (it was 155 bpm). I am pleased to say my weight was only up 3.5 pounds from my last visit, which means I somehow lost 9 pounds since Tuesday! No, not really. I'm sure the discrepancy was just due to different scales, different times of day (my pulmonology appointment was in the late afternoon), normal fluctuations in water retention, and the fact that I had fasted before my appointment and had already had two bowel movements that morning (sorry, TMI, I know!), so I was pretty dang empty. Still, a 9 pound difference seems like a lot. I'm sure if I hadn't fasted, the difference wouldn't have been so extreme. I'm just kind of relieved that I haven't actually gained such a ridiculous amount of weight in a mere 5 weeks!

Other than that, I briefly discussed my heel pain and sleep trouble (some nights it's fine, and then others I wake up to go pee and can't fall back asleep). The nurse said that the foot pain was probably due to my weight increase and added something along the lines of how I'm so small that this must be the heaviest I've ever weighed in my life. Ha! Yeah right! I told her that as a teen I had weighed more, and she said something like, well, teens never have any aches and pains. I just think it's funny that people think of me as small or thin now, since for so much of my childhood and adolescence I was seen as large, heavy, big-boned, and even at times fat!

Anyway, she said for the time being to try stretching and massaging the bottom of my feet with something like a soda can (I already normally do this with golf balls, but I must admit I've been a little lax lately, so I'll have to be more diligent from now on), but if the pain continues to worsen to let them know so they can take care of it before it turns into a serious problem. As for sleep, she said it was fine for me to take Tylenol PM or Benadryl at night if I have trouble sleeping and, if those don't work or the insomnia continues to worsen, to let them know so they can prescribe me something for sleep. Personally I'd prefer to not take anything, but if I get desperate enough, I may just have to. It would probably be worse for Ziggy if I developed a respiratory or sinus infection due to sleep deprivation than if I took some over the counter sleep aids.

My next appointment is set for 29 weeks on August 20 at 10 am. Before I left, I had my blood drawn (they're also checking my thyroid hormone), and they'll call tomorrow only if I didn't pass the glucose screen (if my blood sugar went above 140) and they need to schedule the fasting 3 hour glucose tolerance test. So, in this case, no news is good news. By the way, it turns out I didn't need to fast for this test, but I'm glad I did anyway. Now if I don't end up passing, at least I'll know I did everything I could!

Week 18: Minor Freak Out and Silly Quiz

I can't believe I'm already at 18 weeks! I freaked out this morning because Ziggy's heart rate was over 200 when I measured with the doppler, which just seemed way too high. I thought maybe I was dehydrated since my heart rate tends to go up when I'm dehydrated (when your blood is thicker, your heart has to work harder to pump it through your veins), so I drank a bunch of water and then checked it again 2 hours later. This time the heart rate was measuring between 160-168 bpm, so back to normal. I did a little research online, and it seems that an overly high fetal heart rate can be a sign of fetal distress, hyperthyroidism (I am taking thyroid medication), a few other scary sounding things, and dehydration. I figure in my case it was caused by the latter, but I'll probably mention it to Dr. W at my next appointment just in case. Maybe I have been a bit too strict with limiting fluids at bedtime?

Anyway, in honor of my anatomy scan being only two weeks away (yay!), I decided to do this little quiz that I found on Hoping for Our Own Peanut's blog.

It's a boy if:
You didn't experience morning sickness in early pregnancy
Your baby's heart rate is less than 140 beats per minute
You are carrying the extra weight out front
Your belly looks like a basketball
Your areolas have darkened considerably
You are carrying low
You are craving salty or sour foods
You are craving protein -- meats and cheese
Your feet are colder than they were before pregnancy
The hair on your legs has grown faster during pregnancy
Your hands are very dry
Your pillow faces north when you sleep
Dad-to-be is gaining weight, right along with you
Pregnancy has you looking better than ever
Your urine is bright yellow in color
Your nose is spreading
You hang your wedding ring over your belly and it moves in circles
You are having headaches
You add your age at the time of conception and the number for the month you conceived and the sum is an even number

It's a girl if:
You had morning sickness early in pregnancy
Your baby's heart rate is at least 140 beats per minute
You are carrying the weight in your hips and rear
Your left breast is larger than your right breast
Your hair develops red highlights
You are carrying high
Your belly looks like a watermelon
You are craving sweets
You are craving fruit
You crave orange juice
You don't look quite as good as normal during pregnancy
You are moodier than usual during pregnancy
Your face breaks out more than usual
You refuse to eat the heel of a loaf of bread
Your breasts have really blossomed!
Your pillow faces south when you sleep
Your urine is a dull yellow color
You hang your wedding ring over your belly and it moves from side to side
You add your age at the time of conception and the number for the month you conceived and the sum is an odd number

Some of these I didn't really know how to answer. My urine changes color depending on how hydrated I am and when I last took my prenatal vitamin, I don't think my belly looks like a basketball or a watermelon, I guess I am carrying the weight out front, but I have also gained some weight in my rear as well, I think I'm carrying low, but again not entirely sure, I don't know which direction my pillow faces, my wedding ring didn't do a thing when I hung it over my belly, my left breast has always been bigger than my right, and I have always not only eaten but loved the heel of a loaf of bread (AC and I sometimes fight over it!). So overall, this seems pretty silly and doesn't really tell me anything since I got 7 for each. Only 14 days until I hopefully know for sure!

17 Weeks: Just wait and see

I am 17 weeks as of today! Wow, that sounds so far along. Only 3 more weeks until the big ultrasound, where little Ziggy will hopefully become a he or she (please behave, Ziggy, and show Mama and Baba and, most importantly, the doctor your nether regions :)! It's funny how I go back and forth between imagining Ziggy as a boy or girl. In the beginning I kept picturing Ziggy as a boy, probably because leading up to the IVF process I had a dream that I gave birth to a baby boy. But lately I've been thinking it might be a girl. Apparently if a man has more sisters than brothers, he's more likely to have a girl, and vice versa. Although AC only has one full sibling, a brother, he has two half-sisters. Plus, supposedly his mother was pregnant with a girl when he was about 4 years old, but his father made her abort it (he only found out about it when he was older). She must have been pretty far along too if they already knew the sex.

Girls also run in my family big time. I know they say that the male determines the sex, which is true, but I do remember reading that one theory is that the eggs of some females are more likely to attract or draw in X or Y sperm. Anyway, I don't even know why I'm conjecturing over here--I might as well just wait and see! My mother told me she was convinced I was a boy (she also had dreams about having a baby boy and assumed that my extremely strong kicking was from a boy). Back then they didn't do ultrasounds for normal pregnancies, so of course she didn't find out until I was born. I can't imagine waiting that long personally, but I can imagine it must be pretty exciting to hear "It's a boy!" or "It's a girl!" after working so hard to get the little guy or girl out.

Anyway, I listened to Ziggy with the doppler this morning, and s/he is a lot higher up in my abdomen than s/he used to be (no wonder I was having trouble locating the heart beat last time--I was searching far too low)! It was kind of exciting to observe that, which means Ziggy is growing and getting bigger, and hopefully will really start kicking me soon. I still feel those little fluttery sensations almost daily--about half the time I'm convinced they're Ziggy, and the other half I'm pretty doubtful and assume it's just intestinal rumblings. Again, I guess I just have to wait and see!

Week 16: In which I obsess over pregnancy weight gain and travel plans

Yesterday I had my second appointment with Dr. W at 16 weeks, and I'm happy to report that everything continues to go well. Like last time, after I peed into a cup (I wonder what exactly they're measuring when they do this--maybe I should ask next time), I had my weight taken. Warning: Long, obsessive tangent about pregnancy weight gain ahead!

I was up 8 pounds since last time! Granted my appointment was in the afternoon this time rather than in the morning, which could account for a couple of extra pounds of food and fluid, but still, I was a bit surprised. They didn't say anything so I guess it's not a big deal. Honestly I would rather be gaining too much weight rather than too little, since all the pregnancy books I've been reading state that gaining too little weight can seriously affect the baby, while gaining too much weight is usually more a problem for the mother, in terms of her discomfort in the last trimester and difficulty in losing the postpartum weight. Of course gaining too much weight for me probably isn't a great idea since excess weight will put more pressure on my lungs and make it harder for me to breathe, especially in the third trimester.

But I'm not sure there's anything I can really do about it anyway. I exercise almost every day for 30-60 minutes, I only eat when I'm hungry (which I'll admit is pretty often!), I try to eat really healthfully and avoid sweets as much as possible (sometimes I'll have a bite or two of something AC's having, but this is pretty rare), so what exactly could I change? Because of my history of anorexia, I don't want to start going down a road of worrying about my weight and what I eat. One of my fears before doing the IVF was that gaining weight during pregnancy would trigger my eating disorder. So far that hasn't been the case. For the most part I'm enjoying seeing my body expand, but still, when I read about the official guidelines for pregnancy weight gain and how much one's supposed to gain in each trimester, I start to worry that I'm gaining too much too fast. At this rate, am I going to end up a total blimp by week 40?

From talking to other women who have gone through pregnancy, my impression has been that the amount of weight a woman gains during pregnancy is practically predetermined. I've had a number of women tell me that they gained almost exactly the same amount of weight with each pregnancy, that trying to make changes like exercising more or eating less were pretty futile, that not only was the amount of weight they gained the same, but the pace at which they gained it and where they gained it was also the same. I'm sure that extremes of eating, such as starving oneself or eating tons of junk food, can have a significant effect on weight gain during pregnancy, but it seems that as long as you fall somewhere in the middle of eating and exercising normally, then your body will gain the amount of weight it wants to.

According to all the books I've read, weight gain during pregnancy for woman of normal starting weight should be about 25-35 pounds, and since I started out pregnancy at the lower end of normal for my height, I thought it would be safe for me to gain at the upper end of that amount. My mother gained 35 pounds while she was pregnant with me. I was sort of assuming I would be about the same. Well, it seems I may even exceed that! Oh well, I guess I should just get used to the idea.

Anyway, enough obsessing about my weight! Moving on...Dr. W felt the top of my uterus and measured its height, which was normal. Unfortunately I didn't have an ultrasound, but he did pull out the doppler to measure Ziggy's heartbeat. I had actually just listened that very morning with my at home doppler, which made it a little anticlimactic to hear it in the office. But it was still very reassuring to hear that familiar whoosh, and it was nice to get an official measure of the heart rate (168 bpm, which wasn't far off from my estimated measurement of 160 bpm that morning).

I had blood taken for the AFP screen (that's the maternal blood test that can identify babies with open neural tube defects) and also for the Quad screen (the maternal blood test that can identify babies with Down syndrome, Trisomy 18, and open neural tube defects), although I'm not 100% sure about that. I sure hope they did both. I probably should have double checked with them, but my scatterbrained pregnant brain didn't think to ask. I suppose the AFP screen is more important for me since I have a family history of neural tube defects (my paternal grandmother has mild spina bifida, which manifests as severe scoliosis and back pain), whereas there's no family history of Down's or mental retardation. I'm also having my TSH level rechecked to make sure I don't need to adjust my dose of Armour Thyroid. They're only supposed to call today if the AFP screen comes back positive or my level of thyroid medication needs to be adjusted.

Other than that, I discussed travel plans with Dr. W. He said it would be fine for me to fly to the wedding in June, and not to worry about the "swine flu," that it should have pretty much run its course by then. He did say I should be especially vigilant about washing my hands and trying to avoid people who seems sick, but those are things I should be doing anyway. When I asked about traveling throughout the pregnancy, he said it should be fine to fly up until the very end, but that I shouldn't take any long car trips after 34 weeks because of the increased risk of blood clots. I was surprised that he thought flying even in the few weeks before my due date would be fine (all the pregnancy books usually say no domestic flying after 36 weeks).

Since most likely AC will be leaving Little Rock to go to Albuquerque sometime in October (although we don't know the exact dates yet or if AC will even finish his training here on time), we've been trying to figure out exactly what I should do if we have to move during the end of my last trimester. Unfortunately AC can't just fly directly to Albuquerque. First he has to drive back to Corpus Christi, since that's still considered his permanent duty station, take care of all the necessary out-processing paperwork, and make decisions about our possessions (what we want shipped to Japan, and what we want put in permanent storage). Then he has to drive to Albuquerque, possibly with a trailer hitched to the car dragging some of our stuff. All in all, I'm guessing it will take him at least 10 days, if not two weeks, to get to Albuquerque.

I'll be 34 weeks as of September 24th, and I really doubt that AC will be done with his training by then and ready to go to Corpus. So the question for us is, since I can't accompany him on the car trip, do I fly to Albuquerque and wait for AC there? I wont have a car, I wont know anyone, including my doctors, I don't know how I'll be able to get to my doctor appointments, I'll be completely alone for two weeks, and basically, it will just suck. Or do I spend those two weeks waiting here in Little Rock and then fly to Albuquerque once AC arrives there? Most of the same problems will still remain. Since we're planning on loaning one of our cars to a military couple (they will probably come here to pick it up sometime this summer), I wont have a car, I wont have any of our stuff because AC will have driven it all to Corpus, and I'll be all alone. The only benefit to remaining here during that time is that I'll know my doctors, but I don't know how I'll be able to get to my appointments without a car.

The final option, and the one I think we're seriously considering, is to have me fly to California to stay with my mom while AC's on the road. Once he gets to Albuquerque, I can either remain in California and deliver there or else fly to join him, depending on my health, what the doctors recommend, and how far along I am in the pregnancy. Albuquerque is at a higher altitude, so that might have a negative effect on my lungs during the third trimester and might be a reason not to go there. Meanwhile the benefits of remaining in California are numerous: the weather and climate agree with my health, I'll have access to my mom's car, I know the area, and quite a few things are within walking distance, I have doctors (especially pulmonary) that know me there and could recommend a good MFM, I have a few friends there that I could spend time with, it would be nice to spend some time with my mom, especially since we'll be leaving for Japan in February...Anyway, really the only disadvantage is that I would be away from AC (of course that's a pretty big disadvantage). He would of course fly to California for the birth and use his 10 days of paternity leave and maybe his saved leave as well to extend his stay. Well, we have a lot to think about and decide. Hopefully as AC's training progresses we'll have a better idea of when he'll be done here.

Anyway, assuming my AFP screen is normal, I return to Dr. W's office on June 18th for my week 20 appointment and for the "big" ultrasound, where we'll get to know the sex (assuming that Ziggy is cooperating of course)! Yay! If we bring a DVD, we can also have the ultrasound recorded. I can hardly wait! Ok, this post has gotten way too long, so I'll stop here. I guess this is what happens when I don't update for a week!

Week 14: With a whoosh and a gallop...

Today I am officially 14 weeks pregnant, solidly in the second trimester! It's hard to believe Ziggy has been inside me for 12 weeks now, making his/her home in there :) In honor of my 14 weeks, I decided to give the doppler another try this morning after reading some suggestions online. Other women recommended trying first thing in the morning before going to the bathroom, so the bladder would be full, which would push the uterus up. Supposedly raising the hips with pillows can also help. So, I did both, and something must have worked because amazingly I heard Ziggy's little heartbeat right away! Sometimes it sounded more like a whooshing sound, and sometimes like the clippoty-clop of a galloping horse's hooves. Either way, very cool!

I didn't have a stop watch, so I loosely tried to measure the heart rate using a digital clock. It was somewhere between 130 and 140 bpm, which is in the normal range of 120-160. Next time I listen I'll use AC's stopwatch to try to get a more accurate result. Luckily AC hadn't left for work yet so he got to listen as well. At some point, we should also try to record the heartbeat, so we can send it out to the rest of the family.

Anyway, it was such a huge relief to hear the heartbeat and know that Ziggy is still alive and well in there. I know I'm just being paranoid, but sometimes I really worry that something has happened to Ziggy. Even though it's been weeks and weeks since my single episode of bleeding, every time I go to the bathroom and wipe, I still expect to see blood on the paper, and breathe a sigh of relief when there's none. I wonder if all pregnant women feel this way.

In my case, I have always been extremely aware of the fragility of life before birth. Starting around the age of six, I saw my mother go through five miscarriages, the last one being a set of twins (first she lost one, and then the other). Well, I never literally see her miscarry, thank goodness, but I saw the aftermath. I distinctly remember her crawling into the closet and lying there crying while my step-dad stood by not knowing what to do. At the time I didn't understand what was going on, just that my mother was in pain. Later someone must have explained what had happened to me.

I figure that must be why I have such a fear of miscarriage. That and having to deal with the infertility, knowing that if we lose Ziggy, we can't just wait to get pregnant the old-fashioned way in a few months. Having another baby will mean going back to New York, back to Dr. M, back to another IVF cycle. It would be easier this time, since we already have the frozen embryos, but still, not something I want to have to do. Anyway, I didn't mean to turn this post into a downer, so I think I'll stop here. In the meantime, I am going to try to put aside my fears of losing Ziggy and just focus on this miracle of life that is happening inside me.

Doppler Dissapointment

My doppler arrived today, and I was all set to hear the sweet gallop of Ziggy's heartbeat, but alas, all I ended up hearing was the gurgling of my stomach and what I guess was the placental heartbeat. It was a whooshing sound, and I knew immediately that it was too slow to be Ziggy's heartbeat. I took my pulse, and it matched it exactly beat for beat. I followed all the suggestions I found online, like drinking lots of water so my bladder would be full, using lots of gel (KY jelly in my case), and starting down really low, in line with my navel at my pubic bone, and angling the doppler down, but still nothing. How very disappointing!

From what I've read online, it's pretty normal not to be able to hear the baby's heartbeat this early with a cheap home doppler, so I'm trying not to panic. And the fact that I heard the placental heartbeat is supposedly a good sign. Anyway, knowing me, I'll probably keep trying every day until I hear it or until my next OB appointment (2 weeks from Thursday), whichever comes first. Maybe I'll even bring it in to the appointment to see if the nurse can help me if I haven't found it by then. So frustrating, especially since other pregnant bloggers have been successful with their dopplers even earlier. I guess this is what I get for ordering the cheapest one on eBay!

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!