We're halfway!!

I had my 20 week ultrasound and appointment today and was relieved that everything looks great, and that my bp was 110/64!! This was a pinnacle appointment for me because by this time in my first pregnancy, my bp was starting to creep up a bit.

I can't say that the headaches I've had recently aren't concerning me, but Dr. M. said not to worry. Yet. (Dr. V. is on maternity leave and just had a baby girl.) They haven't been bad, and I had a virus that affected my sinuses, so it's most likely related to that. I only took a Tylenol once.

We decided not to find out the sex of the baby, but Brian couldn't help himself and peeked right when the tech told us to look away, and swears he saw a penis. Who knows. I waffle from day to day between feeling the yin or the yang of this baby's energy. The tech said four times that this baby is "extremely active," which doesn't surprise me given the family of origin of this child, but I had high hopes for a mellow-er babe after my first go-round.

I got really lucky, and met a doctor from Harvard a year ago who has developed the first-ever diagnostic screening test for preeclampsia, which is currently in FDA approval. I had my blood drawn today so that I can send it to him and participate in his research. This also means that I'll find out soon if I have indications of early preeclampsia, that would otherwise be undetected at this point. It is possible that this test will be available before the end of 2011! Now we just have to figure out how to send the blood to Cambridge tomorrow.

If you want to read more about Dr. K's work and the diagnostic test, go here. It is by far the most exciting and promising research advancement in understanding preeclampsia.

OK. That's all for now. Oh, wait. If you have any suggestions for boys' names that will work with the last name Lynn, have at it. We are completely stumped.

The High End of Normal

I got my results back from my 24 hour urine analysis. Dr. V.'s nurse told me over the phone that the results were "good," then followed that up with "but when they did the hour-by-hour breakdown, your level was .17, and .15 is the high end of normal." She went on to explain that .02 higher than the normal range isn't anything to be concerned about. She said it's so insignificant that they don't even consider it abnormal.

I'd like to be happy about the results, and the part where she said they were "good." Here's the thing. I am having an issue with "the high end of normal" part of this. Everything I experienced in my HELLP pregnancy was like that. My blood pressure was never technically hypertensive until my 40 week appointment when it was 140/92 (and hypertenive = 140/90). Well, I guess that's just one example, but the overarching issue is that I always "seemed good" and I really wasn't. So this test result does scare me. 

The positive thing that I'm holding onto is that I stopped in the middle of a 3 mile run to answer the nurse's phone call, and then I kept running when I got off the phone. I just don't want to fool myself into thinking I'm healthy like I did last time. But I am also sensitive to the power of thoughts. I just got the book The Genie in Your Genes at the recommendation of my monitrice.

I will see Dr. V. a week from Wednesday so I will learn more about the results and what they mean at that time. 

In the mean time, I will try to take the advice from my wise self and try to be my usual playful self, without being so serious and focusing so much on all of this medical stuff. I'll let Dr. V. do her job. 

I'm also working on trying to connect more with the baby. I know I avoid doing that sometimes because it's easier to escape from the anxiety and fear than to work through it and get to a place of perfect calm. The thing is, when I really let myself connect with the baby, I do go to a place of perfect calm. 

Oh, and one more thing. At my last appointment with Tanya, during the hypnotherapy portion, as I was connected deeply with the baby, I had a vision of a heavy load of dark muck lifting from my belly and rising into the sky, leaving behind a beaming white light that shone out from my belly. Through this light, I could see the baby and I felt this very strong sense of trust.

Lighting up the Dark

A lot has happened since my last post. We had our 12 week appointment with Dr. V. on Friday and Brian got to meet her, and liked her a lot. It seemed especially poignant that Friday was Diwali, also known as the Festival of Lights, and Dr. V. was dressed in a beautiful green shalwar. She talked about how Diwali is the celebration of lighting up the dark and celebrating new beginnings. I love thinking of lighting up the dark, and there has been this Chinese proverb on my other blog since I started it almost a year ago - It is better to light a candle than to curse the darkness. So I am using this as one of my guiding images for this pregnancy. I want to always be focused on the light, the positive, the hope. 

We also had our first appointment with Tanya, our monitrice (like a doula) on Sunday. She is very loving and healing, but she also suggested that we are making our choice for medical care from a place of trauma. Part of me is like "Of course we f-ing are making our choice fromm that place. We don't want to be in the same traumatizing situation that we were in last time. And I don't want to die!" But I realize that she means that she wants to help us integrate the trauma so that we can honor our true feelings, instead of operating within the trauma. We are going to work with her on healing our trauma as much as we can in the next couple of months. We are so sensitive to being caught in the middle of the sort of midwifery vs. western medicine divide, which is where we spent our horrific HELLP birth. It was just awful to be stuck like that between two places, neither of which seems to really see the woman that was suffering between them. Tanya seems like a balanced yet nurturing healer who will help me listen to my body and my baby. 

She was sensing a lot of fear in me, which she felt the baby was picking up on, so she had us do a wonderful little exercise in which we both thought of a very happy thing for a couple minutes. The energy in the room changed and she said she felt the baby pick up on that happy feeling and shift. It was hours later that we both revealed we had thought of the same thing, our wedding. I know of prenatal psychology, but it's just so hard to be mindful of the baby's feelings all the time. I am working on changing my awareness so that I can be more positive in my own mind. She also said that processing negative feelings with the baby will help when they do come up.

In other news, Tanya picked up on a strong boy energy. I've been sensing that same thing myself lately, and Gavin has been claiming "his baby" is a boy for weeks now. (It started off as a girl [gwirl] for him.) 

She also asked me to do some cognitive exercises to help me with the trauma healing. Many of us who have had HELLP had a similar experience in that one day we seemed like healthy pregnant women, and the next we were being told that our blood and organs were breaking down and our body was in crisis. This certainly shifts the world view many of us had prior to getting sick with HELLP, and I know that I struggle with trusting my body, especially with regards to pregnancy. I have had a host of physical symptoms and pain since my HELLP experience that was preceded, I'm sure, by a sense that things can go wrong inside my body at any time and without warning. Tanya asked me to create a list of:

• the ways my body is healthy
• the ways I've witnessed my body heal
• the ways this pregnancy is going well

When I actually try to do this, the effect of the trauma on my cognitions is so evident. It is soooo nearly impossible to think of my body making it through this pregnancy without any problems. I nearly hold my breath before every blood pressure check, even though it's been exceptionally great this whole time. This will be hard work. I am trying to add to these lists every night in my pregnancy journal. As I look back at this post, I am thinking I will have to add candles to my nightly ritual. Lighting up the dark....

Thanks for being out there!

Dr. V.

OK. Yesterday I found my OB! I had a strong intuition about this practice when I found it online, then heard from a friend who had a good experience with her natural birth in June with them. I haven't felt so taken care of in a long time, medically speaking. I mean, 3+ years ago, I didn't even know what it was to need medical care. Then I got quickly and traumatically schooled in all the ways that people don't care for you well.

Yesterday, I walked into a sanctuary-like practice in a converted warehouse building overlooking the Chicago River. The medical assistant kindly escorted me immediately to an exam room where she talked WITH me, not at me, and asked me to leave my clothes ON. They had a little desk area set up for me to complete my paperwork. I waited in the exam room for exactly 12 minutes, then Dr. V. came in with a genuine smile, sat down and took my hand, apologizing for keeping me waiting! (Which was more than the doctor last week did who had kept me waiting half-naked for two full hours.) She was so great right from the start. She struck the perfect balance between concern about my HELLP history, and seeing me as a woman, sitting before her with hopes and dreams about this pregnancy. She knew her pre-e stuff, which made me feel so safe. She did an ultrasound, which was cool since I've never had an early one before. It was fun to see the little shrimp that's inside of me, and whose heart is already beating. She said that the baby looks to be very healthy so far, and then she actually told me that because of that, my miscarriage risk drops from 20% to 5%. What OB says that? I felt so happy and relieved!!

Here's what she is doing already with regards to my HELLP history:

• Blood draw to test liver and kidney function as well as platelets (and other things, 6 vials in all).
• 24 hour urine to be collected the night before my 12 week appoinment.
• Continue on daily baby aspirin throughout the entire pregnancy.
• Taking this pregnancy one day at a time, viewing it as an unfolding journey and not getting too far ahead of ourselves. I loved that she said this!
• Monthly ultrasounds throughout the last trimester to look at the placenta, blood vessels and the baby's growth.

My next appointment with her is Nov. 5. She estimated my due date to be May 15. She's 30 weeks pregnant herself and I'll see the other women in her practice during her 6 week maternity leave. It's kind of fun having a pregnant OB! I also like that she will have had her own birth experience before she attends my birth. I can only imagine that it's her first baby because they PLANNED to have a winter baby. In Chicago. Her due date is a week after Gavin's birthday. Ugh. We promised ourselves no more winter babies after living through that hellish, frigid indoor entrapment in 2007! ;) 

I am so relieved, happy and relaxed. I feel like I can really get into this pregnancy now. When I first found out that I'm pregnant my immediate reaction was this total state of mental calm. I have that back. And it feels incredible!

The Numbers Game

As a very right-brained person, I have been avoiding, if not completely ignoring, numbers my entire life. They make my head spin. I can't even play card games. Anyway, my HELLP experience caused me to pay attention to numbers and I've overcompensated by obsessing some about them. I can almost see how people take comfort numbers. They're precise. You can measure them and make deductions based on them. Still not my thing, but I get it. So here are the numbers that fly through my head way more often than they should:

• 17: The week that I had my first high-ish bp reading in my HELLP pregnancy. That's in 9 weeks for me, so I'm feeling anxious about that particular week. 
• 130/90: If you have one high blood pressure reading (130/90) prior to 35 weeks gestation, you have a 33% chance of developing preeclampsia in that pregnancy. So far, my highest recorded bp has been 126/85. 
• 13: At 13 weeks, the risk of miscarriage decreases. In my first pregnancy I had a healthy awareness of that possibility, but my new traumatized self is much more aware of that risk. 5 weeks to go.
• 8: I'm running 2 miles twice a week (or more) and aiming for 8 minute miles. This week, I finished 2 miles in 15:36 and 15:49. Not bad for someone who has never had one ounce of interest in competitive running! Oh, and I work out 5-6 days a week, including weight training, cardio and flexibility work. Regular physical activity during the first 20 weeks of pregnancy reduced pre-e risk by 35-45% compared to sedentary.
• 60: The number of grams of protein a pregnant woman should consume. I really struggled a ton and fell short with my vegetarian diet in my first pregnancy, and I often wonder how much that contributed to the "perfect storm" that led to my illness. It's hard for me still, and I am eating some meat to try to help, but I just have a really hard time with ethical, philosophical and environmental issues related to eating animals. I add nuts, chia seeds, quinoa and other sneaky protein sources into a lot of my food but that gets a little old. I've been trying to eat a hard-boiled egg every day, but that often makes me gag and I have to force it down. They say protein powder isn't recognized by your system, but I often supplement at bedtime with some vanilla almond milk with whey protein powder in order to get my number for the day up. I have been eating more cheese than usual and my breakfast cereal has about 10g which is pretty good. I eat high protein bread (5g per slice) and lots of PB. Any other ideas?

My appointment with OB #2 is tomorrow. Wish me luck!!
Amy

Finding "The One"

I cannot tell you how hard the decision of choosing a doctor has become. We are in Chicago, a city saturated with obstetricians, and home to several top hospitals for women's health. You'd think it would be easy. I've spent countless hours asking friends, asking strangers, reading reviews online, looking on VBAC websites and making an insane spreadsheet of my findings. Just when I think I find someone, there's an issue. There's just no perfect situation, so we're stuck feeling like we are gambling on the "best bet."

Today, we had an appointment with Dr. B. Our monitrice who we LOVE recommended her very strongly, and said that if we want a trauma-sensitive OB who will be patient with me if/when I try to VBAC, she's the one. Well, after an initial phone call to her practice had me on hold for over 30 minutes, and the nurse never returned my call, I still called again and made an appointment because Tanya feels so strongly about her. I was soooo excited for our appointment today. When I was pregnant with G, we heard his heart beat with the doppler at our first prenatal appointment and it was magic! Instead of a happy time like that, we were stuck in an exam room for TWO HOURS, starving and nauseous because they'd called me to come in earlier than scheduled so I had no time to prepare my snacks. By the time we arrived, Dr. B. had to leave for an emergency. Another sweet doctor, Dr. D., agreed to see us, but finished up with all of her scheduled appointments before taking us. We literally sat in an exam room, me half-undressed with a sheet across my lap, for two freaking hours.

I'm a therapist who works with a lot of trauma survivors. I talk a lot about "emotional safety" when it comes to trauma. Let me tell you. Sitting in an exam room half-naked with a blood pressure cuff hanging next to me is NOT emotionally safe for me!!!!!

I am scared that if we don't go with Dr. B's practice that we won't be able to find a doctor who would support me in a VBAC. I labored via pitocin, while under a heavy dose of magnesium sulfate, for 30 hours with no pain meds the first time around. It was ugly. My body was shutting down and eventually, after pushing for 2.5 hours (with no urge to push) my contractions completely stopped and I literally thought I was going to die. We consented to a c-section under general anesthesia and minutes later G was born. Any doctor we've talked to who hears that story swiftly recommends a scheduled c-section at 39 weeks. Now, I'm not some crazy VBAC-or-bust nutcase. But I do want to work with someone who is at least open to letting me try if I stay healthy. Is that so much to ask for?

I am trying not to be completely let down. I'm still trying to hang onto my undying hopefulness and went ahead and made appointments with Dr. B. for my 12, 16 and 20 week appointments. But if one single thing doesn't feel emotionally safe at 12 weeks, I'm outta there. We have an appointment with Dr. V. this coming Thursday. She specializes in hypertensive disorders of pregnancy but I fear she may not support me in a VBAC.

Did I mention that Dr. B's practice gave me infant formula?!?!! That pisses me off to no end. First, it's unsupportive of breastfeeding. Second, I'm only 7 weeks and they're already dumping that stuff on me. Ugh. It's going to be really hard doing this mainstream this time around.

The search continues... the clock is ticking...

7 Weeks Pregnant

Blood pressure check-in:
108/55 this morning
115/76 at my appointment

Weight check-in:
149 (no gain yet)

What's Different So Far (at 7 weeks)

After a pregnancy that ended in HELLP syndrome, I can't help but be aware of everything that is different this time around. It helps me stay hopeful that I might not get sick this time. That I might have a completely healthy pregnancy.

So here's what is different so far (not that any of it is an indication of anything):

• Nausea is much milder and less frequent. Good appetite.
• Lots of energy. Barely tired.
• Even better fitness level. 
• Eating more protein. (Yes, even a bit of meat.)
• Better stress coping tools, and less stress.
• Daily low dose aspirin started 2 years ago at the recommendation of our MFM.
• Extra Vitamin D, folic acid, calcium, and magnesium taken prior to and during pregnancy.
• Tea at least several times a week with dandelion root (for blood pressure) and red raspberry leaf (for uterine health).
• Mindfulness and meditation on a regular basis.

I feel really, really great. I don't remember ever feeling this great in my HELLP pregnancy. My nausea is mild and sporadic, really nothing to complain about. I remember thinking "I guess you just feel like crap when you're pregnant." I don't even feel tired. I nearly keep forgetting that I'm pregnant! (Knock on wood...)

I was in good shape when I got pregnant the first time around, working out 7 days a week most weeks. But I have been even more fit recently, despite working out less often. So I think I started this pregnancy off healthier even though I'm 3 and a half years older. One of my best friends and her husband got me into a different mindset with my workouts. They're into Crossfit, which encourages bursts of intense exercise that really push your limits. I've been doing my own modified version of these workouts 2-3 times a week on my own at the Y, in addition to my weekly strength training class.  I know some people are fearful about pregnant women working out intensely, if at all, but I very much believe that my level of physical fitness and my commitment to working out throughout my first pregnancy is what helped me stave off HELLP until the very end of pregnancy since my blood pressure first starting getting highish early in my second trimester. (Many women get sick enough that they have to deliver just past halfway through their pregnancies.) Today I ran 2 miles in 16 minutes, which is much faster that I was running even 6 months ago. I followed that up with a 500 meter sprint on the rowing machine and then some weight lifting and ab work. I have always felt really great when I'm active and fit, and let me tell you, being able to work out like that at 7 weeks pregnant makes me feel awesome!

I wanted to say a little more about the difference in supplements this time around in case there are any readers out there who are in a post-preeclampsia pregnancy or considering one. I am obviously not a medical professional, so please keep that in mind when reading this information that I went ahead and borrowed from the blog of my virtual friend who recently had a preeclampsia-free second pregnancy.

• Low-dose aspirin: Doesn't work for everyone but has also proven to be harmless to the fetus. Works by thinning the blood to reduce chance of blood clots forming in the placenta. Many of those with pre-e get diagnosed with blood clotting disorders that contribute to the onset. Hence certain women are put on much heavier anti-coagulants like Lovenox and Heparin.
• Higher doses of folic acid: Some genetic mutations cause women to be unable to metabolize folic acid which causes homocysteine levels to increase which can cause stroke, pre-e and other placental complications.
• Calcium deficiencies also increase the risk of pre-eclampsia. 

And I LOVE my prenatal! I'm taking New Chapter bought for a great deal at my new favorite website www.vitacost.com

We meet the first of our possible OBs on Thursday and are looking forward to it!

Trying Not to Get Down

I existed on a happy cloud of initial joy and early nausea for about 2 days before being derailed by the news that my husband's best friend, like a brother to us, has cancer. The juxtaposition of the two stories, the life and death feeling of it all, is trying hard to drag me down. On top of that, I am spending every free second trying to research OBs in Chicago who are VBAC-friendly, stellar C-section surgeons, and affiliated with a hospital with a great NICU (just in case).  My anxiety is building as my "high risk" designation flies over my head like a giant banner.

During my research during G's nap this afternoon, I fell into the forums on the Preeclampsia Foundation's site. Don't ask me why I started reading a thread about low milk production following HELLP. Reading some of those posts just brought it all back. I process feelings about certain parts of my experience, but there's always something left undone, waiting to be noticed, remembered. Like how Brian came into the recovery room just as I was regaining consciousness and tried his best to pump milk from my nearly alive body. It just sucks to have had HELLP. It sucks forever. No matter how positive I try to be, how much therapy I do, how much acupuncture or other healing I seek, I just can't stop hating my experience with HELLP. Yes, I have a healthy child, and I realize I'm one of the lucky, lucky ones. But I still struggle with letting go of my anger.

This post is certainly not in the vein of being positive. Since I started tapping this out earlier this afternoon, I found an OB practice that I'm actually pretty excited about making an appointment with. So that's hopeful.

Let the Hoping Begin

I just found out I'm pregnant.

We started trying to conceive exactly 2 weeks ago.  So you'd think I would be ecstatic. And, don't get me wrong, I am super duper excited. But I'm also feeling a sense of caution. "Don't get too happy just yet" says my mind-chatter.

This is not a normal reaction for me.

I have been pregnant once before. And it didn't go so well. I mean, I do have an awesome nearly 3 year old, and time has given me distance from what happened. But my body pretty much failed me, and I almost died from this terrible thing called HELLP Syndrome, which is a rare and severe variant of preeclampsia.

I am starting this blog as my companion along this pregnancy journey. I hope that writing will help other women who have had HELLP and who are pregnant again, or who are still making that gut-wrenching decision to try again or not. As well as helping me cope with the long months of anxiety and a tightly packed schedule of "high risk" OB appointments.

It was two weeks ago when my husband and I were having one of our never-ending discussions about getting pregnant again (since getting "clearance" 2 years ago from our perinatologist).  We realized that if we got pregnant in August, it would mean a May baby, which in the ideal world (that we'd like to pretend to live in) would mean we'd time the birth perfectly to coincide with our beloved Chicago summertime. (Versus the winter hell we went through last time around with a traumatic birth, 2 hospital stays and a generally grumpy newborn followed by nothing but months of frigid gray days.) 

That was it. That was the moment I turned off my fears and let myself listen to the voice deep down in my heart that's been patiently waiting for the chance to exclaim, "I really want another baby!"

So my period was a few days late this week  , but I didn't have any of the pregnancy symptoms I had last time. I'd taken at least 3 pregnancy tests which all came back negative. But still no period. I was so sure that I wasn't pregnant that I had a beer at dinner last night. Then today, on a somewhat anxious whim, I took a 4th test while my son slept and my husband was at a BBQ. I thought I was hallucinating when I saw the faintest ever line on the pregnancy test. I set it aside, took a shower, and then checked it again. Definitely a faint line.

I had a subdued sense of excitement, followed by a brief crying spell, and then racing thoughts about how we haven't yet decided on a new OB, or bought a new house. Then I took a deep breath, and let myself just feel the feeling of finding out there is a new life just beginning to take shape inside of me. I had so forgotten that feeling after all that I'd been through the last time around.

You know what that feeling was? It was hope. It still is hope. I can feel hope growing in my belly. I am trying to be very mindful already of not projecting too much of my own stuff onto this pregnancy or this baby. But I'd be lying if I said this pregnancy wasn't, in part, fulfilling a dream to have a healthy full-term pregnancy, ending in a natural delivery, on my own terms. But that is getting 9.5 months ahead of myself.

So back to today. I want to write this blog to be my day-to-day companion on this pregnancy journey. To help me through the trying times, the fear, the anxiety, the sad parts of me that still hold feelings about my son's birth. But always coming back to a sense of hope. I invite you to come along, or to bounce in and out along the way.

I'm going to do an inner smile meditation and go to bed early. And the hoping begins....