Keeping Calm

I just got back from my weekly midwife appointment. I have a lot of news, a lot of numbers, a lot of anxiety, and a lot of feelings. I'm going to share it all here to just get it out so I can clear my head and start my work day.

• My results for my 32 week bloodwork came back great! My platelets were 185,000! And liver function, uric acid, proteins... all looked great!
• However, my results from my 32 week 24 hour urine collection came back high. The level is supposed to be under 150 and it was 174.9. For scale, 300 is severe preeclampsia. Now, I never had proteinuria in my last pregnancy and I've been told I may have some slight kidney damage from HELLP Syndrome that would make my proteins a bit high. But my 12 week results were normal, and my 28 week results were "inconclusive" which was read as having levels too low to read, so normal. I am really nervous about this one. Amy, the midwife I met with this morning is consulting with the head midwife, Gayle, this afternoon so I will know more later today.
• My blood pressure was good today. 120/70.
• I now have to do Non-Stress Tests (NSTs) for the baby at every appointment. This involves sitting in a recliner for 20 minutes with fetal monitors on my belly. (These are the same fetal monitors I'll have to wear during labor, only I'll be able to be mobile and also get in the tub or shower.) Today's NST was great! It was really neat to see how when I relaxed or talked to the baby calmly that her/his heart rate went down. Starting at week 35 (I'm at the end of 33 now) I'll have to do these NSTs twice a week!
• I have to have weekly ultrasounds for a biophysical exam of the baby. Just another extra thing. As of now, things look wonderful!
• I have to have my blood drawn for HELLP-related tests every week now. 4 or 5 vials. They'll check my liver function, platelet count, hemoglobin and hemocrit (I think), uric acid and some other things. So far so good on this stuff.
• I am still dealing with some concerns about gestational diabetes. The midwives told me today that I do have gestational diabetes. There was confusion at my former OB practice about whether or not I'm diagnosable as they used a brand new test. I only had 1 of the 3 results come back high, and only a couple points high. However, the midwives, who aren't yet using tihs new test, looked into the diagnostic criteria and found that having one number high is diagnosable. They drew blood today to test my A1C. Since Tuesday night, I've been monitoring my blood glucose myself 4 times a day. So far, I have been within normal range. I seem to have a worse time when I'm not eating. There is potentially a relationship between HELLP and glucose intolerance. So when I haven't eaten in a while (like overnight) my body is producing glucose like a normal person, but then not responding in a normal way to balance it out and keep it from going overboard. This type of diabetic response is more like a Type 1 insulin resistant type, so dietary changes aren't necessarily the answer, but they're still asking me to limit my carbs. I'm trying very hard to eat 30-40g of carbs 6 times a day. I'm getting used to the finger pricking and time tracking, as well as the breaks between snacks as I have to wait two hours after eating to test my blood. I have been soooooooo hungry!!!
• I am feeling very, very anxious. My traumatized self is ready to kick into action, preparing as best I can for an early baby or a huge disappointment in not being able to deliver in the Alternative Birthing Center. My whole self is still feeling good. Healthy. Excited. Somewhat calm. Patient. But days like today, I just get totally thrown off by something like a high protein count in my 24 hour urine collection, something that's never "gone wrong" before. I've even been able to keep a pretty straight head despite my glucose issues. 
• I am spending a lot of energy focusing on the baby and connecting to her/him. We are reassuring each other. This baby is so constant, reliable, patient, peaceful and optimistic. It's really amazing energy to be carrying inside your body. When I go there.. to the baby's energy... I feel calm, happy and excited. I don't worry about all of the details and numbers and problems. I'm trying to keep myself there....

Week 33 - Good good good!

Thirty-three weeks and things are good. I am getting really, really excited about meeting this baby! I washed some baby clothes today and have started ordering some new things online here and there. It's fun to be in a mental state where I can start to enjoy that kind of stuff. I've had two prenatal visits with my new midwifery practice and it's been great!

My traumatic stress response has been a little triggered due to looking back at old hospital records as I prepared copies for the midwives, and also because they asked me to do another (my third of this pregnancy) 24 hour urine collection and a panel of HELLP-related blood tests, even though I just did both and had glowing results 5 weeks ago. Tanya reminded me today that I told her once that I had a sense during my first pregnancy that something was off and that I could never fully imagine the birth. She reminded me of how strong my intuition is and that I knew, but didn't really know what it meant or how it would unfold. This time around I can clearly see this birth at West Suburban in the water and I know it's going to happen. Not like a crazy person who's hellbent on making it happen, but like someone who's intuitive and can peek just a little bit into the future.

I am again reminded of the dire need for awareness of preeclampsia and HELLP. I saw my clinical supervisor last week and she told me how wonderful and healthy I look, and how she remembers me looking different last time. I asked her what she meant, and she said she remembers me gaining a lot of weight at the end of the pregnancy and looking bloated and swollen. I shared that with a mutual friend and she said "You know, now that I think of it, that's so true." Even my mom has said that. So what is the problem? Yes, in part it's that we're so paranoid of offending women by talking about weight and appearance that we keep our mouths shut even if there's cause for concern, but it's also that many people have no idea that swelling, bloating and rapid weight gain are symptoms of a potentially deadly disorder of pregnancy. Instead of getting angry, I'm trying to focus on the good part of this - that I am not bloated or swollen. I am gaining more weight now but it's within the normal pace of last trimester weight gain (and I've also finally stopped jogging).

I am in a really calm and positive state of mind about the baby and the birth. From the start, this baby's energy has been peaceful, reliable and steadfast and I am very tuned into that right now.

Here are some stats and info to share:
BP at my last appointment: 108/66 (Yay!!!)
Weight: 170 (started at 150)
Belly size: exactly 33 weeks
Head: Down!
Movement: Tons - but it's getting really tight in there, so no more kicks and punches
Sex Guess: Really balanced male-female energy (Gavin was the same way)
Acne: Like a 16 year old
Energy: Like a 16 year old

If you haven't given your guesses yet as to the sex of the baby, let me know what you think! I'm terribly behind with the baby's journal and that was a fun part of Gavin's - to have everyone's guesses. I'll try to take another picture this week in case you're one to judge by belly shape.

I'm mailing another tube of blood to Ananth tomorrow so I should have results back within about 2 weeks that will give me an idea of the likelihood of getting sick or not through week 39-41. But I'm not even worried. I know it's not happening. :)

Happy (belated) Vernal Equinox & Spring!

Last Quarter Game Change - Week 30

What a roller coaster! Last time I wrote I was coming off the back end of an emotionally turbulent phase and I was in a really bad place. A traumatized place, to be sure. Even as someone who works intimately with trauma in my profession, it was hard to recognize the barrage of physical symptoms I was experiencing as an outlet for my traumatic stress response. In this pregnancy, exactly when I rounded the corner into the gestational time when my symptoms started last time, I had a flurry of symptoms so believable and *real* that I believed them, despite all evidence pointing in the direction that I'm healthy. Sometimes it feels like my brain splits in half - with one side operating from a healthy-minded, holistic, self-aware, trusting place, and the other half in reaction mode, anxious, hypervigilant and craving negative energy. And that other half, my friend, is the ugly animal that is PTSD.

After my last post, I regrouped, centered myself, had a hypnotherapy appointment with Tanya, and was able to leave that traumatized place where I'd been. The physical impact of the traumatic stress response is amazing. My blood pressure, which had been up 20+ points for 2 days, dropped immediately back down to the low 100s/60s where it's consistently been for this whole pregnancy. My thinking totally changed. So much so that I've totally re-assessed my health and my birth dreams and I'm making a serious last minute change of plans that has me so ecstatically happy and hopeful!!

I am switching my prenatal care at just about the last week possible to a group of midwives who deliver at one of Illinois' only true alternative birthing centers. (Don't get me started on the politics of birth in this state.) My OB group has been great at caring for the traumatized pregnant woman that I was in the beginning of this pregnancy, but I see with so much clarity now that I am healthy, this baby is healthy. This pregnancy is, dare I say, normal. My whole conscious life I have dreamed of a certain kind of birth experience, one that was impossible last time around, improbable at best at the hospital where the OBs deliver, and I want it more now than ever. Not only that, I believe whole-heartedly that I will have a wonderful, peaceful and loving experience this time! I am so excited I can hardly stand it!

Tanya helped me see this as an option I hadn't even thought was possible. She anticipated this shift with incredible intuition and care, and had spoken with the practice before our last session to make sure they would allow my transfer, given my late gestation, HELLP history, and VBAC scenario. I had a consult with Gayle, the founding midwife of the practice a few days later and just knew it was the right thing. I am grateful that my (also traumatized) husband was supportive of the plan, especially since his Virgo heart struggles with veering off-plan. Gayle explained that there would be some less-than-ideal situations given that I'd be having a VBAC, but she made me feel so healthy and normal despite those things, giving me so much confidence that it's possible to have a natural birth! I was surprised to learn that the fetal monitor (a super annoying and large belly belt that I had to wear during my 30 hours of Pitocin labor last time) is actually water proof, so even though it's required for a VBAC, I can still labor and birth in the tub, a long time dream!! Gayle was so warm, loving, positive, hopeful and human. It was a world away from even the very best interaction I've ever had with any OB. I remember when I set out to find a provider this time around I was looking for "an OB who's as much like a midwife as possible." That just doesn't exist! Part of my (traumatized) reasoning was wanting to have an actual relationship with the surgeon who would perform a C-section should I end up needing one, after such a terrible experience last time. But I was denying myself an entire pregnancy-worth of loving care for that one detail. And the midwives have a great back-up OB who's a stellar surgeon, as well as a friendly, warm and collaborative healthcare partner to the team of midwives. I am super excited to hear that we don't have to worry about the kind of awful tension and conflict that we experienced last time between our midwife and OB.

Anyway, this is like a brand new day in my life and I am so excited that this pregnancy journey has landed me here, where I'm able to make a decision based on love. <3

ps- I got my 28 week results back from Ananth hours after meeting with Gayle, and I am still in the normal range on everything!! That gets me a huge vote of confidence through week 34-6. I'll be resending my blood at week 32 just to get me that good news through to the end! 

Week 27 Belly Shot

This is from 3 weeks ago - I feel much huger now, but you get the idea! Probably should have taken the photo beFORE going out, not at 2am when I was dragging... ;)