Monday, April 13, 2009

32 Week Perinatal Appointment

We had to get up bright and early today for our 8am doctor's appointment and ultrasound. My first thought for the day....who the hell scheduled the appointment this freaking early (Braeden had a bad night...he has a cold and did not sleep well)! After rushing to get myself and Braeden ready, I was out the door by 7:30am (albeit sans makeup and doing my hair), only to find 390 was backed up already. Traffic stresses me out in general....but when I have to be somewhere on time, it really irritates me! By the grace of God, we got to the parking lot at 8:02am without mommy having a major meltdown or getting a serious case of road rage.

Chris drove separately and also got caught in traffic so he was 10 minutes late. While we waited for his arrival, I gave a urine sample and then proceeded to throw up my breakfast (fruit and orange juice....nasty!). I guess the stressful morning affected my sensitive stomach.....

They called me back for my ultrasound soon after Chris met us in the waiting room. The ultrasound tech took all the necessary measurements, but she didn't really make any comments (technically the ultrasound techs can't tell you much of anything anyway). According to the measurements, Ashlyn weighs about 4lbs 9oz right now! What a big girl..she is right on target to be over 8lbs like her big brother. The tech also said that the amniotic fluid levels were within normal limits.

During the scan I studied the measurments, and I did notice that one of the ventricles measured over 18 mm now (the other was over 14 mm) and the third ventricle measured over 6mm....which means that the ventricles are increasing in size at a faster rate now. The various head measurements were listed as 34weeks 5days and 36weeks and 2days, while I am 32 weeks pregnant.....her head is continuing to get bigger than expected....

After the ultrasound, we went back to wait to meet with the doctor. After showing off for all the other patients in the waiting room, Braeden had a mini meltdown when we would not allow him to tackle another little boy. Chris took him to the hallway to let him roam around and burn off some energy. Finally after waiting forever (actual time...probably 30 minutes), I was called in for my appointment.

First, my blood pressure and weight were checked. For some reason the tech checked my weight twice....I think she just had a "case of the Mondays"...hopefully she wasn't trying to torture me! BP was 142/80....still high. Ugh.....When I met with the doctor she said that right now, my BP does not seem to be related to preeclampsia (phew) because there is no protein in my urine and my 24 hour urine screen was normal. But I do have to watch out for the warning signs....headaches, epigastric pain, vision changes, etc. However, it is recommended that I do biweekly non-stress tests from here on out just to make sure Ashlyn is doing okay in there! So next week I will go for my first non-stress test.

I saw one of the resident doctors first. She was very nice and friendly, and she didn't mind when Braeden wiped his grubby yogurt melt covered hands all our her white coat. She checked the fetal heart rate, which of course put Braeden in a trance and then made him dance once he heard a beat! My fundal height measured right around 32 1/2 weeks. She told me that my 3 hour glucose tolerance test was normal, but that a high 1 hour can indicate a level of insulin resistance so it is possible that Ashlyn will be on the bigger side.

She asked some of the routine pregnancy questions, and then asked if I had any questions. Duh...."can you please tell me the results of my ultrasound please?!" "Oh let me look in the computer here......when was this ultrasound done?" "Hmmm...Around 8:15am...." Seriously, does this doctor's office not communicate effectively or what? It seems like the practice is kind of scattered and rushed....The doctor told me that she would go over to where the ultrasound office is and get the results.

20 minutes later she returned. I would complain that it took her so long, but she brought one of the SPA attending doctors with her so I figured we were waiting to meet him. This guy had the worst stutter....I am not trying to be mean or anything, but at first it was very offputting. But he seemed like a good guy and was very knowledgable. I have to give him credit for how hard it must have been for him to pursue a career in medicine...but it still was hard to take him seriously when he could barely spit out the word "ventricle." I am such a bitch....I should keep these thoughts to myself from now on I think!

So basically, he tells me that in fact the ventricles are getting bigger faster. But he says that in the 3rd trimester that is expected as fluid continues to build up. The head is also getting bigger faster, and he expects it to get too big to deliver vaginally. He basically told me that unless I go into labor prematurely in like the next couple of week, I am more than likely going to have a c-section. We will try to wait until 39 weeks (June 1st), but it might be necessary to go as early as 37 weeks pending an amnio to check for lung maturity. As far as if Ashlyn will need a surgically placed shunt, he says that it is usually only the extreme cases where a shunt is placed right away...but we will not know for sure until she is born.

We will be getting a fetal MRI, which could possibly give us better insight into the situation (more than likely it won't tell us anything new though). The secretary just has to work with my insurance before she can schedule a date. Luckily, I already called my insurance and know that they will in fact cover it for a $40 co-pay. I will get an ultrasound at every doctor's visit from here on out. I go back on May 1st for my 34 week appointment. After that, I will go in every week until I deliver.

Now, I am feeling overwhelmed with everything again. Things were looking reassuring with the last ultrasound, and I was optimistic that I could have her vaginally with no complications. Now, I know that is not necessarily the case....Some women (who are crazy) prefer to have scheduled c-sections, but I am seriously stressed over that possibility. My labor and delivery experience with Braeden was very fulfilling. Granted, I labored forever, needed pitocin, freaked the crap out of Chris, ended up with an epidural, and tore my va-jay-jay....but I felt so proud and accomplished after he was born. Words cannot explain how empowering giving birth vaginally is....and I just cannot imagine feeling that way after having major abdominal surgery! I want to do what is in the best interest of my baby girl...but I still cannot keep myself from whining "I do NOT want a c-section!!"

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