Friday, May 30, 2008

The week in review

Sorry I have been slow in updating. Nothing really new going on - still pregnant, LB still moving and we continue to be not at all patiently waiting for LB to make his/her appearance. Below is a summary of the week. Sorry it is so long.

Brad and I had a wonderful memorial day weekend. In true "Brad and Kami" form we got next to nothing productive done. The best day was Monday when the weather was just perfect. We walked a little over a mile to check out a new breakfast place - which was wonderful. On the way back, we ran across an old neighbor. They were pregnant the same time we were pregnant with Ernest. They have two kids now - the youngest looks to be two. It's crazy to think that could have been us. I was a bit nervous at first to stop and chat, but it went fine. They are are very kind couple and it was fun to reconnect.

On Tuesday, we went to our acupuncturist. She was able to help with my edema a little bit (it hasn't been bad, but aggravating my carpal tunnel) and suggested I drink a bunch of dandelion tea. I drink a cup a day . . .it is kind of nasty, but we have tried worse things to have a baby and it seems to be helping. On the way home we stopped by my midwife's home for our 9th(?) appointment. This one went much better than the last. She went to Senegal recently and she showed me some of the things she brought back. Senegal surrounds The Gambia and have similar cultures. It brought back memories of my time in The Gambia and gave us something to reconnect about. Brad chatted with her husband and we got to hear some good stories about his sail boat tour of Greece. It was a nice evening. The best news: LB's h/b is still strong, my b/p was good (110 /70) and everything seems to be on track.

On Wednesday we went to see our OB. As usual, it was a looooong wait. That worked well though, because my mom was in the adjoining hospital's ER so we hung out with her while we waited for Dr. Wonderful to get caught up. She's fine. She fell and cut her face, but a little skin glue fixed her up. About 45 minutes after our scheduled appointment, we walked back over to my OB's waiting room and, appropriately enough, we waited.

When we finally get back to the exam room and have my b/p checked it was 142/90. A far cry from the day before. I wasn't concerned. After all, I had been hanging out in a hospital's ER or a room full of pregnant ladies for more than an hour - both creating some background stress. Dr. Wonderful came in, noticed my swollen feet (in hindsight, he was probably purposely checking for edema) and chastised me for not keeping my feet up. Why should I? They aren't that swollen and they don't cause any discomfort. He asked if I had done any cervical checks with my midwife. I hadn't. He said the blood pressure wasn't good and that if I was his patient - and we knew my cervix was at least 3cm dilated - he would have induced that day. How crazy is that? My blood pressure was borderline mild - a pregnancy induced hypertension (PIH) diagnosis is considered 140/90. He said that I wasn't spilling protein, but I did have 2 of the 3 other indicators of PIH - swelling and elevated b/p.

Dr. Wonderful suggested we see my midwife on Friday - two days later - and if any indicators got worse to get my kidney and liver function checked. Well, I knew Cathy would think the blood tests were a waste of time. My OB said that if it were up to him, he would get the blood work today. "Fine, let's do it today. We can always ignore the results." "No we can't," he replied. Brad took this to be the end of discussion and asked him if he would fill out my short-term disability paperwork. "Sure. When do you want to start?" I figured it would start when we had the baby. Brad half joked that it would be nice to start sooner. The rest of the conversation went something like this:

Doc: I think you should start tomorrow.
Me: Really?
Doc: Yes. I think you should go on bed rest.
Me: Really? Full bed rest?
Doc: Yes. Get up only to shower, eat and go the bathroom.
Me: Really? Not even take walks?
Doc No, not even walks.
Me: Really? My b/p wasn't even that high and I had just come from the ER - my mom is fine, btw, but wouldn't that cause my b/p to go up?
Doc: The pregnancy hormones should keep your b/p from going up even if you are stressed or nervous. Your heart rate may increase, but your b/p should stay down.
Me: But bed rest?
Doc: Yes.
Me: Really?

We went on a bit longer as he explained how it was suppose to help. It would lower my b/p making it easier on my kidneys and liver. We talked about signs to watch for (which I already knew since my age and using donor eggs increase my risk of PIH), but he said not everyone will have symptoms. He didn't like the idea of me just monitoring on my own, but wanted someone to see me. I had my blood drawn for liver and kidney function and off we went, my head spinning.

Brad and I then grabbed some dinner at our favorite Mexican deli (it has become our mini-tradition after an OB appointment) and I headed off for a visit with my hypnotherapist. That was an interesting experience, but I will save it for another post.

After I got home I called my midwife to see if she could see me on Friday - currently we are not scheduled until Wednesday. I told what my OB thought. She said, "I don't believe it. You were probably just stressed." I told her what my OB thought about that. She said, "I don't believe it."

Ok, that's fine, but can we have a little discussion? Can you expand on that a bit as in, "I don't believe it because I have too many clients with borderline b/p do just fine." I felt very much shut down. Brad said I should have expressed my feelings, but I just let it go. Needless to say, I didn't ask her to see me on Friday.

Wednesday night I didn't sleep well. I was irritated with both my OB and midwife. I think my OB is overreacting. I think my midwife is underreacting - or at least not listening to my concerns. I am 100% against giving birth in a hospital unless it is absolutely necessary. I am frustrated with how I am treated sometimes by my midwife. Still, I know that she has had experience reviving babies (she is a nurse by training), she is mostly hands-off during labor (which I like) and she is a good person. It is probably good that she has such faith in my body to give birth. I still hate that my two caregivers are on opposite sides of the spectrum and I am stuck in the middle trying to figure out what is right for me. To top it off, I think they both resent that I am listening to another's advice. You would think they would both know me better by now. I'm in charge, they are my consultants.

On Thursday, my OB called to say that my liver, platelets and hemoglobin were fine, but my kidneys weren't 100%. He gave me the numbers to research later, but my understanding was that they were just a bit elevated and more water and bed rest could make a big difference. I told him I would not see my midwife, but would monitor my b/p on my own and see him on Monday.

Today is Friday and my b/p is doing ok - it was 130/75 this morning and I am about to run to the store and check again. I have increased my fluid intake and spent about 1/2 the day laying down and 1/4 of the day sitting wit my feet up. The rest of the day not doing what my OB recommended. I feel ok with that because my 2:00 am google scholar research found some research indicating bed rest can actually be bad for mild hypertension because it can increase the risk of blood clots. It also indicated that biofeedback can decrease b/p in pregnant women with mild to moderate PIH. Wouldn't that mean stress could make a difference?

There you have it - an eventful week. In summary, I am on modified bed rest for now, 38 weeks and 1 day along, LB still moving, and I am done with work until at least 6 weeks post delivery.


MrsSpock said...

Wow, bed rest does seem a little overreactive, though I do think it's a good idea to keep an eye on the BP at home.

I tried the dandelion tea myself and found drinking it plain was better than trying to sweeten it with honey or sugar. I basically divided it into two shot glasses and chugged it to get it down.

midlife mommy said...

How frustrating! Just keep your eye on the prize, and try to relax. I've never heard of dandelion tea for edema -- I could have used something when I was pregnant (mine started at 12 weeks).

Jill said...

Please keep your eye out for other symptoms... pre-eclampsia can come on very quickly.

My BP was only around 139/92 when my PIH panel came back with some elevated stuff - that's why Ben was born at 36 weeks.

I think the actual value of your BP isn't as crucial as how much of an elevation it is above your own normal.

Take it easy and watch that BP. And if your vision changes at all, go in ASAP. I know I'm being an over-reacter now. But I'm a worrier like that. :)

I'm glad that resting has already had such a nice impact on your BP. You need to rest!! You're about to have a baby! Sleep while the sleepin's good. :)

Geohde said...

It's probably a good idea to keep an eye on the BP and the oedema, but who knows, LB could make an appearance and that will fix the opposing MW/OB views,


Familyof2 said...

WOW...I agree...bed rest at this point? he/she could come out now and be FINE. However, we need to keep you healthy too!

Best wishes on a healthy happy baby soon! And a happy maternity leave!

Summer said...

Must be frustrating to not be able to trust either your OB or midwife completely because of their biases. It seems like you are able to put their two opinions together and figure out what the middle ground is, though.

I will be hoping these next weeks go smoothly for you.

Lori said...

Wow. What a week.

It's very hard to know when to give credence to "experts," external authorities, with a certain set of knowledge -- and when to give credence to yourself, your internal authority, who knows you better than anyone else.

I think you are doing a great balancing act, Kami.

B said...

Youch. What a week

But can I officially say. Congrats. You are now 38 weeks which is officially full term.

I hope LB makes a speedy, healthy entrance into this world.


Sending all my love, thoughts and even prayers. Sounds like you might be out of action any time soon now (well in a very different kind of action) so Here's to you, your dh, and LB.

I'm thinking of you.


Fertilized said...

Kami- I am sorry that you are not at peace with these concerns and caretakers. You and family are in my thoughts

Michell said...

Sorry about the feeling caught between the two of them. That must be frustrating. I also don't think that the bed rest with slightly elevated BP at 38 weeks seems like a huge (bed rest kind) of worry. Like others have said, continue to be aware of possible signs of problems and hopefully enjoy a bit of extra time to sit and relax before LB gets here.

niobe said...

You know where I'm coming from on this, so you can discount it accordingly, but I would keep a close eye on your blood pressure. I went from normal blood pressure to preeclampsia within a period of less than 72 hours.

Now, obviously, mine was an extreme and unusual case and most people with borderline blood pressure will do just fine. But please be careful.

stacyb said...

hiya kami -- just catching up on all your news...HOLYMOLY you're almost there!!! I hope that you are able to have the birth you want and keep in mind it's the forest not the tree that is important -- at least i found that helpful for myself when my plans for a natural childbirth didn't happen because the baby never dropped and i never went into labor...

my one suggestion, take it or leave it, is that you go through what would happen if you had to give birth in a hospital so you and your doctor and midwife can be on the same page about a plan b if it needed to happen. I did it that in great detail with my doctor and doula and it really helped when, in fact, we needed to go to plan B.

Shinejil said...

I think you're right to try to balance the differing opinions and do what feels right. Bedrest would be a near death sentence for me, so I'm totally for cheating a bit.

Hope the b/p continues to stay where it should and all goes well this week!

Kate said...

What a week! I hate when you get such different answers from two trusted professionals, and then have research that further confuses things! Why does pregnancy via DE increase your chances for PIH? I've never heard that (but I'm new to this whole thing)!

Panamahat said...

Hey Kami, I've been so caught up with NCLM I haven't checked in with you for a week, and look what happens when I turn my back!

It sucks you are not feeling entirely happy with either caregiver, and bed rest sounds like a drag. I hope you get through the next couple of weeks uneventfully. And congrats on 38 weeks. I'm so excited for you!!