Okay, so I have been a slacker. I have not updated this page in awhile.

We had another appointment today. Actually we have had one every week for the last month. Everything has been going very well other than my ankles have been swelling up like balloons. This is slightly concerning my midwife because it can be an indicator of preeclampsia, but I have no other indicators (blood pressure rising, vision problems, extraordinary fatigue, chest pain) and it does go away if I am off my feet for a day.

Our baby shower was fun. We have good food (took half a cake home and then took most of it to work the next day.). Got lots of great stuff and had a generally good time. Oddly this was the first night that my ankles swelled really badly and they have continued to since (see above).

We have had two ultrasounds since I last posted. The pictures at this point aren’t great you can only see one part at a time and most are very hard to identify even if you know what you are looking at. He is growing at a consistent rate and was estimated to weigh 7.5 lbs. at the ultrasound on November 30. That means probably about an 8 lb. baby by the due date give or take a pound.

I had the flu over Thanksgiving, but that did not keep me from gaining 2.5 pounds that week. However this week I had lost that 2.5 lbs. again so I am at a total of 11 lbs. gained over my prepregnancy weight.

This weight loss prompted my midwife to do an internal exam today because she says that many women lose weight their last appointment before they go into labor. I am at 0 station, 80% effaced and a fingertip dilated. This is good since I have been having lots of painless contractions everyday and probably 8-10 that I can feel in my back along with a bit of crampiness in the abdomen. Two weeks ago when she did my Group B Strep test (which was negative) she did an internal as well. At that time I was at -1 station, cervix softened a bit and no dilation. As we were leaving she said she would see us next week if not sooner. This is the first time she has sounded as if she believed that there may not be a next weeks appointment. I am okay with this because next weeks appointment is scheduled for the day after my due date.

I think that catches up all of the slacking I have done. Hopefully the next post will be made from the hospital announcing his arrival.

My blood pressure: 130/78
Baby’s Heart Rate: 138-143
Fundal Height: 33.5 cm

So far, so good. My blood pressure is staying right where it should be. The babies heartrate is where it should be and goes up when the midwife is poking at him to check it (this is what should happen). The fundal height is supposed to be 1 cm for each week of pregnancy so 33.5 cm at 34 weeks is right on track. I have gained 5 lbs from my last appointment. Five pounds in two weeks is a lot, but I was wearing jeans and tennis shoes this week and not lightweight shoes and a sleeveless knee length dress. Two weeks ago I had lost three pounds from the previous appointment so net gain in the last month is 2 pounds. Since I should average half a pound a week, I am right on track. I have gained 8 lbs. total, and have about 6 weeks to go. As of the last estimate, the baby will be about 7.5 to 8 lbs, so I am right on track.

I have had a bit more back pain, but the hip pain has disappeared. The physical therapy, especially time in the pool, seems to be helping. I have had some swelling in my ankles on and off, but no cankles. My hands a really swollen every morning, but once I am up and move them a bit the swelling goes away. This was not uncommon in the past with my arthritis anyway, so it is no great concern.

My midwife has said that I should start doing kick counts. For those of you unfamiliar with this, I will explain. Basically this is a technique that is now being used to monitor fetal activity levels and well being. You pick a time of day when the baby is normally active (All babies have times of day when they sleep and when they are active. Trying to do kick counts when a baby would normally be sleeping is just setting yourself up for undo panic.). The first time you feel a kick, you record the time and then count kicks until you have felt 10. If there are 10 kicks in 2 hours, the baby is moving appropriately. If there are less than 10 kicks in 2 hours, you should drink some juice, eat some food, or walk around and try again. If this does not improve the movement, you should contact your doctor/midwife. I have done these occasionally on my own and usually it take only about 15-20 minutes (sometimes less) to get 10 kicks. Also it is not necessarily a kick, but any movement which is good, because I have no idea how you would determine a kick versus a punch. So I will start doing these once or twice a day, probably after lunch and before bed. That is when he is most active.

We have a baby shower on Thursday and our lamaze class on Saturday and Sunday. I will try to post something about both of those events next week.

I had my 32 week appointment and ultrasound to monitor growth today.

Blood pressure: 132/78
Weight: Lost 3 lbs.
Baby×?Ts heartrate: 145 bpm
Baby×?Ts weight est.: 4 lbs 2 oz
Baby×?Ts head size: ~34w 2d
Baby×?Ts overall size: ~32w 4d

The ultrasound technician said that everything looked good. The fluid levels are good. The heart, kidneys, bladder, and stomach all look good and appear to be functioning normally. I was a bit surprised that the head measured 2 weeks ahead when everything else seems to be right on track. This is a little scary to me as I have to push that head out. This better just be a strange growth pattern and not a consistent thing.

My midwife was not too concerned about the weight loss. I think it is more like I did not gain anything. I wore jeans and a sweater with tennis shoes last appointment. I wore a short, sleeveless, lightweight dress and loafers (which are lighter than the tennis shoes) this time. I think the clothing difference account for most of that 3 lbs. This puts me back to 3-4 lbs over my prepregnancy weight.

My PT seems to have helped my hip quite a bit. Well that and falling on the stairs and pounding my knees into the ground. The fall was not that hard, but I have had little or no hip and back pain since I fell on Friday. Maybe something was just a little out of place and it got jarred back into position.

Update on me and the baby.

Friday I saw my rhuematologist and started physical therapy for my back and hip pain. My rhuematologist said she though everything was going well. She did not see any signs of major inflammation. She wants to see me back in 6 weeks. She did tell methat due to my loose ligaments, and floppy heart valve, it is very likely that i will dialate very quickly. This is news I shared with my midwife today (will get to that in a bit).

After that appointment I went to therapy. The therapist who evaluated me said that she did not think I needed a brace because my pelvis was not shifting around at all. She feels that I have inflammation in the joint from my arthritis and need to strengthen my core muscles and pelvic floor. She gave me a few exercises to do at home, but there is not much I can do because I can’t lay on my stomach (obviously) and I should not lay on my back for any period of time. She has also had me start aquatic therapy 2 days a week. I starte that on Monday. The therapist that I am working with in the pool is 27 weeks pregnant so we have something in common to talk about while I am there.

So far the therapy seems to be helping me. My back and hip feel much better. They are still a bit sore, but getting better.

Today, I had my 30 week appointment. Everything seems to be going well. My blood pressure was 138/70. My heartrate is also a bit elevated. It has been between 88 and 100. My second glucose test was 96 (the first was 94). I have gained 8 pounds in the last month. I have finally passed my prepregnancy weight. I am now 6 pounds above it. My midwife said that normally she would tell a patient to be a bit cautious about gaining that much again, but in my case she is not concerned. Even if I gain that much each month for the rest of the pregnancy, I will still be within the allowable weight gain for my pregnancy.

I mentioned to her that my rhuematologist said that I would probably dialate quickly. She said that normally she does not do internal exams, but with that knowledge, she would like to consider starting them around 36 weeks. That way we will know if I am dialated at all before I go into labor and will know how quickly to get out the door to the hospital (especially since it is about 20 minutes away).

I think that is everything.

So, I was supposed to have an ultrasound and my 28 week appointment today. However, right after I got out of the shower, my midwife called and said that she was at the hospital with a patient in labor and that I should call the office before I come in to see if she will be there or not. The ultrasound was at the fetal diagnostic center at the hospital, so I went to that. After the U/S, I called her office and was told that they had not heard from her so I should come in, she may be a few minutes late, but should be in shortly. Her office(at least the one I go to is about 20-30 minutes from the hospital depending on traffic). I got about three blocks from the hospital and my cell phone rang. It was her office calling ot say she ahd just called and said she would not be in, please let her patients know and have them reschedule. I have not rescheduled yet. The next open appointment is next Tuesday (September 28, which is also my wedding anniversary) and we already have one scheduled the following tuesday (October 5). I really don’t see a reason to go in two weeks in a row at this point, especially since we had the ultrasound today that confirmed that everything seems to be progressing well and the heartbeat is good. She won’t do much else in the office, other than check my blood pressure, weight and urine. The urine might be important, but I just did my GD test two weeks ago and it was fine then. I left a message with my midwife to see what she wants me to do. If seh wants me to come in two weeks in a row I will, but I suspect she will just have me wait.

Anyway, the results of the U/S seem pretty good to me and the tech said everything looked really good.

I respect her a lot because the first thing she asked me before she started was do you know/want to know the gender. I said yes we were told it was a boy. She said that she had seen that in my chart, but did not want to say anything to spoil it, like pointing out boy parts on the screen, if we did not know or want to know.

The placenta is still in front, but more off to the left(which explains why most of the movement I feel is still on the right or in the center. It is not obstructing the cervix in anyway so at least I do not have to be concerned with that.

He has turned so he is head down instead of breech (at least for now).

The measurements of his skull, torso, and femur put him at about 29w or 29w1d (so he is still about a week ahead, just like he was at the 20 week scan) and 2lbs 14oz is the weight estimate. According to the website we look at regularly, a baby should weigh about 2 lbs by the end of 28 weeks. Today is the first day of week 28 so he’s a big boy.

The tech said everything looked good and confirmed again that he is a he. The results still need to be “read” by one of the maternal-fetal specialists. They should be to my midwife in a few days.

We will try to get pictures posted later today. I still need to edit some personal information that I do not want the entire world to see off of the pictures.

We posted a poll of the names we have left if anyone wants to vote.

My midwife is out of town so I had to see one of the OBs that are in the same practice as she is. First they some how had me at 21 weeks when they looked at the chart and had to refigure that. She looked at me and said that I looked rather big for 21 weeks, I replied that I was sure I did since i am 26 weeks. Once they looked at the due date, it was all good.

My blood pressure was 110/60, which is lower than it has been and they were pleased to see that. I was measuring 27 cm, which is about a week ahead, but that is typical for me so far. Baby’s heartrate was good, but I do not know the bpm, she did not tell me or show me. Then the doctor told me that I would need to get my glucose screening done soon. I told her that I had that done last month. She said that was too early and I needed to get it done again. So once again I had to go drink the yucky orange soda and sit. I am now waiting for the headache that i got last time to hit.

I had assumed that I had gained weight this month. I have been eating bread and butter with every meal and we bought a half gallon of ice cream and ate all of it in about a week and a half. However, I have actually lost 3/4 lb. They nurse and doctor asked about how I was eating. When I told them I was eating three meals a day plus a snack and eating pretty much whatever I want when I want and taking my vitamins, they said it was not a problem. They are sure I will start putting on weight very soon as the baby will be putting on the pounds soon.

Anyway, after the appointment, the doctor told me to schedule with my midwife in 4 weeks. My midwife had told me every 2 weeks after this appointment. When I told the appoinment desk this, they sadi that I should wait and ask my midwife next week when she gets back from vacation. I agreed, but now I am thinking that i will schedule the appoinment for two weeks. I will have not seen her for 6 weeks by then and it will be nice to see someone who has been following my treatment more closely.

Basically, I think I really prefer the midwife to the OB and am very glad I chose to see her instead of the regular OB. I think I have gotten much better, more personalized care.

On a completely seperate note, I found two pairs of pants that fit this weekend. Better yet, one of them is blue jeans (the other is black cordory). I know this sounds a bit silly to be excited about, but I have been looking for pants since I was about 12 weeks and have never found a pair. I also got two blouses. I think I now have enough clothes to make it through winter. I was unable to find a single pair of tennis shoes that did not make my feet hurt. I will need to find at least one more pair of shoes before winter. I need something I can wear with socks to keep my feet warm. Maybe I should try my winter hiking boots on. If they fit, I may just wear those and get a nice looking pair of slippers (like leather or something) and wear those inside.

I just spoke to my midwife. The consensus is that the heart murmur and tricuspid regurgitation that I have are minor enough to not warrent antiboitics or further concern. She will continue to monitor it and further testing will be done if anything changes.

Finally got my test results back (sort of). My blood glucose is fine. My iron levels are fine. All the blood work was great.

The echocardiogram did not find mitral valve prolapse, which is what they expected to find if they found anything. Instead, they found Tricuspid regurgitation.
The mirtal valve is on the left side of the heart between the upper and lower chambers. The tricupid valve is between the upper and lower chanbers of the heart on the right side.

My midwife was not certain about antibiotics during labor and delivery. She spoke to the doctors in her practice and none of them were certain either. Most of them said that if it was pregnancy induced, medication was probably not necessary, but some said they thought it might be. She has now kicked my test results back to the cardiologists for futher recommendations.
I need to know about the antibiotics thought because i have a dentist appointment in a few weeks and I will need to take them then also if that is what is recommended.

I guess I just have to wait and see. Either way it does not seem to be anything major to worry about.