Archive for July 2010

The Amniocentesis

July 2, 2010

We arrived early for the 9AM appointment. Sitting in the waiting room, I was excited and nervous, giddy even. My stomach was tying itself in knots. Our car was loaded up with our hospital bags and the car seat just in case.

Earlier in the week, when I explained the plan to colleagues and friends, they were alarmed. “You’re having an amnio? Isn’t that risky?”

I repeatedly explained what the doctor told me. Yes, an amniocentesis carries a small risk of miscarriage. That’s why they use them sparingly in the first trimester to detect genetic and chromosomal disorders. But at 37 weeks, technically full term, “miscarriage” is really nothing more than an early delivery, so the risk of fetal death is just about nill. Even if I were to go into labor and deliver the baby as a result of the amnio, the chances that he would not survive were next to nothing.

In the exam room, the ultrasound technician lubed up my belly and started running the wand over it. We looked at Baby NoName’s limbs and kidneys. She measured his leg bone, his belly, his head. She estimated his weight at six pounds, four ounces, right where he should be for 37 weeks. She looked for big “pockets” of amniotic fluid and estimated the amount of fluid surrounding the baby. She tried in vain to get us a picture of his face, but he had “dropped” so far into my pelvis, that she could not get his whole face, just a profile. “Oh well, we’ll see his face in person soon enough,” I said with an anxious laugh.

The doctor came in and asked if we had questions. Not really. The procedure is pretty straight-forward. They use a needle to extract amniotic fluid from the uterus so that they can determine whether or not the baby’s lungs are fully developed. I asked how long it would be until we had the results. “We’ll call you with the results by 4PM tonight. But I can usually tell just by looking at the fluid. It should be cloudy.” He warned me that the needle is really long. They’re kind of one-size-fits-all, so they need to be pretty long to accommodate moms with a bigger layer of fat. I looked away because I didn’t want to see the needle. I don’t have a problem sticking myself with a needle, but I’m not so comfortable when someone else is wielding the syringe.

He turned out the lights so that he could focus on the image on the ultrasound screen. He joked, “I have to turn out the lights so that I can see better.” I focused on the screen, too. That long needle was kind of freaking me out.

He inserted the needle and I prepared for the sting. But it didn’t hurt at all. Actually, the insertion felt a lot like an insulin shot. After that, I could feel the needle in my belly, but there was no pain. It just felt kind of weird. The whole thing was over in just a couple of minutes. The nurse turned on the lights. “Looks good and cloudy,” he said.

Next he did an internal exam to check my cervix. I was not dilated at all. So assuming that the test results confirmed his “cloudy” diagnosis, Cervidil would be our next step.

In the meantime, we headed over to the fetal evaluation department at the hospital for an hour-long non-stress test. They wanted to monitor the baby and my uterus for normal activity, heart rate, and contractions just to make sure that the procedure did not cause me to go into labor. Baby NoName performed his characteristic turns, kicks, and flips, and, an hour later, the nurse declared the test a success. We were free to go.

The next four or five hours were the hardest part. Waiting for that phone call was excruciating. Right on cue, though, at 4PM, the office manager called from the OB’s office. The results were in and Baby NoName was ready. “Come to Labor and Delivery tomorrow at 5PM. Eat before you come. In fact, eat something good, because they won’t let you eat once you’re admitted,” she advised.

Wow. This is it.

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Three Weeks

July 1, 2010

It’s amazing what a couple of solid hours of sleep will do for you. Thanks to a magic little pill called Ambien, and a wonderful husband who sacrificed his evening shut-eye and took care of the feedings (thankfully Lukas is finally learning to take a bottle!), I have had three nights in a row where I got over four hours of sleep. Four hours in a row! I am not ready to run a marathon just yet (or even a household for that matter,) but I am feeling much more human.

Which reminds me, thanks so much for all of the congratulations and well-wishes over the last couple of weeks. You guys are so great!

I had a follow-up appointment with the OB yesterday. He says that I am doing better, although I am still behind the curve in terms of pain. I’m pretty much off of the Vicodin now (Thank goodness, the side effects were killing me. Night sweats and sinus headaches are no fun,) but I am still taking the maximum daily amount of Ibuprofen.

Besides the expected abdominal pain, I also have a killer lower backache. The OB recommended a heating pad which is helping. If things don’t resolve themselves in a couple of weeks, I might try the physical therapist again.

I had hoped my digestive woes would resolve themselves after the birth, but they are still hanging around. Also not enjoyable, but manageable at least.

My mental state resembles a roller coaster. Most of the time, I am so overjoyed to have this little bundle here with me, that I can’t even begin to describe it to you. Other times, mostly when I am overly tired, I feel overwhelmed and weepy. We’re keeping an eye out for postpartum depression, but so far this seems to be just severe sleep deprivation and a little bit of the “baby blues.” The OB says to take an hour every day for me. I’m not sure how to accomplish that, but I’m going to try. Maybe writing up this post counts?

Breastfeeding is not a walk in the park, but it is much improved. I’ve seen two lactation consultants, including one from the local health department. She came to the house for free and brought a wealth of information on all things baby, including vaccinations, bottle feeding, and milestones. She even tweaked our car seat installation. She also measured and weighed Lukas and listened to his heart, lungs, and tummy. He is growing like a weed. She was astounded to discover that he gained six ounces in a week. She says most breastfed babies gain about half of that amount. His newborn-sized onesies, the same ones he was swimming in last week, are almost tight now.

When she watched us breastfeed, I was dismayed to hear, yet again, that his latch is great. So why am I in so much pain? She was persistent in helping me, though, and she suggested that I pump a little before I feed because I’m making too much milk. This causes me significant pain, especially when he latches, basically because I am too … er … full. Hopefully this little trick will keep me going until my milk supply balances out to his demand. I am trying not to get too hung up on breastfeeding, but it’s hard. I think the hormones and lack of sleep are messing with my practical reasoning skills. It is such an emotional decision to stop breastfeeding, and it’s not like you can change your mind back once you decide to quit. So I’ve made myself a few mini goals; If I can make it to one month, I’ll try for three months and then for four months (when I return to work.) If things are going well then, I’ll shoot for six months. I’m close to that one month goal (just a week to go,) but that three-month goal seems really far off. We’ll see what  happens.

It is amazing what birth, recovery from surgery, and breastfeeding will do for your waistline. I’ve lost 25 pounds in three weeks. I actually weigh about five pounds less than I did pre-pregnancy. Of course, I am still pretty flabby, especially in the belly area, but I almost have a waist again.

Incidentally, my BGs have leveled out some, but they still seem to have a mind of their own. Matching my needs with the right amount of insulin is kind of like hitting a moving target, partly because there is no real pattern and partly because I am exhausted and just don’t have the energy or the time. I am still taking considerably less insulin than I took pre-pregnancy. I was at about 35 units per day then, now I am at about 20 units per day. At the height of the pregnancy, I was taking about 75 units per day. Pretty wild, huh?

Lukas is three weeks old today. I marvel at how much he has changed already. Everyday, he does something new, displays a new personality trait, or grows a little. He’s smiling and meeting my gaze while I feed him. He lifts and turns his head a lot, and uses his strong little legs to push off and squirm during tummy time. Even his eyelashes are growing! And I’m growing, too. Learning his needs and wants, what his cries mean, and how to type with a fussy baby in my arms. Now if I could just learn to care for him in my sleep!