OB

We had our OB appointment at 9w6d.  It was a rough day all around for me.  I woke-up really nervous about the appointment.  And it did not help that I have been extremely nauseous and fatigued over the past several days.  So I was dragging a bit.  I was tired.  I realized as I was sitting in the waiting room that a lot of my nervousness surrounded around our previous pregnancy.  I never really had a great experience in that office.  Not because we didn’t get sufficient care but because most times I was entering that office it was because something was going wrong with the pregnancy.  And here I was sitting in the waiting room a “normal” pregnant woman.  But am I really a “normal” pregnant woman?  It turns out we just have no way of knowing the answer to that question.  We met with a different OB yesterday.  I think this ended up being a good decision for us.  Both of the OBs are wonderful in the practice.  But the OB we met with yesterday had a much calmer demeanor.  This personality seemed to align a bit more with my personality.  So what do I know?

(1) I’ve gained more weight.  But I woke-up today with the decision to no longer stress about the weight gain.  My eating has turned healthier over recent days and that brings me some peace.  The OB was not concerned in the least bit.  I will not eat through my entire pregnancy.  A lot of my weight gain has simply been the only way I can deal with the nausea and hopefully the nausea passes in the next couple of weeks.  The OB still indicated I am very healthy.

(2) My blood pressure was high.  It was 132/78.  But I was NERVOUS.  My blood pressure last week at the REs office was 106/70.  The OB is not worried.  Me either.

(3) I had more b/w done yesterday to get a check of my TSH level.  It is important this level stays in check during the pregnancy.  We also need to make certain my sluggishness has nothing to do with an elevated TSH level.  An elevated TSH level can increase you chance of preterm labor.  We do not need that.

(4) I am of advanced maternal age (AMA).  This was news to me.  I thought the medical community went by the age of the egg at the time of conception.  But instead they go by the age of the mother at the time of delivery.  I will be 35.  I really thought I had gotten lucky and missed the cutoff.  So immediately I gained the gift of additional non-stress tests (NSTs) and u/s during the 3rd trimester.

(5) We have no way of knowing whether or not I will experience preterm labor with a singleton pregnancy.  This is what causes me the greatest amount of stress.  It also causes the OB some stress.  All my previous pregnancy complications could have been simply due to the fact that I was pregnant with twins.  Or I could have a crap cervix and uterus.  So what do we do?  My OB is not certain at the moment.  She plans to consult with the MFM (high risk doctor) and determine if I am a candidate for P17 (progesterone injections) beginning at week 16 and going through week 37.  These weekly injections have been shown to reduce the risk of preterm labor by 33%.  This is great.  The OB is leaning towards the injections.  If I had experienced preterm labor with a singleton, then there would be no question to the importance of the injections this time around.  But I experienced preterm labor with a twin pregnancy.  We also aren’t certain if my insurance company would cover these rather expensive injections.  But then again my insurance company probably doesn’t want a $100k+ NICU bill again either.  So stay tuned.  

(6) Genetic Testing.  There is new genetic testing available to us.  It is called free cell DNA testing.  It is noninvasive b/w that can be done anytime in pregnancy after 10 weeks.  The test reports positive or negative results for Trisomy 21, Trisomy 18, and Trisomy 13.  This is a test that can be done as an alternative to the traditional NT Scan and Quad Screen which is what we did in our prior pregnancy.  It could also be done in conjunction with those tests.  Most insurance companies do not cover the fee cell DNA testing unless you are of AMA.  That’s me!!  The free cell DNA testing is not a guarantee.  It simply means if a result would be positive then it would be advisable to do a more invasive test such as an amniocentesis.  So after much discussion Kara and I have decided to move forward with the free cell DNA testing at our next appointment.  We are not going to do the NT Scan this time around.

(7) My anatomy scan will be done with the MFM.  This is simply because I am considered high risk due to my AMA and my previous preterm labor.  This will be our next u/s and will not take place until about week 20.  YIKES!!

(8) I've been getting headaches.  I had them with my twin pregnancy too.  The OB told me to take 800 mg of Magnesium Oxide before bed each night.  We picked-up the vitamin last night and I took some last night before bed.  I woke-up today headache fee and I have gone ALL day without a headache.  I'm not going to hold my breath.  But I consider it a win!  Today was the first time in over a week I didn't have to pop any Tylenol.

(9)  The OB was able to find little blob’s heartbeat with the fetal Doppler.  This is great considering I am only 10 weeks.  Our little blob has a heartbeat of 175 bpm.  This was literally the best moment of the entire pregnancy for me.  The actual heartbeat of our little blob.  

(10) Our next OB appointment is January 12th.  So I get to be a normal pregnant lady for at least a bit.  And hopefully longer.

I think another favorite moment of the day came when we ran into the sonographer at the OBs office.  Her greeting to us was “congratulations on the one baby ONLY pregnancy” … I could not agree more.

That is all for now.  

Mary