Wednesday, October 31, 2012
Week 34, part one
As an exciting post-Hurricane Sandy and Halloween outing, the whole family came along with me to the perinatologist office today for my week 34 non-stress test (NST), amniotic fluid index (AFI) reading and check up. HB, who is the most wonderful, involved father I know, always comes but today was a bit of a treat because my Mom came along totting a very sharply dressed snowman. I was quite flattered that GW received as many compliments on his home made costume as he did, but given the fact he is such a dang cute kid in the first place I give him all the credit for wearing the outfit with such success... course wearing a jumpsuit of 100% polar fleece inside a warm doctors office for two hours turned out to be a bit tricky (especially since he skipped his nap today), but he managed just fine and put smiles on several many faces. Particularly mine.
So... the appointment. Tam, the sonographer, did a partial sonogram for a basic biophysical profile (BPP) reading since they comprehensively looked at the baby's weight and my cervix thickness last week. It is my general understanding that the doctors only do a full sonogram examination of the baby every three weeks because so many things can vary from one week to the next that it's not worth the extra stress if something may be a simple "water weight" change. Any way, Tam spent the sonogram focusing on Baby's heart rate, her breathing patterns, her muscle tone, her movement and amniotic fluid levels (22.3) - to which I am happy to report Baby got the perfect score of 8/8. She also did another 3D ultrasound and, for the third time this pregnancy, we got to see our little angel's face... granted she stuck her tongue out at the camera today, but hey she's supposed to be practicing that - she's got a big brother to contend with after all!
After the sonogram, the nurses had me do my second weekly NST. Since she was more active after I downed Starburst last week to correct for a low, I checked my blood sugar before starting, noted I was trending low and did the same this week to try to save time. Unfortunately Baby was set and determined to sleep through the Mommy-provided stimulus and after sitting there strapped by a belly band to a loud "wubba-wubba" machine for 45 minutes the nurse came in and gave her a vibroacoustic prod... Having never experienced this before, I must say it's kind of startled me when the nurse first pulled out this wand thing because I didn't know if I should expect a shock or what. But essentially a vibroacoustic stimulator is a hand held machine that sends vibrating sound stimulus into the uterus to invoke a fetal heart rate acceleration - which is the whole point of the NST in the first place. After that the baby responded within the limits they look for at this stage in the game and I was taken off the machine after another 15 minutes.
Bored out of his mind, GW requested to go read a toy book (pregnancy magazine) in the lobby with Grandma and so HB and I went back just the two of us for our meeting with the one and only Dr. Bronsky. I gave him my blood sugar logs and for a matter of several minutes (which felt like several hours) he was dead silent as he looked at my numbers and began strategically flipping through my chart. As I've previously shared here and outwardly complained about at all of my recent appointments, my blood sugar has been continuing to drop into hypoglycemic ranges that aren't normal or ideal for this point in the pregnancy. Since my last blog post where I indicated that my basal rate was decreased to the "low" daily total of 15.3 units I've had to further decrease it to 13.9 units - and I am still seeing numbers in the 40s and 50s! So, finally, he spoke up and said with a voice of mixed relief and concern that the results of my AFI and NST today are fantastic but that the lows in my blood sugar logs likely indicates a problem they're not seeing with the placenta. As the implications of this can be dangerous and my diabetes is "very serious" (his words, not mine), these numbers warrant the doctors to be even more cautious as we finish out the pregnancy and Dr. Bronksy requested that I come in twice a week to the hospital for my testing so that they can monitor Baby more closely and "retrieve" her immediately as necessary.
So as of this Friday morning at 8:30 AM, I begin my new routine of every Tuesday and Friday doctors appointments for the next several weeks of third trimester fun. With any luck there wont be reason to justify more frequent appointments than that between now and delivery, but we'll see if we actually make it to the induction date - which YES we did set today.
Drum roll please...
If for whatever reason I do not go into spontaneous labor before week 38, the doctors have scheduled Baby to be born on Tuesday, November 27! Dr. Bronsky explained that he'll have me come in the night before to be put on Cervidil and, depending on how things went with that, the morning of Nov 27 he'd would start Pitocin and artificially rupture the amniotic sac. If things progress slowly, he said that we could expect to have Baby mid afternoon that day; but when HB mentioned how quick active labor was for my first birth, Dr. Bronsky said it could be much quicker than that.
As I'd rather go into labor spontaneously than wait for this little whumpus to come out on a specifically circled date on the calendar (yes, I think that is weird), I am somewhat hopeful that she'll decide to pleasantly surprise me between now and then with an awkward gush and sharp twinge of pain. Regardless, even if I don't go into labor on my own before then, it sounds like the docs are confident that I'll be able to have the vaginal birth that I've been hoping for and for that I thank God! With how complicated things have been it's at least nice to know that Plan A is what I wanted all along and that Plan B is there as needed...
Since my hands are shaking and my bg is probably low that is all for now. I'll be back again on Friday with another update from the land of the overly poked and prodded.
Diabetic Mommy of One, soon to be Two