Week 37, part one

I don't know how coherent or comprehensive this post will be, but I'm attempting to put something together before the complete emotional exhaustion of the past few days knocks me out.  That said, bear with me.

After writing my blog post Monday night, I had a bit of a melt down.  Caused in part by nerves for the amniocentesis and in part by simply being overwhelmed by the significant differences there have between this pregnancy and the first, I found myself as curled up as a nine month and one week pregnant woman can get in a heap of tears.  You see, with GW, the pregnancy couldn't have been smoother...  I didn't realize I was pregnant until week 12 so I "missed" the morning sickness phase (had it, but didn't know what it was), there weren't any medical complications and he came early and very quickly.  I wasn't restricted to bed, I was very physically active and we generally treated me like a normal woman rather than the delicate creature pregnant women actually are (I distinctly remember carrying a full size mattress from our trailer, across our lawn, into our house and upstairs by myself at 8 months because I felt I could).   Back then I didn't have a clue what I was signing up for or what I could lose if something happened to my fetus.  I didn't have the Mommy Gene, I didn't feel connected to the baby and I generally was waiting for labor to begin so that I could get my "skinny pants" figure back.

But this go around, there is nothing smooth and the stakes couldn't be higher.  Now that I fully comprehend what it means to be a Mom, just how much my son matters in my life and what extent I have given/would give or do anything for his well being and happiness, I am terrified of what a fine line I find myself walking with baby #2.  I knew things would be more complicated this go around with my diabetes, but I had no idea that things would be as hard as they actually have been.  While talking with my nurse at the Antenatal Testing Center Tuesday morning she said that "some people's bodies just don't do well with diabetes and pregnancy" and, unfortunately, that "some people" reference seems particularly relevant to me... which is why all of the complications of the past nine months culminated in a crumpled mess of weepy gooey blah that only marginally resembled me Monday night.

Ug.

So puffy eyed and physically drained, we piled into the truck and drove up to the hospital Tuesday for my amniocentesis and first week 37 prenatal check up.  It took a little while for the doctors, nursing staff and technicians to get things all sorted and settled, but after a quick sit down with Dr. Bronsky I was lying on my back repeating Hail Mary in my head and trying to remain calm for the procedure.  I'd done a bit of research on what to expect and depending on which medical website you look at the sensory explanation of an amnio ranges from a "slight, momentary burning sensation" to "pain worthy of local anesthetic" -- so really I had no clue what I'd signed myself up for as the needle and multiple syringes were laid out on my belly for quick accessibility. 

Taking deep breaths and working extremely hard to keep from contracting my core out of anxiety, Dr Bronsky did a second ultrasound of my uterus (the tech had already done the routine one -- AFI level dropped to 19.6) to locate the best place to insert the needle.  Unfortunately this turned out to be much more difficult than he anticipated because of my anterior placenta and Baby's position. So, if you remember, an anterior placenta means that it is attached to the front wall of the uterus and because I had a partial previa earlier in the pregnancy we know that it is attached quite low to the front wall.  Well, as the baby has grown, so has the placenta and now it covers the entire left half of my belly -- which made it impossible to insert the needle on that side.  Looking to the right side of my uterus, the doctor struggled to find a safe place to test because Baby is curled with her back to my right side and her feet, arms and head pointing to the left.  Since jabbing her with a needle is completely out of the question, that left little to no room for even the thinnest of needles. 

Finally selecting a tiny spot near her tush, Dr Bronsky meticulously threaded the needle between Baby, my rib cage and several many blood vessels through my abdominal wall and into my uterus.  Although I can definitively say that the needle going in wasn't so bad, the needle staying in and being tweaked this way and that to find a clear pocket of amniotic fluid hurt like freaking hell.  Back when I was hospitalized at GTU in 2010 I had to have an arterial blood draw from my wrist and, while that was the hardest blood draw I've ever had to endure, it seemed like a walk in the freaking park compared to this amnio.  OW.  It was all I could do to just keep my eyes closed, continue to breath normally and remind myself that it'd all be over soon...

After what felt like hours of torture (seriously, has anyone told DoD about this yet?) the needle was removed along with enough fluid to check on Baby's lung development and the smallest, dinkest bandaid ever was placed over my cramping, sore flesh wound.  Reminding myself this is all for Baby's own good, my minimal optimism flew out the window when Dr. Bronsky bluntly said that "you know, you can tell lung maturity based on the color of fluid and, from what I'm seeing here, we're definitely not there."  He said they'd still run the tests anyway to see if it'd be safe enough to move the induction date up, but unless things were at a certain level, he and the other doctors weren't confident enough to deliver Baby until next Tuesday -- at the earliest -- because she's just not physically ready to be outside the womb. 

So, not surprisingly, this afternoon we got the results back that confirm that Baby does not have mature lungs...  And although the docs are incredibly concerned about the perpetual drops in my blood sugar and the implications that has for placenta failure, they think it is worth the risk to leave her where she is for another week instead of guaranteeing her a trip to the NICU for breathing assistance.  This, unfortunately, is not to say that she'll have mature lungs by next Tuesday or that she'll be NICU free anyway but it's a calculated risk that the perinatologists think is the best case scenario for a high risk diabetic baby.  I guess this is a good thing that we know she's not ready to come out and that I've got another few days to try to kick this respiratory infection (still feel sick as ever and what's worse is GW caught it), but I'd be lying if I said that I wasn't distraught by the news that things are progressing like diabetes predicted.  I mean fortunately she's not a gigantic diabetes baby, but dang nabit why did my pancreas have to go and screw with her lungs when it has frankly screwed with me and Baby enough for a life time?!  I'm quite done being pregnant and I am completely over being diabetic... one is hard enough as is, but both of them? In the worst combination possible? Not cool.

With November being World Diabetes Awareness Month I feel a bit guilty at just under two years of affliction complaining about the lack of a cure, but you know what? This isn't like a prison sentence -- I didn't do something that made me deserve this disease and therefore the time of incarceration befitting my punishment.  I might not have the decades of frustration and illness that most T1s have, but I'm just as over this disease and the impact it has on my family as anyone else who needs artificial insulin...  How dare diabetes screw with my baby! How dare my pancreas give up on me when I never would have given up on it! How dare people treat me like I'm broken or, worse, like my disease is "not that bad."  This disease flat out sucks and I am frustrated about what it is putting me through and I am angry that my baby girl is being put through the wringer of every possible medical test because I'm stuck with failing beta cells.

AGG!

Since I'm still attached to my pump, still rocking my battle bandage from Tuesday and I still haven't gone into spontaneous labor, we're planning to go back into the testing center on Friday to check on Baby again.   Assuming all continues as is the doctors don't want to move back the induction from November 27, but if things change for the worse or if I go into labor on my own things may either be sooner or later than Tuesday depending on what exactly is going on.  I'll try to keep my update on Friday to something a bit less rant-ish and a bit more concise, but after months and months of high stress composure I was bound to break sometime...

Until then, have a great Thanksgiving folks!

Absolutely Awful Apprehension of Apposite Amnio

Is it just me or is there unjust alliteration in the pairing of "anxiety" and "amniocentesis"?

With the way things have been going since Friday given the increased contractions and labor symptoms I'm having, I'm a bit surprised that Baby isn't here already and that I'm actually facing the needle tomorrow...  Which, obviously, I'm not thrilled about it.  I know that amnios are done regularly and, heck, my mother even had one with me, but given the number of times I see my blood each day and the normalcy of needles in my life I am not terribly ecstatic for yet another excuse to introduce a long sharp needle to my torso.

Perhaps I'm just being a big baby (please refrain from commenting in the affirmative here), but there's just something about the idea of a needle going through my abdominal wall and into my uterus that has me thoroughly freaked out.  It's my basic understanding that it's a generally uncomfortable procedure with very little risk to Baby given the simultaneous use of ultrasound, but I'm kind of done with additional pain and I truly want nothing to do with the stress of further testing.  What's more, I'm not entirely sure what the doctors are going to use the results for in the first place... Amniotic fluid testing during the third trimester of pregnancy is done to check on fetal lung development to ensure that they're mature enough to work properly outside of the uterus.  But with the way my blood sugars have been dropping so dangerously over the past couple weeks, the doctors are talking about taking her out (I don't know if this means induction or c-section at this point) this week and the amnio results they come up with are kind of irrelevant if they think the placenta is too unstable to sustain her until next Tuesday any way.

Don't get me wrong, I'm not scared of the needle or of the pain associated with it.  I've come to accept needles as a given - kind of like the reoccurrence of morning, the unavoidable existence of taxes or the simple fact that all dinosaurs poop (thank you for that insightful revelation Buddy and Tiny Pteranodon).  The part that freaks me out is that this is something I have no prior context to gauge it in and therefore no way to know what to expect, and, also, that the results will either reinforce the current concerns that she needs to be delivered sooner rather than later or that she's got a rough week ahead of her either fighting a failing placenta or struggling to breath on her own.   Bottom line, I'm finding it scary and overwhelming to be counting down the final eight days of pregnancy without even a hint of reprieve from complication... I'd hoped to end this pregnancy on a high, spontaneous labor note but at this point I'm too tired to expend the emotional capital of hoping for something I cannot within reasonable doubt expect.  She'll come out, but only after we've bared the difficulty of pregnancy right to the bitter end.

With my first pregnancy, I went into labor on my own at week 36 and five days -- which would have been yesterday in this pregnancy.  Seeing that this pregnancy is already longer than that with GW (not just by 24 hours, but also 12 weeks longer to be excessively literal), I'm feeling quite a bit frustrated that my water hasn't broken, that labor hasn't simply started and that the anxiety of bringing this baby into the world is dragging on...   Each morning I wake up feeling like another eternity awaits me over the coming 24 hours and given all the complications we've seen over the last nine months, each minute of those hours brings me closer to the end of my rope and a hopelessly emotional precipice.  Now that I know how wonderful being a mom is and how much my babies matter to me, the stakes are higher than ever and I just want to know she's healthy, she's safe and that we've made it across the finish line together, in tact.

I know that doing the amnio is the right thing to do as far as the Perinatal Associates of NOVA are concerned and, as such, I'm on board and will let you know what we come up with.  But for the sake of honesty, my nerves currently have the best of me and I'd definitely appreciate an extra prayer to be sent up for me in the morning if you've got one...  Saint Gerard Mejella please intercede for me!