More Catch-Up on Baby News

I haven't been very good about blogging about my visits to Dr. Stempel and Andaluz lately, so now that I am on maternity leave, I figured I should play catch-up.  :)

I think the last time I wrote, I had just had the glucose tolerance test.  This was around 30 weeks.  My result came back slightly elevated (163), and Dr. Stempel wanted me to take the 3-hour test, which means fasting for 12 hours or so and drinking twice the glucose solution.  I really did not want to take the test if I could at all avoid it.  My suggestion to him as a compromise was to get a little monitor and test my blood a few times a day. 

He said that would be fine, so he wrote me a prescription and I poked my finger 3-4 times a day for about 2 weeks.  I tried to do it 2 hours after eating, but it was tough always remembering to do it on time--especially when I was at work.  It seemed that sugary things like fruit didn't really raise my blood sugar much, but corn chips were a definite culprit as I discovered one night when we had taco salad for dinner and I ate a bunch of them.  Staying away from chips isn't too tough though.  I would have much more of a problem staying away from fruit!  :)

The only thing that bothered me about testing my blood with the glucose monitor is that I wasn't sure if it was working correctly.  The instructions said to run a drop of control solution through the monitor upon first use and then compare the result to a range of numbers specific to that monitor.  If the control result was within the range, that would mean the test was working correctly.  The problem was that tthere was no control solution in the box with the monitor.  When I called the pharmacy to ask about it, I discovered that not only is it something that must be purchased separately, but that they don't even stock it--it would have to be ordered.  Wow.  Okay, that makes absolutely no sense at all.  Why would someone spend time (and pain!) pricking a finger several times a day if they weren't sure the monitor was working properly?  It would make much more sense if the pharmacy stocked the solution and offered it separately from the monitor--like they do with the glucose test strips.  Or if they at least let people know when they picked up the monitoring kit that the solution was available to order, then the decision would be up to the individual over whether they wanted to spend the exra money to make sure the monitor worked right.

Anyway, you can probably sense my frustration with the whole thing.  :)  When I didn't get very high values after steady testing, I decided to quit until I could get some of the control solution.  It came in last week and now I just have to test the monitor.  It's funny that I haven't done it yet--I'm not sure why, unless it's just that I am kind of fed up with the whole thing.  But testing the monitor is on my list of things to do today, so we shall see.  I'm pretty sure that it is working just fine and that my blood sugar is fine too--as long as I can stay away from those chips!  ;)

I had another appointment with Dana during the last week of February and I met her apprentice, Isabelle.  I really, really like Dana and I liked Isabelle very much too.   They are both what I would call soft-spoken (although I would say Isabelle is more so than Dana), and they both have a very calming energy about them.  I love that.  There was a bit of a scheduling snafoo the day of my visit, so Isabelle started my checkup and then Dana joined us later.  What I thought was really cool was that Isabelle explained how the urine testing works--I'd had no idea really what they looked for except for protein.  I think that is one component, but there is a whole list of other things they check.  They dip a plastic strip in the urine and it makes boxes for different things change color.  Then they compare the colors on the test strip with a control diagram to see if anything is "off" about the urine.  They can tell if you are hydrated, if there is too much sugar in your urine, etc.  Very cool.  She showed me how my test strip cmpared with the control, and all of the colors matched!  Yay!

They weighed me at that visit and I was at 144, which was the same as I had been weighing at Dr. Stempel's office.  I had gained 10 pounds total since the start of pregnancy and Dana had seemed a little concerned at our first visit, but I don't remember her stressing anything in particular at the visit with Isabelle.  I just remember feeling very heard and nurtured.  I left feeling very confident in my decision to birth with the midwives, and feeling happy that I was finally getting the type of care I had wanted all along.

Dana had told me that she would be off during March (the midwives take turns having months off when they are not on-call), and so I arranged to meet the woman who would be my back-up midwife, Katherine.  I think I saw her a week after seeing Dana, and I met her apprentice, Alison.  I have to admit that my first impression of both of them wasn't particularly great.  Maybe Dana spoke to Katherine as part of my transfer of care about encouraging me to gain weight.  Maybe Katherine just looked at my chart and thought that 10 pounds was not adequate weight gain for this far into my pregnancy.  Whatever it was, I felt, from the moment the visit started, almost attacked about what I was eating, how much I was eating and that I needed to gain more weight.  Now I know their intention was not to make me feel that way.  I think I just wasn't expecting so much emphasis to be put on that issue since I had asked Dr. Stempel if I was gaining enough and he had said yes, that the baby was measuring fine.  I think he'd been measuring a week or two behind at each visit, but Stempel said the measuring they do isn't an exact science and could vary a bit.  They don't get concerned unless they see a drastic discrepancy between the number of weeks of actual gestation and how the uterus measures.

So when both Katherine and Alison talked simultaneously about how I needed to eat more for my baby, I started to get scared and to feel like I had not been doing a good job--that he was malnourished.  When Katherine palpated my abdomen, she said she didn't feel as big of a pocket of amniotic fluid as she had been expecting and that that was likely from not eating enough.  I felt awful.  Then it was time to get my weight.  It was 140, which was 4 pounds less than I had been weighing for several months, and just last week at Andaluz on that particular scale.  By this point, I really felt bad.  I started crying and feeling like a bad mother before my baby was even born yet.  I know Katherine felt badly--she sat down right next to me and looked in my eyes and told me that I had been eating good, nutritious food--just not enough of it to get the amount of necessary calories.  I had been eating a ton of salad (mostly from Whole Foods which, along with New Seasons, had been a lifesaver in providing easy and healthy lunches and dinners while I was working.)  Needless to say, when I left my appointment, I felt a bit panicky.  I was determined to start eating a bunch of calories and gain weight. 

I discovered WOW gluten-free oatmeal cookies with dried apricot and I think cranberry.  They are big cookies, so I started eating one for breakfast with whole milk.  Over the course of one week, I had a total of 4 burgers from New Seasons . . . some were hamburgers, others were turkey burgers--always with swiss cheese and lots of veggies.  My favorite part about those burgers is that they are like sandwiches (you can choose lettuce, tomato, grilled onion, mushrooms, cucumber, avocado, etc.) with a turkey, beef or bean patty.  I ate a whole lot of the black bean burgers during my first trimester when I was hungry all the time.  :)

Another thing I did was start trying to eat constantly--even when I wasn't hungry at all.  I went through an enire block of my favorite goat milk cheddar cheese from Trader Joe's in one week--as well as a carton of vanilla ice cream.  I looked for cottage cheese made with whole milk, but could only find low or no-fat varieties.  I did find some whole milk yogurt, though.  I have been buying the plain kind (less sugar) and sweetening it myself with frozen strawberries or blueberries.  I have never liked yogurt (and I still don't!), but I know it's got lots of protein in it and is good for both me and the baby.

So when I saw Katherine again last week (a week after the visit where I weighed 140lbs), I was very nervous about getting on the scale, but felt that I must have gained at least some weight.  And I was up 5 pounds!  So now I was back where I'd been, plus one pound.  Katherine and Alison celebrated with me and encouraged me to keep it up.  I had kept a food diary over the course of the previous week at Katherine's suggestion and she said it looked great, that I was now getting enough calories even though I was eating a lot of the same foods each day.  I'd heard from naturopaths before that variety was really important, but Katherine said it was fine to eat the same things.  She probably just didn't want to stress me out about finding a variety of high-calorie, yet healthy foods, now that I had finally started gaining weight. 

When she palpated my abdomen last week, she said it felt better--that there was now more fluid around the baby.  I was glad about that.  I'd gone in mostly in order to be checked for a UTI, since I'd been having a LOT of Braxton-Hicks contractions since I had last seen her.  Katherine said that sometimes when a UTI is brewing, it can cause an increase in contractions.  Of course, I was worried about pre-term labor.  The sheer number of cotnractions I was having seemed like too many (2-4 an hour, every hour, for several hours in a row).  But work had been stressful because of a huge and very important project we were doing for Intel, and I'd been pushing myself too hard.  One night Michael and I didn't leave work until nearly 11:00pm.  Needless to say, I was not a happy camper.  I had so many contractions that night and the following morning that I decided to stay home from work the next day.  Then I had contractions all day while I watched Netflix on the couch. 

I had been debating about when to go on maternity leave (March 16th had been circled on my calendar for several months as my potential last day, but I hadn't made a definite decision).  Having all of those contractions pretty much decided it.  I felt a bit guilty about going on maternity leave at 35 weeks, since I know many women work right up until their babies are born, but I really didn't want him to come early and I was afraid the increase in contractions was my body's way of saying, "Hey! Pay attention!"

Anyway, I left that second appointment with Katherine and Alison feeling much better than before.  I still hope to have Dana as my midwife, but I'm comfortable having Katherine as a back-up.  :)

I think it was right after my glucose test that I had my first appointment with Dr. Dramov (the naturopath who helped me transition off of antidepressants about 7 years ago) and whom I had last seen a couple of years ago.  I wanted to show off my pregnant belly (of course!) since he knew I'd been trying to conceive for a number of years and had recommended different supplements back when I still thought I could get pregnant naturally.  Mostly I wanted to talk with him about his recommendations on vaccinations and on alternative medicine-friendly pediatricians in the Portland area.  It turns out there aren't too many of those, sadly, but I think Eileen has someone she likes and I'm going to check with her the next time we meet up.

Dr. Dramov did look at my most recent thyroid and iron tests.  I was due for another thyroid check and he recommended getting it on a day when I was due for a "double dose" of meds.  Normally I take 25mcg of Levothyroxine Sat, Sun, Mon Wed and Thursday and I take 50mcg on Tues and Friday.  His thought was that maybe I needed a higher dose daily (37.5mcg) instead of just getting the cumulative higher dose over the course of each week.  He also recommended taking a B12 supplement to help with being anemic and also an iron and herbal supplement called Floradix.

I saw Dr. Stempel Monday (35 week appt), and now will begin seeing him every week until the baby comes.  My blood pressure was fine (it seems to stay right around 90/60) and I was up another 4 pounds on the scale!  Guess all those extra calories are working . . .  may back off just a bit though, because I don't want to keep gaining 5 pounds every week--especially if I end up going to term or past term!  :)

I had the Group B Strep test and realized again the difference in the type of care I get from Stempel and from the midwives.  There is no choice in having the test at Stempel's office--I was just told I was having a culture taken.  I can't remember now if Stempel told me it was for GBS or if I asked.  At Andaluz there is informed consent paperwork about everything.  Women  have plenty of time to read the information and ask questions before it's time to decide about which tests they'd like to have done.  I prefer this method of care, even though I was planning to have the GBS test anyway (my friend's baby died of it in the early 90's before routine testing was the norm).  I just think people should have more of a say in their prenatal care if they want it.  If they want to follow the doctor's recommendations, fine, and if making a different choice feels better to them, fine.  The midwives don't really give an opinion one way or the other (maybe because I have not directly asked).  They provide information and then it's up to the woman and her partner to ask questions. The parents of the baby end up making the final choice.

I told Stempel about the midwives' concern with my weight and that I was worried the baby might be too small.  In Stempel's opinion, all is well.  He said the baby is still growing, even if he's a bit behind--I forgot to ask what my womb measured yesterday.  Last week at Andaluz I was up 3cm, so was measuring right on (34 1/2 weeks).  The previous week she had measured me at 31 weeks, so it was quite a big catch-up.  Dr. Stempel said that from his palpation, he guessed the baby already weighs about 6 pounds.  You can imagine my surprise!  Babycenter.com said generally at 35 weeks, babies are just over 5 pounds, but I didn't think he might already be 6! :)

Stempel wanted to check my cervix because of all the contractions and he said not to worry, that it's not doing a whole lot yet.  It's started to soften a little, but that's about it.  He said that he doesn't think I have to worry about preterm labor and that in fact, I may very well go late.  I suppose it's hard for them to say, but that makes me feel a LOT better.  :)  Besides that, since being able to rest over the past 5 days, I've noticed the frequency and intensity of the contractions has greatly subsided.  Maybe that is all I really needed--time to rest.

So we're headed into the final stretch in pretty good shape.  Every day it seems more and more real that our little man is really coming.  I've noticed it especially this week, since I've been home.  I took a baby shower gift card to Target yesterday and did a little shopping (thanks, Erin!), picking up a few things we still needed for him.  Looking at the tiny t-shirts and pants I bought made his arrival more real.  And he moves so much now--mostly stretching.  He's been head-down for weeks, with his torso on the left side of my abdomen.  I used to think his feet were there, because that is where I would feel him moving most, but now I think what I was feeling was him stretching, arching his back against the wall of my womb.  Sometimes I feel what might be a leg or a knee above my belly button, but overall, he is sitting very low . . . I haven't felt any kicks under my ribs yet.

Soon, soon, I will need to change the title of this blog because he will be here!  Or maybe I will start a new one . . . "Living with Baby" or something like that.  :)  Either way, we are so, so very lucky and I recognize that every day. 

We love you, little man.

<3