37w+3d: Graduation from MFM

I had my very last appointment with my MFM... it's so weird to think that I won't be going back into her office any time soon! My MFM has been such a big part of my pregnancy, almost all my monitoring was done over there and I saw her more than I saw my OB. I wish she delivered babies, because it would've been nice to have her deliver my baby boy.

My stats:

• Weight: +19 lbs 
• Blood Pressure: 110/80

The nurse was a little worried about my blood pressure, since they were so close together. I have to admit, I don't really understand blood pressure readings. I just always ask, "is that ok?" My MFM wasn't concerned at all though. 

Only one change in meds, increasing night time Humulin N to 70iu. 

I hugged my MFM and thanked her for all her help throughout my pregnancy. I'm not sure I would've made it through without all of her support and monitoring diligence. There were a lot of scary things going on in my pregnancy and although I was scared as hell a majority of the time -- I knew that I was getting the best care possible and the monitoring that I needed to make sure my baby boy was ok. 

Saying goodbye to my MFM was almost as hard as saying goodbye to my RE! :(  It's strange how you grow so attached to these providers and it becomes normal to see them so often, then it's time to just stop going there as they've done all they could do for their speciality. 

Bitter sweet for sure.  I didn't even think about it being my "last" appointment and I totally didn't bring anything as a thank you! Ugh. I'm definitely going to make a trip to their office after the baby is born to meet my baby and maybe bring them some fruit or something. Still need to do the rounds at the RE office as well. It'll be nice to stop by there, wonder if the staff and nurses will be the same! 

Can't believe I'm this close to giving birth... it's so surreal. 

36 Weeks: MFM BPP + OB NST

My 36 Week appointment recaps.

36w+3d: MFM and BPP

My Stats:

• Weight: + 16 lbs 
• Blood Pressure: 104/60 

The appointment went well. They were a little concerned that my amniotic fluid was low. But it wasn't "low-low" to be concerned about, it was just low for where mine usually is. No changes to meds this week. 

My A1C for third trimester was really good at 5.4% -- which is excellent! 

36w+6d: OB and NST 

My States:

• Weight: +16 lbs
• Blood Pressure: 102/72

The NST went well, baby boy looked good. I did share that I had a sore throat and had a lot of mucus, couldn't sleep. I tested negative on the rapid strep test... but my OB put me on antibiotics, just in case -- to try to clear me up. 

They also made me use one of those masks since I wasn't feeling well. Those things are so hard to breathe in! 

My GBS test came back negative. 

35w+3d: MFM + Last Growth Ultrasound

I had my weekly visit with my MFM today and had my LAST growth ultrasound. I have to say that it was the quickest growth ultrasound I've had. Normally they take up to an hour (or more). But today it took 30 minutes! Maybe because there's no room for him to move around and hide?

Baby boy looks good:

• Overall: 44th Percentile 
• Head: 94th Percentile 
• Abdominal Circumference: 23.6 percentile 
• Estimated Weight: 5 lbs, 12 oz 

They had a hard time getting the abdominal circumference because of the angle. Last time we were in the 80th percentile. So, who knows how accurate these things are. 

But good news: No need for a scheduled C-Section! Woohoo! He's actually looking pretty average in size. They're guessing he'll be about 7-ish lbs for delivery. 

I'm very happy to hear that despite all the scares over this pregnancy, the worry over my blood sugar levels, the worry about having to go with a C-Section -- that baby boy is doing just fine and is an average size. 

I realize that things may progress where I may need an unplanned C-Section... but I'm happy that I'll get a shot at induction first and see how things go. 

My stats:

• Weight: +15 lbs
• Blood Pressure: 112/60 

MFM did mention to me that I should be prepared for what happens post-delivery. They'll be closely monitoring my blood sugar levels during labor. After baby boy is born, they may need to bring him to the NICU to monitor his blood sugar levels if they fluctuate too much. I'm really hoping that things will go smoothly and he won't have to go to the NICU and it makes me sad thinking that he'll be separated from me shortly after being born... But I'm glad she mentioned it so I can prepare mentally at the possibility and not be caught off guard if that happens. 

No changes to my insulin levels. Yay for that. 

Next Steps: Weekly monitoring next Tuesday, Diabetes consult/review and BPP 

34 weeks: MFM BPP + OB NST, Induction Day Scheduled!

I'm a bit behind on my entries, so will combine my 34 week appointments into one entry!

34w+3d: MFM Diabetes Consult + BPP

My stats: 

• Weight: +16 lbs 
• Blood pressure: 100/60 

The BPP went really well. They were able to get everything they needed relatively quickly. Baby boy practices breathing a lot, which is always fun to watch on the monitor. It's also fun watching him move while feeling him move, especially the big movements. Now I kinda know what he's doing in there. The big movements are mostly him adjusting where he is. He goes from facing my back, to facing my side, or facing up. Not much room in there. 

I did have to adjust my insulin levels: 

• Morning: Humulin N 42 iu, Humulin R 18 iu
• Evening: Humulin R 20 iu or 22 iu 
• Evening: Humulin N 68 iu

I think my glucose levels have been varying so much because I've been so busy and a bit stressed at work. Not to mention some other anxiety-ridden stuff going on with my son and his daycare. Just a lot of "stuff" happening at once. 

Next Steps: Growth Ultrasound next week

34w+6d: OB + NST 

My stats: 

• Weight: +17 lbs 
• Blood pressure: 122/82 

It's funny, there's only one nurse at the OB's office that can get the monitors to stay in the right spot during the NST. The other nurses can't get it to stay on the baby and take 10-15 minutes to "try" before bringing in the other nurse that gets it done in less than 5 minutes. LOL. NST looked good! 

I received my FMLA paperwork back. They already submitted it to my company. I called my company to confirm they have everything and to make sure they didn't need anything else from me. They don't -- so yay for that being done. 

Next Steps: Weekly NST next week 

Induction Scheduled for 5/27 @ 7:30am!

I was also able to FINALLY schedule my induction day!!! I'll be induced on Saturday, 5/27 at 7:30am. I'll be exactly 38 weeks that day! 

This is good, I wanted to wait as long as I could and that's the latest the MFM wanted me to go. I need to talk to the OB more about what their typical induction looks like, which I'm going to ask at my next appointment. 

So crazy to think that I have a DATE for baby boy to come. Very exciting!!! I can't wait to meet him :) 

33w+3d: Weekly MFM + BPP

My MFM appointments have been going relatively quickly! Which is a big change, they normally take FOREVER. Stats:

Weight: +15 lbs
Blood Pressure: 110/66

The BPP went relatively quickly. They were able to see everything they needed to see and I think we were done within 15 minutes or so. Baby boy is still head-down and looks perfect! No pictures or anything, he was facing my back and we couldn't see his face.

The diabetes consults are getting so difficult. Work and life just feel extremely busy and I just haven't been able to log and eat well. I just wish there was a way to hit the pause button or something. Insulin changes:

Morning: Humulin N 40 iu, Humulin 18 iu
Evening (before dinner): Humulin R 20 or 22 iu
Evening (before bed): Humulin N 64 iu

I'm still having major needle aversions when doing my shots... It's such a stressor. My MFM did say she was OK with me scheduling induction at 38 weeks vs 37 weeks, which is good news! She doesn't see any issues with baby boy. We'll see what happens at the 36 week appointment though, because that's when they'll decide if a C-Section is necessary or not.

Next Steps: 5/2 weekly BPP and Diabetes consult

32w+3d: MFM Visit + BPP Ultrasound

This week I start my 2x's a week appointments on Tuesdays and Fridays, rotating between the MFM+BPP and OB+NST. Today was the MFM visit and BPP. My stats:

Weight: +13
Blood Pressure: 112/70

Hmph. I went up +3 lbs from last week. Not sure if it was a fluke of clothing or if it's because I ate right before my appointment. Hopefully it doesn't really mean anything. My blood pressure is awesome though, which is really nice.

Bio Physical Profile (BPP) Ultrasound

This is the fastest ultrasound I've ever had, less than 20 minutes. It's nice because that means that they were able to see everything they needed to see. According to WebMd: The BPP measures your baby's heart rate, muscle tone, movement, breathing, and the amount of amniotic fluid around your baby.

The ultrasound tech showed me baby boy practicing his breathing. I'm still amazed that he's in there! I mean, I see him on the ultrasound and everything -- I feel him moving -- but there are still times where it's hard to believe I'm going to have a baby! I was concerned that baby boy had moved since I was feeling movement in weird places, but he's still in the right position, head down. So apparently he's either head butting me, he's punching his way out, and his booty is hitting the right side of my rib cage while his feet are kicking the left. Definitely getting tight up in there for him.

I kinda talked to the ultrasound tech about all this monitoring and how some people don't need all these extra appointments. I am high risk for a few reasons: I'm over 35 -- the call this "Advanced Maternal Age" (AMA), I got pregnant through IVF (which I was surprised this alone would be considered high risk), and I have type 2 diabetes. So basically I'm high risk x3! Yikes. Although the appointments can be a big pain to schedule and juggle, I am a million times grateful I'm getting so much monitoring. It's reassuring that if something goes wrong -- they'll catch it. Also, I don't need to go around wondering how the baby is doing.

MFM Diabetes Consult  

Since I was just at the MFM office last week, I have to admit that the last week was pretty hectic schedule-wise. Easter activities, work commitments, appointments -- it became a bit difficult to consistently check my blood glucose levels 2 hours after each meal. Easter weekend was also very tiring for me in general -- just having a lot of stuff to do. I keep hoping things will calm down and I think they will after this week (I hope!). All my pre-natal classes will be completed - YAY! No more busy weekends, hoping to do some 1x1 activities with my son before the baby arrives, also need to finish baby prepping (almost done!). Work doesn't slow down much until maybe the 2nd week of May. Hopefully that means I'll be able to be more consistent with tracking everything.

Changes to my Insulin:

• Morning: Humulin N increase to 38 iu, Humulin R increase to 18 iu 
• Evening (before meals): Humulin R increase to 20 iu [or 22 iu if glucose is 120 or higher]
• Evening (before bed): Humuli R in crease to 58 iu 

I'm hoping we don't have to add another insulin shot before lunch... We might have to. What's so weird about my glucose levels is, one day my glucose levels will be fine after a meal. I'll eat the same meal (assuming it'll be fine) and my glucose levels will be off the chart. No way to predict when it'll happen and when it won't happen. But my MFM said that's normal because baby is getting bigger and it's just getting harder to manage. 

I'll be doing another growth ultrasound around 35-36 weeks to see where baby boy is at. 

Discussing Possible Induction / C-Section Date

My MFM wants me to talk to my OB about getting "on the schedule" for either an induction or C-Section. We won't know until 36 weeks if I'll need a C-Section, but right now baby boy is measuring really good and not big at all. If things continue this way, then an induction might be the way to go. 

I didn't realize that the induction / C-Section slots can possible "fill up!" So, MFM suggested I talk to my OB and see if we can get something scheduled between 37-38 weeks. Which means between May 20-27!!!! Yikes. If I schedule it in advance, I may be able to choose the day... Other things that are good about it: 1) I can pick a last day of work, 2) I can arrange childcare better, and 3) I'll have a real countdown to a specific day / time. Crazy. 

But it does feel weird to choose the date... mostly because my dad's birthday is that week and one of my much loved foster babies birthday is that week... I also have a bunch of friends that have birthdays that week. So, it just feels weird to me to pick a date. 

Will talk to the OB about it on Friday and see what she says though and when they normally schedule it out. It'll be kind of exciting to get a firm date! 

Next Steps: Next Tuesday BPP and Diabetes Discussion with MFM

31w+3d: MFM Follow-up, Growth Ultrasound

I had my growth ultrasound and diabetes appointment with my MFM today.

My Stats: 

• Weight: +10 lbs 
• Blood Pressure: 128/60

Baby Stats: 

• Overall Percentile: 65
• Head Percentile: 97
• Torso: 85
• Projected Weight: 4 lbs 4 oz 
• Adjusted due date: 6/3 - measuring 1 week ahead at 32w+3d 

Baby boy looks really good! Some cool things about the ultrasound: watching him practice breathing, watching him suck on his hand, and seeing him stretch. He's still head down, but not as far down as he was before. Didn't get any good pictures of him because he kept burying his face in my placenta. It's so cute watching him suck his hand :) Hoping that means that he'll take to breastfeeding!

He's measuring one week ahead, which is what he was measuring before. So, he's on track. The only issue is his torso has gotten a lot bigger, measuring in the 85th percentile. Which is totally my fault since my eating habits have been so horrid. My baby is probably floating around in sugar fluid :(  Poor thing. My MFM said that I really need to watch my food intake so it doesn't impact his growth. Right now, one week ahead is good. But we don't want to see him get over the 95th percentile in overall growth and we don't want to see his torso get into the 95th percentile.

MFM said we should know if I can try for a vaginal birth by 36 weeks or if we'll need to schedule a C-Section. If all goes well in the next few weeks, it sounds like I might be able to choose the date of induction / C-Section date, which is weird to me...! Like I would be choosing my baby's birth date or something. Yikes! In all honesty, as much as I want to meet my baby boy -- I'll keep him in there as long as the doctor's will let me and as long as it's safe. Unless he decides on his own to make an earlier appearance before induction/C-Section.

Can't believe he's estimated at being 4 lbs, 4 oz right now!

I figure, I have about 6 more weeks left of being pregnant -- I need to just suck it up and get more serious about watching what I eat. It's been hard with our schedule being so busy, we've been eating out a lot more than usual and I haven't had time to go grocery shopping in the last 2 weeks. But, things are "kinda sorta" calming down and I'll have some time this week to make a grocery pickup.

Going forward, I'm going to be seeing the MFM weekly. We really need to watch my glucose logs and make adjustments as needed. So, I'm going to go every Tuesday for my diabetes consult and have my Bio Physical Profile (BPP) ultrasound done there instead of at the OB. I'll do the NST weekly at the OB. Hopefully this will keep me to about 2 appointments a week, since I'm combining them. I'll also get another growth ultrasound in 2-4 weeks, depending how things look at the BPP's.

Glucose changes:

• Morning: Humulin N 34 iu, Humulin R 16 iu
• Evening (before meals): Humulin R 16 iu [or 18 iu if before dinner glucose is 120 or higher]
• Evening (before bed): Humulin N 54 iu

I did ask my MFM about my low PAPP-A and low HCG from my first trimester screening... like, if I should still be worried about that. Some of the risks of those test results are: pre-eclampsia, potential growth restrictions, and pre-term labor. She told me I don't need to worry about any of that -- that we would have seen something by now and everything looks good. That made me feel better and I hope she's right! 

It's kinda weird because I have the next 6 weeks booked already for the BPP ultrasound and diabetes consult. Like there are ONLY 6 weeks because I'll be having my baby at the end of all that. Seems so wild and close and starting to feel so very real...!! Very exciting to think about :) He's almost here!!! 

Next Steps: Weekly Diabetes and BPP appointments - scheduled every Tuesday until 5/23.

29w+3d: MFM Diabetes Follow-up

I had my MFM diabetes follow-up today. It ended up being kind of a whirlwind of an appointment because I had to bring my son with me. He has strep throat -- AGAIN! Ugh. This is the first time I've brought him to any of my pregnancy appointments. I didn't really have a choice, since he can't go to daycare/preschool while sick. But with him being miserable, he was a little stinker during my visit!

Stats:

• Weight: +7 lbs 
• Blood Pressure: 118/75 
• Fetal Heart Tones: 154 bpm 

My blood pressure has gone down quite a bit! I think it's because my anxiety / worry levels have started to go down the closer I get to delivery. I think it's gotten much better since I've reached viability and every week I've made since. It also helps that I can feel baby boy pretty consistently and often. 

My glucose numbers weren't horrible, but they weren't great either. We are making some increases (which will probably keep happening until I deliver): 

• Morning: Humulin N increased to 30iu, Humulin R increased to 14iu 
• Evening (before meal): Humulin R increased to 14 iu. However, if my before-dinner glucose is over 120, I am to take 16 iu. 
• Evening (before bed): Humulin N increase to 52 iu. But, I don't have the syringes for this yet -- my syringes only go up to 50. A new prescription was sent to my pharmacy, so I'm waiting for them. Until I get them, I'm to take 50 iu. If my fasting blood sugars are horrible -- I'll need to up it to 52 iu and just use two separate needles (which I really don't want to do!). 

I don't really mind the increase in insulin dosages. I already have to give myself the injections, so the "amount" I inject doesn't matter. I'm just glad we're not adding more injections. Luckily my breakfast and lunch glucose levels are really good, so we don't have to add another insulin dosage before lunch -- which I'm hoping to not have to add ever! 

Overall, the appointment was quick and easy. The funny part of having my son there is that I had to pee in a cup. Who would've thought that having a 3 year old there would have that cause potential craziness -- as he wanted to play with the cup. Ugh. Gross. He also was playing with switches and turned the music to its highest volume in the doctor's office -- startling us. Not to mention him running around like mad and not following directions. 

Boys will be boys! And I'm about to have two of them. LOL. 

OH -- and not MFM appointment related... But, I think I officially experienced my first Braxton Hicks contractions today! I was laying down during my son's nap time and my stomach got really tight. It didn't hurt or anything. Then it went away and came back a few more times. Very strange feeling. I kind of wanted to freak out about it... but I knew they were going to come eventually. I'll just mention it at my OB appointment next week and see what they say. 

Next Steps: 4/11 Diabetes follow-up and Growth Ultrasound 

27w+3d: MFM Diabetes Follow-up and Growth Ultrasound

I had my MFM diabetes follow-up and growth ultrasound yesterday. What's funny is, my appointment was actually scheduled for TODAY and not yesterday! So I must've put it in my phone wrong or something. Luckily they had an opening and were able to see me, but then I ended up being there for over 2 hours... but I suppose that was my fault for showing up a day early to my appointment.

Stats:

• Weight: +7 lbs 
• Blood Pressure: 132/72

Getting a little worried about my blood pressure. I've always had really good blood pressure levels, until the last few appointments. They're not too worried about it, but they are keeping an eye on it. They want to make sure it doesn't get to 140/90. The concern is preeclampsia. I'm at higher risk of developing that because of my diabetes. 

Growth Ultrasound 

This ultrasound I wasn't too concerned about. I can consistently feel baby boy move, so I know he's doing OK in there. The focus of the ultrasound was to see how big he's gotten. Here are the stats: 

• Weight: estimated at 2 lbs, 7 oz. 
• Overall Percentile: 43rd 
• Head Circumference percentile: 94th! Yikes. 
• Measuring about a week ahead 

Baby boy has already turned. It'll be seen if he stays that way. He still has plenty of room to move around. His head was pretty low and we had a hard time getting the head circumference. Supposedly, since he was at an odd angle -- they said the percentile is probably inaccurate. But they also said it's ok if his head is big, that he should still fit through in a vaginal birth... I was thinking, "Ouch." 

It was fun watching baby boy move around and not cooperate with the ultrasound tech. We ended up taking over an hour to get all his measurements and all looks good with him. We got to see him trying to take a breathe, which is really good and on target! He was also moving his lips like he was suckling, it was really cute to watch!! I almost didn't get a picture of his face because he had his face buried in my placenta most of the time. He finally moved slightly and we got a 3D image of him. You can see his little lips, his button nose, and he's starting to get cheeks. It's so weird looking at his picture in wonderment that I actually helped make this little guy. It's funny though, he doesn't look like he's going to have any of my facial features! Have to see when he comes out, but he kind of resembles big brother in a way. 

Always good to have an ultrasound and hear that everything looks good and that baby boy is doing well. 

Diabetes Update 

The last few weeks have been a huge struggle for me... eating wise -- tracking wise -- and motivation wise. I haven't done a great job. I'm glad I could laugh with my MFM because we got into a laughing fit over discussing my diabetes log. I was just honest about it -- no self control, ice cream is too tempting, and I'm just so tired of monitoring/logging. I've been at this since October-ish. I don't complain about it much, as I know it's necessary... But it does take a toll on me. 

We are making some adjustments to my meds: 

• Morning: Insulin N increase to 28 iu, Insulin R increase to 12 iu
• Evening (before dinner): Insulin R increase to 12 iu
• Evening (before bed): Insulin N increase to 48 iu 

With the baby getting bigger, my MFM did say that the insulin will keep increasing. Also, she said that even if you're perfect -- once you hit the 3rd trimester the sugars can get a little wonky. So, best to do my best with monitoring and food choices. 

So, I need to suck it up and just get it done. I just might whine and complain while I'm doing it! I'm dreaming about my first eats after baby boy is born... oh the things I will eat! 

Next Steps: 

1. Next Week - email diabetes log to MFM. In an attempt to keep me "honest" and motivated, I'm going to email my diabetes log to my MFM next week. 
2. 3/28: Diabetes follow-up appointment
3. 4 weeks (not scheduled yet): Diabetes follow-up and growth ultrasound. 

After my next growth ultrasound, I'll be transitioning to weekly appointments with a non-stress test (NST) and ultrasound -- which is also me hitting the 32 week marker in the pregnancy. This can either be one appointment or two... I'm hoping for one weekly. 

25w+2d: MFM Diabetes Appointment

I had my MFM Appointment yesterday to go over my food log. It wasn't very good... I've had a pretty hectic schedule the last few weeks and I haven't been able to log as good as I have been. They weren't bad... just some really bad food choices and then not consistently checking my after-meal glucose levels. My blood pressure was good at 110/68.

We are only making one change this week on my Humulin N morning value. Going up from 20 to 22 iu. The goals for the next two weeks: 1) consistently log after-meal glucose levels and 2) make better food choices.

Antenatal Depression 

I actually wonder how much of the antenatal depression has to do with me not being disciplined enough to check my glucose levels?

I asked my MFM that and she said that she doesn't think it's the antenatal depression, it's probably more the stress from my schedule impacting everything and making the depression worse.

We discussed how I've been feeling lately and I was honest and told her that things haven't gotten much better... so it's a good thing I have a therapist appointment on 3/14 scheduled. We did talk about medication again... The main reason I'm hesitant to take medications is because the drug will go through the placenta and the baby will experience the effects of the drugs. I don't feel good about that... In certain cases, it's better that this happens because the alternative can be really bad... But I just don't know if that's what's best for me. Also, I feel "so close" to the big due date... about 13 weeks left. Can I hold off till then?

The other good thing about seeing a therapist is that after the baby is born, they can put me on meds right away since it won't impact the baby at that point. I did ask about breastfeeding, but she said it doesn't have the same impact as in-utero. The odds of me having postpartum depression are really high for me at this point. I won't be hesitant to take meds after the baby is born. I'd prefer NOT to... but I'll do what I have to do and what my therapist will recommend.

Lots to think about really where all of this antenatal depression is concerned. One problem I'm having is I feel sooooo busy that I don't have any time to just "be" and think about things. Because of this, I think I'm not processing things very well or have time to come to terms with things. There's just so much to do all of the time. I feel so behind.

Post-Pregnancy

Sometimes my brain lives far in the future thinking about things. I had some questions about post-pregnancy. Mainly, what do I do with my diabetes and insulin after baby is born? I guess it depends, I can go back on Metformin or I can take half the dosage of the insulin. Will see how that goes. My MFM is going to refer me to a diabetes specialists. Previously, I was just seeing a regular doctor to manage my diabetes. I think going forward, I'd prefer to see someone that specializes in it to get better care.

Next Steps: MFM Visit on 3/14 for U/S to check growth and Diabetes follow-up

23w+3d: Fetal Echo cardiogram -- All Looks Good!

I have to say... I was WAY anxious for this appointment. It felt like one of the last steps in all my monitoring appointments to make sure (best we can) that baby boy is doing ok.

Fetal Echo

I had my Fetal Echo cardiogram on Valentine's Day. Almost felt like a "date" with my baby boy :)

The point of the fetal echo was to take a close look at baby boy's heart -- blood flow, structure, etc. Baby boy was not having it at this appointment. Once he felt the pressure of the ultrasound probe thingie, he was moving and jiggling -- not being in the right position for them to look at his heart. He was laying with his head facing down and facing towards my back. The ultrasound tech had me lay on my right side -- then back to my back -- then left side -- then back to my back, trying to get him to move. I was getting anxious that we might not get the right look at the heart and have to reschedule. Alas, after chasing him around, he finally got into a good position and we were able to get all the needed measurements.

ALL LOOKED GOOD!!

This is HUGE for me... I am so relieved that his heart looks like it's functioning properly. What's also cool is we were able to get a few face pictures (3d and 4d) -- a little blurry, but you can definitely see his little face in there! He's starting to get some meat on him and his face-shape looks very similar to my face shape :) I've been thinking more and more about seeing his little face and what he's going to look like.

It was really weird doing the ultrasound because I could feel baby boy move and then I could see him move on the monitor. He was really kicking and pushing all over the place, twisting around, moving - he's a busy boy.

He was measuring 5 days ahead and weighing in at about 1 lb, 7 oz and heart rate was at 154 bpm.

Meeting with MFM

My MFM was very happy with my blood sugar levels and she was very happy with the results of the Fetal Echo! Good and good. We are still increasing my Insulin dosages because the baby is getting bigger, so need to make additional adjustments. Changes:

AM:
Humulin N 20iu
Humulin R 10iu

PM:
Humulin R 10iu -- 30-60 minutes prior to dinner
Humulin N 42iu -- at bedtime

We did discuss the potential pre-natal depression... She wanted to put me on meds right away, but I pushed back. I don't want to go on meds... but she said the benefits for the baby could be better in the long run. She was also wondering that after the good Echo, that maybe I'll start to feel better? I'm tasked with monitoring my moods for the next few weeks and I'm to talk to my OB about it next week, if I still feel the depression.

My MFM did get me a referral to a psychiatrist (at my request), so I can talk to someone about my depression. I'm waiting for the referral to go through so I can schedule something. So right now -- just monitoring to see how I feel and then will go from there.

Going forward, we are going to do growth scans every 4 weeks. Then when I hit 32 weeks, I'll have 2 appointments a week -- stress test and ultrasound. These may be able to be combined into one appointment, but have to see how that goes.

Issues with Pharmacy and Insulin Med

Last week I had a mini-issue with getting my Insulin Humulin N refilled at the pharmacy. I requested a refill on Monday, I would run out of Insulin by Wednesday, and the pharmacy said they wouldn't have it until Thursday. So, I ended up 1.5 days without my Insulin Humulin N (which is the long-lasting insulin). Not good.

But the issue got worse. When I finally went to pick-up my insulin, the price was over $100 more than it was at my last refill. Turns out, my stupid Rx coverage charges a "penalty" if you don't go to direct-mail for recurring maintenance medicine. Like WTF. I never received a letter that my insulin would fall into this category and I never really read the "fine print" on my insurance coverage to know that this might be an issue (my fault I guess). So lame. To make matters worse, my MFM that wrote my diabetes prescriptions, isn't in their database -- so they weren't able to transition my meds to the direct-mail. I had to ask my MFM to write new prescriptions and send them directly to my mail-order pharmacy. No way to get reimbursed for the extra $100 charge, unfortunately. Glad it all got straightened out... but still frustrating.

Overall

My 2nd Trimester of pregnancy has felt very stressful for me. All the high risk for Trisomy 13/18, the Low-PAPP-A first trimester screening results, all the genetic testing, and then the horrible bleed at 20 weeks... I feel like I've been on the "edge" of worry and fear since December.

But... baby boy has looked awesome on all the ultrasounds. We had the 15 week ultrasound, 19 week Anatomy scan, and now the 23 week echo cardiogram. There are NO soft markers that they could see, NO issues with his organs/development that they can see, and NO issues with his heart functions that they can see. This is all GREAT and GOOD and WONDERFUL.

Because everything has looked great with baby boy... you'd think I could relax now? It's hard to take months of worrying and concern -- to just stop that fear/anxiety. Every other time I "relaxed," something else came up.

First Ultrasound and Seeing the Heart Beat (5w6d) = Relax, then first big bleed (SCH)
Good NT Scan = Relax, then Low PAPP-A and High Risk for Trisomy 13/18
Good NIPT Results = Relax, then Genetic Counseling and potential concerns on chromosomal abnormalities
Good Anatomy Scan = Relax, then big bleed the next week

So........ as much as I want to relax now -- can you see why that would be hard for me? I'm trying though. I feel like I've gotten the "all clear" in a way from my MFM and that's pretty huge. I'm thinking the pre-natal depression might be playing a part in all this and that maybe the anxiety/stress/worry from this entire pregnancy has just hit a peak and it'll be hard to come down from that? More to explore on that.

For now though == my baby boy looks wonderful, he's active, he's healthy. I couldn't ask for more than that right now.

Next Steps: 2/28/17 Diabetes-only follow-up, 3/14/17 Growth Ultrasound

21w+3d: MFM Follow-up and Ultrasound

It's been an entire week since my big bleed last week. Thankfully the bleeding/spotting seemed to stop last Friday. But it has been a long week waiting for my ultrasound to make sure everything was OK with baby boy. I'm surprised I handled the wait so well... I'm usually more stressed and worried than I was. I think at this point in my pregnancy, I'm just so tired of all the worry... It's hard to worry "more" or "harder" than I already have. I realize there's nothing I can really do if something is wrong... it almost makes me feel defeated in a way... But worrying endlessly just doesn't help and isn't productive.

Ultrasound

They were running behind at my MFM's office, so my appointment ended up lasting a little over 2 hours. I was worried for the ultrasound and once she got the image up - I couldn't really tell if he was moving - because he wasn't moving much at first. Then all of a sudden he started moving around a ton! Such a relief... He was in a breech position and facing towards my back. The ultrasound tech was trying to get pictures of his brain and heart -- we didn't have much luck with that. He was just too active and wouldn't stay still for her to get any good images. Fetal Heart Tones were at 144 bpm.

It was funny watching him grab his feet and touch his face and hit around. I can't feel a thing when he's moving around and he moves a lot.

She didn't see anything that would have caused my bleed last week. No SCH, cervical length was good, nothing wrong with the placenta, baby boy looked OK. So they have no clue what caused the bleeding.

It was so wonderful seeing my baby looking healthy and moving around like crazy.

Meeting with MFM 

My MFM wasn't thrilled about my food logs or my sugars. Being sick the last two weeks I think really impacted my sugar levels. Also, the stress last week from the bleed really set me back a bit - as far as logging my sugars. But good news, my A1C came back at 5.5%. This is REALLY good. The last time they checked my A1C was in November (see blog entry) and my levels were at a 6.0%. My MFM wants to see A1C under 6.0% during pregnancy, so this is extremely good! Basically, my levels are reading like a non-diabetic.

She was going to add more Humulin R to dinner time meals, but I asked her to wait and see how my sugars regulate now that I'm not sick (since my levels looked awesome right before I got sick and I haven't changed my eating habits).

The only change she made was to my Humulin N in the morning, increasing from 14iu to 16iu. Now I'm on:

AM: Humulin N 16iu + Humulin R 6iu
PM: Humulin N 38iu

My next ultrasound will be in 2 weeks and will be the fetal echo cardiogram. Let's see how that one goes... hopefully baby boy will cooperate and we'll get good images. If not, they'll have to reschedule me.

So far... so good. It was a relief to see baby boy today, especially since he's so active. Feeling a lot better after my appointment :)

19w+2d: Anatomy Scan Level 2 Ultrasound

I feel like I've been waiting forever for my Anatomy Scan! In reality, I haven't been waiting very long. I do have to admit that I get a bit nervous every time I have an ultrasound. Yes, I'm excited to see the baby -- but at the same time I get so worried they'll find something wrong. Will the fear ever go away? Maybe not... 

The Anatomy Scan is a Level 2 ultrasound. This is where they look at everything and measure everything on the baby. Mine took about an hour, then we had to look again at a few things -- so total took maybe 1 hour 15 minutes. 

We started off looking through the abdominal. At first I was worried because I didn't really see baby boy moving and couldn't really see the flicker of his heartbeat. So, I held my breath. Then I saw him wiggle away from the probe as the ultrasound tech put pressure on my tummy. Baby boy is in a breach position and was vertical with his bottom sitting on my cervix. 

After we got all the shots they can get abdominally, we switched to a vaginal ultrasound -- where you get really good images and can see baby much better. 

• Measured his head/brain 
• Looked at his kidneys/measured 
• Looked at his bladder 
• Measured the size of his torso 
• Measured his arms/legs 
• Looked at the blood flow from the umbilical cord to the placenta 
• Looked at his heart and the blood flow in the chambers 
• Took another look at his boy parts 

What's interesting is that you can "see" the bladder. If they can see it, that means that baby is drinking the amniotic fluid and peeing it out, which is all good. 

I noticed she paid special attention to the brain, the kidneys, and the heart. She looked at the heart a lot. They didn't say anything was wrong and said everything looked good - they didn't see anything. But it was curious to say the least. 

What was interesting is the positions that baby boy was in! There were times where he was bent and his legs were up by his head! Flexible little guy. He crossed and uncrossed his legs. I also saw him touching his face with his hands. He was sucking his right thumb! Which was really cool to see. I even got to see him yawn and stretch. Pretty amazing to see all of that. 

The ultrasound tech did say that my tilted uterus has "come forward" but it's still leaning towards my back, which is why I haven't really "popped" yet and I don't look pregnant at all. She said it should happen in the next month or two. Will see I guess. My uterus is all the way up to my belly button right now. 

She confirmed that my placenta is not covering my cervix, which is really good. Also re-confirmed that I have an anterior placenta. She measured my cervix and they're going to keep looking at it. They're not sure if it's gotten shorter or not. She got different measurements at different angles. They like to see it above 2.5 and I was between 2.75 and 3.15. They'll keep checking at each of my monitoring appointments. 

Baby boy was extremely active and it was really hard to get any good pictures of him! 

• Fetal Heart Beat at 142 bpm 
• Measuring 4 days ahead (I thought it was 2 days originally but I misheard) 
• He's weighing in at about 11 oz right now -- which is double what he weighed at the 15 week u/s (5 oz) 
• He's at about the 78th percentile, which they say is good 

No soft markers for anything. 

Nothing concerning on the ultrasound. 

My MFM was a little concerned that I may have had some Braxton Hicks contractions. I was very tired over the weekend from my son being sick and I felt some tightness in my tummy one night. I was too tired to pay too much attention to it. MFM wants to monitor me every 2-3 weeks to check my cervix and baby boy's measurements. If I have any Braxton Hicks-type of contractions, I'm to call her immediately. 

I also had some adjustments to my insulin: increase Humulin N dosage at night to 38iu. Overall, my blood levels looked amazingly good! Yay for that. She had NO complaints about them, which is totally awesomeness! I did get some more blood drawn to check my A1C, which they'll check every few months. The last time they checked in November, my A1C was 6%. She'd like to see my levels below 6%. Let's see if I'm there, I think I might have managed to get it below that amount since I've really been watching what I eat (for the most part). 

All in all, I'm feeling REALLY good about my anatomy scan! Baby boy is such a miracle baby to me and I am just so grateful that he's doing ok right now. I just can't wait to meet him and my heart is just overwhelmed with love and gratitude that right now -- all seems well with him. It's been a rocky journey so far in this pregnancy and getting good news is such a relief. 

My MFM did talk about when I should be delivering the baby. She said with pre-existing diabetes she doesn't like to go past 38 weeks or maybe 39 weeks, but she was very firm on the 38 weeks. If things go in line with that, Baby boy will be born at the end of May/first week of June. Which... I think I've kinda thought he would arrive around that time. Will have to see how it all plays out. 

A few other random things: 

• I reserved a daycare spot for baby boy at my son's daycare. 
• I am getting a Prenatal Kit from one of my benefits at work. Yay for free stuff! 
• I've registered for a hospital maternity ward tour in April. 

I need to make a more thorough "before baby comes" checklist. But part of my to-do includes: 

• Going through 0-3 month clothing (my son was born in December so not sure I'm going to have the right seasonal clothes, so need to figure out what will work and what I will still need to get for the baby) 
• Go through crib bedding, blankets, receiving blankets, bibs, socks, hats (I have so much -- need to pick out the right seasonal items for June) 
• Buying a new dresser/chest for the baby's room 
• Buying my son a bed frame -- trying to decide if I want to invest ahead of time on bunk beds for the boys or let them keep separate rooms... Long term planning here 
• Look into birthing classes and register 
• Look into other hospital classes (like lactation classes, newborn care class, etc)  

Just to mention... looks like I've picked up on my son's strep throat...!!! UGH. I go to see the OB tomorrow to get tested and see if there's any medicine I can possibly take while pregnant. 

Ok, I think that's it for now. Long update! 

17w6d: MFM Visit and Genetic Testing Discussion

I had my weekly follow-up with my MFM today and there was lots to discuss, as usual. 

Diabetes Followup 

My blood pressure was really good at my appointment today, which surprises me because I feel like I have all this anxiety... maybe it's all in my head and not really reflecting in my body? They also checked for baby's heartbeat on the doppler. It was kind of funny because we found it right away, but baby moved and it took her about 20 minutes to find it again! You could hear him moving away from the doppler. I think she was pressing too hard. He doesn't normally move if you press the doppler lightly. LOL. It's always wonderful hearing his precious heartbeat. It was beating away at 156 bpm.

I thought my blood sugars looked excellent the last week. I've been cooking at home a lot lately and hardly going out to eat. But apparently, it's still not where it's supposed to be. We are upping my insulin intake AGAIN.

Morning: Humulin N 16iu, Humulin R 6iu
Evening: Humulin N 36iu

Hopefully this will be good and things will stabilize? I was hoping that things would be OK and I can ask about lessening the amount of times I test throughout the day. Testing 6x's a day is getting tough... not to mention that nasty insulin needle. It's so teeny tiny, but sometimes it hurts like hell and burns. Not sure why it's painless sometimes and so painful other times.

There was also a concern that I've lost weight. I guess I'm down 3 lbs since my last weigh-in. She doesn't want to see me lose any more weight. If I lose anymore weight, she's going to have me add more meals into my day. Which is so weird because I feel like I'm eating a lot already! Will see how this goes.

Genetic Testing 

The genetic testing stuff is a little strange and confusing at times. I haven't posted much about it since my initial meeting with the Genetic Counselor last month (read my blog entry here).

The Genetic Counselor wanted to do a genetic screening panel on me, but it would be useless if we didn't have the donor's genetic testing done. Last week I called my sperm bank to have them send over my donor's genetic testing results to my MFM. When I was going through IVF, I specifically chose a donor with the "extensive" testing (read my blog entry here). I'm glad I did! Turns out they test for about 101 potential chromosomal abnormalities. My donor was not a carrier for anything. Which is good news.

Since my donor isn't a carrier for anything, that means they don't need to do an extensive genetic panel on me. We both have to be carriers for the baby to get it. Well, the genetic counselor in all her glory said, "it was unlikely, but not 100% guaranteed." Ugh.

Even though the donor is not a carrier, we are still doing some testing. I went in today for two specific blood tests:

1. Fragile X. I guess this is the only thing a mom can pass on genetically on her own to the baby. The results should come back next week. 
2. Sequential Screening. This test is similar to the 2nd trimester Quad screening, but a little more extensive maybe or maybe it's the same? It checks hormone levels (AFP, Estriol, hCG, inhibin). They will combine these result with my 1st trimester NT blood results and come back with a risk rating on things. This test will take 2 weeks to come back (the torture...!!!). 

The big concern is that my PAPP-A and my hCG from the 1st trimester screening were low, which led to the "high risk" stuff. If any of the hormone levels in the sequential screening come back askew, it's not a good sign. This website explains the Sequential Screening: http://www.healthline.com/health/pregnancy/sequential-screening#Testmeasurements3. The second blood test measures for the following.

• Alpha-Fetoprotein (AFP): The baby’s liver mostly secretes this protein that passes over into the mother’s blood. Too-high and too-low levels of AFP have been associated with birth defects. 
• Estriol (uE3): Estriol is the highest amount of circulating hormone in a woman’s blood while she’s pregnant. Low levels of this hormone are associated with increased risk for Down syndrome and trisomy 18.
• hCG: Human chorionic gonadotropin (hCG) is also known as the “pregnancy hormone.” The body usually makes less of this hormone in the second trimester than in the first. High levels of hCG are associated with Down syndrome, but there are other reasons levels may be high. Low levels are associated with trisomy 18.
• Inhibin: Doctors don’t know exactly the role this protein plays in pregnancy. But they do know that it increases the reliability of the sequential screening test. High levels are associated with Down syndrome while low levels are associated with trisomy 18.

The biggest concern is that there may be something wrong with my placenta and that it can't support the baby or the baby can't get what he needs -- which can lead to some scary stuff. The other concern is that the baby may have a chromosomal abnormality, but this is looking more unlikely due to the good ultrasounds, low risk on NIPT, and the genetic screening of my donor. But as my genetic counselor said, "we can't rule it out."

The genetic counselor is all doom and gloom. My MFM told me, "Don't worry about it."

I think I've been handling all of this pretty well (see my blog entry here where I talk about it). I figure, things are going to work out the way they're going to work out. I can't really control it. Of course I want my baby boy to be healthy. I want him to be born full-term and healthy. But really, I'm getting monitored so closely. My MFM told me not to worry about it. She said if something is funky in the results, we'll just add additional monitoring appointments and we're already doing a lot as is. With such close monitoring, I feel like my medical team will prepare me and hopefully get ahead of any problems (if we are faced with any). I just don't think it's going to be this "out of nowhere" surprise if something does go wrong.

Right now, I'm trying to let myself be happy about my pregnancy. I'm starting to FEEL pregnant. My tummy is getting uncomfortable and I'm getting these odd aches/pains. I'm not complaining though, it just makes me FEEL pregnant going through all these things :)

Hoping to get good news from these blood panels and hopefully be able to relax a little. The next big appointment is the anatomy scan. The results of the scan + the sequential screening should get me to the next stage in my pregnancy.

15w+5: Detailed U/S and meeting with Genetic Counselor

I had a looong 2.5 hour appointment at my MFM. Lots to go over.

Genetic Counselor

I thought after I received my NIPT results that were "low risk" that I was in the clear for genetic concerns. But I was wrong... I guess the First Trimester screening may still play a role in things. I had a low PAPP-A result and low HCG, which is bad. This is all hormone-related.

What they want to do is do something called a Sequential Screening in the 2nd trimester. It's where someone would normally do the Quad Screening, but the Sequential Screening is a little more thorough than the Quad Screening.

What they do is combine the NT Ultrasound results, the First Trimester Screening Results, my detailed ultrasound results, and the Sequential Screening results to come up with a risk value of low or high.

Why all the concern on my hormone levels? 

Turns out that there are a few things that the hormone levels can indicate:

1) The baby has a chromosomal abnormality that can't be seen on an ultrasound, one of the rarer ones. Only way to really know 100% is if this is the case is if I get an amnio.
2) My placenta is not functioning like it should. There's something called Placental insufficiency. This is pretty bad because that means the baby wouldn't be getting all the things it needs from the placenta. Baby can be smaller or have some issues from lack of oxygen, can lead to pre-term labor and/or birth defects, etc.
3) Nothing is wrong.

So right now, still kind of in limbo on how things can go. So, next step is to get the Sequential Screening done.

Genetic Screening 

The geneticist talked and talked and talked about a lot of stuff. But one thing she would want me to do is to get screened for other genetic issues. Which also means they would want my donor to get screened as well... which is where one of the tricky parts come in. I have to call my sperm bank and ask them if they can contact the sperm donor for additional genetic testing. More on this later.

Detailed Ultrasound 

It's so great when I get to see my baby boy! He was moving around and dancing. So crazy to watch him be so active and I can't feel a thing. He had a strong heartbeat of 153 bpm and was measuring about 2 days ahead, which they say is good. Everything that they can see (kidneys, length, etc) looked good and no soft markers for anything.

It also looks like my tilted uterus is coming forward. I found out I have an anterior placenta, so it might take me longer to feel the baby kick.

All in all, baby boy looked amazing and wonderful and great.

MFM Meeting 

My MFM wasn't happy with my diabetes blood logs. My fasting blood sugar was higher than she'd like and I wasn't consistently tracking my glucose levels. We are upping my night time insulin to 22 iu and keeping the morning insulin at 12 iu. I might end up having to add another insulin to my day if my after-meal glucose levels remain high. Breakfast and lunch after-meals have been great, just dinner time where things get a little wonky. She has forbid me from eating french fries and pizza... sadness. My blood levels just got too high with those.

How am I feeling? 

I honestly thought things were in the clear after the NIPT results that I wasn't even concerned about the meeting with the genetic counselor. I don't really know what to think or feel. I have been too busy with visitors and holiday stuff to really let myself think about things. I'm bummed that I can't just have a happy pregnancy and feel good about my baby boy. The worry about things just seems to linger from one thing to the next. I kind of wish that I would be told EVERYTHING at one time so I would be prepared better. But this is all new to me and all new things I have no clue about.

In my heart I believe my baby is going to be OK. He was so active and measuring really well, so I'm hoping the placenta is doing its job. The chromosomal abnormality possibilities.... I'm going to need to figure out how comfortable I am with dealing with it *IF* it comes or if I want to risk an amnio. For my MFM, the risk is 1:400 for a miscarriage with an amnio. They also suggest doing it by 22 weeks. So, I really have to think about that. I don't want to risk my baby doing a procedure that might just tell me there's nothing wrong. But the preparation I can do prior to his birth if something is wrong... has me teetering on the idea. Plus my anxiety is through the roof and not sure if "not knowing" is going to just be too stressful.

A lot to think about and a lot to consider. I'm not leaning one way or another right now. I guess the logical step is to get the Sequential Screening and see what my hormone levels are telling them, then decide on next steps from there.

I truly wish that everything could just be OK and not have all these worries. A boring pregnancy would be so wonderful... I also wonder if all these extra screenings are really worth it? I guess in a way, it's nice to be prepared and monitored so closely -- so we can get in front of any issues. At the same time, there's all this extra worry and there might not be anything wrong with the pregnancy or baby.

I guess I'll have to look back on this experience and ask myself if the worry outweighed the benefit of the extra monitoring. I'm split right now.

I just pray that my pregnancy goes smoothly and that I'm able to carry my baby boy to term and deliver a healthy baby.

Next Steps: 

• 12/30/16: OB, Monthly Appointment
• 1/6/17: MFM, Diabetes Follow-up and Sequential Blood Draw 
• 1/16/17: MFM, Detailed Ultrasound (Level 2) Anatomy Scan

13w+5d: MFM Followup and NIPT re-drawn

I had my diabetes follow-up with my MFM.

MFM Followup 

My sugars looked really good this week. I'm going to stop taking Metformin, as of today. No changes to my insulin levels, keeping them at 12 iu in the morning and 16 iu at night. This may need to be adjusted if my sugars spike from not taking the Metformin. I'm also going to do a "trial" run on coffee... and see what it does to my sugar levels. I normally only had 1 cup a day, but I add creamer -- can't drink it black. So, going to see if the creamer I use will impact my sugar levels.

NIPT Re-Drawn

My MFM did not recommend that I re-take the NIPT now. She wanted me to wait until 15 weeks. She also mentioned that there are studies that show if you have multiple inconclusive tests, that it can mean there is an abnormality with the baby... Which I had already read, so wasn't surprised when she said it. There's also some research to show that women overweight are more likely to have inconclusive tests. So there's that as well. She did say that she thought we would have a good idea about baby at the detailed ultrasound, as the soft markers are usually very obvious at that stage in development. Either way, I'll know soon enough.

Well, I couldn't wait until 15 weeks and wanted to do it now. So, she let me... I'm keeping in mind that if it comes back inconclusive for a second time -- not to freak out... I also think that since I've had time to digest things, that I can deal with the results either way it goes. It's all God's will and out of my hands. Either way, I should know what's going on after the detailed ultrasound (hopefully). I am extremely hopeful that everything is ok with my baby and I pray that I can deal with whatever the outcome is.

Next Steps:

• 12/22/16: MFM, Detailed Ultrasound 
• 12/30/16: OB, Monthly Follow-up 

For a timeline and more details on my pregnancy journey, please click here.

12w+6d: High Risk for Trisomy 18/13

After taking so long to get pregnant, I used to imagine what being pregnant would feel like. I imagined it would filled with so much happiness, giddiness, excitement and so much planning for this new little life.

Things haven't really gone that way for me... First, the low-starting betas. Second, the Subchorionic Hemorrhage. Now, I just found out I'm at a high risk for Trisomy 18/13. 

1st Trimester Screening & NIPT

Last week I had my NT scan and I had my blood taken for two tests: 1) NT Blood Work (AKA 1st Trimester Screening) and 2) NIPT (Non-invasive pre-natal testing) with Panorama. The NT Blood work relates to your hormone levels. The NIPT is a DNA test. 

I have to say, I was not worried about these blood tests AT ALL. I just wanted to know the gender! I didn't even really look into what they specifically tested for. Well, they test for Trisomy 21 (Down Syndrome), Trisomy 18 (Edward's Syndrome), and Trisomy 13 (Patau syndrome). Feel free to look them up. But basically Trisomy 18 and Trisomy 13 are almost always a fatal prognosis where the babies either die in-utero or die shortly after birth. 

The NIPT test through Panorama company came back inconclusive. I was short like .1% of fetal DNA in my blood, so they weren't able to come back with results. I had like 3.4% of fetal DNA and they needed 3.5% in order to process results. 

The 1st Trimester screening came back with a low risk for Trisomy 21 (Down Syndrome) with a 1:6500 chance. Results came back with a 1:94 chance for Trisomy 18/13. Which means I'm high risk for one of these. The 1st trimester screening doesn't break out between Trisomy 18 and 13 because they both have the same hormonal indicators. The NIPT test would be able to break them out better. 

Just to level-set, these tests are just "screenings" and aren't diagnostic. It doesn't mean my baby DOES have these chromosomal abnormalities, I'm just high risk for them. Which scares the crap out of me. 

What's Next? 

The only way to 100% know if my baby has Trisomy 18 or 13 is through an amniocentesis, which is a very invasive test that has a risk of miscarriage... I had no plans at all to do an amnio. But now, I'm not so sure because I really want to know what to expect. Before we get there though, my MFM said that there are normally 'soft markers' they can see on an ultrasound. They didn't see these on my NT scan, probably because it was so early or because they weren't really looking for it. My MFM wants to perform a detailed ultrasound first. The plan: 

1) Repeat the NIPT Panorama test at 15 weeks. 

2) Perform a detailed ultrasound at 15 weeks. 

3) Have me talk to a genetic councilor. 

The detailed ultrasound is similar to the one performed at 18 weeks (at what's normally called the anatomy scan). I'll be repeating the detailed ultrasound at 18 weeks. If any soft markers are found at one or both of the ultrasounds, my MFM will give me a recommendation on whether or not an amnio should be performed. 

OB/MFM Appointments

I had my OB appointment and it turns out I have a UTI (my second one while pregnant) and bacteria vaginosis. I asked my OB why I keep getting stuff, since I haven't had a UTI since I was a kid and never had other issues. She said it's just because I'm pregnant, that our bodies do weird things. So, this might keep happening. The OB wasn't able to find my baby's heartbeat on a doppler, so they told me to have my MFM perform an ultrasound (their ultrasound tech wasn't there). 

My MFM wasn't very happy with my food/glucose logs. I was on vacation and it was nearly impossible to eat regularly or check my glucose levels 6x's a day. We are upping my bedtime insulin, I'm up to 16iu/night and 12iu/morning. They performed an ultrasound to check for the heartbeat and they were actually able to see the baby through the tummy, although it was hard to see clearly. My uterus is still very tilted, but should start to come forward (hopefully). I'm getting some back pain, I think it's due to the tilt. We were able to see baby moving around and hear the heartbeat of 163 bpm. Such a relief.

Eye Appointment

Had my annual eye exam and all is well. 

How do I feel? 

I've been in sort of a daze since I've had the news. I was just letting myself get really excited about the pregnancy and I had just told my close friends and family about being pregnant over Thanksgiving... Now, I kind of regret telling anyone anything. I should've waited for these results. But after my NT ultrasound went so well, I just assumed everything was OK and I wanted to finally share the news. Stupid... stupid. I should have waited. I've only told a few close friends about this "possibility" and don't plan on telling anyone else for now. 

What is so frustrating is that the odds are so very low for the baby having either trisomy. But at the same time, that means that 1 in 94 babies gets the diagnosis. For that ONE baby, how devastating... I can't help but worry about if my baby ends up being that one baby out of 94. I want to think and believe that my baby is OK and believe in the odds. But, I just can't let myself relax or trust in it. I think it has to do with my experience so far being pregnant and just how much I struggled trying to get pregnant. 

I'm trying to "let go and let God" and all that, but my mind and heart just hurt. It's like I'm hitting the pause button. I was going to send out "I'm pregnant" announcements this month, but now I'm going to wait... I just need to get through all this testing. 

I'm a bit envious of other women that have such easy pregnancies and no worries about any of this type of stuff. To be so lucky... 

I wish I could be celebrating my baby instead of worrying. After my infertility struggles - this just all sucks. 

Next Steps:

• 12/22/16: MFM - Repeat NIPT test, detailed ultrasound, and genetic counseling 
• 12/30/16: OB - follow-up appointment 

11w+3d: NT Scan and NIPT Done

FINALLY, after 2 1/2 weeks of not knowing what was going on in my womb and trying so hard to not get paranoid and worried about my baby -- I had my scan today. I was so worried we wouldn't see a heartbeat... I woke up in the middle of the night to pee & I couldn't go back to sleep, worries haunting me :(  Luckily, I had absolutely nothing to worry about! Baby is doing really good!!

NT Scan

What is the nuchal translucency scan? From Baby Center:

The nuchal translucency scan (also called the NT scan) uses ultrasound to assess your developing baby's risk of having Down syndrome (DS) and some other chromosomal abnormalities, as well as major congenital heart problems. 

The NT scan measures the clear (translucent) space in the tissue at the back of your baby's neck. Babies with abnormalities tend to accumulate more fluid at the back of their neck during the first trimester, causing this clear space to be larger than average. The NT scan is not invasive.

The NT scan took a long time, maybe 30 minutes or so. She first tried to do an abdominal ultrasound, but with my tilted uterus, she couldn't see anything. So we had to do the transvaginal ultrasound. I was anxiously awaiting to see the baby's heart beating. The first thing I saw was the baby's legs moving all around! Then the arms fluttering around! It was pretty amazing seeing the little baby wiggling around and I couldn't feel a thing. Baby's measuring really good at 11 weeks, 6 days. Heartbeat was strong at 176 bpm.

The NT took a long time since baby was moving so much that we had to wait until he/she was in the right profile position to get the readings. Good news: the measurements look good! You could see the little nose bridge and the back of the neck measured well. Now, I wait for the blood work to come back to confirm all is well. Which should come back early next week.

What was crazy about seeing the baby is, you could see so much detail! I have a cool picture of the hand, the legs, the brain, I got to see the heart and you could see the chambers. She said it was too early to tell gender, but it's either a boy or a girl. LOL. Seeing the baby, it was just... wow. There's a baby growing inside of me! And the baby's looking really really good right now! It just feels so surreal.

When I met with MFM about my diabetes log, we are upping my insulin a little bit. She wants me to make adjustments as I go so I can get my blood sugars under 95 for fasting. When I asked her about some worry for my holiday travels, she told me to stop worrying! LOL. I'm trying to lessen the worry... I really am! Today it finally felt REAL. Baby's on track, I'm almost out of the first trimester, and everything else is looking pretty good. I feel like I'm in an alternate universe, I am just so happy and relieved and feel so utterly blessed to have this life growing inside of me.

I'm a bit emotional about it all... It's like I'm finally able to believe in this wonderful thing. It's really here. I'm really pregnant.

Another nice thing happened today. I finally broke the news to one of my close friends about the pregnancy. She had gone through IVF and has twins. I haven't shared the news with her because I wanted to get a little further along before revealing it. Well, she's so sweet and offered to come out after the baby is born and stay for a little bit to help out! I don't have any family that is going to help me after the baby is born, so it was very touching to have someone offer. It means so much to me and I'm just so humbled to have such wonderful friends.

NIPT (Non-Invasive Prenatal Test) 

I finally had my blood work taken for the Panorama testing. When the results come back, I'll know the baby's gender...!!! I'll also know some risks related to some chromosomal abnormalities, including Down Syndrome. I'm still guessing my baby's a girl! Let's see if I'm right. 50/50 chance either way. I should get the results by the end of next week or so. Might be some delay because of the holiday, but I'm really hoping to get it in. I can't wait to know if I'm having a boy or a girl.

My next scan won't be until 18 weeks... which seems like an eternity away!!!!! That's when I'll have the anatomy scan. Hopefully I'll "pop" in the next few weeks and maybe start feeling the baby move when I get closer to 18 weeks.

Now... travel for Thanksgiving. Hoping I can handle all the travel and activity. I'm still suffering from fatigue if I do too much, so hoping I can hang. It's hard without coffee!

Next Steps: 

• 12/1/16: Annual Eye Exam
• 12/2/16: OB, Monthly Appointment 
• 12/2/16: MFM, Diabetes Follow-up

11w+0d: General Update + Cardiologist Visit

Have I mentioned I'm tired? The fatigue has lifted a lot, but I'm still not able to keep up to my normal pace pre-pregnancy. When I do a lot of things at one time, I'm just exhausted. Because of this, I've had to make a few changes to things.

House Cleaner 

At the beginning of the year I had started the Dave Ramsey plan. Part of my cutting costs plan was to cut out my house cleaner, who came every 2 weeks. I have to say, I did REALLY good with keeping the house clean for a little while. But once I started back on fertility medications in June/July, things started to go down-hill. Then when I started my FET cycle in August/September -- it got worse. Then the fatigue once I was pregnant... can I say - things got worse!!

I was keeping up with doing laundry, but not folding. I was good at putting things away, but not doing any deep cleaning. The house just got out of control and it was very stressful for me. A dirty house just makes me all out of sorts, like I can't relax. I just didn't have the energy to do anything about it. I finally bit the bullet and hired my cleaning lady back. She came last week and my house is CLEAN and lovely and smells so good! I am so happy that I decided to hire her back and she'll be coming every 2 weeks from now on. I'll just have to find another part of my budget to shave off of to make up the difference.

Diabetes Log

Part of my diabetes management is that I have to maintain a food log and glucose levels. I check my blood sugars 6x's a day: fasting/before breakfast, after breakfast, before lunch, after lunch, before dinner, after dinner. I have to admit... it is so hard to keep a log and to remember to check my glucose levels. I haven't been the best at it. Like when I'm busy at work and have a lot of meetings or if I'm out running errands, I don't "forget" - I just don't have the time to always check. It's frustrating I'm trying to get better at it and be more consistent. I'm finding the weekends are harder vs. the work week, since my schedule is more sporadic. I'm trying not to think about logging my foods through the whole pregnancy because it feels overwhelming. I don't make good food choices a lot of times, because of my busy schedule -- and I don't really know what the solution to that is. I have created a Google Sheets doc to track my food/glucose intake, which is a lot easier than keeping it on paper -- that's helped.

Cardiologist Visit 

As part of my MFM "to-do's" I scheduled an appointment with the Cardiologist to have an EKG and an echo cardiogram done. This was in part due to my diabetes, which can impact the heart. In pregnancy, your heart works harder because you're pumping more blood. So, my MFM wanted me to get this looked at, just to make sure everything was OK.

I'll start off by saying... that I didn't like the Cardiologist. It was hard getting scheduled. The office seems run-down a bit. His staff came across unprofessional and lazy. And I didn't like the way he communicated with me.

First, I had the EKG done -- everything looked good on it. Then, I was supposed to have the echo cardiogram. They had to get approval through my insurance, which took 2 people to call to finally get it authorized. Why? Who knows. But I was sitting there waiting while the first person said it wasn't approved, then the second person called and got it approved. Humph. Time suck.

When I finally met with the doctor, the first thing he talks about is my weight. He didn't read my chart or the notes from the referral - he just talked about my weight. "I think your diabetes is due to you being overweight and if you lost weight, you wouldn't have diabetes." Well, that's nice and kinda a "duh" thing to say. But he didn't read my chart and didn't realize I was pregnant. Do you tell a pregnant woman to lose weight? Then, he went into the whole, "Do you have high blood pressure issues? High cholesterol?" No and no. Then he goes into the whole - let me try to scare the sh!t out of you approach. He says, "Well, you might not have it now - but you will get it as you get older." Like it's inevitable. Nice. He then asked, "have you ever tired to lose weight?" Umm, yes doctor I have. Then I was on fertility treatments for two years and gained it all back. Which, you would know if you read my chart.

Anyways, the Cardiologist was fascinated that I was single and got pregnant through a donor. He said, "Wow, I've heard of women doing this I just never met anyone that's done it." Then he went on to quote a study about it and actually seemed to like me better once he heard this. Well, OK then.

He finally decided to read my chart after that. He then told me that I shouldn't be on Metormin because it causes birth defects... I'm like WTF. My MFM, my RE, and my OB all know I'm on Metformin and no one has ever said that to me or told me stop. Not ONE. He went on and on and on about how I shouldn't be on it for the first trimester and he's shocked my MFM actually increased my dose.

At this point... I could've freaked out. Hello, paranoid pregnant lady worried over this pregnancy. But after the conversation we had on the other stuff, I just figure he has no clue what he's talking about - where Maternal Fetal Medicine is concerned. He might be a genius with hearts, but he obviously is behind things where pregnancy is concerned. He also answered his phone 2x's during his consult with me... Odd.

Then, he checked my heart rate and he said everything looks good. But then countered with some scary a$$ sh!t that "could" possibly happen to me during the pregnancy because of the diabetes and being overweight. Like, really scary stuff. Like WTH.

Then I had the echo cardiogram done, which I don't know the results since the Cardiologist had an emergency and needed to go to the hospital. Seeing my heart on the ultrasound was kind of cool!

Anyways. It was a bad experience. I hate the scare tactics from doctors and worse case scenarios. Scare tactics with a pregnant woman is even worse because my hormones are all crazy and I'm paranoid as heck. Most of the stuff he was talking about wouldn't just pop up out of nowhere anyways. That stuff would be gradual and I'm being so closely monitored, I'm sure my MFM would catch anything and make the appropriate adjustments to my care. What an a$$

Ok, this entry is a bit longer than I thought it would be! Didn't realize how annoyed I was at the cardiologist visit until I wrote it all down. So, I'll end this entry here. Some exciting stuff coming up next week -- the NT scan and the NIPT!! Can't wait.

Next Steps:

• 11/22/16: NT Scan and NIPT 
• 12/1/16: Annual eye exam 
• 12/2/16: OB Visit

9w+6d: Last Day of Meds and MFM injections training

*** Back posting this since I wrote it last week, but didn't publish it. 

I have to admit that everyday I'm pregnant, I give a sigh of relief. I just can't shake the fear. It's so hard to believe that I am pregnant and that everything is going to be ok. Paranoia from my TTC Infertility journey? Just pregnancy anxiety? Or a little of both? 

There's "controversy" over when the 1st trimester really ends. My OB goes by 12 weeks, other places say it's 13 weeks. I'll feel great when I make it to 12 weeks... then 13... then 14 :)

I've told one co-worker about the pregnancy because it'll impact the deal allocation schedule. Felt weird saying it out loud to someone I'm not really close to. 

MFM Injection Training: Insulin 

I have to admit, when I picked up my insulin from the pharmacy, I felt a little defeated. I didn't feel like this originally, I always felt it was almost inevitable to get put on insulin for my pregnancy. I also know why it's necessary and needed. 

However, the reality of picking up the supplies... the reality of doing injections training... and the reality that I'll have to give myself 2-3 injections a day until I give birth... I felt like I failed in a way. When I was diagnosed with type 2 diabetes in 2008, it was one of my lowest moments. It almost felt like the end of things. So dramatic, but that's how it felt at the time. I had said I would never go on insulin. My diabetes has been in control by diet, then with Metformin. My levels have been really good and sometimes even in the "regular" range. 

So although I know it's necessary, it still is a moment where I'm faced with my diabetes diagnosis and that my body doesn't process things like normal people. 

Injections training was quick and easy, since I am pretty skilled at injections at this point. We discussed my food log and she said it's good that my levels stay good when I eat right, she says that's not the case for everyone. It's when I eat badly that my levels go bonkers. So I'm hoping after my food aversions lift and I have more energy, I'll be able to cook and eat better. 

I do love my MFM doctor! She wants me to call on her cell phone to let her know how my dosage is going. I'm not one to bug doctors unnecessarily... but she insisted. Feel very good having her as my doctor. 

First Insulin Shot 

After doing PIO, insulin needles are sooooo easy. I don't even feel it. 

Last Day of Meds 

I had my last day of my IVF Meds... no more Progesterone In Oil, no more progesterone suppositories, no more vaginal estrace, no more estrogen patches. Crazy... it's almost scary to stop the Meds. 

Overall 

Surprisingly enough, so far the pregnancy hasn't been so bad. There was the SCH scare... which still gives me some hesitation to get excited about the pregnancy. The nausea isn't "that" bad, the food aversions suck really bad, and the diabetes impact on the pregnancy sucks. But overall, things have been going well. I think a lot of the food aversions and stress was due to my high glucose levels and worrying about the impact on my baby. 

With all that, I have a good healthcare team in place to help with everything that needs to be helped with. I'm well taken care of and well monitored. 

I worry though because the last time I felt pretty good about the pregnancy was at 7 weeks and that's when the SCH hit... I just hope that nothing crazy or unexpected happens. I really would like a boring pregnancy! Some good news is, I seemed to have stopped bleeding - for now anyways. I've been spotting almost non-stop with stringy blood clots. Yesterday it seems to have stopped. It stopped once before, so will see if it starts up again. 

There's also the anxiety that I haven't seen the baby for a week. I don't have another ultrasound until 11/22, which feels like light years away! The lack of pregnancy symptoms always has me worried that something is wrong. I hope I don't feel like this for the entire pregnancy, but I'm sure I'll feel like this for the remainder of the first trimester. I just hope my baby is ok, it's hard to just "trust" my body after all the Infertility issues and my diabetes. 

Next Steps: 

11/17/16: Cardiologist Echocardiogram 

11/22/16: NT scan and NIPT 

12/2/16: OB followup