Look Who is Getting Big!

Sweet baby B is 6 months! It is crazy how fast he is growing compared to how long it felt like I was pregnant. I don't remember the bigger boys' babyhood going this fast at all! B is such a sweet, easygoing little fellow and I'm sure that is part of it. In the last month he has really developed even more of a personality though. He has started flirting with people and pretending to be shy when they notice him. He has also noticed when we are eating and he isn't getting any! Little piggy loves to eat

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My Journey with Cholestasis of Pregnancy

*I promised I would update you all on baby B's birth and how it all came about but while I was trying to figure out how to get it all out of my head and into writing, I realized I couldn't share that story without sharing this one first. It is the basis of why he came early and I couldn't just leave that out. Plus, its something that I know people are curious about. Its rare but it can have potentially devastating effects and I feel like its important for others to hear about. 

When I hit about 30 weeks in my pregnancy, I started to itch. Having had a PUPPP rash for the last 3 pregnancies, I was used to my belly itching uncontrollably, but this was a totally different beast. It started as a mild itch that really only affected me at night. It was like a weird tickly sensation all over my body. The odd thing about this itch is that it never showed any signs on my skin. No rash, no redness, no hives of any kind and it was all encompassing. Every part of my body itched. At first, I figured it was dry skin and slathered myself with a thick lotion every night before I went to bed with hopes it would help. When it didn't, I tried benedryl. When that didn't help, I mostly just whined to Michael who I'm fairly sure thought I was just losing my mind.

At 34 weeks when nothing else was helping and my family got tired of scratching the various parts of me I couldn't reach (you try scratching your feet when you can't even reach them to put shoes on!), I finally sent an email to my midwife telling her what was going on and asking if there was anything she could recommend to make the insanity stop. Within an hour, one of the nurses called me back and started asking questions.

Was it worse at night? Was it on my palms and soles of my feet? Was I jaundiced at all? 

I answered all her crazy sounding questions and then she explained her reasoning. There was something called Cholestasis of Pregnancy that met most of my symptoms and it could be really bad for the baby. The only thing was, I had no gallbladder so she didn't think that could be it. She suggested a warm oatmeal bath and more lotion. 

I hung up and consulted Dr. Google about the Cholestasis and she was right, it met all of my symptoms to a T. Right down to the depression and exhaustion I had been struggling with but attributed elsewhere. The scary part was when it started getting into how it was harmless to the mother outside the insane itch but had a high instance of still birth if the pregnancy continued too long. Basically, because of the pregnancy hormone changes, my liver was leaking bile acid into my blood stream. It just made me itchy but it could slowly poison my unborn son. 

About the time I started to get really worried, the nurse called me back. She said that she had consulted with the OB in the office and it turned out she was wrong, the gallbladder being gone had no bearing on the possibility of Cholestasis. She made and appointment with me to meet with them in the office on Monday because it was almost closing time but told me if I was too worried to wait to go to the labor and delivery triage and have them test me. 

After I got off the phone with her, I went to see Michael at work and tell him what they had said. I tried to gently explain the risks but all he heard was that B might die. He was rightly as freaked out as I was and we decided to go on into the L&D triage to get checked out.

Once we got there, they hooked me up to the monitors and ordered blood work for a liver function test to check my liver enzymes and a test to check my bile acid levels. The nurses didn't have much knowledge to share with me on the Cholestasis thing. In fact, they had never heard of it and had to look up what it was to even really know why I was so worried about it. 

After about an hour, my midwife came in and told me that the liver test came back normal but it would take probably a week to get the bile acid tests back to confirm the Cholestasis. She went ahead and prescribed the meds for Cholestasis and told me to go home and try to rest. She also told me she wanted to start me on twice weekly monitoring and biophysical profiles until we got the results. I was already seeing a perinatologist and she said she would call them first thing Monday and get us scheduled with them too. We were so glad that they were being proactive and treating this like it was as serious as we knew by now it could be. 

Long story short, it took about 10 (long, tense) days to get the bile acid results in and they were only slightly elevated but still not normal. The perinatologist made the executive decision that because of the symptoms and the fact the meds were helping the itch a little, to go ahead and schedule the induction to be moved up to 37 weeks instead of 39 to reduce the possibility of still birth. It was a relief but still nerve wracking because having a baby that early can come with its own set of challenges.

They continued monitoring me closely for the rest of my pregnancy which I'll admit became a little bit of a chore. Going back and forth to both the perinatologist and midwife's office twice a week was stressful but I knew it was for the best and I held my breath every time they fired up the ultrasound machine hoping to see that little heart beating away first thing. Every appointment, he seemed to be dealing with it well. He had one episode of high heart rate and a couple episodes of weird decels but nothing the doctors were overly alarmed about. Until I hit 36 weeks and change.

I noticed over the weekend that he seemed to have slowed down in his movements. He was still in there and still wiggling but no where near what he had been doing. I drank extra water and told myself he was just running out of room. We were almost there. 

On Tuesday (36 weeks and 4 days), I went in to the perinatologist for my BPP and they asked all the normal questions about his movements and how I was faring. I told them about the decreased movement and the tech took it more seriously than I expected which immediately set me on edge even though I had already seen his heartbeat. She went on with the BPP and told me my water was borderline low and she could tell he wasn't as wiggly during the ultrasound as he usually was. Then she left to get the Doctor. 

I sent Michael a text message really quick and he asked what that meant and I told him I had no clue but she seemed worried. After a few minutes, the Doctor came in and we went over everything the tech had said and what I told her. He checked my fluid levels again and just kind of watched him for a few minutes. That is when he said, "We are gonna need to go ahead and move up your induction. To today.".

Update on Baby #4

Its been awhile, I know. Life has that way of getting busy and getting in the way of the things we do for ourselves, doesn't it? I know its a poor excuse but sometimes, you just can't find the words to explain.

Anyway, last you heard, I announced we are expecting another son this Fall. September 3rd is his actual due date but he will be arriving earlier than that (more on that later). I am still nervously excited about adding to our family again. This pregnancy has been easier in some ways and harder in
a lot of others than the previous 3. Baby B has been easier on his mama hormonally in a lot of ways than the other boys were in that I am not spontaneously bursting into tears every time a sappy commercial comes on and I'm not trying to chew every one elses head off the rest of the time. I'd say the people that love me are quite happy about that.

The weather has also mostly cooperated this year. Knock on wood. We have had our share of nasty hotness but nothing that has really been do or die. Of course it is really just now time for the heat to start ramping up to that point so I hope I didn't jinx myself. I guess I tend to blame the fact that this is my 3rd September baby too. Maybe I am just jaded to the constant sweating and hiding indoors part of it all. We tend to spend a lot of time in the water too though. We have season passes to the local water park and frequent the local rec pool to stay cool.

In a lot of ways this pregnancy has also been my hardest too. Physically, I am more exhausted this go around. You can blame me being older or him being the 4th or whatever you like, I blame not ever sleeping. For serious, I never sleep. I have given up on the laying in the bed making myself miserable by tossing and turning, opting instead to use those overnight hours to catch up on TV or laundry. The worst part is getting lonely overnight. Michael works most nights, so I do spend as much time talking with him over the phone as I can but he stays pretty busy.

28 Weeks

Besides the not sleeping, I have had more "issues" this go around too. It started with a kidney infection early this year, which has now turned into kidney stones. My placenta is lying quite low too. Not quite enough for them to officially classify it as previa yet but they are watching it closely an I am praying it moves up and up.

The exciting part is the measurements though. Baby B has measured big since the very first appointment. He was one week big at 8 weeks and then 2 weeks big at 20 weeks and then 3 weeks big by 28 weeks (See picture). Then, last week when my midwife measured my uterus, it was a whopping 38 weeks and I was only 31. So, 7 weeks ahead. Not cool dude. They went ahead and scheduled an in-depth ultrasound at my next appointment to check the fluid and his size again and all that. The thing is, ultrasound measurements can be off by so much, so I'm not really sure what to expect. Will he be big? Probably. Will he be normal sized and my belly is just extra big because there was only 9 months between him and his brother? Possibly. The not knowing is the worst.

Emotionally, this pregnancy has been difficult as well. For both me and Michael. After losing Gage so suddenly and so dramatically after a perfect pregnancy, its so hard to connect this time. Even though I feel him tumbling around in there and we see him on the ultrasound doing normal baby type things, there is this void. A horrible disconnect. Like its not real. Doing things to get ready for him has been hard. I get panicky every once in awhile at all we have to do before his arrival, especially considering his size and the possibility he could come even earlier than expected, but we just can't.

I can't go through the clothes we bought for Gage and not think of the baby that never got to wear them but replacing every thing we have isn't exactly cost effective either. I can't set up a space for him without wondering if its all in vain. Seeing other blushing, excited pregnant women is like torture. I want to scream at them that sometimes it doesn't matter which brand diapers you pick. Sometimes the unfathomable happens anyway. Of course, being big in the belly department, I get constant questions and congrats from people. I try to take it with grace and style. I try to humor their questions and comments. Thing is, I can't tell people I'm excited to be expecting again when I'm terrified. So often I end up bawling in the car or bathrooms at peoples comments but I can't exactly be mad at them, can I?

The boys are excited though. Well, K is. D is much more cautious this time. I don't know if its because he is feeding off our emotions or if he remembers too well. He mostly just rubs my belly and says he hopes he gets to hold him this time. K is much more involved. I think he is just now really old enough to really grasp the fact there is a baby in there. He enjoys talking to him and playing poke back with him through my skin. He tells him he loves him and tells people all about how hes gonna have a baby brother this time if he doesn't die. All about the brutal honesty, that one.

Really, all we can do is hope and pray for our littlest man. I have to believe that everything is going to work out this time or I'll go insane. We have been working with the midwives and perinatologist to create a plan for his birth and are trying to get as many stop gaps in place to prevent the events of last time from happening again. In case you missed the story, his birth was fast and furious. He didn't get the fluid squeezed from his lungs resulting in pulmonary hypertension. Because of that, they didn't get him the antibiotics for group b like they were supposed to and it took him. Quickly.

This time, I will be induced, probably around 39 weeks, so that we can have more control. We can work on slowing down his trip out and get the antibiotics out of the way before anything is started. It means I will have that classic, heavily monitored, laying on in the bed birth that so many women go to so many lengths to avoid, but I am more than okay with that. At this point, I'd even consider a c section if I knew it meant I'd get to bring him home safely. All I want is a son for Michael to hold and a brother for my boys. Priorities.

Thats the long story of it right now. If you were looking for the condensed version, you are probably disappointed. Sorry. Now you know more than you probably wanted to. Its cathartic to get it all out there though and I know there are so many people who won't ask.