Wednesday, May 16, 2012

No Updates in 4 Months???

Where have I been? What have I been doing?

Good questions! I will try to fill in the 4 month gap with this post.

Since the start of 2012, I have been swamped with finishing my Master's in Nurse Midwifery and preparing for my husband's return in April from a 6 month deployment.  I have also been quite busy growing a little baby.  While this does not take much effort on my part, it is quite exhausting!  

So just a quick run down of what has happened since I fell off of blogging in late January...

Found out the sex of the baby at 11 weeks (hard not to find out when you know what you are looking at and ultrasound machines abound at your work place!) and shared with husband and sister (having a gender reveal baby shower, so keeping it a surprise until then); had a great scan at 12.1 weeks; announced on FB and to friends that we were expecting a baby in August.

12.1 wks

FB Announcement - our dogs wearing "I'm Going to Be a Big Brother/Sister" shirts
Shopped at my first Just Between Friends (JBF) sale with my sister and bought heaps of baby clothes and other supplies for such great deals; finished my last full month of midwifery clinicals - feeling more and more confident by the day; felt the baby move for the first time (so exciting!); had a 16.1 weeks scan that we skyped with my husband in Afghanistan, the baby is still growing well and doing great!

16.1 wks
Caught my 59th baby (wahoo!) and completed over 1000 clinical hours including seeing 637 patients; graduated magna cum laude with my Master's in Nurse Midwifery; spent a week interviewing with a physician/midwifery group for a prospective job; began to work on all the house projects and baby's room; purchased the remainder of large baby needs and created two registries; had a 22.1 week scan and all was still normal with great growth (due to IVF with ICSI and AMA, there are concerns for IUGR - intrauterine growth restriction and fetal demise or stillbirth).

22.1 wks

22.1 wks - look at those lips!

Completed all of the organising/purging/cleaning of every room in the house; painted both the baby's room and master bedroom; completed the baby's room (yay!); welcomed my husband home from a 6 month deployment (so nice to have my best friend back); received the job I had interviewed for in March and they agreed to allow me to work part time/2 days a week + call (such great news!); went on a reunion spa holiday with my husband for the weekend and was upgraded to a top floor, 3 room suite due to his deployment (a wonderfully rejuvenating and lovely time); began Bradley Method Childbirthing classes for my husband to learn about birthing and how to support me in labor (he has no clue what to expect!); began studying for my boards.

Passed my boards!!!! (what a relief - I am beyond excited!), now officially a Certified Nurse Midwife (CNM); had a 28.1 wks scan - first one my husband could be present for and the lovely techs threw in some 3D views for us which were amazing - it's finally all becoming real for my husband since he missed out on the 1st half of the pregnancy; all is still going well with the baby weighing in at about 3#/1360g/67th percentile and everything else (amniotic fluid, anatomy, etc.) is all looking good; working on getting credentialed at the hospital which involves a lengthy contract and application process and getting a NPI (national provider identification) and DEA number in order to be reimbursed by medicaid/care and be able to write prescriptions respectively (the process typically takes up to 3 months, which puts me at the birth of our first child and then I am taking 12 weeks off for maternity leave, so it looks like at this point I will not start working until November.  Hopefully I can keep my knowledge and skills up in the meantime!); trying to find things to do for the next three months with no job and no studies to keep me occupied (maybe I will be better with keeping up with the blog?); started knitting a baby blanket; beginning prenatal yoga classes next week.

28.1 wks 3D profile

28.1 wks hand moving across face, yawning

Looking forward at June
Finishing the house; meeting with our doula to prepare for birth; finishing our Bradley Method Childbirthing class; another growth scan; going to the annual ACNM (American College of Nurse Midwifery) conference in Long Beach, CA (our babymoon!); husband having surgery to fix his varicocele in hope that we can get pregnant spontaneously in the future; maternity pictures; gender reveal baby shower!

2012 Goals and Timeline

At the beginning of the year, I created a post with my 2012 Goals and Timeline, but never published it because for some reason it eschewed my whole blog. So here is a revamped list of my 2012 goals with updates on what has been accomplished so far this year.  The timeline will have to wait for another post.

My 2012 Goals:
  1. Resume daily Ashtanga practise now that I am in 2nd trimester
  2. Hire a housekeeper - best thing that I've done all year!
  3. Look into international midwifery work - ongoing, definitely thinking of pursuing Médecins Sans Frontières as they have short assignment midwifery positions available.
  4. Finish all house projects including baby room - baby room completed, only a few more rooms to go!
  5. Find a yoga teaching job even if it is for only 1 day - have not had time for this, but hopefully can do so after the baby is born.
  6. Look for ways to volunteer and give back
  7. Apply to DNP (Doctor of Nursing Practise in Nurse Midwifery) Program at Frontier - contemplating waiting a year before resuming.
  8. Pay off IVF incurred debt - working on it!
  9. Money - save more, invest more - saving more, but waiting on investing until we are out from under the IVF debt.
(9 is my lucky number, so I'll end there!)

Our 2012 (Ongoing) House Projects:
  • Paint master bedroom
  • Paint master bath
  • Paint guest room - to be done this week and next
  • Paint baby room
  • Paint laundry room - - to be done this week and next
  • Paint main bath
  • Buy, paint and hang 9 new doors - my fix-it-all, handyman of a husband is working on this now
  • Master and main bath remodel including floors 
  • New drapes x 4 rooms, Roman shade x 1
  • White trim throughout house - ditto as above
  • Re-paint previous white trim in semi-gloss white
  • Paint bannister and handrail
  • Hire painters for living room, hallways and stairway
  • Purchase new double ovens
  • Purchase wine fridge to replace trash compactor
  • Hire painter to paint all insets and cabinetry, including kitchen cabinets

It seems like I have accomplished much since 2012 came into focus, but my list does not reflect it as much.  I have literally organised, cleaned, purged and styled every room in the house.  My husband came back from deployment to a completely new and refreshed house.  My last projects that I am going to work on is painting the laundry room (now that my husband is home to move the washer and dryer) and paint the guest room.  My dear spouse has just finished all of the trim, new doors and cabinetry painting in the baby's room (so glad that is all done!) and is now working on the master and guest bedroom.  Our main big things are the kitchen cabinetry painting along with sky high cathedral ceilings in the living room (will probably hire out on the latter) and the remodelling of our guest and master baths.  I am hoping, with all fingers and toes crossed, that we can get everything done in the next 3 months.  I would really love to enjoy our home, completed, after the baby is born and definitely before we have to move again.  It will be so nice just to have everything finished and accomplished.

Sunday, January 22, 2012

1st Trimester Screening

This past Thursday I was 12.1 weeks and I had my first trimester screening.  I had previously done the MSAFP (maternal serum alpha fetoprotein) blood work the week before so that if that and my US came back abnormal, I could have a CVS (chorionic villus sampling) done.

I had the US first (before knowing the AFP results) and all looked great.  There was a nasal bridge, a normal third ventricle in the brain, fluid between chin and chest and the nuchal translucency measured 1.8 mm (should be less than 3 mm).  All seemed normal and healthy with the scan.  I even got to see the sex of the baby (woo hoo!) although that is something I am not sharing until I can first tell my husband.

I then received my instant risk ratio.  Before the AFP and scan, I had a risk of 1 in 102 of Down Syndrome due to my age of 39.  After the AFP and scan, my risk lowered to 1 in 704 with an age of 29.  The Maternal Fetal Medicine (MFM) physician said I could not receive any better results.  He was quite pleased with everything and believes I have a very low risk.  Additionally, my risk for trisomy 18/13 was 1 in 187 before assessment and reduced to 1 in 3721 with an age of 20 years.

I feel very happy with the results and at peace after viewing the scan and seeing my AFP results.  I will have another MSAFP done at 16 weeks as a follow up to make sure everything is still okay and to detect for open neural tube defects.  I feel pretty confident though that all is going to go well with this pregnancy.  This egg survived over all the others, this embryo implanted and kept growing over the other 2 and this baby is still going strong no matter how many sleep deprived nights I have with my midwifery clinicals.  I am hoping every thing continues to go right with this pregnancy and we welcome a healthy baby come August.

A profile view from the scan

Sunday, January 8, 2012

10 Weeks Baby!

I have not posted in some time because I have been feeling poorly AGAIN!  Third time's the charm, right?  I am hoping I am on the mend for good now and that this sad trilogy is coming to a definite end.  I am ready to feel like my normal self again.

Two things happened this past week, both on the same day.

On 4 January, I was 10 weeks exactly.  I celebrated the day with my last dose of progesterone!  Thank goodness that is O-V-E-R!

For 7 of the 10 weeks, I self-administered progesterone injections intramuscularly into my gluteus.  Someone on Twitter had told me that it would not hurt at all.  Pish posh. This was not true.  It DID hurt.  I had such an ordeal with self-injection.  Several times I hit a nerve and one of those times it numbed my whole lateral side of my right thigh for weeks.  My bum was often sore, I had lots of knots under my skin that I rubbed fervently to break up, and several times I hit a blood vessel which spurted blood all over the place once I removed the needle.  NEVER have I had any of these things happen when I have given someone else an injection, but it is a whole other story when you have to try and give it to yourself.

the dreaded progesterone injection

22G needle, 1 1/2 inches long

At 7 weeks, I switched to Crinone 8% progesterone gel.  I thought it would be like using Monistat - insert it in the evening and have cream dripping out of you all day, but luckily this was not the case.  I did insert the gel in the evening, but had no irritating side effects during the day.  No drippage or leaking.  No itching, redness or irritation.  Overall, it was much nicer than giving myself daily injections.  However, on the last day of using Crinone, I felt some vaginal pressure.  I rushed to the toilet thinking it was going to be a blood clot or fetal tissue, but it was just 2 huge golf ball size formations of the Crinone gel.  Sorry, I know, not a pretty picture, but I want to share the full story since no one tells you these things!  Even I was a bit grossed out, but on the other hand, so glad it all came out!  I am not sure if that is typical or why it gathered into golf ball size rounds, but I am assuming that it was the residual part of the gel.  Here, I was thinking all of it was absorbing into my tissues, but no, the majority of the gel was just collecting into balls!

Having the 10 weeks of exogenous progesterone administration be over with was enough reason to elicit a party, but also on the same day, I had my first new OB appointment.  Yay!  I feel like my pregnancy is all grown up now.

I am seeing my midwife for my OB provider and it was nice to see her again after having a long holiday break.  We caught up on all midwifery things and then got down to business.  She asked lots of questions regarding my medical past and we discussed which labs I wanted.  I declined the early glucose testing as I hardly eat any sugar or processed foods, and do not want to take a sugar laden drink that is made of artificial flavors and colors.  I think that drink alone would put me over!  I did agree to an A1C hemoglobin and a fasting glucose.  We are also going to test my vitamin levels (D, B-12, Folic Acid, Ca, etc.) due to being a vegetarian.  I also asked to have my first trimester screening set up.  I want to know sooner rather than later if there are any problems such as Down's (my biggest worry).  We then looked from above at the baby and she was just bouncing up and down and waving her arms.  It was so adorable.  The bedside US at our clinic is not as good (not as high of a resolution) as the RE's office, so I did not get as good of a picture, but you can see the fetus lying head down with her back to the left.  We also observed the heart flicker and heard the heartbeat by doppler from above at 165 bpm.

All seems to be going well.  I gave about 10 tubes of blood that afternoon and should have my 1st trimester screening (blood/US) next week.  Looking forward to all good news so I can relax and plan for a healthy baby.

Sunday, January 1, 2012

Fetal Doppler

When I first found out I was pregnant, I scoured the interwebs looking for a fetal doppler.  Why? you might ask.  Well, because I just could not believe I was pregnant and I wanted to have intermittent proof that there was actually a baby in there and that the heartbeat was still going strong.

I found heaps of fetal dopplers that were astronomically expensive - between $200-400.  Yowzers!  That price was definitely out of my budget.  However, I lucked out and stumbled upon the Sonoline B Fetal Doppler at Pulse Oximeter Online.  The website states that it is normally $349.99 but it is on sale for $52.95 and they even include free shipping!

Photo Courtesy of Sonoline B
I was impressed with the price, website description (includes gel, 2 AA batteries and a 1 year warranty) and that a 3 mhz probe was available (3 mhz is preferable over 2 mhz to pick up the early fetal heartbeat and it is what we use in our clinic), but I was not sure how reliable the product was.  I checked YouTube to see if there were any reviews, and lo' and behold there was one:

Author allharr said in her video that hers worked at 9.5 weeks and gave a good review of the product.

I ordered the doppler and received it promptly as shown and described on the website at 7 weeks, however, I was not able to hear a fetal heartbeat.  Only mine.  I tried at 8 and 9 weeks as well and still nothing.  But early this New Year's morning after the clock struck midnight, I decided to try it out again for a New Year's treat.  Miraculously at 9.4 weeks, I was able to hear the heartbeat!  I am over the moon about it, and of course, I emailed my husband straight away!  I am also relieved to hear my baby's heartbeat after all this sickness I have had.  I am glad the prolonged infections have not done anything untoward to the pregnancy.

I cannot say enough good things about this device.  Why rent a doppler for $20 or more a month, when you can own one for $52?!  It is definitely worth the money if you are a curious, still-in-shock, and/or worried expecting mom-to-be like me.

Have you purchased a fetal doppler?  How often do you use it?  If you purchase this one, please let me know if you like it!