April 2008 - Posts
I saw my rheumatologist on Friday for another check-up. She hadn't received my bloodwork results yet...from what I understand the several thousand dollars worth of blood work I have done quarterly actually produces a packet of results about an inch thick. She receives a consolidated summary of those results...which takes a little longer.
She did call the lab and everything except the cardio piece was back and was maintaining, so that's a good sign. She believes the cardio piece will also remain the same, but will call if it shows any differences. The good news was that my immunoglobulin (Ig) levels were down. Supposedly, they elevate in pregnancy so seeing that they were down slight is a good sign that the Plaquenil is working.
I did discuss my sweating bouts and nightmares with her...sounds like the sweating may just be from my pregnancy hormones, but we're going to keep tabs on that. The nightmares she was surprised about, and said that I should discuss my stress level with my OB as it seems I've got some life stress somewhere and they probably want to be aware of it. If you had asked me, I wouldn't have said I was stressed, but thinking back those dreams do tie in to the period before my son's birthday. I'm going to give it another 2 weeks and at my next appointment raise it with my OB if I'm still having them frequently. I haven't had one in several nights...of course until last night. Was being chased again.
She examined my hands, fingers, ankles, and feet and noticed some tightening in my fingers(RA) and some swelling in my feet. I mentioned how this week I've noticed a line appearing across the base of my toes at night. She said I'm going to need to get off of my feet once or twice each day and put my legs up. Need to watch the swelling as it's also a symptom of kidney issues associated with Sjogren's. Yeah. Now I just need to figure out when I can actually get off my feet.
My next visit is in two more months. Hopefully things will maintain and there won't be any additional changes to discuss.
I had my monthly appointment (a week late...as I spaced and forgot last Monday that I had an appointment) yesterday. Loved only being up 3.5 lbs in five weeks. Holding better course than with my first pregnancy. Although, I had that wonderful stomach virus to thank for the minimal increase.
Got my papers for the lovely glucose screening. Now I just need to figure out when I want to tackle that one...and who I can get to come out and watch my son while I go take the test. Also got my c-section date. As one of the three OBs I've been seeing (as I'm high risk they asked that I not rotate through their entire office) is retiring at the end of June, that left 2 OBs who could actually deliver the baby. As the OB I saw yesterday (who also delivered my son) is going to be on vacation at the end of July, that leaves one OB left (luckily the one that I would consider my primary). She's only delivering on the 30th, so July 30th at 9am I am scheduled to welcome baby #2!!
We talked a little about how this past week I've had a nice case of heartburn (didn't have that the first time around) and my OB let me know that the cramping/pains I'm getting (especially while sleeping) are totally normal. Just hurt like heck, that's all. I had some this morning...as our son was up around 5am and didn't want to go back to sleep I'm sleep deprived and ready for a nap now. Was great having the cramps on top of that. Try entertaining a 2 year old on the run when all you want to do is curl up and lie still.
I have another appointment with my primary practice in 2 weeks, but I have my 26 week appointment with the high risk group tomorrow. Should hopefully get the all clear regarding the baby's heart...haven't heard anything yet, so hopefully nothing has changed in the past 2 weeks. From here on out I'll be meeting with my primary practice every 2 weeks (until the end) and the high risk practice every month for another ultrasound to measure the baby, the placenta, and check up on a few other things. I'm just hoping the glucose screening has similar results as last time - no gestational diabetes. From what I understand, they're going to have me repeat it later on to make sure I don't develop it as Sjogren's Moms are at an increased risk for developing this pregnancy-related condition. Keep your fingers crossed!
Yup, it's there. Somewhere my normally functioning brain is taking a vacation. I missed my OB appointment this week. Not because I was busy, but just because I forgot about it until tonight...only to realize it was Monday morning. And what was I doing Monday morning? Working in the yard.
I went today to get my blood work done this afternoon (along with my son who ate everything I brought him in about the first five minutes we were sitting in the waiting room). I was supposed to wait until my OB ordered my next round of blood work and have it drawn with that, but not remembering I had an OB appointment this week and knowing I am seeing my rheumatologist on Friday, I thought it prudent to get the blood work done. That way, when I discuss my new sweating symptom and show her how my knuckles are splitting in multiple places because my hands are SO dry, she can look at my SSA and SSB levels and see if anything has changed.
I've also decided to start taking my Plaquenil every morning (instead of every other morning) as I can't remember any longer whether or not I took it the day before...and as the fatigue hasn't gotten any better, there's probably no harm in seeing if it gets worse upping the dose. We'll see what the outcome is. At least this way I'm not guessing whether or not it's a day to take the medication.
I had my 24 week appointment this past Friday...had to move it from Wednesday as I had the lower GI piece of the wonderful virus about half of the guests to my son's birthday took home as a departing gift. That lasted from early Tuesday morning until Saturday morning (the joys), and I still really don't have much of an appetite. However, in thinking about the long ultrasound and all the pushing on my tummy that they usually do, I don't think I could have bared to have that on Wednesday.
Friday, although I was still a bit sore, I did go in for the appointment. As I had a 2pm appointment for my ultrasound and a 4pm appointment for my son's 2 year check-up, I made sure I was at the hospital as early as possible on Friday to ensure that I left on time. I entered the office about 10 of 2, and as no one was in the waiting room, thought that was a good sign. I checked in at the desk and they let me know that it would be a few minutes, so I used the bathroom across the hall and then made my way back into the waiting room.
The waiting room is very long and narrow. Probably not more than 5 feet wide, and has chairs on both sides. At the far end of the room is a wall mounted tv, and near the reception area is the water cooler and door to the hallway. When I re-entered the waiting room, I was shocked to see the room was full. Full. There were two younger mothers-to-be (seemingly sisters), each with a stroller containing a child of under a year. In addition, between them, they had 3 girls and 2 boys between the ages of probably 5 and 9. See why the room was full?
Were any of them sitting quietly? Nope. The kids were taking turns either filling cups at the water cooler (and then placing them in the garbage...full), playing musical chairs and threatening their partners with bodily harm, or running up and down the hallway knocking on doors. Wonderful. Would have made any parent-to-be reconsider...except those at a high risk practice. I sat for nearly 15 glorious minutes trying to avoid eye contact as one of the girls just kept egging everyone on. I just wanted to get into my appointment. To top it all off, instead of calming the children down or talking in low voices to get them under control and at least in the waiting room, the two mothers took turns yelling at 8,000 miles a minute in Spanish at the kids. All I heard from the time I walked in the door until they came to get me was a constant, "Naa, naaa, naaa, naa, naa." I couldn't understand any of it, it all was shouted, and I was thrilled when they opened the door and called my name.
When the woman called my name, she quickly followed saying it with, "I was afraid to open the door because I thought I was going to hit one of these kids." Hah.
The appointment went quickly, which was great as they didn't start the ultrasound until 2:20pm. The baby was cooperative, and she was able to get the arm, leg, bladder, kidney, brain, tummy, and heart measurements on the first try. She confirmed that the growth is on track, and the baby's weight is currently 1lb 7oz. The wonderous book I have says that the baby should be about a pound and a quarter, so just a little heavier, but within range.
The doctor monitored the heart immediately following the measurements, and everything is still looking great. Just over a week left before we get the all clear regarding the heart. I can't wait to finally clear that hurdle.
I can't tell if I've reached that "swelling" stage in pregnancy or if it's the Sjogren's, but my rings are getting very tight. I did have to take my rings off towards the end of my first pregnancy...and who doesn't love being pregnant and having strangers glare at your empty hand? You know that what's running through their head is "unwed mother." At least this time I'll have my son in tow :-)
My husband and I threw my son a birthday bash yesterday for our close family and friends. My husband and Mother have been telling me for weeks now that I need to keep things simple. At first I was convinced that I could do it all, but as I began to plan, I knew that I needed to cut back. First being that we didn't invite all of our friends and family. I would have loved to have some more of Griffin's friends (and our friends who have children) with us, but decided to just try and keep the party on the smaller side and invite the buddies he's with most often...besides the playgroup buddies who themselves could be a small party. Maybe next year I'll have a cake and ice cream party for friends and then a separate family party. It's always tough to balance your time between friends you might not have seen in a while and family you might not have seen in a while at these events. Add on any cooking and hostess duties, and there goes my day.
The other area I scaled back on was the menu. I was originally going to have a cooked meal (like BBQ chicken or pulled pork sandwiches), and I was talked into having burgers, dogs, and brats. Great as that meant that it was quick cooking on the grill, and not much prep time in the kitchen (except to set things up and make the ***). In addition, I made a pasta salad, a fruit salad and homemade hash browns. Everything was made on Saturday, so I didn't have to cook much on Sunday. I also made a dip the day before that I cooked on Sunday before everyone got here. My big project was making train cakes. Yes, cakes. I made a large sheet cake with a chocolate cake train on top, as well as two smaller table top trains...which I made out of pound cake and decorated with candy.
At first, I wasn't sure they were going to work out. The cakes kept falling apart as I was frosting them...and that was after an entire day of cooling. I eventually got the little cakes frosted and at that point said to my husband that they might just end up in the garbage...looked more like my son's art project than something edible. However, after just a little candy and some licorice tracks, my son came in and said "t, t" which is his language for choo choo or train. He recognized what they were, so I continued to frost and decorate. Good thing, as I received many compliments on the decorating work...and for our little friends who had to leave early for naps and such, it was easy to send them with a piece of cake without cutting into the large sheet cake.
My husband commented last night that this was the most stress-free event we've held, so I take that as a compliment. However, with all of my planning and a day full of hard work on Saturday while he ran to get haircuts and played with our son, my feet and back are killing me. My hands are definitely swollen this morning, so we'll have to see if this gets better with some fluids and rest, or if things continue on a downward spiral. Supposedly the swelling is going to be worse for me this time around as now I have Sjogren's. I just remember the last month having a hard time walking up the stairs as my feet were so swollen that there was a crease across the base of my toes between my swollen foot and swollen toes. Hopefully that doesn't reappear until later on in the pregnancy...if at all!
This afternoon in talking with my Mother I realized I've been experiencing yet another wonderful "benefit" of having Sjogren's - profuse sweating. Yippee.
The day began with all of the best intentions. We have a family in our group of playmates that is moving to Poland for about 8 months. I can't even begin to imagine packing my entire house full of contents (as they're also renting their home here while away), never mind with a 4 months old, a 20 months old, and a 10 year old. I'd probably be locked up at this point, but this Mom friend of mine not only is keeping her cool, but just finished off a weekend of the 24 hour bug. Did I mention the movers come Friday morning?
Yeah. Take a deep breath. One of the things our group of playmates has done to try and help where we can is to take time during these hectic days to play with her two youngest children at their home while she runs errands and tries to pack. At least this way she can have some uninterrupted time to try and make some progress...because after all, who can get anything done with a toddler in the house? I know my son would be unpacking more quickly than I could fill a box or a suitcase.
Today was our day to tag team with another Mom (who also has a 4 month old and a 2 year old) for a play date. Everything was going smoothly...or as smoothly as it could be with 5 children and two Moms...and then the pressure was on when I realized that my son had pooped his pants. Not a huge deal...just meant I'd leave the other Mom with 4 kids. Little stress started to kick in. I quickly grabbed the diaper bag and ran up the stairs (well, not really, but I moved as quickly as I could). Off came the pants, diaper, wiped him up, back on went the diaper, pants, and presto...clean boy. Before I was back down the stairs I was soaked. Not just glistening or whatever you like to call a mild sweat...I was sweating like I had just run a marathon in 100 degree weather. That passed fairly quickly...then came the real soaking.
All three of the older boys are at a phase where they want whatever someone else has. Completely natural. They tug and pull and whine a bit, and one of us steps in to break things up and usually send one (or both) children in separate directions after the next coolest thing in the room. It happens at every playgroup. We're used to that. Today, the boys were a little more physical...grabbing shirts, hitting a little, but mostly tolerable stuff.
My son...who is still working on talking...dug through a toy bin and pulled out the smallest green plastic shovel that you'd use in a sandbox. Nothing fancy. A shovel. He turned to me and said, "dig, dig." I was nearly overjoyed to hear the words come out of his mouth...and with one of the four month olds on my hip, I stood acknowledging his latest feat. The older boy of the house seemingly has an affinity for shovels, and the two immediately began to brawl over this little shovel. Before I knew it, instead of the pushing or hitting, my son has locked his teeth...yes, his teeth...in the forehead of this other little boy. I honestly thought when I separated the two of them there'd be blood. Luckily there wasn't. However, I quickly turned and secured the little one in his swing, picked up his older brother (who, trooper that he is wasn't even crying...just shocked) and grabbed my son under his arm and tossed him into an oversized chair. I ran to the kitchen (where his Mother joined me) and grabbed some ice from the freezer and started to tend to the "wound."
Mortified. That's about the only word I can use to describe just how I felt. I realize my son was defending himself, but as he's not a talker yet, he can't use words to express his frustration. Instead he usually grabs or pulls the object of his affection. Not this time. This is the first time I've ever experienced this reaction. Over a shovel. The poor little guy who was on the receiving end didn't make a peep, and within a few minutes was running around smiling. Trooper.
I found my son bawling hysterically in the chair. Hadn't moved an inch. Completely surprising as he usually jumps out of a seat within second on sitting in it. He gave me a big hug and was noticeably shaken about what had happened. I can't really say he understood why what he had done was so wrong, but he knew it wasn't good...and I reaffirmed that I was not happy. When I sat down to "talk" with him about how we don't bite anyone, I realized that there was a river of sweat pouring down my back, off my forehead, etc. The Mom of the house mentioned it was a little warm, and the other Mother jumped up to get the two of us some cold water. After all my family had just put these two families through, they were concerned about me. I was just sitting there trying not to cry. And realizing that I probably looked like I had just gotten out of a sauna.
I was able to keep it fairly well together for the rest of the time we were there, and the Mother of the boy was a saint. Said that things happen and her son would be okay. She knew I felt bad, but it was going to be okay. Wow, how are people so understanding? I'd like to think I would be. I know when my son gets roughed up a bit by his other playmates I usually just tell him to get back up and keep going - after all, he's sometimes the instigator. Biting is completely different. I know it was his expression of frustration, but I am still mortified. I know that one of those nightmares I'm going to have will be about this whole experience.
I called my husband on my way home, and of course, did break down crying on the ride. I feel SO bad about what happened, and I can't believe that after all the love and affection we show our son on a daily basis, something like this happens. What is going to happen when our second son is born? What happens when my attention isn't focused 100% on him anymore? This was just over a shovel.
In trying to console myself, I told my Mother-in-Law, best friend, and Mother...all of whom tried to reassure me that these things happen...and it's nothing to do with how I'm raising my son. In my conversation with my Mother she immediately picked up on the whole meltdown (mine, not my son's)...and told me that it was a symptom of Sjogren's. I knew that, but it wasn't until she reminded me that I actually realized that it wasn't just the pregnancy hormones and emotional reaction at play. Nothing like sweating so hard during the day that your hair crunches! Oh the things to look forward to...
Not sure if it's the fatigue from pregnancy, the fatigue from the Sjogren's, or just the general activity that's making me so tired that I literally fall asleep on the couch after dinner. I remember the nights I'd come home from work, grab a bite of something, and then pass out while I was pregnant with my son. I know pregnancy can make one tired. However, this time I have a nearly 2 year old peeling my eyelids open once my head hits the pillow. At least that's what he did last night. My husband thought it was cute. I have to admit, it was kind of cute, but I was also VERY tired.
Of course, no matter how tired I am, there are still things to do. My son's birthday party is this coming weekend, and my husband and Mother both talked me into keeping things simple...rather than cooking a meal for everyone, we're doing burgers and brats. However, I still am planning on making the train cake - he's SUCH a fan of trains. Not Thomas. Just trains. I bought him train pjs today to go with his new big boy room that will have train bedding. It's so much fun to see his face light up - like when I handed him the package with the pjs in the store and he carried it around until I paid for it. Too cute.
We went outside today - it was beautiful for April. While I raked out the gardens and picked up sticks, he chalked the entire patio, steps, and his shoes. He also got in a little plastic golf lesson, and mowed the back lawn for a few minutes with his lawnmower. It's great to be outside - he can't make a bigger mess than I'm cleaning up! Only thing is I can only make piles of stuff around the yard. The bending down and back up again makes me VERY light headed...so my husband will have a project for tonight. He's a real trooper.
I was asked today how far along I was, and for the first time in my pregnancy I wasn't exactly sure. I know during my first pregnancy that once I reached a certain point, my responses (like most other expectant Moms) were more generalized in terms of months instead of weeks and days. With this pregnancy, I was expecting that I would know more precisely how far along I was given that the 26 week mark is so important. I actually had to double check this afternoon, and indeed, I've just past the 22 week mark.
I had my appointment with the high risk group yesterday, and everything continues to look great. I have 2 more appointments (every other week) scheduled right now, and after that point I'll be through the 26 week mark. The heartbeat was slightly lower yesterday (140bpm) and the measurements were a bit lower - which the doctor said was completely normal as the pregnancy progressed.
I did inquire about what my relationship with this practice would be like after the 26 week mark yesterday, and wasn't surprised to hear that the appointments would be monthly rather than weekly. However, the doctor mentioned that they'd be watching the size...or both the baby AND the placenta. I knew that after the 26th week one of the things that they would start watching more closely would be the baby's size, as babies born to Moms with Sjogrens sometimes have a lower birth weight (which wouldn't be the worst thing in my case!). However, I didn't know that the placenta could experience similar growth retardation...which would obviously have impacts on the baby's well being. Guess they didn't want to spring all of the concerns on me at one time, so I'm wondering what the next appointment will reveal.
To recap, post-26 weeks, we'll be monitoring the baby's size, the placenta's size/growth, my swelling (joints and extremities due to the Sjogrens), and I'll have two rounds of gestational diabetes testing (as Sjogrens Moms are at a higher risk for developing gestational diabetes...good thing I lost that weight before this pregnancy...which lowered my risk in general of developing this pregnancy-related condition).
One of the things I decided to do when my son was old enough for me to be gone more than an hour was to "work" as a kitchen assistant at a local kitchen store that holds classes several times a week. The joy of this "job" is that if you don't want to work, you don't have to. You can pick and choose the dates you want to work based on the types of classes they are offering. I usually work one class a month, maybe two if I'm really interested. I don't do it for the money 'cause minimum wage won't get me far. I do sign up to get out of the house and have some adult interaction, learn new cooking techniques (because you learn everything the students do...and get to try all of the food - usually!), and get the 40% store discount. I've bought quite a bit of vanilla to say the least.
I have always signed up for weeknight classes as my weekends are really family time. However, this Sunday there was a ravioli workshop that sounded really interesting, so I opted to spend my Sunday afternoon in the kitchen making pasta. I tried to make my own pasta from a pasta book I received as a gift a few years back the other week. Bad decision. I rolled the tough dough for so long that I would up rubbing the skin off the sides of my thumbs. The noodles were thick enough to be crackers. My husband was a trooper for trying them. They tasted ok, just were thick. I figured out from the class you need to let the dough rest...okay, time to pitch that cookbook.
Well, I arrived early for the class to help with all of the prep, and by the end of the class I was so tired I just wanted to collapse. Partly because the other two assistants weren't working nearly as hard as I was. One just stood there waiting to be told what to do...I don't think she washed one dish. The other one spent the majority of her time in the dishpan...which helped keep things from piling up, but it's not that hard to stand still and leisurely wash dishes. I was constantly moving, lifting, cleaning up, etc. My dry hands were nothing short of shot by the end of the afternoon - between all of the washing, cleaning, and time in the dishpan (with gloves!), it definitely didn't help things. Needlesstosay, my husband and I agreed it would take a special class for me to sign up to be an assistant again before the baby was born.
It didn't help that yesterday I spent the morning cleaning the house in preparation for company we had yesterday afternoon and a playgroup we're hosting on Thursday. It needed to get done, and I just didn't have the energy on Sunday evening to finish. I did get the upstairs clean, but it's tough to vacuum when your son is dragging the toys out you just spent 20 minutes putting away. I have to wonder if he'll ever learn to take one thing out and put it away before taking something else out. I think he gets a kick out of my reaction when he dumps out the bucket of Legos I just searched 10 minutes to locate and place back in the large plastic box. Also, there's nothing like seeing him dump the puzzles it took you 15 minutes to find all of the pieces to and then determine which pieces went with which puzzle. Fun is.
I'm just beginning to sense that I can't keep up like I used to. Can't tell if it's the pregnancy or just the changes I'm experiencing with the Sjogren's. I've got the ambition, just not the follow through...and if I do I PAY for it later.
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