Sjogren's Mom : Gestational Diabetes

30 weeks

amop — Tue, 27 May 2008 22:20:03 GMT

Nine weeks and counting...

I had my latest appointment with my high risk group this afternoon - everything still looks great. The heart is ticking away like it should, and all the measurements show that baby and placenta are growing. My week-by-week book indicates that the baby should be 3lbs at 30 weeks...and although by LMP I'm 30 weeks, I'm 3 days shy based on ovulation.

Either way, the baby was estimated at 3lbs 2oz +/- 10%...so 2lbs 13oz to 3lbs 7oz. They are saying he's "on track," but the question always arises between my husband and myself concerning how big the baby will actually be. We joked that having an "average" size baby (7 or 8lbs) would definitely throw us...as we're used to a baby weighing several pounds more. Time will tell.

They confirmed today that I won't have to take a second glucose screen! YEAH! Supposedly if I was on steroids to manage the inflammation, gestational diabetes would have been nearly a for-sure. Since I'm only on the Plaquenil, the risk is lower and thus, if I passed the first screen I don't have to take a second one later on. Phew.

I am finding myself short of breath already - don't recall that happening until later on the first time around. Nothing like trying to sing your son to sleep and finding you can't get all of the words out. At least I have the excuse of holding him in my arms and rocking back and forth!

Weight Management

amop — Fri, 23 May 2008 00:37:37 GMT

So I got my monthly call from BCBS's nurses to check in on my pregnancy. Up until this point I've thought that they've been polite and helpful, so I haven't minded answering their questions or returning their calls. Having worked in healthcare, I understand that this is a way to "manage" costs by helping members stay on top of their conditions.

Today's call was fairly painless - have I been hospitalized, did I pass my glucose screen, when was my last ultrasound, when was my last appointment, how does the heart look/sound, what was my latest BP and latest weight. That's where the conversation changed. When I told her my weight...which is up 3.5 lbs in the past 5 weeks and is noticeably lower than the same time last pregnancy...she recorded my answer...then asked me if my OB had talked with me about my weight gain. Huh? They didn't talk to me about my 60 lb weight gain the last time, why would they be concerned with me at 29 weeks and up 32 lbs?

I said no, and she pushed a bit saying that a normal range is 25-35 lbs. Yup, I know that. I told her that it wasn't concerning, and that I'm on track to put on less with this pregnancy than I did with the first...and I was able to get all that weight off, which was my OB's primary concern. Didn't sound like she really liked that answer. Too bad. Not like I'm eating crap 24/7. If anything, I'm eating smaller meals, just snacking a little more...on trail mix, bananas, and cheese. Cheese has definitely been a clutch food for me this time around. Think I'm craving the dairy and salt.

Either way, I was happy with my 32 lbs until today. As long as the baby's healthy, I'm not concerned...and I don't have to worry about the gestational diabetes, so there really isn't a need to change my diet. Just should probably get out and walk a bit more to ensure I don't gain too much...especially since the swelling at the end can add a chunk by itself.

She also asked if I was counting kicks. Huh? He moves non-stop as soon as I'm sitting. She didn't like that response either. Said I should feel 10 kicks within a 2 hour period. I think he kicked 4-5 times while I was on my 5 minute call. I don't think it's a concern...nor something I need to fret about...unless I haven't felt him move.

29 Weeks and Counting

amop — Thu, 22 May 2008 10:51:08 GMT

I had an appointment with my primary practice this past Monday - took me 35 minutes to get there, waited about 20 minutes before being seen, and then took the 35 minutes to get home...all for a 2 minute appointment.

The good news is the baby's doing great...as am I. I passed the glucose screen (thankfully, as I had fasted and the phlebotomist told me it wasn't a fasting test), my weight was only up 3.5 lbs in 5 weeks (yeah, as it's usually a pound a week at this point), and I'm measuring on track. We'll see on Tuesday whether the baby's weight is still on track. They're concerned about the baby being small due to the Sjogren's...but I want to know if the baby's going to be big like my first son.

I look over the clothes that I have from my first son...who was born in April, so the summer outfits are around 9 months. Knowing that the seasons are slightly off, I realize I might need to supplement with a few outfits...but am hesitant to buy anything as I can't decide if I should buy 3 months (that's what my first son came home from the hospital in...), 6 months, or should I risk it and get something "newborn." Hard to tell right now.

I continue to have some crazy dreams. Last night I dreamt I went to the Memorial Day parade in a different town than I'd originally planned...and had totally forgotten we were meeting up with friends to attend the parade together. Big mix up...and I was there looking like I had just crawled out of bed wearing the rattiest clothes. Arg. The night before I dreamt that we were going away with family on a vacation...and they forgot to bring us...and left us stranded at my Aunt's home. Home Alone anyone? So what are these "forgetful" dreams saying about me...that I'm forgetting something?

Over the past 24 hours my son has developed a little cold. Thought yesterday it might have been allergies or molars, but he's a bit stuffy this morning. Here's hoping that I don't get this...and it clears up quickly.

Thicky, Orange Flavored Soda-Type Juice Water Anyone?

amop — Mon, 12 May 2008 14:41:47 GMT

Yes, it's hard to describe. It's MUCH sweeter than orange soda (can you imagine?), not quite as carbonated, and definitely much thicker. And they give you 4 minutes to drink 12 oz of it. Yum. Sign me up for a double. It actually doesn't taste all that bad, but going down you feel a bit like you're going to gag. Just a little too thick so it coats the throat.

I got to the lab just before 9am this morning, and the room was packed with every elderly lady in the town. Proceeding to the front desk (where no one is seated) I see a stack of numbers with a sign indicating we should take one...and if we're there for a glucose screening to let them know. As I've had one once before, I realize that you have to drink this fun stuff then sit for an hour and wait to be tested...which is why they probably wanted you to let them know.

I waited patiently in the doorway until one of the phlebotomists came out and called the next number (20...I was 26). I let him know I was there for a glucose screening, and he said to just take a number and have a seat. Hmm. My number was called around 930, so I had sat there just under 40 minutes waiting...only to have the woman assisting me hand me the drink and tell me I had to drink it within 4 minutes, and then in an hour she'd call me in to have my blood drawn. Now why couldn't they have done that at 9am and then taken everyone else? I don't know. All I know is I sat patiently and waited my turn. Anyone else might have thrown a stink, but I figured (naive as I am) that they knew I was there.

I took the bottle back to the waiting room and poured my first of three cup fulls. Down the hatch. I'm not too shabby at drinking anything (my Mother has always called me a camel as I have am amazing thirst...and ability to down drinks). My three cups went down easily, in under a minute (why not just get it over with!), and I let the woman know so she could mark the time. Then I got to wait again. For an hour. Make a good dent in my book, but as I sat in an empty waiting room I had to wonder if I should have been more persistent when I arrived. Hind sight.

After the hour passed, I was called in to have my blood drawn. She lined up the 4 tubes and just before she began I asked her if I was also going to have to provide a urine sample...because I remember doing that the first the through. She said no, and then something about how it wasn't a fasting blood draw. Huh? I was told by my OB not to eat or drink before going there. Ok. Pregnant. Waited an extra 40 minutes to get things done. Then was told I could have eaten? What?

We'll see how the results come back. Have to wonder if it was done correctly (whether the OB gave the right instructions) as it was so different from what I as told. I have my next appointment in a week, so I should know by then whether I passed again...or whether I'll have to go back and take the next level of the test to determine whether I do have gestational diabetes. Keep your fingers crossed!

Happy Mother's Day

amop — Sun, 11 May 2008 16:35:29 GMT

Oh what a beautiful day it is! Sunny and warm. Only wish it would be like this the rest of this coming week.

I went and had a treat yesterday - a pregnancy massage at a local spa. I had one the first time around, and it felt every bit as good yesterday. Nothing like being able to lay on your tummy after months of only being able to lay on your side. Not to mention I got a hot stone foot soak and a foot massage to boot. Felt like a million bucks.

Just prior to my massage I stopped in a local consignment shop I've driven by for the past 7 years just to see what they had...especially since I could "run" in and out without toting a 2 year old. I also went into the antique store right across the way for a few minutes. Nothing can make you unwind faster than a few minutes to yourself. Top it off with a massage, and you're in heaven.

This morning I was hopeful to "sleep in" - whatever I can after the usual run down the hall my son makes around 7am. I was awake around 6 as I had another very disturbing dream...the tops of both of my middle fingers were blown off in an explosion and the doctor wouldn't cover or dress the wounds, so I was trying to get around with these open wounds and exposed bone sticking out. Yeah, great image, huh. The best part is that every time the exposed bones came in contact with anything it sent shivers up my spine. And this was a dream.

So by 7am when my son came running into the bedroom, I wasn't quite in a slumber state...and he wanted to crawl in and watch tv. Which my husband let him. Nothing wakes a Mother up faster than a child in bed...who constantly moves, pulls the covers, and kicks you. Finally around 8 they headed downstairs to let me "sleep," only to have my son climb back up the stairs 10 minutes later while my husband was in the bathroom. He proceeded to whine, and then reach under the covers and pull out my arms and legs and say, "down." Okay, I'm awake, down we go.

My husband made a new omelet this morning - in the oven - with fresh herbs. Real treat. Then I made some banana muffins and we got ready to go to an impromptu brunch at my Aunt and Uncle's house. Nice to see the family and sit out and enjoy the warm weather...and my son and husband went for a long tractor ride with my Uncle. Think my son was thrilled with that treat.

Now I'm sitting with my feet up (as I have to twice a day to keep the swelling down...per my rheumatologist...as swelling is also a sign of kidney issues related to Sjogren's). We're leaving for dinner at my in-laws shortly...and we'll get to try out the cake my husband made. He's pretty good in the kitchen, which I'm thankful for. He can follow a recipe without a problem, but rarely takes it upon himself to do the cooking or baking...just for special occasions.

Tomorrow I get to take the lovely glucose screening. Yeah. Wish me luck!

In The Clear

amop — Thu, 01 May 2008 13:20:35 GMT

Yes, I officially received the "all clear" on the baby's heart at yesterday's appointment. What great news...and although it wasn't unexpected given the feedback we've been receiving, it was nice to finally have a definitive answer. There isn't any chance (well, I guess there's always a possibility...) that the baby will have heart block as it would have been detected by now.

The baby's weight is 1 lb 14 oz +/- 4 oz. The "average" weight is just about 2 lbs at this point, so we're right on track. They'll continue to monitor the baby's weight, the placenta, and me once a month through the remainder of the pregnancy (gestational diabetes and swelling primarily). My next appointment is in late May, but until then I still have the lovely glucose screening to endure.

I also have a "little exhibitionist" as the ultrasound technician quipped. Seems yesterday the baby was VERY active (and I could feel it!), so much so that getting the basic shots were challenging, and she wasn't able to get a profile or face shot for our "ultrasound album." However, the baby did pose for a crotch shot. Definitely all boy. Think they've taken one of those pictures each time we've been in...only shot he'll pose for.

Meanwhile, I'm feeling the baby move much more. Last pregnancy, my son only seemed to move on my left side...this pregnancy I feel the movement much more on my right side. Funny. As I sit here typing he's kicking away. The other joy is the continual heartburn. Didn't have that the first time around...and yes, my son was born with a full head of thick, dark hair. Need to make a Walmart run for some Tums pretty soon!

Nearing 26 Weeks

amop — Tue, 29 Apr 2008 12:16:56 GMT

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!

22w2d

amop — Thu, 03 Apr 2008 17:35:42 GMT

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).