Sjogren's Mom : Weight gain

6 Weeks Post Delivery

amop — Wed, 10 Sep 2008 16:01:08 GMT

I've made it to the final finish line in the birthing process - six weeks post delivery. For the first 2 weeks home, I had the no heavy lifting, no driving, and no more than once up and down the stairs a day rules. Add the no bath, swimming, or exercise (including intimacy) for the next 3 weeks, and here I am at the post delivery finish line.

I saw my rheumatologist yesterday, and atypical to most post deliveries, I have no flare-ups with my Sjogren's. Thank goodness. I couldn't imagine on top of being sleep deprived to the point that I can't open and close my eyes they are SO dry (and I'm not exaggerating), that I'd also be dealing with physical changes in my body due to the stress from pregnancy and delivery. She did an exam and had some blood work done, but overall didn't find any other changes in my being. I did talk with her about the dryness that I experienced the first few weeks, especially the part about how my mouth kept splitting open and wouldn't heal. Nothing more fun than taking a bit out of something and seeing blood on the food remaining. She said that I could have a vitamin B deficiency, so she added that to my blood panel. After donating 10 tubes (no kidding) of blood, I left there a fairly happy camper.

I saw my OB this morning for my post delivery follow-up. Nothing much new to report there. They have me down a whopping 12 lbs. Not quite what I had yesterday, but then again we had Chinese for dinner and I drank a bottle of water on the way in. I'm less concerned with that number right now. Give me a few more months and then I'll really start dwelling on the fact that I have to tackle the weight issue. My blood pressure was great (110/60), and everything looked a-okay with my incision. The doctor was as surprised as I have been that my steri strips haven't fallen off. I guess I actually listen to the physicians a little too much...I didn't try and speed along the process.

One thing that was discussed at length during my visit was birth control moving forward. This was something the doctors brought up towards the end of my pregnancy. Well, not birth control. Sterilization. That's such a harsh word. At the time, I said I wasn't yet ready to make that decision. My husband asked what was involved. He's two and through. Has been from before we were even pregnant with #1. I've always wanted four children. Everyone I've talked with assumes it's the "I want a girl" thing as we have two lovely boys. It could be, but I've always seen myself having more. Not necessarily with a gender associated.

Before delivering, my husband and I tabled the discussion, with the grounds that after a few months with the baby maybe I'd be ready to make that decision more final. Although I'd like more children, and both my OB and high risk OB have said we could, they and especially my rheumatologist have cautioned me about what the risks are. Obviously, the older I am the higher the risk of issues in general, and the more likely we would be for multiples. Nothing like going for a third and getting a fourth. Know people that's happened to. On top of those normal risks, I also have the increased risk of having a child with fetal heart block or other Sjogren's related complications, I have higher risks of miscarriage (due to Sjogren's), higher risk for flare-ups and other Sjogren's related pregnancy complications. On top of it, to be safe, I should be off of the Plaquenil at least 6 months prior to conceiving, so an subsequent pregnancies would have to be well planned. Finally, the stress on my body of another pregnancy could cause the autoimmune disease to go into overdrive. A risk I had this time around, but luckily avoided (keep your fingers crossed).

So, the conversation today laid out all of my options. There is a pill I could take (progesterone only) that is safe for breastfeeding Moms, I could go the IUD route, or I could have some type of tubal ligation (there's two methods). Things to think about. There are risks with each, and it really depends on what we see in our future. Right now, I can't tell you how I'll feel in 2 years so I'm inclined to take the pill and play it month by month. The doctor also threw out there that my husband could be sterilized...and my response is that we were aware, but that wasn't something that I could discuss with an OB. I'm going to read through all of the literature that the OB provided. Not thrilled about the thought of having the IUD, but then I wouldn't have to remember to take the pill everyday. I've also heard of a few people who have gotten pregnant with the IUD in place. Think I'd rather take the pill and know vs. just hope the IUD doesn't slip!

The thing I didn't tell her or my OB at today's appointment is the pain in my neck and back that I've had since last Thursday. Despite being given the go-ahead for all activities, I won't be doing anything strenuous for at least a few more days since I still can't hold the phone between my ear and my shoulder...nor turn my head to far enough to each side to see over my shoulder. Yeah, probably shouldn't be driving. I keep hoping each day it will be better, and truthfully, beside the blog and when it inconveniences me, I kind of forget that it hurts. Just don't have the time to dwell on it. I'm just thinking one foot forward. Change a diaper, feed a baby, keep toddler occupied while I do both. What's for lunch? Get toddler down for a nap, breathe, update blog, feed a baby, change a baby, feed a baby, and somewhere in between it all figure out and make dinner. Phew.

Will I Find My Groove?

amop — Mon, 08 Sep 2008 17:11:54 GMT

I have to wonder. To sum up the past several weeks...I'm tired. Very tired. Thankfully, my partner in crime really is my partner - my husband actually let me "sleep in" (aka, I just had the baby...who's nursing every hour) on Saturday morning while he took our 2 year old out of ear shot.

Let's see...the birth went well, as did the hospital stay. We came home, and the first week or so home my baby kept losing weight and really wasn't interested in nursing. He slept. I got some rest, but was really emotionally exhausted from constantly trying to nurse (for an hour of more at a time...so basically fighting with him) and having no success. Then all of the sudden he latched and was ready to eat...and that's all he did for about 2 weeks. He would eat for 25-30 minutes, we'd change him, lay him down, and within 5 or 10 minutes he would be ready to eat again...all night long.

We finally got into a good groove where he'd eat and then rest (whether sleeping or just content) for about a week or so more, and then he started to spit up. The occasional spit up turned into every time...to volumes of curdy milky spit up that would soak through his clothing, burp cloth, and any clothing we were wearing that was in contact. At first I thought he was just over eating, but even nursing for 10 minutes he'd spit up.

For the past week I've been on a dairy free diet. Yes, no milk, yogurt, cheese, or butter. No milk products. Do you know how many things have milk products or butter in them? Let's just say I've had my fair share of veggies and fruit. Not the worst thing as I'd love to work on the remaining 40 lbs of baby weight I have yet to see leave my body. It's working.

The pediatrician thought that by after a week we'd see some improvement if the baby really had a milk allergy (most milk allergies do go away around the year mark, and aren't a sign of lactose intolerance). Over this past weekend, the baby has been extremely fussy, won't really sleep, and when awake is screaming. He eats for 10-15 minutes, a few minutes later spits a bunch up, then screams for a little while, sleeps for 15 or so minutes, and then wants to eat again. You can just tell something isn't right. No fever, no other symptoms, so I called the pediatrician this morning as the next thing this could be is reflux (GER). We're going to start in with a reflux medication this evening, and if it's reflux we should see some improvement by the end of the week.

The only change I've noticed in the past week with the spit up is that it seemed to just be milky over the weekend (not much curd) and then today there's chunks that look like cottage cheese. Interesting, huh?

Oh, did I mention that on Thursday night I slept weird and woke up with a very stiff neck? Yeah, fun. Thinking it would go away, I just let it go. By Friday afternoon the pain was into my back so I used the giant heating pad throughout the evening. Saturday I wasn't any better...and not really on Sunday either. Actually took one of those big Motrin they sent me home from the hospital with...no help. I'm a little better today, but can't put the phone between my ear and shoulder. Can't lift my head high enough to look at the ceiling. Hurts to turn to the sides, but at least I can now. Ah, and I haven't gotten the all clear yet from my OB (as it's not 6 weeks) so I can't even sit in a hot bath. FUN.

Went to take a nice hot shower last night and my 2 year old climbed up the stairs with me. He proceeded to take his shirt off and lament "bath, bath" while I was getting my towel and letting the water warm up. He got a bath...then I got a very quick shower before he went to bed. All I was looking forward to after spending the entire afternoon cooking and baking (first time since I gave birth, so I was on a mission to get a lot made for the week) was a LONG hot shower. No go. Maybe tonight.

Tomorrow is my 6 week follow-up with my rheumatologist. Will have to tell her that I'm beyond tired (how much is Sjogren's related...we'll never know)...and that I'm so tired my eyes are SO dry I can barely blink late at night. Not much else too concerning. At least that's what I think - we'll see what she has to say.

We're Home!

amop — Tue, 05 Aug 2008 18:41:39 GMT

Everything went as scheduled. No surprises here, as my husband and I are two very planned individuals. I went in to the hospital around 7am on Wednesday morning, by 9am I was walking my way into the OR and getting up onto the table for my spinal. By 915am my spinal was set and they were beginning to prep me for surgery. My husband was escorted in to find my teeth chattering - a side effect of the spinal (last time I had the nausea, so I'll take chattering teeth). He sat by my side until about 935am when the OB let us know that the team was close and if he was interested, he could stand up and watch our son being born. I was just glad he didn't pass out.

Our son was born at 940am, and they whisked him away to clean him up and check him out - initial APGAR of 8, 9 after 5 minutes. All great signs. He was crying like a mad man the whole time - what a great sound to hear from behind the drapes. The OB let us know after everything was over and they were going to wheel me into recovery that he presented ear first...like he was listening to what was going on outside the womb.

My first glimpse of him was on the scale...and as most of the people in the OR knew my first son was 10lbs 7oz, we were ALL eager to see how close our guesses were. He weighed in at 7lbs 15.6oz...so they round up to 8lbs even. He was 21 1/2 inches long - just 1/2 inch short of his big brother. LONG child with very long fingers. He doesn't look too much like his big brother, and definitely has Mom's fingers and toes (including her crooked second toe!).

Everything went like clockwork, they wheeled us into recovery for a little while and by about noon we were settling into our hospital room. He was a great nurser early on, and after his circumcision backed off a bit. We're still working on the ideal latch and a good length of nursing time, but so far so good. The doctors let us know that we could leave the hospital a day early, and given we missed our older son SO much (although he was a real trooper the days we were gone!!), we decided Saturday morning to leave so we were home in time for dinner.

That was a great decision - was amazing to see our older son after several days (we've never been apart!), and we actually got more rest at home that night than I think we would have gotten in the hospital. Unlike our older son, this peanut is a sleeper...he gave us several multiple hour sleep spells the last few nights...and he sleeps most of the day. We went to the pediatrician this morning and although he's down to 7lbs 1oz (his lowest on Friday night was 7lbs 4 3/4oz), the doctor wasn't too concerned given his pee output. We're going to get another weight check on Friday just for peace of mind, but it was nice to have a good feeding earlier today. Here's hoping that stays consistent.

No signs of anything Sjogren's related, especially the heart block. I did get a nice external yeast infection (oh joy) and my feet and ankles are very swollen. However, I've backed off the pain medication and am making due just taking it easy. I definitely had more discomfort early on with the incision, but today was able to get out to the doctor and then out to the sandbox with my older son for a little while. Definitely miss my one-on-one time with him, but luckily my husband's been able to be home with us and helping supplement my lack of availability (especially when it comes to the toilet training). He's also been a real trooper with diaper changes (think I've done 1 these past 6 days...even though I've helped with most of the others).

Here's hoping the next few days I get more mobile and back on my feet...oh, and start dropping the weight. Although it was nice to eat by day 2, it didn't really help me lose anything. Came home a whopping 4 lbs lighter. Woo hoo. Guess the swelling doesn't really help with the weight loss. I know that last time it was a few days after I was home that I finally noticed a big drop. Here's hoping it happens again. Although I'm only up 50lbs (instead of the 60 from last time)...add the 10+ lbs I put on getting pregnant and that's still a nice chunk of weight to get off. I'm in no hurry to be in a bathing suit or modeling skimpy garments any time soon...just looking forward to wearing more than 2 pairs of maternity shorts :-)

39w0d - Tomorrow's the Day

amop — Tue, 29 Jul 2008 16:55:09 GMT

I had my pre-op appointment this morning. It was nice that they had set my expectations appropriately...that we were literally being squeezed into a completely full schedule. My appointment was for 11:15am, and it was nearly 45 minutes of sitting in the waiting room before they called me back to start the process. Good thing I told my husband he should bring his laptop and work on some of the things he needed to finish up! At least he made some progress during our quiet time.

The pre-op went smoothly - I LOVE my primary OB (the one who's delivering the baby tomorrow). Good news is I haven't gained any weight in the past week and a half. Yeah, cap my weight gain at an even 50lbs. My blood pressure was a little high - 130/80 when I'm usually 110/70. Nothing too concerning.

Now I'm just waiting for the call from the hospital to confirm my instructions for tonight and tomorrow (no eating, etc.)...and I'm sitting with my son enjoying some last time together as just the two of us. How bittersweet. I'm thrilled to welcome a new son, but at the same time very sad to say goodbye to the period in my life where it's just little buddy and myself. Bittersweet.

Third NST and Sleep Deprivation: 38w2d

amop — Thu, 24 Jul 2008 15:34:26 GMT

Had my third NST this morning...and they aren't getting any quicker, that's for sure. I had a 10am appointment and was there right on time...and of course, after an hour on the road had to use the bathroom. They brought me right back, let me leave my urine sample, took my blood pressure (140/60...not too bad for walking 4 flights of stairs just prior) and of course my weight. Still the same that I was on Tuesday. Phew. The number surprised the nurse - she said she would have sworn I was much lighter...compliment, I suppose.

I then was hooked up to the machine and left for about 15 minutes...during which time the baby moved twice. Not too bad, so when the nurse came back and checked on me she indicated that she'd give me another 10 minutes or so and then she'd be in to take the paper print out to the doctor. A little over 10 minutes later she came back in, saw the baby had moved once more, and said she'd let the doctor know. Five minutes after that, she stepped back in to say that the doctor would be in shortly.

Nearly 40 minutes after I was hooked up, the doctor came in apologizing as today was a big day for OB emergencies. No problem. I told her while I was waiting for her to come in the baby actually had moved quite a bit (8-9 times). She said that was great as if he hadn't moved more she would have left me on the machine for another 20 minute cycle. Yikes! She did do a quick ultrasound to check the fluid...and immediately noticed it's a little boy...shocker. The fluid looks great, and everything else is in line, so we talked about my next appointment.

Since it is so close to delivery, she suggested that it was more important for me to see the OB that was delivering the baby on Wednesday rather than get in for another NST. If I could do both, that would be ideal, but definitely not necessary. I went out to talk with the scheduling nurse, and after some debate (as the OB is only in on Tuesday...and her schedule is PACKED), we arrived at a time where I could be "squeezed in" and then canceled my NST for Monday. The negative is that I have to once again drive into the city for this appointment, but as the OB is in the hospital tomorrow and off on Monday, Tuesday is the ONLY day I can be seen.

On a separate note, the non-sleeping is really starting to deplete me. I'm just so uncomfortable at night between my aching hips, knees, and shoulders, then only being able to sleep on my sides or sitting upright. I roll every 45 minutes, get up for the bathroom every 2 hours, and just manage to get in mini-naps throughout the night. I tried to sleep in the baby's recliner (we opted for an oversized plush recliner instead of a wooden rocking chair - good move), but even that didn't seem to help things. Instead of pain in my hips and knees, I had a shooting pain down my side. Just impossible to get comfortable. At least my husband is sleeping soundly - doesn't even realize I'm up and about. Good in the sense that I'm not disturbing him, but he's SUCH a sound sleeper I'd have to wonder if something did happen, would I spend my entire night yelling for him.

Here's hoping that I get a solid few hours back to back in the next few nights or the sleep post delivery is going to start to look REALLY great :-)

Second NST: 38w0d

amop — Tue, 22 Jul 2008 18:57:36 GMT

I had my second NST this morning. Again, not an in-and-out procedure. I waited about 20 minutes in the waiting room...during which time I totally forgot they gave me paperwork I was supposed to give to the nurse who called me in. Duh. Mommy brain. Left it on the chair next to me in the waiting room.

I, of course, immediately asked to use the bathroom first. Afterall, I go every hour now...if not more often. Then the weigh in (woo-hoo, can we say 50 lbs!), blood pressure reading (a little high for me at 132/68), then into the room. She hooked me up and things were going very well (or so I thought) when the baby moved 3 times before she came in the first time to check on me. That was 10 or 15 minutes in, and I would have thought she said I was done. Nope. She gave me 10 or so more minutes, during which time my husband arrived for the appointment.

The nurse had mentioned that the doctor had asked I have a biweekly NST AND biweekly fluid check. The second meant an ultrasound...and a potentially unnecessary cost (not to mention MORE time in their office). She was checking on that during her second absence, and when she came back 15 or more minutes later (so much for this being quick), the baby had moved a total of about 8 times. She left me still hooked up and took the print out to the doctor.

Ten minutes later she came back...at which point I let her know that he had moved 4 more times, and it was on the increase. She said that the doctor would be in shortly for my internal exam and to let me know what else we were going to do today. So, I sat there for another 10 or so minutes...by the time I saw the doctor I had been hooked up to the NST machine (and pushing my little Jeopardy button) for over 45 minutes.

The doctor said that the movement looked great, there really wasn't any concern over the fluids (so no need for an ultrasound), then he did the quick internal. No change. No dilation. Things are still sealed tight.

Once he left the room I hopped (well, made my way) off the exam table...only to realize that I had taken a large butt shaped piece of the paper tablecloth with me. My husband got a kick out of the fact that after an hour sitting on that it had adhered to my rear. He was not as happy to help me get it off. Hah.

So, another lengthy and unproductive (which I'm very happy with) visit. Next NST is on Thursday, then I have one more on Monday. Looking forward to seeing whether I have to fit in another internal before Wednesday's delivery. The good news today - they are not going to starve me after delivery this time around. Was nearly 72 hours the first time around before they let me eat. This time it should only be 24 hours. We'll see, I'm not getting my hopes up, but at least now I have ammunition! The hospital nurses wouldn't take, "but I'm STARVING, how can I feed a newborn with nothing in my stomach?" as a real plea for food.

Sign Me Up - Non-Stress Tests

amop — Mon, 14 Jul 2008 14:48:50 GMT

Today I had my next appointment with my primary OB - just a little over 2 weeks left, so they did the Group B Strep culture, listened to the baby's heart, checked my cervix (nothing to report), and then we talked a little about the non-stress test. The OB had asked if I had discussed this earlier, and I let him know that another OB in the practice had called my high risk group to see if it was necessary to be doing weekly NSTs as part of the monitoring for Sjogren's. The high risk group said it wasn't necessary (it is if you have Lupus), but couldn't hurt if the primary practice felt more comfortable doing the testing.

The OB I saw today let me know that since I'm good to go (lungs are developed, etc.) from here on out it was worth doing a biweekly NST to check and make sure that the baby was doing okay. This will monitor the stress on the baby when it moves, and can let the OBs know if there's any concern with the amount of amniotic fluid, the heart rate, etc. I'm not going to question their experience, but I learned upon making the next 4 appointments (every Monday/Thursday from here on out) that they can't do this testing at the office closest to my home, so I have to drive into the city to visit their office just down the street from the hospital. This not only means I need to rely on a family member to watch my son (luckily both of our families are close by), but I need to drive an hour each way for a test that could take as little as 10-15 minutes, or as long as over an hour...in addition to my weekly appointments. Wow.

Good to hear that everything is going well with the baby though, and nice that my OBs haven't said boo about the weight I've gained (48lbs at this point, so cutting it close to the 60 I gained with the first pregnancy). There's no major swelling, although my rings don't fit again. Went for about a week where it was dry enough outside that the swelling wasn't bad and I could comfortably wear my wedding rings...now I'm back to keeping them off as after about 30 minutes my finger starts hurting from the pressure.

We'll see how the first NST goes on Thursday - hopefully this little guy will stay put until the 30th...but I'm not counting on that!

33w1d

amop — Wed, 18 Jun 2008 10:00:10 GMT

Just crossed into the "6 weeks left" phase. Yes, my heart is beating a bit quicker thinking of all of those things I so desperately wanted to get done before the baby arrived...and how we're not making much progress. Like our master bath. My husband began the demo, got the vanity and shower out, but the rest is just lying on the floor (sheet rock and all). Guess that won't be done in time for the baby to be home. Which means it will be later this fall before we actually can get back to it.

I had another visit with my OB yesterday, and did mention the back pain and cramping that I've been having - to the extent that it takes my breath away. I knew it would probably be considered "normal," but as I didn't have any of this before (including the heartburn!), I thought it worth mentioning. Just the baby trying to get comfortable and my body stretching to accommodate. Oh well, just grin and bear it. Actually yesterday was the best day in the past week, so maybe that's behind me.

Everything still looks great in terms of the pregnancy. Well, if you consider me being up 42 lbs (still possible I'll be up the 60 of last time if the swelling does kick in...). The heart sounded great yesterday, and thanks to my first internal exam, we know the baby is head down. So he must be pushing up under my ribs with his butt and feet...or he's still flipping around in there. One more appointment in 2 weeks and then I'll move to the weekly appointments. I don't need the non-stress tests, so that's one less trip a week to their offices I will have to make.

Funny thing was my 2 year old was in the exam room with my husband and I. When it came time for the doctor to start the exam, my son sat down on the landing of the exam table in between my legs and wouldn't move. The doctor and my husband tried to talk him out of staking his claim to Mommy, but ultimately my husband had to just pick him up and hold onto him while I had the minute long exam. Funny thing is - when we're usually out in public, my son won't leave my husband's side...not mine. He's usually pushing me away...like he has had enough of me and wants attention from someone else.

We'll get a final read on the baby's weight next week at my last appointment (hopefully) with my high risk group. At that time the baby should be around 5lbs (just under if you're going by my ovulation date)...so if he's a bit bigger we'll know we should probably pack the 3-6 month clothes.

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.