31 Weeks

So last week I was finally allowed to return to my regular OB, Dr. Piquard. So glad to be back in her office with all the other normal, no problem, pregnant ladies. It was good to catch up and see her and her nurse, Alicia. Everything is back on track and looking good. I still will be following with our perinatologists every 3 weeks for ultrasounds, but I'm back in Dr. P's hands. At my last perinatologist visit I talked with one of the neonatologists (specialty doctor that takes care of neonates) who discussed with me what to expect for little man once he arrives. The verdict... not a whole lot :) Unless something changes with his heart, he'll be treated as a regular newborn with the exception that he will probably need an EKG at some point before he comes home, which can even be done in our room with us there. Once we're home, we'll probably have more frequent pediatrician visits too. But other than that, everything should be pretty uneventful. I can stop taking Digoxin once he's delivered, and we'll just wait and see what his heart does. Like I've said before, the perinatologists think it happened for no good reason, Digoxin stopped it, and being delivered will probably keep it from happening again.


Speaking of pediatrician, I was also asked at this visit who our pediatrician was, to which I replied "I'll try to let you know by my next visit" but my thought was 'How in the world do I pick a pediatrician???' The perinatologists would like to start faxing over information on little man to prepare his doctor and get them up to speed. Matt and I had briefly talked about finding a pediatrician, but nothing serious. How do you even interview someone for that? "Hey, I know you went through medical school, residency, and probably an internship, but do you really know what you're doing?" One of the zillion things I'd like to do this week is pick out a pediatrician, visit their office, and get some basic paperwork filled out. Until today, I wasn't even sure who was going to be seeing little man in the hospital (perinatologist, neonatologist, pediatrician, hospitalist, etc...) Turns out, it's his yet-to-be-determined pediatrician.


On a random note, I've finally started getting questions from complete strangers about when I'm due, what I'm having, and what's his name. The first question, "So, when are you due?" "July 24th" "No way! You're not THAT big! You're barely showing." So apparently this total stranger thinks that I normally look this way?? Inside secret, I'm currently carrying like a 19lb watermelon inside my belly (ok, so yeah, I know that's not all baby, but for arguments sake...).  "What are you having?" "A boy" "(fill in normal response here)".  Third question, "Do you have a name?" "Not at all" "Do you have any favorites?" "Nope" "Well, what names have you talked about?" "About every name I can think of between A and Z." Matt and I were originally thinking we'd come up with a name and keep it to ourselves, and introduce little man by his proper name when he arrived. A surprise of sorts. However, we can't come up with a name at all! Not that we don't agree, we just can't think of one we really love. Thankfully, I have had several people who have told me similar stories, so now I don't feel so bad for not having a name for him yet. We'll get there. Even if it's a day or two after he's arrived.


Other random thoughts/facts/happenings...

• Little man started hiccuping about a week ago
• The physical side of being pregnant sucks.... anyone that says " I just LOVE being pregnant. It's the best thing ever!" is either A) lying B) mentally confused or C) a masochist. Tired, sore, achy, swollen. Giant, non-moveable, non-compressible abdominal mass preventing all normal movement. HOT. HOT. HOT. (yes, I'm aware it's only May) Never sleeping through the night. Kidney stones (I feel like this one alone justifies my point.) I could go on and on.
• Related to above- my abdominal muscles have officially split straight down the middle. My belly has been a source of superb discomfort this past week. It gets worse as the day goes on, and by the evening I'm totally ready to be done with being pregnant. I'd rather take a 31 week preemie instead (obviously, not for reals people). I feel like my muscles are being pulled so tight that my ribs are be slowly removed from my ribcage, which makes breathing effectively a painful task. I think this happening has made me significantly more "pregnant looking" hence the comments from strangers now.
• When Matt's home we take turns reading him bedtime stories from his little library collection. He seems to enjoy it :)

Missed our 29 week picture because I was working,
so here is 30 weeks 5 days.

Smooth Sailing

I can't seem to keep up with the blog recently. I've just had a random few weeks with other things keeping me occupied. 'Pregnant brain' has hit me full force over the past few months.  I couldn't even tell you what I had for breakfast yesterday. After looking through my trusty planner, my interim brain until mine is fully functional again, I've been reminded of several things I've done.

I co-hosted a baby shower for my good friend Courtney (the one having twins!!). Unfortunately I have no pictures of my hard work, but we all had a great time. Delicious food (thank you me) and wonderful gifts (thank you everyone who came) and a great partner in crime to help (thank you Anya!). It would have to be the ONE day that I pass a kidney stone. I was so drugged at her party I could barely keep my eyes open at first. Luckily it passed later that night. And if memory serves me right (which there's a good chance it's not) that was the last one I've had. Knock on wood, fingers crossed.

I also had another OB appointment to check out Little Man and Big Mama. I finally got to take the dreaded glucose tolerance test. Basically you chug a sweet soda in 5 minutes and then have to wait an hour to see how much sugar you've processed. They said they'd call me if there was a problem, and if I didn't hear anything, that it was fine. I've never heard anything, so I take it that I don't have gestational diabetes. YAY! I'm also now being referred back to my original OB, Dr. Piquard. I'll still be followed here and there by the perinatologists for ultrasounds and such, but it is reassuring and good news that they feel safe sending me back :)

Still cute!

My sugar loaded soda (aren't they all??)

My Mom and Elton also came up to go see the Broadway production of Jersey Boys. Good show, and great music! Elton had to head out on the road the next morning but my mom, Matt, and I worked on painting the nursery grey. Matt only got to help for like 20 minutes before he had some work stuff to attend to. So my mom and I painted from 10:30 to like 4ish and got it finished. Looks good. Little Man's room is coming together slowly but surely. Hopefully by the end of May I'll have some final pictures. I'm currently working on refinishing and painting a nightstand (the last piece of furniture that I needed).

Getting started

Dad hard at work painting over the other color
samples.

And finally, Matt and Jeff (a friend from small group, he and his wife Ashley are expecting a baby girl at the end of June!) completed the Warrior Dash over the weekend. Ashley and I had a good time talking baby stuff and cheering from the sidelines. It's basically a 3 mile obstacle course that raises money for St. Jude's. Towards the finish line (where Ashley and I were) we could only see 4 obstacles (a wall climb, an inclined net climb, fire jumping, and mud pit) so I got pictures of what I could. Enjoy!

BEFORE

Fire jumping

Climbing out of mud pit

AFTER- Jeff made it through the whole course
with his hat clean and intact!

27 weeks 5 days

28 weeks 5 days (it was pouring outside
so this was our backup option)

Oh Happy Day

Life is good. After getting rid of all the extra medications I felt much better, and I was okayed by our docs to come down again on my Dig since it was still causing me quite a bit of nausea. I only have to take it once a day now, which makes me feel much better. Our Thursday appointment went very well. I met the only US tech I hadn't at St. Luke's. She went a bit overboard with the US photos, and even gushed "Awww..... he looks just like you!" Who are we kidding here? It's like they say it to make you feel good or something. Seriously, lady. You can't tell, AND you've never met my husband anyways even if you could tell. Our appointments will stay weekly for now since we adjusted my medication again, but I was reassured by the nurse practitioner I saw that if all continued to go well, it's still possible to be transferred back to Dr. Piquard and deliver at Shawnee Mission as planned :) Fingers crossed people.


Since I last posted we also had some family and friends come to help us redo the front landscaping. What was wrong with it? Nothing really. It was just boring and I didn't like it. It took us 2 full days of shoveling out the old mulch, ripping out the old plants, removing the stumps/roots with chainsaws and axes, tilling the rock hard dirt, adding compost, tilling some more, and buying/planting the new stuff. It rained on us a smidgen for 30 minutes the second day but it's so nice to have it done. The night we finished up there was a crazy wind storm that nearly killed everything and definitely made everything lay flat for awhile. After a few days of recuperating and some serious watering, the plants are slowly coming back to life. I think they were a little stressed from it all.


We've added two new items to lil' guy's nursery as well: a rocker and a bookcase. It's slowly starting to come together. We now only need a small night table, paint, and wall decorations. Our goal is to have it ready to go by the end of May. We'll see.


Lastly, we finally went and did our registries. After having heard from a friend that it was a bad experience for her, I was a little nervous. I loved registering for our wedding so assumed that this would be great as well. Turns out I was right :) Apparently I love "buying" gifts that I don't actually have to pay for! Basically Matt and I went and scanned everything we could think of, and then the next day I got back online to review stuff and edited here and there. Most of our items are at BuyBuyBaby, with a smaller registry at Target for the friends and family that don't have a BBB nearby. I think the whole process took less than 2 hours for both places. Pretty painless if you ask me. Matt didn't even get too whiny since he had a gun to keep him occupied. He opted for some things that I could care less about (humidifier cleaner and spare parts?) while some of the things I picked he thought were ridiculous (the froggy water spout cover isn't just for looks people, it's to keep lil' guy's noggin from getting bumped when he's sloshing around in the bathtub, you know you tried to swim and make whirlpools in your tub when you were little, don't deny it). Overall, a great time. Can't wait to actually get some of this stuff and use it when he's here!!!


I still can't imagine life with a baby in the Nunnally household. Sometime when Matt and I are lounging around watching a TV show or doing whatever in our spare time, I think how different it will be with a little one to watch after 24/7. That's some serious responsibility. And while I'm on the subject of responsibility, let's talk naming a person. This is something that should never be taken lightly folks. You are NAMING another human being. Branding them for the rest of their lives. Matt and I have talked about names here and there and brainstormed together. We've come up with several we like and need to find a good first name/middle name combination. We're still working on it and will most likely narrow it down to just a few and either decide and keep it to ourselves, or decide when he gets here. Either way, sorry to say but we're not sharing until lil' guy is here :) 

Before

After (plants will eventually grow big!)

"He looks just like you!"

A good friend sent me some of my favorite flowers to
let me know she was cheering for me and lil guy :)

Our last strip of US photos. Keep in mind,
 I'm nearly 6' tall...

Squinting into the sun!! 25w5d

Learned my lesson this time :)   26w6d

Getting back on track

Well, I feel no need to rehash or go into more detail about the past few days I briefly described. I've vented about it, and can now be done being bummed. I don't want to continue replaying it. My first two days back at work were a little rough, but I think I'm getting better. Against all my better nursing judgement, I decided Tuesday night to quit taking my "extra" medications and go back to just Dig (well not against all my nursing judgement, I used it very carefully and decided this would be fine). They were all either extra precautions (antibiotics) or treating symptoms my extra precaution meds (phenergan for nausea the antibiotics caused). It's now been a little over 24 hours without the extras and I feel about 50% better. So maybe back to normal in another day? I hope so.


Our doctor visits have been spaced out to weekly. And since today's visit was perfect, next week we'll probably get to go to every 2 weeks (if everything still looks good). At that point in pregnancy, you usually start going to doctor visits every 2 weeks anyways, I'll just have an ultrasound to go with it. It really doesn't get old seeing lil' guy this often. He's always doing some new trick. Today he was munching on his first and then literally did the baby "bye-bye"-style wave. The ultrasound lady was cracking up at that. She kept cycling through those few seconds for quite a while until she pulled her professional self back together. So obviously, no SVT and no signs of heart failure (we would only expect to see heart failure if he relaunched into a significant amout SVT like he was doing before.) Yay for Dig working and helping lil' guy out!


I get asked a lot: what's the cause? will it continue when he's born? will he need medications when he's born? The short answers: dunno, maybe, depends. The cause is most likely ideopathic, meaning we have no reason to think anything caused it at all; that it just happened. His heart is structurally normal. He will probably have an EKG of his own when he's born to trace the electrical patterns of his heart, and check for abnormal or extra electrical pathways. Sometimes an extra pathway can cause SVT. It may or may not continue, we'll just have to wait and see what happens when he gets here and the Dig wears out of his system. Our perinatologists have said that just labor and delivery could possibly keep him out of it for good (babies heart function/flow change a little during the first few weeks of life, I'm not explaining all of it, but it's the difference between depending on mom and depending on your own heart and lungs). If he never has SVT after the medication wears off, then we're done with it all and will call it history. Or it could possibly continue. If it does continue, they will start him back on medications and if that controls it, then we'll watch him closely as he grows. They usually will grow out of it. Then again, it becomes history. Worse case scenario, it's poorly controlled with medications, then he can have a catheter ablation (an invasive procedure used to remove a faulty electrical pathway from the hearts of those who are prone to developing cardiac arrhythmias such as atrial fibrillation, atrial flutter, supraventricular tachycardias (SVT) and Wolff-Parkinson-White syndrome. Catheter ablation is usually performed by an electrophysiologist (a specially trained cardiologist) in a cath lab. It involves advancing several flexible catheters into the patient's blood vessels, usually in the femoral vein. The catheters are then advanced towards the heart and high-frequency electrical impulses are used to induce the arrhythmia, and then ablate (destroy) the abnormal tissue that is causing it. Catheter ablation of most arrhythmias has an extremely high success rate. Success rates for WPW syndrome have been as high as 95%. For SVT and atrial flutter, the success rates are 95-98%.---- thank you Wikipedia) and again it's history. In every scenario, it is a treatable condition that can be fixed. My assumption is that it happened for no reason, will most likely never have it again once he's born or it will be easily controlled with a medication such as Digoxin, and he'll just grow out of it. 


Next Thursday (April 19th) we'll have another ultrasound and our 26 week OB appointment. More to come then. Since I was feeling totally poopy over the weekend, we didn't get out usual Sunday picture but here are some of baby to make up for it :)

He's either keeping secrets or picking his nose. You decide.

Yes, another profile picture. We have loads.

Use a little imagination here- baby boy facing left with blurry fist by nose/mouth.

Finally got around to getting a little photo album for
all these US pics we're getting. It holds 52 photos....
and yet I'm already running out of space.

To the point...

I've absolutely not been feeling well for too long now, and therefore haven't been able to get around to this. I'll give more details on Wednesday along with updates after our ultrasound.

Friday: 9am Dr appt turned into 8 hour hospital observation. Baby was fine, mom was not. Kidney stone pain too intense for home therapy. Not able to keep anything down for 18 hours (water included). After IV pain meds, nausea meds, and 3L of IV fluids we were on our way back home.

Saturday: Start yet another kidney stone.... (really? REALLY?!?!)

Sunday: Happy Easter, you've finally passed your umpteenth stone :(

Monday: First day back at work. Feel like puking all day, forgot to take reflux med so have heartburn all day long too. And everything feels like you've been Mike Tyson's punching bag for several days.

Hopefully day #2 at work won't be so bad.

Ups and Downs

Well, the past few days have been eventful. It was so nice to be home again. My body slowly adjusted to the heart medication so I could at least do some yoga and go for walks without feeling like I was running a marathon. Our appointment on Wednesday with Dr. Rajan (pediatric cardiologist) couldn't have gone better. Baby boy never had any SVT while we were doing his echo, and everything with his heart structure is completely normal. No signs of heart failure at all :) I had been having fairly steady nausea being on Dig, and since baby's heart was doing good, we decided to try and come down on my massive dose (twice a day instead of three times). We are going to be seen again this Friday to recheck baby and see how he tolerates the lower levels of medication. 

Well, today marks kidney stone number whatever (I've lost count, I think it's #6). Truly a terrible morning. I still had pain medication from my last stone (like what, 2 weeks ago? it's ridiculous), so I called my new OB group and eventually talked to a nurse who said it would be ok to take with my digoxin. She didn't think it was an infection and neither did I, so she said to follow-up at tomorrow's appointment. I took my pain medication and about one hour later started having some chest pain, shortness of breath, and more nausea. I'd been having shortness of breath and nausea so I couldn't rely on those, but the chest pain was new. I decided just to lay down for a bit and see if that helped; within 10 minutes I felt complete relief. I didn't really know what to attribute it to, so I just let Matt know and told him we'd see how the day played out. Well an hour later it came back, but so tight and painful that I could barely breathe. I almost felt like I was being choked it was so hard to breathe. I laid back down and called the nurse back. She asked me some questions and then talked to Dr. Jackson, who said to come to St. Luke's immediately.

Matt got me, a puke bucket, my stuff, and his work computer in the car and ready to go in a flash. This time it wasn't really going away, which scared the daylights out of me. Not being able to breathe is scary stuff. Not that I couldn't get air in, but I felt like I couldn't get any oxygen. My breathing wasn't doing anything. My chest pain oscillated a little to give me brief periods where it wasn't so bad. By the time we got to St. Luke's, I was shaking and a little dizzy. We went straight to L&D again, and the nurse that had discharged us on Monday was taking care of us again. They took us to triage and laid me down. Of course they started getting the story from us while they checked me out. At this point I couldn't talk in full sentences. Once I had been laying down for a few minutes it started to subside again. I was feeling totally fine again by the time we got to my labs and EKG. Thankfully, all my labs and EKG were normal (other than my slow heart rate which is my new normal). 

They thought another possible cause of the chest pain could be heartburn. So I was given a "GI cocktail" to see if that changed anything. No changes. I felt fine before I drank it though, so who knows. Since we were already there, they checked out my kidney stone too. They were pretty sure that it was just a kidney stone rather than an infection, but to be safe I was started on some antibiotics for 7 days while they wait for my urine culture to come back. I was also started on some Zantac, just in case it was heartburn and not chest pain. We got to go home with strict instructions to return if I have any more chest pain. Even if it was heartburn this time, there's no guarantee that it would be heartburn next time.

I would be delighted to have it be heartburn, but don't you just feel like an idiot? "Hey, I'm pretty sure my heart is seizing up here!" ..... "Nah, it could be heartburn." I'm aware that this can be a common occurrence where severe heartburn is mistaken for chest pain. But my goodness, severe chest pain/nausea/tightness/shortness of breath/dizziness/tingling hands..... it seems like it could've been chest pain to me. I'm not suggesting I've had a heart attack, but some good ol' fashioned angina (chest pain or discomfort that occurs when an area of your heart muscle doesn't get enough oxygen-rich blood)..... absolutely. A heart attack only occurs when that lack of oxygen lasts long enough cause the heart muscle cells damage or death. We're back at home this evening on guard. I just feel like total crap: mild chest tightness, shortness of breath, nausea, kidney stone (pain, frequency, urgency, pain). I would add vomiting to the list but I haven't had anything to eat since breakfast, so my dry heaving is all I've got.

To try and stay a little on the positive side of all this nonsense, baby boy was monitored while we were at the hospital. No signs of SVT and a very normal rate and rhythm for him the whole time! Matt and I were both impressed. I don't want to speak too early and jinx myself, but it's almost like he's been cured. I do realize that I still have high levels of digoxin in my system, but this rhythm was better than it's ever been :) Please keep the prayers coming. Now that baby boy is good to go, let's see if we can get Mom good to go as well.

Going home!!

Today was a great day :) After 5 days in the hospital, we are going home! My EKGs have been stable since starting Dig so no more daily EKGs. Our ultrasound was done by late morning, and baby boy still shows no signs of hydrops. He is still having occasional SVT, but less than 30% of the time. The perinatologist said that it was all very reassuring, and that we could go home and follow-up with them on Wednesday. I actually went to the cafeteria with Matt this time for lunch since we were going to be leaving anyways, and had General Tso's chicken from BoLings (by far the best meal since being admitted). Our nurse was super and had everything ready and waiting for us when we got back. We signed papers, took my prescription and our follow-up card with us, and walked out the door!

Beautiful, warm, and sunny day outside. So nice. The doctors warned us twice that the pharmacy would probably hassle me about the prescription since it's a fairly large dose of medication (about 3x the normal dose), and instructed us thoroughly on it. Sure enough, the pharmacist looked at me like I had 3 heads when I told him that was indeed the right dose and three times a day was correct. I told him that we had just spent 5 days in the hospital and I had been taking that dose for 4 of those 5 days while being monitored. In the end, we got the prescription and headed on home. We unpacked and tidied up a bit. Some friends were kind enough to bring dinner by so we didn't have to go grocery shopping right away (thank you Shannon and Ross!!!). 

It's been so incredibly nice to be at home, on MY couch, in MY bed, in MY shower, in normal clothes. What a relief. I've been trying to listen to baby boy's heartbeat for the past couple of weeks just because I could, and now I know why never heard him. I didn't know what I was listening for with all his wacky rhythms! So I got out my stethoscope again this afternoon and listened to the spot we've been finding his heartbeat with the EFM for several days. I finally found him today, and sure enough he was in his usually wacky rhythm with some occasional SVT. I've posted a snippet of what his rhythms sound like on the EFM (he starts in SVT, then goes to normal, then into a gallop rhythm).

We will now be followed by Obstetrix Medical Group (a group of maternal-fetal medicine specialists who care for women with high-risk and complicated pregnancies) for the time being. It's up in the air where baby boy will be born based on what medications I'm on at the time and how he is doing. I've gotten the impression that there's a chance we could still deliver at SMMC with Dr. Piquard and the Obstetrix team, but most likely will be with just the Obstetrix team at St. Luke's on the Plaza (essentially their group's "mothership" if you will). Either way would be fine with me, now having spent a little time at each of them. To be honest, St. Luke's was nicer than I had anticipated and I wouldn't mind delivering there at all. The staff was awesome, from Ms. Kathy the housekeeper to our team of 5 perinatologists (thank you Drs. Wickstrom, Gibbs, Parrish, Jackson, and Connell -this poor guy was with us ALL 5 DAYS!), Becky (thank you for doing all my EKGs), and our nurses (in particular Kathy, Joanne, Sheena, and Amy). 

Our first follow-up appointment is Wednesday afternoon. We have an ultrasound to check for hydrops, a fetal echocardiogram (echo), labs drawn, and will talk with the perinatologist to discuss it all. We'll also meet Dr. Rajan, the section chief of cardiology at Children's Mercy. It sounds like he's going to be baby boy's cardiologist once he's here. He will be the one observing/interpreting baby boy's echo. Our cardiac nurse practitioners at CMH always tell patients' families that a baby's heart is about the size of their fist. So baby boy's heart is currently about the size of a penny. Imagine trying to locate all the vessels and valves, map out the blood flow between body/heart/lungs, and check for minor defects on a moving target. I'm amazed when I think about it like that, that we can determine any of this on a baby that's barely 1 1/2 pounds! For all my NICU people, he's just now 24 weeks and already 700ish grams; I'm impressed! Please pray for good things at this appointment. No hydrops, no SVT, good dig levels, and a normal echo.

I know it's been said a hundred times, but we say it again because we truly mean it- Thank you, thank you, thank you for your thoughts, prayers, encouragement, and acts of kindness. We are so blessed to know each and every one of you. Keep baby boy in your prayers. We really want a healthy baby come July! 

We weren't home for this one, so the park across the
street had to do, 23w 5d

Matt was having a grand time exercising in the park :)