High Risk/Gestational Diabetes/PreE/Etc.

KLS123 · November 2018

Anyone else experiencing IUGR aka a very very small baby? My sweet LO has fallen down to the 4th percentile for growth so we are in weekly ultrasounds and NST to make sure it's still doing okay in the womb or if they need to get it out early. I'm likely looking at a 37 week induction (December 12th) since the placenta deteriorates after that and can make the growth even worse.

Crossing my fingers I can pass all the NSTs until then!

oaklandava · November 2018

@MrsDho11 HAHA! yeah, it's a struggle.

Warning-really long post and somewhat whiny, but I need to write to get it out and Facebook/social media is not where I want to do that.

Today is not a good day. I woke up and felt off to start with emotionally. Not anything in particular just not "right". Chalked it up to my anxiety disorder and moved on. High risk doctor's nurse calls back finally (2 days later after they decided to put me on insulin as a next step). She said since I'm going out of town Tuesday and won't be back until Monday 11/26, that they'll see me on 11/27 at 2. Well, that's when my regular OB appointment is that was the ONLY available appointment in November. I should have been seen on Monday of this week, but they didn't have anything and then are closed next week, so 11/27 is what they scheduled for the NST and the weekly ultrasound. The nurse proceeds to tell me in a very shitty tone that the diabetes is important and that I should be doing my NST's and ultrasounds with the high risk office instead of the regular OB. I politely explained to her, for the 4th time in the last few months, that my regular OB is doing them because I cannot afford to do them at the high risk doctor. They bill through the hospital and I have already spent $4k on this pregnancy and I am not working. Yes, our insurance sucks, but I cannot help the fact that I am not working and can't afford it. It wasn't part of the plan when we got my husband's promotion and moved. When we moved and jobs opened up, I was visibly pregnant and magically got none of the jobs I interviewed for. She very rudely proceeded to tell me that basically I needed to call my ob and move that because they came first. I asked her to send me to scheduling and I would find out other appointment options. So she did. The nice little lady on the phone told me that they could see me at 12:45 and then I could make my appointment at 2:00pm with my OB. Well look-y there! She asked about the NST and ultrasound, and I had to explain, again, to her the whole deal. At this point, my anxiety was taking over and I was crying so I apologized. She was like "oh honey, people think it's so easy to just lay down and have a baby but your body does all this weird stuff". I told her, Yes, I know, this is my second it's just different this time because my high risk OB and regular OB were the same last time and did not bill through the hospital so none of this stress was there. But, nobody around this area does that on this side of the state. So, boo. She then said "your hormones are all over the place, don't worry about it". Yes I know that but it still doesn't make me feel human LOL

I hate doing appointments that early in the day because my son's preschool is 1.5 hours from my doctor so I end up either having to pick him up early or he misses for my appointments and to be honest, I feel like it's not fair to him. I want him to be able to go to school like he needs to and not sacrifice for all of this. However, my husband is the only one working and can't afford to take days because he's going to take time when the baby comes to help me. We don't have any family/friends in the new place to help, and hiring a sitter is not a financial option right now. My husband makes just enough money for us to not qualify for any assistance and we've exhausted all other options. I'm just completely in my feelings because I feel like 1. the first lady (nurse) made me feel like a shitty mom, 2. she made it out to be like I am not taking the GD seriously, 3. If the insulin was that damn important as you say it is, don't you think that you would have worked me in BEFORE THANKSGIVING instead of just pushing it back to 11/27 when that's convenient for you all because you're booked? I feel like the answer is yes. I just needed to write all of this out to process this. I called my regular OB to talk to him about my anxiety because naturally, it just keeps increasing as we go along. We've got to figure something out before I end up with PPD again this time. So yes, I am a mess today!

End rant. With tissues.

oaklandava · November 2018

@molosmiles
I'd call too--however, no news is probably good news. They've called me quickly with my failures each time so that's why I say that haha

oaklandava · November 2018

@KLS123 I've not heard of that before. Has the growth increased even though the percentiles have decreased? Like, has baby still grown and increased each time?

MrsDho11 · November 2018

@oaklandava I wish I could give you a big old hug.

pttomato · November 2018

@KLS123 I'm sorry you are dealing with IUGR. Fingers crossed baby keeps growing and doing well on the NSTs.

@oaklandava Wow. That's a lot of stuff to deal with. I'm over dealing with my doctor's office and I haven't had to deal with nearly as much a you have. I'm glad you were able to get an appointment and that you don't have to go all the way to the high-risk office for your NSTs.

I put this in another thread, but thought I would post more here. I feel like my OB office doesn't take my complications seriously. I really like my OB and was really happy with how everything was managed when I was in the hospital, but now that I’m not in the hospital, it’s like they don’t think I need to see an actual doctor. My appointment today was with the NP and the scheduler wanted to make my next appointment with her too so it would be 6 weeks between appointments with my OB. The scheduler acted all put out when I said I wanted to see my OB instead of the NP, like it was too hard to do. When I pushed it, they called my OB and suddenly managed to find an appointment for me.

If I was having a less complicated pregnancy, I would have no problem mostly seeing the NP, but with everything I'm dealing with I'd like to see the actual doctor more often. Especially since the NP was clueless about what's been going on with me and can't give me definitive answers on treatment decisions. Today when I went in I was asked when I was going to do the GTT and the NP didn’t know anything about my situation (incompetent cervix, preterm labor, that I'm on bedrest, what meds I’m on), she didn’t even know I had been in the hospital.

We did discuss bedrest and she said they typically go to modified bedrest at 34 weeks and then regular activity at 36 weeks. It would be really nice to be able to get up at least a little, but it still makes me so nervous that it will send me into labor. Getting to 34 and especially 36 weeks would be so, so much better than when I started, but it's still premature on top of his heart defect.

ladystout08 · November 2018

@KLS123 my friend IUGR and they induced her at 37 weeks. He was still a good 5 lbs and he's now a thriving three month old. I know she was stressed to the max for a while though.

@oaklandava so many hugs. What a mess.

DLpanda08 · November 2018

@oaklandava that sounds so stressful. Sending so many hugs and prayers.

@pttomato I don’t blame you for being frustrated! At least you got an appointment with the OB in the end. I can’t imagine the stress that comes with all the things you’ve been through this pregnancy. But no matter what happens, your little guy will have the best start possible because you love him and you’ll do everything possible to get him what he needs.

ersh1010 · November 2018

@pttomato im sorry for all that your going thru that sucks. It's scary to worry about birth defects especially when you are already aware of one.
@oaklandava sorry you had such a difficult day! Im glad you called your ob, hope you get an adequate response from him!

KLS123 · November 2018

@oaklandava oh man mama sending big hugs your way! Ugh I hate when they make it seem like a huge stressful emergency but then are like wellllll we can't schedule you to follow up for another 3 weeks....total frustrating mixed messages!
the baby is still growing but not at a "normal" rate. It has been small since my 18 week AS and was in the 10th percentile back then and is still growing but not as big/fast as they would like to see so that indicates there may be something wrong or deficient with the placenta.

@ladystout08 I'm so glad to hear your friends LO turned out healthy! I would be thrilled to make it to 37 weeks and 5 lbs so it's great to hear that worked out for her. I haven't met anyone else with this issue so my data points are solely from Dr Google which we all know is a disaster.

oaklandava · November 2018

Thanks guys. It's been a mess. Sometimes venting is the best thing you can do...or the only thing. Or both.

@KLS123 Well the baby growing at a normal rate is a positive thing! THat's great. If the placenta is having issues, is there anything they can do to rectify it or is delivery the best option? Dr. Google is definitely a disaster and even though we know that, we still use it haha. I am going to add you to my prayer list that you get some comfort and answers soon!

@pttomato I am so sorry they're not taking you seriously. I know that is so frustrating, it happens here too with my financial issues and my anxiety disorder. They don't seem to get it. Seeing the NP in your case would be extremely frustrating, especially since she doesn't know your history (which is inexcusable I feel like? At least look it up before you meet with the patient) so I think you're completely warranted in how you feel. I'm praying for you to have some piece of mind and baby progresses with as little issue as possible

oaklandava · November 2018

Update...

So, yesterday, I had extreme cramping and diarrhea. I didn't think anything of it because it passed. It happened again today, with a horrible headache, dizziness, and increased discharge. I called the OB because with GD, they told me there's an increased risk of preterm labor especially because my GD hasn't been controlled hardly (hence the insulin appointment next week). So, I drank water and laid down and it seemed to subside some. They told me not to worry too much unless there's spotting along with it. So, I guess I'm just hanging out right now hoping for the best?

Anybody else experienced anything similar?

MrsDho11 · November 2018

@oaklandava a couple weeks or so ago, I had some really bad cramping, combined with pelvic pain and back pain. I went in to get checked out and was definitely not in labor. They suggested drinking even more water and wearing the support belt pretty much all the time. It’s been better since. But I found it frustrating that there’s no clear delineation with those symptoms between normal and concerning. They did make it clear that they don’t consider it a waste of their time, and they do want me to call anytime I’m unsure even if it ends up not being anything.

So stressful though. *hugs*

beachmama14 · November 2018

@oaklandava it’s a good idea to take those symptoms seriously, but they also could be nothing so it’s so hard to tell. With my first labor, it started off with diarrhea/cramping/discomfort. Contractions started soon after that. For me I also started spotting and lost my mucous plug so I knew it was the real deal. I think if intestinal discomfort is on its own, its probably normal, but if it starts happening with other symptoms or in a timeable/rhythmic pattern I would start to be concerned! Hope it all subsided for you.

DLpanda08 · November 2018

@oaklandava I think it’s good that you called. My doctor has said they would rather hear from me and have it be nothing than have me hesitate to call. Especially with GD issues as a factor.

I’ve also found with my GD that I’m more likely to have weird symptoms and discomfort if I’m even slightly dehydrated. Drinking a huge glass of water typically helps.

sweetyjenj · November 2018

Hey ladies! In haven't updated in this thread yet, but at my 28 week ultrasound (monthly ultrasounds due to possible Zika, but thankfully no Zika!! Everything is fine) my amniotic fluid was 24cm and my doctor's office said it was slightly past the upper limit of normal fluid. They sent me to see the Perinatologist and their ultrasound measured my fluid at 21.5cm, and they checked baby and everything is working perfectly.

Then at my 32 week ultrasound on Friday my fluid was at 25cm. Doctor ordered weekly ultrasounds, NST's, and OB visits. I already knew nothing is wrong with baby, but whatever. Today I had my first biophysical ultrasound and they scored him based on how well his systems were functioning. He got 8/8, then we have the NST& OB appointment on Friday. The fluid was still 25cm. My stomach is still measuring at 32 weeks, so it's not enough fluid buildup to throw that off.

If 2 biophysical ultrasounds in a row give him a score of 80%+ then they'll stop the weekly ultrasounds. Of course I want him to pass, but I also like the idea of weekly chances to see him, but also it takes a lot of time doing all these appointments!

Basically, doctor says with too much fluid I'm at high risk for needing a C-section because baby has so much space that he might not stay head down, or he might not what properly in the proces for delivery, or the cord could prolapse or something. My last labor was easy and I hope to have a repeat, but if my fluid keeps building then who knows. I'm also at higher risk for preterm labor.

oaklandava · November 2018

Thanks guys

sorry I couldn't update before now, we have been visiting family without high speed Internet and my mobile bump app hasn't worked since......well, spring? So, I have to be on a computer. Everything is going fine so far, except for the sugar out of control. Insulin Tuesday will hopefully help.

Happy Thanksgiving to all of you guys!

molosmiles · November 2018

I passed the 3 hour glucose. Phew!

But I do start the non stress tests next week. Has anyone started these yet? What should I expect?

DLpanda08 · November 2018

Yay @molosmiles!!! I’m so glad you passed!

tosh24 · November 2018

@molosmiles I started my NSTs/BPPs this week. I had them with DS too. There are usually two parts - monitoring and ultrasound. For the monitoring you lay in a bed and they hook up a fetal heart rate monitor and a contraction monitor to you (externally). You also get a little push button that you push every time you feel movement. They also take your blood pressure. The test usually lasts around 20-30 minutes. They just look to make sure the heart rate is consistent and goes up with the movements you are feeling. And that you're not having any contractions. The other part of the test is an ultrasound where they look to make sure baby is growing on track and check things like baby's movements, muscle tone, etc. and give them a score out of 8. They'll also check fluid level and a few other things. Pretty non-invasive but you'll probably be there for a good hour or so.

I just realized that I'm responding in a thread I never really joined - I've just been lurking. I had a low Placental Growth Factor Protein result in my first trimester which can have implications for things like placental function, IUGR, PreE, and Down Syndrome. So far everything has checked out (NIPT came back low risk, NT was fine, AS was good), placenta is functioning well, baby is growing well, and my PreE blood work came back negative. But as a standard practice, I now have to have NSTs/BPPs from now until delivery. I also have an autoimmune disorder than affects my blood platelets so I am watched more closely by a hematologist. If my platelets dip too low there are a number of things they recommend (steriods, IV transfusion) but it can also have delivery implications since I can't have an epidural if platelet levels are lower than 100 and can't have a spinal (if C-section is required) if they're too low either so I would have to be put under GA. And then there's the bleeding risk. So far things haven't dipped too low but I was supposed to have more blood work done last week and I forgot so I really need to do that ASAP.

molosmiles · November 2018

Thank you @tosh24 . I get why my doctor thinks they are overkill for me. I'm advanced maternal age (36) and no other complications. Sounds like it is going to be expensive. Ugh.

And wow....that's a lot to monitor and keep track of. I had no idea you were dealing with all that.

MrsHudson2014 · November 2018

Hello, High Risk due to multiples, but baby b has a kidney issue so we would have probably ended up high risk regardless.

I just started my weekly NST's and go to twice a week at 34 weeks. Mine don't have me press a button with movement- just the heart rate and contraction monitors plus the quickie ultrasound.

We have already seen the pediactric urologist for baby b. They think it's a blockage of some sort, not a cyst. 3 of the 4 possibilities will require surgery. 1 of them immediate, 2 of them within the first 3-6 months. The latter 2 come with a nephrostomy tube while waiting for surgery.

MrsDho11 · November 2018

The slight differences are so interesting. When I had NSTs with DD, they usually had me pressing the button, but I didn’t have an ultrasound with it. Though at one point they did a growth scan since high BP can restrict growth.

@tosh24 that is a lot. Hopefully everything stays in acceptable limits.

lolson83 · November 2018

Hi Ladies,
I am 34 weeks pregnant, high risk due to being old (35yo) and having high blood pressure at the end of both of my 2 other pregnancies.
Everything was going good this time until I measured 34cm at my 29week appt! I was only measuing 1 week ahead before that. I had a growth US and baby is measuring greater than 90th percentile for weight! No GD at least but I am kinda freaking out I will have a giant baby now.
Going back in on Dec. 5th for another US and then N/S test and Midwives appt on Dec 7th. Going to weekly N/S tests and appts after that.
I would really like to avoid a C-section but feeling pretty worried about increased risk of his shoulders getting stuck. Good news is they will at least plan to induce at 39 weeks which would be nice. I am so huge and I uncomfortable.
As far as N/S tests go just be prepared when you go in towards the end. With my last pregnancy I went in at 38 weeks and babies heart rate was dropping with some contractions I was having and they wheeled me straight next door to the hospital to be induced right then.

oaklandava · November 2018

@tosh24 whewww that's a lot. I'm praying it all stays within the normal/non alarming boundaries for you.
@lolson83 I understand the huge and uncomfortable thing. I'm bigger than all of my friends who are pregnant and ahead of me too. I'm going back for another growth US tomorrow to see, last time he measured 1.5 pounds over where he needed to be so I'm scared he's a giant.

I go tomorrow for an insulin appointment that I am petrified for. My anxiety is completely keeping me up at night and I have not slept in 4 nights. Here's to hoping they get that under control at least

Then, growth ultrasound and NST appointment after that. I think we're supposed to schedule the repeat c-section tomorrow too, but at this point, I can't remember. UGH.

Hoping you guys had a great Thanksgiving and are looking forward to Christmas! We love Christmas in this house

DLpanda08 · November 2018

Lost my mucus plug today. I called my midwife and she said not to worry about it since I’m not having contractions, but of course my brain is still mildly freaked out since it’s so early.

ladystout08 · November 2018

Had another BP spike yesterday. Shot up to 153/73, came down to like 138 after an hour or so. Ran some more pre-e labs and from what I can see in my patient portal they look ok. I wish it would stop spiking and going back down. It's hella annoying.

@DLpanda08 I totally get the worry but that thing regenerates! FX that baby keeps cookin'.

tosh24 · November 2018

For those of you who have dealt with PreE before.....anyone have lip swelling? My legs and feet have been swollen for months and I wear compression socks every day. In the last week or so my wrists have also started retaining fluid and the last few days my hands have been swollen and my joints stiff. Yesterday and today when I woke up, I noticed my lips were super puffy, but not necessarily the rest of my face. So far my BP has always been fine, no protein in urine, and PreE blood work done a few weeks ago was normal. I've never dealt with swelling in either of my other pregnancies before so not sure what's normal.

tosh24 · November 2018

@oaklandava Good luck at your appointment today. I know you're nervous about it but I hope it turns out to be a source of relief rather than further anxiety!

@DLpanda08 I can totally see how that would be a mind trip. I hear that women can start losing their mucous plugs in the third trimester but it doesn't necessarily mean impending labour since it can regenerate. Apparently bloody show (I hate that term!) is more indicative of the labour process starting.

@ladystout08 Ugh, stressful about the BP spikes, but glad it at least goes back down on its own.

ladystout08 · November 2018

@tosh24 when I had it last time, my face swelled. Like cheeks, chin, etc. I don't recall my lips swelling but I wouldn't have been surprised. Is the swelling (all over) soft and squishy or is it sort of hard and leaves and indent?

oaklandava · November 2018

@tosh24 thank you

@DLpanda08 my SIL lost hers and then didn't start labor for another 4-5 weeks, so I agree with @tosh24 that it would stress me out, but it isn't necessarily a bad thing.

tosh24 · November 2018

@ladystout08 No, my lips are soft, like marshmallows. Kind of puffy, more than hard swelling. And yesterday it went down as the day went on. I actually thought it was a food I might have eaten because I have random food reactions that cause mouth swelling all the time. But then when I woke up like that again this morning, I didn't know if I should be concerned or not. Lord, I hope I only have a few more weeks of this stress and baby comes on the earlier side of full term!

ladystout08 · November 2018

@tosh24 that was the key indicator for when my swelling was problematic and my nurse still checks my swelling by palpitating it to see if it bounces back. I wouldn't worry too much. Are you sleeping at an incline?

tosh24 · November 2018

Thanks for sharing your experience @ladystout08. The only place that I'm getting hard swelling is in my calves...those do not feel squishy. But my OB said even though it looks like it should be a concern, because all of the other PreE parameters are coming back normal, he thinks it's just bad swelling/fluid retention. But I need to keep my eye on it. Do you have to monitor your BP throughout the day or do you only take it when you feel "off" to check it out? What symptoms lead you to think your BP has spiked and check it?

ladystout08 · November 2018

@tosh24 you're welcome! I check my BP just when I feel off. I plan to talk to my OB when I see her about continual monitoring to see if we can find a trigger/pattern. I get almost over heated is the best way I can describe it. I get hot, flushed, my hands and feet swell and throb and I get a headache. Usually by the time I check it I think it's either peaked or on it's way back down.

kerryann124 · November 2018

@ladystout08 I get the same thing - feeling over heated and like being able to hear your heartbeat in your ears... I'm also monitoring my own blood pressure at home. Mine has been lower recently, until last night when it spiked again.

Update for me: I got the extra testing even though I didn't meet the 140/90 criteria and turns out I failed the 24 hour protein in urine test pretty badly, but my blood work was normal. They weren't sure what to make of it though since my blood pressure still hasn't spiked for an extended period of time. I've been self-monitoring for anxiety purposes and found resting has really helped. I have a follow up appointment today to get more information. I'm just hoping we can monitor so it doesn't become an emergency situation. Although I'm now 35 weeks, so thankful to make it this far...

ladystout08 · November 2018

@kerryann124 sounds like we're in similar boats with some symptoms but nothing solid. I'm only 31 weeks though so I need to hold out a little longer.

tosh24 · November 2018

@kerryann124 Did you do the 24 hour urine collection after a regular/standard urine sample showed protein? My urine has been clear so far at my OB visits, but although my blood work showed normal liver and kidney function, the results were only slightly below the threshold. My OB seems to dismiss things if you don't have x, y AND z, but can PreE "hide" at all? Wondering if it's worth it to push my OB a little harder especially with all this newfound swelling everywhere. I've had times of feeling intense hot flashes and kind of "out of it" but I just thought it was pregnancy hormones...didn't even consider that it could be a blood pressure thing.

wkuandrea · November 2018

@tosh24 with your other pre-existing conditions, I'd definitely bring up the new swelling. It's good that you are passing blood tests, and urine tests -- are the regular ones showing any protein at all? You might want to ask about the 24 hr collection (which is delightful, as you can imagine) to see if there is anything else. The thing with PreE is that it's "pre"... and can go full blown (and cause you to have seizures) at any time. The body is weird.

kerryann124 · November 2018

@tosh24 No, I never did a normal urine test. I just jumped straight into the 24 hour one, although now I'm doing them weekly (starting this afternoon), so I'll keep you posted if that is positive too. I also feel somewhat dismissed but I think the taking my own pressure at home has helped me relax a bit (assuming its somewhat accurate lol).

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