High Risk Check-in 11/12

marebear15 · November 2020

Not sure how many of us are high risk, but I thought I'd put one up for this week.

How far along are you?

Why are you high risk?

Any additional monitoring or testing this week?

Any concerns/news currently?

How are you coping being high risk?

Any questions?

ruemcclanahan · November 2020

How far along are you? 9+6

Why are you high risk?
Back to back MCs, history of HG

Any additional monitoring or testing this week?
Blood draws are down to just once a week which is nice!

Any concerns/news currently?
Super happy that my extremely high TSH of 18.9 went down to a 2.8!!! Such a big relief. When I found out I was pregnant, 2 days after that high TSH result the asshole doctor said "welp you're definitely going to miscarry so be prepared for that"
So that's been like a dark cloud hanging over this pregnancy but so far so good!

How are you coping being high risk?
I'm actually kinda happy to be high risk during these covid times because it means I'm always allowed a support person! Not everyone in my area gets to have someone with them.

Any questions?
None at the moment!

marebear15 · November 2020

How far along are you?
8w+1d

Why are you high risk?
genetic heart condition and an ICD (defibrillator/pacemaker)

Any additional monitoring or testing this week?
No

Any concerns/news currently?
My OB said it's up to me if I want to start consulting a high risk doctor now, or if I wait until something concerning appears in any of the scan or symptoms I'm having. I have a check up with my EP (electrophysiologist) next week anyways, so I'm going to consult with him and get his opinion. I didn't have to change my medication last pregnancy, but this pregnancy I have an ICD so it might be different.

How are you coping being high risk?
I'm good! Most of this is old news from last pregnancy, but just want to double check all my boxes.

Any questions?
NATM

@ruemcclanahan - I'm glad your numbers are in a better range, great news! That's a rather neat side effect of being high risk. I haven't asked if I get any special privileges at my office, but from the way my OB was talking, it sounded like no.

_orchid_ · November 2020

How far along are you? 7+3

Why are you high risk? Does AMA count? I also have a history of unexplained bleeding during 1st tri, recurrent losses, hypothyroidism, and a leep about 10 years ago.

Any additional monitoring or testing this week? I had bw and an us on Wednesday that went well. Seeing a hematologist today about a blood clotting issue that was found this summer and might account for my recurrent losses. Taking baby aspirin daily for that.

Any concerns/news currently? Nothing!

How are you coping being high risk? 1st tri always makes me very anxious, and once I'm out I'm fine. I've had two other full term pregnancies with the hypothyroidism and cervix checks from the leep so I'm pretty comfortable with that. I'll have more scans from 28 weeks to check growth due to the thyroid, and of course all the blood draws to monitor it. My medication dosage usually changes several times over the course of pregnancy.

Any questions?

@ruemcclanahan so jealous you are able to bring a support person!! I've been allowed to FaceTime DH during my appointments so far but that's it.

@marebear15 good luck at your EP appt next week!

mindyb2019 · November 2020

How far along are you? 9+4

Why are you high risk? AMA, previous losses, hypothyroidism and had a LEEP procedure done 2 months ago.

Any additional monitoring or testing this week? I have an appt coming up on Monday the 16th with the OB to go over things to move forward. I also have an appt on the 20th for another colposcopy at the hospital to see how things are with my cervix, cells and cyst. FX it will all be ok. I’m worried.

Any concerns/news currently? I have to be monitored a lot during this pregnancy because I found out I was pregnant so quickly after my LEEP surgery. My OB is concerned I’ll have a short cervix, so I’ll have to have another ultrasound between 12-16 weeks to get that measured and make sure its in the normal length range or not. If it’s too short, then I’ll have to have a stitch put into my cervix to keep it shut and keep the baby in. FX I don’t have to have that done cause I’m freaked about that. I’m determined to prove her wrong and that all is ok in there. My OB said because I just had the LEEP recently, this pregnancy would more then likely end in miscarriage as I’m a higher risk now then most women, so to be prepared for that. Kind of a dick thing to say when I’m already scared from PGAL. So far so good but still doesn’t make me feel good hearing that 😢

How are you coping being high risk? I try not to think about it or my anxiety would never go away and be through the roof 24/7. I’m nervous and on edge though and worried about things. I would feel better once I get into my second trimester and get past some big milestones.

Any questions? No

@ruemcclanahan That is an asshole thing to say from the Dr about your TSH. I can relate to that from my OB. Some people are not great with deliverance and bedside manner etc. Omg I’m soo jealous you get one support person with you. I’m high risk too and I get nobody 😢 I can’t even video anything for my DH or take pics or have him on the phone. DAMN YOU COVID!!

@marebear15 GL with your EP appt next week. Hope everything looks ok.

@_orchid_ I hope your apt goes well and that they can figure out about the blood clotting issue.

akoros · November 2020

How far along are you? 7w3d

Why are you high risk? AMA, recurrent losses (1 chromosomal, 1 unexplained)

Any additional monitoring or testing this week? No additional monitoring, though I'll be going to the MFM for my NT scan to follow up with them

Any concerns/news currently? Not really. I'm a little weird in that my losses have all been later, so mostly just biding my time.

How are you coping being high risk? Ok? I'm not really letting myself get attached and don't have high hopes for the pregnancy (no particular reason, I'm just pessimistic given my history). So there's that.

Any questions? Debating rotating OBs with my practice. For my last two pregnancies I just stuck with my normal OB-GYN, but for my appointment yesterday I had to see a different one and she made the point that (should it come to it) the OB assigned that day would deliver the baby, so some women like to rotate in the hopes that they will have actually met the doctor they get on D-Day. The practice admittedly has mixed reviews, with my usual doctor being great but others getting dinged (mostly for bedside manner and communication). Part of me wants to stick with a doctor I know who knows my history, but another part of me is wondering if I should rotate.

marebear15 · November 2020

@mindyb2019 - Wow, I can't believe your doctor would say that! Mine is always doing the most he can to reassure me, saying "Healthy mom (mind), healthy baby." So that calmer I am, he believes, the better it is for the baby.

akoros · November 2020

@ruemcclanahan @mindyb2019 Ugh, I swear, some doctors really don't think about how to appropriately say things. I understand wanting to manage expectations and/or prepare a patient for bad news, but still.

mindyb2019 · November 2020

@marebear15 ya I couldn’t believe it either. I’m not really of big fan of her to be honest lol. She wasn’t my choice in OB. I would way rather have this other guy. My GP dr is great though. He was like ok.. I don’t want to hear negative thoughts. Forget what the OB says. This is a new pregnancy and let’s focus on moving forward and staying positive and throwing that out into the universe. Let go of the past and whatever happened before your losses doesn’t mean it will happen again.

_orchid_ · November 2020

@mindyb2019 I love that attitude of your GP!
@akoros I rotate obs at my practice too. I like it bc they all have different strengths, so seeing them all gives me a lot of different viewpoints which I like. I'm not sure what I would do in your situation - it would be nice to stick with the Dr that knew my history, but also rotating would make it different and might help mentally separate the experiences.

_orchid_ · November 2020

My appt with the hematologist today was more than I thought it would be. She said my kind of raised cardiolipins are associated with 2nd tri losses, not 1st. Wants to monitor me through 2nd tri. Normally said she'd put me on lovenox (a blood thinner) at this level, but because I have a history of unexplained bleeding with all my pregnancies she didn't want to do that right now. Staying on baby aspirin for the time being. They took 12 vials of blood and I thought I was going to pass out lol

ruemcclanahan · November 2020

@mindyb2019 @akoros I can't freaking stand this Dr! My regular OB is an angel and I love her and she's been my OB/GYN for over 10 years now. She was on vacation that week so this horrible doctor was in charge of my case for that week.
Thank goodness I don't have to see her and after what she said I requested to not work with her again in the future.

ramzlau · November 2020

How far along are you? 10 weeks

Why are you high risk? Transfer from RE (considered high risk until 12 weeks), AMA (considered high risk for NIPT and Anatomy scan at 18 weeks will be done by MFM rather than ultrasound tech), history of high blood pressure (indicator of preeclampsia), hypothyroidism.

Any additional monitoring or testing this week? We just had our 3rd ultrasound. I do NIPT on Monday and then our last ultrasound of first trimester on 11/30. And check my thyroid again around then.

Any concerns/news currently? Just taking it one hurdle at a time. So next thing is NIPT results. We have family history, so it’s always a bit nerve wracking.

How are you coping being high risk? I enjoy the extra ultrasounds and extra care. It helps with anxiety of PGAL.

Any questions? NATM

@ruemcclanahan Way to go with those TSH numbers! I hope you don’t have to see that horrible doctor again!

@marebear15 It’s good that they are allowing you to judge how you want to handle your care!

@_Orchid_ My synthroid dosage normally changes a few times over the course of the pregnancy too. I have a new OB this time around and he doesn’t monitor thyroid, so I have to go to my primary once a month for it. Seems weird, but whatever, it is worth the extra effort to make sure it stays in good range. Glad your appointment today went well, even if it means prolonged monitoring. 12 vials! Drink lots of water!

@mindyb2019 I am still annoyed that your doctor said that. Your GP has the right mindset! Sending all the good vibes for you over the next few months!

@akoros At the practice where I had DD, they had a similar setup where it was a group practice and doctor on call delivered. Over the course of my labor I had 5 different doctors see me and none of them were my OB. I would recommend rotating, but at end of pregnancy you go every week, so it might be a better time to rotate through some of them. I did end up liking some of the other doctors better than my own OB.

ruemcclanahan · November 2020

@akoros my practice does that too, I only saw the doctor who delivered my son for like maybe an hour total. So for me- I didnt really care.
I would rather just see my regular OB for appointments
My regular OB came in to check on me in the hospital every morning and then in the evening too. She's the best I could gush forever lmao. I was also in labor for 3 days.

akoros · November 2020

Thanks @_orchid_ @ramzlau @ruemcclanahan! I think I might stick with the same one or two until I get through the anatomy scan, and then maybe rotate after. All the appointments up until then will be super high-stress given my history, so I'd rather see a familiar face.

laurad75 · November 2020

How far along are you? 8+2

Why are you high risk? AMA and history of loss - my 3 losses were all unrelated so hopefully just bad luck

Any additional monitoring or testing this week? My last ultrasound with the IVF clinic is tomorrow morning.

Any concerns/news currently? No concerns, just anxiety

How are you coping being high risk? This baby (as well as DS) were conceived via donor egg IVF so I really shouldn't have anything to worry about. My age will give me some extra exams but hopefully this pregnancy will be nice and boring.

Any questions?

sgrn18 · November 2020

How far along are you? 11+4

Why are you high risk? Bicornuate uterus (heart shaped), previous preterm delivery, and classical incision c section.

Any additional monitoring or testing this week? Still waiting on my NIPT results, I’m on day 11!! My 12 week appt is tomorrow but no ultrasound.

Any concerns/news currently? None right now, I have a higher risk of implantation in the c section scar but the ultrasound showed baby on the far side so pretty well away.

How are you coping being high risk? After my last delivery I knew I’d be put in this category for each pregnancy. And while my health isn’t at risk, I hate the risk of having a further preterm delivery. I know I have a while before I really need to worry about that but it’s always in the back of my mind.

Any questions? None for now

_orchid_ · November 2020

@laurad75 I hear you on wishing for a boring pregnancy! Good luck tomorrow at your appt
@sgrn18 ahh I hope your NIPT results come in today! Glad to hear baby implanted in a great spot. My mom and a close friend have bicornate uteruses, but my mom didn't find out until menopause. Will you have closer monitoring as baby grows bigger?

sgrn18 · November 2020

@_orchid_ I’ll have regular ultrasounds in the 3rd trimester for growth. Usually the biggest issues are breech baby and preterm birth as they run out of room quicker. DS was so wedged up in on of the horns during the c section and that’s why they had to extend my incision on the uterus to get him out.

llamamamawearspajamapants · November 2020

How far along are you? 10+2

Why are you high risk? previous history of elevated BP which developed into HELLP while in labor with DD. Thankfully by then I was ready to push, so I was able to deliver and then start mag as treatment.

Any additional monitoring or testing this week? I had an early u/s and check-in appointment last week everything looked good. It’s tough because the concerns I have are all 3rd trimester concerns. So for now it’s all take your baby aspirin and hope the reoccurrence stats are in your favor.

Once I hit my anatomy scan I’ll meet with a MFM and get more scans/appointments after 20 weeks. I believe weekly (half virtual, half clinic).

Any concerns/news currently? More mental than anything. “Odds are good” since hellp has a lower reoccurrence rate than pre-e and I don’t have any other risk factors (I’ve never needed BP meds, not obese, not AMA). The OB who oversaw my treatment last time indicated a “8-10%” risk of reoccurrence.

How are you coping being high risk? I bought a home blood pressure monitor. I also reached out for a referral for a perinatal psychologist because it hit me that my midwife group, while lovely, is never going to address my baggage from this. I can see my labs were bad, but I never felt sick or had symptoms, so the whole experience was a total mindf*k. I would like to be seen as a person and not just a potential problem. It might be better actually talking to a MFM or a high-risk OB who can give me better answers.

Any questions? Anyone ever had success keeping BP low with reduced sodium/ exercise? I was really hoping to have more concrete steps to take.

akoros · November 2020

@llamamamawearspajamapants I hear you on struggling with the wait. My issues all showed up in the 2nd trimester, so I just feel like I'm biding my time and hoping that the odds are in my favor (despite very much not being in my favor before)

llamamamawearspajamapants · November 2020

@akoros the whole phrase just reminds me of the Hunger Games!

mc0303 · November 2020

@llamamamawearspajamapants I developed pre-e last time and had to be induced. I also had zero symptoms! I only caught it when I did bc I have a blood pressure cuff. My BP would skyrocket in the OBs office so he had me tracking it at home for a more accurate reading. At home my BP was perfect until one day I woke up and felt weird and checked my BP and it was through the roof and stayed that way. My GP told me there’s really not much you can do to prevent pre-e from happening 🤷🏻‍♀️ Besides the baby aspirin. It’s pretty horrifying tbh. I did a lot of therapy from the PTSD of the experience. God forbid it happens again, but at least this time I’ll know what to expect.

akoros · November 2020

@llamamamawearspajamapants Me too! I just couldn't think of a better way to say it

llamamamawearspajamapants · November 2020

@akoros @mc0303 my home blood pressure monitor arrived today. It plays a “soothing” medley three times while it does a reading

ramzlau · November 2020

@llamamamawearspajamapants I love that your cuff plays a soothing tune lol. I have a home bp monitor as well since I had elevated bp with DD. I don’t know any other steps to take to keep it low aside from the normal avoid stressors, etc. I think @mc0303 is right in that high bp is not a cause of pre-e but a symptom so I don’t think there is really anything to do to prevent it. My approach this time is to expect it, so at least I am prepared vs last time at 36 weeks when I had no clue that high bp was a cause to induce early. We didn’t own a single diaper yet and I wasn’t packed for the hospital (we lived 2 hours from hospital and OB was across the street from hospital when they decided to send me for induction) and car seat wasn’t unpacked or installed. This time I will be ready super early! But also, I fully support finding someone to talk with just to not have old feelings to process as you go through this birth.

_orchid_ · November 2020

I'll ask again in tomorrow's thread, but does anyone have any experience with lovenox injections? The hematologist just called and told me I need to start them based on the results of last week's bloodwork.

akoros · November 2020

@_orchid_ If you don't mind me asking, do you know what testing you had done? For now the MFM just wants to try baby aspirin, but it didn't occur to me that there could be a test that might indicate whether that is thinning my blood enough.

_orchid_ · November 2020

@akoros my cardiolipin antibodies (IgG specifically, I think; might be IgM). When I saw her on Friday I told her about my pregnancy history with bleeding, so she said to stay on just the baby aspirin. I only got to speak with her for a few minutes today and had so much info thrown at me that I didn't have time to ask much, but basically my levels were high enough that she wants me on lovenox despite the bleeding history. Weirdly this is the least I've spotted/bled during a pregnancy, despite baby aspirin, so I'm wondering if that has to do with clotting.
She also told me that based on these results I need to see a rheumatologist, so it seems like it might be in line with some autoimmune issues. Anecdotally, my BIL has a ton of autoimmune issues and part of what kicked off the investigation into his issues was that he kept developing cysts... So I'm wondering if the two under my arm could be a sign of something?

akoros · November 2020

@_orchid_ Ah, interesting. I have a separate clotting issue (cardiolipin antibody and antiphospholipid antibody levels came back normal), so not sure that sort of test would change anything for me. Autoimmune issues are so strange (and sneaky!), I hope they figure it all out for you!

_orchid_ · November 2020

@akoros can't hurt to ask your Dr next time if there are any tests you can run to check if the baby aspirin makes a difference!
Thanks, if it is autoimmune the rush of hormones at the beginning of pregnancy probably just sent my system into a tizzy. Bodies are weird.

sgrn18 · November 2020

@_orchid_ I give lovenox injections every day at work but I’ve never given them myself. They can burn a bit and will likely give you bruising at the injection sites. But ask away hopefully I can answer things for you!!

edit spelling

_orchid_ · November 2020

@sgrn18 thank you! I'm picking up something at my pharmacy tomorrow and taking it to the hematologist's office so they can show me what to do. I'm 8w today and it sounds like she wants me to start this asap- is it typical to take it this early? Kinda freaking a bit too bc I'll have a RCS so wondering about blood thinners with that. Ahhh

sgrn18 · November 2020

@_orchid_ I don’t know a whole lot about timing but I met a girl who did lovenox injections from the beginning of her pregnancy. With surgery they will likely tell you to stop the injections a day or two before. Heparin (active ingredient in lovenox) has a very short half life so it’s out of your system pretty fast!

High Risk Check-in 11/12

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