We had the first of our weekly appointments with the perinatologist. As the guys at work refer to him, the paleontologist … I think they are convinced we’re having a velociraptor.
The Past Week
Last week, Missy had protein in her urine and the doctor became concerned. Throughout the week, Missy had a 24 hour urine test and a 3 hour glucose test. The urine test was to see if there was protein in the urine and the glucose test was to check for gestational diabetes. As the week progressed, we were strolling through Target and got a call from the hospital. The doctor’s office was calling letting Missy know that the urine test results were back and her creatine was high. I immediately knew what this meant, but Missy was a little fuzzy about it until she jumped on the iPhone. Curse smartphones.
Creatine is something everyone has in their body and is a by product of feeding your muscles. Too much and it could indicate impaired kidney function, which is a marker for preeclampsia. Missy became a little distraught, but once we realized that if the number was too high the nurse would have called ANY of the doctors in the office and we would be in the hospital. A little more research showed the numbers were slightly elevated and not high enough to cause any concern. Whew. Somehow, the medical system needs to do a better job of this when the say “high.”
The rest of the week was uneventful with the baby very active, Missy being tired and Shannon starting all day kindergarten everyday. This was a bummer since she was only going all day 3 days a week and 1/2 day 2 days a week. Our little girl is growing up.
Cardiologist
We had an appointment with the cardiologist yesterday, Dr. Nash. Great guy and fellow tennis player. He is hyper vigilant concerning Missy’s blood pressure and wasn’t happy with her average readings. Typically, the perinatoligist runs point on all changes to medication, but Dr. Nash went ahead and increased a medicine. Other than that, the appointment went awesome. He was happy with Missy’s health through pregnancy and was encouraged about our efforts to track the blood pressure.
Missy changed her dose last night and it’s immediately paid off. Her readings today have been lower!
Today
Our cabinet is full of stuff … supplements, vitamins and urine test strips. Urine test strips? Yep. When I go serious low carb I test myself to ensure my body is generating tons of keotones, which indicate your body is burning fat. They also measure protein in the urine …
We seized this and started testing Missy’s urine each day … sometimes multiple times. We had a couple of days with some protein, but lately it’s been none. Awesome. Remember, protein in the urine is another indication of preeclampsia.
At 3:40pm today, we had the appointment with the perinatologist. I met Missy at the elevator and I could tell something was wrong. She told me she tested her urine before leaving home and there was protein. I did my best to settle her down, but we both knew that wasn’t good.
You need to understand that the perinatologist is always busy and you always wait. Our 3:40pm appointment turned into a 4:20pm one. When we got into the exam room the nurse took Missy’s blood pressure and it was high.
For the love of … Protein in the urine and now a high blood pressure reading.
The doctor comes in and is pretty happy. I think to myself, “These guys do a good job hiding things.”
He comments on the blood pressure and Missy immediately pulls out the urine test strips we use and explains her BP was high due to the bad news of the protein. The doctor looks at the notes and tells us the 24 hour urine test showed no protein nor did the urine test Missy took when we arrived for our appointment. He then laughs.
It took me a second to process this all.
He went on to explain he’s not concerned in the least bit. From time to time everyone has protein in their urine, which is why the 24 hour test is done. If that is clear, there isn’t a concern.
I then said, “So, what you’re saying is that protein in the urine is something we can cross of our unnecessary concern list?”
We all laughed.
He moved on to the blood pressure and Missy explained about the change Dr. Nash made. He was happy to hear this and was satisfied the BP was fine for now.
Missy and I smiled.
He turned around and got a little serious. Explaining that everything is going well now, he saw no reason to admit Missy to the hospital or give the baby steroids to increase lung development. This is done when a preterm baby is about to be born. It’s like the express lane for lung development and attempts to prevent RDS (respiratory distress syndrome). The doctor did say we’re now going to have weekly visits and ultrasounds.
When he left Missy and I laughed so hard. The roller coaster ride is starting, but today was all good news. We’re going to make it to week 26.
Coming Up
We haven’t had an ultrasound in four weeks and I gotta tell you, I am pumped for another one. That’ll happen on Monday morning at 9am. I cannot wait to see him again since I feel like I know him from listening and feeling him move.
The ultrasound will focus on a few things:
- Development: Are all the parts growing properly?
- Size: He should be 1.5 pounds.
- Cord blood flow: This is the critical measurement and what caused Missy to be admitted with Shannon at 29 weeks. There is a certain volume and pressure of blood flow that needs to go from Mom to baby, so the ultrasound ensures it is fine.
We’re also going to start getting things going at home. Shannon has decided that when she switches rooms she needs her own bathroom. I have no idea where she got this idea, but she has her eye on Cassie’s room ….
So, that is where we find ourselves right now. Thank you all for your continued prayers and positive thoughts. I cannot tell you how much it means to Missy, Cassie, Shannon and me.
Love you all.
Details and Thoughts
Perinatologist
Perinatology is maternal and fetal medicine. The doctors take care of high risk pregnant mothers and their babies. Sometimes, it is frustrating when dealing with them due to their constant balancing act between mother’s and baby’s health. Many times we found ourselves strenuously trying to convince the doctor Missy could handle her high blood pressure, but each time the doctor walked us back.
Their balancing of treatment is a specialized skill and one which doesn’t have a safety net. Do too much for the mother and the baby suffers, while focusing on the baby could impact the mother.
We found the best perinatologists are confident, clear and concise. Telling you the truth with statistics based on their practice put us at ease, while the ones who tried to see the best outcome in everything were grating. This became especially true as we had our third and fourth experiences.
Preeclampsia
The word itself strikes fear into pregnant mothers. Our first pregnancy experienced preeclampsia, but we were lucky to not experience in the later ones due to vigilant care. As long as proper prenatal care is given and regular doctor visits occur, your chances of experiencing preeclampsia are low. Keep in mind, there are times you won’t experience any of the symptoms, which means regular prenatal visits are critical.
If you have any of the symptoms, please let your doctor know right away. Don’t worry if you feel you’re being a pest or your symptoms aren’t important. Your doctor can help you determine what is cause for concern.
The cause of our preeclampsia in our first pregnancy was more than likely due to ignorance of the warning signs.
Respiratory Distress Syndrome (RDS)
RDS is the number one enemy of premature babies. Lungs are one of the last organs to mature even though they are formed 34 days after conception. The bulk of lung capacity and function happen after week 29.
Premature babies can suffer from a number of issues falling under the RDS umbrella:
- Lack of lubricant in the lungs
- Immature lung development
- Immature blood oxygenation
Affecting 20% of babies up to 5.5 pounds and 66% of babies up to 3.3 pounds, RDS is battled with steroids given to the mother up to 48 hours before delivery. The steroids instruct the baby’s lungs to begin increased inflation and prepare for breathing.
In 1969, Sir Graham Collingwood Liggins observed additional lung maturity in premature sheep if steroids were introduced prior to birth. Pre birth steroid administration to help premature babies has occurred since 1972 and is a safe and effective method for reducing or avoiding RDS.