Week:35.5

Weight: +1

Two posts in one week? Yes, it’s been a goody of  a week and I need to vent! I was already stressed at the beginning of this week because of the sheer number of doctor’s appointments I had to go to every week. I have at least three medical appointments a week from here on out till my due date. I thought that all these appointments were the boundary for my threshold of pain. Apparently, I was about to get really tested to see where my breaking point really is.

Tuesday I had appointments all day at CHOP to meet with their maternity team. It was decided early on by CHOP’s pediatric cardiologist that with the baby’s condition I would deliver at CHOP but continue my prenatal care at Abington since it was closer and since I was more comfortable/familiar with them. I had agreed to this and have had my OBGYN group fax all the updated reports on appointments and gestational diabetes updates to CHOP. I thought this was all going well until I met with the CHOP maternity team. CHOP has a special maternity ward with about 8 deluxe suites that are exclusively for mothers whose babies have special needs. Since we know Andrew has to have a surgery within the first few days of his life, it was decided that it’d be super stressful to transport him to CHOP if I delivered elsewhere. You have to apply to deliver at CHOP and meet their criteria list. Basically since I wasn’t high-risk, it was thought I’d be an ideal candidate. The plan is for me to have a normal, vaginal birth and start Andrew on meds to prepare him for surgery.

The CHOP OBGYN team wanted me to have an ultrasound from their end even though I’ve had several with Abington, one as recently as last week to check on fetal growth since I have gestational diabetes (GD). I’ve had about one ultrasound a month for the last few months as it is. I understand CHOP wanting one of their own though, so I submitted happily to the notion at first.

When I arrived for my day of appointments at CHOP, I was told I had to do my ultrasound at UPenn Med (across the street) since CHOP’s own radiology dept was booked with appointments. I agreed and went across the street to UPenn Hospital to wait for my ultrasound. Now since I’ve had about 5-6 ultrasounds so far at Abington and 2 fetal echos, I’ve gotten quite used to the ultrasound experience.

I was greeted by a young ultrasound tech who informed me that she would be performing the ultrasound, but when I got to the radiology room, I saw that there was an older, more experienced tech guiding my tech with the procedure. Since I was shy of just 35 weeks and they needed thorough pics of anatomy, growth, development etc. they told me it’d be a full hour appointment at the very least. I wasn’t too comfortable with the idea of an inexperienced tech working on me. In my experience, some techs are incredibly aware of how much pressure they’re applying to you and whether or not you’re comfortable throughout the ultrasound, while others are totally unaware and jabbing away at you. I’ve been lucky to only have one or two ‘painful’ experiences and whenever I’ve stated that it hurt, the tech or radiologist has immediately re-positioned their transponder wand.

This time, I was in serious pain the ENTIRE time. The tech was pressing down sooo hard on my pelvic region, stomach, and ribs. I was in tears and yelling “owww” exclusively the whole time. She did apologize but then her and the more experienced tech explained that they just really want to get the most accurate best pictures they could of the heart and all the other organs to make sure the baby is healthy. It was just ridiculous after a certain point. I was ready to stop the whole procedure because I was crying and biting my tongue in pain. I dont’ understand how jabbing a 35-week pregnant woman can possibly be safe?! But I just really wanted to get through the appointment and NOT have to reschedule. I really wanted them to get the best pictures they could, so I decided to just be a trooper.

I knew this was a sloppy appointment also by how much ultrasound goo the tech was getting all over my pants, sweater and sides of my body. After a certain point, I felt like I was covered in wet goo! The tech told me that it was really hard to get spine pictures since the baby was sitting to the side of my uterus, facing forward, head down in my pelvis, and he was NOT moving for anything no matter how many different positions they were trying to get me into, or how much bouncing of my belly they did with the transponder wand.

Finally they had a radiologist come in to try to take a picture of the spine. I explained how I had just had an ultrasound less than a week ago at Abington and they got great pictures of the spine. So if they couldnt’ get such great pictures here at least they could be reassured by Abington’s reports and analysis. They acted like that wasn’t a possibility. I have NO idea why they would continue to let me have care at another OBGYN group if they are going to dismiss reports or not work with their results. It’s baffling to me why I was bothering to do ultrasounds elsewhere when CHOP was just going to disregard them?! Wasn’t it just unnecessary, extra invasive procedures for me?

The radiologist was giving “tips” to the tech about how to get the baby to move and change positions. I know my child at this point. He ain’t moving for anything if he doesnt’ want to. He’s been head down for a week or two now. I can stand on my head and this child is NOT changing positions. I really dont’ care what some ‘experienced’ radiologist thinks she can do to get my baby to move. Of course, despite her cockiness and getting me in all sorts of silly positions, the baby didn’t move one inch. I have never experienced him be sooo still during an ultrasound. I honestly think he was just scared silent from this super crazy experience. When I commented that I was a mess from all the goos, the radiologist rudely informed me that the gel doesnt stain clothing. Um, yeah lady, but I really dont’ want to walk around with wet jeans and shirt for the rest of my appointments all day!

We had inquired about the weight of the baby. Andrew had grown steadily ahead of his expected weekly rates all along since the first ultrasound. We were told by the head radiologist at CHOP, who performed our fetal echo, that his head circumference size and femur/leg measurements were bigger than the average baby’s. The last weight I got at Abington was 4 lbs 8 oz for 33.5 weeks, about 60th percentile for growth. They told me this was a little ahead but not so bad and that my gestational diabetes was not making him overly big, which was a relief!

At this appointment, they were telling me the baby’s weight was only 3 lbs 13 oz., only the 30th percentile for growth and weight. I was utterly confused and immediately got scared that I was having placental issues or gestational diabetic issues if he lost weight like that in one short week. I inquired about the margin of error in the ultrasound. That’s when the radiologist got extremely snotty. She looked at the tech and asked, “Where are these people from?” . The tech stayed silent so I informed her that my husband and I live in Philadelphia. She went on some spiel about how UPenn was the BEST hospital with the BEST equipment, blah, blah, blah. Never mind that ANY ultrasound performed later in pregnancy has a higher margin of error than earlier on in weeks since the baby can be head down (making head circumference difficult to assess), scrunched up (making it hard to measure femur length), and that there’s just generally a lot going on in terms of your fluids and the baby’s fluids. I’ve heard that there’s also a whole pound margin of error in most ultrasound errors. It’s not an exact science, especially later on in pregnancy!

I was also told by my regular OBGYN team that after 25 weeks they don’t even look at weight really anymore unless it’s to assess if weight is being gained and how much from ultrasound to ultrasound, (which is the case with GD). So they dont’ look at the total weight in numbers, they just look at ounces, pounds increased from one period to the other.

I decided to just not talk to the radiologist anymore because I was fuming mad. I had informed her that I wasn’t doubting her assessment or the hospital’s reputation, but that I was just trying to find answers for two varying weights given to me.

I didn’t want to dismiss the Abington ultrasound so quickly because I’ve had a few with them and gotten steady growth numbers. Could 3-4 ultrasounds all have been wrong in a row?? UGHHHH! I decided to text one of my friends who’s an OBGYN and she told me that later on in pregnancy and once the baby’s head is in the pelvis, weight is very hard to assess. Also when I googled fetal weight according to ultrasounds I read something about what a common mistake it is for techs to press down too hard with the transponder on the mother’s belly since that could compromise the baby’s abdomen and give incorrect readings for weight! This tech was squeezing down on me the entire time.

Now on top of everything else I’m worrying about, I’m worried about this child’s birth weight. It was all too stressful. I was beyond the point of angry. I was just silent at this point. I wanted to go home and cry.

On top of all that, once I met with the CHOP OBGYN team after the ultrasound appointment, the CHOP OB disagreed with Abington’s GD management care. Abington wanted to put me on meds for my borderline sugars. CHOP didn’t want that. Finally,   the decision got made (after I voiced my frustrations of working with two different teams with two different methods), that I would switch over my entire OBGYN care for the remainder of this pregnancy to CHOP. The doctor did note the birth weight and told me it’s still a ‘normal’ range, just 30th percentile, about 2 weeks behind. He said my amniotic fluid was matching that measurement it seemed. He said they would do another ultrasound in 3 weeks but didn’t seem too concerned. He said I could just be having a smaller baby, which often times matches newborns with Andrew’s condition. I just don’t know what to think.

My priority since I’ve heard Andrew’s diagnosis was to make sure that nothing else can go wrong with the pregnancy and to get him out healthy and ready for his impending surgery. I feel like lately I’m hit with all these roadblocks: the gestational diabetes diagnosis, the conflicting management advice, the conflicting ultrasound info. One week I’m told not to gain too much weight because the baby could be fat and that would make a harder delivery and compromise his lung function. The next I’m told he’s too little and can possibly not be ready for the surgery he needs as a result. I mean it can make a saint into a sinner!!

I went home feeling completely deflated and just so scared about carrying this child inside of me. It seems like so much responsibility and the weight of all of it was really beginning to take its toll on me mentally and physically. I know that I need to vent and get it out, have a good cry and then just rejuvenate again for tomorrow’s new challenges. It just gets so hard sometimes when your boundaries get tested and re-tested again and again.

I went home that evening and took a long nap missing my prescribed snack and mealtime. Saji was doing some home repairs around the house. He didnt’ want to wake me up since he figured I was tired both physically and exhausted from a long day mentally. I was so sore and aching from the ultrasound experience as well and he knew that. I woke up 5 hours later with low blood sugars and I was so mad at him for letting me sleep that long. Additionally, nothing was really ready for dinner. All the things Saji was suggesting was not ideal food for a diabetic. It was finally decided that he’d go to a nearby diner and pick me up something to eat.

I just started sobbing when he left. The whole day had me so spent and frustrated and I totally lashed out at my husband and made the nap/dinner situation more dramatic than it was. Immediately then my little one gave me a series of kicks in the ribs. It was reassuring and I immediately stopped the waterworks reminding myself that I had to be upbeat and positive for him.

In the grand scheme of things, I do know I am going through something profound and that I don’t need to belittle this time in my life. I don’t need to try to be upbeat and super strong 110% of the time. I am allowed to have a breakdown once in a while and get it all out of my system. I’ll always look back on this time and remember this period of stress and hardship. I know I only have more of it to come in the next coming months. But I’m also re-reminded that I need to continue to lean on God and my faith. That He will NEVER allow me to be tested beyond what I can bear. I’ve been setting the limitations for that testing and I know I shouldn’t.

I know that I have an incredible support system in my family and friends and when I start to fall apart, people will get really concerned and worried. I cannot allow that to happen. I have to to be strong. I know my mom was really worried because I called her and my mother-in-law after the long day and they both were really upset for me for having to go through all this. My mother just wants to come visit and stay and cook and care for me. And my mother-in-law keeps lamenting to me that she wishes she can do more for me rathen just cook an occasional meal, etc. I know both sets of parents feel helpless to a certain point. Just like I don’t want my child to go through any of the struggles he’s about to face, I know our parents feel the same way for me and Saji. I coudn’t even speak to my dad on the phone that evening and I always can talk to him even if it’s just to say “I don’t feel like talking” for a minute. It’s hard as a parent for your child to endure something. I’m beginning to just really experience that. Several times throughout the day I’ll do this silly bargaining with God or play a game with myself where I chose 2 terrible worst-case scenarios and chose one rather than having my child go through this. Things like me having some sort of terminal disease or developing some horrible condition in exchanged for Andrew to be 100% healthy. It’s not productive at all I figure, but i’ts natural as a parent to do this.

It’s always darkest before the dawn and maybe I’m not even near that bleak hour yet. Maybe I’m only at midnight. I still need to get through the rest of this bleak, dark night. I need to make it through for my little one, with both my strength and sanity intact.

I came across this quote this week while watching an episode of The Sopranos this week and it really stuck with me:

 Sometimes I go about in pity for myself, and all the while, a great wind carries me across the sky.” – Ojibwe saying.