Bed Rest

I am trying to catch up a bit on blogging, and although there aren't many readers, I think it will be a good way for me to try to remember things!

From my last post, it is pretty evident that my pregnancy always fell into the "high risk" category, therefore I knew bed rest was always a possibility, but it came somewhat unexpectantly.  I went to my normally scheduled OB appointment (32 weeks, but was just at 33 weeks)--was a little bit late as far as weeks go because I had been on an inpatient peds month and just couldn't go to the doctor.  I was so excited to get a peak at our little guy on ultrasound since I had growth ultrasounds at every single appointment due to my high risk for growth restriction in our little guy.  It was always so reassuring to see our little man and to see how big he was getting. He was always measuring 2 weeks ahead of my due date with weight in the 80th percentile and HC > 97th percentile, so we figured the risk for growth restriction was long past us.  Ultrasound looked fantastic which was always a relief.  Then it came time to be seen by the doctor. . . I go in and have my blood pressure checked and it was 162/98--certainly on the high side.  My doctor came in, of course concerned about me, and started talking about the possibility of preeclampsia and what I might need to have done as far as testing goes. We didn't want to make any decisions until BP was rechecked...came back and BP was 158/102.  A call was made to triage to get a bed ready for me and I was briskly rushed to triage which was just down the hall with Dr. Rose carrying my purse and coat.  He helped get me settled and introduced me to the nurses and then went to talk to the staff on call.

I wasn't every SUPER worried about things, probably because I had just seen Max on ultrasound and knew he looked great and I hadn't had any symptoms at all of preeclampsia.  Marc couldn't come to my appointment with me so I tried to remain calm for him knowing that he couldn't get down to the hospital for a bit.  I underwent further work-up and everything continued to look okay, lab work and everything.  My blood pressure came down slightly to the 140s and in came the staff physician with my new plan.  It was bed rest immediately and I had to start betamethasone (injectable steroids to help with the baby's lung development in the case of a pre-term delivery).  After I was "cleared" I had to go complete the MRIs I was scheduled to have that day.  It was not pleasant to lie flat and still at 33 weeks pregnant, but I was grateful that the staff still did all of my imaging despite my being late due to my adventures in triage!

  I had to go back to Mayo the next day for a 2nd injection and again my BP was high in the 150s, so it was back on monitors again and again things looked okay.  I had to go back for a follow-up appointment just 2 days later to see how the BP was and to see if bed rest was still needed.  BP was still on higher end of normal, but was a bit better and labs still checked out okay, so I had medication changes and remained on bed rest.

I was on bed rest from 33 weeks until Max arrived at 38 weeks 4/7 days.  I had to drive to Rochester twice a week for ultrasounds and non-stress testing (monitoring baby's heart rate) along with doctor's appointments.  It was not pleasant. . . I had a lot that I needed to get done and finally had the time to do it, but was unable to do it.  Days were long for sure.  I am just grateful to my co-residents and program staff for taking so much of the stress away for being gone from work.  I can't even begin to tell you wonderful everyone has been!  I am also so appreciative of Marc for all the chores, grocery trips, and just generally putting up with me and for my mom who came up while Marc was traveling for work.

Thank goodness bed rest is over!

Pregnancy

As some of you might have noticed, I was, throughout my entire pregnancy, a bit hesitant to talk too much about things and certainly waited to make the news public.  I worried every single day about our baby boy until the day he arrived--I still worry, but it's a different kind of worrying!  When I was young (probably 10 or 11), I remember my doctors saying that adolescence and pregnancy would be the most difficult times for my health.  In fact, there were many times when I even wondered if I'd be safely able to carry a pregnancy.  I remember being upset about this even as a little girl because I was the girl who packed a diaper bag for her dolls and brought them to our church nursery where Oma would "watch" my babies.  I remember making "bottles" for my babies by mixing water and baby powder and positioning all of my Magic Nursery babies in the living room floor and watching them all.  I even had a magic nursery pouch that had 3 babies in it that was designed to wear on your belly.  It even had a button you could hit to make the babies "kick."  I don't really know what Mattel toys was trying to promote with that, but I had one and I thought it was super cool.  All this to say, that even at a young age I realized what this potential "difficult time" meant.

Soon after Marc and I got married, we decided to go see a Maternal Fetal Medicine Specialist to discuss if pregnancy was even an option for me.  We weren't interested in having kids at that time, but we knew that if pregnancy wasn't possible that adoption and/or surrogacy were paths that would take a lot of time and we wanted to prepare appropriately if needed. (We still may adopt some day too!) Fortunately the doctor told us that it was certainly possible, but remained risky.  I was a third year med student when I went to see him and remember him specifically saying that I needed to be in a place in my career where I could go on bed rest if need be at 20 weeks.  He even told me that if I were a lawyer he wouldn't even worry about me so much.  I repeat that only because my older sister is an attorney and my little sister will graduate from law school in the fall.

There were a variety of procedures and tests that were recommended to me to have done prior to thinking about having children.  Some more invasive than others and most that I didn't want to do!  Still without thinking about kids yet, once we found out we were moving to Minnesota, I started establishing specialty care up here at the Mayo Clinic, which was the only place my providers at ACH (Arkansas Children's Hospital) knew about to best manage my medical care.  I traveled up to Mayo in May 2011 just after med school graduation to see a cardiologist in the Vascular Center at Mayo.  He, again not being an OB, gave me much more reassurance that I could carry a pregnancy and even said that the procedures recommended to me were not necessary in my case, which relieved me!  He dictated my clinic note while I was still in the room and kept referring to me as "Dr. Whipple (hadn't changed my name yet), which sounded so weird to me!

Once I found out I was pregnant, it was easy then to decide to go back to Mayo for care.  So once we found out that we were expecting, back to the cardiologist I went and same day met our OB.  We got 2 pieces of great news that day.  The first of course, seeing our little peanut on ultrasound and knowing that I was in fact pregnant.  The second being that I didn't need Lovenox, an injectable blood thinner, during my pregnancy.  Our OB was fantastic and so knowledgeable.  He even emailed me several articles about Klippel-Trenaunay in pregnancy.  There were few case reports and limited literature, but nonetheless all good information.  Maybe one day, my case will be written up.

Although we had some good news, we realized the potential speed bumps in the road ahead and kept the news to ourselves for quite some time.  I was able to avoid bed rest for about 13 weeks longer than originally anticipated at the very first MFM consult several years prior and continued to avoid the injections (until post-partum). Although there were some complications, Marc, my family and I all feel blessed that the pregnancy went as smoothly as it did and now we have our sweet, sweet Max!

Thanks for reading this and now maybe understanding a bit of why we kept things to ourselves for a while.  I am sure all of the daily anxiety didn't help my blood pressure, but now we have our little one who makes it all worth it!

More to come later, and as Max and I establish a routine, I hope to be blogging more!