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So the appointment today was rather inconclusive. My blood pressure was highish (127/84) and my urine was measuring 1+ protein on the dipstick. So both are higher than they have been at any point during this pregnancy but not so high that he can say I’m definitely heading towards pre-eclampsia, or take any kind of action really.

I think he was reassured, at least for now, by the fact that I haven’t been having any headaches or blurred vision and no visible swelling. He said I don’t really need to worry unless I start hitting 90 on my diastolic reading or getting consistent readings over 85. He also ordered a repeat protein/creatinine urine ratio and comprehensive metabolic panel along with the CBC and iron studies Dr. OB ordered.

He also confirmed that I’ll need to start NSTs at week 32 (I forgot to ask how often I need them done). Since baby boy is currently measuring 56% for growth he said there was no need to start them before that. I also got a peak at the actual measurements from last Friday’s growth scan and his tummy and femur were both measuring right on track, his head was measuring 2 weeks ahead for width, but Dr. MFM said they don’t really look at the width because this just varies based on head shape and the other head measurement was only one week ahead so that is not really far enough head that it would indicate any kind of issue. I guess he is just going to have a basketball shaped head or something.

Unfortunately, during the quick ultrasound the nurse did today she confirmed that kiddo is still breech, and not only is he breech, he was actually presenting as footling breech today, the most dangerous kind to attempt va.ginal birth with! When I commented about that to the nurse, she looked at me funny and said, “They will not let you attempt to deliver if he’s still like this!” Which, I know. I told my mom and she was like, “Well in the old days you would have one or both of you just died during labor, so a c-section really isn’t so bad.” Which, again, I know. I’m glad that if he decides to stay this way we a) have the technology to know ahead of time and b) can have a c-section, but I really, really hope he turns! The nurse tried to reassure me that it’s far too early to worry about this but she did say that it seems like the ones who prefer the breech position tend not to want to turn. She didn’t know that he’s been breech pretty much the entire pregnancy as far as I can tell 🙁 I need to start doing those turning exercises.

I’m actually a little surprised that Dr. MFM didn’t order a 24-hour urine collection but I guess at this point he feels the ratio will be good enough since based on my dipstick it doesn’t look like I’m spilling that much protein. I’m guessing that if the ratio comes back much over 1 that that will be when I once again know the joy of the giant pee jug in the fridge. (Who doesn’t love that right?)

I also completely forgot to ask about bedrest, but I’ll see him again on the 21st so I guess I can ask then. I won’t lie, a little part of me was hoping that with all these little unreassuring signs starting to pop up he would put me on sooner rather than later but I guess he doesn’t think it’s necessary yet which I guess is still better than the alternative. I started perusing the pre-eclampsia forums yesterday and it does sound like even if I’m showing signs, I still have a long way to go til I get to full blown pre-e and given how closely I’m being monitored, it’s unlikely I’d suddenly get so bad that I’d end up suddenly dying of seizures. I hope anyway.

I can’t believe I’ve officially made it into the third trimester. What? How did this happen so quickly? Pregnancy has both inched by and flown by in the blink of an eye.

I had another PR interval and growth scan today and baby boy is measuring 3lbs on the dot! He’s still measuring slightly large for his gestational age and today the tech pointed out that all his measurements are average except he has an above average sized head which is why he measures big. Eek! The good news is that his heart still looks perfectly normal, as do all his organs, my cervix is still long and closed (3.48cm), his fluid levels look great and his cord does NOT appeared to be wrapped around his neck (which has been my new thing to obsess about for the past couple weeks). The doctor says as long as his next check in two weeks looks good they won’t have to do anymore. I am both happy and sad about this. Happy because baby boy has passed all his ultrasounds with flying colors but sad because we won’t get to see his adorable little chipmunk face as regularly anymore. My OB said I’ll most likely start NST’s the week after we stop the ultrasounds though, so he’ll still be getting plenty of monitoring.

In slightly less good news, the kiddo remains firmly in a breech position. I know it’s a little bit early to worry about this but he has only been head down in ONE ultrasound since week 18. He does not seem to enjoy being head down and if he is stubborn like his dad he’s not going to turn into a position he doesn’t want to be in (Paul was a c-section due to being breech). I’m really, really hoping he’ll turn on his own in the next couple weeks but if not I’ll ask my doctor about ECV.

So today marks 29 weeks on the dot, and I must say this week I definitely started feeling pretty third trimester-y, also known as more and more uncomfortable. In an effort to remind myself that no, it’s really not that bad, I thought it might be a good time for a quick comparison of my pregnancy symptoms at 29 weeks versus my lupus flares.

Physical Appearance:

As of Tuesday I weighed about 127lbs or 17lbs over my pre-pregnancy weight. At the height of my last flare I weighed almost 140lbs and if all goes according to plan I won’t hit that even by 39-40 weeks. My weight gain during pregnancy appears to be confined to the ever-growing belly and my bo.obs and I’m pretty comfortable with how I look in a bikini right now 🙂 On the other hand, during my last flare I certainly grew a massive, bloated belly (that appeared about 5-6 months pregnant) and also retained water in my legs, and thanks to the prednisone I gained weight (fat) in my thighs, back, neck and face. I felt completely disgusting and gross and hated the sight of myself in the mirror or pictures.

During a couple bad flares my feet swelled up to the point that I could not fit them into my sneakers and a friend who saw them said they looked like play-doh. So far (knock on wood!) I haven’t had any water retention issues during pregnancy.

Flares caused my hair to fall out en masse, whereas after my body adjusted to my new meds (which cause hair loss) I’ve gotten lots of compliments on how nice my hair has looked during this pregnancy (even when I haven’t even brushed it in a few days!). I will say that pregnancy has wreaked havoc on my skin but I have a sneaking suspicion that the condition of my skin could also have something to do with long-term steroid use so who knows…

Physical Limitations:

During my last flare I had to buy a shower chair. When things were at their worst, I literally could not stand up long enough to wash my hair, much less condition or even think about shaving my legs. When I was showing a friend around our (new at the time) condo, he commented about the “pregnancy” chair (his sister had recently had a baby and I’m assuming she bought one during pregnancy which is why he associated it that way) and it was like a knife through my heart. As of right now I haven’t had to use the chair during this pregnancy – not even to shave! – that will probably change in a few more weeks but hey 29 weeks without needing to sit in the shower ain’t bad 🙂

I’m still pretty mobile at this point, I can make it easily up and down the stairs, I do have a little trouble rolling myself out of bed sometimes because I’m not used to being so front heavy! My back does start to hurt if I stand or walk too long but I can still go on shopping trips of reasonable length and walk around the neighborhood without much issue. The times I’m most uncomfortable is actually when I’m sitting in the office and I can feel the kiddo pushing up seemingly under my ribs and my mid-back starts to ache like crazy.

One of the first signs of my last flare (other than the joint pain) was that I could barely walk a half a city block without becoming short of breath and dizzy. Walking up the stairs was a difficult feat, it was painful on my joints and I just didn’t have the energy to do it. I had to take it one step at a time, hold on tight to the banister, and stop to rest on my way up. The swelling in my lower extremities would also get really bad if I stayed on my feet for too long and would actually become painful and make me feel like my feet might actually burst from all the fluid. Needless to say, I did not spend much time walking around or even just standing up.

Joint pain is always excruciating during flares, sometimes debilitating to the point where the simplest every day task feels impossible. I think I’ve mentioned the devastating feeling of barely being capable of wiping yourself after using the bathroom. To be honest, that has gotten a bit tricky during this pregnancy but only because my belly is starting to get in the way! Don’t worry though, I’ve figured out the trick to it 😉

I’ve had some joint pains here and there during pregnancy, mostly in my hips, back and tailbone, but I know it’s small potatoes compared to what I’ve felt in the past. I’m happy to report that (again knock on wood) I haven’t had any carpal tunnel issues that I hear are common in pregnancy.

I’m going to have to finish this up tomorrow because I’m too sleepy to continue. Hopefully I can get a good night’s sleep tonight.

Because no pregnancy would be complete without the unscheduled visit to the OB, I had my first today.

It started yesterday when I noticed a sharp pain in my shoulder that would come and go. I didn’t think much of it but decided to do a quick Google search. That was my first mistake, obviously. Dr. Google, ever the alarmist, told me do not pass go, do not collect $200, call your doctor immediately. Seriously, it actually said, and I quote, “Do not go to bed.” I decided Dr. Google was being ridiculous though and I went to bed but when I started having the pain again at work I decided it probably wouldn’t hurt to call the nurse and see what she thought. She also wasn’t overly concerned but given my medical history decided to squeeze me in with one of the other doctors in the practice after work (my doctor was post-call).

So after work, in the pouring rain, I waddled my pregnant self over to the OB’s office and was told basically nothing. They checked my urine and I am leaking a little more protein than before but I remember my nehpro telling me that that would not be unexpected for me during pregnancy given my history. The OB pretty much echoed that and said given my normal bp reading (120/78) the protein alone was something to note but nothing to raise an alarm about. It does have me rethinking my bright idea to cut my own meds though. Hm…I have an appointment scheduled with my nephro on Monday so we’ll see how it is then I guess.

She also said that shoulder pain is a really rare symptom of pre-eclampsia, she said just to keep monitoring my blood pressure because she’d really expect to see that go up if it was pre-e. She said they more often expect abdominal/liver pain and changes in vision/headaches as symptoms of pre-e so without any of those she doesn’t think the shoulder pain is related.

As for my ultrasound yesterday, they didn’t do growth measurements and the baby was not feeling super cooperative so we couldn’t get any good pictures of his face, boo. But we did get glimpses of his face and holy crap it looks like I’m gestating a chipmunk! This kid is going to have his poor little cheeks pinched nonstop if these ultrasounds are any indication!

They took a sample for a ffn but after checking my cervical length (which was 3.6cm) they decided not to bother sending it in. I’m guessing if I don’t have any other symptoms maybe they will bypass it at my OB visit too? I really don’t like being poked and prodded down there if it’s not necessary and won’t change how my case is treated anyway…

The OB said something kind of weird at the end of my visit that got me wondering once again if this is something said to “normal” preggos or just people like me….she was like, “Anyway, it’s pretty good to get to 27 weeks!” I mean, I guess it is, and I’m thankful that I’ve made it to 27 weeks but I’d really like to get at least another 7 weeks further along if at all possible!

On another note, Paul is planning a short trip to LA when I’ll be 36 weeks pregnant. One of his good friends is getting married so I get him wanting to go but I’m so worried he’ll miss the delivery 🙁 He is flying down Saturday morning and flying back Sunday night and said he obviously won’t go if I’m having any signs of going into labor, but I’m like what if there are no signs?? That doesn’t happen very often though right? I know if I really do suddenly go into labor he can probably catch an earlier flight (after all LA to SF has flights every couple hours) but I’m still a little worried…

Anyway, today is 27 weeks and it’s Friday! So thankful for the weekend, hopefully I can get over my jet lag and recuperate from the traveling.

I’m back from Hawaii and as far as I know all is still well. I’m so thankful that we were able to go on our trip and that nothing scary happened while we were there. The little bub cooperated quite nicely by being active on both the flight there and the flight back and for most of the trip in general. He did have a couple of quiet days but luckily I had the doppler with me for some reassurance.

Paul and I were able to take maternity photos, I’ll post some here when I stop being so lazy. Our photographer was completely amazing and I’m so glad I decided to get my hair/makeup done too! If anyone is going to Oahu and wants to have pictures taken, let me know because I have a great recommendation for you! There are also some belly shots we took ourselves where you can REALLY see how big I’ve gotten. For the most part, when I’m fully dressed you can see a bump but I still look like I’m carrying quite small. Most people are shocked to hear how far along I am (except my mom who seems to think I’m normal to huge).

I can tell that the belly is growing quite a bit though by the beached whale feeling I get when I try to roll myself out of bed. It’s actually pretty funny except when I’m afraid I’ve somehow hurt the baby as I maneuver around (I’m pretty sure I’m not though and I’m just being paranoid). Bending over has also become quite a gargantuan task and requires careful planning and body placement. Today I noticed that a shirt that previously fit just fine over my belly now must be carefully monitored and frequently pulled down so as to avoid flashing bare pregnant belly to my coworkers. I feel like I’m waddling but Paul says no, not really, so I guess I still have a ways to go. I have another ultrasound tomorrow and am excited to see how big the bub has gotten since before we left for Hawaii. At my 25w (exactly) ultrasound he was estimated at 1lb12oz so I’ll be interested to see how far over 2lbs he is now given I feel like I’ve definitely had a growth spurt.

These past few days I’ve been constantly hungry. Unfortunately a lot of what I’ve been craving is food I can’t get in California! We had these amazing Japanese style pork bowls in Oahu and I want one SO bad! I also weirdly started craving wax apples, which is a fruit I’ve only ever had in Taiwan, it looks like a cross between an apple and a pear and is sweet and foamy texture inside. Drooool. But unfortunately they don’t grow in the US and are too fragile to be shipped.

Something else I noticed is that in Hawaii my skin totally cleared up! No new acne at all. Once I got back to SF, a new one sprouted on my chin. Blech. Luckily it’s small, but now I’m convinced it’s a combination of pregnancy hormones and San Francisco that’s been causing all my breakouts. Can’t put all the blame on the kiddo apparently.

My blood pressure did go up a bit while we were in Hawaii, but still within a reasonable range. (Yes I’m the girl that went to Hawaii with my blood pressure cuff and fetal doppler). It was running 120/80 (which is really more like 120/70 since my cuff runs high) but now has dropped back down to 108/72 (which again is more like 108/62) as of my last reading last night.

I also cut my own dose of Imuran because I think they had me on a high-ish dose and I’d really like to be on the minimal dose necessary since I want to breastfeed. I cut myself down to 100mg instead of 150mg and so far *knock on wood* it seems to be fine. From what I’ve read 100mg is a perfectly acceptable dose. Like I said, my bp has been fine, still only trace protein in my urine as of two weeks ago and no joint pain other than those associated with normal pregnancy (lower/mid back pain). I haven’t told my docs yet but plan on letting them each know at my next visit with each of them.

According to my own scale, which I think is most accurate since I weigh myself first thing in the morning, I’m up about 13lbs from my pre-pregnancy weight. If I go to 40 weeks and gain 1lb per week this puts me right on track to gain 26lbs which would be the low end of normal for someone with my pre-pregnancy BMI. My doctor said 25-30lbs would be ideal for me since I’m small to begin with so he’s totally happy with where I am.

As for the positive FFN, since my cervix still looked long (3.3-3.6cm) and closed as of the Friday before we left for Hawaii, no one seems overly concerned about it. I also haven’t had any more BH episodes since that week so my OB said just to repeat the FFN when I go in for my monthly exam (in two more weeks).

The best part of the past couple weeks is that I feel the baby SO much more now. I feel him all over my belly now and can feel all types of different movements. I think I’ll be able to start discerning body parts very soon – or at least I hope! Lately he’s been getting the hiccups on a daily basis. It’s starting to become very clear that my body is not just my own anymore and I couldn’t be any happier about it. It’s times like these that I’m actually grateful for all the struggles I faced to get here because I never take any part of this pregnancy for granted. I’m so beyond thankful for the opportunity to be this close to my baby boy, to get to know him better than anyone else in this whole world before anyone even gets to lay eyes on him. It is truly a miracle and so precious to me and I just thank God every day that I get to experience every bit of this. It’s definitely not all fun and games but it’s more than worth any of the discomfort I’ve experienced so far. Maybe this will change as I get bigger and more uncomfortable, but I LOVE being pregnant!

In a little over a week I’ll be 28 weeks, this is significant because this is when Paul and I decided we’d really start buying baby stuff. The survival rate for preemies at 28 weeks is something like 80-90% so while we know anything can still happen, it seems like that is the right time to really start preparing for having a baby live in our house! As of right now we have one half-full box of stuff shoved into our storage closet and besides that you’d never know that we’re supposed to have a baby in just over 13 weeks.

Here’s one pic from our maternity shoot for now until I figure out which ones I want to share.

Ugh. Things have been just too perfect haven’t they? Time to throw a little drama into this pregnancy, but hopefully not too much.

On Monday afternoon, after a day mostly spent relaxing in bed, I noticed I was having a lot of uterus tightening – Braxton Hicks contractions. It was happening frequently enough that I started timing them and noticed they were coming every ten minutes or so and while they didn’t exactly hurt it was starting to make my stomach feel quite sore. It started around 3 or 4pm and went on until about 7pm. I decided not to call the doctor since it went away.

On Tuesday afternoon I was sitting at the computer for a few hours, rushing to finish up an assignment due for my early childhood ed class when around 3:30pm or so I noticed I was having the tightening again. My uterus didn’t always get rock hard every time, sometimes it would just become noticeably tight, but again they seemed to be coming every 8-10 minutes or so. I decided if it didn’t go away by the time I showered and had dinner and relaxed on the couch for awhile I would call the emergency line, but by around 7pm it went away again.

I had an appointment with my OB yesterday so I mentioned it to him and he decided to do a FFN just to put our minds at ease, especially with me going to Hawaii this weekend. The FFN test if negative is very predictive that you will NOT be going into labor anytime soon, but the positive result is more ambiguous. It could mean something or it could mean nothing. When he was taking the sample he said that the swab brushing against the cervix had caused a little blood so not to freak out if I had some spotting or discharge but I saw the sample he took and it looked quite pink.

Of course, I got home and started googling and lo and behold, blood in the sample is very likely to cause a false positive. And, of course, I had zero BH contractions yesterday and today.

I finally spoke with my OB this afternoon and he said he had wanted to wait to call me until he spoke with my MFM and I knew that this couldn’t be good news. He said he was surprised by the result, he had run the test expecting a negative result (based on my symptoms and how my cervix looked when he took the sample – he said it looked close and thick) but it turned out to be positive. However, he and my MFM said they think this is likely to be a “red herring” and said they don’t think I need to do anything unless I start having painful contractions, in which case go to L&D to be monitored. Also, they want me to make sure to mention the positive test at my u/s tomorrow so that the tech checks my cervical length. Assuming no painful contractions and a cervical length above 3cm, they think it’s okay for us to continue on with our Hawaii plans.

It’s just so frustrating because in my gut I really don’t feel like this is anything. I was a little bit worried after Tuesday and my stomach felt so sore from all the tightening, but yesterday was totally fine and let’s face it, the belly is starting to really grow now, noticeably so this week, which can cause BH contractions and all the soreness everywhere.

I think as long as my cervix is nice and long tomorrow, we will feel okay about going on as planned. Obviously if it’s short or even borderline, I think we are just going to cancel and eat the cost of whatever isn’t cancelled in time to recoup deposits. Both my doctor’s are in agreement that the cervix length will mean more than the FFN result so I’m keeping my fingers crossed that everything is still looking long and closed tomorrow.