35 weeks

Almost there. Just 10 more days till induction.

Honestly I’m thankful to have an end date in sight. I’m getting increasingly miserable. The itching from cholestasis comes and goes. Cool water helps. But between that, the lack of central air and therefore massive temperature differences in the apartment and the crazy ups and downs in weather, I now have a cold. A really bad one complete with a runny nose, cough and a post-nasal mucus drip that’s making me throw up.

I had (yet another) NST today. Baby has not been cooperative for the last few ones and had to be jolted awake with apple juice. Next time, I’m just going to eat something sugary first because why not enjoy it? My usual gynec is on vacation so I saw another one today. Most of the time when I attempt to see this other gynec, she’s out on a delivery. I don’t understand — they have a practice of several people and rotate call schedules. How is she always out on delivery? So today, she showed up, made a comment about how I should have drank juice earlier (umm, I tried asking the nurse about it but this nurse also didn’t put in any effort to try and get baby to move and I can’t change positions without her being involved). And then when I said I had a few questions, she just sighed and said “you know, I really don’t have time right now to answer anything. Your usual doctor will talk to you about the induction next week.” Wow. Ouch. I asked if there was someone else I could talk to then and she was like, “ok fine make it quick.” Just.. I cannot get behind this. I’m sorry my baby didn’t cooperate with your schedule. But hell, not like you’ve cooperated with mine either. Also, isn’t this your job? Hubby and I are not impressed with this doctor. Also, I miss my sarcastic and yet comforting gynec.

It’s a little amazing to think that in 10 (or 11) days, we’ll be parents. I think Hubby and I are increasingly aware of that and using this time to just be together. Not really do much – just cuddle up and talk and spend time together. It’s strange to think of – something we’ve been working towards for years now will finally come to fruition. And yet I wonder at how ready I am to be a mother. Mostly I tell myself that everyone learns along the way and that it’s a shared experience.

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Week 33

Baby’s still doing ok. I’ve been so worried but baby seems to be doing well in spite of all the issues.

It was such a huge relief to see my own gynec today. She was just like “man, you keep developing all these rare issues!” (Ok, this sounds weird when I write it but it was actually quite comforting). I kept asking what I was doing wrong but.. all these are things that just happen and no one understands why. At any rate, there’s an end game now.

Induction is (mostly) scheduled for Jul 19. Basically the moment I hit full term, baby’s coming out. Mostly I’m relieved — it seems like baby will be much safer and healthier on his own than in my body with a myriad of issues going on.

Is this my ideal L&D. No. Do I care? Nope. Baby here safe and healthy matters infinitely more than whatever imaginary ideal L&D. Well, and my being ok. The main risk seems to be the usual induction risk – chance of C-section is higher.

In a fit of panic shopping last week, I bought all the basics — diapers, wipes and so on. We don’t have a huge amount of clothes but we were planning to wait till we figure out what we need first anyways.

And I’m trying to figure out what to mentally prepare for. There’s some likelihood of a short NICU stay — with GD, sometimes the baby has trouble with sugars at first. That’s fine — this is one of the best hospitals in the area and I trust their care. Also there’s always the possibility of issues like jaundice. But all these are known things that doctors know how to manage. Also mentally preparing for a possible C-section.

So big things left — we need to decide whether to bank cord blood or not. And if so, with who. I’m inclined to bank, if only to (indirectly) support the scientific research. But this also depends on the cost. Thoughts?

It’s funny (by which I really mean sad) how much you’re aware of negative outcomes post-infertility. I have been meaning to donate my leftover IVF meds. Of course I waited till the first trimester was over so I’d feel more secure. Then with the GD, I was never sure what to expect. Now… now I’m still worried about stillbirth risks. And so we still haven’t donated meds because … well, I want to be prepared for all outcomes still. And I don’t have the same confidence that so many of my friends seemed to have had. And so I will wait another 3 weeks before donating and then.. hopefully I can breathe.

Almost 33 weeks: More complications

Ok, so the thing I was worried about – yep.

So basically I know have a diagnosis of cholestatis. Not much is known other than its a liver condition that arises in pregnancy sometimes.

What changes? Now I’m on weekly NSTs and growth ultrasounds. Medication list is now: synthroid, iron supplements, prenatals, vitamin D and now, ursodiol (I think that’s the spelling).

Also now my end date is at 37 weeks so ~ 4 weeks from now. If I go into labor naturally, great. Otherwise, induction.

And now I’m on the high risk category with instructions to come in immediately if I feel any changes in fetal movement.

Baby, hang in there! You’re doing so well so far!

Week 32: Not quite sure what’s going on

So good and bad stuff from the 32 week check up.

On the plus side baby’s active and moving tons and has a good heartbeat. He’s passed two Non-Stress Tests with flying colors. He kept kicking off the monitors today which was kinda hilarious. Baby has also consistently measuring in the 75th percentile so.. looks like a bit of a bigger baby. He’s already 5(!) pounds. I’m convinced I heard this incorrectly. GD is still at the barely under control point. Honestly I think I’m going to start pushing endocrinologist to start insulin, at least in the morning when it’s the least controlled. Weirdly enough, after a few weeks of looking like it’s going up, fasting sugars are totally back under control.

I’ve not been sleeping well – frequent bathroom trips, some heartburn, some in-law drama. But so far, I’m compensating by sleeping in most mornings (and trying to get away with working at home more).

The bad: Well, after last week’s doctor run, the liver function tests came back.. not great. Some of those levels are rather elevated so they drew blood again today to see if that was an aberrant day or something else. They have to wait for the bile test results to diagnose cholestatis. I don’t fully understand what this means but some of the impact of the diagnosis — well, they’d induce at 37 weeks. I’m fine with that. But mostly I worry because stillbirth probabilities go up a lot. So now I’m on weekly NSTs and supposed to observe fetal movement.

I’m trying to take things one at a time. Liver function wasn’t great but also not too bad. Everything else looks fine. And there’s nothing to do until the bile tests come back. We’re going to kick into high gear to finish buying everything we need and setting up the nursery. I should make sure that my STD paperwork reached my office correctly. And then, well, I guess as with everything over the last several years, we just hope and pray.

32 weeks: Ups and Downs

Mostly things have been going ok. Rather too hectic at work but with a deadline done today, that’s a chunk off my plate. Random off-and-on family drama but that’s a ranting post for another day.

GD is within control (barely). Still a ton of work but so far my endocrinologist would rather not introduce insulin if I can manage. Slightly anemic somehow (inspite of massive amounts of greens) so on an iron supplement.

As for the roller coaster: So I’ve been itchy a lot during the pregnancy. Last few days, my hands and feet started itching, well, I don’t know about more than usual but it got to the uncomfortable point. Perhaps it’s psychosomatic but I also know that it’s a primary symptom of a liver issue in pregnancy (one of my friends had it). I flagged it to my clinic who was immediately like “come today”. This was rather nerve wracking because I thought it was me being paranoid and they’re clearly treating it seriously. So cancelled meetings and off we went. They drew blood (that result takes 10 days to come back) and in the meantime did a non-stress test on baby. Baby passed with flying colors. And waiting on mommy. (As I write this, I’m trying to itch my feet so it’s clearly not all psychosomatic).

Depending on the test results, we’ll see but at this point, I was having to start coming in weekly or biweekly for non-stress tests because of the single artery thing. And the doctor talked about inducing early depending on the sugar levels. So.. even if I do have the liver issue, the management would be basically the same except with an added medication. Except they would almost surely induce at 37 weeks rather than wait and see.

Honestly, there are parts of being pregnant that are really cool. But for the most part, I’m going to be grateful for baby to be out (where the patients are both now independent and can be treated like that) rather than baby in. It kinda feels like my body’s not doing a great job of taking care of baby so I’d rather baby be where he’s safer.

So for now, nothing I can do other than what I’ve already been doing.

On the plus side, I have a bunch of stuff to look forward to — baby shower is this weekend! Doing a photoshoot next week. Starting those birthing classes next week.

Reunions

It was my 10th year undergrad reunions last weekend. It’s a bit of a big deal for us – tons and tons of people go back and it’s a lovely way to reconnect and at least some of the friendships haven’t changed much since college so its nice to fall back to old patterns.

You know how you have dreams of what you’ll do when you (finally) are pregnant/have a baby? Well, for me, I had always imagined walking in my 10th either pregnant or with an infant or a little 2 year old trotting beside me. (Yes, I have a ridiculous amount of affection towards my alma mater).

I ended up not going but it’s for the best of reasons — I’m finally pregnant. It’s too hard to travel right now so.. I’ll make it back for my 15th.

For all that reunions can be fun, it can also be emotionally painful. Too many reminders of things not working out in life where you see everyone around present their perfect lives. If I wasn’t pregnant, I don’t know that I would have gone either — too painful to see all of my cohort who had babies with seeming ease (well, judging off of time between wedding/completion of some graduation program and baby). Other friends feel ‘behind’ on the track of life because they’re still finishing their PhD’s or not yet married or seriously dating. I’ve learnt that each person progresses through life on their own path and that’s ok. Though I do envy the ‘easy’ lives.


We had some friends visit last week – friends who now live in a different country and so haven’t seen in a couple of years. They brought along their 18 month old who was adorable and happy and sweet. But I found myself thinking a lot about the could-have-beens. So many of our friends had kids about 1.5-2 years ago and so their kids are the age that ours could have been if things worked out quickly. I keep telling myself that none of that matters, that our baby is on the way here now. But it’s very hard not to let those thoughts seep in.

I try and take the good from it. Having so many friends who are a bit ahead of me helps in many ways – I know not to freak out if kiddo cuts his teeth late (or early). walks late (or early). I know kids will grow at their own pace. I observe their various parenting techniques and catalogue them into “unrealistic for us”, “smart and should adopt” and “what were they thinking??”.

But that pang hasn’t really gone away and I don’t know if it ever will.


Hubby asked me today whether these would be our last relaxing weekends. And I realized, yeah they might be. But you know, we’ll have our parents around for the first year so we can still escape a little. And I know we’ll find our ways to keep relaxed and not go-go-go all the time.

For all that other friends recommended taking this time to eat out, do things and enjoy sleep, for various reasons that hasn’t happened to us. And I think in some ways I was feeling guilty/pressured because of that. But you know what – we have been doing things that we enjoy. Just that we’re homebodies so mostly that means renting a movie and watching it together. Or just hanging out together.

At this point, I’m mostly just impatient to get the next couple of months over with and move onto the next phase. As for what comes with that – well, we’ll see.

Week 28

We’re getting there!

Other than the GD, everything seems to be chugging along ok. My OB was commenting that there are so many things that are potentially going wrong with/for me but they all seem to be balancing out and working out somehow so she’s not overthinking it. Our little one is currently at the 77th percentile so he’s growing ok. I am a little concerned about longer term developmental issues with the single artery but well, growth is a good indicator of health so I’m telling myself not to worry too much. It does mean that the non-stress tests start in a couple of weeks – with the single artery, they would have started at 32 weeks. And if I start insulin, I’ll start those even earlier.

Other things resolved themselves – low lying placenta grew higher so I don’t have to worry about placenta previa. Baby was breech last time but now seems ok.

Certain things in the pregnancy seem to be happening like clockwork. At exactly 12 weeks, my nausea disappeared – one day, I woke up and it was gone. The moment I hit the third trimester, I started getting the random aches and pains that people talk about – pelvic, some lower back. I had noticed that my hip joints seemed… looser? Turns out this is a totally normal thing that happens in the last few months. I’m getting one of those belt thingies to help with support and manage some of the aches.

Some things I’ve been doing to control GD are turning out to be really good for my overall health/body. I’m hydrating a lot – that’s always good (the glucose measurements are higher when dehydrated). The exercise – I definitely get my 10k steps per day. It’s actually kinda amazing to me — in my first trimester, for various reasons (post-implantation being careful, nausea, deadlines), I was essentially a couch potato. Maybe 1kish steps a day. Now it’s just part of what I do. That being said, I am finally hitting the stage where I’m trying to push for insulin because walking this much is just.. less feasible now. BP is consistently at 110/70 (from my usual 120/80). I’m not sure if that‘s good but at any rate, there’s a consistent effect.

And funny thing – in spite of the getting-bigger tummy in front of my body, my weight is exactly the same as 16 weeks ago. As far as I can tell, I’ve lost most of the excess fat in my back. Bra size is down. Maybe other places? Hard to tell.

For all the random worries with pregnancy, mentally I’m just so much more at peace now than this time last year or even six months ago. The weight of the uncertainty is much lighter. Of course, those fears will never go away but it’s more muted now. I’m taking great comfort from the fact that baby seems strong and active (he kicks me all the time).

I’m so curious to meet him and see if his personality matches what I’m guessing! I think he’s going to be a good south Indian kid who’s addicted to coffee like all the rest of us – whenever I drink coffee, he gets super active. Also probably drive us nuts with his energy. Hopefully a decent sleeper? A lot of his movement seems to be during the daytime. Also a very touch sensitive baby – one time when he was kicking a lot, I started to rub my stomach and he calmed down.

The part that I’m terrified of in the months ahead isn’t L&D – I figure that’s going to be hell but fast and done with. But the newborn sleep deprived stage – no idea how I’ll survive that. I suppose like everything else in life – grit your teeth and push through. And try and enjoy the little moments.

To-do Lists

Part of the reason I’ve been so stressed these days is the sheer amount of work to get done before baby gets here (10 more weeks!). Unfortunately a bunch of this is also non-negotiable. The to-dos:

  • Write and submit a first author paper (*cough* and do the analysis). This one’s on a deadline with 4 weeks to go so I can’t really push it off.
  • Analysis for a second paper. Also due in a month or so.
  • Debug/chug things along for a third project
    • Ideally re-write/re-submit that paper as well.
  • Chug things along for project #4. Thankfully no real deadline here other than to spend a few hours a week on this.
  • Submit a research statement for a workshop (umm, this was a super last minute thing that my PhD advisor told me about two days ago and is due next week. And if I get in, it’s going to be an interesting trip to pull off).
  • Give a talk in one of the labs
  • Buy everything for baby
  • Set up everything for baby
  • Baby shower
  • Plan maternity photoshoot
  • Work out maternity leave plans (I have parts of this done but it now includes things like Hubby is traveling after I go back to work and therefore I need to figure out how to cover that time)
  • Work out in-law coping strategies (long story)

Some of these are perhaps lower priority than others. Like I can imagine many people thinking ‘photoshoot – who cares’. Well, in this case, I do. I love having photos to document times like this. And after struggling to get to this point, I want to remember it and have pretty pictures to keep in my memory.

I finally wrote up a list with dates which really calmed me — there’s still time to get these things done. I’ve also been increasingly dumping things on Hubby’s plate (baby monitor, stroller – he can do the research for a change).

One thing I’m glad I managed to settled is an arrangement between my two labs where I work full-time in one than the other instead of splitting my time 50-50. Effectively, I wasn’t getting enough done on either side and with the deadline, it was making me awfully tense. The other consequence of that is one of the guys on project #3 got ‘promoted’ up into co-primary person status with me. I suppose it takes away some of my ownership but it’s also not the worst thing since I’m going on maternity leave anyways. I was so wary of bringing this up with my bosses in case it looked like I wasn’t capable of doing my job. But at some point, enough was enough. Other things factored in like one of the research assistants who was supposed to be putting in 20hr/wk was putting in.. like 2. I’m not kidding. After 2 months of this, I just threw him under the bus (figuratively) because frankly, I don’t have the time or energy to make up for someone’s lack of planning.

Another thing I’ve been struggling with is just the sheer number of meetings I have – 12 hrs each week. Maybe this is normal in some jobs but in a postdoc, you really really want to have large stretches of time to just think and work. So now with the full-time in a lab, I think I can start skipping some meetings which will be a bit of a relief!

Even with that, there’s still a ton of work to be done. And then there’s the baby-related planning/work. Oh and the weird family-related stress points (short version of long story is in-laws insisted on coming right when baby is born even though it would make more sense to come in the fall. And while they’re helpful, they’re also the type to have a lot of expectations of “but this is the way we’ve done it for generations.” My diet is definitely going to be a sticking point. As are decisions about sleep training and breast feeding. So I’m trying to create a firewall so I don’t have to deal with all this when I’ve literally just given birth).

So.. mostly I’m trying to manage by tackling things by due date and urgency. And trying not to panic. There’s still time. And things will get done as they always do.

“Enjoy life now”

I’ve been having a lot of ups and downs lately (more downs frankly). A lot of this is just the sheer amount to do that’s overwhelming me.

I was talking to a friend and asking “will this just get more exhausting post-baby?”. And she was like “try to enjoy this time, it’ll be way harder afterwards.” Which isn’t particularly encouraging. But also honestly, I cannot imagine that once baby is here my lifestyle being more restricted than it already is.

Because of GD (primarily though perhaps other things too), I don’t go out much anymore. And by not much, I mean that since November, I’ve gone out to eat.. 3 times? Something like that. (And I love to eat and try new things and experiment with food). It’s just too much stress and energy. We still visit friend’s houses sometimes but it’s much easier if they come over and I can eat my meals in peace.

I can’t imagine that my life gets more restricted with a baby. Then at least I can leave baby at home with his grandparents for a night while hubby and I go out for dinner. Or I can strap baby on and go out for an ice cream or to the park. If I get hungry while out, I can grab a scone and not overthink it.

What I realized today is that such advice usually comes from people who have had an easy time of it pre-baby. They got pregnant easily and didn’t have to change much lifestyle-wise through their pregnancy and then once baby came, *bam*, huge changes. Hubby and I on the other hand — we’ve been having a restricted lifestyle for years now, first through fertility treatments and now through pregnancy. We’ve had to time going out with injections, vacations with treatment cycles (or just skip vacations altogether), plan for 7am blood tests, coordinate stresses at work with all this. Now that’s switched to timing going out with my finger pricks, making sure I can walk after a meal, packing food to go anywhere.

My mom was saying that one of her nieces said something similar. How she just wanted the baby to come so she could go back to only worrying about herself. And I don’t know details but I think her story is similar — PCOS, lots of fertility issues, GD, not an easy pregnancy.

We’ve actually been lucky — my parents have been able to come out and help with various things so Hubby and I could concentrate on work. And baby. But I can tell that several friends are jealous of how ‘easy’ we have life when mom can cook everyday and dad takes care of groceries and we don’t need to add too much for a relatively smoothly running household. What they miss is that even if we don’t have our baby here yet, we have a lot more needed to run the household than they did. If we don’t have time to cook, I can’t afford to just eat out or grab some takeout. During treatment cycles, I couldn’t carry groceries or laundry. (Perhaps my doctor was extreme but hell, it worked.) Not to mention, the sheer number of doctor appointments both during treatments and now. So while yes, having parental help has been a godsend, it’s not like our life is easy even with that. All it means is that I have the luxury of working out my diet/lifestyle instead of going straight to meds.

I think one thing that non-IF folks tend to underestimate is the sheet mental load of juggling all this. It’s constantly on your mind – what you can eat, where in the cycle you are, how to say “no, I don’t want to hang out” because your beta is that day and you want to have space to just cry if you need to. And I’m not finding GD all that fun either — there’s too much mental effort involved (for the record, if I thought starting insulin would decrease my stress, I would but I’m not sure it will). And that just because you don’t have a baby physically here doesn’t mean that your life is free and easy and unrestricted and you can do whatever you what.

Background stress

I was talking to my mom the other day about something that was bothering me i.e. stressing me. And she made a comment about how she knows that things are ok in my life when I start talking about that topic.

She mentioned how she’s noticed that everyone has their things that cause them general stress. These might not be small things but they’re ever present. But when something major is going on, that eclipses any of the lower lying stress.

When I thought about it, I realized that, at least for me, this is absolutely true – I have certain fallback ranting topics. And honestly, I’m really lucky. For the last couple of years infertility related stress has basically dwarfed everything – a lot of the time, even work stress. And I’m incredibly grateful to now be stressing about both smaller things like what stroller to buy to bigger things like gestational diabetes. Some are easier than others but none are anywhere near as emotional draining and difficult as the roller coaster ride of IF and its treatments.

When I was talking to a friend about how difficult I was finding pregnancy (this was right after the GD diagnosis), she made a good analogy: A lot of my friends are/were in med school or phd programs. Neither is easy. But I always envied those in the med programs because while it was hard, it seemed tractably hard. You knew how well (or poorly) you were doing. You knew what the path was. You knew how to achieve the next step. PhD programs on the other hand were the opposite – for so much of the time, we were wandering, unsure of even if we were doing well let alone how to do better. There was rarely a clear goal in sight but rather just slogging hoping something comes out of the work. That’s rather akin to pregnancy vs IF. Pregnancy can be physically hard and challenging. But you know the end post and you know that if you hang on, you’ll get there. IF on the other hand is this whole realm of not knowing what the next step should be or if it would work. I’m simplifying, of course, but the general idea carried over.

And sometimes I still wish I had gone the med school route 🙂