36 Weeks, Cholestasis & Induction

Yesterday I hit 36 weeks. Holy cow I feel so lucky to have made it this far.

While yesterday was a huge milestone, today is even bigger. It’s our last day hanging out with Nora before BBS arrives because…..I’m being induced tomorrow :0

A few weeks ago we scheduled my cerclage removal for tomorrow, Monday, the 19th. I’ll be 36 and 2 when the stitch comes out. But my doctors were torn on when I’d actually go into labor. My OB thought I’d go that day, while my MFM thought I’d go a few days later.

We don’t need to guess anymore because they decided as a team to induce me after the cerclage is removed (assuming I don’t go into labor only own). That’s nearly 14 weeks (3 1/2 months) of bed rest for BBS and I. Wow!

You might be wondering why they’d induce after I’ve come this far. Late last week it was confirmed that I developed cholestasis of pregnancy.  About 10 days ago my entire body started itching like crazy. At first it was mainly my hands and feet, but then it spread everywhere. 4 benadryls + an ambien couldn’t make me fall asleep through the itching. It was horrible. I called my OB’s night nurse and told her my symptoms. The next day my doctor sent me for lab work to test my liver function and bile acid. The results came in confirming the condition, UGH. Below is a quick overview of what Cholestasis is.

According to What to Expect:

Cholestasis is a liver disorder that most often occurs late in pregnancy, typically during the third trimester. While it  occurs in just one to two pregnancies in 1,000, it can cause complications in your newborn — which is why it’s important to recognize the symptoms and talk to your doctor if you think it might be affecting you. Fortunately, early diagnosis and active management by your doctor can help ensure you and your baby have a safe and healthy pregnancy and delivery.

A quick biology lesson: Bile, excreted by the liver and stored in the gallbladder, helps your body break down fats into fatty acids that your intestines can absorb. Cholestasis is a condition that slows down the normal flow of bile into the gallbladder, causing a buildup of bile acids in the liver — which in turn spills into the bloodstream, causing intense itching. Possible causes include:

Hormonal changes that occur during pregnancy (especially in the third trimester): Extra estrogen can increase cholesterol levels in bile and decrease gallbladder contractions.

Gestational diabetes: This disease is often associated with a higher risk of cholestasis.

Genetic disposition: If an immediate family member has had cholestasis during pregnancy, be sure to tell your doctor.

Gallstones: A collection of small stone masses in the gallbladder caused by imbalances of bile (pregnant women are also more at risk of gallstones due to increased estrogen levels) can also be the cause.

With regular prenatal care and monitoring, your baby will likely not be affected during pregnancy and after delivery. Studies have found little increased risk to babies when their mothers have only mild cholestasis and low amounts of bile acids. However, in cases when maternal bile acids are higher, cholestasis can increase baby’s risk of a low birth weight, a slightly lower Apgar score, lung immaturity and preterm delivery — which is why early diagnosis and treatment are so important. In extremely rare cases, stillbirth is a risk, though it may be prevented if labor is induced before week 38.

I can’t believe I’ve managed to add more goddamn lemons to my pile. But there you have it. Because this condition can put BBS at risk, we’re opting to induce at 36 and 2. In a perfect world, we’d wait until 37, but BBS’s non stress tests have been a mixed bag. So we’re choosing to be safe than sorry.

So this is it my friends. I thank you from the bottom of my heart for all of your love and support on this journey. Please send your continued good vibes my way – pray for an uncomplicated delivery and that BBS makes his debut healthy and happy.

I’ll post more once he’s born. But please be patient with me. Even though I’m being induced, he might not arrive until Tuesday. And even then, we’re going to want some family time to process this whole journey. If BBS goes to the NICU I expect that we’ll be quite busy with that – but I’ll do my best to post updates here for you all.

With all my love and thanks!

I heart how Maisey’s lurking in the corner of this pic. Haha

Trip Down Memory Lane

Update: We’re still chugging’ along (knock wood). My next ultrasound is on the 30th. Fingers crossed everything remains stable until then.

As BBS’s impending birth becomes more real to me, I can’t help but think back to when Nora was born. So much love. Love like I’ve never felt before.

I, like all second time parents to be, am worried I couldn’t possibly love another tiny human as much as I love Nora. But, after what BBS and I have been through, my love for him is already immense and it’ll just keep growing from here. I can’t wait to meet him (well, you know what I mean – I can’t wait for him to be done cooking and then meet him!).  I’ve been so heads down and focused on the immediate task at hand, that I lost sight of the joy in carrying and growing another human life. Don’t get me wrong though, I only allow myself to enjoy it in measured doses for fear of jinxing everything. Some of the fun things I’ve done recently are ordering decor for BBS’s nursery and personalized thank you cards for him. It’s been really nice to feel happy instead of scared and worried.

In the meantime, I never published Nora’s entire newborn photo shoot. There are lots of duds in there for sure – but I don’t even care anymore – I’m overwhelmed by love (and pregnancy hormones!) and want the world to see them all.  Hope you enjoy (esp the few that include Maisey — she’s such a character)…

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(Photo credit goes to Kim Lind Photography)

 

 

And on the 53rd Day…

I went home.

After 7 1/2 weeks on hospital bedrest, I’m heading home. BBS is still safe ‘n sound in utero. So my doctors are letting me take this party back to my own bed. I’ll still be on strict bed rest at home, but at least I’ll be home.

I’m so happy that I’ll get to see Nora on a daily basis. She only came to visit me on the weekends because I felt it was important for her to maintain her routine and have stability during the week. I wanted her to go to the park and run around outside everyday, not come to the hospital and sit couped up in my room. The upside to all this craziness is that Paul and Nora have enjoyed an incredibly special two months together. Their bond has been cemented and then covered with tar for good measure! And, extra little bonus, Paul can now do a mean ponytail 😉

But truly, not seeing Nora regularly was the absolute hardest thing  for me to deal with. I had to emotionally shut down during the week in order to cope with her absence. Thankfully BBS is an extremely active kiddo. So his kicks, punches and rolls served as a reminder of WHY I’m sacrificing. His life and health far outweigh my own ache and long for Nora.

Whenever I feel down about this process, I force myself to refocus by recalling how far I’ve come. When I was first admitted, my doctors fully prepared Paul and I to lose BBS. Upon admission, Dr. Katz gave me three choices (1) do nothing and allow my body to finish delivering BBS and he would pass away, (2) take medicine to purposefully end the pregnancy and try to get pregnant again at a later date or (3) do everything medically possible to save BBS knowing there are zero guarantees. I was alone at the hospital when given these choices because Paul and Nora were still making their way up. For me, the conversation was surreal but not scary. I think I may have even laughed at the first 2 choices (perhaps a nervous habit? or maybe a sign of how naive I was about how bad my situation was?). Number 3 is what I chose on June 14th and I continue to choose today. No brainer.

Perhaps one day I’ll blog about the insanely tough conversations we’ve had with the neonatologists and about the stats of my ever shortening, basically non-existent cervix. But not today. Today I focus on the next stage of the fight. I’m not to the finish line yet.

I have very mixed emotions about leaving. Mentally, I like knowing that the doctors and nurses can spring into action within seconds should anything go down. But I have to remind myself that I’ve been super vigilant thus far and I’ll continue to be equally, if not more so, at home. Emotionally, I lose a bit of confidence every time someone says something like “What?!! You’re going home? Are you sure that’s a good idea? Whose decision was it? Well, don’t overdo it at home.”

Ummm, thanks for basically saying you have zero confidence in me. It’s insulting and undermining. I’m the one who has fought every second of every day for the past 53 days to keep my child alive and safe. I’m the one who lays in bed all day long. I have constant heartburn because I eat my meals laying down. I have the beginning of bed soars on my thighs because I lay all day. I worry every.single.time I get up to go to the bathroom. Trust me, it’s me who knows more than you what’s at stake here. I realize that you say these things out of concern, but you’re effectively saddling me with your own fears. Please stop putting me in the position of comforting and reassuring you.

The reality is that I will go into labor one day. Whether that happens tonight (on the very night I arrive home) or one month from now is irrelevant because it won’t be my fault. It won’t be because I walked to the bathroom in my home instead of festering in the hospital and walking to the bathroom there. It won’t be because Nora jumped onto the bed to read a book or snuggle with me (newsflash she does all of that when she visits the hospital). It won’t be because I walked into the kitchen to get a water refill. It won’t be because I did or didn’t do anything.

Next steps/milestones: Tomorrow I’ll hit 30 weeks which is a HUGE accomplishment and something I plan to celebrate with Paul, Nora, Maisey and BBS. I’ll have an ultrasound Wednesday the 10th. They’ll measure the baby and check the cerclage. Dr. Katz will look at the results and determine if I can stay at home or if I need to come back in.

Sorry I went so deep with this post, apparently I had a lot of pent up emotion…

Final spin on the monitors before being discharged 

 

Day 24 – 25 Weeks 5 days

Hey everyone,

Just wanted to do a quick update for you. We were supposed to leave on our babymoon tomorrow – oh well – guess we’ll take a raincheck on that one!

I’m on Day 24 of my incarceration, errr, I mean, hospital bed rest stint. In all seriousness, I do, at times, feel like a prisoner, though its arguable that prisoners have more freedoms than I at the moment 🙂 But, when I start to feel that way, I just remind myself that this is all for my son. And, of course, he’s worth it.

Everything with my body, the cerclage and baby are holding stable. I do fetal monitoring and contraction monitoring 3 times a day. So far I’m not really having any contractions to speak of. The few I have are not painful, so are likely just Braxton Hicks – which are normal at this point in a pregnancy.  Baby boy is super active and recently moved from breech to head down (though he can easily move back to breech since it’s still really early). I get my amniotic fluid levels checked twice a week, and so far so good on that front. I get an ultrasound to check the cerclage every two weeks — my next one in July 13th.

My doctors are becoming cautiously optimistic.  While we still talk in terms of days, not weeks. They each (my OB and my high risk surgeon) have said they’re hopeful I get to 28 weeks and beyond.  My surgeon went so far as to say that he’ll be going on vacation in late August for 2 weeks and ‘I’m not to have the baby while he’s gone’. If I behave, he said he’d remove the cerclage on September 15th. That, ladies and gentleman, is TEN WEEKS from today. Holy goddamn hell. Thats a long way away. But my due date is October 15th, so to hold this guy in until September 15th would be awesome!

So that’s the update for you. Here are a few of my upcoming mini-milestones (in case you wondered about the inner workings of my brain):

  • Make it to my in-room massage on 7/7 (that’s today, yay, I made it!)
  • Make it to the RHONJ premiere on 7/10
  • Make it to the Flipping Out premiere on 7/13
  • Book another in-room massage for next week and make it to that
  • Make it until week 27 (7/16) when my OB gets back from vacation
  • Make it to my 41st birthday (7/17) b/c mama’s hoping for a damn good present this year 🙂

So those are the goals for the next little while — you can see I’m trying to keep it light and simple! Stay tuned for a post on tips n’ tricks to surviving a prolonged hospital stay. Figure I might as well pass along some things I’ve learned along the way…

xoxo

 

 

 

 

Hello, I Have Cancer….

I wrote this two years ago and just came across it in my draft posts. I added a little bit at the end to bring it up to date. Enjoy:

So I was watching the Tig Notaro Netflix documentary and I decided it was high time for me to write my own reflective story. So here goes:

Hello, I’m infertile.  I thought the very worst thing in my life was that I couldn’t get pregnant.  For years my husband and I tried. We tried the old fashioned way. We tried the least invasive way. We tried the middle of the road invasive way We tried the most invasive way, multiple times over. Yet no pregnancy and no baby.  I wept and I wept every single month that we failed to get pregnant. And I say “we” loosely.  When you struggle with infertility, it quickly becomes an “I” game, not a “we” game. I had to do all the shots, I had to take all the hormones I had to check my underwear everys single time I went to the bathroom praying that my period wouldn’t show her nasty face. Sure, my husband was also infertile in a way — but he wasn’t physically going through anything. It was all on my shoulders and I was failing, miserably.

And after three years of infertility treatments, including 10 IUI’s with and without injectables and 4 IVF rounds including a few frozen embryo transfers, we still were without a child.

It was the worst kind of hell a person could be asked to live through.  I was working full-time at a very demanding start-up company.  I was juggling my personal hell with my professional goals.  It was horrible. I was miserable. I thought it was the very worst thing that could ever happen to me in my whole entire life. And then I was diagnosed with cancer.

If I could go back and whisper in my own ear, here’s what I would tell myself.

Andrea, hold tight to Paul even though you’re mad that he doesn’t feel “in the mood” and your ovulation window is closing. Hold tight to him because you can’t have a baby anyway. Hold tight to him and love him purely. You are about to find out that having a baby the old fashioned way isn’t an option for you. So hold on to this connection as long as you can. Nobody really talks about it, but having sex “on demand” is horrid — it can break a couple in half quickly. So hold tight to this loving man who appreciates you and your body, even though it hasn’t yielded a baby.

Andrea, you’re now 8 months into your fertility journey. Keep your head held high. You’re doing the right thing. It sucks to have to give yourself shots and that you cringe every time a friend posts her ultrasound to Facebook announcing her pregancy. Remember, she doesn’t know what you’re struggling with infertility because you’re intent on keeping it a secret from the world.

Andrea, why are you still keeping this a secret? It’s now been 3 years since you started this journey. your medical expenses have topped out over $100,000 and you’ve given yourself over 1,000 shots to the belly. Don’t you think it’s time to share this complete fucking hell with somebody?

Andrea, don’t you feel so much better now that you’ve told your family what you’ve been struggling with. Honestly, this has been the WORST thing imaginable. But it’s been really nice to have their support. You feel a new sense of energy and sticktuitivness, Ready to conquer the next hurdle.

Then you feel the lump. You talk to Paul about it but try to brush it off. You talk to your fertility nurse about it and try to brush it off.  Then the lump persists. You can’t ignore it. You go to the doctor and she fells it and orders some follow-up tests. Still, in your mind, you brush it off. What.could.be.worse.than.3.years.of.infertility?

Breast cancer.  It was laughable to me when it happened. Fucking hilarious. Seriously, for real?

After all that’d I’d been through, I got cancer. Wow.just.wow.

Andrea, just hold on a little while longer. 2 more years. You can do it. You can handle having your breasts amputated. You can handle surgical recovery. You can handle chemotherapy. You can handle your body being reduced to a lump of shit with no muscle definition or endurance. You can handle testing your marriage, yet again. You can handle it all.

Andrea, you can handle it all — but you will have your moments. You will have those times when you dont want to be the superhero. When you don’t want to smile through the tears. When you dont feel like asking another person how THEY feel. When you want to be selfish and cry. and weep. and weep. and weep. and wallow.

Andrea, your beloved dog will die unexpectedly just as you are feeling like yourself after chemo is finally done. This will knock you an on your ass. You will question everything that you thought you understood in this world. You will become angry. More angry than when you found out you had cancer, You will be sad. So sad. Sadder than when you couldn’t have a baby month after month after month.

You truly thought you’d been dealt the worst of the worst. First the infertilty, then the cancer, then your fucking dog died. What next? How much lower can you go?

Andrea, you will look up through your tear-drenched eyes and see the love that your husband has for you. You will realize he is all you need in this world. Baby, no baby. Dog, No dog, Cancer, no cancer. He is your salvation. Stop taking him for granted. He is incredible. Look no further. He’s been at your side the whole time. Quietly and not so quietly rooting for you. Whether you know it or not. He’s been your biggest fan.

Andrea, you’ll get the type of cancer that’s incerdibly aggressive — BUT it’s the kind with no aftercare for 10 years. You can hop yourself up full of hormoes and still carry a pregnancy.

Andrea, you will become pregnant and enjoy every single second of it, including the birth.

Andrea, all of your wishes and dreams WILL come true and you will be happier than you could’ve ever imganined. You will want to bottle the emotions because they’re like crack. You could make a fortune selling this feeling to other people.

You are one lucky son of a gun. What a long strange trip it’s been.

Post script – you get pregnant for a second time and almost lose the baby at 22 weeks. Life seems likes it’s at another all time low.

Andrea, hang in there. After an emergency surgery and nearly 8 weeks of hospital bedrest, you’ll get to go home and serve another 7 weeks of bedrest. But at the end of the day, you’ll get a second baby who is perfect.

In the end, you’ll end up with a daughter and a son. They are perfect in every way.

Andrea, your marriage is still intact and strong. Hopefully the shit show the past 7 years will become a distant memory very soon…..

xoxo.
Me

#TBT – Full Circle

Throw back Thursday — I wrote this piece when we were on vacation last month:
Here I am, once again, blogging by the pool on the magical island of Kauai.  My absolute favorite place on this earth.  We came here on our “cancermoon” in 2012 to center ourselves before my surgery and chemo.  The island worked its magic and we got back to San Francisco ready to face my cancer head on.
We were also here on Kauai that dreaded day when Dr. Smith called to tell us that IVF didn’t work.  Earlier today we walked by the store and bench we sat on in Hanalei when the sad news was delivered to us. We got a little emo remembering that day – then looked down at Nora in her stroller and felt like we won the lottery!
This trip, we’ve come full circle.  It’s been 2 years since I finished treatment, I have a full head of hair again and my beautiful, perfect daughter is here with us (only piece missing is crazy Maisey).
It feels so nice to be reclaiming those sad times and to *finally* rewrite our story.
But I can’t help but wonder and feel scared when Paul says things like “we have our whole lives to watch Nora grow and take her on adventures”.  Last night at dinner he said something along those lines again (a perfectly natural statement for any new parent to marvel about) and I quietly whispered “what if I don’t have my whole life to watch my baby girl grow and thrive?”  And told him that I feel scared and sad when he makes grand, long-term statements like that. I could see Paul processing my statement and; for the first time in a long time, he just sat quietly and looked at me with love. Normally he’s so quick to say “You’re fine now. And you’re going to be fine” but this time, he didn’t give me a canned answer. He just accepted my feelings and didn’t try to fix the situation or dismiss my fears. His eyes were sad, I could tell part of him wanted to be the cheerleader and dismiss my negative nelly thoughts — but I’m so glad he didn’t.  It was only a 2 minute exchange, but I felt closer to him than ever.  The reality is that I might get cancer again. or I might not.  That’s it. There’s nothing more to it. It may or may not happen. But having already been there, I really don’t want to go back.
I also think that all new parents feel a sense of mortality when they bring a baby into the word.  I think it’s natural to want to be there for your child no matter what and to wonder what would happen to your child if you weren’t there.  It’s scary to think about whether you’ve had a history of cancer or not.
I look forward to every milestone with my precious, gorgeous, smart Nora. But I don’t allow myself the luxury of looking too far into the future. I just enjoy every single moment of every single day with her and my wonderful husband. Life is damn good right this very second and I am so thrilled to be living it!
   

Nora’s betrothed

Hung out with Bish, Jamie, Mish, Rion and River today. Safe to say that River and Nora are going to be boyfriend and girlfriend….