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)

 

 

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

 

 

 

 

I’m 11 Months Old Today!

I can’t believe I’m 11 months old today! Mom tried to take my picture with the bear and age block on the rocking chair just as she’s done in past months, but I had other ideas. Check out the video below, haha!

I just spent a week on the east coast at my uncle Chuck’s house with all of my mom’s family for Thanksgiving. We had a blast. I got to hang out with all of my cousins and play the entire time! Mom posted a ton of pictures below for you to see.

I’m officially walking more than I crawl. My mom says I’m a force to be reckoned with. I have some serious ants in my pants and I love keeping her on her toes throughout the day. I’m super curious and adventurous — which means I’m often getting into things that mom says are “no-no’s”!

I babble and sing like it’s my job. I can say “dada”, “mama”, “mai-mai”, “E-I-E-I-O”, “Hi” and I can growl like a pirate “arrggh”.  I clap along to “If you’re happy and you know it” and I wave my arms like a crazy person for “Where is thumpkin?”

While I’ve made a lot of progress on the moving and communication fronts, I still have NO teeth! lol And I’m still a picky eater who wants everything pureed to a pulp. What can I say, I like what I like!

I met Santa Claus at the mall and helped mom and dad put up our Christmas Tree. It’s been an action-packed month! I wonder what excitement my 11th month will hold………

 

 

 

Breast v. Bottle

Guys! I can’t physically breastfeed so PLEASE, for the love of all things sacred, stop asking me about it!

Ever since I found out I’m pregnant — I joined a new club — the “mom-to-be” club. I’ve waited years to gain entrée into this one and am elated to finally be here! As I suspected, people crawl out of the woodwork to offer support, guidance and helpful tips. It’s incredible!

Most notably, however, is the ease with which people talk at you about breastfeeding. The conversation always starts from the assumption that you’ll be breastfeeding.  For the oodles of women out there who choose not to breastfeed for their own personal reasons, this is a terribly invasive and rude conversation.

For me, it’s just a kick in the gut.

Obviously perfect strangers that I meet now have no idea I had cancer.  All they know is that I have weird, short hair (what can I say? I’m in that awkward grow out stage right now!)

20140902-124635-45995478.jpg and I’m having a baby. Great! inevitably, the requisite baby small-talk commences: “OMG, congrats! Your bump is so cute! When are you due? Is it a boy or girl? How are you feeling?” Then comes the breastfeeding convo: “Are you going to breastfeed? It’s a total bitch – hands down, it’s the hardest thing about being a mom. Natural Resources, which is in your neighborhood, offers great classes on breastfeeding — they’re worth the money.”

Since they’re strangers, I politely explain to them that I can’t breastfeed because I had a bi-lateral mastectomy.  I give my 2 minute cancer bio and that usually quiets the conversation. Only the most special people like to return to the topic 5 minutes later. It’s usually in the form of “Well, since you’re not breastfeeding, your boobs are going to KILL after the milk comes in and you have to let them dry up.”  Ummmm, no they won’t. I’m not sure how many ways I can tell you this — but while my breasts are anatomically stunning (!) and easy on the eyes, they’re 100% silicone.

It’s shocking to me how many people who are fully aware that I had breast cancer and a bi-lateral mastectomy STILL mention nursing to me! OH EM GEE, for real? This includes family members and fellow BAYS (my breast cancer support group) friends.  As for my BAYS ladies, there are many paths to treatment for cancer. Some of my BAYS friends had lumpectomies, or single mastectomies and the possibility of breastfeeding still exists for them. Some breastfed their children before being diagnosed, so they don’t stop to think about having a baby post DX. But still, I expect more from this group of people.

Now that I’m showing, these conversations happen pretty frequently. I’ve heard a lot of silly things come out of people’s mouths. But this next one is by far my favorite: “There’s so much pressure to breastfeed, it’s like you’re a monster if you don’t want to do it — you’re so lucky, at least you don’t have to choose whether or not to do it — the decision’s been made for you — AND nobody can give you grief about it because you don’t have boobs” WTF? That one is up there with my favorite breast cancer insult “Well, at least you got the easy cancer.” Not comforting people, not comforting.

Here are my conclusions:

1. People are so damned excited about a brand new life entering the world, they get amnesia about any and all sickness you had in the past.  Essentially, babies are blinding! (This helps me explain away close friends and even family members who talk to me about breastfeeding.)

and

2. People don’t really understand what a bi-lateral mastectomy entails. Little refresher for you – all of your breast tissue is removed in surgery. You are left with skin, pectoral muscle, anatomically shaped implants and rib cage. In that order. I assure you, there’s no breast tissue. No milk ducts. Nope, no possibility of milk comin’ outta there.

In all, it just sort of sucks to be reminded so frequently that I had breast cancer because it makes me think about the limitations I’ll face after giving birth. It makes me sad that I don’t have a choice in whether or not I nurse our baby. I’m also really sad that my chest is still pretty numb, the skin on my chest is cool to the touch (silicone implants aren’t a great heat conductor) and my implants are pretty hard. I wish I could give our daughter a nice warm, squishy landing pad to snuggle up to (and that I’d be able to physically feel her laying on my chest). But I can’t, and that’s sad to me.

If there’s one lesson I want you to take away with you from this post, it’s this: the breast v bottle conversation is as taboo as asking someone who they’re going to vote for. It’s really not your business, so please don’t go there.

 

 

 

 

Curiosity Killed the Cat

2014 is shaping up to be a fine year — much better than craptastic 2013!

As you know, we’re finally pregnant (yay!). So many of you have reached out to offer your congratulations. I can tell that people are genuinely giddy with happiness over our baby girl.  A number of people sent me messages saying that they haven’t been this excited since they found out that they, themselves, were having a baby! It warms my heart to know that you all have been on this ride with me.  Through the bad, and now the good!

A number of people have asked me for details on the whole process. Rather than answer the same questions over and over, I’ll just list them all out for you. Here goes…..

1. Are you using a surrogate?
No, we did not have to go the surrogate route.  I had triple negative breast cancer, which means the cancer was not hormone driven. Which means I’m not on hormone blockers for 10 years post chemo. Which means I can safely carry a pregnancy. That was my belly bump in the last post 🙂

2. See, I told you you’d get pregnant when you least expected!
No, this was not a surprise pregnancy. This was a well thought out, and highly planned pregnancy. We used our frozen embryos and availed ourselves of the best medical science has to offer!

3. So IVF worked the first time you tried after cancer and chemo?
Sadly, no.  This was our third embryo transfer post chemo. We did a transfer last summer, another last fall, and then this last one — which worked — in April.

4. What changed? Why did it work?
I have no earthly idea to be perfectly honest.  I will tell you this though — after the first two transfers failed, we ditched our original IVF doctor and moved over to Dr. Mitch Rosen at UCSF. Dr. Rosen has gotten all of my girlfriends pregnant — the man is truly a genius. As much as I hate to admit this next one, I think the 6-week cleanse also helped. My body was fairly clean and in good shape at the time of the third transfer.

5. Are you having twins? So many IVF pregnancies are multiples.
We did transfer two embryos, but I am carrying a singleton pregnancy.

6. Are you having a girl or boy?
Girl!

7. When are you due?
January 3, 2015

8. Do you have a name picked out?
We have it narrowed down to two names, but that’s as far as we’ve gotten.

9. What are the two names?
Nice try! We’re keeping that secret 🙂

10. How are you feeling?
Knock wood, I’m feeling great. I’m 18.5 weeks along and, much to Paul’s chagrin, am fully embracing nesting! We’ve already started converting our guest room into the nursery.

11. Are you working?
Not in the traditional sense. At the moment,  I’m simply enjoying this whole experience. I’d say I worked pretty darn hard to get to this point, so I’m cherishing every moment of pregnancy. Come January, I’ll be a full time mommy to our daughter. I hear it’s extremely tiring, yet rewarding work. I cannot wait for my new job!

 

Oh Baby!

20140714-175109-64269744.jpg

Well, after a long 4.5 year fertility battle, with a bout of cancer thrown in for giggles, I’m so thrilled to let you all know that I’M PREGNANT!

Baby girl Sieminski is expected to arrive on January 3, 2015!

As a long time infertile, I wasn’t sure this day would ever come. I have to pinch myself every day to be sure I’m not dreaming. Paul and I are beyond happy and excited. We feel like the “pause” button on our lives has finally been un-clicked.  We’re no longer in a giant holding pattern! Woo hoo!

In other news, Maisey is quite excited about this latest development (she just has a funny way of showing it!):