The past and the future collide

I find myself wondering what would have been had my previous pg not ended in mc as April 15th—what what would have been my due date—draws near. I’d be getting ready to possibly go into labor and deliver soon. Don’t get me wrong, I am so incredibly grateful for my current pg but the pain of the child that I lost previously still has the power to shake my soul to its core. When I find myself beginning to dwell on the coming ‘anniversary,’ I change gears mentally and try to think happy thoughts (like say, of who should be the next Idol cast off and—yippee—new episodes of Desperate Housewives—nothing like TV to distract me). But I wonder how I’ll handle the coming day, and what it may hold for me emotionally. The sore is still there, the scab slightly healed over, but one big brush against it and all could be lost, the scar perhaps bigger…or maybe it will continue to heal and shrink, yet never go away. It will be a part of me forever.

Of course, the one BIG thing that manages to get me into happy thoughts again when I start to bring myself down, is the thought of the dancer currently growing in my uterus. Like her parents, she still has no rhythm and I’m not complaining. Today I had a visit to the perinatalogist and all was good. My blood sugars are under control, no glucose or protein in my urine, my BP was 116/72, and my fundal height measured only a few days ahead of my actual gestational term. So all continues in a good vein.

The one thing that made me stop and take pause was my doctor’s questioning today as to whether or not she has me on a high enough dose of dexamethasone. See, too low a dose and my dancer stands to become virilized (i.e., develop a larger-than-normal clitoris and/or labia, which sometimes can require surgery to correct). Hmmm, now call me crazy, but I myself wondered whether I was on a high enough dose of the dex after reading a research article that said a pregnant woman with CAH needs to be on 0.02 mg of dex per kilo of weight. Which means that I started this pg out slightly under-dosed and now, given my pg weight gain, I should be on a dose currently double what I’m on. But I figured, she's the specialist with a real degree )while mine only came from the google school of medicine) so she knows what she's doing. The kicker in this, however, is that by now (26 weeks along), the baby’s sexual organs have formed…so wouldn’t increasing my dose be a case of too little too late? Or—in light of this lateness—a case of the doctor covering her ass? Tomorrow I go to the lab first thing in the a.m. for a fasting blood draw to measure my testosterone, 17 hydroxyprogesterones (free and total) and DHEAS levels to see if the dex has my levels suppressed enough (which = baby’s levels being suppressed enough). Hrumph…we’ll see.

But, in the meantime, the past and the future will collide on April 15th. On one hand, I’m so incredibly overjoyed by the little girl who is now part of my life. Each day that passes brings me one step closer to the reality that she—a real live baby—may be coming home with us in late June/early July (crossing all crossables, knocking on wood, and making pagan sacrifices in her name—okay, just kidding about that last one). Yet, I lament that she will never know the little boy who came before her, who was lost, and exists only in the memories of both A and I—and it breaks my heart all over again.

Another year older, but not necessarily wiser

So...tomorrow is my birthday. I offer this not to receive any obligatory congrats or warm wishes (though they're heartily appreciated) but for the fact that I can't believe I'll be 36. Inside I still feel like the self-conscious, crazy 21 year old I was when I met A. How did I get to be an "adult?" When did this change take place? Even more importantly though, where did the years go? No idea....

As an early birthday gift to me, yesterday found me at the OB's office for a regular visit. The basics: lost one pound since my last visit two weeks ago (for a total gain so far of 24 pounds); urine negative for protein and sugar; BP 118/76; fundal height where it should be' baby's HB "lovely." Ah, but I also learned that I am now entering the 'critical zone'--that period of time in pg where if you're going to develop gestational diabetes, it will happen. This can be anywhere between now (24 weeks) and 28 weeks. So my used-to-be-every-four-week OB visits have now been bumped up to every two weeks. It seems they want to really monitor my urine--not to mention that I'm to continue faxing them my four-times-daily blood glucose readings twice weekly. But the upshot is that I got a bit of good news--an 'early' birthday present if you will--because of my risk for GD, I will be getting at least one more ultrasound (around 28 weeks) to make sure la principessa is still measuring where she should. Hallelujah--another u/s! 'cause lord knows I'm going through serious withdrawal, having not had one since the level II on Valentine's Day. Next up is my peri visit, March 28th.

Other than that, in honor of my entry into the world 36 years ago tomorrow, A and I will join some dear friends tonight for dinner at a local kid-friendly establishment (since all our friends reproduced some time ago and have children in tow). Then we will drive down to the Keys house for some R&R (okay, I'll get the R&R while A will get to do some home projects there, namely make sure a roof leak he fixed on our last visit two weeks ago took). Early evening Sunday will find us at my MIL's for birthday dinner. All in all, a big birthday weekend...not...and that's just fine by me.

Oh, but there is one more thing...typically every year for my birthday, I buy myself something fabulous ("fabulous" not necessarily meaning expensive but perhaps something that I've had in my sights for a while) but this year I am completely out of ideas and have seen nothing that's caught my eye recently. At the same time, I've been trying not to spend too much $ since we may actually have a third member of our family in a few months and well.... So, anyone have any suggestions? Buehler?

Dream a little dream of me

For the first time in my life, I had a baby dream. Perhaps it's odd that I've never had one previously. But just the other night, I had a lovely dream where I was home, there was a baby in a crib in our nursery, and I went in during the night to see if the baby was breathing while it slept. I put my hand in front of its glorious little nose but yet could not feel its breath. As I leaned in to check for breathing, that baby opened its beautiful eyes and looked at me and I knew it was alive, that I was its mother, and that it was the most wonderful feeling I'd ever had. You can believe that--upon awakening--I'd never wished more in my life for a dream to be a deja vu...hopefully foreshadowing what's to come in a little more than 16 weeks.

Ho hum

No big news to report. I continue to wrestle with the mom dilemma, especially since she e-mailed me the other day to say she'd found a place to live in the new "old" town and would be heading back there on April 1st (instead of August 1st as previously planned). I really appreciate your feedback on the whole mom issue. I guess I'll just have to see, something I'm not especially good at doing. I'm an 'immediate action/results' kind of gal. Now on to way to much pg talk so please skip it if you like.

On other topics, yesterday I had a regular OB appt. Whoo-hoo, here's to 22 weeks! I got to meet doctor #4 (out of 5 in the practice--alas, the final one left to meet is dr. hottie) who was pretty nice. It was the first time I had my fundal height measured, but I didn't think to ask what it was so I have no idea if it was normal or not. I imagine it was or I think he'd have said something about it. Instead, he simply measured me and then wrote it in my chart.

Luckily, I continue to have no swelling, or headaches, or protein/sugar in my urine (again, though, no one has told me I do/don't have it, I fly on the assumption that they'll tell me if/when I do). We got to listen to la principessa's heartrate on the doppler and the doc could barely get it. I told him she's usually more on my right side and, voila, he found her loud and clear exactly where I said, which made him chuckle. She's a dancer--though she has no rhythm!--who likes to tap dance on my uterine walls, whacking me with her arms for good measure. (A few nights ago was the first time A got to see her move as she whacked my belly but good while we were listening to her heart on the doppler before bedtime.)

When doc #4 took my BP yesterday, he merely wrote it in my chart. I know enough about my wonky BP to ask what it was (130/82). He then goes on to mention that it's up slightly from my previous appts and he's wondering if it may be the start of an upward trend (me, I think it was a result of the salty triscuits I ate a half-hour before the appt combined with the stressful drive to the doctor's office from work). So now I will be measuring my BP at home twice a day and letting them know if I notice an upward trend. Two successive measurements after yesterday's appt found it down to 125/81 and then 114/77. So let's hope it was the triscuits and traffic combo that caused the initial slight elevation.

See the thing is though that my version of congenital adrenal hyperplasia (the rarer 11-beta version) has hypertension as a side effect. I've been on anti-hypertensive meds in the past but have been off them for about 2 years now (a point I made to doc #4 at the visit). Despite that, doc #4's slight concern about the start of an upward trend now has me worried about pre-eclampsia. As if I don't have enough to worry about. At the same time, I'm just going to keep measuring my BP and continue/start new things to do what I can to take good care of myself. And, yep, that means I'm going to have to cut out some of the eating (but, damn, food tastes so good!) as I've gained 20 pounds so far (with 18 weeks left to go=a lot of potential for more, ahem, maternal 'growth'). Yikes. Again, though, it's not something any of the docs has mentioned as a problem--I know that excessive weight gain can't help the BP any.

One other thing that came up at the visit is that I won't have to take the glucose tolerance test to check me for GD at 28 weeks. Since I measure my blood sugar levels at home 4x a day, there's no need. Yea! But I will need more bloodwork next month--CBC, syphilis and HIV (state of FL requirements).

So that's it in a nutshell, v boring. I go back for my next appt in a few weeks and see the peri again at the end of the month. See, very 'ho hum' indeed but ho hum is nice, no drama in these parts--hell, I think I've had enough of that to last me a lifetime!