28 Weeks/OB Follow-Up

I know it seems like I say this every week, but it was yet another big day in the Wicker House. You would think I would be desensitized to "big days" by now. But I'm not. So I still have one day a week that I'm a nervous wreck.

Back to the OB I went today. This was one of probably two appointments ever that I have had to go solo. But I think I actually felt calmer without Kevin for some reason today. I think maybe there is some "performance" pressure when Kevin is in tow. Is my cervix holding up? Am I gaining like I should? Am I growing the baby properly? Is my body failing the baby? I hate to feel like I'm not only letting the baby down when things aren't looking great, but also Kevin too. So after the fact, I realized it was kinda nice not having Kevin there.

I haven't been out of the house in a week, since my last OB appointment. It sure was nice to be out! And I got to drive today--I haven't done this in three weeks! Feeling "normal" again and being out around people while taking in some sunshine was a very welcome change. Good for the psyche, for sure.

The whole OB saga today lasted 3 hours! Oh my goodness, can they please get a more efficient system. I had to go back to the waiting room three different times! I saw the doc first. She did a vaginal exam, all felt and looked normal and also did another FFN test to see if my body is gearing up for labor in the next two weeks. I'll get those results in a couple of days. Hoping for a BFN for the first time in my life! Update: FFN is NEGATIVE AGAIN! Yea! Great news!

I also asked more questions:

Does she believe that most women are very deficient in Vit D and need more than what we get in prenatals? "Yes. Vit D is super important and we need a lot more than what we get in our diets and in vitamins."

Is she still okay with my weight ( My weight held this week, I did not lose any more, I weighed 123#. A total weight gain of 11 pounds)? Yes. You just carry small and you still have time to put on plenty as the baby will be putting on a lot of weight from here on out. You should reach your goal of 20 pounds total weight gain. I'm not worried as the baby is right on track on all growth scans.

Can we start vaginal progesterone as there is new literature that states that it helps stabilize a shortening cervix? This is a very new study you are referring to and we don't really know that it will help those who have not delivered a preterm baby in the past and who only have a shortening cervix. Also there are no long term studies on the effects of progesterone in babies after birth. Although one would assume it would be fine as there is a lot of natural progesterone in the body while pregnant. If your cervix continues to shorten  and if this is something you would like to try I would be willing to try it off-label, but for now, if things are stable, I say lets hold off on it, as we truly don't know the long term effects on babies/kids when things like Prometrium and Crinone are given late in pregnancy for an extended period of time. You have to do a risk/benefit analysis.

How much can I sit up instead of laying down, because I can't lay down 24/7? You can sit up, but try to stay reclined, and for no more than 4-6 hours a day.

Sex yet? No. You need to hold off at least a few more weeks. (Argg!)

I assume leaking nipples are normal? Yes, very normal. Just don't stimulate your breasts at all, as this causes contractions.

Can you check my fundal height so I can feel like a normal pregnant lady? It is measuring about 26-27 inches. ( I turn 28 weeks tomorrow). I consider this totally normal because all of the baby's growth scans are right on track and fundal height is not an exact science.

What can you tell me about a saliva test that measures estrogen and it being a good predictor of preterm labor? This is a very new test. They are still doing some studies on it and it looks like it will probably one day be used in practices to help determine who will go into early labor in conjunction with the FFN test, but it is not yet readily available for use in practices.

What is the cervical length that would totally worry you and cause you immediate concern? 1.5cm and below. So we still have a little room.

The final: I head back for weekly sonograms/exams and FFN tests every 2 weeks from here on out until 34 weeks or until I deliver, which ever is first. She said she would not measure my cervix anymore after 34 weeks. I can certainly stay on bed rest to keep the baby in there cooking past this point, but as far as being concerned about delivery after this point, 34 weeks is her last goal as far as getting me through this preterm labor/short cervix debacle.

So as of tomorrow we will have met our first goal, 28 weeks. Yea!! Then we have 30 weeks, 32, and then 34 weeks. But obviously I want to keep this baby in there as long as possible! My mom will be coming into town next Monday and will stay with us for about 10 days so that someone is with me during the day until we make it to our next goal of 30 weeks.

I also had my very kind and sweet hair dresser come to the house today to give me a hair trim. I originally had an appointment with her the day I went into the hospital, but obviously I couldn't make that appointment. She was sweet enough to offer to come to our house and cut my hair in the kitchen. Yea for keeping the hair nice and shaped up!

Oh, and how could I forget to update on the sonogram today! Unfortunately, my sono tech Debbie was out sick today, so I had someone else. Didn't love her. I seriously don't know if she knew what she was doing. She couldn't answer any of my questions. Not one. Not reassuring. You better bring your A game when dealing with this chick.

So she puts in ol' wandie and says my uterus is contracting. I know you cannot get accurate measurements when this is occurring. She waits about 20 seconds and begins taking measurements. I know it takes minutes for a contraction to subside internally. She takes a few measurements, quickly, and does not give me any of the readings. Hello! I'm a crazy preterm pregnant lady--I need information pronto! I've been waiting all week for this day!

I then go on to ask her if my mucous plug was still fully intact. ( I asked this because of the change in vaginal discharge since going into preterm labor) Her response, " I can't say. You can't see that on sono." Hmm...Debbie makes note of my mucous plug on every sono. Okaaayyy....I then ask her if there is any funneling or dilation seen in my cervix. Her response, " I can't really say. I have to go back and look at all the pictures after we're done, write my report and submit it to the doctor." Again, Debbie tells me if there is any dilation or funneling at every sono. What the heck is going on here? Next question I ask is if she can tell me what my cervix was measuring. Her response, " I can't say. After we're done here I'll go back and look at the images and check the computer and it will give me an average of all the measurements." AGAIN, Debbie always shows me all of my measurements and gives me the average immediately. She also didn't do an abdominal sono to get some good pics and measurements of the baby like Debbie does either. So no cute pics of the baby today. But I did see that the baby was again head down sitting on my cervix. Little stinker! Doesn't he or she know that we kinda need the pressure off my cervix!? :) Hoping for Debbie next week! I admit, I'm not very flexible.

I knew I wasn't leaving the office without finding out some results, as this was the information that made the day a "big day". Luckily, I convinced her to go and check with my doc before I left her sono room, and sure enough, the doc wanted to see me to discuss the sono results before I left. Thank goodness.

Cervix measurement today: 2.54cm. This is down about .25cm in a week. A slow decline, but still a decline. The doc also said there was some funneling at my internal os. Hmm...not excited to hear this either. She then went on to compare the pics from today to those of last week and she said they are very similar. She said she thinks I'm still stable and we need to stay with the same plan. I brought up the fact that it looks like every week we are losing about a quarter of a centimeter off my cervix. The doc agreed with this and said that even though there has been a continual decline, it's not drastic, I'm still stable, and since the baby is now getting heavier and will be gaining about a half pound every week from here on out, we should anticipate seeing a decline every week from here on out. But we want it to be gradual and minimal.

So we're still week by week. I am again disappointed, of course, that we are not getting better news every week, but I guess I could be getting dastardly news instead of just 'ok' news, and that's something to be really thankful for! So we keep doing what we're doing and wait it out on a weekly basis. So continued bed rest it is. Yea!