Baby & Body

 

Baby & Body

I was going to update after my next visit to SLC last week, but my hepatologist canceled my Wednesday appointment on Monday morning. I guess he was updating himself on my recent bloodwork from my OB and decided that he wasn't concerned and didn't need to see me. I guess we can call that good news! In order to fill in all the gaps, I have to back up a bit. 

My last blog post was pretty dire and scary-sounding because there just were so many unknowns and questions and I really, really didn't feel well at all. I started to feel better physically around the second trimester, as hoped, and I was being seen every 3 weeks by Maternal Fetal Medicine. 

One appointment was generally about me and my body:

• Check my weight, swelling, blood pressure (veins that were causing issues), etc. 
• Keeping an eye on my kidneys (potassium levels) due to the increase in my water pill
• Checking my liver enzymes to see how my liver was functioning
• ... and I'm sure other things

Then, 3 weeks later, they did a growth ultrasound for baby:

• Checking amniotic fluid levels
• Checking how baby is growing and developing

These alternated all through the second trimester and until just recently where I am now being seen every 2 weeks. 

I just want to start by thanking everyone who is has been fervently praying and thinking about me, the baby, and my family because as of every appointment so far, we have had good news. I am 32 weeks pregnant, baby is on track for size, and the most shocking news - MY LIVER ENZYME LEVELS ARE STAYING NORMAL the last time we checked. They were in the 30's! To put that into perspective for you, they were high 1000s when I was hospitalized for 8 days and my "normal" the year following was around 1-200 usually. 

Current Life & Concerns

That being said, we are keeping on keeping on. I definitely struggle with energy on a day-to-day basis and generally try to give myself rest whenever I can. I am going to be slowing down every more starting in October probably as we get ready for baby. As I get farther along, there is a concern for swelling, increased blood pressure and phlebitis in my veins on my legs (which has come and gone). We don't want any varices bleeding or bursting in my esophagus or any blood clots forming causing pulmonary embolism. 

So things have been good, we have been living life, getting out of the house while we can... and now have Covid. Perfect, right? Just wanted I needed. As soon as I found out, I called my OB, they got me an albuterol inhaler (I have asthma), they told me pregnancy safe and liver safe OTC meds I can take, and I was just crossing my fingers that I didn't get it as bad as I've heard and read. My symptoms have been more cold-like than flu. My OB didn't want my O2 to get under 95% since I'm pregnant. I had a hard day where I used my inhaler a little bit, but have been taking Mucinex to help with congestion and have actually been fairly ok besides being extremely exhausted and weak. The whole family has taken turns and we are just all laying low for a while. I'm still sick and I know the symptoms hang on for a while but I'm just thankful that I am not in the hospital because being there could potentially get me even sicker than just having Covid. I'd much rather stay home and wait it out. 

The Final Battle - Delivery

The anesthesiologist who will be at my delivery called a few days ago to talk to me about my health history, anesthesia history/experience, and talk about options. I already knew getting pregnant that I would be having a c-section. Mason was a natural delivery, but Noah was an emergency c-section, and Everett was a failed VBAC that ended in a c-section. My OBs told me that it's possible to try a VBAC but they would be worried about blood pressure/varices during pushing so I opted to just do a c-section again. 

I thought choosing the c-section meant it was simple, get the epidural, do the surgery, the baby is here. Well, of course, it can't be that easy and there are concerns. Your liver produces plasma proteins that help with blood clotting which is why when I was in the hospital my INR was so high. They had to give me plasma before they would do a liver biopsy. The same theory applies here. My INR has been in a good/normal range since I've been out of the hospital and on my medications so they aren't concerned right now. The day I am scheduled for the c-section, they will admit me, take a blood sample and see if it's safe to do an epidural or not. The worry is that if my blood isn't clotting properly, blood from where the needle enters for the epidural can continue to bleed in the epidural space, increase pressure on the spine and cause paralysis. Plan B if we can't do a c-section with an epidural would be to go under general sedation. The concerns there are 1.) me aspirating due to pregnancy (everything is harder to keep down when there is so much pressure on the stomach which is why pregnant women have acid reflux issues) and 2.) general anesthesia crosses the placenta and would make baby sleepy at birth. They would have to be very fast with the c-section so the baby gets as little sedation as possible. Sleepy babies have a hard time taking their first breaths and starting life outside the womb. 

As we are entering the last full month of pregnancy, the OB will continue to keep a close eye on the baby and me with frequent appointments, blood tests, and ultrasounds. The goal is to do a c-section at 39 weeks unless other issues arise. At least 5 more weeks is preferred since 37 weeks is considered full-term. I'm thankful we have gotten past the viable dates, made it to the third trimester, and now I just want to keep him cooking as long as possible and stay as healthy as I can be. I have to be honest, eating when you can't taste or smell is really not appealing. 

Hopefully, the next update will be after delivery with a healthy baby boy and we'll see what happens with my body after pregnancy. It's anybody's guess at this point.