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Blue eyes again?

It was a shock to us when Natalie had blue eyes in her first year (which eventually turned to the hazel-ish color they are now).  I think Andrew may be following the same path.  His eyes were a definite grey when he was born and now they’re taking on a twinge of blue……can’t wait to see how they turn out!

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Posted in parenting.

GD Diet

I’ve had a surprising weight loss from this pregnancy.  I only gained 12 lbs (compared to the 25-30 lbs I gained with Natalie).  My whole third trimester was on a diet to lower my blood sugar levels due to the gestational diabetes.

I’m now about 15 lbs below my prepregnancy weight.  I’m only about 5 lbs heavier than when I got married which is just insane to me.  I’m even below my pre-Natalie-pregnancy weight.  After having Natalie, I couldn’t get lower than 5 lbs above my prepregnancy weight.

Yes, in the last few weeks, I’ve lost 27 lbs.  Call it the “have gestational diabetes while pregnant” diet.

I have to say it’s pretty awesome…then again, who knows if I’ll be able to maintain this at all.  Since giving birth, I’ve been helping myself to the treats/snacks I craved but couldn’t eat during my last trimester…but hopefully once things settle, I can adopt my previous “lower carb” diet.  My goal is to stay relatively where I am by the time I go back to work.

Posted in Uncategorized.

Feed, Supplement, Pump….Rinse, Repeat

I’m on a nursing vacation right now.  Andrew’s weight isn’t quite where the pediatrician wants it to be. 

Birth = 6lb 13oz

1 week = 6lb 3 oz

2 weeks = 6lb 5.5oz

3 weeks = 6lb 8oz

Every baby loses weight in the beginning..but then starts gaining, and they like to see about an ounce a day gain.  He should be back at his birth weight now but he isn’t.  The good news is that he’s at least gaining weight.

His latch seems good and he seems to drain my breast well, so there’s concern that my milk supply may’ve taken a hit in the beginning…so we are doing everything we can to boost it up.  In addition to taking 9 capsules of fenugreek a day, I’m now pumping after every feeding and also supplementing him with an ounce of pumped milk after each feeding.  I was also asked to switch to a hospital grade pump — so I went up to Northwest Medical Supplies this morning and rented a Medela Symphony (I would’ve preferred to rent from the much-closer Village Maternity but they didn’t have any available…until an hour after I came home from NW Medical Supplies, darn it)

I’ll be back for another weight check next week and see from there what to do…hoping he’s at his birth weight by then.  Until then, there isn’t much time for me to be able to leave the house due to the pumping.  I really admire those moms that exclusively pump—how do they have time to ever run out and do errands?

Posted in parenting.

First couple of weeks

The first couple of weeks with a 36-weeker are different from a 41-weeker (Natalie).  Between Andrew being our second child and him being a pre-term baby, our experience feels different.

First off, he’s generally more sleepy.  We have to wake him up for most feedings (except at night – usual day/night switching for a newborn).  This results in him being less efficient with feeding in general.  Fortunately, he has latched on without a problem but he falls asleep sooo easily.  We’ve been concerned about him getting enough milk and his weight gain.  At his 2 week checkup, he was still below his birth weight….so now I’m pumping after every other feeding and also supplementing him with that pumped milk.  This is both to get him more milk and to also ensure my milk supply doesn’t die as a result of him possibly being less efficient.  I also recently started taking fenugreek to help out (with Natalie, I didn’t even bother with fenugreek until I went back to work!)  I was first concerned about pumping so much because, in my mind, pumping early results in oversupply…but at this point, with his lack of weight gain and concern about that affecting my supply, I’m happy to pump.  Still, I’m not a huge fan of pumping.  Wasn’t thinking I’d be doing it so much so early…but at least he’s getting breastmilk.  In his first week, we had to supplement with formula since he was pre-term to keep up his weight..but we stopped that pretty much after my milk really came in.

The other thing we had to deal with was jaundice — not surprising for a preterm baby but nonetheless, a new thing for us as Natalie was never jaundiced.  When we left the hospital on day 2, his bilirubin levels were still great (about a 9) but by the time we saw the pediatrician the next day, they had jumped up to a 17 (eeks!).  Treatment plan = phototherapy!  This is basically a tanning bed for a newborn.  Fortunately for us, his levels were low enough that home phototherapy was an option, rather than spending nights at Children’s Hospital.  So, for the next week, we had the services of In-Home Phototherapy where a nurse came everyday to weigh him, take his blood (darn heel pricks are no fun), check his temperature and ask about feedings and wet/poopy diapers.  At first, his levels started going down—when they hit 12, they took the lights away..but that only lasted 48 hours before his levels went back up to a 17, so back onto the lights.  This time, they kept him on until they were down to a 9.  All in all, we had to do the phototherapy for a good week.  Good thing he’s generally sleepy as we couldn’t really swaddle him or anything.  Also good thing we hit a hot streak in Seattle, so it was fine having him be unclothed for a whole week too!

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Other than that, we can already see improvements in him – like being more alert, latching on better, getting less jaundiced and (we hope) feeding more.  We have another weight check for him on Monday – crossing fingers that he’s gained weight!

Despite all that, things do seem easier with Andrew than they were with Natalie.  I just remember the first week or two being such a blur with Natalie….and that nights were just awful.  I remember with her newborn pro photos taken at one week, I could barely consider putting makeup on or changing out of my nursing tank top..and that Matt was super cranky.  But this time with Andrew, we had the photographer come out when he was 4 days old—I had no problems changing and “putting on my face”…and Matt was in a great mood.  Maybe this second time around we are just less stressed with things?

Natalie’s been a sweet sister to Andrew.  She loves telling visitors “come see my baby brother!”…and when she sees him, she says “awwww, he’s so boo-ti-ful”.  Anytime he cries, she likes to find a pacifier to give it to him…and of course, she loves giving him kisses on the head.  She enjoys any opportunity to hold him, but wants to be careful with hurting him, so if he starts crying while she holds him, she says “baby wants to get out.  I’m all done!”

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My parents are here helping out til the end of the month which is SO helpful.  It’ll be an interesting challenge when they leave, particularly if one of us has to be on our own with both kids.

Posted in parenting.

Introducing Andrew Wei-Hien

Little did I realize that my last post would be the day before going into labor.  Yes, baby boy has arrived way earlier than we ever imagined and we are completely in love with him.  

Andrew

Born Tuesday, June 18th, 2013 at 4:17pm

Weight = 6lb 13oz

Length = 19.75”

20 hours of labor, 2 hours of pushing

36 weeks 3 days into the pregnancy at birth

I knew with the cholestasis that there was a risk of pre-term labor but I certainly did not expect to go into spontaneous labor in my 36th week! What a shock.  Fortunately, Andrew is relatively healthy and doing really really well for being a 36 weeker.  Here’s my birth story and how it all started….

Before going to the hospital…
On Monday the 17th, it was business as usual.  I decided to work from home since I had no meetings.  I was sitting on the living room couch all day but something felt off all day.  I was feeling a little more crampy than usual and the weight of baby was killing my pelvis.  I was noticing that laying back on the couch was not as comfortable as sitting up or standing which was odd, but I didn’t think too much of it.  Matt came home with Natalie at about 4:30pm and had a conference call before needing to leave for a hockey game at 6pm.  At 5:45pm, I drove myself over to the Metropolitan Market to grab some dinner items.  I remember needing to really hold my belly up while I was there and feeling crampy, thinking to myself “man, it’s hard to walk around now”.  At 6pm, Matt left for hockey and I was alone with Natalie to deal with for dinner and such.  By 7pm, the cramps were picking up and I recall my OB telling me to call if I felt menstrual-like cramps.  I really didn’t think much of it because my contractions with Natalie did not feel like cramps at all, rather major pressure in my tailbone (in retrospect, that is because I had back labor with her — now I know that there is a HUGE difference in the way contractions feel with back labor vs non-back labor!)   My first thought was hoping everything was okay with baby and worried about needing to go to L&D to do a NST that night….but then the cramps seemed to come and go at regular intervals.  I called L&D to get advice—they said to time things and call back.  At 8:53pm, I sent a text to Matt:

“Worried about these being real contractions, getting worse.  Just lost a lot of mucus plug”

He got home shortly after 9pm.  At that point, I was attempting to get Natalie to bed upstairs but was having to breathe through some of these contractions and even moan out loud.  Natalie was even saying “mommy, why are you crying?”  I would say “I think baby wants to come out of the belly” and she was like “no no, baby can’t come out.  He’s in the belly!”  In any case, Matt had another conference call planned for 9:30pm but upon seeing me, he cancelled it.  In my mind, I still didn’t believe I could be in labor and was just worried if baby was okay.  I thought it would be good to take a bath to calm down the contractions, so Matt took over putting Natalie down while I did that.  During my bath, I experienced 2-3 more contractions, which told me these were more real.  I called L&D again to give them an update, they said to time things which I hadn’t really been able to do.  I started timing my contractions.  They were 5-7 min apart on average.  OMG.  I called L&D back and they agreed it would be good to come in just in case.  I still didn’t think it was really happening but started packing up assuming this was the real deal.

I started to text girlfriends because my parents weren’t in town yet.  I knew Jigna was coming back from a family trip to Mexico that night.  I also called Asayo and Sri.  Jigna came over at midnight after I told her we were going to head to the hospital.

Thank goodness I had a half packed hospital bag.  I threw together the toiletries and electronics in and Matt quickly packed himself  a bag.  Things with Natalie were crazy as Matt and I were a bit frantic between packing, calling L&D, Matt notifying work, etc…..but we finally semi-got her down after 11:30pm or so (I know, crazy—our little night owl)

Arrival at the hospital…
We got to the hospital about 12:30am and checked into triage.  First things first – internal check.  I about dropped my jaw when they said “6cm dilated and 90% effaced”.  That’s when it hit me that this baby was coming.  We then called my mom, shocked her with the news so that they could make arrangements to fly to Seattle earlier.  Then we moved into the labor & delivery room.

Things weren’t bad (did I mention that regular contractions are so much easier than back labor contractions?)  I got hooked up with IVs and monitors and labored on a ball.

Around 3:30am, we were exhausted just from lack of sleep and I decided to get an epidural.  It took awhile to get it in just right but I finally got that tingly sensation in my legs and could relax.  Matt took a much needed nap and I attempted to close my eyes…though honestly, there was so much adrenalin pumping in me that I unfortunately couldn’t actually sleep.

In the morning, they checked me again and saw I was still at 7cm.  Not surprising since my water hadn’t broken yet.  “Things will move along faster once your water breaks”…but they wanted to be careful: with my polyhydramnios, there was risk of baby floating upwards when the water breaks and the cord prolapsing down, resulting in an emergency  c-section.  They had hoped for my water to break on its own.

9:45am – decision to artificially break my waters carefully.  With 2 residents working together, they poked a small hole while the other gently pushed down on baby from my abdomen to prevent him from floating up while the other guided his head to cover the cervix and watch for the cord.  After what seemed like minutes and minutes of the water draining (remember I had A TON of amniotic fluid—it was ‘quite impressive’ according to all the nurses and residents), they successfully broke my water and then inserted a catheter to monitor the strength of contractions.

My contractions were slowing down and not as strong so I was put on a small slow drip of pitocin….started off at a 1, dialed up as far as a 6 and eventually settled on a 4 to get just the right amount.

1pm – I was 9+ cm dilated and fully effaced but baby was still at –1.  Even though I’d been changing sides every hour, we decided to sit me up as vertically as possible for an hour to see if gravity would literally help get him down.

2pm – baby is now at at +2! The vertical sitting really helped.  Time to push!

I pushed for over 2 hours.  The first hour wasn’t too bad but it was hard to tell that anything was happening.  In the last hour, they brought out a mirror for me to actually see what was going on.  That was sooo motivating….especially since I was getting absolutely exhausted by then.  The lack of sleep from the night before was catching up on me coupled with the physical labor of pushing what seemed like every minute.

4:17pm – baby Andrew emerged and it was absolutely amazing.  They immediately put him on me and Matt got to cut his cord.  It was sweet relief to be done and so joyous to finally meet our baby boy.

I got my desired VBAC (vaginal birth after cesarean) and it was such a wonderful experience.  I thank all the staff at UW Medical for being supportive of this.  I credit taking things slowly and having me change positions frequently to the success.

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Posted in pregnancy. Tagged with , .

T minus 13 days

*gulp* Less than 2 weeks before getting induced.  Had my weekly appointment this last Friday:

  • Total weight gain = 12 lbs (nothing compared to the 25-30 I gained with Natalie—I blame the GD diet)
  • Baby passed NST fine
  • and the good news is that my LFT came back with numbers in the normal range!  ALT was 33 and AST was 24, so perhaps the Ursodial medication is working
  • Also, since I’m getting induced in 2 weeks, did the Group B Strep test and that came back negative (wahoo!)

So the plan is still getting induced on the 29th….though part of me wonders what the odds are of me going into spontaneous labor before that.  I’ve been showing minor signs of my body preparing (I’ll spare you the details) so we’ll see!

Here’s a picture of me at 36 weeks 1 day.

Posted in pregnancy.

ICP Awareness Day

What a coincidence – today, June 10th, is officially ICP (Intrahepatic Cholestasis of Pregnancy) Day…almost a week after learning of my own diagnosis.  I’ve learned this because I’ve since joined a Facebook group, Yahoo group and Babycenter group to learn more.

I’ve learned a lot over the last few days.  It’s been pretty overwhelming.  On Friday, I had my OB appointment, prepared to hear her recommend an induction at 37 weeks.  Much to my surprise, she was pushing for a much later induction at 39 weeks for the following reasons:

  • She knows there is strong data that a medically intervened delivery (i.e induction or c-section) before 39 weeks typically leads to more post-delivery issues (like jaundice, respiratory problems, etc….)
  • While it is the norm for cholestasis diagnoses to induce at 37-38 weeks, the data is weaker for why it’s needed that early
  • The reason why induction happens then is because bile salt acid levels can dramatically increase after 37 weeks – causing maternal bile to leak into baby’s lungs, essentially “poisoning” them.  Eeps!
  • Odds of a stillborn birth, or fetal demise, in all pregnancies is like 1%.  With cholestasis, those odds can rise to 4-5% depending on how severe the case is
  • The OB believes I have a mild case of cholestasis since my levels are 24 – it’s over 40 where they get more concerned
  • Thus — assuming both weekly NSTs (stress tests) and LFTs (liver function tests) come back normal, she felt waiting til 39 weeks to induce was a good recommendation.

I had a NST and baby was fine..and then did a blood draw before leaving.

Then, Saturday morning, the results of my LFT came back with the numbers elevated.  There are 2 numbers – the ALT and AST, both of which should be under 40.  My ALT was 94 and AST was 43…so pretty elevated.

With that new information, the OB consulted a number of perinatologists and eventually called me – with the new recommendation to induce at 38 weeks instead.  It keeps delivery within the window of recommendation for those with cholestasis while being closer to the due date (that is, closer than inducing at 37 weeks) to reduce post-delivery risk.  I felt much much better with that date.

So — the plan is to be induced on Saturday, June 29th.

I could still go into labor on my own naturally before that (for some reason, those with cholestasis tend to go into labor earlier than others)..and if so, that’s fine as the baby is just ready to come out if so.

Am I nervous about induction?  Sure.  I didn’t get induced with Natalie.  I’ve heard great stories about induction but also long, painful ones.  It could last a few hours or a few days.  Let’s hope it’s swift but not so fast that it’s slamming and painful.  But moreso, I’m just wanting to do what’s best for the health of this baby boy.  The more I read about cholestasis, the more I freak myself out.  I just need to watch the fetal movements and think positive thoughts in these last few weeks of pregnancy.

T minus 3 weeks!  Eeps!

Posted in pregnancy.

Pregnancy: Polyhydramnios + Cholestasis

Ooo, this blog post has fun medical terminology in the title! Well, in addition to gestational diabetes, I’ve now also been diagnosed with polyhydramnios and cholestasis.  It’s crazy to me how my first pregnancy was a breeze but this one has minor complication after minor complication.

As I mentioned in my last post, I needed to get a growth ultrasound to check out what’s going on….so I went in last Friday when I was 33 weeks 6 days along and learned the following:

  • Baby was approximately 6 lbs (in the 85%-tile…so yeah, a bit big)
  • Head circumference equivalent to a baby in week 38
  • That said, measurements via ultrasound at this stage have about a 3 week margin of error, so not tooo concerning
  • However, I had a TON of amniotic fluid.  I guess normal range is about 5-25cm and mine was 28cm.

As a result, I’ve been diagnosed with “Polyhydramnios” which basically means I have a lot of amniotic fluid.  There is a slight correlation with gestational diabetes so it’s not surprising.  I won’t know what this really means til I meet with the OB this coming Friday but her quick email to me wasn’t particularly concerned…just something to be aware of and explains my fundal height measurements and the occasional lower pelvic pressure I feel.  I’ve heard many stories of moms with more amniotic fluid than usual and it didn’t imply much in terms of baby size or when baby actually arrived…just that when the water broke, it was A LOT of water.

Next – in my last pregnancy, I had developed this severe itch near the end of my 3rd trimester that turned out to be a mild case of PUPPS, resolved eventually by a prescription antihistamine and then was gone.  For the last 2 weeks, I’ve been feeling a mild itch on my hands, feet and belly—quite similar to my first pregnancy though it hasn’t come close to the severity of the last pregnancy.  That said, it was so miserable that I’ve been keeping my eye on it – and I remember in the last pregnancy, as a precaution, they tested me for cholestasis since itching is usually a side effect.  I tested negative then.

In anticipation of the itch returning, I asked at my last appointment to be tested again for cholestasis….and this time, it’s positive!  I have to admit, I was a bit surprised.

So what is it?  It basically means the pregnancy hormones are causing my bile to not flow as quickly, causing it to back up in my liver and as a result, the bile acid is spilling over into my bloodstream.  That explains why I’m itchy.  It’s a concern for baby though because baby is dependent on mom’s liver to move the bile along…otherwise, the maternal bile will get into baby’s liver.  Yikes.

So what’s happening?  After a brief phone call with the OB, I know the following:

  • I’m going to start taking a pill 3x/day to help move the bile along
  • Beginning this week, I’ll go in for weekly NSTs (stress tests) since there is now an increased risk of fetal distress
  • Because of the cholestasis, doctors usually recommend having the baby deliver earlier—so my OB was implying a possible induction around week 37-38 once lungs are fully mature…or be warned I may naturally go into labor early as cholestasis seems to bring on early labor.

Um…wow.  Am I even going to make it to July?  I really wasn’t mentally prepared for a June baby.  That’s like in 3 weeks.  Anyhoo, I don’t have an induction date and don’t know for sure what is going to happen but it’s looking more and more like I might have an end-of-June baby.

On the bright side — with the growth ultrasound, I got a surprise 3D ultrasound which I didn’t even know was offered.  I’ve never gotten one as these aren’t usually necessary and women will pay a couple hundred dollars for one, which I never really thought was needed….so lo and behold is an amazing 3D photo of this little boy!

…and just for kicks, here’s a side by side of him with Natalie when she was born:

Posted in pregnancy.

Pregnancy: 32/33 week appointment

Had my appointment yesterday at 32w 6d.  Baby is STILL measuring large.  Fundal height has me at 37 weeks, eeps! Total weight gain still isn’t much – maybe 15 lbs? Anyway, planning on scheduling a growth ultrasound for sometime next week to see what’s going on.

Otherwise, blood sugar levels have remained nice and low, so the OB has been happy with how I’ve been controlling things with my diet.  It’s still amazing to me to see what causes my sugar levels to go up in different foods.  For example—I have a fairly high reading with a bowl of Fiber One cereal and some skim milk (like 130)….but if I eat a McDonald’s Egg McMuffin, my reading is really low (about 94).  What gives?  Or compare 2 slices of pizza (112) to ham and butter on a baguette (140).  My newest breakfast, since cereal is pushing it, is making chia pudding.  I’ll just prep it the night before – 3 Tbsp of chia seeds, 1 cup of unsweetened coconut milk, a bit of vanilla extract, a bit of agave nectar and then throw in some slices of strawberries to taste.  Eating half of that results in a reading somewhere in the 90’s.

I haven’t posted pregnancy pictures much – so here’s me at 33 weeks today:

Last weekend, Sri and Jigna organized a Baby Sprinkle for me over at Sri’s house.  It was really lovely seeing a bunch of girlfriends from all parts of my life, and despite me already having most of what I need leftover from Natalie, I got lots of wonderful gifts.  Every fellow mommy at my shower is also a mother to a boy (Jigna’s the only one that also has a girl) – so it was fun hearing tips about boys, learning about different types of trucks, etc.  Fun times.

The only other pregnancy-related update involves home preparations.  We’re not in a huge hurry to change up the nursery since baby will be in our room initially, but we do want to get Natalie moved into a big girl room soon so she doesn’t rebel or have any negative associations with the baby.  We are going to move her into Matt’s former office upstairs – which has involved moving all the books, bookcases into the basement as well as the sofabed, aquarium and desk.  We are close and have most everything out.  Yesterday, I took advantage of the Memorial Day sale at Land of Nod and ordered a new bed and dresser for her, which will arrive next weekend – so that’s our deadline for getting stuff moved out and hopefully we can plan on her moving into a new room then.

Once that’s done, I can focus on putting all the hand me down clothes I’ve gotten for this boy in the nursery and changing up the décor from something less girly than pandas and pink butterflies.

Posted in pregnancy.

Pregnancy: 30 week appt

For the most part, pretty straight forward appointment.  Can’t remember my total weight gain but it’s not much — I’m up in total maybe 12-14 lbs.  Not much.

Anyway, the big UGH is that I’m measuring large again—my fundal height measurement was 33.5.  [sigh]

Not doing anything about it now, will wait to see how it is at my next appointment, but it’s likely they’ll have me go in for a growth ultrasound.  I’m extremely wary of growth ultrasounds as they have a reputation for having a high margin of error.  We did one with Natalie when I was 40 weeks along and I was told she was some ginormous 10 lb baby.  She was born a few days later at 7lb 4oz.

Anyway, the big concern with getting a growth ultrasound is that they may associate a large baby with my GD condition, in which case they’d have me start taking medication to manage the blood sugar levels more (even though I’ve been managing it through diet fairly well).  And by taking medication, I become “high risk” and would need to come in for twice weekly NSTs (stress tests essentially).  Anyway, none of this has happened yet but it’s just something that could be in my future.

Otherwise, my only complaint: I’m starting to get itchy.  That is, my belly, feet and hands get really itchy at times.  It hasn’t gotten to the point where I am incessantly itching but I fear a replay of what happened in Natalie’s pregnancy where I developed this hormonally-driven itch that prevented me from sleeping for 2 days in a row, resulting in me calling the OB in tears and then finally being given a prescription antihistamine.  Well, now I know better and have already given the OB a heads up that the itch is starting.  I just hope I can see it coming before it gets bad.  That was not a fun experience and I don’t want to relive it.

Posted in pregnancy.