Growth Scan - March 29 2017

I had my 28 week Growth Ultrasound with Dr. Perni; Everything looked perfect as could be. I saw 4 chambers in a beating heart, and I got to see his face close and personal with a 3D Imaging of it. He was measuring 2lbs 15oz at 28 weeks 6 days. Perfect in every way. I cried.

(heres a photo for tomorrow; a day early :P Shhh)

Belly Progression - 19 Weeks to 27 Weeks

As a plus size mama, you often don't see a lot of woman doing the weekly belly photos, but I wanted to post them so that people could see progression, so here is 19 weeks to 28 weeks.

MFM Visit - March 22 2017

 I had been craving excessive amounts of ice, and was going through a 7lb bag in a week, I also had weird cravings for excess garlic salt, and so there was concern of vitamin deficiencies, and/or Addisons steroid adjustment needed. Labs were ran, and it was determined I was EXTREMELY iron deficient. By Extremely, I mean I was at a 4, and normal levels are 41-186, and my Ferritin was also very low. My Vitamin B12 was borderline low, my Vitamin B6 was low. It was determined to start me on immediate iron therapy, ferrous sulfate, 325mg twice a day, in addition to my prenatals, and also IV Iron Infusions. This is going to be fun, NOT! Iron in this amount makes you EXTREMELY constipated and so Miralax and I will become best friends.

Gender Reveal - March 16 2017

As promised, here are the gender reveal photos :) 

Credit goes to Nicole DeHoff for these beautiful photos!

Check her out here: https://www.nicoledehoffphotography.com/

She is also going to be our birth photographer :)

Didn't they come out just amazing? I think considering the day, they came out amazing.

(it was cold, the wind was uncooperative, and the sun wasnt really the best)

New MFM Appt - Dr Perni - 3/15/2017

I met with Dr. Perni today, on 3/15/2017. She was a very nice doctor, she went over my entire medical history in detail. My Doula, Vivi, also attended the meeting and was happy that this doctor took the time to go over my in depth complicated medical history. It was decided at this meeting the following:

- Fetal Echo DOES NOT need to be repeated; Will Run Lupus Antibodies SSA and SSB to check to see if baby has these, as they can cause issues with a rare form of heart block, which occurs in 1% of lupus pregnancies. Also encouraged to follow-up with pulse-ox, echo and EKG after baby is born.

- 28 week Growth Ultrasound, and then every 2 weeks thereafter. These are referred to as "serial growth ultrasounds" because they happen so frequently. They will be checking things like babies anatomy, babies weight, babies positioning, and anything like IUGR that may show up and potentially complicate the already high risk pregnancy.

- Antenatal testing starting at 32 weeks. This basically is where they will do NSTs, Biophysical Profiles, Monitor for Pre-Eclampsia, and any additional testing.

- Strep B Swab at 36 Weeks.

- Plan to Induce (if no other complications occur) at 38-39 weeks. 38 weeks is June 1st, and 39 weeks is June 8th. 

- We discussed options of continuation of Lovenox with scheduled delivery vs changing to Heparin at 36 weeks. I advised I would discuss this with my Hematologist at my appointment on April 6th and see what her preference is.

Overall, a wonderful appointment with this doctor. The only complaint I have is that because Cleveland Clinic is a larger practice, it may not be Dr. Perni who delivers me. This makes me a bit nervous, because I don't really like the idea of going into a scheduled induction with a plan, and having some random doctor who I don't have history with, delivering me.

I will also re-verify with Pediatric Cardiology that Dr. Komarlu does not want a follow up fetal echo to be done.

I also finalized what I think will be my birth plan and what I want to have happen with the help and assistance of my doula, and of course Matthew, on March 16th, and I am pretty happy about this. 

Most people don't know what a birth plan is... 

Basically, its a plan of action for what you want to have happen in labor and delivery. It gives you control over this. Since I have a scheduled induction, the only real thing I am adamant about is that it is kept as natural as possibly can be, and the ability to move around and eat/drink is important to me. Of course there are a few other things in there, that are specific to me like holding off on vaccines until we know MTHFR status, as well as the heart related tests and whatnot, and we decided that visual helps the nursing staff a lot more, so that is why we chose to do visual.

Here is what my birth plan currently looks like:

March 12th 2017: Update

I had my Detailed Fetal Echocardiogram, on 2/27/2017. The Cardiologist told me that the babies heart looked good. She told me that she could not rule out if the Baby has 4 chambers, still. Left side fully developed. Baby has the PFO and PDA open which is normal should close after birth. If it doesn't, than there would be further testing to check for CHDs. 2 of 4 arteries/veins visualized. Doctor couldn't properly visualize them entirely which means she couldn't tell if they were going the wrong way or not. Baby is lagging behind by a few weeks measurement wise. There is also a bright spot on the heart called an echogenic intracardial focus. It's a marker of downs syndrome, but since MaterniT21 came back normal, doctor doesn't want to worry about it. (Gabby also had this, so I wonder if its a genetic thing?) Doctor is concerned that with my lupus the baby could have heart rhythm issues associated with specific antibodies and with diabetes could have thickening of the heart but that they will wait for the results of the antibodies to come back and if needed follow up with a second fetal echo in 4 weeks. She also mentioned because of my Diabetes, there could also be risks associated with thickening of the heart. She mentioned that the baby should have follow up echo done at the hospital upon birth because of history and can't tell if any holes are present or not because baby isn't born yet and those typically aren't detected in utero in fetal echos.

I had my Rheumatologist Appt on 3/1/2017, Basic follow up. Rheumatologist decided, that like other specialists, he cannot properly see me/treat me for my issues, during pregnancy. To continue my Plaquenil, Tramadol and Prednisone.

I met with the Doula on March 9th and decided to hire her. So Vivi is going to be my birthing support/labor coach/advocate. For those who don't know what a Doula is, a Doula is a woman who is trained to assist another woman during childbirth and who may provide support to the family after the baby is born.

I had my pain management appointment on 3/10/2017, and the pain management doctor decided there is not anything she can really do for me while being pregnant. It was decided that it would likely be best to wait until the baby is born prior to proceeding with further care. She did mention that she can always safely repeat the trigger point injections during pregnancy if I should need them. Follow up was scheduled for the end of June after the baby is born..

I had my Gender Photo Reveal Photoshoot on March 12 2017 with the AMAZING Nicole DeHoff. It was cold, windy, and the sun was not in our favor, but I hope to see awesome photos from my photographer friend. Once they are in, I will be sure to post them.