My new hobby, and a progesterone question all in one!

I just wanted to share a picture of myself enjoying my latest hobby. It's something I try to squeeze into my schedule at least once or twice a week. In fact, I was thinking as a side business perhaps I should look into designing a more comfortable table or chair to enjoy the experience in. Perhaps a comfy recliner type chair that allowed you to "put your feet up" for the exhilarating experience? I wonder if any infertility patients or bleeding first trimester pregnant women have contacted La.zy Boy for their input. Here's me enjoying that new hobby at that maternal fetal medicine (MFM) office before our appointment with my peri last week. I can't believe I was missing out on this one of a kind experience my whole life before fertility treatments. So many women out there don't know what they're missing (cold gel, the dildo cam...ahh the memories we'll have :-) Shhhh, don't let the cat out of the bag or else there will be a run on transvaginal ultrasounds at a RE's or MFM office near you, leaving none for the rest of us!

When I was at my OB doctor's office yesterday, he shared with me the dictation notes from the MFM appointment last week that the peri had written. Most dealt with the complications possible for person with a unicornuate uterus during pregnancy. I always appreciate it when my doctor shares my actual chart with me so that we are completely on the same page, including notes from a consult appointment he referred me to. I have to love the last line summary of the notes written by my peri "in summary, discussed with patient (me) issues of a unicornuate uterus such as preterm labor, most likely breech presentation, IUGR, uterine rupture, incomptent cervix and other complications likely to occur in at least greater than 50% of each pregnancy. Hmmmm, my first honest reaction....YIKES! Or perhaps, what the f--k! Then I thought, what the heck...lets throw a complete previa in the mix! But to be honest, it's not something I didn't somewhat know before. I think it just hit home a little more now that I'm actually pregnant and saw it in a dictation note from a respected physician.

Sometimes medical lingo gets thrown around at appointments that my husband attends, leaving me to later when we get home find a website that explains the appointment in clearer terms. My husband is probably one of the smartest people I know, but that's one of the downfalls of me going to physicians I work with, also as a patient. Often at appoinments they skip over some things that they would explain to everyone else and my husband is left going, "huh?" I can only imagine it's how I feel when he comes home from work spouting off facts about telematics, infotanment equipment and things more involved than 802.11. ALthough, I'm proud to say I finally understand binary numbers after all these years, something he's quite proud of teaching me :-)

So anyways when looking for so additional information for my husband, I found this and I thought this website summarized problems with a unicornuate uterus well.

What effect do uterine abnormalities have?




A unicornuate uterus (a womb with one 'horn') happens when the tissue that forms the womb does not develop properly. This is a very rare condition. A unicornuate uterus is just half the size of a normal womb and the woman has only one fallopian tube. However, she usually has two ovaries. Often there is a simultaneous abnormality of the kidneys, such as one kidney instead of two, diagnosable by abdominal ultrasound or, more specifically, by a special kidney x-ray study called an intravenous pyelogram.

On fertility: Women with a unicornuate uterus may have difficulties conceiving, because they have only one fallopian tube. However, pregnancy in women with this condition is far from unknown. In general, uterine abnormalities do not prevent a woman from getting pregnant, but they may make it more difficult for her to carry a baby for the full nine months of pregnancy.

On pregnancy: Women with uterine abnormalities, particularly unicornate uterus, are more likely to have complications during pregnancy or delivery, whether the baby was conceived spontaneously or by Assisted Reproductive Technology (ART), compared with women with normal shaped uteri.

If the uterus is an unusual shape, many babies will settle into the breech position rather than into the normal head-down position. If you are expecting a breech baby you will be offered a caesarean because this is currently considered the safest way for the baby to be born.

If you have a unicornuate or bicornuate uterus you may go into premature labour because there comes a point where there simply isn't enough room for the baby to grow any more, and over-stretching of the womb triggers labour. Alternatively, the cervix (neck) of an abnormally shaped womb may not be strong enough to keep the baby inside and it opens too early and lets the baby out. This is called a weak cervix, sometimes called an "incompetent cervix" and it tends to be a problem for women with an abnormally shaped uterus who are expecting their first baby. The more pregnancies you have, the less of a problem it tends to be.

Sorry that this is truly a boring post, I know. It even has me yawning! Well, my bleeding actually looks like it is trying to transition to the red spotting I am more comfortable with. My OB wants me to continue the progesterone through week 12 now instead of only week 10 like previously planned due to the bleeding. Supposedly the placenta should be taking over some of that function by now, but we're continuing those extra two weeks just to be safe.

I have a question for anyone who might be able to help, so please pass it along if you would be so kind. It deals with progesterone shots at 16ish weeks. Has anyone used it at this point? My OB said that if after I stop the progesterone after 12 weeks I still have a lot of cramping and bleeding, then we'll be giving me a once a week progesterone shot to "keep my uterus quiet" and hopefully decrease the likelihood of future problems. I need to clarify the purpose of this. I understand the smooth muscle relaxant property of the drug, but I'm unclear of it's use at this particular point in the pregnancy. Is the progesterone to prevent the likelihood of preterm labor? Or is it to decrease bleeding caused by a uterus contracting too soon? Is the once a week shot continued all the way through the remaining portion of the pregnancy? Thanks in advance for you help. If you've used it before at that point, I'd love to hear why they put you on it and how long you took it for.

I hope that my uterus decides to continue to behave. I think it should learn a lesson or two from "A uterus divided". Her poor uterus gave her a run for her money this weekend as well, but is currently behaving and not causing any more bleeding. So go over and wish her a better week ahead if you get a chance. Gosh this was too long of a post. Word vomit tends to be a downfall of mine these days...sorry.

Spot's 10 week booty shakin'

Today I went in for yet another visit with my OB doctor courtesy of the weekend bleeding shenanigans. My placenta has still decided to take up residence in the wrong area, so the complete previa is still there for now. Good news is all is well with the little Spot for now. He is now officially 10 weeks old, and I made it through the weekend still pregnant, so I guess I accomplished both my goals! The bleeding has slowed down a lot since last Friday when I was sentenced to couch arrest. Did I ever mention how slowly time passes when you are occupying the same position for a few days? Although, after returning home from Ohio yesterday, I have found new meaning in the phrase Home Sweet Home. If you must be on a couch, the best one is your own!

On a more interesting note, my OB teased me that Spot was a girl since the heartbeat was even higher than last time, clicking away at 178-182 beats per minute. He also declared that Spot was a booty shakin' baby since he/she looked like they were dancing on the ultrasound screen. The upper portion (head section) was somewhat still, but the arms were moving all around and the lower half was all over the place. Spot's bottom was moving up and down. It honestly looked like Spot had entered Dancing with the St.ars (Booty Shakin' with the Stars?), and had forgotten to tell us!

I'm still on some limited activity until the bleeding has made it's grand exit. But now that it has slowed down, I'm able to do a bit more. I'll return next week for another visit, and hopefully all will be quiet until then. If you get a chance go give evil stepmonster a hug, she got her beta results in after her IVF and they're inconclusive neither positive nor negative yet. She has to wait awhile longer and go back again! That's got to be tough. I have more to update, but for now I'm wiped out and am ready to crash into bed so that's where I'll be! Thanks again for all the positive stories and encouraging words, that's what keeps a girl going!

Back to the couch you go!

Even though I haven't been nauseated in several days, I promised Sully that I had a cartoon to go along with her all day nausea, so here it is.

While I was at work Friday, I was assigned to labor and delivery again (vs the main OR). Lately though, I've loved being up in that department because recently the CRNAs at our hospital have finally been credentialed to do the epidurals ourselves on the laboring women. We no longer have to be accompanied by an anesthesiologist to do the epidural. It's so satisfying to be able to walk into a patient's room when we've been paged for an epidural, do the procedure ourselves, and see the patient have some pain relief before we even leave. Before that, we would have to wait for the anesthesiologist who was assigned to OB to come from the main OR or outpatient, which sometimes would take 10-15 minutes depending on what they were doing. Meanwhile we were with the laboring patient who was uncomfortable, and even though we are trained to do them, were unable to until recently. The patients seem more satisfied, the L & D nurses do, as well as the OB/Gyn doctors. All in all life is good up there now!

Well, yesterday I had just gotten done with an epidural, went to the restroom and discovered a nice return of the bleeding episodes I have come to know over the past weeks. I left the hospital to go home a little early and rest to see if it would stop. It actually did! My husband and I had plans for the weekend to go to his parent's house in Ohio for their wedding anniversary party that they were having 150 attending at a hall hear their home. We would stop on the way back to celebrate Mother's Day with my family on Sunday, then return home. So we packed up the car, including our dog and set off.

By the time we got to Ohio, the pesky bleeding had make a repeat visit. I emailed my OB doctor, and he answered back telling me to continue monitoring things, and that I had to spend the whole weekend on the couch. As long as the bleeding wasn't greater than X amount per hour, I could be on couch rest and house arrest until Monday. He wanted me to come in Monday for yet another ultrasound and an appointment with him. If anything increased, I should give him a call at home, or a page and meet him in our L & D department for an ultrasound and exam. I was relieved that if it increased I wasn't going to have to go through the dreaded ER on a weekend. We live in a larger metro area, and even though the hospital I work at, and my doctors practice out of is in a suburb, the wait for non life threatening visits in the ER can take hours on a weekend, sometimes several hours.

So back to the couch I go, yet again. As I write this, my husband is with his parents and the rest of his extended family at the hall their having the anniversary party at, and I have assumed the position of couch queen once more (only this time it's not my own couch, and I'm in a different state). The good thing is that my bleeding has slowed down a little, but is still heavier than it has been in previous episodes. The even better thing is that I have my dog with me to keep me company! It's amazing how when you're not at home, and you're by yourself it feels kind of lonely really quickly and time passes much slower. But my dog is snuggled up with me, actually resting her head on the pillow next to me like she's part of the couch or something. My husband has promised to show up in a little bit with some food from their dinner, but more importantly a nice sized slice of cake :-) Priorities, I know...priorities.

It's kind of ironic, the first Mother's Day that I can even come close to considering myself a mother after several years of not even being close to that statement, I'm spending curled up on the couch by myself with my dog as my closest form of companionship. My husband offered to stay home, but after driving all the way here, it seemed a bit silly for him to stay and watch me rest on a couch. Instead of getting high fives and congrats from his extended family on the news of our pregnancy on Mother's day weekend, I'm left worrying if after all this, we're actually going to be able to take a baby home in 20 or 30 something weeks. There just seems to be an eternity worth of space between some of the ladies in labor I was placing epidurals for yesterday at work, and myself almost 10 weeks pregnant. It's odd how the course of pregnancy seems so different from one woman to another. Some women haven't even seen their doctors at 10 weeks gestation, except for some lab work to confirm the pregnancy. I will only be 10 weeks in a few days, but I already feel like my doctor's office is a second home. Maybe I'll just start having my mail and calls forwarded there, what do you think?

For now, I'll keep up my current mantra of one day at a time. Current goal: remain a couch potato and try to keep my sanity until Monday's appointment. Secondary goal: make it to 10 weeks, which is also Monday. See that was easy, just make it to Monday and both goals achieved - presto! Long term goal: get complete placenta previa to move just a little bit in the following weeks so some of this bleeding stops.

I just realized that I could hear a cow mooing from the neighbor's house/yard/field whatever they call it. Being in a rural area is so funny when you're not used to it. Even funnier is the look on my dog's face as she's trying to figure out what strange creature is making that odd noise. She looks a bit bewildered! I've been tagged by KC, and I promise I'll come up with some interesting facts about myself for next post. I just think I made this post way too long already. Well, I hope everyone is having an exciting weekend. Have some excitement for me okay? Thanks again for all of your kind thoughts on Spot's last modeling picture.

9 week picture and answer session

Today I had my nine week appointment with the peri from the maternal fetal medicine group. My husband met me at their office and we got to see little Spot on the ultrasound for quite awhile. Heartbeat was ticking away at 168. The ultrasound tech did both an abdominal one and atransvag one, and then the peri came in and wanted to do a transvag one himself, so it seemed to take awhile. We got 12 cool pictures to take home, but their printer printed most of them dark. When Spot first made his grand appearance on the screen, I heard my husband gasp. I thought something was wrong, but he was just sosurprised at how much bigger Spot had gotten since he saw the ultrasound in person two weeks ago. He was most amazed to see the heart beating so clearly. Last time he saw it, it was so tiny it was hard to find. The peri also seems to think he knows where the bleeding I'm having is coming from, finally!

When we were done with the ultrasound, we sat down with the peri to talk about things. He saw a complete placenta previa right now. He said many people have this early on in pregnancy and then it moves. However, he feels like with the cramped space that the baby and placenta have due to my unicornuate uterus, it may not. Furthermore, because of the location it was at, and due to the small space of my uterus he is pretty sure that is what is causing all of the bleeding. The problem with early ultrasounds (prior to seven weeks and even 8 sometimes) is that the exact location of the placenta is not easily seen, thus explaining why it has been difficult to visualize until now.

Spot is measuring only 6 days behind, instead of the 9 days he or she was behind last week, which is great. I won't bore you with all of the details of the appointment and discussion, since the peri loves to talk and we were there over two hours. But basically we'll just continue the weekly checks and ultrasounds for right now. I'm supposed to keep them informed as to how much red spotting I have, and if I have any bleeding to let my OB or him know right away. I am so glad I can actually call it spotting and not bleeding the last few days! We will know a better idea of how my cervix looks at 12-14 weeks to know if a cerclage will appear in my crystal ball future. He wants me to continue the progesterone through week 12.

Even though the little one is only nine weeks old, I was shocked to learn that Spot already has a functioning kidney and is urinating. I find that every time I go to the bathroom now, I wonder if both Spot and I are peeing at the same time! Another interesting thing I've discovered in reading is that Spot already has some fluid in his ears and is establishing a sense of balance. Hopefully, he or she will take after my husband since I am completely uncoordinated and am always tripping over my own two feet. I'm one of those people more likely to fall going up the stairs, than down. In addition, the iris of each of Spot's eyes are functioning, yet the eyelids are still fused shut. Perhaps that is how my husband feels when he is searching for his glasses in the morning?

I always leave feeling better than when I came, after seeing the little one on the screen. The office could check all of the boxes they felt like today or labeled me however they please : severely threatened spontaneous miscarriage, complete placenta previa, unicornuate uterus....bring it on! Nothing can squash my happiness that another week has passed. We've pulled through one more week closer to having a little one to take home someday. It's still so early, but if we keep making it one more week, and one more week, then eventually we'll be beyond the point of viability. Well, this has been a long enough post as is, I guess I'll have to save the rest of my rambling for another day!

Show some love

I'll update more after my appointment at Maternal Fetal Medicine, but if you get a chance in the meantime, go give La La a hug and some kind words, she's having a really scary experience right now, and has lost one of the babies.

I got a new car!

I've been trying to branch out from my pregnancy ramblings as much as I can. I don't want everyone to think that all I do is fill the day with thoughts of cramping, spotting (or bleeding on exciting days), limited activity restrictions, and worrying. Well, okay that's pretty much how I occupy my time, but not all of it! So here's an attempt as some different new more exciting topics. This weekend I got a new car!

On Saturday my husband and I continued my search for a new car since the lease on my Jeep is up in a couple of months. We didn't plan on actually leasing or buying a new car that day but we found a deal we couldn't pass up. I ended up getting a Lin.coln MKZ. I needed a car with all wheel drive since I take call for work and the roads here in MI aren't always plowed at 4AM. We were able to find one in black. Retail therapy always makes a girl feel better!

This weekend was truly a great one. We didn't do anything in particular, except normal things. Saturday we got my car, had a nice dinner out, and Sunday my mom and I went shopping to my favorite mall. Later I came home and made dinner, we took the dog for a walk and my husband worked outside. The weather Sunday was beautiful.
The best part of it all? I felt absolutely great! I even stayed awake for Desper.ate Housewives and Brothers and Si.sters . My husband looked at me and asked where his wife was and if she was coming back. I hope this feeling sticks around for awhile, a girl could get used to this :-)

Okay, just one quick update on the p - word front. Next up on Wednesday I get to see the OB from the maternal fetal medicine group (peri for short). I'll get another glimpse at Spot on ultrasound and we'll get a baseline cervix check which will continue at least every other week until we're out of the danger zone. Danger zone for incompetent cervix that is. My husband is going to meet me at their office since I'm not sure how long the appointment will last, in case he needs to jet back to work.

Well, I'm off to make some homemade enchiladas in honor of Cinco de Ma.yo. Who am I kidding, that's just an excuse for me to eat Mexican food again. And oh yeah (pssssttt... I'm nine weeks...just don't say it too loud. I don't want to scare Spot away or taunt any of his pesky bleeding comrades to appear instead.)

Attack of the puppy hamburglar

What do these two have in common? Well, they both like to steal hamburgers, or at least hamburger buns!

Yesterday when I got home from some errands I opened the door, heard some plastic crinkling followed by a big burp. The package of hamburger buns I had put on top of our refrigerator must had fallen down and my 7 pound furball ripped open the plastic, and ate four buns. Yes, the 7 pound dog ate four entire buns, and a little plastic to go with it. She probably would have eaten all eight had I not interrupted her canine feast. She actually let a large burp out, rolled on her side and looked like she was ready to fall into a carbohydrate coma of bliss. I was first worried about the plastic, but she wasn't in any respiratory distress so we were okay there. Next I was worried aboutdoggie bloat that small dogs can get that can be dangerous. But she seemed A-okay so I just watched her for any change.

Later that night when I was folding laundry she jumped up and nestled herself between the clothes. She looked at me with her big eyes like "I don't know who ate the hamburger buns, sweet old me couldn't possibly do a thing like that." Ahh, dogs are like kids in that you never know what they'll do!

On the pregnancy front things have been somewhat quiet, which I'm grateful for. I've still had some spotting every day, some days heavier than others, some days much redder than others. Still doing the limited work hours - just part time. I went to my regular OB doctor for a visit yesterday since I'm officially done with the RE. It was some what of a relief to be in a normal office with big pregnant bellies all around me. Yet it was so odd, because I felt like I shouldn't be sitting among them. As if somehow I didn't belong, there must be some mistake or something. But enough of that, maybe I'll explore that crazy thinking some other day.

I had yet another ultrasound which was great. I'm getting used to being able to see little Spot often, I've been spoiled with that. Everything was great and the heartbeat was cruising along at 170 beats per minute. Spot is still measuring about a week behind at 7.5 weeks, instead of the 8.5 it should be. But I think all of them measure either behind or ahead of schedule somewhat so I'm not even worried about that little discrepency. We set up my appointment to meet with the perinatologist at the maternal fetal medicine group (MFM) for next week to get a baseline cervix check and another ultrasound. We talked about me being co-managed by my OB and the MFM group, which was something we had discussed a few months ago. I've already met the doctor from the MFM group that I like for a preconceptual eval of my unicornuate uterus and possible complications a few months ago, so next week there shouldn't be too many surpises.

Basically I'll be seeing either my OB or the peri once a week throughout the pregnancy. My OB talked about doing weekly cervix checks to make sure it's not shortening (one of the most common complications with a unicornuate uterus is second trimester loss due to incomptent cervix). Around the 12-14 week mark we'll decide whether a cerclage is neccessary and go from there. All of the monitoring does nothing but make me feel better, I definitely won't mind making the extra trips to their offices. My OB doctor gave me his home number and cell again and told me to call at the slightest bit of sensing anything was wrong or with any changes. So to say that I left the office feeling about 100 times more comfortable would be an understatement.

Hopefully things will stay quiet until my next week Wednesday appointment. And hopefully all is well in blogland for everyone else! Until then my main goal is to put the pooch on a low carb diet until she burns off those four hamburger buns. I'm only kidding!