Pregnancy...Rolls Forward

June 16 marks 28 weeks and the third trimester! Baby is about 2 1/4 lbs (like a Chinese cabbage) and is roughly 14.8 inches. The pictures were taken a little early--the 14th--because I knew since I was on restricted activity I wouldn't be going anywhere all week and not be dressed. Spent the week in my pajamas, except for Monday and Tuesday when I had doctor appointments.
Always wonder what I look like from behind--if someone coming up from behind me can tell I'm a pregnant lady. That's why I took a random back shot.
June 14th I had my 4th appointment in Maternal Fetal Medicine with the perinataologist. It was the third time in a row I met with Dr. Jackson, which was a pleasant surprise since there are four doctors that rotate coming down to St. George. They started something new where they record the ultrasound and give you a DVD...I love that! Wish I had a recording of Porter's. When I asked they said they didn't have the equipment or capability to record them. So this was a pleasant surprise. I usually get 4-5 printed pictures from every ultrasound but this time I only got one. The technician thought she'd printed more but apparently didn't. She also tried to get a 3D picture of Caleb for us, but little guy wouldn't cooperate. He would face the wrong way or have something in front of his face. We even tried moving him by having me move this way and that, but to no avail. That technician was so fast--especially compared to the last one--which I found disappointing for the DVD. Anyway, Dr. Jackson had a note from Dr. Lunt to make sure we checked the cervix. Something was in the way (I'm guessing Caleb?) of getting a good picture of it in the ultrasound, so they said we needed to do a vaginal ultrasound. Oh joy. Just when I think I'll be able to leave an appointment without being violated. =P The great news is my cervix was perfect! Closed, long, and I think it was 4.5cm and they said a normal length is 2-3 cm, so they were pleased to see that. It meant there was no indication of labor and that's what we want to see. Dr. Jackson's opinion was that we could discount the results of the fFN test, but Dr. Lunt feels otherwise. When I asked again about an estimated delivery date Dr. J said at the latest we would go to 37 weeks and induce if he had not come by then. He said with the sensitization there is no reason to keep him in past 37 weeks to risk severe anemia. The velocity of the blood flow in Caleb's brain was 34 which is good. It's still low. According to measurements from the ultrasound Caleb was about 2 lbs 7 oz and right on target. When I asked Dr. J's opinion about being on restricted activity he felt there was no need. He said, "I think you can get up and walk around; if Dr. Lunt yells at you tell him I said so." I have decided to follow Dr. Lunt's advice and opinion however, since he is the one who knows me, knows my history, and sees me on a regular basis.
The chart is what we go by to see how severe the anemia is for the baby. They look at the velocity of the blood flow in the brain by Doppler ultrasound and the faster the flow the more anemic baby is. So far Caleb has been in zone D which is where we want him to be. Getting into a higher zone means being watch more closely and less time in between visits. If he were to plot in zone A that's intervention time meaning a blood transfusion or possibly early delivery. All depends on how severe it is, how far along we are, and how baby is doing. I almost forgot at one OB appointment Dr. Lunt told me I was a little anemic and needed to start taking iron pills with a stool softener. Wednesday June 22nd I had my OB prenatal appointment with Dr. Lunt which was a check up from the hospital stay as well as the routine visit. I told him Dr. J's reaction to the fFN test results and about not being worried; his response was he didn't have luxury of not worrying. True 'dat. He also said we would start weekly appointments/visits due to being high-risk, in addition to weekly progesterone injections. He said you usually start those earlier ( I think he said around 16-18 weeks?), but they would still be effective. One thing he talked about was how others (those in Maternal Fetal Medicine) were concentrating on the sensitization and forgetting preterm risk. I'm glad he's on top of something that was primarily overlooked. It was mentioned that we may start weekly cervix checks depending on what was going on with my body. I asked about being on restricted activity and he said at least another week and to "spend the majority of day sitting down off feet".
June 23rd we hit the 29 week mark. Baby is thought to be about 2.5 lbs--like a butternut squash--and is a tad over 15 inches. (picture 6/25)That evening a nurse from Dr. Lunt's office called and asked if I could come in the next day for the first progesterone injection. I was given the option to bring someone in with me who could be taught how to give me the injection or have it given to me in the office. I opted for them to do it in the office since I'd be in there every week anyway to be seen and checked. Besides, the only person I think I would want or trust to give me injections like that would be my sister Michelle, but for some reason she won't come out from Ohio to do it every week. =P That first injection didn't hurt was it was done until Monday...4 days later! Then it was sore ALL day and I could see a little bruise. Ouchie. Wednesday June 29th was the next OB appointment. I think it was the quickest appointment I've ever had there: I was in and out of there in 35 minutes. I usually don't even see the doctor by then. It was great! Either they were really on top of things or it was early enough in the morning to not be behind at all. He asked how I was, when the next perinatologist appointment was, listened to Caleb's heartbeat (128), and said he'd see me in a week. I asked about being on restricted activity and he said yes to continue that to be safe. So I can probably count on that until baby is born, meaning take it easy as possible and do as little as possible. I was given another progesterone injection which hardly hurt when done, but that evening I started to feel it, and the last one still hurt. Two sore cheeks/hips at once! Hopefully they will always feel better before the next one. Since I know I'll be in there weekly we went ahead and made my appointments for the next six weeks. One thing I learned that I had misunderstood thus far was the anemia chart and where Caleb was. I thought because there was anything to plot on the chart that it meant he was anemic, just very little. Apparently he's not anemic at all! The specialist report that Dr. Lunt read recorded an "absence" of anemia. That's way better than what I thought! Dr. Lunt said the Doppler readings of Caleb's brain's blood flow are where a normal baby would be. Yippee! Now if only it could just stay that way...June 30th we officially made it to 30 weeks! Baby should be about 3 lb--the head of a cabbage--and is about 15.7 inches long. (picture 7/1)July 7th was the 31 week point. (About 3.3 lbs--like 4 navel oranges--and over 16 inches long.) The day before (7/6) I had my weekly OB appointment. All went well--minus having to pee in a cup when I can no longer see over baby belly. I told doc I had had some days recently where I have been sooo tired and if it was possibly a side affect from the injections or my anemia. He gave me a blanket "yes" and said it's "the progesterone, anemia, and pregnancy." Three whammy's. Lucky me. Caleb's heartbeat was great at 130 and Dr. Lunt ordered blood work to be done to check the titer. Here's an explanation on that:

"Antibody titer is a laboratory test that measures the presence and amount of antibodies in blood. The antibody level in the blood is a reflection of past exposure to an antigen or to something that the body does not recognize as belonging to itself. The body uses antibodies to attack and remove foreign substances." http://www.healthcentral.com/ency/408/003333.html

I went to the lab for the blood work right after my super early appointment (7:45am) and by 2pm in the afternoon I received a call from my OB's office. It's NEVER a good thing when THEY call ME. It was one of the nurses calling by instruction from Dr. Lunt to let me know the lab results. The titer went up. June 10th it was 1:32 and here a month later it was 1:128. They wanted me to know just FYI and to make sure maternal fetal medicine knew that during my appointment the following week. So what that translates to is my body is producing more antibodies which attack my baby (who is a positive blood type). I will probably start seeing the perinatalogist more than once a month. They'll most likely have to follow Caleb a lot closer now that we're seeing what we anticipated seeing. My poor little baby. He's just a little guy. He never hurt nobody.