Wednesday, March 25, 2015
Tuesday, March 24, 2015
Hiccups!
I woke up this morning to a weird sensation. One side of my tummy was moving softly every 1-2 seconds. This went on for about 2-3 minutes, then stopped. I realized midway that Baby Griffin was hiccuping! How adorable! I woke up his sleepyhead daddy so he can feel the little hiccupy movements. Love love love.
That's all I wanted to say. Haha!
That's all I wanted to say. Haha!
Tuesday, March 17, 2015
Monday, March 16, 2015
Baby name reveal!!
Because I want to shout it out to the world ---
Our little darling's name is:
Griffin Andrew Chan! :)
Griffin: a mythical creature that's half lion and half eagle. Means noble and brave. Inspiration for Gryffindor. My little fighter's perfect name.
Andrew: just a name his dad thought of that will go well with his first name. Idea came to Daddy as he was brushing his teeth the morning after we found out the gender.
:)
Love.
Updates: Me and the baby
We're on our 25th week by tomorrow. Last week, as scheduled, I did my second doppler, and the results were as follows:
- Because I reverted back to my daily heparin injections, the level of flow for my left uterine artery improved a little bit, though it was still sub-par.
- However, because of the length of time of the blood flow being sub-par, the middle cerebral artery showed slight elevation. The doctor's explanation for this is because the system detected that the blood flow is less than ideal, it automatically tells the arteries to prioritize the brain, hence the middle CEREBRAL artery. Is it just me or anything with the word "cerebral" is just freakout-inducing?
- Anyway, weight-gain wise, the perinatologist doing my exam initially told me that the baby's weight was coming in within normal values. It turns out that he's hitting only the 18th percentile in terms of weight. While this may be normal for most pregnancies, (1) my OB wants him to be over the average in case we need to resort to preterm delivery ; (2) we are aware of the blood flow issue, which means his current estimated weight of 636grams is really not meant to be his size at this time, if it weren't for the blood flow issue. This second point debunks the possibility that this just might be his size or that he may be a small baby, really hitting the smaller percentile. We do know that me and my husband are not particularly small people, plus, the subpar blood flow means the baby would probably weigh a lot more if he had access to more nutrients and oxygen. So it is a bit worrisome but not cause for worry --> something most doctors say to me, which I don't really understand.
Anyway, my immunologist upped my heparin dosage to 50 units per shot, daily, from 35. She also initially prescribed a steroid for me - something I took during the first trimester- that is an immuno-suppressant drug meant to essentially tell my immune system to calm the F down because the baby is NOT an invader. I already bought the pills for 2 weeks as she prescribed, when my OB (whom I saw the day after) said NO. He told me to get these progesterone shots from him every week instead of the steroids. He explained that the shots essentially isolate the immune suppression to just those that affect the baby and leave out the rest of the body. The pills, on the other hand, are like a bazooka explosion of suppressing effect, which means my entire resistance will be down. Because I'm pregnant, getting sick or catching a really bad bug is not a good idea, even with this blood flow issue. So, I followed him as usual, as he seems to be more of a thinking doctor than my immunologist is.
So there we stand, at almost 25 weeks. My next scan will be on April 1, for my 3D ultrasound, and then April 7 for my third doppler which I PRAY SHOWS ALL NORMAL RESULTS.
On the matter of the 3D ultrasound: People usually get 4D ultrasounds, but since the difference between 3 and 4D is just that the latter is in video format, I opted for 3D instead. Also, there are no medical reasons for other people to do it, but in my case, I do need to, because the immune drugs I took at the first trimester carry a risk on the baby to develop a cleft palate. This was a risk I knew about going in, and it was a smaller risk compared to the scarier prospect of my immune system triumphing over the baby, so we went ahead anyway. Since the 3D scan will be able to see the baby's face clearly, assuming he is cooperative and stays still, this would definitely allay my fears. Or inform us of procedures he may need after delivery. I am praying it is the former.
Oh, and it doesn't end there: So far, we've been monitoring the baby and the blood flow issues due to my overly enthusiastic immune system. I've been feeling exhausted lately, sometimes dizzy and lightheaded, and I would also get shortness of breath. I chalked it up to usual pregnancy symptoms as advised by Dr Google and to my asthma. It turns out, when I asked my OB about it, he looked alarmed and asked the nurse to take my BP. My BP then, even after eating a good breakfast and taking the stairs up to the 3rd floor of MMC, was only 90/50. He said this was not good at all, married with the subpar blood flow. My acupuncturist wasn't happy about it either, when I told her Saturday afternoon. She said this was a threat to me, not just the baby. And since the baby was depending on me for blood, then it was something that needed attention right away.
So not only am I supposed to up my calorie intake, I am supposed to take more salt into my system and more 'hypertension-causing' food too. Lechon, here I come!
So, definitely an exciting pregnancy, won't you say?
Last night, my mom saw me injecting my tummy with the 50mg heparin and as a result, she also saw my bruise-laden tummy. One bruise in particular was so unsightly, my mom's face fell and I think she felt sorry for me. But seriously, I do not at all feel bad for myself, despite all these things I need to do to my body to get my baby delivered safely. Nothing else matters, really. No physical pain is too painful to bear. Just that he is safe and healthy. Sometimes, I think the worry and the anxiety is much much worse.
Please pray all goes well !!
- Because I reverted back to my daily heparin injections, the level of flow for my left uterine artery improved a little bit, though it was still sub-par.
- However, because of the length of time of the blood flow being sub-par, the middle cerebral artery showed slight elevation. The doctor's explanation for this is because the system detected that the blood flow is less than ideal, it automatically tells the arteries to prioritize the brain, hence the middle CEREBRAL artery. Is it just me or anything with the word "cerebral" is just freakout-inducing?
- Anyway, weight-gain wise, the perinatologist doing my exam initially told me that the baby's weight was coming in within normal values. It turns out that he's hitting only the 18th percentile in terms of weight. While this may be normal for most pregnancies, (1) my OB wants him to be over the average in case we need to resort to preterm delivery ; (2) we are aware of the blood flow issue, which means his current estimated weight of 636grams is really not meant to be his size at this time, if it weren't for the blood flow issue. This second point debunks the possibility that this just might be his size or that he may be a small baby, really hitting the smaller percentile. We do know that me and my husband are not particularly small people, plus, the subpar blood flow means the baby would probably weigh a lot more if he had access to more nutrients and oxygen. So it is a bit worrisome but not cause for worry --> something most doctors say to me, which I don't really understand.
Anyway, my immunologist upped my heparin dosage to 50 units per shot, daily, from 35. She also initially prescribed a steroid for me - something I took during the first trimester- that is an immuno-suppressant drug meant to essentially tell my immune system to calm the F down because the baby is NOT an invader. I already bought the pills for 2 weeks as she prescribed, when my OB (whom I saw the day after) said NO. He told me to get these progesterone shots from him every week instead of the steroids. He explained that the shots essentially isolate the immune suppression to just those that affect the baby and leave out the rest of the body. The pills, on the other hand, are like a bazooka explosion of suppressing effect, which means my entire resistance will be down. Because I'm pregnant, getting sick or catching a really bad bug is not a good idea, even with this blood flow issue. So, I followed him as usual, as he seems to be more of a thinking doctor than my immunologist is.
So there we stand, at almost 25 weeks. My next scan will be on April 1, for my 3D ultrasound, and then April 7 for my third doppler which I PRAY SHOWS ALL NORMAL RESULTS.
On the matter of the 3D ultrasound: People usually get 4D ultrasounds, but since the difference between 3 and 4D is just that the latter is in video format, I opted for 3D instead. Also, there are no medical reasons for other people to do it, but in my case, I do need to, because the immune drugs I took at the first trimester carry a risk on the baby to develop a cleft palate. This was a risk I knew about going in, and it was a smaller risk compared to the scarier prospect of my immune system triumphing over the baby, so we went ahead anyway. Since the 3D scan will be able to see the baby's face clearly, assuming he is cooperative and stays still, this would definitely allay my fears. Or inform us of procedures he may need after delivery. I am praying it is the former.
Oh, and it doesn't end there: So far, we've been monitoring the baby and the blood flow issues due to my overly enthusiastic immune system. I've been feeling exhausted lately, sometimes dizzy and lightheaded, and I would also get shortness of breath. I chalked it up to usual pregnancy symptoms as advised by Dr Google and to my asthma. It turns out, when I asked my OB about it, he looked alarmed and asked the nurse to take my BP. My BP then, even after eating a good breakfast and taking the stairs up to the 3rd floor of MMC, was only 90/50. He said this was not good at all, married with the subpar blood flow. My acupuncturist wasn't happy about it either, when I told her Saturday afternoon. She said this was a threat to me, not just the baby. And since the baby was depending on me for blood, then it was something that needed attention right away.
So not only am I supposed to up my calorie intake, I am supposed to take more salt into my system and more 'hypertension-causing' food too. Lechon, here I come!
So, definitely an exciting pregnancy, won't you say?
Last night, my mom saw me injecting my tummy with the 50mg heparin and as a result, she also saw my bruise-laden tummy. One bruise in particular was so unsightly, my mom's face fell and I think she felt sorry for me. But seriously, I do not at all feel bad for myself, despite all these things I need to do to my body to get my baby delivered safely. Nothing else matters, really. No physical pain is too painful to bear. Just that he is safe and healthy. Sometimes, I think the worry and the anxiety is much much worse.
Please pray all goes well !!
Tuesday, March 03, 2015
Updates
Baby and I hit 23 weeks today! A week more to go until we're officially 6 months pregnant. Time for some updates:
1. Because of my immune issues, my immunologist asked me to do a doppler velocimetry test at Week 19. It's apparently a test that only a perinatologist (i.e. high-risk pregnancy OB) can perform so St Lukes could only pencil me in on my 21st week. I was a bit anxious about this, as it was a good 2 weeks after the ideal time, but I had no other choice. Anyway, the test is a colored ultrasound that measures the flow of blood from and to the baby. The two uterine arteries supply blood into the umbilical artery, which reaches the baby. The ideal results is normal for all three arteries.
My results showed that while my right uterine artery was doing its job, my left one was supply blood at a sub-par level. This led to the baby coming in a bit underweight (about 453 grams VS the ideal 500 grams at the gestational age he was in). Plus, he is so far coming in at about a week and a half advanced in terms of height. Which makes his being underweight even more concerning. The weight that bones account for is higher than usual, because he's taller.
Of course, this got me worried. On one hand, I was relieved my very cautious OB insisted I still did heparin shots even though my immunologist said I could stop already at 12 weeks. Dr Manahan said he is more comfortable if I at least did every-other-day shots instead of stopping altogether. Back then, I figured, might as well follow his advice, as it's better to have been safe than sorry. Turns out, it's SUCH A GOOD DECISION because I refuse to even consider what could've happened if I did stop. The flow may not have been good at all. As it is, my baby relies more on the right side's flow, it being at 100%.
So what's the next step? My immunologist actually said to keep up my every-other-day heparin shots until my repeat doppler velocimetry on March 10th. I think her approach tends to be on the 'chill' side, because (1) she is the head of PGH-Immunology; hence, I think she carries a 'keep costs at a minimum' mindset ; (2) the majority of her patients are much more complicated cases compared to me, because she usually tells me not to worry because other people have it much harder.
My OB, on the other hand, is really more a doctor with patients that, well, for the lack of a better term, can afford to spend. He also has a belief, which I share, that it's always better to spend more on preventive care now, at the prenatal stage, and it's always more worth it compared to spending later on when the baby is out and we have issues post-natally. I agree wholeheartedly. I know that there are people with more limited means than us, and there are people who have worse immune conditions than me, but no offense, I really only care about myself and my baby as far as this pregnancy is concerned. I want to and will always do the best I can and pick the best possible option for my baby. It's got nothing to do with anyone else.
So, suffice to say, my OB said to disregard my immunologist's instructions and resume daily heparin. This way, the March 10 velocimetry test will be even more useful for us because we'll know if daily heparin gets the job done (rather than evaluate if the every-other-day should really be stopped). If the results are still sub-optimal, then I can up my dosage to twice a day. More blood flow means more nutrients, more oxygen and much better care for my baby. To Dr Manahan, the every-other-day is off the table. Minimum daily is the way to go, at the minimum.
He also told me that since my baby is a bit underweight, I have to eat WAY more than I currently do. I must admit, I have not really been eating significantly more than I did before. I know this is normal for people with normal pregnancies - you are, after all, only supposed to add a few more calories on top of your usual diet. But Dr Manahan wants me to prep (physically and mentally) for a possible preterm delivery. He says if my immune reaction gets worse (and it just might get worse because as the baby grows bigger, the bigger the signal it makes to my immune system that there is a huge invader to my body), at month 7, doctors usually deem it safer for the baby to be out of the womb than remain in it. This means that the bigger I can get my baby at month 7, the better the outcome can be for him. He also already administered the sulfactant shots to me last week -- this is the steroid typically given at month 7 if there is a risk of preterm labor. It hastens the dev't of the lungs - the last organ to develop. He says it's better to give a dose now, then see later on if my baby will benefit from a second round. This way, we give him the best shot possible at having capable lungs even if he meets the world ahead of schedule.
Doesn't this sort of approach just make you feel safer under a doctor's care? I'm really grateful I met this guy and that he's the one taking care of me and my little fighter.
2. We've settled on a name! Love love love it!!!
3. Work is boring. (haha!) But the good news is that the huge bonus that we're looking forward to is confirmed to be arriving to our bank accounts on March 10. Hooray! Such a blessing to receive this year of all years, when I am scheduled to take some months off with no pay. Thank you thank you. I am so so so grateful.
That's about it. Pray for me that my results on March 10 are normal.
:)
1. Because of my immune issues, my immunologist asked me to do a doppler velocimetry test at Week 19. It's apparently a test that only a perinatologist (i.e. high-risk pregnancy OB) can perform so St Lukes could only pencil me in on my 21st week. I was a bit anxious about this, as it was a good 2 weeks after the ideal time, but I had no other choice. Anyway, the test is a colored ultrasound that measures the flow of blood from and to the baby. The two uterine arteries supply blood into the umbilical artery, which reaches the baby. The ideal results is normal for all three arteries.
My results showed that while my right uterine artery was doing its job, my left one was supply blood at a sub-par level. This led to the baby coming in a bit underweight (about 453 grams VS the ideal 500 grams at the gestational age he was in). Plus, he is so far coming in at about a week and a half advanced in terms of height. Which makes his being underweight even more concerning. The weight that bones account for is higher than usual, because he's taller.
Of course, this got me worried. On one hand, I was relieved my very cautious OB insisted I still did heparin shots even though my immunologist said I could stop already at 12 weeks. Dr Manahan said he is more comfortable if I at least did every-other-day shots instead of stopping altogether. Back then, I figured, might as well follow his advice, as it's better to have been safe than sorry. Turns out, it's SUCH A GOOD DECISION because I refuse to even consider what could've happened if I did stop. The flow may not have been good at all. As it is, my baby relies more on the right side's flow, it being at 100%.
So what's the next step? My immunologist actually said to keep up my every-other-day heparin shots until my repeat doppler velocimetry on March 10th. I think her approach tends to be on the 'chill' side, because (1) she is the head of PGH-Immunology; hence, I think she carries a 'keep costs at a minimum' mindset ; (2) the majority of her patients are much more complicated cases compared to me, because she usually tells me not to worry because other people have it much harder.
My OB, on the other hand, is really more a doctor with patients that, well, for the lack of a better term, can afford to spend. He also has a belief, which I share, that it's always better to spend more on preventive care now, at the prenatal stage, and it's always more worth it compared to spending later on when the baby is out and we have issues post-natally. I agree wholeheartedly. I know that there are people with more limited means than us, and there are people who have worse immune conditions than me, but no offense, I really only care about myself and my baby as far as this pregnancy is concerned. I want to and will always do the best I can and pick the best possible option for my baby. It's got nothing to do with anyone else.
So, suffice to say, my OB said to disregard my immunologist's instructions and resume daily heparin. This way, the March 10 velocimetry test will be even more useful for us because we'll know if daily heparin gets the job done (rather than evaluate if the every-other-day should really be stopped). If the results are still sub-optimal, then I can up my dosage to twice a day. More blood flow means more nutrients, more oxygen and much better care for my baby. To Dr Manahan, the every-other-day is off the table. Minimum daily is the way to go, at the minimum.
He also told me that since my baby is a bit underweight, I have to eat WAY more than I currently do. I must admit, I have not really been eating significantly more than I did before. I know this is normal for people with normal pregnancies - you are, after all, only supposed to add a few more calories on top of your usual diet. But Dr Manahan wants me to prep (physically and mentally) for a possible preterm delivery. He says if my immune reaction gets worse (and it just might get worse because as the baby grows bigger, the bigger the signal it makes to my immune system that there is a huge invader to my body), at month 7, doctors usually deem it safer for the baby to be out of the womb than remain in it. This means that the bigger I can get my baby at month 7, the better the outcome can be for him. He also already administered the sulfactant shots to me last week -- this is the steroid typically given at month 7 if there is a risk of preterm labor. It hastens the dev't of the lungs - the last organ to develop. He says it's better to give a dose now, then see later on if my baby will benefit from a second round. This way, we give him the best shot possible at having capable lungs even if he meets the world ahead of schedule.
Doesn't this sort of approach just make you feel safer under a doctor's care? I'm really grateful I met this guy and that he's the one taking care of me and my little fighter.
2. We've settled on a name! Love love love it!!!
3. Work is boring. (haha!) But the good news is that the huge bonus that we're looking forward to is confirmed to be arriving to our bank accounts on March 10. Hooray! Such a blessing to receive this year of all years, when I am scheduled to take some months off with no pay. Thank you thank you. I am so so so grateful.
That's about it. Pray for me that my results on March 10 are normal.
:)
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