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.

:)