Wednesday, November 11, 2009

Pregnancy Q & A

Baby Toes


Many people have asked questions about pregnancy, my health, and how all of that works together. I'm going to answer the questions that I can remember below. If I forgot your question, please feel free to ask it again. If I have enough energy later, I can do a Q & A part two.

Q. How does pregnancy affect your illness?

A. Health wise, there is one benefit to being pregnant, and that is the 50% increase in blood volume. This allows me to stand up a little bit longer while pregnant because there is more blood available to circulate back up to my heart, lungs, and brain while upright. The downside is that it also hurts more to stand up. I have more blood circulating to my heart, lungs, and brain than I normally do, but I also have more blood pooling than I normally do. All of that pressure in the veins in the lower half of my body gets very painful at times.

Pregnancy makes my gastroparesis a little more difficult to deal with. Gastroparesis is a partial to full paralysis of the stomach muscles. Thankfully, my stomach is only partially paralyzed. I am still able to eat food, albeit sometimes liquid food, in small quantities. My stomach works very slowly, so it has been difficult at times to consume the extra calories I need during pregnancy. Despite this, the baby is growing well. Even when I can't gain enough weight, Adelaide has been packing on the pounds!

I had to make medication changes because of pregnancy. Some of the medicines I normally take aren't safe for the baby. I was nervous about the medication changes because I wasn't sure how my body would function without them. We were able to find different medications, though, that are safe for the baby. They don't all work as well as my previous meds, but they are working well enough that I can get by without my better meds for a while. It's worth the sacrifice for Adelaide. :)

Pregnancy makes my Joint Hypermobility Syndrome (previously called Ehlers-Danlos Type III) more of a problem. This is a connective tissue disorder, and it causes me to have stretchy veins, faulty collagen production, and loose joints and ligaments. During pregnancy joints loosen even more, which is hard on my muscles. At times it feels like the only thing still holding my hips in place are my muscles. As I am able, I do leg lifts in bed to help strengthen the muscles and keep my hips from hurting so much and feeling like they are falling apart.

Q. How does your illness affect pregnancy?

A. I'm not really sure, actually. I've never been pregnant and healthy at the same time, so I don't know what normal health and pregnancy are like. There has been very little research on pregnancy and dysautonomia, so doctors can't give much of an answer either. Many doctors report that women with POTS can and do have healthy, normal pregnancies. There is currently a medical study being conducted on POTS and pregnancy that I am participating in. I am hoping that these doctors can gather a lot of information and help answer questions that many patients and doctors have.

My current pregnancy is progressing normally, and the baby is very healthy from everything we can tell. It doesn't make sense considering how weak and tired my body is, and considering the fact that I don't have good circulation. If I stand up for too long I actually turn blue and purple from the waist down because of blood pooling. How does the baby get enough oxygen and blood flow at times? I don't know. I can't answer that other than to say it is a miracle. God is in control. He is taking care of Adelaide and is growing a healthy baby inside of me despite my health problems.

Q. What are your plans for labor and delivery considering your health problems? Will you have to schedule a C-section?

A. I am planning to do things as naturally as possible during labor and delivery. It is best that I avoid any unnecessary medications and anesthesia because my body may or may not respond well to them. I did have an epidural for the last two hours of labor and delivery with William, but that was four years ago, and my health was better then. The anesthesiologist said that he would give me an epidural, but that it would be best if I wait as long as I can. He can't guarantee that my body will respond well to it this time around.

While I would prefer to avoid an epidural all together, I realize that it is very likely that I will need one eventually. If labor lasts more than a few hours I will need an epidural so that I can rest and take a nap. We will start the epidural at a very low dose and gradually increase it if I need it and if my body can tolerate the drug.

More important than avoiding the epidural is avoiding extreme fatigue, which leads to an increase in brain fog and other dysautonomia symptoms for me. And even more important than avoiding extreme fatigue is avoiding a c-section if at all possible. Unless the baby's or my life is in danger, we won't do a cesarean. My body doesn't heal quickly or heal well. Recovering from a c-section would be very difficult for me. Also, the anesthesiologist wants to avoid giving me that much anesthesia unless it is absolutely necessary.

We are considering inducing labor in a couple of weeks for three reasons. One, Adelaide is getting very big. She has been putting on about 3/4 of a pound a week according to ultrasounds. If she keeps growing at this rate she will be over 12 pounds by the time I'm 40 weeks along! I would prefer to not have to induce, but if the choice is either induce two weeks early or have a c-section at 40 weeks, I'm going to choose to induce. The second reason for inducing is that it would allow me to start labor at the beginning of the day instead of at midnight like I did last time. I was up all night, and it was very hard to recover from the lack of sleep, not to mention recovering from labor at the same time. It would be great to labor during the day and sleep at night. The third reason, though probably not so important in the long run, is that if I were to induce I could choose to do so on a day when my doctor is available in the hospital. I like my doctor so much. I am very comfortable with her, and she is familiar with my health problems and knows what I like and what I need. Plus, she's just a lot of fun!

Q. How will you handle midnight feedings?

A. With a LOT of help! Will is planning on doing the majority of the midnight feedings, as he did when William was a baby. I will help out as I can, but I know that realistically I won't be able to do much in the middle of the night. My body is too weak and slow when I first wake up. Plus, with each hour of sleep that I lose, my health only gets worse. Over time the lack of sleep really adds up and I become a totally and completely useless mess. No one but Will and William have ever seen me at my worst, but trust me, it's not pretty! I can barely move in bed, I can't answer yes or no questions, I can't walk, and I get so exhausted that I can't even cry anymore. So... to hopefully avoid as many of those totally crashed out days as possible, Will is going to help with midnight feedings. He's wonderful.

8 comments:

Zona Wilson said...

Baby girl foot - so cute! Can't wait to meet Adelaide on your blog! Your answers were very informational and I look forward to learning more as you are able to answer more of our questions.

Amy said...

Hey girlie! Thanks for taking the time post...take care of yourself...get some rest! Praying for you!

Qavah said...

What a great cliffhanger! I'll be checking back for more. :) I'm thinking of you as Adelaide's birthday approaches!!

Jesslikesstuff said...

Ooooh, yes a clifhanger! I'm curious too!

Thanks for the information. I am really looking forward to seeing your little girl on here once she's arrived. My daugther is turning one on Nov 28 so it sounds like our little girls will have similar birthdays!

Keep up the great work -- being pregnant is a chore at the end even for the healthy!!

Krista said...

It looks like she was spared the Reilmann Toe gene. Maybe it's recessive...

JaelCustomDesigns said...

Popping in from SITS!
Happy SITS Saturday Sharefest!

This was very informative information, I hope everything works out just the way you would like it to for L&D.

God Bless!

lemonologie said...

Your story is so inspiring. Thank you for sharing!

I hope the remainder of your pregnancy goes well!

Mariel Torres said...

Congrats! I wish you the best in everything... I'll be praying for you :)

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