Tag: cholestatsis

E’s Unconventional Conventional Birth

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E will be 2 years old in less than a month. In honor of that, here are some details about his birth.
I always thought it would be so cool to have the whole, water-breaking going into labor, rushing to the hospital with my pre-packed bag business, but both my kids were scheduled. E was a planned c-section. I woke up that morning feeling like I was going to throw up from nerves. Two years ago, I had this painful surgery, painful recovery, and then I have to do the exact same thing again. It was terrifying driving to the hospital knowing that in t-minus 3 hours I was going to be sliced open and have my baby cut out of me.
They checked me in and told me they were running behind. I was, honestly, a little relieved about that. I felt like I needed just a little bit more mental prep time. (MP is what my family calls it. Before you go to work, you have to have an hour of MP.) My family was there with me. Like parents, siblings, daughter. They were supposed to get there when I was in surgery, but because the hospital was running behind and my family was being super impatient, they came and waited with me in the pre-op room. The nurse got me ready, and I lied about my weight. Just by a few pounds. Who doesn’t? You feel at your worst, and then they ask you how much you weigh. They should just give you a paper to write it down on. Somehow saying it out loud is so much worse.
Finally my nurse came in and said it was time to go to the operating room. I asked her where the stretcher was, and she said we would just walk to the OR, and she could hold my IV bag. It’s terrifying enough to get cut open, but at least wheel me in! Walking myself into the OR was like the walk of death. The frustrating part is that the husband can’t come in until after you are all ready to go. So, I walk in the freezing OR and they are all just talking, like this is so normal and not terrifying. I know I have used terrifying a lot in this, but that is what it was, terrifying. They told me to hop up onto the table. “Hop up.” I felt like I was a little kid at a doctors appointment. “Just hop on up and we’ll stick this giant needle in your spine.”
They got that over with, and gave me some information about what was going to happen. Who the baby’s nurse would be, etc. They also asked me if it were okay if they had a high schooler in on it. She was thinking about being a doctor. “The more the merrier,” I said. They started giving me the medicine in the spinal block and warned me that a small percentage of women have blood pressure drops with it, and if I am one of those women, they would just give me a drug to counteract it. “I guarantee you I am one of those women,” I told them. On a good day my blood pressure is 90/60. I had a doctor tell me, “You’ll live forever with blood pressure like that, but on a side note, do you pass out a lot?” The answer is yes. I blackout a lot. That is a tangent though. Back to the story. They were about to start cutting and they still hadn’t sent for Eric. I asked them if he could come and join, and they said, “Oh yeah, the husband. Someone go get him.” He finally was there and they started. My blood pressure did drop, and they did give me the drug. About 6 times. I would start to fall asleep and they would get it back up. They got Baby E out quickly, and he started to cry. After the fear surrounding the Cholestasis*, it was joy hearing my little baby cry.  It felt surreal to finally see this baby, that we spent the last month protecting. Doing ultrasounds, NST’s, watching him.

Side note: Did you know they take out some of your organs sometimes during a c-section? I had heard tales, but didn’t think there was truth to them. I started to get shoulder pain and the doctor ever so casually told me it was extra air intake due to a certain organ being on my stomach. Eric was engrossed in all of this. He had asked me previously, if this time could he not stay by my head and maybe get closer to the action. He just felt like last time he didn’t get as good of a look as he would have liked. I told him no, obviously, that his number one duty was to stay with me and keep me from being terrified.
After they whisked the Baby E away and brought him to my waiting family, they started to stitch me up. They asked me how I was doing, I told them bored. I just wanted to get out of there and go hold my baby. It takes like 3 minutes to get the baby out and then you have to sit there for 20 minutes while they stitch you up. They finished, and transferred me to the stretcher. The doctor came over and shook my hand, and said, “Congratulations” and walked out of the OR to her next waiting c-section. I’d had surgery before I had my babies, but I can’t say until that moment, that I had ever had the good fortune of a doctor shaking my hand afterward right there in the OR.
The hospital stay was good. The nurses were nice, even the one who hid the formula in a cabinet because she did not approve of my supplementing with formula. I’ve had good experiences with my c-sections. Definitely not something, I’d choose, but my babies were healthy and so was I through it all.

 

*http://www.mayoclinic.org/diseases-conditions/cholestasis-of-pregnancy/basics/definition/con-20032985

My Itchy Pregnancy.

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I’m a googler. I google everything. My husband gets mad at me because when we’re watching movies together at home, I will start to google information about the movie and the actors. By the end of the movie, I know it all.

I also google health questions. If I get a weird twinge or pain- I google it. It’s not that I’m afraid that I’m sick, it’s just that I am just so interested in the why. Why does my leg get this certain twitch in it after I walk up a big hill? Why does my knee hurt only on the third Tuesday of every month? Thanks to Google, I have a very wide array of random knowledge. A girl I knew told me she grew up across the street from a Vegas troupe. I googled them. 30 minutes later I was telling my husband all about it. The accident. My opinion on what happened. I like to know things.

When I was 32 weeks pregnant, I woke up one night with really itchy hands and feet. I thought it was kind of weird. Usually when I itch during pregnancy, it’s on my belly where I am doing the growing. And this was really itchy. In the morning, I googled it. At my most recent doctors appointment, they had put me on a high dosage of iron for anemia. I figured it was a side effect.

I started typing in itchy hands and feet. Trusty google predicted exactly what I was going to say next. “Itchy hands and feet during pregnancy” It finished it up for me.

The first search result was from mayoclinic.org. Cholestasis of Pregnancy.

They gave a definition:

“Cholestasis of pregnancy can make you intensely uncomfortable but poses no long-term risk to an expectant mother. For a developing baby, however, cholestasis of pregnancy can be dangerous. Doctors usually recommend early delivery.”

Not the benign answer that I was expecting. I went down the list through the search results. The more I googled, the more I realized the seriousness of the situation. I called my doctors office and spoke to a nurse. “I’ll schedule you in with the lab at the hospital. When can you get down there? Right away?” The urgency in her voice left me with one option. I got there right away.

I tested positive.

The doctor called me to deliver the news. In order to ensure my baby was born healthy, I needed to get blood work done weekly. I needed 2 Non Stress Tests a week. I needed an ultrasound once a week. It was strange to go from a relatively healthy pregnancy to high risk within a morning.

Movement is important in Cholestatis. At any moment your bile acid levels can rise and you lose the baby. We needed to know my baby was okay and moving. If I didn’t feel my baby move in a certain time period, I needed to go to Labor and Delivery right away for an ultrasound. It was possible that they could deliver the baby right then if he seemed distressed, unresponsive or his heart was slowing down.

During the Non Stress Tests, E’s heart had to peak a certain amount of times to make sure he was okay. “Hold on, let me have the doctor look at this” was a dreaded phrase. One I heard too often. E really enjoyed his naps it seemed. I was so worried all the time. I was worried that they would miss something. I was worried my baby would stop moving. I was worried I would be one of the loss stories. I had so much fear.

At first the itchiness was unbearable. Forget my past knowledge over what I thought was intolerable itching. The Chicken Pox seemed like a walk in the park by comparison. It was unreal. Antihistamines did not work. Lotions did not work. I scratched myself until I bled and there was still no relief. Ice packs were my best friend. I would bury myself in every frozen thing in my house. In spite of the torture I was going through, I was one of the lucky ones. After my levels normalized, my itching went down. Others are not so lucky and itch the entire pregnancy.

My bile levels stayed normal. My baby stayed moving. I had my baby at 37 weeks. The NICU was on hand just in case. He was amazingly healthy.

June is ICP Awareness month. (Intrahepatic Cholestasis of Pregnancy) It’s important to me to share my experience because there are women who were not as lucky as I was. They didn’t realize that they had ICP and they lost their babies. Even though ICP is fairly common, (1 in 1000 pregnancies) there are people who don’t know anything about it. Like I hadn’t.

Here are some facts.

What exactly is cholestasis?

“[Cholestatsis is] a common liver disease that only happens in pregnancy. Cholestasis of pregnancy is a condition in which the normal flow of bile in the gallbladder is affected by the high amounts of pregnancy hormones” –americanpregnancy.org

What is the treatment for Cholestasis?

1) Medication in the management plan of ICP.

Different Medicines to control the itch and to keep your bile acid levels down.

2) Early Delivery in the management plan of ICP.

The ideal time to deliver is between 36-37 weeks if symptoms can be managed. It is not common to have to deliver the baby earlier than that.

3) Additional management plan of ICP.

Monitoring

Blood Work

Fetal Monitoring

Below is an amazing website. It answers questions, has success stories, doctor recommendations for each state. Everything you could want to know about Cholestatsis.

http://www.icpcare.org/