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#11
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A healthy person is...
"Pologirl" wrote in message oups.com... Anyway, my midwife says that locally (she thinks due to the altitude, which is well above sea level), it is more common for women with uncontrolled blood glucose to have babies with IUGR, than babies with macrosomia etc. And that a diet low in simple carbohydrates (not low calorie! not low carb!) seems to improve (increase) the growth and birthweight of the babies. That is good enough reason for me to do the 3-hr, 100g glucose tolerance test. I was going to say something about this in previous posts. When I saw the dietician, my diet wasn't restricted. I had to make "choices", but I wasn't ever starving or eating too little, and I'll admit I was probably eating better than I'd been prior to being diagnosed. If I remember right, I ate something like 4-5 carb choices for breakfast, 1-2 for a snack, 4-5 for lunch, 1-2 for a snack, 3-4 for supper and 1-2 for a bedtime snack. Or something like that, but I was eating frequently and well. Also was given a bunch of info on proportion sizes, etc. If the diet was restrictive, to be honest, I wouldn't have done it. Joy |
#12
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Gestational diabetes, oligohydramnios, IUGR
I am SuperWoman, capable of dodging speeding bullets as fast as her OBs
shoot 'em! Gestational diabetes. I passed the 3-hour GDTT (which is also the diagnostic test for diabetes, period) with no blood glucose counts over 100 (in whatever units are used in the US). Whew. That test took about 4 hours total, and involved 4 needle sticks. I had the blood draws for all the other tests done at the 4th needle stick. In all, 4+8 = 12 little tubes of blood. Monkey Boy sat on my lap throughout and was very good. This serves to acustom him a little to the scarier aspects of his own physician visits. If Mommy can be calm for a needle stick, so can he. He already knows they hurt; what he does not know, being only 2, is how adults would prefer him to deal with them. Oligohydramnios. This week's US showed no fluid in the baby's kidneys now, and plenty of amniotic fluid. No hydronephrosis and no oligohydramnios, yay! And the dramatic increase in amniotic fluid is further evidence that the baby's kidneys are normal. Re IUGR, the US also produced much better measurements all around except abdominal circumference (AC). But I think here too this baby is taking after Monkey Boy. His AC too was disproportionately small in prenatal USs and at birth. So the suspected IUGR may indeed be not IUGR, rather nothing wrong at all. The baby also passed this week's 2nd NST, again with flying colors. And the US showed good breathing motion, so the baby's lungs are maturing nicely. Next week, I get a prenatal visit, which should include results of all the blood tests hunting for a blood clotting and/or immune system disorder. ALso, two more NSTs and an US, the US to look specifically at the sacrococcygeal teratoma (SCT). In this week's US, there does appear to be an abnormal extra artery in the vicinity of the SCT. That could be very, very bad news, by allowing the SCT to grow much faster than the rest of the baby and hence become much larger. But as we are now at 30 weeks, the prognosis is not anywhere near as dire as it would have been 10 or even 5 weeks ago. And this baby clearly is otherwise healthy and vigorous, all good signs in case growth of the SCT does necessitate an early C-section. |
#13
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Gestational diabetes, oligohydramnios, IUGR
Andrea Phillips wrote:
[...] I really admire the matter-of-fact way you're taking all of this as it comes at you, though, that's for sure. Partly, that's an act. One way to Make It So is to Act As If. Part of me desperately wants to have a complete breakdown and let/make someone else be in control of everything. But there isn't anyone to do that for me. DH is very caring and supportive, but he had a very sheltered upbringing. This is all way outside his experience and his comfort zone, and he copes mainly by thinking about other, less scary things. At present he also cannot cope with the unpleasant discovery that our roof leaks, something that I too am mostly ignoring. 2yo Monkey Boy is very sensitive. He saw me crying one day in frustration at screwups with our medical insurance, and said "Mommy is broken." That just about broke my heart. He was only testing a theory, I suppose, because he was relatively calm. I am his rock, so how can I break? Contrast that to the following scene. We watch maybe 1 hour of TV per day; today he saw on a TV show a figurine accidentally smashed, and broke into violent tears and wailing. We immediately turned the TV off and I held him and assured him the people on the show would glue the broken figurine back together and it would be all okay. He took maybe 5 minutes to calm down. |
#14
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Gestational diabetes, oligohydramnios, IUGR
"Pologirl" wrote in message oups.com... I am SuperWoman, capable of dodging speeding bullets as fast as her OBs shoot 'em! FABULOUS!!! That is awesome news all around. Hopefully, now, there isn't anything going on with an abnormal extra artery. You are in my thoughts often, pologirl, and I am so happy for you and to read such a good report! Joy |
#15
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Gestational diabetes, oligohydramnios, IUGR
"Pologirl" wrote in message ups.com... Andrea Phillips wrote: [...] I really admire the matter-of-fact way you're taking all of this as it comes at you, though, that's for sure. Partly, that's an act. One way to Make It So is to Act As If. Part of me desperately wants to have a complete breakdown and let/make someone else be in control of everything. But there isn't anyone to do that for me. ((((HUGS)))) I know, so know, the feeling. DH is very caring and supportive, but he had a very sheltered upbringing. This is all way outside his experience and his comfort zone, and he copes mainly by thinking about other, less scary things. At present he also cannot cope with the unpleasant discovery that our roof leaks, something that I too am mostly ignoring. I remember the day my ceiling in the kitchen started pouring water from a roof leak. I just sat there and watched it before I did anything because it felt quite overwhelming to do anything at all!! I will say, that once the pregnancy ended, and all the what ifs, maybes, hows, the uncertainty, unknowns, became more dealable, I guess would be the word. My son is here, he had major surgeries within hours of being born. I feel blessed and lucky he survived, and he's had surgeries since then. They are life-sapping events, but they also end up being life renewing, if that makes any sense. I told my husband after Grant was born, "y'know all kids come with the potential to have problems, but this one has huge warning labels". When people want know whether he'll be able to walk, or they assume because he's alive he's Healthy, it's hard to answer. It used to matter a great deal, and now, it's more about what can he do, and I'll be pleased with whatever we get. My house is an utter and complete disaster. Somedays, I look at it, and I care. Actually, lately, I have been achieving somethings around here. I think what you and your hubby are going through is normal. It Will get better, but it does take time. 2yo Monkey Boy is very sensitive. He saw me crying one day in frustration at screwups with our medical insurance, and said "Mommy is broken." That just about broke my heart. He was only testing a theory, I suppose, because he was relatively calm. I am his rock, so how can I break? Contrast that to the following scene. We watch maybe 1 hour of TV per day; today he saw on a TV show a figurine accidentally smashed, and broke into violent tears and wailing. We immediately turned the TV off and I held him and assured him the people on the show would glue the broken figurine back together and it would be all okay. He took maybe 5 minutes to calm down. That was, and has been, the hardest part for me, how this affected the other kids. Not easy. Poor Monkey Boy. My son was two, also, and he turned three shortly after G was born. G was in the hospital when my second daughter was to have her fifth birthday party, and he was to have his third. It broke my heart having to miss that day, and when I returned he just DID NOT UNDERSTAND. It has been tough figuring out how to not let him completely run roughshod over everyone (he expressed himself through lots of anger and hitting, biting, punching) and giving him the love and reassurance (and understanding) he needs. My 5yo tells me everytime I leave the house she doesn't want me to go because she's afraid I'll hit a deer and die. My 7 yo is a bit more blase about things, but she's asked often, when we're going through a surgery, if G will die. Your poor little tyke. They are so amazing, aren't they, in seeing how we feel? I think my kids are what held me together no matter how often I just wanted to break down. There were days (are days) where I didn't hold it all together, but I think my kids have been my rock so that I can be their rock, y'know? I hold onto them, and therefore I'm strong for them. I often receive comments about how strong I am, but I don't think that's the case. I'm doing what has to be done. When you are in the situation, you have the choice. Do i deal or not? When you choose to deal, you take it one day at a time. Sometimes you fail, sometimes you succeed, most of the time you just "do". Being at 30 weeks was a tough time. Those last few weeks are so full of ups and downs. Positive appointments, negative appointments, it was crazy. so close, yet so far. Take care. You continue to be in my thoughts. Joy |
#16
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Gestational diabetes, oligohydramnios, IUGR
Joybelle wrote: Hopefully, now, there isn't anything going on with an abnormal extra artery. I hope not too. But it is a very bad sign. We have been expecting the tumor to eventually grow itself an arterial tap, but hoping it would not happen. Without its own dedicated blood supply, a tumor cannot grow very rapidly; with one, it can. |
#17
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Gestational diabetes, oligohydramnios, IUGR
"Pologirl" wrote in message oups.com... Joybelle wrote: Hopefully, now, there isn't anything going on with an abnormal extra artery. I hope not too. But it is a very bad sign. We have been expecting the tumor to eventually grow itself an arterial tap, but hoping it would not happen. Without its own dedicated blood supply, a tumor cannot grow very rapidly; with one, it can. Hope all is well, Pologirl. Do you have any recent news about the abnormal extra artery? Hugs to you and your sweet baby. Joy |
#18
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Gestational diabetes, oligohydramnios, IUGR
"Pologirl" wrote We have been expecting the tumor to eventually grow itself an arterial tap, but hoping it would not happen. Without its own dedicated blood supply, a tumor cannot grow very rapidly; with one, it can. Joybelle wrote: Hope all is well, Pologirl. Do you have any recent news about the abnormal extra artery? Hugs to you and your sweet baby. Thanks! Bottom line: no news is good news. This week's US again showed what appears to be a new, dedicated artery, but the mass shows no significant growth since 2 weeks ago. Baby's kidneys, bladder, heart, head, spine, placenta all look normal. The bladder still appears to be pushed a little high in the abdomen, but the kidneys and heart are where they belong. Growth is on curve, and 2 non stress tests were normal, all of which suggests the baby is simply small, not suffering IUGR. The gazillion blood tests fishing for possible maternal causes of IUGR are not all in yet, but all those in so far are normal. The amniotic fluid was okay but less than last week's abundant volume: I need to continue drinking far more water than feels like enough. Ugh. The US radiologist was very surprised not to see significant growth of the mass, and wondered out loud if the mass might not be a sacrococcygeal teratoma at all. In which case, WHAT IS IT? It looks even less like a neural tube defect... Argh. The MRI planned for after the baby is born will be important here, to see before surgery exactly how large this mass is and what organs are involved or impacted. Once the baby is outside me, the MRI team can use a special tiny-baby sized sensor array to get new images of much higher resolution. Then the surgical team can make its own plan of attack. |
#19
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Gestational diabetes, oligohydramnios, IUGR
Pologirl wrote: This week's US again showed what appears to be a new, dedicated artery, but the mass shows no significant growth since 2 weeks ago. Baby's That's something of a relief, then. kidneys, bladder, heart, head, spine, placenta all look normal. The bladder still appears to be pushed a little high in the abdomen, but the kidneys and heart are where they belong. Growth is on curve, and 2 non stress tests were normal, all of which suggests the baby is simply small, not suffering IUGR. The gazillion blood tests fishing for possible maternal causes of IUGR are not all in yet, but all those in so far are normal. The amniotic fluid was okay but less than last week's abundant volume: I need to continue drinking far more water than feels like enough. Ugh. So far so good... Hey, maybe there's something to having a poclet of the internet rooting for you, then The US radiologist was very surprised not to see significant growth of the mass, and wondered out loud if the mass might not be a sacrococcygeal teratoma at all. In which case, WHAT IS IT? It looks even less like a neural tube defect... Argh. The MRI planned for Gosh, that's got to be so incredibly frustrating. To become so informed about what you're facing and then find out now that it might be something totally different, which you may not be prepared for... when are you due? And at this point do you stand a good chance of making it to term, or are you likely to see an early induction/section? It sounds like things are going well enough that they'll let you keep cooking for now since it doesn't look like IUGR, but the situation can change pretty rapidly. after the baby is born will be important here, to see before surgery exactly how large this mass is and what organs are involved or impacted. Once the baby is outside me, the MRI team can use a special tiny-baby sized sensor array to get new images of much higher resolution. Then the surgical team can make its own plan of attack. How fast will all of this happen after birth? Within hours? Days? Weeks or months? |
#20
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Gestational diabetes, oligohydramnios, IUGR
Re IUGR, I am dealing with two schools of professional approach. The one says "baby under 10th percentile equals IUGR, period; monitor closely and if *anything* looks off do an early C-section". The other says "baby under 10th percentile equals *possible* IUGR: must find out if baby is falling off its growth curve. If so, monitor closely and if anything *else* looks off do an early C-section". My current management reflects a compromise between these two schools. This baby is under 10th percentile on several measures, but is on curve. Nonetheless, I am being monitored very closely. So far all looks okay. An OB without nerves of steel probably would be thinking "IUGR + SCT = take the baby *now*". But by all accounts, babies with SCT do better the longer they are allowed to cook, all else being equal. The diagnosis of SCT itself is not sufficient reason to take the baby early. What if this isn't an SCT? To some extent, it doesn't matter. A tumor is a tumor, and any tumor that gets a good blood supply can grow so fast that it kills the patient. I still think it is an SCT, despite the unusual course of development. I asked my team at AFCC specifically about the blood supply issue, when I first met with them, and they assured me that most SCTs they first see growing slowly continue to grow slowly. This is contrary to the (necessarily somewhat simplified) textbook chapters on SCTs, which either state that all SCTs grow at an incredible rate, or are vague on this point. But, I am comfortable with AFCC's experience with SCTs. I have to say this baby is already a survivor. Of babies diagnosed with SCT before 30 weeks, fully 25% are terminated and another 35% die of complications before they make it to 40 weeks (in or ex utero). The very first decision I made was not to terminate, to give this baby a chance, but I did have to think about it. I made my decision on two points. One, the situation was not already hopeless: the mass was small and both of us were otherwise healthy. Two, among the "SCT stories" I found on the Internet (most written by the mother), by far the most painful *to me* were the ones in which the mother chose to terminate and later learned enough about SCT to realize her baby might have had a chance not only to live, but to live a normal life. I am pro-choice, and my personal choice in this pregnancy is to gamble on life. Post delivery, the plan is for surgery within hours or days. Within hours only if there is a serious complication that makes haste necessary. Any unnecessary delay is to be avoided, because the mass can within weeks become malignant and in any case the mass will interfere with various bodily functions that become necessary once the baby is ex utero. The interference can rapidly become life threatening. |
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