18 weeks

Tomorrow marks the day that I am 18 weeks pregnant. That means two more weeks and I am at the halfway point! Yay! Some days I feel like I still have SO much longer to go but getting to the halfway point has been a huge goal of mine for months so it feels good to have it actually near. Yesterday my nurse came for a weekly visit and changed the bandage and took vitals. Each week my skin is more irritated and raw under the bandage. It itches quite a bit most days now but I try my best not to scratch it because then the bandage comes loose. When my bandage was removed yesterday there was a rash everywhere underneath and a few places that were bleeding along with lots of bruising. The nurse said that unfortunately irritation like that is normal and that sometimes women get it so bad that their skin looks like raw hamburger. YIKES! After hearing that I counted my blessings and realized my rash isn''t so bad. It doesn't spread outside of the bandage at all so all is well.

She called back with my levels today and it is much of the same. My potassium stayed the same at 3.7 so low but barely. My sodium dropped again so is down to 133 which is the lowest point it has been at. Frustrating since last week it went up a few points but I have come to terms with the fact that I haven't had normal labs in months and this is just how things are going to be for awhile. We are going to stick with the same regimen as I have been doing the last several days- two bags of fluid (2000 ml) a day which I run both at night. Both bags are sodium chloride to help boost my sodium and one is infused with potassium as well. Nurse will come back again next Tuesday to do labs.

My cramping/contractions have settled down the past few days. I mostly only feel them towards the end of the evening when it is getting close to IV time. This past Sunday we were out shopping and I started getting contractions that were painful 20 minutes apart so we came home and once I got some water and rested they settled down. I just need to take it easy. I go back to the doctor in 2 weeks for my 20 week checkup and the anatomy ultrasound so looking forward to that.

Baby is moving more and more every day. I love feeling the little kicks and taps. This is the fun part before the movements get too painful! :) My belly continues to grow- here is a picture from today:





I feel like my belly has grown a lot in the last few weeks! Oh and the random thing on my arm would be the shower bandage that Jeff creates for me each time I want to shower! At first somehow the PICC would always get wet but he is a pro now and my arm stays nice and dry! Here's a close up:

I am so thankful to have Jeff. He helps me so much. He gets my IVs ready every night and injects all my meds and just pretty much keeps everything under control. I don't know what I would do without him!

A setback...

I had a surprise visit to my OB today. Since last week I have been having some cramping mostly at the end of the day and in the evenings. It is not incredibly painful but I would describe it as uncomfortable. I assumed it was from returning to work and being more active during the day at school. Well last night the cramping got worse but I had Open House after school so it was a very long day and I attributed it to that. Usually when I get home and put my feet up, the cramping goes away but last night it went on through the night and continued throughout the day today. I decided to give my OB a call around noon just to see what he said. He wanted me to come in right away after school and even though he didn't have any appointments squeezed me in.

First he listened for the baby's heartbeat and it took quite awhile to find which of course made me nervous. He finally found it VERY low in my pelvis and said that's why it was tricky to find. Apparently baby is snuggled in way down low! Anyway, heartbeat was in the 150s and nice and strong. Then he checked my cervix and thank goodness it was still long and closed. He made sure that I was well aware that if my cervix was shortening I would be DONE with work and on bedrest. Ummm...that isn't really a good thing for me to have happen right now so praying that doesn't become a reality for me!

Basically the doctor said that the cramping could be one of two things: preterm labor (which at this point he does not think based on my cervix) or the result of my kidneys being stressed and releasing a hormone that is causing me to contract. He is fairly confident it is the latter which makes sense because of all my dehydration issues. His best guess is that the reason the cramping is getting worse is because I went from two bags of fluids a day to one a week ago and that is stressing my kidneys. SO, I am back to two bags a day. This presents a little problem now that I am back at work. In order to run a bag before work, I will have to get up at 4 AM! So he is letting me try running two bags back to back at night for the next two nights. It isn't ideal because it is best to spread the bags out so you don't lose as much fluid so quickly after the bags are done but it is worth a try. If my cramping gets worse at all, I am to come in again tomorrow to have cervix rechecked and we will go to a morning bag and a night bag and I will just have to suck it up and get up early. As it is, even the two night bags is going to be tough. That is about 3 and a half hours on the IV each night starting at 8 when Ella goes to bed! It is definitely not ideal but I know it needs to be done for my health and that of the baby.

I guess I am just feeling really down tonight because I feel like this is such a step backward. I am 17 weeks today and naively thought that I might have a chance to get my PICC pulled by 20 weeks. Now I feel like I am further from that goal than ever. I will have to get this situation under control which will take a few weeks I am sure, then wean to one bag a day again for several weeks and THEN possibly entertain the idea of trying without fluids. I am not sure that will ever happen at this point. :( Since I am feeling down I decided to make a list of all the things I miss and am looking forward to when baby is here and this pregnancy is over! :)

I miss...
*being able to shower on my own whenever I want without having to have Jeff wrap my arm from elbow to shoulder in plastic
*being able to go to bed whenever I want to- not when the IV finishes
* having both arms PICC free and free from itching
*eating delicious meals and having them always stay down
*being oblivious to electrolytes and not having a clue what sodium and potassium levels are!
*enjoying a glass of wine at the end of a long day :)

Exhausted!

Today was the first day of school for students. My day went really well but I am SO tired now. It was a lot of running around helping students get settled this first day, getting them supplies, helping with schedules, etc. I was really nervous for today- especially to meet my 8th and 9th graders but it went well and I think I will feel even better after I get this first week under my belt. I just need to get used to being back at work and how tired it is making me.

I had a nurse visit today directly after school and my nurse couldn't come so I met with a different one. It always feels so good to get the dressing changed on my PICC although today after it was cleaned with alcohol it burned so bad for about an hour that I could have sworn my skin was being eaten by the chemicals! Yowch! Blood pressure was good at 110/65 and still a bit fast resting heart rate. I assumed since my appointment was so late that I would hear back tomorrow about my bloodwork but they called me back about thirty minutes later with the results. Good news- my labs are improving! My sodium increased to 135 so it is just shy of normal (136-145) and my potassium decreased just a touch to 3.7 from 3.9 last week which is in the normal range. My glucose was also normal at 74. I was so happy to hear that my bloodwork was good! My OB said that getting less fluids would probably help my levels improve and he was right! I hope to continue to keep them in the normal range. I will continue to recieve potassium and sodium intraveneously since my body can't maintain on its own right now. I will see my nurse again next Monday to check levels again and hope I can keep on a positive track! I am still feeling dehydrated by the end of the day and still nauseous most all of the time but am hopeful that 20 weeks will be the magic mark and I will feel better!

Weekends go too fast!

Gosh I had forgotten how fast the weekends go by when I am working! I enjoy the time at home with my family so much and combining that with getting lots of cleaning, grocery shopping, etc. it just flies by! I have been feeling about the same but every day am able to eat more and definitely have more of an appetite. It is so hit or miss what will cause vomiting- today it happened to be brushing my teeth of all things! Yesterday I was able to keep pizza down at dinner but got sick after rice at lunch. Ugh. Oh well at least I am able to start eating foods with taste from time to time. I have noticed now that if my stomach gets too empty I also start getting nauseous and that is when the dry heaving is usually the worst so I will need to stay on top of that. Last week I did pretty well at work although it really wore me out. I did get sick at school twice- once right before open house night but that's not bad. Tomorrow is my first day with students so I am nervous and anxious to see what this new position brings. Hopefully I can keep my sickness in check. Tomorrow after school my nurse will be coming to do my weekly blood draw and dressing change. I will be interested to see how my levels are after changing to one bag a day this week. I am not sure if they will be affected or not. I will update Tuesday when I hear more.

Finally, I had the second part of my screening this week for chromosomal disorders such as Downs Syndrome and Trisnomy. I got a call on Friday that my results for both parts of the test came back normal. What a relief and it was a good way to end the week with some good news!

16 Weeks!

Well as of yesterday I am 16 weeks pregnant. I like to think of it as four months pregnant because for some reason that sounds farther along. :) I remember back a month or so ago setting a goal for myself just to make it to 16 weeks and here I am! I have started to get a baby belly and am feeling baby quite a bit. I love the little kicks and flutters going on in there reminding me what all this is for! :) I have been having a lot of Braxton Hicks contractions already and did mention this to my doctor and he said it is due to dehydration and my kidneys working harder than normal but nothing to worry about. I had an appointment Wednesday for bloodwork and will see my nurse Monday after work to check levels again.

I started back to work on Tuesday and things are going pretty well. Of course being in a new position I have a lot to learn and it is an adjustment but I think I'm really going to like it. I have of course been extra tired in the evenings and start feeling pretty sick and have headaches which tells me it is time for my IV. I am doing okay so far with one IV but am not feeling quite as hydrated as I did when I was on two. We will see how things go. Tonight I had open house from 5:30-7:30 so am exhausted and just got started with my IV. I have started having much more of an appetite although what I can eat is still tricky. Often old favorites will sound really good but then will make me sick when I eat them. Today I had several hours in the day when I didn't feel nauseous and that was great! I was even able to meet my mom and take her out for lunch for her birthday at Culvers. I had a grilled chicken sandwich and it stayed down. :) However tonight at open house I started feeling pretty sick and did end up throwing up in the staff bathroom. :( A few steps forward a few steps back I guess. Next milestone I am looking forward to is 20 weeks- that is my next official doctors appointment and we will also have an ultrasound and it is also the HALFWAY mark. I think I can, I think I can...

End of Summer

Well today was my last official day of summer. Tomorrow I head back to work only this time I will have a new position and will be teaching ESL to middle school students. I am all over the map on how I am feeling- nervous about my new job, sad to end the summer and knowing I will miss playing with Miss Ella everyday, but at the same time I am relieved that this just means I am one step closer to hopefully feeling better or at least one step closer to delivery. :) It is funny how this time last year I was a nervous wreck thinking of sending Ella to a new daycare for the first time and this year I feel so calm and ready for her to go back and see her old friends and her beloved Granny Pat. I know she has been bored with me at home so this will be good for her. :)

I had a nurse appointment today. It was so good to have my bandage changed- this heat does a number on it and it was coming loose at the edges and just getting dirty and gross. I love having a clean bandage and hope it stays that way for at least a few days. My arm under the bandage has been itchy this week and has developed a heat rash but nothing like the rash I had before so that is good. My arm has been a little sore right where the line goes in and when she moved the bandage we found a scab that had been caused from some drainage I think (gross I know). Vitals were good today- my blood pressure was down in normal range at 96/64 but my resting heart rate is still high which I guess is pretty common for my condition.

They called me late this afternoon with the results of my bloodwork today. Good news- my potassium is back in normal range at 3.9! Yay! I was hopeful that I would get to stop the potassium IVs but my OB says I need to stay on potassium since my body can't regulate the level on its own so now it looks like we have the correct dosage. I will stay on 15 mil equivalents indefinitely. Unfortunately my sodium is still low at 133. It did not change at all even though I have been getting sodium chloride IVs twice daily now for a week. As I am getting the IVs not only does the potassium burn but I can taste salt the whole time but apparently all that tasting isn't transferring to bump my levels up! As of now we are just going to keep doing the sodium chloride bags but the pharmacist said that if my level drops more we may have to do something else also. Ugh. Finally my glucose has gone back into normal range now that I am off the prednisone. It was 71 today and on the prednisone had been in the high 90s and low 100s. So we will keep on keeping on. Tonight was my last twice daily IV and tomorrow since I am back to work I am going to see how one bag a day goes. We will monitor my levels and hydration and adjust as needed. Lets hope it goes well!

PICC Anniversary

Today it has been one month since I got my PICC line in. I never would have thought I would be getting IVs twice daily for a month and thought for sure when I got it in that it would be a few weeks or a month at max but here we are. Hopefully I won't see too many more of these "anniversaries."

The past two days have been rough. I have been having bad headaches and increased nausea along with what I think might be some low blood sugar spells. I get shaky and weak and sweaty sometimes. I think maybe my blood pressure has come back down after getting off the prednisone and maybe I am just adjusting. I'm hoping that this is just a bad few days but if things don't improve over the weekend I may call my OB just to be safe or maybe just wait to see how my levels are doing when the nurse comes Monday.

Only a few more days until I start trying just one IV a day. I can't wait! I hate the morning IV because it means I have to get up earlly and time everything just right so we get it done before Jeff leaves for work and I also have to figure out how to squeeze in a shower and watch Ella in there so it just starts the day off on a not so good foot. I can't wait to just do them in the evenings for awhile and see how that goes!

OB Visit Update

Today I had my regularly scheduled OB visit. I was anxious to go and talk to my doctor about all that has gone on the past few weeks. He is so great and sat with me for over 45 minutes talking about everything. He explained to me about what it means when my sodium and potassium levels are low and how it is nothing to mess around with. He said he isn't worried right now that they are a little off but just wants to keep a close tab on things and make sure we are constantly monitoring and adjusting what goes in my bags as needed. Low potassium and sodium can lead to some major problems with heart function and other things so it is important to watch. He said that when my level dropped to 3.1 that was concerning and he doesn't want that to happen again. I asked why things aren't getting better as far as the levels are concerned and he explained that it is kind of a double edged sword- my sodium and potassium are off due to the fact that I am getting intraveneous fluids. Since this is not a natural way for the body to get fluids it can sometimes throw electrolytes off. But of course NOT getting fluids isn't an option right now so we just have to adjust accordingly. He said that normally, people getting fluids don't have this problem with electrolytes especially if they are able to eat some like I am but he said I am just one of the unlucky ones.

I talked to him also about the fact that I am going back to work next week and am wondering how the heck I am going to run two bags a day. He agreed that having to get up so early every day to run a bag may run me down more which would defeat the purpose. He was fine with me trying one bag just at night starting next week when I go back to work. We will see how it goes and adjust with needed. There are some possibilities if I am still dehydrated- I could run two bags at night which would just take a long time or he even mentioned the possibility of running a quick saline bag straight into my PICC instead of using a pump over my lunch hour. Obviously its not ideal but those are possibilities we will explore if need be. My hope is that one bag will be okay and that I can continue to increase my fluid intake on my own.

I got to hear the baby's heartbeat today for the first time on my belly and it of course was great to hear. It was in the 150s and he found it way over on the right side of my belly so baby must be snuggled up in there right now. :) My OB actually does not need to see me again until my 20 week ultrasound appointment which isn't for five weeks. It seems like a long time not to go to the doctor but I will be seeing a nurse weekly and having bloodwork done and will be in contact with my doctor each week adjusting my fluids and what goes in my bag.

Finally, I asked him when he thought I might hope to get the PICC line out. Naively, going into the experience, my goal was to have it out within a month but that is obviously not happening. He was honest with me and said that if I were going to get it out soon, it would have already been taken out. He said he was hopeful that I would get better by 14 weeks but since I didn't it is really anyone's guess as to when I may be better and ready to be rid of the PICC. He did ask me to be prepared to keep it in until DELIVERY if necessary. He said that is not out of the realm of possibilities. That was hard to hear. I am glad that he was honest with me and that I am prepared for the worst but certainly hope my fate is different. He said he has had some patients get better around 25-30 weeks and others at various points before that. So basically I could wake up tomorrow and feel better or this could be the way things are until little one decides to make an appearance. Regardless, when and if I do start feeling a big improvement including keeping down a large amount of fluids on my own and no vomiting, I will call him and at that point he will take me off the fluids for the week and I will just flush my line daily to keep it from clotting. If I am able to make it a week, then we would pull the PICC. Right now I have set a goal for myself of 20 weeks. It is something to look forward to and hope for and if at that point, I am not feeling better, I will set a new goal. We will see and time will tell...

Feeling frustrated

My nurse came for a scheduled visit today to change the dressing on my PICC and do my vitals in addition to drawing blood for lab work. My PICC site looks great with no sign of a rash or infection as of now which is great! I talked to the nurse about how I am so ready to be done with the potassium IVs and she was pretty confident that if my levels came back normal today that I would be back to just fluid IVs.

Well, then later in the day I got a phone call from my OB's nurse letting me know that my bloodwork came back abnormal again. My potassium level dropped from 3.7 to 3.5. I guess normal is considered 3.6 so obviously I am very close but it isn't good that level is dropping again. It isn't alarming and actually makes sense since my potassium levels in the IV were dropped but it is disappointing that my body isn't able to maintain the level on its own. My sodium also dropped and is at its lowest point that it has been this entire time at 133. 136-145 is considered normal.

Home health care came out this afternoon with new supplies and they have changed my fluid bags to saline instead of lactated ringers which should help with my sodium levels. They have increased my dosage of potassium to 15 mil equivalents and I will do this for the next week. More bloodwork next Monday and then we will go from there. I am disappointed and frustrated because this was not the news I was expecting or hoping for but it is what it is I guess. It goes to show how much my body has been through in the past few months and I guess it will just take time for things to regulate themselves. I am anxious since next Tuesday I return to work and I was really hoping to be taking a turn for the better by that point. My hope was that by next week I would be down to only one evening IV a day but I am not sure if that is a possibility yet or not. I see my OB tomorrow and hope to talk to him more about what my levels mean and what the plan for the upcoming weeks and months entails.

On a final good note, after I finish the IV I am currently getting, I will be taking my LAST antibiotic dose tonight! 12-15 pills a day for the last two weeks has been crazy so I am SO glad to be done after tonight! Yay! I will just be on my oral and injectable Zofran now plus the twice daily IVs. I will update tomorrow after my OB appointment.

Making progress...slow and steady

Today I had a follow up visit with the dermatologist and another nurse visit. The dermatologist appointment went great! He was so pleased to see how well my rashes look and said to continue the meds through next Tuesday and then I should be good to go! My arm looks awesome and my neck still is a bit pink but not nearly as noticable. Yay!

My nurse visit was a quick one today as it was just a blood draw to check my levels again. My OB wanted to see how my levels are doing now that I have been on the potassium for three days. The good news is that my potassium is up from 3.1 to 3.7 (has to be 3.5 or higher to be normal) which is great. I was really hoping that she would say I would be done with the potassium but the OB wants me to stay on it a bit longer. She said it is great that my levels are back up in normal range but I need to remember that I am getting potassium intraveneously twice a day so we need to see if my body can maintain the level without the extra help. I was getting 20 mil equivalents in each iv bag and now they have cut the dosage to 10 mil equivalents. I will do that through the weekend and will have more blood work on Monday to see how the levels are then. I was really hopeful that I wouldn't have to continue running the bags for four hours but it looks like I will need to for a few days longer at least. I'm crossing my fingers that my potassium stays up and on Monday I will get the all clear to just got back to my regular fluids which I can run faster.

In other level updates, my sodium stayed the same which is still low at 134. We will keep watching that. My glucose (blood sugar) is also all messed up but the doctor warned me this could happen. Apparently the prednisone that I am on causes glucose intolerance which leads to high blood sugar. I have actually been having the opposite problem and my glucose has been on the low side always in the 60s but today it was 108! Yikes! Normal is 70-100 but nothing to worry about since we know it is med induced. Its no wonder I don't feel great though- gosh my body just is going through a lot I think! My last day of the prednisone is Monday so then hopefully things should go back to normal.

I mentioned to my nurse that the potassium IVs burn when going in and she said that was normal and why we have to run the bags so slow. Apparently when given in a regular IV they often have to add a numbing medicine because it can get so painful but then you have to be on a cardiac monitor. I can deal with the burning but it is just a bit uncomfortable. SO I just need to get through this weekend and finish up my meds early next week and hopefully I will get to start weaning off fluids. I will see the nurse again Monday and the OB Tuesday. Updates then. :)

Nurse Visit

Yesterday was my regularly scheduled nurse visit. My nurse Traci came to change the dressing on my PICC, do vitals and draw blood for labs. The good news is, she was very happy to see how well my rashes are healing. My left arm looks great with just a little redness where the site went in and two little white scars from where I was poked. My neck is even starting to look good and I can actually wear my hair up without feeling like an alien. :) Traci changed the dressing on my new PICC and it looks great too! No rash so far or anything out of the ordinary! Yay! She found out that there is latex in the netting that I was using to hold my line on the first PICC and we are wondering if I am allergic to latex which caused the rashes. Who knows?!

On to the not so great news. Oh yes there is always some of those it seems huh? Traci called me back yesterday afternoon with my lab results and they weren't great. My sodium went back down which is disappointing because last week it finally went back up into normal range. It is at 134 and needs to be 135 to be considered normal so it is just slightly off but I wish it were moving in the other direction. Previously, my doctor told me he doesn't get really concerned until the number drops to 130 so just something to watch. However, my potassium dropped really low which is really unusual for me since potassium is the one thing that my levels have always showed completely normal! Normal levels are 3.5-5.0 and yesterday mine was 3.1. Apparently sodium and potassium work hand in hand so to see both levels dropped below normal is concerning and frustrating.

Traci said she needed to get a hold of my doctor right away but he is actually on vacation this week. So she ended up talking to the on call doctor (who happens to be the OB who delivered Ella!) and he said that I need to get more potassium ASAP and ordered it to be put into my IV bags and delivered to my house last night. Apparently low potassium can have symptoms like heart palpitations and weakness so Traci asked about those. Well I am always feeling weak these days but I have been having palpitations when laying on my left side. I assumed it was due to the new PICC that I have on that side. Traci said that my PICC was probably overshot and too close to my heart, so another nurse came later yesterday and pulled my line out a few centimeters to see if that would help.

Because potassium straight in the bag is a bit much for the body to take on, I will now be on the IV machine for FOUR hours a day. :( Two hours in the morning and two at night. I am pretty bummed about this just because its a lot of time to be immobile and its hard to do with Ella around and Jeff working. So far the plan is for us to get up at 6 to run the first IV so hopefully Ella will still be sleeping during most of it and that way Jeff still has time to get ready for work after. The night IV we will start when Ella goes to bed at 8 PM and run until 10. Its depressing and not the news I was hoping for but what do you do? Traci will be back on Thursday to draw more blood to see how this potassium is helping and I also have a recheck at the dermatologist Thursday so he can take a final look at the rashes. I will update more then if anything has changed...

Healing

Good news to report- my rashes are getting better! I still have a long way to go and to the average person my neck still probably looks terrible but I can tell it is getting better! The meds I am on are powerful and sure do work fast so I am thankful for that! My arm is about 80% better with just a bit of a rash left and a big red mark about the size of a quarter near where the line went in. I am still not sure what is going on with that area- it doesnt really seem to be part of the rash so I am going to check with my doctor the next time I see him if it doesn't improve. My neck is MUCH less red and not painful anymore! It is drying out a lot and of course peeling which is lovely but I know thats part of the road to getting better! Here is what it looks like today:

On Monday my home nurse is coming to change the dressings on my new PICC for the first time and to do my vitals and bloodwork. I am hoping that we can keep this PICC rash free so it can do its job without complications! So far, only the first day did we have a scare in which there was blood backed up in the line but it has been smooth sailing since. It is getting tiring to have to be hooked up to the machine twice a day but I am hopeful that maybe I only have to do it for another two weeks until I go back to work and then maybe I will wean down to once a day. I will update after my appointment with her tomorrow.

I am anxiously waiting for Jeff to get home with my little monkey Miss Ella who spent the night at Grandma's. They went to Indianola to watch the hot air balloons and it sounds like she had a blast! Hopefully next year we can all go and will have a new little one with us as well. To end the post, here is a sweet picture that my friend Cristi took of Ella that makes me smile :)