How to fly when pregnant

October 31, 201615 Comments

As a bit of a jet setter with all my work travels, I have written in the past about the effects of flying and jet lag on infertility….but now I am 31 weeks pregnant I wondered what are the effects of flying whilst pregnant?

I don’t have lots of facts for you on this blog post, I know – unlike me! However, I can tell you that the general advice is not to fly after 37 weeks or 32 weeks if you are carrying multiples. Every airline has different rules about letting pregnant women fly, so check before you book your ticket!

Just because it is OK to fly before 37 weeks, this doesn’t mean that you won’t suffer side effects of flying when pregnant!! Overall you are likely to experience leg swelling, bloody nose, ear problems and motion sickness will probably make any pregnancy related nausea worse. Deep Vein Thrombosis is a higher risk if you fly when pregnant.

Here I offer you the effects that I have personally experienced and some lessons I’ve learned along the way.

So far, I have taken three transatlantic trips in my first trimester, two in my second trimester and two in my third trimester. Two of these trips in the first trimester have required me to make two connections – that’s three legs of flying!!! These trips were quite intense on my body and took a lot of energy out of me. But overall, I survived them all! I would like to say that I got used to flying when pregnant, but unfortunately as I get closer to my due date, it becomes more uncomfortable and I discover new challenges!

Picking the right seat in advance. Choose your airline carefully! Check out the average legroom by airline here at these two websites: US Airlines overview & All airlines at seatguru.com. Even before I was pregnant I would choose an aisle seat because of my terribly weak bladder and Irritable Bowels….but this has never been so important when pregnant. Even when I was 6 weeks pregnant, I went to the toilet over 20 times on a 7 hour flight. It was ridiculous! I use the Seat Guru app to check in advance where the seat is in comparison to the toilets. I like to choose to sit about 4 rows or so from the toilet – not so close you get the smell, noise and annoying people bumping you, but close enough to make a dash for it when it is empty!!

Upgrade if you can afford it. Sounds obvious! I have tried to upgrade on the red eye (overnight flight) a few times, but have failed to succeed! Last time I was 5^th on the list, and all 4 people in front of me got upgraded!! I was gutted. Showing off a big bump doesn’t help unfortunately. I had even saved up lots of my air miles just for this purpose knowing I’d pregnant at some point in the future!! I don’t have several thousands of dollars to just buy a business class seat, so I’ve stuck it out in economy for all my flights.

Drinking and Feeding yourself. Carry an empty plastic water bottle whenever possible to keep hydrated, particularly if you get stuck on the plane before takeoff or taxing after landing, it might be almost two hours by the time you get your next drink!

Fill up your carry-on bag with snacks for both journeys. I also learned that it’s important to keep snacks for the return journey too just in case you are departing a foreign airport and the shops aren’t open, or certain foods make you nauseous.

I made the mistake of relying on the lunch given out on the plane…they cooked a pasta in a tomato herby sauce and before I even got the food I felt sick from the smell of the herby sauce. That was the only choice, so I went hungry as I tried to force it down me, it just wasn’t happening! I also slept straight through an entire meal service because of my tiredness so missed out on food, by the time I got off the plane, got through customs and security again for my next flight, I hadn’t eaten for 7 hours. I was feeling so, so sick. I didn’t just have the hun-grumps I was feeling light headed and dizzy. Fortunately I had water with me at the least.

And another tip – don’t carry nuts, seeds, fruit or dried fruit otherwise it is likely you will have to declare them to customs when you land in another country– and ain’t nobody got time for that!

Getting in the Sleep. In my first trimester I was suffering a lot from pregnancy tiredness, add on a 5,6 or even 7 hour time zone difference and I am screwed. For my trip to Turkey I travelled through 4 different time zones. I strongly suggest not trying to follow a routine, rather listen to your body and sleep when you can. This is not easy to do. I had to be at work at certain times and so that meant waking up in the middle of my sleep cycle…I was permanently tired and yawning throughout the day. Fortunately, most people knew about my pregnancy very early on so they didn’t take it personally as I yawned through their briefs!!!

Remembering your Medication. This was a nightmare. I got it wrong big time with my second trip. My first trip I did the progesterone in oil intra-muscular injections and administered them myself. It was challenging and I hated it, but in terms of timing this one was easy. Do the injection just before going to bed. It didn’t matter about the time zone change because the progesterone lasts several hours longer than 24 hours, so it didn’t matter. However, this time around after struggling with giving myself the injections, I took the progesterone capsule suppositories, 3 times a day. This was really hard to do, especially with a 7 hour time zone difference. I think the first day I travelled I took too much, then on my second day and third day I forgot to take my second suppository in the middle of the day because I was so busy with work. Then I forgot to change my estrogen patches I was supposed to do on the red eye flight to Turkey. I remembered the afternoon that I arrived in Turkey when I got into the shower. So I would suggest putting reminders in a phone with the exact timings so as not to forget.

Don’t forget the sick bags. Have one of those airline paper bags in your bag just in case you are in a queue and you can’t hold it in! Fortunately, it didn’t happen to me, but there were times when I panicked I might puke and couldn’t make it to a toilet in time!!!!!

Coping with strange smells. On one flight I was sat near a man who had a bad Bodily Odour problem. I was trying not to vomit in my seat, hoping I would just get used to the smell for my 8 hour flight. Fortunately, he moved two rows forward and my sensitive nose was saved! But I have experienced smells of things I can’t bear with people sat next to me and then generally in foreign countries the smells are just different. This is something I don’t know how to resolve or overcome. It’s just one of those things I guess I’ve got to suck up. Sorry I don’t have any ideas of how to cope with this, it is more of a warning! Do you have any ideas??!

The swelling and back aches. Later into my second and third trimesters I noticed that when I got off the plane the veins in my arms were massively swollen! At first I was terrified, I looked like a freak and worried they were going to burst or a sign of something bad! But I discovered later that this is to be expected when flying when pregnant. There is also no avoiding crappy airline seats – I pack a spare feather pillow, fleecy blanket and neck pillow to make my seat more comfortable. I have also treated myself to a maternity massage where I had 60 minutes of pure bliss focusing mostly on my lower back. I have discovered in my third trimester that the lower back has quite a lot of tiny muscles I never knew existed!!

Get yourself Global Entry. I successfully applied for global entry half way through my pregnancy – this enables you to use the automated passport border control as a ‘trusted traveller’. The reason I got this was because one time I arrived into Chicago and queued for 2hrs to get through border control…I was feeling very faint by the end. Nope. I decided I am not doing that again, particularly for much later on in the pregnancy! I almost punched the woman behind me in the queue because she obviously came from a country where there was no such thing as personal space. I think the hormones didn’t help me with my patience! So I applied and got a conditional approval after two weeks of applying – then had to wait three months for an available interview slot time that I could get to. This interview was really quick and easy, it wasn’t so much as an interview for me, more of simply provide my finger prints and have a photo taken.

The other good thing about Global entry is that it also gives you TSA pre-check which is really nice…getting your shoes on and off in the third trimester is a pain in the butt so this has been a nice luxury!!! In my first trimester I travelled to Turkey, and as a result for four trips after I must have been put on a ‘list’ and got ‘extra screening’, known as the dreaded SSSS that gets printed on your boarding pass. If you ever see this on your boarding pass – it is the ‘not so secret code’ that you will get extra screening. All this means is that I got a thorough search of my bags, swabbed for explosives and a good pat down. As long as you don’t fuss about it, the security agents are pretty good about it.

Take it easy and take a taxi. I learned the hard way that a taxi is a must! I am usually good and whenever I can get public transport I do. I personally think it’s a lazy expense that some of my colleagues take. So for my first trip I took the train and walked to the hotel for 15 mins. However, this was actually a bad idea. It was warm and I was dressed for the cold airplane, I almost passed out on my walk to the hotel! Then lifting and carrying bags up and down stairs when there are no lifts is equally dumb (especially when I had my poor hyper-stimulated ovaries being tender still!).

Know who to call when things aren’t right. Have a list of phone numbers you can call in case of an emergency, get info on doctors & hospital numbers/names/addresses for where you are going before departing. Fortunately, I’ve not needed this (although I learned this lesson more recently with my experience during the Brussels attacks and the importance of having emergency contacts ready to go and not stored on your phone!).

Not for everyone – telling people you are pregnant. I know that many people do not like to tell others before the end of the first trimester about their pregnancy, I absolutely get that. But for me on these work trips it has been really helpful. I don’t feel guilty for running out of the room to the toilets when I need to, I don’t need to explain the yawning, I don’t need to explain why I am not drinking alcohol when everyone else does, generally I have felt comfortable overall because I have told people I am pregnant. I don’t need to make excuses or justify my actions or wonder if people are guessing I am pregnant!

So that’s all my thoughts! There are also some things that Baby Science Project suggested to me from her extensive work travels during her pregnancy…such as flight socks and baby aspirin. I never used these…mostly because I haven’t been able to find any socks that aren’t horribly itchy.

My OB said I am OK to keep flying up to 34 weeks, assuming I pass all my checkups! Although it is not top of my list to do when pregnant, it actually hasn’t been quite as bad as I thought. It is definitely true that the first and third trimesters are the worst for travelling. In the first trimester it’s the nausea. In the third trimester, it is just uncomfortable and difficult to move around. But….I survived to tell the tale.

Deciding on genetic screening

June 26, 2016June 26, 20169 Comments

At my first Obstetrician appointment at 10 weeks we talked about the options for genetic screening. My first homework assignment was to go away and figure out what we would like to screen for….in addition to finding out what our insurance would cover.

Aneuploidy Testing: These are the tests available for screening Trisomy 21 (Down Syndrome), Trisomy 18 (Edward’s Syndrome), Trisomy 13 (Patau Syndrome) and open neural tube defects (i.e. Spina bifida and anencephaly).

My OB offers three options for screening:

NIPT- Non Invasive Prenatal Testing (i.e. Harmony or Verify). This is a simple and accurate non invasive prenatal screening blood test. The test can be performed anytime after 10 weeks of gestation. In addition an AFP (alpha-fetoprotein) blood test to test for neural tube defects is also taken at this time. It is also possible to discover the gender of your baby through this test. Approximate cost $825.
Sequential Screening with Nuchal Translucency. This is a two-step test to detect whether a fetus is at increased risk. The test has a narrow window for testing (first step is performed between 10-13 weeks of gestation). It includes 2 blood draws and an ultrasound. The ultrasound measures the amount of fluid behind the baby’s neck (called the nuchal translucency NT). The blood tests measures three different hormone levels, these measurements in combination with maternal information such as height and weight are used to calculate the baby’s risk of Down’s Syndrome or Edward’s Syndrome. The AFP blood test (described in 1) is also taken. Approximate cost $580
Quad Screen (aka quadruple marker test). This is a blood test that measures levels of four substances in a pregnant woman’s blood – AFP, hCG, Estriol and Inhibin A. typically this screen is done between weeks 15 and 20 of gestation. Approximate cost $305.

If any of tests come up with a positive result then additional testing can be performed (These are the more invasive tests you may hear about such as CVS or amniocentesis where the doctor extracts a sample of the baby’s cells from the uterus. Amniocentesis is where a thin needle is inserted through the belly and into the amniotic sac to take a sample of the amniotic fluid. CVS is where the doctor uses a needle through the belly or cervix and takes some placenta cells. These tests carry a very small risk of miscarriage).

Additional Screening Offered:

Cystic Fibrosis. Cystic fibrosis is the most common inherited disease of children and young adults. The carrier frequency is 1 in 24, to 1 in 97. Both parents need to be carriers for a child to be affected (25% chance). 1 in 2500 children born are affected. Cystic Fibrosis is a disorder of mucus production and produces abnormally thick mucus leading to life threatening lunc infections, digestion problems, poor growth, infertility and more. Symptoms range from mild to severe, but individuals with severe disease may die in childhood. With treatments today, people with Cystic Fibrosis can live in their 30s. Cystic Fibrosis does not affect intelligence. Approximate cost $800.
Spinal Muscular Atrophy (SMA). SMA is the most common inhered cause of early childhood death. The carrier frequency is 1 in 47 to 1 in 73 in the US and both parents need to be carrier or a child to be affected (25% chance). 1 in 11,000 children are affected. SMA is a progressive degeneration of lower motor neurons. Muscle weakness is the most common type with respiratory failure by the age of 2 years old. Muscles responsible for crawling, walking, swallowing, and head and neck control are most severely affected. Approximate cost: $625.
Fragile X Syndrome (the most common inherited cause of developmental delays). Fragile X syndrome is an ‘X-linked’ genetic disease which means it is only carried by the mother. Unfortunately, 1 in 250 females are carriers and a child has a 50% chance of being affected if this is the case. 1 in 4000 boys is affected with Fragile X and 1 in 8000 girls. Approximately 1/3 of all children born with fragile X also has autism and hyperactivity. Approximate cost $390.

What have we decided?

We decided we would like to do the NIPT (Non Invasive Prenatal Testing) for the aneuploidy testing. Why? The accuracy is significantly higher than the other two tests and the false positive rate is very low (0.1%) compared to the other two tests (sequential screening rate is 3.5%, quad screen rate is 5%). Our insurance also covers it, plus it would be nice to have an idea of the gender – although that is a Brucie Bonus because the chances are we are going to wait until a lot later for a gender reveal party, so we are in no hurry!

We will also ask for Fragile X syndrome screening too because one of my brothers has autism and my mum doesn’t know if she is a carrier, so it makes sense to take the test.

My next OB appointment is tomorrow – Monday – afternoon to talk through what we would like to do and to go over my blood test results from my first appointment (they all came back clear, including my slight anemia which I was worried about, so that’s good). If I have my blood drawn tomorrow then the results will take 2 weeks to come back. Another 2 week wait!!

On a side note, I didn’t know much about Down’s syndrome, Edward’s syndrome or Patau syndrome….so I had a read about it all. It’s very interesting to find out more and I’m glad I have educated myself about these a bit more.

Survivor’s Guilt

June 24, 201620 Comments

I have a broad understanding of Post Traumatic Stress Disorder (PTSD) I’ve read a lot about it…so much so that even my Instagram advertises about PTSD charities on my feed (weird).

this advert about PTSD came up on my Instagram feed

There is one thing that I suffer from and that is Survivor’s Guilt. This is when someone believes they have done wrong by surviving a traumatic event when others did not. In my case I have double the effect. Why? Because I survived a horrifying terrorist attack and second, I survived infertility…all within weeks of each other.

I did not know anyone personally who died in the Brussels terror attacks. But I saw people who were dead or dying being carried out on stretchers, left alone on the side of the road as I helplessly watched. At the time I wanted to help, but of course I couldn’t, I was (sensibly) being pushed further and further away from the airport. I have these images burned into my head of a man with his body broken, dusty, bloody, head with loose bandages wrapped around his head, face indistinguishable and arm hanging out, quietly moaning. All alone. But I was behind glass some 20 metres away watching this happen in front of my eyes as more as more people were stretchered out.

I get it. They have a system of triage, there were only so many first responders who were there in the first 20 minutes after the explosions. The cordon was set up to protect people. After all, there was a third bomb in there. We know tactics of terrorists are to create mass effect by targeting the first responders. But that boundary, the distance was so close, but so far. I heard people were saying – I’m a first aider…I’m a nurse…I can help. But they weren’t allowed to. I can’t get my head around those very short moments.

I feel guilty for surviving, for not being able to help. Sometimes my mind is heavy with these thoughts. This doesn’t outwardly appear to affect me overall. Well, I don’t think it does. But I do have some bad dreams (to be expected), not regularly, but perhaps it does affect my sleep. I wake up very early some days, I tend to put it down to my jet lag, but actually, it could be a symptom of PTSD. I don’t have problems falling asleep, and I’m not afraid to fall asleep, so I don’t feel like it is an issue.

Then there is my pregnancy. I am overjoyed we finally achieved our dream, we fought hard to get here! But along the way, I have made friends with some very lovely women who have struggled with infertility too. And the feelings I have are that of guilt. Guilt that I have left them behind. Similar to survivor’s guilt, and in some ways could be classified as such. Infertility is traumatic. I feel like I took the last life boat and rowed away from the desert island leaving you all behind in uncertain conditions. So some days I haven’t been able to open and read blog updates, Instagram is hard to scroll through.

For those of you who are reading this and now worrying about me (my mum probably!!!) It’s OK, I’m OK. I am sensitive to my levels of anxiety and sadness, and how that impacts my daily life…and I am OK. Writing this down is kind of a release to me, and re-reading my writing makes me see things more objectively. And that helps.

I found some words that are helpful (I think) on strategies to cope with survivor’s guilt:

“Rather than focus on the burden of guilt, remind yourself that you and your loved ones have been given a gift — the gift of your survival. Embrace your will to survive and fight the forces that challenge your way of being.”

Reading these words make me feel happy because deep down I know they are true, I just need to remind myself of this when I start to feel sad or guilty.

PC Diary: Heading out of the first trimester

June 21, 201622 Comments

The Pudding Club Diary @ 12w2d

I have been pretty bad at this – I have sooooo much running around in my head right now that I want to blog about but have been so darn tired or busy to type it out. I need some kind of Dictaphone equivalent to easily extract my thoughts from my head!

Another week on work travels – I am back in beautiful Bavaria, Germany as I write! My third transatlantic trip in my first trimester. And they are not kidding, travelling in the first trimester sucks a lot. However, this trip has so far been easier than the previous two, I’m starting to feel a little less nauseous now. Whoop whoop, can’t complain about that!!! (But don’t show me a salad leaf just yet!)

The beautiful view of Bavaria from my hotel room!

I was worried that I might not be able to fit into my work trousers this week whilst in Germany so I decided before I left to go and buy some new maternity work trousers – just in case (I had already popped a button on one pair of my trousers!) The elastic band trick doesn’t work with most of my work trousers because they have metal sliders rather than buttons. So off we went hunting for some cheap super stretchy clothes! I knew there was one dedicated maternity clothes store in town, but I had heard that some chains such as Target, Kohls and Old Navy did maternity clothes so I thought I’d try those stores first. But everything in those stores were too casual or too summery and so I ended up in the dedicated maternity store anyway.

In the maternity clothes store I bumped into a friend who I didn’t know was pregnant (but had suspected based off a group text message and putting 2+2 together) and so it was just confirmed by her simple being there! It was a really lovely surprise because she had been told by her doc years ago she may have problems conceiving, so I am really pleased for them because that wasn’t the case in the end!! Whoop whoop – screw you infertility!! AND we are both due within a week of each other! CRAZY!

Anyway, back to the clothes buying…I went a bit overboard and finally thought what the hell, as I am here I might as well buy it. My reluctance to buy any maternity clothes was based on a fear of losing Rocky. I overcame that reluctance, and it felt really good to be finally in acceptance of this pregnancy.

A nice little haul of maternity clothes 🙂

And so with this acceptance it was time to do my first bump picture. I know that I don’t look pregnant to the casual passer by. I look like I ate a lot of pies! But seeing the bump for real in this photo – I couldn’t believe it, there are definitely outward signs now of a little baby growing in there!

Week 12 bump picture

When I saw the doctor at 10 weeks she said to stick with the gentle exercise, like walking and swimming, but for the first time in months I felt capable of doing a bit more exercise. So I got out the DVDs a friend from work gave to me and did a bit of a prenatal workout. I did one of the routines with Chris. It is a 20 minute partner exercise where your partner provides resistance and balance support…it was actually really fun! However, I ached like hell for two days afterwards. Not a good idea to start an exercise routine the day you fly for 8 hours on a plane! My poor back did not like me one bit. Ahh well, it’s all good for you Rocky!

The prenatal workout DVDs I was given!!

Finally, something that I found a little bit insensitive, and also kind of amusing in some weird typical way that is infertility…my bump app told me that obviously we had sex to conceive our baby, otherwise I wouldn’t be pregnant, DUH, – well actually, this is OBVIOUSLY NOT the case with us! I wish that it had been the case…instead we had almost 17 other people involved in the conception of our IVF baby!