Tag: IUGR

A ‘grave’ situation

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My new primary care doctor is thorough, for which I am glad.  At my annual workplace medical she examined my thyroid and asked me if she could run one other test that wasn’t on the list my work requires me to do.  I said ‘of course, whatever you think is necessary’.  But then my test results (TSH and Free T4) came back showing I had a hyperthyroid and she wanted me to see an endocrinologist to figure out why. Cue Dr google.  What is a hyperthyroid?  What does it mean?

Turns out I had all the symptoms I had put down to postpartum and getting older in general.

  • Tiredness – I was struggling to get up in the mornings, feeling exhausted having just slept;
  • Heart beating hard and occasionally very fast, I’m always on the verge of feeling like I’m catching some kind of cold;
  • Pain in my neck I’d put to sitting funny at my desk;
  • Chris had noticed I was always warmer than him (very unusual because I am constantly cold!!!), I was feeling warmer in the office despite it being very cold!
  • When I got sick it was taking me a lot longer to shake it off. I caught a summer cold and the sore throat persisted for over two weeks.
  • Random sore throats that would come and go quickly. I have a toddler who exposes me to all the germs in the world??!
  • Also hand and feet numbness which has been going on for two years, my old doctor ran tests back then, nothing conclusive, decided it was probably postpartum arthritis and I would get over it soon when I stopped breastfeeding. It never went away.  It just never got worse.
  • My new doctor told me off for being underweight, I told her that was not true the scales in the office must be off, my clothes hadn’t changed. Actually I had lost 5lbs and hadn’t noticed so I was close to being underweight on the BMI scale.
  • Finally, the last thing was that I was getting quite short tempered and easily irritable. At work one day recently I slammed the phone down.  I was really mad at someone who wasn’t listening to me.  Everyone came to ask me what was wrong!  It just wasn’t like me.

None of these things I felt worth mentioning to my doctor at my workplace medical because on their own are little thing, but in hindsight perhaps I should have.  I did mention being slightly tired but put it down to being a parent of a toddler.  When in reality, Aviana sleeps incredibly well and is not a little night terror, there is no reason really why I should be tired.

The endocrinologist I was referred to was not available until November (I was referred in July), I thought that was an insane amount of time to wait so I called around looking for a doctor who would take on a new patient sooner.  Eventually I found one who was available in September so I asked my doctor to send a referral to this one.  Like magic, she managed to get me an appointment with the specialist for the following week.

So the following week, the endocrinologist asked me a few questions and took an ultrasound of my thyroid.  He explained that there were a few things that can cause hyperthyroidism and we needed to investigate all of them.  He did an ultrasound and ruled out any masses – my thyroid was swollen on the left side – just where I’d felt the pain in my neck and ignored it.  I also was now able to see what my primary care doctor had felt – my thyroid was clearly swollen.  I just thought my neck was getting fatter!  I had some more blood tests taken and my TSH levels were getting lower and my T3 and T4 levels higher, only just slightly abnormal.  Another test, TSI, came back normal – this was the test that would have given me a clear diagnosis of Grave’s disease.  The endocrinologist told me my symptoms weren’t that bad because many people with advanced hyperthyroid would be sat shaking, anxious, heart racing with their eyes bulging out.  So whatever it was it was caught early, most likely its early onset of Grave’s disease, an autoimmune disease that attacks the thyroid.

The endocrinologist emailed me to say I had a choice (I have a choice?!): to wait and be monitored or to start taking a drug that would help control my thyroid.  Of course, given a choice I will always try the non-drug route.  But then in that time period I also found out my father had a stroke because his thyroid had stopped working and has been on thyroid medications since.  I mentioned it to the doctor and he changed his mind and told me given my family history, he would prefer I took the drugs.  OK so not much of a choice now.  So here I am on 5mg of methimazole every other day.  This is a very low dose given my blood test results.

Chris picked up my prescription and the pharmacist told him that these drugs take some time to get used to and can have some nasty side effects, they printed a detailed sheet for him to give to me.  That made me feel nervous.  I did some research online and many of the side effects included nausea, headaches, upset tummy, weight gain and pretty much all the other reactions someone may have to drugs in general.  I joined a support group on facebook and learned that it is best to take the medication with food before bed.  The first day I took it I was at a party, 20 minutes after taking the tiny pill I suddenly felt like the world slowed down, I couldn’t feel my heart beating as hard or fast that it felt really strange.  I felt like a weight had been lifted off my chest.  Chris told me I looked like I was stoned.  But that didn’t last too long.  Over the next few days I started to feel less tired, I had more energy and my heart was not pounding as hard.  I guess I was ill after all, I just hadn’t noticed it.

I bought a fitbit to help monitor my heart rate.  I’ve been taking the medication now for almost four weeks and my resting heart rate has come down a little bit….however I have started to do exercise again as I have felt like I’ve got my energy back, so maybe that’s related to the exercise or a combination of the drugs and the exercise.  In general, I haven’t any side effects – I put the weight back on immediately, but not excessively and I sometimes experience nausea a few hours after taking the pill, but it’s not terrible.

I spent a bit of time researching the thyroid and infertility.  It turns out that your thyroid can mess up your fertility.  I took a look back at my TSH levels that my primary doctor tested every year for my annual medical and there were high-normal.  My Reproductive Endocrinologist never tested my thyroid, but if she did or looked at my annual results from my primary care physician some RE’s would have considered my TSH levels for fertility too high and may have given me drugs.  Perhaps this all explains my unexplained infertility after all?  I found out that thyroid tests are now included in the standard workup at the clinic since I least went 4 years ago which I am glad about.  But that doesn’t really matter right now as we are not planning to TTC.  Our frozen embryo remains on ice.  Even if we did want to TTC, the drugs I am on currently are toxic in the first trimester so that would be problematic. Plus I would have to get my thyroid levels back to being normal before getting pregnant.

Oh did I also mention that thyroid problems are relate to IUGR?  May be another explanation for something so unexplained in my life?

My next monitoring appointment is Friday.  I’m hoping for positive news that the drugs are working and I don’t need a higher dosage.

Our little Christmas Pudding has arrived

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I never thought the end of my Pudding club hunt would come at Christmas. In the UK we typically have Christmas pudding as our dessert at Christmas dinner. I don’t think this could be the most apt end to 2016 on the Great Pudding Club Hunt.

 Aviana Ruby arrived safely on 21st December at 9.21PM (21/12 @ 21:12!!!!) weighing a teeny 5lbs 1oz and measuring a staggering 19.5″ long!!!! 


I will write my birth story another time but quickly here is what happened. I was admitted to the hospital at 9PM on Tuesday 20th December, to be induced at 38 weeks because the doctors felt Aviana would thrive better outside of my body as she was suffering from intrauterine growth restriction (IUGR). I was given Cervidil to ripen my cervix, the doctor likes it to be in for 12 hrs before it is removed (it’s kind of like a tampon thing that hurts like hell). On Wednesday 21st at 10AM our doula arrived and the cervidil was removed. I began labour naturally, so the doctors held off giving me Pitocin, but unfortunately at around lunchtime my contractions slowed down and I had to start the Pitocin induction. 

The contractions got stronger and harder and more painful, but Chris and my Doula coached me through the pain. We tried almost every birthing toy in the box in the hospital and every position possible to survive without pain meds. I started pushing at about 8.45PM. Unfortunately several times Aviana’s heart rate was decelerating dangerously and there were a couple of moments when it looked like C-section was on the cards. At one point all I could think of was do whatever is best for my baby to survive, I don’t care what needs to be done, just save my baby! 

I only pushed for 37mins, but this was mostly because her head was so low already and a lot of amazing work from the team, I was coached to push and she had to be vacuumed out. The Neonatal Intensive Care Unit (NICU) team were on standby – a terrifying feeling – but they weren’t needed in the end. The feeling of her coming out in the last and final push was euphoric. She was a lovely sticky warm gooey mess and she was placed on my abdomen and Chris cut the cord. Yes she was tiny and super skinny, but her APGAR scores were 8 & 9!! So amazing. We were able to do skin to skin after she was thoroughly checked and NICU team sent away. I was also able to breastfeed within the first hour too. 

On Friday 23rd at lunchtime, we were all discharged from the hospital. Having a pain med free vaginal birth meant I was able to leave earlier than was expected. Many people were surprised at how healthy Aviana was and how quickly we were allowed to leave! When we left Aviana was just 4lbs 12oz. On Christmas Eve we followed up with our pediatrician and she weighed just 4lbs 8ozs, my milk hadn’t come in by then, so we are supplementing breastfeeding with some formula now, hoping she starts to thrive.

Aviana Ruby truly is the best Christmas gift I could ever receive. We have been so fortunate that things have worked out so well despite hurdles thrown at us along the way. My heart is simply full of extreme gratefulness and happiness to finally meet Aviana, AKA Rocky, AKA my little sweet Christmas pudding.


Wishing all of you a Christmas full of love and joy XX

Same old story – it’s just unexplained

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PC Diary @38Weeks 0 Days

The unknown doctor came in, shook our hands and looked at us in turn, he looked concerned.  But after a strange pregnant pause he managed to get the words out….”Everything looks good with the flow to and from the placenta”. Phew…a sigh of relief! From the look on his face, we both thought he was going to say something bad.  Another awkward pregnant pause and he said to us “We don’t know why your baby is measuring small.” (This doctor had very a very strange and awkward bedside manner)

Chris and I had bets on how this appointment with the Maternal Fetal Medicine (MFM) specialist would go.  We both bet it would be ‘unexplained’, because that just seems to be the way the cookie crumbles with us.  Unexplained infertility has done that to us, it has better prepared us for accepting the unknown.  By the way the unknown SUCKS.  But nevertheless, we seem to be able to handle it a lot better now.  We think that the doctor was expecting us to give him a hard time about not knowing why Rocky is measuring small.  But instead we just said, OK so there is nothing obviously seriously wrong? Although, she was even further behind than our past growth scan in the 3rd percentile (She was in the 5th percentile the week before), but these measurements have error inaccuracies, especially at this late stage of the pregnancy. There was no denying the fact that she is still very small and behind.

The doctor recommended that she be delivered in my 38th week so we can get her out of me and feed her up.  Later that day I went back to my OBGYN for another non-stress test and an ultrasound to check on my amniotic fluid levels.  All was looking good.

It was an emotional roller coaster day of nerves and relief.  We don’t know exactly how healthy Rocky will be when she arrives into the world and what the impact of the growth restriction has been on her, if any.  Perhaps my anemia was the culprit, perhaps it has been my bowel problems not getting the right nutrition to her or perhaps she is just a naturally skinny thing.  We don’t know, but that’s OK, because we are going to meet her very soon and hold her in our arms.

At my next appointment with my Obstetrician we talked about the induction process.  We had been penciled in to arrive at the hospital on the evening of the 20th December to have my cervix ‘ripened’ overnight.  Rocky is currently head down and engaged at Stage 0 right now, and I am still 1cm dilated and 50% effaced, which is a good thing and may mean I don’t need to have my cervix ripened.  If that is the case, then I may be asked to come into the hospital in the morning of the 21st December and they will put straight onto the drug Pitocin (it mimics oxytocin, the hormone which causes contractions).  The doctor warned us how long this process can take 12-24 hrs, and there is no way of knowing how my body will respond.  Sometimes a small baby can be a good thing and time can go quicker and I may have an easier time pushing her out!  Or sometimes not….  they will keep a close monitor on Rocky because sometimes growth restricted babies struggle to keep their heart rate up during contractions.  If Rocky’s heart rate decelerates then there is a very good chance I would end up having a cesarean section.  But the great news is, there is no reason for me to not have a vaginal birth.

My birth plan is that I wish to avoid pain medication at all costs.  However, I am now being induced using Pitocin and this can cause contractions to be a lot stronger and successive far quicker than a natural labor would be.  This means that there is a higher chance of this being painful!  My current feelings are that I will try my dammed hardest to not ask for the pain meds – in whatever form.  Chris is well versed in my desire, and my doula will be there to help me get through it too.  Although I want a vaginal birth, I have spent some time thinking about how to cope with an unexpected c-section.  I am now feeling ready for that moment because I know Rocky’s health is the most important thing to think about.  Luckily I will be on one of my favourite obstetrician’s service that day and I feel like I can trust her.

All this being said, the past week has been strange.  I had some plans for my maternity leave…I was excited to be taking some time to myself and thought 4 weeks before Rocky’s arrival I would have some time to do these things – Christmas dinners with friends and colleagues, executive development program study, knitting, Christmas card writing, email sorting, Christmas shopping, housework, blogging and more.  But with being on ‘rest’, many doctors appointments and not knowing what is going on has actually been exhausting and I have done very little on this list.  Even the things that don’t require me to leave the house for I haven’t been able to focus on, I have just been lethargic and brainless.  It doesn’t help that I am not even sleeping well and having lots of pregnancy related nightmares.  I might be physically well rested, but my brain sure isn’t.

Finally, just one more thing.  Now when people say to me, oh you look so good for 37/38 weeks pregnant…I actually feel bad inside.  I now know that my bump is small and I have put on little weight to the detriment of Rocky.  Until I meet her and hold her safely in my arms, that guilt is not going to stop, no matter how much people will tell me it’s not my fault.

But guys….I am almost at the end of all this…I am on the brink of exploding with happiness about that!