The final countdown

We are now DAYS away from the small guy arriving and us becoming parents and it is blowing my mind!  I have definitely been feeling more anxious these past few days than at any other time since the early days of the pregnancy. This is also not helped by practically everyone who crosses my path saying encouraging things like:

You’re never going to sleep again
Life as you know it is over
Enjoy the peace while you can

I remember people also said similar doomsday-style messages of “encouragement” before we were married and they were all complete BS because I really like being married. I do wonder what on earth inspires people to say such negative things dressed up as a joke or a lighthearted comment.  I mean seriously, you’ve been through this before so why are you not being more encouraging and saying what a wonderful new dimension having children brings to life? And – as my Mum says – if you don’t have anything nice to say, don’t say anything at all. I think I really need to walk around with earplugs in for the next few days or else I might have a heavily-pregnant-hormone-induced rage at someone soon.

Yesterday we had our last appointment with our doctor prior to delivery. It was overall unremarkable in a good way – baby looks great, he is still measuring long (tall) and weighing in at 3.2kg / 7 pounds already!! Keep in mind I’m at 37 weeks and 4 days, if baby reached 40 weeks or more he would be really big (as would I be). Eeeek!  The doctor said these measurements are not exact though.  Also, the doctor kept emphasising that his weight was because he is long, not because he’s overly chubby.

The baby has dropped more into a position ready for birth.  He’s not fully engaged in the pelvis yet, but he’s certainly on his way.  This was no surprise to me as I have also noticed the bump sitting lower.  This has positives and negatives… positive because I can now breathe a bit easier (yay) but negatives because if he so much as shifts to one side I feel like I need to pee urgently.

Every time the baby moves these days – and he moves a lot – it is awkwardly uncomfortable.  It’s like he’s shuffling my internal organs!  Also the Braxton Hicks are getting more strong each day and sometimes take a bit of heavy breathing for a few seconds to get through. This has put the fear into me that I could go into labour earlier than my scheduled c-section which would be bad in my situation.

Why bad? As I’ve described previously, as part of my battle against reoccurring miscarriages, it has been discovered that I have an issue with thrombosis – a condition called Antithrombin III deficiency.  Put simply, this means I have a deficiency of a protein that stops blood from clotting and I’m at higher risk of blood clots generally.  There is a theory that if you have this deficiency it can be a high risk factor in causing miscarriage and so the treatment is blood thinners, in my case daily injections of Clexane.

Clexane is routinely used as a blood thinner during IVF transfers as it is believed it may assist with successful implantation of the embryo. The dose that most people are given for this practice is usually 2000mg or 4000mg and only for a few weeks, but I started on 6000mg and am now up to 7000mg – quite a high dose!! I have been taking the daily injection since early November and, apart from it being very expensive and not claimable on insurance – it also means that any kind of surgery needs careful management.

From a pregnancy delivery perspective, and because I’m having a scheduled c-section, I need to be very specific about when I take the Clexane ahead of my surgery. The anaesthetist won’t do an epidural if I have taken the Clexane within about 24-36 hours because there is a risk of the epidural needle striking a blood vessel and causing spinal bleeding which can… well, it can lead to horrible things like paralysis.  These are the things that keep me up at night currently!

Now throw into the mix that if I go into labour naturally:

a) I won’t be allowed to labour naturally due to my previous myomectomy (surgery to remove a fibroid which also involved taking a chunk out of your uterus, thus making the uterine wall thinner and more at risk of uterine abruption during labour)

b) I will need to deliver via c-section ASAP but won’t be allowed to have an epidural if I have taken the Clexane within 24 hours (which I will have as I take them every morning) and will instead have to deliver under a general anaesthetic.

I do not like any of these options!!! So most of my appointment with the doctor yesterday was discussing my options for taking or not taking Clexane.  As the Antithrombin III deficiency was identified by a haematologist and not my ob-gyn, he can’t really over-rule the dosage and also I don’t want him to as the end of pregnancy brings with it the highest  risk of a blood clot generally.  That could be very, very bad for both baby and for me!! We ended up agreeing to speak to the haematologist to see whether I could at least reduce the dose to 4000mg- which would mean an epidural would be possible within 12 hours of the last injection – but she has come back this morning to say absolutely no to that as it would be “very dangerous”.

While very glad everyone has mine and my baby’s welfare in mind during these discussions, hearing the haematologist say stopping/reducing the Clexane dose now would be “very dangerous” did not make me feel at all calmer!  In fact I had a bit of teary moment during my appointment, but the doctor did say my concerns were justified so that made me feel a tiny bit better about the crying. Also the nice ladies at reception were all trying to get me a drink when I came out.  Maybe it’s not good for business when heavily pregnant women come out into the waiting room looking like a mess!  Haha!

So now I am having regular chats to the small guy inside me and encouraging him to stay in there for a few more days until the date of the scheduled c-section.  I am also on the alert for any and all suggestions that labour could be on the way (bleeding, bloody show etc) because in that case I will FOR SURE stop the Clexane!

In between all of that, I also decided yesterday to clean the fridge which I had not expected to be as dirty as it was.  Then I started on the drawer where I keep my cutlery/silverware and that was also more disgusting than I imagined so it got scrubbed out too.  After that the kitchen floor looked like a muddy army had passed through it so I mopped the floor.  That was all in all about 3 hours physical work yesterday and so I was pretty tired after that! The fridge does look spectacular though.  I even took a photo of it! Hahahaha!

The weather is insanely hot still and my feet have gone out in sympathy.  They are not huge but they are definitely a lot more puffy than normal.  I’ve tried elevation, ice baths, light walking and frankly they just stay the same so I think they will until baby arrives.  I’ve decided unless they suddenly go huge (i.e. a sign of pre-eclampsia) that I’m not going to worry about them any more. That’s the benefit of only having days to go as you think, okay I can deal with this if it’s only for a short while!