26 Weeks, or Something Like That

I haven't done a good job keeping track of where I am in this pregnancy.  I also haven't done a good job preparing for Baby Boy.  Oh well, it will all get done.

As I near the end of the second trimester, I want to jot down an update on how this pregnancy has been going.

My Interstitial Cystitis (IC) has not been good lately.  As Baby gets bigger, there is more pressure on my bladder.  I noticed about three weeks ago that urgency has gotten worse and worse.  I have been going to the bathroom A LOT.  Not that I always need to go to the restroom, I just feel like I need to go.  I really am blessed by the movement of this kiddo.  It reminds me that he's okay.  However, I'm not too grateful when he kicks me in the bladder.  Ouch!  If I remember correctly, it seems like IC is worse this pregnancy.  During my last pregnancy, I continued taking my medication, Elmiron.  Since Karis had an irregular liver enzyme count while I was breastfeeding her, I decided to quit taking Elmiron.  I do not plan to resume use until I'm done nursing #2.

Another pregnancy symptom that has started bugging me is acid reflux.  This is about the same time that it started during my first pregnancy.  Tummy is getting squashed.  Tums works the best.  Sometimes I sleep sitting up.  Speaking of sleep, I've been hot and uncomfortable!  I'm looking forward to cooler weather.

Last thing is "Pregnancy Rhinitis."  I also experienced this through my entire pregnancy with Karis.  My nose is constantly stuffy or dry and prone to sinus infections.  Using a Neti pot every day has been a great preventative measure.

25 Week Bump

9 Month Check-up Update

I said I'd update you after Karis's 9 month appointment with her pediatrician.  I've put this update off, because unlike usual, we didn't have a happy visit.  Usually I'm excited to report all her new stats to you.  This time, Doc had some concerns.

Here are her current stats:

Head Circumference: 16.5 inches/10th percentile

Length: 27 inches/25th percentile

Weight: 15 lb. 12 oz. /5th percentile (I read one chart that said 10th)

Karis's head and length continue to grow at a steady pace.  Her weight, on the other hand, is increasing very slowly.  If Karis had always been in the 5th percentile, the doctor would be fine with her staying that way, but since her percentile continues to decline, that causes concern.  Doc said, "Let's wait until her one year appointment to make a decision."  I quickly responded, "I don't want to wait.  This has been a concern at her last several appointments.  If she is malnourished, I don't want to continue to starve her.  I'm worried that my milk supply is too low."  He suggested weighing K before and after feedings to see how much milk she is getting.  He also increased her solid meals from 2 to 3 per day. 

A couple of days after the appointment, Doc called Michael at 7:30 in the morning.  I was worried immediately, because usually the doctor's office calls me.  Doc informed Michael that Karis's blood count came back showing that Karis has elevated liver enzymes.  He will see her in a month to retest.  I did some research and came to two conclusions. 

1.) The medication that I take for IC, Elmiron can cause liver problems, so maybe it was affecting her.  Decision: as long as I am nursing or pregnant, I will never take Elmiron.

2.) I read some scary things on the Internet, but the one that sounds most probable: low weight and malnourishment can cause an elevation of liver enzymes.  When weight and nourishment improves, the liver heals quickly.

So, I increased Karis's solid meals immediately.  I also tried supplementing with soy formula, but Karis threw it up the first time.  After doing a weight check, we learned that Karis was getting 5 ounces of milk during her first feeding and 2 ounces during the others.  Yikes!  She is supposed to get 6 - 8 ounces per feeding.  I tried some regular formula, and Karis did well with that, but we want to be careful with the milk, since Michael has a milk allergy.  This dilemma has left me stressed, worried, and panicky.  What kind of formula am I supposed to give her?  How much?  When?  How much is this going to cost?  Is breastfeeding really coming to an end?

After much prayer and research, my worry has calmed, and we have a good plan for baby K.  Research shows that breastfed babies slow down on weight gain after about 3 months, and this tends to alarm doctors.  Often, they recommend that mothers supplement or stop breastfeeding all together.  No way am I going to stop breastfeeding.  If I've still got some milk, why stop?  I am slowly introducing organic soy formula.  Karis is doing well... hopefully Doc will agree in a few weeks. 

Tiny Cutester in her Toy Box

IC and the Stay-At-Home Mommy

A while ago I complained about the loneliness of being a stay-at-home mom.  However, it obviously has many benefits.  Of course, it is what's best for my daughter; that's why I do it.  Staying at home also makes my pain from interstitial cystitis easier to control.

Clothing
Luckily I don't have to wear business attire.  Loose fitting clothes are the best, specially on bad IC days.  I like to wear PJ pants, cotton shorts, gauchos, skirts, or scrub type pants.

Water
I drink water literally ALL day long.  It's great for keeping the bladder toxins diluted.  Plus, water helps keep up my milk supply for baby, and it helps keep her hydrated.

Bathroom Breaks
Since I drink water all day, I have to go to the bathroom frequently.  Of course I can't always go to the bathroom immediately (if I'm in the middle of feeding Karis or a diaper change).  However, I'm able to get there in a more timely manner than when I had a classroom full of students.

Stay Active
When baby is sleeping, it's easy to lay in bed and think, "Poor me and poor bladder."  I think this just makes it hurt worse.  When I get up, put on those cotton shorts, go for a walk, and get some chores done, yes the pain is still there, but at least I'm not laying around thinking about it.

Rest
Staying active is good, but enough rest is essential!  Some people don't need much sleep, and some people need a lot.  I think I'm somewhere in between.  But I have to get that rest to take care of my health.

Eat Well
I live in a small town, so fast food isn't really much of an option.  Staying at home gives me time to prepare healthy, non-greasy, non-spicy food.


Elmiron
I've had an off and on relationship with my IC medication, Elmiron.  Lately, I've not been taking it for several reasons (mostly because it's not approved for breastfeeding).  On rough days, I'm sure to wear the loose clothes, drink extra water, and try to stay busy.

Staying Active: Just Completed a 5k
(in my favorite cotton shorts!)

IC and Breastfeeding

I knew that my pregnancy would affect my Interstitial Cystitis, and luckily it really wasn’t that bad.  However, I figured that once I had my kid, my IC would either improve or just return to the way it was before I got pregnant.  Wrong!

Lately, I have been aware of my IC every day.  It’s not horrible, but it is there.  I explained to my doctor what is going on, and she told me that since I am breastfeeding, I am still experiencing hormonal changes that cause dryness.  I asked her if it is safe to continue Elmiron (only drug on the market for controlling IC symptoms).  She said it’s up to me.  There has not been enough research to approve or disapprove of it for nursing mothers.  I have no idea what risk I’m putting Karis under if I continue taking Elmiron.  However, Elmiron has been approved for pregnancy, so I assume it’s safe for nursing.  Karis’s pediatrician asked me to only take it when I need it.  The problem is that Elmiron takes a couple of days to get into the system.  It was designed to be taken daily for pain management.  For now, I am taking it every day (except for today, I forgot, oops).

Enough is Enough

For several years, I have taken 2 medications to keep my IC under control.  Elmiron and Elavil worked well for me.  Elavil is not approved for pregnant mothers; so, I got off of that immediately with no problem.  (Fortunately, I was blessed with a low stress job.  That helped keep pain down too.)  I continued to take the Elmiron throughout my pregnancy.  After Karis was born, I learned that there has been little research on the safety of Elmiron for breastfed babies.  Since no one has said that it's safe, I didn't want to take the chance with my precious baby.  For about 6 weeks I was pretty much symptom free.  Then, I had some mild pain that was manageable with Tylenol.  During week 10, I was experiencing more severe IC pain that was not relieved by Tylenol.  One morning I decided I'd had enough.  The pain was wearing me out, and I wasn't able to get to the bathroom as frequently as my body was telling me to.  So, I took the Elmiron.  I've been taking it for several days now, and this episode hasn't calmed down completely.  I will continue my morning dose of Elmiron.  :-/
I've heard that some women with IC have no symptoms after pregnancy.  I was excited, thinking I would be a part of that group, but I was teased during the first 6 weeks after Karis's birth.  Oh well.  It was nice while it lasted. 

IC doing well... until lately

I haven't said much on the blog about IC, because it has been quite normal.  I've had flairs, caused by God only knows what, sometimes lasting up to a week.  I had those random flairs before becoming pregnant.  As our baby grows, the only abnormal IC related discomfort I've experienced is when she kicks or moves near my bladder.  It's an alarming, stabbing feeling that only lasts a second.
As I write this, I am 35 weeks pregnant and aware of my IC every day.  Before, I only experienced urgency during flairs.  Now, the urgency is consistent.  With this 5+ pound baby sitting on my bladder, I always feel like I have to go to the restroom.  I could go every 5 minutes and spend the whole day in the restroom.  That's no way to live.  So, I try to ignore the urge the best I can until I can't stand it anymore.  I go about every hour during the day and every 2 hours at night.  Car rides have been the most painful.  A road that seemed smooth before all of the sudden is like a mountain range.

First Trimester

The first 6 weeks of pregnancy ignorance was great!  The doctor confirmed my pregnancy at 8 weeks.  I went 10 weeks without any symptoms, and just as I thought, “This is too good to be true,” the morning sickness began. 

I felt nauseous pretty much every day, and I threw up about 2 mornings per week.  It was hard to drag myself to work!  I did have to call in sick twice.  I hated doing that.  The best relief for my morning nausea was saltines.  My mom suggested keeping saltines on my night stand.  Every morning, I’d eat a few crackers and sit in bed for about 5 minutes before rushing out of bed.  Tums were great too!  During this time, I had zero appetite, and I lost 6 pounds (that took a long time to regain).   At week 14, I felt like this would never end.  Was I going to be unlucky and have morning sickness throughout my pregnancy?  I was encouraged by a friend who said her morning sickness lasted until week 16, and luckily my story was the same.

In addition to nausea, my Interstitial Cystitis flared up a little bit during the first trimester, sometimes for a week or two without ceasing.  I didn’t feel pressure on my bladder, because the baby was still tiny.  The urgency, burning, and frequency increased.  I believe this was due to hormonal changes, because I did not change my meds or eating habits.

The last significant pregnancy symptom during my first trimester was tender breasts.  Tender may not be the right word.  They HURT LIKE CRAZY!  At first, I thought, “This is no big deal.  It feels like the usual soreness I get at the beginning of my cycle.”  But it just kept getting worse, and worse, and worse.  I used ice packs or cold bottles of water for relief.  The reward for the pain was extra attention from my husband due to my changing body.  See, it’s not so bad. *wink*

Trying to Conceive (TTC)

WARNING!!! This post may be TMI, but keep in mind, the purpose is to inform IC patients about my personal experiences with pregnancy.  STOP reading if you’d rather not know my personal details.

At my preconception checkup, I asked my OB lots of questions, including, “What if this takes a while?  When can we find out if my husband or I have fertility problems?”  She told me to try for a year and come back if we are unsuccessful.  A year?!  I’m way too impatient for that.

I immediately began researching conception.  I also printed a wonderful chart from thebump.com.  This helped me keep track of every little detail about my cycle including: start, finish, ovulation days, temperature, soreness, cramping, love-making days, etc.  I bought an inexpensive “basal body temperature” thermometer from the grocery store.  In addition to the chart, I kept track of all of these using 2 different apps on my phone.  (I know… a little obsessive)  The apps told me my fertile days and the best days to try to conceive.

Well, obviously books, charts, and apps won’t get a person pregnant!  It was time for Hubby’s favorite part, getting busy.  I read that when trying to conceive, after a session of love-making you should try to just lie down for 10-15 minutes (please don’t make me explain why).  That was difficult!  IC patients are prone to infection.  To prevent infections, cleanliness is key.  After trying to conceive, I wanted to jump up, go the bathroom, and take a bath to relieve that usual pain.  There were many times that I think we may have missed out on fertilization because I could not lie there.  I’d just say, “Oh well; next month.”  However, some people don’t think it matters whether or not you lie down for a while or get up right away.

A person with IC has to take advantage of the good days and rest on the bad days, but that was difficult when a chart was telling me exactly which days I must make-love.  I found myself, once again saying, “Oh well; next month” when I was experiencing too much discomfort to try to conceive.  I hate to tell you this, but by the fourth month, I was just desperate to get pregnant already; so, I had to fight through the pain on those bad IC days.

Yikes! I really hate to end a post in this discouraging way, but I’m being honest.  Trying to conceive was not simple, and it took time.  Both partners have to be understanding, and sacrifices have to be made.  Keep reading to learn about the rewards Michael and I are already experiencing…    

Leap of Faith

For about 10 or 15 years, I’ve felt a strong calling and desire to adopt children.  This is mostly because I’m deeply burdened by the overwhelming number of children in orphanages and foster care.  The thought of any child growing up without a loving mommy and daddy brings tears to my eyes.  Another reason I’ve wanted to adopt is because, since I was diagnosed with IC, I’ve learned that pregnancy and labor can be a painful mystery.  Lastly, as an adult I’ve realized that I’ve never had a desire to bear children.  I’ve never once thought, “It’ll be so neat to feel a baby in my belly and try on maternity clothes.”  (Of course, I played house and carried a baby doll around when I was little, but I never wanted to pop one out!) That realization made me wonder if God’s plan for me is to adopt one or several children.

I would have been perfectly fine with adopting all of our children and having none naturally.  However, my husband, Michael has always dreamt of having offspring with his wife.  We both spent several years discussing/researching the options and praying for God’s will.  Michael still didn’t feel that same tug on his heart.  That’s perfectly understandable!  I think adoption is wonderful, but I know that God does not call everyone to do it. 

Finally, we decided that we would try to have our first baby and see where God leads us after that.  This was a terrifying decision, because like I said earlier, I have NEVER wanted to be pregnant, and I never thought I would be.  Of course, we put it off, because the other terrifying part is the knowledge that our lives (finances, time, etc.) will drastically change when there is a baby to raise.

In May 2010 we said, “Ok, we can’t put this off anymore.  God wants us to “be fruitful and multiply,” and we want to be obedient to his calling.”  So, even though we were still scared, we leapt into the unknown.  Now that we are expecting, I have spent a lot of time worrying and even crying in fear that I cannot take good care of this baby.  My Sunday school and small group friends have been wonderful prayer warriors.  Lately, I’ve felt an unimaginable peace in knowing that our baby girl is safe in God’s magnificent hands.

Rewind... IC Diagnosis

Let me back up a little, and tell you about the beginning of my whole IC experience.

In November of my senior year of high school I began feeling like I had to go to the bathroom all the time (even after I went).  Urgency is the main symptom of a bladder infection, so that is what my gynecologist treated me for.  I experienced no relief.  Then, my doctor treated me for a yeast infection.  Wrong again.  Next, she wanted to do a pregnancy test.  That was just offensive.  I felt like the doctor didn't have a clue.  She could have diagnosed me with a broken toe, sprayed some Windex on it, and we'd have made just as much progress with my diagnosis. 

After that, I saw a urologist who told me I have an overactive bladder.  He actually said, "On the day God handed out bladders, you just got a bad one."  Wow! Is that even medically accurate?... NO!  His comment was based on the fact that I had a lot of urinary tract infections when I was little, but I had surgery when I was six to correct that.  I was a little relieved to have the "overactive bladder" diagnosis, because now I had an excuse for being late to classes.  (I had to go to the restroom between every single class and sometimes during class.)

Stop number three was the urologist who did my surgery when I was six.  He too, was stumped. 

Stop number four, another gynecologist.  She was stumped, but helpful because she referred me to Dr. Lapin in Houston's medical center. 

In February, the fifth doctor I saw was Dr. Lapin.  He performed a medical procedure called a hydrodistention with cystoscopy and a biopsy.  During the procedure, I was asleep while the doctor filled my bladder to its maximum capacity.  Then, he took pictures that revealed that the lining of my bladder was thin and irritable.  It also had pin-point bleeding.  The hydrodistention and biopsy ruled out many other problems, but it also pointed directly towards Interstitial Cystitis.  At last!  We knew something was truly medically wrong with me; I wasn't crazy!

After the diagnosis, I realized I'd probably be seeing a urologist more frequently for treatment.  Therefore, I felt that I'd be more comfortable with a female doctor.  Dr. Lapin recommended Dr. Delhey.  She has been wonderful!  We started out with just one treatment at a time, trying to figure out what works for me.  After perusing MANY options, we discovered that the best prescriptions for me were: Elmiron (the only drug specifically designed to treat IC), Elavil (a mild anti-depressant to relieve stress and pressure on my bladder), and Ultracet as needed (a strong pain reliever).  Now that I am expecting, I only take Elmiron and Tylenol.

Throughout four months of uncertainty and six doctors, my parents were very persistent in finding someone who could help me.  I don’t know what I would have done if they didn’t research, schedule appointments, and take me to all those doctors.  Thank you Mama and Daddy for being my advocates!