A week of appointments

I had a very busy week for medical appointments last week!

1) The hospital antenatal appointment

I had my regular hospital antenatal appointment on Thursday 3 Feb. S came along with me for the ultrasound, which was quick, but great. Baby's doing fine - he/she is at about the 70th-75th percentile for growth, and weighed in at 2lb 15ozs (or 1326g in new money), according to the prediction. The head circumference was 276.8mm, the abdominal circumference was 245.0mm, and the femur length was 54.7mm. After the scan S headed off to work, whilst I went in to see the various docs.

Dr I had a new trainee registrar with him, and introduced me as a star pupil (which was nice). After checking my blood results from last time, and looking over my monitoring diary he pronounced himself very happy with how things are going, and told me to keep on keeping on! Next time, (4 weeks) I'll have my third trimester retinopathy screening, and Dr I explained that he's trying something new for this. Instead of doing the screening himself, he has convinced the local screening service to do a trial run of coming into the clinic with their camera equipment, which should improve the accuracy of the screening compared to the 'old-school' version. The only hitch was that since this is so new, it's not quite clear how to book the appointments so that they line up with the antenatal ones. I'm quite the guinea pig (!) and have been asked to call the screening folks in a couple of weeks to confirm that all is going to plan with the appointment!

After Dr I, I saw S, the obstetrician, who checked my scan results and asked how things were going (including the trip to France, and the carpal tunnel). I explained that France had gone fine, although I'm glad to be back and close to the antenatal clinic for the remainder of this pregnancy, and that I still hadn't seen the physio, although I was due to go the next day. My bloods, scan and urine were all fine at this appointment, and my BP was 100/60, so S was also happy to see me again in four weeks for a repeat scan.

After heading off for the usual round of blood tests I left the clinic about an hour after I'd arrived (which must be some kind of record - and thank goodness, since I had to hurry straight to London to speak at a conference. Arrived in the nick of time!)

** I called up for my blood test results a few days after the clinic appointment and apparently all is fine. My HbA1C was 6.5%, TSH was 2.0, Free T4 was 9.6 and Free T3 was 4.7. Liver function and Alb/Creat also normal. Hurrah. That means my HbA1C has been 6.5% or lower throughout my whole pregnancy.

2) The physio

Next stop was the physiotherapist, who I saw on Friday 4th. I had a little scare when I arrived at the local community hospital in my neighbourhood, which I've never had to visit before. It was being redeveloped, with big 'hospital closed' signs at each entrance. WTF? Rather than freak out, I parked and wandered around the side of the hospital, where I found a tiny sign pointing towards the physio department, which is apparently the only part of the hospital currently open. What? They couldn't have put a note in my appointment letter explaining this?! Ah well. The physio was a lady called P, who was very quick to confirm that I have carpal tunnel syndrome and to agree that wrist splints worn at night are the way forward. She also suggested some exercises that might help relieve it (aside from the frantic hand-shaking, which she agreed is very effective!) The two which stick in my mind are sitting with your hands out in front of you above heart level, and doing the 'windscreen wipers' with both arms (from the elbows), which apparently helps to mobilise things. She tried to fit splints then and there, but had run out of the larger sizes (she only had small with her), so promised to send me some in the post once she got back to her main office.

Whilst I was at the physio I also took the chance to ask about some pains I'd been having in my pelvis the last few days. Right down low, near my bikini line (but inside), quite sharp muscular pains. I'd worked out that doing pelvic floor exercises and resting a little helps relieve the pain, but wanted to know what it was, and if there was anything else I might do. P explained that this could just be bad pelvic girdle pain, although it might also herald the start of SPD (Symphysis Pubis Dysfunction) which is more severe, and is where the bones of the pelvis, the symphysis pubis, open too wide - they open by a couple of milimetres in any pregnancy, but more can be very painful. She explained that good posture is key (and told me I'm pretty good anyway - must be all those childhood ballet lessons), and that I should listen to my body and not overdo the walking or stair climbing (although keeping mobile within those limits is good). If/when I feel pain I should slow down (seems to be after about 15 minutes of walking), and I should also make sure that my work chair and car seat have good lumbar support. I should also try to keep my knees together when climbing in and out of the car - imagining I'm wearing a miniskirt! - to stop any strain. Pelvic floor exercises a couple of times a day (5 x 10 seconds) should also help. I was really glad I'd asked the question. P also told me at the end of my appointment that she'd leave me on an 'open appointment' until I'm 6 weeks postpartum, which means that if I have any problems and would like to see a physio again all I have to do is call.

** The wrist splints arrived on Thursday of this week. They fit fine, although they're not exactly stylish or elegant (or god-forbid sexy!) I've slept with them for two nights, and I have to say that whilst they've banished the carpal tunnel syndrome very effectively they take some getting used to. It's a bit like sleeping in boxing gloves, I'd imagine (having never tried that!), and I find it hard to get comfy. I slept pretty poorly the first night, but did a little better last night, although I took the splints off this morning at about 6.30 and then curled up again for my precious Saturday lie-in. It was heaven to get them off! :) I'm going to persevere for a while though, and see if I can get used to the splints. S hasn't been clonked on the head yet, so he's being very sweet about it!



3) The community midwife

My final appointment of my busy week was this Wednesday (9 Feb) when I saw the Community Midwife. Instead of seeing J, the midwife connected to my surgery, I saw the midwife from the surgery that shares the same premises, another lady called J! My BP was 120/66 and my urine was fine, except for +1 glucose (which probably came from overenthusiastically treating a hypo in the night, since S was away and I was a bit nervous to be sleeping alone). She asked about fetal movements, and I explained that I'm feeling plenty, although they come at specific times of the day - a couple of hours after meals, and just as I'm going to bed (S tells me that he sometimes puts his hand on my belly in the middle of the night and can feel my little passenger squirming then, whilst I'm sound asleep!) I did explain that I certainly don't feel 10 every hour, which is what some of the books tell you is normal, and J explained that this is new guidance. She prefers the old rule of 10 in 12 hours, which I can certainly tick off! :) J also gave me an new leaflet at this appointment which deals with the '28 weeks and beyond' part of pregnancy. It's an interesting read - it explains more about pain relief options in childbirth, and some of the things that you can expect when you're in labour. After talking me through the leaflet she listened to the baby's heartbeat with a sonic aid (it was good and strong at 130 bpm, and I never tire of hearing it!) and then measured my fundal height and felt for the baby. It turns out that baby was in a slightly bizarre position - head down, yes, but seemingly doing a handstand, so carried quite high. This made the fundal measurement large for dates at 33cms, but given the growth scan last week J wasn't too worried. She said baby will probably be back in a normal spot by next time. We made an appointment for me to see other J again in 5 weeks, when I'll also be attending the two Js parentcraft class and coffee afternoon for local mums to be.

Well, I think that's it for the update - except that we've moved into new veg territory since last time I posted. Could I really have one of these inside of me? Might explain why my centre of gravity has shifted so much?! :)

Marseille Trip and Two Huge Pregnancy Landmarks

I have been so bad at posting recently! Since the new year I've been trying to dial things back on the work front and take a few days off here and there, before finally going on maternity leave on 16 March. Great in theory, but as it turns out, difficult in practice. The problem is that I still have to do all the things I usually do, and if I have fewer days I just end up working longer on the days I'm in the office! S and my Mum are both pointing out the silliness of this strategy, and I'd have to agree, but somehow the aspiration and the reality remain poles apart. I have a really intense job at the best of times, and I'm juggling a bunch of projects which I'm really committed to, whilst also trying to set things in order for my handover (the person who's taking over from me for the next year is a good friend, so I want to make her life as straightforward as I can, so that she'll still be speaking to me when I come back and resume my job). Anyway, I'm trying to turn things around now, so maybe I'll have time to blog a little more often.

One good thing is that I've done my last foreign travel before baby arrives. My work trip to Marseille was really great - I got to catch up with some of my favourite people, our conference was fabulous and we've set some new things rolling (just in time for me to wander off into the sunset for a year!) However, it was super-tiring, and I realised that pregnancy is catching up with me a bit now, and I can't do the early mornings and late finishes like I used to (carpal tunnel syndrome and a baby dancing on my bladder are playing havoc with my sleep patterns!) The train journey was a breeze - much better than flying, and once I got onto the Eurostar everything was very smooth (I had a few delays on the UK side, but fortunately not enough to cause me to miss my connection - although it was a close run thing!) The TGV was also great - very comfy, and very convenient. In fact, I think I'll be doing more rail travel in Europe even when I'm not pregnant - anything to avoid the dreaded Charles de Gaulle airport! I have to say though, I'm glad to be home. I had a little scare on my last morning in Marseille when I tripped and fell in the street after getting my feet tangled up in a piece of wire. Although I landed on my side, rather than directly on my bump, it was a frightening experience, and made me feel quite vulnerable to be so far from home and my brilliant doctors. A lovely gallant French chap rushed to my rescue and picked me and my shopping up - there was lots of waving and gesticulating, and he was evidently very cross that 'such a dangerous piece of wire' had been dropped in the street to trip up poor pregnant ladies. My French wasn't quite up to all of the nuances, but I was grateful for the sentiment all the same! I took myself back to my hotel room for an hour or two before I had to head off to the station, and luckily for me the baby obliged with some wriggling, squirming and kicking just to let me know that he/she was okay. I boarded the train relieved to be heading home though...

Here's a snap I took in Marseille of the view from our conference room window - it's amazing that anyone did any work at all! Although the weather looks great, and it was beautiful, it was also pretty cold, and we were surprised one evening by a couple of hours of heavy snowfall.



Since getting home from France I've reached two very exciting pregnancy landmarks. Today is the beginning of my third trimester - I've arrived at the 28-week point, which means I probably only have another 10 weeks to go (eeeeek!) However, my favourite moment of the whole pregnancy came in the early hours of this morning (1 am) as S and I were settling down to go to sleep. For as long as I've been able to feel the baby moving (ie. since Christmas Day), S has been putting his hand on my belly whenever I tell him that the baby's moving, and has been trying to feel it from the outside (so to speak). Last night he felt the littl'un for the first time -which was a magical moment. We went off to sleep full of excitement for what's to come. We're already a family, but baby will seal the deal.

Tomorrow I have another hospital antenatal appointment, and another scan, then on Friday a trip to the physio to discuss my carpal tunnel syndrome, and on Wednesday of next week I'll be seeing the midwife. I'll post again when I've had my appointments...

A Tale of Two Hospital Visits

Visit One:

Last week's hospital appointment - my 24 week visit - was a rollercoaster ride. I started off by having an ultrasound scan to check the baby's growth. S was with me, which was lovely, since we both had the chance to see our little person. The whole thing was over pretty quickly, unlike the anomoly scan, but the news was excellent. Baby's head circumference and abdominal circumference were both at around the 70th percentile, and the length of the femur was around the 50th percentile. The estimated weight of our little fetus was 1lb 9ozs (or 701 grams in 'new money'). It was lovely to see baby's heart beating away, and to know that my placenta's not blocking the exit! My amniotic fluid was normal, and the deepest pool measured 4cm. Finally baby's presentation was cephalic (head down) this time, rather than breech. The midwife doing the ultrasound explained that they're looking for the abdomen to match the head since this suggests that all's going to plan... and our little one isn't suffering from macrosomia, so it seems like my tight control is doing the trick. So far so good. On arrival for the scan I'd been told that they don't do scan photos once you're past 20 weeks, which was a little disappointing, but the midwife who did the scan snuck us a couple of freebies showing the baby's profile. I think they're the best pics yet - here's an example. I love that you can see so much detail of the baby's profile.



Once the scan was complete S headed off to work, and I headed back to the waiting room to wait for my appointments with the diabetes team and obstetricians. When the nurse collected me from the waiting room I was asked to provide a urine sample. Feeling a bit dehydrated, and not really needing the loo, my sample was pretty dark in colour, of which more later. First of the doctors to see me was Dr S, one of the obstetricians, who sat down with me, went through the scan results, and then talked me through some of my questions. I mentioned that I felt I was having to work pretty hard to stay hydrated, and she advised me to keep drinking throughout the day and try not to get too thirsty. We also talked through the fact that I'd had a very peculiar rash on my hands (red, prickly and swollen) on Christmas Day. I showed her the remnants just as Dr I stuck his head round the door to say hi, then came in to join us. Dr S concluded that the rash wasn't pregnancy related, just a bit of dermatitis (probably contact dermatitis) and nothing to worry about, which really put my mind at rest. I also mentioned that I've been getting pins and needles in my hands (fingers and thumbs) in the night, and keep having to change sleeping side and shake like crazy to get the blood flowing again. I was wondering if this was carpal tunnel syndrome. Dr S concurred, and gave me a referral to the physio department, who might be able to help. Apparently they could give me splints to sleep in if they think I need them. We also discussed the fact that I have a work trip coming up in a week or so, and I wanted to hear the team's advice. I'm travelling down to the South of France for a conference, and have decided to take the train rather than flying. In the scheme of things it doesn't seem to make much of a difference time-wise (a couple of hours) and I'm told that the Eurostar is much more comfortable. I've travelled by TGV before and been very impressed with the convenience and level of comfort, and I've had some horrible experiences at Charles de Gaulle airport, so I'll be glad to avoid changing flights there. Dr S agreed that the train might be more civilised, and advised me to keep well hydrated, wear flight socks, and keep mobile throughout the journey. Otherwise she thought it was fine to travel, and reminded me to take my yellow pregnancy notes with me. She also wrote me a prescription for the compression stockings, to save me a bit of money.

Dr I went through my log book with me whilst Dr S went off to find my urine results. He was really pleased with how things have been going - my HbA1C was 6.6% at my last appointment, and I'd managed to get my meter averages down since then, even taking into account the excesses of the Christmas period. I'd been a bit worried about my thyroid results, since I'd been told they were borderline when I called to get my blood results after the last appointment, but Dr I felt that they were still okay, if a little on the low side of normal. Another bit of good news.

At this point my urine results found their way into the room - apparently I was showing +1 for protein, +1 for ketones and +3 for glucose. I'd had a massive hypo in the night, so wondered if I'd overcorrected a bit too much, but it seemed a little strange, since my sugars had been great in the morning at 6.0 mmol/l. Not such good news. Dr S also took my blood pressure, and it was quite a bit higher than it's been at 150/90. Hmmm. Dr S told me I'd need to come back to the hospital two days later (on Saturday) to visit the Day Assessment Unit and have the tests repeated. She explained that she had slight concerns, but that it could just be a blip. She didn't mention the words pre-eclampsia until I did - as a big reader/researcher I knew that this was a possibility based on the symptoms. Dr S explained that it was pretty early in the pregnancy for such a development, and not to worry (but that's easier said than done, of course). Otherwise Dr S and Dr I both thought that everything was going pretty well, and agreed that I wouldn't need to return for another routine appointment for four weeks.

The next stop was to have my bloods taken by S, the diabetes midwife (I've just realised how many S's there are in this post - S my hubby, Dr S the obstetrician, and S the diabetes midwife!) After the usual struggles to find a decent vein (a theme of my hospital appointments, since I have rubbish mobile little veins!) I had blood taken for another HbA1C, as well as electrolytes, kidney function tests and to re-check my thyroid function. Whilst I was having the blood taken S and I had a little gossip and catch up, and I explained about my upcoming visit to the DAU. S explained that I just needed to turn up, as they don't make appointments in advance, and that I might want to consider getting there pretty early (9am) since it can get very busy. She asked if my blood pressure had been taken with the cuff that was in the consulting room, and when I said yes, she mentioned that it was a pretty small cuff for my arm, and that they usually use a larger cuff for me. She explained that might have affected the reading. She was going to try again with a larger cuff, but before she could do so she was called into another room, leaving me to head back to reception in order to book my next visit.

I spent the rest of the day at work, trying not to worry too much, and came home in the evening determined to do a little bit of research. I found out three things of interest:

1) If you're dehydrated and your urine is concentrated, you can have higher levels of protein show in your urine than if you're properly hydrated. (See this factsheet).
2) The wrong size blood pressure cuff can have a significant effect on readings, and can lead to mis-diagnosis of hypertension in larger pregnant ladies: see this website, and this one (for more general information).
3) Pre-eclampsia is scary, but not untreatable. Here are three resources which I found reassuring: patient.co.uk, Mayo Clinic, and NHS Choices.

All of this made me feel a little better. I bought a new home blood pressure monitor that same evening (a clinically validated wrist one, which is perfectly accurate if used properly, and in any case better than the one I currently have, which has a cuff too small for me), and to self-monitor in order to feel more in control of the situation. My BP when I got home was super high - 160/96, but it fell back to 123/76 later that evening, once I'd chilled out a bit, stopped worrying so much, and had a good chat and cuddle with my lovely hubby. It's been at good levels ever since!


Visit Two:

Saturday morning's excursion to the Day Assessment Unit at the hospital was much more reassuring, and in a funny way it was nice to see inside the Maternity Unit and meet some of the people there, even if I did have to go through a little scare first!

We arrived at 9am, and had to wait for security to unlock the door to maternity reception before we could even get in! I'd been scrupulous about drinking plenty of fluids over the prior 24 hours, in order to avoid the possibility of dehydration, and when the admitting nurse checked my pee sample it came up negative for everything - protein, ketones, glucose, the lot! I was shown to a bed, and my temperature and BP were taken. My temperature was up a little (I did feel a tad hot, and since then I've had a bit of a sore throat), and my BP came in at 140/80 - with the large cuff :) The nurses checked my notes, and spoke to the duty obstetrician (Dr M), then came to explain that they'd take some bloods for analysis, and would do serial blood pressures every half an hour (four in all), which meant that I'd be in the unit for a couple of hours at least. Well, we'd come prepared - both S and I had books with us, and my resourceful husband had even brought a flask of coffee (unneccessary, as it turned out, since we were invited to help ourselves to hot drinks from the day room!) My second BP reading was lower than the first, at 134/68, and the midwives were so surprised that they double checked it! Between my second BP reading and the third one of the midwives came and measured the height of my fundus (26cms, about 1-2 cm over the expected reading), and then as a treat let us listen to the baby's heartbeat using the doppler. So exciting, since it was the first time we'd heard baby's little heart chugging away. It was rattling along at 158 beats per minute, which is within the normal range. My third BP was 116/62, at which point Dr M stuck her head round the curtain for a chat. She was happy with my BP results, and told me that all of the blood tests had come back normal, so she was happy for me to go. She agreed that dehydration and a small cuff could have been the problem, and in any case, I was fine according to the DAU's tests. I mentioned my up-coming travel plans, and Dr M thought it was absolutely fine to go ahead with the trip. I asked if I should procure some protein strips for checking my urine at home, and she said they don't usually provide them to ladies unless they've had significant and ongoing problems. (Being a control freak I bought some from Amazon when I got home - they're identical to the NHS ones!) We left the hospital about two and a half hours after we arrived, and both S and I felt much much happier. Definitely better safe than sorry!

Postscript:

Today I had my 25 week appointment with J, the community midwife (and her trainee student K). My BP was 122/64, my urine sample was negative for all the nasties, and my fundal height was 27cm (still 2cm over!) We also listened to baby's heartbeat, which was around 150 bpm. I think I could listen to it all day every day! I also collected my MAT B1, which will allow me to complete the paperwork for my maternity leave at work tomorrow. All in all it was a pretty routine appointment, and I've booked another for four weeks' time. So, I'll be at the hospital next on 3rd February, and then I'll see the midwife again on the 9th.

Last, but not least: fruit and veg. Since my last fruity update my little passenger has graduated a couple of levels...

I've been feeling something new...

I can finally feel my little passenger wriggling! As the weeks ticked by I was starting to worry just a tiny bit. I know that it can take longer to feel movement in a first pregnancy, and it can take longer for the larger lady (ie. me), but I was kind of working towards the 18-22 week target that all the pregnancy books and websites seem to agree on. As it was, my little passenger was saving up for something special. I felt baby's first little flutters on Christmas Day (at 22 and a half weeks) when we got back to Mum and Dad's after spending the day with my aunt. At first I wasn't entirely sure if I was imagining things, but throughout the week between Christmas and New Year I felt more and more little wriggles, squirms and flutters. Yesterday, New Year's Day, was the best so far - we were out for dinner with some friends and I swear the littl'un actually did a somersault! What a Christmas gift. S and I have had a wonderful time seeing family and friends, and the last few days we've been hanging out at home together, enjoying just slobbing about, but the best thing of all about this Christmas has been the reminder that soon there will be three of us - a proper little family.

Happy New Year to all - I think 2011's going to be some kind of wonderful!

A long overdue post / Anomoly Scan in three parts

Wow, it's been a while. Things have been really hectic, but that's no excuse for failing to post for weeks on end.

I had my twenty week anomoly scan and associated medical appointments at the hospital on 9 December (with a return visit on 14 December). Mum and Dad came with me since S was staying up in London for a couple of days for meetings. It was lovely for Mum to be able to come into the scan with me as my one accompanying adult, although I did feel a bit mean leaving Dad in the waiting room. The anomoly scan can take a while, and I was in for about half an hour whilst the two ultrasound midwives (who both share my name!) measured and checked every part of baby... except for the bits that baby refused to show off, despite all our best efforts. I announced at the beginning of the scan that we didn't want to find out the baby's gender, and asked that we be told to close our eyes when we got to that bit of the scan. However, it turned out that there was no risk whatsoever of finding out since baby was tucked down low in my womb, in a breech position, curled up like a little hedgehog. This meant that we couldn't see the very lowest part of the spine (important to see in order to check for spina bifida). Baby also had a hand over his/her face, which meant that we couldn't see the lip in order to check for a cleft lip/palate. We decided that I should go off for my other appointments and then come back for another go to see if my little passenger had moved into a better position.

First I saw Dr I, who went through my numbers and discussed tweaking doses a bit here and there - especially background insulin. We agreed that my requirements seem to be taking off, and he told me that I can be a little more aggressive with my doses. Recently I seem to have been in a pattern of testing and correcting more than I'd like, and of course, with Christmas coming up I'm going to have to be at the top of my game anyway, given all the naughty food temptations which will be coming my way!! Dr I also dialated my pupils in order to check my eyes for retinopathy. At this point he ducked out for a few minutes whilst one of the Obstetricians popped in to see how things were going. She was surprised at how upbeat I sounded, saying that most ladies tend to complain of feeling tired and run down at this point in pregnancy. Although I have been tired things have gone pretty smoothly for me so far, so I actually feel pretty lucky, all things considered. We then talked a little about what comes next for me in terms of my care - she walked me through the typical care plan for pregnant ladies with pre-existing diabetes and then explained that based on the results of my ultrasound I'd be having growth scans every four weeks starting from 24 weeks. This is good news, since if there was anything to worry about in the scan I'd be down for fortnightly scans instead. At this point she swapped again with Dr I, who checked the back of my eyes. He could see evidence of one or two tiny microhaemmorhages in my right eye, but said they were nothing to worry about - especially given where they were located. We agreed that I'd come back for my next diabetes and obstetrics checks along with my 24 week scan, in early January (Thursday 6th), and in the meantime he ordered a bunch of blood tests (not quite the full works, but most of them!) S, the diabetes midwife took my bloods for me, and then it was off to see the ultrasound ladies for a second time to see if baby was co-operating. The second scan was much shorter, and we managed to tick off the upper lip, but still no luck with the lower spine. At this point I was free to go, although feeling a little tender along my bikini line from all the prodding and poking. I booked to come back to the hospital on Tuesday 14 December, and then headed out to lunch with my parents.

Here are the results of the (first two) scans (which all fell within the normal ranges):

Biparetal Diameter: 47.2mm
Head Circumference: 183.7mm
Posterier Ventricle: Transcerebellar Diameter: 20.1 mm
Nuchal fold thickness: 4.4mm
Abdominal Circumference: 152.8mm
Femur length: 33.2mm

Heart action present, Fetal movements visible, Presentation Breech.
Amniotic fluid: normal.
Cord: 3 vessels.
Placenta: Anterior clear of os.
Heart: 4 chamber view normal.

The following were visualised and appear normal: head, brain, face, neck and skin, abdominal wall, gastro-intestinal tract, kidneys and bladder, extremities, skeleton.

All in all it was pretty amazing. We even saw 10 little fingers!

Here are a couple of pics:


When I went back for the third bit of the scan on Tuesday 14th baby was still curled up in a little ball, and still in a somewhat awkward position, but the good news is that we were able to see the lower spine and the skin covering it. All is fine - the little heart was beating, the baby was moving, and baby's mum is just delighted!

I finally rang up for the results of my blood tests this afternoon. I'm amazed to say that my HbA1C was 6.6% - hurrah! It sounds like my thyroid function might be drifting a little though - so that's one to discuss at the next appointment. I was told early on that I'm borderline for an underactive thyroid, so it's not a total surprise. Everything else was apparently fine, so I'm looking forwards to a more detailed discussion of my bloods when I go back in January.

Things get even busier for us tomorrow, with S's parents arriving for a few days visit. They're staying with us until Christmas morning, when we head off for a few days to see my parents. The way things have worked out this year we'll be having three Christmas dinners in a row - Christmas Eve with the in-laws at our place, Christmas Day with my aunt, and then on Boxing Day we'll all descend on Mum and Dad's. That's a lot of turkey! We've had a few inches of snow in Bristol, so everything's looking very Christmassy indeed. Mum and Dad have also had snow in Berkshire, and S's parents have apparently had a foot or more in South Wales. Fingers crossed that they can travel to Bristol safely.

Merry Christmas to all!

I'll sign off with the obligatory fruit and veg update...

Visiting the Midwife

I saw J, the community midwife, again on Tuesday. This was a pretty short visit - just a chance to get back the results of the various blood tests I had last time, have a BP check, and hear a bit more about what to expect at this stage of the pregnancy.

I've always wondered what my blood group is, and now I know. It's A+, which is the second most common for people in the UK. My husband is O+, for the record (which is the most common). I also found out that I don't have HIV or syphilis (didn't think I did, but nice to have the proof!) I'm also not a carrier of sickle cell or thalassaemia (due to my ethnicity I'm very low risk anyway, but again, nice to have the confirmation). Being a researcher, as soon as I got home I did a little googling to help me understand the results of my full blood count, which just looked like alphabet soup on the page. Here's what I found out about what all of those acronyms mean:

WBC - total white blood cells
RBC - total red blood cells
Hb - Haemoglobin (low Hb= anemia)
Hct - Haematocrit (the fraction of the whole blood volume that consists of red blood cells)
MCV - Mean Corpuscular Volume (the average volume of the red blood cells)
MCH - Mean Corpuscular Haemoglobin (the average amount of Hb per red blood cell)
MCHC - Mean Corpuscular Haemoglobin Concentration (the average concentration of Hb in the red blood cells)
Platelets
Neutrophils - may indicate bacterial or viral infection
Lymphocytes - higher with some viral infections/leukemia, lower in HIV
Monocytes - raised in bacterial infection, TB, Malaria, leukemia and ulcerative colitis
Eosinophils - increased in parasitic infections, asthma and allergies
Basophils - increased in bone marrow disorders like leukemia and lymphoma.

Good news for me - everything was in range, except for the Eosinophils, which were at the very top end of normal. Since I've had asthma since I was four, and also have masses of allergies, this was to be expected.

I also had my blood pressure taken. It was 120/64, which is brilliant for me. I asked whether BP tends to go down in pregnancy, and was told that it can do, although it usually finds its way back up to the levels seen at the booking appointment by the time women reach the third trimester.

We also talked a little about what I can expect to happen over the next few weeks. I'm 17 and a bit weeks now, so I may start to feel baby's movements any time (this usually happens between 16 and 22 weeks, and can be on the later side in first pregnancies and bigger women). The advice from the NHS is that you should expect to feel movements every single day after 24 weeks, although they won't be consistent throughout the day since baby has a cycle of sleeping and waking. If you don't feel a movement, or if you are having noticeably fewer movements, then you should call the maternity unit by 9pm, and they will bring you in for tests. We also talked through the symptoms of pre-eclampsia. This is more common if you have close relatives who've had it (my mum did), if you have diabetes (tick), a BMI of 35+ (tick), and if it's your first pregnancy (tick!) Signs to watch out for include raised blood pressure, protein in the urine, bad headaches that don't go away, blurred vision (or flashing lights/spots in front of your eyes), bad pain below your ribs (especially on the right hand side) and vomiting. Again, any problems, and you call for help immediately!

I'm not seeing the midwife again until I'm 25 weeks, so that will be around mid January. In the meantime, if I want my Mat B1 form before then (which in the UK allows you to arrange maternity leave, amongst other things), I'll need to contact J at 20 weeks, and she'll leave it behind the counter for me at our GP's practice. Next stop in the pregnancy wagon train is my 20 week scan on 9 December.

I also finally had my flu jab today, so I'm typing this with a very sore left arm! :(

I'll finish off with the obligatory fruit/veg pic (although I'm a little suspicious of this one, since I think onions are usually smaller - at least they are when they come out of our veg box or from our allotment!)

A very quick post for World Diabetes Day

I didn't want today to go unmarked on my blog. It's World Diabetes Day.



Last 14 November I had no idea that there was a World Diabetes Day. Since then, in preparation for this pregnancy I've taken my diabetes in hand, and got my HbA1C down to 6.4% (a number I haven't seen for ten years or more!) I've worked hard, and proved to myself that I can do it... but I haven't done it alone, because this year I discovered the DOC - the Diabetes Online Community. Diabetes, especially Type 1, can be incredibly isolating - but thanks to the DOC I don't feel so alone any more. So, this is my big thank you to all the wonderful D-bloggers out there who've become my support network. YOU ROCK!

Happy World Diabetes Day.