December 29, 2004
36wk Checkup
Yesterday I had my first prenatal appointment with the ob/gyn in Houston. This doctor and her partner had been highly recommended by a friend of Jill's (Dale's sister).
I had figured the appointment would be more lengthy than usual, even without them doing an ultrasound, since I was a new patient and I'd have to fill out paperwork and give them time to go over the records I'd brought down from Austin. I was right. We arrived about 30 minutes before my appointment time but weren't called back until 45 minutes or an hour later.
First, the nurse did the usual vitals stuff. Then she went over some of my records with me, trying to clarify the ectopic/heterotopic pregnancy stuff. After several minutes she finally understood that 1) I had been pregnant at the start of the year, but it was ectopic and I started to miscarry but had to use methotrexate to end the pregnancy, 2) I was diagnosed as pregnant in May, then at the end of the month, I had another ectopic pregnancy removed, this time surgically, and 3) I had a normal uterine pregnancy at the same time as the second ectopic, and that is the baby I am carrying now.
I really hate meeting a new medical person who looks over my records and says, "oh, you're carrying twins?" Please, just keep reading and don't make me answer that again.
After the question and answer session, I got to strip from the waist down. When Dr. Storey arrived, she surprised me by walking in, announcing her name, then going right past me to the counter where she started to flip through my records. I'm sort of used to shaking hands when I meet a new doctor, or at least having them make eye-contact. Dr. Storey asked a few questions then came over to examine me. I had my uterus measured again and she (painfully) checked my cervix. She said I'm not dilated yet, but my cervix is getting "soft and mushy." I guess that's progress.
Dr. Storey then told me that as a gestational diabetic patient, she would probably want to have me deliver 1 1/2 to 2 weeks early. Since gestational diabetic patient babies tend to be a bit larger, she wanted an early delivery to reduce the chances of needing a C-section. I have to confess that got me a little excited, but I was honest and told her that based on the weekly ultrasounds I've been having, my Austin doctors hadn't seen any reason yet for the necessity of an early delivery. She said they would decide soon, based on my next ultrasound and check up, and the "readiness of [my] cervix."
After that, the nurse came back in and we did a fetal non-stress test. Two elastic bands were strapped around my torso, one high, one low. The upper one measured contractions of my uterus. The lower was positioned to record Olivia's heartbeat. I was given a small control to hold with a button on top that I was supposed to push whenever I felt a movement. Olivia had been fairly active shortly before the test because I'd had some carbs (snack time), but she was still and sleeping again by then. The nurse pulled out this little device and said she was going to "zap" the baby to wake her up. She assured me it doesn't hurt and zapped my arm to prove it. Basically, it's a big joy buzzer that vibrates very rapidly and makes a loud buzzing sound when the trigger is pulled. She placed the head of it low on my belly and gave Olivia a quick zap. There was an immediate reaction. My uterus contracted and I could feel the baby spasm and kick in protest. Satisfied, the nurse left, saying the test would last about 15 minutes.
Though the zap startled her, Olivia was back asleep almost immediately. I only felt a movement every couple of minutes. After what seemed like more than 15 minutes, we stopped being able to hear her heartbeat through the monitor. I looked over at the machine, and the heartrate display was all over the place. It would jump to 220, then drop to 80, then go to 150. The printout that was feeding out of the machine no longer showed the fairly consistent jagged line of her heartbeat. Instead, it was a very broken set of small dashes and marks. I wasn't worried about the baby at all. I knew she'd just shifted and the monitor couldn't read her any more. I told Dale to get the nurse but he was being ornery and refused to move. After about 5 minutes of this, the nurse came in and repositioned the monitor.
She said we'd probably be done after about 5 more minutes. I was really glad because the position wasn't particularly comfortable and I was getting really restless. The monitor started to lose the heartbeat again, so the nurse ended up standing there for 5 minutes pressing it against my belly and zapping Olivia about once a minute. The baby was being so stubborn! She would jerk when zapped then immediately go back to sleep. Finally, the nurse went out to get the doctor. I pressed the monitor until Dr. Storey came in. She looked at the printout and said it looked good, so I was finally unhooked. I swear the test went on for 30 or more minutes. I think Olivia and I were both relieved when it was over.
That was pretty much the end of the visit. As we were checking out, Dale asked about preregistering for the delivery. We were instructed to asked for a form at the information desk downstairs, which we did. But there we were told we had to go to the information desk in the east wing. (We were in the north wing.) So we walked down to the east wing and I got a folder of forms to fill out. The preregistration itself I was told I could do online, but there are other papers I'm going to have to fill out and bring back next week.
So, Olivia and I are still healthy and doing well. I will get the results of my group B strep test later this week and have them sent to Houston. Then Dale and I will head to Houston again next week for my next ultrasound and prenatal appointment.