37 Weeks pregnant – Home stretch

The pregnancy bump is in full force, although most identify it only on side profile.  I am all baby.

I am now onto the final few weeks of pregnancy and it has been another adventure to add to the books.  I left off at a 33 week update and I would say that the home stretch has presented itself with a few more twists and turns.  Pregnancy is an individual experience for every woman myself included.   I always wondered what the last few weeks would bring as those are the weeks your baby is packing on the pounds, taking whatever it needs from its host.  Yeah I said it, my baby is eating me.

I last left off questioning my iron and hemoglobin levels.  I had a clinic visit on March 11th where my levels were deemed low but not so low that something needed to be done.  But let me back up a little. Previous to this visit (end of Feb) is where I learned my levels had not increased but additional blood work was run.  I received a phone call on March 4th from the dietitian that my zinc level and albumin levels were also low.   Zinc is important for immune system function and albumin is a type of protein.

So what did this mean? Start taking 10mg of zinc 2x a day.  This brought my individual supplement total up to seven.  But wait there is more!  Zinc competes with iron and calcium when it comes to absorption in your body.   So they cannot be taken together and I need to take it twice a day, along with taking iron twice a day and calcium once a day.  You can see where this is going.  So for the past few weeks my supplement regime has gone something like this: wake up – prenatal vitamin and vitamin D, 2 hours later – Zinc, 2 hours later iron, 2 hours later, calcium, back to zinc, then iron….somewhere in there B12 and Omega 3.  Inevitably, I forget one of them per day.   I’ve tried putting them all in a bowl in the morning and slowly taking one whenever I head to the kitchen.  I feel for all of those people who need to take daily medication.

I decided to finish working on March 21st.  This would be about a month prior to my scheduled due date.  This was not an easy decision and it ultimately boiled down to my inability to stand or walk for prolonged periods of time, I was down to fifteen minutes.   The difficult part was that my brain was all gung-ho but my hip was saying, “Noooo”.  The baby has been growing and started to push right onto my sciatic nerve during movements and would send shooting pain down my leg.  I was fearful of falling while treating patients and this is what ultimately stopped me from working.  Those who know me, know that I LOVE my profession and what I do so when I stopped, it was like a piece of who I am was also taken away.  Not to mention, leaving my work fam for a bit.

But in my heart, I knew that this is temporary and my physio self will be replaced with a new self, “mom self” very soon and some of this void will be filled.   I did not really want a full month  (or more) off of work though.  However, I have always suspected that the baby may come early at 38 weeks.

As people know, I am a big believer of the universe’s plan and working in certain ways for certain reasons.  Let’s now jump ahead to my March 25th appointment – Ultrasound and clinic visit (week 36).

During this visit, I learned that my Ob-Gyn is a master at the sandwich approach of explaining things.  For those of you who do not know, this is where a person will begin telling you the great things, followed by some bad things but closing with great things again.

She began by explaining that the baby is growing well at an estimated weight of 6lbs 1oz and the blood flow to the placenta was looking good. Amniotic fluid, also good.  Then she asked how I was feeling and if I had been feeling the baby moving.  I replied, that there was lots of movement.  Here I thought, she would now say, “Great, see you next week for follow up”.  But instead I got, “the radiologist called me after your ultrasound and mentioned to me that your placenta looked odd”.  She followed up with drawing a picture that demonstrated that my placenta is calcifying and was getting calcium/fibrotic deposits inside.  This is normal for someone who is around 41-42 weeks term but advanced for someone who is 36 weeks. Especially since my 32 week ultrasound was normal.  From my understanding, this means that the placenta is hardening and eventually it will stop working as it should.  This was the centre of the sandwich.

Next she went back to the good news, “but your baby is growing and the blood flow looked good”.  Followed by, “I think we will want to induce you next week or the week after before it stops working as well”.  I think after I heard, “induce next week”, I just nervously laughed and left the clinic filled with many emotions.  Excited baby is coming very soon, shocked that baby is coming so soon, happy I only get a week maybe week and a half off work, upset that I only get a week or so off work, etc.  I’m happy my mom was with me at this appointment to clarify some details for me afterwards.  I’m pretty sure I went to La La land after that news.

However, I did ask if I could keep doing Zumba (since I was still doing it…36 weeks proud!). The answer was, “umm, I don’t think we want to increase your heart rate to make your placenta work any harder than it should”.  I knew this would probably be the answer but I needed to hear, “No”.    So to my Zumba community – I will see you all after the baby is born!  However, I was cleared to continue with Yoga and general gentle exercise.

Once we left the clinic, I was booked for another ultrasound on April 1st (the following Monday) as well as a non-stress test (to evaluate baby’s heart rate and levels in utero).  Then an induction date would be set based on these results.

Now back to my belief of universe working in certain ways.  Although it was shocking to know that our baby would be here before the second week of April.  I had always said, “I hope the baby comes around 38 weeks”.  This will definitely be the case now.  In addition, my hip continues to get worse  as the baby grows and maybe this was also another way to get me back to normal faster.  Finally, my eating has become more difficult and at my last clinic visit, I actually had lost some weight.  I now sit at a 16lbs weight gain with this little guy.

So everything for a reason right?  Brandon and I are really looking forward to meeting this little guy and having a new chapter open in our lives.  I know that labour and raising him will be a challenge, but what’s life without some challenges?  The harder the challenge, the sweeter the reward 🙂

 

 

 

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29 Weeks Pregnant – A well overdue update

Hey Friends!

This stomachless pregnancy update is well overdue. I made the mistake of watching “Tidying up with Marie Kondo” followed by listening to her entire audio book and have been de cluttering like mad the past few weeks. I wondered when the nesting would begin but Marie has kicked it into full gear. But today I take a tidying break to give you all a much needed pregnancy update.

Since my last update, I have seen my Ob-gyn twice. Once just after Christmas where I was referred for a blood work up for my iron levels as well as to measure my blood sugar levels, and more recently Jan 24th where I completed my 28 week ultrasound as well as got updates on my previous blood work .

Normally women who are pregnant complete a glucose test around 24 to 28 weeks to test monitor for gestational diabetes. From what I understand, this involves drinking a large quantity of a sugar beverage followed by a blood work one hour later. Due to the no-stomach-thing, I did not have to do this test. Thank goodness because I think it may have killed me. Or just given me violent diarrhea and full scale dumping. Instead, I completed some blood work.

Throughout the month of January, I continued to work my regular hours and regular duties. I continued to attend the gym 1-2x a week for Zumba and home yoga daily for about half an hour. My fatigue level started to increase near the last couple weeks of January and I started to look green and pale at the end of the day. I was falling asleep on the couch around 8:30pm every night but figured it was just regular pregnancy fatigue. I also started to have minor dizzy spells and felt slightly faint during the last couple of tracks of my Zumba class. You probably know where this is going.

On my Jan 24th follow up, I was notified that my iron level was low and I needed to double up on my iron supplements. I have been taking Ferramax 150mg since my surgery as stomachless folk often have iron absorption issues post total gastrectomy (TG). This made all too much sense after hearing my results and started doubling up immediately. Within a week my energy levels improved as well as my colour. I will likely have this level rechecked in the future to ensure I am not anemic and if it remains low – I will be referred for an iron IV infusion. This is also common post TG and in pregnancy (especially during the late 2nd trimester into the 3rd).

In terms of my blood glucose levels, I did not have gestational diabetes so this was a bonus. Continue eating ice cream, baked goods, and chocolate for me! I am convinced this baby will be 1/4 chocolate.

On this visit I also had a 28 week ultrasound. At this point in time, I had gained about 10lbs above my pre-preggo weight. The issue the Ob-gyn is concerned about with people who have TG’s is the baby not gaining enough weight. Much to my surprise, I was notified that the baby is currently in the 73rd percentile. Which means that he is bigger than average! I heard these scans are not the most accurate for actual birth weight but I’ll take it. I am hoping to have a 6-7 pound baby but if this scan is accurate, I may have an 8 pounder. Yikes! Maybe I better slow down on the sugar….

In terms of physical mobility, my right hip and pelvis continues to be an ongoing issue and although I am doing as much as I can for it (Yoga, stretching, Physio, and massage therapy) it is getting worse as the baby grows. I’ll spare everyone all the details as I do not like to complain but I am confident that it will all go away once the baby is born. I am determined to keep up with my physical activity though throughout all of this pregnancy.

In terms of eating, my appetite is the best in the morning to mid day. Although, I have been eating a lot, my weight gain has been minimal. This morning I was at an 11 pound gain. As he continues to grow, the baby is taking all the good nutrients he needs and my body composition has been changing. Less muscle mass…larger belly. I think I am all baby.  The evening is a different story. Often it is hard eat the same portions I was able to eat a month ago and I have issues with food getting stuck. Dinner time is the most difficult. I find standing and eating the easiest. Sometimes, I try to shift the baby position around as I suspect my intestines and pseudo stomach are getting all bunched up and the pipework is getting kinked. If I’m successful, I usually feel a good gurgle and the stuck food sensation goes away. I also try not to eat too late into the evening to avoid bile reflux in the middle of the night.

Believe it or not, my surgical scar looks better than it ever has and I think all this belly stretching is stimulating more cell repair. I also think this baby is breaking a lot of old adhesions from surgery. You go baby!

Anyhow, my next follow up is next week. I am down to the every two week appointments now. I am now 11 weeks off of my estimated due date. Homeee Stttreeettccchh!!

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Me at 27 weeks pregnant

Pregnancy post total gastrectomy

I have been a little MIA from the blogging world over the past few months. Not because I didn’t have any ideas but I was saving up for some big news!

After last years adventures with IVF + PGD +PGS followed by a natural pregnancy and a miscarriage, we are happy to announce that we are expecting. I write this with both excitement and hesitation. As you all know, I am an optimistic person and prefer to see the light in situations. However, after experiencing a miscarriage, it is hard not to be semi-guarded when expecting. We announced to our friends and family after the infamous end of first trimester, but I did not feel comfortable posting anything onto social media. After speaking with Brandon and thinking about it long and hard, I decided that I wanted to blog about being pregnant without a stomach as it may help many other women trying to make that tough decision about when to have their stomach removed. I know I was there back in 2014 and it was not an easy one.

I was one week out from meeting with a fertility clinic as it had been almost 1 year since our miscarriage last year. I decided to take a pregnancy test about a week before the appointment and much to my surprise, it was positive. I was four weeks pregnant. This was back in mid August.

I had suspicion that something was going on as I was able to eat some ice cream, which I shared with the world on my last blog post. This happened to me last year before the miscarriage. I was able to tolerate sweeter foods easier. That was my first sign.

I called the fertility clinic to let them know about our natural pregnancy and they still followed me for the first eight weeks. At this point, I was transferred to a high risk maternal fetal medicine clinic. During my appointments at the fertility clinic, ultrasounds were taken at the six week and eight week mark. Each one filled with nerves that we would receive bad news and then joy that things were going well.

Once I was transferred to the high risk clinic, I first met with the regular maternal fetal medicine clinic and a genetic counselor to discuss the hereditary nature of the CDH1 genetic mutation as well as how one can go about testing a fetus for the gene. We had already decided in advance that if we had a natural pregnancy the child would not be tested until it is old enough to make the decision on their own. But for those who are interested, doctors are able to test for the gene using Chorionic villi sampling or amniocentesis. At this point, the expecting parents can decide to terminate the pregnancy or keep it. It is not an easy decision for anyone, that is for sure. In Ontario, these tests are covered which adds more layers to the decision making process of IVF with PGS/PGD (costly) vs. natural (testing is covered).

Thankfully, we were already prepared for all of these decisions as my genetic counselor discussed all this with me back in the day when I found out I was positive for the mutation.

I had morning sickness from weeks six to week fifteen. It actually was afternoon/evening sickness which allowed me to get through my work day but knocked me out at night. I experienced brutal nausea from about 4pm to when I crashed at night around 8pm. I attempted vomiting hoping it would make it stop but that is one thing that I have not been able to do since my stomach removed. So it was basically like being stuck with constant motion sickness for a nine weeks. Props to all the women who have this throughout the entire pregnancy and for those who don’t, you are lucky!

Around week six, I started to develop coccyx (tailbone) pain which has progressed into right sided glute/hip pain which radiates a quarterway down the back of my leg. Thankfully, I have many great physios friends who with who have been keeping it manageable. It is a real pain in the butt!!

In week 16, I was able to feel the baby kick and in week 17, I was able to see some kicks and feel them on the outside. They say that people may not feel these things until 20 weeks or later in pregnancy but I think us stomachless people are so body aware, we pick it up faster. The baby kicks more after I eat, I am assuming because all the intestinal noises from digestion must be pretty loud in there for it. The baby is sitting on my left side and fairly low.

In terms of weight gain, I have gained about four pounds since becoming pregnant. The Ob-gyn recommended that I gain 5-8lbs by week 20. I also recently completed my anatomy scan which occurs around weeks 18-22. Again, I had some ‘scananxiety’ but thankfully, everything was normal. I have still not gained much weight and I have a small bump. My Ob-gyn was not concerned about the lack of weight gain as it is too early to tell if the baby is growing appropriately.

Anyways, I plan to keep people up to date about how things are moving along. Pregnancy post gastrectomy is not a topic that many blog about so I think this will serve as a good platform to blog more frequently again.

October – two things to recognize…okay maybe three

Hey -yo!

I’m still here, alive and well.  I’m currently sitting in my favourite local Starbucks shop with my fall favourite…Pumpkin Spice Latte of course.   Recently, I decided I no longer wanted to pay an extra 70 cents for a lactose free milk and just got it with regular milk.  I wouldn’t recommend drinking a full glass of milk; however, I have found that the tall cup size latte gives me minimal discomfort.  Also, I ask them to add only 1 pump of the syrup to decrease the sugar content and no whipped cream.  What would fall be like without pumpkin everything, right?

Anyhow, I’ve been meaning to write a post for a while now but have been struggling a little bit with the content.  October has given me a new opportunity to write about three things close to my heart.

One of the main reasons I have not posted throughout the summer was that it was a little bit of a summer of highs and lows.   October 15th is Pregnancy and Infant Loss Remembrance Day and I wanted to discuss something that I recently experienced that society doesn’t like to discuss.  I think we should.  I’m breaking my silence.

Following our IVF disappointment, we decided that we were okay with trying to conceive naturally.   I don’t know if technology will be advanced enough cure stomach cancer; however, I do have hope that the medical world will have better ways of detecting the cancer, screening for it, and managing it.  After all, in the CDH1 gene mutation was discovered approximately 20 years ago and look where we are now.  I’m here.

Shockingly, I became pregnant immediately.  On June 14th, I had a positive pregnancy test – I was 6 weeks pregnant.  We were excited.  Who would have thought it would have happened so fast?  My cycle has been fairly irregular since surgery so we thought it would take a long time.  As the weeks went by, we starting thinking about our new future with a little one.  On the Canada Day long weekend, we gave our immediate families Happy Canada Day cards with the announcement inside – it was week 8.  I didn’t have my first ultrasound until week 12 and we knew we weren’t supposed to tell anyone until after this time but we couldn’t keep the secret much longer.   After all, if anything was to go wrong, we would want the support from our families.

On July 25th, we made our way to the hospital for my first ultrasound.   Both of us were nervous, it would be the first time seeing our future child.  The hospital was busy and we waited 2 hours past our appointment for me to be called in.  Finally it was my turn.  The ultrasound tech told me to lie down and then started taking images of my abdomen.   About five minutes in, she stopped and went out into the waiting room to get my husband.   He joined me and the tech left again.  Minutes later, she returned with another man.  I knew something wasn’t good.   Both of them reviewed the images.  He paused – looked at us and started introducing himself as the Ob-Gyn at the hospital.  “I’m sorry but you are miscarrying”.   I don’t think I’ll ever forget that day just like I’ll never forget the day of, “I’m sorry but you tested positive for the mutation”.  He went on to explain that the fetus stopped growing at 8 weeks and asked me if I had any cramping or spotting.   I did not.  I had what was called a “Missed Miscarriage”.  It means the fetus had stopped growing but your body still thinks your pregnant so nothing happens.

Both of us were devastated.  I described it as a deep, deep sadness.   Did I do something wrong? Why did this happen to us? Did the residual IVF hormones release an egg that wasn’t ready?  We’ll never know.  But I doesn’t end there, my body thought I was still pregnant and I went for another week and a half before I was given medication to pass the tissue.  It took another month for my hormone levels to drop back to normal (the time when a pregnancy test shows negative)  and a total of 9 weeks after the miscarriage for my period to return.  In May I was pregnant, by August I was not.

I have learned that I heal from speaking to others about my experiences.   In discussions with friends,  I learned that many of my other friends and colleagues have also had miscarriages.  One in four pregnancies result in miscarriage.   It was more common than I had originally thought.   Some say , “Oh, if left to go to term, it would have had serious health issues”.  Although this is likely true as miscarriages that occur prior to 12 weeks are due to chromosomal abnormalities, the flip side is that it could have also been perfectly healthy and gone to term.  You morn the loss of what could have been.

Time heals and we both are doing well.  I am optimistic about the future.  But now October 15th has a greater meaning to me.

Infant loss

The second thing I wanted to quickly recognize is Breast Cancer Awareness Month.  Since the stomach cancer is a non-issue for me anymore, the only other cancer I know I am at high risk for is Lobular Breast Cancer (40-60% lifetime risk).  The older I get, the more I start to think about it and having my Ontario Brest Cancer Screening letter come to me every October is always a reminder that I’m not in the clear.  Which brings me to the marketing for getting genetically tested.  People may not realize but there is a large psychological component associated with genetic testing and testing positive for something.   I would HIGHLY recommend speaking with a genetic counsellor prior to deciding to be genetically tested.  They can identify all the benefits and RISKS to being genetically tested.  They can also be there to support you depending on the outcome.   It may be a simple blood test but there are many other implications.   The most stressful time for me was between finding out I was positive and deciding what to do next.   I am so thankful for my genetic counsellor.
Number three – In just over a week I will be celebrating my 33rd birthday.  It’s three years more than my would be grandfather who passed away at 30 due to stomach cancer.    Even though I may be getting older, I’m thankful to be getting older because I honestly think I wouldn’t have made it much longer if I didn’t have the chance to prevent this cancer.