21 Week Ultrasound

This morning was our 21 week high risk ultrasound and everything went amazing! We have a very healthy growing baby girl! She now weighs 11 ounces and Doctor Morales says that everything looks perfect. He sees no birth defects, and our quad scan (detecting Down Syndrome and other abnormalities) came back negative. She is growing right on track and is moving around like crazy. She waved to us on the ultrasound and gave us a thumbs up! Her heart was beating around 143 bpm and it was loud and clear. The ultrasound tech gave us 6 printed pictures! This baby is going to have a huge photo album before she is even born. 

View from above. You can see her belly button!

Her little feet!

My favorite: It's a GIRL!

Profile picture with umbilical cord

Tachycardia in POTs

My dad gave me a heart rate monitor, which I have been wanting for a while now. I can always tell when my heart rate increases dramatically, because I feel the physical effects of it immediately. I usually feel my heart beating fast, I feel short of breath, and I feel the blood pooling to my lower extremities. I have two blood pressure monitors that also record my pulse, but they do not work when I am moving around. I knew what to expect when I put the heart rate monitor on, but I guess it still surprises me every time I see the numbers.

I always had a very low resting heart rate until I developed POTs. When I was a personal trainer, my resting heart rate stayed around 65-75bpm. Now that I am pregnant, and I have POTs, my resting heart rate has averaged around 80bpm.  This is considered below average for a healthy 25 year old woman.

A 'normal heart' rate is considered anywhere between 60 and 100.

When a person exercises, they gain the most benefits and lessen the risks when they exercise in their target heart rate zone. Usually this is when their exercise heart rate (pulse) is 60 to 80 percent of their maximum heart rate. The maximum heart rate is the highest heart rate achieved during maximal exercise. One simple method to calculate your predicted maximum heart rate, uses this formula:

220-your age = predicted maximum heart rate

For example: 220-25 (my age) = 195bpm

As as person progresses in their exercise, the percentage of their maximum heart rate can be gradually increased.

If i wanted to exercise and see a benefit, I would want my heart rate to be 60-80% of 195 while exercising:

195 x .60 = 117bpm
195 x .80 = 156bpm

HOWEVER....

I have POTs and that changes everything. As you will see in my video, my heart rate jumps almost above 80% just from standing up! A normal persons heart rate should only increase 5-10bpm upon standing. My heart rate jumps up 30+ beats, while my blood pressure drops drastically. So the question is, am I getting a workout every time I stand up? It sure feels like it!

Watch my heart rate (Sorry it is sideways!):

Week 20

Baby Baker is the length of a banana or the size of a cantaloupe!

HALFWAY THROUGH OUR PREGNANCY JOURNEY!

The baby has become pretty active, but not consistently yet. I had two days that I didn't feel her at all and I got a little nervous, but it is still so early that I will not always feel her. Last night she let me know that she is in there for sure! Around 11pm, I was laying in bed and she was dancing around none stop for an hour! It was the greatest feeling! Both my mom and Darrell have felt her move now!

Week: 20

Total weight gain: 14 lbs!! Kind of a lot when you think that the baby is only like 10-12 ounces right now! But they said I was "underweight" before I got pregnant and that I need to gain a little extra...

From thebabycorner.com:

Where Do I Stand With My 14 lb Weight Gain?

Based on your pre-pregnancy weight of 108 lbs., we calculated your BMI to be 18, which is considered underweight according to the Institute of Medicine of the National Academies. This week you should weigh between:

117 and 122 lbs

Congratulations! You are right on target for a healthy weight gain during your pregnancy! During your first trimester, you should gain between 3 and 5 lbs.. Thereafter, you should be gaining between 0.92 and 1.3 lbs. per week until the end of your pregnancy.

At full term (40 weeks pregnant) you should weigh between:

136 and 148 lbs
Total Target Weight Gain: 28 to 40 lbs.

Pregnancy symptoms this week: PIMPLES! Yuck!!!! 

POTs symptoms this week: Headaches and dizzy episodes almost everyday... beginning to wonder if this steroid is working at all? Shortness of breath, or the feeling that I am not getting enough Oxygen. This could be from the pregnancy itself, or from POTs. 

Best moment this week: Today! Knowing that I am halfway through this journey toward meeting our daughter!!

Mood: Happy all day, but anxious at night. 

Sleep: Dreams, dreams, dreams!! 

POTS

I want to really focus on POTS awareness. It is a newly researched disease that not many people, including doctors, know about. Whenever I go to the ER, I often feel that I have to be smarter than the doctors. It is very surprising if one of the ER doctors knows anything about my condition or how to treat it. This is so frustrating, because by the time I get into the ER after passing out, and sometimes even having seizure like convulsions, my vital signs show up normal and they send me home with "dehydration". 

 Most POTS patients develop POTS when they are in their younger teen years, allowing them to outgrow the disease by the time they hit their early twenties. Unfortunately, I didn't develop the symptoms until I was about 17 and it has only gotten worse. I am 25 and it is the worst it has ever been, and I don't know if I will "outgrow" this awful disease. When I was in high school, I was an all star soccer player. I ran track, lifted weights; you name it, I was involved in it! I started having a lot of stomach issues my senior year and was in and out of doctors offices and hospitals with no answers. My freshman year in college, I collapsed outside of Wal Mart and was rushed to the emergency room. While at the hospital, the doctors performed a laying, sitting, and standing blood pressure test. My blood pressure dropped to 60/40 before passing out in the doctors arms. I was sent home with "dehydration".

In 2005, I had a positive tilt table test. Not only did I fail this test, I failed miserably. I had less than 1 minute of head-up tilt before I had a syncopal episode. My blood pressure was not palpable and they had to stop the test. They initially told me they were going to tilt the table and watch my vitals for 15 minutes. So much for that. They diagnosed me with Neurocardiogenic Syncope and put me on 5mg of Midodrine 3 times a day. 

The Midodrine helped manage my symptoms, keeping me off the ground most of the time. However, it gave me horrible goose bumps and chills on my head and legs. I couldn't stand the side effects of the medication, so I only took it on days I felt it was needed. 

POTS wasn't highly recognized when I was first diagnosed, so they had misdiagnosed me with Neurocardiogenic Syncope. Luckily, the medication and symptom management is relatively the same for the two conditions. It took years before I was properly diagnosed with POTS. 

Before I became pregnant, I was able to manage my symptoms pretty well. I perfected blacking out and was able to stay standing and let it pass (most of the time). I was able to take my medication when needed, and stay out of the hospital. The day I became pregnant, everything quickly took a turn for the worse. I had to stop taking my medication. My first trimester, I couldn't stand up without help. I was always throwing up, which caused dehydration, which caused dizziness, and fainting. It was a viscous cycle. Luckily, in the second trimester, I have shown much more of an improvement. I haven't been stomach sick so I have been able to keep my fluid intake at a high level. Recently, I was prescribed a medication called Florinef. I started taking it 3 days a week and I found that I was only passing out and getting dizzy on the days I was not taking it. So as of yesterday, my cardiologist wants me to try taking it 5 days a week.

I have tried to find research on patients with POTS and pregnancy. It is pretty much non existent. This leaves me questioning everything with this pregnancy.  My high risk doctor has never had a POTS patient, and neither has my OBGYN. My cardiologist has 4 other patients my age with POTS, but none of them are pregnant. I feel like I am going to be an experiment. 

I have so many questions about being pregnant and having POTS, but no one has the answers for me. I want to know if I will get better or worse after this pregnancy, and if my daughter will have POTS. I want to know if I will be able to pick up my daughter without the worry that I might pass out with her in my arms. Will I be able to have more children? I want to know that I will have a safe delivery, and that my blood pressure drops aren't going to affect my baby. I want to hear her heart beat every day because I am always worried that every time I get dizzy or black out, it is going to affect my growing baby. I don't want to feel guilty every time I stand up too quickly, thinking that I could be hurting my child. 

I can only sit back and take things day by day. I have high hope that everything will work out, and everything will go back to normal after she is born. I have an amazing group of doctors who are going to make sure everything goes well. I have an amazing, supportive family and group of friends that are making these 10 months a lot easier. I feel very lucky to have these people in my life and to know that there is always going to be someone here to help. 

Here are a couple of informative videos about Postural Orthostatic Tachycardia Syndrome:

Symptoms of POTS outlined by Dysautonomia Information Network

• Fatigue (which can be disabling)
• Sleep disorders (can cause unrefreshing sleep and an increased need for sleep)
• Headache/migraine
• Myofascial pain (characterized by regional muscle pain accompanied by trigger points)
• Neuropathic pain
• Dizziness
• Tachycardia
• Exercise intolerance
• Clamminess
• Anxiety
• Flushing
• Postprandial hypotension
• Blood pooling in limbs (can make legs feel heavy and appear mottled and purple in color)
• Intolerance to heat
• Feeling cold all over
• Low blood pressure upon standing
• Cognitive impairment (may include difficulties with concentration, brain fog, memory and/or word recall)
• Narrowing of upright pulse pressure
• Cold hands
• Hypovolemia (low blood volume)
• Chills
• High blood pressure
• Hyperventilation
• Numbness or tingling sensations
• Reduced pulse pressure upon standing
• Low back pain
• Aching neck and shoulders
• Noise sensitivity
• Light Sensitivity
• Disequalibrium
• Arrhythmias (irregular heart beats)
• Chemical sensitivities (May have multiple chemical sensitivity and can be very sensitive to medications - may only need small doses)
• Easily over-stimulated
• Feeling full quickly
• Feeling "wired"
• Food allergies/sensitivities (some foods seem to make symptoms worse)
• Hyperreflexia
• Irregular menstrual cycles
• Loss of appetite
• Loss of sex drive
• Muscle aches and/or joint pains
• Swollen nodules/lymph nodes
• Polydipsia (excessive thirst)
• Weight loss or gain
• Feeling detached from surroundings
• Restless leg syndrome

Week 19

Baby Baker is the size of a mango!

I love counting the weeks, because they go by so fast! When I think about the months still to come, I feel like it will be forever until I get to hold my little girl in my arms! 

This week, I got on the treadmill for the first time and it felt great. Granted I could only walk a mile and half, before over doing it, it's better than nothing!  The fatigue that I feel is overwhelming. Between your normal pregnancy fatigue and POT syndrome, I feel like I need to lay down all the time. When I go to the grocery store, my body feels like I ran a marathon after. I hope that it gets a little better further into my 2nd trimester, but it seems like the bigger I get, the worse it gets.  We did our registry at Toys R Us and it was a very fun and exciting 2 hour process! But when we got home, I didn't get out of bed for two days! 

On a great note, we heard her heart beat this week and it was loud and clear 135-140 beats per minute! :-) I lOVE that sound! 

A little extra:

Total weight gain: 10 lbs! Finally getting some weight gain!

Cravings: Sushi ALL the time! I could eat it every day if I was allowed! Also, toasted bagels with butter!!

Best moment this week: Her kicking is now less of a gas bubble feeling and more of a "Hey Mom! Here's a kick and a few punches so you know I am here!" I can't wait until Darrell can feel her too!

Next ultrasound: February 7th

Next cardiologist appointment: Tomorrow

Next OB appointment: February 17th

Name her yet?: Not yet, but we have a few names at the top of the list, and the final name isn't too far from the making!

POTs symptoms this week: Sadly, yes. I had two bad syncope episodes this week and a lot of dizziness and fatigue. Why isn't my medicine working?! ERG!

Maternity clothes?: Oh I've been there... I may be little but I am carrying so low that none of my pants button! I've got two very comfortable pairs of maternity pants that I wear every day (thanks Carol!), and am starting to need some longer shirts! My cute little tank tops aren't so cute anymore...

Mood: I feel lucky (and so should Darrell!) because I have not been hormonal at all the entire 19 weeks. I have had very few days where I was a little extra emotional and cried watching a few TV shows but nothing more than that. I have had no angry mood swings! (yet!)

Oh Belly!

It's Been Requested, So Here It Is!

Week 6 - I Promise To See You Again Flat Belly!

Week 8 - The Gross In Between Phase

Week 18 - Oops I Skipped A Few Weeks! Definite Baby Bump Now!

Trying to suck it in!      This one is for my future Nole child!

                                                   

Ultrasounds

Most pregnant women only get two ultrasounds their entire pregnancy. Being high risk finally has a benefit! I have had a total of 6 ultrasounds already, and I will be getting one every four weeks from now on. I get to hear her heart beat about every 3 weeks or so, between my high risk doctors appointments and my regular OB appointments. She has a very strong heart beat that I can't hear enough!! 

10 Weeks

First Ultrasound - Looks like a peanut!

 12 Weeks

Only two weeks later, she is starting to look human!

17 Weeks

She is now 5 ounces, and has long tiny fingers!! 

I am going to ask for a full body picture at my next visit.

At my last ultrasound, my high risk doctor, Doctor Morales, closely examined the baby. He looked at her heart, her kidneys, her spine, and her brain. He says that so far everything looks great. He said she is small but healthy! I also got to talk to him about the birthing plan, which I was really concerned about. I probably won't be able to push, since I will likely black out after each contraction. Doctor Morales told us that I should not have to push, and that with that with time, the contractions will push the baby out on their own. He said that most hospitals will check the mom so often and that as soon as she becomes 10 centimeters dilated, they force her to push. This is not how my labor will go.  It may be a longer process, but it will be a more natural and less stressful one. I LOVE my doctors!