early bird.

Will came home this weekend and we had a great time together! we celebrated our anniversary early since he left for west virginia early monday morning. since he had been gone for so long, his boss gave him the day off on friday so we headed out to the lake with the boat (because what else would we have done with a whole day off? haha). the weather was amazing and there was not a single person out there with us, which is pretty rare. the lake is naturally warm so it was not refreshing to swim there for most of the summer, but since it was windy and cooler than usual (upper 60's), the 94 degree water felt amazing. the rest of the weekend was mostly spent relaxing and resting. we watched football, caught up on some shows, and just had a great time together. it is true that absence (and hormones) makes the heart grow fonder :)

i noticed saturday evening that i was really itchy but didn't think much about it at the time. by sunday night, the itching had gone from bad to worse, especially on the soles of my feet and the palm of my hands. there were no visible rashes, redness, or bumps so i called my doctor's office monday morning. they had me come in and see the on-call doctor. after explaining my symptoms to her, and checking for a few other tell-tale signs, she preliminarily diagnosed me with cholestasis of pregnancy and prescribed me a steroid treatment to follow for the next week. instead of me explaining what cholestasis is, i'm just going to give the American Pregnancy Association's definition:

"Pregnancy hormones affect gallbladder function, resulting in slowing or stopping the flow of bile. The gallbladder holds bile that is produced in the liver, which is necessary in the breakdown of fats in digestion. When the bile flow is stopped or slowed down, this causes a build up of bile acids in the liver which can spill into the bloodstream. Intrahepatic cholestasis of pregnancy (ICP) affects less than 1% of pregnant women.
Cholestasis may increase the risks for fetal distress, preterm birth, or stillbirth. A developing baby relies on the mother’s liver to remove bile acids from the blood; therefore, the elevated levels of maternal bile cause stress on the baby’s liver. There is a risk of the bile acids crossing the placenta, and a risk of reduced oxygen to the baby.Women with cholestasis should be monitored closely and serious consideration should be given to inducing labor once the baby’s lungs have reached maturity."

the nurse strapped me in for a non-stress test, which is where they wrap two monitors around me; one to check the baby's heartbeat and one to check for movements and contractions. the NST also indicates that the placenta and other functions are working properly. i ended up being monitored for the full 90 minute session because her heartbeat was pretty low and she wasn't responding to any of the external stimulation (after a period of non-movement, they press a buzzer on your skin to try and "wake up" the baby).

i also had blood work done to confirm the preliminary diagnosis and also to see how elevated the bile levels are in my bloodstream. the on-call doctor scheduled another NST, an ultrasound, and a consultation with my primary doctor to discuss an early induction.

i went in that morning expecting to walk out with some kind of anti-itch cream or medicine. instead, i left feeling scared and uncertain. i hated to give Will that kind of news while he was away from home. when i called him, i tried to stay optimistic and positive about everything, even though i was struggling to hold it together. his voice sounded really small on the other end of the line. i know that he hates traveling so much, especially when i'm so mentally, physically, and emotionally exhausted. he is the greatest though, making sure he does as much as possible for me in advance before he leaves for the week. he has been working so hard to provide for us and i'm so thankful for his determination.

i got the phone call about my blood work results this morning. the nurse called me to tell me the results did confirm cholestasis and my bile levels were elevated. i'm not sure of the technical terms but normal scores are between 1-20 for one factor and 1-10 for another. my results were 50 and 20. they will do another blood draw again in a week to see if the steroids have helped bring those levels down any. i still have another week and a half until Audrey is "term" (37 weeks) so i don't think anything will be done before then, as the risks would be time in NICU mainly for underdeveloped lungs. i was told to be very conscientious about making sure i still feel her moving a lot, and to rest as much as possible. I also have a ton of NST's in my near future to keep her development closely monitored and make sure her health isn't being jeopardized. Will and i have our consultation next Thursday morning. I'm sure we'll know a lot more then so we will keep you updated.

as you can guess, i've been a crying mess all day. it's taken me almost two hours just to get through this post. i had a little talk with our tiny Audrey and told her to hang in there because she has so many people out here who love her so much and need her to just be okay for a little while longer. she gave me one of her usual spazzy leg kicks in response so i think she understood.