35 weeks

35 weeks finishes and 36th week starts today.

Yesterday they were supposed to book my date for Caesarean. Guess what, they started it all over again and I am given few more appointments to discuss it over!! The consultant who agreed to do C sect for me was not available yesterday and his registrars couldn’t find a clear instruction from their boss (the consultant who agreed).

Baby is lying across now. I guess after trying head down position and breech position for sometime, now she wants to sport all other possible positions in her dear place before she gets stuck. Baby, looking at how things are going now, you may not get to come out easily by getting your mother’s tummy cut open. Better get stuck in head down position and stop playing sports there.

Have been having itching for the last ten days. I started reading about it, came across few others having similar problem during the last weeks of their pregnancy, watched the movement of the baby all the time, made sure to try different moisturising methods to see if the itching was anything to do with not enough moisture for the expanding tummy, noticed some general itching elsewhere, cross checked that if the itching is there on the palms and foot then only it needs immediate attention, but after ten days of such self monitoring, and considering the seriousness of Obstetric Cholestasis (OC), I decided to go to my GP. GP asked me to give blood for testing. Did that yesterday morning. The result was checked yesterday afternoon when we went to see the consultant for booking date for C sect. Found out that important aspect of the testing was not done. Partial testing gives comforting result that there is no indication of OC but it still needs to be confirmed. The confirmation test will take two weeks. But as it is holiday season, it is going to take three weeks. OC cannot be ignored until the result comes, so fetus heart beat is going to be monitored every day.

Getting C section confirmed is the last thing in my mind now. Hope it is not OC. Hope my baby is alright. I will bear uncertainties and related complications. Just turn around and stay in head down position. I will bear uncertainties and related complications. I owe you at least that much.

Info for others (specific to UK),
When you suspect OC related itching, i.e, itching on your foot and palms, then book appointment with your consultant immediately, not with your GP. GPs do not seem to know what to test and what step next, and how soon you need to be under monitoring etc…

PS:
The whole OC testing and monitoring happened because I ate a bar of bounty (and there was a Nurse2. I owe her big time). Let me explain how.
We were happily discussing things about booking the date on the way to hospital. Balan gave me a bounty bar. I ate it. At hospital I gave the urine sample for regular checking. The nurse was little confused looking at the stick she used to test the urine. I asked her if there is anything she is concerned about. She told me that there is some glucose in my urine. I told her I ate some sweets on the way to hospital. She said that that could have done it. Then checked my previous records and confirmed that I did not have this before. Then I assured her that I was going to see my midwife the next day, so I can get it checked again. She was fine with that. But, she had a question, why I was going to see the midwife in the same week as all the needed check ups are done here in the consultant unit as well. I told her that I was going to inform my midwife about the date of C sect once it is confirmed here today and then also I am going to check the result for OC test. She said that is fine. She didn’t record the result of urine test done and left it open for the midwife to do it. Then by chance another nurse happened to come there and asked her what was that about. Nurse1 explained things. Nurse2 got alarm bells about sugar. She immediately took me to another room and started talking about sugar. Then I told her about the bounty bar. She said, yes, it could have done it, but she still wanted to rule it out. So, she wrote a request for blood test then and there. She also asked my why I was going to see midwife. Seeing the blood test request being written, I asked her to include OC repeat test, as that is what is written in the Internet that OC may need repeat testing before it can be detected. She was surprised and asked me to explain and in the mean time she started accessing the result of my first OC test. I told her I gave blood just that morning. She still checked. The results were already in. The result showed no indication of OC. She was happy with that. She told me that result of another test for OC will take two weeks to come in and in the mean time she asked me to discuss this with my consultant NOW.  I thought, may be she thought that this was what my appointment for that day was about and that is why she was asking me to discuss about it. So, I said fine. Then she asked me, how many tubes did I give? “what tubes”? “blood”. “Just one”. That rang some more alarm bells for her. She immediately went and discussed few things with my consultant, briefed him. She briefed me too that some more blood need to be taken for another test which is what will confirm whether -ve or +ve for OC and it will take two weeks.  This was not requested by the GP. Consultant explained me again. He wrote request to take blood for OC testing. Seeing that my Caesarean date booking not getting discussed at all, and also not knowing the seriousness of OC, I slowly started it. He was least bothered about it, but still listened to me and told me to discuss it with head midwifery as she needs to say OK before it can be done. Again he explained about the tests that needed to be done for OC ad two weeks time to get the result. I asked him whether it is OK to hold on for the next two weeks until the results come in. When he replied that I was going to be checked everyday in day unit until the results come, I realised the seriousness of it. Consultant wrote another request for scanning. (he checked the heartbeat in the mean time. checked the position of the baby as well in the mean time). Nurse2 again took me to her room, booked an appointment with the head, midwifery, explained me few things, she herself tried her hands in trying to convince me for vaginal delivery, asked me to rush to pathology section to give blood NOW, attended another desperate mom-to-be. I saw her on my way to pathology section, she was running back from there, informing me that they are still open and I should really run there. She went and informed the pathology section not to close as there were some immediate blood samples to be taken. It was few minutes later than their usual closing time. We rushed there, gave blood. Came back home.

Baby is moving fine.

Update:
1. OC is almost cleared. Still waiting for the bile acids test result. It will take at least another couple of weeks to get the results, thanks to the holiday season. Until then some fetal heartbeat monitoring will be continued.
2. My consultant is on holiday until Jan 8th. Until then there won’t be any news about booking the date for my C sect, as his registrars are refusing to touch the subject. I have banged my head against all possible brick walls so far. One more brick wall to be banged against on the coming Monday, though I do not have much hopes. When he comes back from holiday, I am not sure what priority he will give to my problem as there will be heaps and heaps of cases waiting for him to attend. But once he gets to my case, I will know the date. And then, when he gives me the date, it will most likely be in that week itself, quite possibly within a day or two (of meeting with him).
3. Baby’s position: we have come in full circle. Head Down – Breech – Lying Across (baby head to my left) – Lying Across (baby head to my left)- Lying Across (baby head to my right) – Head Down – Lying Across(baby head to my left)!! I don’t know whether to doubt these midwives’ skills or to be amazed at my baby’s skills. It makes it more difficult for me to be convinced to go for normal delivery.  

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2 Comments (+add yours?)

  1. Anitha
    Dec 19, 2007 @ 16:31:00

    Oh Prema, I know how distressing it will be -waiting for OC test result. I have been through it all, it turned out to be PUPPS in my case, but I was worried every single day until I got the results. It started around the 33rd week time for me also, tried umpteen moisturizers, I was put on Benadryl(antihistamine) too. Caladryl, Lubriderm, Eucerin, Vitamin E cream, slathering moisturizers 3-4 times a day, using cetaphil cleanser for bathing, aveeno oatmeal bath for itchy skin nothing worked for me for 4 weeks. Only after the application of topical steroid(1% cortisone) around 37th – 38th week, the itching/scratching came under control. Where did the itching start? If it STARTED on your palms/soles then there is a chance that it might be OC. For me it was my belly that was itching for the first week, then it spread to my arms, legs and thighs. When I started reading about OC, my palms got itchy. (I don’t know if I started imagining that my palms also itched or if my palms really itched). It was such a big nightmare, I really was paranoid, we went to the hospital 3 times during that time period to check on the baby. It took us only 10 days to get the result. From what you tell, sounds like it will not be OC, do not worry much, just keep track of the baby movements. Moisturize as much as possible. Soak in lukewarm water in the bathtub for sometime, just pat dry your skin and apply moisturizer immediately(within 2-3 mins), it helps in retaining the moisture. Do not take hot showers, it dries the skin. Reduce salt and avoid general allergy causing foods from your diet(brinjal,yam, anything you used to be allergic to). Take care.

    Reply

  2. Premalatha
    Dec 20, 2007 @ 14:29:48

    Anitha,

    OC is not indicated so far. itching doesn’t start on my palm. I do get some on my soles and palms later but it doesn’t start there. That is why I got paranoid. May be I am imagining.
    Baby’s movement is fine so far.
    Thanks for the tips. Will start the elimination process to know which food to avoid. thanks a lot.

    Reply

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