This was not an easy day at all. It was kind of marred ahead of time - it was intended to be a nice day out for me and my MIL, then Iain too ... I expected just good news and reasonably good food .... I had my POPS study scan at 11:30 in the morning, then the Growth Scan for the antenatal team at 2 pm. Iain took the day off to be with me and the baby.
The first scan was fine, but the baby's left kidney didn't look like it had been draining fully, kidney looked fine. The POPS people don't have my records or a point of reference, they just collect data, and so the midwife doing the scan said she'd let the scan lady know for the afternoon, which she did.
We met Claire and Martin from our Antenatal Classes in the food area, and chatted away with them till it was time for us all to go to our appointments. They are nice people. Claire had had good news - her placenta previa is no longer an issue, the placenta has moved up, I am so pleased for her. Really hope all goes well.
I was pretty calm about the kidney, but I was chatting a lot, it's hard not to just worry - but really there was nothing to worry about at that point, as far as we knew all was well.
The 2 pm scan showed that the kidney looks healthy, and the amniotic fluid levels are fine, and though the middle of the kidney is a bit swollen (hydronephrosis) this is probably what happens to loads of babies - a pipework issue that resolves itself before birth. There is nothing to be done ahead of the birth, no reason to have him early, we just need to scan him after birth - a few days after, when he is rehydrated. Maybe he'll need antibiotics, maybe he won't need anything, maybe he will need some procedure later.
The sonographer said she needed her supervisor to see, and she did. Same comments. They could not find his right kidney - just the puffy left one! So I dunno where the other kidney is ... I guess they just could not see it. Anyway, off they went to talk to the Paediatric Consultant Mr Lees, who happened to be in clinic that day across the hall I guess. He said he would see us next week for a detailed scan, and we need to talk to the Renal Dr.
Great.
Way to scare us ... I am impressed with their efforts at efficiency in this case - and actually, apparantly we are being seen so soon as they happened to have a slot - I realise it is very unlikely that there is a serious problem, such as a really defective kidney, or long term damage - his kidney itself looks healthy after all, and there is plenty of amniotic fluid so they are working. All that fluid means his lungs should not be under-developed (the amniotic fluid is necessary for lung development which is a key task of his about now). So far so good. No reason to doubt him, or his development. Of course, loads of UTIs when he is tiny would mess his system up, and if whatever it is does not fix itself, it will need to be fixed, and it is important all that happens.
I am upset that he will have to have tests at the very least, really soon after his birth, very intrusive and upsetting, and if he needs antibiotics his gut will suffer greatly.
Iain and I had a tough two days, it really did feel like a tough parenting situation, and I guess no big decision will be any easier really, ever ... from now on, as they will all be about the baby/child. We are three of us now, as sure as if the baby were already with us here.
We also had a long chat with Dr Simmonds, who 'wouldn't' risk having the baby at home ... he raised the spectre of the mythical dead baby ... as Doctors love to do, and before seeing him, the Obs Registrar said nice things about my sugar levels and said he would recommend continuous foetal monitoring but did not anticipate any problems for me, and didn't see why my birth would not be totally uneventful - but that whatever my sugars are, they are controlled with Met and exercise and diet, and that does not change the fact that there is something wrong with me. So you never know what the risk is. This made me feel like shit, made me feel really, really bad - so I'm a freak, no matter what ... I'm defective and frankly, a bit of a cow to be selfish enough to put a baby, another person in my crappy, defective, useless body that never works ...
Coming after the perfect baby who now can't drain his left kidney revelation, and coming before seeing Simmonds, it was a hard thing to hear.
I was tired, my sugars were messed up with the hospital food, the stress, and the waiting in the heat ... I was feeling really bad, and crying. That made Ruth, one of the midwives spend some time comforting me, which I appreciate, and Simmonds spent a long time with me, again, which I do appreciate.
I asked about figures - what are they for GD patients and outcomes at the Rosie - how many of these GD mum's babies need help because of insulin issues at birth, how many of those had numbers like mine - how much good have I done? Is it likely to have been enough? Anyway - get this - there ARE NO FIGURES for GD women, and only 1 years numbers on Type 1 and 2 diabetics ... ????!!!!
Teaching hospital.
One of the best in Europe he told me.
Audits - that's what I was thinking, they MUST have to audit the service - they spend a shedload on diabetes monitoring for every woman who fails the OGTT ... wtf???
I am disgusted really, as I can't make my informed choice based on the Rosie now.
He did tell me about the best studies that have been done recently on the outcome of treated GD patients ... most notably the HAPO study. He was convinced that it was pretty risky to have a baby with GD ... much riskier than we used to think.
I looked up the study, he is right. My sugars may well be nowhere near low enough. BUT we have seen how small the baby is - average size. His bits and pieces and organs and limbs are all average.
My sugars have been so steady, and pretty low ... nowhere near other people. My fasting reading has almost always been low low low. The baby's activity level has not been uber high or super sluggish, he has been extremely reassuring.
I think these are good signs. I do not want to make decisions based on fear.
I do have more questions for him about the outcome, the results of that study. I understand that badly controlled impaired glucose tolerance is a worse deal than previously thought, and the threshold is lower than previously thought ... fair enough, I suspected that anyway. But how did I do??? We have tons of data on me ....
Iain and I are still keen on the home birth.
I spoke to Kerry the midwife the next day, we need more info on what the hospital birth would be like in order to decide and prepare - we could always end up there anyway, and knowing what the facilities really are (not that breeze through full of complains that they called a hospital tour) and what it would really mean for us ... we need that. Anyway, she said they have a consultant midwife whose remit is to go through all that and help women make a choice. Good.
Trouble is, the woman had a letter sent to me - arrived on Saturday - saying see you on Monday. WTF - I am not going without Iain. Could the stupid cow not have called me? Idiotic - how stupid are they over there? Waste of paper and postage too. Ridiculous. They have all my contact details and Kerry could have called me. I am NOT going on Monday on my own to be bullied and harrassed when we are already going on Tuesday, together. The letter says we are happy to re-book, well you'll have to, love, bloody cheek!!!!
Hmmpphh.
Iain and I also went to the Midwife's clinic at the Roysia Surgery the day after the scan, to talk about the homebirth some more - we are taking it seriously that so many people feel their advice should be 'we wouldn't ...' - Simmonds, the midwife ... they have been caring for me, and they all make the big sad scared eyes .... and issue vague warnings without actual numbers .... They are the only professionals we have access to, and their advice has been helpful in other areas, we don't intend to ignore their advice without consideration. That would not be consistent.
So Iain had questions - Simmonds' scare tactics had shaken him, which depressed me no end. He didn't actually let the fear take over, thank goodness, and ultimately he trusts my judgement over random fears that don't even belong to us ... which is good to know. We came through this, it was not pleasant, but we came through with no problems, just sadness caused by other people's fears. Our own fears are reasonably easy to put into perspective. They don't cease to be, how can they, but we actually have done and are doing all we can, and all we need to. Nothing is certain - but what we are trying to do gives all 3 of a us a good shot at success and peace surely.
Having talked and cried a lot the night after the scan, I woke up crying, and Iain did not feel he could leave me and go to work. We decided to get some answers. The midwife, sadly, was Jane ... who is a bit of a character .. does not do home births anymore, and had 2 caesareans herself and is of the opinion she and her kids would be dead otherwise .... so we're not even on the same planet really when it comes to birthing.
Anyway, she was happy to raise the dead baby spectre at will too. I do switch off inside on people who do that. To each their own I suppose, I'm beginning to think the world has 2 sorts of people in ... dead baby spectre enthusiasts (they happen to also be the weak minded with no imagination) and the rest of us (and of course I know babies die, don't be so stupid and go get some self respect while you are at it).
'Nuff said I suppose, I WAS after some professional advice, and some information I could use ... but her ideas on what happens to a woman birthing ... [a woman in labour I suppose] well, what can I do with all that ...?
I tried to get something out of it, all I could hear were warnings about a pre-ordained chain of sad, constrained events, none of which has any place in birthing unless someone puts it there, IMO. She also really felt like I was against hospitals, anti-interventions ... 'you'd probably call them ... call them ... interference ...' she said.
Well, I do call interventions ... er ... interventions, that is what they are, and of course I know at times someone with a drug, a scalpel, some forceps, or something does need to intervene. I am not a fool, and I know as much as a layperson can find out easily about the interventions that are carried out on the NHS. I have had several interventions for goodness sake - the conception of the baby was with Clomid, my Met is a huge intervention, my scans, my supplements, my food manipulation, sugar control - I work with medicine, with the doctors I trust, and with myself. What else can I do???
And why does accepting help or asking for help mean I have to buy in to the fear and whole kit & caboodle when it comes to the mega-pack of interventions? Taking Metformin helps me and the baby. I believe continuous foetal monitoring will not. No one else can choose. So let me choose, stop being a baby and sulking and trying to make me feel bad about choosing ... OMG ... why do these people feel the need to make me sad ...? WTF ... playground shenannigans or what?
Am still disgusted, days later.
Jane said the SOM (supervisor of midwives) would have to come speak to me about risks to me and to the midwives, come see me with Annabel, and maybe a SOM would have to be there at the birth. I said, fine, I don't mind who thinks they need to be there from the midwives side, I may decide to stick with the homebirth plan, or go to hospital, I can't say yet, and it's pretty standard for the SOM to be involved in a case like mine.
No one has called yet to sort it ... I guess I'll call Annabel on Monday. What a pain ...
If they are planning to bully me, they can think again. I would like information, and advice on how to do this safely and well .... and I refuse to let people stress me out now.
As it is the place is not tidy and that makes me stressed out - and we still have furniture moving issues hanging over us ... messing up the whole month.