Wow! I can't believe I am 6 months into this pregnancy!! It's weird because in some ways it seems as if this pregnancy is just flying by, but at the same time this has been my most physically challenging pregnancy to date and sometimes it feels like it cannot go by fast enough! I'm splitting this post up into two parts because this first one is extra long and correlates to my appointment with my midwife. For those of you only interested in the short story version of my 24 week update via the picture & survey... that's part two. I'll spare you the rest.
Anyway, I had my 24 week checkup with my midwife yesterday and everything looks great for the most part. I was shocked to learn when I went in that my thyroid levels from my previous visit weren't normal like I'd assumed they were. Apparently my results were faxed to my primary care doctor, but no one from their office called me and so I assumed no news was good news. However, when I met with Sunita yesterday I found out that was hardly the case.
Remember last month when I blogged about my week from hell? I had been hospitalized twice for a migraine lasting nine days. I was barely eating or drinking and I was vomiting from the pain so bad that I was dehydrated and in excruciating pain? Well, I had been without my thyroid medication for about a week due to some mishaps with the pharmacy and, while usually it's not significant enough to cause health problems, it caused some issues this time. Combined with the fact that I am pregnant and Owen sucks up my stores of thyroid hormone for himself completely depleted my levels and caused a major imbalance--- one they now think is the cause of that catastrophic headache I had.
I am hypothyroid. I was diagnosed with Graves' Disease in February 2004 and had an ablation done on my thyroid that summer, rendering it inoperable. The organ itself is there, but doesn't function and so I will be on an artificial hormone replacement for the rest of my life. It is vitally important to take your medication every day and continually be monitored as your thyroid is responsible for many bodily functions, one including directing your metabolism. Headaches are common for those who suffer from thyroid imbalances among other more serious complications. Hypothyroidism especially during pregnancy needs to be monitored as your unborn child relies solely on the mother's stores of T3 and T4 (the thyroid hormone secreted in the bloodstream) to help with all areas of growth and development until 24 weeks, when the baby's thyroid is fully functionable and able to secrete it's own stores of T3 & T4 at which the dependence on the mother's hormone decreases. How does a thyroid function work? Well, it starts in the brain actually. Your pituitary gland releases a hormone called "Thyroid Stimulating Hormone", referred to as TSH to tell your thyroid to release the its hormones, T3 & T4, into the bloodstream to carry out their various functions. People who are hypothyroid typically have an overactive pituitary and underactive thyroid...meaning that an abnormal amount of TSH is being pushed out to the thyroid but the thyroid is still unable to produce enough of its hormones. The pituitary recognizes the lack of T3 & T4 and therefore overworks itself trying to stimulate the thyroid into action. This is what happens with me and especially without the introduction of medication.
A normal TSH level for someone like me is between 0.3-2.5 uIU/mL which should result in a T3 level between 2.3-4.2 and a T4 level of 0.75-1.76.
My levels looked like this from my 9/22 blood draw (a week after the onset of my nine-day migraine):
TSH: 40.495 (abnormally high)
T4: 0.88 (normal)
T3: 1.6 (low)
Yes, you read that right. At the highest level, my TSH should have only been 2.5. It was 40.495!!! That's over 16 times as high as it should be at it's highest!
Seeing as I haven't had an episode like that since, they think that most likely my headache was caused by this imbalance. However, they drew my blood again to recheck my levels to see if they are still elevated or if they've regulated themselves. If they are normal or still a bit out of normal range, I assume that they will either keep me on my current dose of medication or increase it just a bit, but I am already on a pretty high dose that is consistent for patients like me that essentially need full thyroid replacement. However, if my dose is still extremely elevated there might be something else they are missing that needs to be addressed. They have also checked my antibodies to see if I might be suffering from an auto-immune disorder, especially one related to hypothyroid patients called Hashimoto's (which is essentially the extreme opposite of Graves' Disease which is for patients who suffer from extreme hyperthyroidism like I did back in 2004 before my ablation). I should get my test results back tomorrow so hopefully I will have some answers then.
Aside from all of the thyroid issues, everything else looks great. I am currently measuring 2.5 weeks ahead of schedule (I'm 24 weeks measuring at 26.5) and that could be because Owen is a big boy, I'm stretched out from having kids close together, or I'm farther along than originally thought. I already knew that my EDD was off at least by 3-4 days as the cycle I conceived was an awkward one so who knows. My LMP was 4/27 which would have given me an EDD of 1/31 or 2/1, but based on when I know for a fact I conceived, I should be due around 2/3 or 2/4, which is where Owen's measurements are tracking for the most part... but they gave me a 2/7 due date for some reason. It's only a matter of days anyway, but my midwife seems to think that I actually ovulated twice in my cycle and got pregnant during the 2nd ovulation cycle and it's that difference that is throwing off my due date. Either way, coupled with the fact that I'm on baby #3, my due date is a few days off, and Owen is measuring ahead of schedule, I'm most likely looking at a late January delivery.
In addition to all of those factors, Owen is a "low rider", haha. At our 20 week ultrasound he was shown in the head down position. Babies at this stage are still small enough to move and turn (although most babies start traveling head down by around 28 weeks on average) so there was no guarantee that he'd stay that way, but I'm fairly certain he hasn't moved from his head down position. I told my midwife that I'm feeling a combination of sharp pains and "flickering" by my cervix which I think is being caused by him pushing down with his head and movements from his hands/fingers when he moves them by his face. I feel something large that occasionally bulges on my left side which I assumed to be his back and butt and then the "kicking" sensations I feel are over on my right side or up by my rib cage (yes, already... this kid is crazy!). While palpating externally, they were able to confirm my assumptions: Owen is more than likely head down, he's already very low in my pelvis from what they can tell, his back & butt are on my left and his legs & feet are curled off to my right.
Heartbeat was nice and strong and everything else is just tracking right on schedule. I go back November 17th for my 28 week visit and then I start going every 2 weeks after that. I may be doing that lovely glucose test for Gestational Diabetes at my next visit, but I'm undecided. They urge most moms to do it, but I am generally very low risk and my midwife says that she cannot definitively recommend that I do the test and, from a medical standpoint, it would be completely feasible for me to decline it. The jury's still out on that one...
Ok, next up is the survey & belly picture!!
Subscribe to:
Post Comments (Atom)
No comments:
Post a Comment