My History with Autoimmunity: Dylan (Pregnancy. Round Two.)

Dylan

November 2011 I found that i was pregnant again, enter Dylan. Still in the same shitty marriage. Still in the same tiny house. In a better paying, but more stressful job. Still the breadwinner. A lot had changed, yet much had remained the same. I quickly realized I couldn’t endure another pregnancy like the last. I had to do something quick before the nausea, migraines and constant sinus infections took hold.

I had always had prenatal care from the local OBGYN clinic providers, but this time I wanted to do something different.  I had heard about a local naturopath/midwife who practically guaranteed dream pregnancies and easy deliveries if you followed her protocols; at this point I was willing to do anything. ANYTHING. I found her contact information and gave her a call, unfortunately she had moved out of state. Unable to find a local midwife that would accept a VBAC and still being somewhat scared due to Jack’s disastrous delivery (Ugh! fear based decisions)…coupled with the fact that I was employed and insured by the hospital system…I decided to return to the care of the OBGYN clinic, but this time the midwife would be advising me via telephone and email after every appointment. The goal was to have the most uneventful pregnancy and delivery I could in a hospital setting, while also foregoing all of the admissions because of migraines and NOT undergoing another C-section.

My first appointment I had mixed feelings and a lot of anxiety.  You see, once you have had a Cesarean the doctors will almost certainly encourage you to go that route for subsequent pregnancies. The first appointment was with a PA, but I could see I was already getting met with resistance when I brought up my desire to attempt a VBAC. Upon returning home for the day I had a phone call with the midwife where I relayed all of my vital signs and pertinent data, we discussed diet her diet protocol; no flour, no sugar, no soda. Seems simple enough. Right? Wrong! At the time I was regularly preparing elaborate baked goods and treats for family and friends, it was my love language, and also a form of stress relief.  It was a huge shift to stop eating flour and sugar for me, but I did it.

I had pretty bad nausea throughout the day, so I was advised to cut dairy, especially milk. The issue seemed to resolve itself rather quickly. I went cold turkey with the necessary dietary changes, after all the one thing I had tried worked like a charm, so she must have been right about the others. I started feeling pretty great, despite being pregnant, best of all I had gone several weeks without a headache, sinus infection or debilitating migraine. I was hooked. As time went on I went from merely avoiding those particular foods and their typical accouterment to searching for recipes to replace what I occasionally felt were missing. It was 2011, remember, Gluten Free had yet to go mainstream. Even in the food blogger space there wasn’t much to be found (If only I’d been able to get internet at my dingy old farmhouse then this blog would be a lot older!) What did come up repeatedly when searching for no flour, no sugar was Mark’s Daily Apple, a blog/community devoted to the “paleo” diet. I dove in and never looked back.

By the time I had reached the end of my pregnancy I had gained almost no weight, dropped two non-maternity pants sizes (I was “overweight” to begin with and lost about 20, then gained about 20) I only had ONE headache that required treatment and I felt great right up until the end. My vital signs were good and I was having a very uneventful pregnancy. My Hashimotos was asymptomatic and even seemed to be in pretty good control (or so I/they thought based on TSH/T4, now I know those aren’t the most reliable markers of overall thyroid function and that we should have also been monitoring antibodies at least once a trimester in addition)

The day before D was born I had been cleaning and organizing the basement, full on nesting mode. I received a call from my mom letting me know that my grandpa had died. Between the dusty, dingy basement and all the crying I had a pretty good headache cooking, by 2 am I couldn't get it under control and resorted to a trip to the ER to get my usual cocktail of demerol and phenergan so I could stop vomiting and sleep.  After all, I was still just over 38 weeks. Things did NOT go according to plan. The ER sent me to Labor and Delivery for assessment, despite not having significantly elevated blood pressure or protein in my urine they admitted me and started IV magnesium under the premise that I was likely developing preeclampsia, which the only solution is to get the baby out. In the blink of an eye my perfect pregnancy and easy delivery had been thrown out the window. Shortly after getting situated the on-call physician came in to talk to me, to lay on the pressure to just do a repeat C-section and get it over with. I stood my ground, at that point there was no other reason to proceed, but that didn’t stop him from coming back several times to try to convince me. Relief came at nearly eight o’clock when the new on-call physician came in to see me; it was the one and only doctor in the practice who had been willing to entertain the idea of me trying for a VBAC. He broke my water and stripped my membranes in hope of moving things along, after all I had already been admitted for nearly 6 hours and the clock was ticking. In a world where time is money, patience is limited.

My labor was everything I had hoped to avoid. I wasn’t allowed out of bed. I called the midwife to fill her in on how things were progressing, let me just say, she was LIVID. Instead of being able to be up ambulating around the room or the OB floor, I was required to be in bed, minimally elevated. In addition to the IV, I was subjected to continuous blood pressure and fetal monitoring. On a couple occasions I would defy the rules and rock in the rocking chair as my midwife had advised, it never lasted long though as the alarms would sound and the nurses would return to force me back to bed. Being in bed on your back definitely increases pain and slows labor. I eventually begged for an eipdural, which also tends to increase labor length, as does the stress and tension associated with being in an unfamiliar environment and being accompanied by someone who was seeking drugs and pity. 

Eightteen hours. I labored for eightteen hours, including close to an hour of pushing before Dylan was born at almost midnight. My eyes were bloodshot, I had periorbital petechiae (freckle like bruising from ruptured blood vessels around my eyes) and I was exhausted, puffy and generally feeling awful. I wasn’t allowed to eat the whole time and by the time I could the kitchen was closed, I was offered kraft mac and cheese and a bologna sandwich on white bread, man that was a far cry from what I was used to eating and far from nourishing my body after the marathon it had just completed. That being said my pain management didn’t require more than the occasional Ibuprofen which generally seemed to perplex the nurses-- why was I rejecting the narcotics they continued to offer every two hours, when it seemed I should be begging for them. 

I wanted nothing more than to go home as soon as possible, but they wouldn’t discharge us until D was seen by the pediatrician the following day; he was still pretty sleepy from the massive amount of Mag I received, he wasn’t nursing well because of this, his blood sugar was low and his bilirubin was climbing. When all was said and done we wouldn’t be discharged until late that afternoon. I never did develop pre-eclampsia and by hospital standards I had a pretty average experience. It was what it was, and thankfully it was mostly over. D had to be on a phototherapy blanket for a week after birth, but after that it was business as usual, he was a pretty happy and chill baby.

My thyroid labs showed little change following pregnancy. My energy was fair and I was relatively asymptomatic, nothing that would have stood out as a postpartum Hashimotos flare. I felt better than I had following either of my previous pregnancies, I was sold, I considered it a success. I continued following a paleo-ish diet for the foreseeable future just because I was feeling better than my norm. I had dodged the bullet this time.