Hematologist App't

Last week Hugh and I went to see a Hematologist in Raleigh to ask about the different options we have concerning labor. Having Hugh go with me to all of these Doctor's appointments has been wonderful. We have several options ahead of us.

Question #1: Is the external version safe for a person who has low platelets? Any dangers?
Dr. Treemont, this particular Hematologist, showed no restrait in advising the version to us. The main reason mothers have to go to a version appointment prepped for surgery/labor is because there's a chance the placenta could be torn from the uterine wall while manipulating the baby's position or there could be umbilical cord issues. I guess that's a good thing that the version is still an option for us, but I'm still very hesitant. I simply do not have a peace about forcing her head down. I know that many people choose to have a version, and I think that's great. However, in this particular case, I'm a bit nervous about the procedure.

Question #2: What if my platelet count continues to drop? What interventions need to take place?
As of two weeks ago, my platelet count was 78,000. One has to have at least a 100,000 platelet count to choose to have an epidural. (By the way, a 100,000 count is still considered very low, out of range, and abnormal.) The only time my counts have ever been lower was when I had a bad strand of the flu that I thought I was never going to overcome(back in GA). When one gets sick, the number drops. Everyone's platelet count drops, but my reservoir is just not as extensive as the average person's. As the birth date draws nigh, the counts will continue to drop. Dr. Treemont did not seem too alarmed by my counts. He said I could have major surgery at 40,000. However, anything below 40,000 will need attention, such as a platelet transfusion. Then, the issue at hand would be to watch how my body would react to someone else's blood.

One cool thing we learned is that at my OB's office, when my blood is drawn, they send the test tubes off and call me the next day with the results. Given that amount of time(1 day), platelets will clump together and give a somewhat inaccurate count due to the clumping. At the Hematologist's office however, there's a lab right there, and I get my results 5 minutes later. As of last week my platelet count was 83,000. Not much higher, but a little bit.

We also learned that even though my platelets are fewer in number, they are younger than a normal person's platelets, because they get recycled faster. My body works hard to produce platelets at a fast rate. They are younger, thus are more efficient and work better than older platelets. So, that brought us at ease knowing that fact.

Question #3: Are there any other options?
Minutes prior to this Hema appointment, we found out at my OB's office that I would have to set a c-section date, and she informed us that I would have to have "general anthesthesia" with my c-section, since I do not have enough platelets for an epidural c-section (which is what most people have.) I would be completely put under and what shocked us the most was that Hugh would not be able to be in the delivery room either. We were COMPLETELY shocked. Even though I was going to completely miss my baby's birth into this world , at least Hugh could be there to tell me all about it or to video her first moments: her first breath, her first cry, his reaction while "in the moment". When we learned that Hugh couldn't even be in the room, since general anesthesia is more risky, we were crushed.

Now, fast forward 30 minutes to the Hematologist appointment. He gave us an option that greatly encouraged us. Six days prior to my scheduled c-section, I would start taking a high dose of steriods(prednisone) to boost my platelet count. It would boost me over 100,000, so I could have an epidural and so that we could both witness our daughter's beautiful birth TOGETHER. We turned to each other and smiled after hearing this option.

Question #4: What risks are there in taking Prednisone?

• I would become extremely hungry.
• My body would start retaining more water.
• My ankles would probably swell a lot.
• I would gain weight quickly, but only for 6 days(probably around 5 more lbs.) A side-effect I'm willing to take, even though I've gain WAY too much weight thus far.
• There are no apparent risks to our baby girl at this late stage in the pregnancy. Actually, the steriods would develop her lungs at a faster rate. Now, if I had taken prednisone all throughout the pregnancy, her endocrine system and genitals would have possibly been affected. But at the end of the pregnancy, there are no known risks.

We were/are pretty excited about this new option. However, after researching the effects of prednisone, I learned that it does cross the placenta and breastfeeding the baby should be avoided for up to 4 hours after the last dose. AUGH! How discouraged I became upon reading this. I am a HUGE fan of breastfeeding, and in our last birthing class, a breastfeeding specialist came to teach us the main things. We learned so much! We also knew that the first few weeks of breastfeeding, the baby receives colostrum, a God-given natural colostrum that boosts babies' immune system. It cannot be duplicated. It also cleans your baby's system out, which is very important.

On Wednesday, the day before Thanksgiving, we will run the steriod idea by our OB to see if they would support this option. If so, then my next question would be about how/if the breastfeeding would/could be affected by the steriods. Granted, I'm only taking them for 6 days. However, the dose is very strong. I will slowly wean myself from the steriods by lowering my dosage as the c-section date draws closer.

So, there ya have it. Either you are the type of blog reader that loves to learn and you've learned a lot...or you are the blog reader that really doesn't care about details and are probably sawing logs by now zzzzzzzzzzzzzzzzzzz................

We thank you to the nth degree for all of your wonderful, encouraging prayers. Everytime someone tells us they have prayed for us, we are greatly encouraged and do not feel alone in this. I am still holding out hope that she will turn due to our Webster's Technique that we're doing at my Chiropractor's office several times a week. I have accepted the fact that a c-section just might be the way she's born, but I will continue to lift up this request to the Lord until the last day, waiting in expectation. I want to look back and have no regrets. We have set her birthdate if she doesn't turn: Wednesday, December 6th, 12:50 p.m.

Please join us in waiting in expectation to see if the Father would see fit to turn our baby girl into a vertex(head down) position. I trust that He knows so much more than we do. He's so much smarter than we are. He's omniscient and omnipresent. He's so capable of anything. I trust Him. To hear the words that I could have a natural, unmedicated birth....I would jump for joy!!! Most people would cry to hear that, but I would be ever so grateful to be able to work through her birth. That path has it's fears as well, but I would much rather labor than have surgery. Pray that we would remain strong, encouraged, and would not lose heart.

Blessings to you all for making it through this educational blog!!! :)