Tag Archives: hyperthyroidism

20 weeks (give or take)

So even though I’m still in my pajamas and might actually stay that way today (it’s my birthday, I’m allowed), I figured I couldn’t let another week go by without documenting this pregnancy at least a little.

A few pictures from this morning:

Few things…

I don’t know how my tummy and this baby are growing considering I’ve only gained one pound (net). But they are. Neither my midwife or my OB are worried about it. But I still can’t help wondering where the heck that tummy comes from. It’s got to weigh something, right?

Umm, my hair. Does anyone else out there feel like their hair COMPLETELY morphs when they are pregnant? I mean yes, there is the more/thicker phenomenon that is usually attributed prenatal vitamins, but I honestly haven’t been that great about taking them and I am still experiencing it so I don’t really know if the vitamins are what causes it. What I’m talking about though is completely different texture and volume. I now have tons of random little hairs I find in my head that are so kinked up that you would swear that it isn’t possible for them to grow from my head. It is completely frizzy and poofy, but still oily and flat by the end of the day. I always blow dry my hair after a shower which makes it stay pretty straight, but now when I do that it really doesn’t seem to help. An hour later my hair is wavy in some parts (especially by the nape of my neck) and straight in others (like on top). So yesterday I tried to scrunch it with product and not fight the wave/curl, but I really hate my hair feeling all crunchy and weighed down by tons of product. Plus, a few hours later I still had the same partially straight/curly/wavey thing going on and it still looked bad. I just don’t know what to do with it. Spending tons of time in front of a mirror with a straightening iron just isn’t practical for me and I really don’t want to fry my hair that much anyway. If you have easy beauty secrets to share, please do so.

The boy thing. Honestly, I’m over it. I was over it the next day when I saw my doctor. I was definitely over it Saturday night when we walked through the mall and window shopped boy clothes. Besides, when you read stuff like this, it really puts things into perspective. A healthy baby is all that really matters, right?

So yeah, saw my doctor again the day after the ultrasound and seriously again I have to just praise how cool and laid back he is! Still nothing was said about the midwife homebirth thing. I brought up some things from my last appointment with our midwife and he talked about them with me completely cool and calm just like he was would when working with any other medical professional. I can’t tell you how many times my other OB full on sneered when I brought up something my midwife said during Bean’s pregnancy.

The main thing we talked about was hyperthyroidism again. At my last blood draw that my midwife did, my TSH levels were a little on the abnormal side. She said that when she looked into it that basically since I’m not experiencing any symptoms of hyperthyroidism that it is up to me whether I want to go on medication for it and whether the risks of the medication really outweight the benefits of it. Last time around my OB just said I really need to be put on medication and didn’t give me much insight or options into it. Well, if you’ve read this blog for long you know that after giving birth I found out that the medication I was on could cause Bean to have hypothyroidism. She had to get her blood drawn once a month for the first six months of her life and she is supposed to get subsequent screenings for it every single year for the rest of her life. Looking back, I don’t know that the medication really did all that much for me last pregnancy and if I had known about the blood draws for Bean I probably wouldn’t have taken it.

So anyway, I gave my doctor copies of my labs and we talked about what my midwife said and the results.

“Well your results aren’t really that glaring to me. Actually your T3 and T4 levels, which are more active and a better indicator have gone down since the first blood draw she did. So that is really encouraging for me. Experiencing the amount of nausea, vomiting and weight loss that you did can really mess with your thyroid levels. Were you still feeling sick at this last draw?”

“Yes.”

“OK. Well then that could be the reason for the levels on here. I think we should redraw in two weeks and see where you are at. Since you are feeling much better they might be back to normal. You don’t feel hot or like your heart is racing? I mean other than how this heat can induce?”

“No, I don’t have any symptoms like that. It’s funny, I’ve completely adjusted to the weather here after only a few months. My friends in Bakersfield are so excited this week that it is cooled off there in the 80s and I’m over here complaining about it.”

“Yeah, this heat can make anyone feel like they have hyperthyroidism. Anyway, like I said your levels really aren’t that glaring to me. I’ll check with an endocrinologist and see what they have to say, but I don’t think you need to go on medication and I completely understand your concerns about not wanting to subject your new baby to blood draws. I’m sure that is not fun.”

With regards to the ultrasound and screening test…

“Well I talked to the perinatologist this morning and he said there were no markers for Downs Syndrome and that the baby is measuring behind what your LMP says it should be.”

“Right. Just like I thought because I have longer cycles and ovulate later than most women.”

“But he said everything looks good. Now, since the measuring dates are so far off what we could do is contact the state and ask them to recalculate your numbers based on the dates of the new measurements. I don’t know if they’d actually do that though. Or we could redraw and send them off again. But honestly if he says there are no markers I’m comfortable with that and don’t see any reason to act if you are not concerned.”

“I’m not concerned and I’m really not interested in participating in another test with them.”

“Yeah, I think that is a good decision. The ultrasound and your history give us no reasons for concern.”

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Next day feelings and findings…

Well first of all I was able to talk to my midwife.

I don’t want to completely throw my OB’s opinion out the window at this point, but some of the things he said yesterday were just so erroneous that it is hard to take the other things as seriously. It doesn’t completely discredit what he had to say, but it does call his credibility into question.

The sterile thing is just a big load of crap, obviously. This is for a lot of reasons. First of all L&D wards are not by any means sterile. You have people coming in and out (like dads, family and friends), eating snacks, going to the bathroom, etc. Nurses and OBs do wash their hands, but not like they do when prepping for a surgery. Also, Stephen’s point about super-bugs was very valid. The antibacterial soap they use to wash their hands is what causes the super-bugs because it doesn’t kill everything and what stays alive is stronger and resistent to the soap, etc. And what else is in hospitals? Sick people and diseases. Furthermore, if doctors were really concerned about home environments being sterile enough they wouldn’t let you bring your baby home 24 hours after the birth (sometimes less), or maybe not ever. We would all raise our kids in hospitals, wouldn’t that be fun?

Then the fact that he just went into the general homebirth is unsafe thing until we actually prodded him makes me think that he was just going to say anything he could to make me think I was making a dangerous decision. Plus the research at this point does not support the statistics he tried to throw at me. If that was the case the UK’s ACOG equivalent wouldn’t be trying to increase the number of homebirths. Countries where homebirths are something like 30% of the population wouldn’t be doing better than us as far as infant/maternal mortality is concerned.

As far as pre-eclampsia/eclampsia and stressed out heart rate concerns… those things don’t just show up suddenly in labor. Yes, hyperthyroidism does put me at a higher risk for them (if left uncontrolled), but we would know through monitoring whether that was an issue before the birth. Also part of the reason my midwife has me continuing my care with my OB is to have these things monitored if something serious does come up. And she assured me that if anything with either my heart rate or the baby’s heart rate was abnormal that would be immediate cause for transfer. She’s not going to ignore the signs of something going wrong. Plus, something I think I haven’t mentioned on here is that she’s also worked it out with one of the other licensed midwives in town to have her attend my homebirth as well. So I will have two trained women at my birth monitoring me and making the situation as safe as possible.

Baby breathing difficulties… my midwife was able to find one study last night that dealt with this issue. It was a really small study though. Out of 248 births, two babies had breathing difficulties. One was exposed to high levels radio-active iodine (one of the drugs used to treat hyperthyroidism, but you’re not supposed to take it in pregnancy) and had a goiter so big it caused the collapse of the baby’s esophagus. The other baby’s mom was treated with PTU and had some difficulty breathing upon birth, but there isn’t much information given about this case including the dosage of PTU that the mother was on. We could have a late ultrasound to see if the baby is doing things that are helping it to practice breathing too like swallowing amniotic fluid (something I’ve witnessed on our previous ultrasounds). Also the fact that she gets the hiccups all the time is another good sign that she’s getting prepared to breathe.

So after she found this study my midwife called me again and told me about it. Then she said that she was going to call my OB and talk to him about his reasoning for declaring my pregnancy high risk. She also wants to know what information/studies he is basing his opinions on.

I’ve also gotten several responses to a post I put on a message board about this and everyone from midwives to those with the same condition as me have said that thyroid issues do not risk you out of homebirth as long as your TSH levels are closely monitored throughout the pregnancy (which mine have been). Also hyperthyroidism is more of an issue if it is something you’ve had for many years rather than something that developed as a result of pregnancy. My midwife said if the former had been the case she would have told me that I needed to have my baby in a hospital.

It was very nice of my doctor to make the offer that he did as far as attending my birth. That has not gone unnoticed in my mind because that was actually a concern of mine. To go from a 1 in 10 chance to 95% is pretty good.

Also he did say that he wouldn’t run from caring for me even if I did decide to ultimately go ahead and homebirth. My midwife has had many patients with OBs that have refused to see them anymore for making this decision.

Stephen said he’d still support me in my decision, but he also thinks that based on what the doctor said the best of both worlds for me would be to go to the hospital and have our midwife as our doula.

At this point I’d say things are more up in the air. I’m just really anxious to see if my OB is going to be willing to talk to my midwife and what will come of that conversation. I’ll probably know more tomorrow. I just didn’t want to leave things hanging like I did yesterday. I covet your prayers and even little tidbits of information/research you come across (thanks Ruth!). I definitely have a lot to think about.

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