My labor and delivery!

The last day being pregnant. 

My amazing son was born on March 22 at 12.48 am! He weighed 8 pounds 1 ounce and was 21 inches. The last few weeks of my pregnancy were challenging. I was tired, uncomfortable and just ready to be done! I worked until 4 days before I delivered and those last few weeks of work were very tiring. It was hard physically to work with my patients and hard mentally to stay focused.

We had planned an induction around 39 weeks as my OB thought this was the ideal time to deliver and to put less stress on my body. After a back and forth with my Enbrel (tapering at 34 weeks only to start it again), I stopped Enbrel completely at 37 weeks. My joints and uveitis remained quiet and I restarted Enbrel two weeks postpartum. I felt good about having about 5 weeks without Enbrel in order to boost my immunity and my baby's.

Meeting my son for the first time. 

On the morning of March 21st I drove myself into the hospital (as to not get carsick!) to have a baby! Since I was induced, I didn't have that crazy in labor car ride and it seemed just like every other day. They started the induction around 11.00 am and by 5.00 pm my water broke and I was 4 cm dilated. At this point, I chose an epidural and around 11.30 that night, it was time to start pushing! At 12.48 am, my little boy was born! Everything throughout my induction and delivery went well with no complications.

We were fortunate to have lots of help throughout the first few weeks so we could just focus on our son. We didn't even have to grocery shop for the first 3 weeks! I functioned much better then I thought I would on 2-3 hours of sleep a night and my husband and I took shifts for napping. By my 6 week postpartum appointments, I felt like I was getting the hang of this whole motherhood thing!

Amazingly my joints and Uveitis have been completely stable. My glaucoma eye pressure has also been great. I have had so little pain that I have been able to walk 3 miles at least 2 times per week, which is something I have never been able to do. Honestly, my arthritis is the last thing on my mind! Here's hoping that this calm continues to last. He is now 2 months old and growing fast! I will continue to update about "parentingwithJRA" or "motheringwithJRA" on my main blog at www.allgrownupwithjra.com.

Stay tuned!

Third Trimester Update

Update: My son was born on 3/22/2017 and is amazing. However, I started writing this post during my third trimester and never posted it. More updates about my labor and delivery next. 

Third trimester and I'm feeling very much like that monkey. I am 35 weeks with about 4 1/2 weeks left and it feels like it may never end! The beginning of the third trimester was nice! I had a nice round belly, energy and had learned how to manage my least favorite symptom of heartburn. We had my baby shower and we were blessed with so many generous gifts!

However, the past few weeks things have been more difficult. First, I started talking to my doctors about what to do with my Enbrel dose as we get closer to delivery. After a lot of back and forth between my OB and rheumatologist with many confusing and different opinions, we decided to taper my enbrel at 32 weeks. It was frustrating coming to this decision because I didn't feel like either of my doctors had strong opinions either way and left a lot of the decision up to me. After a month of the slow taper, I started to become sore again. It was hard to determine if this was a flare or just the added pregnancy weight. However, finally my OB and rheumatologist agreed to go back to weekly enbrel doses as I was worried about a flare right before delivery. Enbrel is considered safe during breast feeding and I will just need to let my pediatrician know in order to delay any live vaccines.

In terms of pregnancy symptoms, the fatigue, aches and pains and cramps have increased this past week. I have had weekly non-stress tests and during each test I have been having contractions. Although, I have not felt these so no one seems concerns yet. However, it was scary when the nurse mentioned this! It made it seem much more real! Baby continues to kick constantly and usually I can see his foot poking out around my right side.

In my final few weeks, I have lots of "nesting" tasks I want accomplished, but we will see what really gets done! I can't wait to meet this baby boy.

Second Trimester Update: Weird Pregnancy Symptoms

I am 30 weeks pregnant now. I can not believe I am done with my second trimester and only have 10 weeks left! The second trimester is typically called "The Honeymoon" trimester, because a lot of the nasty first trimester symptoms have stopped, but you are not big and uncomfortable yet. Although my nausea has decreased and my energy has improved, my first trimester symptoms were just replaced by strange, new second trimester ones!

Skin Changes: I noticed some weird skin changes these past few months. First, I had a weird red rash after a hot shower and then I noticed my first stretch marks! I had been applying cream to my belly, however, these stretch marks appeared on my bum! I didn't think to apply cream there! Luckily, they will be hidden from most people.

A Third Boob: Wait, what?! Yes. One of the strangest symptoms I had this month was noticing a large lump/swelling of tissue under my left armpit. Of course I immediately thought I was dying of cancer. This symptom caused a very stressful few weeks. After it being observed by my OB, they requested an ultrasound. Luckily, the ultrasound was negative and the lump has not changed. I am following up with a breast specialist next week to be on the safe side. However,  the consensus seems to be that it's nothing concerning and has to do with the extra pregnancy hormones that may have made some accessory breast tissue to swell. So basically a third boob. Awesome!

Gestational Diabetes: My last hurdle of the second trimester was my glucose loading test.  This is the one-hour test where you drink the sugary drink and then have your blood tested one hour later. I was told I could eat a meal of protein an hour before the test and I was worried about feeling faint so I had some scrambled eggs that morning. However, I found out that I failed this test by 4 points. I was crushed and felt like I was putting my baby in danger. After a stressful week where I changed my diet and ate like I had gestational diabetes, I took the 3 hour glucose tolerate test. I passed this test without any difficulties! As part of my hospitals protocol I had to meet with a nutritionist and as the silver lining to this experience, I feel like I am more conscious of how much sugar and carbs are in the foods I eat.

I am excited to start this final trimester of pregnancy. It is getting closer every day and I can't believe we will meet our baby boy in 10 short weeks!

Pregnant with JRA: First trimester re-cap!!

I can not believe I am already well into my second trimester of pregnancy! It is surreal, exciting and terrifying all at the same time. The first trimester was a blur of surviving the nausea and anxiously waiting for each follow-up ultrasound appointment. I feel thankful that I have had three successful and healthy ultrasounds thus far and things are moving along right on track. I have to admit, only in the past week or so I have really begun to feel it's real. My stomach has started bulging out and it's becoming harder and harder to hide the truth!

I am going to try to remember as much as I can about those first 12 weeks now for a re-cap:

Weeks 4-6: As a result of my IVF procedure, finding out I was pregnant was slightly different than typical. I had my embryo transfer on July 5th and literally watched them insert the embryo that is currently wiggling inside of me. How strange! I waited 5 days before taking a home pregnancy test, knowing that it could be a false positive or false negative, since the IVF medications makes pregnancy tests less reliable. However, it was a positive! At this point, I wasn't even 4 weeks pregnant yet! I was thrilled but still cautious. I waited an agonizing 10 more days before having my first blood test which confirmed the good news!

Weeks 4 and 5, I actually had lots of bloating and nausea, however, I was still on many IVF medications and recovering from the whole process, which added to my malaise feeling. This was confusing because I then started to feel much better around week 6, which increased my anxiety.

Weeks 6-8: The first of my real pregnancy symptoms begin to really start these week. I began to have nausea randomly throughout the day where all of a sudden, I would feel sick to my stomach. I found chewing gum and ginger chews helped as well as eating lots of ritz and saltine crackers. I was usually feeling better by dinner time but then I frequently felt nauseous again after dinner as I was trying to fall asleep. Fortunately, I never actually threw up, but I frequently gagged and dry heaved. Awesome! These few weeks, I was also anxiously awaiting my 8-week ultrasound. It was such a relief to finally see a beating heart!

Weeks 8-12: My nausea started to decrease around week 9-10, which although is a fantastic feeling, it also begins to cause more anxiety about "why am I feeling better?" However, the extreme fatigue started to set in around week 9 and 10. I was exhausted and had to consciously think about staying awake. Fortunately, this week ended with our 12 week ultrasound! Everything looked great and it was so surreal to see baby moving around inside my stomach!

Weeks 13-16: Start of Second Trimester: I definitely started to relax more after the 12 week ultrasound, however, I still found myself often having to remind myself that I really was pregnant. Around weeks 13-14 my stomach started to be more noticeable and I dove headfirst into buying maternity clothes. I may never wear regular jeans again! Although the nausea and fatigue subsided, I was greeted with new symptoms of pounding headaches and heartburn. My OB recommended Tums and zantac which has been helping the heartburn and the headaches are starting to decrease. This week ended with our 17 week ultrasound which was the fetal anomaly scan. This ultrasound was really neat because they looked at every organ, the heart, legs, arms, face, kidneys, etc. It was really cool to see the four chambers of the heart pumping blood as well as the bones in the baby's legs. Everything looked good and baby wasn't cooperating to roll over so we get another ultrasound in four weeks to look at the spine. Baby was moving all around but I haven't felt it yet. I'm looking forward to that in the upcoming weeks.

JRA: Amazingly, everything has been good with my Arthritis and Uveitis. I have some aches and pains in my knees but I think it's from carrying more weight and trying to walk 2-3 times per week instead of Arthritis symptoms. Hopefully, as I get bigger each week, my joints will continue to be quiet.

More updates soon!

IVF Cycle #1- Embryo transfer and the two-week wait

Five days after the egg retrieval, we found our way back in the familiar IVF operating unit. I started to drink water on my way in as directed and by the time I had been checked in, I was bursting at the seams! Supposedly, they had the most patients ever that day and the doctor was running over an hour late. This hour turned into two and I had enough time to empty and refill my bladder three times before the transfer! The transfer was painless and easy, much like a pap smear. A very caring and motherly nurse explained everything step by step to me. As the doctor was inserting the embryo she told me not to move and I don't think I have ever been so still in my life! It was over in 15 minutes and we were given pictures of the embryo and the embryo inside my uterus. It was a very surreal experience. 

Our embryo!

My clinic does not require any amount of bed rest. I took it easy that afternoon but did go to my acupuncture appointment that same day. Although, it was probably the least relaxing acupuncture session yet! I was lightheaded from not eating lunch yet and my head was spinning with too many thoughts! I took it easy the following day as well. Thus began the two-week wait...

This two week wait was very hard. My mind was spinning with thoughts about if it worked or didn't. I battled back and forth between taking a pregnancy test or not. However, after five days I caved and decided I wanted to know the outcome with my husband by my side instead of at work with a phone call. I took a test on the night of day 5 (after hours of googling home pregnancy tests after IVF) and it was positive! Faint, but positive! I took two more that week and all were positive. This made the week leading up to my pregnancy test so much more bearable! It was also nice to have one week that only my husband and I knew about the news before telling our parents. I had three HCG blood tests that all showed doubling and now begins the more dreaded three week wait until our first ultrasound!

I am having mixed emotions this time. I am obviously thrilled that it was successful, but I still can't quite believe its real. I am having some pregnancy symptoms such as heart burn and fatigue and I began to feel a little nauseous this week. However, I know that I am guarding myself from becoming too excited yet. I am hopeful that this will change as time goes on..

IVF Cycle #1- Week 2 of stimulation and Egg Retrieval

Week one of my first IVF cycle went by quickly and uneventfully. However, week two was more challenging:

Cycle day 7: This day I went in for my first monitoring appointment. I had blood work and a transvaginal ultrasound. They said everything looked good and I had 6 follicles on the right and 3 on the left. They had me add in the Centrocide at this point and decrease my Gonal-f from 150 to 112.5

Cycle day 8-10: For the next three days I continued with morning ultrasounds and blood work. They kept my Gonal-F at 112.5 and on day 10 I had 10 follicles on the right and 6 on the left. I was feeling OK, but becoming really tired from all the early morning injections and appointments.

Cycle day 10: On day 10 I was told to trigger at 9.30 pm with Lupron and HCG. I was unnecessarily anxious for the HCG trigger, which was my only intramuscular injection all cycle. However, it didn't hurt at all. In fact all of the IVF injections hurt way less than my weekly Enbrel injections.

At this point in the cycle, I was feeling quite bloated and wore only elastic band pants or skirts for the rest of the week!

Egg Retrieval: We left our house around 7am for our egg retrieval in order to arrive the required 1.5 hours early. Once at the hospital the nurse checked me in and began gathering my medical history. At this point they left my husband in the waiting room for him to be called to produce his sample. However, my husband and I were texting back and forth and after a 30 minute wait still no one had come to get him. This was frustrating as I was anxious and would have appreciated if he had been able to stay with me. Finally, I asked where he was and one of the nurses went and got him and assured us they would find him when he had to produce his sample. I walked into the OR independently, they got me settled on the table and then begin giving me the anesthesia and that's the last thing I remembered. I woke up and my abdomen was really crampy and sore with sharp pains. The nurse gave me one dose of pain medication which took the edge off but I was still quite sore, so she gave me one more 1/2 dose before I left. They had collected 22 eggs which was great!

Retrieval recovery: I spent the rest of the day at home sleeping and resting. The next day I was still sore and my lower back was really achy. I went to acupuncture but that was all I had the energy for. On the second day after my retrieval, I felt less achy but I became very nauseous in the morning after taking my Estrace pills and felt nauseous on and off the rest of the day. I made sure to drink lots of water and gatorade during this recovery and my bloating decreased little by little. I also had to take a pill called cabergoline to decrease my risk of OHSS due to the high number of egg retrieval. Fortunately, by the third day post egg-retrieval, I felt much better and more like myself! We learned that we had 18 eggs fertilized! I was so thankful to know that we will probably have some embryos to freeze. It made me feel less stressed about our fresh transfer having to work, knowing that we have back-up!

Today in just a few hours is my embryo transfer! I am nervous and excited! It's strange to think there will be an embryo inside of me this afternoon! I have acupuncture tonight at 6pm and then I plan to just rest and take it easy tomorrow and return to work on Thursday! Fingers crossed for success!

Let's get this party started: IVF Cycle #1 is underway!

This post is long over due but a lot has happened since my last entry. First of all, I got my "box of meds" in the mail. Having had JRA my entire life, I am used to having tons of medications and am not easily overwhelmed with complicated medical regimes. However, this was a much larger box then I was expecting. It also contained a ton of 1 1/2 inch intramuscular needles. This caused me to panic, because under my protocol I only have one intramuscular injection. After a panicked 9.00 pm phone call on day 2 to the on-call fertility pharmacy nurse, we realized these needles were intended to be the syringes you used to mix the medicine, and you could just unscrew the needle cap. Crisis averted. 

Cycle Day 2: I was on birth control pills for two weeks. I had no side effects from these pills but it was a long two weeks anxiously awaiting the green light to proceed with the injections. I had my baseline ultrasound on cycle day 2 to determine my Antral Follicle count and make sure there were no cysts. I started my Gonal-F injection this night. It comes in a nice epi-pen style injection and I barely felt it.

Cycle Days 3-5: I dutifully completed my Menopur injection each morning around 6.30 and my Gonal-F injection, every night around 8.30. I felt ok throughout most of this week. I was definitely feeling tired, crampy and more bloated by day 5. However, I think I felt tired from waking up at 6 every day to do the injection. I went to acupuncture on day 5 and have my first follow-up ultrasound and blood work on Day 6.

The one thing I did that I felt was really helpful was to make a calender to keep track of all the medicines. There are a lot of medicines to keep track of and it helped the weeks go by quicker when I could cross off the days! I invoked Daeneyrs, the mother of dragons, from Game of Thrones as inspiration for my cycle. I felt like she was a strong inspiration!

Will update more!