OB Appointment

I've been seeing my OB once/month ever since my first appointment with her.  I really like my doctor.  Dr. P never seems in a hurry, even though I know she has a very busy schedule, and always takes the time to answer my questions.

The first thing that happened is the weight in.  I've gained about 34 lbs so far.  I hope it doesn't end up being much more.  Although, everyone does tell me it doesn't look like I've gained much weight, which is nice to hear.  I haven't had any swelling and most of the gain has been in my belly.  Actually, in my hips and thighs too, but nobody else can tell that.

The nurse tested my urine sample, and everything was normal there.  No urinary tract infection and no protein in the urine.  My blood pressure is still pretty good, thank goodness, at 120/78.  It's been pretty stable with the exception of the first few appointments when I was SO anxious about the first trimester and meeting a new OB.

I had to wait about 15 minutes for Dr. P to arrive because she had a few surgeries at the hospital and was running late.  No big deal.  I had my list of questions ready for her.

1. My biggest concern was the rash I have on my stomach.  It's been there now for a few weeks and seems to be getting worse and starting to get extremely itchy.  I also have a lot of itching along my spine in back.  Dr. P thought the rash was pregnancy related and fairly normal.  We both agreed that it is probably PUPPP (Pruritic urticarial papules and plaques of pregnancy), an annoying hives-like rash that presents no long term effect for either mother or babies and goes away within a short time after delivery.  
2. Right side rib pain.  I actually don't think it's my ribs at all, but in that area.  It's been bothering me for over a month and I have mostly attributed it to being because that is where Baby B is hanging out.  However, sometimes it's more than just an uncomfortable sort of pain, but more like a burning pain, and it is sore to the touch.  I had asked the MFM doctor about it previously, and she said it could be my liver and an indicator for pre-eclampsia, but didn't think so because I had no other issues at all.  I brought it up to Dr. P because the pain has continued and of course, because the MFM doc mentioned pre-eclampsia, it's been a worry for me.  Dr. P agreed that it sounded like normal pregnancy pain due to the expansion of the ribs and the muscles stretching.
3. I asked about the moles growing on my nipples.  I've had a LOT of moles growing and needed to know if this is normal and would it effect breast feeding when the babies get here.  She took a look at my nipples and assured me that it was normal.  She also said to expect them to maybe get a little darker and the nipples to increase more in size as well.
4. Breast pump.  I had called my insurance company quite awhile back to find out if they would cover a breast pump.  They said that they do (YAY!), but it would need to be from a preferred provider.  Soooo, I asked Dr. P about that.  She gave me a written prescription for a breast pump.  The problem is I am not sure how or where to claim it.  I will be calling the insurance company again to find out (hopefully) what to do.
5. My hands have been falling asleep when I lay down.  I told Dr. P I thought I was getting pregnancy induced carpal tunnel.  She didn't really say much about that, but did recommend sleeping on my side with my top arm over a pillow.  She also told me to get hard/firm wrist braces if it becomes a major problem.

After addressing each of my questions, Dr. P found both babies heartbeats and said they are rockstars. She told me that I was doing really, really good with this pregnancy.  I haven't had any major issues and the babies have looked great at every u/s so far.  I left the appointment feeling pretty good about things and feeling much relief that my blood pressure was good.  She did send me to the lab for some blood work, just to rule out any other possibilities for the rash and to check the liver, just in case.

The guy doing the blood draw looked about 15 years old.  I was a little nervous to have such a kid poke a needle in me.  (I know I've mentioned before how much I hate needles)  He wasn't very gentle, but he was a nice enough guy.  I survived.

I called Hubby on the way home to let him know how the appointment went.  He can't come to the regular OB appointments, because we need him to work!  He takes the time off for the u/s's with the MFM, but we can't afford both.

Later that night, around 6:00, I got a phone call from Dr. P.  Uh-oh.  Can't be good news if she's calling so late after I just saw her a few hours ago.  She was calling to let me know that the blood work does show an elevation in my liver enzymes.  She asked if I've ever had any problems with my liver.  No.  Have you taken any Tylenol lately?  No, I haven't taken anything this entire pregnancy so far.

She's still waiting to get a few more results from the blood work, and is going to have them check it for Hepatitis, which she says she's sure won't be an issue, and I'm sure it won't be either.  I will also be getting a phone call to schedule an u/s for my gallbladder.

I didn't think to ask any questions when she called, but I spent the rest of the night and today worrying about what this means.  I don't know how serious this is, or what complications we may be looking forward to, other than what Dr. Google says.  I'm trying not to freak out because, well, we just don't know anything yet.  However, that doesn't stop me from worrying.  A lot.  There IS a problem with my liver.  It's just a matter of the severity of it.  Dr. P thinks it's just pregnancy induced, but what does that mean exactly.  I didn't ask.

I tried to call the clinic to get more information today, but Dr. P has Thursday's off so I just left a message.  Either she will get back to me, or a nurse will follow up.  I haven't heard yet.  I also haven't received the call to schedule the gallbladder u/s yet either.  Ugh.

So, while the appointment went good yesterday, my day didn't end so well.  I was up most of the night because of the intense itching on my belly.  I laid with a cold washcloth over it for relief.  I also said a few prayers that the problem with my liver will resolve itself and won't be a big deal.  Now I'm just waiting....