Monday, October 22, 2012

c'mon baby!

I'm due on friday and so far the baby is high and free instead of low and engaged. While that can change at any time, it's starting to make me think we're going to have a bonfire baby instead of a halloween baby. I'm okay with that- just struggling to accept a scorpio instead of a libra ;)  I'm still feeling alright, most of the time, though I'm having a issue with my iron and it's making me breathless and causing palpitations and such which just aren't fun or comforting.

On Oct 6th I went to an antenatal class at the birthing centre and saw my midwife. I had the weirdest cravings for ice that had suddenly developed over the last two months- which I just thought was a pregnancy thing- then I started craving soap. awkward. I told the midwife about these things and she didn't seem concerned, she said that pregnancy makes us crave weird things. Since they are really the only cravings I've had I didn't second guess her. I also told her that I hadn't been feeling well lately- heart palpitations, breathlessness, etc- she said my blood pressure was fine and that this was also normal with the increased blood pumping through my body etc. Lucky for me, my lovely wife is a bit more persistent on these things and kept asking about my blood results from august- which I couldn't seem to find in my notes- and neither could the midwife. So she went to her trusty computer and printed them out. Then she told me that my iron was VERY LOW. so low that I wouldn't be able to have the baby there. My blood was last taken in August, so there was no telling how it had changed, for better or worse, since then. She took more blood and sent me home with iron pills in the meantime. I got my blood results the next day and it was even lower than it had been in august which wasn't the news I was hoping for. At the time I still had 3+ weeks to get my iron up and stay at the birth centre- but now I've just got to cross my fingers and hope for the best. I could go into labour at any time and I won't know my latest blood results until 4pm today, so I'm hopeful that the pills have been working. I really wish they hadn't mucked this up and that I had been told early on- like august, for example- because then I wouldn't have to worry. But, as they say, the best laid plans of mice and men often go awry...

We're making lemonade out of the situation and toured the Lister MLU last week. I've tentatively booked there in case my iron isn't up where it needs to be for edgware. I'm a little bothered by the fact that Edgware missed something so crucial to me being able to give birth there. The weird thing is that since October 6th, I've had 3 different phone calls to tell me my iron is low. They obviously have procedures in place to notify (or over-notify) patients of their bloodwork, so why they missed it in the beginning is beyond me, but there's nothing I can do about it now except hope for the best.

I'm learning a lot as a result of this iron issue and it's worth sharing. I think I can sum it up by saying midwives and doctors don't always give the best info and the best thing you can do is inform yourself.
  • First: I should say that I haven't been entirely open with my medical history since being in the UK. In the USA our medical system and insurance system is so messed up that it's best to keep some things to yourself. For example, I have crohns disease and I've never disclosed this to any medical professional in the UK. Perhaps I should have, but at this point I still feel good about my decision to keep that to myself. I was worried that they would intervene in ways I wasn't comfortable with, or treat me differently for trying to conceive- I now know that those things wouldn't have happened, but still best to not let it out here so that it doesn't ever get back to the USA. In the USA I worked tirelessly to have all evidence of this removed from my records to the best that I could- and I'll say that after 20 years I was fairly successful. My main reason is that being treated with medication was making me more sick, and the whole ridiculousness of getting insurance as an adult (having been diagnosed in childhood) I couldn't get my insurance to pay for simple things like a common cold or flu because my crohns (a pre-existing condition) made it an expectation- and I was told that I would be unable to EVER carry a child to term as a result of the severity of my crohns. Through my own research and self medication I was able to put my Crohn's into remission and so far, VERY successfully carry a child to term. I've dealt with anemia a lot as a result of crohn's, however, this seems to be normal pregnancy related anemia.
  • Second: when I was given the news that my iron was low, the midwife gave me a sheet about foods for PREGNANT women to eat to increase their iron. The list included liver. I figured that a heme iron was the best way to increase my iron so I went to the store and bought liver on my way home from the clinic that night. I had a plan in mind that I would take my pills daily and also eat one serving of liver every day for the week. I began my plan and did this for five days. On the fifth day I got a phone call from the midwife to tell me I had low iron. I told them I knew and that I was taking the iron pills and eating liver and would be back in another week for more bloodwork. The woman on the phone was furious that I was eating liver and had a go at me for being so careless during my pregnancy and told me the baby could have birth defects because of my actions. I told her it was on the sheet they had given me. She told me to throw away the sheet- and any leftover liver. This left me paranoid, needlessly. While liver isn't ideal to consume during pregnancy due to the large amount of vitamin A in it- the most critical time to abstain is the first three months in terms of birth defects and brain damage. Even though I was full term when I consumed it, it still isnt' a good idea to eat as much of it as I was eating, but at least I wasn't needlessly paranoid after a bit of internet research. Also, the midwife told me to take my iron pills with orange juice. I said that I didn't like OJ, but that I eat grapefruit every morning- she insisted that I switch to OJ because she wasn't sure if grapefruit would inhibit absorption. I asked a different midwife at the same place for a second opinion and she explained that the reason they recommend OJ is for vitamin C, and anything with vitamin C- like grapefruit or kiwi is perfectly acceptable. So much conflicting information!
  • Third: I went in on sunday for my next set of bloodwork. We discussed the liver mixup, and I gave them back the sheet they gave to me and told them they should probably update it. The midwife told me I should eat something more enjoyable, like kiwi fruit, which she claimed had 50% of my daily recommended iron as well as the added benefit of vitamin c. This seemed a bit absurd to me since I'm pretty knowledgable about the fruits and veg that contain high amounts of iron (Kale, blueberries, olives, etc- and the latter two are only in the 15-20% category of daily intake- but they are the highest) I googled it, and as I expected Kiwi contains a minimal amount of iron- though it is good to take to help the iron be absorbed by your body due to the vit. c content. 
  • Fourth: If you crave weird things, like soap, ice, mud, clay, etc- and you're getting breathless for what seems like no reason- don't let the midwives brush it off- at a minimum verify your most recent bloods, or demand more recent bloodwork. iron can change quickly and it can be really hard to bring it back up- especially it if gets dangerously low. Not to mention the risks to your life, and the baby's during childbirth, from low iron. 
I guess what I'm ultimately getting at is that the doctors and midwives tend to repeat information without saying WHY, or without understanding WHY they make the recommendations they make. It's best to ask them WHY and if they don't know make them get back to you on it. after all, they are supposed to be looking out for your best interest. 
Also, when it comes to iron issues and anemia, there is a risk of being too informed about it. For example I read on many websites that I should take the pills with any form of milk or dairy because it inhibits absorption, but then I read the box my pills come in and they are coated in lactose- which seems contradictory. Also, even if you follow everything exactly as you should, everyone's body absorbs iron differently and there is no way to guarantee your hemoglobin will increase to the extent it is supposed to- so you just have to try your best and not stress about it.

I'm going to try that right now!

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