17 Weeks Pregnant, More Blood Tests, Perinatal Psychiatrist, Checkup with Maternity Doctor, Results of Genetic Screening Tests, Appointment for Next Ultrasound, Acupuncture, Chiropractor, and Contemplating Where to Live as Our Needs Change

Current mood . . .

Last Friday, near to midnight, my husband arrived home from his business trip and ran straight to the bathroom where he started vomiting violently. Apparently, after a strange tasting chicken dinner in business class that night on a flight, he had started vomiting on the airplane. He was sick with food poisoning and then the recuperation from being so violently ill the rest of the weekend. I was exhausted and still trying to recover from the horrible cold that I had come down with that week. So, we were a miserable pair that weekend. Our reunion after yet another week of separation was not what we had hoped for.

Monday, I was in the lab first thing in the morning for my appointment to have another blood test. I was having my lithium carbonate level tested, as well as my kidney function (this is important to do regularly when on lithium, as it hard on the kidneys).

Another blood test . . .

Tuesday, I drove out to the Victoria General Hospital to see my perinatal psychiatrist (the perinatal psychiatrists in Victoria all practice out of the Victoria General Hospital where the Child and Family Ambulatory Unit or CFAU is and where babies are born, as opposed to most other psychiatrists who practice in town either at private practises or at the old psychiatric hospital, Eric Martin Pavillion, and who do rounds at the Royal Jubilee Hospital in the new psychiatric ward there).

A beautiful morning to be at the hospital.

Parking lot selfie.

In the waiting room at the hospital.

The perinatal psychiatrist and I reviewed my lithium carbonate level. It was up from 0.5 mmol/L to 0.62 mmol/L in a month. This was good news, as my lithium level had been below therapeutic range last time it was measured and I was feeling very unwell in December. In response, my perinatal psychiatrist had raised my dose of lithium from 900 mg once per day to 1050 mg once per day. It was necessary to raise my dose, because my blood volume had been rising as my pregnancy progressed. Sometimes more than one dose change is necessary during pregnancy, due to both blood volume increase and weight increase. 0.52 mmol/L is considered in our lab’s measurements the lowest therapeutic level. When I was feeling stable in the autumn, my level was around 0.70 mmol/L, so perhaps I’ll feel even better if my level climbs a bit. Lithium level does take a while to rise in the blood. In fact, for those on lithium as a treatment, two years is considered to be a short time to be on this still little understood drug, which is still the leading treatment for bipolar disorder (though researchers still can’t figure out why it works on many bipolar patients but not others and why no better drug has been developed in all the decades since its introduction as a mainstream treatment).

The perinatal psychiatrist and I then discussed my kidney tests, which were all within the normal range. The perinatal psychiatrist said that kidney levels were even less likely to look out of normal ranges while a patient is pregnant, since her kidneys are working furiously, pumping everything through her body at such a high rate due to the pregnancy.

We then discussed what the plan was for around the time of the birth. She says that since it’s so hard to predict exactly when someone will go into labour, I should not stop taking my lithium until I actually go into labour (as opposed to on my due date). After I stop taking lithium and have given birth, the hospital will test my lithium level with a blood test in the hospital (bipolar patients tend to be held longer than patients without bipolar disorder after birth to ensure that they are stable before being released back home) and then she will decide what dose of lithium to start me on again (this could be a couple or a few days after the birth, so as to avoid toxicity since I will have been on a higher dose than I would need post pregnancy and I will lose so much fluid during the birth). I feel satisfied with this plan and reassured that she does not seem at all worried (this is a big change from the time when Kay Redfield Jamieson, the famous bipolar author and professor, was contemplating having children when her psychiatrist told her that she should NEVER have children given her disorder- she's a truly inspiring woman whose writings have brought me a lot of comfort since my diagnosis).

The psychiatrist recommended that I come back in to see her in about a month or perhaps even six weeks, after I have another blood test to check my lithium level again. I chose an appointment a month away to make sure that my lithium level stays in the therapeutic range and doesn’t fall below it again. I don’t need more of a challenge than being pregnant by having a mood episode that could render me in the psychiatric ward (I never, ever want to end up there again). As it is, while I am coping better than I was in December, my anxiety levels have been quite high lately and I've been waking from nightmares frequently with panic attacks. My sense of hopelessness and fear that I'll miscarry again have also continued to be a problem. I can't help but wonder if the reason why I haven't had an upswing in my energy level in the second trimester, as all the books seem to be saying that I should be, is because my lithium level is still sub-optimal and I'm just not feeling very well mentally (could also be the darkness and gloom of this time of year in the north too).

After my appointment on Tuesday, I went to the mall to continue my (frustrating) search for maternity-like clothes. I tried to find a pair of maternity jeans, so that I could wear something other than dresses and leggings with tunics. Unfortunately, there are limited fits in tall sizes and I was in between sizes (and they looked bizarre, were expensive, and seemed to not be that great quality) and the regular length maternity jeans were capri pants on me, so I left the maternity store empty handed. I wandered over to The Bay. I managed to find two bras that fit my larger bust well. I also found a pair of regular black cotton leggings in a larger size that fit and can replace my black leggings from Walmart which are now worn out and full of holes. This at least will keep me for a while, as I figure out what my next wardrobe related move will be. The maternity clothing marketplace seems expensive and not that great (sort of like regular clothes but uglier and made with cheap fabric). It seems I might just be in regular clothing in larger sizes for the rest of my pregnancy. 

Wednesday, I had an appointment with my maternity doctor in the morning. My husband is in town working for the next few weeks and he came to the appointment with me, so that he could meet Dr. Down and hear the results of our genetic screening tests. I gave my urine sample to the MOA and then proceeded to the room to be weighed. The scale showed that I had gain a bit more weight, but as the MOA said, I’m pregnant and I should be gaining weight (my endocrinologist is not of this view, but oh well, I can only do so much, since I am pregnant).

In the waiting room at the doctor's office.

Dr. Down said that he had just received my results back from the screening centre at the BC Children’s Hospital the day before. I had the two blood tests plus the nuchal fold ultrasound (the tests looked for raised risk of the fetus having chromosomal abnormalities like Spina bifida and Down Syndrome). He said that my results were excellent and did not show any flags that would indicate that I should have further testing like the paid Harmony screening blood test or amniocentesis (a relief as this carries its own set of risks).

Dr. Down looked at my sinuses to check if I was starting to get an infection. He said that my sinuses were inflamed, but so far not infected. I was to continue with saline, some Tylenol for pain and swelling, and I have been using non-drowsy antihistamines the last few days, Loratadine, which is also apparently fine in pregnancy.

Dr. Down took my blood pressure, which he declared perfect (no surprises there, sometimes nurses are alarmed by how low it is, so I wasn't expecting it to be high). I asked about pain in my pelvis and if it could be ligaments stretching out. He palpated my abdomen and said that it was most likely the ligaments stretching out, as my uterus was not painful when he palpated it. He then put the goo on my abdomen to listen to the fetus’ heartbeat. My husband looked on with amazement, as he heard the fetus’ heartbeat for the first time since our first ultrasound on his birthday in November, when we found out that we were pregnant and that the IVF had been successful (he has not been able to be at the subsequent ultrasounds and doctor's appointments as he's been away on business). Dr. Down said that everything seemed normal with the heartbeat around 150 bpm. He said that I should get my appointment soon for my developmental ultrasound (done between 18-20 weeks). When I see him in a month, I will find out the sex of the fetus (you can choose not to find out, but we are going to find out).

Car selfie . . .

When I arrived home, I found the appointment for the ultrasound (they are still sent by mail, very retro). My appointment is January 31st, when I will be 19.5 weeks pregnant. My husband thinks that he will be able to be there, which is great news because this is apparently the most interesting ultrasound that happens during pregnancy, when one can see the fetus in great detail (and where one can discover the sex of the fetus from their doctor in a visit after the ultrasound since the ultrasound tech cannot tell you).

Thursday, I went for my first acupuncture visit in a month (it’s monthly now, instead of weekly). As usual, she put needles in my lower legs to connect to fertility meridians. Since I’ve still had gastrointestinal symptoms like indigestion and some constipation, she put a needle in my very high stomach area. For anxiety, she put needles in my chest. She put a needle in the top of my head and one in the top of each ear.

Before acupuncture.

A needle in the top of my head and one in each ear and two in my chest.

When she returned to check on me, I asked if she could do something for my congested sinuses. She put needles on either side of my nose which she called “whiskers.” She also put a needle between my eyebrows. I will return for another round of acupuncture in a month.

From less head needles to many head needles.

Today, I’m 17 weeks pregnant. I simply cannot believe it. I still have trouble believing that I’m actually pregnant, let alone almost half way through (and so close to finding out what the sex of the thing is!).

17 weeks pregnant.

I went to the chiropractor today. My neck and back continue to be stiff (with some spasming), though less tense than the previous week. I will return for another adjustment in a week.

My husband and I have been discussing what to do with regard to our future and where we’re going to live. Unfortunately, the place we live is not big enough for a new addition to the family. In Victoria where we live, the vacancy rate for renting (0.5%) is even lower than crowded and overpriced Vancouver (0.7%) with very few places offered for rent and even less places that are not a crack shack or one step above a crack shack. If one does find a place that doesn’t look shocking, in a neighbourhood that one actually wants to live in, the prices for a small basic house with two or three bedrooms are thousands of dollars per month. If one wants to buy a house in Victoria, the numbers are even more grim (average house price is about $950,000 now in the core). We keep wondering if this is a good place to raise a family. When housing is so expensive and scarce, perhaps it’s time to look elsewhere.

Canada is suffering from housing problems coast to coast though, a result of years of low interest rates and other government policies designed to put off the inevitable correction that we should have had following the financial crash. The government is more interested in “growing”’ the “housing industry” in Canada (practically the only sector that is growing in Canada now) and rewarding dangerous levels of debt in taxpayers and penalizing savers. We just can’t see how a family can get ahead nowadays when they are spending 60-70% of their after tax income on housing (common figures on the west coast of Canada where places like Vancouver and Victoria have increasingly less units available while people continue to flock to the cities to live thereby ensuring that rents will continue to climb).

People have said that I should live somewhere near to some family who can/will help me when I have a baby, as I suffer from bipolar disorder and may have a need for extra support if I become unwell from my disorder or if my husband is away travelling for work and I don't have him turn to. That is not an option where we are and my husband could not do his job from where his parents live, so in-laws are not an option either. The other option is to hire people to help out. In Canada, this costs quite a lot, especially on top of high housing costs, food costs, etc.. My acupuncturist directed me to the Doulas of Victoria website, where one can find a list of doulas available for postpartum services. I didn’t know what that they did anything postpartum. She told me that they can do things like help with the baby while you take a nap, help with housework and laundry, and answer questions about childcare. She said “you know stuff a mother or sister would do.” I scoffed at this characterization of what family would do. I know I’m on my own. My acupuncturist told me that it is like paying for a nanny by the hour. It is an interesting idea, but it doesn’t solve our housing problem.

We remain unsure of what we should do, but with time ticking down, we have to decide soon what our next move should be.

Housing prices in Canada make us feel like this . . .