Dr. Appt.

I went to the perinatologist today. Because of my low platelet count, I am now considered a "high risk pregnancy." Don't worry...it sounds scarier than it is.

We had to drive all the way downtown to see the doctor, but it was an overall positive experience. We did get another ultrasound done, which I wasn't expecting. They are guessing that Jackson weighs 6lb, 8oz right now (we all know those are complete guesses, although the tech said she was pretty sure on this one b/c Jackson "behaved"). The best news is that he looks perfect and is exactly where he needs to be developmentally, etc.

The platelets issue is just a concern for me...I've known since my first bloodwork drawn that I have low platelets. Platelets clot your blood, so not having enough is obviously a problem. My aunt (Dad's sister) had this problem, my grandmother and my great aunt also have low platelets, so it's completely possible that I came by it honest. Their concern is threefold: 1) I can't have an epidural below 100 (I've also known this since the beginning and am not scared of that); 2) I'm at risk for severe bleeding anytime, obviously specifically during a vaginal delivery or c-section (more so with a c-section) and might need an emergency blood or platelet transfusion if that happens; and 3) Becuase the platelets are SO low (below 50), I'm also at risk for spontaneous internal bleeding. Through blood tests, they have ruled out auto-immune disorders (lupus, stuff like that) and because all of my other bloodwork/organ function is normal, I just have what's called Thrombocytopenia (low platelets for an unknown reason). There are two possibilities. One is that it's b/c I'm pregnant, although they say women with gestational thrombocytopenia typically bottom out at 70 or so. The other possibility is that I have it all the time, and pregnancy (or something else) is making it worse.

The treatment is a low dose of steroids, which if it will work will work immediately. The doctor has seen GREAT results with this in a lot of patients. Even if it doesn't raise it high enough for a epidural, it would be nice to avoid spontaneous bleeding. I was very concerned with how the steroids would affect baby, but the doctor assured me that this steroid and dosage would not cross into the placenta at all. While this issue doesn't affect him directly, me needing a blood transfusion or spontaneously bleeding obviously could impact him negatively. I will have more bloodwork done Monday and the doctor will call me to talk about how the steroids are working and where we go from there. If it's working, I can take a lower dose steroid for the next few weeks until delivery.

I will still see the midwives for the rest of my checkups, delivery, and post-partem visits. This is great news for me b/c I've come to love the midwives I've seen! However, the doctor has already referred me to a hematologist this summer so that we can figure out if the low platelets are gestational or not...deciding from there what the problem is and how to treat it.

I'm not thrilled to be taking steroids in all honesty, but feel like it's something I need to try in order to protect myself and sweet Jackson. I know God is watching over us, so he'll protect us and get us through the next few weeks.

Thanks to all for your thoughts and prayers! :)