My midwife is out of town so I had to see one of the OBs that are in the same practice as she is. First they some how had me at 21 weeks when they looked at the chart and had to refigure that. She looked at me and said that I looked rather big for 21 weeks, I replied that I was sure I did since i am 26 weeks. Once they looked at the due date, it was all good.

My blood pressure was 110/60, which is lower than it has been and they were pleased to see that. I was measuring 27 cm, which is about a week ahead, but that is typical for me so far. Baby's heartrate was good, but I do not know the bpm, she did not tell me or show me. Then the doctor told me that I would need to get my glucose screening done soon. I told her that I had that done last month. She said that was too early and I needed to get it done again. So once again I had to go drink the yucky orange soda and sit. I am now waiting for the headache that i got last time to hit.

I had assumed that I had gained weight this month. I have been eating bread and butter with every meal and we bought a half gallon of ice cream and ate all of it in about a week and a half. However, I have actually lost 3/4 lb. They nurse and doctor asked about how I was eating. When I told them I was eating three meals a day plus a snack and eating pretty much whatever I want when I want and taking my vitamins, they said it was not a problem. They are sure I will start putting on weight very soon as the baby will be putting on the pounds soon.

Anyway, after the appointment, the doctor told me to schedule with my midwife in 4 weeks. My midwife had told me every 2 weeks after this appointment. When I told the appoinment desk this, they sadi that I should wait and ask my midwife next week when she gets back from vacation. I agreed, but now I am thinking that i will schedule the appoinment for two weeks. I will have not seen her for 6 weeks by then and it will be nice to see someone who has been following my treatment more closely.

Basically, I think I really prefer the midwife to the OB and am very glad I chose to see her instead of the regular OB. I think I have gotten much better, more personalized care.

On a completely seperate note, I found two pairs of pants that fit this weekend. Better yet, one of them is blue jeans (the other is black cordory). I know this sounds a bit silly to be excited about, but I have been looking for pants since I was about 12 weeks and have never found a pair. I also got two blouses. I think I now have enough clothes to make it through winter. I was unable to find a single pair of tennis shoes that did not make my feet hurt. I will need to find at least one more pair of shoes before winter. I need something I can wear with socks to keep my feet warm. Maybe I should try my winter hiking boots on. If they fit, I may just wear those and get a nice looking pair of slippers (like leather or something) and wear those inside.

I just spoke to my midwife. The consensus is that the heart murmur and tricuspid regurgitation that I have are minor enough to not warrent antiboitics or further concern. She will continue to monitor it and further testing will be done if anything changes.

Finally got my test results back (sort of). My blood glucose is fine. My iron levels are fine. All the blood work was great.

The echocardiogram did not find mitral valve prolapse, which is what they expected to find if they found anything. Instead, they found Tricuspid regurgitation.
The mirtal valve is on the left side of the heart between the upper and lower chambers. The tricupid valve is between the upper and lower chanbers of the heart on the right side.

My midwife was not certain about antibiotics during labor and delivery. She spoke to the doctors in her practice and none of them were certain either. Most of them said that if it was pregnancy induced, medication was probably not necessary, but some said they thought it might be. She has now kicked my test results back to the cardiologists for futher recommendations.
I need to know about the antibiotics thought because i have a dentist appointment in a few weeks and I will need to take them then also if that is what is recommended.

I guess I just have to wait and see. Either way it does not seem to be anything major to worry about.

Appointment Today
Blood Pressure: 132/70
Baby's Heartbeat: 145 bpm
Weight: Gained 4 lbs. (this means I am now breaking even with my first appointment and still down about 3 from my prepregnancy weight.)
Measurement: not sure, she did not say, I did not think to ask

When I consulted with Maternal Fetal Medicine in October, they said I should have my heart monitored at each appointment because I was born with mitral valve prolapse and an irregular heartbeat. I had a battery of tests done every few years throughout my childhood, but when I was 20 or 21 the prolapse was no longer detected and the murmur cased by it had disappeared. Today, my midwife detected the telltale murmur again. She said it could just be a normal variant that sometimes occurs in pregnancy, but with the history of prolapse, she would like to have it checked. So tomarrow at 8:45 I will go to have an echocardiogram (sp?) done to determine if I need to have any changes in my care.

I will also be going for my 1 hour glucose test and bloodwork to check my iron levels.

I need to check with my midwife about the serial ultrasounds to check growth rate recommended by the Maternal Fetal Specialist at my Level II. I asked her about them, but did not ask about when they should be done.

Some notes from the Ultrasound:
He is currently laying breech, but as we all know that does not matter at this point. The placenta is right in across the front of the uterus which would explain the fact that I have felt only a few kicks a day (they have to be pretty strong to feel them through all of that tissue. All of the organs and limbs look perfect. All of the measurements are about a week ahead right now so even though we are at 20w2d, the measurments are mostly around 21w3d. Weight is estimated at 15oz - 2oz.
On the plus side the doctor doing the Level II part of the scan said she was going to recommend that my doctor do regular ultra sounds to keep an eye on growth because of my arthritis. Sounds fine to me. I thought this would be the only one unless this one showed problems. It is also the only one that my insurance would pay for unless more were deemed "medically necessary". I think a maternal-fetal medicine specialist saying that they should be done will qualify for that.