Something that may explain why I lost Liam.

I know I said I had posted the last about him. But it doesn’t mean that I have forgotten him or have gotten over my loss. Truth is, there’s not a single day when I don’t remember him. Not a single night when I don’t replay the scenes and events at the hospital in my head before I sleep. Not a single instance when his memories do not bring tears to my eyes.

Right now, as you’ve probably noticed in my recent posts, I’m fussing over my enlarged thyroid, which prompted me to research more about it. And the more I research, the more I realize the correlation between thyroid disorder and pregnancy, and the risks it poses to the unborn child.

Somehow, it points to the fact that this thyroid disorder might have caused my baby to develop undetected respiratory problems, which could further explain why he wasn’t able to survive despite the ventilator and medications administered to him. Or why he passed meconium inside my tummy in the first place.

I have mentioned before that I’ve always had a slightly bulging neck and hinted that I may already have a thyroid disorder even before I got pregnant, which has worsened during the course of my pregnancy.

The thyroid gland enlarges slightly in healthy women during pregnancy, but not enough to be detected by a physical exam. A noticeably enlarged gland can be a sign of thyroid disease and should be evaluated. Higher levels of thyroid hormone in the blood, increased thyroid size, and other symptoms common to both pregnancy and thyroid disorders-such as fatigue-can make thyroid problems hard to diagnose in pregnancy.

…

Subclinical hypothyroidism — a mild form of hypothyroidism that has no apparent symptoms. Subclinical hypothyroidism occurs in two to three of every 100 pregnancies. [SOURCE]

If I did, these were the possible effects on my pregnancy and my baby:

Significantly more placental abruptions (relative risk [RR], 3.0; 95% CI, 1.1-8.2), deliveries prior to 34 weeks (RR, 1.8; 95% CI, 1.1-2.9), and respiratory distress syndrome (RR, 1.8; 95% CI, 1.0-3.3) were found in the SCH group. These differences persisted after controlling for maternal age, race, and abruption. [SOURCE]

The function test result during the first month of my pregnancy showed a normal-high TSH and normal-low TS3 and TS4.

Test results will show high levels of TSH and normal free T₄ [for subclinical hypothyroidism]… High levels of TSH and low levels of free T4 generally indicate hypothyroidism. Because of normal pregnancy-related changes in thyroid function, test results must be interpreted with caution.

But the doctor thought nothing of it. I couldn’t blame him though, because I didn’t tell him I was pregnant. I didn’t realize it might have an effect.

If subclinical hypothyroidism is discovered during pregnancy, treatment is recommended to help ensure a healthy pregnancy. [SOURCE]

Because the symptoms of hypothyroidism are almost similar to pregnancy-related complaints, I wasn’t aware then that something might be wrong. But now that I’m no longer pregnant, the symptoms are more apparent:

Hypothyroidism signs and symptom may include:

Fatigue
Sluggishness
Increased sensitivity to cold
Constipation
Pale, dry skin
A puffy face
Hoarse voice
An elevated blood cholesterol level
Unexplained weight gain
Muscle aches, tenderness and stiffness
Pain, stiffness or swelling in your joints
Muscle weakness
Heavier than normal menstrual periods
Brittle fingernails and hair
Depression

[SOURCE]

Nine of those symptoms reflect how I’m feeling since I gave birth until now; fatigue, muscle aches and joint paints most notably. And there’s actually another condition that I’m looking into — postpartum thyroiditis — which could explain the lump in my throat.

Postpartum thyroiditis — a painless inflammation of the thyroid gland that develops within the first year after childbirth — often lasts from several weeks to several months. For some women, postpartum thyroiditis leads to long-term underactive thyroid (hypothyroidism).

…

For the majority of women, thyroid function eventually returns to normal. However, some women who develop postpartum thyroiditis develop hypothyroidism and require lifelong thyroid hormone replacement therapy. Because hypothyroidism presents a significant risk to developing babies, it’s important to make sure the condition is under control before attempting another pregnancy. [SOURCE]

These are only speculations based on a cursory online research. I will still consult with an endocrinologist to know exactly what type of thyroid disorder do I have and if indeed  it had an effect on my baby.

I know getting the facts now will no longer bring Liam back, but at least, I will be more knowledgeable of my condition and prevent unfortunate consequences, if and when God blesses me with another pregnancy in the future.

When people ask why I didn’t take a picture of Liam, I tell them that I don’t want to be reminded of how he struggled for his life at the NICU and what he looked like with all the machines connected to him. And I certainly don’t want to take a picture of him after he died.

So the only “pictures” that I have of him are these ultrasound scans that were taken when he was still inside me. At least in these photos, he was well and alive.

*{For some reasons, I couldn’t find the scanned ultrasound images. But I still have the original prints with me. Just too lazy to scan them and upload here.}*

These are the only visual proof I have that show that for 39 weeks, however short that may seem, I became a mother. I miss you so much Baby Liam.

I was awaken by a sharp, throbbing pain on my left abdomen early morning of Sunday, December 11. It was accompanied by a more-painful-than-usual contractions on my tummy and pressure on my hips and lower back. At first, I thought I just needed to go to the bathroom, but after almost 30 minutes of trying to empty my bladder, the pain persisted so I went back to bed and hoped that relief would come soon. But what followed were more painful contractions that occurred every 5 minutes or so.

My mother asked me to stand up but I couldn’t do so without doubling over. My knees were wobbling with each wave of contraction and I was holding on to the back of a chair for support. It was then that they decided to bring me to the hospital. Initially, I just wanted to go to a nearby clinic and have an internal examination (IE) or “cervical checks” because it could just be a false alarm. But my mother, judging from the way I was wincing in pain, thought that I might be going into labor already and said it’d be better if we head straight to the hospital.

When we reached the hospital an hour later, the pain has subsided and the contractions were not as intense nor as closely spaced as they were. The doctor who performed an IE confirmed that I just had a false labor and promptly sent me home after monitoring my baby’s heartbeat and my contractions for an hour.

Two days later, I had my weekly prenatal checkup with my OB and she performed an IE on me again. She noted that my cervix is still closed, uneffaced (not yet thinning) and posterior (pointing toward the back) but is already softening. She added that it would probably be 1 to 2 weeks before I have my real labor and that I might even give birth a few days before or after, or on Christmas day itself. But stressed that I should continue to observe any signs of labor, especially if my water bag breaks or if I start bleeding or spotting, because no one can accurately predict when I will go into labor.

I asked what if my due date falls and baby isn’t out yet. She said we’ll wait for a week first and if still nothing happens, I’ll be induced for labor on January 2. So basically, it’s a waiting game for all of us.

Currently, I’m 10 days away from my due date, which is on December 26, but if I were to choose, I’d like to give birth now. Aside from being excited to see and hold my baby, this waiting game is becoming more and more uncomfortable and difficult for me.  My mother would always remind me that all these discomforts and pain are part of my new role as a mother. But then, even she would wish that I give birth soon whenever she sees me how much pain I’m in.

But like what I said on my previous post, it’s all baby’s call. Whether he wants to come out already or stay a little longer inside, it’s all up to him. As much as I want to free myself from all these discomforts, my more fervent wish is to have a safe and normal delivery and to give birth to healthy, happy baby boy.

Baby isn’t the only one who’ll be needing stuff while at the hospital. That’s we need to have our own hospital bag, too. Here’s what I’m packing in the bag:

For Me:

• 3-4 maxi dresses or sundresses (because they’re easier to slip on and are breastfeeding-friendly)
• 1 jacket, cardigan or bolero (to keep me warm and covered)
• 6 granny panties
• 2-3 bras (nursing bra, if possible)
• 1 pack of maternity pads
• disposable nursing pads
• nursing cover (when I need to breastfeed discreetly)
• 2-3 pairs of socks
• 1 pair of slippers

For D:

• 2-3 T-shirts
• 2-3 pairs of shorts
• 2-3 pcs of underwear
• 1 pair of slippers

For both of us:

• 2 blankets
• 2 pillowcases
• 1 extra pillow
• bath and face towels
• toiletries such as soap, shampoo, toothbrushes, toothpaste, Betadine feminine wash (for me), cologne, etc

Other things:

• money and ATM cards
• ballpens
• plastic/disposable plates, cups, utensils for food
• styro cups and bowls for soups and hot drinks
• dishwashing liquid and sponge

It’s never too early to prepare. So when my 7th month rolled in, I decided to have a few trips to the mall, often with D, sometimes with my mother, to buy baby’s stuff. But before heading to the mall, I compiled a monster list of things that most babies use and trimmed it down to the essentials.

Most first time moms tend to overcompensate for their baby’s needs and end up buying things that they won’t be able to use simply because they have too much of everything. But I wanted to be practical and planned to buy only the things that our baby will use for the first month or so. I figured that if I need more of a particular item, or if baby will need something that we don’t have, I can easily go to a nearby mall and buy, or ask someone to do it for me (in my case, it’s probably going to be D). This way, we can be sure that the things we purchase will actually be used by our baby and therefore, avoid overbuying stuff.

So I remove from the list the items that serve the same purpose as another item, items that are nice-to-haves but not really necessary and items that our baby won’t need for the next 1-3 months.

And these are what we ended up buying:

• 9 shirts (3 sleeveless, 3 short-sleeved and 3 long-sleeved)*
• 2 pairs of pajamas*
• 2 onesies*
• 1 frog suit*
• 9 pairs of mittens
• 3 pairs of socks* (rather than booties because they say booties tend to fall off easily)
• 2 bonnets*
• 3 bibs
• 2 dozens of gauze clothes (I need a lot because I want to put baby on cloth diapers as soon as he stops excreting meconium)
• 3 pairs of nappy clamps
• 4 hooded receiving blankets (2 plain and 2 towel fabric)
• 8 pcs of wash clothes
• 3 pcs of burp pads
• 2 sets of comforter with bolster pillows (1 for use on the bed and another for the crib)
• 24 pcs newborn disposable diapers (good for the first few days while baby is still pooping meconium)
• 2 pcs 4-oz. feeding bottles (only 2 because I plan to breastfeed)
• 1 bottle cleaner
• 1 changing rubber mat
• 1 baby bath cradle
• grooming kit and toiletries which includes nail clipper, comb and hair brush, tongue cleaner, baby powder and powder puff, warming oil and regular baby oil, baby wash, baby wipes, alcohol, cotton
• baby clothes powder detergent
• lots of plastic storage boxes

*0 to 3 months size

I still have a few things that I need to buy, but I don’t think they’re as urgent as the ones above:

• bottle sterilizer
• breast pump
• cloth diaper system (sized diaper covers, fleece fabric as liners, hybrid cloth diapers)
• nasal aspirator
• medicine dropper/spoon

While these are hand-me-downs from my 3-yr. old nephew that we don’t have to buy anymore:

• baby bath tub
• crib/playpen
• stroller

Hospital Bag

A lot of moms advise to have the hospital bag ready as early as the 8th month. I started packing mine a week or two before I entered my 9th month. My OB said that in the hospital where I will give birth, baby normally stays in the room with the mother after she gives birth, provided that birth is via normal delivery and baby has no complications that will require him to be at the NICU. Unlike staying in the nursery where most baby’s stuff are provided for, room-in means we have to bring everything that my baby will need during our stay in the hospital.

So what are the items that went inside the hospital bag? Well, like what I said, we need pretty much everything on my list so I placed a few of each items:

• 3 long-sleeved shirts and 1 “borrowed” short-sleeved shirt (something about my mom’s superstition)
• 2 pairs of pajamas
• 1 frog suit (going-home outfit)
• 6 pairs of mittens
• 3 pairs of socks
• 2 bonnets
• 4 pcs of gauze cloth
• 4 hooded receiving blankets (2 plain and 2 towel fabric)
• 8 pcs of wash clothes
• 3 pcs of burp pads
• 1 set of comforter with bolster pillows (for use on the bed and in the car)
• 24 pcs newborn disposable diapers
• 1 changing rubber mat
• toiletries which includes baby powder, warming oil, baby wash, baby wipes, alcohol, cotton

I also placed and segregated baby’s clothes inside resealable plastics, to keep them clean and the bag organized. I brought more plastics so clean clothes won’t mingle with used and soiled ones.

Likewise, baby’s hospital bag contains other things that are equally important — the documents. Here’s what we’re bringing:

• Photocopy of marriage certificate
• CF1 and CF2 forms, MDR and ID from Philhealth (I think you can also secure CF1 and CF2 forms from the hospital)
• MAT2 form and ID from SSS
• My OB’s admitting orders
• Baby book and other pertinent medical records (such ultrasound and lab results, etc)
• Mock birth certificate (You know how some hospital personnel would mess up spellings and info, or how in the middle of a painful labor, a nurse would ask you to fill-out your baby’s birth certificate? One mom smartly suggested to prepare a mock birth certificate that you can just hand over to the nurse, to your husband or to whoever is tasked to get these information. You can even pattern it after your own birth certificate to make sure that all possible questions are covered. It’s also better to have it printed out than handwritten to ensure legibility and avoid wrong spellings.)