The pregnant woman's business trip from hell (or at least heck)

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trillianastra

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The pregnant woman's business trip from hell (or at least heck)

Post by trillianastra » Mon Feb 1, 13:36 2016

Okay, this is a little bit ranty, but if I were to say what conversation I'm looking for, it would probably be (1) sympathy and (2) advice on managing a fairly intense career while pregnant.

For those who don't read the New Members thread that closely, I'm two-weeks-new to Spacefem, and 6 weeks pregnant. Last week, I went on a business trip across the country (INTO the heart of the area affected by Jonas). The trip was for a summit with the team I work with, a team spread across 7 offices on 3 continents (plus an island--those crazy Brits). 35 people converged on one location, to spend 9 hours a day in intensive meetings doing long-term strategy planning, technology design, and vision definition. And me? I was experiencing a litany of pregnancy symptoms that read like a list from What to Expect. The entire list. Fatigue, check. Dizziness, check. Nausea, soreness, cramping, check check check.

Then FIFTEEN MINUTES before I'm supposed to get up in front of the entire group on the first day of the summit, I visit the restroom, and discover that I'm spotting. Well, I had a chemical pregnancy (very early miscarriage) last month, so I immediately assume the same thing is happening. So, I get to stand up in front of everyone while I assume I'm just at the start of losing the baby and talk about our strategic plans to this large group like nothing is going wrong. Thank goodness, I had 24 hours of very light spotting, then nothing. But the symptoms continued for the rest of the week--dizziness that rendered me unable to lead sessions, fatigue that made attending the evening social events impossible, and emotional swings that left me blurting out stuff to people that I really, really shouldn't have said. I ended up informing four colleagues that I was pregnant, just because otherwise they were going to think I was off my rocker. I haven't even told my PARENTS that I'm pregnant yet.

I head up a pretty large group at a pretty large company--it's responsible for about 15-20% of our annual revenue. Expectations are high, and so is the stress.

How in the world do I get myself through the next 6-8 weeks (which includes our twice-yearly strategic planning sessions and a mandate from some execs to get three major planning/research projects done) with the kind of symptoms I'm experiencing? How did you do it? What are the pointers? I don't want to end up falling flat on my face at work (literally or figuratively), especially since I was just informed that I'm not getting promoted this year due to some perception issues at the executive level. So...if I create more perception issues at this point, I'm pretty much doomed.

Help? Sympathy? New job offers? *sigh* I'll take it all.

--trillianastra

antfancier
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Re: The pregnant woman's business trip from hell (or at least heck)

Post by antfancier » Tue Feb 2, 11:26 2016

Sorry I can't give you any advice, but I do have lots and lots of sympathy. I'm 32 weeks pregnant and just spent the last two weekends on a really intensive training course (which included taking certification exams! Eurrgh!) and am wiped out. I had to call in sick today because I couldn't take it physically or emotionally any more. All those first trimester symptoms came back again so I just gave up and stayed in bed today. I feel terrible about letting people down (co-workers and new students/clients who have just started their courses and had their teacher ditch them on the second day).

I guess the only thing you can do is maximize on the times when you're feeling good (or at least not totally shitty) and try to do as much work as possible then. It's tough when your own schedule relies heavily on other people because it's difficult to take time out, but at least if some of your colleagues know you're pregnant they might be able to cover for you sometimes or work around your particularly bad moments.

I really, really hope you feel better soon!

careme777

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Re: The pregnant woman's business trip from hell (or at least heck)

Post by careme777 » Tue Feb 2, 11:46 2016

Obviously, everyone experiences pregnancy a little differently, but I would encourage you to prioritize sleep over anything else. I remember early on I was absolutely bushed every single day by about two p.m. It was unlike any 2p.m. slump I've ever experienced, I could barely function I needed to sleep so badly. I was lucky enough to make my own schedule and have a home office, so I would schedule clients back to back in the morning, come home and crash for a few hours in the afternoon, and then get all my paper work done in the evening. If you can slip in a cat nap anywhere, I would suggest you do it. Can you nap during lunch breaks? Slip in 20 minutes of shut eye during your coffee break? Eat while you're working and get some sleep. And get to bed early early early. No TV in the evenings. Go to bed at 8 or 9 if you can.

Second tip is to eat constantly, and drink lots of extra water. Start packing granola bars and snacks in your purse and pockets. If you start getting "morning" sick (which might start soon, and which can last the whole day) many small snacks will keep the nausea at bay, and might help with the lightheadedness and feeling off.

It's hard to keep it quiet early on when you feel so off. I told many more people than I was expecting to because I felt so drastically different.

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Re: The pregnant woman's business trip from hell (or at least heck)

Post by missmay » Tue Feb 2, 17:31 2016

i've been luring around her my whole pregnancy and finally made an account so i could respond to this!
i'm 26 weeks along now myself. i have a pretty demanding job, i work more than full time between my first year of teaching college students plus per diem hours in health care. i can't have an "off" day at work, either, so I feel your pain with that. i also feel so private about the pregnancy, but that's just not an option really.

what i have found during pregnancy is that your body WILL get what it wants from you, whether or not it's convenient, and the longer you try to deny it, the sorrier you will be! I agree with the sleep and frequent snacks and hydration suggestions. These things do help. Get rid of anything extra you can to make room for taking care of yourself, and if you have a partner, explain to them that you need help right now, you are growing a person. some people just have really rough first trimesters - you need extra care, and there's no getting around it! for me in some ways i feel lucky because my midwife told me to start with the self-care before i got pregnant. i'm queer so i don't have easy access to sperm and was feeling frustrated by how long it took to get pregnant. my midwife told me that i would improve my odds with really careful self-care, not pushing myself to exhaustion so often, food, sleep, water, etc. i took her advice.

early pregnancy is so hard, it's invisible but takes an enormous toll on your body! but it prepares you for later pregnancy and then birth and then having a baby, in some ways. you will totally survive the whole thing, and in the process maybe your priorities shift. i'm not suggesting that you will care less about your job either because i definitely don't. on the other hand, maybe while you're out on maternity leave, you will find a new job that's a better fit for you. maybe there's a time consuming hobby you don't get to do for a few months. maybe your house is less clean. maybe there is some hidden inefficiency in your day that you can get rid of. for now the priority has to be taking care of your needs while you grow a whole person inside you.

i hope you feel better soon!

trillianastra

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Re: The pregnant woman's business trip from hell (or at least heck)

Post by trillianastra » Thu Feb 4, 9:59 2016

Thanks, everyone. I WISH I could prioritize sleep--I think that's one of the big problems I'm having. If I go to bed early, I just wake up earlier--sometimes as early as 4am. (I usually wake up at 6.) My husband is being super-helpful at home (over the past couple of weeks, he's been known to sneak in to the kitchen while I'm resting and get dinner almost completely finished even though I'm the primary cook). We have some pretty cool massage chairs in the office that I can use, so I may just start blocking a half hour meeting on my calendar around 2 every day to go hide in that conference room. I've been noticing that small snacks are making a difference too, so thanks for that idea.

It's good to know that others have had to take the "telling more people" route too. I felt so terrible that I was telling colleagues who I don't even really think of as friends before I told my parents, but I guess you do what you have to in order to make it through the day.

The past few days have been even MORE of a roller coaster. The NP at my OB/GYN office saw me for the first ultrasound on Monday, but we'd gotten betas done Saturday/Monday too, and she declared them insufficient and basically told me I was going to miscarry. She even acted surprised and a little dismayed when she saw a sac on the ultrasound and declared it to be measuring only 5 weeks, when I'm six weeks along (bad sign). Then, Wednesday, my numbers kept going up (my doubling time was ~82 hours, and my levels were well above 10,000), and she ordered a higher-res ultrasound to "rule out ectopic pregnancy."

The higher-res ultrasound not only revealed an embryo, it measured at 6 weeks, 5 days (when I was actually 6w2d), AND had a heartbeat! So I spent two days adjusting to the idea of miscarrying again, only to discover that I have a very viable pregnancy. (And a 4 cm uterine fibroid, which was screwing up the original ultrasound a little.) So now I kind of want to dangle that NP out the window for her pessimism (and she even admitted that for HCG levels over 6,000, a doubling time of up to 96 hours was normal, so why was she saying that a double time of 82 hour was a sign of a non-viable pregnancy?!?!)

My best friend used this doctor, and said that she's worth the slog through the initial appointment with the NP, but I think I need to talk to the doctor about the behavior of the NP.

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rowan
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Re: The pregnant woman's business trip from hell (or at least heck)

Post by rowan » Thu Feb 4, 11:54 2016

trillianastra wrote:My best friend used this doctor, and said that she's worth the slog through the initial appointment with the NP, but I think I need to talk to the doctor about the behavior of the NP.
Yes, absolutely! It's one thing to be realistic about chances, it's another to scare the fuck out of people. Glad to hear things are measuring well & you got a heartbeat!

(I don't have any advice on the original topic; I was unemployed during my pregnancy)
spacefem wrote:All your logical argue are belong to us!

lyra211

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Re: The pregnant woman's business trip from hell (or at least heck)

Post by lyra211 » Thu Feb 4, 13:12 2016

Yeah, that NP sounds like a nut. We had to rule out ectopic pregnancy for me this time around because I have some known tubal scarring (courtesy of a midwife who made some very bad medical decisions, including not treating an infection, after our daughter died in my first pregnancy), so they monitored things very closely from the start. From that experience I learned that most ectopic pregnancies never get above an hCG level of 1000, and if they do get to ~2000 or so, that's when you start to have dangerous symptoms and effects. So if she was waffling about slow doubling times at hcG levels in the thousands (which, you're right, are supposed to be slower anyway) and not instantaneously checking you for signs of ectopic pregnancy (which should have been blindingly obvious on ultrasound at that point), she was being awfully irresponsible!

trillianastra

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Re: The pregnant woman's business trip from hell (or at least heck)

Post by trillianastra » Fri Feb 5, 11:24 2016

Wow, lyra211, that's really interesting information. So it sounds like she wasn't just screwing up mildly--she may have actually been reacting medically inappropriately. I'm glad it's (so far) worked out fine, but I definitely need to talk to the doc about this. :mad: :bomb:

I guess it's somewhat common for more seasoned medical professionals to rely on the information they got in their initial training, but isn't that what continuing education is for? If the people on this thread understand all this stuff, she sure should have been able to as well. I hate relying on Google as a research tool, but when I can't trust what I'm hearing from the NP, what other choice do I have? My Mayo Clinic Guide to a Healthy Pregnancy doesn't go into THIS much detail!

And rowan, I love this:
Yes, absolutely! It's one thing to be realistic about chances, it's another to scare the fuck out of people.

lyra211

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Re: The pregnant woman's business trip from hell (or at least heck)

Post by lyra211 » Sat Feb 6, 11:09 2016

Yeah, I went back and checked some sources -- here's the table that I sort of remembered from when I was going through the ectopic scare:
http://www.advancedfertility.com/ectopic.htm
So, half of ectopic pregnancies never get above an hCG level of 1,000, and only 9% ever make it above 10,000. Needless to say, the ones that do keep rising to those very high levels tend to be the scary ones, since those are the ones that keep growing and can cause things like tubal ruptures.

I can't link to it because it's subscriber only, but Up To Date (which has reviews of the most recent medical studies) has the following to say about the hCG threshold of 2,000 (some practices use 1,500 instead) and diagnosis of ectopic pregnancy:
The diagnostic criteria depend upon the relationship to the hCG discriminatory zone (serum hCG level above which a gestational sac should be visualized by TVUS if an IUP is present). The hCG level of the discriminatory zone varies, but in most institutions it is 1500 to 2000 IU/L (see 'Discriminatory zone' above and 'Clinical protocol' above):

Below the discriminatory zone

If the serial hCG level does not rise appropriately across at least three measurements 48 to 72 hours apart and there is no evidence on TVUS that confirms an IUP, the pregnancy is considered abnormal. A presumptive diagnosis of ectopic pregnancy can be made and the patient may be treated. In selected cases, uterine curettage is performed to confirm the absence of an IUP (see 'Curettage' above).

If the serial serum hCG level is rising appropriately, the patient is followed until the hCG is above the discriminatory zone.

Above the discriminatory zone – The diagnosis is made based upon the absence of TVUS findings that diagnose an IUP OR findings at an extrauterine site that confirm an ectopic pregnancy. The presence of a gestational sac with a yolk sac or embryo is diagnostic of a pregnancy. The gestational sac is an early finding and is suggestive of, but does not fully confirm, an IUP (see 'Transvaginal ultrasound' above).
You were clearly WAY above the discriminatory zone, so she shouldn't have been trying to make a diagnosis based on your doubling times anyway -- she did at least do the right thing by ordering an ultrasound, and it sounds like your case may have been complicated by the presence of a fibroid, so there's that. But it's hard for me to understand why she was even bothering with hCG when you were six weeks along, once she knew your levels were well into the thousands -- my RE told me that by the time you hit a level of 2,000, the betas don't tell you much anymore and it's all about ultrasound at that point.

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