All done

Claire loves to be "all DONE!" with things. I never thought about how many times you say "all done" over the course of the day, until I had a two-year-old to parrot it. After every meal, every cup of water, "all DONE!" Diaper changes are "all DONE!", getting dressed is "all DONE!", putting anything away or closing a door is "all DONE!".

Well, today it's my turn. I am "all DONE!".

Other than the lung stuff, I'm pretty much okay. Oh, sure, I'm tired of the heartburn, and getting generally impatient to meet the baby, but I'm not otherwise physically miserable. I'm pretty small still, only measuring about 34 weeks, so it's not like I'm hauling around 12 lbs of baby like last time. I've had zero swelling, and I haven't outgrown all my maternity clothes. I'm sleeping fine at night, and my hips don't hurt except when the baby occasionally twists himself into weird positions. I still enjoy feeling him kick and wriggle. The random bouts of contractions are tiresome, but I don't have a problem toughing those out for ten more days.

I'm all recovered from the cold, too, except that someone forgot to send the memo to my lungs. I'm basically done with the cough and the snot and the sinus stuff, but it's been more than a week since I had even 70% of normal lung capacity. I'm hovering around the 60% mark most of the time, and while albuterol opens me up a little bit, it's short-lived, and wears off well before I'm supposed to take my next hit. I still feel tight all the time, get winded walking into the kitchen, can't get out a full sentence without needing to take a breath. It's the asthma exacerbation which won't end.

If I weren't pregnant, this would have been fixed a week ago with a round of steroids. That's how I got diagnosed with asthma in the first place -- I went to the pulmonologist to find out why my colds lasted for three weeks and required steroids to clear up. After the disaster last October, the plan was that we'd start with the steroids sooner rather than later, once my peak flows started going downhill. For a wonder, and probably because of the pregnancy, I didn't catch any kind of upper-respiratory infection last winter/spring, so we never had occasion to try it.

I understand where Dr. Pro is coming from with avoiding steroids. When you take oral steroids, it can suppress your body's ability to produce its own hormones. If you've been on steroids recently and have any kind of major physical stress happen, you can go into a full-blown adrenal crisis if you don't get extra doses of steroids. Since childbirth and major abdominal surgery definitely count as major physical stress, it's sensible to avoid them if at all possible in a patient who could deliver literally any day.

But you know what? I like to breathe properly, and would very much appreciate the chance to do so again. I don't feel like we've got this under control, and I feel like I could easily over the edge into being in bad trouble. It's pretty clear to me that I am not improving, and past history suggests I won't for at least several more days. So, if I can't get better without steroids, and I can't have steroids because I'm pregnant, well, I've got a brilliant idea.

I will be 38 weeks tomorrow by LMP. The dating is iron-clad, and I even have the extra edge of having had steroid shots during all the PTL fun. However, at 38 weeks, the risk of transient lung issues is still a little bit higher, given that I'm having a repeat c-section. If it were just a matter of being tired of being pregnant, yes, we would probably do better to wait another week. But when you put the baby's theoretical lung issues up against my actual ones, I am thinking that maybe the picture changes a little bit.

I see the OB this afternoon, and the pulmonologist after that. We're going to talk about steroids again, and if everyone feels that those are off the table, I'm going to ask if delivering the baby is an option. I don't know that it will be -- there are anesthesia considerations too, if the spinal fails and I have to have general, so we'll see what all the doctors say. But I'll tell you, I am "all DONE!", and ready to bring this nightmare of a pregnancy to a close.