[Pregnancy Diary 美國懷孕週記] [W5-W6] 1st Prenatal Appointment (virtual)! Also spotting... 第一次產檢是視訊! 少量出血..

Hi hi! This post is mainly about our experience with our FIRST EVER prenatal appointment. Before we found out we were pregnant, I sort of wondered how a prenatal appointment would go since I've never had one! Aside from a few friends who just recently had a baby, I really have no one to ask and learn about what to expect from a prenatal appointment and pregnancy in general (other than reading up strangers' experiences 😄). Hoping what I share can be helpful for those who are like me - new to pregnancy and learning as we go in this time of the pandemic!

嗨嗨! 這篇主要是分享第一次產檢的經驗. 在發現懷孕之前, 我就有些好奇產檢大概會怎樣(畢竟從沒遇過!) 除了少數幾個朋友最近剛生過小孩, 身邊真的沒有幾個人可以請教關於產檢和親身懷孕的經驗(除了網路上看陌生人的分享). 希望這篇能帶給一些和我一樣 對產檢毫無經驗的人 且又是在疫情期間摸索的新手孕婦 一點幫助!

On April 19, Monday, we had our first prenatal appointment in our living room. The appointment was made a week ago over the phone, and we had it scheduled for 11:00am with a nurse from the OB/GYN team. We logged on KP website 15 minutes before the meeting and just chilled in front of the webcam (aka scrolling on our phones) until the nurse showed up. I kept thinking it didn't feel like a prenatal appointment because it was all virtual. We were wearing our pajamas and there were no scans, no tests involved since this was all done virtually at home!

四月19日那天是個星期一, 就是這天有了第 一次在自己家客廳產檢的經驗. 這天的產檢是一星期前電話裡預約好的, 預約的時間是早上11點. 替我"看診"的不是醫生, 是一位婦產科的護士. 我們在約好的時間15分鐘前就登入KP的網站, 然後視訊開著玩手機閒聊等護士出現. 那時一直覺得這很不像產檢, 因為整個是視訊. 我們當時穿著睡衣, 因為是在家視訊當然也沒有任何檢查!

Rachel, the nurse we saw, showed up a few minutes late and had some issues with the sound on her end. So she had to reconnect and when she came back again, it was fine, though we secretly thought maybe she wasn't feeling well herself because she kept squeezing/hard blinking her eyes very frequently. 

那天跟我們視訊的護士叫做Rachel, 她遲到了幾分鐘 而且她的電腦那邊好像音訊方面出了一些問題. 所以一開始還有等她重新連結重弄視訊, 這部分其實沒什麼, 只是我們私下覺得她好像那天人不太舒服 因為她一直不斷的眨眼睛. 

In the reminder email that we got days before the appointment, we were told to expect the meeting to go for about 45 minutes. The appointment actually lasted 55 minutes, probably because we asked so many questions! We prepared a long list of questions for her. Also planning on asking some of them again in the next appointment just to get another confirmation from another person. Although we bombarded Rachel with all kinds of questions, Rachel never once rushed us during the meeting, so that was good. I felt good about getting each question asked and didn't have to cut short to save time.

產檢前幾天收到的提醒有提到這個檢查大約45分鐘, 實際上從頭到尾共55分鐘, 大概因為我們準備了很多問題花了不少時間在問答上面. 在這個檢查前, 我們就準備了很多問題要問, 也打算有些問題在之後的檢查也會再問, 想看看不同的醫療人員的看法.

Once the "technical issues" were resolved, the official "first prenatal appointment" began! The meeting began with a few general questions about my social life, family history of certain health conditions, and whether or not I had a preference about giving birth at a hospital or elsewhere or if I had a special food diet, and then this prenatal appointment went on like a health education session. 

當那些"技術性問題"解決後, "第一次產檢"就正式開始了! 一開始先問了些關於我的社交生活跟家庭病史相關的問題, 以及我對生產地方的偏好(在醫院生或別的地方), 也問了我有沒有什麼特殊飲食習慣, 之後這個產檢就變得比較像是健教上課一樣.

Some of the questions were "Do you have families or friends nearby, locally, that can support you both physically and mentally throughout this pregnancy?" "Do you feel safe where you're living?" "Do you work?" "What type of work do you do?" "When was the first day of your last period?" "How many days did you typically have in each cycle?" "Do you have cats?"

我被問到的有些問題是 "當地有沒有家人或朋友在附近, 可以在孕期中給予身心方面的支持協助?" "在住家感不感到安全?" "現在在職嗎?" "工作屬性是怎麼樣的呢?" "最後一次月經來的第一天是什麼時候?" 每次週期大約多久?" "有養貓嗎?"

Some key items Rachel emphasized on...

• No more scooping cat litter! This is because pregnant women should avoid any chance of getting exposed to toxoplasmosis, which is parasite infection. While I'm positive our cats are healthy (they get routine checkups more frequently than their owners do), I was already avoiding it due to my own concerns about breathing any small amounts of tiny dust from cleaning the litter while TTC. Hence, it's mostly been hubby's job for a long time...and now we got an order from the nurse, so I'm going to avoid it even more haha.
• If I decide to take a bath or get into a hot tub (not recommended), soak for no more than 10 minutes. In my own reading about pregnancy, I learned that this is to avoid the pregnant woman's body from getting overheated (over 102 F) as that can be very dangerous for the baby, especially during the first trimester!
• Avoid papayas. Unriped papayas can cause uterine contractions which could be dangerous in pregnancy. Ripe papayas in normal consumption may be ok, but it's better to avoid papayas in general.
• Aim to eat 200 extra calories each day, and drink plenty of water throughout the day because baby-making takes a lot of energy (whether the mom can feel it or not)!
• In-person prenatal appointments at 28 Weeks checkup and for the remainder of the pregnancy
• NIPT doesn't screen for every single chromosomal abnormality, it mainly screens for 3 common ones.
• If a symptom worsens or something starts to bother, call KP instead of messaging KP because the message system can be slow.

幾樣Rachel強調的地方有...

• 再也別去挖貓砂! 這是為了避免任何因為清理貓砂而接觸到貓咪糞便裡的寄生蟲造成感染. 雖然我很確認我們的貓咪很健康(她們比主人還常定期看醫生做健檢), 我很早以前就在避免挖沙, 純粹是自己擔心吸進挖貓砂造成的小灰塵對備孕有不良影響. 所以其實已經很長時間幾乎都是老公去挖....只是現在有護士的下令, 我更不會去挖沙了 哈哈
• 若要泡澡或泡hot tub (不建議), 浸泡不要超過10分鐘. 我自己讀到的懷孕資訊提過這是避免孕婦的體溫過高, 孕婦體溫若超過102度F對胎兒可能造成危險, 尤其是第一孕期的時候!
• 避開木瓜. 未成熟的木瓜可以造成子宮內膜的收縮, 所以對於懷孕的人來說這不安全. 成熟的木瓜其實大致上還可以吃, 只是為了安全起見乾脆所有木瓜都避開比較好.
• 初期階段, 每天吃的比平常多200卡洛里就可以, 且多喝水補充水分 因為身體要製造一個胎兒是很耗體力的事 (不管孕婦本身有沒有感覺)!
• 第28週的產檢跟之後的產檢都會是面對面的檢查.
• NIPT不會檢查所有異常染色體, 大致上是偵測較常見的三種異變染色體.
• 若有症狀變嚴重 或有擔心的地方, 直接打電話給KP比網路系統傳訊息有效率的多.

Some of the things Rachel asked and we confirmed were

• Location to give birth. Hospital? Which KP hospital? Birthing center? At home (the recent pandemic has led more and more pregnant women to choose to have a baby at the comfort of their homes)? To be honest, I thought it was kinda too early to ask & decide on the spot for new soon-to-be parents, but we decided to give birth at a KP hospital near our home right then. We had already done our research on KP locations and their health plans in our area before choosing to go with their insurance, a whole year before trying to get pregnant, so location wasn't a brand new thing to think about for us, though I felt it could be overwhelming during the very first prenatal appointment for new expecting parents.
• If I would like to have NIPT (Non-invasive prenatal testing) to screen for certain chromosomal abnormalities. I said yes. I intended on asking about it if she hadn't, so to me it's good she mentioned this.
• If we would like to have a hospital birth tour. Of course I would love to! Though this is something that we'll schedule only probably in the 2nd trimester and would still need to see how the hospital guidelines will be by then about COVID precautions.
• If we would be interested in KP's Centering Pregnancy program which is a combination of private check-ups and a group learning experience with other expecting parents who have similar due dates. In my opinion, it's pretty much taking a group health class with other expecting couples. The group sessions are all held online due to COVID precautions. We said we're interested to try out a couple of sessions and decide from there if we want to stick with it throughout the pregnancy. The nurse said that's fine and we could opt-out anytime. Click me if you would like to read more about KP's Centering Pregnancy program.

有些Rachel特別問到 我們也確認的事項有

• 生產地點. 在醫院生? 哪一家KP醫院? 另外找生產中心? 在家生(因為疫情所以有越來越多孕婦選擇在家生的趨向)? 說實話, 我其實覺得這個部分有點太早問新手父母, 不過我們是當場就直接決定會在離家不遠 也在KP系統底下的一家醫院生. 在計畫懷孕一年前我們有先自己做功課查了KP的體制跟家附近的KP醫院, 所以這個對我們來說其實是很早就決定好的. 不過我是真的覺得第一次產檢就問決定要在哪裡生了沒感覺對第一次當父母的人來說或許有些措手不及了.
• 有沒有興趣做NIPT? 我回答我要做. 我本來就打算若她沒問 我也會主動提起要做NIPT, 所以她主動提到這個我是覺得滿好的.
• 有沒有想參觀醫院的產房. 當然我說我很有興趣! 不過這個要第二孕期才能去做預約 而且也要看到時候醫院針對疫情控管的制度來安排.
• 對KP的"Centering Pregnancy"有沒有興趣. 這是KP體制下的一種產檢"規劃" 除了有一般一對一的產檢之外, 也會跟一小群其他類似預產期的準父母們 一起上有關孕期和生產相關的課. 現在這些group sessions都已因為疫情關係改為網路互動. 我們的回答是 有興趣但目前只想試試一下再決定要不要一直參與到生產. Rachel也說沒關係, 之後不想參加隨時也可以退出. 若對KP的Centering Pregnancy有興趣可以點我去看官網解說.

Overall, I didn't enjoy the appointment much. While our nurse talked about a lot of information, such as what not to do while pregnant and what warning signs to look for, and she was patient with answering our questions, I felt everything was so books and guidelines. Also, I'd say about 95% of the time when she was talking, she was reading word by word from a pregnancy guide. At the beginning of the video chat, she had me open a pdf file (the same pregnancy guide she was reading) and asked me to follow along as she went on page-by-page. She didn't read every single page (thank goodness). She read about 15 pages of the booklet during our meeting and used the booklet to answer most of our questions. Whenever we asked a question, she'd say "this is what the guide recommends" and stopped there without giving any opinion or explanation. Her response was mostly something like "that's how it's done" - it's hard to describe the vibe I was getting, but to use simple words - it just felt cold. 

整體而言, 我並沒有很喜歡這的產檢. 雖然護士講了很多關於懷孕的資訊, 包含該注意的該避免的飲食等等, 而且每次問問題時也很有耐心地回答, 但我覺得整個過程很"教科書"的感覺. 而且, 幾乎每次她開口說話, 大概95%左右, 她都是邊看著一本KP的像是孕婦手冊的pdf照念. 從視訊的一開始, 她就指示我打開一個pdf檔案 (期間她一字一字照唸的同一本), 要我頁頁跟著她唸到哪我就跟著讀到哪. 她沒有整本念完(還好沒有!). 她大概讀了其中的15頁然後任何我們問的問題都用這本來回答. 每次我們問問題時, 她就會說"手冊建議的是這樣"然後就停住, 也沒有給她個人的見解或者一些解釋. 大部分時間她的回答就是"就是這樣做" - 在這個產檢過程中, 讓我有種很難形容的感覺, 只用幾個字來形容的話就是 感覺很冷清.

One of the questions Rachel asked was if we wanted to know the gender of the baby once the NIPT results come in (around Week 12-13). We told her we'd like to keep it a surprise until a little more down the road! She emphasized that once we decide to keep it a surprise, we won't be able to find out even if we change our minds later. So W asked her what about during other check-up visits, like when there's an ultrasound scan, could we ask about gender by then if we decide to? We knew there's an anatomy scan on Week 20 and that would be an opportunity to reveal gender if we want to by then. Rachel's response was... "once you decline to know the gender before you get NIPT, then they won't include it in the results" and blinked like 4,5 times in a row. At that moment I was thinking...."uh...did you hear his question...?" and she repeated it again when W further explained what he meant. So, I told Rachel my grand scheme of keeping the gender a surprise until we're ready to be surprised by a baker 😁. Yes, you read that right. I love the idea of a gender reveal cake! I don't even love eating cakes but I wanna do this (W can finish all of the cake by himself!)! A gender reveal cake is a cake that tells you whether you're having a boy or a girl. It's not uncommon to hear about it in the states. For those who have not heard of it before, it's basically having a doctor write down the gender of the baby and seal the note inside an envelope. The envelope will be opened ONLY by a baker (or whoever you hire for doing this) and a cake will be decorated accordingly to reveal the gender! Rachel wasn't sure how we could do it. She said "I know some couples like to do that, but I don't know how they do it" and went on again about if we decline to know about gender before we get NIPT, then we just won't know it. I don't know why she didn't think we could still find out the gender before delivery, but I came up with a solution....I said we can just bring an envelope with us to Week 20's ultrasound appointment and ask the sonographer to write down the gender on a sticky, put it inside the envelope, and seal it for us. Rachel said "oh there you go." I was like "whew, ok, we got a solution!"  Many expecting women are worried about a million different things during their first appointment, and there I was working on a solution about keeping the gender a secret until whenever we decide to reveal 😂 

Rachel有問到我們在NIPT檢查時, 想不想事先知道性別 (最快檢查報告大概會在12-13週左右出來). 我們的回答是 我們想保持成一個驚喜到之後的孕期! 她強調一旦我們決定要保持為驚喜, 我們之後想改變主意也沒辦法知道性別. 所以接著W就問她 NIPT之後不是還有高層次超音波檢查嗎? 那時候應該可以照得出性別? 我們之前讀到的資訊都有提到20週左右會有一個高層次超音波, 也知道那時候會做比較精密的檢查也看得出性別.  Rachel的回答..."當你拒絕透過NIPT得知性別, 他們就不會在報告書上提性別," 然後連眨了好幾下眼睛. 那時候我的想法是"痾...你到底有沒有聽到他問什麼?" 當W重新解釋他的問題後, 她重複了同樣的回答. 所以, 我就直接形容了我想的大計畫 - 先不要知道性別, 保持驚喜一直到烘培師傅的揭曉😁. 沒錯, 你沒讀錯. 我超愛這個寶寶性別開箱計畫! 我根本不愛吃蛋糕但我想弄個蛋糕開箱(蛋糕老公吃光就好了)! 蛋糕開箱其實就是打開蛋糕盒子時, 透過蛋糕來得知懷的是男生還是女生. 這個在美國並不少見. 基本上就是讓醫生在一張紙上寫下寶寶的性別, 然後放進一個信封裡馬上密封起來, 只有烘培師蛋糕師(其實什麼師都可以)可以打開. 然後蛋糕會依據性別來被裝飾! Rachel不確定我們怎樣可以這樣搞. 她說"我知道有些人想這樣玩, 但不知道他們都怎麼辦到的"然後又再次強調 我們如果在做NIPT檢查前拒絕知道性別的話, 那我們就是不會知道. 我不懂她為什麼覺得在生之前我們就是沒機會再知道性別, 但我直接說出了我想到的方式.....我說 我們可以自己準備信封, 在20週高層次超音波時交給技師, 請人家當時把性別寫在一張便條紙然後放進信封裡封印住就好了. Rachel接著說 "喔 這樣就可以唷." 那時候我整個就是 "呼, 有個解決方案了." 許多孕婦在第一次產檢都很多擔心的事, 而我就在那想著怎麼隱瞞性別到之後想公開的時候😂

After the appointment was finished, W asked how I felt. I told him it didn't feel like a prenatal appointment at all because there was no test to confirm a pregnancy or check on progress. It felt more like a consultation session. Also, I really didn't like it much because I already knew most of the information mentioned throughout the whole session, thanks to the vast amount of information available on the internet. Having been in the research field for many years, I'm aware of how to look up information and how to distinguish between credible sources and opinions. I know it's better to still have some information provided by the provider just in case a new mom misses something, so an appointment of throwing out information is still something I can appreciate of. Nonetheless, it seems redundant to read a booklet with a nurse for a good chunk of the hour - a bit like a waste of time. I would've appreciated it more if we rather used that time to get a blood test or go over more on genetic screening in detail. 

產檢結束後, W問我覺得如何. 我回他 完全不像產檢 因為沒有做任何檢查來確認懷孕或狀態. 比較像是一個諮詢療程. 還有, 真的沒有很喜歡這個"產檢," 因為整個過程大部分提到的資訊都是我原本已經知道的(這是多虧資訊超發達的網路阿). 在研究領域打滾許久, 也清楚怎麼分別可信任的資訊. 我明白有提供這些資料還是好的 總比新手孕婦不小心漏了什麼重要資訊好, 所以對於一個即使是狂丟資訊的產檢我還是覺得感恩. 不過我是覺得整個看診時間大部分時間用在"護士一起陪讀孕婦手冊"滿浪費時間的. 我覺得若是能把那個時間用在抽血檢查或多討論一些基因測檢的資料會更好.

Below are some of the questions we asked during the meeting. Answers from the nurse are in blue.

• Can I bring a support person (aka husband) with me to each of the in-person meetings? (due to COVID, different healthcare providers in different states have different guidelines, some don't allow prenatal visits to be accompanied by anyone including family members and partners, some had to give birth alone)  The answer is Yes.
• When is the best time to travel while pregnant? Usually, the second trimester is when many people travel while pregnant. Many people do it. I don't see a problem with this unless your ob has concerns.
• Is it safe to take a dip into a hot spring? (I was referring to our trip to Iceland) As long as the water isn't too hot and you don't stay in it for too long. No more than 10 minutes is what the guideline recommends.
• How much tea can I have each day? (the nurse had just talked about the recommendation is no more than 200mg of caffeine per day) The guideline says no more than 200mg. So maybe no more than a glass? Different tea has a different amount of caffeine, you'll just have to calculate them and watch for how much you drink.

下面是一些我與W主動問的問題. 護士的回答用藍色表示

• 每個面對面的產檢, 我可以帶一位support person(就是老公)一起去嗎? (因為疫情關係 各州各醫療機構應變方式不同 有很多地方不讓孕婦帶任何人陪同做產檢 甚至生產也只能一個人 家人配偶都不能陪同). 答案是 可以
• 什麼時候最適合孕婦旅行? 通常許多人選擇在第二孕期的時候出去旅行. 很多人在懷孕時旅行, 我不覺得會有甚麼問題, 除非婦產科醫生有特別提醒什麼.
• 泡溫泉安全嗎? (當時我有提到我們預計要在夏天去冰島) 只要溫度不過高(手冊建議不超過100F度) 請不要待在水裡太久. 孕婦手冊提到的是每次泡不要超過10分鐘.

The following is a list of this week's symptoms and some thoughts that have been floating around in my head.

4/19 Monday: woke up feeling bloated and immediately noticed sore nipples, some cold-like symptoms like feeling tired, stuffy nose, and overall soreness. Sinus headache for the first time in years! There was pain between my eyebrows and discomfort somewhere deep under the bridge of my nose when I woke up. If I lean forward and touch my cheeks, my cheeks & nose hurt. If I don't lean forward, touching my cheeks doesn't cause much discomfort. Had the virtual prenatal appointment in the morning. Took a long nap in the afternoon (like a 5-hour nap!!!) I wasn't even feeling that tired so I didn't set an alarm, little did I know I'd pass out for hours!

4/20 Tuesday: bloated, mild cramping a few times like a period cramp, disrupted sleep due to sore back/hip/abdominal area, frequent pee-pee. Sinus headache was gone in the morning, but back in the afternoon. Stuffy nose is still here but feels slightly better than yesterday. I started doing kegel today (KP pregnancy guide recommends pregnant women to practice Kegel exercise daily as soon as finding out about being pregnant to help strengthen pelvic floor muscles and this can help the body prepare for delivery and recovery afterward). First time doing kegel and at first, it was a bit confusing to where & how to use a specific muscle and whether I was doing it right or not. Mayo Clinic's suggestion on "imagine you are sitting on a marble and tighten your pelvic muscles as if you're lifting the marble" was not helpful as I couldn't imagine lifting any imaginary marble with my pelvic muscles. Like how...? WebMD's instruction helped me to find my pelvic floor muscles, and theirs was just "pretend you're trying to stop the flow of pee." This did the trick! I did 3 reps while lying on the bed, each rep with 10 counts of 8 seconds hold with 8 seconds apart from each "squeeze." (For information on why kegel exercises matter, you can click here to see what Mayo Clinic says. Men can also benefit from kegel exercises.

4/21 Wednesday: sore nipples, bloated, acne (nooooo 😣), woke up feeling fatigued and tired. The stuffy nose is just like yesterday...and almost feels like I'm going to get a cold. Sinus headache is very mild today. Did 1 set of kegel.

4/22 Thursday: Sore nipples. Mah boobs feel like someone hit them last night! The stuffy nose is mostly gone (or I got used to it...). Mild cramping in the early morning. Did 3 reps of kegel exercises between noon and late afternoon. Didn't feel so bloated this morning which was a nice change! Noticed mild soreness around the pelvic floor around 3:30pm. I was just getting up from the floor and felt the unfamiliar soreness down there. I think it's from doing those kegel exercises? I took doggo and catto out for a walk this afternoon. It was nice to be out in the sun with them (super sunny day)! I only walked them for about 25 minutes and they both got knocked out already. One lied in the stroller and another lied on the carpet within 3 minutes of getting back inside the house. 

4/23 Friday: sore nipples continue...tiredness too didn't fade one bit. Disrupted sleep. Hard to fall asleep and hard to stay asleep. No sinus headache today. I like it when my eyebrows, nose, and face don't hurt 😎.

4/24 Saturday: Frequent urination, sore boobs. Still no more sinus headache. Mild stuffy nose all day still. However, today is the first time I really feel worried about this pregnancy. We were playing a computer game together and I felt like using the bathroom so I went. This was when I noticed pink spotting at around 9pm while wiping after using the bathroom (nothing on the undie). I kept telling myself pink spotting can be normal in early pregnancy. Don't stress about it, I told myself as I stood in the bathroom. Then the next time I wiped after using the bathroom, I saw dark red streaks on the tissue. I didn't feel any severe type of cramp whatsoever. I had felt some mild cramps leading up to this day but nothing that was truly painful. We did the deed that morning and I was really thinking maybe that caused light bleeding? We called KP's early pregnancy hotline and I was quickly connected to a nurse who connected me to another nurse named Amanda from the ob team. Amanda quickly introduced herself and told me she had my chart in front of her, then asked how I was doing? After about 5 minutes of reporting what I saw and answering some questions (about pregnancy symptoms), Amanda told me it's most likely nothing to worry about. She said 1 in 4 pregnancies experiences some spotting and most times pregnant women who experience spotting end up delivering healthy babies. She also reinstated that pink and brown spotting are generally normal in early pregnancies. She sounded very caring and had a very gentle, soothing voice. She really helped me feel a bit calmer. She also asked me if I had done any work (scans, bloodworks) and I said no. She asked if I had been seen by an ob yet (I wondered why she couldn't see that on my file since she said she had my chart with her). I told her I have an appointment scheduled with my ob but that's gonna be a virtual one and it's in June. Amanda quickly said, "the covid thing has really changed many things here, that must be frustrating and I'm sorry you're experiencing this." In a way, I was so relieved to hear that because someone actually acknowledged that not having a scan or any work and having to wait for weeks, on top of noticing spotting, can be nerve-racking.  She then told me she had a few options for me. Option 1 was she could order blood tests for me on Sunday (next morning) and schedule me with a primary care provider for Monday or Tuesday, and the doctor will discuss my results and do a scan to make sure it's not ectopic. Option 2 was she could still order blood tests for the next day, and the results will be sent to an ob team who work with pregnant women with early spotting and/or bleeding. Someone from the ob team would see the results on Monday and contact me then schedule for an in-person visit later in the week to check on me. The procedures would be the same, it's just a difference of whether I wanted to be seen by an ob or not. I told her I prefer option 2, so this is what we'll do. 

4/25 Sunday: We went to Beaverton Medical this morning to do my blood tests. Two tests so two vials. My hcg result came back within just an hour (KP.org notified me it was ready and I could log on to see the results). HCG: 2455. I'm trying to stay positive. W says he's not worried because the number looks to be in the normal range for 6 weeks. I'm worried because it's more on the lower end of "normal," plus we saw spotting last night. My second blood test result came back about 5 hours later with the info I already knew: I'm O positive. It's been a long day. I'll probably write a post about this day later. Symptoms: nipple soreness, acne on chin, frequent trips to the bathroom, and fatigue in the afternoon. I didn't notice any spotting during the first three bathroom trips this morning. Throughout the day, I looked carefully at the tissue and wiped several times before and after using the bathroom. However, I saw a tiny bit (like 2 drops) of brown blood on the tissue around noon. I know brown blood means it's old blood, so I tell myself that's a good sign because it's not new blood. W also thinks it's a good sign. Our thinking is that since the color is not vibrant red, and that it's actually dark brown, meaning it's likely the spot that bled has stopped bleeding already. I haven't seen any spotting after the brown spotting around noon. It's almost midnight on Sunday.

以下是本週的症狀和心情筆記:

4/19 星期一: 起床就感到脹肚, 奶頭痠痛, 有點像感冒的感覺, 感到累, 鼻塞, 全身痠痛. 多年來沒感受到的sinus headache今天竟然來了! 就是感覺鼻樑跟眉毛的深處會悶痛. 身體往前然後碰臉的話會感到兩頰靠近鼻子的地方也會有悶痛. 若身體不往前, 雙手捧著臉頰 就沒有不舒服的感覺. 早上在家視訊產檢. 下午睡了一下, 竟然一次就睡了5小時的午覺!! 我沒有感到 那麼累 所以也沒設鬧鐘, 沒想到竟然昏睡了那麼久! 

4/20 星期二: 脹肚, 有幾次像經痛的酸痛感, 睡不好 因為腰酸背痛屁股痛, 常常尿尿. Sinus headache早上起床時沒了, 但是下午它又回來了. 鼻塞有比昨天好一點了 但還是在. 今天開始做Kegel運動 (KP孕婦手冊建議孕婦從發現懷孕第一天就開始天天做這個來增強骨盆腔肌肉, 可以幫助之後的生產及有助之後恢復). 這是我第一次嘗試Kegel, 一開始還有些不確定到底自己有沒有用對肌肉. Mayo Clinic的解釋是 想像坐在小玻璃球上然後用你的骨盆腔肌肉夾緊彷彿要把它給夾起來. 老娘無法想像用骨盆肌夾起玻璃球. WebMD的解說比較有幫助! WebMD說 想像尿尿到一半止住尿. 喔 這個我懂! 今天躺在床上做了3組的Kegel, 每組都一次十下, 每一下"夾著8秒" 每下中間間隔8秒. (更多關於Kegel運動的資訊, 可以點我來看看Mayo Clinic怎麼說. Kegel不是只有女生才適合做, 男生也是可以利用kegel來改善一些生理狀況) 

4/21 星期三: 乳頭痠痛, 脹肚, 長痘痘 (喔不~~~~😣). 起床就覺得今天身體特別虛, 睡醒就是感到累. 鼻塞依舊存在 就是一種感覺像要感冒了. 做了1組的kegel. 

4/22 星期四: 乳頭痠痛. 胸部感覺像是昨晚被人揍過! 鼻塞幾乎像要沒了(還是我是習慣了...). 早上有輕微的像經痛的感覺. 中午到傍晚之間做了3組kegel. 今天早上沒有感到那麼脹氣. 下午3:30左右 有感到骨盆腔那邊酸酸的. 我本來是坐在地上 正要從地上站起來突然骨盆腔那邊感到一股以前沒感受到過的酸痛感. 我猜是因為這幾天在做kegel的關係?  今天下午帶著貓貓狗狗出去散步. 在太陽下跟他們一起出去走走的感覺很棒! 我一個人帶著他們在大太陽下只走了大概25分, 他們兩隻就累爆了. 一隻在推車裡直接睡著, 另一隻回到家不到3分鐘就在地毯上攤了. 

4/23 星期五: 乳頭痠痛沒停過. 身體還是覺得累累的. 睡的很不好. 很難入睡, 也很難維持睡著. 不過今天沒有sinus headache. 眉毛鼻子臉不痛的感覺真好😎

4/24 星期六: 常尿尿, 胸部痠痛, 不過sinus headache今天也沒有. 一整天還是有輕微的鼻塞. 但是, 今天是我第一次對懷孕感到擔心. 我們這天跟朋友們一起連線玩電腦遊戲, 中途我覺得想尿尿, 於是就去廁所. 這時候大概是晚上9點, 上完廁所後用衛生紙擦拭的時候一擦發現粉紅色一片(內褲上都沒有). 我告訴自己 剛懷孕時有少量粉紅色的出血也可以是正常懷孕情況會發生的. 站在廁所 我跟自己說 不要自己嚇自己. 之後的 下一次上完廁所用衛生紙擦的時候, 衛生紙上有深紅色血絲. 我並未感到任何劇痛. 幾天前有持續時不時有些像經痛的悶痛, 但沒有真的月經來的痛那麼痛. 那天早上我們有性行為, 所以我有在猜可能是這個原因導致輕微出血? 我們當晚打電話給KP的早孕專線, 很快地有個護士接電話然後幫我轉給婦產科的一位叫Amanda的護士. Amanda很迅速地自我介紹之後, 說她手上有我的資料, 問我身體覺得怎麼樣? 我馬上跟她形容看到的血量, 回答了她一些問題 (都是關於懷孕遇到的症狀), 大約五分鐘後, Amanda說這個狀況應該是不需要擔心的. Amanda說1/4的機率懷孕的女生都會遇到出血, 而其中大多數的人都生出健康的嬰兒. 她也強調粉紅色和咖啡色的分泌物在剛懷孕時屬於正常現象. 她的聲音聽起來非常溫和, 有真的讓我心安一些. Amanda問我有沒有做過檢查了 (抽血, 照超音波)? 我回她沒有. 她接著問我有給ob看過了嗎 (那時我有點好奇不是說有我的資料 怎麼沒看到我只有給護士視訊看過一次). 我回答她 我有跟ob預約 但是被排到6月而且還會是視訊. Amanda馬上說 "疫情改變了很多程序, 你一定感到很焦慮, 很抱歉你遇到這種狀況." 聽到她這樣講, 我真的感到一種解脫, 因為有人終於理解了那種 初懷孕沒被安排任何檢查 必須等好幾個禮拜到面診 加上已經發生出血的狀況 的緊張感. 接著她告訴我 她有兩個選擇可以給我選. 選項1是她可以馬上幫我約隔天做抽血檢查, 也幫我約星期一或星期二跟一個primary care的醫生 (等於不是婦產科醫生) 做些基本檢查來排除子宮外孕的可能. 選項2是她依舊幫我約隔天做抽血檢查, 然後報告會在星期一或星期二交給婦產科的一個專門幫助有出血症狀的孕婦的團隊, 由那邊的人再連絡我預約一星期內的產檢來看有沒有什麼需要注意的. 無論是哪種選項, 檢查項目都是一樣的, 差別就只是我想不想只給專門婦產科的醫生看. 我跟她說 我偏向選項2. 於是我們就這樣安排了. 

4/25 星期日: 今天一早我們去了Beaverton Medical做抽血. 兩個檢查所以抽了兩小管的血. 我的hcg數值不到一小時內就報告出來了(KP網站馬上通知報告出來 自己上網看的到結果). Hcg數值是: 2455. 我正在試著保持正面的心態. W說他不擔心, 因為數值在6週的平均範圍裡. 我對這數值感到擔心因為這是偏低的數字, 加上前一晚才發生見血的狀況. 第二個抽血報告則是大概5小時候出來, 不過這報告裡的資訊我早就知道: 我是O型血型, O +. 今天做了不少事 去了很多地方. 也許晚點我會另外寫一篇分享有關這天的事. 今天的症狀有: 奶頭痠痛, 下巴長了痘痘, 常尿尿 (中間沒喝任何液體也能尿), 跟下午感到特別累. 今天早上起床後的三次上廁所都沒看到血絲. 一整天下來我每次上廁所前後都很仔細的觀察衛生紙. 今天中午的時候衛生紙上有看到一點點的咖啡色的血跡 (大概就兩滴的程度). 我曉得咖啡色代表是舊的血, 所以我告訴自己這是好徵兆. W也覺得是好的跡象, 我們的推測是因為不是鮮紅色的血, 而既然咖啡色既然是舊的血排出來, 表示出血位子應該止住血了. 從中午那次之後就沒有看到新的血跡. 現在是星期天晚上快12點. 

Lastly, as a reminder, everything shared here is just my personal experience and my personal opinion. When in doubt, make sure to consult with your provider and listen to your body cues :)!

How was your first prenatal visit? How far along were you when you had your first visit? Have you been asked some questions you haven't thought much about yet? 

最後, 提醒大家這邊分享的都是個人經驗和個人看法. 若你有任何疑問, 記得要跟醫生溝通跟注意自己身體的反應!

你的第一次產檢經驗怎麼樣呢? 當時你是懷孕幾週了? 有沒有被問到一些之前還沒想過的問題? 

💗CM