We went in for my 24 week appointment yesterday, and had a really good discussion with my doctor about what is to come, and where to go with my treatment from here. With my doctor in complete agreement we made the decision to forgo the PUBS testing at 32 weeks (PUBS is a test much like an amniocentesis, except instead of taking amniotic fluid, they actually puncture the umbilical cord and take a sample of the babies blood supply). The test itself is just so risky to Maddox, and while there are benefits to it (like finding out exactly how effective my treatment has been, and providing opportunity to transfuse the baby with more platelets if needed) we all seemed to agree that the risks are greater. This is all a game of "which is riskier," and this was just the first of several tough calls we will have to make during the last phase of this pregnancy. Ultimately skipping the PUBS eliminates any possibility that this will be a vaginal deliver, it's just too risky without knowing the babies counts.
So, because we have no real way of knowing how effective my treatment is at this level without the PUBS, we have to assume that it isn't being as effective as it should, and increase it in one way or the other. In two weeks I will begin what is called "salvage therapy" which at this point means adding prednisone to my daily regimen. Prednisone is a steroid, which I'm not gonna lie scares me. I knew it was something I was most likely going to have to take towards the end of pregnancy, but I didn't expect to be taking it for three months. I'm nervous about what type (if any) side effects I will experience, worried about developing gestational diabetes as a result of it, just plane worried! I've been pretty balanced and steady for the most part during all of this (with the exception of a few little meltdowns to my mommy), but for some reason this decision has sort of knocked me off kilter a bit. I will regain my balance, what else can I do? As my mom said, I'm in the middle of it now, it's not like I could turn back or call a time out!
In the mean time, here are a few pictures from our last ultrasound. Maddox is healthy and perfect, no hemorrhaging or abnormalities. He's active as can be and best of all doesn't appear to be oversized like Jax was by this point!