Holy crap, I'm pregnant.

Last Monday, I took a positive pregnancy test.  Today, at the OB/Gyn, they stuck a probity probe up in Lady Town and confirmed it.

There's a baby in there.

I think I need to change the name of my blog.  Being on dialysis is interesting, but being pregnant on dialysis makes for far better reading material.

So how does dialysis affect pregnancy, you ask.  Well, first off, a disclaimer.  If you are on dialysis and thinking about getting pregnant on purpose, don't do it.  The statistics vary somewhat, but most medical communities agree that dialysis patients are only 50% likely to have a healthy baby at the end of this.... And to get to that healthy baby, it is necessary to dialysis at least 20 hours a week.

I'm only 6 weeks pregnant, but I have already upped my dialysis regimen.  Instead of going MWF for 3.5 hours, I am going MTWFS, for 4 hours, nearly doubling my time spent on the machine.  I may end up increasing the time after lab work, if it shows that my pre-treatment BUN is still too high.  Despite the fact that this pregnancy was unplanned and unexpected, it is not unwanted.  We won't let mistakes in fertility happen again, so this is my one shot at a biological child.

I've adjusted my diet to focus heavily on fruits/veggies/and protein.  I used to cheat with Coke, despite the fact that it's a dialysis no-no.  I figured if it was just that one cheat, and I took my binders, it was no big deal.  I had tried before to give up those delicious cans of phosphorous and sugar, but was never able to go more than 8 days without.  I haven't had one since 6 Nov.  Turns out all I needed was the proper motivation.

Since vitamins for the general population would dialyze out, my doctor has doubled my dose of Nephplex, which when doubled is roughly equivalent to a prenatal vitamin.  I can't wait for all the hair and nail benefits.

All of my dialysis meds, Phoslo, Renvela, Toprol, Calcitriol, Epogen, Ferrlecit, have been approved by the OB, but are considered Class C drugs for pregnancy, meaning that there is not enough data to deem them harmful, but also not enough to give them a full green light.  The doctor seemed somewhat concerned, as he has never delivered a baby to a woman on this combination of drugs.  This worries me, but as I need them all, what can we do?  Hopefully as I dialyze more often, my need for the binders will go down, but we'll see.

I had also been concerned about the use of heparin in my treatments, but the OB assured me that heparin does not cross the placenta, and so poses no issue.

So far, the symptoms have been pretty standard.  I've been exhausted (it's hard to grow a person from scratch), a little nauseated without too much vomit, experiencing light cramps as if the area down there were stretching and preparing, and also breast tenderness.  According to What to Expect, all of those things are perfectly normal.

Because of my unique situation on dialysis, my outlook is somewhat different from that of a healthy woman.  Virtually ALL dialysis patients are hospitalized in the last month of the pregnancy.  Of the 50% of women who deliver a child, about 80% of those deliver way early, around 32 weeks.  The babies spend 1-2 months in the NICU.

This isn't how I would have chosen to do this.  I had planned to adopt a child who already exists and needs love, rather than taking all of these risks.  Now that it has happened though, I am going to do everything I can and focus on the best possible outcome.