Baby Dotzour: Week 39 Update

9.jpgJune 20.  I cannot believe that Baby D’s due date is just seven days from now!
Bryan and I celebrated our 6th anniversary on Sunday, which was a lot of fun.  We went to a hot and sunny Mallards baseball game here in town.  I had a good time at my 10th high school reunion on Saturday night.  Anne came over and painted a sunflower on my enormous belly.  Baby has been growing ever bigger, and with hot weather in the forecast this week, I imagine I’ll be ready to deliver whenever he wants to join us.  Bryan is beside himself with anticipation about meeting him, and each day we’re getting closer to seeing his little feet instead of feeling them push out of my side:)  My next (and last scheduled) doctor’s appointment is on Wednesday.

Babycenter.com Update

How your baby’s growing: Your baby’s ready to greet the world!
He continues to build a layer of fat to help control his body temperature after birth, but it’s likely he already measures about 20 inches and weighs a bit over 7 pounds. (Boys tend to be slightly heavier than girls.) Your baby’s organs are fully developed and in place, and the outer layers of skin are sloughing off as new skin forms underneath.

How your life’s changing:
At each visit, your midwife or doctor will do an abdominal exam to check your baby’s growth and position. She might also do an internal exam to see whether you’ve started effacing (when the cervix thins out) or dilating (when the cervix opens). If the week passes and your baby stays put, don’t panic. Only 5 percent of babies are born on their scheduled due date. And your baby can’t make you wait indefinitely for his arrival. If you go past your due date, your provider will schedule you for fetal testing (usually a sonogram) after 40 weeks to ensure that it’s safe to continue the pregnancy. If you don’t go into labor on
your own, most practitioners will induce labor when you’re between one and two weeks overdue.

Pregnant women on television sitcoms always have their water break dramatically — in the middle of a crowded room, of course — just before going into labor.
Don’t worry about a similar scenario happening to you. Membranes rupture before the beginning of labor in less than 15 percent of pregnancies, and it’s not normally an enormous gush — usually a small gush or a slow leak. In any case, if your water does break (or you even suspect you might have a leak), call your doctor or midwife right away, but stay calm — it may be hours before your first contraction.

We’ve identified a treatment strategy

On Friday, June 17, we met with Mom’s oncologist, Dr. Diggs, to talk about treatment options for dealing with her cancer.  We came to the meeting having done a lot of research and full of questions about which treatment would be most appropriate for the stage and type of cancer Mom is facing.  Dr. Diggs spent quite a while talking with us, and by the end of the meeting, we decided to go with the clinical trial: Gemcitabine and Radiotherapy Versus Gemcitabine, Fluorouracil, and Cisplatin Followed By Radiotherapy and Fluorouracil in Patients With Locally Advanced, Potentially Resectable Adenocarcinoma of the Pancreas
Early the week of June 20, Mom will be placed in one of the two treatment arms.  She’ll get a chemo port placed in her upper chest, and may be starting her treatment by Friday.

The data manager for the clinical trial is Lisa Peronto.  She met with us after Dr. Diggs, and we liked her a lot.  I think she’ll help us navigate all the doctors and appointments and details of Mom’s treatment, and it’s good to know we’ll have someone looking out for her and helping us by serving as a clearinghouse for our treatment questions.

She’s planning to set up an appointment mid-week to have a catheter placed in Mom’s upper chest for chemo treatments and blood drawings.  It should be a day surgery.  For more info on this type of catheter, see this website.
Dr. Gibson (her surgeon) would normally be the one to do this procedure, but as he is out for the next couple weeks, Lisa was going to identify a different surgeon on his team to place the catheter.  While I know she’s not looking forward to the procedure, the catheter will keep the doctors from having to poke her for blood draws or chemo drugs during her treatment.

Sometime this week, they will also assign Mom to one of the two arms of the study.  There isn’t a clear “better” arm to be assigned to.
Here’s how the study looks:
Arm A (standard therapy arm)

  • Gemcitabine and radiation therapy once a week for six weeks
  • Four to six weeks of no therapy
  • CT scans to see if the tumor is resectable and if so, surgery (if it’s not operable, potentially go back to the Gemcitabine and radiation therapy again.)
  • After surgery, four to six weeks of recovery
  • Gemcitabine once a week for two weeks followed by one week of rest.  Repeat five times.

Arm B (the experimental arm)

  • Three weeks of no chemotherapy
  • Radiation therapy and 5-FU for six weeks
  • Four to six weeks of no therapy
  • CT scans to see if the tumor is resectable and if so, surgery (if it’s not operable, potentially go back to the chemotherapy followed by radiation).
  • After surgery, four to six weeks recovery
  • Gemcitabine once a week for two weeks followed by one week of rest.  Repeat three times.

Once we know which arm of the study Mom is assigned to, I’ll write up a calendar with her expected treatment schedule.  The radiation therapy takes about 30 minutes per day.  Chemo in Arm A takes about one hour per day and in Arm B takes about four hours per day.

Breastcancer.org
has some nice info on their website about what to expect from chemotherapy.  Lisa did give us a gentle warning that this treatment regime isn’t an easy one and that Mom is likely to experience nausea, hair loss, loss of appetite, and fatigue.  The chemotherapy also may cause low white blood cell count and low platelet counts (making her more susceptible to infection and bruising).

At this point, Mom’s Cancer Antigen (CA) 19-9
count is 450.  The average is 37, and the standard for resectable tumors in under 1000.  We’ll be tracking this number through her treatment and will be hoping that chemo and radiation help to drop it down.  It can serve as an indicator of how well the treatment is working.

During the meetings with Dr. Diggs, we talked about two alternative drugs, Avastin (bevacizamab) and Erbatix.  Both of these are currently being used to fight other kinds of cancers and may have applications for pancreatic cancer, but it isn’t clear that either drug benefits pancreatic cancer.  They work by cutting off the blood flow to the tumor.  For more info on Avastin, click here.  For a general article on these studies, click here.
I also have the results from a variety of clinical trials that used
these drugs and can give you links if you’re interested.

OK, enough info for today!  Take care,
Althea

Internal stents are placed

On Friday, June 9, Mom had an internal metal wire stent placed in her bile duct.  The tumor at the head of the pancreas had blocked the bile duct, and the stent should keep the duct open so her liver and pancreas can drain like normal into the small intestine.  Mom’s body didn’t react very well to this procedure, and they kept her in the hospital until Tuesday.  On the 14th, doctors tested the bile duct and ended up inserting two additional stents.  Mom went home later that day.  She’s not feeling well, however, and we’re hoping that in a couple days her body will adjust to the poking and jostling it’s been getting and she’ll feel better.

After Friday’s stent placement, Mom ran a high fever for a couple of days, had a moderate amount of pain, and felt nausea and gastrointestinal discomfort (which makes sense since the stent is pretty much in her intestine).  They had expected to release her on Friday night, but it wasn’t until Monday that she was feeling better.

They had a test scheduled for Tuesday, June 14, so on Monday, they decided to keep her in the hospital for another day.  On Tuesday, a radiologist tested the stent by injecting contrast dye into the bile duct and using an x-ray to see how well the dye was able to travel throughout the system.  Apparently
they felt like the single stent wasn’t working well enough because they added two more.  Although she was in quite a bit of pain after this procedure, Mom felt well enough to go home on Tuesday night.
As of Wednesday morning, however, she’s still experiencing pain and continues to struggle with gastrointestinal discomfort and nausea.  Hopefully her body will adjust in the next day or so.

We have an appointment with her oncologist, Dr. Diggs, on Friday, June 17.  At this point, we’ll be discussing treatment options.  We’ve been doing a lot of reading and research, but if anyone has suggestions or input, please contact me by the 17th so we can take your input into consideration as we look at treatment options.

That’s the update for now.  Take care,
Althea

Baby Dotzour: Week 38 Update

9.jpg

Two weeks until Baby D is due!  At my weekly appointment yesterday, the doctor said that he was still head down, heart rate was lower…around 130, he seems to be growing well, but my weight has been stable the last three weeks.  I’m not as comfortable as I’ve been up until this point, but that’s to be expected. Mostly feel like I have a bolder attached to my belly!  We can’t wait to meet him soon.  He’s due on the 27th.


How your baby’s growing:
Your baby has really fattened up. She likely weighs between 6 and 7 1/2 pounds now (boys tend to be slightly heavier than girls), and she’s probably between 19 and 20 inches long. She has a firm grasp, which you’ll soon be able to test with your pinky! Her organs are fully developed and in place, but her lungs and brain — though developed enough for her to function now — will continue to mature right through childhood.

Wondering what color your baby’s eyes will be? You may not be able to tell right away. If your baby is born with brown eyes, they’ll likely stay brown. If she’s born with steel gray or dark blue eyes, they may stay gray or blue or turn green, hazel, or brown by the time she’s 9 months old. That’s because a child’s irises (the colored part of the eye) may gain more pigment in the months after she’s born, but they won’t get “lighter” or more blue. (Green, hazel, and brown eyes have more pigment than gray or blue eyes.)

How your life’s changing: It may be harder than ever to get comfortable enough to sleep well at night. Take it easy through the day — this may be your last opportunity to do so for quite a while.  [I continue to sleep just fine through the night…thank heavens!!!…but rolling from side to side results in a
fair amount of grunting and groaning.  I know what my horse felt like when she was really pregnant.  And I understand the grunts!]

Keep monitoring your baby’s movements, too. Though she’s crowded, she should still be active.

Swelling of your feet is normal in these last weeks – [I’ve started to notice this especially when it’s hot and humid.  hmmm, it’s been hot and humid a lot!]

Encourage your partner to relax and enjoy some activities he won’t have time for after the baby arrives.

Mom’s laparoscopy has good results – no new tumors

On Thursday, June 9, Mom had a endoscopic surgery called laparoscopy.  The purpose was to look to see if the tumor at the head of the pancreas has spread to other portions of the abdomen.  And we got good news!  Dr. Gibson found no new tumors, and that means that Mom can start a combination of radiation and chemo soon.

Dr. Gibson reiterated that Mom’s cancer, is a mucin andocarcanoma. He warned us that there’s a high probability that the tumor has shed some microscopic cancer cells to other parts of the body.  But the good news is that none have grown to the point that they were visible from today’s procedure.  Our hope is that chemotherapy will destroy any metastic cells before they grow.

On Friday, Mom had surgery to have a permanent stent placed in the bile duct (which was being blocked by the tumor).  Dr. Gibson compared the metal stent to a chineese finger trap (see a photo). They’re keeping the external drain in until Monday (to make sure that the internal stent is working correctly), and then they’ll take it out on Monday the 13th.  This will mean she’ll have to give up her external bile bag, which I’m sure she’s become attached to over the last week (just kidding!).

She’s also supposed to be meeting with Lisa, the data manager for the ECOG study that we’re looking at right now for her chemo/radiation treatment.  That appointment is scheduled for Tuesday the 14th.  We should be able to get questions answered about her participation in that study during this meeting.

Dr. Zinda, an oncological radiologist will be meeting with Mom sometime next week to schedule a surgery to install the ports through which they will deliver the chemotherapy drugs.  These are called venous access device (VAD) and are surgically implanted devices that provides long-term access to a major vein.  Not a pleasant thing to look toward, but it will allow her to start her chemo treatments soon.  It’ll also mean she won’t get poked with needes every time she goes in for treatment, which in general will be a very good thing. Here’s more information and another good definition.

The following Friday, June 17, we’re meeting with her oncologist, Dr. Diggs, to talk about treatment options.  I’m hoping that her treatment will begin the following week.

For those of you would would like more information on pancreatic cancer, I’ve found the National Cancer Institute to be a good source: http://www.cancer.gov/cancertopics/types/pancreatic

I’ve found that breastcancer.org is a good website in terms of providing lots of good, readable content on cancer treatment (esp. what to expect from chemotherapy).

Here’s a list of clinical trials that Mom may be eligible for:
http://www.cancer.gov/search/ResultsClinicalTrials.aspx?protocolsearchid=1657219

Here’s info on the treatment that her oncologist, Dr. Diggs, recommended.
http://www.cancer.gov/search/ViewClinicalTrials.aspx?cdrid=258056&version=patient&protocolsearchid=1657219

Also, here’s a brief bio on Dr. Charles Diggs. and one for her surgeon who has been leading up her diagnosis and treatment, Dr. Scott Gibson.

Baby Dotzour: Week 37 Update

9.jpgJune 6: We’ve reached full term!  Baby Dotzour is now big enough to be born, but we’re planning on keeping him in for at least another couple weeks.  All continues to be well with our pregnancy, and the nursery is nearly ready.  We can’t wait to meet him!!

How your baby’s growing: Congratulations! Your pregnancy is now considered full term — meaning your baby is developmentally ready to handle life outside the womb. (Babies born before 37 weeks are pre-term and those born after 42 weeks are post-term.) Your baby probably weighs a little over 6 pounds at this point and measures between 19 and 20 inches, head to heel.

Many babies have a full head of hair at birth, with locks from 1/2 inch to 1 1/2 inches long. But don’t be surprised if your baby’s hair isn’t the same color as yours. Dark-haired couples are sometimes thrown for a loop when their children are born blonds or redheads, and fair-haired couples have been surprised by Elvis look-alikes. And then, of course, some babies sport only peach fuzz.

How your life’s changing: The next couple of weeks are a waiting game. Use this time to prepare your baby’s nursery or to take care of tasks you may not get around to for a while after your baby’s born. Take naps and catch up on your reading while you can.

You may be getting a lot more Braxton Hicks contractions now, and they may last longer and be more uncomfortable. Sometimes — when they start to come frequently — you may even think you’re in labor.

No surgery for Mom now…a week until the next test

On Friday morning (June 3), Mom met with Dr. Sharon Weber, a doctor of surgical oncology at the University of Wisconsin Hospital.  After looking at the CT scans that were sent from St. Mary’s, Dr. Weber told us that it’s her opinion that the tumor is currently inoperable. So our next step is to do a laparoscopy next Thursday to check for other tumors before beginning chemo and radiation.

The tumor (which I am considering naming Poco in order to encourage a tiny tumor with a slow growth habit) is in a part of the pancreas called the uncinate process.  When it’s in this location, it can be there for a while without exhibiting symptoms, which may be why it could get to be 4×3.7 cm in size before causing problems.  It doesn’t seem to have masticated (spread to other parts of the abdomen), which is a good thing.  However, the tumor (Poco) is classified as advanced as it involves about three centimeters of the superior mesinteric vein (SMV), and Dr. Weber thinks it is unlikely that any doctor would be willing to operate at this point.
“So what do we do next?” you ask?  We need to do a laparoscopy to look for tumors that may have spread but didn’t show up on the CT scan.  We want to know this before we head into a chemo/radiation regime because radiation won’t be effective if it has metastasized. Mom called and made an appointment for Thursday, June 9 to have this operation done (it will be an out-patient surgery).

We would also like to get a wire stent implanted so Mom’s bile goes back to the GI track instead of draining externally. This would be another relatively minor surgery, and we still have to look into scheduling it.

Mom should be able to start chemo and/or radiation in the next few weeks.  Depending on which course of action we take, the chemo/radiation regimes take around six weeks and then you wait another four weeks or so before doing a CT scan to see how much the tumor has shrunk.  The goal of these treatments is to shrink Poco to the point that he can be removed (probably by Dr. Weber).

So that’s our news right now.  I won’t have any further updates until after the laparoscopy results are back which won’t be until next Friday at the earliest.  Besides reeling from the magnitude of this news, Mom feels all right, and we’re all pulling together to find our way through this maze.  I know that we have a lot of people out there thinking of us and sending us their wishes and prayers.  It is very much appreciated.

Week 36 Update

9.jpgHe’s almost 6 pounds and nearly full-term, and boy is he feeling big!  We’re four weeks from the due date!

Week 36 Update from the Babycenter.com

How your baby’s growing: Your baby is still putting on the pounds — about an ounce a day. She now weighs almost 6 pounds and is a little less than 19 inches long. She’s shedding most of the downy covering of hair that covered her body as well as the vernix caseosa, the creamy substance that covered and protected her skin during its submersion in amniotic fluid. Your baby swallows both of these substances, along with other secretions, which will stay in her bowels until birth. This blackish mixture, called meconium, will become her first bowel movement.

At the end of this week, your baby will be considered full-term. (Babies between 37 and 42 weeks are considered full-term; a baby born before 37 weeks is pre-term and after 42 is post-term.) Most likely she’s in a head-down position by now [HE IS], which is optimal for a smooth delivery, but if she isn’t in the next week, your provider may suggest scheduling an “external cephalic version,” which is a fancy way of saying she’ll try to coax your baby into a head-down position manually, by manipulating her from the outside of your belly.

How your life’s changing: While your baby continues to grow and crowd your internal organs, you may find that you’re not as hungry as you were a few weeks ago. Smaller, more frequent meals are often easier to handle at this point. On the other hand, you may have less heartburn and have an easier time
breathing when your baby starts to drop down lower in your pelvis [THIS HASN’T HAPPENED YET, BUT I’M LOOKING FORWARD TO IT!]. This dropping — called lightening or engagement — is more likely to happen before labor if this is your first baby. When it does, though, you may feel increased pressure in your lower abdomen, making walking increasingly uncomfortable. Some women say it feels as though they’re carrying a bowling ball between their legs, or as if the baby is going to fall out. (Don’t worry, she won’t!)

You might also notice that your Braxton Hicks contractions are a little more frequent now [THEY ARE, ESPECIALLY WHEN I WALK UP/DOWN STAIRS]. Be sure to review with your practitioner exactly when and where to call her when you think your labor has started. As a general rule, you should call when you start having regular contractions coming every five minutes for about an hour.

Moving forward from a rough weekend

The past three days were tough ones.  Mom had a couple more
procedures done, and at this point we’re all learning as much about pancreatic cancer as we can.

On May 29, Dr. Baker did a procedure called a percutaneous transhepatic cholangiodrainage (PTCD) with biopsy. He was able to insert a tube in the center of Mom’s abdomen that goes through her liver, down the bile duct toward the pancreas.  He then inserted a drain so the bile that has been backing up the from the liver, gallbladder, and pancreas can drain to a bag outside her body.  He also took a biopsy of the tumor that sits at the head of the pancreas.

Later that afternoon,  Dr. Allen explained that the tumor is about 3×4 cm (medium-sized as he described it) and is located right at the head of the pancreas.  The biopsy showed a mucin Adenocarcinoma tumor which means that it probably started in the pancreas.

This isn’t the news that any of us wanted to hear.  It’s hard to treat pancreatic tumors. The tumor is encroaching on a major blood vessel (the superior mesenteric vein) making surgery very difficult.

Dr. Diggs, the oncologist talked to our whole family on Monday morning.  He said that there are two doctors at the UW Hospital who may be able to do surgery to remove the tumor at this point.  He and Dr. Gibson, the surgeon, are going to send Mom’s films to them this week to see what they think.  If surgery is not possible immediately, the primary treatment will probably be radiation and chemotherapy with the hopes of shrinking the tumor  to the point that it can be removed.

They may also need to do additional endoscopic surgery to implant an internal stent so the bile can drain internally into the intestine.  They’ll also want to do laparoscopic surgery to look for other tumors in the abdomen.

Dr. Gibson kept Mom in the hospital on Monday in case the UW doctors would be able to transfer her directly to the UW on Tuesday. However, this morning they said that they wouldn’t be able to see her until later in the week, so after a mind-bending weekend, she’s back at home as of mid-day on Tuesday.  She has an appointment scheduled on Friday morning with Dr. Webber at the UW.  Hopefully, we’ll know more after that, but who knows, it could be until next week before they run the next set of tests (MRI, catscans, ultrasounds) that need to be done.

It’s been a completely surreal set of days and I know we’re all still trying to absorb information.  The doctors have been very helpful and informative, and I’m glad that Mom gets a chance to be home for a while until we take next steps.

I have lots more details on treatment options, and I’m looking into support systems for families struggling with cancer.  I’m also learning how to talk about this and internalize it to my life.  I know we all are. So this isn’t a fun note to write, but I know that there’s an amazing group of people out there who love Mom and who will be interested in following her condition.  If you have questions, please give me a call.

At this point, we’re glad that there are a variety of treatment options available, and we’re moving forward with a hopeful attitude.
~ Althea

Baby Dotzour Weekly Updates – second and third trimester

Letters to family and friends from February 14 – May 10

February 14
Week 21 Baby update
Hi All!
According to my June 27 due date, I’m now over half way there. Something tells me, though, that the second half of pregnancy is when things get really interesting. Maybe that comes from seeing how huge Vicki’s belly is. She even said that when he flips around in her belly that it makes the bed jiggle!
Happy Valentine’s Day:) Bryan made me a delicious dinner including cake tonight, so my taste buds and belly are very happy right now. We painted the nursery (actually, now we’re going to re-paint the ceiling since it came out way too strong with the colors and color washing technique we used). My mom also recently gave in to grandmothering urges, and we got our little guy some really cute outfits last weekend. I should take photos of the clothes to share! We found a cute little polar bear printed sleeper that will look great with the bear hat and mittens Aunt Melanie sent:)
The last week has been a good one pregnancy-wise. Besides feeling my belly skin stretch and often falling asleep before 9 pm, I can’t say I’ve felt much different. I still munch on food all the time. Big meals are hard to do when one’s stomach is being impeded by a big sweet-potato sized baby:) I’m feeling light popping feelings or soft fluttering feelings, and they’ve become stronger where I’m sure I’ve felt something. I can’t say that I’ve really felt a strong nudge yet. Many of my regular shirts still fit around the girth, but they’re getting too short! It’s pretty amazing to see all these changes happening in a relatively short number of weeks. I’ve only told a few people at the gym that I’m pregnant, and I get some secret enjoyment out of working out with people who don’t know. It’s not going to be too long, though, before my belly reveals my secret.
Well, I’ve got to finish packing my bags…I head out tomorrow to the Milwaukee area for a Gathering Waters-run land trust retreat. I’ll be back home on Friday. Hope you had a fun Valentine’s Day doing sweet things for the people who make you smile. Love, Althea

Baby Center week 21 update
Your baby now weighs about three-quarters of a pound and is approximately 10 1/2 inches long. Her eyebrows and eyelids are fully developed. You may soon feel like she’s practicing martial arts as her initial fluttering movements turn into full-fledged kicks and nudges. You may also discover a pattern to her activity as you get to know her better. Some babies are restless in the evening, for example, just as you’re trying to fall asleep. Others get busy during the day.
From http://www.babiesonline.com/pregnancy/week-by-week/week21.asp Your baby is still pretty active and continues to move all over in the amniotic fluid. However, towards the end of this trimester the baby will begin to settle, usually in a head down position. Your baby is beginning to show evidence of eyebrows and eyelashes and the hair on his scalp is much more visible. He wakes and sleeps in regular intervals, similar to what a newborn would do. This may be apparent to you in his movement patterns. He regularly ingests and absorbs large quantities of the amniotic fluid and excretes urine. Your baby is approximately 27-30 cm (10-10.5 inches) and weighs about three quarters of a pound.

February 23
Week 22…and moving around!
Hi All,
It’s been a good couple of weeks. First of all, the sun is heading back, which makes me so very happy. This week I haven’t had to turn on the porch light to see the back steps when I leave the house in the morning, and when I left work yesterday, I caught a glimpse of the sun before it set. When I got home, natural light was still coming in the windows…a phenomenon I thought only took place on the weekends. It feels good to see that the sun is returning to us!
Then there’s the fun part about really being able to feel more distinct baby movements. I wouldn’t say the “kicks” are strong yet, but they’re noticeably not just stomach rumbles, and he’s often pretty active as I lie down to go to sleep. I haven’t been sore or uncomfortable, and even though I’ve gained about five pounds and my belly is sticking out a bit more, I don’t feel cumbersome or restricted in movement. So it’s a great month.
One of the girls at the gym asked me today if I was pregnant, and that marks the first time someone has asked. It’s getting to be obvious, but I think it’s a pretty cute belly, so I’m OK with the change:) It’ll be easier when the news spreads more and it doesn’t have to be explained to everyone!
I’ve got a pot of three Hyacinth bulbs on my desk, and they’re starting to sprout. A nice shot of green with promises of sweet smells in a few weeks.
This weekend Bryan is going to Ann Arbor to see some friends before one of them moves back to Australia. We’re planning to make another trip out this spring so I can go too. I’m going to Seattle for a meeting of a Carleton alumni committee that I serve on. I’m really looking forward to seeing a bit of Aunt Kate and Uncle Greg! Thanks to Mom, Dad, and Joey for watching April while we’re gone:)
That’s my news for now. I’m really looking forward to seeing Mom and Dad Dotzour in Chicago in a couple weeks. Here are links to a couple Ofoto albums I’ve uploaded: Photos of our short-lived snowman…Tippy
Photos of the painting and re-painting of our nursery
Have a great week! Love, Althea

Babycenter update – Week 22
Your baby now looks like a miniature newborn, checking in at 10.9 inches and almost 1 pound. Her skin will continue to appear wrinkled until she gains enough weight to fill it out, and the fine hair (lanugo) that covers her head and body is now visible. Her lips are becoming more distinct, and the first signs of teeth are appearing as buds beneath her gum line. Her eyes are developed, though the iris (the colored part of the eye) still lacks pigment. Eyelids and eyebrows are in place, and her pancreas, essential for hormone production, is developing steadily. Your stomach may become a hand magnet — people will touch it without asking permission. It’s okay to say no. And if people are telling you that you look smaller or bigger than you should at this point, remember that all women grow — and show — at different rates. What’s important is that you see your practitioner for regular visits so she can make sure your baby’s development is on track.

March 4
Week 23 update on Baby Dotzour
Hi All,
I’m running behind this week…I haven’t even had a chance to check my hotmail account to see what the babycenter said about the growth of Junior this week. Yesterday I had another monthly doctor’s appointment. Just a quick hello, how’s it going, but it’s always fun to hear the little guy’s heart beating. I met with the nurse practitioner this time, and she seemed to have a lot more time to answer questions. She let me listen to him move around and to the heart beating for quite a long time. The heart beat sounds more like a strong, regular beat (at the beginning it was a soft swishing sound). She said it was in the 150s. He’s kicking inside me right now! As my belly as expanded the last couple weeks, he’s moved north, and I’ve been feeling lots of movement right below my sternum and on either side just below (and out!) from my rib cage. Bryan felt him move for the first time a couple days ago. Sometimes when I sit in meetings, I’ve started to get where I can see my shirt tapping slightly. When he’s really active, which isn’t super often, it feels like there’s a pingpong ball in me:) I think in the last week or so, he’s gotten stronger and the soft nudges have turned into strong nudges and soft kicks. As my belly has grown out this month, I’ve started gaining weight. Not surprising given how hungry I’ve been! This week my appetite has lessened a bit (I just have to remember to assess when I’m hungry rather than sticking on the munching-all-the-time that I was doing last week!). Feeling great otherwise. I missed nearly a week at the gym between my trip to Seattle last weekend, my conference on Monday, and laziness on Tuesday and Wednesday. But now I’m back in the swing of things. We are REALLY looking forward to warm weather. My doctor gave me a thumbs-up about doing the Settynde Mai walk on May 15 again this year, so I’m looking forward to beginning to train for that. So is April. She can’t wait for us to resume walking her:)
I took some photos of the baby clothes that are hanging in our sweet nursery right now.
Have a great Friday and a wonderful weekend! Love, Althea

Baby center update Week 23
Your baby is more than 11 inches long and weighs just over a pound. His skin is red and wrinkled. Blood vessels in his lungs are developing to prepare him for breathing. He can swallow, but he normally won’t pass his first stool (called meconium) until after birth. Loud noises heard often in utero — such as your dog barking or the roar of a vacuum cleaner — probably won’t faze your baby when he hears them outside the womb. Feeling pretty good? Turn on the radio and sway to the music. With her sense of movement well developed now, your baby can feel you dance. Those dainty fetal movements have progressed to karate kicks. You may even be able to see your baby squirm underneath your clothing.

March 9
Week 24 update on Baby D.
Hi All,
Hope your week is going well. I don’t feel like I have much to report this week… I’ve been super hungry these days. And I get sleepy if my blood sugar gets too low. But I still haven’t been that tired (until about 8 pm:) or experiencing many other symptoms. I took my first Yogamom’s prenatal yoga class last night and really enjoyed it. I haven’t regularly gone to a yoga class in about a year, and it felt great to find a good instructor and a nice space. It was also kind of neat to join a bunch of other pregnant people for the evening. I felt like I’d found a little club I didn’t know I belonged to:) Some of the women were at 39 weeks…I’m not quite ready for that yet! They were huge and seemed pretty uncomfortable. I imagine that if I follow a similar pattern to others that in a month or two sleeping well is going to get much more difficult. Last night I slept with a little pillow under my belly, and that seemed to be pretty comfortable. Bowser’s still sleeping under the covers with me (he’ll probably stop when the weather warms up), and he was a bit confused about why there was a pillow down at his spot by my belly. Sometimes when I wake up in the night and am just awake (I’m hoping this is a pregnancy phenomenon that goes away soon!), I hold a kitty in each arm and think sleeping cat thoughts to try to get myself back to sleep. Last weekend we helped Terry move on Saturday, and on Sunday I hung out a bit with my family, took the dog for a walk, and didn’t do much else! Bryan’s still getting over his respiratory cold, but he seems to be getting better this week. That’s my news for the week! Love, Althea

Babycenter Update – week 24
Your baby’s growing steadily, gaining about a quarter of a pound since last week, when she was just over a pound. Since she’s almost a foot long, that makes a pretty lean figure, but her body is filling out proportionally and she’ll soon put on more baby fat. Your baby’s skin is thin, translucent, and wrinkled, her brain is growing rapidly, and her taste buds are developing. Her lungs are developing “branches” of the respiratory “tree” and cells that produce surfactant, a substance that helps the air sacs inflate easily.
How your life’s changing: The top of your uterus is now an inch or so above your belly button, which means it’s about the size of a soccer ball. With the skin on your abdomen and breasts stretching, you may feel a little itchy now and then. If your skin is dry, keeping it well moisturized may help. Also, your eyes may be sensitive to light and feel gritty and dry. This is a perfectly normal pregnancy symptom known as dry-eye. To ease your discomfort, use an artificial tears solution to add moisture.
Most women will have a glucose screening test (also called a glucose challenge test or GCT) between 24 and 28 weeks. This test checks for gestational diabetes, a high-blood-sugar condition during pregnancy. Untreated, high blood sugar increases your risk for having a difficult vaginal delivery or needing a cesarean section because it causes your baby to grow overly fat, especially in his upper body. It also increases your baby’s risk for complications like low blood sugar at birth. A positive result on your GCT test doesn’t mean you have gestational diabetes, but it does mean that you should have the more involved glucose tolerance test (GTT) to find out.

Week 25, and kicking!
March 15
I just wrote this note, but then I accidentally opened a new link in this window, and my message was lost. Argh! So what I just said was something like:
Our little guy has been moving around a lot in the past week or so. His movements have become stronger and more regular, and it’s become more possible to have people feel him when he’s moving. A couple weeks ago, he’d kick, but when I put Bryan’s hand there, he wouldn’t move again for minutes or more. Now when he’s active, he moves for quite a while. In fact, this morning, Bryan could feel him bopping around before I was even fully awake. He said, “Wow, he’s moving,” and I had to think about it before I noticed that indeed he was!
Bryan and I had a great weekend in Chicago with Mom and Dad Dotzour. The sun was shining, the Chicago River was dyed Kelly Green, and we were in great company. We went shopping for some fun maternity (and paternity) clothes, and I’m feeling very stylish. What fun!! The girls at work are throwing a join baby shower for Vicki and me on Saturday, so that should be fun! It’s my first baby shower…as a guest or as a baby-bearing person.
Have a great week! Love, Althea and the Great Expansion
PS. We’ve been having fun looking at baby names. Here’s a neat website that graphs how common names have been over the last 100 years. A fun site to spend some time surfing: http://www.babynamewizard.com/namevoyager/lnv0105.html

Babycenter Update: Week 25
How your baby’s growing: Head to heels, your baby now measures about 13 1/2 inches. His weight — a pound and a half — doesn’t sound like much, but he’s beginning to exchange his long, lean look for some baby fat. As he does, his wrinkled skin will begin to smooth out and he’ll start to look more and more like a newborn. His hair is probably recognizable now (in color and texture), although both may change after he’s born.
How your life’s changing: Your baby’s not the only one with more hair — your locks may look more full and lustrous than ever. It’s not that you’re growing more hair, but the hair you’d normally shed is sticking around longer than usual. You’re getting bigger by the minute, but that’s no reason to stop exercising — just modify your routine as your body changes.
When you have your glucose-screening test at 24 to 28 weeks, your practitioner may take a second tube of blood at the same time to check for anemia. Although your blood volume increases dramatically during pregnancy, the total amount of your red blood cells becomes diluted — a problem sometimes called physiologic anemia that’s common in the second and third trimesters of pregnancy. If your blood tests show that you have anemia, your caregiver will likely recommend that you take a supplement.
Have you started thinking about baby names yet? Choosing a name is an important decision, but it should be a fun one, too. Look to family history (Great Grandpa Zeb), favorite locations (Venice, where you honeymooned), or cherished literary or film characters (Greta, Meg, or Rhett, for example). Check out a couple of baby-name books to help you brainstorm, too.

April 4
It’s catch-up week…Baby Dotzour week 26, 27, and 28 update
Good morning!
I got pretty far behind on sending weekly updates. I think I’ve just been really focused at work, and when I get home, I don’t like the idea of spending more time in front of a computer! Bryan and I had a wonderful weekend. The weather was just incredible…the ice on Lake Monona melted on Friday or Saturday, and all weekend the sky was blue and the sun was shining, and the air was warm. Ah, it was delightful. We had fun being home owners and spent quite a bit of Saturday cleaning out the garage, cleaning up the yard, and washing the house and windows. All our neighbors were out too, and we enjoyed revisiting with people…winter just isn’t the most social of times! The dogs were all very happy to see each other again too. April has been a three-legged dog the past few days. We had a thunderstorm last week, and she dug at the basement floor until she wore her toenails down to the quick. After bleeding all over, it seems like her nails are starting to heal, but they clearly hurt a lot, and our poor girl is in quite a bit of pain. That doesn’t stop her from rolling around on her back and cuddling, though. Hopefully she’ll heal up soon. Bryan and I went for a walk down to Olbrich Gardens last night and walked around for a while. There’s hints of little tips of green coming out here and there, and we’re looking forward to seeing the progression over the next few weeks.
So what’s been going on baby-wise? Well, let’s see, since the last time I wrote, I’ve continued growing. I think my belly is about 38 inches around. Sometimes I feel pretty huge:) My co-workers threw a baby shower for Vicki and me on March 19, and that was a lot of fun. It was the first baby shower I’ve been to, and I enjoyed learning the games and talking with lots of other people about babies. We got some fun books and CDs and bath stuff and some of the essentials like nail clippers and brushes and thermometers. I’ve been given so much. Our next step is to find a dresser so we have a place to keep it! Bryan and I have been visiting day care options, and while we haven’t settled on our solution yet, we’ll need to decide soon as all the spaces to start in October are filling up (and most are already gone!). It’s amazing how far ahead you have to plan! And it’s really hard to know how to make the right decision. I haven’t even met the baby yet! I took my glucose test during week 26, and the results from that came back normal, so I don’t have to worry about gestational diabetes at this point. Good thing, because I don’t want to have to limit my ice cream and cookie intake! The blood tests showed that my iron levels were a little low, so I’m taking an extra supplement and trying to eat more meat. Vicki is at 38 weeks this week (she’s due on April 16), and she’s now taking many more supplements. Apparently as the baby gets bigger, it starts pulling more of what it needs to grow from the mother’s body, so it becomes harder to keep your own levels of certain elements high when Junior keeps using them to grow! I’ve sure been eating enough, though. I’m hungry all the time, or at least every couple-few hours, and there’s just no dissuading me when I’m ready to eat. mmm foooooddd. That said, the scale still says that I’ve only gained 12 pounds, but given the size of my belly I’m not sure how that’s possible. My last doctor’s appointment was last week, and the heart sounded good. She said it was at 149 beats/min. He was pretty quiet for a week in mid-March, but action has steadily picked up again, and this weekend, he startled me several times and learned how to insert a foot up into my ribcage. Fun trick.
That’s a catch-up of the last few weeks. My next doctor’s appointment is on the 18th (then go down to every two weeks). Bryan and I start a child birthing class on Wednesday night and continue that until mid-May. We’re also signed up for a couple infant care classes a breastfeeding class, and probably other classes that I’ve forgotten about.
Have a great week! Love, Althea and Baby D

Week 26
http://www.babycenter.com/mybabycenter/126.html
How your baby’s growing: Your baby now weighs a little under 2 pounds and measures about 14 inches, from head to heel. The nerve pathways in her ears are developing, which means her response to sounds is growing more consistent. Her lungs are developing now, too, as she continues to take small breaths of amniotic fluid — good practice for when she’s born and takes that first breath of air. If you’re having a boy, his testicles are beginning to descend into his scrotum — a trip that will take about two to three days.• Note: Experts say every baby develops differently — even in the womb. This developmental information is designed to give you a general idea of how your baby is growing.
How your life’s changing: Around this time, your blood pressure may be increasing slightly as it returns to its normal pre-pregnancy range. (It was at a low from 22 to 24 weeks.) Though preeclampsia most often occurs in the last trimester, this is a good time to be aware of the warning signs of this dangerous condition that occurs in about 3 to 7 percent of all pregnancies. Signs you should be alert for include swelling of the hands and face, sudden weight gain (due to water retention), blurry vision, seeing spots before your eyes, sudden severe or persistent headaches, or upper abdominal pain. By checking for high blood pressure and protein in your urine, your caregiver will monitor you for preeclampsia at your routine prenatal visits, but call her immediately if you have any of these symptoms before your next appointment. Early identification of preeclampsia is essential for the health of you and your baby.
If your back seems a little achy lately, you can thank pregnancy hormones (which are loosening up your joints and ligaments) and your shifting center of gravity. Walking, standing, or sitting for long periods, bending and lifting can all put a strain on your back. A warm bath — or cool compress — might bring relief. Or you may want to schedule a prenatal massage by a trained therapist. Use a pregnancy wedge when sleeping, to support your back and abdomen. Try to maintain good posture, which will help reduce the strain on your back, and always take care when bending and lifting. If you experience severe pain or numbness in any area of your body, call your practitioner.

Week 27
http://www.babycenter.com/mybabycenter/127.html
How your baby’s growing: Your baby is really starting to fill up your uterus. This week he weighs almost 2 pounds and is about 14.4 inches long with his legs extended. He can now open and close his eyes, and he sleeps and wakes at regular intervals. He may suck his fingers, and although his lungs are still immature, they would be capable of functioning — with assistance — if he were to be born prematurely. Chalk up any rhythmic movement you may be feeling to a case of baby hiccups, which may be common from now on. Each episode usually lasts only a few moments, and isn’t bothersome to him, so enjoy the tickle. With more brain tissue developing, your baby’s brain is very active now. Wonder what he’s thinking?• Note: Experts say every baby develops differently — even in the womb. This developmental information is designed to give you a general idea of how your baby is growing.
How your life’s changing: Your body is gearing up for the final lap, so you may start noticing some new symptoms. Along with an aching back, for example, you may find that your leg muscles cramp up now and then. They’re carrying extra weight, after all, and your uterus is putting extra demands on your circulation. (As your uterus expands, it puts pressure on the blood vessels that return blood from your legs to your heart and on the nerves leading from your trunk to your legs.) Unfortunately, the cramps are likely to get worse as your pregnancy progresses. Leg cramps are more common at night but can also happen during the day. Flexing your foot (by pointing your toes forward and then flexing them back toward your shins) stretches the calf and should give you some relief. Walking for a few minutes or massaging your calf sometimes helps, too.

Week 28
How your baby’s growing: By this week, your baby weighs a little over 2 pounds and measures about 14.8 inches from the top of her head to her heels. She can open her eyes — which now sport lashes — and she’ll turn her head toward a continuous, bright light from the outside. Her fat layers are beginning to form, too, as she gets ready for life outside the womb.
How your life’s changing: If the blood work done at your first prenatal visit showed that you’re Rh negative, you’ll receive an injection of Rh immunoglobulin to prevent your body from developing antibodies that could attack your baby’s blood. (You’ll receive another shot of Rh immunoglobulin after you give birth if your baby is Rh positive.)

April 11
Week 29 Baby D update
Good morning!
Looks like it’s going to be another lovely spring day. I wish this weekend could have had several more days in it! April came to work with me this morning, so she’s pretty excited about that. Much more interesting than being at home. I got a note from Grace and Tim yesterday: “john patrick ernst was born at 10:03pm on wednesday, april 6, 2005. he weighed 7 lbs 14 oz and is 20 inches long. everyone is doing great and grace’s mom is here for the rest of the month to help out. love, grace and tim” He looks like a really sweet guy…it’s amazing to see photos of Grace as a mom! Joey came over yesterday, and he and Bryan went to the driving range and then I took him grocery shopping. I am a FUN older sister. Bryan has been starting to work on getting a website going so we’ll be ready to post images when Junior comes along. Our little guy isn’t moving all the time, but when I eat or lie down, he can make some pretty strong movements. Vicki’s friend gave her a couple tubs of summer maternity clothes, and now that the warm weather is here, I can wear them. Today I found a pretty purple dress that still had the tags on it. I’m lucking out in the maternity clothes department! Tonight I have another prenatal yoga class, on Wednesday we go to our second childbirth class… Starting to learn about all the things we need to know before our little guy comes:) Have a great week. Love, Althea

Week 29 Update:
How your baby’s growing Your baby now weighs about 2 1/2 pounds and is a tad over 15 inches long from head to heel. His muscles and lungs are continuing to mature, and his head is growing bigger to accommodate his brain — which is busy developing billions of neurons. With this rapid growth, it’s no surprise that your baby’s nutritional needs reach their peak during this trimester. To keep yourself and him well nourished, you’ll need plenty of protein, vitamin C, folic acid, iron, and calcium. (About 200 milligrams of calcium is deposited in your baby’s skeleton — which is now hardening — every day.)

April 18
Week 30!
Happy Sunny April Day!
This month has been just beautiful, and the word is that the temperature today could get up to 80! I’m going to have a hard time staying at work this afternoon. I just had my 30 week doctor’s appointment this morning. It takes all of 3 minutes…they weigh me (up two pounds in the last few weeks), take my blood pressure (steady at 95/60), listen to the heart beat (147 beats/min), measure my belly (30 cm from bottom to top), and ask if I have any questions. My doctor is due in about a month, but she still wants to see me one more time. I’ve got the names of a couple of her co-workers, though, so in a couple visits I’ll be going to someone else. Bryan and I are in our third week of our childbirth class. It’s a lot of fun, and I’m looking forward to going again on Wednesday. This week is kind of busy…I’ve got yoga tonight, our class on Wed., Joey’s play on Thursday, and then on Friday I’m going over to Jack’s house for the Wildflower weekend. We’ll walk around and look at wildflowers. I’m looking forward to it! On Saturday night, we got the fun call that Vicki had delivered her baby. They named him Alexander Elkin Ivey, and he was 6 lbs, 15 oz; 20 inches long. Her labor was fast. She went to the hospital at 5 and was 8 cm dilated and delivered at about 9:30 – no drugs! She called Sara, my co-worker, at 10:30 to share the news, and Sara said she sounded great and very happy. I’m really looking forward to meeting the little guy! Hope you all have a great week. Love, Althea

BabyCenter week 30 update
http://www.babycenter.com/mybabycenter/130.html
How your baby’s growing: Your baby’s a bit more than 15 1/2 inches long now, and she weighs almost 3 pounds. A pint and a half of amniotic fluid surrounds her, but that volume will decrease as she gets bigger and fills out your uterus. Her eyes open and close, she’s able to distinguish between light and dark, and she can even follow a light source back and forth. Once she’s born, she’ll keep her eyes closed for a good part of the day. When she does open them, she’ll respond to changes in light but will have a visual acuity of only 20/400 — which means she can only make out objects a few inches from her face. (“Normal” vision in adults is 20/20.)
How your life’s changing: You may be feeling a little tired these days, especially if you’re having any trouble sleeping. You might also feel clumsy, which is perfectly understandable. Not only are you heavier, your balance is off and your joints are loosened, thanks to pregnancy hormones. Those loose joints can actually cause your feet to grow a shoe size –permanently.

April 25
Week 31 and going on a trip
Happy Monday! I’m getting ready to leave the office for the week, and I just thought I’d send you this update quickly before I fly away. The last week has been good. Pretty uneventful. Our little guy is really making some strong movements. He’s doing less kicking and more pushing. In fact, when Bryan and I went to the UW band concert last week, we couldn’t believe how much we could feel him. I think we was trying to get out through the front:) I was out at Jack’s last weekend for the annual wildflower walk. The weather was a bit chilly, but not too bad once we were walking. I didn’t camp, though. Too cold for me! And early in the morning instead of going bird watching, I looked at the sun rise from out the window. Then I went bird watching when the sun was warming everything up.
Bryan and I had a nice day at home yesterday, and we went through about six tubs of baby clothes/toys/gear a friend brought over. We ended up returning nearly all of it. I can’t imagine that a person needs so much STUFF to raise a baby. I think we’ll get things as we need them, but I’d rather not feel over-run with equipment that I don’t even know that we’ll need. It sure is fun to look through things, though. And now we have some baby spoons, new outfits, and a mat for the baby to lie on and play with dangling toys.
I’m leaving for Washington DC this afternoon. I’ll be lobbying and at meetings Tuesday through Thursday. On Friday, I plan to visit museums and play until Bryan flies in. We’re looking forward to seeing Grace and Tim and Baby John on Saturday and Sunday. This is my last scheduled flight before Junior comes, and I’m looking forward to the trip. I’ve got a couple last things to finish up before I leave today, so I’ll bid you a warm goodbye. Love, Althea

Week 31 Update from Babycenter.com
http://www.babycenter.com/mybabycenter/131.html
How your baby’s growing: This week, your baby measures about 16 inches long. He weighs a little over 3 pounds and is headed for a growth spurt. He can turn his head from side to side, and he’s beginning to accumulate a layer of fat underneath his skin in preparation for life as a newborn. As a result, his arms, legs, and body are filling out.• Note: Experts say every baby develops differently — even in the womb. This developmental information is designed to give you a general idea of how your baby is growing.
How your life’s changing: Have you noticed the muscles in your uterus tightening now and then? [I HAVEN’T YET] Some women feel these random contractions — called Braxton Hicks contractions — in the second half of pregnancy. Lasting from 30 to 60 seconds, they’re nonrhythmic and irregular and, at this point in your pregnancy, they should be infrequent and not painful. (When you’re within a few weeks of your due date, it’s normal for Braxton Hicks contractions to become more frequent and even somewhat painful; in fact, they’re often called “false labor” because sometimes it can be hard to tell them from the real thing.)

May 2
Week 32…two months to go:)
Happy May!
Bryan and I just got back from a great trip to Washington DC. I spent the first part of the week staying with my friend Kacy and going to meetings for the national Land Trust Alliance. Then on Friday evening, Bryan flew in and we had a great time visiting some museums, eating at fun restaurants, and staying with Grace and Tim and their new baby John Patrick. In DC, the flowers were blooming and the air was warm, and there was so much going on that we would have needed to stay for a year to see it all! We visited the Air and Space Museum and the new American Indian museum on Saturday morning. The International Spy Museum was too crowded and expensive. We had a great time holding and looking at baby John, and it was a lot of fun to get a sneak peak of what life is like a few weeks after a baby comes. Grace’s mom had been staying with them until Saturday, so we were there at a time of transition. My friends from SNRE, Jennifer and Lara also came by, so it was great to see them too.
Our little baby keeps growing bigger. He’s making lots of big movements and can really push hard sometimes. Today my ribs feel a bit like they’re being pulled apart, and I can’t say that the sensation is altogether comfortable. Our baby’s doing quite a bit of traveling in utero. He’s already been to Oregon, Washington, Texas, Kansas, Illinois, Virginia, Maryland, DC, and probably next weekend Indiana (briefly) and Michigan. I wanted to make a trip up to St. Paul to see Maretta at school, but I don’t think that’s going to happen! We’re running out of time:)
I haven’t been as ravenous the past couple weeks, and I’ve actually been less tired in the evenings (I can stay up until 10 sometimes!), so that has been nice. Bryan and I have an infant care class tonight at St. Mary’s (our hospital), so that should be a good opportunity to check out the facilities and to practice washing and diapering a baby.
That’s my news for this week. Hope all is well with you, and I’m going to be watching the skies and looking for some springtime weather. It IS May! Love, Althea

Week 32 Update from the BabyCenter
http://www.babycenter.com/mybabycenter/132.html
How your baby’s growing: By now, your baby probably weighs almost 4 pounds and is almost 17 inches long, taking up a lot of space in your uterus. She has tiny toenails now, and her fingernails have grown in, too. Some babies have a head of hair already; others have only peach fuzz. The baby’s irises can now dilate and contract in response to light. Due to the deposits of white fat underneath the skin the baby’s skin is no longer red but pink.
How your life’s changing: Your blood volume (the plasma plus red blood cells) is now about 40 to 50 percent greater than before you became pregnant to accommodate the needs of you and your baby. (This extra amount also helps make up for any blood you’ll lose when giving birth.) You’re also gaining a pound a week now, and roughly half of that goes right to your baby. With your uterus pushing up near your diaphragm and adding pressure on your abdomen, you may be dealing with heartburn [NOT YET] more often or feeling a little short of breath. To help with shortness of breath, try eating smaller quantities more often (rather than three daily feasts) and sleeping propped up. Those smaller meals should help with the heartburn, too.
As your baby grows, the increasing concentration of weight in your growing belly causes a change in your posture and a shift in your center of gravity. Plus, your abdominal muscles are stretching, hormones are making your ligaments more lax, and your growing uterus may even press on some nerves. All of this can contribute to low back pain.

May 10
Week 33 Update
Good morning!
It’s a lovely May day. I got back from my trip to Ann Arbor at noon yesterday. It was a wonderful trip. I was so happy to get to visit with friends and co-workers, and it seemed like each half-day held a new reunion with a dear friend. Staying with Heather and Michael was a lot of fun. It had been too long since our last visit. And I hadn’t seen Marcia since her baby Jordyn was born in October. I’m still smiling from all the good times I had. Then it was great to come back home to my boy and my home and to know that I’ll be staying here without traveling for a long time. Bryan did some transformations to the basement bathroom while I was gone. He’s really learning some plumbing techniques! He’s also been our dandelion warrior and has been digging up the weeds with determination. Such a guy! Keeping our yard healthy and saving me from trying to bend and squat with my big belly.
I had a doctor’s appointment on Friday. My belly is 33 cm from bottom to top. Right on track. Still at 17 lbs of weight gain. On Friday, he was head down with his back toward my right side, and his heart rate was 150 beats/min. My OB gave me some suggestions for baby doctors, so we have an interview with one in a couple weeks. My doctor is due to have her baby on May 13, so this was the last appointment I have with her. She referred me to another doctor, Gary Waters, so I hope I like him! I have my first appointment with him on Wed. May 18. Since the doctors rotate who is on call at the hospital at any time, there’s only a 20% chance that I’d have “my” doctor there to deliver the baby, so in some ways, it feels like it doesn’t even matter who my actual doctor is. That’s one reason we’re planning on getting a doula (birthing assistant) to be with us at the birth. We think it will be nice to have someone experienced with natural childbirth who we know ahead of time to be there as an advocate for me and as a support for Bryan. Nurses can be great, but they switch shifts and don’t necessarily know your birth plans. So finding a doula and writing up our birth plan are two things we’re going to need to work on soon. Our child birth class has two sessions left, and we’ve had such a great time. The baby has been moving around, and when he pushes out it feels kind of like a rock. He seems to react when I rub or scratch on my belly, so we have fun doing that sometimes when I’m lying around. Hope you have a great week! Love, Althea

Week 33 BabyCenter Update
http://www.babycenter.com/mybabycenter/133.html
How your baby’s growing: This week your baby weighs a little over 4 pounds and measures 17.2 inches from the top of his head to his heels. His skin is becoming less red and wrinkled, and while most of his bones are hardening, his skull is quite pliable and not completely joined. This will help him ease out of your relatively narrow birth canal.
How your life’s changing: You may be waddling a bit now, as your baby fills out even more of your belly. It may be harder to sleep comfortably, too. For relief, try sleeping in a recliner or propping yourself in a semi-upright position in bed. You may be feeling some aches and even numbness in your fingers, wrists, and hands. Like many other tissues in your body, those in your wrist can swell, which can increase pressure in the carpal tunnel, a bony canal in your wrist. Nerves that run through this “tunnel” end up pinched, creating numbness, tingling, shooting or burning pain, or a dull ache. Try wearing a brace or propping your arm up with a pillow when you sleep. If your work requires repetitive hand movements (at a keyboard or assembly line, for example), remember to stretch your hands when you take breaks.