Saturday, March 26, 2011

Hospital admission #2

Because we didn't have enough excitement yesterday, this morning I woke up and soon started having contractions...or what I thought were contractions. Severe cramps that came and went, lasting a few minutes, coming every 10 minutes, hurting enough to make me curl up and grit my teeth and clench my hands...seemed close enough like contractions to me. (I've not had cramps like this the entire pregnancy except for a couple weeks ago when I had 3 in an hour that were just like this and stopped when I laid down.) I didn't pay attention to what time the first one started because I didn't really expect it to continue, but I did count them, and around an hour later, there were 6.

We debated what to do. I called my mom (trying to figure out if these were really contractions) who of course told me to call the doctor. (They'd already told me to call if I had 6 in an hour yesterday and previously, but I wasn't really sure that they were the real thing.)

Joe and I decided to not call the doctor yet and to count for another hour, paying attention to the time this time. In about 55 minutes, I had 6 more, so I grudgingly called my ob's exchange number. Her partner called me back, (she's going to be out of town all of this week for a conference), asked a few questions, and decided to send me in to the hospital just to be on the safe side. With my classical c-section and only being 31.5 weeks, she didn't really want to chance it. (Classical c-section= higher than the normal risk of uterine rupture with contractions/labor.) I wasn't so much eager to go to the hospital AGAIN but I pretty much figured that they'd send me in to get monitored, and I didn't really want to chance that it was real contractions either. I didn't especially want them to keep happening (and I especially did not want to be back in the hospital already with the threat of magnesium sulfate to stop labor if it was real- been on that crap once to prevent me from seizing when I had HELLP, it's pretty miserable.) But I also didn't want to go in and look like a nutcase imagining contractions. So lose-lose there.

By the time we got there, OF COURSE, they had pretty much stopped. The Women's Evaluation Unit that I was admitted too yesterday for observation was closed today, so we went straight to L&D, where they admitted me for observation and put me in a room that was almost the same as the room where I had been before and the first two days after Olivia was born, while I was still on magnesium sulfate. This room was facing the opposite direction as my room last time, and a little bigger, so not as bad as yesterday but blech. I guess that's the problem with delivering at the same hospital where I had her. They got me on a contraction and baby heart rate monitor, did my vitals and all of that fun stuff, and left us for awhile. I had a couple more strong cramps there in that time, at least.

Then I got checked and swabbed for leaking amniotic fluid and infections. I was a fingertip dilated which they say is okay but seems to me that it's awfully early for me to be starting to dilate already. They apparently weren't concerned about that but I'll be mentioning it to my high risk doctor on Monday. (I'm not sure that they ever even talked to my high risk doctor, even though I told them her name too as my doctor, I didn't ask again because I was afraid she'd be fed up with everything and decide to just keep me...I didn't especially want to stay.) Plus I figured my ob's partner would let high risk doctor know if she was concerned.

They left us for a couple more hours while they waited for all of the results. Everything looked normal except that I have a UTI and an "irritable uterus"- when I had those cramps the line did jump up on the contraction monitor, but not high enough to be a real contraction, but not my imagination either- which is probably being caused by the UTI. The baby looked great on the monitor the entire time. (Of course he did!) The cramping thing isn't real contractions but not really exactly good, either. They sent me home with a prescription for antibiotics for the UTI and figure that should fix it.

So the good news is that I'm fine and the baby is fine. The bad news is we spent Joe's entire weekend off pretty much in the hospital and have gotten nothing done. (Both times we've come home exhausted and crashed. There's just something draining about being in the hospital.) Hopefully this was just a really bad weekend and bad timing and that this isn't a bad omen for how the next (LAST!) month is going to go because I'm so over the drama.

I'll be back in the hospital Monday for high risk appointment and hopefully steroid shots (pretty sure the past 2 hospital admissions seals the deal as far as getting them now vs. waiting one more week), Tuesday I'll be back for round 2 of steroids and monitoring, and then again Friday...I'm hoping that just maybe I can avoid getting admitted between all 3 trips. Although as I said to Joe as we finally got lunch late this afternoon, "It's kind of nice to go to the hospital with something maybe wrong and get released still pregnant and okay. Almost like a normal pregnant person." Honestly, when I went into the hospital with all of the pain with Olivia, *this* was how I expected it to turn out...that they'd watch us for awhile, figure out what was wrong, fix it, and send me home, because that's how it usually goes (I guess.) Granted, if I hadn't been high risk and getting monitored, I would have never been admitted yesterday and probably they would have had us wait longer today if I hadn't had the classical c-section. So not completely normal. But almost. 

Friday, March 25, 2011

Hospital admission #1 (+ growth update)

So this morning, we went to monitoring as usual, except I had Joe come with me because we had a bet going for his size and today was my growth ultrasound. (I thought he'd be close to 5 lbs and Joe was thinking close to 6 lbs.) WELL, Luke decided to be especially uncooperative today, with a non-reactive nonstress test PLUS four or five sharp and 30+ second lasting decelerations. (It was bad enough that my favorite nurse faxed the test strip to the doctor, which they don't typically do there, they just sum up what it looked like for them.) So we went on to the growth ultrasound and biophysical profile, he was sluggish as far as movement and did not practice breathing= big fat fail.

My high risk doctor was on duty in the perinatal center and she was already weary about the direction things have been going, (although of course everything has been better the last couple of days although now that I've been released, I'm noticing the heartburn is back). so she decided to have them send me to the hospital to get admitted for more monitoring.

So there we went. They were expecting me and put me in a room and gown right away and on a monitor. Everything was normal. And the baby was suddenly very well behaved. (Of course he was!) After a couple hours of a very well behaved baby, (Joe napped while I watched the news and then Ellen and then we argued about what to put on after Ellen), they decided to send me down for another biophysical profile and would decide what to do from there.

I didn't mind getting admitted to the hospital so much, since with Olivia I arrived at this particular hospital via a stretcher and ambulance, that part was different. And I don't even remember ending up on that particular floor though I guess I was probably there (you kind of skip the front desk when you arrive escorted by EMT's and I wasn't exactly looking around the last time.) Being in a room, with monitors, not exactly sure how worried to be, sent there unexpectedly without my hospital bag or anything but my purse (last time I at least brought a book and my purse), was a little unsettling and deja vu like, to say the least. But with Olivia, we could never hear her heartbeat on the monitors (they tried and tried and then checked on an ultrasound to make sure she was still alive, and even when they put the monitor right where she was on the ultrasound, it didn't pick it up, because she was so little (they still made me wear the stupid contraction part anyway though.) So it wasn't as bad, because I could hear his heart beating nonstop and if it sounded like it slowed down I could glance up and see what his heart rate was. And I wasn't in any pain and feeling decent, so it was different enough that I wasn't totally having a post traumatic stress flashback. But when we waited forever for them to come get me, and I had to get in the wheelchair in 2 gowns and a sheet over my lap...that was a little too similar and a little too much like after we waited and waited for them to come take us for the last ultrasound with Olivia.

Granted, a different hospital, different situation, and this time I was wheeled past the NICU on the way to the ultrasound instead of a nursery...but was still horrible. Even though I'd just sat listening to his heart rate for a couple hours and feeling him move like a was too similar to being wheeled to the last ultrasound with Olivia and having the worst discussion of my life with the high risk doctor there. (It was actually in the ultrasound room where they told us it was HELLP and they managed to talk me into delivering after we learned she was in distress.) So by the time we were in an ultrasound room and Joe and I were alone, I definitely had a mini breakdown. Joe thought I was freaked out about the baby but really it was just too much like last time at that particular moment. (I'm really really glad it wasn't at the same hospital, where we had that last ultrasound with Olivia, or it would have really really spazzed me out.) By the time the ultrasound tech was in, I was better. But blech. I used to have flashbacks all of the time that first year, especially while driving to work, I'd be thinking of one thing and all of a sudden I was reliving one of the bad moments from that week. This wasn't exactly like a flashback, but it had me a bit freaked out, for sure.

Luckily, today was nothing like that day. The little stinker baby decided to practice breathing TWICE, long enough each time to count, and after being shaken up quite a bit by the ultrasound tech (she literally was shaking my belly so much with the ultrasound probe that it made the table move...I wanted to tell her to stop shaking my baby! Sheesh, leave the poor kid would never be okay to shake a newborn like that. When she left the room I asked Joe and he said it bugged him too...I mean, I know they like to poke and prod them a little to get them moving but this was a little extreme.) Anyway, he moved enough (and I wasn't especially worried about that because he'd been moving like a maniac with the monitor on upstairs), and everything else looked good. The tech left and my high risk doctor came in shaking her head with a big smile, "Didya miss me?" Apparently we did.

So she decided no more monitoring at the other place near us which is only 5 minutes away, she wants me to do monitoring at the hospital where they have a doctor right there and so they can send me right upstairs if he's causing trouble again. Which is fine with me, I'd been considering that anyway. But it's going to suck as far as driving 30 min vs. 5 min and not to mention the perinatal center in the hospital is *much* more busy so it's going to be a big time suck too. Those things are trivial so I'm not really worried about it, it's just probably going to make monitoring an all day affair as opposed to an hour or so.

I was glad that they sent us to the hospital vs. shrugging it off and sending me home, I'd have been a neurotic mess all weekend. As it is, I'm a bit on edge, though not nearly as edgy as I would be if I hadn't watched his heart rate look pretty perfect with several nice accelerations for 3ish hours. I go back Monday to see my high risk doctor, get steroid shots, and possibly monitoring again. (I know I have monitoring on either Monday or Tuesday, right now it's scheduled for Monday but I'm going to try to reschedule it for Tuesday, I forgot I'm going to have to go back for the second round of steroid shots Tuesday anyway.) Besides that, everything is normal, though obviously they want me to keep doing kick counts and pay attention to how he's moving (and also, apparently I was having some contractions on their monitor so they want me to keep an eye on that too.)

The most dramatic part of the day (besides the whole getting admitted to the hospital and the baby having a pretty crappy NST this morning bit), was when all of a sudden the monitor started making a shrill alarm noise. Joe looked at it quickly and realized it was out of paper. But really! You would think they'd come up with a nicer, less alarming "out of paper" noise, lest they give some poor pregnant woman a heart attack when the monitor on the baby starts alarming!  Whoever came up with that idea should be smacked a few times. (And apparently that's not just here, the monitors other places do that too. That's just messed up, I think.)

In other news, for his growth ultrasound, he measured in at 5 LBS! (+/- 12 ounces.) I think it put him in the 73 percentile so not that bad as far as too big (considering last time was 76 percentile) and exactly what I expected.

Apparently a nice, boring, uneventful pregnancy is not in the cards for us. This is going to be a very long 4.5 more weeks.

Tuesday, March 22, 2011

31 weeks, trouble brewing.

Yesterday was 31 weeks which is a pretty good place to be, gestational age-wise.I'm expecting to make it another week, but I'm not sure how much farther beyond that we are going to make it.

The good news is that Luke is doing well. He easily passed the biophysical profile today (they did that before the NST just in case). I know he had one good acceleration on his NST but he needed two, he had a few more accelerations but they weren't quite high enough to count as reactive. But best of all, again no decelerations at all. (He was in a different position again today, so I'm really thinking his feet above his head and pressing into the cord may have been the problem.) And today I had the good nurse who always saw his decelerations before.

The bad news is that now that Luke is behaving, I'm showing some somewhat alarming warning signs. If it was just one of them or I didn't have the history and risk factors that I have, it probably would pretty easily be dismissed. But since that's not the case, it really seems to be that trouble on the horizon. My hands and feet are a bit swollen and I had an unusual amount of weight gain, especially for me this pregnancy, which indicates it's not just my imagination. My blood pressure has been funky. Every day for the past week or so, I've had one blood pressure that has been off, sometimes not too bad, like only +10 higher than my normal, and sometimes a bit alarming, like +20 higher than my normal. Sometimes it's only the top number high, sometimes the bottom, sometimes both. And I monitor my blood pressure three times a day, it's always off at a different time, but then the other two numbers for the day will be normal or even lower than normal. And then there's the heartburn. I've had heartburn off and on since the mid 2nd trimester. And it's always freaked me out a little bit, because when I was pregnant with Olivia, I had severe heartburn pretty much constantly for about 2 weeks before it turned into upper right quadrant pain and HELLP syndrome. (It wasn't that I mistook my upper right quadrant pain as heartburn, they were definitely different, it was just having that as a prelude to trouble has made me uneasy whenever heartburn comes around this time.) Earlier in this pregnancy, though, the heartburn was always in my throat and more like acid reflux, it was relatively mild, and generally went away with a few Tums unless I got crazy and ate something like chili. I haven't even had heartburn in a month or so, but all of a sudden it's been back (about last week), it's not in my throat anymore but deep in my chest, and it's constant and severe. Any one of those things alone would be okay, I know swelling can be normal, I know heartburn can be normal, and I know 2 of 3 normal blood pressures is not that alarming, but all together and with my past, 36 weeks is looking doubtful, and if we do somehow make it that far, it's especially doubtful that they are still going to bother with an amnio to check his lungs first.

Yesterday I saw my high risk doctor and my blood pressure was pretty far up there especially for me (133/88, top number is about +20 and bottom number +15 from my normal.) I wasn't sure that it would concern her, still being under 140/90, but luckily she looked at it and said right away, "that's high for you, isn't it?". We went over all of the other suspicious things and now my usually very calm and cool high risk doctor is not feeling so optimistic. She's been saying this whole time not to worry until she tells me to worry, and that she will tell me when she's worried. (Not that it has ever worked.) Yesterday, she didn't exactly say she was worried in those words, but she said, "You are making me very nervous." She was glad that I had monitoring  today and Friday (blood pressure was 127 / 72 , another one of those high for me top numbers), she wants to see me again on Monday and was emphatic to call if anything new is amiss. She also ran a full panel of labs and said I'd be hearing from them if anything was off with my bloodwork, so I assume it was okay since I haven't heard from them. (And I don't really expect it to be off at this point, I think what is going on now is mostly a prelude to trouble that this time we know about, but not really trouble yet. And despite whatever may be going on with me, the baby is seemingly perfectly content and active.)

Because she's seeing me next week anyway, and it doesn't *seem like* at this point, that we'll be delivering this week, she decided to hold off on steroids until next Monday. There are two good reasons for this, first and most importantly, the steroids are most effective the closer to delivery they are given (but better a little early than not at all for premature babies.) If trouble comes up this week enough to send me to the hospital, then I still will end up getting them this week. But if everything stays status quo, it's really a lot better for the baby for us to get them next week. (I don't think she'll push it back any further than that with all of the ominous signs.) Secondly, almost everyone has said that the steroids are going to screw up my blood sugar levels. My blood sugars have been fantastic and very easy to maintain with very minimal effort on my part. So if we can keep them fantastic for one more week without adding steroids to screw them up, that's okay with me too.

I'm remarkably nonchalant about this newest drama. I guess since we started this pregnancy with a 60-70% risk of pre-eclampsia just from my history, then there was notching in the blood flow early on, which is an added risk, and then it turns out I had gestational diabetes, which is another added is kind of  expected. Really, it's quite astonishing and fantastic that we've made it this far....8 whole weeks farther than I made it with Olivia and we can probably stretch this out for AT LEAST one more week, hopefully 2 more. I can't get too horribly down about that. The main thing that's bugging me about it is not knowing how much longer we get. I would really like to not deliver next week with my OB out of town for a conference. And I would really like to make it to the 3D ultrasound on Monday.My baby shower is supposed to be April 3rd but that's looking a bit iffy, but if I can make it to that, then the next day will be 33 weeks, and my OB will be back. But my body and history has had horribly bad timing in the past (not only because Olivia died so close to 24 weeks, but because I had started a new job in August and they were switching over insurance plans at the time. So I had their old plan for only September, and a new plan starting in October. They had 3 different levels of plans, and I wasn't due until January and this was decided before there was any drama, so I picked the worst plan for September and the best plan for October on. She was born on September 28th and I was discharged from the hospital on October 2nd. Picking the worst plan cost us several thousand dollars in deductibles/medical bills, which we would have at least been spared from if the date had happened to be October 1st.) So, I'll be holding my breath through next week with my OB out of town and the baby shower that Sunday.

There's always a chance that things may take a turn for the better or at least stay the same, but I'm not really holding my breath on that.

Friday, March 18, 2011

Hooray Luke!

Today was one of our best monitoring appointments yet. Luke had a REACTIVE nonstress test (aka "passing") (at least according to the nurse who seemed mildly incompetent-she put the blood pressure cuff on upside down and proceeded to use it and then looked totally puzzled, deemed it "broken", and got a different one which she did put on correctly. Not exactly confidence inspiring. And she wasn't new, apparently she's been doing this for 20 years. She was nice, though.)  I kept a close eye on the test strip and it looked decent, no big variables (there was one dip that I thought looked might have been low enough to be a variable deceleration but it wasn't a *huge* drop and the aforementioned nurse didn't seem to think it was. When she checked my fluid levels on the ultrasound (which I'm pretty sure she didn't measure correctly, I've had my fluid levels measured like 8 times the last few months, I've never seen them measured the way she did it, and it didn't even save on the computer/machine, she had to add it up manually- they measure "pockets" of fluid in 4 quarters of the uterus and add it together for the fluid level, normally they just stretch out the controller things, save it, and the computer/machine adds it, what she did looked different, didn't save, etc.)

Anyway, while she was checking the fluid, he was moving around flexing his hands and sucking his thumb or attempting to suck it, and even breathing consistently. So, I'm pretty sure he would have pretty easily passed a biophysical profile within a few minutes, if they had done it. (They didn't do it because he passed the NST, except for that the doctor had ordered BPP's 2x weekly until 32 weeks, so I guess apparently nurses can disregard that if they pass the NST, which seems kinda strange to me, but whatever, he passed and looked good and I'm confident he's doing pretty well for the time being and would have easily passed the BPP too, since he'd pretty much done everything required just in the time she checked fluid levels.)

I've had 2 less than stellar nurses in a row for monitoring. (I won't even get started on the nurse I had Tuesday. She was much, much worse than the nurse I had today.) It wouldn't be as concerning if there was a doctor hanging around there keeping an eye on things. But there are no doctors where I go, they are at the actual hospital and sort of teleconference with the off site extra monitoring place that I'm at. Thus, the doctors have never actually even seen one of my test strips, (they can see ultrasound stuff because the computers are connected, but the NST's aren't really on a computer, it prints out paper the old fashioned way), so they are relying on the nurse's interpretation of the NST, which wasn't as concerning when I had great nurses, but now... On Tuesday, Luke had a nonreactive/failed NST (supposedly no variable decelerations but I'm almost positive there was at least one- she barely even glanced at the test strip at all). Anyway, so at the very least, he didn't "pass", but the nurse didn't even call the doctor at all to even let them know. (He did pass the BPP so she sent me home without talking to the doctor at all or at least not while I was still there. All of the other nurses I've had have always called the doctor after a not passing NST, and then again after the BPP, before letting me leave.) So, I'm seriously considering making the 30 minute trek to the hospital for monitoring, which will be a pain twice a week with gas prices, but whatever, if that's what it takes. I know that not all of the nurses are going to be perfect, but at least at the hospital perinatal center, there's a doctor around keeping an eye on everything. I'm going to wait to make that decision because I'm hoping one of the really good nurses will be back next week and this week was just a weird fluke. (Right now my monitoring place is only 5 minutes away, and there's only the ultrasound tech and a nurse present, so whichever nurse is there is who I get, and there seems to be no rhyme or reason to the schedule that I've picked up on.)

I haven't actually seen my OB for an appointment since back in January when we were approaching the dreaded 23 week mark, back then she was saying how happy she'd be to see me at 28 weeks. (She did stop and talk to me 2 weeks ago about my blood sugar fasting numbers, but it wasn't the same as an appointment.) I saw her on Thursday for my appointment, finally, and she was so absolutely jubilant when she burst into the room it actually made both me and in turn the baby jump. She kept saying over and over again how excited and happy she was to see me so far along. In the face of that contagious enthusiasm and excitement, it was a little bit harder to be all "By the way, I'm still terrified that this baby is going to die." So she kind of relaxed me a bit.

I'm measuring 33 weeks (!!) at least by tape measure. (To which she says that's perfectly fine with her, as I'm delivering no later than 37 weeks and having a c-section, as long as my blood sugar levels stay as good as they have been.) I've gained barely any weight since last time. Our next (and maybe last?) growth ultrasound next Friday shall be interesting for sure, I'm definitely expecting that he'll already be at the upper limits of 4 lbs...which means that we probably really are on track for about a 7 lb, 36 weeker. She is really hoping that his lungs are mature and thinks next week for steroids is probably a decent idea to give them time to work and just in case something happens that would require us to deliver earlier than 36 weeks or without the amnio reassurance of mature lungs. (She also told me that apparently the hospital initially told her she couldn't schedule me for April 27th when she went to have them schedule it, something about the residents being in training or something that day, she fought them over it, "We need that date!! I don't need a resident!" and won.) She's not too worried about contractions as long as it's less than 6 in an hour. So it was pretty much a good appointment all around, until I went to the truck, dug around in my purse for the truck keys for 10 minutes, and then realized they were in the truck, locked. Fun times.

It's really nice to feel like I get this weekend "off" from worrying. I'm sure it's only a matter of time before something new starts up, but for now, I'm enjoying the break.

Monday, March 14, 2011

30 weeks (!!!)

I could have done without the 4 or so slushy inches of snow today, first of all, but thankfully it didn't really mess up our plans, though we probably spent a little less time at the cemetery because it was so cold. We plan to go back in a few weeks, though. (It's about 40 minutes away so we try to go monthly at least, but the ultrasound place happened to be about 10 minutes away from it, so it sort of worked out, except for the stupid weather.)

Anyway, I think we've solved the heart rate dropping mystery. Luke was in his favorite position, sort of head down and sort of transverse/horizontal (laying across me), with his feet over his head. That pesky but all important cord was tucked between his face and his legs. I should mention that when they do ultrasounds for the biophysical profile, almost every single time, his legs have been over his head, he usually has the nurse laughing at his antics. So. It's easy to see how/why the cord may be getting compressed. Thanks to his knees being in front of his face and the cord being between them, we didn't really get great pictures. But, it was well worth it for the sneak peak and peace of mind. I'm not totally at ease about it, but I feel a little bit better. If nothing else, it will help me get through *this week* before new drama of some sort starts.

Anyway, here's a couple of the pictures we got:
This is one showing him hugging his knees over his head,

And this one is okay for his face...the girl assured us that his lips aren't actually messed up and they just look a bit odd because of the cord being partially in the way between his legs and face...(and that's his shoulder/arm at the bottom, I'm pretty sure.)

And this is what he looks like from the outside:

Things are moving along relatively okay.  I'm still not so sure that pre-eclampsia isn't on the way, but so far there's nothing alarming and I think I should be able to make it at least a couple more weeks at this rate provided things stay status quo.

I did have a couple of contractions yesterday which is not going to please my doctor at all when I tell her on Thursday. (Even though they clearly weren't, "I'm in labor" contractions, because of the type of incision on my uterus, any contractions really aren't great. I'm not sure how big of a deal they are exactly because we haven't talked about it yet.-I know that labor is definitely bad and they'd deliver immediately emergency-like or try to stop it. But not so sure how bad just plain contractions that aren't really indicative of labor are.- I didn't call yesterday because at first I thought it was bad cramps, and by the time I figured it out around the 3rd one in an hour, I sat down to make sure, and they stopped and haven't started again. So I figured it could wait unless it started again, especially since for my monitoring they put a belt on to monitor contractions too and I have that tomorrow.) So maybe that will be our next drama and maybe not.We'll see. I'd much prefer that kind of drama instead of more crappy nonstress tests or something else, if we must have some sort of drama, which it seems we must. Besides that, I'm kind of shocked at how good I feel back rib pain...just some annoying heartburn and numb hands and sometimes dizziness (and bending down is quite annoying, as is getting up, and turning over to my other side in bed.Anything that requires a big shift in position, basically is a bit annoying. I'll take it though!)

30 weeks is a really good place to be, drama or not, it's farther than they realistically expected us to make it. I've never been in the 30's before. Now I try to remember that for every 1 day in utero saves 2 days in the NICU, so hopefully we can go another few weeks and keep our NICU stay either nonexistent or minimal.

Saturday, March 12, 2011

Not so reassuring. (29+5 weeks though!)

This week has been a bit more eventful than I would have liked.

On Tuesday, Luke had another crappy nonstress test, complete with two big variable decelerations and two smaller ones. But then he went on to pass the biophysical profile/ultrasound with good movement, muscle tone, practiced breathing, and good fluid levels, so they patted my back, muttered something about it maybe being the cord for his nonstress test, and sent me on my way.

On Wednesday, I saw my high risk doctor. She agreed to give me steroids at 31 weeks and ordered them at the pharmacy so I actually have the medicine right now, I'm supposed to bring it to my next appointment so the nurses can give me the shots. (Honestly, between fertility treatments and lovenox, I've given myself enough injections and Joe's given me injections that I figure we could probably manage it on our own. But that's fine by me.) When I brought up the NST's and asked about the cord, she said, "Honestly, it could be because the cord is in his way and getting pushed/compressed sometimes or it could be wrapped around him." Then she hastily added that they won't deliver for it, unless there are other signs of issues or distress. I kind of understand that, but it doesn't mean I like it. I don't want a 29-30 weeker unnecessarily, but I'd take that over having a stillborn baby any freaking day. They weren't all that worried about how things were going with Olivia (or at least they weren't *acting* worried), until it was too far downhill and too late to save her. This all feels a bit deja vu. Different symptoms and issues, but I'm petrified that we are headed towards the same bad ending.

Everything else seems to be going okay, I think pre-eclampsia might be on the way in within a few more weeks. My heartburn is back. My blood pressure is randomly suspiciously higher than normal for me. (And a couple weeks ago even when I was really stressed about the first bad NST, my blood pressure was still really good.) Joe thinks my face and hands are looking a bit puffier and my mom thought so too maybe (but I haven't gained weight which would indicate swelling). And I wake up every morning with both of my hands numb, which my high risk doctor said is definitely swelling and "she's watching". At this point, pre-eclampsia (especially in another couple weeks if these NST's don't get better) would be okay with me, because I know my doctors aren't going to wait around watching and seeing how bad it gets for very long (especially with a big baby whose already had steroids) before just delivering. And at this point, I just want him safely out on the outside. I wish we could keep him in utero up till 36 weeks, but right now, I like the risks of him staying in a lot less than the risks for 30 weekers. (Obviously my doctors don't feel the same way. So short of me going into labor, getting suddenly sick very quickly, or the baby actually showing signs of distress or worse, it looks like he's staying put until something else changes or until Joe learns how to perform a c-section. I'll pass on the amateur home c-section.) Also, they aren't interested in doing a blood flow study because the baby's growth is good and my blood pressure as of Wednesday was normal, so they don't think it's related.

Friday's monitoring was more of the same. He passed everything with the biophysical profile (though it took every second of those 30 minutes before he finally decided to breath for a full 30 seconds, in the meantime put on a show wiggling and moving around rather than breathing, or he'd take two breaths for 5 seconds and then stop and move.) Then we did the nonstress test and this time he had 3 variable decelerations but reasonably okay accelerations. With the decelerations, his heart rate dropped to 110 for about 20 seconds (I think that's how many seconds, I haven't figured out how to tell seconds/minutes on the test strip yet, but it was looking like a u, staying lower for longer before bouncing back up, rather than a v), while his baseline was at 140 beats per minute. Because of the variable decelerations, they deemed it another bad NST, but since he passed the biophysical profile and otherwise showed no signs of distress, sent me on my way. In the meantime, their advice was to keep an eye on my blood sugar and to make sure I feel movement. So extremely helpful.

I found a different place that does 3d/4d ultrasounds and they have a Monday "quick peak" special. I'm doing that on Monday because I want to have a good look at where this cord is and what's going on with it. Getting to see the baby in 3d/4d early doesn't hurt, either. We're still going to do a longer 3d/4d ultrasound at my ob's office at the end of March, but that's forever away, and I'm hoping that it *might* give me a little extra peace of mind. I'm prepared that it might totally backfire if we see the cord around his neck or something, but I think I'd rather know than not, even if that is causing it. (And I know that a lot of babies are born with cords around their necks and are just fine. I'm a little too used to ending up on the crappy side of statistics, though.) And I'm aware that the cord could be around him sometimes and sometimes not, so seeing it or not seeing it Monday doesn't necessarily mean anything. I'm always up for another ultrasound, though, and it's been forever since we've gotten good pictures of him. (Plus, in the back of my mind, I think, if this baby dies too, I'll forever regret not doing this.) And! Considering he's probably definitely over 4 lbs now and likely headed towards the 5 lb mark, by the time we do the regular length 3d/4d ultrasound, it might not be as great quality because he'll have a lot less room in a couple weeks. Joe just sighs and goes along with it.

The crib mattress has arrived. I haven't decided if we're keeping it because I'm not sure I'm comfortable with the way it fits in the crib, I can almost fit 2 fingers, though I'm convinced there's no way the baby could fit his head in between the crib frame and mattress and when he's little he won't be sleeping in the crib anyway, so that's probably okay. But I'm not sure that I'm happy with the firmness of it, either. "Firm mattress" to me means slightly less firm than sleeping on the floor, so I'm not sure any mattress would fit that bill. I bought it from Amazon and I have a year to return it for free, (we kept the plastic on it) so I'm thinking it over. It is sort of organic (a lot of mattresses that call themselves organic aren't really, I went with something I thought I could live with. It does have some of the fire proofing chemicals-namely boric acid- but at least no PVC/vinyl.) And I figure if we splurge on a truly organic mattress cover, that will matter less.

And the stroller is here and assembled too. And not to mention about 10 cases of diapers of all sizes. I was excited about all of the stuff, now, it's a bit harder to get excited because all of the stuff is a gigantic reminder of how much we have to lose...again. I thought I was kind of over that but apparently not so much. Instead of being like, "Hooray, I love this stroller", it's more like, "God, I really really hope we get to use this stroller." It suddenly feels like I'm 21 or 22 weeks pregnant again and holding my breath to see what happens next and hoping that it will turn out okay this time.

On the brighter side, I'm looking forward to getting a sneak peek at the baby on Monday, when I'll be 30 weeks. And we're down to just almost 6 weeks or less to go. (Although if the next 6 weeks go like this past week has been, I may make Charlie Sheen look mentally stable in comparison by the time we deliver.)

Friday, March 4, 2011

"Reassuring for gestational age" and BPP pass!

I still brace myself for bad news for almost every appointment. It was especially bad in the first trimester. After everything went so horribly wrong with Olivia, I had no expectation that it would go right this time and I didn't dare get my hopes up. I think I googled the miscarriage stats by week like every day. It was insane. I don't know how Joe put up with me. Every ultrasound, I held my breath until it was clear the baby was still alive. Even now, when they are looking for a heartbeat, I tense a little, even if I just felt him kick me moments before.

When I sat down in the comfy recliner for our NST today, I pretty much told her that the baby was probably not going to do very well. Even though I'd just drank a soda about a half hour before, he wasn't very active. It wasn't "I'm worried he's not active" because I'd still feel him moving every once in awhile, it was just he wasn't doing 10 movements in 5 minutes like he'd been doing earlier at 6 am. Much to my surprise, he did pretty well, after a slow first 5-10 minutes or so, he perked up. Best of all, there were no dips/drops/variables or whatever you want to call them. He had several 10 beat per minute lasting 10 second accelerations (which is the 28 weeker standard), and once a 15 beat per minute acceleration but I don't think it lasted long enough or whatever, for her to give him a "reactive" test since they have to go by the 15 x 15 standard. (She said it's like giving a 3rd grader a 5th grader test.) Instead of calling it nonreactive, she labeled it "reassuring for gestational age. "

Luke was especially good for the biophysical profile today. He got the movement and tone points quickly, my fluid levels are good, and then he even practiced breathing for longer than 30 seconds. I asked her if practicing breathing has anything to do with lung maturity, apparently it doesn't, it's just one of those things they start figuring out how to do around this time, but they don't actually *have* to breathe to be okay whilst in utero, they can be lazy and let their moms breathe for them. And it doesn't really have any influence on lung maturity.

Joe put Luke's dresser and crib together today which freaks me out and makes me excited at the same time. The dresser turned out much, much, better than I expected. We got a really good deal on a regular dresser at Big Lots, I just happened to see an ad one day and we got lucky with it, it was their last one left. I worried that it might be a little too short to use as a changing table but it turned out it's the perfect height and it matches the crib better than I expected too. So now we need to settle on wall decals (we're going to do a giant mural with them) and accessories and a mattress. (I'm picky about mattresses but am not too crazy about the prices for organic ones so I'm still deciding on a decent compromise.) But anyway, the room is coming along pretty nicely and I'll have pictures soon.

Tuesday, March 1, 2011


 First of all, thanks for thinking of us and for for all your nice comments and notes, we really appreciate it!

I love making it to a new month still pregnant. With Olivia, there were so many months that I was still "supposed to be" pregnant and wasn't. October. November. December. January. I even kept counting in my head how many weeks I should have been just to torture myself until it got to the point where I couldn't stand it anymore. Those months and weeks and days were such a crappy never ending blur.

But here we are in March with only one more month change left! Granted, we'll miss out on May I hope, but as far as I'm concerned weeks 37-40 of pregnancy don't sound like much fun to me anyway, I'll happily skip them and meet our little (big) guy instead.

Speaking of the little-big guy, I think he's gone through a growth spurt since Friday. For one, I noticed yesterday in the mirror that my belly seems to be sticking out more and even the nurse practitioner thought so. (Fundal height is measuring at about 29 weeks which is actually right in line with the baby's size predicted via ultrasound.) I haven't gained any weight in the last 3 weeks which isn't really bad and isn't really great since I'm supposed to be gaining a bit now, but whatever, I'm not exactly starving either of us. (Actually I'm kind of baffled by it.) Anyway, the other reason I think he's had a growth spurt is because I can now usually SEE him moving via my belly and all of a sudden his movements are a lot stronger. I think on Friday he'll do very well for the monitoring if what I've been feeling all day long is any indication.

Speaking of the monitoring, so the deal Friday was that he was having sharp variables/ drops, which like I said, they don't *like* to see, and it wasn't so much that he was having them in general, it was just that 4 in 20 minutes is a lot and they were pretty sharp. On Monday, his only variable/drop was much smaller. *AND* normally they don't do monitoring for 27-28 weekers. For 32 weekers, after they establish a baseline they want to see his heart rate go up for 15 seconds by 15 beats per minute. They call this "reactive" but basically it means passing. (A "reactive" NST is supposed to ensure fetal well being for about 3 days.) Anything less than that is by definition "non reactive" or in teacher terms, failing. But he's at a disadvantage since he's only 28 weeks and they don't really expect to see the "15 by 15" yet, for him, they are looking more for a "10 by 10"...10 seconds/10 beats per minute acceleration in conjunction with movement. She was going to give us a new label and call it "reassuring for gestational age". BUT. He ended up moving enough that she ended up calling it "reactive" instead. And then the biophysical profile (BPP) was the same as last time, breathing but not long enough, he was too busy moving around by then for that pesky breathing crap and who needs to practice breathing anyway when you have a mom to do that for you....except this time he "passed" the BPP because the reactive NST is worth 2 points. So on Friday he had a 6/10, fail, because -2 for NST and -2 for breathing. Monday was 8/10, -2 for breathing which is still not really bad this early. She said they are going to do a full BPP every appointment until 30ish weeks or so probably because the NST's will likely be iffy with the 15 by 15 standard. And we're officially twice weekly until the very end. Thank god I'm not working because there's no way I could keep up with all of these appointments and work.

I saw the nurse practitioner and my OB yesterday, though the NP did the appointment and my OB just stopped my briefly to talk. They aren't worried about all of the variables/drops that we saw Friday and think it was probably immaturity/movement/etc. and not something that's a big deal like a cord issue or whatever. And they were especially happy with the results from Monday. And that he's measuring so big after Olivia was so tiny. They have no idea why I haven't had a repeat blood flow study and apparently there was even a high risk doctor's order for another one in one of the reports that they never did, which should have been done a long time ago. She said she was going to put another order in for it but I'm kind of over it since he's obviously growing okay and I'm not showing any signs of trouble. But, whatever. We scheduled a fun 3D ultrasound for March 28th/ 32 weeks. That will be a great way to celebrate making it that far. Those pictures sort of creep me out, to be honest, but I really suck at surprises/secrets/etc. and I can't wait to see what he looks like. I hesitated to do it for a minute when I asked if they thought it would be overkill since I'm basically having a half hour ultrasound twice a week for the BPP. (But it's not like I get to see his face or anything, we are mostly watching his abdomen for breathing.) She laughed and said nah. And I figure what's one more ultrasound at this point. So we're doing it. Hopefully. But that's forever away and I can only think one week at a time.

My blood sugar fasting numbers have been borderline high since I started testing. My ob would like it under 90, high risk ob would like it under 95, I'm usually around 93 and sometimes 97-98, etc. It's not outrageously high that they knew I needed meds right away, and I've played around with the diet and even when I follow it exactly and eat a protein before bed (protein is supposed to level blood sugar out which sucks for me because I'm not much of a fan of any foods with protein), my levels will be high...actually higher than when I don't follow the stupid diet at all. They don't want me exercising and after I went crazy this weekend "nesting" anticipating delivery at any day this week, my fasting numbers were still high. Ironically, I can eat Olive Garden (minus breadsticks and drinking water) and my blood sugar levels an hour later were *fantastic*. Like 100 when they only want them 140 or under. So, I don't understand this at all. They decided after today (fasting blood sugar level 97 for the second day in a row, and last night I tried not eating a snack or anything before bed at all) to put me on meds. Right now it's just one pill at night and we'll see how it goes. So I guess I would have failed the 3 hour and I'm glad I didn't bother to take it. I'm nervous that the baby's growth will slow down (although I don't want a 10 lb 36 weeker and I don't want his blood sugar to be messed up), my high risk ob's nurse talked about his growth being at 78% like it is a bad thing. Um, after a severely growth restricted 1 percentile baby, 78 percentile sounds fantastic to me. (But I think she was just trying to convince me that meds are a good idea even though I really didn't need to be convinced, if they had put me on meds from the start that would have been fine by me.) I'm also a little curious to see if this is going to make me start losing weight because I'm already not really gaining...they aren't really concerned with me not gaining at this point but I'm pretty sure they don't want me gaining. But anyway, we'll see. I'm actually okay with it if I even need to go on insulin shots, I'm already doing lovenox shots so it's not like it really will be anything new.

So this week means a lot of exciting stuff. For one, March! Also, the first time I've ever been in the third trimester and 7 months pregnant, only 8 weeks to go.

Anyway, here's our big growth spurt picture:

I'm kind of liking that the bigger my belly gets, the smaller it makes my butt look in comparison.