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.


Raquel said...

HI- I found your blog a couple of weeks ago. You are definately an inspiration that a successful pregnancy can be done after pre-e and hellp.

Glad all is working out and that little Luke is doing well. <3

Anonymous said...

I've been following your journey with Luke - congratulations on making it as far as you have, and I'm sure that you'll make it to 37 weeks!

If it's any comfort to you, my son was born at 36 weeks, and although I didn't have any steroid shots, his lungs were perfectly fine. They were a bit goopy because I had a c-section, but after an hour of CPAP he was good to go. He was tiny, though - 5 lb 4 oz at birth, and 4 lb 12 oz by the time we left the hospital. Sounds like your baby is tracking to be much bigger than that, which is awesome!

- Annabelle

MrsH said...

Hey, that is great news! everything seems to be going stellar with this pregnancy then. I am surprised that the nurses do the ultrasounds for you guys, for us it is only the ultrasound techs and the obstetricians. The NST's are easy to read for any ob nurse, so don't worry about the actual ob's not having read them, that should not be a big deal. There are clear rules about variability and deccelerations that any one of the nurses on the ob floor can interpret.

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