October 15, 2012

 I carry your heart with me (I carry it in my heart) I am never without it.” -E.E. Cummings

Those of us who have lost a child do not really "need" a special day to remember them, in my humble opinion. We remember them every day. We remember them as their birthdays/ "angelversaries" come and go each year. We remember them as our due dates come and go. We remember them as our rainbow babies reach milestone after milestone that we never got to see with them. We remember them as we wonder when and how to tell their younger living siblings about them, or as their older siblings ask questions that don't have any good answers. We remember them every Christmas, every Thanksgiving, every holiday. We remember when we see a little boy or little girl or twins about their same ages when we are out somewhere. We remember the positive pregnancy test. We remember the ultrasounds. We remember holding them. We remember saying goodbye. We remember, we remember, we remember. Always.

But still. It's nice to have a day where we can share. Not only am I remembering our baby today and always, I remember my friends' babies as well. This is a pretty sucky club that no one in their right mind would ever want to join. But it is nice to know that we aren't alone. And it means so much when others take a little time to remember with us.

Crazy week.

Oy, what a week this has been.

Somewhere during the week, Luke either had a growth spurt or figured out standing on his toes and stretching to reach stuff, because areas that used to be toddler-proof by the virtue of their height suddenly aren't (like the door handles, the top edge and middle of our tall dresser/chest, etc.) I also watched Luke go in his room, or soon to be ex-room, and shut the door and then turn the handle and open it. A few times, actually, as he was pleased with this new skill and did it over and over again. I hate those handle covers so I'm going to hold off using them for a bit longer b/c he didn't open any other doors yet, I don't think he's figured out they are all the same, but that's probably coming soon.

On Monday I had a growth ultrasound, monitoring, and an impromptu MFM appointment. The growth ultrasound was fine, he's estimated at 5 lbs 9 oz at 34 weeks. I expected that he should have been a bit bigger than that by now seeing as he was 4 lb 9 oz a month ago and I thought they are generally supposed to grow half a pound a week. In any case, he's measuring about a week ahead for pretty much everything, and they aren't worried about it. I went on to do monitoring and while the baby passed easily and my fluid levels were good, my blood pressure was on the high for me side, and I mentioned the headache I had had most of the weekend and more swelling. The nurse mentioned it to the doctor who wanted the nurse to call my doctor and see if they wanted any labwork or tests ordered before they let me go. The nurse tried for an hour to get in touch with my OB, who was apparently on a plane, and her partner, who was in surgery (said my OB's office today.) Finally they just called my high risk doctor instead, who was right upstairs and told them to send me up to see her.

It was really weird going into the MFM office at a time when they had no other patients yet. (She only was seeing patients that afternoon, technically.) At monitoring, my top number was a little high but the bottom number was normal. Upstairs, the top number was normal while by bottom number was high. Still, not alarmingly high. (Like 131/70's, 122/91...though normal for me is like 110/60 and so that was why the 131 had the nurse a bit concerned since that was a little high for me.) No protein in my urine and my weight wasn't great but I'm swollen, same old, same old. My high risk doctor ordered labs but no 24 hour urine since my diptest was clear and my blood pressure is okay and they aren't going to deliver me for protein anyway.

But she talked a lot about pushing up my scheduled c-section from Oct.26th to the week before (37 weeks to 36 weeks), and with no amnio. (She actually asked when it was scheduled and how many weeks that would be and then laughed and said "god, she's such a hardass." But she acknowledged that without an amnio (to confirm lung maturity, not for anything that would actually help the baby), there was a risk of NICU time. She told me to see my OB and she would call her about it after my monitoring today. (My OB and MFM know each other well, my MFM was my OB's doctor for her two pregnancies.)

Oh yeah, and she talked about me "resting" again. When I asked her exactly how far I was suppposed to take that, she said lay down and "REALLY rest' for 2 hours in the morning and 2 hours in the afternoon. HAHAHAHAHAHAHA. No one gave Luke that memo. That sounds GLORIOUS. It hasn't happened yet. Though I did take a 2 hour afternoon nap with Luke one day. I can usually at least get some afternoon downtime while he naps.

We also had the "so are you going to do this again?" discussion, for probably the 20th time this pregnancy. I laughed and asked her if she's going to keep asking me because she wants to see at what point I change my mind or if I will. (I went from saying pretty emphatically yes, one more, in awhile... at the beginning... to just making a face and shrugging on Monday.) She grinned at me and said yep, then shook her head at my answer and said, "man, you have nerves of steel." (I guess because I didn't say emphatically "no! please tie my tubes!")

So then there was yesterday. After my bad headaches and swelling, it seemed like things had settled down a lot. Only for my OB to walk into my appointment and make a face and say I looked puffy and she wasn't thrilled that my weight is up 6 lbs in 2 weeks. (Swelling. Or Reese's Peanut Butter Cups. Blaming it on swelling over and over is starting to seem kinda lame, but seriously, I can't wear shoes or socks because they don't fit on my feet. Flipflops till November it is.)  Then she went on to say how she was glad I was still pregnant at least, because the last time she saw me, she wasn't so sure I'd make it two more weeks. (HUH? What the hell? After I left frustrated because she said she thought I'd sail to 37 weeks with no problems? Evidently she really was taking the "not stress her out" approach but that just made it more frustrating. Then again, she was pretty nonchalant when things were getting ugly with Olivia too as far as her growth and then my pain, while talking about maybe having to deliver at 24 weeks. So obviously she thought it was bad...I don't know. I don't get it.)

Anyway, she didn't mention if there was protein and I didn't ask. I'm really not in the mood to pee in a jug for 24 hours right now for the heck of it anyway. I told my OB about how my high risk doctor wanted to move the date up a week and skip an amnio and OB went on to tell me that if it was 36 weeks they HAD to do an amnio. I shrugged and said MFM was saying she was going to call her today. So my OB told me to have MFM call her after my monitoring. Monitoring went well although the baby nearly failed the NST for being too active to get a baseline. Finally they got it though he was CRAZY the whole time. The test strip was just a giant back and forth zig zag that the nurse had to get my MFM to okay. I told my nurse about the whole delivery date confusion and that my OB wanted MFM to call her. She went to talk to my MFM while I was on the monitors and came back and said, "She said you are delivering at 36 weeks. She's going to call and talk to OB after you are done with monitoring."  So all of that happened and then they had me wait until the doctors had talked. (In the same "naughty chair" I sat on Monday while they tried to call my OB.)  Luckily this took only 20 minutes and then I heard my MFM's loud voice looking for me. She was bemused. "So, do you want to know what [OB's first name] said to me?" ..."She said she will not deliver you at 36 without an amnio. And I do not want you to have an amnio." We talked about it a little and are going to try to make it to 37 weeks, again, the original plan. But my MFM wasn't completely thrilled about it and she said, "One more little thing. Just one more little thing comes up and that baby is out."  So I am on a short leash.

For the record, I actually don't really want to deliver at 36 weeks anyway right now. For one, I'm pretty sure my due date is actually off a little bit...I fudged the dates a little in the beginning because I wanted an ultrasound a couple days early. (The ultrasounds have always matched up to it pretty well though.) I definitely don't want to deliver at what they think is 36 weeks but is really 35+5. Secondly, Luke was born at 36+2 (we know for sure due to the fertility treatments I did), and had jaundice and issues eating. Neither was a huge deal, and both can happen even to babies that go post due date, but still, I'm hoping that delivering close to 37 weeks will help.

I also have a few more trivial reasons that obviously don't carry any weight if there is a real medical reason to deliver. (My ob is just arguing that swelling and even spilling protein in reasonable amounts is not a good enough reason to deliver if the baby is doing well and everything else is okay.) Anyway, my trivial reasons are...
#1- Next Saturday is the SHARE walk in remembrance for babies. And that's not really "trivial" but obviously I would not put this baby's health at risk for a walk if it came down to that. (I probably won't actually walk, even though it is a short and slow walk, one of my friends walked last year a few days after recovering from gallbladder surgery, so it's not like I'm running a 5k here. My dad is outraged that I'm even thinking about going, so if I walk, I'm going to have to hide from him.) It's a really nice ceremony and balloon release and I am hoping to go, if I'm not in the hospital.

#2- We are making progress, but our house is still nowhere near ready for the new baby. I need to wash the carseat cover and a bunch of stuff and drag out all the baby stuff I've packed away (and make room for it around all the toddler crap we have everywhere.)  I finally got Luke's room 98% cleaned out and he and I tried out sleeping on his twin bed (on the floor, we decided to skip the toddler bed thing- and we have a bedframe and box springs for the bed but he's rolled off the couch a few times sleeping so he's not ready to be off the floor yet) last night. It went pretty well, for the most part.But still, there's way too much to be done and I need more than a week.

#3- This is the most trivial reason of all. Olivia was born on the 28th (Sept.), Luke was born on the 27th (April), (so was I but Dec.), and my scheduled c-section for this baby just works out to be the 26th. So 28, 27, 26. If I have this baby before the 26th then it ruins that "connection". And I guess while that is trivial, it also gives me some inner peace that it will be okay, like it's some sort of sign, considering it's not like we planned to give them back to back numbers when we were trying to get pregnant. (With this baby, my insurance plan renews Nov.1st, so we were hoping to have an Oct. delivery date so we didn't have to pay the deductible twice for the same pregnancy. No worries with that! But we definitely in no way  planned for the 26th and it was my OB who scheduled it for that day.)

Also, my OB asked yesterday if I want to do anything "permanent" for birth control. Like she wants to sterilize me! (She hadn't talked to my MFM yet so it wasn't like they are conspiring about it.) I was surprised, because both baby factory and I'm pretty sure my first choice hospital are both Catholic hospitals and I thought they don't allow it, even during c-sections according to our grief support person who is a nurse there. (Although maybe with all of my medical history my OB has a good enough case for it. And maybe that has changed with the new healthcare laws.) And also because I'm only 28. I mean, I know I'm getting up there on c-sections, this will be my third, but before all of this drama, even my conservative high risk doctor was okay with me having one more. And while the drama is annoying and time consuming, I'm not so sure that it's so bad that I should consider NEVER having another baby. I mean, DEFINITELY, I don't want to get pregnant or do this again anytime soon. (I do not recommend having kids 18 months apart, at least so far from what I have experienced of being pregnant with a toddler.) And I'm well aware that the risks of preeclampsia increase with age and time between pregnancies, so it's not like we can wait indefinitely either. But I'm definitely not yet willing to consider shutting that door permanently at this point. I know my pregnancies are annoying and melodramatic, but sheesh, I didn't think it was that bad. Anyway, I just told her no. We may decide that we really are done as time passes and stop here. But it's nothing I'm ready to decide permanently.

Can this week be over now?

To put it mildly, we are not off to a great start this week.

-Last night my brother (15/sophomore) was playing in his JV football game (he usually plays 95% of the game- offense, defense, special teams, etc.) when he came off the field, said something to the coach, and the trainer came over and started talking to him and pulled him off to the side. He was up against a kid who was a senior, 100 lbs more, and well over 6 feet tall. My brother is not a small 15 year old, but this kid was way, way bigger. Anyway, I guess he got hit hard and his head started hurting and he was dizzy. The trainer was mildly concerned but his eyes were fine. Today she redid some kind of test that they do for concussions. (They do it at the beginning of the year for a "baseline" and then again if there is any question of a head injury.) Anyway, it was significantly worse than his baseline at the beginning of the year so they suspect he did indeed have a concussion. The latest stuff on head injuries and football players in particular is terrifying, to me. My brother is now whining because they only have 3 games left this season and if his (our current) pediatrician even THINKS about letting him go back on the field this season, I definitely will be switching. (Actually, I'm already planning to switch anyway, but this would just tell me that he is even more laidback than I thought.) I don't see how they can let him risk having two concussions in a month as a 15 year old. (My brother has a kid on his team who in 8th grade had 3 concussions in less than a year, all from playing football. What that kid's parents were thinking, what his doctor was thinking, I don't get it.)

That is the sucky part of having boys. Luke already starts clapping whenever he gets a glimpse of football on tv. I think that's just from going to my brother's games. But he will sit on my dad's lap and watch at least a full quarter of the game, perfectly content, which is a huge thing for a 17 month old. I do not plan to let Luke play football, at all, ever.

-My appointments yesterday were okay at first. (Baby needed 20 extra minutes to pass the NST but did, fluid levels were up to 10.) Then I went to see my high risk doctor and she was out. Her seriously dumb nurse practitioner saw me instead...not the one I saw last time. She smiled at me brightly and the first thing out of her mouth was, "So, are you planning a VBAC this time?" (Somehow she glanced at my chart enough to see I had c-sections but missed that it was a classical.) I had heard about this particular nurse practitioner before, it wasn't until she started talking that I realized it was HER though. She said several more dumb things and it was pretty much a waste of time. I don't think she had any idea why I was there, why my doctor is seeing me weekly, she was inappropriately unconcerned about everything, it was a joke.

-This morning Joe found out that their company has now officially lost their government contract (and the appeal.) Lockheed Martin is the main company taking over, but there is a different major company taking over the part that mainly does Joe's job. There are rumors that they *have* to re-hire 85% of the people currently working there as part of the contract, but nothing I've actually seen has convinced me. Also it sounds like they plan to cut staff and cut salaries. The company that is taking over Joe's part of things is pretty notorious for frequent layoffs. It's also pretty up in the air when the takeover will happen, he has a couple more months there at least, most likely. But still, I really hate all the uncertainty. I'm sure it will be fine, he's already had a couple of interviews and he gets calls and emails from recruiters pretty regularly, but ugh, not really what we wanted to be thinking about right now.

- This afternoon while we were at lunch with a friend, Luke ran off. I got him and had him by the hand walking towards the door when he got mad about leaving and tried to throw himself down, while I was still holding his hand. He started crying but at first I thought he was just mad but then he started crying harder and was holding his hand awkwardly. We tried to get him to move it and he wouldn't really, even to grab things he likes, like car keys. Thankfully Kim who is a nurse was the friend that was with me or I would have probably totally panicked because the first thought that came to my mind was taking him to the ER since we were only a few minutes away from the hospital. I think she suggested I call our pediatrician instead and they fit us in pretty quickly. Of course today would be the day when someone decided to have a major car fire on the highway and shut down two of the three lanes at a time when there normally is no traffic, ended up being over a half hour of traffic.(Which gave me much too long to stress about him being in pain- having to deal with him getting an xray, or his arm fixed, or in a sling or cast, and also having child protective services called on us for injuring my child...it was a super fun drive.) Luke fell asleep in the car so at least I knew he wasn't totally miserable.

He cried when I had to maneuver him out of the carseat and he was still awkwardly holding his arm by his side in the waiting room as he pointed at the fish in the fish tank and played with the germy toys. When the nurse called us back she even glanced at him and asked, "his left arm?" Yep. Then she had me put him on the baby scale and he freaked out and cried and cried. Even as we were back in the exam room, he was still sobbing. I picked up a book and started reading to him and as he calmed down, he started turning the pages with his left hand all of a sudden. (Before he wouldn't even reach out and grab anything with his hand.)  Then he reached up and grabbed a different book from the counter beside us, with his left hand. It wasn't much longer that the doctor came in. Decided he must have had "nursemaid's elbow", or a dislocated elbow, and that he must have fixed it himself. I took off his shirt and he didn't so much as flinch. The doctor pressed on his shoulder and elbow and wrist and moved them around and he didn't flinch at all either. He said he would order an x-ray if I wanted it, but didn't think it was necessary or would show anything. He was clearly fine by this point so I opted out of an x-ray.  We have wasted a lot of money on unnecessary pediatrician visits (two colds that were just colds) and an unnecessary ER visit (crying), but this was BY FAR, the best "wasted" copay money because at least if nothing else, we went in with his arm hurt, we came out with it 100% better, even if the doctor didn't have to do anything...it was a huge relief that we didn't have to deal with xrays or the doctor fixing it or anything. He played normally all evening using both hands and arms, dancing around, etc. So I am completely reassured that it's fine. And I am really glad I didn't spend 200 extra dollars taking him to the ER.

Toddlers are so fun. 

Luckily, I'm out of bad things, but it's only Tuesday, and considering it's only been two days into this week, it's been bad enough. I'm a little afraid to leave the house tomorrow.

9-28-12

It's hard to believe it's been three years. That we should have a three year old.

Happy birthday Olivia. We love you and miss you so very much.

Day to day.

Yesterday I had 3 appointments.

My OB was annoyingly calm about everything. She still thinks we can make it to 37 weeks (and even started lecturing me about some difficulties 36 weekers can have, like I'm just tired of being pregnant or something...) And then she mentioned she saw my protein level test results and called it "good" and nonchalantly mentioned I was spilling protein again on their diptest and didn't raise an eyebrow that I'd gained 4 lbs in a week and 10+ lbs in 2 weeks (that day when I gained 7 lbs between the two appointments? I really did gain 7 lbs between the two appointments. Yesterday my weight was exactly the same at my OB and MFM, so the difference was probably not their scales.)

She is so frustratingly calm that it makes me question why I'm even wasting the time and money to see her. And so calm it makes me again think back to three years ago and wonder if things would have been different at all if I had been seeing a different doctor, if I had asked to see a high risk doctor, etc. I mean, the Friday before I got sick, I called begging them to take me out of work and put me on bedrest. The nurse was going to call me back on Monday after talking to the doctor who was out of the office. Monday I went into the hospital at 3 am and came out almost a week later with a dead baby. The week before, I saw my OB for the extreme upper right quadrant pain I was having. She suggested I try prenatal yoga. Then we did the ultrasound and saw Olivia was extremely far behind in growth, so she saw me again, and said that I was probably developing preeclampsia. I was only 22 weeks with a severely growth restricted baby, in severe pain, and she sent me home because my blood pressure was normal and my urine was clear. She even mentioned that slow growing babies are at risk for being stillborn and that we may have to deliver as early as 24 weeks because even that early, some babies are better off outside where they can grow rather than in utero where something major is wrong. She didn't order bloodwork or a 24 hour urine. She didn't send me to a high risk doctor. She let me keep working. (In fact, I specifically asked about bedrest. She mentioned it wasn't proven to help...which is true...but it would have been better than doing nothing.) I was supposed to follow up in 4 weeks, and I was 22 weeks, so I was relieved because I thought that that at least meant we should make it to 24 weeks. I know she had no idea how bad it was or would get, and I do really ultimately think that *most* ob's would have done the same thing...my blood pressure was good and my urine was clear. And I don't think it ultimately would have made much of a difference, even if I had been put on bedrest then, we were in such bad shape, bedrest probably wouldn't have made a difference, or maybe just bought us a week, but even a week longer likely wouldn't have saved Olivia. But still...she disregarded some pretty serious stuff...stuff that could have ended up killing me before we ever even made it into the hospital. So it's not only frustrating that she seems to be on another planet at this point in this pregnancy, it's triggering some feelings I thought I had resolved a long time ago.

My high risk doctor is not nearly as relaxed. I asked if she thought we were still okay to deliver at 37 weeks and she stared at me like I was crazy and said, "I'm a realist. Let's just see how your monitoring goes downstairs."  I pressed her about it a little more and she elaborated that while she would LOVE for me to make it all the way to 37 weeks, she has no intention of walking on egg shells for an extra week unnecessarily and the best case we are probably looking at...if everything stays status quo and we can limp along a few more weeks...is delivering at 36 weeks with no amnio. Because at this point, I have steroids, and the baby's lung development is secondary to the risks of preeclampsia and/or HELLP...seizure, stroke, placental abruptions, etc., so if she decides it's time to deliver because of my symptoms getting worse or signs that the baby is starting to have issues, whether his lungs are completely ready just yet is irrelevant (they likely will be fine anyway) and we don't need the added risk of the amnio putting me in labor (again). She is also really nervous about my weight gain, which she said is definitely swelling, and was not happy to hear that I had protein again in my urine that morning. (Though I had a clear test there.) Luckily she decided not to do another 24 hour urine just yet, I think she doesn't really want to know if that's much worse yet, since there is no recommendation or guideline on delivering for protein levels alone and the baby is doing well and my blood pressure has been good and I haven't had any symptoms of HELLP, yet. And probably, if I'm able to have some clear tests at least, it isn't that much worse yet.  But still, she had pretty much the opposite attitude of my OB, which was actually kind of reassuring that I'm not crazy.

The baby keeps doing really well on his nonstress tests, except for the pesky fact that my amniotic fluid levels have gone from 18 to 15 to 13 to 11 over the last 4 times they were checked. A lot of things can affect measuring fluid levels, (especially the baby's position and the person who is doing the measuring) but they should stay relatively constant, generally speaking... (With Luke they were around 15-16, sometimes up a little from that, sometimes down a little from that, but right there in the middle with no pattern up or down, just some minor variation.) They want them a 10 or higher, so if this trend continues, on Thursday my high risk doctor is not going to be happy. I don't think they'll deliver at this point for fluid levels unless they get really bad, but I wouldn't be surprised if it earned me bedrest officially or even getting admitted with iv fluids to see if that might help. I distinctly remember one person on the Preeclampsia Foundation forums who was in the hospital because of low fluids and they were trying to get them up with IV's and drinking, when she had a placental abruption that her doctor happened to be right there in the room watching the baby's monitors and they managed to get the baby out just in time via emergency c-section and probably saved his life. In some cases, low fluid levels can proceed other things going haywire, so while this trend is still within a perfectly normal range, I'm not incredibly optimistic that I'm going to be leaving the hospital Thursday after my monitoring in lieu of everything else going on too.

On the bright side, we are really close to October, I'm really close to 33 weeks (Friday), and I'm still feeling pretty good, overall. Fingers crossed we can make it a few weeks more. Or at least till October.

Lots of updates.

Today I was at the perinatal center for monitoring. I happened to glance up at the time the nurse stepped in the door to call someone back when I realized it was my favorite nurse from my pregnancy with Luke. She is mostly working at the perinatal near my house now (and I haven't done anything there except my second ultrasound), so I haven't seen her yet this pregnancy. She didn't even call my name, she smiled and motioned for me and I went back, and she told me she grabbed my file on purpose because she remembered my name. (I think Luke and his eventful monitoring sessions may have stressed her out as much as it stressed me out.) She was as awesome as ever. It's too bad they don't have doctors at the perinatal center by our house, because I'd love to get to see her for all my NST's again. (And not drive 30 to 45 minutes for them.) These days, though, I'm at the hospital for appointments weekly anyway so it actually is easier to have an appointment then monitoring right there in one chunk of time, it's just the second time of the week that it's a pain to drive out there only for that. Though with all of the drama and uncertainty, I feel better being by the hospital and with doctors there.

Baby boy looked good. And showed us he is a boy multiple times during my fluid checks, it was impossible to miss. I still don't understand how people with surprises can have monitoring and not see boy parts if they are having a boy unless they aren't watching a lot of the fluid check. Or maybe my boys are just super proud of their parts and like showing them off in ultrasounds. Anyway, while they were doing fluid checks, he was moving well, practicing breathing, fluid levels were normal, and he flipped back to head down again. He kept moving off the monitor for the NST so that was a little tricky, but eventually when I held it down where he was, he easily passed.

The only thing that has me wondering a little about how he's doing specifically, is that his/my amniotic fluid levels have gone from 18 to 15 to 13 in the last week and a half. They want it over 10, so at this trend, it could be at or below that next week. But there are a lot of explanations for the variance...like the fact that the measurements were done by 3 different people, or the fact that he was head down, then breech, then head down again. So it's not something I am super concerned with, knowing it could be right back up to 15 or more on Monday, but it's something I am "watching". Low fluid levels can be a sign of fetal distress--I had that with Olivia when things were bad--and that's why they check it with the NST every time.

I saw my high risk doctor briefly who was happy with how things looked, told me to start trying some stronger meds for the heartburn to see if that helps, and said she'll see me next week. So we are a couple hours away from 32 weeks and it is looking encouraging we may even make it to Oct. That's as much as I can dare to hope for just yet.

I am really looking forward to just vegging out around our house (hopefully getting some cleaning done...or SOMETHING constructive done...like laundry) tomorrow. Four appointments a week was time consuming enough when I was pregnant with Luke, now it's just a joke, it seems like there is no time for anything else. Next week I have 5 appointments between my OB, high risk doctor, 2x monitoring, and a dentist appointment...that's assuming I don't have to do any bloodwork or labs or a 24 hour urine, which I'm guessing is very likely in my future. Then Friday is Olivia's birthday (which I have hardly had time to think about while at the same time am thinking about it way too much.)

I half-heartedly packed a few things in a bag and threw it in the van today just in case I didn't get to leave the hospital. Important stuff like comfortable clothes, my Nook and charger, cell phone charger, toiletries, the camera, and an extra book. I think it's a pretty good prevention from getting admitted, because usually my hospital admissions have caught me unprepared...with Olivia I had my purse and a book and that was all. With my hand, nothing except my purse and my dad. (And Joe did a really bad job of packing clothes for me, thank goodness for my mom! He did get my Nook and chargers and laptop, but still, comfortable clothes are VERY important when you are stuck in the hospital.) Even with Luke, I had a bag mostly packed, but I was busy cleaning and planning to put a few more important things in it at the last minute when my water broke and that went out the window. (Important stuff like his baby book!) So still, we ended up calling my parents at some ungodly hour in the morning, I think like 2 or 3. And at first we just told them what happened but that they weren't planning on surgery till 7 so they could take their time. But then my contractions picked up and 7am turned into 4 am and suddenly we were calling them and asking them to go to our house ASAP to get the baby book so they could get his footprints/handprints done in it...they were literally wheeling me into surgery when someone in the room said, "Oh, here's the baby book!" So yeah, I'm thinking that as long as I keep a bag in the car on days I have appointments, maybe we can even make it to Oct.26th. I'll just have to try not to unpack it when I get low on laundry and stuff.

Our house is not so much a fun place to be at the moment. Luke is being very much a 1.5 year old, which at the moment is exhausting. Joe is stressed out about his work situation (contracts are still in limbo, he's had a few interviews, pretty certain he will have *a* job, not so sure it will be the same pay, etc.). And then there's me and this pregnancy and trying to keep up with Luke and also worrying about Joe's job and blech, blech, blech.

Luke is a little pistol, to put it mildly. I think his favorite thing in the universe is dogs, although he also really likes his cars and ride on toys and saying "beep beep" over and over. This morning my mom came over and watched him for a little bit while I had a new pediatrician "meet and greet", and when I got home, I managed to accidentally let our husky out. Luke got into the spirit of trying to catch him (holding my hand) by patting his legs and yelling "dog! dog!"  like he always tries to do to get the dogs-any dogs, anywhere- to come to him (which has never ever worked, but the poor kid sees it works for Joe and I, so he keeps trying and trying.) Luckily, Koda stopped at a fenced yard a few houses away that had a couple of dogs out, tried his best to get in a fight with a pit bull in the yard but luckily the fence between them prevented it (I was actually more worried about him hurting another dog vs. getting hurt, he's such a pain in the butt.)  My mom was still there and managed to grab our dog and drag him back to our house (and probably only bothered to try to catch him because she knew I would if she didn't). Ugh, dogs. But watching Luke hitting his leg and yelling "dog! dog!" so intently like it might just work, almost made "the chase" worth it. I could have done without having to carry him home kicking and screaming and trying to squirm out of my arms because he wanted to walk around the neighbors' yards (not people we know or have ever even seen before). So I'm not sure who actually had it worse, my mom dragging our 40+ lb husky by the collar while he tried to stop/pull away over and over (and FYI, huskies are pretty strong), or me carrying the 30 lb toddler trying to kick me in the face and jump out of my arms. Fun walk home.

HELLP

I almost made the title of this "the second worst outcome", and I wanted to, but given my current pregnancy drama, didn't want to stress anyone out unnecessarily. So you are welcome! :) As far as I know, I'm fine, baby is fine.Both rounds of steroids are in, 24 hours until they should be fully kicked in, so hopefully the baby's lungs should be good to go, whenever he is born. (Hopefully not until October!) Nothing really new to report except last night my heartburn was so bad it woke me up at 3 am and took a couple hours before I could go back to sleep, and dinner was nothing spicy, so that's erm, sucky, but could be normal. (It is NOT "upper right quadrant" pain, thankfully.)

Anyway. I remember someone, I think probably Brooke , talking with her doctor or someone medical not long after her daughter Eliza was born still, and them saying that losing the baby was the "second worst outcome". And when she questioned that, they either said that the worst outcome was losing the mom and the baby, or possibly just the mom. (Sorry to be vague, my brain isn't working so great at the moment.)

 Obviously, I think losing the baby AND the mom would definitely have to be the worst outcome, losing two lives with one pregnancy. Nobody goes into pregnancy expecting to die, or even thinking that women still die in pregnancy in this day and age, especially not in countries with medical care like we have in the United States. I can see how a doctor might think that losing a mom is the "worst outcome", but from a mom perspective, I'd say losing a baby is the "worst outcome".  I would have gladly traded places if we could. But then Luke wouldn't be here, so in that respect, I'm glad I didn't die.

But I still vividly recall a medical professional trying to comfort me in the hospital after they told me we had to deliver and Olivia was most likely not going to survive," You are young. You have family. You can go on and have other babies". Really, not that comforting or helpful in that particular moment, though I know they meant well and were trying to save my life at the time. But all I wanted in that moment was THAT baby, our baby girl, the one who was still inside me at that moment, moving around, but so small I couldn't yet even feel her, even if her survival meant I had to trade my life for hers. I knew even then that they couldn't promise I would ever get pregnant again, or that we would ever have a healthy living child, or that having a living child would just make up for the one that we lost. (It doesn't "make up for it", but I am glad, now, to still be alive so that he can be here.)

Anyway, apologies for rambling. What I am getting at that even as recently as this month, women in the United States are dying from HELLP syndrome and preeclampsia, sometimes their babies survive (usually, in these cases, it seems like the baby does survive), sometimes they are both lost. As sad as that idea is, for a baby to be motherless and a father widowed in what should be the happiest time of their lives, it's worse when you see the faces...the young, healthy women glowing with pregnancy and glowing holding their new baby, only to die soon after.

Even though we lost so, so much because of HELLP, it could have been even worse, which was impossible to think at the time, almost 3 years ago. But now, I know I am lucky to be here. These stories of women dying could have easily been me. If we hadn't gone to the hospital when we did. If they had sent me home when they initially found almost nothing wrong. (My initial labs showed my liver enzymes just "slightly elevated" with everything else totally normal. They thought my liver enzymes may have been elevated from gallstones...They kept me anyway. Six hours later, my liver enzymes more than doubled, and my platelets dropped by 100,000. I continued getting worse over the next two days before things finally started getting better. My platelets went from 250,000 upon admission (normal) to 40,000 at the worst (the worst category of HELLP, "class I", which is 50,000 and lower), in a matter of a couple days. Even as my labs got worse, I didn't feel any worse. These stories most certainly could have been me.

I am at higher risk than most to develop HELLP again. We can't say for certain that this is where it's going, yet, but a lot of the symptoms I am having are all too familiar. This is why I got the steroids now, in case we need to deliver soon.  And this is why I'm on a pretty short leash as far as how long this pregnancy will go. Since my blood pressure barely acted up last time, it may not act up again this time. (I suspect if I look at my records closely, it was only high when we were in conversations about Olivia dying, etc.) , there were one or two barely elevated readings over the entire week+ that I was hospitalized. I don't really like how my symptoms...the swelling, the heartburn, just feeling off, are seeming to be progressing and constant. It is impossible to predict though, how much longer we have left. On Friday, I will be 32 weeks. Just one day, one week, at a time, at this point.

I came across this video today from a friend on Facebook, it is not to ask for donations, but simply to put a face behind one of the stories and spread more information and awareness about HELLP syndrome. September seems like it is a bad month for HELLP especially, though maybe I'm biased because that's when I got sick and diagnosed with Olivia. At the beginning of the month, on the PreEclampsia Foundation, a bereaved mother wrote about her daughter who died from HELLP 4 days after delivering her baby boy a month early. (The video below is not the same story, it has been on YouTube for 3 years, but both women who died were young and healthy and in the hospital when they died.) Like preeclampsia, there is no "cure" for HELLP besides delivery, and often it gets worse after delivery before it gets better (it got worse in my case as well). Sometimes (usually) HELLP presents first as preeclampsia, with protein in the urine and elevated blood pressure, and as preeclampsia gets worse, it can develop into HELLP, with red blood cells breaking down (Hemolysis), elevated liver enzymes (EL), and lowered platelet count. (LP). It basically attacks the organs and blood of the woman.  Sometimes women are like me, and don't show they typical preeclampsia symptoms while going directly to HELLP. (In my case, swelling and severe upper right quadrant pain...around my rib cage/bra strap/back on my right side especially...pain that came and went for WEEKS...were my telltale symptoms.) It typically doesn't happen until the third trimester, but can happen (rarely) as early as 18+ weeks. It most commonly occurs in first pregnancies, when women are the most vulnerable because they don't know what is "normal" discomfort in pregnancy and what is not. (I even posted on internet pregnancy message boards about my rib cage pain, and was reassured it was normal by everyone.)

Here is someone else's HELLP story, with some good medical information in there as well.