Saturday, July 12, 2008

Another long day

Another long day today.

Had my 6w postpartum appointment with my OB this morning. Nothing earth shattering. The hospital hadn't sent her the results of my MRI so she didn't know I didn't have brain cancer. She was relieved.

I seriously love my OB. Really, all the doctors involved in giving Robbie life were freakin' amazing. My RE, My OB and of course, Dr. C- one of the neonatologist. (We need a name for him. Dr. Mcsomething. Hmm. I'm not very witty tonight. Help a girl out here.)

Anyway, we had a nice chat. She asked about my husband's doctor's appointment. She even commisserated that August 22nd was way to effing long to wait for a scope.

I've still been having some pain on my right side. She sent me for labs a few days ago to make sure my liver was really okay. It is. The latest theory is that it's my gall bladder. I've been trying to eat a little better the last few days and it seems to be improving. I figured I'd just call my PCP if it acted up again. Honestly, my OB has done enough for me and this isn't her area. But she all but insisted on writing me an order for a gall bladder u/s. She knows I don't really like my PCP so she just helped me out. I really need to send them all a thank you note.

Speaking of "all of them" her nurse is back from maternity leave. Turns out that her son had some sort of heart issue when he was born and had to have surgery. He was in the same NICU Robbie is in for about a week. (He's totally cured now, though.) Anyway, she was just so sweet. She asked how the docs were treating us and told me which one she didn't like I have had very little interaction with her, so I can't say if I'd agree or disagree, but it amused me that she opened right up with who she did and didn't like. She asked about the peris that I worked with and I told her about Dr. Sunshine. You could almost see her making a mental note that he was an ass. Again, made me laugh.

Anyway, really, the only thing of real interest was the discussion about birth control. Our original plan was that we weren't going to use any. I mean, it took us long enough and enough medical intervention to get pregnant that the chances of us conceiving on our own is fairly slim. But as the fertiles point out- sometimes Bam! it happens. And that was fine with us.

Until preeclampsia.

Now, the thought of being pregnant again makes me want to puke. But what will we use? With breastfeeding, hormonal would be something progesterone only. The mini pill, depo, IUD or implanon.

I'm DEFINITELY not going back on depo. (Much to my doctors relief- her respone was "Good. Because I hate it.")

IUD could be complicated because I never dialated and it could actually be a problem with my classic c-section. (That was news to me. Creepy! It could hook my scar or something insane.)

I don't want the implant because I'm not really prepared to make that long term of a decision yet.

The mini pill wouldn't be bad, but I know myself well enough to know that I'm not going to remember to take it at the same time each day. I can't manage to get myself a drink of water half the time. And I've heard the spotting-all-the-freaking-time horror stories.

So that leaves barrier methods. I was sort of angling for a diaphragm but she said she doesn't like them because they're just not really effective. I guess they're listed pretty high on the info they give out, but in real life, they're more like 75-80% effective. Worse than condoms.

She suggested condoms. Cue me making a snarled face. I hate condoms. And I'm not 17. And I hate condoms. Did I mention that I HATE condoms?

So now what? Theoretically, I shouldn't ovulate while I'm pumping so regularly. And I probably wouldn't get pregnant even if I did. But.. what if. It's just too high risk right now. Hell, I think my doctor would kick my ass if I turned up in her office pregnant again. We won't even discuss the emotional & physical toll it would take on me.

I still don't have an answer. David would use condoms if I asked him to. He's a saint like that. But damn.

Anyway, enough about that.

After I left the OB's office, I went to the hospital. Since I was there so early, I was present for rounds. Dr. M and the NP decided to take him off his steroids completely. He was getting such a low dose that they decided it was pointless anyway.

Then came the discussion about his lack of weight gain. He did gain 12 grams last night but Dr. M doesn't think it's enough. But he's already maxed out all the way around. But he decided to go up on his volume anyway. You could tell the NP didn't approve. Apparently they normally go with 130-160 ml/kg. he's already at 160. The doc said to put him up to 8.5ml/hour which put him at 162 calories. The NP did the math and said it was 165. He said to do it anyway.

Then the nurse chimed in that Robbie has had some diarrhea. She clearly didn't like the "more volume" answer either.

Dr. M asked to see a diaper. The nurse changed Robbie and showed him. Yep. Runny. The doctor said to do it anyway. When I pushed and asked if his poop was okay, Dr. M leaned in and whispered "he needs the calories."

I should point out that Dr. M is notoriously the most conservative Neonatologist in the group. It's been mentioned several times. So I tend to believe that he wouldn't be pushing if he didn't really feel it was important.

His feeling is that Robbie's breathing is poor because he's puny. And he's puny because he's using all his calories working so hard to breathe. So something somewhere has to be pushed.

So cross your fingers. I'm worried. I'm worried about the diarrhea in general, but also about them overdoing his feeds.

I listened to Dr. M talk to some parents whose son had to have part of his intestines removed today because they were necrotic. Not what I needed to overhear today.

These things that you just never think about are all SO IMPORTANT now.

They also decided to alternate him between CPAP & nasal cannula. Robbie had several As & Bs overnight and this morning, so they're hoping the CPAP will help, but also don't want to hurt his nose any more than absolutely necessary.

The first round of CPAP started at 11:30 this morning. Robbie was NOT A HAPPY BABY. He work both his nurse & me out. Trying to get it in the right place so it worked, keeping his mouth shut so it didn't blow out his mouth, keeping him calm.. it was exhausting.

When it was time to go back on the cannula, we kangarooed. SO much better than yesterday. He slept most of the time and was down on his oxygen to as low as 23% at one point. Much better day. 3 hours of good love.

He went back to bed just before shift change (7pm) and was just wide awake and super alert. I swear to you that I think he smiled. Twice. I mentioned to his night nurse from last night that I could have sworn he smiled and she said he smiled last night. Now, I know he can't smile yet. But he certainly did look happy. I beamed.

Then he had to go back on the CPAP. Fortunately I guess he was just so tired that he passed right out. She got him in a good position and we all agreed not to disturb him.

We left around 9 and he was still snoozing. I called at 10:30 (I couldn't find my camera- I left it there.) and she said she hadn't touched him. He was on 28% and doing great.

What a relief.

I just checked in again and he gained 10 grams tonight. Again, not the 30 they hope for. And he's still having diarrhea.

She's going to mention it to a NP and see what they think. From my limited research, it can be due to him getting too many calories for him to absorb. So I don't really understand how ADDING to that is going to help. I'm not a doctor. But I'll certainly be asking about it again tomorrow.

That was pretty much the day in Robbie.

As for me, I think the lack of sleep and just general stress level got to me. I was pretty weepy this afternoon. I still see him struggling to breathe and it scares me. And it pains me.

And thinking about going back to work.. well.. it's not pretty.

And scary stories slip into my mind sometimes. There are many, many more success stories, but the bad ones seem to linger longer. I've had a few nightmares. I won't rehash them but you can imagine. I even dozed off while kangarooing this afternoon and dreamt that he had turned blue. I awoke with a start and checked him and his monitors. Both were fine. And that was one of the more mild ones.

I worry about how I'm going to manage when he does come home. I'm afraid I'll be a basket case checking him every 5 minutes. I think I'd have been a paranoid mom anyway. And now, there is no hope. I'm just terrified all the time.

But.. I forge forward. To love someone is always a risk. And I've never loved that way that I do now. It's a great risk. Good thing he's worth it.



Just Me. said...

Trish, I am here praying for you guys and really do hope Robbie will be ok soon.

I love this bit: To love someone is always a risk. And I've never loved that way that I do now.


Amy said...

Wow, that does sound like a long day. I'm continuing to pray hard for you. And I love that Robbie looked happy. :)

Mrs. Spit said...

Little Pooper!

I'm so glad he smiled for you. That's so exciting!

As for birth control, your doc. may also be hesitant to prescribe estrogen based birth control, as it is often linked with an increase in BP.

You do have the option of the Nuva Ring and an IUD if estrogen based bc won't work for you. You can breast feed with the IUD.

Robyn said...

I used the nueva ring for awhile. There was no forgetting to take a pill or anything. You leave it in for 3 weeks and take it out for 1. I really liked it.

Anonymous said...

Trish, I contiue to pray for you and Robbie and check your blog everyday for updates.

about the birth OB refused to put me on anything hormonal :( and we had to use condoms for the last year. It sucked, but better than getting a surprise I guess. Hang in there.

Kim said...

I'm always thinking good thoughts for you guys.

I am allergic to most forms of birth control, and also hate condoms (because I'm not a whore.. we're married! Ha!). We obviously never needed to prevent anything that wasn't happening in the first place, but I have many friends who are faithful NFP (natural family planning) followers and have never had a slip up. So I really think that could be a great option for you. I'm sure you have the charting stuff down, and that's basically all it is.. knowing when you should (allegedly) be most fertile and abstaining those days.

Two Hands said...

I hear lots of people say that little babies can't smile, but they really don't *know*. If you think he smiled, then I'd go with it.
I'm sorry you're having nightmares though. You don't need to worry while you're sleeping too :(
Praying for you all.