Thursday, October 27, 2011

33

And here I am 7 weeks more pregnant than I made it with Robbie. That's sort of insane to me. I remember Robbie at 7 weeks old. He was off the vent, but still on CPAP. I'd gone back to work and was trying to split my time between working and being with him. He was still beyond tiny. Chello already likely weighs more than Robbie did when he came home from the hospital on his actual due date. It's a lot to wrap my mind around.

David came to bed just after midnight tonight and I said "Hey baby?" "Yeah?" "Thirty three weeks." He grinned a sly smile and whispered "wow." We're both just in awe.

A friend from the NICU brought me lunch yesterday. Her daughter was Robbie's NICU girlfriend, born at 25 weeks. We talked about how we never even new the 32/33 weeker families. They were there and gone before we could even say hello. I'm sure it didn't seem that way to THEM, but we were both there 14 or so weeks. It seemed like the blink of an eye and they were gone.

This week's labs were amazing. No protein this week because it was my pee-jug-break week, but my ALT was down essentially to normal. Not "Trish Normal." I mean actual normal. It should be 40 or under and it was 41. There a bunch of other tests that I don't usually bother with the numbers on, but apparently everything was improved this week. Funny, too, because it was David's birthday and between that and a lunch one day, I had 3 restaurant meals last week. I tried to make good choices, of course, but it's difficult to keep your sodium down with anything out. And yet this week's results were the best in months. I think this means I need more Italian food, right?

My blood pressures have been a little unstable. I've had to watch them more closely and focus on relaxing to get them down a bit. Nothing terrifying, just creeping up towards 140/90 sometimes and I get anxious (which doesn't help.) Last night I ended up with a horror-movie quality nose-bleed and the first thing I thought about was my platelets. Eventually I got it stopped and I was fine (and my blood was clotting while I watched, so really, it was fine) but it was gross and a reminder of how quickly things can change.

Otherwise things are quiet here. I've been reading a ton. I wanted to read 50 books this year. 6 weeks of bed rest has made that easy, I finished #51 tonight. (The Hunger Games- Two thumbs way up!) I watch a ridiculous amount of TV and make lots of lists. Robbie had his first school field trip today. They went to the pumpkin patch. I was very sad not to be able to go with him but my dad went and they had a great time.

My anxiety level has been creeping up a little again, though. It's funny because I was doing better for a while, but I think being able to almost reach out and touch full term makes me feel vulnerable that it could still be snatched away. Probably in a similar way to how 24 weeks made me more nervous, not less. Logically I know that even if the baby came now, she'd likely do well, but I also know that a preemie is still a preemie and you can't count on anything.

My favorite peri okayed scheduled my c-section at 38 weeks. Of course, he warned that if I start having any kind of regular contractions (even if I'm not feeling them) or if my labs worsen, that's it. But he doesn't think an amnio is necessary. He says we plan for the best and if something changes, we deal with it then. That's what I wanted him to say, so it made me happy. I go back to the OB on Monday and will hopefully be scheduling my section for 5 weeks from today. That would be December 1.

I'm trying not to get really hung up on that date. I've always had the feeling that we were having a baby in November, and I know that things can change in a matter of hours with preeclampsia, but the notion that I am having a baby in 5 weeks or less is pretty surreal.

Chello has been pretty active most days and I find myself thinking "wow, I'm really going to miss this." I have absolutely zero doubts about this being our last pregnancy. I'd love to raise more kids, ideally adopting out of foster care, but even if I can ever get David on board that plan, I KNOW I can't take another pregnancy. We got pregnant relatively easy this time (for a couple of old infertiles anyway) but this is clearly an insult to my body and the stress is just crazy. I think even my OB would disown me if I suggested it.

I also know this is an amazing experience that not everyone gets the opportunity to have. I get to feel my baby kick inside me. Sometimes I can even tell which body part is doing what. Sometimes I poke and she pokes back, seemingly saying "Leave me alone!" She gets pissed off at the monitors and goes all crazy for a few minutes when they strap them on. This one has a temper. Oh boy! Sometimes her reactions to things makes me laugh. Robbie has a flute that he loves to make horrible screeching sounds on and Chello will kick. I think she's telling us to keep it down out here.  These are special moments that I will miss.

For now I'm just trying to treasure them and each day that I get to experience them. Thirty four is a huge milestone in pregnancy and I'm looking forward to it coming. But right now, 33 feels pretty damned good.

Trish

Friday, October 21, 2011

32

Made it to 32!

Monday's OB appointment was.. surprising.
My OB was overjoyed at being at 31.5 weeks. You really can tell she's shocked, but in a great way. She actually said I may go full term. She did say it with some skepticism, but just the fact that she dares to hope was nice to hear.

We talked about Dr. Bitchy's desire for an amnio. She wanted to know how I felt about it. I said that I understood it, but was a bit confused since I thought it had already been decided that it didn't matter. My plan is to talk with my favorite peri at my next check there (next Monday.) She was fine with that but warned me that he is typically more conservative as well, so he's probably more likely to also want the amnio. If he does, that's fine, but I trust his opinion more than the others, so I'd like to hear his thoughts.

We discussed the all important timing of the C-section. And this is where it got interesting. I said that I wished we could go to 38 weeks, but I understood that we had to be conservative with my uterus. She actually shrugged and said "Well, you know.. if you're like you are now, we might be able to do that."

I almost fell off the exam table. I said "REALLY? How far can we push my uterus?" And she basically gave me the Very Serious Tone and said "IF you aren't contracting, we MIGHT be able to schedule you for exactly 38 weeks." I got that she was giving me the "don't get your hopes up" speech, but I think she really wants to give me what I want if it's safe. I seriously almost cried.

I know it's early, but so far I've only felt one contraction and that was in the hospital last week when I was dehydrated. Not unexpected. Now, of course, this would require a good deal of luck on my part and if there's anything we've established, I'm not really the luckiest procreator in the world, but even the possibility is pretty darned exciting to me.

It wasn't all sunshine and roses. She did kinda catch me off-guard at one point. We were discussing timing of appointments and how I had been comfortable not having an NST this week (they left it up to me) because of how things had been going and how closely I had been watching my blood pressures at home. She said "yeah, that's the only reason you're not in the hospital. Anyone else, you'd have been there. I trust you to keep a close eye on things and call if anything is wrong." That was sobering. I knew she meant it as a compliment -"what a great patient you are!" but it was a very real reminder that things are not As They Should Be.

However, in other good news of the week was that this week's labs were downright great for me. My protein was actually down in the 280s. It hasn' been under 300 in 6 weeks, so that was cool. My ALT was down in the 60s which is still kinda cruddy, but probably still a little below what I've come to think of as "Trish normal." And my AST was 28, which is actually REAL normal. I guess last week's crappy labs can officially be deemed a symptom of the plague and dehydration.

While my body isn't exactly performing fantastically, it's trying pretty hard. I'll give it credit. We're at 32 weeks. When the doctor is giving you steroid shots at 26 weeks, you really don't expect to see this milestone. Or at least, I didn't. I'm pretty thrilled.

Outside of the medical stuff, I'm doing pretty good. I've definitely hit the uncomfortable stage. Sometimes the baby is on my lungs and I can barely breathe. I pretty much feel like I have to pee 24/7. And I'm fairly certain the floor is getting further away because it sure seems like a long way to pick up a sock these days. It's still mostly amusing to me. I'm down about 8 pounds from my pre-pregnancy weight, so I'm not any fatter, but everything is definitely rearranged and making moving around more difficult. I'm sure bed rest is only making that worse since my muscles are probably atrophying as I type this.

I also seem to have insomnia. I think it's ironic that I spend so much time laying down and so little time sleeping. I'm sure it's a combination of hormones and just the fact that all this laying around doing nothing screws with a body's rhythm. I'm trying to think of it as practice for a newborn, but I know there's no such thing. Fortunately all this doing nothing doesn't require a lot of energy, so for now I'm getting by. All in all, I think I'm doing pretty well for an 8 month pregnant woman with cranky body organs. Every day is an answer to prayers.

Bring on 33.

Trish


Sunday, October 16, 2011

Misconceptions

Since I was sick on Monday, I had rescheduled my peri appointment for Friday. They did my weekly labs at the hospital on Monday (to rule out pre-e) and the nurse told me that she called my OB with the results "they were fine with them." so I figured that part was taken care of.

Thursday, my OB's office called and wondered if I'd gone in for labs. I explained about the hospital. She insisted I needed to have them drawn anyway. I was confused, but whatever. I had to go to the peri center on Friday anyway (which attaches to my OB's building by a walkway) so I'd just have them drawn on Friday while I was there.

My per appointment went fine, if slow. I swear they are the most inefficient office in history and since we're now adding weekly NSTs to my appointments, that meant 2.5 hours to get a growth check and NST. Growth looked good. Chello measured 49%, estimated weight 3lb 12 oz. She was active and moving around. My fluid was an 11. They checked my weight (down 5 pounds for the pregnancy), BP (122/72) and urine dip (trace). Then I had my first NST. Chello had the hiccups at the beginning, which was cute. She got what she needed and it was fine.

Dr. Bitchy was there that day and she was unusually chipper. She said I looked great on paper. She wants me to schedule my c-section. She said she wants me to have an amnio and deliver just before 37 weeks or in the 37th week w/o one. I explained that it doesn't seem to appear I'm going to make it that far, and she agreed, but wants it on the books anyway. I was a bit confused because Dr. Sunshine actually said he wouldn't bother with an amnio and just deliver anyway because he'd rather be a few days short of lung maturity than risk my uterus rupturing and that's why we'd planned on steroid shots at 34 weeks no matter what. I told her I already had steroids, she was pleased I'd had them, but still wants the amnio. She wrote a note to my OB to tell her as much.

Then I went off to my OB's office. I still wasn't sure why I even needed it, but whatever, it's just a blood draw. Thank goodness needles don't bother me. When I got there, the phlebotomist came to get me and as we were walking back, she asked one of the nurses to tell my OB I'd made it in, then explained that she'd been looking for me. Again, this struck me as odd because I already had labs this week, but whatever.

As we're back in the room, my OB wanders by, sees me and comes in, saying "Oh good! I was wondering where you were!" (Mind you, I didn't have an appointment with her, so she just meant for labs.) I expressed my dismay about doing them again and she said "well, they were so elevated at the hospital, we needed to check them again." Elevated? What happened to "fine?"

Apparently my AST was in the 50s, my ALT in the 90s and my protein was 2+. Not what most would call "fine." The hope was that it was because I was sick and dehydrated, but obviously it needed to be watched. Cue annoyance with the hospital. I wish I'd have insisted on the numbers when I was there, but frankly by that point I was just relieved to be able to sit upright and go home. I figured fine was fine and I'd get the details later.

In any case, my OB asked if the peri lab had checked my urine & BP and was happy to hear that everything had been normal. The phlebotomist had been attempting to get blood the whole time w/o success. She declared that I was still dehydrated despite the fact that I'd been drinking water even while in the peri lab. Because my checks that morning had been okay, Dr. G said we could just wait until Monday and do the whole workup (24 hour urine included) then if she couldn't get it.

She also looked at the note from my peri, also expressed dismay at the amnio recommendation and shook her head. The phlebotomist finally declared defeat to my veins (I now really look like a heroine addict) and said we'd do it all Monday.

It really only makes sense that being sick would have screwed with my labs on Monday.  I was super sick, for sure. I just really hope that next week's labs bear that out. I'm thrilled to be at 31 weeks at all, plus not in the hospital, but I still really have my heart set on November.






Now I'm going to vent a little.

A lot of people seem to be REALLY hung up on the whole 37 weeks delivery. I'm getting a lot of disapproving comments and looks about not being able to 1) delivery vaginally and 2) do so closer to 40 weeks. Truthfully, it's starting to get to me a bit.

I wish that those things were options as well, but unfortunately that's something that preeclampsia took from me. Robbie was born via classic c-section. That means my uterus was cut vertically instead of horizontally that way is normally done these days. That weakens the muscles of the uterus quite a bit leaving me at risk of rupture if I were to labor. As a matter of fact, Dr. G mentioned that part of her concern with the dehydration on Monday was that it could cause contractions which she does not want on my c-section scar.

When I was admitted to the hospital to have Robbie, Dr. G was very kind in explaining both how Robbie would have to be delivered and what it meant for the future. I had been hoping for a med-free delivery with him, so of course I was disappointed, but it meant less stress on Robbie and less risk of brain bleeding, so it was never in question that it needed to happen.

Then, there is also the fact that my organs are not happy. The longer I am pregnant, the more damage I am likely doing to them. My kidneys, in particular, concern me. When Robbie was born, my proteinuria was at 9,000. Remember that it only takes three HUNDRED to qualify as preeclampsia. Nine THOUSAND was my number. That's kidney failure level. Everyone was actually surprised they worked as well as they did after that kind of insult. Right now I'm living in the land of 300-400. That's not awful, but not great, either. And they really don't need any more damage.

And as I get more and more unhealthy, there are also risks to Chello as well. If she's not getting the blood flow she needs, her growth and development are at risk as well. This is why I'll be having an NST every week from here on out. If she starts to show signs of stress, she may well be better out than in.

Even if things don't get significantly worse in the next 6 weeks, my doctor has to balance the benefit of Chello in the womb for a few extra days vs extra stress on my organs. All of that combined means they're going to err on the side of caution when it comes to picking a time for Chello to come.

It isn't that I don't wish for more time. I'd love 38 weeks. I'd love 40 weeks. But most important is as healthy a mom and baby as possible. That's why Chello will be coming when she will. Not because I'm lazy or misinformed or my doctor is lazy or whatever it is that people seem to imply when they express their opinions on my birth plans.

I realize that there is a large contingent of people for whom things like "The Business of Being Born" is their bible. And good for them. I'm glad they have the luxury of that idealism. However, that is not my life.

I still think that pregnancy is amazing and miraculous. I still lay in bed and marvel at the alien kicks in my belly. I hear people blame lack of bonding on the fact that it took a half hour an hour to hold their babies after birth. But I'm quite well aware that I can bond with my baby even if he's in a plastic box for months, and I don't get to hold him until he's 5 days old, and then only for 30 minutes. What Robbie's birth taught me is that God laughs at plans.

I'm hoping for the best, but also knowing that whatever may come, we will roll with the punches. As amazing as pregnancy is, it's also terrifying and often dangerous. I'm confident in our choices and happy to explain them to most anyone with questions. The real rub comes when people don't ask questions, but just assume the worst- about me or my doctor(s) or the hospital or whoever they think doesn't agree with their picture of how things "should" be.


So right now, the plan is to deliver as close to 37 weeks as possible. I'm hoping to schedule my section for the day before Thanksgiving. That would be 36+6. I pray that my body and Chello both hold out that long. But if they don't, we'll handle that if it comes. For now, I'm still just looking at every Thursday as a new milestone. Come on 32!


--Trish

Thursday, October 13, 2011

31

This week wasn't uneventful, but the event wasn't what I would have anticipated. I did make a visit to the hospital this week, but it wasn't for preeclampsia and I didn't have a baby. So we'll call it a win.

If my life were a novel, the foreshadowing would have come last Tuesday when I took Robbie to school and read the notice on the door. There had been several cases of a stomach virus confirmed in the school. They're great about notifying us about those things, though sometimes I almost hate it. It's not like we can avoid it anyway. In any case, I read it with dread and I think may have even audibly said "Lovely." before going about my business.

Sure enough, Friday night, Robbie began having symptoms. I'll spare you the gory details, but trust me that things were ugly at our house for a couple of days. He seemed to weather it pretty well on Saturday, other than a light (but not non-existent) appetite, and a definitely out-of-character 4 hour nap, he seemed mostly okay. Sunday brought the fever and he writhed around for a while telling me "tummy hewts. tummy hewts" which pretty much broke my heart. Fortunately some Mylanta and another 4 hour nap seemed to help and by Sunday night, other then lack of energy he seemed himself again.

The whole weekend I kept thinking how much I REALLY didn't want to get this, but all he wanted was me, even yelling at David, "NO! Need to snuggle mommy!" and crying when David tried to give me a break. And then Sunday night, my stomach started to hurt.

I hoped it was just reflux, but just before we went to bed, I told David I really didn't feel right. I hoped I was wrong, but I was pretty sure I was infected. Again, I'll spare you the details, but by 4:30 that morning, it was clear that I was definitely not okay. Truthfully, I don't think I've been that sick since I was a kid. The only good thing I can say about it is that it was the kind of sick that I knew wasn't preeclampsia, so I wasn't worried about that.

By the morning, I thought I might be improving. I was supposed to go to the peri lab for my NST & U/S, then by my OB's office for my weekly labs. I debated if I could make it or not, but around 9, decided that I thought I could. David had taken the day off to stay with Robbie rather than dragging him around the hospital with me all day. Robbie actually woke up perky and begging for food, but as he'd had a fever the day before, he still couldn't go to school. I told David I was going to try to shower and make my appt.
As soon as I stood up, I knew it wasn't going to happen. Fortunately I'd kept a bucket nearby in case Robbie needed it, and.. well.. again, the details.. spared.

After I cleaned myself up a bit, I called the peri office and told them I wouldn't be in. Then called my OB's office and explained what was going on. By this point I was pretty sure part of my inability to stand was dehydration, and I couldn't stop shaking. The nurse called me back in less than 5 minutes. She immediately went through the pre-e checklist. I assured her that I was 99% sure it wasn't that, and explained about the daycare plague. She said she'd check with my doc and call back. She hadn't even pulled my chart yet. I am both comforted and troubled by the fact that she heard my name and "vomit" in the same sentence and didn't even have to look at my chart to worry.

She called back a few minutes later and told me to go to L&D. I was probably going to need fluids. It was almost a relief. It took some shuffling (my dad left work to come be with Robbie so David could drive me to the hospital. God bless my dad.) and I packed an overnight bag and got a shower (though I had to take some breaks in the middle so I didn't pass out) just in case.

In the end, I really only spent a little more than 2 hours at the hospital. The intake nurse commented on the fact that I got sick even though I was home on bedrest. All I said was "My son. He's 3. Daycare." and she nodded knowingly.

The nurse who took care of me was great. There was no doubt I was dehydrated, so they started me on saline right away, then added Zofran which is a miracle drug, I've decided. They put me on the monitors, which pissed Chello right off. She had to be chased down once and did a lot of speaker kicking to vent her frustration. But she passed with flying colors. I told my nurse I'd cancelled my labs earlier, so she ran them for me anyway. My BP was goodish (135/75, I think) but they wanted to rule out pre-e issues anyway. She didn't give me the lab results, but apparently I passed everything I needed to. They hung a 2nd bag of fluids, let me have some ice chips and once I successfully kept that down, and finally peed a little, I was allowed to go home with a script for for Zofran and an order for fluids & crackers only for the day.

After 2 hours on a gurney made for a Little Person, I was very glad to get home to my pillow top mattress. Robbie'd been having a grand time with grandpa. Me catching his plague was quite the boon for him.

I did have to take another dose of meds in the evening, but otherwise by that point felt quite a bit better. Tuesday morning David took Robbie to school so I could go back to bed. I had a raging headache, but otherwise felt okay. After some Tylenol and sleeping more than I've slept since before Robbie was born, I woke again starving and like a new person. I had officially survived.

The last few days have brought some waves of nausea, but I couldn't honestly tell you if those are remnants of the plague or because Chello has decided to take up residence in my upper abdomen these days. Either way, it's been manageable, though if anyone knows where I can pick up a good deal on a balloon for the next 6ish weeks, I'd appreciate it.

My rescheduled peri appt is now Friday morning, so we'll see how Chello looks then, but she's been very active and really did show off a little at the hospital on Monday, so I'm hopeful that things will be good. Next stop- 32.

Trish

Thursday, October 6, 2011

30

THIRTY.
THIRTY.
THIRTY.

When my 12 week baseline labs came back and my protein levels were already over 200, the covering OB said "well, we've got to get you into the 30s" but she said it in such a way that you can read "but I don't know if that's going to happen..." in her tone.

When my 24 week labs showed my liver enzymes and protein up, I thought it was the beginning of the end.

When things got even worse at 26 weeks and I got the "come for steroid shots NOW" call, I thought I'd be lucky to see 27.

Last week when my AST had risen, I thought "any time now."

This week I had what I'm now going to call a mild case of food poisoning hit me and I thought my stomach was going to burst, I wondered if we'd make it another 12 hours. I repacked my hospital bag, washed all our preemie clothes, and got as much home stuff situated as possible.

But here we are anyway. Labs this week were stable or improved. Protein down to 310, AST back down to 30 (that's NORMAL!), ALT only slightly higher at 79, but that's still not as high as it's been in the past. I'm pretty sure the nurse at my OB's office thinks I'm insane to be so excited over not-great numbers, but right now, not-worse is the same thing as great.

Thirty weeks is still too early, and this baby does not remotely have permission to come any time soon, but damn.. thirty feels good.


Trish