Friday, March 26, 2010

28 Wks, 5 Days: Gah! Something Irking Me

Okay. Notice how I start every post with "Okay" or "So"? Ha! Anyhow...

I've been reading a lot of blogs lately. And I have noticed something. There seems to be this trend of looking down on mothers who do not choose a 100% natural childbirth. And electing to have a repeat c-section? OMG, I must be evil!

Maybe it's me. Maybe the 2 awful, horrendous pregnancies I have endured have clouded my judgement. But I thought the end result desired in a pregnancy was a healthy baby and mother. Call me silly. Yes, I realize that c-sections and medicated births can have an impact on the baby and mother that would not be present in a natural childbirth situation. But sometimes, natural childbirth is just not possible and not advisable. I don't think the fact that my sons' births were/ will be highly medicalized makes me any less of a woman or mother. I don't think a woman who goes through natural childbirth is any more deserving of a big decal on her SuperMom costume. After all, I went through 4 months of contractions with no pain meds with E, and am on the road to doing the same with this one. And these weren't little uterine hiccups. These were Contractions, capitalized intentionally. 2 to 3 minutes apart. For hours/ days/ weeks/ months on end. So yeah, I have a c-section scar. But I bet I am more deserving of superhero status than the woman who endured 12 hours of this stuff. And in the end (of E's pregnancy and God willing, this one as well), there was a healthy baby. I call that a success. And in no way see how it means I failed or that the medical establishment failed me.

So what of these natural childbirth plans? I think they are fabulous. I truly mean that. I am all for women being empowered and knowledgeable of what they can do. And I agree that not everyone needs a medicalized birth experience. But some of us do. And even if there is a slim chance of any type of deterioration of mom and/ or baby, why would one even chance it?

Which brings me to the concept of freebirthing. This angers me more than anything. Don't know what it is? It is the concept of women giving birth at home with no medical assistance at all. Not even a midwife present. Just mom and whomever she deems fit to be there to witness the miracle of life. The advocates for this practice will tell you that women have been delivering babies like this for as long as we have been here. Yep, true. Very true. I'm picturing ol' Aunt Gertrude in a log cabin or shanty somewhere, back before we had a road system, hitching up her sweat-drenched skirts and trying to push out a baby. Yes, women used to do it all of the time. Not because it was radical or better for them or baby, or because they had some notion that this empowered them. They did it because they had no other choice.

So I read some research somewhre that sort of drove me crazy a little bit. I wish I had the link now, but it said something to the effect that the rate of infant death has actually increased with the medicalization of childbirth. Really? Seriously? That must completely demonize medicine and make us all want to freebirth, right? Ummmmm, NO! Where were these statistics from? Were there ways of tracking our vital staistics back then that there are now? I can say, as a healthcare provider, that patient deaths are tracked very thoroughly. We have very accurate ways of keeping these statistics. But this was not always the case, and certainly wasn't the case when women did not have the medical options they do now. When Aunt Gertrude gave birth in her shanty. I can see how this would make it look like the medicalization of childbirth has increased infant mortality, but quite honestly, I don't believe it one bit.

So why risk it? I know from professional experience that even a full-term, seemingly healthy infant can take a turn for the worse and require some sort of resuscitative measure in an instant. In that instant, would you not want someone there to intervene on your baby's behalf? Does this mean we all need to submit to the narcotics and epidurals and elective c-sections? No, absolutely not. But I would at least want someone there with higher qualifications than basic CPR, and some equipment that may become necessary. Well, there is always 911, right? Ha! Have you ever called an ambulance? I remember a time I was having an anaphylactic reaction. Me. A registered respiratory therapist who could tell the operator exactly what was going on and how dire the situation was at the time. I could feel my airway closing up and knew it was a matter of minutes before it would become sealed off and I would need to be intubated then or would die. It still took them 9 minutes to get to my house. When you have a neonate who needs to be resuscitated, 9 minutes is a lifetime.

So if you want the natural, unassisted childbirth, there are options for you. There are birthing centers where you can do your thing, but there is help nearby if needed. There are midwives who will come to your home who have the training and wherewithal to know what to do in an emergency. And yes, there are highly credentialed physicians and specialists to help with the most complicated of deliveries. They will even allow you to come up with your own birthing plan. But please do not jeopardize your child's life. And do not look down on me for not taking the same path you did.

Thursday, March 25, 2010

28 wks, 4 days: On Easy Amusement and Getting Busted

So after my ultrasound yesterday, J decides we need some things from the store. He wants to stop at Wally World on the way home. I'm game. I was going to sit in the car like always, but I thought, since I now know for sure that I am not going anywhere but to doctors' appointments and tests for at least the next month, I would look for things to amuse me. No, not knitting again!

So I get on the little motorized wheelchair and off we go. I ended up getting a stack of cheesy paperbacks that I normally would not read. The kind that provide no mental stimulation, but are quick entertainment. All of them are suspense novels, so they should be fun. I find myself excited to read them, and cannot wait to finish the book I am currently reading so I can start on the first one. Isn't that silly? I remember when my sources of excitement were perfect scores in organic chemistry or another perfect 4.0 pre-med quarter (by the way, I did that again with the courses I finished up from home this quarter--still a 4.0, but it means more when you aren't even allowed to go to class). To get this excited over a $8 paperback I picked up at Wally World? I feel so frivolous and silly. I guess it is just another side effect of bedrest. I will take amusement in any form these days.

So we get the books, we get the grocery items we need, and as I am rounding the corner on my little motorized cart, who do I see? Ha!

"OhMyGod! J! It's my DOCTOR!!!!!!!" And it wasn't just any doctor from the practice. As a high-risk patient, I see them all, but know some better than others by sheer luck of who is on call when I am suffering from my dysfunctional uterus. But this was the one who had, just the day before, discharged me from the hospital. Just the day before! The same one who had told me to give up on even trying to go back to work. In fact, his exact words were that I was to do "absolutely nothing" until delivery. And here I was zipping around Wally World on a scooter. Oh. Crap. I was sure I was busted. But he kept walking as I was preparing my defense in my head. As in "You know, Doc, I am only out of the house because I just returned from the ultrasound YOU ordered." Plus I was on the cart instead of walking the store, and my little brethine pump was dangling by my leg. Had I been walking, I am sure I would've been noticed. You can't miss a huge, waddling pregnant woman, holding her belly like she is gonna deliver at any minute, especially when you are an OB/GYN. It's kinda like me not being able to avoid noticing the huffing-and-puffing emphysematous patient with their oxygen. It's my field, so I pay more attention to that. But as it was, I was on the cart, and way below his eye level. And I may or may not have been hidden by a huge display of cases of Pepsi products that were on sale in the aisle between us as he passed me.

Of course we get to the checkout, and I am trying to be as quick and discreet as possible in case he didn't notice me. Well, as discreet as possible for a hugely pregnant woman in a bright red maternity blouse, on a motorized cart. It's kind of hard to blend into your surroundings with those conditions. And of course E starts throwing a fit for some candy he sees in the checkout lane, after I have bought him a book and a toy plane at the store we originally visited to get a "few items". He's making me even more obvious, and he knows I am trying to avoid the doctor, so he uses this to get what he wants. Smart kid. I am acting fishy, so J explains to the checkout girl that I am supposed to be on bedrest and just ran into my doctor. She laughs at us the entire time she is bagging our purchases. The rest of the trip is carried out like some covert operation. I try to speed from the checkout to the exit, but the battery is going low on the cart, so it is going s-l-o-w. I can't walk to the car through the vast parking lot, so I have to wait at the door for J to pull the car up to the door. Even more chance to be noticed. E waits with me, and draws even more attention as he starts begging me for quarters for gumball machines. I only have my debit card, so I have to tell him no, which makes it a thousand times worse. I finally get into the car and we whisk away without my doctor passing me again.

So now I am wondering. Did he see me? Is he bound by the same etiquette that affects all of us in healthcare, in that you do not acknowledge your patients in public to protect their privacy and personal space? Or did the Pepsi cases save me? Will I get grilled at my appointment on Tuesday about why I was at the store? If he did see me, I wish he would've said somthing. I could've explained, and I would've gotten high marks for the fresh fruits and veggies in my cart. But nope. Now I am just left to wonder!

28 wks, 4 days: Yesterday's Ultrasound and Why Medical People Should Not Be Allowed to Google

Hmmmm. Apparently the Indocin I got in the hospital can cause some side effects. Lowered amniotic fluid levels (oligohydramnios), as well as heart defects in the fetus. I wish I would have known this then, but nobody told me, and I honestly did not ask. I realize that sometimes it is just a matter of the risk out-weighing the benefits, and vice versa. And I trust my doctors. Looking back, they were very judicious with its use, and now I know why. I can't be upset or angry. When you have a patient who is 27/28 weeks preggers, contracting every 2 minutes, you simply have to make it stop. And they did.

So anyhow...They wanted me to go in for a STAT ultrasound yesterday to check things out and survey for any possible damage. So I go. J drives me, and sits in the car with E. It is the first time he has missed an ultrasound, and he is bummed about it, but I don't know what all they are going to do, and feel like E shouldn't be there in case they want to do something that reveals part of me that should not be revealed to my 8-year-old son.

The baby seems perfect. Too perfect. He had taken up residence by my rib cage, with his little feet dangling downward. Which explains the full feeling I had. He was literally, crown to rump, right there. His little heart was doing exactly like it should. His organs appeared to be intact. And he is still big. As in they estimate his size to be 3 pounds, 15 ounces right now. This places him in the 95th percentile for size at this gestation. If a baby truly puts on a half a pound a week in the last trimester, that would mean he would be over 9 pounds at full-term, and somewhere around 6 at 34-35 weeks. Looking back, E was 6 pounds when born at 34 weeks, so he would've been a big boy too, had I carried him to term. So this is famliar territory.

But the fluid...At 26 weeks, I had excess amniotic fluid. I still do, and it has worsened. I know the dangers of low fluid. I have resuscitated babies in the NICU for this problem. But too much? Huh? Could it be bad? I ask the tech who did my ultrasound,and she said the first thought with both a big baby and excess fluid would be gestational diabetes. I don't have that. My 1-hour glucose tolerance test was normal, but since I met the clinical picture for diabetes, they made me do the 3-hour one anyhow, and it was also perfect. So no, not that. I asked if it could be dangerous, and she told me that it gives the baby more room to flip and turn, so there is an increased risk of cord entanglement. So far, Zachary is fine. She also said with the uterus being bigger than normal, it can fool the body into thinking it is further along than it is, and can cause preterm labor and birth. Things that make you go Hmmmmmmm...

So I come home, and I start to google polyhydramnios. Bad. Very bad. When you have no idea what you are reading, googling medical info can seem scary, but ignorance puts a blinder on you in a way. But when you know, like I know, what some of these things are, it can scare you to death. I should not be allowed to google anything medical. I should block the action from my computer. Kidney anomalies, diaphragmatic hernia, heart defects, swallowing and GI defects, other generalized birth defects. Uhhh.

So now I am scared. And even more anxious for this pregnancy to be finished so I know Z is okay.

Wednesday, March 24, 2010

28 Wks, 3 Days: Eh--Feeling So-So.

Actually, I feel completely full of...baby. It seems like this kid is enormous and is leaving no room for anything else in my body. Nothing is sacred: my liver, my bladder, my stomach, complete with the remains of the lunch I just ate. But the number of weeks I have left until I am full-term can be counted on less than two hands, an the number of weeks left before I can safely deliver can be counted on one. But I picture him in there, poking on the squishy bits of my insides and wondering what they are. Maybe he, too, will have a career in medicine. We have already determined E is going to be an engineer, with his passion and gift for taking everything apart and putting them back together. Of course, E wouldn't say this: he says he is going to be a pilot.

27 Wks, 6 Days: Again. Seriously?

Okay, so I wake up Saturday morning, the morning after I was up until 3:30 AM doing the monitor-bolus thing. I actually wake up about 4 hours later, at 7:30. I'm still contracting. Not bad, but I am not eager to repeat the experience of the night before all day so I keep my mouth shut. And I wait. In fact, I wait too long, and the contractions get closer and closer together. Finally, at about 11 AM, I put myself on the monitor for an hour. And then I send it. And then the nurse calls back. 27 contractions that hour, between 11 and noon. She asks me how I feel, and I am brutally honest:

"I feel like, if I could dilate, I would've already had this baby. I feel like my body is trying to deliver him, and I am fed up."

I tell her that I'm not sure that the contractions ever really stopped. I know I slept for about 4 hours, and have no idea if they continued then or not. I just know they were there when I went to bed, and they were there when I woke up. That's all. So she decides to skip the monitor-bolus routine and just calls my doctor. And they want to send me to the hospital. I tell her I am going to shower and eat first, and then I will go, and I do. Within 30 minutes, we are on our way.

The doctor has decided before I even get there that I am most likely going to stay. I do. They start the mag sulfate drip at 3.0 grams, and off I go to my room. But the contractions don't stop. I get Indocin for the first time ever, and that slows them to a stop. Over the course of the first night, they wean the mag to 2.0 grams. Then the contractions start back up again somewhere in the middle of the night. And continue. More Indocin the next day. They stop again. Another doctor is on call for the practice and he comes in and tells me to just hang on until "the completion of 31 weeks" and that the "mortality rate decreases to zero at that point". Uh. Okay.

But this time, the nurses have me worried. And J. They are talking about risk of uterine rupture. They tell me that they have seen where a woman contracts and contracts against a closed cervix and finally, her uterus ruptures. This scares me to death, and is something I had not considered up until that point. Something new to worry about.

Over the course of 3 days, the contractions come and go. They make changes to my medications. And they keep me there. I'm not even allowed to bathe. I am so dirty I can smell myself and feel like the right to have my most basic needs met has been stripped away from me. Finally, J arrives with an arsenal of bath products, and I perch on a stool while he gives me a sponge bath. This, of course, is against doctor's orders, but I don't care at this point. I am in tears and miserable, so my nurse doesn't even try to force the issue, but instead tells me to let her know when I am finished and quietly closes the door. I am so grateful at that point to have a husband who loves me unconditionally, because I am nasty. And he doesn't say a word, but instead, helps me clean myslef up.

Finally, on Monday night, I get my progesterone injection. From that point on, I have 3 contractions. Total. The doctor comes in Tuesday and I immediately ask him if I can go home. He looks at my strip on the uterine monitor and says he sees no reason to keep me. I am free. And happy.

I leave that place hoping that the next time I am there, I will leave with a baby. I have about four and a half weeks left before I will be okay to deliver. Before I will reach the point I did in E's pregnancy. And I know now that, with the way Zachary looks in utero, he will most likely be fine from this point on. Every week from here on out is just icing on the cake for me. No one wants a preemie, but I am to the point where I am finished. And I'm just tryingto hang on. The point of viability has come and gone.

Saturday, March 20, 2010

27 wks, 6 days:Can a Girl Just Sleep, Already?

Yesterday, I felt horrible. I had a stressful day worrying about bills, my job, my insurance. I cried a lot and got one of those raging headaches I get after hours of crying. I felt dizzy and nauseous, and after having J check my blood pressure, laid down to rest. I slept off the nausea and dizziness, but then the contractions started.

I put myself on my monitor at about 11 PM. I was feeling crampy on top of it. I wanted to see what I was doing. I know what the process is like, so I should've known better.

I had 14 contraction from 11 PM to 12 AM. The nurse calls and tells me to give myself a bolus and re-monitor for an hour, starting at about 12:30 to allow the bolus to work. I do, and monitor from 12:30 to 1:30. This time I had 10 contractions. Better, but not good enough. Another bolus, wait 15 minutes and re-monitor from 12:45 AM to 1:45 AM. 7 contractions. Another bolus, then re-monitor from 2 AM to 3 AM. Wait for the nurse to call, which happens at about 3:20. 4 contractions. I am finally allowed to sleep.

Of course by this point, J has been awake a long time, since he had clinicals yesterday and had to leave earlier in the morning than usual. He and are both exhausted. I cannot sleep from the contractions and the monitoring, along with the jitteriness that goes along with 3 brethine boluses. I am laying on the sofa, and he is in the recliner. And he keeps snoring so loudly. This gets to me more than anything.

I know this pregnancy hasn't been easy on anyone in the family. Of course it hasn't. But I feel that for someone who shared an equal part in the creation of this baby, he has had to make minimal sacrifices. He's only missed 2 days of school, while I had to drop out completely. I had to surrender my career temporarily, which meant the world to me. I am the one who has to endure the pain. I worry about the bills and other financial aspects. Other than driving me to appointments and to and from the hospital, when needed, his life has remained largely intact. The fact that he could not just suck it up and be there for me was too much to handle, and I went off on him. It may have been unfair--he did get substantially less sleep than me yesterday--but now I am awake, contracting again, and he is snoring away the bad night we had last night. I can only wish for sleep. Then he is going to wake up and study all weekend for exams, while I just watch. This makes me jealous, as I want more than anything to go back to my life.

27 wks, 5 Days: The Catch-22

I found some disturbing info out yesterday: I only have 4.8 weeks of FMLA job protection left. Does this mean I am fired at that point? Not necessarily. It is then at the discretion of my supervisors to either hold my job or post it as available. The good news is that by then, I will be beyond 30 weeks along, and will probably deliver soon thereafter. Unless they find another RT who wants my job from within the hospital, they will have to interview, hire, and orient someone new. For a new hire, that is about an 8-week process at best. By that point, I will be recovering from delivery and would be back sooner than they could do that. But that is only if there isn't a cowoker who wants to snag my position...

My big worry is my health coverage. After 4.8 weeks, my short-term disability pay ends. If my job is no longer, so is my health coverage. Which means that I will have to pay for a c-section without the benefit of health coverage. My only hope is that our premiums are paid a month in advance an I will have about 4 weeks or so left of coverage after the last premium is paid. If that is the case, my delivery will be covered.

So now I feel like I am in a bind: do I demand that the doctor deliver this baby early so I know it is paid and I can get back to work sooner to preserve my job? Do I just let it ride and hope it all works out for the best? Or do I go into the office on Monday with guns blazin' and demand that I be allowed to return to work? My boss did agree to accomodate a reduced work schedule. I can get a scooter from work to eliminate the running all over the hospital. That is a big deal right there. As it is right now, I am allowd to get up and cook for myself, shower, go to the bathroom. I see no difference betwen that and riding to a patient's room and giving them a treatment. Except for the whole job-preservation thing. And the whole paycheck and insurance thing. And if I make it even easier by only working 8-hr. nights? The 8 hours in the middle of the night are the slowest. It can get busy, but it is less likely. Taking the 4 hours off the top of my shift is taking the busiest part away, and while it wouldn't seem so to someone who has never worked in healthcare, shortening from a 12-hour shift to an 8-hour shift is a big difference.

This seems like the most favorable option. It will help with our finances right now. It will preserve my health coverage, and buy some more time so I can use the remainder of my leave for after the baby comes, when I am recovering from a c-section.

But will my doctors go for it?

Thursday, March 18, 2010

27 Wks, 3 Days: Down

I hate to post anything else that is negative in nature. I get kinda sick of it, to be honest. But I started this little blog to document this pregnancy and that is what I am going to do...

I am completely down right now. It goes beyond boredom. I can surf the 'net, read a book, watch a movie to cure that. My favorite is watching tv on the internet. I love when networks post tons of episodes of shows on their websites, so even shows I haven't watched I can catch up with. I thought about taking up knitting or crocheting or some other crafty pasttime, but then I had flashbacks of bedrest with E's pregnancy. I was determined then that I was going to learn how to knit. I figured I am a bright person and could figure it out, so I went on a frenzy. I got all of the stuff I needed, along with some how-to books, and started my attempt. Ha! That was not a good idea for several reasons. First, I don't take failure very well. I am a perfectionist, so if whatever I produced didn't come out looking like a commercially manufactured product, I would've died. Second, I am easily frustrated, and didn't handle it well when my first attempts at stitches came unraveled in my hands, over and over again. Third, I cannot leave a task unfinished. It does something to me. I have to finish what I start, right then and there. So the three of those combined made the attempt at knitting even more stressful than the boredom. I learned a lesson there. So then I got the idea, with this pregnancy, to make some of those fleece no-sew blankets. They're adorable, and seem easy: you just knot the fabric at the edges. So I looked at materials to make those and made a discovery: fleece is expensive. Well, it wouldn't be bad if my income were not drastically reduced right now, but it is, so that prohibited that experience. Any extra money right now needs to go to paying bills in advance, and getting baby stuff. That leaves me with books. Lots and lots of books.

And E. E does not get it, no matter how hard I try to explain. He wants his Mommy. The other day, they had some sort of skate party after school. I had no warning of it, whatsoever. We didn't even know where the skating rink was, but if I would have had notice, I could have planned ahead and sent him with J. I, obviously,cannot go. But I still tried. I found the rink, and tried to contact them to get info on when-where-how-etc. No answer. J was going to try to take him. Of course E made the raisin face, as we call it, where his eyes crinkle up and he really cries. He wanted not only to go, but for me to go with him. And yesterday he came home with one of those Scholastic book order forms, with an itemized list of what he wanted from it. This is sort of my fault. We have always had this little unwritten policy in the house: toys and video games come with a limit, as do dvd's. But books? If the kid wants books, he gets them. Books are good for you, are educational, and more. We don't limit books. But he wanted about $300 worth of books from this book order! I had to say no. I tried to explain that while mommy isn't working, we are on a tighter budget, and I may have to temporarily say no to some of the extras right now, but that it will not always be that way. That before he knows it, we will all be back to our old selves. He didn't buy it, and I think it was less about him understanding and more about my delivery. After all, I am starting to doubt if things will ever be back to normal. I doubt if I was very convincing. It breaks my heart not to be able to give him the things he wants, and this is made even worse by the fact that he just doesn't get it.

And J. Poor J. On two seperate occasions, I have had to call him home from school. We have one car, and they won't let me taxi him around, so he takes E to school in the morning then heads to his classes. So if my doctor or team of nurses see fit to send me somewhere, I have to either call him or call an ambulance. I'm not calling an ambulance. The result is that when they are overly cautious with me and send me to the hospital, J has to come home and take me. It makes me feel horrible. Then I try to talk myself out of feeling bad by rationalizing that this is his baby too. I have to deal with the pokes and prods, the needles and contractions and medications with their side effects. He can't be the one to do any of that. But he can be the one to have to take me where I need to go. I just know that if he fails a class, I will feel responsible. I shouldn't. He just has school. For years, I have juggled school, work, family with no problems. He should be able to handle school and driving me places. But this is me. I can't rationalize my way out of my feelings for some reason--I don't want to be a burden to anyone. And I have turned into nothing more than a burden.

Work--I shouldn't even care, but I have found myself being snubbed lately by coworkers. These are coworkers who, by the way, I have covered for on countless occasions. There was a period of time when we were so short-staffed at night that I would work as many as 7 12-hr. shifts in a week, not only to cover for people who were sick or out on leave, but also to pad the staffing so the ones who were there didn't have to work quite as hard. There was one period of time where we had three full-time night-shift therapists off on FMLA: one was sick and the other 2 had babies. I worked for them, and though I may have been grouchy and tired, I didn't complain. And I was in school full-time then, too. Now the tables have turned and I am the one out, and they won't even speak to me. Again, I shouldn't care, but I would be lying if I said I didn't. It makes me wonder how I am going to be treated when I return after all of this time off.

I guess I just feel a little alienated. J and E go to school all day, leaving me here with nothing but my thoughts. I'm bored and had my life virtually ripped out from under me. I'm under financial strain, when I am used to simply picking up extra shifts at work when money gets tight. That isn't an option now. Everything has changed, and I am feeling low, so these other issues feel a thousand times worse than they would have under normal circumstances. This, too, shall pass, I guess.

Tuesday, March 16, 2010

27 wks, 1 day: New Game Plan?

After they increased my brethine dosages on Monday, J brought this up again: I seem to have bigger problem on the weekends. Just when I thought it was me, and that it was some weird psychosomatic phenomenon, he mentioned my shots. As in I get them on Monday nights. And I seem to have problems in the last 2 to 3 days before the next one is due. So I mentioned this to the home health company's nurse, and she started reviewing my records. Then she mentioned that while their pharmacist would never initiate it, some OB's request that their patient's get the injections every 5 days instead of every 7 days.

Could the progesterone every 5 days be my ticket out of this?

27 wks: Back I Go

Gah!

Today is the 27 week mark. So now, regardless of what pregnancy book you are reading, I am going to be officially in the last trimester.

But yesterday...Good GOD!

I woke up as J was leaving for school. About 30 minutes after he left with my car, the contractions started, but these were different. They started up under my rib cage and would spread down the lower half of my body, and almost felt like they were going all the way down to my knees. And they hurt. And started out as really frequent. No building up and getting closer together, but about 3 minutes apart from the start. So I pick up the phone and try to call my home health nurse, like always. No phone. My landline was out. It was so bizarre because I had internet, which is from the same company. I couldn't call my nurse, my doctor, J, or even 911! What to do???

Well, thank you, Facebook and Yahoo! A friend of mine from Michigan was online, and I IM'd her to see if she could call J for me to get him home. She did, and 15 minutes later, he came through the door. He had to call the phone company, and scared the living daylights out of some poor rep who answered the phone, when he told her what was going on, and why we needed our sevice restored immediately. Thank God, she had it fixed within 15 minutes!

So the first call was to my doctor's office, who advised me to go ahead and do what I normally would. I ran a strip on myself and sent it in to the home health company. I don't know how bad the contractions were, but the nurse who called back is usually pretty liberal with me because she knows my story, that I do this. But even she seemed kind of concerned. We did the whole monitor-bolus-monitor-bolus thing all day. At some point, in the afternoon, she icreased my dosage of the brethine again, and as she was leaving for the day, she had me run another strip. She said she was going to let the after-hours nurse know what was going on, and that she would be the one calling me back after the strip was sent.

In the meantime, my other nurse showed up to give me my progesterone injection. I knew I was still contracting, but I also knew they no longer hurt and were further apart. So while she did her home visit, I continued to monitor. The monitor beeped to let me know the one-hour mark was up about 15 minutes after she left, and I sent the data. It wasn't long bfore the after-hourse nurse called to tell me I had 9 contractions in the hour. But it was still over the 5-an-hour threshold my doctor gave them, for the fourth time that day, so she insisted she call and talk to him. Of course, it had to be one of the doctors in the practice who doesn't know me well. And he is known for being on the cautious side, so that is how I ended up in labor and delivery again last night.

It was probably a good thing. There were no cervical changes, but I was dehydrated. So after 7 attempts, they got an IV in and gave me fluids. I woke up this morning feeling much better, aside from the big purple splotches up and down my arms from blown veins after IV sticks.

Sunday, March 14, 2010

26 Wks, 5 Days: So Relieved

I had a crazy day yesterday.

It started when I called the home health company nurse. J had me freaked out. I just had the lower abdominal and lower back crampiness, which he said is a sign of preterm labor. That is when they had me put myself on the monitor, and I posted the results of that yesterday. They had me bolus myself with brethine, then I got a normal scheduled bolus an hour later. Then it was back on the monitor for another hour.

Instead of the nurse calling me to say she got the strip, she called to say that they were experiencing heavy storms in Georgia, where she is located, and that she didn't get it. So she made me call my doctor, and it just happened to be the only doctor in the practice I have not met yet. I was sure he was going to tell me to go straight to OB Mecca, but he didn't. I told him I would rather have an aneurysm than go back to the hospital...any hospital. So he allowed me to stay home with the agreement that if anything changed or just felt different, I would go or at least call him back.

I settled in for the night, but somewhere along the way, I noticed that Zachary hadn't moved in quite some time. My very active baby was very still. So I got worried, and I called my friends at L&D, who told me to drink something sugary and/or caffeinated. I sent J up the road to get me 2 bottles of frappucino, since everything I had in the house was sugar-free. And I chugged them, laid down, and tried to count kicks. The home health nurse finally called back to tell me they were up and running, and that my last strip had 17 contractions on it...better, but still too much activity. I told her what was going on with the baby, and she gave me some more pointers, and said she would call back to check.

By the time she did, I had felt him move. Twice. In 3 hours. So she tells me I need to go on in to have it checked out, and she calls my doctor and L&D for me. Off I went.

I get there, and they have me pee in the cup an gown up, like always, and put him on the monitor. There it was...the little heartbeat that can make everything better. And then he started moving. Then and there. Thanks, Zachary! I mean, I was so relieved he was okay. I had been so scared that I had even called my RT colleagues to tell them that if they got a call for a 26 weeker, it was my baby. That is how scared I was. But why couldn't he do that at home? Little stinker!

So they watch me and the baby both for a while. And,well, it's me. I was having contractions every 3 minutes. Some resident buddies of mine were down there, and came into my room to chit-chat and keep me company. They stared at the strip of contractions like I was some sort of medical puzzle to solve, even though they weren't my doctors. Not that I don't think very highly of them, but I have a tough time working with anyone who has seen all of my business. That, and I am high risk and need very qualified OB's and not family practice residents. Everyone laughs at my issues with them seeing me naked, but have you ever worked a code at 3 AM with someone who has had their hand in your hoo-ha???

So I laid there. For 2 hours. Amusing myself by listening to the sounds from the next bed over in triage. The OB nurses had told me there are women out there who fake labor/ contractions. The idea was so bizarre to me. Who would do that, and how??? My friend C said they bare down like having a bowel movement, and it makes the toco jump, but you can tell between it and a real contraction, that real contractions are like rounded waves (she showed me mine on my strip as evidence) and that the fake kind were spiky and went straight up and down. As someone who has contracted uncontrollably through 2 pregnancies, this seems so bizarre to me, but apparently women get sick of being preggers and do this to try to get admitted. After hours, the doctor declares failure to progress, and they either get pitocin or a c-section. Well...The woman in the next bed over was a faker. 37 weeks pregnant and wanting to have her baby. She was asleep, and I could hear her snoring the entire time, until her nurse went behind the curtain to tell her that she was not in true labor and would be going home. Then the tears started, and the fake grunting and heavy breathing. I saw her husband leave the room, and when she was in there by herself, the noises stopped and I heard snoring again. As soon as the husband was back, she started up the act again. Unreal!

So my nurse comes in after she has talked to my doctor, and since it is me, they gave me the choice: stay and have them try to stop the contractions or, so long as I hadn't dilated, go home and call/ come back if anything changed. I knew if I stayed and the contractions stopped, they would just start up again sooner or later. Only a handful of them actually hurt, so I said I wanted to go home. The faker heard. And wanted to know why she didn't have the same choice, because she wanted to stay.

And that is how I was able to sleep in my own bed last night. But I left the hospital stumped. The faker was taken to her room while I was signing my discharge papers, after having thrown a tantrum. And it drove me crazy. She'll probably have her baby this weekend, and I hope it's okay. People just don't realize...

Saturday, March 13, 2010

26 Wks, 4 Days: Fed Up

My home uterine monitoring company just called. Apparently I had 28 contractions in one hour. Funny thing is that I didn't feel any contractions, just a mild, all-over crampiness in my lower back and lower abdomen. I have had 3 brethine boluses in 3 hours from my pump and we are trying to avoid another trip to the hospital.

On a seperate note, I got my appointment for my c-section in the mail today: June 3. Any bets that I won't last that long? That is 17 days before my EDD. Ha!

Friday, March 12, 2010

26 Wks,3 Days: Kick Counts and More

Baby Z was trying to kill me last night. Kill me!

This little booger can't be very long yet, but I was feeling him kick down by my groin, and at the same time, up by my rib cage on the opposite side of my body. I couldn't breathe, couldn't do anything to get comfortable. I lifted my shirt to look at my belly and J busted out laughing. Apparently, he had stretched out, and all that could be seen from the outside was this diagonal ridge that ran from my right rib border down to my left hip. I picture him in there, stretched out, arms over head, just chillaxin'.
The doctor wanted me to start doing kick counts this week, twice a day. I understand the value of this, and so I have been complying. Everytime I go to count the kicks, I do as it says in the instructions. I get comfy in a quiet place, settle in on my left side, and wait. And within five to ten minutes, Zachary provides enough movement to satisfy the doctor for 2 whole hours. At first, I did exactly as I was told: I laid there and counted the kicks for 2 hours. One time there was 48,and another time there was 54. They tell you they look for at least 10 in 2 hours. So eventually I started stopping after he got to 20 or so. The whole point is to make sure he is okay in there. I assure you, he's fine.
What I'm worried about, however, is his sleep-wake cycle. I know this seems silly, but when E was born, the patterns he showed in his sleep were identical to the ones he had in utero. Awake all night, asleep all day. But Zachary? Zachary is awake all of the time. He kicks all of the time. All day, everyday. He even keeps me up at night with it. Don't get me wrong: I love his little kicks. It tells me he is okay in there. If I don't feel them, I start to feel this twinge of panic. But what is this baby going to be like when he is born? Either this kid is not going to sleep, or he is going to have restless leg syndrome.
Other than that, this week has been uneventful. No crazy contractions since Saturday. I will have a few here or there, but nothing consistent that would send us to the hospital. I am afraid to admit this, but I think being grounded from work has done the trick. I won't be seeing my doctor this week, but I am sort of afraid. I was planning on trying to get them to allow me to return to work on a reduced schedule. The financial picture in this house is getting pretty ugly. And they could take my lack of contractions as a sign that I can, or they can take it as evidence that I really do need to be on bedrest. It could go either way. Not to mention, I will be seeing the only doctor in the practice I have yet to meet at my next appointment. They want us to meet all of them so we will see a familiar face when it comes time to deliver, in the event that someone new is on call. The only exception is for the women who are to have repeat c-sections. I was in that group, so got to pick the doctor I saw each time, as we knew who would be delivering me. But then my uterus had to go and get all dysfunctional, and I got placed in their high-risk group of patients, and now I have to rotate. Oh well. I have my favorites in the practice, the ones I click with better than the others, but they are all wonderful.
The only other thing I have to mention right now is that J noticed a trend this past weekend that may be the answer to my problems. When the contractions get to be at their worst, it is always at the end of the week. I just thought it was bad luck: weekends, doctors not in the office, etc. But he reminded me that I get my progesterone injections early in the week. When I start contracting like crazy, it is closer to the day I am due for the next shot. Hmmmmm.

Why??? A Rant

We aren't destitute.....yet. I have been going over our family's finances for the entire week. Over and over and over. The bottom hasn't fallen out yet, but by crunching numbers, I have determined that it will. So I started making phone calls. Don't I pay taxes that go to fund programs that help people like us? Yes, yes I do. $28K in taxes last year, to be exact. What I found is disturbing...

I have been told that I cannot receive any sort of aid because I am married, because I made too much last year, and any other myriad of poor excuses.

I am a college-educated woman who has worked. Brought home the bacon. Been the breadwinner. Yet now, unable to work, I find that I cannot get help? Yet my taxes can go to others who want to, or feel they are entitled to, sit on their butts. There is something wrong with this. Seriously. And what is most disturbig to me is that, in a matter of 12 to 16 weeks, I will be back to my old self, working like a dog and earning a salary far above the average in the U.S. This is as temporary as the definition of temporary can get.

This is what is wrong with our public assistance programs! We talk of welfare reform, and say that we want to see change that produces individuals who eventuall work toward self-sufficiency, but someone like me can't get approved. This is what we need: programs that help hard-working Amecans who, for one reason or another, cannot work. Temporarily. Not as a lifestyle choice, or as a permanent condition, but temporarily. For the permanently disabled, we have disability and social security. And don't penalize me for having a degree and being in the middle class prior to my downfall. Or for being married. Isn't the middle class supposed to be th heart and soul of America? No, being in the middle class is like a shove into the world, saying "You're on your own, kid!". We can be upwardly mobile socioeconomically. W can work and achieve education, and better our status. But don't let anything happen to decrease your income, because there is no safety net. And when you fall, you will fall hard.

Wednesday, March 10, 2010

Court-Ordered Bedrest? Old News, But Interesting

http://realityrounds.com/2010/01/17/sunday-ethics-maternal-vs-fetal-rights/

I found this in the pages of Reality Rounds, a blog I recently stumbled upon. Check it out!

Watch "Born Too Soon"


Stumbled across this link this morning. How interesting that in my last post, I was just talking about the risk of delivering a 34-weeker. This documentary gives lengthy mention to late-preterm delivery.


This is taken from KET. Some interesting information is discussed on prematurity and social ills, smoking in pregnancy, and more. On an interesting note, the hospital where I delivered E is highlighted.
(Image Credit goes to KET and their wbsite. It isn't mine.)

26 Wks, 1 Day: Brothers Fighting Already?


Baby Zachary's amazing little kicks and squirms are getting stronger by the day. A true reflection of what is going on in my uterus, they tell me he is okay. If I go for any length of time without feeling them, I start to secretly worry about him. There is nothing like feeling him kick. Nothing. Relief washes over me with each nudge from his little arms and legs. And love does also. My baby. I can already tell how cute and sweet he is, how amazing he is sure to be. He's my Zachary.

Lately his kicks are strong enough to see. J has been able to feel them from the outside for some time, because he has felt it before with E and knows what he is looking for. They would have to be pretty pronounced for E to be able to feel them. Now is the time. As I was sitting on the sofa one day, I felt him kicking up a storm, and had E come over and put his little hands on my belly. Nothing. E's little face fell in disappointment. He could have waited and he would have felt Zachary kick, but he is a busy little boy with his own agenda, and didn't want to sit and wait.

Yesterday, I was laying on the bed and E came up and kissed my bare belly. Then. Right at the perfect moment, and in the perfect spot. Zachary kicked where E's little face was located. E felt it on his cheek. He gave a little surprised gasp, and looked at me with the most priceless look of shock on his face. "Was that him?" he asked. "Yep", I said. It made his day. He laughed as he told Daddy that Zachary kicked him in the face.

Now,before he does anything, he wants to kiss his baby brother in the hopes that he will feel Zachary again. He is truly going to be an awesome big brother. And it makes me kind of sad that we didn't have them closer together in age, that there will be an almost 9-year gap between the two of them. Will they still find a way to be close, or did we rob them of that?
(Image: Zachary's Foot at 25 weeks, 2 days)

26 Wks, 1 Day: Perfect?

On Monday, I had my 26-week appointment. Other than losing 12 pounds last month, the pregnancy got a perfect bill of health: perfect blood pressure, perfect 3-hour glucose tolereance test results, perfect little heartbeat, perfect height of fundus. Perfect, other than the contractions and preterm labor that plague me.

By some pregnancy books, have started the last trimester and by others, it will not start until 2 weeks from now, at the 28-week mark. But either way, wow!!! At times, it seems like this pregnancy has lasted forever. At other times, it seems like the time has flown. And other than being on bedrest and having the preterm labor issues, I feel great. My body has adapted to the brethine pump, so I no longer feel the insane tachycardia and jitteriness that goes with it, even after they increased my dosages this past weekend. I'm not nauseated, don't have crazy heartburn, am not as sore as I was in the first trimester. Other than some pain in my left hip, which is sure to be nothing more than pregnancy-induced sciatica, and Zachary's wonderful kicks and punches, I wouldn't even tell you I feel pregnant. I do feel fat, but I have this great baby belly. With E, I just looked horribly obese, to the point that people couldn't even tell I was pregnant. But this time? Ummmm......not the case.

I am starting to get a little apprehensive about the delivery. My doctors tell me they are going to stop everything at 34 weeks, which is when I had E. I am having a repeat c-section and am not even given the option of a VBAC, but they won't even schedule it. One of the joys of having a scheduled c-section is that you know, without a doubt, when your child will be born. You literally get to pick their birthday. But they know that as soon as the brethine pump and progesterone shots are stopped, I am going to go into labor on my own, making any attempt at planning null and void. And I know that, after the prenatal care I have had, the close watch they have kept on Zachary, the steroids, and more, that they will deliver him then. But do I want them to?

This brings up a question of how truly lucky were we with E? I have learned in my line of work that a 34-week preemie can be perfectly healthy or they can have problems. It can go either way. E was perfect: over 6 pounds, which is big for a 34-weeker, but still small. I'm not sure, but even if he would have been full-term, he may not have even been considered low-birth-weight at that weight. He may have tottered on the edge of that line, but I don't think he crossed it. I remember him as baby: he was pefect. Petite features, pefectly proportioned. He was a little on the long side for his gestational age, making him even skinnier as his 6 pounds was distributed over more body length. And I didn't see him immediately after delivery, but I know he didn't even need suctioning, which is so commonly needed for c-section babies, as the trip through the birth canal doesn't occur to squeeze the fluid from the little airway. My mother-in-law was there, taking pictures of him, and I remember her telling me that he cried and screamed when someone would pick him up, but as soon as they laid him in warmer, he would be quiet and still and just look around, as if to say "leave me alone, people, and let me check out my new world". When I was finally taken to the recovery room, and got to hold him, he was perfectly quiet and still, laying there wrapped in his little bundle, on my chest. The only negative thought I could have about his birth is that he couldn't latch on, making our attempt at nursing in recovery awkward and leading to bottle feeding instead of breastfeeding as I had intended. That had as much to do with me as it did with him. Neither of us were in it at the time.

So back to Zachary: If I let them deliver him at 34 weeks from horrific contactions that aren't producing cervical changes, am I taking too big a risk? Because delivery at that stage would be for me, not him. And doctors can tell me what they think the odds are, but even if I were to deliver at a perfect 40-week mark, no one can guaruntee a healthy baby. In this cruel world, babies that seem perfectly healthy in utero can emerge with anomalies no one could have predicted. I am saying all of this now, but at 26 weeks, I can already tell that the contractions are getting more frequent, are harder to make go away, and are more and more painful with each passing week. How bad will they be at 34 weeks? How much will I be able to take? Is the gamble too great a risk?

Sunday, March 7, 2010

25 Wks, 5 Days: Bedrest and the Eight-Year Anesthetic

Bedrest.

I have dreaded that word, but have anticipated it from the time I saw 2 pink lines on the home pregnancy test. I didn't want this. I used to work for a hospital where I would come home at the end of the day hating my job. That isn't the case anymore. I love my job. I love my coworkers, from the nurses and doctors I work with, to the other RT's, to the nurses, and all the way down to the housekeepers. I don't want to jeopardize that. And I am worried about the financial well-being of my little family. We have had some rough times, and we always bounce back, but after so many of those, you get tired. I mean really tired of having to rebuild. I know somehow we will survive this also. I just don't know how at this point. I'll cut expenses as much as possible, save as much as possible, and get help if I need it. I guess I'll have to wait and see, which is the hardest part for a type-A control freak like myself.

Yesterday, as I was contracting every 3 minutes, I hung my head and asked J if it was this hard with E. "Yes, baby, it was," he says. " But it was different because we were at a different place in our life and our marriage." It seems like a funny question for me to be asking him. I, of all people, should know. I was there.

They tell you that you will forget the pain of bearing a child as soon as you hold your baby. In some ways, I agree with this. I can tell you that E's pregnancy was a nightmare. I remember that much. I can tell you about the time a doctor told us we should just abort him and try again. I can recall other bits and pieces. The viscosity of the mag sulfate, cranked to the highest possible dose, and the throbbing in my arms as it entered the vessels. The purple-black bruises up both arms from both failed IV attempts and having to have labs drawn every 2 days. My white-knuckled fist grasping the bedrail as the contractions ripped through me. But that's it. Little tiny snapshots. Heartbeats, really, in the 34 weeks my body managed to both maintain him and try desperately to rid itself of him. Back then, I could have told you the entire story, in great detail. Somewhere along the line, the edges blurred, as if the 8 wonderful years of my life since he entered it have served as an anesthetic. As if Mother Nature or God, either one, is whispering in my ear, "It's all okay. You survived that, and now look at the reward. Look at this beautiful person who is here as a result of your toughness and grit." I can tell you the story, but the raw emotion is removed from it. It is just another event in my life. I think I needed the 8 years of watching him grow and giggle and learn and laugh in order to recover from the manner in which he entered the world.

So now here we are, fighting the same battle and it feels both the same and completely different. E's pregnancy seems easier now, looking back, and I don't know if this is because of different circumstances, or if it just seems so because I know E, and that has erased the degree of difficulty from my mind. 8 years from now, when Zachary is 8, will I have forgotten? Will knowing him and holding him and watching him grow serve to take all of this from me? One can only hope.

25 wks, 5 days: Same Stuff, Different Day

I wake up early Saturday morning, and the house is still quiet with sleep. But my body is not. I am contracting like crazy. They came back sometime in the middle of the night after that dreaded trip to Wal-Mart. So I put myself back on the monitor and record them. I really want to push the little button on my pump that will deliver a brethine bolus, but the nurses at the company that manages it have warned me not to do this without them telling me to do so. They keep track, it would seem, and more boluses means I use more of the medicine, which is shipped to my house in pre-determined quantities.

My unscientific timing had the contractions at about every 3 minutes or so until 8 AM, which is when the pump delivers an automatic bolus, and when they call back, the nurse tells me that the monitor picked up 8 contractions in the first half hour, and that they seemed to slow down after that. She tells me the usual, to drink plenty of fluid, to bolus myself, and to run another strip about 20 minutes or so after the bolus has been delivered.

I do as I am told, and run another strip. The nurse calls back, and can hear the tears in my voice through the phone. She is genuinely worried and I have had 20 contractions in that last hour. She asks me how I am feeling, and with my mental filter no longer in place, I am brutally honest: "Like shit", I say. Not "I feel terrible" or any other combo of words I would normally use when speaking to someone in a professional capacity. I am beyond caring about that at this point. She tells me she is going to call my doctor, and I wait.

Dr. D is on call. She is the one who almost sent me to OB Mecca at 21 weeks. When I finally talk to her, I remind her that I just left OB Mecca on last week, and plead with her not to send me back to that place. Se gives me her cell number so I no longer have to go through the paging service to reach her for the day, and gives me some instructions: take 3 tylenol, drink a ton of water, and lay on my left side. Then she wants me to call her on her cell in half an hour. She also tells me that until I reach 32 weeks, if I have to go to the hospital, it will be OB Mecca, and she knows how I feel about it, so she is trying to avoid it. I tell her I will do anything, even standing on my head if I have to. I am ovewhelmed with gratitude at this point. Most doctors would argue that I have to go. Instead, my team of doctors really does listen to me, and tries to keep my feelings in mind. They send me when I need to go, and will not hesitate when it is necessary. But instead of making me rush off to the hospital each and every time, they take me into consideration. After all, I have been hospitalized 5 times since January 29th. If I ran everytime I had these contractions, I would have been at the hospital every day.

So for a few hours, I am in constant contact with both my doctor and the nurse at the monitoring center. Through rest and boluses, the contractions start to spread out, and I am relieved. The nurse wants me to reprogram my pump with her over the phone. My dosage for my continuous infusion is increased, as is for my automatic boluses and the demand boluses, and they move those to every 3 hours instead of every 4 hours. By the time all this is done, the contractions have spread even further: 8 minutes apart. My doctor is pleased with this,and tells me to not hesitate to call her cell for the rest of the day if needed. She also tells me "no more going to Wal-Mart". And that she will assume that if she does not hear from me, that all is okay. And she also says the dreaded word: Bedrest. What I have been trying to avoid from the minute I discovered myself to be pregnant.

So with that, I have avoided hospitalization yet again.

Saturday, March 6, 2010

25 Wks, 4 days: Did a Trip To Wally World End Life as I Know It?

We had to go. We needed some groceries, and while I am to "rest" while off of work, I am not on bedrest. My doctors say there is no real proof it does anything in preterm labor cases, anyhow.



So we go to Wal-Mart. I loathe Wal-Mart, especially on a Friday afternoon. Too many people, all in a hurry. And rudeness. They cut you off with their shopping carts, try to run you over. I have a hard time, because I am having some mild contractions, so I am trying to stay out of the way of the crazy shoppers because I have to go so....slow. J tries to get me to use one of the motorized whelchairs, and I refuse to do this. We get what we need and try to get out of there. The lines are enormous, and by this time, I am really hurting. There is a lady at the front of our line with 2 carts, both overflowing. After the slow cashier gets all of it rang up, she proceeds to hand her a stack of coupons. Several of them don't scan, and there is is one for 25 cents that the cashier tells her they cannot take. She argues. I am just about to give the woman a quarter so she will let the cashier finish and get the line moving, when the cashier concedes. Then the woman pays with her food stamp card, which the machine doesn't want to take, and another battle ensues. J looks at me and tells me to go to the car and wait. I do, but then wait for J in the car for another 40 minutes, as that is how long he had to wait.

Sitting in the car, the contractions get worse. I am sitting there, waiting on J, thinking I am just about to deliver this kid in my car when J finally emerges. And we come straight home, where E, bless his little heart, puts away the groceries for me as his daddy unpacks them from the car. So I am free to strap myself to my monitor and send a strip to the monitoring people. They call back in 10 minutes to tell me what I already knew: I had 15 contractions in that one hour.

Through boluses from the brethine pump, they get the contractions slowed down to a quiet roar, and I am permitted to stay home for the night. But by this point, I am really scared. This was me trying to go to the grocery store. I haven't worked since being discharged from OB Mecca. What is going to happen when I try to work the next night?

Friday, March 5, 2010

Don't Let Me Go, Daddy: On Raising a Son

So I bought this CD because I loved the song "Then". We were on the way to Babies 'R'Us to pick up some stuff for Zachary on the very same day we found out his gender. I had held off buying anything because I really couldn't find anything I liked that was gender-neutral, making it necessary to wait. We had gone to Target first, where I bought this CD along with some baby items, and I popped it in in the car. That was the first time I heard this song, and it made me tear up a bit. "Anything Like Me" by Brad Paisley.

If you have never had a son, you probably won't get it. But it reminded me of E. E is mischievous and rotten and messy. He's rough-and-tumble, all-boy. He has a sweet, angelic side too. But mostly, he just does stuff to either make me shake my head and laugh, or bite my nails and worry. He is delightfully male. And fun.

So last night, in the unseasonably warm sunshine we had, with the piles of snow from previous weeks' snowstorms melting fast, he decides he wants to try out his new in-line skates. He asked for those for Christmas, as well as a skateboard and other things that have the ability to maim my baby. He hasn't had a chance to really try them out yet. J decides he will take him outside and give him that chance.

Of course I have to be the mom. "Helmet, elbow and knee pads are not optional!", I exclaim. He does as he is told, and scoots outside on his little butt, completely garbed up. I watch from the window as J holds him up and helps him get started. "Don't let me go, Daddy.", he says. It is so cute and I am so amazed, witnessing this moment between father and son. E's blind trust in J, and J's unfaltering presence for our baby boy. And I also know that there will be times when Daddy has to let go. And I will too. Where we cannot protect him from bumps and bruises, whether physical or emotional in nature.

In that moment, my thoughts turn to Zachary. In that I get to do this again. I've never raised a girl, and I never will, so I cannot speak on it. But raising a boy can be scary, but it is by far the most rewarding challenge I have ever experienced. I think it is made to be even greater a challenge when you go through so much to bring them into the world. We do the medicines and the tests and the doctors' appointments and hospitalizations to keep them safe and protect them when they are in the womb (and in my case, to keep them in there),and that is hard. Very hard. But is it really any easier when they are out here with us? When there is so much more from which to protect them?

(Image: Blissful laughter, E at 5 years old, playing in the backyard. I snapped a pic of him with one hand while tickling him with the other.)

25 Wks, 3 days: J's Take on This?

Hmmmm. This may sound silly, but I find myself wondering what it is like to be the man in a complicated pregnancy. Or any pregnancy, for that matter.

We women are so lucky. To carry a child and have it grow inside of you forms a bond that cannot and will not be broken. And men have their role, too. But it just seems so much more abstract looking at that role from the outside. This is, of course, coming from a woman who has a very involved husband. There has only been one appointment in all of this that J could not attend, and that was simply because E had a snow day at school, making it ncessary for him to go along with us. J kept him ouside and occupied while I saw the doctor that day. Other than that, he is there with me every step of the way.

I remember his excitement at finding out E was to be a boy. He had almost the same reaction when we found out Zachary's gender. Does it make them feel more manly to produce sons? Lke in some ancient culture where sons are a tribute to their virility?

I wonder how J feels about all of the problems I have, if he regrets that he married a woman who is flawed, and cannot seem to do the one thing that women are supposed to be able to do. I know this view is slightly skewed. I know women who have had fertility issues, and know it is not their fault, and that it makes them no lesser a woman. But when it is you that has trouble, this is how you see it: you are flawed, defective, unnatural. Or maybe that is just me. Who knows?

I could ask J how he feels. We have been married for the better portion of a decade. When I say he is my best friend, I am not just saying that as the cliche of marriage. He truly is. My partner, my lover, my soulmate, my confidante, my biggest fan, my worst enemy, my entire world. But J is also....well....J. A tough-talking Marine Corps Veteran. A good-ol' boy raised in the country. He doesn't talk about his feelings unless he has to. They come out eventually, but only when he is overflowing with emotion and it spills out of him more like an involuntary response. Kind of like a bucket collecting rainwater: it gets full to the point that there is no place for the water to go but to spill over the sides. That's J.

But still...I cannot help but to wonder what this all feels like for him.

Thursday, March 4, 2010

25 wks, 2 days: Stupid Pump and Other Stuff

Grrrr. My infusion pump kept me awake all night. The catheter goes in my upper thigh, or I can put it in my stomach, which I cannot seem to bring myself to do, so thigh it is! But every 2 days or so, I have to alternate legs. This time it is in my left thigh. The problem with this is that I can only sleep on my left side, propped on a nest of pillows. So every time I would move in my sleep, the tubing would get pinched and the silly thing would beep and buzz and vibrate to tell me it was occluded. I got no sleep last night as a result, but I am also not having contractions, so it is worth it.

As for today, I have another day without plans. I really should finish my book I have to read for my women's literature course. I didn't drop out of class completely. I had one easy-as-pie online course and the women's lit. My professor for the course has young twins and was on bedrest for their pregnancy, so she understands and has exempted me from attending class. I read the required books, then submit reading journals and papers to her via email. So I am still in school part-time. But I don't want to read or write a paper.

All of this has me thinking. My life up to this point has been so crazy. I would work up to 60 hours a week as an RT, doing 12-hour night shifts, then attend class full-time during the day. Any breaks, though they were few and far between, would be occupied with E and J. There would literally be days where I would not sleep. I ended all of that after I discovered I was pregnant. No more overtime, no more demanding courses at school. No more.

Part of me misses my crazy life. I've always been the type to thrive on stress. And I have to have a challenge or I lose interest. But this? This is kind of nice. I can focus on going to work when I am able, can relax and do things I want to do during the day while my boys are gone. I don't know if I am feeling this way because it is a break and I was getting burnt out, or if this is a permanent change. I have wanted to be a doctor my entire life, and that is what we were gearing up for. I was almost there. I would have taken my MCAT and started applying this quarter. I don't know how to want anything else. To change my plans now seems so scary to me. But after almost losing E all those years ago, and now with what we are going through with Zachary, I feel like I should be content to just stay home and raise my sons. And be with my husband. And I actually can picture my life like that: sloppy kisses, peanut butter sandwiches, milestones reached, baby giggles, bedtime stories, and more. Prestige and income mean nothing to me right now. Maybe it is the hormones.

Wednesday, March 3, 2010

About Mag Sulfate vs. Other Tocolytics

http://www.medindia.net/news/Preterm-Labor-Drug-Causes-More-Side-Effects-22808-2.htm

25 wks, 1 day, still: A New One at the Call Center?

Ha! Hahaha!

I have to run at least one strip on my home monitor once a day, no matter how I am feeling. By now, I am sure they know when I am having a good day, because my strip is usually transmitted in the evening. More like an afterthought to a good day. As in "Oh, I haven't contracted like crazy today and they are probably wondering where I am...."

Tonight was one of those nights. J and I worked together in the kitchen to cook some penne, then the three of us stuffed our faces to the point that I felt like I had no room to breathe between Zachary's delicious little squirms and kicks, and my full-to-bursting stomach. Then I strapped myself to the monitor as I lay on the sofa, waiting anxiously for the long beeeeeeeep that tells me the hour is up. So I could move, and find a better position for breathing. (Note to self: stop eating so much when it makes you feel so miserable!)

So J transmits the recording for me while I get comfy, and the nurse from the call center telephones to let me know she has reviewed the strip. She seems alarmed that I had 2 moderate contractions. That's all. 2. I giggle at this and explain that 2 in an hour is wonderful for me, and serves as further proof that it has indeed been a good day. And I joke that as long as they aren't more numerous and coming every 2 to 3 minutes, we are good. I don't think she knows how to take me. She keeps asking if I feel okay, and seems puzzled when I tell her I feel great. I decide that she must be new. Or she hasn't seen one of my strips or heard of me before.

J and I get a good laugh out of this. We probably shouldn't. It really isn't funny. But we have to find some humor in it. In the crazy rollercoaster ride. If not, we will go insane.

25 wks: I Can't

So we bought everything, I think. There are still odds and ends that will come up. I haven't bought bottles yet. And we need more bibs. And a highchair and swing. J's mom is buying those for us when she comes up when we have Z. I have already bought the matching carseat, stroller, and playyard. We have the crib bedding and changing table. It's all set up and ready for Baby Z. And the child has more clothes than I will know what to do with. The little outfits are all hanging there on their pristine tiny blue hangers. The dresser drawers are stocked with tiny socks and onesies and sleepers.

So what can't I do? I cannot manage to finish what I have started. This wouldn't be a big deal for most women in my condition. I, after all, have months to go before Z's planned arrival. But I am approaching the last trimester. According to the baby books, these are my last weeks in the second trimester, as a matter of fact. I should finish up my preparations. This is one of my pregnancies. Meaning Zachary could come any time. Or I could be put in the hospital indefinitely at any time. Anything can happen. I should be ready. But I can't. I just can't.

24 wks, 6 days: Me and Z, Just Chillaxin'

E is at school. So is J. The house is quiet. So is my uterus. In other words, no crazy contractions yet today. So we are just hanging out, me and the fetus. Actually, he is kicking up a storm because I just fed him what had to be the most delicious snack: oats and honey granola bars dipped in milk. Mmmmm. Pregnancy does weird things to me. Granola? Me? Normally it would be Oreos and Diet Mountain Dew for me, but that isn't exactly good for Z. And milk? Forget it. I hate milk normally.

I don't know what to write today. There are no harrowing journeys to tell you about. But with all of the bad, I feel like I have to document the good also. And I am feeling decidedly upbeat. I have been perusing the web looking for links I can put in here for other blogs and websites from people who have gone through complicated pregnancies. I do this, of course, so that in the event that this blog is stumbled upon by someone seeking info on preterm labor, they can find information here. Instead, I am finding these heart-wrenching stories of every obstetrical nightmare known to man, of love and loss, and the things we women endure to become mothers. It has made me appreciate E and appreciate that, although I am miserable, Z is thriving. I feel so appreciative and blessed right now. I have had traumatic pregnancies, but I have also had the priviledge of being the mother to a little boy who, by all rights, should not have made it into this world. But Nope, E is here, and beautiful and healthy and strong. A living tribute to God or modern medicine or whomever you want to put your faith into. I am choosing, for now, to assume that Zachary will be the same, that I will get to meet this sweet little boy in about 8 weeks or so. The gift we never knew we wanted.

24 wks, 5 days: Never So Happy To Be So Embarrassed

Seriously? I tried to stay away. I get tired of having to call my doctor all of the time. I hate going to labor and delivery.

But we are sitting there. Watching television. And I feel something wet. Gross, I know. It came after a mild contraction. Then again, and again. I check it out, and my panties are soaked. Eww. I didn't pee. I don't have any crazy discharge. I try to smell it, and reach no conclusion.

I try everything to discern if this is me leaking amniotic fluid. I even resort to some pretty crazy things that are too embarrassing to mention. I call L&D and find someone working that I know. I try. I try. I try. I just left OB Mecca and the mag sulfate drip behind me this morning. I don't want to go back to the hospital. J has to study for a test, and I don't want to let him down. But of course they tell me to come in.

It wasn't fluid. We don't know what it was, and don't think it was urine either from the odor. But it was embarrassing. But I was so happy I didn't care. My RN friends laughed as I hung out with them at the nurses station, throwing my hands up in triumph, exclaiming "YES! I may have peed my pants!!!"

24 wks, 5 Days: OB Mecca or OB Hell???

An ambulance takes me into Cincinnati to OB Mecca. A registered nurse has to go with me because of the mag sulfate drip. The EMT and paramedic look really nervous when they hear I am contracting every 2 minutes on the mag. They plead with me not to deliver the baby in the ambulance. "We don't want to do that today", they joke. I tell thm I am registered respiratory therapist and have resuscitated babies of this gestational age, that I will not let them deliver my baby in the ambulance. At any cost. The whole experience is kind of surreal. It is about 8 am, and we are driving through Clifton. I know that drive. I take it all of the time to get to my morning pre-med classes at the University of Cincinnati. I know it is wrought with idiot drivers, juggling their coffee and cell phones while trying to navigate traffic. And I am the worst control freak/ backseat driver. But yet here I am, strapped to a stretcher, watching traffic through the tiny windows in the back doors of the ambulance.

We get to OB Mecca, and J is already there. I had called him from my hospital room as the transport team was walking in the door to get me, and wonder first how he beat me there, followed immediately by the question of whether or not he wrecked my car in his rush to get here. I had told him not to rush, that I was fine. But it is J. I've learned not to question anything in our 9 years of marriage.

The OB Mecca staff puts me in their triage, which is the first chance I get to be pissed off. I am on mag, uncomfortable, have been awake all night, and have been sent by a very reputable physician. Why triage? Why not my room, with a bed instead of a stretcher? They won't let J back as they ask me admission questions they have to ask everyone. No, I do not have any sexually transmitted diseases. No, I do not feel I am at risk for them. No, my husband doesn't beat me. In fact, I tell the nurse, if he tried, I could take him. I know they are just doing their jobs, but I am frustrated and tired and miserable. I try to be nice. What is more likely is that my attempt is coming out as a dry, sarcastic version of myself that emerges when I have had it. My mental filter is no longer in place. But it doesn't matter. When J finally comes back to the room that is the size of Harry Potter's broom closet under the stairs, I hear the nurse tell him that his wife is hilarious. At least she likes me.

After changing all of the tubing, a resident comes in. I know it is a teaching facility. All of the OBs in the practice I go to did their residencies here. I expected it. And I am all for being a learning experience for residents. I work with residents. I also let them prescribe my family mmbers antibiotics for strep throat, or manage my asthma. But this? With my OB history? I don't really like being a learning experience in this situation. Anyhow, she does a pelvic exam that feels more like she is trying to extract tonsils from the wrong end of my body, does her little swabby thing to make sure there are no creepy-crawlies in my nether regions, as they do with everyone, and I am on my way to my room finally.

This is when all hell breaks loose. Once I get in my bed, it all hits me, and I am upset. Becuase of the visiting policies at all area hospitals due to H1N1 fears, J won't be able to visit because he will have E with him. E can't visit me. My baby boy will be absent so long as they see fit to keep me here. And by default, J will be also. He has class during the day, and E with him at night.I am going to be alone. Plus all of the smiling faces of my coworkers have been removed from this scene. I don't get the "she's one of us" perk package. This seems silly, but this is what opens the flood gates. And I cry. I cannot stop crying, as a matter of fact, which made what followed all the more worse.

They started asking questions. Why am I on a brethine pump? Why the mag? I'm not dilating so it is false labor. But how can I continue in a pregnancy contracting every 2-3 minutes? At what point do we try to stop them? If the are waiting fo me to dialte, it won't happen. I just don't. I try to explain.

Then there are the contradictions. They will stop the mag drip as soon as I am back on my brethine pump, which had been stopped for the ordeal. But wait! Just a minute ago, I didn't need it. What the hell? Through the course of 2 days, they treat me like crap. Thay act as if my team of OB's in Northern Kentucky know nothing, when in truth, they all completed their residencies there. They act as if the people at my place of business are incompetent, which I take as a personal affront. I am not a NICU therapist, but I am also not an idiot and work for an excellent, award-winning hospital.

The entire experience leaves a bad taste in my mouth. They ended up letting me leave the next morning. I got the home health company to reprogram the brethine pump (that I don't need) so they would stop the mag drip,and I was out of there. I never want to go back, but I know I will eventually end up there again. I have about 8 or 9 weeks to go before I can safely deliver Zachary. And I know that it is the best place for a preemie in this area, barring a local children's hospital. But at the children's hospital, I would not be in the same place as the baby, so it is not as desirable a choice.

24 wks,4 days : In the Hospital

So there I am, in the hospital. I can no longer feel the contractions, so I think the mag sulfate is working. I know from my nurse that this is not the case. Mag relaxes the smooth muscle of the uterus, and this is how it stops contractions. But it hasn't stopped mine. I just cannot feel them anymore. She holds up my strip to show me, and there is literally not a flat area on it, as my uterus goes through waves of contractions, a new one starting every 2 minutes. "Andrea, this is an active labor pattern!", she tells me. Gradually, my dose of mag increases until I am on 3 grams. At this point I am maxed out on it. They start adding brethine boluses, and these seem to work.

I ask about my KB test, and discover that it was positive. I don't know what this means, so I call J, who is home with E, and ask him to google it for me. He cannot figure it out for me, and noone there knows how to interpret my weird result. And somehow, over the course of the night, I go from not being able to feel the contractions, to feeling them but not being in pain, to actually having discomfort. When I get to the point where I find myself having to stop and focus on my breathing through them, I let my nurse know. Something is different. Something has changed.

Somewhere around 5 AM, my doctor comes in. I feel terrible, as I know he isn't even on call for my practice anymore, as it has switched to the next day. But he has been awake on the phone with my nurse all night, and makes the special trip in to see me. But he explains the KB test, finally. It means that there has been a breach in my body, and that there are fetal blood cells in my blood sample. In other words, a hemorrhage has occured. It isn't bad, and I am not in excrutiating pain or gushing blood, so it is probably just mild trauma from the fall. What he is concerned about is the change in my contractions. And he seems apologetic as he tells me he is sending me over the river from Northern Kentucky into Cincinnati to what I mentioned in an earlier post as our OB mecca. He knows I don't want to go. I have terrible memories of that place from E's pregnancy, but he pats my leg and tells me that if I were his wife, and this were his son, that is where he would want me to be at that point. I am 23 weeks pregnant,and this hospital is known for their NICU, even keeping micropreemies alive at points when noone thought they were even viable. For Zachary, I have to go.

On a side note, I was started on my Celestone course for Zachary's lungs. Should be finished with that soon.

24 wks, 3 days: Terror and Good Coworkers

Sunday morning, I was trying to sleep the day away in preparation for a night shift that night. I had to run a one-hour strip on my monitor like I do everyday, so I plugged myself in and let it do the work while I dozed. I remember it beeping, and in a sleepy haze, handing it to J to transmit the recording to the company. A few minutes later, J is waking me up, thrusting a phone at my face. It's the home health nurse, and she wants to know my pulse. So I wake up and count it for her. But then I can't go back to sleep. So I get up. Errrrr, I tried to get up.

What happened next was so quick it was a blur. I remember my toes getting caught on a rug beside the bed. I know I sailed through the air, landing flat on my belly, my head just inches from the closed bedroom door. J and E both barge in, wondering what the awful sound was, only to find me there, still on the floor. It wasn't a big deal at that instant. Pregnancy makes the most graceful of us become foddering and clumsy. When I was pregnant with E, my favorite pasttime was falling down stairs. We've since joked about it because it happened so often that I would automatically shout out "I'm okay!" from my landing at the bottom, to keep J from panicking. This hasn't happened during this pregnancy. Or at least it hadn't.

J was frantic. He rushed to get E dressed, and was running around the house like a mad man, explaining to E that Mommy would have to go to the hospital. I kept telling him I didn't, that I was fine. I just felt like I was being punched in the stomach, but it wasn't the excruciating pain that marks a placental abruption, which is what one would worry about in a time like that. (In truth, I don't know what it feels like to be punched in the stomach, but I imagine it to feel like I did!) I called my doctor more to appease J than I did out of concern.

The doctor calmly asked my blood type, and told me to go to the hospital, where they would be expecting me. He explained that they would do some blood work and just check things out. So we went.

They drew labs, something called a KB Test. I had no idea what this was, but I was okay and the baby seemed to be okay. As a matter of fact, I giggled at the sounds of him swimming around in there. He was happy as a lark. They said the test would take about 2 hours to come back. Okay. Whatever. But of course, this is me we are talking about. I should wear one of those "Hello, my name is..." stickers afixed to my chest, but instead of A, for the time being, it should instead say "Obstetrical Anomaly". Of course I was contracting and of course the nurse had to report it to my doctor. And thus my relationship with magnesium sulfate (for this pregnancy, anyway) started this past weekend. The poor nurse didn't even have to tell me what she was going to do. She came back from speaking with the doc, and just frowned. I knew what that meant. "He ordered mag.", I said. She just nodded.

If you have never been on mag sulfate, it is hard to describe. The minute the stuff starts hitting you, you feel like you have an intense sunburn, with heat trapped beneath your skin, unable to escape. Some people get weak. Some people vomit. I don't do either of those, but just feel miserable, generally. And hot. Very, very hot. But I've been down this road before. I know it is the big dog for preterm labor. I was on and off of it for a month with E. It is, by all rights, familiar territory for me. I consent to it, but tell them I want to able to eat. I am starving, after all. They let J come back to see me, and I give him a Mickey D's order, and send him running for it.

That is when it happened. Right then, when my husband was in some silly drive-thru getting me a stupid cheeseburger. Every nurse on staff in L &D (or so it seemed, as there were 5 of them) was suddenly at my bedside, clutching at my wrist to check my pulse, feeling on my belly to find Zachary. His heart rate had decelerrated to a point where they could not distinguish between his slowed heartrate and my quickend one from the brethine pump. But my time in my profession, where I have been called on to resuscitate newborns has taught me enough. I knew a decel like that meant fetal distress. I was hysterical. J was getting a damned cheeseburger for me. And they were muttering sentences about "delivery". And me? I wasn't rational at that point. I got on the phone, in the midst of that flurry of activity, and called my department at the hospital to let them know I would not be there. I'm glad I did.

I don't know how long it took, but before I knew it, as I was sitting there with the nurses thinking Zachary was seriously in jeopardy, 3 calm and smiling faces popped up from behind the curtain. My coworkers. To check on me. The one I had spoken with on the phone had heard my tone of voice and had called in the troops to come and make sure I was okay. God bless those girls. They calmed me down and reassured me until J was there again.

Zachary was okay. Whatever had caused the decel went away and his heart rate picked back up. I was admitted on my mag sulfate drip. But for the first time in all of this, I really truly had to think that my baby was at risk. For a few minutes, I had to think that this was not just me being me, contracting like I do. This has been going on for over 5 weeks now, but I took for granted that I would deliver a healthy baby in the end, like happened with E. This experience showed me that nothing is a given.

Tuesday, March 2, 2010

24 wks, 1 day/ 2 days: Unrelenting

So on this day, I go back to work, and am assigned an ICU at the hospital. This has to be the favorite part of my job, as I get to really use my brain, to an extent. And this is the first time since all of these complications have started that I have had such an assignment. But an ICU assignment can either be easy or hard, and there is no way to tell from one day to the next which it is going to be. This one started easy. It didn't finish that way. I started with 3 ventilator patients and ended my shift with 9. The night was full of patient transports and receiving full arrests from other facilities and other areas of the hospital. I really gave the brethine pump a run for it's money. By about 4 AM, my belly felt so tight I could barely stand it. I couldn't feel any distinct contractions, just tightness and pain. So one of OB RN friends runs into me in the hall, and tells me how crappy I look. Somehow, I ended up on a monitor just to see, and was contracting every 3 minutes. Gah!

The contractions weren't the biggest issue though. My phone started ringing off the hook. This patient had blood coming out of his endotracheal tube. Another patient needed to go for a stat head CT. And they were relying on me. I could have put my foot down and called one of my coworkers to do it, but I couldn't bring myself to do it. After all, my problems are not their problems. I am so tired of feeling like a nuisance, like a non-contributory party. And no one has said anything to me to make me feel this way. I do on my own. I am so used to being independent that have a hard time asking for help that is not offered. Yeah, I talk a good game. I know that the baby comes first and all, but I cannot just suck it up when push comes to shove. In the end, it made for a very exhausting night at work, both physically and emotionally.

The night did have a slight silver lining, however, when I returned home contracting every 3 minutes. Through the home monitor and the brethine pump, and several phone calls between myself and a home health nurse, I was able to get everything stopped without having to go back to the hospital. She would have me run a strip, then call and have me give myself a bolus, then repeat. We did this until the contractions were completely stopped! Sweet!