32 Wks, 6 Days: Again

Back to the hospital. It went like this:

I got them to change my orders on my monitor. Instead of 6 or more contractions in an hour, they changed it to 6 or more painful or overly strong contractions in an hour. In other words, unless I hit the little marker on the monitor 6 times, I should not have to go to the hospital.

Or so I thought.

All day yesterday, I was hurting pretty badly. I took some pain medication and slept most of the day, then woke up to do my required monitoring. The nurse called me back, very concerned, saying that I had 36 true contractions, and that while she realized my orders had been changed and I didn't mark any of the contractions, she felt like she had to call my doctor. The same doctor who told me only painful contractions would count, that we would wait until 37 weeks, that they didn't care was the same doctor on call yesterday. So I thought I was safe. I understood her concern and told her to go ahead and call if she had to, but that I expected him to dismiss it.

He didn't.

They had me go in. Gave me a liter of fluid, but this time, the nurses felt so bad for me that instead of treating me like a pin cushion, they called IV Therapy. Iv Therapy makes up the Kings and Queens of Vascular Access in our hospital, and she got my IV on the first stick. I actually got my hopes up when the nurse told her to put an 18-gauge in me "in case we end up sectioning her". They also had me stop my pump while there for heartrate again.

Of course the contractions didn't stop. They called the doctor back, and he said it was okay for me to go home. Per the request of the home monitoring nurse, I called her to let her know I was home. She tried to remain professional, but could not even try to hide the exasperation in her voice. She told me her day job is still to be a L&D nurse at a large high-risk OB hospital, and that she has never seen them send someone home who was contracting over 30 times an hour. The poor woman was so flabbergasted that she was literally stammering on the phone. I found myself feeling sorry for her--she knew I didn't want to go to the hospital and was so apologetic about sending me, but was honestly concerned, only to have her worries and professional opinion completely disregarded.

And now? Now I am in complete pain. The weight of my ever-growing uterus has done things to my body that are too embarrassing to mention, and this was exacerbated by the pelvic exam and laying in a hard stretcher for hours last night. I didn't sleep last night. Finally, at about 4 AM,I took 2 pain pills and dozed for about 2 hours, only to be awakened by more pain. That's it.

I've been taking the pain meds religiously every 6 hours today, and have not even been able to move until now. Still, I cannot cough, sneeze, strain, laugh, or switch positions without this pitiful whimper that escapes my lips no matter how hard I try to control it. Each time, J and E come running to check on me. The nurse who is on today called to check on me, and told me she could hear the misery in my voice without even laying eyes on me. All I could hear was pity in hers, which I hate. I told her I would not be monitoring today. All that would do would be to put her in the professional dilemma of calling when I didn't want her to, or of being completely complacent like my doctors, against her better judgement. I don't think I could tolerate that bed again, or another pelvic exam with this pain, so I want to avoid another trip to the hospital at almost any cost. I think the only thing that could get me there now would be if I honestly thought Zachary was in some sort of danger.

31 Wks, 6 Days: Crunching Some Numbers

2: The number of times they made me monitor yesterday.

34: The number of contractions I had in the first hour of monitoring.

3: The number of brethine boluses I got between attempts at monitoring.

54: The number of contractions on the second strip. Yeah, that's right. Not a typo. The OB nurse at the call center said she has never seen anything like it in her 25 year as an OB nurse. And yes, I felt them all.

4: The number of nurses at the hospital that it took to get my IV.

13: The number of sticks it took the 4 nurses to get my IV.

2: The number of IV bags they gave me. Also the number of Percocet it took for them to get me to be able to sleep.

5: The number of hours I slept once I got home.

36: The number of hours this has been going on. They will not stop. And so long as I am not dilating, they do not care. I wonder if my uterus could spontaneously combust. If it could, at this point, I am sure it would. Today, I actually had 0 contractions. Great right? Nope. Because now they are so frequent, that they don't even last long enough to be considered contractions. Just very frequent waves on a monitor strip, which resembles an EKG more than it does uterine activity, according to my husband. Just wave after painful wave. As soon as one stops, another starts, to the point that I cannot even feel distinct contractions anymore, but rather this wrenching feeling like my guts are being ripped from my body.

They offered me morphine at the hospital yesterday. I should have taken it instead of the weaker Percocet. But there is honestly something wrong when the pain is so bad that they offer me morphine. Me, a pregnant woman. The offer makes me realize that they realize how miserable I am. If they know am that miserable, isn't it time to act?

But nobody cares. My home health company doesn't even care anymore. I ran the strip today like a good girl, and since I was seen yesterday and the doctor on call didn't care, they don't either.

I have no faith in the 34 week mark anymore. I have a feeling they will change it once I get there. As in, "Well, you made it this far. Let's see if you can make it to 36 or 37."

And I will lose my mind.

I am a prisoner in my own body, and I cannot endure another day of this.

31 Weeks: Back to the Hospital and Baby Ginormo

After having pain in my old c-section scar had me doubled over, I had to call my doctor to see if I needed to be seen today or not. Of course I was told to come into the office, so I went. My BP was 175/ 82, so I was immediately sent to L&D, where I went through the usual routine. But this time they did a full ultrasound to ensure that everything was okay. It was. My BP normalized, and the pain was deemed to be the result of scar tissue and adhesions in there.

But...
Zachary is measuring, at his current gestational age of 31 weeks, at 5 pounds, 4 ounces. His gestational age calculated by the ultrasound: 35 weeks, 1 day. Still huge.

We got some awesome pictures of him, though, and even got to see him yawn. J had gone to pick E up from school, so he got to be there to see his baby brother on the screen for the first time, instead of just looking at grainy pictures. He saw it all, the yawning, squirming precious baby boy, complete with the little heart beating away. A wonderful experience for him.

A perfect little leg, from thigh to toes.

And speaking of toes...

The sweet little profile

Angel face. We can see he looks like his brother.

This one required some explanation. The ultrasound tech gasped, "Look at all of that HAIR!" Apparently the white halo-like shadow around the top of his head is his hair, lilting in amniotic fluid, and he already has a head full!

30 Wks, 5 Days: My Meltdown

I did my required monitoring strip in the early afternoon yesterday, and about 5 minutes after sending it, I got a call to tell me I had 26 contractions in one hour. I couldn't feel them, but just felt a constant tightness in my belly that was uncomfortable. The nurse had me give myself a bolus, then wait an hour and give myself another, then re-monitor. On the second strip, it actually worsened and I had 29 contractions. So they insist on calling my doctor.

Of course the nurse is still at the doctor's office, as it is during business hours, and she tells my home nurse to send me to the hospital....again. And that she will let the doctor on-call know I am going. I really don't want to go, and am concerned that the instruction to go is some knee-jerk reaction, that they aren't keeping in mind who this is, that I do this. So I call the doctor myself, and pretty much beg him to stay home. I'm worried that this is it--that I will get there and they will keep me until I deliver. He tells me this is not necessarily the case and says we will see if I am dilating any and go from there.

So I go, and of course I get a nurse who has never had me, but she is older and seasoned and has seen it all, so she doesn't panic. She is more worried that my blood pressure is up, as is my heart rate. I tell her the history of the pregnancy, how badly I wanted to stay home, and she understands.

They call my doctor, who gets one of his colleagues at the hospital to check me, and they want to do a fetal fibronectin. I'm not really happy about that. I know those can take forever to come back, and I also know that as I get further, with my history of preterm delivery, it is likely to be positive. So they check me afterwards, and of course am not dilated any but the doctor notes that my cervix is very soft. And after waiting, we find out the fetal fibronectin is negative. Good! They are calling my doctor at this point, and I am waiting for word that I can go home.

Wrong. He wants to keep me. "Just overnight, sweetie," the nurse says. He wants me to stay for observation overnight and IV fluids.

No. NoNoNoNoNo. NO! I start crying hysterically at this point. I know this song and dance. and I have a complete meltdown on my poor nurse. This is what I tell her:

They'll put me in with "just IV fluids". And the monitor. And I will have contractions all night, because it's me we're talking about. And in the morning, another doctor will be on for my practice and will see that I am contracting, so then it will be mag sulfate. Then someone else will be on Sunday, and they will say, "Gee, you aren't quite 32 weeks, so let's ship you to another hospital." And so it goes.

And I would be fine with all of it if I were feeling the contractions, or even if the mag sulfate worked for me, but I know it won't. It didn't with E at this stage of the game, and it didn't the last time with this pregnancy.

I want to go home. I am not dilating, the FFN was negative, I am not in pain (other than back and hip pain from the way they keep making me lay on the uncomfortable stretcher in order to keep Zachary on the monitor).

No. I'm going home.

The nurse asks me if I will sign treatment refusal forms, and I cry and tell her yes. I don't want to upset my doctor, as I respect him too much and understand why he wants me to stay, but I have to go. I just keep telling the nurse, "I'm DONE. I'm sorry, but I'm just DONE!"

I want to be home with my husband and son in these last days of the pregnancy. I want to sleep where I am comfortable and be able to eat. I want to be able to bathe. If I stay, I tell them, it is because they are going to deliver this baby. I've had enough.

This has been going on for 11 weeks. Painful injections, first every 7 days and then every 5. Having to stick myself with needles every 2 days for my pump. Heart palpitations from the medicine. Lowered blood pressure from the medicine. Hospitalizations, both inpatient and outpatient. Scars all over my arms and legs from needles. Probable nerve damage in my left hip from the time someone gave me my shot wrong. The times in the hospital where they wouldn't even let me bathe myself, one of the most basic of human needs. $2K worth of just insurance copays per month. Medical bills piling up- a $500 copay for every inpatient stay. My most-likely-lost job. My abandoned education. J's abandoned education. Being alienated from everyone I know.

But you want a healthy baby, don't you?

You're damned right I do! I have done all of this for no one but him. I have had no benefit. J has had no benefit. And E most certainly has not had any benefit from this horrendous pregnancy. And I will endure more. More contractions, more painful injections and needle sticks. More of everything as the pregnancy reaches it's end.

But I am finished. And I am going home.

I don't know what happened from there. I know she called my doctor again and told him what had to say about the probable chain of events. That I was willing to sign papers stating I was leaving against medical advice. She said his response was , "And she is probably right". So he agreed to let me go, without signing papers, so insurance would pay.

Now I'm worried. I'm afraid I have upset my doctor, whom I absolutely love. Or the L&D nurses I work with and rely on. I'm afraid that, since I couldn't feel these contractions, that when I do my required monitoring, the whole process will start over again later today. That I will have to do this over and over before I finally deliver.

30 Weeks: The End-of-the-Road Blues

I just got back from my 30 Week check at the doctor's office. Good Lord!

I'm trying to stay positive, so first of all, Yay!. Hooray for 30 weeks. Another milestone reached and another week closer to a healthy baby. But...

I didn't blog about this over the weekend because, well, I just didn't feel like dwellng on it. The progesterone shots every 5 days were seeming to work. I have not had to go back to the hospital in 2 weeks, which is a small victory. But Friday, I started to have breakthrough contractions--every 3 minutes, to be exact. We got them stopped with the monitor-bolus-monitor routine, without me having to report to L&D. Then nothing but mild crampiness on Saturday. But Sunday? Phew! Every 2-3 minutes again, for literally hours. They increased my brethine infusion rate and my doctor allowed me to stay home when, after 4 hours, we got them slowed to 6 contractions per hour. Then I went for my appointment this morning...

First, the doctor walks in the room and says "So! How is your uterus doing?", which I find absolutely hilarious. We talked a bit because I am starting to worry about reaching the same point I did in E's pregnancy where the meds just stopped working and I never stopped contracting. He asked how many boluses it took to get them stopped yesterday, and said that if it gets any worse, they are just going to put me in the hospital until I deliver. His exact words? "If the boluses stop working, pack your bags!" I reminded him that mag sulfate didn't even stop them last time, and he agreed, but pointed out that I am nearing the time where I was when I ended up finally delivering E. So instead of my being further along serving to reassure, it is just causing me to be labeled as a giant time bomb. As in we're getting to that point, where no one knows if the contractions will be able to be stopped, and the only way to ensure that I don't have a baby in my house is to keep me in the hospital under close watch. It's like my uterus is the Boy Who Cried Wolf. So many trips into the hospital, contracting worse than a woman in the final stages of labor, with no cervical changes. So many days at home doing the same thing, and we all assume it is all okay because,well, it's me! There really is no way of knowing when it all stops being okay, so I understand the rationale behind his statement, but would pretty much rather have a lobotomy than spend weeks in the hospital.

So I'm trying to hang on. I'm getting really exhausted from all of this, and have that Woe-Is-Me attitude. I'm so tired of needles and painful contractions, of financial difficulties and mounting medical bills. I want to have the I-just-want-a-healthy-baby outlook on all of this. I do, because I really do want a healthy baby. But this is where the rubber meets the road in one of my pregnancies--it gets harder and harder to hang on, harder and harder to endure. This is the stage where I want to scream from the rooftops, "But what about me? Doesn't my well-being matter, too?" I don't, because I am a mother. It is my job to be completely selfless for my children. There have been countless times where their needs come before mine and I do not whine because that is the job for which I signed up from the minute I decided to have children.

But here? On this blog? I feel like I can whine all I want. Because this is really, really difficult, both emotionally and physically. And because this is the main reason I started this blog in the first place- a documentation of what happens, of how I feel, of the process I endure to bring a child into the world.

I'm ready. I'm ready to give this baby the food off my plate, the clothes off of my back. I'm ready to work endless hours to pay for his education or go without something I truly need to give him something he truly wants. I'm ready to be that crazy woman you see lined up in the cold at Christmas to get The Toy of the Year, freezing just to see a my child smile. I don't care about sleepless nights in steamy bathrooms to relieve croup or stopping what I am doing to mend skinned knees. It doesn't bother me to balance a textbook on one knee while rocking a colicky baby to sleep. I've done all of that and more. It's my job.

But I'm also ready to have my body back, and to be free from pain.

Just a few more weeks.

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.