34 Wks, 2 Days: Just Waiting

Waiting waiting waiting. 9 More Days.

I am having terrible hip pain today and had the hardest time getting out of bed. I'm not even supposed to be out of bed yet, but whatever! I'm having him next week, so I don't even care anymore as long as the baby is safe. Unfortunately, the pain is keeping me from doing what it is that I really want to do. And tonight I get my last ever progesterone injection! WooHoo! Those suckers really do hurt, even though my home nurse is the best at giving them. I've had one where I had to get it in the doctor's office, and one where I had to get it in the hospital, and I will take her technique over theirs anyday! The concoction is thick and oily, and so once the medicine starts to spread in the tissue of my hip, a simultaneous burn and ache spreads down my entire leg on whatever side she is injecting. Sometimes the burning is intense and lingers for hours, at which point J laughs at me because I will literally sit with an ice pack on my bum. But no more after tonight. I cannot complain. Something has kept Zachary in there, and I really think these were the answer.

Other than the hip pain, I am just feeling anticipation. What will Little Booger look like? Will he have J's eyes or mine? My petite nose or J's angular, straight one? Will he be quiet and peaceful or will he be high-strung and spirited like E? How big will he be? I'm predicting a little over 7 pounds because of the last full ultrasound I had done where he was measuring 5 lbs. 5 oz. a few weeks ago. Most importantly, will he be okay? Is he as ready as I am?

32 Wks, 2 Days: Can I Call It or What?

I hit the 32-week mark Monday, and I was excited. Until they sent me to the hospital again. That was the 4th time in roughly the past week. It seems my brethine pump is doing strange things to my heart, and the insane contractions of Saturday still have not stopped. Again, not dilating. So I follow-up in the office Tuesday as planned, and the doctor I saw pretty much told me that, while he did not want to sound heartless, it doesn't matter how miserable or uncomfortable I am, so long as baby is fine. So now they are saying 37 weeks. I knew it would happen. I've been to this show before and I know how it ends.

Tuesday afternoon, I did my required monitoring, and of course my uterus was doing insane tricks, so the nurse had to call my doctor, and of course my doctor had to tell me to go back to L&D. Trip number 5 in 8 days. I begged and pleaded, and tried to "respectfully decline" to go, at which point I was told I would be labeled a non-compliant patient, which would cause issues with my insurance company. I had no choice but to go. In the process, they had me stop my pump temporarily because my heartrate was 136, a contraindication of brethine. Nothing changed. Everything was the same, except the contractions were bigger and badder, but still not causing me to dilate. They tried giving me a one-time dose of Procardia (nifedipine) which did nothing other than cause my blood pressure to lower and gave me a raging headache that lasted into this morning. I was sent home with the same instructions I got Saturday, Monday, Sunday, and at the office on Tuesday morning.

So what are my instructions? I have been thoroughly educated on the symptoms of uterine rupture, as it seems I am a prime candidate right now with all of these contractions. I also found out by complete accident that, while my external incision from E's delivery was transverse, my actual uterine incision is classical. If you aren't well-versed in c-section lingo, this is bad. A classical incision is straight up and down and an even higher risk for rupture. I didn't know this until someone mentioned it in conversation. Apparently they got it from the OR report from E's delivery.

In a nutshell? I am still at home, having over 40 contractions per hour, on narcotic painkillers that are no longer working, and waiting for a crisis. A crisis that could kill me and the baby. My home nurse told me today to not even monitor, as the doctors don't seem to be doing anything about it and it is completely futile at this point. The only result will be that I will have to rush to the hospital again. They keep having me temporarily suspend my brethine infusion for heartrate, then start it back up when my pulse is again under 120. My nurse from the call center, my home health nurse who administers my progesterone injections, and even my case manager from Humana are all infuriated that this is being permitted to continue, that not only is it permitted, but they are actually prolonging the pregnancy. But they are not my doctors and can essentially do nothing. They will not even do the amnio at this point. When asked why, he said "Why risk infection?"

Why. Risk. Infection????

Because I do not want to die. Because I do not want lose my unborn son. Because I don't want to ruin my heart with the medications. Because I am tired of disrupting E's life. Because I cannot stand the pain anymore. Because after steroids and the best prenatal care money can buy, odds are that Zachary is okay now. I am not anymore, on the other hand.

A simple course of antibiotics can cure an infection. There is no simple cure for anything mentioned above.

31 Weeks, 1 Day: I Take It All Back

I have been a whiny baby lately, complaining about this pregnancy and how I am "done".

I lied. I'm not done. I wish it were easier, but I want him to be healthy. And be in there as close to full-term as possible.

I'm nervous. Today, I have to go back to the doctor to "check everything out". They're worried about my BP and pregnancy-induced hypertension. Not pre-eclampsia yet, as none of my lab values mesh with that. Urine, blood..everything was normal but my blood pressure. My BP has always been perfect. As a matter of fact, when pregnant with E, I was on Procardia for preterm labor and they had to stop it because it would cause my normal BP to drop, then when I would do anything that would cause it to lower more, I would randomly pass out. I had to take cold showers bcause the heat would cause me to vasodilate and John would hear a big thunk! where I would hit the floor. So when oral brethine didn't work this time, that is how I ended up on the pump. They didn't want to add nifidepine to the mix.

So yesterday, when they sent me to the hospital for PIH, I was the talk of L&D. From my stretcher in triage, I could hear the doctors and nurses at the nurses' station talking about it. "She's here for PIH and on a brethine pump!" They kept implying that it would have to be stopped, and the doctor that sent me to the hospital in the first place even said so much--that if BP became a problem, they would have to stop it.

Hmmm. Stopping the brethine pump.....

I've been fantasizing about this for weeks. What it would be like to sleep without worrying about rolling over on the tubing and occluding it. Of worrying about the syringe emptying in the middle of the night, causing me to miss a scheduled bolus and wake up contracting. To be able to take a hot bath because there is no catheter on my thigh that cannot be submerged in water. To be able to go to a doctor's appointment or anywhere else and not have to worry if I have enough batteries or meds to survive the trip without going into labor. About not having something constantly attached to my body.

And if they stop the pump,they are going to stop everything. My progesterone shots. Most likely my home monitor that works in conjunction with the pump. I'm getting scared.

The truth is that, while I have been getting really sick of this stuff, I also realize that there have been countless times where I have avoided hospitalization because of it. And as much as I hate it, I hate being in the hospital even more. And I know that, while they have spent months trying to find the delicate balance of injection frequencies and infusion rates to keep me from having breakthrough episodes of contractions, those breakthroughs would occur more frequently without the stuff. Or my contractions just won't stop, period. And my beloved son will be born too early. Or if he isn't, I will lay in misery in a hospital bed, contracting away, in pain, with my needs not being taken into consideration as I incubate him longer. Neither one is an option I can live with right now.

I'm really scared for myself. And terrified for Zachary.

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.

29 Wks: Don't Look Now, But...

The weekend has passed! It's Monday,and I am exactly 29 weeks prego today. As in almost 30. As in the prefix 3. As in just a few more weeks in the grand scheme of things. Ahhhhh.

And...

Wait for it...

No contractions. No trips to L&D. No IV's. No mag sulfate. Ha!

My home health nurse came by Saturday to give me my P17 shot. This was the first week of me getting it every 5 days instead of every 7. I cannot help but wonder if this is a coincidence or if this is my ticket out of these crazy contractions. Am I fixed?

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.

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?

22 wks: Is This About A Horse???

This is funny now. It wasn't then.

There is something that has become commonplace since I had E. Progesterone injections to prevent preterm labor. And my doctor wants me to have them. I say whatever works! But I know nothing about these. I google some, and hear they are all the rage. I call the contact number to get the ball rolling. I call my insurance, and some dumb rep tells me they aren't covered. Then the OB nurse tells me they are. I am beyond frustrated. I do some reading to discover they may be contraindicated in asthma. I call the pharmacy to ask, and am reassured.

Finally the OB nurse calls and gives me a number to call. These people are supposed to get me set up. The meds will come to my house, and I will get the injection at my doctor's appointments weekly. Okay. I call. I'm supposed to ask for Bob. No last name, no extension number. Just. Bob.

The first thing I hear when I call is a recording asking me if I am a veterinarian. Ummmmm. No. But before I can hang up, a female comes on the line. I tell her my name, that I was told to ask for Bob, that I am pregnant and trying to set up progesterone injections.

"Is this about a horse?", she asks. No. It's not. I'm human, and so is my baby. "Oh ok", she says. Bob gets on the line before my mind can stop reeling. And before he says hello or anything, he tells me he needs my credit card info. What? Just a second ago, someone asked me if I was a horse!

"Wait a minute! I have insurance!" I tell Bob.
"We don't DO insurance here", he tells me, rather rudely. He says he needs my debit card info so he can ship the supplies and meds to me.

"Okay, whatever, how much is it?", I ask.

" One thousand, five hundred and sixty-two dollars."

I tell Bob I will call him back and hang up. I am not about to give someone Cart blanche with my bank account when just a second earlier, I was being questioned about my species. And I call the OB nurse from my insurance company.

Somehow they pulled it off for me, and they arranged it so a home health nurse will come to the house to give me my shot once a week to the tune of $135 weekly. Okay. But I at least I know it is medication designed for a human.

J comes home from class to find me sitting in the floor, crying hysterically. Of course he asks what is wrong, and I tell him the story. My new nickname, as a result, is Seabiscuit.