Monday, March 29, 2010

The Big 3-0




Yesterday Baby Girl turned 30 weeks. We celebrated by bringing treats for the nurses and they surprised us with a "30" balloon.

Last night my body rebelled and I started bleeding again, this time more than I had before. We went back over to high risk labor and delivery for the night to be observed. The bleeding has not gotten any worse and Baby Girl looks great on the monitor so this morning I am back in my usual room. I am doing my best to stay calm and wait it out. The idea is to keep her in until the bleeding becomes an issue for her or me.

I wanted to share some pictures of life in the hospital for Anneliese. This has become her second home and she really walks around as if she owns the place. This experience has added words such as tourniquet, vacutainer, blood sugar and Doppler to her vocabulary. If she goes into the medical field one day I won't be one bit surprised.

Annie in the chapel-her new favorite hospital hangout



Roaming the halls




Watching the helicopter take off






Getting gloves on to help her favorite nurse draw my blood




Frustrated that she can't get blood to come out my finger-she says she needs a sharper needle. If this kid ever gets her hand on a phlebotomy basket I'm in trouble.




She is getting more and more eager to meet her baby sister and has some interesting ideas about babies. One nurse asked if she was going to help change diapers and she replied "NO! Baby sister does not have a butt." When we were listening to the baby's heart beat I asked Annie what she thought her sister was doing in there and she immediately replied "drinking her bottle but she is almost out of milk so we need to get her more." She has also requested two baby sisters but no brothers. I am anxious to get back home to her but at the same time wanting to give this little one as much time to grow as I can. Regardless it is out of my hands so I am riding it out.

Thank you again to everyone who has been helping with Anneliese. This pregnancy has really been a group effort and we are grateful for everyone's support.

Friday, March 26, 2010

Gestating Jenny

We have made it one full week past my placental abruption. Last weekend it seemed delivery would be eminent so I am very grateful for this additional time. Things continue to be stable-no bleeding and just a handful of contractions.

Baby Girl has looked great on her daily nonstress tests. She continues to show off with "15 by 15's" when she is only required "10 by 10's." The nonstress tests are one way we know that she is happy and thriving on the inside.

We had an u/s for growth on Wednesday. The fluid was the lowest it has ever been, but that was not a surprise. The best news is that she is now measuring 2 lbs 10 oz, up 10 ounces in two weeks. If we can get another week or two in she should be around 3 lbs (no longer a micro-preemie). We were able to get much better views of her face this time and she bears a striking resemblance to her big sister.

Today marks six weeks as an inpatient. This Wednesday I realized I do have limits in dealing with roommates. At 5AM my very needy roomie tried to start a conversation. She remarked that I sounded tired (yes....it was FIVE in the morning and she had me up until 2AM). I replied that yes, I was tired and she then asked what time she should wake me for breakfast. I had a moment of clarity-I need to buy myself a private room for a few days or risk my sanity. It was a smart decision as my mother was bringing Annie for a long visit and this roommate had a tendency to lose control of emotions and swear, scream and cry. Not exactly the ideal environment for my two year old.

So here I sit in a private room. There is a full sized bathroom with an actual tub and shower (no more showering in a 2 ft by 2 ft cube!). There is a lovely view of the houses across the street but best of all I am alone!!!!!! Obviously I can not continue to pay $40 a day for the duration of my stay but the nurses are working on getting the residents to sign off on my room being "necessary for my mental health." At this point I really think it is.

My mother is in town and bringing Annie for nice long visits in the afternoon. Yesterday we met the very real Easter Bunny on the elevator. The look on her face when the elevator door opened and there stood the Easter Bunny was priceless. She was very excited and told all the nurses about the Easter Bunny and how "he did not step on her foot."

We also had great entertainment last night at dinner. Annie developed a soda obsession this week and has been trying to convince my mother to let her have some. She told Grandma "I have soda every single day....I even have a special pink cup just for my soda!" Now, to the best of my knowledge the child has had exactly two sips of soda in her young life. I told her when she is old enough to eat broccoli she will be old enough to have her own soda. Last night I happened to have Chinese food with steamed broccoli and my incredibly picky eater ran right over to try it. I assumed she would spit it out but no, she ate four big pieces! I had no choice but to pour her some Coca-Cola (ever my daughter, she says she "hates Pepsi"). She had a few sips but then switched back to milk. I am still in shock that my "white food only" child actually ate something green and said she liked it.

I am hoping for a peaceful weekend. Having a private room means Steve can occasionally spend the night so we may have a sleep over while my parents are in town.

Sunday, March 21, 2010

Happy 29 Weeks, Baby Girl!

Despite all the developments of last week we have made it to 29 weeks. It has been an incredible 14 weeks since my membranes first ruptured.

Things have stabilized, so late Saturday night I was moved back to the antenatal floor. They were willing to keep me on high risk for additional monitoring as long as there were available beds but Saturday night proved to be a big night for birthing babies. The wonderful nurses on 3-1200 had kept my room intact and waiting for me.

Now we are back to NSTs only three times a week which is really a struggle for me. Being on the monitors offered me peace that I am unable to find otherwise. On the upside my contractions have decreased drastically since being off the monitors. I have a feeling that the physical pressure was making my uterus that much more irritable.

Steve was able to stay with me for three nights. Despite the stress of possible delivery it was a nice reprieve to have time together. He was able to catch some extra sleep and sit still for several hours at a time. He has had so much on his shoulders for months now and I am grateful he was able to have a small breather.

I am happy to be back with my regular nurses. I may be developing some sort of Stockholm Syndrome. I am so much more comfortable in "my" room and with "my" nurses. Life is also much better now that I am allowed to eat and drink again. Being deprived of even ice chips is no fun, especially when it stretches over 36 hours with no end in sight.

I have gone a fantastic full week without a roommate. I may not have the room to myself again during my stay as tomorrow they start replacing the disgusting carpet in the hall which will force them to close several rooms at a time. It was nicE while it lasted!

Baby Girl continues to do well and seems happy to have the monitor off of her. We had a nice long visit with Anneliese today and watched Toy Story 2 for the hundredth time. It was so wonderful to snuggle Annie and relax.

I am hoping and praying to make it to at least 30 weeks. It seems right now that every day we get is a true victory. While the bleeding has stabilized I am now at a higher risk for further placental abruption. The ultimate goal is still 34 weeks but as we discussed with the doctors on Thursday it is unlikely to make it that far (but I would not be one bit surprised if this little one shocks them all).

I am praying for the strength to make it through the last leg of this pregnancy and into what waits for us after delivery. We are so grateful for the love and support we've received. It has helped to lighten our load considerably. Here is hoping we will have no new news for awhile!

Friday, March 19, 2010

28 Weeks 5 Days

It's Steve again.

Jen is still on the high risk floor. The bleeding has slowed down, but she is still having contractions. They aren't allowing Jen food in case of an emergency C-section. She hasn't had anything but a few ice cubes in over 24 hours.

Baby girl tested the emergency delivery system earlier today. Her heart rate dropped for a prolonged amount of time due to a cord compression. Within seconds a large medical team arrived to take Jen to the OR. But luckily a change in baby's position relieved pressure on the cord and her heart rate has been fine since. It was scary but reassuring to know that the staff could respond so quickly.

We will keep everyone updated.

Thank you to everyone for your thoughts and prayers.

Update

This is Jennifer's husband, Steve. Jennifer started experiencing some bleeding Thursday afternoon and is now being monitored on the high risk floor. Mother and baby girl are stable and it's just a precaution. We will update when there are new developments.

Sunday, March 14, 2010

28 WEEKS!



March 14th has been circled on my calendar since early January. Reaching 28 weeks was a major goal for me and it always seemed just too far away. Now it is here and it feels a little bit like Christmas. As an added bonus I also started my second round of steroids today. They will be in full effect Tuesday morning. This has all given me a new sense of calm. Reaching 28 weeks and having both rounds of steroids leaves me with the feeling that if she were to be born now she stands a much better chance. Assuming she has lung development we are in a completely different place than when I was admitted at 23 weeks 5 days.

My move back into the hospital has been very smooth. I met a nurse in the nigh risk ward who asked if I have really been ruptured since 15 weeks. She said it was "amaaaaazing!" What a perfect adjective for our little warrior baby. I returned to the regular antenatal ward Saturday morning and was welcomed back to the very same room and bed that I had left just days before. I have also had great reunions with my favorite nurses. I hadn't realized just how attached I had become to them until I returned.

My temperature and heart rate are all in the normal range so most likely the sickness I felt on Friday was just the arrival of the cold Annie gave me.

My new motto with being hospitalized is "I'm not sweating it." Roommates swearing at their unborn babies? Roommates upset at being in the hospital and missing parole hearings? Roommates being here several days without brushing their teeth or washing their hands? I am not sweating it. I am here and I will be here until I deliver. I am not letting the hospital experience take away from my last days (or weeks) of pregnancy.

Anneliese has adjusted to me being back in the "hopsibul" although she asks me to come home all the time. She too has bonded with the nurses and gets upset when certain ladies are not working. Last night we discovered a long hallway with a ramp during our wheelchair ride. Steve would get a running start and then send us flying down the hall. Annie is a big fan of this and it gives Steve a bonus workout. I am glad that even in the hospital we can create happy memories together.

This morning Annie helped nurse Heather find Baby Sister's heart beat. Baby Girl is back to her tricks of hiding from the nurses during heart rate checks. Having Annie's help encouraged her to come out and show off her strong heart beat. When nurse Heather left Annie said "Thank you for all your help!"



Today I am taking a break from worrying and will just celebrate that we made it so far. This is a very happy day.

Friday, March 12, 2010

Back in the Joint

Today I woke up feeling a little under the weather. Nothings dramatic-just the overall feeling of coming down with something. This can be the first sign of infection, though, so we were directed to OB triage to get checked out. When we got to triage they immediately said I was being admitted to the high risk floor.

So far everything looks good. Baby Girl is on a monitor and has been doing just what a baby her age should be doing. I do not have a fever and both of our heart rates are normal.

I will be staying for at least a few days to be cautious. They should move me from high risk to the regular antenatal floor (aka my home away from home) sometime tonight or in the morning.

I am disappointed to not be spending the weekend at home with Annie and Steve but know that I am in the best place possible for Baby Girl.

Wednesday, March 10, 2010

breaking out

Yesterday Baby Girl had a wonderful no-stress test. My blood sugars have been incredibly good regardless of what I eat. I now refer to the diagnosis as My-So-Called-Diabetes.

Today we had another routine u/s and Baby Girl is a nice solid 2 pounds. My AFI (amniotic fluid index) was only a little over 3 cm, but I lost a great deal of fluid last night and was expecting it to be low. We also had a long heart to heart with the attending maternal fetal medicine specialist. She feels that I am at a point where we could safely consider following the pregnancy as an outpatient. I have been very stable and they expect things to continue to be stable. She thinks we are competent enough to monitor things for infection and we live close enough to get to the hospital in an emergency.

This is something we have talked about a great deal and is not a decision I take lightly. I have reached a point, however, that I think for my mental health I would be much better off at home. The risks of being away from the hospital are very low according to everyone we have talked to. It would be different if I were on monitors here 24/7 but I am not. Therefore the chances of them catching a compressed cord here in time to do anything about it is as likely as I am to notice at home. We are renting another Doppler so I can listen in at her whenever I want and I can come in as an outpatient for non-stress tests and u/s.

We also know that we can choose to be readmitted at any time, so this is somewhat of a trial run. I have promised to not go upstairs more than once a day and to rest as much as possible.

So, when Steve is done with work today he will come get me with Anneliese. I can not wait to tell her I am coming home and to have the freedom to spend time with her every night and tuck her into bed. I am not 100% comfortable with leaving the hospital but when we weigh the true risks against the benefits it is the best choice for us right now.

Thank you again for your thoughts and prayers. We are certainly very hopeful for our little girl and it is so nice to watch her grow bigger and stronger with each u/s. Today the doctor told us she is optimistic. This is the first time a doctor has said something remotely positive about the potential outcome (the second most positive statement being "it is not impossible"). We thank you for being hopeful with us.

Sunday, March 7, 2010

27 Weeks

We had a nice uneventful weekend and have safely arrived at 27 weeks. Annie and Steve had a long visit yesterday. We were hoping that she would take a nap but she snuggled with me wide awake while Steve crashed and had a well deserved rest.

Today Baby Girl Tee was unusually quiet. She is normally very active after mealtimes (this girl loves to eat vicariously) but today there was barely any response. When things hadn't picked up by 1:00 I became concerned and the nurse decided to do a non-stress test to put our minds at ease. As soon as the monitor was in place Baby Girl snapped to attention and gave a perfect strip. Once again she had accels that would make a 32 week old fetus proud. She also had hiccups for a good ten minutes and this provided much amusement for her parents. Steve hadn't heard them before and of course thought his daughter had the most adorable hiccups known to mankind.

Anneliese is getting more and more interested in the idea of having a sister. We passed the nursery once on a wheelchair ride and Steve held her up to look at the babies. She became very upset when we had to leave and demanded that I get her baby out of my belly NOW. She has big plans for the two of them. Today she told us how she would "take Baby Sister to the zoo but the baby would be scared of the elephants and she would help her." It is a bittersweet thing to hear her make plans for a future that is so uncertain. There is no way to explain this to a two year old so right now we are letting her dream and hoping there are no difficult conversations in our future. In the meantime I enjoy having my daughters together and watching Annie rub my belly and talk to her baby sister. It reminds me of long ago, before the pregnancy took such a complicated turn. Annie would sit on the bed next to me and talk to my stomach. She once pushed on my belly and Baby Girl started kicking her hand. I wasn't sure if I had witnessed the first time they played together or the first time they fought.

The maternal fetal medicine team is meeting this week to decide on the timing for my next round of steroids. The hospital does not have guidelines in place so it's decided on a case by case basis. There is some disagreement on whether they should do it at 28 weeks or hold off and hope she is born later. They will only do a maximum of two rounds (2 shots each round). There is evidence that any more than that carries risk to the baby. The attending doctor this afternoon said "more than two rounds and they start seeing small heads." We, of course, want Baby Girl to keep her nice big Mellem-noggin.

I am hoping they decide to do the injections sooner than later. They have to be given at least 48 hours before delivery to be effective and in our situation delivery is very hard to predict. They are most effective for two weeks following the injections but it is not as though the effectiveness drops down to zero after 14 days.

One thing that may be hard to understand is that the steroids can only help mature lung tissue that is present. If her lungs are severely undersized due to the low amniotic fluid the steroids will not change the outcome. We are choosing to have hope, however, and want whatever lung tissue she has to be as mature as possible. I am very much hoping to get another round of steroids in before she is born.

Here's to making it a whole 12 weeks with ruptured membranes!

Friday, March 5, 2010

Three Weeks on the Inside

I have now been enjoy the luxurious accommodations of Strong Memorial for three weeks. I sometimes wonder why we decided to admit so early when things have proven to be uneventful. Steve then reminds me that if I had been at home all this time things probably would not have gone so smoothly. If only we had a crystal ball (or heck-even a Magic 8 Ball) to predict the future and know the best course of action to take.

Today Baby Girl had her regularly scheduled NST. The nurse stayed for the first few minutes to see how she was doing and of course there were a few variable decels right off the bat. She explained again how these are to be expected, especially in our situation. They do not worry unless it is a "deep decel." As if on cue Baby Girl then gave a very deep decel. Her heart rate dropped from the 140s down to 80 and stayed for about 10 seconds. The doctors on rounds were visiting my roommate and quickly ran over. Once I changed position her rate popped right back up but it gave us all a good scare. The doctors decided to leave me on the monitor for another full hour to see how she did. If there was a pattern of deep decels I would be moved to the high risk floor for a longer period of monitoring. Luckily Baby Girl was very active the next hour and gave a great heart rate strip.

The reality is that with such low fluid she is more vulnerable to cord compression and we have an increased risk of a stillbirth. They assure me this is not a common outcome but it is a very real possibility. The hospital policy in my condition is to monitor twice a week. They do not see value in constant monitoring as long as everything else looks good. For about the millionth time in this pregnancy I am wishing there was a window into my uterus so I could always know what it going on.

Other than that things are going well physically. I can still answer "no" to the numerous questions that would signal a problem. No contractions, bleeding, chills, abdominal pain etc. Well, Baby Girl has been sticking a very cute appendage out my lower right side so I have some soreness there but nothing that would indicate chorioamnionitis, an infection of the amniotic sac.

The doctors seem to feel that since I have lasted this long with ruptured membranes I will not likely go into labor on my own in the near future(but no promises). The biggest risk for early delivery is still infection. They still can not give us reassurance regarding if she has lungs or not. I know intellectually that there is no way for them to predict but I still resent being left in the dark. It must be some sort of "kill the messenger" issue I'm having.

My blood sugars have been so good I have been downgraded to testing only three days a week. I am a master of carb counting.

Anneliese is learning hospital lingo. As we passed the nurses station last night she asked me "Mommy, do you need your blood sugar?" She gets a special thrill out of witnessing my finger sticks and heparin injections. The nurses were afraid it would scare her but I see it as an opportunity to show her how to be brave with needles. So far she's learned to be brave as long as the needle is not intended for her.

Thank you as always for the good thoughts and prayers. We are so grateful for everyone's support!

Wednesday, March 3, 2010

26 weeks 3 days

This week has gone smoothly so far (I would knock on would but am surrounded by laminate). Her NST went well with several mini-accels and a big whopper of one. She has now settled into regular periods of activity during the day. I can count on a lot of movement in the early morning, late afternoon and then the big finale at 10PM. I really enjoy that time with her.

The only discouraging part of the week has been increased fluid leakage. This is the longest period I've gone with such constant fluid loss. I have had very leaky days in the past but it usually slows down within a day or two. I keep hoping that she will change positions and act as a "cork."

My gestational diabetes has been easily managed with diet. If you are what you eat, then right now I am well balanced, boring and repetitive. My issues with the food service here have really improved. I had complained enough to earn a red mat on my tray, meaning every meal sent up is checked by a supervisor first. Normally I would feel self-conscious about complaining but now I see it as necessary to my survival.

I also spoke up for myself yesterday and asked to have my overnight nursed changed. The nurses here have been overwhelmingly wonderful with minor exceptions. Even the nurses I do not feel a bond with I trust are competent and I feel confident in their care. There is just one nurse that makes me want to hide in the bathroom when she enters my room. The morning of my oral glucose test she drew my blood twice. She missed once and fished around (not so pleasant in a hand stick). The next time she was able to get into a hand vein but then panicked. She demanded I hit the call button, yelled at me when no one answered and kept asking "didn't you hit it???!!!" (a little snicker here for a nurse being on the other end of the call bell during shift change) After screaming into the hall she was able to get someone's attention. She never attached the plastic hub the vacutainer tube fits into-she never even brought one into the room. I got to sit with a painful needle in my hand for several minutes while she tried to procure one. Anyhow, this did not leave me feeling very warm towards her, especially as she snapped at me and never apologized for her mistake. I had her as my nurse once after that and she got upset while taking my blood pressure because the sign over my bed says "no BP on right arm." I had to explain that when she is facing me her right is my left. I really wish I was making that up. The next night I asked to be switched rather than endure another 12 hours worrying that I would be depending on her in an emergency.


Anneliese is doing well and enjoying her days in the care of family members. She has become a staff favorite during her visits and clearly enjoys the attention. Somehow Steve has managed to hold himself together while being pulled in many directions. I am, as always, grateful for having such a wonderful husband. I would say right now I am not even taking things one day at a time-it is much more like a few hours at a time. I can't explain the stress of living with this much uncertainty compounded with the stress of being hospitalized long term. I look down at my stomach and tell her this is an act of love. I want nothing more right now than to see my daughter survive. This is the hardest journey of my life but worth every bit of increased chance it gives our baby girl.

Thank you again for your continued support and prayers. It helps to carry us along.