Stress and Nonstress

Today we are halfway through April and I am starting to wish I could slow time down a bit. As anxious as I am to be paroled and get back to my life I am not ready to face the delivery of Baby Girl. It seems the whole floor is feeling the pressure of it. I am lucky to have so many nurses who are committed to this baby and her outcome. It is clear how much people want the best for her.

Yesterday Steve had a rare lull in his workday and was able to stop by the hospital. This worked out well for two reasons-the hospital cafeteria was hosting a jazz club event and Baby Girl Tee required some extra attention.

Our sweet girl has been slacking on her NSTs this week. She should have two accelerations in 20 minutes but lately it takes her 40 minutes to an hour. The first day or two of this I wasn't overly concerned but now that it has been four days straight I am worried that it is a trend. Yesterday she outright failed for the first time. It was a relief to have Steve here as I was growing nervous. When a baby fails to have a reactive NST the next step is a biophysical profile (BPP). You can get a total of 10 points but going in with a failed NST means we were already starting with an 8/10. If the score drops down to 4-6 the doctors have to start evaluating whether or not she is better off being delivered.

There was a delay in finding an ultrasound tech so we ran away to the jazz lunch. I was under the impression that there would be live music but it was a CD. Still more music than I get most days. The best surprise was that the food was not prepared by the cafeteria-it was all local food vendors. All you can eat without spiking your blood sugar! There were an impressive amount of vegetarian selections including a wonderful vegetarian gumbo. I was the only patient there (at least the only one sporting a blue gown) but it was SO nice to have a diversion.

Baby Girl clearly loves vegetarian gumbo because she rocked the BPP when we returned. We actually saw practice breathing for the first time. You wouldn't think a moving diaphragm would be adorable, but it really is. She also squeaked by with just enough fluid to pass and had plenty of good movements. Her little frogger legs are looking chubby. As we suspected she is also very much head down now. So she passed the BPP with 8/10 and we made it through another day. Right now I am waiting for her next NST to start and hoping she peps up for it.

Today one of my favorite nurses said she spoke with the attending regarding the slow NSTs and while the doctor is concerned it is not concerning enough to warrant delivering a baby at 32 weeks. I agree but I also hate sitting here waiting for something else to go wrong. I also hate that my doctor will speak frankly with the nurses but not with me.

I have decided that after the delivery date is set I will not be talking with the NICU again until she is born and we know exactly what we are facing. We met with a neonatologist yesterday as we are trying to determine the best timing for delivery. These doctors can shred hope with great efficiency. I have started to challenge their prognosis openly. The truth is, this hospital does not see many women with pPROM this early who go on to make it this far (in the recent memory of the nurses there has been one in five years with a similar scenario. Her baby lived). My impression is that they are basing their opinions on the very few cases they have handled (which I consider to be anecdotal and not statistically significant) or on studies done in the 1980's. I have found many contemporary studies that suggest much better outcomes with current NICU treatments. It seems we are also being lumped in with women who have low fluid for other reasons, such as kidney complications. While there may be some similarities with lung development issues it is still a very different diagnosis. Now when I am given an overly negative outlook I ask specifically what they are basing their opinion on. I understand we have very good reason to be concerned, but we also have more reason to hope than they allow. I remind myself every day that doctor do not know everything.

For what it's worth, Baby Girl Tee actually does have a first name, but my husband has developed some superstitions and does not want it shared before she is born. We are still working on the middle name and Annie has given us some interesting suggestions (including the ever popular Cinderella). She still wants to name the baby Emily but Steve is firmly set on the name we chose.

Annie is, as always, my walking ray of sunshine. Seeing her in the evening lightens the stress of day. The other night we were in the chapel and I read the Lord's Prayer to her. A few minutes later she wanted to read it to me. Her version goes like this "Please give us our lunch as fast as you can." Amen!