Sunday, April 29, 2012

Fun While It Lasted

No sooner had I finally posted about getting discharged from the hospital and enjoying (mostly) my time at home, then I go and get myself admitted again.  Go figure.

Thursday was yet another NST appointment.  The boys looked fabulous, as usual.  But after talking with the splendid Dr. G on Monday, I knew now what to report and what not to ... well, I'd had a headache that was just not going away since Wednesday morning.  Fairly news worthy, I suppose.  As it was Dr. G on-call that day though, I just knew I was asking for yet another trip to Triage and a possible admit.  

The short version: I was right.

The long version: Though my blood pressures had been pretty benign up to that point (borderline for a "normal" pregnancy ... expected with a preeclamptic patient), while in Triage they shot up to the 180s over 100s at times.  Very strange.  I wasn't stressed or worried and, at the time, wasn't in pain.  I nearly bought myself a c-section right there.  However, after they started an IV and threatened some Labetalol and surgery, my body decided to somewhat behave and my BPs settled in around the 150s over 90s.  

Of course, not to be outdone, my uterus decided to join the party.  

Apparently, I'd been feeling far more contractions at home than I realized.  Here I thought it was just my precious little J trying to get as up close and personal into my ribs as he could get, but as I watched the monitor I noticed each time that happened it was actually a contraction pushing his poor little noggin up up up.  Additionally, for nearly three days I had been feeling pressure and cramping - just as I used to feel before AF started.  Yet, PB's little butt is quite low and I just attributed it to normal pregnancy pressures with his rear end helping out.  Yet as the afternoon wore on, they became more and more painful - and more focused near my cervix.  They weren't in any regular pattern, so though I could tolerate the discomfort over all, it was the periods where they were less than a minute apart for ten minutes at a time that exhausted my patience and my tolerance.  I was not a happy girl.  As if all the contracting wasn't fun enough, they of course needed to find out if they were causing dilation - so I got to experience my first vaginal exam.  I was happy to learn that my cervix was still closed and only 50% effaced, but it was quite the unpleasant experience since my cervix was still very high and posterior like it should be.   Ah my poor patients, I can certainly empathize with you now!  

After nearly 9 hours in Triage, I finally got the fabulous news that I was being re-admitted to the hospital.  My time at home was fun, but short-lived.  Ah well.  At least this time I have a view of the real world - trees, sky, people - and the nurses are wonderful and caring.  I am definitely in it for the long-haul this time.  No babies?  No going home!

On a brighter note though ... we made it to 32 weeks on Tuesday!!  That was our first goal.  Ultimately I'm hoping to make it to 36 weeks, but I'm counting down two weeks at a time.  

Friday, April 20, 2012

Home Sweet Home

I've been home for nearly a week now.  I know, I know - bad blogger!  However, I'm kind of glad I decided to wait a bit before posting because there are feelings I've had to process being here.  

Yet, I'm jumping ahead of myself.  

Despite the pre-eclampsia, GDM, and VCI, the boys and I became stable enough that our perinatologist, Dr. G, decided we were all ready to go home after 17 days in the hospital.  It was such a relief as the night before I'd had yet another break down, homesick and depressed about being stuck in a room with no light and no view.  It was also totally unexpected.  Up to that point, all the doctors had been preparing us for a long stay.  Can I tell you the excitement I felt when Dr. G walked in that Saturday morning with a hearty "Adios Amiga!"  

The first week, I had a pretty nice view!Then I got a roommate and was moved to a private room. 
Unfortunately, tho they tried to brighten things up, it was still a wall that never saw the light of day -
it looked like it was overcast every day.  I was there the last week and a half.  =/

Easter morning, my awesome CNA gave me this cute little bunny-bear.  It made my day!
Notice the flowers on the wall?  My sister brought those in and made the dungeon room
a little more cheery. =)

That first weekend was filled with mixed emotions though.  About a month before, I had surprised Momma B with tickets to see the San Francisco Giants play opening weekend.  That day happened to fall on the very weekend I was discharged.  My poor girl was so stressed trying to get the house ready Saturday afternoon and evening since she was going to be gone most of the next day - grocery shopping, picking up my insulin prescription, getting a TV for our bedroom, and having to go back to the hospital to pick up insulin syringes as that order never got sent ... and then having to make sure I had dinner and snacks on time as well as cleaning for guests that were coming the next day and laundry.  I had yet another pregnancy-induced emotional breakdown because I felt so helpless and such a burden on poor Momma B.  No matter how much she reassured me and hugged me with sweet words of how much she loved taking care of me, I still couldn't stop feeling so infirm.  It took me a few days to accept her help fully without that guilty feeling that started the waterworks every time.

One of the biggest problems with bed rest at home is the lure of movement.  Technically, I'm not supposed to climb stairs, however there have been a couple days I've gone and stayed downstairs out of "necessity," though mostly for a change of scenery.  Then there are the numerous appointments that are necessary.  I have Non-Stress Tests (NST) scheduled every Monday and Thursday.  Then there are the doctor's appointments - one on Tuesday, then another today.  All of these require getting up, getting ready, and, of course, going up/down the stairs.  It has led to some increased swelling and increased blood pressures.  

In fact, at my doctor's appointment on Tuesday, I found I had gained 4.5 lbs in the three days since I'd been discharged - again, fast weight = water weight! - and my BP was 152/96.  Not pretty.  Our usually upbeat OB became more serious that morning and sent me back to the hospital to be evaluated in Triage.  Though it took four hours, we were finally told all my labs were normal, my blood pressures had returned to normal, and the boys were beautiful on the monitor - thus I got sent home.  YAY!  However, it definitely made me very aware that I need to be better at this whole bed rest thing.  I've been avoiding the stairs since unless absolutely, completely, totally required!  

Today, was definitely essential though.  We had an ultrasound appointment with my perinatologist and couldn't believe how well these boys of ours are doing.  PB is a whopping 5 lbs 2 oz - measuring in the 98th percentile!!  And though J is starting to slow down a bit at 4 lbs 4 oz, he's still measuring in the 75th percentile!!  The measurements were all very proportionate, so those are just genetics not GDM.  We've definitely got some big, healthy boys on our hands!  Momma B may just get her wish of 7 lb babies after all - even if they're early.  Who woulda thunk it?!

I'm now settling in at home and keeping these boys growing for, hopefully, at least another three weeks.  The visitors have been a little less frequent, but I'm totally okay with that ... Momma B took a couple days off to just spend time with me and I have my beautiful kitties that never fail to keep me amused (and were ever so excited their mommies were home again!).  Since my mother is flying in this coming Tuesday, we've been enjoying having the time to ourselves since that will be quite limited from here on out.

Moral of the story is, challenging or not, there's no place like home!  =)  

Two of the biggest reasons I am happy to be back home on bed rest.
These kitties are so loving and attentive.  Can't be unhappy with them around!

Wednesday, April 18, 2012

I Got an Award!

I can't believe it!  I got a Liebster Award from the awesome ladies over at More Than Words.  I'll admit, I've never thought I'd get any awards ... it was never a reason for writing, that's for sure ... but it means a lot to know there are people out there that appreciate this little blog of mine.  

The Liebster Blog Award works like this:
  • Show thanks to the blogger who gave you the award by linking back to them.
  • Reveal your top five picks (ideally, those with 200 or fewer followers) and let them know by leaving a comment on their blog.
  • Post the award on your blog.
  • Bask in the love from some of the most supportive people on the internet - your fellow bloggers.
  • And best of all – have fun and spread the karma!

Of course, I'm thrilled to pay it forward!

Saturday, April 7, 2012

Hospital Day 10

Yep, I'm still here.  Good times.

Fortunately, my pre-eclampsia is now pretty much under control.  My blood pressures are back to a normal range, my labs have remained normal, my second 24-hour urine came back with less than half the protein levels as the first, and I've now lost over 10 pounds of water weight ... which means my swelling has substantially decreased and my feet, hands, and face look normal again!  

Unfortunately, that is no longer the reason I am being kept in the hospital.  On Monday night, J's fetal heart tracing started to look decidedly non-reassuring.  Up until that point, his heart rate would vary just as it was supposed to with accelerations with each movement.  Completely healthy and normal.  All of a sudden he became tachycardic averaging about 170 bpm and his variability all but disappeared - it looked nearly like a flat line.  For babies in utero this normally means there is some sort of problem with their oxygenation.  The doctor ordered a stat Biophysical Profile (BPP) to check his breathing, muscle tone, fluid levels, etc.  J scored a perfect 8 out of 8.  So in spite of the crummy looking strip, he was healthy and happy in there.  This went on for four days.  The boys were getting monitored twice a day and each time J's strip looked the same - flat and tachy.  Every day I got a BPP with a reassuring perfect score, but the mystery continued.  

Finally, yesterday Dr. C - another of our amazing perinatologists - decided to do the BPP herself so she could check for abnormalities the ultrasound techs wouldn't usually look for (i.e., possible placental abruption, cysts on the umbilical cord, cardiac regurgitation).  That's when she discovered that J's umbilical cord did not insert into the middle of his placenta like it should.  Instead he has a condition called Velamentous Cord Insertion (VCI) in which the umbilical cord inserts into the fetal membranes before it makes it to the placenta - and his is also a marginal insertion.  Dr. C likened it to the umbilical cord typically being protected by Tupperware, but the weak spot in the membranes is only protected by Saran Wrap.  Add to that, the extra fluid he has in his sac due to the pre-eclampsia and the resulting pressure exerted on his cord was too much for the weak spot to handle, thus making his heart work overtime to compensate for the lack of circulation.  She gave me Lasix to decrease the fluid levels and, hopefully, the pressure on J's umbilical weak spot.  

Well, it worked!  I lost 2 pounds of water weight overnight and the next monitoring J looked like an entirely different baby!  His heart rate was in the 120s, perfect variability and tons of accelerations with each movement.  I couldn't help it.  I started crying out of relief and joy.  Though I trusted my doctors - esp Dr. C! - I couldn't help but worry if this was going to have any long-term affects and it was driving me crazy not knowing why.  Having a solid reason for his crummy strip and then to see it change back to happy and normal all in one day was simply more than this momma's fragile emotions could handle.  

There are risks involved, obviously.  We have to closely monitor my weight, J's fluid levels and his fetal heart tracings to ensure everything stays happy and normal.  I will probably keep getting doses of Lasix occasionally as the pre-eclampsia is still there and will continue to cause me to retain fluids.  We have to also closely monitor J's weight gain  because this can cause him to lag behind his brother, especially now in the third trimester when they're running out of room and their main job is to gain weight.  As any of this can change within a matter of days, they will not be sending me home until after I deliver these boys.  And we're definitely going to have a cesarean section - 1) because PB refuses to get out of breech position and 2) because with VCI there is a risk of hemorrhage when the water breaks.

Honestly, I'm fine with a c-section.  With twins, it was always a possibility and I made peace with it long ago.  I firmly believe it will not effect my bonding or breastfeeding abilities.  As long as these boys are safe and sound, then I will welcome them however they come!  

Personally, I think J was sending a signal to us all that his momma needed to be watched carefully.  The docs were thinking of sending me home when he started acting up.  If he hadn't, we might not have found out about the VCI until it was too late.  Who knows?  Our little J is one smart cookie!  

Monday, April 2, 2012

Sneak Peek

I'll have to get Momma B to bring in her flash drive so I can load more photos, but in the meantime here are a couple of photos of what we have done to the nursery thus far.  I wish I were home to help her put the finishing touches up, but since she has the decorator's eye - not me - it may be better it's up to her.  

The very start ...

One of the two cribs.  Looking forward to getting the pictures and shelving up above!

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