They should really start giving out frequent flyer points or something in there. By now I should qualify for a free snack or something.
So, went in on Wednesday to the hospital for the BPP. It was the "off" week for us- when they do weekly BPPs they still only measure biweekly, so the off week is mainly for monitoring baby's well being and bloodflow and not his size. Bumblebee did well on his NST and then looked cute on ultrasound. After a little prodding from me, she did a quick measurement of the belly and I was relieved to see that it has apparently grown a little since last week. Still measuring well behind, but had gotten no worse. I have to wait until this coming Wednesday for the "official" measurements and we'll see then where we are, but the bloodflow is still good, his heart rate is good and he's moving well.
Then they took my BP. 160/105, so up to L&D I'm sent.
I sat around, again. It's getting routine going up there. Triage was again full so I sat in pre-op once again. It's quiet there and further away from the delivery rooms so at least you can't hear people screaming etc. I was there a few hours, they did another NST and took bloodwork. It came ok, I was relieved that there was no HELLP evident especially since I have recently been awarded the third trimester badge of heartburn (which I can totally see how people confuse with epigastric pain). I was spared the med student questioning and jumped right to resident, who I've dealt with several times now so my admittance, which I knew was inevitable, was a little swifter.
The only negative, there was no private room for me. The inn was full.
So, I was stuck in a ward room for the time being. There were four beds, but only two of us. The other lady was lovely- she was 33 and on her 6th (SIXTH!) baby; her oldest is 10. She spent a lot of time on the phone singing to her babies etc., which drove me slightly nuts but wasn't too bad. She was 34 weeks and had been having contractions, so her doctor admitted her to assure that she would rest. I guess having 5 small kids at home is not a good recipe for at-home bedrest. As roomies go she was fine, but as I find the whole maternity ward thing stressful in itself, and MUCH prefer my own room.
I was with her all night, and all the next day. Late in the afternoon on Day 2 the nurses started preparing another bed for the next patient, we were getting a new roommate. Someone dropped flowers off on the nightstand. I snuck over to take a peek. There was an "It's a boy" balloon in the bouquet.
They were bringing a new mom and a BABY into my room, three feet from my bed. I don't think they normally mix the high-risk pregnant and the recently delivered but there was no space anywhere else.
I almost panicked. It makes no sense, I know. I'm supposedly having my own baby in a few weeks, but I still don't do well with other peoples' babies. And excited grandparents. And beaming new moms and nurses that say congratulations instead of I'm so sorry. It's bad enough being on the ward in general, and now you're putting a baby NEXT to my bed???? I could feel my heart race and my bp go up.
I buzzed the nurse. Can you please check on my room for me? Please?
Roomie was excited about a baby moving in. I guess when you have 5 (almost 6) of your own you're a real baby person.
They brought in the mom and baby. I couldn't handle this at all. Grandparents filtered in and spilled over their side. Everyone was oohing and aahing and taking pictures. The little one made some sounds. The thin curtain between our beds was the only barrier between me and their foreign world.
Just when I thought I was going to have to just walk out, sit in the hallway or whatever I needed to do to get the hell out of that room, nurse arrived with a wheelchair. My room was ready.
Sigh.
After that it was a noneventful visit. BP came down ok with an adjustment in meds. Another good NST today. I was discharged today at lunchtime and am home again on bedrest, back on the homecare program.
29 +1 today. Next week the coveted 30 week mark.
I'm going to go take a nap and then I'm catching up on your blogs.
Friday, August 28, 2009
Monday, August 24, 2009
TGIM
This was the most frustrating weekend. I thought it would never end.
I get in these moods sometimes where I just can't sit still (considering I'm supposed to be lying/sitting, this is a not a good mood to be in). I wander from room to room of my house and can't settle. My mind goes a million miles and I can't make it stop. I get very frustrated at the littlest things and I snap at everyone/everything in my way. It was one of those moods this weekend. Plus, it was very hot and humid, and I just couldn't get comfortable.
Since I'm not allowed to go anywhere, people have been coming to visit me. Although I do appreciate this very much, and it breaks up my days, sometimes I'm not in the mood for visitors. Although no one expects me to be hosting and pouring drinks, etc., I am expected to carry on a conversation. Depending on the visitor I may or may not be in the mood. The only bad thing about having people visit is that it's hard to get them to leave when I'm tired of visiting. There were a lot of visitors this weekend, and I was not feeling social.
Our shadow baby visited again, twice actually, on Friday and then again on Saturday. Friday wasn't too bad. As I've written before, I just can't imagine Charlotte at that age. The little one is almost walking now, and is so, so happy. She never fusses or cries, and according to her mama sleeps 11 hours straight at night. I'm sure I wouldn't have been so lucky. Saturday's visit was a little more tense, as MIL was also visiting (dear god) and was oohing and ahhing over shadow baby, and that made me uncomfortable for some reason. My frustration was also probably in part (large part) to the fact that I had just spent another half an hour explaining, again, to MIL that you can't cure growth restriction by chomping down more calories. She's been scouring the internet, but being of the generation that can't tell junk mail from real email, and banner ads from an actual website, who knows what she's actually reading. Plus she misinterprets a lot. Basically clueless on all accounts. I gave her the addresses of a couple of reputable websites, but considering the level of medical jargon there is quite high, I'm not holding out much hope for any significant comprehension on her behalf. Anyway, the conversation went something like this, for your daily humor installment:
MIL: So, I was looking up growth restriction on the internet....
Me: (thinks, oh no)
MIL: And it said all you need to do is eat more.
Me: Um, no. I eat lots. I think that's only true for growth restriction caused by malnutrition. I am definitely not malnourished.
MIL: Well, it said you need to eat more.
Me: I've already gained way too much weight this pregnancy. I DEFINITELY am eating enough.
MIL: You need to eat more red meat.
Me: What?
MIL: Your iron is low. That's why the baby's not growing.
Me: I asked all my doctors about that. It's irrelevant.
MIL: You need to ask your doctors for iron shots. That will fix everything. That will fix your blood pressure too.
Me: Um, no it won't. (I was getting very annoyed by now.)
MIL: Well, when I was pregnant with M my doctor always said..... (blah blah blah)
Me: They've learned a lot in the past 30 years.
And on, and on, and on.....
Somehow my bp stayed stable all weekend. I have no idea how, as I had smoke fuming from my ears most of the time.
I told M to stop inviting his parents up to visit. He can go see them if he wants, but I need a break from the ILs before I lose my mind. I was approaching violence over the weekend, I really was.
Another BPP on Wednesday. I know we'll check bloodflow but I'm not sure if we measure this time; I know their policy is to only do measurements every two weeks. Dr ObGYN wasn't surprised to hear the results at this morning's appt. She figured with my history it would only be a matter of time before growth would slow. There's still a chance that it was a glitch, and that bumblebee's in there now having a big growth spurt to catch up. Only time will tell.
***
Lovely nurse was here on Sunday to do a NST. We had to wake up the Bee 20 mins in with some juice and tummy jiggling, but he passed after that. She was chatting away during the test, as she always does, and she said,
After you deliver you'll have these gas movements and you'll think it's the baby kicking and then you'll see the bassinet next to your bed and remember, oh yeah! I already had the baby.
I couldn't tell her I knew exactly the feeling, and that it's so much worse when for a second you think you're still pregnant and then you remember your baby is dead. I'm sure you all know the feeling.
I get in these moods sometimes where I just can't sit still (considering I'm supposed to be lying/sitting, this is a not a good mood to be in). I wander from room to room of my house and can't settle. My mind goes a million miles and I can't make it stop. I get very frustrated at the littlest things and I snap at everyone/everything in my way. It was one of those moods this weekend. Plus, it was very hot and humid, and I just couldn't get comfortable.
Since I'm not allowed to go anywhere, people have been coming to visit me. Although I do appreciate this very much, and it breaks up my days, sometimes I'm not in the mood for visitors. Although no one expects me to be hosting and pouring drinks, etc., I am expected to carry on a conversation. Depending on the visitor I may or may not be in the mood. The only bad thing about having people visit is that it's hard to get them to leave when I'm tired of visiting. There were a lot of visitors this weekend, and I was not feeling social.
Our shadow baby visited again, twice actually, on Friday and then again on Saturday. Friday wasn't too bad. As I've written before, I just can't imagine Charlotte at that age. The little one is almost walking now, and is so, so happy. She never fusses or cries, and according to her mama sleeps 11 hours straight at night. I'm sure I wouldn't have been so lucky. Saturday's visit was a little more tense, as MIL was also visiting (dear god) and was oohing and ahhing over shadow baby, and that made me uncomfortable for some reason. My frustration was also probably in part (large part) to the fact that I had just spent another half an hour explaining, again, to MIL that you can't cure growth restriction by chomping down more calories. She's been scouring the internet, but being of the generation that can't tell junk mail from real email, and banner ads from an actual website, who knows what she's actually reading. Plus she misinterprets a lot. Basically clueless on all accounts. I gave her the addresses of a couple of reputable websites, but considering the level of medical jargon there is quite high, I'm not holding out much hope for any significant comprehension on her behalf. Anyway, the conversation went something like this, for your daily humor installment:
MIL: So, I was looking up growth restriction on the internet....
Me: (thinks, oh no)
MIL: And it said all you need to do is eat more.
Me: Um, no. I eat lots. I think that's only true for growth restriction caused by malnutrition. I am definitely not malnourished.
MIL: Well, it said you need to eat more.
Me: I've already gained way too much weight this pregnancy. I DEFINITELY am eating enough.
MIL: You need to eat more red meat.
Me: What?
MIL: Your iron is low. That's why the baby's not growing.
Me: I asked all my doctors about that. It's irrelevant.
MIL: You need to ask your doctors for iron shots. That will fix everything. That will fix your blood pressure too.
Me: Um, no it won't. (I was getting very annoyed by now.)
MIL: Well, when I was pregnant with M my doctor always said..... (blah blah blah)
Me: They've learned a lot in the past 30 years.
And on, and on, and on.....
Somehow my bp stayed stable all weekend. I have no idea how, as I had smoke fuming from my ears most of the time.
I told M to stop inviting his parents up to visit. He can go see them if he wants, but I need a break from the ILs before I lose my mind. I was approaching violence over the weekend, I really was.
Another BPP on Wednesday. I know we'll check bloodflow but I'm not sure if we measure this time; I know their policy is to only do measurements every two weeks. Dr ObGYN wasn't surprised to hear the results at this morning's appt. She figured with my history it would only be a matter of time before growth would slow. There's still a chance that it was a glitch, and that bumblebee's in there now having a big growth spurt to catch up. Only time will tell.
***
Lovely nurse was here on Sunday to do a NST. We had to wake up the Bee 20 mins in with some juice and tummy jiggling, but he passed after that. She was chatting away during the test, as she always does, and she said,
After you deliver you'll have these gas movements and you'll think it's the baby kicking and then you'll see the bassinet next to your bed and remember, oh yeah! I already had the baby.
I couldn't tell her I knew exactly the feeling, and that it's so much worse when for a second you think you're still pregnant and then you remember your baby is dead. I'm sure you all know the feeling.
Friday, August 21, 2009
MIL rant
A little distraction for today. It's been awhile since I've ranted about my MIL.
Last night M and I were trying to explain growth restriction, and how Bee's lack of belly growth could potentially be a bad sign, and how it's too early to tell right now, but Bumblebee might come sooner rather than later.
She looked at me, and in a very mean, condescending tone, said Well, you'd BETTER hang in there longer than that.
Yes, because it's my choice to have a preemie. We're just evicting him because I'm sick of bedrest.
Argh.
There's been lots of other snarky remarks too, but I'm going to block them all out.
* * *
Thank you to all commenters- your support means so much. It helps me get through my day when I get your feedback. Makes a big difference to my morale, really does, in these lonely days.
To answer a couple of questions from you all:
What do I do with all my time? To be honest, I don't know. I don't sleep in much, I'm usually up and ready for the day before 8am. I eat raisin bran, and check email, and sit on the couch. Sometimes I watch a movie, more often than not I'll fall asleep. I read, sometimes. Before I know it it's supper time and M is home, and that's pretty much the end of my day. Of course, most days I have to head out of the house to an appointment of some sort, or the nurse comes in, and that takes a chunk. I check my blood pressure, a lot. That's about it. My meds make me groggy so I find it hard to be productive. I just wait for days to pass.
Steroids for baby's lungs? I haven't discussed them, yet. We had them with Charlotte of course and we discussed early in this pregnancy that I will have them again, if/when early delivery is imminent. I guess we're not imminent yet (which is good). I remember Dr MFM telling me that they wait to give them as there's apparent evidence that the later you get them the better. So, if tummy still hasn't grown in the next two weeks I'll be expecting shots.
BP is a bit high today (142/96), so hopefully it will settle again. Yesterday was eerily good and I find that's usually followed by a spike. As long as the bottom stays under 100 I don't have to go to the hospital.
Ok, I'm off to lie on my left side.
Last night M and I were trying to explain growth restriction, and how Bee's lack of belly growth could potentially be a bad sign, and how it's too early to tell right now, but Bumblebee might come sooner rather than later.
She looked at me, and in a very mean, condescending tone, said Well, you'd BETTER hang in there longer than that.
Yes, because it's my choice to have a preemie. We're just evicting him because I'm sick of bedrest.
Argh.
There's been lots of other snarky remarks too, but I'm going to block them all out.
* * *
Thank you to all commenters- your support means so much. It helps me get through my day when I get your feedback. Makes a big difference to my morale, really does, in these lonely days.
To answer a couple of questions from you all:
What do I do with all my time? To be honest, I don't know. I don't sleep in much, I'm usually up and ready for the day before 8am. I eat raisin bran, and check email, and sit on the couch. Sometimes I watch a movie, more often than not I'll fall asleep. I read, sometimes. Before I know it it's supper time and M is home, and that's pretty much the end of my day. Of course, most days I have to head out of the house to an appointment of some sort, or the nurse comes in, and that takes a chunk. I check my blood pressure, a lot. That's about it. My meds make me groggy so I find it hard to be productive. I just wait for days to pass.
Steroids for baby's lungs? I haven't discussed them, yet. We had them with Charlotte of course and we discussed early in this pregnancy that I will have them again, if/when early delivery is imminent. I guess we're not imminent yet (which is good). I remember Dr MFM telling me that they wait to give them as there's apparent evidence that the later you get them the better. So, if tummy still hasn't grown in the next two weeks I'll be expecting shots.
BP is a bit high today (142/96), so hopefully it will settle again. Yesterday was eerily good and I find that's usually followed by a spike. As long as the bottom stays under 100 I don't have to go to the hospital.
Ok, I'm off to lie on my left side.
Wednesday, August 19, 2009
Bumblebee on the decline
Good news and bad news.
Good news- I just got home from my bpp. It is the first time I've been allowed to go home from a biophysical. Up until now I've either been an inpatient or been admitted immediately following.
Bad news- Bumblebee's growth is slowing.
I'm not surprised, I figured it would come. I guess in the past few weeks with reasonably-controlled bp and a great biophysical two weeks ago, I've become cocky. I was taken down a notch today.
His tummy has only grown 2 days' worth of growth in the past two weeks. Head and arms are on schedule. Legs are short. It's the tummy that's concerning. According to Dr MFM, it's the tummy that's the first to go, and is usually the first sign for more growth restriction later on.
Of course, it's an inexact science, and there are ranges and all that. There's a chance it could catch up. But, with my history, there's also a good chance that he'll stop growing altogether soon. When that happens, he comes out, as leaving him in is a good recipe for stillbirth. At least he's big enough now that he has somewhat of a chance on the outside. 28 weeks tomorrow, but as we're now measuring behind, I don't know how comforting the dates are anymore.
Please little bee, hang in there a few weeks more.
I should be saying, please placenta, don't starve my baby.
I really, really suck at this whole "growing a baby" thing.
Good news- I just got home from my bpp. It is the first time I've been allowed to go home from a biophysical. Up until now I've either been an inpatient or been admitted immediately following.
Bad news- Bumblebee's growth is slowing.
I'm not surprised, I figured it would come. I guess in the past few weeks with reasonably-controlled bp and a great biophysical two weeks ago, I've become cocky. I was taken down a notch today.
His tummy has only grown 2 days' worth of growth in the past two weeks. Head and arms are on schedule. Legs are short. It's the tummy that's concerning. According to Dr MFM, it's the tummy that's the first to go, and is usually the first sign for more growth restriction later on.
Of course, it's an inexact science, and there are ranges and all that. There's a chance it could catch up. But, with my history, there's also a good chance that he'll stop growing altogether soon. When that happens, he comes out, as leaving him in is a good recipe for stillbirth. At least he's big enough now that he has somewhat of a chance on the outside. 28 weeks tomorrow, but as we're now measuring behind, I don't know how comforting the dates are anymore.
Please little bee, hang in there a few weeks more.
I should be saying, please placenta, don't starve my baby.
I really, really suck at this whole "growing a baby" thing.
Monday, August 17, 2009
Daily news
Bumblebee is doing well. We've had 2 non-stress tests in the past few days, and although he slept through the first, he was active in the second and we got the results we wanted. We have another BPP on Wednesday so hopefully he'll be bigger and do all the things he's supposed to do.
Had an OB appt this morning. Everything seems fine. She is so genuinely excited about us getting this far- I don't think anyone thought we would. Only 3 more days until trimester 3! And just a couple of weeks until the coveted 30 week mark!
Dr ObGYN informed us that she'll be taking holidays the first 2 weeks of October. NOOOOO!!!!! That was when we expected Bee to come; I'll be between 34-36 weeks. After all of this pregnancy and last, I just can't imagine being under the care of another doctor at the very end. My MFM should still be here, but she doesn't do the daily rounds and daily care that the ObGYN does. If I'm still pregnant, I'll be put under the care of another OB, and while she is very lovely, she's not my doctor and I have no history with her. It makes me sad that my beloved doctor might not get to deliver this baby. Sigh. I mean, really, as long as the baby's ok it doesn't matter who delivers, but I always pictured it being my own doctor. She's been so good to us over the past two years. Maybe I can make it to 36 weeks???
Disappointing.
Bedrest is going ok. Here are my hospital-dictated stipulations, if you're interested:
- Majority of day either lying flat or sitting/reclining as tolerated (I'm supposed to aim for 20-22 hrs a day)
- Very limited walking within the house
- Preferably no stairs or limited use (we live in a two story house and this has really changed how I spend my day)
- No work outside the home
- No housework (no complaints here!)
- Allowed to prepare very simple meals (on feet >10 mins)
- Brief shower only or bath if condition allows
- No driving, passenger only for exceptional medical appointments
- Prescribed bedrest exercises
So, it could be worse, but it's pretty restrictive. At least it's not for too much longer.
Back to the couch I go....
Had an OB appt this morning. Everything seems fine. She is so genuinely excited about us getting this far- I don't think anyone thought we would. Only 3 more days until trimester 3! And just a couple of weeks until the coveted 30 week mark!
Dr ObGYN informed us that she'll be taking holidays the first 2 weeks of October. NOOOOO!!!!! That was when we expected Bee to come; I'll be between 34-36 weeks. After all of this pregnancy and last, I just can't imagine being under the care of another doctor at the very end. My MFM should still be here, but she doesn't do the daily rounds and daily care that the ObGYN does. If I'm still pregnant, I'll be put under the care of another OB, and while she is very lovely, she's not my doctor and I have no history with her. It makes me sad that my beloved doctor might not get to deliver this baby. Sigh. I mean, really, as long as the baby's ok it doesn't matter who delivers, but I always pictured it being my own doctor. She's been so good to us over the past two years. Maybe I can make it to 36 weeks???
Disappointing.
Bedrest is going ok. Here are my hospital-dictated stipulations, if you're interested:
- Majority of day either lying flat or sitting/reclining as tolerated (I'm supposed to aim for 20-22 hrs a day)
- Very limited walking within the house
- Preferably no stairs or limited use (we live in a two story house and this has really changed how I spend my day)
- No work outside the home
- No housework (no complaints here!)
- Allowed to prepare very simple meals (on feet >10 mins)
- Brief shower only or bath if condition allows
- No driving, passenger only for exceptional medical appointments
- Prescribed bedrest exercises
So, it could be worse, but it's pretty restrictive. At least it's not for too much longer.
Back to the couch I go....
Wednesday, August 12, 2009
Ah, the guilt.
Official bedrest day 2. I've been on "reduced activity" since 12 weeks but at least I had driving priveleges, and "leaving the house" priveleges, even if it was just to go to the library. Ugh. Going nowhere now, which is fine if that's what it takes, but it makes for long days.
My nurses have come, yesterday and today. They are lovely. We do all the regular pre-natal stuff- bp of course, urine, reflexes, doppler heartbeats. We'll do non-stress tests 2x a week in the comfort of my living room which is a hell of a lot better than trekking off to the hospital all the time. I love hearing Bumblebee's heartbeat, and he seems to resent dopplers and monitors, and constantly tries to kick them away, which makes everyone laugh. What a little scalliwag.
The head home care nurse came to visit me in the hospital before I was discharged on Monday. She gave me the synopsis of the program, and proudly stated that We've never had a bad outcome. I asked her what she meant. They've never lost a mom, or lost a baby.
Never lost a baby?
The prenatal home care program is in place for people like me, high risk moms, lots and lots of them pregnant women with high bp. Other problems too. They've been at this seven years and they've never lost a baby.
I wasn't on this program last time.
I'm a different patient this pregnancy. I am well informed, maybe too well informed. I know the risks, the symptoms, the statistics. I've lived them. I know what the ambiguous epigastric pain feels like first hand. I've met with neonates and psychologists and I've read everything I could find about HELLP and pre-e and how to give yourself the best chances. I have an idea of what to expect if we deliver at 28 weeks, 30 weeks, 34 weeks. I keep over-the-top records of bp readings, urine sticks, medications and tests. My doctors rely on my own homemade chart more than the records they keep on my behalf.
Last time, I knew nothing.
I remember the first time at the doctor that my bp was high. I was about 14 weeks with Charlotte. He took it manually and frowned, and then hooked me up to a digital machine that would do 6 readings and average them. He left the room.
They started. 170/113, 168/110, 182/115. I didn't even know enough to know that they were high. 120/80 stuck out in my head as "normal", but I knew nothing about where normal ended and high began. There was a poster on the wall about diabetes, listing factors that would make you high risk. One of them was blood pressure higher than 135/85. I remember thinking, wow, mine must be high then. It took my gp and two specialists a full month or more to figure out a dose of medication that controlled it for the time being.
After that, I read a lot about high bp in pregnancy. Very very few resources mentioned that the baby could die. Most of it talked about bedrest for a few weeks pre-delivery, at most, and HELLP was always mentioned, but never dwelled upon. It was considered serious in everything I read, but it was always at the end of the pregnancy, so you just delivered and everyone lived happily ever after. Once in awhile there would a disclaiming sentence like occasionally presents in the second trimester.
So, now, with little bumblebee heading towards real, true viability and Charlotte's memory box sitting on my dresser, I wonder constantly, what would have happened if I knew then what I know now. My intellect tells me that nothing would have changed. HELLP would have set in at 24 weeks and that would have been it. All the monitoring and knowledge wouldn't have made any difference. I felt exceptionally well cared for last time- my doctors were diligent and thorough, but there was no history to rely on. My care this pregnancy has been more informed on all counts. We all know what we're watching for. I have done everything in my power that I possibly could do to get myself this far along, as, like you, I know the horrible horrible side of having it crash.
My brain might be logical, but my heart wonders and worries that I didn't do enough last time, that we made bad decisions and didn't take things seriously enough until it was too late.
M came to pick me up at the hospital on Monday shortly after my conversation with the neonatologist. I was thrilled with my 90%, but I was expecting a number somewhere around there because I've done so much reading and research in the past year or so. M is not as well versed in the stats. I was so excited to tell him, and while he was so happy too, his face fell a little bit and he said, Charlotte was so close.
She was, but she was also so very far.
My doctors always comment on how I'm going the extra mile in this pregnancy, how I'm the model patient, how I make their jobs so much easier. They assume it's because I'm desperate to have this baby survive. They're right, of course, but part of it is also because if something bad does happen to bumblebee, I have to know that I did everything. My diligence is partly selfish. The guilt is not something I could survive twice.
Now that things are going well there's this new guilt surfacing, the "what-if" guilt. A weird version of survivors guilt, even though we still have a long way to go.
I just want to be one of those glowing pregnant women. Must be nice.
My nurses have come, yesterday and today. They are lovely. We do all the regular pre-natal stuff- bp of course, urine, reflexes, doppler heartbeats. We'll do non-stress tests 2x a week in the comfort of my living room which is a hell of a lot better than trekking off to the hospital all the time. I love hearing Bumblebee's heartbeat, and he seems to resent dopplers and monitors, and constantly tries to kick them away, which makes everyone laugh. What a little scalliwag.
The head home care nurse came to visit me in the hospital before I was discharged on Monday. She gave me the synopsis of the program, and proudly stated that We've never had a bad outcome. I asked her what she meant. They've never lost a mom, or lost a baby.
Never lost a baby?
The prenatal home care program is in place for people like me, high risk moms, lots and lots of them pregnant women with high bp. Other problems too. They've been at this seven years and they've never lost a baby.
I wasn't on this program last time.
I'm a different patient this pregnancy. I am well informed, maybe too well informed. I know the risks, the symptoms, the statistics. I've lived them. I know what the ambiguous epigastric pain feels like first hand. I've met with neonates and psychologists and I've read everything I could find about HELLP and pre-e and how to give yourself the best chances. I have an idea of what to expect if we deliver at 28 weeks, 30 weeks, 34 weeks. I keep over-the-top records of bp readings, urine sticks, medications and tests. My doctors rely on my own homemade chart more than the records they keep on my behalf.
Last time, I knew nothing.
I remember the first time at the doctor that my bp was high. I was about 14 weeks with Charlotte. He took it manually and frowned, and then hooked me up to a digital machine that would do 6 readings and average them. He left the room.
They started. 170/113, 168/110, 182/115. I didn't even know enough to know that they were high. 120/80 stuck out in my head as "normal", but I knew nothing about where normal ended and high began. There was a poster on the wall about diabetes, listing factors that would make you high risk. One of them was blood pressure higher than 135/85. I remember thinking, wow, mine must be high then. It took my gp and two specialists a full month or more to figure out a dose of medication that controlled it for the time being.
After that, I read a lot about high bp in pregnancy. Very very few resources mentioned that the baby could die. Most of it talked about bedrest for a few weeks pre-delivery, at most, and HELLP was always mentioned, but never dwelled upon. It was considered serious in everything I read, but it was always at the end of the pregnancy, so you just delivered and everyone lived happily ever after. Once in awhile there would a disclaiming sentence like occasionally presents in the second trimester.
So, now, with little bumblebee heading towards real, true viability and Charlotte's memory box sitting on my dresser, I wonder constantly, what would have happened if I knew then what I know now. My intellect tells me that nothing would have changed. HELLP would have set in at 24 weeks and that would have been it. All the monitoring and knowledge wouldn't have made any difference. I felt exceptionally well cared for last time- my doctors were diligent and thorough, but there was no history to rely on. My care this pregnancy has been more informed on all counts. We all know what we're watching for. I have done everything in my power that I possibly could do to get myself this far along, as, like you, I know the horrible horrible side of having it crash.
My brain might be logical, but my heart wonders and worries that I didn't do enough last time, that we made bad decisions and didn't take things seriously enough until it was too late.
M came to pick me up at the hospital on Monday shortly after my conversation with the neonatologist. I was thrilled with my 90%, but I was expecting a number somewhere around there because I've done so much reading and research in the past year or so. M is not as well versed in the stats. I was so excited to tell him, and while he was so happy too, his face fell a little bit and he said, Charlotte was so close.
She was, but she was also so very far.
My doctors always comment on how I'm going the extra mile in this pregnancy, how I'm the model patient, how I make their jobs so much easier. They assume it's because I'm desperate to have this baby survive. They're right, of course, but part of it is also because if something bad does happen to bumblebee, I have to know that I did everything. My diligence is partly selfish. The guilt is not something I could survive twice.
Now that things are going well there's this new guilt surfacing, the "what-if" guilt. A weird version of survivors guilt, even though we still have a long way to go.
I just want to be one of those glowing pregnant women. Must be nice.
Monday, August 10, 2009
L&D trip 2
Ugh, the past few days have not been the most fun.
On Thursday morning my bp was high at home, like 161/109. I was heading to the hospital anyway for bpp #2, so I planned on mentioning it to my MFM and going from there. We had a GREAT bpp. The technician was the same as we had with Charlotte, and she remembered us and gave me a hug, and was oh so sweet. Bumblebee was a real star, scored 8/8, and *get this*, is measuring a tiny bit ahead of schedule and is TWO POUNDS!!!! As the mom of a 380gram baby this is the jackpot. I was measuring 26 weeks on the nose and that was very exciting. Plus, all doctors have agreed to use Nov 12 as my due date so I roll over my weeks on Thursdays now instead of Fridays.
After the ultrasound they checked my bp and it was still high, 152/108, so they sent me off to L&D. It was crazy busy so triage was full, so they wheeled me around corners and then put me in pre-op. I had never been there before, but poor M remembered it well as it was where he waited to be admitted to the OR for Charlotte's birth. I think they kept him there for 20 minutes or so before he was allowed in. It brought back a lot of memories for him, and he got quite emotional, which is unusual for him especially lately. It was intense.
Needless to say I was admitted to the hospital, and finally released this morning. I'm now on official bedrest and have home care. Nurses are coming to my house every 2 days to "officially" record my bp, check urine, do non-stress tests etc. I am not allowed to go anywhere except to my doctors. There are boring weeks ahead of me (lots of them, I hope).
Over the past few days I've been poked, prodded, had lots of reflex tests, non-stress tests, etc. I did NOT have any mag sulfate, an iv, or steroids, so I knew that delivery wasn't imminent. I had a meeting with the neonatal team this morning to discuss what I can expect if we deliver prematurely. If I delivered today, at our hospital, they said Bee would have about a 75-80% chance of survival. As of Thursday, at 27 weeks, it's 90%. 90%!!!!! Can you believe that? And he said the chance of survival with no long term complications is good as well at that gestation. I think I'm going to make it a good bit farther than that, so I'm feeling pretty good.
So, now that I'm on "official" bedrest, and I can't drive or walk or do much of anything really, the days will probably start to really drag. At least now I feel like I'm getting somewhere. And next week it will be 28 weeks- trimester 3- and I never ever thought I'd get there.
Now I'm off to catch up on everyone's blog. They really need internet in those hospital rooms.
On Thursday morning my bp was high at home, like 161/109. I was heading to the hospital anyway for bpp #2, so I planned on mentioning it to my MFM and going from there. We had a GREAT bpp. The technician was the same as we had with Charlotte, and she remembered us and gave me a hug, and was oh so sweet. Bumblebee was a real star, scored 8/8, and *get this*, is measuring a tiny bit ahead of schedule and is TWO POUNDS!!!! As the mom of a 380gram baby this is the jackpot. I was measuring 26 weeks on the nose and that was very exciting. Plus, all doctors have agreed to use Nov 12 as my due date so I roll over my weeks on Thursdays now instead of Fridays.
After the ultrasound they checked my bp and it was still high, 152/108, so they sent me off to L&D. It was crazy busy so triage was full, so they wheeled me around corners and then put me in pre-op. I had never been there before, but poor M remembered it well as it was where he waited to be admitted to the OR for Charlotte's birth. I think they kept him there for 20 minutes or so before he was allowed in. It brought back a lot of memories for him, and he got quite emotional, which is unusual for him especially lately. It was intense.
Needless to say I was admitted to the hospital, and finally released this morning. I'm now on official bedrest and have home care. Nurses are coming to my house every 2 days to "officially" record my bp, check urine, do non-stress tests etc. I am not allowed to go anywhere except to my doctors. There are boring weeks ahead of me (lots of them, I hope).
Over the past few days I've been poked, prodded, had lots of reflex tests, non-stress tests, etc. I did NOT have any mag sulfate, an iv, or steroids, so I knew that delivery wasn't imminent. I had a meeting with the neonatal team this morning to discuss what I can expect if we deliver prematurely. If I delivered today, at our hospital, they said Bee would have about a 75-80% chance of survival. As of Thursday, at 27 weeks, it's 90%. 90%!!!!! Can you believe that? And he said the chance of survival with no long term complications is good as well at that gestation. I think I'm going to make it a good bit farther than that, so I'm feeling pretty good.
So, now that I'm on "official" bedrest, and I can't drive or walk or do much of anything really, the days will probably start to really drag. At least now I feel like I'm getting somewhere. And next week it will be 28 weeks- trimester 3- and I never ever thought I'd get there.
Now I'm off to catch up on everyone's blog. They really need internet in those hospital rooms.
Tuesday, August 4, 2009
Visits and nurseries
So, I did go to the hospital to visit friend and baby. It was ok, in fact, I kind of enjoyed it. She was understandably tired and weak, so we only stayed 10 mins or so, but long enough to see the sleeping little one in his bassinet and chat to our godson and hand out gifts. There was nothing revolutionary, nothing that surprised me really. It was something I don't think I could have done a few months ago, but now it was ok. The baby was sweet (aren't they all?). I didn't want to hold him, and I'm glad that he was sleeping so it wasn't an issue.
We now have a baby room in our house. We weren't going to touch it for some time, until after there was a better chance that there would actually be a baby to live in it. M doesn't like to be bored, it was a rainy weekend, and he wanted something to do. A quick trip to the hardware store and we had paint and mouldings and two days later, a baby's room, with assembled crib and everything. It's cute. Some visiting relatives brought gifts this weekend so I even have a blanket and some little clothes. Slightly surreal.
Charlotte's room was never done. We had all the plans for what we wanted to do, but we also thought we had all kinds of time. Nothing ever changed in there, until a few months after we lost her when we turned the room from an office to a spare bedroom. It's still that today, and there have been many, many nights when I've ended up in there to sleep. You know, on those sad nights when you're up pacing the floor at 3 am. When we started thinking about a room for this baby, I just couldn't give him Charlotte's room. We decided to use the third bedroom, and I'm glad we did. It's new, it was never intended for any other, and it doesn't hold the missed possibility of the other room.
It's strange having a nursery. Makes it more real. I keep wandering in there wondering if this baby will live in it.
25w4d now. Getting along. Drs are happy. BP was a bit high yesterday but ok today. The next BPP is on Thursday so we'll see how the growth is going and whether or not my worries last time had any base. Bumblebee has been quiet lately which freaks me out some, although his heartbeat is strong at the doctors'. We'll see.
The doctors have said, from the beginning, that because I had a classical c/s last time, they'll probably do an amnio around 34-35 weeks and deliver asap after that. They don't want to risk me going into labor, and really, with my history, if I make it that far I think everyone will just want this baby OUT. Including me. It occured to me yesterday that's in 10 weeks, not even. 10 weeks is nothing. 10 weeks is forever.
Of course, I could have this baby in two days, next week, in a month. Hopefully hanging out as long as possible, but the end is coming, one way or another.
Please come home, little bee. We need you here.
We now have a baby room in our house. We weren't going to touch it for some time, until after there was a better chance that there would actually be a baby to live in it. M doesn't like to be bored, it was a rainy weekend, and he wanted something to do. A quick trip to the hardware store and we had paint and mouldings and two days later, a baby's room, with assembled crib and everything. It's cute. Some visiting relatives brought gifts this weekend so I even have a blanket and some little clothes. Slightly surreal.
Charlotte's room was never done. We had all the plans for what we wanted to do, but we also thought we had all kinds of time. Nothing ever changed in there, until a few months after we lost her when we turned the room from an office to a spare bedroom. It's still that today, and there have been many, many nights when I've ended up in there to sleep. You know, on those sad nights when you're up pacing the floor at 3 am. When we started thinking about a room for this baby, I just couldn't give him Charlotte's room. We decided to use the third bedroom, and I'm glad we did. It's new, it was never intended for any other, and it doesn't hold the missed possibility of the other room.
It's strange having a nursery. Makes it more real. I keep wandering in there wondering if this baby will live in it.
25w4d now. Getting along. Drs are happy. BP was a bit high yesterday but ok today. The next BPP is on Thursday so we'll see how the growth is going and whether or not my worries last time had any base. Bumblebee has been quiet lately which freaks me out some, although his heartbeat is strong at the doctors'. We'll see.
The doctors have said, from the beginning, that because I had a classical c/s last time, they'll probably do an amnio around 34-35 weeks and deliver asap after that. They don't want to risk me going into labor, and really, with my history, if I make it that far I think everyone will just want this baby OUT. Including me. It occured to me yesterday that's in 10 weeks, not even. 10 weeks is nothing. 10 weeks is forever.
Of course, I could have this baby in two days, next week, in a month. Hopefully hanging out as long as possible, but the end is coming, one way or another.
Please come home, little bee. We need you here.
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