Friday, July 10, 2009

Bed Rest and 26 weeks

I know it's been FOREVER since I posted. I feel bad about that, because I'm mostly doing this for myself to look back on later. I'm not comfortable nor optimistic enough to have an actual pregnancy journal - the last one I bought, I ordered online and it arrived the day after I was told I was for sure having a miscarriage. So it sort of feels like bad karma. And a grief journal is utterly depressing, so that's why I just combine everything here. It's hard to keep it all separated anyway - my emotions are typically really muddled and don't always fit nicely into 'pregnancy' and 'grief.'

Anyway! A lot has gone on. Our precious boy is still indeed a boy, and has clearly been so at every ultrasound :) so that's great. He's doing amazingly well - measuring a little ahead of his gestational age, and is showing no more markers for Down syndrome. Ultrasound isn't particularly good at identifying babies with Down syndrome - it's about 50-50 - but what it does mean is that if he by chance is chromosomally enhanced, he's quite healthy, with no apparent heart issues. Which is what ultimately matters about the whole thing.

Unfortunately, while he's doing great, his 'home' is sort of giving out. The hubs insisted that I call the on-call OB this one night when I was feeling an unusually high number of Braxton Hicks contractions. I put him off for awhile, knowing that 'drink water and lay on your left side' was what I would probably be told if I hadn't already tried that before calling. An hour and a liter of water later, it wasn't really helping, so I went ahead and called, even though I was totally sure everything was fine and we were just overreacting. The doctor told us to come in to be on the safe side given my history, but told me she wasn't really concerned so not to freak out. We get to L&D (thank goodness we even knew where it was - we had been on the hospital tour literally like 4 days prior or something, just because I had a feeling we should!) and I'm told to change into a hideous hospital gown, and they put me on the contraction monitor (the hospital lingo is 'toco' for future reference) and it's not really picking anything up, so everyone's feeling pretty good about things. The doctor decides to check me for dilation, just to cover all our bases... And lo and behold, I'm a centimeter and a half. At 23w4d. Not cool! My heartbeat (which is also being monitored) flies off the charts, which gives me away, as I had been trying to be cool, calm and collected. So the doctor tells us she's going to admit me, and writes down an estimated length of stay of six weeks. We then start talking about the implications of severe prematurity (oh thanks, I really had no idea! *eye roll*) and lets us know that before 24 weeks, depending on the condition of the baby they often won't attempt to resuscitate at all. Of course I knew this, but it's quite different reading facts and statistics versus being told "FYI, you're dilating - if your baby comes tonight you're just gonna have to watch him die - there's not too much we can do." Of course she was more sensitive about it than that, but that's what it boils down to. So anyway I'm admitted and get to do all this fun stuff like be hooked up to an IV and given every antibiotic on the planet through it - just in case, as the cultures wouldn't be back for 48 hours - and started on indomethacin to stop my invisible contractions. And the first dose was given rectally - is that a word? In my bottom lol.. It was awful!! And for the first 24 hours I had no bathroom privileges... I had to use a bedside commode and I wasn't allowed to shower! Not fun. The next day I saw my perinatologist and got an ultrasound, where we learned that my cervix was dynamic and funneling.. Opening and closing from the inside. It measured a wonderful 4cm when closed, but would open up and only measure about 1cm. The baby's head was down low but thankfully not engaged or anything. So things were not good, but not as dire as we thought they might be, and I got bathroom privileges!

So, I was on strict bedrest with bathroom privileges and on indomethacin and a variety of antibiotics, as well as continuous toco monitoring (24/7) for 72 hours... And then they switched me to taking Procardia for the contractions instead, since indomethacin can decrease the amniotic fluid level. It turns my face *bright red* and gives me a headache about an hour after I take it, but it seems to be working fairly well and has the fewest side effects for mom/baby of the available medications used to treat PTL, so it's all good. After that things are kind of a blur... I'm not really sure how many days I was in that hospital, but when the Procardia didn't help how dynamic my cervix was, my peri decided it would be better to transfer me to a hospital with a level III NICU. I had no idea he was planning to do that, so I totally panicked when they told me.

They transferred me by ambulance, although not a speeding, blaring siren ambulance, just a calmly driving one :). It was still scary. I was having mild contractions every 2-3 minutes according to the monitor during transport, and they took me to a LDR room as opposed to an antepartum room. I was totally freaked that they did this. As it turned out, they were just being extra careful until the doctors here had a handle on what was going on with me, but they didn't tell me that, so I thought that they thought that delivery was imminent. Luckily that wasn't the case, and I'm still here in antepartum!

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