Tuesday, March 31, 2009

Back Home Again

Went to the Maternal Fetal Medicine appointment this afternoon. They first did the biophysical profile which was fine. Then, after explaining to 3 different people this mornings events and that I was not leaving until a doctor spoke with Dr. Brazus, they took me to another room to do the preeclampsia check. No protein and the blood pressure was better. 130 something over 90 something. Dr. Conover, who I have not yet met, talked to Dr. Brazus and they decided to send me back home. I am to call Dr. Brazus in the morning which the nurse thinks is for another protein check. I think it's interesting that every other time I've ever been to MFM, a doctor has come in to talk to me, but this time, with this different doctor, he didn't. Not impressed.

I was given the okay to go to the conference tomorrow for work, but will call Dr. B during one of the morning breaks. More tomorrow...

Could today be the day??

I had my OBGYN appointment this morning and immediately wondered if something was up when I realized I'd put on 5 lbs in a week and my blood pressure was up to 149/82. Dr. B. came in and verbalized a concern for preeclampsia because in addition to that, I had protein in my urine. Then she measured my stomach. Should be 37 cm (since I'm 37 weeks today). I measured 42 cm. No wonder my pants don't fit and my belly hangs below my shirt--not one of my better looks. I was 3 cm dilated and 80% effaced. She thought my ankles were more swollen than usual, but I assured her that they are ALWAYS this swollen. I told her about the sharp pains in my upper abdomen--like needles. She had the nurse take my blood pressure again. It was up to 155/83. Since I already have an appointment scheduled today at 3:20 with Maternal Fetal Medicine, she let me come home with strict instuctions to make sure I didn't leave their office this afternoon until they talked to her. Had I not had this appointment already scheduled, Dr. Brazus said she would have been doing blood work on me and all kinds of fun tests this morning.

If there's no update to this blog this evening, you'll know where I am....

Wednesday, March 25, 2009

Still going strong!

Yeah! Another perfect 8 out of 8. The ultrasound tech, Julie (love her!) said this is the best and most active she's seen the baby. She also said the baby is VERY photogenic. VERY important quality in a baby. Dr. Hiett came in, was pleased and sent us on our way, but not until after indicating that he was a bit surprised I hadn't delivered by now and complimenting me on my "very tough cervix." Why, thank you. I try.

They scheduled another BPP ultrasound for next week. Forgetting my schedule and that I'm in a conference all day Wed and Thurs, I had to call back to reschedule. It's now rescheduled for Tuesday afternoon instead of Wednesday, and the only downfall with that is that I'll have to drive all the way to Women's. I really wanted my appt to be at the fancy new Fisher's building, not because of the closer proximity, not because it's a fancy new building, but because they are opening a BRAND NEW OLIVE GARDEN right next door. Dang it.

Received a bunch of information in the mail today from the fetal care coordinator (Rosie) at Women's Hospital with lots of helpful info on the NICU, visitation, rules, etc. She had already told us a lot of the stuff when we went to tour. The written information seemed a bit more strict, which is okay. I like a strict NICU. Some of the differences, for example: I was under the impression that as long as a visiting child had a copy of their immunizations, they could visit, but the paperwork makes it sound as though only siblings can visit. Which isn't all bad. I thought that you could use a cell phone in the NICU, but the paperwork says phones must be off, not even on vibrate. Jason reminded me though that at Riverview, we weren't technically supposed to use cell phones either but the nurses gave us the okay. Guess we'll see when we get there. When we've actually experienced a bit of time in the NICU, I'll post any guidelines, rules that you guys may need to know in case you want to visit at the hospital. (I'll be there for almost a month probably--hope I get some company, hint, hint.)

Tuesday, March 24, 2009

This and that...












I'm 37 weeks today and there's not much to report. We just came from the doctor and I'm dilated to 2.5 or 3 cm. "A stretchy 2.5" to quote her exactly. No non-stress test today because tomorrow I'll have another ultrasound...a biophysical profile...instead. Back to hoping for the big 8. My stomach is measuring 38 cm which is the same as it measured last week. Still having contractions, sometimes a couple an hour, but they aren't concerned until there are about 6 an hour. Thank goodness they are nothing painful or uncomfortable.

I'm trying to tie up all the loose ends around here and racking my brain trying to think what I may be overlooking. Bag: packed. Bills: payed. Books: returned. I still have some work to finish up. 2 more nursing homes to visit and lots of cases to write up. And that has to be done by next week. I have a conference on Thursday and Friday next week which won't be terribly fun to sit through. After the conference I'll be officially done with work. My most important thing is that the boys have their "Preschool Sings" program on Sunday and I would hate to miss that. Nicholas especially is so excited for his "program". He's our little singer--you should hear this kid sing in the car. A bit out of tune, but quite entertaining.

With the help of mom and Paula, the nursery is all ready. The crib is up, clothes washed, and all the pink makes it look like a Pepto volcano erupted. Love it!

Update tomorrow on the BPP results.

Wednesday, March 18, 2009

8!

When we went in for our follow up BPP (biophysical profile--I'm starting to sound like a doctor, huh?) the ultrasound tech wasn't ready yet, so the Dr. Harry (my new favorite at Maternal Fetal Medicine) decided to hook me up for another non-stress test. If for some reason this test was finally reactive, I wouldn't have to have the scan (the BPP) (the biophysical profile) (maybe I should add a glossary to this blog). Well, it wasn't reactive as usual. So then it was on to the BPP. They saw the tone, the movement, everything right away except for the breathing movement. But about 15 minutes in, it was there. Hallelujah!! So we scored our 8 and are off the hook for another week. Dr. Harry is calling Dr. Brazus (OBGYN) (maybe I should add a glossary and a list of characters) to recommend just skipping the non-stress tests altogether since they're always non-reactive and since I just have to keep making follow-up appointments for the BPP). My next BPP is scheduled for a week from today. I'll know tomorrow if I still need to see Dr. Brazus on Tuesday or not.

Thanks for all your comments, positive thoughts, and well wishes. There's no question that I'm blessed with the most loving and supportive network of family and friends. And this baby has the biggest cheering section imaginable.

Another 6. Crap.

We scored another 6 this morning. She would show the breathing movement for quick moments, but not for a continuous 30 seconds that the test requires. Little stinker. So the doctor came in and talked to us for a little bit. He said he wasn't terribly concerned, that when a baby has Down's and therefore develops a bit differently, her brain may just be sending messages to the rest of her body a bit differently. Because of that, he can't say for certain that everything is okay, but he's not terribly worried about it. He wanted us to do another scan (which, if I remember correctly, the technical term is a biophysical profile) tomorrow and scheduled it in the afternoon at 2:40 so I could eat a big meal first and maybe it would just be a more active time of day for the baby. Poor Jason. He's got to be pooped since it's like the middle of the night for a guy who works midnights.

Then, strangely, when we got home and walked in the door, the telephone was ringing. It was the receptionist at Maternal Fetal Medicine asking if we could come in today at 2:15 instead of waiting until tomorrow. Hmmmmm. She couldn't really give me a reason why other than to say it might save me a trip tomorrow. It all seems a bit vague and I don't know if the doctor saw something after we left or had second thoughts. I just don't know. I'm really not worried. In my mind I figure, worst case scenario, they send me to the hospital and I deliver a tiny baby today. That wouldn't be so bad. Not ideal, but definitely not so bad. Wish I could post her ultrasound pics--she's darn cute.

So the hospital bag is packed just in case. I figure if I don't have it, I'll need it. If I have it with me, I won't need it. Still thinking "8"! And what to eat for my big lunch before we go back.

Tuesday, March 17, 2009

Non-stress tests, NICUs, and neonatologists, Oh my.

Today was a long day. After dropping off Nicholas at Paula's house and Blake off at preschool, Jason and I went for another non-stress test. Like last week, I could feel the occasional kicking, but the test was still considered "not reactive". If I understand correctly, the heart rate should be going up a bit with each movement, and it wasn't. Since I was already scheduled to have an ultrasound later in the day, Dr. Brazus told me to make sure and tell them that the NST was not reactive. Dr. Brazus decided against checking me to see if I was any more dilated because she didn't want to take the chance of anything happening prematurely. Even though I am technically 35 weeks along today, because of the extra fluid I am measuring 38 cm and extra fluid can lead to premature contractions. She, like Dr. Hiett, thinks I will deliver before my scheduled delivery date of 4-14-09.

From there, Jason and I went to St. Vincent Women's Hospital for our tour of the NICU with Rosie Groves, the fetal care coordinator. The NICU is located on the 2nd and 3rd floors. There's no difference in the floors other than the 3rd floor has about twice as many beds. There can be 4 people at the bedside at a time, visitation is 24/7 with some restrictions on children. Rosie will mail me the details of that. They have lactation rooms on each floor with all the equipment I'll need to pump and freeze breast milk. They also have a family lounge with tv, computer, Wifi, fridge, showers, lockers. We went into a classroom there at the hospital to meet with Dr. BenSaad, one of the 18 or 20 neonatologists. He was very kind, very informative. During the delivery, a neonatologist, a nurse, and a respiratory therapist will be in the room with us. If the baby comes out crying, no problem. We will be able to hold the baby and spend some time with her. If she's not crying, they will give her a breathing tube. They will also (regardless of the breathing status) put a tube down into her stomach to clean it out, since she will be unable to pass or digest anything that's built up in her stomach. All this will be done in our room (assuming no complications arise). The baby will be on an IV at the beginning. After the surgery, she will have a tube feeding in addition to the IV to start trial feedings. We will be able to hold the baby as long as there's no breathing tube and in most cases, the babies don't have the breathing issues. I felt really good about all that I learned, all that I saw. Finding a balance of how much time to spend with the baby and how much time to be home with my boys will be difficult, but just knowing that I can call the nurses any time day or night and that the neonatologists check in with me daily is great peace of mind.

After leaving the NICU, we drove back to St. Vincent Carmel for our appointment with Maternal Fetal Medicine. The ultrasound was not only for a growth scan, but also because our NST was not reactive. The baby is currently measuring 4 lbs, 9 oz which is a pretty good size. Still lots of fluid--no surprise. Julie, the ultrasound tech did a great job in explaining what they look for following a non-reactive NST. There are 4 things like breathing (which is technically not breathing, but movement of the diaphram like in breathing), tone, muscle movement, and something else I can't remember. Each of the 4 things counts for 2 points and therefore, we want to score an 8. We scored a 6 because they couldn't monitor the breathing movement. With a score of 6, we have to return for another scan tomorrow at 11 a.m. If we score another 6 it could mean another follow up scan or possibly another amniocentesis to see if the lungs are fully developed. If a baby scores 2 or 4 they would most likely have the person deliver that day. Yikes. Praying for 8!

Tuesday, March 10, 2009

34 weeks

I'm 34 weeks along today. Went for my weekly non-stress test. Since the baby hasn't been terribly active, I've been eating plenty of junk, er, breakfast, before going into my appointments in the hopes that baby will get really busy kicking and moving, making the NST go quicker. Don't want any more of those 2 hour tests like I had 2 weeks ago.

So I went in for the test and they found the baby's heart beat right away. But no movement. They brought me in some juice to drink and she made a few movements, enough to move her around and make it hard to read the heart rate. Then she stopped making any movements again. So after 2 hours they gave up. Note to self: next time, take a book.

I didn't think much of it since there had been some movement, but then Dr. Brazus came in and told me that she wanted me to drive to Women's Hospital and have the Maternal Fetal Medicine people do a scan (another ultrasound). She assured me she would tell me if she was terribly concerned and she wasn't--just precautionary.

I don't think any of this would have really phased me except that less than a year ago I watched a dear friend go to the hospital for decreased movement and even though they'd found a heart beat at first, she ended up having a stillbirth at 35 weeks. So needless to say, I got really scared. Oh, the thoughts that can run through your brain.

So I drove to Women's Hospital but was instructed to first stop and get something to eat on my way. NOT hungry, but ate anyway. They took me back and hooked me up for an ultrasound. Again, there was the heartbeat right away. Reassuring. They saw she was breathing. Good. Then they had to wait to see if there was movement. Longest half hour of my life. At first the ultrasound tech was quite chatty, pointing out body parts, and making some small talk. But she was really quiet as she would wait for movement. And wait, and wait. Finally you could see the baby's lips move in a sucking motion as if she had a pacifier in there. It was something, but the tech wanted to see more movement. Finally a stretch with her arm, finally a kick in my ribs. Ouch. Beautiful!

Oh the relief. The doctor came in to say she passed her test and everything looked fine. He reassured me that with the large amount of extra fluid I have, that there could be times that she would be doing backflips and I may not feel anything.

The last thing I brought up to the specialist was telling him that Dr. Brazus had suggesting talking to him about scheduling my delivery. He said they could set up the delivery for 39 weeks which is what they typically do, but he also said he didn't think I'd go that long. Because of the extra fluid and my increased size, my body may think that I'm further along than I really am and I might deliver ahead of schedule. But he decided to schedule me for Tuesday, April 14. The nurse still had to call the pediatric surgeon to make sure that was okay with them. Kathy, a nurse, called me at home a couple hours later to confirm that I was "on the books" for April 14. At 6 a.m. Yawn.

Thursday, March 5, 2009

Welcome to Holland

by Emily Perl Kingsley

I am often asked to describe the experience of raising a child with a disability—to try to help people who have not shared that unique experience to understand it, to imagine how it would feel.

It’s like this……When you’re going to have a baby, it’s like planning a fabulous vacation trip—to Italy. You buy a bunch of guide books and make your wonderful plans. The Coliseum. The Michelangelo David. The gondolas in Venice. You may learn some handy phrases in Italian. It’s all very exciting.

After months of eager anticipation, the day finally arrives. You pack your bags and off you go. Several hours later, the plane lands. The stewardess comes in and says, “Welcome to Holland.”

“HOLLAND?!?” you say. “What do you mean Holland?? I signed up for Italy! I’m supposed to be in Italy. All my life I’ve dreamed of going to Italy.”

But there’s been a change in the flight plan. They’ve landed in Holland and there you must stay.

The important thing is that they haven’t taken you to a horrible, disgusting, filthy place, full of pestilence, famine, and disease. It’s just a different place.

So you must go out and buy new guide books. And you must meet a whole new group of people you would never have met.

It’s just a different place. It’s slower-paced than Italy, less flashy than Italy. But after you’ve been there for a while and you catch your breath, you look around….and you begin to notice that Holland has windmills….and Holland has tulips. Holland even has Rembrandts.

But everyone you know is busy coming and going from Italy…and they’re all bragging about what a wonderful time they had there. And for the rest of your life, you will say “Yes, that’s where I was supposed to go. That’s what I had planned.”

And the pain of that will never, ever, ever, ever go away…because the loss of that dream is a very significant loss.

But…if you spend your life mourning the fact that you didn’t get to Italy, you may never be free to enjoy the very special, the very lovely things…about Holland.

Tuesday, March 3, 2009

Dilated!

I had my second non-stress test today with no problems. If may have helped that I ate sugar in excess before going, so there was lots of baby movement to document this time. The test was completed in a half hour, much better than the two-hour test from a week ago. While they typically start checking the cervix at 34 weeks (I’m 33 weeks today) after voicing some concerns to my dr, she checked me today instead of waiting. Luckily, I’m not leaking any amniotic fluid which was great peace of mind. I was surprised to learn that I was dilated 1.5 cm, but Dr. Brazus said that this isn’t terribly surprising or cause for concern on a 3rd pregnancy. I’m also 25% effaced but the baby is still high which is good. Don’t want her escaping just yet.