Friday, October 16, 2009

Shrimp is an ornery buggar

I believe a lot of you follow me on Facebook so you are somewhat aware of the drama we have experienced this last week. In an effort to document so that we can remember this for when Shrimp does show his/her face, I'll post all the sordid details for you here. Alert, this may be TMI for some so if you don't want to know all the gory details, don't read. So, before I launch entire the entire book I will have to write today, let's get down to business. Shrimp at 27 weeks:

This week, your baby weighs almost 2 lbs (like a head of cauliflower) and is about 14.5 inches long with her legs extended. She's sleeping and waking at regular intervals, opening and closing her eyes, and perhaps even sucking her fingers. With more brain tissue developing, your baby's brain is very active now. While her lungs are still immature, they would be capable of functioning - with a lot of medical help - if she were born now. Chalk up any tiny rhythmic movements you may be feeling to a case of baby hiccups, which may be common from now on. Each episode usually only lasts a few moments, and they don't bother her, so just relax and enjoy the tickle.

So onto the details.

Saturday, October 4th - Thursday, October 8th

Saturday night, I began to feel a low down pain in my pelvic region. Right near the pelvic bone. It began that evening as we were watching some movies and I just remember how much it ached. I was holding up my belly it was hurting so much but as it was constant and not intermittent, I didn't worry about it too much. We went to bed and woke up Sunday morning and the pain was gone. It did return again that night, and after several glasses of water and laying down in bed, it again went away the next morning. But at this point I was a little concerned as it seemed very symptomatic of the UTI I had a few weeks ago, so I called my doc who pulled me in for a urine test. Preliminary results came back negative and they sent out for more definitive results. Again Monday night, I had this pain that disappeared by morning. Tuesday night, the pain returned but this time I noticed some very strong, what I thought were Braxton Hicks, contractions. There was no pattern to them and after a few big glasses of water, they disappeared entirely. Wednesday was no different. Thursday, I noticed a lot of clear, mucosy discharge that again had me calling the doc. Results had come back on UTI and were negative, and they figured because the discharge was mucosy, there was nothing to worry about. They had no qualms about me getting on the plane. Me, on the other hand, still didn't feel like something was entirely quite right, but as I'd been consistently reassured throughout the week I thought I should trust my doctor.

Friday, October 9th

I got up for my flight that morning and the first thing I noticed was the low pain I'd felt all these last few days was still there. As it was consistent, I just figured that this was just how it was going to be for the rest of the pregnancy. So I continued on the way to the airport, boarded my flight and went on my way. At the end of the 2nd flight, I began to notice that I just didn't feel right. I can't really explain how I felt, but it just wasn't normal. I needed to find a bathroom so decided to find my way down to baggage claim and take care of business while I was waiting for my bag. First thing I noticed was the mucos plug. I wasn't really alarmed at that point, just figured it was something that would grow back but felt I should call my doc anyway. They called back as I was on the shuttle bus to the rental car center and advised me to go straight to a hospital. They weren't overly concerned but thought it was best that I get checked out immediately. So I picked up my car (was a 1.5 hour wait, grr!) and headed immediately to the closest hospital, Banner Good Samaritan. After confirming with my insurance that this hospital was in network, I went in and was immediately sent up to OB Triage. Nurses there were very reassuring and felt for sure they would check me out and send me on my way in 20 minutes. You could see the shock in the nurses' eyes when she checked and found I was 2cm dialated. Asked if I had been feeling contractions, and of course I hadn't. She went immediately and got the doctor who came in about 15 minutes after the nurse originally checked me. Doctor checked and I was in the midst of a contraction (which I didn't feel) and was no dialated to 3cm. On top of that, my bag was bulging and doctor thought she could feel a foot. At this point I think I called Andrew and my parents and told them I wanted Andrew to head down immediately. Mom called my boss and Andrew and they worked out a schedule to come down. Doctor grabbed an ultrasound machine, nurses were flying around me trying to start IV's, give me steroid shots for Shrimp's lungs. It was pandemonium. About the only part I really remember here is the doc looking at me and saying "you know it's a boy, right?" I looked at her and went no. I did not hear a word after, so I don't know if she was in a round about way telling me it's a boy or if she was asking before she saw anything. She also said baby was footling breech, meaning Shrimp's feet were facing the birth canal and were pushing and kicking on the sac. They rushed me to L&D but had to stop in a hallway while waiting for my room to be cleaned, where of course the effects of the magnesium they had started me on began. I started puking in the middle of the hall. Nurses were running all over the place to get bins to catch it all in and start anti vomiting drugs. Finally get me into my room, where my uterus still won't cooperate. I remember one nurse yelling at my uterus to calm down as she gave me quick shots of Tributilene. Finally they had things calmed down. I was on IV magnesium sulfate and was only showing some irritability instead of full blown contractions. They placed me on a catheter as I wasn't allowed out of bed. The neonatologist came to speak to me about the chances of babies born at 26 weeks and 3 days. Survival rates were 75%-89% but babies needed significant help. It was, in a sense, comforting to know that odds were atleast in our favor but still terrifying. Things remained calm for the night.

Saturday, October 10th

Andrew arrived in around 7 am that morning. I was still on the mag and things were still rather calm. Doctors were still uncertain at that point of what really was going on but they were optimistic. They were watching for signs of infection to try to explain the sudden labor and were also concerned about the heart shaped uterus. The doc indicated in a purely diplomatic way that he felt my doc back home was an idiot for allowing me to travel at all with this unique uterus. Things remained quiet however, and we became optimistic that we would atleast make it to 32 weeks. Mom and Dad arrived sometime this day, but I don't remember when. I received the second steroid shot this evening. I needed to get in what they call the "steroid window" when the steroids would have the best effect on the baby if we had to deliver. We went to bed very optimistic.

Sunday, October 11th

Things were still mostly quiet, but then I was still on the mag. I think I would have the occasional contraction, but nothing that worried the docs at this point. At 4:30 I was in the steroid window, so they needed to stop the mag. The reason to stop the mag was it could cause long term effects on me and short term effects on Shrimp. For me it could cause a pulmonar y edema (fluid on the lungs) and an increased risk of osteoperosis. For baby, it can cause additional calcium deposits that could cause issues with Shrimp's baby teeth. All of that would be resolved when the permanent teeth came in. It could also cause more brittle bones for both of us. For the first few hours, things were again calm. Andrew and I settled down to sleep, I was given some Ambien to help me to sleep, and my parents headed to the house they were staying in (childhood friends from Andrew's church in Iowa). Things were really calm and the mag was weaning out of my system. We were confident that my body would hold it's own.

Monday, October 12th

We were woken very early, I think it may have only been 11 pm to midnight. I'm not sure, because I was on the ambien so I had no recollection of being woken up. I was told I was talking about mazes and frogs as the doctor and nurse were trying to talk to me. Andrew was very confused having gone to sleep thinking all was well and was roused from a deep sleep to be told that they had to do an amniocentesis. Bright lights were on everywhere and Andrew was very freaked out as he didn't understand how things went from being perfectly fine to lots of irritation and contractions. Tributilene was not working to stop them and docs were worried that there was an infection in the amniotic fluid that was causing me to contract. Andrew thought with all the activity and the messages he was getting from the medical staff that they were going to deliver the baby right then and there. He called my parents in and they performed the amnio right there in the room. Then the tense wait began to see what the results were. If it turned out there was an infection in the amniotic sac, then they would have to deliver me immediately as it was not safe for the baby. If there was no infection, they would get aggressive on stopping the labor. I had progressed from 3cm dialated to 5cm dialated and was 100% effaced and the sac was still bulging. Baby had moved from footling breech to just standard breech. Results came back from the amnio as negative, there was no infection, so they immediately started the mag. The continuously monitored me and baby through the night, I don't think the nurse really left my side. None of us slept. They checked me again early morning to find I was still 5 cm, 100% and 0 station. Bag had moved up a little bit in that it no longer felt as "tight" as it had in previous checks. Labor had again stopped with the mag.

Later in the morning, after only being on the mag for a few hours, I began developing problems breathing. My lungs were very sore and doctors became concerned I was developing a pulmonary edema. This was very troubling as if I was, then they would need to stop the mag again and there was no telling what my body would do. Would I immediately start laboring again? Doctor prepared us to deliver that day. I was only 26 weeks, 6 days. Results came back that I did, indeed, have a pulmonary edema and they stopped the mag. Then the doctor checked me again, and found out 2 things. 1. Baby had moved back up. I was -2 station and no longer with a bulging bag. 2. I was only 3cm dialated and 40% effaced! He was no longer as concerned that I would deliver that day! We couldn't believe it, things don't go "backwards" in labor. We knew it was God at work and protecting Shrimp, it was the only real explanation. The next miracle was I did not start contracting again. In fact, my uterus remained remarkably calm with no medication bar Motrin! Hope was back alive. They saw no reason I wouldn't make it to atleast 32 weeks.

Tuesday, October 13th

I was removed from the catheter and allowed out of bed to shower and pee. They also discontinued the Motrin therapy as it can reduce the amount of amniotic fluid for Shrimp and decided to place me on a tributilene pump, which would give a continuous stream of the medication into my system. There are no long term or even any effects on baby with this medication. I am at risk for another edema, arrythmia or gestational diabetes. So after 32 weeks they will re-evaluate keeping me on this med. I am still on complete bed rest, however, and am not allowed out of bed really. It was another calm day with 1-2 contractions every 6-8 hours.

Wednesday, October 14th

I graduated! They moved me from labor and delivery to antepartum. Basically this is a reduced level of care and monitoring as I no longer needed to be continuously monitored. I'd been very calm and there is a bit higher of a freedom here, however I am still on the bed rest. We did manage to get a quick ultrasound as Andrew was very concerned since he can't feel all the movement I can. Another miracle...Shrimp was no longer breech, but was instead head down! We couldn't believe it! His/her back was arched but was practicing breathing and wiggling around.

Thursday, October 15th

Still on bed rest, still in antepartum, still no real activity. Shrimp is very active and having regular parties in my uterus. Hates being monitored and will literally push up at the monitor whenever it's on. Is getting big enough that I can literally see my belly move when he/she wriggles. We've had three ultrasounds since the first when the doc said "you know it's a boy, right" and have yet to be able to confirm that. Shrimp has been characteristically stubborn and has kept the legs crossed for each subsequent ultrasound.

Friday, October 16th

Another very quiet night. Doc came in to tell me that I may be released at 32 weeks if things continue this quiet. However, I will not be allowed to leave Phoenix. Airlines will not let me on with how far dialated I am and it's not safe for me to drive 20+ hours into desolate areas.

So anyway, that's where things currently stand. We are still optimistic about 32 weeks. I am in great spirits.

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