NICU Day 3: Monday Nov 8

Today was my first day home from the hospital. So where did I go first thing this morning? Yep, of course. Back to the hospital ...... as a visitor, that is.

My little guy is looking a little bit stronger today. His bilirubin levels have increased, so they are adding additional phototherapy underneath his body. This means he will now be exposed to lights from both above and below. The overhead lights come from a machine that sits above his isolette. The underneath lights come from a pad that he lays on ... it plugs into the wall and lights up. It's basically like a double-sided tanning bed now. :)

The pressure on his CPAP was lowered to 6 Liters last night, and he was doing well with that. So today the doctors switched his breathing assistance from the CPAP over to a high flow nasal cannula. The nurse explained that the it's not really a step down from the CPAP, but rather it's more of a lateral move. The two are considered equal alternatives as far as the level of respiratory support they provide. He is now getting 5 Liters of pressure from the cannula. It's a lot smaller so I'm hoping that maybe Jonah is a little more comfortable with his new tubing.

One of the arterial lines in his umbilicus was removed today. Only one left. His blood cultures are still negative, so he finished his antibiotics today. The facial bruising is still pretty severe but it's improving each day. I'm pretty sure I was also bruised just as severely due to our traumatic delivery .... however I just haven't looked yet. I don't really want to know!

Jonah was a lot more active today. He sneezed, yawned, and wiggled around a tiny bit. Before now he has mostly just laid limp like he was in a coma. I think this was due to all the Magnesium Sulfate I was on at the time of delivery -- and hence Jonah was affected too -- the Mag is yucky stuff and it suppresses your central nervous system. They told me that it would take a few days to work out of his system, and that he would be much more "awake" once it was gone.

My milk came in this afternoon ..... literally as I was sitting at Jonah's bedside. I could feel my breasts turning into rocks as I sat there. So I'm now getting actual milk when I pump (about 2 oz total per pumping) rather than just the colostrum. At this point, every waking moment I spend away from Jonah is mostly consumed with producing milk for him. I am trying so so hard to make the whole pumping thing a success. I feel like it's the only thing I can do to help him; the only thing I have any control over. I feel so grateful that I've had a lot of help this time from the lactation consultants at Northside. They really do everything they possibly can to help the NICU moms because the breastmilk is so vital for those tiny ones. Jonah's neonatologist even called it "medicine". That's how strongly they view it. I, of course, want to do any and everything I can to help Jonah grow big and strong .... so they certainly didn't have to twist my arm or anything.

After visiting Jonah today, I went to "A Woman's Place" downstairs at Northside. It is a little boutique full of lactation consultants and wonderful ladies who did a personal appointment for me ... fitted me for nursing bras and hooked me up with everything I need to run my dairy farm. I also stopped by Babies R Us again once I got back to Douglasville to pick up a few extra's. So once I got home I could barely walk ... I wayyyyyyyy over-did it today. I've been in bed for roughly 15 weeks, and then I basically got up and started moving at 100 mph today. I feel like I've been in a train-wreck. Really hoping for some good sleep tonight.

NICU Day 2: Sunday Nov 7

I convinced James to go home last night and stay overnight with the kids. Our goal in all this chaos has always been, and will continue to be, to keep things feeling as "normal" as possible for Gracie and Jamin.

I got very very little sleep last night, maybe 2-3 hrs or so. I'm still having a lot of pain, which makes it difficult to sleep. And now I'm pumping every 3 hrs, even at night. Add in an overdose of fear and worry and you've got a recipe for sleep deprivation.

The lactation ladies came by again to see me this morning. We are now getting small amounts of colostrum, which we freeze and take upstairs to NICU. They will mix it in with the donated milk he is getting. I have rented a hospital-grade breast pump, so I can keep up my dairy farm routine at home.

Jonah is having a hard day. They had lowered the pressure on his CPAP overnight, from 7 Liters down to 6. Today he's had lots of retraction (where his chest caves in when he breathes), so they've increased it back up to 7 Liters.

He's also having a hard time digesting the 3 cc's of breast milk. He's having lots of "residuals", which is what they call the green icky stuff that comes up into the stomach and indicates that his little intestines are not digesting properly. So the nurses have been forced to hold (or skip) several of his feedings today. He is still getting 100% of his nutrition through the IV, so it's not like he's starving. It makes sense that his body does not know how to digest food, given that he's still supposed to be getting his nutrients from a placenta and umbilical cord right now.

He remains under the phototherapy lights, and his bruising has gotten a tiny bit lighter today.

My sister, parents, and Gracie came up to the hospital to visit me this morning. I don't think anyone really knew how to react when they saw Jonah laying there in his isolette. Gracie was just bubbling with excitement ... she talked about how cute he looked and how he was the teeniest baby she'd ever seen in her whole entire life. She was begging to hold him, of course, and doesn't seem to really get why no one is allowed to hold or cuddle him yet.

In other news, little Jonah finally got a middle name. It happened about 3 minutes before discharge, when the nurse was practically standing there staring at us waiting on the birth certificate. We couldn't put it off any longer. Since James agreed to the first name I had picked, I let him have full rights to the middle name. He picked Ryan. I was less than excited about it. But I bit my tongue, wrote it down, handed the birth certificate to our nurse, then got in the wheelchair and came home.

I was discharged around 5:00. Leaving the hospital without Jonah was hard. James was very emotional. I had to remind him (and myself) that this was different than the last time we left the hospital empty-handed, after Isaac was born. On the ride home we talked about how fortunate we were to be at Northside and to have my amazing team of doctors. Now Jonah has his own amazing team of doctors. This could be so much worse. I really feel like we've been lucky, as strange as that probably sounds.

We made a quick stop by Babies R Us on the way home for breastfeeding (pump) supplies. We were so confused because the time changed last night, so at first we thought they were closed. But just as we exited on Chapel Hill Road, James realized that the clock in the car was really an hour ahead now, so we had exactly 20 minutes to shop. Small victories.

When we got home, we were surprised by an impromptu "welcome home" party planned and executed by Gracie. (Tammy and Laura were home with her, they might've helped a little). We had Hello Kitty party hats, "It's a Boy!" balloons, and sparkly purple streamers. My friend Sherry had made a delicious lasagna dinner for us. It felt wonderful to come home to a hot homecooked meal. I had to exit the party a little early because my pain had really kicked back up again, but I loved it nonetheless.

NICU Day 1: Saturday Nov 6

I've spent much of today in a complete fog. I absolutely can not wrap my brain around everything that has happened. I keep looking down at my tummy ... I almost forget that I'm suddenly not pregnant anymore. Even just telling the story of how I went into labor ..... it is so surreal because I'm in total disbelief over what we're experiencing.

I'm sure the lack of sleep doesn't help matters.

I was up all night, I think I managed to get maybe an hour or hour and a half of sleep. They made me finish two bags of pitocin in my IV after Jonah was born, I'm not 100% sure why. I'm assuming it's because of my clotting problems. In any event, it's meant that I was having very painful contractions all night long ('cause I haven't had more than my share of awful contractions yet?!??). They're giving me 2 Percocet every 4hrs for pain, which I'm taking around the clock. It takes the edge off but I'm still hurting pretty badly.

I'm also having horrific pain in my ....... umm ........ "perinatal area". Dr. Grogan did an episiotomy but I'm starting to wonder if maybe the knife slipped and she's cut me in half of something?? Holy cow I never hurt this badly with Gracie or Jamin. They're telling me that the pain is worse because Jonah came out "sunny side up" (or posterior), the nurse said posterior birth is way wayyyy more painful than a normal birth ... both during and after.

In the interests of preserving your mental comfort, I won't say anything more about that.

I was able to go up and visit Jonah in the NICU twice today. He is so tiny and lifeless looking. When I look at him, all the breath leaves my body. I'm not sure how else to describe it. It's kind of like suffocating and feeling like you have to vomit all at the same time.

I spoke with Dr. Henkis, one of the neonatologists. He told me Jonah was given surfactant through the ventilation tube last night. This is a substance naturally found in the lungs which allows the alveoli sacs to remain open. Preemies lack surfactant, which means that the air sacs will collapse between breaths. This is why premature babies are said to have "immature lungs". The clinical term for it is Respiratory Distress Sydrome (RDS). Xrays were done this morning on Jonah's lungs and confirmed moderate-severe RDS. I am told this is a normal "preemie thing", and is expected at 29weeks gestational age.

He was taken off the ventilator this morning, and is now breathing with the help of a CPAP machine (Continuous Positive Airway Pressure). This forces air into his lungs and helps keep those alveoli sacs open. He is getting 7 Liters of pressure on his CPAP, and 25-30% oxygen (normal room air is 21%).

His bruising is slightly improved today, but it's still pretty scary looking.

They inserted a feeding tube today and will start feeding him 3 cc's (approx. 1/2 teaspoon) of donated breast milk every 3 hours. I think the milk donation is an amazing service and I'm so grateful it's available to us. Northside reserves the donated milk only for their micro preemies, who need it most. Because my own milk won't come in until 3-5 days post-delivery, the use of donated milk allows Jonah to get a jump start on the calories. A lactation consultant came to see me this morning, and I've started pumping every 3 hrs around the clock. Once my milk comes in, we will be able to stop using donated milk and switch over to mine.

Jonah's main source of nutrition right now is TPN, which is an IV solution that supplies 100% of his nutritional needs. They inserted a PICC line into his left arm this morning, and the TPN goes in there. They are also administering antibiotics through that PICC line. He has two arterial catheters in his belly button. These go directly into arteries that used to be his umbilical cord. They use these for constant blood pressure readings, as well as drawing blood samples without having to stick him repeatedly with needles. They told us that we will not be allowed to hold him as long as these umbilical catheters are in. There are about a dozen other lines, tubes, and sensors attached all over his little body. I haven't learned what all those are yet.

He had bloodwork done this morning, and so far there are no signs of infection. So that is huge. They are also doing blood cultures looking for infection. Those will take a few days to get results back. He will get a chest Xray every morning I'm told, as well as a daily Xray of his PICC line to make sure that it's in the proper location and not slipping.

They began phototherapy on him this afternoon, because he has jaundice. I'm pretty sure this is something that just about every preemie has, since their livers are not fully developed. Dr. Henkis said Jonah's bilirubin levels will be a little worse because he has such severe bruising on his face. Apparently when your body breaks down the bruises (red blood cells), bilirubin is left over, which causes jaundice. So they are tied together. The nurses put these teeny tiny little "sunglasses" over Jonah's eyes to protect him from the phototherapy lights. They look hysterical.

On a side note, James went home early this morning to shower and get some clean clothes. He told Gracie the news that her baby brother was born. She was super excited, but upset that Mommy would miss her last soccer game. I am also sad to have missed it ... I have missed every game this season (except for about 12 minutes of her first game), and I was really hoping to go to the last game.

I still can't believe we're actually doing this. Blows my mind.

The Longest Day Ever The Longest Blog Post Ever

I am still in complete denial as I write this:

OUR BABY BOY WAS BORN TODAY.

It is difficult for me to describe how truly unexpected and traumatic this was, giving birth suddenly at 29 weeks 2 days gestation. But I want to try and record how we got here.

On Monday I saw Dr. Garcia for my weekly check. He walked in, gave me a high-five, and said, "Well I'll be darned, Kristi made it to 28 weeks!" He checked my cervix and reported no change. We discussed the upcoming move we would eventually make from my once-daily Lovenox shots over to the twice-daily heparin shots. He said he wasn't in any hurry to make the switch at this point because my condition looked stable. The reason a switch is necessary is because you can't give birth or have an epidural with anticoagulants in your system. Lovenox stays with you for 24hrs after your dose. Traditional heparin, however, only stays in for 12hrs and its effects can be reversed if necessary by the use of a second drug (it's name escapes me at the moment). With Jamin's pregnancy, we switched to heparin at 26 weeks because they felt labor could happen at any time. We eventually scheduled the delivery date, and stopped using the heparin about 48 hrs beforehand. So I was able to have an epidural and a safe, pain-free delivery. But here I was on Monday, with Dr. Garcia telling me we didn't need to make the switch yet, and I went along with it.

In retrospect, I can clearly see that this was our one big mistake. But I digress ...

The next day, Tuesday, I saw Dr. Mann for our weekly ultrasound. Everything looked great, in fact my cervical measurement had actually lengthened to 2 cm. The other bit of good news was that the placenta's location had moved significantly from the week before ... it was now measuring 4-5 cm away from the cervical opening. Dr. Mann told me she now felt confident we had dodged the C-Section bullet ... the placenta's current location meant we should be safe to have a vaginal delivery at this point. We then had the same Lovenox vs. Heparin conversation that I'd had with Dr. Garcia the day before ... Dr. Mann said she would plan to switch me over sometime around week 34. She also said we could relax a bit since my condition was stable and I was almost 29 weeks. She said she felt like we'd hit a plateau -- the pre-term labor symptoms were leveling off and she anticipated things would stay calm now. She was so confident, in fact, that she didn't want to see me again in 7 days as usual, instead she had me schedule my re-check for 14 days away.

I left there very encouraged and relaxed .... two great reports in two days and both my doctors were on the same page. I even ran a few errands after leaving Dr. Mann's office since we were now "relaxing" a bit.

One day later, Wednesday, I began having the teeeniest tiniest bit of light pink spotting. The amount was so small, it actually took me several hours to determine if it was really there or if I was seeing things! I didn't worry though, since I'd just had two cervical exams over the two previous days, and often times an internal exam is enough to cause a little spotting. By Thursday, though, the spotting hadn't gone away, it seemed to be a tiny bit heavier and I had also noticed that my contractions were feeling more intense. I called Dr. Garcia's office first thing Thursday morning, and his nurse didn't seem concerned at all. She agreed it was probably just the cervical checks that kicked this off, but suggested I come in the following day to let Dr. Garcia take a look just to be safe.

So the next morning, Friday, I arrived at Dr. Garcia's office for my 11:15 appointment feeling kind of silly. By then the spotting had completely stopped altogether, and I felt like I was wasting everyone's time! Especially since I had just been there 4 days earlier. I told Dr. Garcia about my spotting and mentioned that my contractions had been feeling more painful, and that I was beginning to feel pain in my cervical area when I was contracting. He agreed it was probably nothing, but wanted to take a look just in case. Roughly ten seconds later he said, "honey, I'm sending you back over to The House". The House is his code-word for my home away from home .... Hotel Northside. He said I was was dilated 2 cm and my membranes were bulging, meaning the amniotic sac was protruding through the cervix into the birth canal.

I was shocked. I said, "Seriously? You're admitting me???", to which he responded, "Well YEAH, I can't send you home like this!!!" Ugh.

So I asked him a million questions, trying to figure out what our treatment plan would be and how long I'd be stuck there this time. He explained that he was not on call this weekend so I would be treated by his partner, Dr. Grogan, from now until Monday. He said Dr. Grogan would probably check for an infection (common cause of pre-term labor) and pump me full of antibiotics. I would likely get two more doses of the betamethasone steriods, and they'd start me on the Magnesium Sulfate to try and get the contractions under control. I asked him "How much time do you think we can buy?" and he told me, "Well our goal would be to get another week. But it could be 14 days, or it could be 4 weeks ... we won't know until we get you admitted, get some bloodwork and have a little time to fully evaluate what exactly is going on." He then begrudgingly agreed to let me drive myself around the corner to the hospital, since I had come alone and didn't have anyone else with me.

Thoroughly annoyed, I left his office carrying my admission paperwork and went downstairs to the main lobby. I was a little frazzled and didn't want to drive while making phone calls, so I found an empty bench in the corner of the lobby and spent the next 15 minutes calling James and Sara to update them. I told Sara I had a feeling that this time I would be stuck at the hospital until the baby was born.

James was right in the middle of picking up Jamin's new dresser from the furniture store when I called to tell him the news. He needed to get back to work to tie up a few loose ends, and get the dresser home and unloaded before the rain came. He then had to get Gracie checked out of school and grab my already-packed suitcase before driving out to join me at the hospital. So he was a few hours away.

I drove myself over to the hospital and was admitted around 1:00. I was put in a teeeeny tiny room (more like a closet!) #LH9 on the Labor & Delivery floor. It was not a labor/delivery room however, it was more like a triage room ... just large enough for a gurney and a chair. My nurse was Wendy, she had long red curly hair just like Wendy of the fast-food variety, which made me giggle. Wendy told me they were planning to keep me in the triage closet for a few hours while they evaluated me, and then would decide whether they would move me upstairs to HRP (where I spent my 18-day stay on bedrest), or if they would put me in a L/D room.

When I arrived in my closet I was having contractions roughly every 10 minutes or so. I was ordered to give myself a demand dose on my terbutaline pump, and then they adjusted my bed to put me in trendelenburg position, which basically means I was semi-upsidedown to take pressure off the cervix. Having missed lunch (I had been at Dr. Garcia's office since 11:15), the extra dose of terbutaline on an empty stomach was making me quite jittery so I felt icky but still calm.

My contractions were becoming more frequent (about 7 min apart) and more painful as I laid there upside down, and every time I would contract I could feel pain inside my cervix. For the first time I began to worry a little bit, because the last time I could remember having this type of pain was when Jamin was born. But Nurse Wendy was not flustered, she listened to my concerns and promised to relay them to Dr. Grogan ... but continued to re-iterate that our plan was to get things under control and get me back upstairs on bedrest.

I was still feeling pretty relaxed and calm until Wendy came to start an IV for saline. It took her 3 TRIES, each time poking around in my vein for 90 seconds or so before declaring it a failure and pulling it out to try again on the other arm. I am not one to be a wimp about needles, but this was getting quite painful and after a few minutes the tears started rolling. She eventually called in another nurse who got it on her first try, but by the time they left the room I was badly bruised and fighting hard not to come unglued. I was really desperate for James to arrive because I didn't like doing the painful things by myself and I really wanted his hand to hold.

Around 3:45 Wendy returned to my room holding two bags of clear IV fluids and announced, "Dr. Grogan has ordered the big guns". I immediately burst into tears, because I knew what she was carrying must be Magnesium Sulfate. This is the one drug I hadn't taken yet but had been dreading for months. I begged her to wait until my husband arrived, he was roughly 30 minutes away and I couldn't bear the thought of doing the Mag by myself. She apologized but explained that we had to get started now.

And so, I laid there in a heap of tears as she removed my terbutaline pump and began administering the Magnesium. She gave a "loading dose" of 4 grams/hr, which lasted about 20 minutes. After that I was switched to 2 grams/hr. All the horrible stories people had told me about the Mag were true: I instantly felt like death. By the time James arrived I was in pretty bad shape ... I had an achey awful feeling all over, the worst headache of my life, my vision was super blurry and I could barely open my eyes. For a short time it seemed to help my contractions a bit, they slowed down to roughly 12 minutes apart. Dr. Grogan came by and told me everything I already knew: we're going to watch you over the next few hours, repeat the steroids, yada yada. I inquired about an epidural. My last shot of Lovenox had been around 10pm the night before, and I had this awful feeling that the whole 24-hrs-of-Lovenox-thing was going to cause a major problem. By this time it was around 5:00 or so, and 10pm felt like a loooong way away. Dr. Grogan said my platelets and PTT (clotting factors) looked great so far but it would be the anesthesiologist's call as to whether or not I could get the epidural prior to 10:00. He gets to make the final decision, since it's his butt on the line of course.

Administering the epidural before the 24-hr mark is no trivial matter .... if your clotting factors aren't adequate, you run the risk of bleeding into your spinal space and becoming paralyzed. So obviously it's something they take very seriously. Wendy called down to the anesthesiologist, then came back in to deliver his verdict: He was pleased that my platelets were 160 and PTT was good ............. however he would not touch me prior to 10:00pm.

Yep, this was definitely going to be a bad night.

So I laid on my left side, upside down, in the dark (I had a headache), holding James' hand. At one point he suggested, "we should probably give the baby a name before he's born". Really?! 'Cause I'm pretty sure I've been saying the exact same thing for three months now. So, for the 1,000th time, we went back through my potential-baby-name list. It contained the same 4 names I had repeatedly suggested for weeks and weeks: Benton, Jonah, Hudson, Jensen. James said he liked Jonah the best, which was also my favorite of the four. I'm pretty sure he would've agreed to pretty much any name that I wanted at that point, given the kind of terrible physical condition I was enduring. (And rightfully so, might I add). Thus we tentatively agreed on a first name, which felt a little surprising given that this had been a hotly debated and overly-contentious issue for months at our house, and yet we had just accomplished the task in less than two minutes of casual conversation.

My pain was worsening but I was somewhat holding it together until I had to pee. Nurse Wendy informed me that I was no longer allowed to stand up and walk to the bathroom since I was on Magnesium. I had had two options: catheter or bedpan. I told her I was choosing neither. Couldn't my husband walk me to the bathroom to make sure I didn't fall? Nurse Wendy said no way. I protested, politely at first .... and when that didn't work I resorted to begging and eventually just crying hysterically. A bedpan felt humiliating to me, and the catheter I feared would be painful (the two previous times I was given a catheter, I had an epidural first so couldn't feel a thing). So I did what any self-respecting girl would do .......... I stubbornly decided to just hold it! Wendy tried to tell me this wouldn't work, but I wasn't listening.

After several more minutes of waiting, my contractions were getting increasingly painful and it quickly became obvious that Nurse Wendy was right. Having a full bladder just made the pain worse. I agreed to the catheter but asked for some pain medication first. She gave me a 50mg shot of Demerol (which went in the booty) at 6:05, waited 15 minutes, then did the catheter. It hurt but I managed. She then gave me the first steroid shot (also in the booty). The steroid is thought to produce surfactant inside the baby's lungs, thus helping to boost lung maturity before an early delivery. It has to be in your system for 24hrs in order to be effective, at which point you get a second dose. So maximum effectiveness is within 48hrs of the first dose, and the benefit lasts several weeks. I got both shots earlier in this pregnancy, around 24weeks gestation, but since that was 5 weeks ago Dr. Grogan ordered that I repeat them.

As time passed, my contractions grew more frequent (about 5min apart) and the pain was becoming borderline-unbearable. The longer I laid there, the more I became convinced that I must be dilating further. I must've told Wendy 100 times how badly I was hurting, and that these really felt like labor contractions. Finally I asked her to call Dr. Grogan to check my cervix. Dr. Grogan responded around 6:30, checked me, and announced I was now 3cm dilated. So things were progressing. She ordered my Magnesium dose increased to 3 grams/hr, then explained that this was the maximum dosage, saying "We've got nothing left. This is it." I pretty much knew that already. There were no more magic medicines, no more options. I asked her what were the chances we'd be able to delay delivery at this point, she said probably 50/50. Again I begged for an epidural, and was told that they would go ahead and order it, have it ready and waiting so that we could get it placed promptly at 10:00. Again she said they would continue to watch me, but she would try to get me out of the closet and into an actual room.

James continued to sit and hold my hand, but at this point the contractions were absolutely excruciating. I was trying super hard not to be an obnoxious patient. But things got so awful that my pride took a backseat to my pain, at which point I began screaming through each contraction. Eventually they were coming about every 90 seconds, so I was no longer getting a break in between to recover. I was also having really terrible pain in my lower back with each contraction. Nurse Wendy was in and out a few times, but mostly it was just James and I alone. At one point James was standing to my right, trying to encourage me. He was saying, "honey, we've just got to make it to 10:00 and then it's all gonna be okay". But all I could focus on was this large clock hanging on the wall right behind his head. It read exactly 7:15. I remember telling him that there was no way we were gonna make it to 10:00. Either the baby would be born, or I would be dead .... but I was quite positive that one of these two things would definitely take place prior to 10:00. Feeling like that baby was certain to come soon, I asked him to please go out into the hall and get some help.

He ran out and quickly returned with Mr. Anesthesiologist, who had been standing just outside in the hall. Ahhhh yes, the guy who got me in this mess by refusing my epidural! He stood at my door with a fake smile on his face, explaining why he absolutely would not touch me before 9:59, but "we do have some other options for pain control". As he was giving me his speech I began having another contraction, but this one was 10 million times worse than all the others. I shouted "THE BABY IS COMING! I HAVE TO PUSH!". James and Mr. Anesthesiologist were both frozen in their tracks. Neither of them moved, they just stared at me dumbfounded. I turned to James and barked, "DOOOOO SOMETHING!!!!!!!!!!!" and then I began screaming like a complete maniac for help. In an instant there was a swarm of people in my closet, all wearing their surgical scrubs, masks, and their little blue hair nets. Dr. Grogan examined me and said, "She's fully dilated, let's go." I was still screaming, so loud and so crazy that when I heard myself I was actually frightened. They immediately began rolling me out of the closet and into the hall, but I was clutching the railing on the side of the gurney and my head was hanging off the side, which meant they couldn't fit me through the doorway. There were a million strangers around me, and everyone was shouting at me. The need to push was so overwhelming and I was convinced that if I moved an inch then the baby was surely going to come out. I managed to fold my head half-upside down and they were able to get me through the door.

We were then running down the hallway in a full sprint. It was complete chaos. All the medical people were shouting orders, and for the life of me I could not stop my crazy screaming. I kept yelling that I had to push, which garnered a collective roar of "DO NOT PUSH!!!!!"

I heard James' voice coming from somewhere, saying "We're going to the O.R. Kristi". I remember feeling incredible relief. Only a few more moments of this horrific pain and then I would be asleep. I heard a loud barking on my left side, and turned my head to see a large nurse hysterically screeching at me to CALM DOWN!!!! I felt my water breaking. Every muscle in my body was begging me to push, it was almost out of my control. Trying to not push felt impossible. The pain was indescribably awful. Through the sea of noise there was one voice to my right that somehow caught my attention, I turned to see glasses, a pair of kind eyes, and some tattoos peeking out from the neckline of his surgical gown. He was loudly calling my name. When I locked eyes with him, he said, "We're going to help you". I was still screaming like an absolute manic, the only words I could muster now were "JESUS! JESUS! JESUS!" The kind eyes asked, "are you a person who likes to pray?" I nodded. He said, "Okay well then we're just gonna pray our way through this". I didn't have the ability to say a prayer out loud, so I just continued to say the name of Jesus repeatedly. It was truly the only word I could say.

We arrived in the O.R. and the first thing I remember seeing were those giant round lights overhead. I heard Dr. Grogan say, "Time of rupture, 19:29" (my water had broken in the hallway at 7:29). Then she started giving orders to the NICU team, who were waiting there. I was lifted off my gourney and onto a new table. There were panicked voices coming from every direction, the rush of people moving and preparing instruments and equipment. I closed my eyes. My only thought was getting the pain to stop. Then I waited, comforted by the certainty that at any moment someone was going to inject something into my IV and all this would be over.

I felt someone near my feet moving and clanking around, then lifting my legs up and placing them in delivery stirrups. I was so confused. Wasn't I having a C-Section? This is obviously the O.R. right? I managed to mutter, "weh-weh-weh-we're pushing???" Someone behind me urgently responded, "Yes, we're pushing! We've got to get this baby out right now!" I couldn't believe what I was hearing. There would be no merciful anesthesia to put me to sleep. There would be no C-Section. Instead was going to to deliver my baby with no epidural. I wasn't even supposed to be having a baby today! I could not have been more physically and mentally unprepared for this. I shouted, "I need my husband! Where is my husband?" I heard his voice to my left yelling, "I'm right HERE!" I looked around and saw a sea of identical people, all in their matching surgical scrubs, masks, and little blue hats. There must've been 3 dozen of them. I couldn't see any faces, only eyes. Finally I found James' eyes, he was right next to me and I hadn't even realized it.

We began pushing. The pain was horrifically, unspeakably awful. The crazy screaming came back. I seriously had no control over it. There was someone standing right behind me, who would throw my head up every time I was pushing. The kind-eyed tattoo guy was on my right squeezing my leg. James was on my left. There were at least 30 other little blue strangers in the room. I'm pretty sure every single one of them were shouting orders at me. I pushed for what felt like forever, though I think it was actually more like 15 minutes.

With previous deliveries I was instructed to push only during a contraction, the doctor would count to ten, then I would get a break. People would pat me on the head and tell me what a fantastic job I was doing, while I laid there and waited for the next contraction to start. This experience could not have been more different. There were no breaks. There were no pats. I pushed when I was contracting; I pushed when I wasn't contracting. It was pretty much constant pushing. People were screaming at me the entire time .... YOU'VE GOT TO PUSH AS HARD AS YOU CAN!! Really? What the heck do you think I'm doing????? WE'VE GOT TO GET THIS BABY OUT RIGHT NOW! Yes, I realize that, but thank you for the kind reminder.

At one point I remember asking tattoo guy, "Are we close?" I was so confused because I had delivered Gracie and Jamin on the third push. Why was this taking so long?? Tattoo guy avoided my question, and responded, "Just keep pushing!" I did not realize it at the time, but the baby was coming out in the posterior position, or "sunny-side-up". Apparently this makes vaginal delivery exponentially more difficult (not to mention more painful). I was pushing like crazy, but since everyone was still urgently yelling for me to PUSH HARDER I assumed that meant we weren't making any progress. I was quite positive I didn't have an ounce of physical strength left in me, and the pain was so overwhelming I didn't feel like I had any control over my body at all.

Dr. Grogan did an episiotomy (which, I must tell you, feels just as horrible as you would imagine without an epidural) ..... and finally, at 7:45, Jonah was born. Instantly, the torture ended and relief flooded me. There was a fleeting moment, where the chaos around me stopped and I focused on my reprieve from the pain. Then, the deafing silence hit me. The relief vanished and a new wave of anguish overtook me: Why don't I hear him crying?

A moment earlier the room was filled with loud chaos. But now ....... you could hear a pin drop. I began mumbling frantically, "Is he breathing?" No one answered me. I asked again. And again. And again. No answer came. Just silence. My body went completely numb. I started straining my head, frantically trying to catch a glimpse of him. He was only a few feet away, to my 2 o'clock. There was an entire team of little blue people feverishly working on him. I stretched and strained but could not see him. There were too many people between us, standing in the way. I could only see the top of the resuscitation bag which they had over his nose and mouth, pumping air into him. Then I knew the answer to my own question: clearly he was not breathing.

Dr. Grogan started saying something to me. I didn't even hear a word she was saying. "Does he have a heartbeat?" I begged. She responded with, "I'm not sure honey, I'm here with you and he has an entire team with him. But we're here for you and you're gonna be just fine". I turned to tattoo-guy and muttered, "why isn't he breathing?" He too gave me a non-answer: "I dunno, I can't really see him, I'm over here with you, and we're gonna make sure you're okay". Furious, I finally managed to snap, "WELL GO LOOK THEN!" Tattoo guy silently walked over to the corner where the NICU team was swarming over the baby. He disappeared from my view. He was gone for what felt like an eternity. Instictively, I did the only thing I could: I quietly called on Jesus, just repeating His name over and over. At last, tattoo guy returned, saying, "They have intubated him, so they are breathing for him now. They are taking him upstairs". A moment later, I turned to see the NICU team standing at my bedside with the baby in a closed isolette. They opened the little door. I touched his face. And then they were gone.

I remember hearing someone ask "What's the baby's name?", to which James replied, "Jonah". So it was official: Jonah Wren.

After that moment, it's all a blur. All the "normal" delivery room essentials continued without a hitch ... placenta, collect the cord blood, stitches, etc, but in my mind it's one giant fog. I just remember laying there crying. I don't even remember leaving the O.R. James says we were moved to a recovery room, and stayed there for quite some time, but I have no recollection of that at all.

My next tangible memory is being in my post-partum room, 162, when the NICU doctor came in. It was the first word we were finally given about Jonah's well-being. I remember having a long conversation with her, though I can't remember 90% of anything she said. My brain was still super foggy. I do remember her telling us that he had really severe bruising on his face due to the traumatic delivery. His Apgar scores were 1, 6, and 7. And she recited some statistics about 29-week preemies and cerebral palsy.

Dr. Grogan also came in, though I can't remember a single thing we discussed.

Around midnight, we were taken upstairs to the NICU. We were warned by several different nurses beforehand about the facial brusing. But I was still unprepared for the severity of what I saw. Jonah's entire head .... everything from the neck up .... was completely black. His chest rose and fell with the force of the ventilator. His body laid limp. I don't think I was capable of absorbing the gravity of it all. I just stared in disbelief.

We came back down to 162 and attempted to get some sleep. I found this impossible, of course. Between the overwhelming worry for Jonah, the parade of nurses in and out of my room, and the pain I was in .... I didn't sleep a wink.

Frequent Flyer

Well, my hiatus from Hotel Northside lasted for exactly 10 days. Sunday night I began having stabbing pain in my upper back, just under my right shoulder blade. Every time I took a breath, the pain was horrifically unbearable. This made it totally impossible to breath normally, so I resorted to taking these short, shallow puffs of air because it hurt less.

I decided to play Dr. Kristi and diagnose myself .... afterall I'm practically halfway to my medical degree, right? Thinking I had a kidney infection, I ignored James' pleas to go to the Emergency Room and insisted that I just wait until the morning to see Dr. Garcia. I remember the last time I had a kidney infection I had the same pain in my back and deep breaths were painful, so this made perfect sense to me.

Apparently my medical skills aren't quite as sharp as I thought.

I went in to see Dr. Garcia first thing Monday morning, telling him I had a kidney infection. Roughly five seconds into the exam Dr. Garcia informed me that my kidneys are located nowhere near my upper back/ shoulder blade area. Furthermore, he said what I was experiencing was actually CHEST pain. I protested, because my chest did not hurt at all; the pain was in my upper back. Dr. Garcia then proceeded to give Dr. Kristi a quick anatomy lesson: the pain I was feeling in my upper back was inside my chest cavity. Sometimes chest pain is felt in the front, and sometimes it is felt in the back, he said.

Hmmm. Who knew??

He then spent the next two minutes YELLING AT ME because I hadn't gone to the emergency room as soon as the pain started. He actually raised his voice and wagged his finger at me! Defending myself, I explained that I truly thought it was just a kidney infection, and yes it hurt terribly but I didn't think pain would kill me. His eyes nearly popped out of his head and he snipped, "WELLLLL, if it's a pulmonary embolism, then yes actually that CAN kill you!!!!!"

OOPS.

Apparently chest pain + shortness of breath + pregnant girl with Protein S Deficiency = pulmonary embolism. Perhaps I should resign my medical license?

As it turned out, my faulty self-diagnosis didn't spare me a trip to the ER afterall. Dr. Garcia sent me straight there. I signed myself in and sheepishly explained to the triage nurse why I was there. She pulled up my name and social security number on the computer and quipped, "Oh my! You're a frequent flyer!"

Ummm, yes I am. Does this mean I get VIP status? Do I get bumped to the front of the line???

No such luck. After waiting 1.5 hrs, I was given a room and a really fantastic doctor named Dr. Funk. Her name was laughable but her medical skills were much better than mine! She was super thorough and openly offered a detailed explanation of everything she was thinking and why she wanted to order certain tests. My kind of girl.

Seeing that I was in terrible pain, Dr. Funk gave me a shot of morphine in my IV. Wow. It made my head super loopy, but sadly it only masked the pain for about 15 or 20 minutes. So I just went back to holding my breath again! About an hour or so later she suggested we try a dose of IV Dilauded. I did find that it helped the pain, and I could finally catch my breath. But again it wore off after about 20 minutes and then my pain level was back to being a 10+++. So after two tries with the Dilauded I decided to give up on the pain meds and just grit my teeth.

Dr. Funk's initial plan was to try and avoid exposing the baby to lots of radiation. Normally she would order a CT scan right off the bat, she told us, but since I was pregnant she wanted to try and rule out a pulmonary embolism using other means.

Two chest x-rays, an EKG, a renal ultrasound, 700 bottles of bloodwork and 8 hours later ......... we still had no answers. The x-rays and ultrasound came back normal, but my EKG was "suspicious" and my bloodwork showed elevated D-dimers, which could possibly indicate a clot. So Dr. Funk decided that we had no other choice but to do the CT scan of my lungs. Exposing the baby to the radiation is not ideal, she explained, but it's a matter of determining which is worse for the baby. Obviously if I have an undiagnosed pulmonary embolism and drop dead, that's far worse for the baby than the radiation he would receive from the CT scan. Seemed like a no-brainer to me! So I consented to the scan.

Incidentally, I had this exact same thing done 5 days after Jamin was born. In fact, when they got me down to the CT room I realized it was actually the exact same radiologist that had done my last CT scan roughly 18 months earlier. Gosh I've really spent way too much time in that hospital.

After prepping me with the contrast dye and getting me all situated inside the machine, Mr. Radiologist proceeds to pull out his clipboard and read aloud a two page long legal disclaimer. So I had to sit there and listen to him inform me of all the risks to my baby because of this radiation I'm about to receive ... birth defects, later development of cancer, up to and including death, blah blah blah. So I burst into tears, signed the stupid paper, and cried through the entire test.

I find it incredibly unfair that I should have to make such a decision. As if I don't already have enough things to worry about regarding my baby?!??

Thirty minutes later we were told the CT scan showed clear lungs! No clots! Dr. Funk decided I must have pleurisy. This is normally treated with anti-inflammatory drugs, but those are a no-no during pregnancy. So we would have to let my body fight the pleurisy on it's own, with pain medication to keep me comfortable in the mean time. I was given a prescription for Percocet and quickly discharged.

Since my return home I've been resting and recovering. Fortunately my pain is drastically improved, and so far I've only had to take 1/2 of one of the pain pills they gave me. So I'm considering myself lucky. A pulmonary embolism would've been a disaster, but pleurisy I can handle.

Looking Back

My dear friend Kim sent me these shots the other day. She came to visit me at Hotel Northside several days ago, and brought along her trusty camera. We had hours and hours of girl talk, which was beyond wonderful. Here's a glimpse into life on hospital bedrest .....

GOING HOME!!!!!

On September 21st I left home for my weekly doctor's appointment. I was planning to be gone for a few hours. Eighteen days have ticked by and now I'm finally returning home!!!

OH HAPPY DAY!

The on-call doctors made rounds this morning and informed me that all is well enough for me to be discharged this afternoon. I am so so so so thrilled to be getting out of this place!

There was some confusion as to whether or not I would require an ultrasound today before they would clear me for discharge, I was getting conflicting information from different people. But as of right now I am told that I will not have an ultrasound today, instead I will come back on Tuesday to see Dr. Mann (as an outpatient this time!), and resume my weekly ultrasounds then. I also have to schedule an appointment with Dr. Garcia for the end of next week. So apparently it looks like my doctors visits have now escalated from once weekly to twice weekly. I also need to try and get rescheduled for Dr. Duncan, the hematologist, who I was supposed to see the day I was admitted here. Not sure if I will have to repeat my bloodwork first before I schedule that, so that is something I'll have to get ironed out but more than likely that will mean two trips to Emory instead of one. But seriously, who cares? I would drive to Kentucky and back at this point in order to get a break from this hospital.

My nurses are busy trying to get everything set up for my transition home. They've been on the phone with Alere, the home care company, making sure my home nurses are prepared for my return. We have to get my terbutaline pump switched over today before I can leave -- right now I'm using a hospital-owned pump which has to be removed and replaced by the home pump I was using before I got here. Ironically the two pumps are identical ... the exact same model and everything ... just that one is hospital property and one is Alere property that has been temporarily rented to me. I am told they cost about $5,000 a piece so it's super important that we don't get them mixed up or else I will be receiving a giant bill! Right now I've actually got two Alere pumps at my house, in addition to the third hospital-owned pump in my leg, which has made me so nervous b/c I was terrified that James would misplace the box at home or Jamin would get into it and decide to "hide" them away in a random drawer somewhere like he does with everything else he discovers. Between the two home pumps and the toco monitor I have about $13,000 worth of Alere's equipment in my bedroom so it's a bit nervewracking to be responsible for that stuff!

We're working on getting my medications situated so that I won't miss any doses during the transition from hospital to home. Right now the plan is for James to come up around 3:00 this afternoon with my home pump, at which time we'll get the infusion site changed and discharge paperwork completed and then I should be FREE! Well ......... free to go straight home and lay still 24/7 in my bed ......... but still a major improvement over my current living conditions so I'll take it. I am hoping if all goes smoothly I should be home around 5:00 or so. Sara is making us a big dinner so we can celebrate with a home-cooked meal. It will be so nice to be done with hospital food for a little while! And I seriously CAN NOT WAIT to see the faces of my little ones when their Mommy finally walks in the door, that will be quite a reward.

Last night before bed I was laying here thinking, "wouldn't it be great if this is the last time I have to sleep in this hospital pregnant? And the next time I'm here is when the baby is born?" But then instantly that thought made me paranoid because it would, of course, only be great if the baby is close to full-term next time I come back! If I come back in two or three weeks then of course I want to still be pregnant. Ughh, if only my brain had an off switch. Or at least a pause button. I need a break from myself.

I had a meeting last night with one of the NICU nurses. She came down to the HRP floor to chat with some of the bedrest patients, and spent almost an hour in my room. Basically the idea is that she would answer our questions and give us some basic information so that in the event that we eventually need her services we will be a little less confused and scared. Being the type of person that thrives on information, I actually found this to be really helpful because I do feel more prepared now after talking with her. She actually offered to put me in a wheelchair and give me a "tour" of the NICU, which I declined, because that felt a little too scary. I don't want to actually see it unless I have to. But talking about it was good. She gave me a lot of information about how the NICU works, how it's organized, and what I could expect.

The policy here is that any baby born prior to 35 weeks gestation is automatically admitted to the NICU, regardless of their weight or condition at the time of birth. So even if we make it to Dr. Mann's current goal of 34 weeks, we would still have to do a NICU stay for at least 1-2 weeks. I am grateful to know this ahead of time, because I can get mentally prepared now. In my mind, I can already "plan" for it at least in theory, and then if it happens I won't have to panic as badly. And of course, if it doesn't happen, then it will just be a giant wonderful bonus! When you have a Kristi-brain you have to do some mental tricks sometimes and planning for worst-case-scanario is one trick I've found that actually seems to help reduce my stress a little bit.

A million thank-you's to everyone who has prayed for us, sent notes of support, visited, sent food, babysat, and loved my family over the last several weeks. We are so incredibly grateful for your outpouring of generosity. Please please please continue to pray for us! We are 25weeks 2 days gestation today, so we are certainly not out of the danger zone yet and we have a long road ahead.

Coming Unglued.

Today marks 17 days in the hospital, and my extended stay here is really starting to take its toll. I’m not sure how to accurately describe it, other than to say I am utterly and completely exhausted in every way imaginable.

My physical condition has really deteriorated over the last 3-4 days. The baby is fine, and my cervix seems to be holding this week so I am celebrating those accomplishments, as they are really the two most important things at this point. Aside from those positives, though I am really struggling physically. I am pitifully weak …. the “I-can’t-possibly-walk-myself-to-the-bathroom” kind of weak. Upon standing, my legs immediately begin to burn and it takes incredible effort to move them. Taking ten steps feels like the equivalent to running a 5K. I can no longer stand up for the short time it takes me to brush my teeth. Instead I now have to sit down while I brush because I literally can’t hold myself up for 60 seconds. Even laying still in bed feels exhausting, I have this tingling all over and a heaviness in my chest that makes breathing feel like a chore. I ache everywhere. I just don’t feel normal in any way.

This has been the subject of several discussions of course, first with a few nurses and then with my doctors. Everyone seems to agree that what I‘m feeling is a result of “de-conditioning”, or my body just sort of shutting down due to not moving for such a long period of time. I’ve been in bed for 7 weeks now, though the last 2 here at the hospital have been way more extreme that what I did at home, as I am literally lying still for all but maybe 15-20 minutes a day. I have leg exercises, which the physical therapist taught me the first week here, that I am doing every day in bed. Though I am told the exercises will not really improve my condition, I still do them because I’m hopeful they will slow down further deterioration.

I have a hard time believing that I could feel this drastically horrible just because of “de-conditioning” …. this is not my first rodeo and I’ve done many long weeks of bedrest before and never felt this bad. But there doesn’t seem to be any other obvious reason … my blood pressure is staying up around “normal”; my hemoglobin and hematacrit are low but not insanely dangerously low. I’ve decided that perhaps it’s simply because my bedrest has never been this drastic before now … in the past I’ve always managed to get up for a little bit each day, whether it was throwing a load of laundry in the washer or walking downstairs for dinner. Now I am laying constantly, 99.9% of the day and I suppose that must be what’s making the difference in the way my body has responded.

Emotionally I am finding myself in similar territory. I mostly swing back and forth between moments of intense frustration, sadness, and overwhelming anxiety. I am annoyed and angry at my body, my circumstances, my confinement, and my inability to do even simple things by myself. I am homesick and sad because I miss my kids, my husband, and my old life. And I’m nearly paralyzed with worry and fear because I can’t quite seem to shake the feeling that something awful is about to happen.

Fighting the fear has become a daily battle. I mostly try to not think about the possibilities, and often I’m successful with that. But there are moments when it catches up with me and the anxiety is too strong to ignore. I am terrified at the thought of having a micro-preemie, or worse -- another stillbirth, and I find myself over-analyzing every bump, gurgle, and twinge I experience … Is my water breaking? Am I bleeding? How many contractions have I had this hour? Why isn’t the baby moving? It’s like waiting for the sky to fall. And I realize that, here I am again, now 25+ weeks into the pregnancy and I haven’t allowed myself to bond with this baby and I refuse to even give him a name for fear of “jinxing” it. As if that makes one bit of sense.

I also have equal amounts of worry for my family … this whole experience has been so hard for James and Gracie and Jamin. What condition will my family be in when this is all over? Will my kids be scarred and traumatized because their mother was absent for so long? Will my husband survive the stress of being thrown into single parenthood? Will Gracie be able to focus in school? Will Jamin start acting out in resentment? Already I can see the little cracks forming but I feel helpless to stop them. My kids appear to be struggling a little more this week … Gracie with some attention-seeking kinds of behaviors and Jamin melting down whenever he is separated from his dad and throwing frequent temper tantrums. And then there’s James … he is so strong and he puts on a brave face, but I can see in his eyes that he’s struggling and it hurts me.

I am desperate to go home and I’m hoping that perhaps once I get there some of my physical and emotional conflicts will begin to lessen. I had my 18th ultrasound two days ago and Dr. Mann was pleased … my cervix has lengthened back up to 2.5cm. The polyhydramnios has improved a teeny tiny bit. The placenta has not moved since last week, but my docs are now saying they could attempt a vaginal delivery based on it’s current location.

After the ultrasound, Dr. Mann said she was initially planning to keep me here until I hit 28 weeks, but if I wanted to “try” going home for a bit she would allow it. So we are cautiously planning for discharge sometime tomorrow (!!!!!) as long as my symptoms stay stable. I CAN NOT WAIT. I am trying not to let myself get too excited, in case it doesn’t happen, but that’s really hard to do of course. She warned me that there is a high likelihood I will end up back in the hospital again, and seemed fairly certain that we should anticipate that happening sometime in the next few weeks. From what they’re telling me, most likely I will have to return sometime soon for a magnesium sulfate wash. The possibility of needing this is highly distressing at the moment because I’m told the side effects are awful. More on this later. For now I’m pulling the denial card and it’s working quite well so I’m not ready to give that up yet!

Pray for us.

Magic 24!!!

Today is a day to celebrate.

It's a day of victory .... I have officially reached "viability", 24weeks gestation. This is such a huge deal for us, thank you thank you thank you Jesus!!! If the baby were born today, he would have approximately a 50% chance of surviving delivery, though the chance of severe disabilities is much higher at this point. The survival rates and long-term outlook gets better and better each week beyond 24.

Basically what all of this means to me is that I'm praying for week 28, when the survival rate is over 90%. My plan is to get to week 28 and then to begin praying for week 32! Dr. Mann's ultimate goal at this point is week 34.

Sara brought Jamin up this morning, we were able to visit for about an hour. He makes me so happy. I could just sit here and smell the top of his head all day ...... if only he'd hold still for longer than ten seconds! And some girlfriends stopped by around lunchtime. Jill brought me a ridiculously giant bag of chocolate and Chelley brought some pizza. Yummo.

So overall it's been a much better day today. I'm trying to stay positive and just to be grateful for the fact that we've made it this far. My contractions are picking up a bit this afternoon. I've had several doses of Indocin and will be getting my first betamethasone shot in about 10 minutes (sitting on an ice pack at the moment!) Dr. Grogan and Dr. Matsumoto (aka HOT-su-moto) came up to see me this morning. Dr. Matsumoto warned me that sometimes contractions will start picking up frequency within the first 24hrs after betamethasone. So that's something they will be watching out for.

Nurse just came in with my shot ..... eeeeeeeeeeeekkk wish me luck! :)

NOT HAPPY.

So it turns out that a much-anticipated ultrasound scheduled for "early morning" translates in hospital time to 2:30 pm. I was just about outta my mind all day waiting and waiting and waiting.

They finally wheeled me down just after 2:00 and then I sat alone in an exam room for what felt like an eternity. More waiting.

At last the ultrasound tech appeared, got me changed into the lovely white sheet and we finally got started a little after 2:30. She spent a great deal of time observing and measuring baby's heart, brain, and other anatomy. Repeatedly she kept saying how beautiful and how perfect he looks. Thank you Lord. He is actually measuring big for the first time today -- about a week ahead of schedule. She was very pleased with this, since he's likely to be a preemie so the bigger the better. He now weighs 1 lb 10 oz.

Finally came time for the dreaded "transvaginal" portion of the exam, to measure the cervix. I seriously think I stopped breathing for like two minutes ........ anxiety overload. I've been so desperate for a good long measurement that would allow me to go home.

Alas, not today. Once again I knew the instant I looked at the screen. I could see clearly .... short cervix, and placenta hasn't budged. The tech took some measurements, said she was "stretching it" as best she could for my sake ..... but only came up with 2.0 cm.

I layed there alone again for another 20-30 minutes waiting nervously for Dr. Mann to come in and deliver her verdict. When she finally appeared I could tell she was pretty disappointed too. She knows how badly I want to go home to my family. She apologized and then confirmed what I already knew: I'm stuck here.

She then measured my amniotic fluid and said the polyhydramnios has returned. It's measuring 20 cm, which is not terribly high, but it's still enough to put extra pressure on the cervix and cause it to further shorten. We have seen repeatedly now with the last two pregnancies --- every time the fluid goes up, my cervix shortens. She ordered another 72-hour course of Indocin (my fourth now with this pregnancy), which should help reduce contractions and hopefully lessen the fluid.

She also ordered the betamethasone injections to begin tomorrow. This is a series of 2 steriod shots, given 24 hrs apart, which help to ripen the baby's lungs. It's basically a precautionary measure they take, so that if/when the baby comes early then they've already gotten a jump-start on lung maturity. I've had these before with both Jamin and Gracie so I know they work! Only downside is they hurt like @%$!!!!! ...... way worse than all my other shots combined ....... so I'm definitely not looking forward to getting those again. Maximum benefit of the betamethasone is at 2 weeks after getting the shots, and there is some benefit at 4 weeks post-shot. After that the beneficial effects seem to wain. She said they would repeat them again 8 weeks after, if baby hasn't arrived yet, which would be 32 weeks. They can only be repeated once.

Baby is head-down and sitting low, which - together with the extra fluid - explains the pain and pressure I've been feeling all week in my cervix. I'm reeeeeeally hoping the Indocin may help with this. The placenta has not moved since lsat week, so at this point we're still dealing with a marginal previa.

She's keeping all my other meds the same --- I got my weekly 17P shot yesterday, to fight pre-term labor. I'm still getting my lovenox shots and aspirin every night to prevent a blood clot. Subcutanous terbutaline which I get through my pump 24/7 to reduce contractions. I'm on Macrobid for the bladder infection. Colace and Metamucil twice a day for the inevitable side-effect that happens when you're laying still 23.5 hours a day. I get an additional calcium supplement and a folic acid supplement to counter-act bone loss that's associated with long term use of lovenox. Librax for the irritable bowel syndrome, which allows me to eat. Ambien at night so I can sleep in this awful bed. Protonix and handfuls of Tums for the heartburn. Oh, and a prenatal vitamin. And now of course we're adding Indocin and Betamethasone.

So basically I am single-handedly keeping the hospital pharmacy in business. I hate hate hate hate taking this much medication. Especially while I'm pregnant.

James is on his way up to see me, he tried to sneak out of work an hour early so he could get here before dark this time. I had sat here and cried for like an hour after my ultrasound, and in an effort to cheer me up my nurse called Dr. Mann and requested "wheelchair privileges" for me. This means that my visitors are allowed to wheel me downstairs to a little garden area where I can sit outside for a bit and get some fresh air. I am really looking forward to it .... everyone keeps saying how crisp and fall-like the weather is this week, and I haven't breathed outside air in 8 days so I'm eager to feel it on my face, even if it's just for a few minutes. It might just be enough of a relief to keep me from jumping out the window for another few days.

Please continue to pray for me. Emotionally I'm having a hard time with the idea of being here for another week or longer. My body and mind are both weary. I want my family back. I want my bed back. I want my life back.