The newest member of "Team Wren" ....

..... is a jolly 'ol Scottish lad named Alexander Duncan, or as I've nicknamed him: Dr. Genius. Seriously, this guy is insanely brilliant. And he has spent the last 40+ years researching and treating thrombosis patients just like me.

Most hematologists are actually practicing as an oncologist/hematologist, this was the case with my previous doc, Dr. Munjal, and 95% of other hematologists in practice. These doctors must have a wide range of specialty .... they primarily treat cancer patients and as such they usually specialize in bone marrow, stem cell transplants, and the like. The result is that these doctors, though considered "hematologists", only end up with a basic working knowledge of the less-common hematologic issues like Protein S Deficiency. Dr. Genius, on the other hand, does zero oncology. And he does not specialize in a wide range of hematology problems .... instead his entire career has focused on basically TWO THINGS: 1) Congenital and Acquired Thrombophilia (yep, that's me); and 2) Complications of pregnancy due to hemostasis (hello! me again). He literally sees more thrombosis patients in a week than most "specialists" will see in a year (or at least, that's what he told me!).

He is widely published, highly regarded as an expert, and patients travel from all over the country to see him. Not to mention, he's kind of like a big teddy bear with his irresistible Scottish accent and his grandpa-like demeanor. How fortunate I am that he practices in Atlanta, and moreover that he is now officially the newest member of "Team Wren". I would love to brag and say that I researched this guy and sought him out for his clinical specialty, moving mountains in order to score an appointment with him ... but that's not so. The truth is that I landed in this guys' lap without even knowing it, all of which was God's work and I was oblivious at the time. I consider this the first miracle of Pregnancy #4, and the details are just too cool not to share....

On May 13th I was having my annual "pow-wow" with Dr. Munjal, my hematologist of almost 4 years. Outside of pregnancy, I just see her once a year to check on my numbers and make sure all is well. My last visit with her had been shortly after Jamin was born (April '09), and at that time they actually scheduled my next visit for May 13, 2010. So I literally had this appointment written on my calendar for a full year. Mid-way through our visit, Dr. Munjal began telling me some things about Protein S Deficiency that totally didn't make sense to me .... things which were 180 degrees contrary to everything she had told me for the previous 3.5 years, and things which were completely contrary to everything I'd read and researched.

This was not the first time I'd had a bad experience at her office. Recall Nurse Know-Nothing advising me to "google it" last year when my Protein S #s were dangerously low. There were other little things too, which bothered me from time to time but I ignored them b/c the thought of switching doctors was too overwhelming.

So here I sat in her office that Thursday afternoon, completely dumbfounded and confused by these crazy things she was telling me, feeling like I was in the twilight zone or something. Always being one to wear my feelings clearly on my face, Dr. Munjal obviously noticed my displeasure and finally asked if I wanted a second opinion. I thought for a moment and then agreed to her offer.

She proceeded to refer me to her own partner, at a second office .... gee thanks. When I caught on to that I told them NO THANK YOU, I would like a referral to someone outside of this practice please. The nurse suggested Emory, and I said fine.

A few moments later I was sitting at the receptionist's desk while she set up my referral over the phone and faxed all my medical records over to Emory. I asked her the name of the doctor I would be seeing, she told me she didn't know -- it was a large group with many doctors and they would decide who wanted to see me once my referral went through. I left there annoyed at my experience with my doctor of almost 4 years, but feeling grateful that I would be getting someone else soon who would probably be better in the long run. I wouldn't really need to see them for another year anyways so in the grand scheme of things it wasn't a super big deal.

TWO DAYS LATER I DISCOVERED I WAS PREGNANT.

And immediately it became a super big deal! So as I laid there on the bathroom floor that Saturday night bawling my eyes out, with all the fears hitting me like a ton of bricks, it suddenly occured to me: I don't even have a doctor right now!!! Could there possibly BE a worse time to be in-between hematologists?!? Of course, you know the rest .... I completely freaked out because, well, I am Kristi afterall, and that's what I do.

Monday morning I got a call from a lovely lady at Emory who had received my referral and wanted to bring me in sometime in July or August for a consultation. I sheepishly explained ...... "well, something major has changed ..... uhhhhh ..... I'm pregnant." She managed a polite "Oh my!!" and immediately understanding that July or August would not work, she scheduled me to come in within a matter of days. Just as we were hanging up the phone I asked her the name of the doctor I would be seeing. She gave my Dr. Genius' name .... which I scribbled on a piece of paper .... and as soon as I hung up with her I consulted my good friend, Google. When I pulled up Dr. Duncan's profile on Emory's website I nearly fell outta my chair. Here I had just obliviously fallen into the lap of one of the most highly esteemed experts at precisely the time when I would be needing him most.

Instantly it hit me that God had orchestrated this entire thing, and for the first time in days I stopped crying and felt a bit of peace knowing that God was in control of this entire pregnancy and He already had all the details figured out for me.

Dr. Duncan is the Medical Director of the Special Coagulation Laboratory at Emory University Hospital. He is also the Medical Director of Emory University Hospital's Hemapheresis Unit. And now he's been appointed as the Hematology Director of Douglasville's own Team Wren, which I'm certain has to be the single most minuscule accomplishment of his career but nonetheless I'm quite thrilled to have him!!

Meet Baby Wren #4!

Well, it's official. We had our second ultrasound last week, this time we saw a teeny tiny embryo and a perfect little heartbeat fluttering away at 133 beats per minute. Baby is measuring 2-4 days small but Dr. Garcia feels that all is well.

My actual due date is January 19, though of course our ultimate goal will be 36wks again which would put us around December 22-ish. At this point I feel compelled to confess:

I am still in complete disbelief that this is actually happening.

Dunno why I can't seem to wrap my brain around the whole thing ... we've known for weeks now and yet I haven't seemed to move past the shock and denial of it all. I certainly am beginning to feel pregnant --- a little nausea here and there and fatigue so severe that most afternoons I have to prop my eyelids open with toothpicks. I'm still in the gym twice a week (trying to hold on as long as I can ...) but in general I just feel WEAK. It's weird how something so tiny can physically wreak havoc on you in a matter of days really. From an emotional standpoint I would be lying if I didn't admit I'm feeling quite disconnected from this little life, which I know from experience is just a self-defense mechanism so I'm trying not to heap guilt on myself for it. I know the bonding part will come in time .... I'm planning to not let myself wait until 20+ weeks like I did last time!

I've been back on the lovenox injections nightly for about three weeks now .... needless to say my poor abdomen is completely covered in dark purple spots. I actually never completely got rid of the bruised-tummy look, despite the fact that I was off the shots for a total of 1 year and 4 days. I've been carrying around two gigantic brown bruises, about 2-inches in diameter, on either side of my belly-button for over a year now. These are souvenirs from Jamin. I've had several different doctors look at them (hematologist, dermatologist, obstetrician), and they've all told me various versions of the same thing: these are signs of deep tissue damage caused by repeated trauma of lovenox and heparin shots. They may continue to fade with time, but all of my doc's have gently suggested that I try to get used to them, as they are likely to be permanent without some kind of laser treatment. My hematologist explained that the heparin is probably to blame more than the lovenox ... bruising and scaring on heparin tends to be worse and I was injecting heparin for a total of 16 weeks due to preterm labor, rather than the 2 or 3 weeks we had originally planned. I am quite offended that nobody warned me about this ahead of time! And I'm secretly hoping that maybe if I am able to stick with the lovenox for a longer period of time this go-round maybe I can avoid more ugly scars. Well, a girl can hope anyways. In the meantime I've been trying to rotate my injection sites around every night, in an effort to share the love so to speak, and not bombard one or two spots repeatedly. I have no idea if this means that I am less likely to get two giant areas of "tissue trauma", or if it just means I will end up with twenty little spots of "tissue trauma". I also can't decide which is worse.

A month ago I was actually looking forward to getting a new bikini this summer. Now ........ mmmmm ......... notsomuch. Here is the last "normal" picture I will probably have of myself for awhile, taken on Memorial Day (7weeks) before the bruising got bad:

Please excuse my ultra-grumpy expression .... I think I was annoyed at James because he was rushing me. :) Not my fault ......... it's the HORMONES!!!

Foggy Brain

So much has happened since we discovered our pregnancy shocker, my brain is on overdrive but still can't seem to keep up. Apparently it is still in stage 1: SHOCK AND AWE, and hasn't been able to fully move on to stages 2,3,4,5,6,and 7 which include analyzing repeated doctor visits, scrutinizing lab tests, inquiring about prescriptions, organizing insurance paperwork, and all the rest.

After the home pregnancy test on Saturday 5/15, I called my OB, Dr. Garcia (who I absolutely adore) at my earliest opportunity which was that Monday. He wanted me to come in immediately, so I went that afternoon. He did some bloodwork, which came back showing my progesterone at 35.12 and HcG at 701. So we were happy with those results. The following Friday night 5/21, I began spotting of course. Never fails, I've done this 4 times now! And it always seems to happen on a weekend, when I have no way of getting in to the doctor. The panic set in full-throttle and I laid low all weekend, tried to stay off my feet, and started the internal pep talk where I attempt to convince myself not to worry.

By Monday 5/24 I was back in Dr. Garcia's office for an ultrasound. I was 5w5d along at that time. They could see a gestational sac and a yolk sac, but no embryo. They could also see blood, but couldn't determine where it was coming from or what was causing it. He basically told me it was 50/50, could go either way ... either I had ovulated a little late in my cycle, making it a few days too early to see an embryo, or the pregnancy was not viable and was doomed to miscarry. I tried to stay positive but found that to be difficult, particularly because we had seen Jamin's heartbeat via ultrasound at that same gestational age. He did more bloodwork, and the results came back on Tuesday showing progesterone at 42.4 and HcG at 10,526 ... a very encouraging sign.

Wednesday I saw my GI Specialist, Dr. Manocha, who has been trying to help me manage some problems since February. I was given an endoscopy in March and found to have gastritis, an H.Pylori infection, and Irritable Bowel Syndrome. I've been on multiple medications to help alleviate the pain and symptoms .... all of which I had to stop taking cold turkey the day I found out I was pregnant. Unfortunately there is pretty much nothing he can give me now that I am preggo, so with sympathy in his eyes he told me to call him next year after I've delivered and stopped breastfeeding. In the meantime I guess I will have to grin and bare it, and pray it doesn't get too unbearable. I have days where I have almost no symptoms and I feel fine, and then a flare-up will come and I'll be miserable for several straight days. There seems to be no reason or pattern behind it, though we do know that hormones and stress tend to aggravate it.

Thursday I was back at Dr. Garcia's office to repeat the bloodwork. Those results came on Friday and showed progesterone at 37.3 and HcG at 20,878! In a healthy pregnancy, HcG is supposed to double every 48 hours, so this was a reassuring result for us since it was roughly twice the level that was measured on Monday afternoon. Based on the bloodwork alone, we are now feeling confident that the pregnancy is viable. The nausea and EXTREME fatigue I've started feeling over the last three days are just icing on the cake. Annoying to deal with, but good sign of a healthy pregnancy .... so I'll take it.

I go back Wednesday at 1:00 for another ultrasound and exam with Dr. Garcia. I will be 7w0d so we fully expect to see an embryo and a strong heartbeat!

God has a sense of humor!

Sooooo, after a year's absence, I'm back to blogging. Of course that can only mean one thing:

I AM PREGNANT. AGAIN.

Yep, go ahead and scrape your jaw up off the floor. Don't feel bad, I had that very same expression on my face for a solid week. No I'm not offended. I promise, whatever you're thinking, I've already thought it ten times over.

Everyone seems perplexed, and rightly so .... so to clear up a few common questions let's just get a few of the nitty-gritty basics out of the way:

1. No, we were not trying. In fact, we were actually "trying" to schedule a vasectomy, having just gotten the referral 4 days before discovering the surprise.

2. No, I had no clue. No symptoms, no "little feeling", nothing. Not even remotely on my radar. I had a period, which started ... and then abruptly stopped .... and never came back. After a few days James convinced me to use an old test I had shoved in the back of the linen closet just to put my mind at ease so we could go out and enjoy our date night without any worries. Yeah that didn't quite go like we planned.

3. Yes there were lots of tears. And a few words I'm now embarrassed to admit I said. I actually collapsed in a heap and finally laid on the floor of my bathroom closet sobbing. No they were not happy tears. Let's just say it was not my proudest moment. Among my immediate concerns, were "How in the world are we gonna survive this again?"; "Please don't make me tell my Mommy!"; and "Promise me that no matter what happens I will never have to drive a mini-van!"

4. Yes I've stopped freaking out. And yes, I'm now equal parts excited and terrified. But there's lots of both.

The next question everyone keeps asking me is ... "Scared, but WHY???" Assuming that these folks either have major short-term memory loss or just flat don't get it, I'll clarify. Forget the fact that spilling the beans to my mother felt like the emotional equivalent of being 15 yrs old and telling her I'm pregnant .... I guess I could best describe it this way:

95% of my fear is surviving another pregnancy: The wild ride of ups and downs ... the stress and worry at every single doctor visit, the cervical measurements, the hospital stays, the endless months of bedrest, the shots, the home monitoring, the burden on my husband, my kids, and our family ... watching my health deteriorate before my eyes. In all honesty I don't feel like I've recovered from the last roller-coaster ride, emotionally OR physically. And I still have the stupid bruises on my stomach to prove it.

5% of my fear comes from the thought of what will happen AFTER the pregnancy, at the end of the battle when a healthy baby is finally here, God willing ... I do worry about taking care of three, dividing my time even further, etc ... all the normal mom stuff. The two little ones will be roughly 20 months apart (again, God willing) so that of course seems like a huge challenge, but honestly there is only a very teeny tiny part of my brain that can see past the gigantic hurdle of pregnancy to even begin to worry about these things.

I think I summarized it best when I told a friend recently, I feel like I've just started climbing Mt. Everest without a single day of advance notice or preparation. The mountain that lies ahead of us is giant and rugged and I know it well. And the ugly truth is that I don't have the endurance, or the mental fortitude required to fight my way up to the top. Just the thought of it is overwhelming and exhausting and makes me want to quit. There is no way I'm gonna be able to climb that thing again.

After four straight days of crying I finally calmed down enough to open my stubborn eyes and see that God was already making arrangements and working out the vital details (like my new super-duper hemotologist Dr. Genius at Emory) .... and ever so gently He reminded me that I don't have to climb anywhere. I can just trust that God knows what He's doing and rely on Him to carry my whiny butt up.

So that's my plan.

THE FIRST WEEK HOME

So it turns out that caring for a brand new little life while simultaneously trying to recover from immese physical trauma will make it pretty much impossible to do any blogging.

My apologies.

Our first week home with Jamin was ...... well ....... a DOOZY to put it lightly. We were discharged from Northside on Easter Sunday in the afternoon and happily limped home to settle in. I had been having a lot of pain in the hospital, which I couldn't really understand because I don't remember being in much pain after Gracie was born. They were giving me 2 percocet plus 800mg of Motrin every 6hrs around the clock, which helped but never really took care of it. Since it was a holiday, the hosptial was a ghost town .... my doctor never came by for rounds on Sunday, and so as it turned out I was sent home with zero medication. I didn't sweat it though, just figured I could just take 4 over-the-counter Motrin and tough it out.

First thing Monday morning I made arrangements for Jamin to be seen by Dr. Kaufman, our fantastic pediatrician, because I could tell he had jaundice. We noticed it developing in the hospital, but the stupid on-call pediatrician there refused to test his billirubin levels for some reason. He is high risk in the first place simply due to his prematurity, and also the fact that we were exclusively breastfeeding. We could see him turning yellow, but they kept telling me he was fine.

Lukily Dr. Kaufman knows I am a vigilent Mommy, so when I called they told us to come right in. They confirmed that he was definately jaundiced and did a heel stick to test his billirubin. We also saw the Lactation Consultant while we were there to work out the last few kinks in our breastfeeding routine. At this point Jamin was nursing well and we were really starting to get the hang things. He and I make a really good team!

We had to run next door to Douglas Hospital to drop off the blood sample at the lab for the billirubin test. But to do this, we had to register Jamin as an "outpatient" of the hospital. Ahhhhhhh, yes ......... that means ridiculous waiting for some slow hospital employee to fill out 2 pieces of paperwork. While sitting in the waiting room I suddenly had this excrutiating pain in my upper-middle back. It was a sharp stabbing pain on my right flank. It came suddenly and the tears were immediate. James kept asking, "What happened? What did you DO?" and holding back sobs I could only manage to say "Nothing! I was just sitting here!" The pain was so intense and it hurt each time I took a breath. Mercifully, the slow lady finally called our name, processed our admission and got us out of there. I crawled home and took another 800mg dose of Motrin, which pretty much did nothing.

Tuesday morning I called Dr. Garcia's office about the pain and they instructed me to come in at 3:00. But first we had to go back to the pediatrician's office, as Jamin's jaundice was worsening. He was nearly glow-in-the-dark yellow at this point! They did another billirubin draw, which they found to be 14.1 (in the moderate range) and checked his weight. He was down to 5lbs 6oz. I left there and went straight to my own doctor's appointment, but had to see Mia the midwife since Dr. Garcia was in surgery. She walked right in and told me I had a bladder infection .... had the prescription for an antibiotic already filled out and in her hand. She didn't listen to a single word I said or give me more than 2 seconds to ask questions or voice my concerns. I explained that the pain I felt was high up in my upper-middle back on the right side, how could this be since your bladder is way down low in your abdomen? She brushed me off and mumbled something about me feeling much better by tomorrow on the antibiotic. I tried to explain that I was in immense pain and 800mg of Motrin was not helping ... to which she suggested I could also take some Tylenol.

As if that was going to help.

Annoyed, I grabbed my prescription and left. I figured I would just tough out the pain one more day, since she assured me that I would notice a huge improvement in 24 hours.

That night I woke at 2am to feed Jamin. I literally could not stand up out of bed, the pain was so horrible. All I could do was lay there and moan. I also began shaking uncontrollably with chills, which I've never had before. James panicked and called Dr. Garcia's emergency line, and the nurse there of course told him to take me to the ER. I refused to go. Why would I want to sit in the ER waiting room at Douglas Hospital for another 6hrs, to have some yahoo give me a pain pill and tell me to follow up with my doctor? NO. If I'm gonna sit in pain for 6hrs, I'd like to do it from the comfort of my own bed, and by 8am Dr. Garcia's office will open and I can actually receive some treatment. James thought I was nuts but knew that once my mind is made up it's a fruitless arguement on his end.

So as soon as the office opened Wednesday morning, I called and went in to see Dr. Garcia, who was thorough and attentive as always. He said his guess was something with my kidneys, since they are way up high in the flank area (right where my pain was), and since I was having pain while breathing. Apparently your diaphram is adjacent to the kidneys, so each time you take a breath your kidneys get "bumped" a bit and can result in intense pain. The midwife, of course, would have figured all this out if she had taken 5 seconds to LISTEN TO ME the day before. The other possibility, he said, could be pulmonary embolism, since the pain was sudden onset and followed a "thrombophilic event" (i.e. giving birth) by 2-3 days. With my blood clotting disorder, a PE is one of the most serious risks I face and the highest time of incidence is the post-partum period. He assured me that a kidney problem was way more likely than a PE, but given that a PE can be fatal ......... we want to be 100% sure of course.

So off I went, BACK to Northside Hospital. My new home away from home. I told the admissions lady that I wanted a frequent-customer punch card .... "stay 10 nights get the next night free" or something similar. Soon after getting a room and settling into bed the chills came again and a new wave of pain had me in a heap of tears. The doctor came in to get my history, at which point I cried, apologized for being a wimp, and then cried some more. Apparently he could tell I was in serious pain because his first order was for IV Dilaudid. That marked the first time I had been pain-free, which felt fantastic, but sadly only lasted for about an hour. This was followed by a CT scan of my lungs, which required contrast dye to check for PE .... then an ultrasound of the kidneys to check for kidney stones .... followed by more Dilaudid .... followed by more IV meds to keep me from puking because of the Dilaudid .... followed by an IV of antibiotics ... and finally ending with something in my IV which just knocked me out cold. Seven hundred hours later I was finally discharged and sent home with a diagnosis: super-duper infection of the kidneys, with a touch of pleurisy. And, oh yeah, I still had that bladder infection too, but compared to the rest it has gone pretty much unnoticed.

So .... Good news: Kidney infection + pleurisy = easy to treat. Bad news: More painful than childbirth.

And worse yet, as a result of my latest hospital adventure, we were forced to stop breastfeeding. I was at stuck there for 8-9 hours (during which time James was at home feeding Jamin a bottle), and then when I got home I was unabe to move for another 8-9 hours (more bottles). James did 100% of the baby care during this time. Once I was finally up and around again, I had to "pump and dump" for 24 hours, because the contrast dye I was given during the CT scan is excreted in breastmilk. By the time I had pumped for 24hrs and had reached the point to safely feed again ...... my milk was gone. Seriously, dried up, not a drop left .... GONE.

I proceeded to cry about it the remainder of Thursday and most of Friday.

I am still completely devastated about the whole thing. He and I were getting so good at it, he was happy, I was happy, and then ....... we lost our milk. SO. NOT. FAIR.

Friday we were back at the pediatrician, again ...... to check billirubin and weight a third time. Good news on both fronts: billirubin is down, and weight was up to 5lb 9oz.

James returned to work Monday so this week it's been just me and the kids! We are adjusting well. Jamin is a laid back, roll-with-the-punches kind of guy. Thank you LORD! He is so precious and sweet and insanely tiny and omigosh he smells so good. Gracie has totally embraced the "Big Sister" role and adores her brother. I am sleep deprived, and physically functioning at about 40-50%, but otherwise fine. Emotionally I feel good, much less hormonal and wacky than I felt after Gracie was born. I did have one weepy moment two nights ago .... at 2am rocking Jamin is his blue chair. I was professing my unending love for him (!! don't all new Mommies do this ??), when I was suddenly overcome with sadness wishing I'd had the same opportunity to say those things to Isaac before he died. I only cried for a few minutes, then pulled myself together and moved along. I think one weepy moment is allowed considering all we've been through.

We are hoping that weeks 2 and 3 are much more relaxing and less drama-filled! Thank you all for your continued prayers and sweet thoughts. I will try to update more regularly as my (lack of) schedule allows!

A day of MIRACLES

Well, friends .... I have given birth to angel. I am so in love with him that it hurts. Here are the labor/delivery details, I will try to keep it brief (which clearly you know by now, is tough for me).

Pitocin and saline started about 7:30 am. The contractions instantly became quick and pretty painful. My awesome nurses had already called down to pharmacy and had a special epidural concoction (without fentanyl) waiting here for me so there was no delay. I had a long and detailed pow-wow with the anesthesiologist to discuss all the risks with the heparin and the fentanyl allergy. We had the epidural placed around 8:00ish. I had forgotten how scary that is, whewwwwwwww. Especially after the guy has just explained my risk for a spinal hematoma and paralysis.

About 5 minutes after the epidural, my blood pressure went down to 80/39. The anesthesiologist began running frantically and within seconds produced an injection of norepinephrine . That brought it back up a bit, but it never got higher than 90's/40's.

By 8:15 I couldn't feel my legs. Actually couldn't feel much of anything at all. At one point I even asked the nurse, "Am I still having contractions?". She replied, "ummmmmmmm, YES, they are huge and coming every 2 minutes!".

THANK YOU JESUS FOR THE EPIDURAL!!!!

At 8:30 the midwife, Joy, came and broke my water. I was so numb I didn't even blink. She reported at that time that my cervix was 4-5 cm dilated and 100% effaced.

Shortly thereafter, my beloved Dr. Garcia stopped in with a very uncharacteristically serious demeanor. He explained that he had a family emergency, his son was being transported to the hospital, and he was uncertain if he would be able to deliver me because he would be leaving at some point.

At first I kind of panicked, but then I reminded myself that God had already answered every prayer and that He had orchestrated every detail so I was trusting that it would work out regardless. We continued to hope that Dr. Garcia would be available, but made a back-up plan for the midwife Joy to deliver if necessary.

Between 9:00 and 10:30 I rested comfortably. Laura arrived with Gracie, Jessica with Adam, and my parents were both here. I was completely calm and relaxed with zero pain. Honestly if there hadn't been anyone else in the room I would've just fallen asleep. My mom stood by my bed and rubbed my legs, and I just layed with my eyes closed. I felt just an overwhelming sense of peace and calm. I did not worry, I did not obsess over details or what-if's, I didn't give any thought to all the things that could go wrong. THIS IS TOTALLY UNLIKE ME!!! So clearly the hand of God was at work! I swear I could feel His presence so close in that room and somehow all the scary things just melted away.

Around 10:45 the midwife came in and asked if I was feeling pressure like I wanted to push. I reported that I had not felt any pressure at all. She explained that she was watching my monitors out in the hall and it looked to her like it might be time for me to push. As she was talking to me about it, another contraction came and I did feel some pressure. So she checked my cervix and said, "the baby's head is HERE, it is definitely time to push, DON'T MOVE!"

I was shocked! I hardly felt anything at all, no pain, just a tiny bit of pressure.

My room was soon filled with nurses setting up equipment and making preparations. Joy paged Dr. Garcia and got his voicemail. She didn't even know at that point if he was still at the hospital or not. She stood with me and held my hand while we waited for a call back. I was praying that he would respond, but at the same time was not afraid of what would happen if he did not. Joy waited by my bedside with the phone in her hand for 8 or 10 minutes. Every two minutes or so she would lift my blanket to peek, and would say, "okay, I don't see the head coming out yet so we are okay to wait another minute or two". She told me I had to stay on my side and hold still because if I turned to my back then Jamin was going to come out. Totally crazy!

Dr. Garcia did call back, praise God, and a few moments later he came in the room, slipped on a pair of gloves, and began giving me instructions on pushing.

I started pushing at 11:05. I pushed through three contractions. Again, almost no pain. After the third contraction Dr. Garcia reported I was about to tear and asked my permission to do an episiotomy. As soon as he did the episiotomy, he asked me to give one small push. I did and at 11:15 Jamin fell right out! He was crying before his trunk and legs were even delivered! We knew in an instant that his lungs were just fine, THANK YOU JESUS!!!

I immediately told James that the labor and delivery were seriously the EASIEST part of the whole pregnancy! And it's true. All the months of injections, IV's, blood draws, medication side effects, blood pressure issues, and sleepless nights ....... truly a million times more difficult than actually giving birth.

As you can well imagine, we are just overwhelmed with gratitude for what the Lord has done. I can honestly say I have witnessed Him perform an absolute miracle with my own eyes. He carried us through an onslaught of nightmarish obstacles, and ended the journey by answering every single one of our prayers. Tonight I look back on my posts from earlier this week, I look at all those prayer requests, and I smile. God must've just used that like a check-list or something. He met every need, even those that seemed almost impossible. And then He poured his presence over us so heavily today, at every single stage of the labor and delivery, His hand was there and every single thing just fell into place beautifully. We could never have imagined a more perfect experience.

Tonight the three of us are resting and just staring at eachother in disbelief! Jamin is being a little lazy with the breastfeeding, he just wants to sleep and sleep and sleep. We have hardly heard a peep out of him since he got here!

Please pray for James and I to get some rest tonight. And please join us in giving praise and glory to the Miracle-Maker!!!!

update per James "the trilogy"

"kid Awesome" is here! 5lbs 13oz and 18.5 in. he's handsome and agile! Kristi is doing great and Gracie is PUMPED! WREN out..

update per james volume 2

time to push, pray for me to be tough and I guess Kristi too!

update per James

probably wont be quite as detailed but here goes. they came in and broke Kristi's water about 30 min ago and now she is resting. Dr. Garcia may not be able to be here due to a family emergancy so if that is the case we will go with planB. the midwife. Kristi asked for you guys to be praying for Dr Garcia and his family as well. Wren OUT!

Getting Started

FRIDAY MORNING 7:40AM

Got up around 6:00, never could go back to sleep. Got a quick shower, which felt great. They've just started my IV, with pitocin and saline. I have to get another bag of saline in me before we can do the epidural - so that should be another 30 minutes or so.

The midwife is coming up in about an hour to break my water. Should go fast after that.

SO SLEEPY

IT'S 4:00 am. I AM UNFORTUNATELY AWAKE.

Contractions are very very painful. Having lots of pressure and pain in my cervix. I'm not hooked up to anything -- no monitors, no meds. They seriously haven't laid a finger on me other than the two little blood draws they did when I first arrived last night.

This pain is making me think I'm continuing to dilate. I don't know if I'm in "active labor" or not. But I do know my body well enough to declare that Jamin will be here today, whether they give me pitocin or not! He is coming on his own accord. So much for "induction"! Boy God's timing just amazes me sometimes.

I slept a bit from about 1:00 until 3:15 am. But been up since then. The contraction/cervical pain is keeping me awake, as well as really bad pain in my back. I'm also having trouble getting comfortable in bed due to the soreness in my belly at the spot where the amniocentesis needle was inserted yesterday morning. It is very sore to any movement or touch.

My bloodwork showed platlets at 173 and PTT was 26, both within nomal range. Praise God! So we are safe to go forth with the epidural. They are calling downstairs to pharmacy to make special arrangements for an epidural mix without fentanyl.

James fell into a coma-like sleep about 2.4 minutes after he laid down last night -- actually before the nurse even left my room and all the lights were still on! He has slept like a log all night and doesn't seem disturbed by the fact I'm up going to the bathroom every thirty minutes!

Pitocin and epidural should get started around 7am. I've got less than 3 hrs to get some rest. Please pray for epidural free from allergy problems, normal blood pressure, labor/delivery with no complications, Jamin healthy and strong.

Stay tuned .............

Jamin is halway here already, LOL!

THURSDAY NIGHT UPDATE, PART THREE:

10:30pm: Really quick ... Mia just came in and checked my cervix. I am already 4cm dilated and 90% effaced! Jamin's head is at +1 station, holy cow! She said they will start pitocin and epidural around 7am, then break my water. She said Jamin will most likely be here before lunch, in her opinion way before lunch in fact.

I am not hooked up to any machines or IV's for the night. So we can actually SLEEP! My nurse just came in and did a blood draw so they can run a PTT test. This will check my Factor X (clotting factors) to make sure it's safe to have the epidural tomorrow. Should have those results within the hour.

WE ARE GOING TO BED .......... GOODNIGHT!!!

T minus 9 hours

THURSDAY NIGHT UPDATE, PART TWO:

A quick update .... we're here at Northside. The admissions process was farily quick and painless, praise the Lord! I am in room C2 on the ground floor. My nurse is Rachael, she is super sweet.

We just finished the 60minute process of paperwork. I am hooked up to the monitors waiting on the midwife, Mia, to come by to confirm Dr. Garcia's orders for the night. I think we've got the Cervadil confusion ironed out, so I'm relieved about that.

I'm soooooooooooo extrememly tired, I'm really wanting to unpack my bag and get ready for bed so I can go ahead and get some sleep. Problem is I'm not allowed off the monitor until Mia gets here, so I'm stuck waiting for a bit. I'm so desperate for some shut-eye!

I'm anticipating that Mia will order IV fluids through the night like Dr. Garcia had planned, and then we'll begin pitocin first thing in the morning when he arrives. Should be early, like 7:30ish.

James is THRILLED with our room, because it has an actual "bed" for him rather than the fold-out chair thingy that requires the bottom 3 feet of his body to hang off the end! He says he feels like a frat boy in a dorm room. :) Then he noted that the only thing cooler than this arrangement would be if we had bunk beds.

Please continue to pray for us: good sleep tonight, no labor until the morning, labor/delivery free of complications and a healthy strong baby.

We will update in the morning...........

GREEN LIGHT!

THURSDAY NIGHT UPDATE

So ............. not much time, it will be short:

Got the call from Northside Hospital about 6pm. Amnio results are in and showed mature lungs! Praise the Lord, all our prayers are being answered one by one!

Laura just came and picked up Gracie. James and I sat down and ate Monterrey's take-out for dinner ... I pigged out majorly since I know that once I arrive at the hospital they will not allow me to eat until after delivery.

James is loading up our bags right now and we will be on the road to Northside in about 10 minutes.

Please pray for smooth admissions process. There was some confusion on the phone with the nurse who called me, she said I was scheduled for a "Cervadil induction". Cervadil is a medication that is commonly given the day before induction, it is inserted vaginally and softens the cervix in preparation for the next day. However, Dr. Garcia specifically told me last week that he does NOT want me to have Cervadil tonight, because I am so "ripe" that it will likely put me in to labor and I would end up delivering before he arrives at the hospital tomorrow morning. I explained this to the nurse over the phone .... she said we would worry about it once I got there.

So please pray that this issue is corrected easily with minimal stress. Also pray for no delivery overnight! Jamin can't arrive until AFTER 7am tomorrow morning!!! Please pray for James and I to get restful sleep tonight, and for Gracie to continue to feel better tomorrow. And of course, the biggie: pray for a supernatural labor and delivery with no complications, and Jamin strong and healthy!!

Will update again once we are settled into the hospital and have a room number, etc.

THANK YOU SO MUCH FOR PRAYING!!!!!!!!!

Countdown: T minus 18 hours

THURSDAY MORNING UPDATE:

I can't start without first thanking each of you from the bottom of my heart, for your continued prayers and encuraging words. God is doing miracles already today and there is no doubt in my mind that He is hearing each of those prayers. Please keep 'em coming!!!!

I got about 6 hours of sleep last night. That was miracle #1!! Gracie slept like a total log all night long ........... miracle #2. Mom drove me to Northside this morning while Laura stayed at the house with Gracie. We ran into some traffic but made it there in about an hour: miracle #3!

I had my 18th (and hopefully final) ultrasound, and Jamin looks fantastic: miracle #4. They estimate he weighs about 5 lbs 14oz. Then Dr. Mann came in to do the amnio, at which point I was so terrified I was trying not to shake. It went well and we survived: MIRACLE #5!!!! It hurt pretty badly, but only lasted for like 30 seconds. I kept my eyes closed, focused on holding very still, and just prayed through the whole thing. So I didn't see anything scary, but my mom reported it was not a pleasant site to observe. I was then hooked up to the NST monitor for about 20 minutes after the amnio, just to make sure the baby was doing okay after the procedure, and all looked well.

On the way home I called Laura to check on Gracie. She reported that Gracie woke up in a fantastic mood and seemed to be feeling really good, she ate a banana and some water for breakfast: MIRACLE #6!!! What a giagantic relief!

I then got a call from James telling me that WWIII was avoided and our family drama appears to have reached some peaceful resolution: MIRACLE #7!!!!

So much has turned around in the last 12 hours .... oh the Lord is at work!!

I've been resting and trying to stay off my feet as much as possible since I returned home. Laura went back to work and mom has gone home, so it's just me and Gracie for now. She is perky and energetic like her "normal" self, and has had a piece of bread and more water and a lollypop in the last hour.

Please continue to pray for us. We are expecting to get a call with amnio results sometime between maybe 4:30ish and 6:30ish tonight. At that point we will get Gracie handed over to her Grammie, and James and I will head back to the hospital for admission.

Please pray for: mature lungs, minimal confusion receiving amnio results and coordinating admission, and decent sleep for James and I tonight. Also please pray for traveling mercies for my sister, who will likely end up on a red-eye flight tonight from Colorado back to GA.

God is in control of all of these details and so much more! We are so incredibly grateful for your prayers!

I will update more tonight as things change ...........

Don't worry ... my hissy fit has passed!

First of all, a tremendously gigantic thank you for all of your prayers. God is hearing! I am feeling much better tonight and I think I'm done with my panic. So sorry you all had to witness that, gag!

Gracie continued throwing up until about 2:00 today. Since then she has held down a popcicle, 1.5 pieces of bread, a small cup of applesauce, and about 8 ounces of water. Thank you Lord! Still no fever. Please continue to pray fervently, that she rests well tonight and has no further vomiting or fever at all tomorrow!

This evening after James finally got home I snuck out to have a pedicure. There's a little nail place about 500 yards from my neighborhood, and I was super desperate for a quiet moment away from the stress at home. Boy it did me a world of good! Having someone rub my feet for an hour made me feel like a million bucks! PLUS ....... the added bonus is that my toes are beautiful and I won't have to be embarrassed at the hospital. Well, okay, let's be realistic: LESS EMBARRASSED at the hospital, given the fact that I'll be naked from the waist down and chances are no one will be looking at my toes anyways. But I digress .........

By the time I left the nail place it was already dark. Driving home, I looked up and noticed that the moon was full and round. And it hit me like a ton of bricks: it will be a full moon this weekend when Jamin is born. This probably doesn't seem significant to you, but let me explain.

Isaac was born on a full moon, back on September 2, 2006.

Ever since that time, I see a full moon and immediately think of Isaac. I can't tell you how many nights I have spent over the last 2 1/2 years, staring at a full moon missing my little boy. For a long time the sight of it made me incredibly sad. But as time has passed, seeing a full moon now brings a smile instead of sadness. For me it feels like a connection to Isaac.

So tonight, driving home, after a marathon-stressful day ....... to glance up and see that moon was quite a moment. And knowing that Jamin will be born on Friday, when the moon is still full, that just seems so perfect to me. I feel like Isaac was sending me a little message ..... "I'm here, Mommy. I'm fine. And you guys will be fine too!"

I continued driving, my mind trailing off .... just feeling grateful for that moon and that moment. Suddenly I began hearing some words repeated over and over on the radio, which was playing quietly in the background. I turned up the volume. It was a song I'd never heard before. Repeatedly, this guy was singing:

"God will lift up your head"

"Your story soon will end in joy, end in joy, end in joy"

I have no clue who sings this, as I haven't been driving lately and therefore haven't been listening to the radio much at all. But those words stung my heart and instantly I felt an overwhelming peace hanging heavily over me. Yes, I cried a little bit. I *am* a wimp, afterall. But if you've ever been in a situation where you have clearly sensed a very close presence of the Lord, you'll understand why there were tears.

He always knows just what I need, and when. Tonight I just needed a little reminder that He is here, He is in charge, and He's got all this covered.

Who among the gods is like you, O LORD ?
Who is like you—
majestic in holiness,
awesome in glory,
working wonders?

(Exodus 15:11)

Limping to the Finish Line

Or really, it would be more accurate to say:

DESPERATELY CLAWING OUR WAY TO THE FINISH LINE.

We now have just two days left until Jamin's arrival, and let me tell you, we are being pummeled from every angle. Please forgive me if this post comes across as super whiny. I'm trying not to whine, truly I am. But I am so overwhelmed, seriously I just need to vent for a moment.

My contractions are growing ever more frequent and painful with each passing hour, every time I think they can't possibly get any worse .... they do. I am contracting about every 6-10 minutes, even though I'm now on the maximum dosage of terbutaline. I also have significant pain way low in my cervix, which does not go away despite hours of laying in bed. I'm guessing that I have to be continuing to dilate. If Jamin is not halfway outta me by the time I arrive at the hospital Thursday night I will be shocked.

Being on the max dosage of terbutaline has me geeked outta my mind. Man, that stuff is nasty. I was on it for nearly 5 weeks with Gracie, and now 12 weeks on/off with Jamin ...... but seriously I am still shocked sometimes at how awful it can make you feel. I am constantly trembling, heart racing, and sometimes have difficulty catching my breath. It's also doing a number on my already problematic blood pressure. Needless to say, sleep is pretty much out the window at this point.

I am still checking Gracie's little head twice a day for nasty bugs. So far we seem to be in the clear, THANK YOU LORD. But Doctor Kaufman says we're not quite out of the woods until Friday. So I'm optimistic, but afraid to declare victory too soon on that one.

My babysitter, Brandi, has landed herself in the hospital now .... complications with her blood pressure and potassium levels. Please pray for her and baby Savannah! Her absence is sorely missed, as I haven't had any help here at the house all week and I am pretty much totally unable to do anything by myself right now.

"THE" family issue that I've been praying about is not resolved, in fact it's only grown a million times worse. I was up at 4:00am this morning having a panic attack over this whole mess. I am trying not to break under the stress, but I'm close.

And last but not least .......... the coup de grâce ............ Gracie woke up at 7am this morning vomiting. James took her to the doctor, where it was determined that she has an unidentified stomach virus. We have no idea at this point how long she will be sick or when she will be passed the contagious point. She has not developed a fever yet, which is the yardstick by which the doctors generally determine the contagious period. We were instructed that if she has no fever and no vomiting by tomorrow, she is fine to come to the hospital to meet her brother on Friday.
But if she has any fever or any vomiting tomorrow, then she has to stay away. I haven't even had the heart to tell her yet .......... she will be DEVASTATED. As I am. All we can do at this point is wait and see.

In the meantime, James and I are washing our hands so feverishly that the skin is ready to fall off. We are praying that she recovers quickly, and that neither of us contract it. We are feeding her small sips of pedialyte, which seems to be our only option as she was throwing up water earlier today. If/when she keeps down the pedialyte for 8 solid hours, then we can try some bread or applesauce.

I am desperately begging for your prayers!!! We are so overwhelmed and my brain can hardly function at this point. I truly want to just break down and cry for a bit, but I don't even have the energy to do that.

Please pray for:
1. Gracie: no fever, hold down foods, recovery by tomorrow, no head lice.
2. James and I: no stomach virus, a few hours of sleep, maintain sanity.
3. Jamin: mature lungs by tomorrow!
4. Pregnancy complications: amnio tomorrow morning with no problems, normal blood pressure, contractions and cervical pain under control, NO SPONTANEOUS LABOR.
5. Gigantic family thing: resolution before WWIII breaks out.

Okay, that's all my brain can handle for now.

Preserving the Journey

Well let me just start by saying that I am one lucky girl. I have been so fortunate to have TWO very talented photographers capture a few of my pregnancy moments. The resulting images tug at my heart strings and thrill my mind to know that a little piece of our journey will be preserved forever.

Andrea Vantrees is a photographer from Douglasville. She came to our home and photographed the whole family. She was so much fun! Here is a peek at the results:

Right now Andrea is working through the painstaking process of digitally removing the ugly tummy bruises from each picture. By the time she is done, no one should ever know about my love-hate relationship with Mr. Heparin.

Check out Andrea's website to see more: http://www.andivanphotography.com/index.php?splash=1

Makin' plans

Today was a super busy day. It began at 9am when I got a phone call from Gracie's beloved preschool teacher, Mrs. Meyer, who apologetically informed me that Gracie has been exposed to head lice by one of her classmates. Isn't that fabulous timing? I seriously had to hold back the tears on the phone, I simply can not add anything else to my plate right now. I am completely overwhelmed as it is, both emotionally and physically, ughhhhhhhhhhhhh.

So I've been nervously checking her sweet little head every chance I get, and so far I don't see anything. I am PRAYING that nothing materializes, I will just lose my mind if I am having to fumagate my entire house and scramble to rid my baby of nasty bugs next week on top of preparing for Jamin's arrival. I am seriously way over my stress limit as it is.

My blood pressure problems have been worsening this week. This is something that we've been fighting for the last 6 weeks or so - my pressure basically drops super low periodically throughout the day. I will have these episodes where I feel totally fine one moment, then tingly and faint the next minute. They have been giving me IV fluids at the hematologist to try and help boost my pressure, but that only helps for a day or two at best. Wednesday I had Brandi take me to the fire station since it's right around the corner from my house .... my pressure was 86/40. The paramedic explained (and my doctor's have confirmed), that basically this is a result of me being a thin person, and my body is just overwhelmed with the pregnancy and all the medications I'm on.

My contractions have been increasing to insane frequency this week as well. I'm regularly having 6-7 contractions per hour ... earlier this week I topped out at a record 9 in one hour. I am feeling very heavy and painful pressure down "THERE"; I swear when I get up to pee I'm thinking, "Jamin please don't fall out!". It's crazy. I can definately attest to the fact that my body is about to give up on this whole pregnancy thing.

My mom arrived at noon today to drive me to my TWO back-to-back doctor's appointments. I saw Dr. Mann first, and had ultrasound #17. Jamin looks great, he weighs approximately 5lb 11oz! (This should put him in the neighborhood of about 6lb 3oz at birth.) I then saw Dr. Garcia, who felt my cervix and reported I'm about 2cm dilated and still 80% effaced. He looked me square in the face today and said, "I absolutely can not believe you are still pregnant!". I told him ... me neither, but my God is in the miracle business!

We are all set up for next week's induction. Here's the plan at this point:
Thursday 4/9 I will have the amnio at 9:30am, performed by Dr. Mann at Northside Hospital. She must have the sample off to the lab by 10am in order to receive the results back same-day. We are expecting results around dinnertime Thursday evening. This will be after office hours, so it will be the on-call physician who will call my house with the results. If we get the green light, then we will grab our bags and head to Northside Hospital to be admitted (late) Thursday night. They want to have me in a room and prepped the night before the induction.

Because I've been having issues with my blood pressure, Dr. Garcia wants to "drown me with fluids" he said .... his goal is to get about 3bags of IV fluids in me between Thursday night and Friday morning. He will arrive Friday morning 4/10 around 7:30am to begin the induction. He will start a pitocin drip and break my water and hopefully it will be quick!

I will have to come off my aspirin this weekend, and off my heparin by Wednesday, so that it's all out of my system 24hrs before the amnio. By induction time it will have been 48hrs since my last heparin dose. This is pushing it a little to have no anti-coagulants for this length of time, but my docs are confident we'll be okay. At least with plenty of time for these meds to wash out of my system, it means it should be safe to get an epidural, which is a gigantic relief for me!

We WILL have to take special precautions with the epidural, since I'm allergic to fentanyl (one of the narcotics commonly included inside the epi). Dr. Garcia says the anesthesiologist should be able to exclude just the fentanyl and leave the rest, and I should still get adequate pain control. The epidural also lowers your blood pressure, so they will be watching me closely for that. The 3 bags of fluids should help combat this problem.

SOOOOOOOO .... hopefully we will have a healthy baby here by Friday afternoon! I will plan to take the laptop with us to the hospital, and I'll have James try to post an 'announcement' on the blog for everyone.

We will re-start the heparin approx. 12 hours after delivery. That will continue twice a day for 6 weeks post-partum. It is safe to take while breastfeeding.

Please be much in prayer for us as we limp through these last few days! Here are the specifics that are worrying me:
1. No head lice for Gracie .... PLEASE JESUS!!!
2. No spontaneous labor, Jamin needs to hold on until Friday 4/10!!
3. Safe amnio on Thursday, minimal pain with NO COMPLICATIONS
4. Fast amnio results showing MATURE LUNGS
5. Minimal confusion receiving amnio results and coordinating hospital admission
6. Decent sleep Thursday night for both myself and James.
7. Maintain safe blood pressure levels
8. Labor free from complications and Jamin HEALTHY AND STRONG at delivery
9. Resolution of a family thing, which I can't discuss, but the Lord knows what it is .... please just pray for "THE issue" to be resolved with minimal stress and hurt feelings.

I am so so grateful for your love and prayers, for your phone calls, for your sweet offers of help, for the food you've sent, or your words of encouragement .......... THANK YOU!!! The Lord has truly just carried us through this whole journey, and one way He has done that is through the generosity of our friends and family. To Him be all the honor and glory forever and ever, amen!!!

She's CRAFTY ..... and she's just my type

So I'm not sure if I've mentioned it yet ..... but I've spent a lot of time in bed lately.

As I lay here day after day I often find myself falling into the tried-and-true Kristi habit of worrying endlessly and obsessing over scary pregnancy things. So to keep my brain occupied, lately I've been working on little projects when I feel well enough to get out of bed. Don't worry ... I don't go far! Just to the little card-table in the corner of my bedroom where I've set up my sewing machine.

My first project were the curtains I made for Jamin's nursery:

Once I started sewing again, the crafty bug really took over and I decided to try some new things. I made this blue chenille liner for Jamin's laundry basket. It matches his room perfectly!

Then I switched my focus from room decor over to clothes. I started making fun appliqued onesies, which was a totally new thing for me. I'm so impressed with how cute they turned out, and I can't wait to see my little guy wearing them!

I even made some girl onesies for my babysitter, Brandi, who is expecting a daughter, Savannah, just 9 days after my own due date. It was fun to finally work with some pink fabric!

The next thing I really want to learn is to sew baby pants. I wish I had time to try it out before Jamin gets here, but at this point I'm struggling to wrap up all my projects in preparation for next week's induction .... so tackling NEW things at this point seems unwise. Oh well. I will teach myself to do it one day! :)