Solitary Confinement; Day 3 of 148

Friends, I have landed myself in the Slammer. The Big House. The Black Hole. The Pen. Or as my doctors and I like to call it:

THE COMPLETE LACK OF INDEPENDENCE AND MISERABLE CONFINEMENT ALSO KNOWN AS EXTENDED BEDREST.

Ugh. Extended .... as in .... a really long period of time. Twenty-one full weeks to be exact. Or 148 days. Or 3552 hours. But who's counting?

The last few weeks have been crazy and overwhelmingly stressful and ....... let's just say I haven't been in the best mood. Needless to say, blogging has landed somewhere around #450 on my list of Top 500 Things to Worry About. So while there are so many complicated things going on at the moment (more than I can possibly blog in one sitting), let me try to summarize how I got here:

12.5wks: I started having contractions

13wks: I began the weekly 17P injections and was told to reduce my activity and "put my feet up" as much as possible. Though Dr. Mann never explicitly said the dreaded "B" word, James and I knew what was coming and decided to plan ahead. So we began searching for a nanny to help out here at the house during the week.

14.5wks: My home nurse started making her weekly visits. I had ultrasound #10 and found out we are once again on TEAM BLUE - it's a boy! Dr. Mann also discovered I have Placenta Previa. These are categorized in order of severity as marginal, partial, or complete. Mine is a Complete Previa ..... because, it just wouldn't be a Kristi pregnancy if it weren't the worst case scenario, of course! I was told there was a "very good" chance the previa would resolve on it's own as the pregnancy progressed. If it didn't resolve, however, this would exponentially complicate matters since the biggest risk with a previa is hemorrhaging and of course I'm on blood thinners (Lovenox and Aspirin, to combat the Protein S Def), and also I tend to have early cervical thinning / preterm labor which in the case of a hemorrhaging previa would require immediate Csection, and could potentially be a very premature delivery.

17.5 wks: We hired a nanny, though she needed to work out a notice with her previous employer so she hadn't started yet. I had ultrasound #11, at which Dr. Mann reported a slight improvement in the location of the placenta, though I still had a complete previa. But she was hopeful that it may continue to move and eventually resolve itself. My cervix measured 3.5 cm long, which was down from my last measurement (4cm) a few weeks ago but still on the lower end of the "normal" range so cautiously we considered this a bit of good news. However she also found a new problem: Polyhydramnios. I had this with Jamin's pregnancy as well, it's basically too much amniotic fluid around the baby. There are several risks associated with this by itself, for me the most urgent being that it increases pressure on the cervix causing it to thin and dilate too early (which is already an existing problem for me). So again it's one more issue to further worsen the other issues. While all the complications are happening independently of one another (the previa, the preterm labor, the Protein S Deficiency, and now the polyhydramnios), the end result is that they all interact to negatively effect eachother and essentially make the next problem even worse.

I was given an oral medication called Indocin, which I also took repeatedly during my pregnancies with Isaac and Jamin. This drug is used to help slow contractions, though one of its (normally undesirable) side-effects is that it tends to reduce amniotic fluid. For most women this would create a problem, but for someone like me who has polyhydramnios, this side effect is actually what we're trying to achieve. The downside is that Indocin can only be taken for a max of 72 hours, because any longer than that can cause heart defects in the baby.

18.5 wks: Dr. Garcia signed a "Georgia Disabled Persons Parking Affidavit" and I was able to obtain a temporary handicapped parking pass. This felt a bit upsetting at first, but I quickly found it to be incredibly helpful and quite a relief for me, particularly during my weekly parking adventures at Northside. I had ultrasound #12 with Dr. Mann, which showed the previa unchanged and the polyhydramnios still present (meaning the 72-hrs of Indocin I took last week did not work). Worse news was that my cervix was now measuring 2.8cm (down from 3.5 just one week ago). I'm told a "normal" cervix at this gestational age should be somewhere around 4-5cm long .... whereas 2.8cm would be normal sometime around 36-38+ weeks gestation as delivery approaches. All of this brought Dr. Mann to finally utter that awful word that I've been so desperately hoping to avoid: BEDREST. She also told me to repeat a second 72-hr course of Indocin, and ordered a terbutaline pump and home monitoring of contractions with a toco machine (will blog more on this tomorrow).

I left there feeling extremely unhappy though not one bit surprised .... we knew all of this was coming, it was more just a question of when. The only thing that kept me from going into a complete panic was the fact that the new nanny, Sara, had just started working. Her first day was on Monday, and I was ordered to begin total bedrest on Tuesday! Yep, that's God's timing folks.

Today I finished my 3rd day of bedrest. Only 145 more to go! (Let's pretend that makes me feel better). I'd be completely lying if I said I'm not immensely freaked out by the long road ahead of us .... the list of complications we're facing and the potential for disaster has my mind spinning most days. But even still, I have this peace knowing that I seriously have the most amazing and highly-qualified team of doctors, and they are throwing everything but the kitchen sink at me. There is no medicine I'm not already on. There is no treatment, no intervention available that we're not already doing. They are literally doing every single thing in their (limited) human power to make this work ....... and guess what that means?? It's no longer up to us. This entire journey rests solely in God's very capable hands, as it has since Day 1 before my doctors and I even knew what obstacles were waiting for us. I don't know for certain that God has another happy ending in store for us, though of course that's what I'm praying for. But I do know that regardless of how this whole thing ends, He will carry us through and we will survive.

Please continue to pray for us!

Never a Dull Moment: 14.5 weeks

Oh how I have longed to be one those lucky lucky women who seem to sail right through pregnancy; whose bodies just naturally know what to do ... whose biggest worries consist of what color to paint the nursery and what style of shoes best accommodate their swollen feet.

Alas, I will never be one of those women.

I used to feel a little bitter about it, but really, that's just ugly. Over the last few years I've learned to let go of the envy and instead embrace the struggle. God gets to show off in a major way every time I am pregnant, and that's pretty cool, right?

But being in the midst of the battle means there's never a dull moment at the Wren house. Such has been the case over the last few weeks. Around 12 weeks I began feeling abdominal cramping, which at that time felt like a dull ache similar to menstrual-type cramps. Upon seeing that I had a higher white count in my urine, Dr. Garcia assumed I must have a bladder infection, and started me on an antibiotic. Two days later we got the test results back showing there was no bladder infection afterall. Nurse Debbie called to share the "good news", and I immediately began to cry. Indeed this was not good news to me ... it meant that the cramps must actually be contractions.

Since that time they have strengthened a bit, in frequency and severity. They are now more distinguishable as contractions, coming and going, worsening at different times of the day and under different circumstances. In addition I'm now feeling pain and pressure in my cervix whenever I stand or walk for more than a few minutes. Today I saw Dr. Garcia and he insisted on an ultrasound to measure the cervix, even though I am seeing Dr. Mann tomorrow and she will be doing the same measurement. I love that he takes no chances, waiting 24hrs was just not even an option for him. He is a better-safe-than-sorry kind of guy, and that is just one of the many reasons why I adore him so.

The ultrasound showed my cervix to be 4cm long, which is great news! Dr. Garcia ordered me to start the 17P injections today rather than wait until week 16 as we originally planned. The 17-Hydroxy-Progesterone is the weekly intra-muscular injection that is thought to reduce the risk of pre-term labor. Aetna Pharmacy had already shipped the vials and needles to me about a month ago, but had not yet finalized arrangements for a home nurse to administer these to me each week. So when I came home from Northside, I retrieved my medication and began searching for someone qualified to inject it for me. My first stop was to the sweet servants at the local fire station, who helped me repeatedly while I was pregnant with Jamin and having blood pressure problems. They were eager to help today but explained that their regulations forbid them from administering an injection unless I became a "patient" which meant I would have to go to the ER! No thanks :) I almost got up the nerve to inject myself in the leg muscle (pure desperation!) when I remembered two sweet friends with some medical training. Gotta love generous friends who don't mind getting their hands dirty to do you a favor!

So I was able to get my first shot this afternoon, and beginning next week Aetna will be sending a nurse to my home each week to do these for me. The "standard" protocol requires 17P to continue weekly until 34 weeks gestation (though the thought of "standard" is almost laughable to me!) ... but if this is the case I will have about 20 more of these shots left. This got me thinking about my Lovenox shots, and for the sake of entertainment I decided to count those too. Now I'm wishing I hadn't counted! So far I've had 67 Lovenox injections (tonight will make 68), and if my math is right I have about 196 more to go. I haven't shared the bad news with my tummy yet (it won't be too happy).

In happier news, we are insanely anxious to finally learn the gender of the baby! I've had three ultrasounds in the last three weeks (one today in fact), each time hoping to learn whether we'd be on Team Pink or Team Blue this go-round. Alas, each time the technician could only manage to tell me: Team Yellow. Ugh! I hate hate hate hate hate not knowing! And yes I do realize I am an impatient brat and yes I know that most women have to wait until 20 weeks to find out. I have no earthly idea how these women control themselves that long because I would literally pull my hair out if I was forced to wait until then! So kudos to you ladies! You have much more self-control than I do!

Hopefully our waiting game will end tomorrow, when I see Dr. Mann. She assured me at my visit 3wks ago that we would definitely be able to tell the gender this time ... so unless the baby is curled into a teeny tiny ball with a metal plate covering the pertinent parts, I think our membership on Team Yellow will finally come to a close. James, Gracie, and I are all hoping for Team Pink this time, though James says he has a "feeling" it's a boy. Gracie has her heart completely set on a sister, who she plans to name Moe. She has very firmly made up her mind and I'm pretty sure she's not changing it. I tried to talk to her about the possibility of another brother, to which she declared that we will just dress him in pink and call him Moe anyways. So this could present a slight problem. And I am cheering for a girl, just because the last two have both been boys and it would be fun to have some pink in the house again. But of course I know that my plans are not God's plans (only took me 31 years to figure that one out!), so I will take whatever He gives me :)

Stay tuned for the big announcement tomorrow!

There's a light at the end of this tunnel ...

Lots of big news to report:

I endured my VERY LAST injection of 17-hydroxy-progesterone Friday morning. I will really miss seeing my sweet home nurse, Sharon, each week .... she always gives me a comforting word of advice and straight answers to my questions and concerns. However I will most definitely NOT miss the 40-foot needle, the bruises, and certainly not the limping that takes place for days afterwards.

ALSO ..... I'm excited to say that Jamin will almost definitely be arriving within the next two weeks ... we have an induction date!!! Dr. Garcia wants to induce tentatively on Friday April 10 (which is Good Friday -- how cool is that?) I will be 36w2d at that point. Due to the medications I'm taking, particularly the heparin, he feels the safest route is to get Jamin OUT as soon as his lungs are mature and ready.

The plan at this point is to do an amniocentesis in the morning of Thursday April 9th. This test carries risks, along with the largest needle known to man .... both of which scare the crap outta me. But it also will tell us the level of Jamin's lung maturity. We should have the results back by Thursday afternoon. If all looks well with his lungs, we will go forth with the induction on Friday morning April 10. Dr. Garcia says I'm "ripe and ready to go" (his words), so he anticipates that the induction will only require a small dose of pitocin to get the ball rolling, at which point I should labor and deliver quickly.

I am so eager to meet Jamin, and to end what feels like the world's longest pregnancy rollercoaster ride!

In the meantime, I'm slowly scratching things off my "must do before the baby arrives" list, and praying that Jamin actually WAITS until April 10th. My contractions have really been borderline out-of-control for the last 3+ days ... upwards of 6-8 per hour ... so I am practically holding my breath.

I'm in great need of your continued prayers! Please pray specifically for (1) a safe amnio procedure (2) mature lungs by April 9th; (3) no spontaneous labor prior to April 10th; and (4) comfort for our fears.

More updates soon!!!

33 Fun-Facts

Growing up, my family would always kid that I was the queen of "fun-facts", a.k.a ........ useless bits of information that most people don't really care much about. Today I've decided it would be fun to share 33 little facts about my pregnancy, to celebrate 33 weeks of pregnancy. Many thanks to my dear friend Katie for sharing this idea. So sit back, pay close attention, and get your #2 pencils ready. There will be a pop quiz sometime next week.


1. I am now 33 weeks pregnant. To date, I have had 16 ultrasounds, 47 doctors appointments, 19 cervical exams, and approximately 304 needle sticks. The needle number breaks down to 140 lovenox shots, 17 progesterone injections, 112 heparin shots, 27 blood draws, 1 diabetes screening, 2 steriod injections at the hospital, and 5 IV's.

2. In an average week, I'm currently having about 672 contractions, swallowing 63 pills, choking down about 70 peppermint Tums, and spending 21+ hours attached to my toco monitor.

3. I tried to count the number of times I've complained ..... but let's just be realistic .... totally impossible to estimate.

4. Maternity clothes and I don't really get along. After three pregnancies, I can honestly say that I have never owned a single pair of maternity pants that fit me. This time around, I decided not to waste my money, and instead focused on buying "normal" clothes one size bigger than I would normally wear. This method has worked beautifully, up until about 2-3 weeks ago. It now requires a small miracle to button my jeans, and the change to warmer weather has left me with no short-sleeved shirts to wear. I refuse to buy anything else, though, since I only get to leave the house for doctor appointments and I keep thinking the baby will come any day now.

5. I am secretly terrified that I'm going to stab Jamin in the head with my heparin needle. The logical part of me knows this is pretty much impossible to do with a normal-sized syringe, but the mom part of me worries nonetheless. Since I inject in my stomach, right near the belly button, I practically hold my breath every 12 hours and try to think happy thoughts. This has gotten especially difficult lately, since Jamin moves and rolls and kicks non-stop, so injecting is like trying not to hit a moving target. I can literally feel him rolling under my fingers when I put the needle in. Add in a dose of terbutaline, which results in uncontrollably shaky hands, and you can understand my paranoia.

6. I recently found out that heparin is made from the intestinal mucous of a pig. Yes you read that correctly. Apparently the same is true for lovenox. I learned this lovely little tidbit after asking Dr. Garcia why the pamphlets from the pharmacy have warnings about allergies to pork and pork products. Since Dr. Garcia is constantly kidding around and exaggerating for the sake of a good laugh, I honestly thought his explanation was a joke until I got home and looked at my heparin vials. Sure enough, right there on the packaging, it says: "Porcine Intestinal Mucosa". So now when I inject my heparin, I must control my fear of stabbing the baby, steady my trembling terbualine hands, beg Jamin to hold still, AND I must also control my gag reflex while fighting off visions of pig intestines. It's gotten to be quite a task!

7. I have a medic-alert bracelet, which I ordered the very first week of my pregnancy. I wear it every single time I leave the house because I have this fear that I will collapse while alone in public and no one will know what the heck to do with me. My bracelet contains my name, a description of my most important injections, a list of my drug allergies, and emergency contact numbers for James and Dr. Garcia. I honestly won't venture past the mailbox without that thing on my arm.

8. If I have a choice between drinking a glass of water, or a coke, I almost always go for the coke. Yes I often feel guilty for it. But I'm almost positive it doesn't make me a bad mother.

9. I am convinced that I have taken more medication during this pregnancy than I have in the previous 29 years of my life combined. I have no way of proving that, but nonetheless I'm quite positive it's true. And it bothers me immensely.

10. I'm equally convinced that I know more details about pregnancy complications than most medical professionals. I can easily quote statistical studies of cervical measurements and their corresponding rates of preterm delivery, the failure rates of 17P, or the percentage of fetal fibronectin inaccuracies.

11. I haven't been able to touch my toes since around Christmas-time. I normally keep a strict foot-regimen and maintain my own professional-looking pedi, but my lack of flexibility has resulted in an embarrassingly unkempt appearance. Every week when I see Dr. Garcia and put my feet up in those dreaded stirrups, I feel the overwhelming need to apologize. He usually rolls his eyes, and tells me that he's seen lots of gross things in all his years of medical practice and unpainted toenails don't even crack his top 100. I believe him, yet feel embarrassed anyways.

12. I *can* still shave my legs, though doing so requires a serious feat of olympic-worthy gymnastics. By the time I'm done I'm so exhausted that I literally have to sit down in the shower to catch my breath, at which point I half expect to see Bela Karolyi burst in shouting, "Zat vaz faantasteek my leetle friend!" while waiving a gold medal and a bouquet of wild flowers in the air. But so far, no Bela ... no gold medal ... and no acknowledgement of my super-human one-footed back-bending abilities. It's kind of disappointing to be honest.

13. I can personally attest to the fact that it really IS possible to get heartburn from ingesting only a sip of water. It makes no difference what I eat, or when I eat, or how much I eat. Even when I DON'T eat ..... the result is constant unbearable heartburn. In the morning I wake up, on an empty stomach, with heartburn. If I'm in a sitting position, but bend over slightly (to write, or type, or sew) I can literally feel acid coming up my throat. I have tried Zantac, Tagament, Protonix, and endless bottles of Tums. There is no cure.

14. Despite spending countless hours confined to my bed ..... I hardly EVER turn on the the tv. I spend most of my time playing games with Gracie, or surfing with the computer in my lap, or on the phone, or making lists, or working on sewing projects. Honestly the only time my tv gets turned on is when Gracie wants to watch Noggin, or when James gets home from work.

15. I remain amazed/horrified/entranced/scared to death by the endless ways pregnancy alters my body. So far I have gained 15 lbs, but my waist has grown NINE INCHES! Yes I measure it. No I'm not obsessed. I just like to record every detail, it's so neat to look back on later. I can tell you, for instance, that while I currently weigh less than I did when 33 wks pregnant with Gracie, my tummy is much larger in size now than it was back then.

16. A few weeks ago I noticed that I'm developing melasma on my upper cheeks. This is the nicely-named "mask of pregnancy" .... basically extra pigment, though it should be only temporary, praise Jesus. I never had this with either of the other two pregnancies, but it's quite ugly. One more ego-buster on top of all the other ego-busters pregnant mommies must endure ....

17. Hormones will apparently cause extra hair to grow in strange places. 'Nuff said on that subject.

18. I am baffled and completely intimidated at the prospect of shopping for a nursing bra.

19. I often worry about the physical difficulties I may face after Jamin is born .... just getting my body to function normally again. Right now I can only walk short distances without pain shooting thru my weakened leg muscles, and a trip up the stairs causes serious fatigue and breathlessness. Most days I feel like a 30-year-old woman in a 90-year-old body.

20. I've decided whoever started the rumor that "pregnancy is beautiful" has clearly never been pregnant before. See #4, #11, #12, #15, #16, and #17.

21. The later stages of pregnancy have given me crazy dreams. Not the "oh-la-la" kind of crazy dreams, but the "I-need-a-psychiatric-evaluation" kind of crazy dreams.

22. I have learned that people really do stare when you go to a public place in a wheelchair. Traveling this way has been a very eye-opening experience.


23. I am completely terrified of getting stretch marks. So twice a day, for the duration of my pregnancy, I have slathered $79-a-bottle prevention cream all over my abdomen. I have no idea if it will actually make a difference, but my fear of stretch marks is worse than my fear of wasting money.

24. Sometimes in conversation when I'm talking about Jamin, I accidentally call him Isaac. It freaks me out and I hate it.

25. I have a freakish-looking marble-sized hand tumor on the top of my right wrist. Dr. Garcia tells me it's just a ganglion cyst .... basically a minor thing but a serious annoyance. Occasionally my three middle fingers will go numb. Dr. Garcia referred me to his hand surgeon and I'm planning to pay him a visit once I'm not pregnant anymore (I think I have enough doctors for the time being!)

26. Despite my now proficient use of needles, I *still* have to look away EVERY SINGLE TIME I have a blood draw. There are just some things you don't ever get used to.

27. I've had my packed hospital bag sitting by the door for the last 7 weeks, and I'm convinced that the one time I forget to bring my cellphone to the doctor with me will inevitably be the time I am sent to the hospital in labor.

28. I find myself extremely annoyed by the women who sail through pregnancy with zero complications but yet have the nerve to make a huge fuss about minor things like swollen feet.

29. I absolutely, unequivocally, can not WAIT to have my body and my life back ... yet at the same time I know, without a doubt (because I am nuts), that in the very near future I will feel extremely sad and miss being pregnant.

30. I am astounded to think of how drastically my perspective has changed from the first pregnancy to the third. The things that seemed so gigantically worrisome the first time -- like whether I'd require a C-Section or whether I'd master the art of breastfeeding -- really seem so trivial to me now. I could honestly care less about that stuff at this point, as long as my baby ends up safely at home with me.

31. I've had to physically restrain myself from choking people who find out about my bedrest situation and make comments like, "I sure wish **I** could lay in bed all day and have people waiting on **me** hand and foot!!!" ...... as if being stripped of your freedom, confined to your bed for 23 hours a day and allowed to do NOTHING beyond wiping your own bottom and worrying endlessly about the safety of your baby and the well-being of your family is actually a VACATION and not TORTURE.

32. My needle bruises have served as comic relief throughout my pregnancy. About 2 months ago I was making an "emergency" trip to Dr. Garcia's office ... it was one of those scheduled over the phone, be-here-in-30-minutes kind of appointments. I have *never* seen any other provider at his office, because I just have too much going on and no one else really wants to deal with me, but on this day Dr. Garcia was out so they stuck me in quickly to see a midwife named Mia, who was super sweet. She made jovial conversation with me, checked me out, and then lifted my shirt to do the "push on your belly" maneuver .... at which point she stopped dead in her tracks. Her lighthearted demeanor immediately became urgently serious, and she pulled up a chair, sat down next to my exam table, and grabbed my hand. Thinking she must've seen something hugely problematic, I began to panic. Then she looked right into my eyes and said, "Kristi, I need you to tell me right now how you got those bruises on your stomach. Is your husband unhappy about the pregnancy?"

33. In spite of all the hardships and challenges this whole experience has brought us, I don't regret our decision to take the plunge. Even if I had known eighteen months ago all that was in store for us, I would choose to do it again without hesitation. I'm just so grateful to be pregnant.

Breaking Back

I'm 16weeks now .... and right on schedule my horrifically debilitating back pain has arrived! With every pregnancy I've been plagued with this, the can't-move-without-crying kind of pain in my mid to lower back. Some days when I'm super lucky it radiates through the booty and shoots down both legs, causing me to walk with a gimp that James can't resist making fun of.

To compensate for his giggles, James treated me to a massage at BodyWorx Spa last week. The massage was fabulous, but somehow it actually made the problem worse. I have tightened up so badly that I literally can not take a deep breath without pain shooting down my back and tears filling my eyes.

And since I'm on the topic of pregnancy discomfort, can I just say that I've also (ahem...) observed, that I am covered in black bruises, I can't sleep, I have to pee every ten minutes, I have unidentified fluids pouring out of my nether-regions, I'm eating Tums and Colace by the handful, I'm so tired that I can hardly walk straight, and I have medicine coming out my eyeballs.

But again, I'm not complaining. I am blessed to be with child.

Adding to my super-fun experience this week are Braxton-Hicks contractions. They have started already. Dr. Garcia says not to worry at this point (doesn't he know by now that "Worry" is my middle name?) ..... I'm just praying that my cervix holds up. I'm trying to stay off my feet as much as possible, which is hard with Thanksgiving approaching. And drinking 60+ ounces of water each day is not helping my frequent-pee problem, but I digress ....

My second set of injections is scheduled to start next week. They are giving me 17-alpha-hydroxy-progesterone, 250mg injections, once per week. This treatment is fairly new ... it's given to women with previous preemies, and is thought to reduce your risk of preterm birth by up to 30%. These are intermuscular injections (unlike my lovenox which is just subcutaneous), so I am unable to do them myself. So they are sending a high-risk obstetrical nurse to my house each week to administer the injections and monitor me for pre-term labor. Once again, thank GOD for insurance.

Matria, the home healthcare company, sent all the injections to me this week via FedEx overnight express. I made the mistake of opening the package and inspecting everything. With much trepidation and horror I report to you that I *observed* .... those needles are freaking gigantic. Probably 4-5 times the size of my Lovenox needles. Apparently the medication is compounded in castor-oil, so it is very thick (almost looks like vegetable oil!) .... and giant needles are necessary to push it through. The home nurse called this week to arrange everything, her name is Sharon. She seemed nice on the phone, but even still I keep picturing her chasing me through my living room with a 40-foot needle. I'm terrified of her already.

I am blessed to be with child. I am blessed to be with child. I AM BLESSED TO BE WITH CHILD .......