Grrrrrrr!!!

Why does it seem that every time we celebrate some good news, something crappy comes along to ruin the celebration? At 24 weeks, I was so thrilled to hit the milestone of "viability" and celebrated all the way to the doctors office ..... only to find my cervix was dangerously thin and I would be ordered on full bedrest.

A similar quandry occured earlier this week, when I oficially hit the 28-week mark on Wednesday. This was a major milestone for us, as the survival rate is over 90% at this gestation, and the risk of major long-term problems lowers significantly. Back during my second night in the hospital I had a sweet nurse named Emmie who grabbed my arm and said, "listen to me: you set your eyes on 28weeks and focus every bit of energy you have on that". Since that night I have been counting down the days until we got here.

So Wednesday morning, I woke up overjoyed and overwhelmed with gratitude that God carried us to week 28. A small number on the calendar, which likely seems insignificant to most pregnant women .... but to us reaching 28 was a gigantic miracle. Brandi picked Gracie up from school at noon, and then the three of us headed to my weekly OB appointment.

Dr. Garcia entered my exam room and immediately said, "28 weeks .... WHOO-HOOO!!!", and then proceeded to give me a high-five and a hug. Gosh I love my doctor. He then felt my cervix and reported, "feels about the same as last week" ..... thank you Lord! He also did another fetal fibronectin test, the results of which he promised would get to me within a few hours. My last Ffn test was about 2 1/2 weeks ago, and came back negative. A negative test means you have a 95% chance of NOT delivering within the next 14 days.

I had already made up my mind that today's test would be negative too .... after all, we're in this for the long haul. We have already mentally prepared ourselves for 8-10 more weeks of laying flat for 23.5 hours a day, babysitters, wheelchairs, injections, donated meals, and all the rest.

I was so confident in a negative result of this test, that I told Brandi on the way home from Northside we should have an ice cream party to celebrate my 28-week victory. Gracie thought this was a grand idea, of course, so once we got back to Douglasville we swung through Cold Stone and placed our to-go order. Brandi set up a little card table next to my bed, while Gracie gathered no less than ten of her stuffed animals to join the party. Together we all pigged out:

About five minutes into our celebration, right around the time that Gracie's face was coated in a nice even layer of chocolate and my own ice cream had that perfect 80% frozen / 20% melted consistency .... the phone rang. It was Dr. Garcia's nurse, Debbie. Now Debbie and I are on the phone at least 2-3 times a week because I've always got so much going on. I feel like we're pen-pals or something. We always joke that once this whole mess is over we're going to meet for some Starbucks.

The second I heard Debbie's voice, I knew something was wrong. She sounded nervous and upset. I said, "I hope you're calling with good news!"; to which she responded, "WELL ........."

My test came back positive.

My heart sank but I stayed calm and got all the relevant information from her. I hung up and sat here for a moment to let it sink in. Then I realized I would have to call James and tell him the news and my heart sank for a second time. I toyed with the idea of not telling him until he got home from work since I really didn't want to ruin his entire day, but Brandi convinced me that I needed to call him immediately and I knew she was right. I called and heard myself tell him in a very lighthearted manner that this didn't mean anything 100% .... the Ffn has false positives all the time .... we've made it to 28 weeks so we're past the super-scary point anyways .... and everything's going to be just fine.

I then spent the next three hours with Dr. Google trying to convince myself that all of that garbage I had just fed him was remotely true.

Unfortunately, Dr. Google can not tell me the exact accuracy of a positive Ffn test, because all the highly-esteemed "experts" and all the major studies have come to varying conclusions. I did learn that a most say your chances of delivering within 7 days is somewhere around 20%; within 14 days the percentage varied from 30% to 40% depending on who published the study. In my own experience with Gracie, I had a +Ffn at 32w5d; and she was born 16 days later.

Ever since receiving Wednesday's news, I've been trying super-hard to stay positive and resist the normal Kristi-response of freaking out. For the most part I have stayed quite calm, although I've had a few brief ocassions here and there where the fear rises up and I have a weepy moment. I decided that maybe I'd feel a little more prepared if I at least packed my hospital bag, so yesterday I made Brandi take me to Target (my first non-medical venture outside the house), to pick up hospital necessities like a travel toothbrush and 17 mega-paks of maxi pads. The trip was quite comical: me in a wheelchair with two shopping baskets in my lap, Brandi pushing me while trying to carry more items under her arm, and Gracie trying to force Brandi out of the way and whining that she wanted to push and/or ride the wheelchair herself. Sheesh, I wish I'd had the forethought to take a picture of *that* for the blog, we were quite a sight I'm sure!

So I've spent much of today trying to put together a pile of things for the hospital bag, and making several more phone calls to phone nurse Debbie, trying to work out insurance issues. My 40-foot-needle-toting home nurse, Sharon, came today for my weekly 17P injection, and informed me that Blue Cross/Blue Shield had denied Dr. Garcia's request to add continuous monitoring to my home care regimen. Last week he put in orders for Matria to set up a monitoring station in my bedroom .... the same toco monitors and fetal heart tone monitors they use in the hospital to assess your contractions and the baby's response to them. With the home system they are able to connect the monitor through your phone line, and it feeds the information to a nurse somewhere out in cyber-world, who reads your strip and pushes a big red panic button somewhere once she sees things getting problematic.

Apparently some dude in a suit at Blue Cross thinks that I must not really need this monitoring, because they've refused to pay for it. Maybe the suit-guy thinks Dr. Garcia is just out to get him. Or maybe he thinks he'd rather get another $10,000 bill from Northside Hospital than pay an amount 1/100th of that to cover my home monitoring. I don't know what the heck he's thinking quite frankly. But I'm extremely angry and frustrated today that once again a representative from my insurance company thinks that he knows more about what I need than my doctor does.

So Dr. Garcia's office is now fighting with Blue Cross on this matter .... however the monitoring was ordered by Dr. Garcia SEVEN DAYS AGO. Today is now Friday again, so the best we can hope for is to get some response from Blue Cross on Monday .... another three days away. In the meantime, I now have a +Ffn, time is ticking, and my hands are tied.

Geez, like I don't have enough to worry about at the moment?

I think I need to go re-read that scripture my friend, Heather, sent to me this morning. Where is it? Ah, yes, here, Philippians 4:6-7 ...

Do not be anxious about anything, but in everything, by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus.

I'm trying. I really really am.

Relief!

Finally: I can catch my breath!

Had my weekly appointment with Dr. Garcia today. He took a Fetal Fibronectin sample and sent it off to the lab. I held my breath for 6 full hours until the nurse called with the results: NEGATIVE! Praise the Lord for that!!! I feel so much better knowing I can relax a bit since chances of something happening within the next 14 days is small. Dr. Garcia said he would most likely repeat the test every 2weeks from now on just to keep a super-close eye on things.

They also did my glucose screening, which required chugging that lovely orange-syrup nonesense and then more needles. Yick! I should get those results next week.

YAY for finally catching a break! :) I celebrated by doing something I swore I'd never do: I created a baby registry. Online of course, can't venture out to a store - doctor's orders! But seriously this feels like a huge step for me. I am still feeling very hesitant about the thought of actually having a baby shower - I've had two sweet offers to host but honestly I still feel really wierd about that and I'm not sure whether or not I'll accept. Mostly because it's a second baby and so that feels selfish in a way, but also because I guess I haven't fully let myself trust that we are truly going to have a healthy baby at the end of all this.

Even still, feels like progress to me. Baby steps.

2.7 and holding!

Today was my weekly check up with Dr. Mann. My cervix is measuring 2.7 cm, which is only 1mm shorter than last week. This is great news.

The fluid problem, however, is much worse. It's measuring 31cm, which is about double where it should be. Dr. Mann says the fluid is way down low in the pelvis and is putting even more pressure on the cervix. The baby is also head-down, which is additional pressure as well. She feels confident that if we can get the fluid under control, then it will help slow the cervical thinning.

To try and lessen the fluid, she is putting me back on another 72-hour course of Indocin. We did a course last week but have no way of knowing if it was helpful at all. One of the unwanted side-effects of taking Indocin (for those with "normal" pregnancies), is that it can reduce amniotic fluid. It does this primarily by slowing the baby's renal function (kidneys), literally making them urinate less often. Since amniotic fluid is primarily composed of baby's urine, then less urine = less fluid. So for women with normal amounts of amniotic fluid, this side-effect is a dangerous concern. For me, since I already have too much, this side-effect would actually be a desired outcome. Indocin also helps calm contractions, since it's a NSAID drug and relaxes the muscles.

She also wants to give me a fetal fibronectin test (Ffn), to assess my risk for delivering within the next 14days. I had this test done with Gracie, so I'm pretty familiar with it. Ffn is a glyco-protein that is usually only found in the cervix when delivery is immanent. So if we find the proten present (+ result), we know something is much more likely to happen within the next 14 days. Conversely, if we don't find the protein present (- result), we know we have a very good chance of making it at least 14 more days.

The purpose of the test is really to give doctors a better snapshot at the time-frame they are facing, to determine if more intervention is necessary. When I had the test done with Gracie at 33 weeks, it came back positive. At that point I was hospitalized again, and given the steroid injections meant to boost her lungs in preparation for an early delivery. As it turned out, she was in fact born roughly 2 weeks later.

Dr. Mann was unable to obtain the Ffn sample today at my appointment, because she had already completed a vaginal ultrasound, and by doing so had compromised the "sterile environment". Eww. Because of this, she's calling my super-fab OB, Dr. Garcia, who I'm already scheduled to see this Friday, and asking him to collect the sample and run the test at that time.

Soooo .... until then I'm still stuck here in bed, praying for a negative result on Friday so we can relax a bit.