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!

Team BLUE!

Holy crap we're having a BOY!!! We found out yesterday during my first trimester screening. I was shocked that we were able to see "it" so clearly, I was only 13w0d!

But alas, there on the screen we saw the unmistakable "toilet shot", and the ultrasound tech announced quite confidently that we are indeed having another son.

I'm feeling a little shocked, and if I'm being honest - a wee bit sad. I've been hoping for another girl, mostly because I have such a close relationship with my own sister and I wanted that experience for Gracie. And also for selfish reasons - I feel like emotionally this will be much harder for me to handle since it's a boy. I worry that I will forever be comparing him to Isaac ... the way he looks, the way he talks, the way he runs, the way he laughs ... wondering if that's the way Isaac would have been. I was hoping it would be a girl in part so I wouldn't have to deal with some of those emotional complexities.

BUT .... once again God's plan is His own and I am getting on board. It will be an adventure shopping for blue for a change! I've already started peeking at cute little blue nursery decor online - though I don't have the guts to actually purchase a single thing!

With the gender discovery, of course, has come the inevitable battle over the perfect name. And once again, James and I can't agree on a single thing! We always have the hardest time with this! James is set on the name Cash, in honor of his pseudo-hero Johnny Cash. I think the name is cute ...... FOR SOMEONE ELSE'S KID. But not for mine. Can't explain it really other than to say it's just kinda weird. Gracie loves the name because it makes her giggle, so last night the two of them were double-teaming me, begging "puleeeeeeze let us name the baby Cash!". I told James no, I don't like it, the name is weird, and not to mention -- what in the world could we possibly use for a middle name since it's so strange, I mean what goes with Cash? Gracie came rushing in from the other room shouting, "REGISTER!!!!". So apparently at this point my child's name will be Cash Register Wren. Fantastic.

In other news .... my latest hematology tests have me breathing into a paper bag. Went to the hematologist last week, though for some reason I got stuck with the nurse practitioner rather than the doctor. Won't be making that mistake again -- she was completely clueless. But my Protein S numbers have plummeted dramatically, hence the bag-breathing. Recall that I have an inherited heterozygous Type III Protein S Deficiency. Sometimes it's referred to as Type IIb rather than Type III. In a nutshell, there are three types of Protein S measurements: "total", which measures the actual amount of protein in your blood, "free", which measures only the amount of protein that isn't already bound to other blood components, and "functional", which measures how well the protein is actually working (irrespective of the amount present). My disorder, Type III, is a functional deficiency, which means my free and total #s are both normal but my functional #s are abnormal. For instance, my functional levels have hovered around the upper-40's to low-50's over the last two years (normal is considered 60-120), while my free and total numbers have always stayed in the normal range.

At this office visit, Nurse Know-Nothing reports to me that my functional #s are down to 24. (I have honestly never even *heard* of numbers this low before.) And to top if off, she tells me I now have a free deficiency as well - down from the normal range to just 27. When I asked her if this will cause a major problem, she shrugs and says "I'm not really sure, but as long as you keep taking your lovenox then I think you should be okay". Well that's super reassuring. Convinced I'm going to drop dead from a pulmonary embolism as soon as I get in my car to drive home, I asked her if it's possible that pregnancy would artificially drop my numbers so dramatically, at which point she tells me - again - she's not sure but I could google it if I wanted. Yes, that's right, that was the advice given to me from the licensed Nurse-Practitioner at the hematologist's office, the folks who are supposed to be knowledgeable specialists in blood disorders. I was furious ... I take time off of my day, arrange childcare for Gracie, sit in your waiting room for an hour and a half, pay my $40 copay, and you want me to GOOGLE IT?!?!?

Needless to say, I'm looking for a new hematologist.