Coming Unglued.

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

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

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

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

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

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

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

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

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

Pray for us.

Magic 24!!!

Today is a day to celebrate.

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

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

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

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

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

NOT HAPPY.

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

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

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

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

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

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

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

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

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

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

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

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

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

Tick. Tock. Tick. Tock.

Today is Monday ..... my 7th day as a guest at Hotel Northside. My stay so far has been long, boring, and torturous. Under these circumstances, though, I suppose boring is actually a good thing, because at least there's no immediate disaster taking place.

Not much has changed since I got here, I am continuing to have painful cervical pressure which worries me. At first they were telling me this was just caused by a bladder infection (which we discovered at 4am on my first night here), but now after being on the antibiotic for several days with no improvement in the pain, they have determined it's apparently not bladder pain afterall. The doctor has ordered that they do not perform cervical checks unless absolutely necessary, simply because I have a previa and repeated checks can kick off a bleeding episode. So they are a little hesitant to investigate too far when I complain of pain. The midwife did check me again Saturday night, and said no change. Dr. McDaniel (who is Dr. Garcia's partner) and Dr. Gomez (who is Dr. Mann's partner) were on call all weekend, and each came to see me several times. They are guessing the pressure and pain I'm feeling is caused by the baby's position -- meaning his head is way down low and he's just pushing right on the cervix. I am nervous that this will cause additional thinning, but we won't have any way of knowing until tomorrow's ultrasound measurement.

In the meantime they are recommending that I lay completely flat for as many hours as I can stand it. This means reclining my bed so it's completely horizontal, putting a stack of pillows under my butt, and laying on my left side. I am unable to do anything in this position ...... the computer and reading are pretty much out so the only distraction I have is the TV, which I can see from that angle thank God. I can usually only stand to be this way for about 2-3 hours at a time, and then I have to sit up for a bit and take a break for the sake of my sanity.

My entire body is aching from lack of movement. I am in bed for about 23.5 hours a day. I take a 10-15 min shower each night before bed, and otherwise I am only allowed up to go to the bathroom. My back hurts, my sides hurt, my neck hurts, my legs hurt ........... everything just aches. And the longer I lay here, the more uncomfortable I get.

I've been on complete bedrest for 5 weeks now and physically it's really starting to show. I'm suffering from muscle atrophy in my legs. I started noticing the beginning signs when I was at home about two weeks ago. Walking up the stairs to my bedroom caused intense burning pain in my thighs and calves; and overall my legs visually look significantly shrunken. Apparently it's obvious to others too, because my very first morning here on the HRP floor the nurse examined my legs and immediately scheduled a physical therapy consult.

The physical therapist showed up Friday morning to teach me some exercises I can do each day in bed. They are pitifully simple things .... like point and flex your toes, raise and lower your leg about 12 inches off the bed, etc. When we first started, she would give me specific instructions on a particular exercise and ask me to do a set of 20 reps on each leg. I was internally rolling my eyes and thinking .... seriously??? Any 100-yr-old grandma could do these, this is silly. Then we'd get to rep #7 or 8 and I was out of breath and my legs were trembling. I found myself incredibly embarrassed, because these simple little movements were really difficult for me. I was laying there listening to her count repetitions out loud, having flashbacks to 6 or 7 months ago when I was in the gym with a personal trainer lifting a ton of weight. And now it's a struggle to lift just the weight of my own leg off the bed.

She explained that the burning pain I felt trying to walk up the steps is likely nerve pain, since over time the non-use of those muscles will mean that the nerve endings no longer fire normally. She said I would be unable to regain the muscle and nerve loss until after the baby is born, but regular repetition of these exercises (twice a day) while on bedrest can help prevent further loss from happening. I found this to be super depressing, as you can imagine. I am forced to lay here day after day, month after month, and watch my health decline and my body shrivel up into a shadow of it's former self. There's not a single thing I can do about it and that just frustrates me to no end. I get even more annoyed when I consider that when the baby finally arrives, I will be expected to suddenly get out of bed and run 500mph and physically function at 110% .... caring for a newborn and two other little ones all day and all night. Yet I won't be able to walk or stand normally. After Jamin was born it literally took about a year before I felt like my body had fully recovered -- before I could do everyday things, like walk to the mailbox or climb the staircase, with ease. So now I find myself, 6 months or so after finally returning to "normal" ....... starting the process all over again.

SHEER FRUSTRATION.

These kind of thoughts have my head spinning most days. Being here has turned into a bit of a mental battle. Luckily I've had a handful of visitors come by to distract me and that's been a huge help. On Friday I had a fluffy visitor show up unexpectedly:

A little spaniel named Rugby, who is part of the hospital's "Happy Tails" program. The doggies come around every Friday and visit bedrest patients. He was super sweet! They put a sheet down over my bed and he just jumped right up and made himself at home in my lap for a few minutes. I enjoyed talking to his owner and getting a few little puppy kisses.

And I finally got to see my kiddos Saturday afternoon, which made me soooo happy! I have missed my family like crazy, it is really hard being so far away from them. Gracie had an upper respiratory infection all week (which James has been forced to handle alone, a first) ... but by Saturday she was finally feeling well again and a visit was in order. Jamin was super wiggly and wanted to explore every nook and cranny of my hospital room, but Gracie just plopped herself right up in my bed and cuddled the whole time she was here. Which is just what I need! Can't get enough kiddie lovin'. Look at this card Gracie made for me .....

She is so sweet I could just eat her with a spoon. Seriously.

I've had visits from a few friends and family members too, which I'm incredibly grateful for! It gets really lonely here and I am such a social person so I hate being by myself this much. I've been so desperate for human interaction that I've caught myself trying to make long conversation with any and everyone who walks in my room .... nurses, food service ladies, housekeepers, lab technicians ..... I'm not picky. Come to think of it, they probably think I'm incredibly annoying because I won't stop talking whenever they come in. I am super grateful to my friends who have visited, sent notes and flowers, made meals for James, babysat the kids, and offered to pray for us. We are so fortunate to have you guys and your generosity really does make days like this a little easier to handle. And can I also just say ......... THANK GOD FOR SARA, our nanny! She has been invaluable, I seriously don't know how we would be surviving the day-to-day without her, she is managing the kids and household and keeping us afloat. God has placed all these people in our lives at just the right time and is providing for all our needs.

I am seeing Dr. Mann tomorrow, for ultrasound #17. My last one was Thursday morning and showed my cervix had lengthened quite a bit since my hospital admission. Dr. Garcia came by this morning for rounds and told me that Dr. Mann might consider discharging me tomorrow if my cervical measurement is excellent and we have no other surprises going on. I am trying not to get my hopes up, but honestly I am just DESPERATE to go home! So I am praying that by some miracle my ultrasound will be all roses and she'll agree to let me outta here.

I will update when I know more .... should be early tomorrow morning (hopefully) when I'm taken downstairs for the ultrasound. Pray for us!

HOTEL NORTHSIDE ........

I'm trying to pretend that it's similar to the Ritz-Carlton or the W Hotel (afterall, I do have a nice skyline view of the city) .... but when mealtime comes it's pretty hard to fool my tummy. Alas ... the food sucks, the decor is depressing, and the smell is pretty sterile. It's not a posh hotel. IT'S A HOSPITAL.

My stay here started unexpectedly on Tuesday. I had two doctor's appointments scheduled, my OB at 11:00 and my hematologist at 2:30. At the OB's office, I saw the midwife Wendy for the first time, since Dr. Garcia is on vacation. Wendy came in and chatted for a bit about my lovenox, measured my belly, and announced I was all set to leave. Skeptical, I asked her, "aren't you gonna check my cervix?" Since Dr. Garcia checks it every single week, it was hard for me to believe I was gonna get out of there without wearing the tissue paper sheet for a least few minutes. Especially since the night before I had been up until 2am with excessive contractions -- 7 per hour -- and a malfunctioning terbutaline pump.

She agreed a cervical exam was a good idea. Two minutes later I heard her announce that I am dilated 1cm, and immediately we both knew how lucky it was that we checked. Prior to this exam we have been seeing cervical thinning, or effacement, for several weeks. But no dilation until now.

Wendy instructed me to get dressed, and by the time I made it out to the hallway she already had Dr. Mann (perinatologist) on the phone. Dr. Mann's office is just around the corner on the first floor of the hospital, so plans were made for me to head straight over, sit on the toco monitor for a bit, and then have an ultrasound.

I grabbed a quick sandwich at the deli in Dr. Garcia's building and went straight over to Dr. Mann's. I only had a few contractions while sitting on the monitor, so I was hopeful that she would check me out and send me home. That hope faded the second the ultrasound technician got started and I saw the image of my cervix on the screen. Instantly I knew it was bad. It was visually shorter (effaced), and before the tech even began taking measurements I knew I had just landed myself in the hospital.

Dr. Mann entered the room a few minutes later, and with a sarcastic smile she said:

"WELCOME TO HOTEL NORTHSIDE! Your room is ready and waiting."

I tried to remind her that I've been a guest of "Hotel Northside" several times before and it has never been a relaxing stay. But she wasn't dissuaded. My cervix was measuring 1.7 cm long, down from 2.8 exactly one week ago, and dilated 1cm on top of that.

I asked her if I could at least go home and pack a bag, which prompted her to look at me like I had six heads. She responded, "Absolutely not. But I will allow you to put your pants back on, and those cute high-heeled shoes which you won't be wearing again for a really long time". Super. Then she told me I would be staying for "a while". I asked her for clarification, "do you mean I'll be here for weeks and weeks?", to which I got a resounding YES.

They literally brought a wheelchair to the ultrasound room, and wheeled me straight upstairs to admissions. Before I even had a chance to make a few phone calls, I was a in labor & delivery room on the high-risk floor hooked up to the monitors. I scrambled to call my hematologist's office to cancel my 2:30 appointment, and started making a list of necessities for James to pack and bring to the hospital. Of course, the list included my makeup and flat-iron, so maybe I'm presumptuous to call the entire list "necessities".

They started me on Indocin, the 72-hour tocolytic, and re-inserted my terbutaline pump. The rest of my meds stayed the same. I was poked, prodded and jabbed about once every 45 minutes for the next 24 hours or so. The steady stream of nurses coming in and out with medications and such made it impossible to sleep. I began having what felt like cervical pain "down low" sometime around 3:30 am, which prompted the midwife to wake me up for a cervical exam at 4:00. She took a urine sample and decided I had a bladder infection somewhere around 4:30 am ...... which meant more medicine ......... and as it turned out I got a total of about 2.5 hours of sleep that first night.

Yesterday afternoon, Wednesday, I was moved upstairs to the "HRP" floor. This is the high-risk perinatal unit, where they send women who are on hospital bedrest to gestate for endless weeks. I was settled into room 105 just before dinner and had yet another terbutaline pump placed in my leg. Around 8:00 pm I began hearing the most horrific noise emanating from the room next door, which I quickly discerned to be the sound of an unfortunate woman barfing her guts out. She vomited violently, without stopping, for about an hour and a half. When she wasn't puking she was crying loudly. It was so pitiful (and yucky) to listen to, I felt so sad for her. My nurse finally came in and explained that my neighbor had hyperemesis and has these violent spells of vomiting day and night. In her next breath she said she had already put in a transfer request so I could get moved to a quieter room. Everything in a hospital seems to run in slow motion, of course, so it was midnight before I was finally transfered down the hall to room 120.

This morning I was taken downstairs to Dr. Mann's office for an ultrasound. We found my cervical measurement had increased significantly since my admission, up to 2.9 cm! So this was fantastic news, but not enough to inspire confidence from Dr. Mann. She said she was keeping me here, for three reasons: (1) I gave her a "really good scare" and she wasn't quite over it yet. (2) My cervix seems to be voilatile, and just as quickly as it increased length, likewise it could loose length overnight. And (3) I had only about 16 hours of my Indocin course left, and we had no way of knowing if the crazy contractions would return as soon as my last dose wore off. She did not want me at home when coming off the Indocin. So her plan is to re-evaluate me with another ultrasound next Tuesday. Depending on how the cervix looks at that time, and what's going on with my contractions, she will make a decision on how much longer I stay at Hotel Northside.

For now I'm settled in and trying to make the best of it. It is incredibly hard being so far away from home and I miss my family like crazy! As much as I really don't want to be stuck at the hospital for weeks and weeks, at the same time I know that if I'm lucky ........... I'll be here for weeks and weeks. "Viability" is considered 24 weeks, this is when premature birth carries a 50% survival rate. My immediate goal is to get to week 28, when survival is over 90% and the long-term outlook is relatively good. Once God gets us to week 28 then I will start praying for week 32. Please join me!

21 Weeks and still standing! Well .... mostly laying.

Oh gosh .... where to start??? There is so much swirling in my head right now, I've got a major case of Kristi-brain at the moment. Worry overload.

First a bit of good news: I saw Dr. Mann last week for my weekly ultrasound (Lucky #13!!!) and we finally saw something to be happy about. The Polyhydramios is gone. Yep, that's right: GONE. Praise the Lord! The second round of Indocin did it's job, and my fluid is now measuring 16cm, which is considered perfectly normal. It's been so long since I've had anything "normal", I was beginning to forget what that feels like. But now I remember ...... ahhhh yes it feels fabulous.

My cervical measurement was stable, in fact it actually increased ever so slightly to 3.1 cm, so that was also good news! Our other big concern, the placenta previa, has not moved. It's location remains unchanged (boo). Before now, Dr. Mann kept expressing confidence that it would eventually move, though that was weeks and weeks ago. So I asked her, "Are you still feeling confident that this thing is gonna move?" .... to which she got very quiet and paused for an awkwardly long time, and then responded "Well I really hope it's gonna move!"

Ummm, yeah. I really HOPE it's gonna move too, obviously! But you conveniently didn't answer my question.

A week has passed since that conversation, and so as you can imagine that's more than enough time for my brain to kick it up a notch in the worry department. This stupid previa has scared the crap outta me since the day we found it. When you combine a previa with blood thinners and preterm labor ..... the possibilities are downright terrifying! The potential for disaster is way too high for my liking.

So today, at my OB appointment with Dr. Garcia, I had to pick his brain for a bit. He is always such a straight-shooter with me, he doesn't sugar-coat things. I ask him a detailed question, and he gives me a very detailed answer. 100% of the time. It is the reason why I trust him so completely. So many times before, with other doctors, I felt like I had to ask the same question 4 different ways before I was given a semi-complete answer. But Dr. Garcia does not beat around the bush, he doesn't leave me wondering, and I absolutely adore him for it.

So I asked him today .... at what point will we know whether or not this previa is going to move?? He told me 28 weeks. He said the next 2+ ultrasounds I have with Dr. Mann should be very revealing ... if the thing is gonna move we should start seeing some form of slow migration happening in the next 4-6 weeks. If we get to week 28 and it's still a complete previa, we can be pretty certain that we're stuck with it and we will have to develop a plan for how to deal.

So of course I had to ask .... in the event we're stuck with it, what will our plan be? He explained that he would have to consult with Dr. Mann and they would have to get creative and, as he said, "put our thinking caps on". But as of today, his recommendation would be:

1. Switch immediately from Lovenox over to traditional heparin (these are cousins; Lovenox is a form of heparin). The reason for the switch is to increase your chances of not having blood thinners in your system at the time of delivery. A single shot of Lovenox stays in your system for 24 hours. And once it's in, there is no way to reverse it. So if you go into labor, or need to do an emergency delivery, within 24hrs of your last shot ...... you're in trouble. Traditional heparin, however, stays in your system for 12 hrs (which means you need two shots a day instead of just one). But the advantage is that if an emergency delivery is needed, or you spontaneously go into labor, you've just bought yourself 12hrs. Also, the effects of heparin can be reversed, with another drug (can't think of the name), which can be given as a shot at the hospital. This shot can fully reverse the effects of the heparin within a few hours, at which point it is safe to deliver.

2. Immediate hospitalization if I have any bleeding at all from the previa. If the bleeding gets "bad" (exactly how much is considered "bad" I have to wonder???) ... then he will deliver via C-Section regardless of gestational age. Assuming we have no bleeding, and we can get a few weeks further, then ....

3. Administer betamethasone (steriod) injections around week 33. This is a series of 2 shots, given 24hrs apart, which boost the baby's lung maturity. Because lungs are the very last thing to develop in the unborn baby, premature delivery means that major lung problems are frequent and dangerous. I've had these shots with both Jamin and Gracie, and I firmly know they work! They also hurt like a $%&@!!!!! but that's beside the point :)

4. Perform an amniocentesis at week 34. This will assess the baby's level of lung maturity. I had this with Jamin as well. There is some particular type of protein that they look for, it's presence indicates the lungs are mature enough and it is safe to deliver. Assuming all looks well, then ....

5. Deliver via C-Section at week 34.

I'm obviously freaked out that the doctor's best case scenario assessment with a previa involves delivery 6wks early. But I know that he would never ever in a million years recommend that unless it was the absolute best alternative for the baby. And there are a lot of "if's" to get to that point so there are many factors playing into this scenario which could change. So to a small extent it's like trying to predict the unpredictable. At the same time, though, it's the unpredictable part that has me so worried. There are so many things that could happen which would force a delivery even earlier than week 34.

My biggest fear at this point, which I shared with Dr. Garcia, is that I will have further cervical change, which will cause the previa to start bleeding, and since I'm on blood-thinners it will be really bad .... they will be forced to deliver, and we'll end up with a very very very premature baby. Nodding his head, his response was "that could very well happen, and that is my biggest fear too. But we are already doing everything humanly possible to prevent that from happening. At this point all we can do is react quickly if/when something happens".

He did say that sometimes cervical thinning by itself won't be enough to cause bleeding, it depends on how quickly the change is taking place. He said cervical dilation is more likely to cause bleeding. So I took this as a glimmer of goodness because in the past I have tended more toward very early thinning, like 20+ weeks, but then not dilated until like 30+weeks.

He stated repeatedly that the previa still has a chance of moving sometime over the next seven weeks, and twice he said "I really hope it moves". Hmm, now where have I heard that before?

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!

Fast Forward!

A few weeks have passed since my last post, I've been generally whiny and feeling an overwhelming lack of energy ... to the point that the very thought of blogging was enough to make me tired. Blahh. Here's a condensed version of the last few weeks:

I've had three more ultrasounds ...... the 5th being at the Perinatologist office due to sudden onset of heavy bleeding around 9 1/2 weeks. Dr. Mann was not available, so I saw one of her colleagues Dr. Matsumoto ... or as she calls him: Dr. HOT-su-moto. She calls him this because, well, he's kinda young and hot. Not really the guy you want to see when you have to explain how you have blood gushing from your nether-regions. Yeah, so that was a pleasant experience. The good news is that he was able to very clearly see that the blood was originating at the cervix -- not the placenta -- so that was a best-case scenario for us really. Disaster averted.

My 6th ultrasound was done about a week later, another "quickie" scan at Dr. Garcia's office. And the 7th was last week, with Dr. Mann during our nuchal translucency screening. It was so fun to see the baby again ... wiggling and spinning and waiving. The best part was that I got excellent results from the screening and all seems to be progressing just as it should. I was only 12w1d at the time of the scan, but even so Dr. Mann offered to take a peek at the "special parts" to try and determine the gender. She squinted and strained and did everything but stand her her head ..... but alas, just too early to tell. She said if we'd had one more week it would've been so much more clear. I knew ahead of time that the chances of being able to determine the gender at 12wks is super slim so I really wasn't surprised or disappointed. I see her again in 2 1/2 weeks and she promised we would know for sure by then! :) I am still hoping for team PINK, all the while recognizing I get absolutely zero say in the matter and will simply have to take whatever is given to me! James says he is cheering for team Pink, but has a "feeling" it's a boy again this time. Only time will tell!

I saw Dr. Duncan (aka Dr. Genius) about two weeks ago for my hematology appt. My bloodwork from the previous appointment (taken around 7wks gestation) came back showing my Protein S levels to have plummeted down to 25. It is normal for Protein S to decline naturally during pregnancy, but it's definitely not normal for it to drop this low. We expected it, though, since the exact same thing happened at the very beginning of my pregnancy with Jamin, when my level was about 24 at week 7. The concern comes from the fact that my Protein S will continue to fall throughout the pregnancy, so then it becomes a game of "how low will it go???" All we can do is continue to watch it and adjust my Lovenox dosage as needed. But oooohhh how much better I feel this go-round just knowing I am in the hands of one of the most competent hematologists in the country and he is watching me closely. He took another 800 bottles of blood from me at my last visit and I am still waiting on those results. His nurse is actually supposed to call me tomorrow, fingers crossed.

I am now 12w5d and beginning to have some painful cramping. I saw Dr. Garcia today for my regularly scheduled appt ... he says I have a high # of white cells in my urine so he's speculating the pain is caused by a UTI, aka bladder infection. He sent off a culture of course, but the results will take 48hrs to get back to us so in the meantime he's already started me on an antibiotic just in case. Tonight the pain is literally worsening with each passing hour, so I'm beginning to feel a wee bit nervous and praying it's really just a UTI and not something more worrisome. I began having contractions with Jamin around week 16, and with Isaac at week 12 so of course my mind is already running away with that possibility. He also gave me a pap while I was there today (just because it was time), and so now I'm bleeding profusely again because my stinkin cervix apparently is so frail it begins to bleed if the wind blows too hard or if someone stares at me too long. Doesn't take much.

So I'm back to where I started: feeling generally whiny. Now you see why I took a break from blogging?? :)

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.

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!!!

Ending the Hiatus!

So I'm sure all 4 of my blog fans have undoubtedly noticed that I've been totally absent lately. The last few weeks I've been quite grumpy and just couldn't really think of anything remotely positive to say. Every time I would log on and start to update my blog, a bunch of angry complaints and whines would pour out and, not wanting to preserve my ugliness for all to see, I would hit the delete button. Trust me when I say, you should thank me for it.

So here's the condensed version of the last three weeks, to catch you all up to speed:

From an emotional standpoint, I've been a bit of a mess. Super hormonal, super grouchy .... and super annoying I'm sure. Mostly this has stemmed from an overwhelming frustration at my confinement, my inability to do anything for myself without some version of a babysitter chastising me like I'm 10 years old again, and my general lack of freedom and normalcy. Cabin fever doesn't even begin to describe it. We're talking about TEN FULL WEEKS of bedrest, afterall. Then there has been my constant inner battle, dealing with my intense discomfort for depending on other people, and my general refusal to accept help. My control freak issues have been especially ugly to deal with. The Lord is really trying to work that outta me and I've just been kicking and screaming the whole way.

From a medical standpoint, not much has changed. My cervix has continued to shorten, and at last measurement was back down to 1.7cm, which was the same measurement I had the day I was admitted to the hospital. The polyhydramnios has also returned, so I was back on another 72hour course of Indocin to try and reduce the fluid. We won't know if that was successful until tomorrow, when I see Dr. Mann again and have another ultrasound to measure everything. At this point, even if the extra fluid is not gone, our options are limited, because Indocin can not be taken at or beyond week 32 (can cause heart defects in baby past that time). So the course I took at week 31 was our last shot at reducing the fluid.

I've had a few issues w/ my blood work .... mostly my hemoglobin and hematocrit levels are continuing to lower, this is mostly just causing me to feel wiped out and icky. At my last two visits to the hematologist, my blood pressure was way low, around 80/59 .... so they gave me some IV fluids to try and perk me up.

Dr. Garcia told me yesterday that my cervix is now about 1cm dilated, which is really nothing to write home about.

So it's with much amazement that I report: I am still pregnant, and I could likely stay that way for a while longer! If I'm just being honest I must admit, I NEVER NEVER NEVER in a million years thought we'd get to week 33. But here we are, and I'm embarrassed to look back and realize once again that my faith has been sorely lacking.

Saw my OB yesterday, the hematologist today, and will see my peri tomorrow. I am interested to see how Jamin has grown since our last measurement, he should be about 4.5 - 5 lbs now if all is well! Isn't that astounding?

I promise I won't take a long absence again .... after all, I have 4 whole fans who are counting on me! But the break was a necessary one, and for your benefit, I promise!

Awesome News!!

Today was a big day. I got to shave my legs AND put on makeup AND dry my hair! WHEW, I know, stop the press, right? Well for me it was a big deal anyways. I actually felt somewhat like a normal person.

But wait .... my day got even better. Way better in fact. First of all, today marks 29weeks 0days. A huge victory! Second, I had my weekly check-in with Dr. Mann today (my perinatologist) and we got a fantastic report! I was actually super nervous leading up to this appointment, because I had the + Ffn test last week and my contractions have become progressively more painful and more frequent over the last three days especially. So I was practically holding my breath during the ultrasound today, to the point that I was laying there thinking, "well, at least my hospital bag is packed already". Once again my lack of faith was showing.

As it turned out, my cervix measured 2.5cm today! That's great compared to my previous measurements! And .... Jamin has gained a whole pound in the last three weeks. He's now up to 2lbs 14oz! Goodness I breathed such a huge sigh of relief.

Dr. Mann is still concerned about the contractions, so she gave me some oral terbutaline to take as needed since my insurance company is still denying the terbutaline pump. Her other gripe was my weight. Again. I'm telling you, she just really never seems to get past that. I have gained back about 2.5 of the 4lbs I had lost in the hospital .... thanks in part to the delicious chocolate cake that Mrs. Parmer baked me and the yellow iced cookies that Jerah brought! YUM. I tried to tell Dr. Mann that there was really no need to worry, because the Girl Scout down the street promised that my six boxes of cookies should be arriving by next Tuesday, and this means that five of them will be gone by Friday. But apparently she wasn't convinced.

So she's putting me on a special high-protein diet. She wants me to consume EIGHTY GRAMS of protein a day! I don't even know if that's humanly possible, I guess we'll find out. She wants me to accomplish this by drinking three protein shakes a day each containing at least 20grams, plus eating my normal three meals a day totaling 20 more grams. I told her I'm worried that the three shakes will fill me up and make it so I'm not hungry enough to eat three normal sized meals .... and she told me if I have to pick between a shake or a meal she wants me to drink the shake. I'm glad I asked b/c I probably would've done the opposite thinking it was the better choice.

So ... tomorrow James is heading out to GNC to do some protein shopping. I think it's too bad that I'm confined to bed, otherwise we could take advantage of this opportunity to pump me up and enter a bodybuilding contest. Wonder if they allow pregnant women to enter the competition? Hmm. Of course, my legs are in the beginning stages of muscle atrophy due to five weeks of constant laying, and I don't think they give out an award for "worst atrophy". Pooh. I could totally win that one.

Thank you to everyone who is saying prayers for us, clearly God is hearing and He is unfolding a miracle before our eyes! We are so grateful to have made it this far, and even more grateful that it appears we will be able to squeeze a few more weeks out of this pregnacy! God is good.

Bye Bye Bruises?

I'm almost afraid to say anything for fear that I will jinx it. But I will hold my breath and do it anyway .....

I think I might be done with the black-and-blue-tummy-look I've been sporting since August.

This is a super-big deal for me. And it's all thanks to this:

That's my new friend, Heparin. Now I'm no fan of medicine, and especially not the kind that requires needles. But this stuff .... ahhhh .... has been a nice change. For 27 weeks I have injected myself with Lovenox each night before bed. Lovenox is Heparin's less polite cousin. They essentially do the same thing - thin the blood - but Lovenox stays in your system for 24hours, while Heparin washes out after about 8-12. There are a few other differences too, but this is the main one. Doctors like lovenox because it's more stable in your system and requires less vigilent monitoring. Patients like lovenox because the syringes are pre-filled and only have to be injected once a day. The problem with lovenox is that you can't deliver a baby while taking it. There's a pesky little quandry of bleeding to death during delivery (generally not the desired outcome), and the fact that you can not have an epidural while it's in your system (which remember, is 24hours after you've taken your shot). So usually doctors will switch their pregnant lovenox users over to heparin around 36-38wks, in preparation for delivery. Heparin will be out of your system 8-12 hours after you inject, plus it's effects can be reversed with another medication (yep, another shot) once you get to the hospital if they see that labor is progressing quickly. Lovenox, on the other hand, can not be reversed. If you're on it when you go into labor you're kinda screwed.

Rather than waiting until week 36-38 to make the switch, my doctors have been planning all along to switch me around week 32, since I've never actually made it to week 36. But in light of last week's events, they have decided instead to switch me now at week 27. Technically I could deliver any day, though of course that's not the plan, but it's not worth the risk to stay on the Lovenox.

So, Wednesday I saw my hemotologist and OB. We ditched the Lovenox and welcomed Heparin into our home. I was less than excited about the switch, because originally my doctors were telling me I would have to inject Heparin THREE TIMES A DAY, yikes! I have been majorly struggling to manage once a day with Lovenox, so the thought of 3x's the needles made me want to cry. As my tummy grows and the skin gets tighter and tighter, it gets more and more difficult to inject. Each night gets more painful and takes longer to complete. So I was dreading the switch to 3 times a day.

Well, Wednesday I got two pleasant surprises: (1) My doc changed her mind and decided twice a day was enough; and (2) The needles are waaaaay smaller and way easier to inject! Because the syringes are not prefilled (instead you draw it up from the vial), you can pretty much use any size needle you want. My sweet pharmacist at Publix hooked me up with insulin needles, they are teeeeeny tiny and I can barely even feel them going in! So while I now have double the needles, the whole process is seriously half the trouble. Hardly any pain, and ...... dare I speculate ...... less bruising???????

Well it's only been two days so I don't know for sure yet about the bruising. But I'm hopeful that there will be an improvement. I will happily bid a fond farewell to my pitiful blue and purple sidekicks and welcome that nice smooth photogenic bump that I see in all my pregnancy magazines.

It may be premature to celebrate, since it's only been two days, but I'm doing it anyways. This morning I took what will hopefully be my last picture of lovenox bruises. They are a few days old now and finally starting to fade:




And just for giggles, since we're documenting it all, let's just compare this bulging image to it's predacessor. Here I am back in early September, after my first week of Lovenox:




Ahhhh, yes .... that was back when my belly button went IN instead of OUT. And there were some muscles in there somewhere. I almost don't remember what that feels like. *SIGH*

As for the rest of my week, here's the abbreviated update: My cervix is measuring about the same (praise the LORD!). My doc's are planning to increase the home care I'm receiving from Matria and sweet nurse, Sharon (the one with the 40-foot needles). There is some confusion, however, as to what exactly the doctor has ordered. One says an NST (non-stress test) and home monitoring each week, the other says a terbutaline pump. I'm praying it's only the former, because the thought of a terb pump has me shaking already. That stuff is horrendous ... I took it by pill every 4hours with Gracie, but now the new technology allows it to be attached to your hip with a needle under the skin, and it pumps out a continuous dose 24-hours a day sub-Q. I'm trying not to think about it until I know for sure what they've decided. It will be Monday before I hear back on that. Dr. Mann was initially saying NO on the terb pump because she's afraid it will make me lose more weight (nausea and vomiting are common on the pump, in addition to the tremors and shaking you normally get with the oral dose).

Apparently I've somehow managed to lose 4lbs since returning home from the hospital last week. I have no clue how. I've literally laid here in bed eating double-cheeseburgers. And my biggest form of exercise consists of wiggling my big toe. So go figure. I had been up 12lbs over my pre-pregnancy weight; but since losing 4 that now makes me +8 overall. So yesterday Dr. Mann had a mild hissy fit and told me that I have to start drinking Ensure three times a week. And then said she's afraid to order a terb pump because she doesn't want me to lose any more. Dr. Garcia, on the other hand, hasn't said a single word about my weight .... he's waaaaaay more laid back about that stuff.

Those of you who know me well know that food and I have always been great friends. Particularly the yummy fatty variety. So no worries ... I'm eating lots! Today, in fact, I had a large bacon-egg-and-cheese buscuit, a coke, and a piece of pound cake for breakfast. Maybe I should take a picture of myself eating all this junk to quiet down Dr. Mann?

Let's see, what else? We've rented a wheelchair to make my trips to the doctor a little easier. I asked Dr. Mann yesterday if I could go to church Sunday if I take the wheelchair and promise not to stand up .... she said absolutely not! I'm very bummed about that but I will try again next week! I haven't been to church since Jan 4 and it's killing me.

I was at the doctor three times this week. I have three doc's and they each want to see me once a week. It's kind of tough getting out to Northside and Piedmont in my condition, I have to have someone drive me now ... we're trying to make arrangements so that I will have less visits each week. Although for me the doctor's visits help my sanity because it's the only time I'm allowed out of bed and it's nice to have a reason to wash my hair every now and then. Wednesday was a big day for me because I got to put on makeup *AND* get this ..... I even shaved my legs! I know, wow, right?

Other than that, I'm only getting out of bed to pee. It's a very boring existance. However I can't really complain because we have been so blessed all week with just an outpouring of offers for help. It is absolutely overwhelming. We've had tons of meals brought to us this week, and had a few friends drop by to have a "picnic" in my bed to help me pass the time. My parents came this week and painted Jamin's room for me - a huge undertaking! We've had others offer to come take Gracie for a playdate which has been super helpful. And ... best of all .... we've found Brandi.

Brandi is the new lady of the house. She comes each morning when James leaves for work, gets Gracie up and dressed, feeds her breakfast, and takes her to school or ballet, etc. She runs all my errands for me, brings all my meals and medications to my bed, and serves as a constant companion and play-toy for Gracie. I can't even begin to tell you what a relief it is to have her here. I will blog more about that next week.

So for now I'm trying to relax a little (nearly impossible task since my brain is still functioning) .... and I'm counting each day passed as a small victory. Today I am 27weeks 3days, thank you Jesus! I've got my eyes firmly fixed on week 28 .... that will be a huge milestone to pass and there will be much celebration next week when we get there.

A most heartfelt and profound THANK YOU to all of my sweet family and friends for the flood of generous assistance this week. I don't even have the words to adequately express our gratitude. We are overwhelmed by your kindness and love day after day and we are forever grateful.