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!

Jitterbug!

Guess where I'm going today???!?!?!!?

Ummm, yeah, nowhere. Ha, just bed. The walls are starting to cave in on me. Many people are asking me about the terbutaline pump and the monitor, and since I have a wee bit of extra time on my hands these days (pffff), I thought I'd show you what these things are and how they work. I had never seen a terb pump myself until it arrived at my house on Saturday. I had scoured the web in nervous anticipation, looking for pictures or diagrams, or something to ease my mind, but didn't find much. It would've been so helpful to see some pictures beforehand and get a better idea of what to expect.

I'll start by showing you what my belly looks like while I'm hanging out in bed:


There are actually two separate devices here. The first is the terbutaline pump, which is the little black thingy with buttons. It is attached to a tiny blue tube which is inserted into my right leg. The second is a toco monitor, which is the belt around my waist and the little grey box with lights.

First up, the terbutaline pump. Terbutaline is a drug designed to relax smooth muscle (i.e. lungs, uterus). It's actually intended to be an asthma drug, but is widely used "off label" by OB's who want to calm the uterus and lessen the frequency and intensity of premature contractions. Terbutaline comes as a pill (which I have taken with all 3 of my previous pregnancies), or in injectable form. My peri intends for this to be "long term use" (which, by the way, terbutaline has never ever EVER been proven effective at such) ... but since it's supposed to be long-term she feels the best method for me this time is a pump rather than the pills, which are taken every 4 hours. By contrast, the pump stays in 24hrs a day and administers a constant dose subcutaneously. Here's how it works:

I have a million little vials of terbutaline. They live in my refrigerator. The only thing I like about them is the hot pink label ... very "diva":

The vial gets inserted into this little hand-held pump:

It's size reminds me of those rockin' pagers we used to have circa 1998. Though it's a little thicker (width-wise) I think. The vial slides down into the back of the pump ... right underneath the cap you see on the top where the blue tube is attached. Each vial is pumped out at a slow continuous rate and lasts me about 24 hours. So roughly once a day I have to replace the vial with a full one from my fridge. This is a quick process and I only find it to be incredibly annoying b/c the thing beeps incessantly at me for several hours when the vial starts getting low. This morning it was every 10 seconds from about 4:30 am until I finally gave up and went downstairs to change it at 6:30 am. It's the same feeling you get when your smoke detector beeps non-stop until you change the battery (by which time you'd rather just throw the whole freakin thing out the window!)

The pump is programmable, it's all digital, so I can adjust my dose if needed. I can also administer an instant "bump", called a demand dose, if the contractions are bad and I need a little extra. It runs on one AAA battery. And taking a shower with it is quite a hoot. I'll leave that one to your imagination :)

Attached to the pump is a long blue tube, which delivers the medicine into my body through the little round button-looking thing you see on my thigh:

There is a needle, which inserts a catheter under the skin. The needle is then removed and the catheter remains and is taped down. The button-part goes on top and allows the tube to spin so I can move and sleep comfortably. Once it's in, you really don't feel it, promise :) This entire piece has to be removed and changed every 3 days. You have to pick a new location, open a fresh set of tubing and a new needle, and reinsert the whole thing. I think I'm basically planning to rotate back and forth from the left leg to the right leg. I also have the option of using my inner thigh, or my abdomen ... but since I already use my abdomen to inject the Lovenox every night I feel like I need to leave that whole area open if possible!

Once it's all situated, the pump itself can be placed inside an incredibly ugly navy blue canvas case/pocket protector/fanny pack thing, so it can clip to your waistband. Seriously it's the ugliest thing ever! I'm hoping to find a more aesthetically-pleasing cell phone case (if I can make the pump fit inside?) ... or if all else fails I'll just bedazzle the crap outta this navy blue nightmare! Ya know, for entertainment's sake. We'll add some rhinestones and some tacky bling and at least I will laugh when I look at it.

So that's the terb pump in a nutshell. Overall it's not as awful as I expected .... the pump itself isn't really the problem, it's the medicine that makes me miserable. The side-effects are super duper unpleasant. It's a heart-racing, hands-trembling, unable-to-breath type of thing. I'm finding the side effects with the pump to be slightly less severe than what I experienced with the pills. However with the pills you at least get a bit of a break, whereas with the pump it is constant, neverending, blahhhhh. So having done both now, I can't make up my mind which one is "better" or "worse". Obviously the pills don't involve needles so for that reason alone I'd say they have the edge.

My other contraption is a "Home Uterine Activity Monitor", it's identical to the toco monitor at the hospital or the peri's office, but thankfully it's a smaller version:

The purpose of this thing is to record uterine contractions. I have to hook myself up to this monitor a few hours a day, luckily it's not around the clock! The "belt" has the round monitor attached which goes around the belly, and is connected via the grey cord to a little rectangular box with lights and buttons. That's where I can turn it on and off, or if I'm feeling a contraction at the time I can push a special button so it's recorded on my toco strip. The little box also holds all the data recorded from the monitor belt.

When I'm finished recording and I'm ready for a break, I remove the belt, and the little rectangular box gets plugged into this machine next to my bed:

I push a few more buttons and then this machine wirelessly transmits the saved data (via satellite) over to a set of nurses, in FLORIDA of all places! After 5pm, or on weekends, the data gets transmitted to the "on call" nurses, who are in Philidelphia. The nurses download the data and it prints out as a toco strip, just like at the hospital .... the long paper strip with all the little mountains showing your contractions.

About 15 minutes after I transmit my data, I get a phone call from the nurse, who tells me how my strip looked. If I'm having more than 2 or 3 contractions per hour she will have me administer an instant "demand dose" on my terb pump. This forces the pump to give me 1-hour's worth of medicine over the span of 15 minutes. I then have to get back on the monitor for another 30-60 minutes and retransmit an updated strip, then wait for another call back. We continue this process until the nurse feels confident that my uterus is "calm", at which point I get to take a break from the monitor for awhile.

I had a similar monitor during my pregnancy with Jamin, though I like this one better because it's an updated version. The old one was analog and had to connect through my phone line (sort of like a fax machine). This one is all digital and it sends the signals wirelessly so it doesn't tie up my phone. That's a major plus b/c with the old machine it never failed that someone would call me at the precise moment I was trying to transmit my strip ... causing the machine to melt down and I'd have to start all over again. And a pregnant lady stuck in bed has VERY LITTLE PATIENCE for these kind of mishaps!

I'm headed back to Dr. Mann's office tomorrow afternoon ..... to see if all these stupid machines have made one bit of difference! The main things she'll be assessing tomorrow are: (1) cervical length -- has it shortened from 2.8 cm since last week; (2) Amniotic fluid levels -- did the second round of Indocin reduce the fluid or do we still have polyhydramnios; and (3) Placenta's location -- has it moved up at all or do we still have a complete previa.

I will try to do a better job of updating in a timely manner :) Pray for us!

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!

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!!!

33 Fun-Facts

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


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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


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

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

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

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

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

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

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

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

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

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

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

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.

Hospital Day 2

So the whole Ambien thing was a fun experience. Last night I asked the nurse to give me just a 1/2 dose (5mg) to start since I've never taken it before and had heard crazy stories about hallucinations and such. After the 5mg I did begin feeling very tired and relaxed, but somehow still unable to get over the hump and actually FALL ASLEEP. So an hour later I buzzed her and asked for the other 1/2 of the dose. At that point it got a little hazy ..... I was semi-asleep and semi-awake at the same time. Hard to explain. I could hear the TV and I could hear the nurses walking by and talking outside of my room. So I wasn't fully asleep. But I wasn't fully awake and alert either. I "slept" like this from about 11:30 until 4am.

At 4am I found myself standing next to my bed with the lights on searching for my glasses. I have no idea what lead to me thinking I needed my glasses, or why I got up, I have no recollection at all. At one point I was crouching on the floor looking under the bed, when my nurse came in. I am hooked up to a million different monitors so she was immediately alerted when I got out of bed.

She walked in and politely asked if I needed help with something. I told her yes, I can't find my glasses can you help me with that? She went right to work searching, and asked "were you up late reading?" I replied no, I've been sleeping. She then asked, "okay, well why do you need your glasses right now?" There was a long pause while I tried to search my brain for the answer. It was in that moment that I realized I didn't have an answer because I had turned into one of the Ambien-crazies just like I feared! I truly had no idea why I was looking for my glasses or what I even needed them for. But I did have just enough mental clarity to recognize that I was confused and disoriented. So I finally just bit the bullet and admitted, "I'm so sorry, I totally can't remember! I feel really silly because I just realized that I'm not making any sense. I'm so sorry I bothered you!"

She was such a sweetie, told me "no worries, this happens to just about everybody on this stuff" .... tucked me back in and turned out the lights. And yes, she even found my glasses for me. Nurse of the year award goes to Jen! :)

Every other nurse I have met here has been equally fabulous. Even the other staff that are not nurses. The food lady that takes my food orders and brings me my meals .... wonderful. This morning when my shower head wasn't working right .... they immediately sent a maintenance man who took care of it in less than 5min. I have been very pleased with the care I've received here and I feel very fortunate that I am in *this* hospital, with *these* doctors .... the Lord has really shown us great favor and surrounded us with everything we've needed. Certainly I'd much prefer to be at home in my own bed (with zero contractions, perfect fluid, and a 4cm thick cervix of course!) .... but since we can't have that, then this truly is the next best place for me to be. I feel very grateful.

I was up (and alert I should say!) around 6:30 this morning. I ate breakfast and immediately began begging the nurses for permission to take a shower. Dr. Scott came by doing his rounds, he is one of Dr. Garcia's partners. I had never met him before. He was short and to the point ... basically repeating everything I had already known. And I was able to sweet-talk him into allowing me a shower so that made our chat super successful in my book!

After my shower I was greeted by Dr. Allen, a perinatologist who works with Dr. Mann. I had never met him before either. He went through the same 5 talking points that Dr. Scott had just finished an hour earlier .... so much so that I told him "nope, I don't have any questions, thank you!". HA! Now anyone who knows me will get a good laugh out of that! Normally I have lists of questions which I literally whip out of my pocket when the doctor walks into the room, at which point the doctors will laugh and tell me I need to stop doing so much research, and then I convince them to grab a comfortable seat so we can chat until they've answered every last one of my concerns.

It may seem extreme, but hey .... my perinatologist literally charges my insurance company upwards of $700 AN HOUR for being in the same room with me, and this fee does not include ANY medical procedures she might perform, it's simply a fee for her presence. So the little lists of overly-detailed questions are just my way of making sure she actually *earns* a tiny bit of that disgusting fee. But I digress....

After the doctor visits, my day has been quite slow and boring, really nothing new has changed. So that's the best we can hope for under the circumstances! They've pumped 3 full bags of fluid into me just since this morning, so I've spent the majority of my day making the endless trips to and from the bathroom, literally like every 10-15 minutes. It's a laughable ordeal really: First I have to unplug my 2 fetal monitors and throw the cords around my neck so they don't "fall in". I then remove my IV bag, and drag it all in with me too. I then have the pleasure of urinating into the oh-so-dainty and fashionable bowl insert-thingy which they place inside the toilet to collect and measure your urine output. Then there's the artform getting the pants back up without ripping the IV port out of my wrist, followed by more rearranging of the chords, which by now have winded into a 7-layer ball of madness, wash hands, limp back to the monitoring station, spend five minutes untangling the 7-layer ball of madness so that I can plug everything back in and get the IV bag hung back up properly. I have learned all the right buttons to push in case the machine honks at me or doesn't like the direction of my plug. Once the machine is happy and I see my toco strip is moving regularly again, I am free to get back in bed. Ahhhhh. Rest. Exactly 7-15 minutes after that my bladder is full again and it's time to repeat the entire process! Annoying for sure, but seriously I'm not complaining because it's the only form of "exercise" I've been allowed to have for about 6months now. And truly, if my biggest complaint of the day is that I have to pee 7000 times ..... then that means life is pretty good at the moment considering the alternatives!

Beyond the never-ending bathroom adventure, really the rest of my day has been quiet. And it's been nice! I've enjoyed the quite really. Pastor Jamal from CCH stopped by after lunch and we chatted eachother's brains out for well over an hour. He is always so fun to talk to! I made him promise that next time we meet to catch up that we will do at at Five Guys over cheeseburgers and cokes. He was quick to agree to those terms, so I'm holding him to it.

He prayed with me before he left, and it was a surreal moment when he prayed Jamin's name out loud. Hearing someone *else* say that name, in prayer and petition no less, was so neat. He has been "my" Jamin in my mind for many weeks, but having him officially be recognized as Jamin by the outside world was heartwarming. I'm so glad that James and I ended up agreeing to a name on Monday of this week .... this way all our praying friends can lift him up now by name. I know God is already getting thousands of petitions on behalf of Jamin Wren and I know he hears each one. That's so comforting for me.

James worked until early afternoon, then left to pick up Gracie from my parent's house. Then they came here to hang out for a while. Jessica came too! So it was a nice visit. Gracie was enamoured with my "magic bed" which moved up and down and all around at the touch of a button. She declared that she wants one for her room now. I tried to squeeze as many cuddles out of her as I possibly could (when she was sitting still, that is). I sure miss her.

I made them all stay until 8pm when my second steroid shot came, during yesterday's I was alone and I really wanted a hand to hold this time. I've been *dreading* it .... seriously all day when I look at the clock I've thought, "uugggh, only x number of hours left until my stupid steroid shot!". James held my hand, Jessica bolted out the door to wait in the hall, and Gracie got as close as physically possible to the injection site because she wanted to see every detail ... to the point that her nose was an inch from my bum and we had to tell her to back off a bit! She does the exact same thing on Fridays when the home nurse does my 17p shots .... apparently she's fascinated by the whole thing! Maybe we have a little nurse in training or something?

After my whines died down a bit, James and Jess headed out with Gracie. I am so relieved that James and Gracie will be sleeping at home in their own beds tonight, and Gracie will get to go to school tomorrow. I'm really wanting to make this whole ordeal the least disruptive as we can for her. So anything we can do to stick to her schedule and maintain a sense of normalcy is our plan.

I ended my night tonight having a verrrry long girl-talk with my night nurse, Emmie. Turns out we have a lot in common. She is a devoted Christian, and she and her husband (who works here upstairs in the NICU) are going to seminary to pursue full time medical missions work in Eastern Europe. Emmie is currently 37 weeks pregnant herself, so we swapped pregnancy stories and she shared with me all the "insider" info she knows about anesthesia and such. As we talked she began to inquire more about Isaac and the circumstances of his birth. So I shared with her some of the chaos and absolute trauma of that night. I explained that this is one reason I'm so fearful of delivering this time without an epidural. She promised me that the pain of an abruption is SEVERE, ten times more severe than just a normal non-medicated delivery. She assured me that the pain I experienced then was exponentially worse than anything I will feel this time if we aren't able to use and epi. She is actually the second nurse to tell me this, and I trust her. I feel slightly better having the knowledge, but I'm still overwhelmingly terrified at the possibility of a non-medicated delivery.

We shall see. Only God knows right now.

Our plan for tomorrow, as best as I understand it, is that radiology will come up and get me early in the morning. Like, perhaps 7am early. They will do the ultrasound and bring me back up here. Dr. Garcia and Dr. Mann will both come by at some point tomorrow to see the ultrasound and determine a tentative long-term course of action. It could be immediate discharge, it could be 10+ weeks gestating upstairs, it could be fifty different options somewhere between the two.

My mind is weighing heavily on me tonight, I think because I shared Isaac's birth story with that sweet nurse, and of course our worst fear right now is that something that awful would happen again, to Jamin this time. And the fact that my "fate" tomorrow is so unknown .... that's causing a lot of anxiety as well.

So, against my better judgement, I think I will buzz Emmie and give the Ambien another shot. But JUST 5 mg tonight! I don't care to see fairies or gingerbread men in the corner of my room.

If anyone from Northside calls in the morning and seems frantic, tell them to look in the shower or inside the large tall cabinet next to the TV. To me those both look like good places to hide if you're hallucinating!

HERE WE GO AGAIN...

Tonight I'm blogging from a hospital bed. That means my day did not go well.

I went to my weekly peri appointment today at 1:00. There Dr. Mann saw that my cervix has thinned down to just 1.7 cm thick. Seven days ago it was 2.7, so we've lost an entire centimeter in a very short time. It should measure about 4-ish.

Apparently 1.7 is down into the "panic" range. Dr. Mann took one look and immediately declared that I was heading straight to the hospital. Her immediate goal was to start the betamethesone (steroid) injections to boost the baby's lung maturity. It takes 48 hours to get the full effect from those (2 doses given 24hours apart), so she wanted to begin them asap. She also wanted to begin monitoring and administer the tocolytic drugs if the contractions get too frequent. The baby weighs approximately 1lb 14oz.

Unfortunately I was there at her office by myself, with James at work and Gracie picked up from school by my parents. So this was very difficult news to swallow all alone. I stayed totally calm and focused while talking to Dr. Mann, trying to understand every detail and ask lots of questions. But once she left the room I lost it. All I could think was "I CAN NOT have a baby at 26 weeks, it's NOT an option". I know way too much about the survival rates and the long-term neurological and physical complications. Even a momentary thought of living that is simply unbearable.

I clammored out of Dr. Mann's office and down to the elevators, while trying to call James and explain that I was coming home to pack a hospital bag and he needed to meet me there. My mind was so jumbled, and apparently multi-tasking was more than my brain could handle. I inadvertently rode up and down the elevators twice in each direction before I could figure out which one was the right floor to get to the bridge for the parking deck. Dr. Mann's office is inside the main building at Piedmont Hospital, so that's a lot of floors! I rode for quite some time, trying to hide my obvious tears and confusion and avoid the stares from the doctors and nurses who loaded, unloaded, and then loaded again before I could figure out where I was going. The whole thing was quite ridiculous, given that I've been to that office at least two dozen times and under normal circumstances I can get there and back with my eyes closed.

I finally made it to the car and began calling family and friends. My dear friend, Jerah, promised she would call everyone from the church and ask for prayer. She said all the right things and really calmed me down! By the time I fought traffic and made it home I was almost normal again. I packed enough clothes for 4 nights, just in case, and packed an overnight bag for Gracie so she can stay with my parents. James and I then loaded back up and ventured to Northisde.

We got here around 5:00ish. It was weird checking in at admissions because every other woman in line with me was gigantically pregnant. Apparently if you're being induced, you're supposed to check in between 5 and 5:30 the night before. So there I stood, surrounded by relieved women, ready to pop and giddy with excitement that it was almost time to celebrate their big moment. As we each got to the front of the line, the admissions lady asked us how many weeks we were. All I heard was 39, 38 1/2, 40(!), and one 37 weeks. Then it's my turn: I tell them 26weeks 0 days. Everyones eyes turn to stare and I get a few looks of sympathy. And for a moment the fear rose up again.

They quickly put me in a room .... first actually before the tummy-popped induction girls who arrived before me. I'm on the first floor (I think? This place is huge) .... room B11. After seven thousand consent forms and admissions papers, they started an IV of fluids and gave me my first betamethazone shot (steroid). James had run out searching for some dinner when they did those .... and with the steriod shot I literally had to turn my head and bite down into my pillow to keep from screaming. That pain was horrific. I remembered from Gracie's pregnancy that those hurt badly; but time had erased the memory of just how bad they really were. Guess that's a good thing really. I have to get one more tomorrow night and then I'm done with those.

My other meds have pretty much stayed the same: I'm getting my Lovenox shots every 24hours, my 17P shot on Friday, aspirin, and all the rest. They've also added terbutaline shots when my contractions get too frequent, but so far they haven't been bad.

The plan at this point is to keep me here at least until Friday. The midwife came by earlier tonight and said quite honestly she has no idea how long I will be here .... could go home as early as Friday or could have to stay for another 10 weeks. It all depends on what happens in the next two days. On Friday Dr. Mann will come by to give me another ultrasound and re-measure everything. Based on what she sees she will make the judgement call at that time.

I have two doctors coming by tomorrow - one is Dr. Mann's partner and the other is Dr. Garcia's partner. Then Mann and Garcia will both come on Friday.

I was given an Ambien about 25 min ago (my first one ever, little nervous about how that will work out!) .... so I'm praying it will turn my brain off for the night and help me rest. I had to beg James to leave and go home to sleep in a real bed instead of this pathetic chair-thingy. He has refused all night but finally about an hour ago agreed. He got up at 4am this morning to drive his mother to Piedmont for an upper-GI test, so he is running on empty. Praying he gets some good rest tonight too, he sure needs it.

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.

Viablility: YES! Bedrest: NO!

So today was a day of good news/bad news. Which should I report first? Hmmm.

Good news: I have offically reached the all-important, super-vital milestone known as fetal viability. This is the gestational point in pregnancy at which doctors declare that a baby has a chance of long-term survival if born early. Most doctors will not intervene to save a baby before this point.

I am praising God for the miracle of 24 weeks! He alone has provided me with a very highly-skilled team of expert doctors, given us the right medicines, and strengthened my body for the journey.

I was thrilled to head back to see Dr. Mann today (perinatologist), for another ultrasound and our weekly pow-wow. I've been especially nervous these last few weeks, knowing that the cervix was starting to show signs of effacement (thinning) between weeks 16-18. During that time, my cervix thinned from 4.0 cm to 3.5cm, but has stayed put since then.

Which brings me to the bad news: At today's measurement, the cervix is down to 2.8 cm. And there's more: polyhydramnios. This is a fancy word meaning there's too much amniotic fluid surrounding the baby. Dr. Mann explained that this is a major problem because all that fluid causes additional pressure on the cervix, causing it to thin even more. Excess fluid alone can cause pre-term labor and delivery. Added to the fact that I already have a previous history of preterm, am continuing to have frequent contractions, and now a very thin cervix ..... it's an enormous concern to my doctors.

She explained that polyhydramnios can be caused by different things: 2/3 of the time it's "idopathic", which means no known reason. About 15% of the time it indicates gestational diabetes in the mother. In the remaining cases it can be caused by a baby with birth defects, or any of the trisomies. At this point she is feeling confident that I fall into the 2/3 category, for whom this happens "just because". I will have my diabetes screening in two days, so we should be able to rule that out soon. And they have already checked the baby's anatomy top to bottom a million times, but she spent extra time double-checking his heart again today just in case. She reports all looks fine and she sees no indication of any defects.

Dr. Mann then proceeded to tell me the word I've been dreading to hear since this all began: Bedrest. I knew I was gonna end up here at some point, so it's not like it's a surprise or anything .... I was just really hoping we'd get much further along before we had to deal with this. With Isaac and Gracie both I was on bedrest about 6weeks each time. And I nearly lost my mind being cooped up like that! If we make it to the end this time it would mean SIXTEEN weeks of bedrest. Seriously a marathon. They may have to put me in a rubber room sometime around week ten or so.

I am trying not to panic. The doctors keep telling me that as long as the cervix stays above 2.0 cm then it's not time to freak out. I would be lying if I said I wasn't full of fear ... I am. But I'm trying my best to fight it and not let it paralyze me. Of course I will do everything within my own power to keep this little guy inside and healthy for as long as the Lord allows. And my doctor's have all assured me they will do everything humanly possible on their end. I am confident in their skill and I am grateful for the excellent top-notch care they are providing me. I guess the challenge once again becomes accepting the fact that this is out of our hands for the most part: God and God alone will decide the day and time that our little boy will come into the world. I am trying to take comfort in knowing that He already knows the time, and He already has the details worked out. Being the kind of person that needs to control things, of course this is quite hard.

Dr. Mann has put me on a 72-hour course of Indocin which we are hoping will accomplish two things: (1) slow contractions and (2) reduce the amount of amniotic fluid. I was on this medication back during the chaos with Isaac, so I'm quite familiar with it and I have high hopes that it will help this time. It can only be taken for 72 consecutive hours, though, which is the main drawback of this medicine, since longer dosages can result in heart problems for the baby. I will take my first dose tonight as soon as James gets home and has a chance to run to the pharmacy for me.

Aaaaaand so ..... the rollercoaster ride picks up speed ........

The halfway point!

I can hardly believe I'm 20weeks already! The last several days have been emotionally draining to say the least .... with passing the "milestone" gestational date when Isaac died, Laura being in the hospital, and fears of increasing contractions and a thinning cervix. Praise the Lord we've all survived, and Laura is just fine despite a good scare.

I must say I expected Isaac's milestone date to be sad, but in all honesty I was not expecting it to be so completely overwhelming. I literally spent the entire day in tears, and on the way home from Dr. Garcia's office I stopped by the cemetary (haven't been in a while). There I sat, alone, sprawled out in the grass, weeping like a crazy woman while it snowed.

Not my proudest moment.

I'm blaming it on the hormones. And the fact that our current circumstances have increased my fears of a repeat. I've been seeing Dr. Mann (perinatologist) every 2 weeks ... each time I go she does an ultrasound and takes careful measurements of my cervix. At week 16, it was measuring 4.0cm, which is good. Two weeks later (week 18), amidst increasingly frequent contractions, it had shortened to 3.5cm. This is right at the bottom end of the "normal" range, but of course its enough to have my mind racing with fear. I go back again on Wednesday for another measurement - I'm praying for no change so I can relax a bit. Right now James and I are holding our breath, to some extent it feels like waiting for the other shoe to drop. We talk about our fears often, which helps just to know I'm not alone. James is also immensely stressed and frightened.

Though he can't blame his fears on the hormones. That's one of the perks of being pregnant!