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.

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!

How Low Can Ya Go?

Last week I got a call from Dr. Duncan's nurse at Emory telling me the results of my latest Protein S labs, which were taken at 10weeks gestation. My "Free Protein S" had fallen to 19 (!!!!), down from 25 at 7weeks gestation and roughly 48 pre-pregnancy. "Normal" is considered to be somewhere between 60-150ish.

We knew this was coming, since Protein S naturally falls during pregnancy (even for the "Normal" folks). So while we were expecting them to fall, we were never expecting them to fall this low. The hematology nurse who called freely admitted she's never seen numbers in the teens before, which I also expected, but even so hearing it out loud didn't feel too good.

I managed to confine my mental freak-out to just a day or two, and now I'm just taking comfort in the fact that God's got me covered. And the icing on top of that cake is knowing that Dr. Duncan is monitoring me very closely, and there is no doctor more qualified for this scenario than he is.

In fact, I'm feeling so confident, that I'm now taking bets on just how low my Protein S will drop before this is all over with. We expect that it will continue to fall as the pregnancy progresses, the lowest point being at the end of the pregnancy. So now it's just a game of "How Low Can Ya Go?" .... without triggering a disaster, of course. Anyone want to take a guess? We need to award a prize to the person who gets closest without going over!

I'm thinking if numbers in the teens are nearly unheard of, would I just be a complete freak of nature if I had a single digit number? If so, then that's my goal. Just another chance for God to show off!

BRING IT ON PROTEIN S!!

Tonight I'm reminded once again what a complete miracle Gracie is. I'm always calling Jamin my "miracle boy" and eager to share with anyone who will listen how God brought him here. But knowing now that my Protein S drops to unheard-of levels in the first trimester of pregnancy ... and knowing that I was clueless and unmedicated for my entire pregnancy with Gracie ... and knowing that we both survived ... seriously blows my mind!

I'm also resolving not to whine anymore about those stupid Lovenox shots. Yes they hurt and yes I absolutely hate injecting myself every night, but since they are keeping me alive right now I suppose it's only fair to stop complaining about them.

Thank you God for Lovenox!

Meet Baby Wren #4!

Well, it's official. We had our second ultrasound last week, this time we saw a teeny tiny embryo and a perfect little heartbeat fluttering away at 133 beats per minute. Baby is measuring 2-4 days small but Dr. Garcia feels that all is well.

My actual due date is January 19, though of course our ultimate goal will be 36wks again which would put us around December 22-ish. At this point I feel compelled to confess:

I am still in complete disbelief that this is actually happening.

Dunno why I can't seem to wrap my brain around the whole thing ... we've known for weeks now and yet I haven't seemed to move past the shock and denial of it all. I certainly am beginning to feel pregnant --- a little nausea here and there and fatigue so severe that most afternoons I have to prop my eyelids open with toothpicks. I'm still in the gym twice a week (trying to hold on as long as I can ...) but in general I just feel WEAK. It's weird how something so tiny can physically wreak havoc on you in a matter of days really. From an emotional standpoint I would be lying if I didn't admit I'm feeling quite disconnected from this little life, which I know from experience is just a self-defense mechanism so I'm trying not to heap guilt on myself for it. I know the bonding part will come in time .... I'm planning to not let myself wait until 20+ weeks like I did last time!

I've been back on the lovenox injections nightly for about three weeks now .... needless to say my poor abdomen is completely covered in dark purple spots. I actually never completely got rid of the bruised-tummy look, despite the fact that I was off the shots for a total of 1 year and 4 days. I've been carrying around two gigantic brown bruises, about 2-inches in diameter, on either side of my belly-button for over a year now. These are souvenirs from Jamin. I've had several different doctors look at them (hematologist, dermatologist, obstetrician), and they've all told me various versions of the same thing: these are signs of deep tissue damage caused by repeated trauma of lovenox and heparin shots. They may continue to fade with time, but all of my doc's have gently suggested that I try to get used to them, as they are likely to be permanent without some kind of laser treatment. My hematologist explained that the heparin is probably to blame more than the lovenox ... bruising and scaring on heparin tends to be worse and I was injecting heparin for a total of 16 weeks due to preterm labor, rather than the 2 or 3 weeks we had originally planned. I am quite offended that nobody warned me about this ahead of time! And I'm secretly hoping that maybe if I am able to stick with the lovenox for a longer period of time this go-round maybe I can avoid more ugly scars. Well, a girl can hope anyways. In the meantime I've been trying to rotate my injection sites around every night, in an effort to share the love so to speak, and not bombard one or two spots repeatedly. I have no idea if this means that I am less likely to get two giant areas of "tissue trauma", or if it just means I will end up with twenty little spots of "tissue trauma". I also can't decide which is worse.

A month ago I was actually looking forward to getting a new bikini this summer. Now ........ mmmmm ......... notsomuch. Here is the last "normal" picture I will probably have of myself for awhile, taken on Memorial Day (7weeks) before the bruising got bad:

Please excuse my ultra-grumpy expression .... I think I was annoyed at James because he was rushing me. :) Not my fault ......... it's the HORMONES!!!

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

Lots of big news to report:

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

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

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

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

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

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

More updates soon!!!

33 Fun-Facts

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


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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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


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

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

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

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

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

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

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

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

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

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

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

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.

Breaking Back

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

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

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

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

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

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

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

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