Monday, June 29, 2009

We set a goal!

We had a great appointment today. Emmy looked great on ultrasound and actually had a reactive section on the NST. I might have found the secret....drink juice for the hour before the NST. We'll see on Thursday if that plan works. I was only on the monitor for 30 minutes. That is a first. I'm usually on for an hour. Then we went into the exam room and had the door open. Dr Fosnot (my favorite doctor) walked by and said hi as she was going by, then backed up and came in. She was kinda talking to me about plans and then told Dr Young (who my appointment was scheduled with) that she was just going to finish and take over the appointment. I was really excited because she really sits and explains things. All the doctors conferenced this morning and came up with a plan for me. Here's what they told me:

I'm back on strict bedrest for the rest of my pregnancy. There's no chance of coming off of it.
We're still doing bi-weekly NST, weekly ultrasounds, and weekly visits. We're still worried about the chance of another spontaneous bleed. They are sending me to a High Risk doctor for a more extensive ultrasound and recommendation for delivery. My OB's couldn't come to an agreement when it comes to delivery plans. Some want to induce me at a certain point, others want to let me go into labor spontaneously. So they decided to get the High Risk doctors input and they'll pretty much do what they suggest. We're hoping to get an appointment with them next week so then we'll have a good idea as to whats going on. If the high risk guys feel like its in the best interest to deliver the baby now, thats what we'll do. If they say let me go into labor on my own, thats what we'll do. If they say induce me, that's the plan. So we'll learn a lot next week.

Dr Fosnot says there is a good chance I could make it to term, or close to it because I've been so stable over the past few weeks. She doesn't think I'll make it to 40 weeks but she thinks there's a reasonable possibility to make it to 36 weeks. She's nervous for another bleed because she thinks it will be a substantial one if it happens. She also voted for letting me go into labor on my own because she doesn't want to hyperstimulate my uterus with the induction. All of these things increase the risk for my bleed. She thinks that even if I go into labor on my own I'll come in bleeding but at least it won't be because my uterus is so overstimulated by pitocin. Unfortunately its all a waiting game and like she reminded us, "there's no true right or wrong choice"

Our ultimate goal is to get to 34 weeks and any day past that is icing on the cake. They won't stop my labor after that point because Emmy's lungs should be mature enough to handle life. If I go into labor before 34 weeks, they'll try to stop my labor to give me steroids to help mature her lungs. The good thing is that we're over a lot of the long term problems associated with prematurity (cerebral palsy, retinopathy/blindness, severe developmental delays). We're looking at respiratory problems if her lungs aren't developed enough (oxygen supplementation, possibly intubation/ventilation). We're also looking at some feeding issues since her sucking reflex won't be completely developed so she may need a feeding tube until she can learn to suck on her own. I'll take those complications over any long term complication any day. But each day she stays inside me is a day in the right direction.

Thats all for now. We'll see how she does on Thursday and what my fetal fibrinectin says. Oh yeah, they did another one since its been over a week since the last one just to be on the safe side. Hopefully its still negative.

Friday, June 26, 2009

Another day spent at Morton Plant

Oh yeah...6 hours at the OB Assessment center. We went to the office for my routine NST and Emmy, as usual and expected, wasn't reactive on the strip. Usually this is not a big deal since she's still really young but today I had a significant increase of uterine activity so they wanted me monitored a little more. So we headed to Morton Plant, got set up in the same room as last time and had the same nurse around 1245. My hemoglobin hadn't changed (10.9) and we did another Kleihauer-Betke test (the one that counts the fetal cells mixed with mine). Emmy looked great on ultrasound. I had them double check that she was still a girl....and she definately was. MP's ultrasound machine is really good and we got a great look at her face. I think she's going to have Noah's nose and cheeks. After a slight delay by blood bank (aka 2.5 hour delay) they started counting the cells and found 1 in about 200,000. So that wasn't too bad. Emmy looked ok on the strip. She had one variable (dip in heart rate) but only that one so I was able to go 7pm. So my day consisted of being put on the monitor at the office at 1045 and coming off of it at 645. Gotta love it. I go back on Monday for another NST, ultrasound and office visit (with Dr Young, who sent me to MP today). We'll see what happens.

Wednesday, June 24, 2009

A little extra

So yesterday's appointment was really good. I'm still not dilated, my fetal fibrinectin was negative, and I finally had no blood in my urine. So things are looking pretty good. Still contracting but since I'm not dilated, its not a worry yet. The baby still isn't reactive on the NST but she's still a little young to have a great strip. So the verdict.....I can add some activity to my day. I'm not on strict, strict bedrest anymore. I can't over-do it but I can try to do a little more each day. No work though. I think they want to see if I can actually tolerate increased activity. We'll see if bleeding starts again, if contractions intensify, and if I have any cervical changes. I think its a great idea...see what I can and cannot tolerate. We'll get a better idea of how to handle the next few weeks. We're still aiming for 32 weeks and then making a new plan for the next few weeks.

So I'm excited to go to Shandie's baby shower tomorrow. I left so abruptly from work so it will be nice to see all the girls.

However, I'm miserable right now. Horrible back pain, more contractions and more intense ones at that, and generally uncomfortable, but no bleeding (definately a good thing). I sat on the floor for Noah's speech session yesterday...bad idea. I made my own lunch today (exciting feat....haven't done that in 2 weeks), took a shower, and went with Mom and Noah to get Noah's haircut. So needless to say, I'm uncomfortable and miserable. It will be interesting to see what happens on Friday at my appointment. I think I'm going to tell them that I feel a lot better being on bedrest. I'm not supposed to see a doctor but we might end up having the doctor in the clinic peek her head in to talk things over. Who knows. If anything, I'm having another ultrasound and visit on Monday so we'll definately know then if these contractions are doing any damage yet.

Oh and the Rays are up 7-1 on the Phillies!!! My boy Jason Bartlett had a big hit, scored 2 on it, and then ended up getting a run on a fabulous Gabe Gross liner down the first base line.


Monday, June 22, 2009

Nothing exciting

Nothing really exciting to report. I go to the doctor tomorrow so we'll see whats up then.

Here's what I've been up to so far:

Books read:
Harry Potter and the Half-Blood Prince (again)
Harry Potter and the Deathly Hallows (again)
Fowl Play by Janet Evanovich
Grand Finale by Janet Evanovich

Now I'm starting the Sookie Stackhouse series...the TrueBlood books. John's read them all and I heard they're pretty good. Plus the show is AMAZING.

Movies I've watched:
Wedding Planner
Wedding Date
License to Wed (it was a wedding themed day on HBO)
The American President
Twilight (and I'm going to watch it again tonight)
Knocked Up (only one of the funniest movies ever....we watch it whenever its on)
The Dark Knight
The Sisterhood of the Traveling Pants 2

I'm leading a boring life. Although Mom and I did go through all of Noah's baby clothes. I can't believe how many outfits that kid had when he was a baby. Some still had tags on them.

I'll update with tomorrow's excitement.

~JRC and EPC~

Friday, June 19, 2009

I was a rebel today

Went to the doctors for monitoring. Emmy looked pretty good on the strip. She had a few little variables (fluctuations in heart rate) but the doctor was ok with it today. She decided that I need to have bi-weekly NST from now until at least 32 weeks. So we're spending the beginning of the week and the end of the week at the office. They are going to be on a true first name basis with me.

No bleeding so we were able to get my fetal fibrinectin test. We'll have the result of that by my appointment on Tuesday. She also informed me that I have a bacterial infection, kinda like a yeast infection. So I'm on 7 days worth of antibiotics. To top it off, this infection is known to cause pre-term labor. Awesome. Just another thing to add to my risk factors. If I carry this baby to term, it will truly be a miracle.

She did mention that we are pretty much out of the woods for the baby to develop cerebral palsy if I had to deliver her right now. Thats a huge weight off my shoulders. Thats one of the huge complications of prematurity that I was concerned about. But its nice to know we're looking good from that aspect.

On to more fun stuff....I was a rebel and walked around Walgreens for about 10 minutes while waiting for my prescription to be filled. It was nice to be able to stretch my legs and walk a bit but after being on bedrest for a week straight, my body was not used to walking. I was glad to sit down afterwards.

Now its Rays time (aka Jason Bartlett time!!!)

~JRC and EPC~

Thursday, June 18, 2009

Picture update

Here's Emmy's pic from Monday. She's 29 weeks, 2 days. She's going to be the most photographed baby before she's born at the rate we're going. Kelly, the US tech, gives me pics everytime she scans me. I'm having weekly ultrasounds so we'll see how many pics I end up with by the time Emmy arrives.

So its been forever since I posted a belly it is. I'm 29 weeks, 5 days. We took it after my daily luxury, a 15 minute shower. Its the most time I spend vertical a day.

Tomorrow is the big appointment. Hopefully we'll be able to do the fetal fibrinectin test to see if I might deliver in 2 weeks. No ultrasound tomorrow, just NST. So I think we'll start finishing Emmy's room next week. Mom picked up some of the final touches for it today. And I guess I'll be directing the decorating while everyone else is actually working. I'm over this bedrest thing. I survived a week of it so far.
I had a pretty good day today. Hope it continues tomorrow!
~JRC and EPC~

Tuesday, June 16, 2009

Bartlett's back!!!

Jason Bartlett is back!!! He's my boyfriend on the Rays and has been on the DL and subsequently negatively affecting my fantasy team. But its nice to finally have him back in the lineup.

Is it possible for your muscles to go into complete shock after only 4 days??? All of my joints and muscles hurt already. I'm a little more crampy today but I really think just sitting down all day long has something to do with it.

And isn't it sad that the highlight of my day is when I can take a shower?!? 15 minutes of standing. Its amazing all of the things that I took for granted before this happened.

~JRC and EPC~

Monday, June 15, 2009

The Plan is:

I'm on bedrest until the baby is born. They couldn't find the abruption again on the US but I'm definately having one. I'm still spotting (bummed out by that last night since it meant I couldn't have my fetal fibronectin test today) and I'm definately having "uterine activity" aka contractions but I'm not dilating. After being at the dr's office for 4 hours, this is what we've come up with.....

Its official bedrest, meaning I can go from the bed to the couch, I walk to the bathroom then come back, I can take a short shower every day and sometimes make a sandwich. Let me tell you how excited I am about that. However, she did say if I'm not bleeding, not contracting, and doing ok, I can go to church. She said there was a chance I could go back to work if the FFP (fetal fibronectin protein) was negative and I made it to 31 weeks. Then she remembered I was a nurse and said no way. She knows how well we nurses take care of ourselves during our 12 hour shifts. I used to wish to get called off of work and now I'm totally bummed I can't go. But at least I'm at home right now and not in the hospital.

The baby looks great on ultrasound (or biophysical profile, aka BPP). She's moving like crazy (possibly because of the contractions) but moving nonetheless. They caught 30 seconds of breathing which was nice to see. I do have a little extra amniotic fluid so I'm going to do some research to see if polyhydramnios could have any connection to abruption. Although on the NST (non stress test: the monitoring they do), she's not really reacting too great. They like to see a drop in heart rate then an immediate increase after movement and she's kinda hanging steady. But since she's so little still, its not a concern.

So here's what's in store for me. This abruption is a serious deal. Right now its a small partial separtation or chronic abruption. But there is a chance that it can continue to separate and cause serious problems....aka severe hemorrhage. So it has me freaked out a little but I'm trying not to focus on it. She also mentioned possibly doing an oral tocolytic (med to stop contractions) even though the OB community is trying to move away from using them (supposedly they don't work too well) and they are even throwing around the idea of starting steroids to start prepping the baby for the world. I'm not excited about that because it makes it seem like they think I'm probably going into labor soon. So its pretty nerve wracking. I'm on Vistaril to try to stop some of the cramping (and I'm a big wuss...I couldn't tolerate 50mg and had to ask for 25mg. I don't know how our kiddos take a full dose without falling asleep for 12 hours). I have to go back on Friday for NST and a visit and hopefully I'll have no bleeding in the meantime so I can have the FFP. Then its weekly NST, BPP, and visits. Its going to be a very long 11 weeks (if I can keep her in that long). I'm just an interesting case and they really don't know what to do with me. So its weekly visits, bed rest, and fingers/toes crossed.

~JRC and EPC~

Sunday, June 14, 2009

So much to tell....

So let me catch everyone up really quickly. We finally bought our house. We closed on it May 22nd (John's birthday) after holding the title company/real estate office hostage (thats for another day). We did a complete renovation in like 1.5 weeks and it looks amazing. I can't thank my dad and Tim for everything they did. We moved in, started to unpack, we're getting used to the idea that this is our home. We've kinda hit a plateau in unpacking and decorating though.

Baby news. Its a girl! Her name is Emily Paige...Emmy for short. Or if you're Noah, her name is Bob. I'm 29 weeks and up until last week, things were going smoothly. Ok that should catch everyone up to 4 days ago.

On Thursday (June 11) I woke up at 5:40 am and started getting ready for work. I noticed I had some bleeding and abdominal cramping but nothing too bad so I decided to go to work and wait until the OB's office opened at 8:30. When I got to work, I was cramping pretty bad and was still spotting. They sent me home (I tried to stay until I could talk to the OB but that was shot down big time). I should actually thank Jean and all of the night shift girlies for being so forceful. I called the on-call doc and she said to make an appointment. I got one for 10:20. Mom took me and I was definately having some bleeding but I had not dilated....good sign. Dr Dadisman put me on the monitors for a while to see if she could catch any contractions. Well I had about 3 and there was something else on the strip that caused her to contact the on-call doc to figure out a game plan. I was sent to Morton Plant Hospital to continue being monitored. Well I was planning on it being a quick visit. At 3pm, the nurse comes in and wanted to draw my blood for a test to check if there were any fetal blood cells mixed with mine. I was also contracting every 2-3 minutes (nothing big, I didn't even feel most of them). Then she said the doctor wanted to come and see me when she was done at the office (5pm). So I was stuck there. Mind you....I haven't been able to eat since breakfast that day and the 2 packs of graham crackers they gave me to try to wake the baby up. So Dr Ritter came, checked me out...I was still not dilated. Because I wasn't dilating and wasn't feeling too many of the contractions, if the test came back negative I could go home on strict bedrest until Monday when she wanted me back in clinic. If it was positive then I would be admitted overnight to run more tests. And of course, it was positive. The blood bank called when they had found 3 fetal cells and they were still counting. So I got to spend the night in a L&D room, had an ultrasound, was on the monitor every 8 hours, and finally got to eat. The next morning, Dr Fosnot came in and said I could go home. I had a probable abruption (placental separation from the uterine wall) although we couldn't see it on the ultrasound. So I was sent home on strict bedrest (I could take a shower, walk to the bathroom, and I could stand for no more than 15 minutes) and I have to go back to the doctor tomorrow for more monitoring, ultrasounds and appointment.

So I've been going insane just sitting around. I can't play with Noah and I don't think he understands why Mommy can't get off the chair. Its breaking my heart. Not to mention that I'm bored out of my mind and my butt hurts so much from sitting. I hadn't had any spotting since Thursday night but at 5pm today, I was blessed with spotting. So now I don't know what the plan will be. I'm just praying I'm not admitted for the rest of my pregnancy. Keep your fingers crossed.

I'll be posting more frequently because I'm bored so this is my way of venting.

~JRC and EPC~