Friday, June 14, 2013

Background Thus Far!

I realize I'm being eclectic about the order of my posts, but I promise that this is the last backlog!  It's been hard to figure out when this started, or if there were any signs that this was here's the story starting from when things might have been iffy.

Monday, May 6th
OB Appointment, 23w4d

A few weeks before, I started noticing a few (what I think/thought/assume) Braxton Hicks contractions.  One day at work (April 4th, to be exact), I was feeling quite a few, and thought I'd try out my contraction timer.  The BH contractions were averaging maybe 10-15 seconds long, and 15 minutes between.  They were highly irregular, and I thought there were several reasons contributing.  One, it's hot here.  I just need to drink more water (and if I remember correctly, that was what fixed things up that day).  Two, somewhere I heard BH contractions start earlier in successive pregnancies, and since this isn't my first, it's bound to be earlier.

In any case, at the appointment, I mentioned this to the doctor, along with a reassuring "I'm sure I just need to increase my water intake and so on".  He agreed and made sure to ask if they were regular or more than 6 times an hour...which they weren't.  And also re-emphasized that if there were more than 6, to call!  The rest of the appointment was straightforward and easy, and we got another peek at the baby to get the rest of the measurements that she wasn't in a good position for the last time.

Tuesday/Wednesday, May 7th & 8th
Food Poisoning!

Probably not related, but Mike, Daniel and I were up half the night (and into the next day), violently ill with food poisoning (we'd ordered pizza Tuesday night...only one who didn't have any, Jared, was the only one spared!).

Friday, May 24th
1-hour Glucose Test, 26w1d

Got off work early for the holiday weekend, so I decided to go take the 1-hour glucose test.  In the days leading up (maybe even the week before?), I was still feeling BH contractions, and occasionally one of them (maybe once a day) would make me stop in my tracks and go OW!

Tuesday, May 28th
Results of Glucose Test

Good news!  I passed the 1 hour glucose test (so no gestational diabetes, no 3-hour glucose test!).  Weird news (although not that weird, I guess), is my iron levels were low.  They didn't say how low, but they asked me to start taking 325mg iron, twice a day.  I know it's not a big deal and all, but it just seemed funny to me because I eat red meat (I LOVE red meat!), I take pre-natal vitamins and I figured being anemic wouldn't really be an issue.

Thursday, May 30th
Major work upheaval, start of increased stress level was not a good day.  I won't go into detail, but our worlds got rocked, and I could feel a massive headache building (either brought on by fits and bursts of crying or otherwise).  I did take some ibuprofen to deal with said headache.  I was in just as bad of a state as everyone else at work, and luckily Mike drove me home that day.

Friday, May 31st
A going away party lunch, day off work

Given the stress of the events at work, my boss (lab head) basically suggested that we just take the day off (off the record) and maybe get together at her place to vent and chill out.  There was also a going away party for a friend in another lab.  I felt like I really needed to get out of the house (and we'd left the other car at work anyway, so I needed to pick that up), and we ended up talking half the time about the events of the previous day.  It was a bit emotionally draining, but it was good to be in positive company.

Afterwards, I didn't end up making it over to hang out with the rest of my lab mates.  I was too tired.  My belly hurt.  At least I got a good nap in from about 3pm onwards.  It was going to be a long weekend!

Monday/Tuesday, June 3rd & 4th
Organization and mad-panic days

Both days were spent either getting things organized in lab notebooks, cleaning, and doing any last minute experiments.  I was feeling like I could get most things done in a reasonable time, and had a focused plan of attack for when certain things would be completed before the lab shut-down.  I actually ran myself a little ragged on Tuesday doing 3 protein gels/transfers and preparing for immunoblotting.  I also stood quite a lot in front of a PDF machine, scanning autorads and doing that type of thing.  That day, in particular, I remember having more painful contractions, even though I was too busy to time them.  I was keeping very hydrated, and as off of my feet as I could (but I was still running around more than I had in the past few days).  Stress level still pretty high, and I had a meeting with HR set for Wednesday.  I felt like I was in limbo as to my future until I had that meeting, so that stressed me out just a bit more as well.

Wednesday, June 5th
From work to hospital, 27w6d


Today is the day everything came to a head.  On the one hand, I was anxious to meet with HR to get things "figured out", but I was also preparing myself for it to be very mentally draining.  The meeting went "well", and I was able to sort of hold it together without crying too badly until the end.  At which point I had to sit in her office and settle down for a bit (thankfully, she's a very understanding person!).  I am tearing up just a little bit just thinking about it, that's how much these things affect me.

Contractions, contractions, contractions.  A couple of them hit me pretty hard, enough to stop me in my tracks and brace myself against a shelf in the lab.  The weird thing that I'd noticed (and today wasn't the only day this had happened), was that usually water is supposed to help, as is sitting down.  But water actually brought them on, or made them worse.  And they didn't stop even when I changed position (which the only two positions I was in was standing or sitting, but still).  I still couldn't clock them at being very frequent.

I debated long and hard with myself to call the doctor's office, at the very least the nurse, to see if there's anything I was missing or I should do.  I had a regularly scheduled appointment for the next day (my 28 week check-up) and I really contemplated putting it off until then.  But I also knew that I have a very bad habit of downplaying symptoms at a regular appointment, and I don't want the doctors to get the impression that I wait until an appointment before saying anything.  So I called.

I had lunch with Monica, which actually relaxed me, but was still feeling a lot of tightening periodically.  I ended up missing a call back from the nurse at the doctor's office.  I thought, great, they're going to think I'm playing phone tag.  So I called them back and talked to the nurse...she actually lead most of the questions after I started with "I'm having a lot of Braxton Hicks contractions", including whether my discharge had changed (hard to say, but lately it had seemed like the goo was getting more copious, and I mentioned that I didn't know if I was sweating more, peeing myself, or what, but there was usually some extra watery fluid there).  Was the baby moving less?  I had to think really hard, but it seemed that maybe she was.  Dropped lower?  Maybe!  She had been breech, laying sideways for the longest time, but recently it seemed as though she might have turned head down.  In any case, rather than waiting until my appointment the next day, they suggested that I go in, just to be on the safe side.


I got to the office just before my appointment and I could still feel the contractions every so often.  And by every so often, it was still maybe every 15 or 20 minutes.  I'd taken care to be well hydrated recently as well.  I get called back and first thing's first...urine sample.  Testing for UTI, checking the usual stuff as well.  As I expected, I was very well hydrated (probably the best I've been for any appointment!), no UTI, no sugar or protein.  So far so good.

It was my first time meeting Dr. Pottorff (new doctor with the practice since I had Jared) and she was super nice as well!  I think I've mentioned before how I really, really like everyone there.  Anyway, I told her what was going on, and she set up to do a few things...again, my expectation was to rule things out along the way.  First was testing for amniotic fluid.  I was pretty sure I wasn't leaking fluid, but it's easy to check.  So that was quickly eliminated.  Second step was to run a fetal fibronectin test.  The doctor explained that it would take a while for the results (they send it out), and that a negative result would indicate that the chances of going into labor in the next two weeks were very low, so that would put minds at ease.  Lastly, the cervical check.  I can't obviously tell what's going on in that region, and the earliest I've ever been checked is at around 34 weeks (with Jared, when I was 3cm then, but low).  And the results were 1, maybe 2cm dilated, but still high.  I sort of figured that maybe I just dilate early anyway, and it was a good sign that my cervix was still higher up, rather than lower.

Before leaving, she asked if I'd mind hanging around to see if the ultrasound tech was available for a quick scan.  Just to check cervical length and see how the baby was doing.  Who am I to turn down an ultrasound, of course, and luckily she was available right away.  The tech did a whole bunch of measurements with the transvaginal ultrasound, mentioning nothing as she was doing it.  No real shots of the baby in that one.  She asked if I wanted some shots of the baby (of course!), and switched to the abdominal probe.  I was SO happy to be able to see her, and she was moving around, facial features becoming more distinct and everything.  As I got dressed again, I expected to be told that everything was OK with the baby and my cervix (aside from the 1-2cm dilation) and to just go home and wait for the fFN results.

Instead, Dr. Pottorff came in with very different news.  She handed me the fFN test and had me go to the hospital for monitoring of contractions for a little while.  My cervix was 1-2cm dilated, but it was shortening (1.5cm by ultrasound).  This was just getting more and more complicated.

I ran home really fast to grab my phone charger, and I had the wherewithal to grab a pair of PJ pants and a tank top "just in case"  (thinking that if I took it, then I wouldn't need it...).  At that point, I even told Mike that I was just going there for monitoring and that I'd probably be sent home after a while.

Around 3pm

I arrived at the hospital and went to OB triage.  The admissions lady was with someone else, so I waited.  She was pleasant, and had a lot of stories to tell.  But, of course, she seemed like there wasn't a huge rush or anything to get me back.  After she took all of my information, insurance and stuff like that, I went through and got set up in triage.  I handed my fFN swab to the nurse, and was set up in a room (I kept my dress on even...goes to show you how I didn't think I'd be there long!).

Around 4pm

The news comes back.  Positive fFN test.  My heart sinks.  Especially since I knew that negative was good (and to be expected), but positive was inconclusive.  As much as I try not to look at the contraction monitor, I can't help but notice the little bumps, and I really try hard to keep still and relaxed (as if I could will them away???).  My head is going in a thousand different directions, and I don't think I was even comprehending at the time whether I was going to be admitted or not.  Or just get treatment in triage.  In either case, the time was drawing nearer for Mike to come and switch out cars (mine had the car seats) so he could get the kids.  I called my parents and told them what was going on (trying to talk while fighting back tears) and asked them to watch the boys.


My IV got started with standard saline and a bag of magnesium sulfate.  I also got the first steroid shot to help the baby's lungs develop, with the understanding that I'd need a second shot 24 hours later.  Mike made the car switch (didn't stop inside, just switched cars and went to pick up the kids) and headed to drop them at my parents.

Around 5pm

I have help getting changed into a hospital gown (no easy feat getting out of the dress with an IV in one arm and monitors strapped to your belly) and prepared for admission.  The nurse prepared me for the worst with both the steroids (it ended up not stinging or hurting as much as she prepared me for) and magnesium (which was prefaced with "you may feel like you have the flu...nausea, sweating, chills, feverish".  A half hour in or so, I was dealing with everything pretty well, and asked to use the bathroom (and was able to get myself there without any problems).

Around 6pm

I get transported to my room in Pod C of the 3rd floor.  One of the OB residents comes in and talks with me a little bit (either she was more vague on details, or I don't remember due to being in a bit of a daze).  She brings the portable ultrasound to do a quick check to see where the baby is laying and just a brief check overall (apparently, between the office and hospital, she went back to lying transverse).  Another quick cervix check and I'm still at about 1.5cm.

Around 7:30pm

Mike gets to the hospital, and Dr. Hebets comes to talk with us.  At this point, it's becoming more clear that I'm going to be there for at least another day or two.  I get some dinner and I prepare for the long night ahead.

Around 11pm

An NP from the NICU comes to talk to us about what we might expect IF we had a premature delivery.  She was very thorough, and had her own personal experience with pre-term labor.  We got a chance to ask a lot of questions, and it was actually pretty comforting (in a strange way) to be prepared for what we might experience, and how things would change as the baby stayed inside longer and longer.


I was told the next morning that I was having between 7 and 8 contractions an hour in the early evening.  Eep!  Sleep was not fantastic, as the baby was moving around so much that her heartrate would drop off of the monitors.  My overnight nurse, Shauna resorted to trying all sorts of rigging to get the monitor to stay in a good spot.  And then she and another nurse would have me try laying on my side, then the other side, and so on.  I was so tired that at one point I am pretty sure I dozed off while two people were messing around with monitors on my belly.  I got up SEVERAL times to use the bathroom (peeing like a liter each time!), and had vitals checked whenever I got hooked back up.

Thursday, June 6th
Morning - 28 weeks!

Around 6am the parade starts.  First the resident.  Nurse comes by again to do vitals.  Breakfast arrives.  Dr. Hebets comes by.  Then Mike has to go and get the kids from my parents to take to daycare.

Early afternoon

Visitors!  Hooray for visitors!  I am SO happy, probably one of the happiest moods that I've been in.  But I also am starting to realize how fuzzy my brain has gotten from being on the magnesium.

After everyone from work departs, I have lunch, Mike returns for a bit (before having to go get the kids again and deposit them at my parents).  4:30pm arrives, and it's time for my second steroid shot.


A bit less of a parade coming through.  They decided to take the fetal monitor off, which meant less messing around with trying to keep her heartrate on the monitor.  However, my pulse-ox was dipping pretty low, so they gave me supplemental oxygen.

Friday, June 7th
Early morning - 28w1d

Around 4am I woke up choking and coughing.  It felt as though I had inhaled liquid, but I think it was just an illusion caused by oxygen being fired up my nose.  The nurses came to check on me (which, gave me opportunity again to use the bathroom and feel more comfortable...ah).  I stayed up for a little bit (couldn't go back to sleep right away).  I finally dozed off again, only to have a lady come to draw blood for labs at around 5am.  I managed to doze off again, and the resident came in.  This time I was really not so with it, so I have a bad memory of what was said.  Breakfast came.

Since the baby was off the monitor overnight, my day nurse (Carol...she was there on Thursday as well!) came to do a non-stress test (NST).  Basically hook up the monitor, check her heartbeat and assess whether she was having accelerations in her heart rate.  Her heart rate was a bit low from the magnesium, presumably (in the 120s).  First we tried orange juice.  Not much of an increase.  Then a little buzzer on my belly to wake her up.  The baby would wake up and jolt, but she wasn't having really fantastic, at least 15 second long increases in her heart rate.  But it wasn't too terribly concerning.

In another good bit of events, Dr. Mayer came to talk to us.  Another person who experienced pre-term labor, and knew first hand the effects of the magnesium.  The longer I stayed on it, the more wobbly I was, the more my head was not so clear and it just wasn't really all that pleasant.  She did another quick cervical check (still at around 1.5cm), and set us up to have a full ultrasound in the afternoon to assess how the baby was doing.


Monica came by in the early afternoon (dropping off some Diet Mountain Dew...hooray!) and talking for a bit.  The ultrasound people came by and gave me a heads-up that they were coming to get me, but their heads up ended up being about 2 hours (at which point I ate some of my lunch and visited).  The transport person came just as Monica was leaving, and back down to triage where the ultrasound was.

The ultrasound was probably the most involved that I've ever seen done on any of my kids.  It was done by a student (which is fine), but they were much more slow and methodical, and not really pointing out anything super fun.  Towards the end, her supervisor came and redid some of the measurements and finished up (taking about 5 minutes to do what the student had taken about a half hour to do).  And then transport comes back and I'm deposited again in my room.

By the time I got back, it was nearing 4pm, and they were given the go-ahead to just take me completely off of the magnesium.  Which also meant that I didn't need to be pumped up full of saline either, but they kept the IV in (just shut off).


With only a contraction monitor on, I was a fair bit less encumbered, which was good!  Mike and I watched a little TV (just random junk, still), and I dozed off and on until they came in one last time to do vital checks and all of that stuff (at this point, still having to have them unhook me from monitors before using the bathroom...and still measuring how much I was peeing...ha!).

Saturday, June 8th
Morning - 28w2d

The usual parade didn't come in really much at all...I didn't see a resident until around 9am, and didn't see much of anybody except for the people bringing breakfast.  The new morning nurse came in to do another NST, and the babies heart rate was higher than before (in the 140s), but still not really doing the accelerations (orange juice and the buzzer again!).  They weren't too terribly worried though.

The only thing that made me a bit nervous in the morning was that the nurse kept mentioning how I could be there until late afternoon?  This was a bit of a departure from what Dr. Mayer had mentioned (even that we could go home at 11pm the night before, at the earliest...I wasn't too excited at pushing to get discharged in the middle of the night, but I was thinking more along the lines of maybe before noon???).

After the NST, breakfast and all of that, Dr. Mayer came in one last time with discharge orders.  Ibuprofen 600mg every 6 hours (pretty simple!) and follow up with the office during the week.  The nurse took my IV out and I got ready to go home!  We packed up and were on the road right before 1pm!

The Stats

As this comes to an end (and I feel like I've written or told this same story a few times), the stats for my time in the hospital were like this.

Contractions:  Max 7-8 an hour
Fetal fibronectin test:  Positive
Cervix: 1.5cm dilated, 1.5cm length

3mg/hour of magnesium sulfate for 48 hours
Two shots of steroids (for lung maturity)
600mg ibuprofen every 6 hours

No comments: