Saturday, July 20, 2013

Entering "Expectant Management" Phase

Well, today I am 34w2d!  It has been a VERY long day, and it even seems like now that it's both a blur, and a bunch of crazy days all wrapped up together.  This is an EXTREMELY nerve wracking phase, and one that is wreaking some serious havoc on my emotional state.

In my head, I replay all of the changes in my thoughts that have gone down in the past few days.  The week started with becoming more nervous at the increase in contractions that I was experiencing.  The nervousness turned to a bit of anger before/during/after my weekly doctor's appointment.  I kept debating with myself whether I should have trumped the doctor and gone to OB triage on Wednesday.  I had that same feeling on Thursday, but drove myself into an emotional tizzy because I was home alone then...and I was really having a hard time convincing myself that contractions were bad enough to warrant a visit to triage.  Friday morning was a more of a relief, because I expected that all of my worries would be monitored in a good place.  Relief turned to a little bit of shock (not expecting things to have escalated as far as they had).  Shock turned to relief again when the suggestion came down that they might be able to manage things with terbutaline.

At that point, my thought had to quickly shift between "great, we're going to hold this off again for the time being!" to "this is really happening, we're going to have a baby tonight!".  There's a lot of mental preparation that needs to go into both scenarios...the expectation that they can stop labor (and you can relax after they do), or the expectation that you're going into this full throttle, and you'll have a new baby soon.  Both of those were as fickle as the wind.

In any case, the run down of things right now is that I'm in the antepartum unit (AGAIN...I had one of the same nurses I had last time...funny).  I have no idea in the world if my cervix has changed (which is apparently the thing that was holding me back from delivering...funny).  Apparently my amniotic sac is still bulging out, yet it's totally fine to be up and around (and the doctor even said I could go wandering through the hospital...that's another odd story that I'll add if I feel motivated).  I'm also still bleeding ("bloody show" or whatever...could be just messing around with my cervix, but it's way more than the "usual").  The decision was made to pull me off all monitors, so no idea either at how many contractions I had past a certain time.  Basically, they're putting me in a hospital bed, giving me free reign, and expecting me to declare when it's time to have a baby.

But do I want to know?  Is it going to help to have continuous monitoring so that I analyze every change, expectantly?  If something major did show up, am I ready to be whisked away, thinking that birth is imminent, only to have it stall out again (isn't this the dilemma of every pregnant woman?)?

So anyway, in replaying more moments through my mind, I can't help but wonder what could have been done differently.  I was pretty keen to get terbutaline the first time (in triage) to stop contractions.  Should I have declined that?  If I'd declined that first dose, would they still have wanted to give me more to afford that time to get antibiotics into me?  Did all of that terbutaline stall things out TOO much?  Should I have turned down the stadol?  I have no idea what that did to the labor stuff.  Would an epidural have been better, or a possibility?  In the end, what are all of these drugs doing to the baby?  She has been going absolutely crazy inside!

As a last bit...I'm also becoming so depressed because I'm starting to dissociate this whole process with an end result...a baby.  I have to remind myself that she is GOING to come out, and all of this will be a crazy memory, but in the here and now, it's almost difficult to bond with her while she's on the inside...and hard to come to realize that she's going to be the same baby on the outside very soon.

While this was all very deep and stuff...I still don't feel like I've adequately sorted everything through in my head.  But I do know that last night was the one of the first times that I felt quite secure in the thought that I was going to have a baby.  Kids were taken care of.  Mike was with me.  Everything was in a good place.  I really just hope that the time is perfect in the same way when it finally does happen.

Now in Labor/Delivery!!!

OK so finally got contractions back with the program...

Attempted rest/sleep around 11pm.  Contractions picking up, so unable to really sleep.  1-2 every 10 minutes.

12:30a.m.:  still at 6cm.  Given stadol for pain (awesome!!!)

2a.m.:  contractions in full force, stadol worn off.  STILL 6cm.  Given another dose of stadol.  Contractions about 4 every 10 minutes!

3:30a.m.:  stadol worn off...need bathroom break.  Painful contractions.  Dang it, still 6cm!  Giving more stadol.

6a.m.:  contractions same, maybe less painful... again still 6!!!

9a.m.:  I can eat!  Doing that, then back to getting things back on the road...

Friday, July 19, 2013

Live...from OB triage...

So here I am at the hospital once again...this won't really be live live...just a timeline of how things go Yeah, I'm that bored

Got here just before noon, set up in triage.  As soon as I got hooked come the contractions!  Still at 5cm (so no change there!), but the contractions were coming at a rate of about 4 in a 10 minute window. Lots of blood.

12:20 p.m.:  Shot of terbutaline.  Makes the heart race, but flat lines contractions!

1:20 p.m.:  Feeling the terb wear off a little...waiting to see if contractions return...

2:00 p.m.:  cervix check.  Lots of bloody show, 6cm...bulging amniotic sac.

4:00 p.m.:  all set up in labor and delivery.  Getting antibiotics for GBS.

5:30 p.m.:  second terbutaline shot (stalling to make sure those antibiotics have a 4 hour window to be effective). 

Almost 7:00p.m.:  I'm in pain...menstrual cramps on crack!

Thursday, July 18, 2013

Bedrest Part 2 - Days 12 & 13

I guess I might subtitle this one "A Comedy of Errors" (or at least what I'm about to write, regarding yesterday).  In any case, before I get into marks 34 weeks!  It's a happy blog-post day because I get to post an image, rather than just spamming with text.

A short summary of everything, too (for those who don't want to read the details below), is that I've gone from 4cm (as of last Thursday), to over 5cm.  Tuesday and Wednesday nights were the first time I've ever been kept up or been woken up by contractions (this includes when I was pregnant with both boys too...just as a frame of reference).

My appointment Wednesday was at 10:15, and it was with a new doctor to the office (new to where her name isn't on the door or picture isn't on the wall...and I actually had to ask who that was when the appointment was made!).  Anyway, we dropped the kids at daycare and got there at around 10.  And waited.  And waited.  Then starts the weird comedy of error stuff...

Right around 10:45, I get a phone call.  It was coming from the doctor's office!  And, yes, I'm sitting in the waiting room at the doctor's office then.  I answer, and it's a nurse, saying that she's calling from the doctor's office (as if I couldn't tell from caller ID) with my test results.  I laugh and tell her that I'm actually sitting in the waiting room, how funny.  After she tells me that the results are negative, I ask what test she's talking about.  At that point she fumbles and asks to put me on hold.  Smart.  A few minutes later she comes back and tells me it was a bacterial/yeast culture they did last Thursday (which no one told me about).  Nice to know that they're just calling people 6 days after a test with results...and not even sure of what the test is.

So as I mentioned, it was 10:45 when I got that call, and I was still sitting in the waiting room, even though my appointment was at 10:15.  After another 5 minutes or so, I go up to the receptionist and ask to make sure that they didn't forget about me or something...and she just says apologetically "Oh, I'm sorry, no, they're just running late today"  (what's funny is that on the little TV monitor in the waiting room, every once in a while it flashes "Been waiting longer than 15 minutes?  Please inform the receptionist, your time is valuable to us!").  And the wait continues.

Finally, around 11:30 we get called back (so, if you're keeping track...that's an hour and a half that we've been sitting in the waiting room).  I'm actually pretty darn uncomfortable, having had pretty constant contractions the whole time in the waiting room, but trying to keep cool and calm about it.  All the regular stuff gets done (pee in cup, weight, blood pressure, yadda yadda) and now to wait for the doctor (another 10 minutes or so).

Doctor comes in, introduces herself and she's got nice enough bedside manner and all.  But she asks how I'm doing, and I respond with "a little uncomfortable".  Now, anyone who knows me, knows that I have a sort of auto-reply to when people ask how I am.  I have been deathly ill, figuratively speaking, and someone will ask me how I am and I'll squeak out a "I'm fine, thank you" and might add a "How are you?".  Anyway, I couldn't honestly answer that I was "fine", because I was really kind of uncomfortable from everything.  So the doctor responds to that by asking if I'm just uncomfortable because it's a little hot out.  Well, yes, it's hot out, but I sort of frown, because the reason I don't feel good is because of contractions, not because of heat (I'm not even outside 99% of the time anyway).  OK, so I can't fault her on asking that, but after I mentioned the contractions thing, that's the start of a whole bunch of things that indicated that she had not even glanced at my chart.

"Contractions?  Have you been having a lot of those?".  Yeah, pretty often, actually.  She looked confused.  She asked if I've had my cervix checked at all this pregnancy.  Well, if you looked at my chart, you might see that.  You might also see that I've had a positive fetal fibronectin test at 28 weeks, been hospitalized twice, was dilated to 4cm last week, and I've been taking nifedipine since I stopped the ibuprofen at 32 weeks.  But she knew none of that, and continued with the shocked and surprised look when she was confirming it on my computer record.

At that point, she mentioned that she no longer wanted to do the fFN test, because she was certain it would just come back positive.  I actually really wanted to know, just based on whether it might afford me another two weeks of security that I wasn't going to deliver.  If it came back positive, then it wouldn't be a guarantee that I'd have this kid before 36 weeks (obviously), but I'd just deal with it.  Instead, she mentioned that she'd check my cervix, and mentioned (before the check) that if it's changed from the 4cm, that I might get sent to the hospital.

And then for the check.  Oh yeah, I'm more than 4cm.  So she asks a few more questions about contractions.  How frequent?  Can Mike tell when I'm having one (and he responds with "um, I can't tell just by looking at her, but I can if I feel them if I'm touching her belly"...that's kind of a "duh" question). She tries to probe more about whether they're actually painful or not, whether I can talk through them (which, I can talk through them usually just fine), or whether they "take my breath away".  To me, these are kind of stupid questions, mostly because I can't honestly say that I'm in severe pain (compared to contractions that I've felt the hour before Jared was born...THAT hurt).  With those I was talking too, albeit very incoherently.  Does it take my breath away?  Well, Mike can tell something is up when my breathing pattern changes, and I do sometimes unconsciously hold my breath or breathe more shallowly until a contraction passes.  I don't know if that qualifies as having my breath taken away.

In any case, she said not to go to the hospital unless I had 3 or 4 an hour that I couldn't talk through, or those that took my breath away.  Oh, and did she mention that the hospital isn't going to do anything to stop labor now?

So here I am, in a weird sort of limbo.  I don't question whether I'm having contractions (I am pretty sure I am).  They are actually worse (as in, they hurt marginally more and they keep me awake at night) than when I was admitted at 28 weeks.  I question whether I'm having more than I perceive, just because that's the way it's been in the past.  Every time I've gone to the hospital for monitoring, I end up getting admitted, which scares me too.  But, based on description to a doctor in the office, I feel as though my contractions are not "good enough" for them to do anything about.  And not that they would do anything anyway, since I'm 34 weeks now?  I don't want to play the game of going back and forth to the hospital, and constantly second guessing myself as to whether it's time or not.  And I don't want to risk not getting to the hospital in time.  But it's pretty much exactly what they're forcing me to do until this kid comes out.

Well...the events of yesterday pretty much overtook this entry...and today was not nearly as interesting because I was in and out of sleep for a good part of it (remember, I slept like crap due to contractions!).  But hey...I'm a full 34 weeks right?

Tuesday, July 16, 2013

Bedrest Part 2 - Day 11

Another monsoon-y, stormy day in the late afternoon!  Luckily, we were all getting back home as the wind stated to pick up and a little bit of rain started to hit.

But, I digress.  Today wasn't too bad of a day, all things considered.  Since it's Tuesday, it's my "home alone" day, but it went by pretty normally.  I'm finding that the longer that I stay on bedrest, or just hanging around the house in general, doing minimal work, the less motivated I get to do sedentary tasks.  I have a running list of things in my head that I would get done, but they usually involve more than just being still.  Things like laundry, dishes, cleaning the carpets, and so on.  So I end up spending just a lot of time thinking about them, or debating with myself as to whether I could really do them.

There's plenty of things I could do while just being still, it's just getting started on them that is hard.  At first, I was really into making chain mail things (and I still think about it!), but I haven't actually touched it in quite a few days, and I look over at the bag of rings and just can't get motivated.  It's really quite sad, because it's something I enjoy doing.

The other thing that is taking motivation to start is a project (or, actually, projects, plural) that I'll probably be kicking myself for not starting or coming anywhere close to finishing.  Back around the time Daniel was born, I had a little cross stitch kit that had all of the birth announcement type information on it.  When we were in the hospital still, and he was getting his tan on under the bili-lights, I did start on it, but I didn't get very far.  I actually have no idea where it is now, but that's neither here nor there.  Jared came along and I didn't have one for him, and I didn't even attempt starting one.  Recently, I rediscovered a frame that I'd purchased probably before Mike and I got married that had 3 openings that would be perfect for 3 of the cross stitch things.  Perfect...this is kid #3, so I could get a headstart and it wouldn't take me much time to finish it off when the baby comes (later on, when there's a 4th, I can just get a different frame).

So here's my process...decide how I want to make them (kind of uniform, but pink for girl, blue for boy, or whatever).  Then decide on how complicated I want the design.  A while back, I actually went looking for sample kits of the birth announcement designs to base mine off of.  After just thinking about it for a good long while, I got a program to help with the gridding, and just the other day I went and dug out my supply of fabric and thread.  Now, for two days all of the supplies have been sitting on the bed or next to me in a little bag.  However, today I actually opened the frame to get a measuring guide for how I'd cut the canvas fabric to size.  And that's as far as I've gotten.  The frame actually sucks quite a lot (it came from Wal-Mart, go figure...some of the glue melted and adhered to the plastic, the back wasn't fully perforated for easy opening in the first place, and so on).  In the end, I should just do it, but I just keep thinking "I'll need a different frame"  (drag feet).

Well, tomorrow is Wednesday, and time for another doctor's appointment.  I feel like things are getting down to the wire, and there will be a baby SOON, relatively speaking.  One thing that's happened as of late (that isn't too worrysome...but does make me more aware) is baby movements.  I never really thought about how much the boys moved when I was pregnant with them...they just moved.  None of the doctors ever had me do formal kick counts for either of them either, and I think the most consideration it had at appointments was the question "feeling the baby move?".  Recently, though, this baby has been quite eclectic in her movements.  I'd say she's more active in the evening time when we're watching TV, but that isn't too unusual.  During the day, I would still feel her move.  However, there have been two days (today being one...the other was this past Friday/weekend) where I realized that I hadn't felt her move in a while.  Over the weekend, I remember watching TV and not noting much movement, and joking that she was probably going to start kicking around just as I was trying to go to sleep.  I slept without any baby-induced disturbances, but the next morning I didn't feel her move until around 11 or so (hours after drinking orange juice, eating, sitting still, and any other tricks).  Last night, I did feel her moving around, but she stopped as I was falling asleep, and I didn't feel any movement until later this morning (when I did, it wasn't a whole lot, more like just shifting position while she slept).  It always ends up being fine, and certainly reassuring when she does move, but it makes me hyper aware when she does things like that!

In contraction-land, things are sort of holding steady, although today I was experiencing a little bit of the return of the rhythmic back cramps.  I didn't have a lot of the full belly tightening (that I noticed), but I'm getting that really heavy feeling, and lower pelvic cramping again.  Given that I'm on the lowest dose of nifedipine right now, I guess it could be increased (if that's an option), or something like that.  I figure it's only going to be about 2 more weeks on this stuff anyway, and then it will become a free-for-all.  I guess we'll see how things go at the doctor tomorrow!

Monday, July 15, 2013

Bedrest Part 2 - Day 10

It's July 15th!  That means it's my mom's (and her mom's) birthday!  I used to have a bigger fixation on that date when I was pregnant with Daniel, thinking how cool it would be to have him (or her...we didn't know he was a he at the time!) on that date, making for 31-year generational gaps.  Anyway, having a baby, I'm guessing, isn't likely in the next 3 hours, so I'll call it safe to say that this one isn't going to be born on July 15th.

Well, all things told, today wasn't too bad of a day.  The most notable thing is that it rained like crazy, with equally if not crazier winds.  When we went to get the kids from daycare, there were a bunch of trees that were ripped down and still some standing water on the road.  Messy.

The rain also made it super humid and muggy (yuck)...which I was sort of oblivious to because I adopted a new temporary home for a little fan next to the bed.  I sweat so much that having the fan works especially well to cool me down a little more.

In other news...and this is Jared seems as though he has taken to (*wait for it*)...potty training!  Over the weekend he pee'd several times on the potty (and did it this morning as well).  The big test was seeing if he'd do it at daycare...and he did!  This evening, I asked if he had to use the potty, and as it happened, he was in the middle of dropping a #2.  I carefully put the poo in the toilet, and asked if he still had to use the potty (and he nodded he definitely had some unfinished business to take care of).  No sooner than I put him on, he pees a little, and finishes up his poop job! No way?!

Well...that is pretty much it.  I'm really trying to perk up a bit, and feel like I'm a little more productive, just to keep my mind off of anything that could mess with my stress levels.  Happy Monday!

Sunday, July 14, 2013

Bedrest Part 2 - Days 8 and 9

I should probably subtitle this one...IN SEARCH OF LAST-MINUTE CHILDCARE

OK, so I didn't make it 3 days in a row with blog posts.  But, in any case, it's the weekend, and the days sort of all blur together.

I've managed to stay out of the hospital for a whole week (hooray!), but it's been sort of a half-rest kind of week.  I get conflicting opinions on whether I should be on "strict" bedrest or whether I can be sort of on "modified" bedrest, which is much more lax.  On my hospital discharge paperwork from last weekend, it says "Bedrest...bathroom privileges only".  Yet, I've been told that that is probably too extreme.  I can see the doctor's going, "know your limits", and "rest when you need to", but that's a lot easier said than done (especially knowing me...I test the limits quite a bit, and I always seem to believe that I can do more than I actually can).

In any case, enough dwelling on that other stuff for a while.  My latest obsession is finding emergency childcare, should something happen in the "off hours".  I don't think I will really feel at ease until this issue (in particular) is in place.  Not only do I have to have plans...but I need alternative plans as well!

So here's the run down so far.  If something happens in the middle of the night or on the weekend (when the boys are NOT in daycare), they'll likely need someone to take them for a bit.  I hate imposing on people or asking about these things, but ideally, the least amount of stress would be if someone could just stay the night with the boys at our house, so we didn't have to wake them up.  Plan two is dropping them off somewhere, and plan 3 is taking them to the hospital with us if we can't get a hold of anyone.

As I mentioned in a previous post, our other option was a drop-in daycare, but I've kind of dismissed that as not really working for us.  I won't stop looking around for another place though, possibly!  The next alternative is lining up some sort of sitter/nanny service that could come out in less than an hour.  Still evaluating options/taking referrals for that one.  I've even decided to make use (for the first time...ha!) of work's "employee assistance program"  (kind of like a concierge service type thing).  We'll see how that works...I'm always taking suggestions, so if anyone reads this...I'm open!