Friday, October 31, 2008

Happy Halloween!

This is our little pumpkin's third Halloween. If she arrived on her due date, it would only be her second. Considering her due date was November 9, 2006, it is reasonable that she could have arrived a week and a half to two weeks early and celebrated her first Halloween that year anyway. However, it is doubtful that she still would have been in the hospital with a feeding tube and oxygen. Anyway, here is a little Halloween greeting from our precious little pumpkin. My how she has grown...


Second Halloween - 2007

First Halloween - 2006

Thursday, October 30, 2008

22 Weeks and It's Clear My Pregnancy Ticker is Wrong!

Yes, I am 22 weeks today, however the countdown is incorrect. My girl was born at 24w 5d and was 107 days early (with a 105 day NICU stay). According to the calculation on the above ticker, at 22w 0d, I have 108 days left to go. Not exactly accurate. But hey, at least it can accurately keep track of how many weeks have passed. I suppose I can deal with that. The tracker with the baby on the right side is more accurate. And, if you click it, it will alter the info: how many weeks so far, how many days so far, how many weeks left and how many days left.

I just had my 7th P17 shot. For some reason, as the weeks are passing, I am bleeding more and more with each shot. Today, I actually bled through my jeans a bit. It's no biggie as I'm just concerned about getting the medication. A little blood on the back of my jeans is the least of my concerns.

Nothing new to report. I did forget to mention that when I saw Dr. G on Tuesday, I asked if lifting Missy Girl was too much. He has seen her and she is weighing in at 26 lbs these days. He assured me as long as I lift with my legs, and not my abdomen, I am fine to continue to lift and carry her. That made me feel good to know that in his opinion, I am not doing too much. And so I shall carry on!

Tuesday, October 28, 2008

Today's Appointment

I am so glad that I moved my appointment up by a day. There is nothing like peace of mind. Officially, there were no office hours today. Dr. G was in the perinatal testing center and Nurse Barb called up to let him know that I had arrived. It was nice having the office to myself.

I did a urine test just to be sure I was infection-free. Because it was just me, Barb and I actually spoke about my past experience. It all started because I made the statement that I thought I might have overdone it at the NICU Reunion on Sunday. Then it all began about how devastating that was - my first pregnancy. This was the most sympathetic I've ever seen her. I confessed that these worries could be all in my head as I approach what I often times refer to as my "danger zone". I am terribly close. Barb acknowledged that many woman have difficulty around the time of the "anniversary". Well, the office certainly doesn't work off a sympathetic or understanding feeling. It is actually on the cold side with little emotion at all. This was the most I ever got.

My weight remained the same as last week, my blood pressure as low as usual and the baby's heart beat again, music to my ears. He was moving quite a bit and when Dr. G did the transvaginal scan, Baby Boy was sitting right there. Perhaps that is part of my discomfort too or maybe I should say "perceived discomfort". With Missy Girl, I would get kicked and punched - basically, she jabbed me all the time. Baby Boy tends to roll around, never actually executing a blow. It is a very, very different feeling. And, when he is very low, as he was today on the scan, it causes uncomfortable sensations that cause my mind to wander.

My cervix is good. Dr. G was pleasant and I am beginning to feel more and more comfortable as he is quite familiar with this particular part of my anatomy. I like the consistency of the same practitioner measuring and viewing my cervix each week. He certainly knows by now what he is looking at.

Dr. G did not seem at all put-out by my presentation in the office this morning. He actually encouraged peace of mind. Ah, just the kind of doctor I am searching for...

Additionally, he inquired as to whether or not I placed a call to the service over the weekend. Apparently, another practice was on call (very rare) and they received a call in which the patient didn't identify themselves or if she did, it was not written down. They were trying to piece it together. Looks like I am one of the "trouble makers" that automatically pops in their minds. That's good. That's really good.

A Rough Night

Last night was a terrible night. I tossed and turned with crazy worries about how I would navigate the hospital alone, how would I park and get to the doctor's office? What if bad news was delivered? I have only myself to blame.

I was too scared to even get up to go to the bathroom, for fear of membrane rupture, bleeding. I longed for baby boy to move, letting me know he was still alive inside. Was there a cord accident? This is what the early morning hours will do...

Finally, I realized in my state of restless sleep that my previous post was incorrect...

It was Dr. G who delivered "the news" last time but it wasn't on a Tuesday. No, it was a Friday that I learned my membranes were bulging. It WAS a Tuesday, however, that I went in suspecting a problem, only to be told all was well...

I returned to the doctor's office on Friday, that same week, just three days later, and didn't leave until my daughter was fighting for her life in the NICU.

Monday, October 27, 2008

Did I Over-Do It?

The question on my mind today after feeling pelvic pressure and a low back ache is, did I over-do it this weekend?

On Saturday, Missy had a Halloween party and was everywhere! I was on my feet the entire time and didn't hesitate to turn on a dime to catch up with her. Thankfully Hubby arrived and was able to take over the herding duties.

Yesterday we attended the NICU Reunion where our girl was born. It was an emotional day as well as a physical day. Again, I was on my feet the whole time not to mention the walking to and from the parking garage.

Today being a Monday, Missy had school. Taking advantage of alone time, I did push through my morning routine of changing the sheets, picking up toys, cleaning my kitchen and vacuuming my floors. I picked her up at noon and she slept all afternoon. When she got up she was relatively non-demanding so I did get to sit around a bit.

Realizing the discomfort was not my bladder, I knew I needed to take it easy. I was also concerned that something could be amiss so I called and moved my Wednesday appointment up to tomorrow. They are squeezing me in, (thanks, Dr. G) as they don't have office hours on Tuesdays.

I am a little nervous because Tuesday was the day I got bad news with Missy and Dr. G was the one to deliver it.

Anyway, once Hubby got home and we put the alarming carbon monoxide detector to rest (we called the gas company who came out on an emergency call) I got to settle in with my feet up.

Here's hoping tomorrow is a good day...

Saturday, October 25, 2008

Other Medical News...

Just to follow-up on my visit to my Primary Care Wednesday night, I have a cold. Until my symptoms continue for about a week to 10 days, I won't be diagnosed with a sinus infection and therefore, the only thing that was prescribed, ironically enough, was a Xopinex inhaler. My heart rate was elevated at 112. For some reason, since having Precious Miracle, when I get sick, there is a direct impact on my heart rate. Since we have a pulse ox at home, I've been monitoring it daily. It's still on the high side - much higher than Hubby's which is consistently in the high 60's.

At this point, I have been taking infrequent and only as-needed puffs on my inhaler. Perhaps a puff or two per day - usually at night before bed, is when my cough starts and my chest gets tight. I will admit I took a Benadryl (told by both docs it was okay!) - just one Benadryl - to help dry up my nose so I could sleep. It worked, no coughing and no waking every five minutes to blow my nose.

Finally, my doc was happy with my weight. Thank goodness.

On another medical note, I followed up with my breast surgeon yesterday. She did a full exam and showed me my ultrasound images from earlier this week and the ones from over the summer. She was pleased with the way my surgical site was healing. She gave me a clean bill of health and said unless I have issues, she doesn't need to see me back. Another thing to cross off the list...

Let's hope breast feeding goes well with this one. I never had mastitis with my girl but did get painfully blocked ducts that needed work to unclog. In fact, that's what first got me seeing the breast surgeon. She actually had to perform a needle aspiration to relieve the pressure. She claims the lump she removed in March was not at all related to my breast feeding days. I was concerned that my year-long relationship with a hospital-grade pump had caused some damage.

Thursday, October 23, 2008

21 Weeks With Info on Omega-3 Fatty Acids...

Today marks week 21. I received my shot today from my neighbor Kim. They were never really difficult to take but with the sixth shot, it is seeming more and more routine. Not that I like pain but when you are prepared and distance yourself with some breathing, it is a piece of cake. Also, I just think if I can't handle a shot then all that goes with delivering this baby is going to seem that much worse. You just do what you have to do.

I have found some links discussing Omega-3 Fatty Acids and the possible link in prevention/reduction of preterm labor. Many of the sites out there are medical journals which are password protected. There is not a ton of info but since there are no harmful effects, I am willing to give it a try. So far, so good. As I mentioned yesterday, I have had zero episodes of pelvic tightening and/or feelings of irritability. There is much research to be done and hopefully for the sake of the babies, this will prove to be an effective treatment option in the prevention of PTL.

http://altmed.creighton.edu/Omega3FA/evidence.html

http://www.ebmonline.org/cgi/content/abstract/226/6/498

And probably the most basic site:

http://www.pregnancy-info.net/omega3.html

Wednesday, October 22, 2008

The Dancing Dr. Carlson

Today after Kindermusik, the Nut and I drove to the hospital for my 11:30 appointment. I broke my neck to get there on time and was quite surprised when we arrived with time to spare.

Going with Missy in tow is seeming more and more the norm for my weekly appointments. Seeing how crowded the waiting room was, I went to the desk to announce my arrival and asked how long until I should come back. I was told 30 minutes. I thought that was perfect timing as Missy's Halloween card was completed and ready to be hand-delivered to both the Development Office (not development as in milestones but development as in fund raising) and the NICU. We made our way through the hospital, saying hello to the many people we met during our NICU days.

We complied with the request to be back in half an hour and walked back in to the Perinatal office at noon. Well, we waited and waited. We used the potty, colored, read books, ate snacks and explored the entire waiting room. We sat in every possible seat, scheduled my weekly appointments through Thanksgiving and then we started to lose it.

By the time we were called back, it had been another half hour plus. My girl who had been oh so good, was now a crying, blubbery mess. It was pushing 1:00 and we were both tired and hungry.

So the details: I have gained five pounds thus far, or at least since they have been monitoring my weight. I see my primary care this evening as a follow up to my "anorexia" diagnosis (remember lack of appetite, not purposeful diet restriction) so I am curious as to her take on my weight gain. The Perinatal office is fine with my weight gain, by the way.

Dr. Carlson came in and my girl was just a disaster. He actually started singing, "The Wheels On the Bus" and engaged her in looking at her baby brother on the ultrasound monitor. That is one of the major differences between Dr. C and Dr. G, Dr. C always checks the baby first. He always prints pictures and then goes on to the real reason for the visit - my cervix. I like the fact that he realizes there is a life growing inside me and that we recognize that life first.

I was a little caught of guard when during his scan of the baby he gasped. It was along the lines of "oh gosh" or "oh my God". The exact wording escapes me but I felt a panic set in. He quickly followed it up with "You do know what you're having?" I informed him we were well aware there is a baby boy baking in there. Well, without being too wordy about it, Dr. C has fallen victim to expressing his amazement over the boy parts this child possesses. He then went on to label an ultrasound image with "I am a boy" and then proceeded to print two copies. Let's just say he is very much a boy. And for some strange reason, people feel the need to point this particular physical trait out every single time it appears on the monitor. Enough already!

Dr. Carlson then went on to check my cervix. At the same time, Missy sneezed and asked for a tissue. Talk about multi-tasking. There I am on the exam table, having my cervix evaluated while leaning sideways off the table with a tissue up to her little nose encouraging her to "blow". It was quite a comical site. Perhaps even more comical was the little jig Dr. Carlson performed as his phone rang. He was very intent on entertaining the once 1 lb 6 oz - 27 month-old he himself delivered.

Because of the nose issue, I never got an actual number on my cervix this week. It's okay though. There is no funnelling and I am long and closed. In terms of chit chat, I didn't have too much this week other than to inform Dr. C that I really want him to deliver me. He told me his expectation is that I will get to term (37 weeks) and that we can just schedule it with him. I emphasised that if that is not the way things work, I really want him anyway. He assured me we would know more as my pregnancy progresses.

I told him that Dr. Davis prescribed the Omega-3 Fatty Acid (Lovaza) and that in the past week since beginning this three times daily regimen, I have had zero in the way of uterine tightness and irritability. Dr. C seemed surprised by this latest cocktail and commented that he will do some reading about it. I told him that it could all be in my head and if so, that's fine. But I highly doubt it. I really feel like I am irritability-free. Perhaps it's just a coincidence and my body just stopped as I started this new drug.

Finally, I am not feeling 100%. I am congested and have sinus pressure. Missy has been sick and I kept her home from school this week (Monday and Tuesday). She is back on O2 at night time in addition to her inhalers. Well, I wouldn't call her sick. She is having an asthma flare up. She is tight and has a cough. The temperature here has dropped over the weekend and I think that is now presenting as an additional "trigger". Previously, her asthma was exacerbated by viral infections, ear infections and the like. Anyway, Dr. C said my primary care could prescribe an antibiotic if needed and went through the list of acceptable options.

So aside from the long wait, it was a good visit. Dr. Carlson is clearly my favorite doctor in the practice and I let him know that today. Oh, and he informed me, much to my chagrin, that he may not be able to deliver a full-term baby through my previous c-section scar. I thought I had a typical scar, size-wise, if not a bigger than usual one. My understanding was that the smaller the baby, the more room you needed for delivery. Yes, he agreed that is true, usually. But for some reason, not with me. Turns out the morning of delivery at 24w 5d with my Nut, I actually went into labor. I suppose that explains the bleeding and while I had little pain, it was enough to thin out my lower uterine segment, which allowed him to make the low-transverse cut on my uterus. Typically, preemies born via c-section are delivered via vertical incision, maybe not on the outside, but certainly on the uterus. I always attributed my receiving the more preferable cut with Dr. C's skill level. Turns out it was my body that dictated that one.

And finally, I had a scan yesterday to monitor the post-surgical issues I had following my lumpectomy last March. Turns out the fluid and debris is diminishing. I follow-up with the doctor on Friday but the tech seemed to think they'd bring me back for one more evaluation.

Tuesday, October 21, 2008

On My Mind and Feeling Guilty


In spite of the fact that I shared the mission of October 15th, a day for remembering all the babies lost to miscarriage, stillbirth and neonatal death, with my church group and our many friends who have lost precious babies, I was feeling extremely guilty for not acknowledging the day on this blog. Please forgive this message for being a week late but know that it doesn't diminish our commitment to remembering these lives lost all too soon. I am sure there are many readers who have lost their children, and regardless of the age or gestation at passing, we want you to know that you and your children have been in our thoughts and prayers.

In fact, allow me to share a page out of a special prayer book I created for Miss Girl. Her life began as a fight to live and based on what the doctors told us, there was a 50% chance she would not be here with us today. Every single night, I remember how blessed I am to be holding my precious miracle. I want her to appreciate her life and literally cherish every single breath she breathes for they are all a gift. I want her to always know just how precious life is and to never abuse the life that has been given her.

(You may need to double click the photo in order to read the text.)



Sunday, October 19, 2008

Bladder Woes and Bedding

My little guy has been pressing on my bladder recently and I have to admit, I am slightly nervous that I may very well wet my pants. I catch myself doing a quick Kegel to stop what I think might be the start of an accident. Embarrassing. Very embarrassing. It is not associated with laughing, coughing, sneezing or anything else. It just comes on out of the blue. When I see the doctor this week, I will ask the nurse to check for infection. It really doesn't feel like one but I want to be 100% certain.

On another note, we are working on transitioning Little Miss from the nursery to her new big-girl room. She will be the proud hand-me-down recipient of the same furniture both my mother and I had growing up as girls. It is at the furniture refinisher and just yesterday we chose our stain. It will be done in approximately three weeks and between now and then I need to purchase a full-size mattress, box spring and new bedding. We also need to clean out the guest room in order to accommodate this newly revitalized furniture. My hope is that Little Miss is nicely settled in her new room before the baby arrives.

Speaking of the baby, I finally made the call last week to Karl's, the place where Missy's baby bedding and furniture came from. We went a little extreme on her nursery and in the spirit of saving a few dollars by not totally redoing the entire room, we are going to just switch out the bumper. Last time, before we knew we were having a girl, we chose two different fabric options: pink & chocolate and blue & chocolate. Basically, her nursery consists of a beautiful chocolate velvet dust ruffle that I plan on using for Baby Boy. All I need to do is confirm they still have the velvet. That is the inner part of the bumper. Then I need to select a blue fabric for the outside.

I've learned a lot since my last pregnancy and plan on purchasing the sheets, blankets and changing table pad cover at Babies R Us or Pottery Barn Kids. We already have a neutral corresponding chair and ottoman and I don't need the matching quilt, changing pad cover and stuffed bear or bunny. That was just a total waste of money but, I suppose the first time around, a mistake that is often made. I just had to have everything. I wised up a little.

Thursday, October 16, 2008

My Weeks Now Start With A "2"...

It is hard for me to agree that this is a milestone - to reach 20 weeks. My goal is to get to at least 34 weeks and anything before that gestation is just not something I am interested in thinking about. It could be argued that I need "mini milestones" to break the time into smaller chunks, if you will. For me, my weekly Progesterone shots, cervical scans and photo shoots are more symbolic as I physically cross off a shot(right side of the blog), sigh a breath of relief that my cervix is still holding and sport my stylish get-up only to file the picture in a newly created folder labeled "x weeks". I take comfort in knowing one more week has gone by, ignorant to just how many more are left to go. Well, maybe not ignorant, I just don't dwell.

To think 20 weeks is something to get excited over, it's not. Yes, I am that much closer to the day this child will ultimately be born (whenever that may occur) but 20 weeks is not yet viability. And with Precious Miracle born on what is considered the "cusp of viability" I don't consider 24w 5d to be anything exciting either. In fact, as a preemie mom, I know the complications that could affect a baby at any gestation and I realize that term is no guarantee either.

I guess my point is I'm just taking this day by day. That is all I can do.

So today, I had my official anatomy scan. This one was ordered by my local group. Yes, they did the same exact thing on Monday. It wasn't set up to be that but they did it anyway - here's hoping there are no insurance issues. In my opinion, the more people who look at my baby and my cervix, the better the chance that if there is something wrong, it will be caught. Consider it a "safety net" of sorts.

Hubby joined me for this scan as it has been some time since he's seen the little guy. Wouldn't you know, Jennifer, the same tech who preformed Precious Miracle's anatomy scan performed Baby Boy's scan. She also happened to deliver her son three weeks shy of Girlie's NICU graduation. So we had babies in the NICU together for a short period of time. And, she even remembered my girl by name. Very impressive.

Baby Boy got another glowing report and it is quite unanimous among the people who scan him, that he is extremely proud to be a boy. He is in no way bashful and let's it all hang out, so to speak.

Another plus from today is that I met a new doctor. Why didn't I know this man existed prior to today? Dr. Megerian (not sure how to spell it) was so nice and knowledgeable. He has a great bedside manner and I inquired about having him perform my weekly cervical checks. He is closer and did I mention his bedside manner? He answered all my questions with thorough explanations that not once sounded condescending, nor did he make me feel rushed. Bottom line, I like this guy and although he doesn't deliver, has a "relationship" of sorts with my local group that could allow me to possibly see him for my weekly scans. I put a call into Nurse Barb today and am just waiting to hear back. It had better not be an issue as the tech's thought it would be just fine.

Also, since I had a scan scheduled on the same day as my shot is due, I thought it would make sense to have the nurse at the testing center administer my P17, instead of inconveniencing Kim on another Thursday morning. So not only did I have my scan, but I got my shot too. There is certainly something to be said for getting the shot at home. At home I immediately put the heating pad on the injection site. Since I had to drive home today, I thought my heated car seat would work, but it fell short of providing me the immediate relief being home with the heating pad offers. Kim, I really appreciate your help! Thank you!

Oh, I should just wrap up that my cervix looks good. This doc had his own opinion that as long as there is no funnelling, then who really cares what my cervix measures. Okay, I see his point. But, it is very reassuring to know what the number is each week. He was kind and gave me a number to put my mind at ease and I am falling between 2.9 and 3.2 ish. It just depends on how you measure. Oh, and I saw just how reliability between operators can vary. He showed us the different techniques on how to measure cervical length. It was quite the learning experience.

Monday, October 13, 2008

Wow!

Let me first start off this post by saying that on Saturday, Dr. Davis CALLED ME to check in! What a doctor! I filled him in on my trip to L&D and confirmed I would be paying him a visit today, Monday.

Today's visit entailed a full one-hour scan of Baby Boy! It was the most thorough ultrasound ever! The baby was evaluated from head to toe: his ventricles, cerebellum, hypothalamus, nucal fold, nasal bone, lips and eye orbits were identified and images of each were saved. His heart was evaluated, inspecting all four chambers, the aorta was located, his kidneys, bladder, stomach/intestines all found and imaged. We saw his hands, counted fingers, saw his feet and measured his humerous, femur, skull and abdomen and confirmed his gestational age is extremely accurate with my dates. He is just about 12 ounces right now. His spine was inspected from top to bottom. And speaking of bottom, his boy parts were very evident and actually the very first thing that popped up on the ultrasound monitor. If I didn't know he was a boy, it would have been very, very, apparent and I am NOT at all trained in ultrasoundography. Bottom line, we have a very healthy looking little boy baking right now. His fluid levels are all good too. We are very thankful to hear good news about our little boy blue.

My cervix was also part of the evaluation. My TAC looks great and is still holding firm. My cervix is long and closed and even with fundal pressure remains uncompromised. More good news!

Of course the cervical measurement I got today was less than the measurement I have been getting from Dr. G for the past three weeks. This prompted much questioning on my part as it is time I fully understand the discrepancy.

It goes like this: My total cervix is 3.3, the number Dr. G has been consistently getting. However, the total cervix is NOT what is keeping this baby safe and sound. It is my functional cervix, which is essentially the cervix that begins at my cerclage (TAC) to the external OS (basically at the vaginal junction). This number is a lesser number measuring 2.9. Since Dr. Davis is the guru on this, I will request next time my local group measures my cervix, that they go from the point of the TAC to the external OS. I just want to make sure that those numbers still jive. (By the way, the below diagram does not show a TAC in place, just the female anatomy.)

Due to my trip to L&D last week, I asked Dr. Davis about PTL and if I am concerned over nothing: cervical insufficiency and PTL are two separate issues. (The only reason I contracted with my first pregnancy was because I had dilated. And apparently once you dilate, you automatically start contracting.) He agreed, CI and PTL are two separate issues but here is where I muddy that distinction up: I have a small uterus. The reason, Dr. Davis stated for pointing this out to me while I was in recovery back in March after having my TAC placed, was exactly why I ended up in L&D: uterine irritability. I totally appreciate his honesty. But to be truthful, my fishing expedition about PTL was so my mind could be put at ease. I was really hoping he would say, unlikely!

So in his medical opinion and as someone who has personally handled my uterus, what I experienced last week, what prompted a phone call to my local group, a phone call to Dr. Davis and a trip to the hospital is not growing pains after all - it's my uterus feeling all irritable. By the way, did I mention Braxton Hicks were evident on today's scan?

What does this mean??? Well, Dr. Davis assures me that my TAC will hold. That come 24w 6d (the day after Precious Miracle was born) I will still be pregnant and that by the time I reach 25, 26, 27, 28 weeks, my anxiety levels will start to decrease. However, I could start contracting and every attempt will be made to treat those contractions and stop labor. We hope this does not occur until I am at least 34 weeks.

In subsequent research, I have learned that women with uterine irritability are less likely to respond to tocolysis (meds/treatment to stop PTL). (I wonder how I responded to the mag sulfate I was given the first time around. I should ask next time I go to my local group.) BUT, with frequent cervical evaluations (transvaginal ultrasounds), it is the hope that cervical change is detected BEFORE labor gets to the point of no return and therefore can be effectively treated.

What's more, is that Dr. Davis said Tylenol will not treat uterine irritability but that Ibuprofen will. But Ibuprofen is one of those meds that works better as prevention. I explained that I am not into taking meds to take meds, especially when he warned me that amniotic fluid levels could be grossly affected between 26 and 34 weeks and that it is under no circumstances to be taken beyond 34 weeks. Tylenol, on the other hand is risky to my liver and as a pregnant woman, I was equated with an alcoholic. Based on my size I am not to take more than 2 regular strength tablets three times a day.

And finally, Omega 3's are said to help out with this, which I was taking until the thought crossed my mind that my pills could be full of mercury. Dr. Davis wrote a script as the prescribed ones are more controlled than the over the counter supplements.

All in all, it was an information-filled day. My head is swimming. I have much more research to do. Dr. Davis reminded me he is only a phone call away and is here for me any time I need him. He promises to get me through. Oh, he also told me, which he could tell everyone - but I'll pretend that's not the case, that little guy is, "a cute kid". That made me smile as did the hug I got before I left.


This "cute kid" looks just like his daddy! Maybe we should go back to III??? But then again today was my daddy's birthday (he would have been 54) and I wondered if today was the day we found out baby boy was a baby boy, if we would have, or at least I would have, felt compelled to go with Karl John.

Saturday, October 11, 2008

My First Trip to L&D...

Something was just not right and I needed to put my mind at ease. While Dr. C and Dr. D were both correct in the end, I am suffering from major growing pains, the mind of a micropreemie mom took over. Last night after taking my second dose of Ibuprofen and after Hubby spoke with Dr. Davis at 11:00 (I had fallen asleep), I woke up to pretty concerning symptoms of tightening and back pain. My mind wandered to labor, and, God forbid I waited, envisioned my membranes rupturing as a result. The panic and fear of losing this little boy was too much to take. So at midnight or shortly thereafter, we placed a few calls. My brother, Precious Miracle's God-father, drove over to sleep in our guest room while Hubby and I left for the hospital.

I called Dr. C's answering service, requesting they let him know I was on my way in and that there was no need to return the call. It was late and I didn't want to disturb him anymore than I already did.

We took the same route that I took the day that I found out my membranes were bulging. I commented to Hubby as we entered the turnpike that "last time" I drove myself in his car and that it was a Friday. This time, we were in my car, my "mommy car", a car we didn't own until after my nut came home from the NICU. And I was relieved that while it was only a few hours into the new day, it was Saturday, not Friday. Superstitious???

It took us about 35 minutes to get to the hospital. We walked in through the ER and they called up to L&D to let them know I had arrived. I got a funny look when the triage nurse asked if I thought I was in labor and how many weeks along I was. I immediately followed it with my, "my daughter was born at 24". That seemed to justify my early presentation.

We snaked our way through the hospital. Since Precious Miracle graduated from the NICU, the hospital has undertaken a major renovation project to the "Mother Baby Unit". Hubby and I were trying to orient ourselves with how we remembered things. We passed the step-down nursery (special care), where Precious Miracle had once taken up residence. It adjoins the well-baby nursery. It was determined that the bank of L&D rooms across the hall from where I was taken, was where our girl fought to survive. Literally, the same space in this world where her little body was jiggling from the pressure of the high-frequency ventilator (oscillator) desperately required to keep her alive, not to mention all the other wires and tubes attached to and going into her 1lb 6oz self. Now these rooms are a place where new life is brought into the world. Imagine that, a place where we cried so many tears, a place where so many other families cried the same tears and now tears of a different kind are being shed in the same space for babies of another kind, babies who can take their first breath all on their own and maintain it.

It is kind of nice that the hospital has changed. It is not the same place and I think that is a blessing for me. This is a new experience, a different pregnancy. Things are going to be different all the way around.

Back to the visit, they took a history, monitored the baby's heartbeat (lovely sound!) and hooked me up to the contraction monitor. I was so relived (as was Hubby) that there was no activity! It was such a comfort to see nothing on the monitor as I continued to feel the same tightening sensations that brought me to the hospital in the first place. My mind was put at great ease and that is a fabulous thing!

The resident consulted with Dr. C over the phone and it was determined, after they confirmed I did not have a UTI, that I could go home. We were at the hospital a total of 2 hours. It was a three hour night, ah early morning out, between the hospital visit and the 30 minute drive each way.

So the bottom line is: I'm stretching! No, being a subsequent pregnancy doesn't eliminate this part of the process. And, she kept emphasising the fact that I am "petite" seemed to mean that I would feel more growing pains than perhaps someone not so petite.

After all the back and forth, I can honestly say that I can rest easy, knowing the pain is just that, pain. It is not contractions, oh, which reminds me, they wanted to check my cervix, but I put my foot down about no internal exams. They were going to do a transvaginal ultrasound but felt since there was no uterine activity, the chances of my cervix going through any change would be unlikely. I have to say I was relieved to have avoided another scan. I will be evaluated by Dr. Davis on Monday and don't mind waiting the weekend now that I know what is going on or more importantly, what is NOT going on!

Friday, October 10, 2008

Can I Get My Story Straight?

At the risk of sounding contradictory, I called Dr. Davis on his cell phone tonight at 6:30. I feel horrible "bothering" him but he assured me he would not have given me his number if he didn't want me to use it.

After my last post, which was written on the heels of my walking in the door after a day in the car, my pains came back. Or maybe I should clarify, the tightening returned, in spite of my Tylenol. I scoured the Internet looking for explanations on contractions, pelvic tightening and braxton hicks. I came across an entry from a woman who experienced what I am reporting only to lose her son at 22 weeks. I thought about the great physician, Dr. Davis, who is on my side and supportive of my physical and emotional needs. If something terrible were to happen, how could I forgive myself for NOT doing something about the "not quite right" feeling I have? I am a preacher of standing up for oneself so why then won't I or wasn't I practicing what I am so good at telling everyone else?

I am conflicted once again. If only New Jersey were closer, Dr. Davis would become my primary doctor and I would deliver at any one of the multiple hospitals at which he has privileges. Losing faith in my local group has been an on-going battle for me and I feel as if it's too late in the game (19w 1d) to make a drastic change. And remember, I really want the NICU where our Precious Miracle was born to care for our son. In fact, the piece that I really want to is nurse my hopefully non-critical care, non-special care newborn son in the lactation room that was dedicated in honor of our Precious Miracle. Gosh the emotion surrounding that is just too much.

Anyway, my conflict comes from the fact that Dr. Davis told me Tylenol is the most dangerous drug in my medicine cabinet. He said more than three doses in 24 hours could cause liver damage in me, a pregnant woman because I am pregnant. I asked about the baby and thankfully, he is not the concern. Dr. Davis told me to take 600 mg of Ibuprofen and four hours later take another 600 mg. That puts me at 10:30. He then wants me to call him back at 11:00. 11:00 P.M.! I argued that it's too late for me to bother him but he insisted that that's what I am to do.

The man who acknowledged the emotional pain I suffered having a 24 weeker, the man who agreed that a woman knows her body, the man who recognizes the emotional component to pregnancy and the man who advocated for me to get my TAC, is the man who has my trust and confidence. He placed around my cervix, what I hope to prove as a life-saving stitch, so this precious little boy can enter this world without the traumatic and painful experiences my Precious Miracle so innocently had to endure. If only all doctors and medical practitioners could be as wonderful as Dr. Davis.

Finally, as an aside, Dr. C did offer for me to come to L&D. I just get the feeling I am always an inconvenience as instead of dictating what I should do in unclear situations, there is always an option to stay home and... While I want very much to be a partner in my care, an active participant, when I call because something is wrong, I want a doctor to be a doctor and tell me what is in my best interest - like get yourself to the hospital pronto or call me back and let me know that everything is okay...
And no, I never got to a "flattering" shot - but thought it would be nice to document how I look at 19 weeks in my usual attire...

Flu Shot - Check

I headed to the county health department today to get my $20 Thimerosal-free flu shot. It was a relatively easy experience. It is truly amazing the resources that are out there - you just have to know where to look and who to ask.

Tylenol has become my friend these past 24 hours. I have been keeping up with the dose as when it lapses, the pain comes back. Even when it doesn't lapse, I still feel discomfort every so often. I don't want to be a neurotic nut during this pregnancy but want to catch any issues well enough in advance. I feel like I'm walking a fine line. My huge flags for heading straight to the hospital are increased discharge and any bleeding whatsoever. This other stuff could be growing pains and since for the most part, the Tylenol is working, I think I'll stick with that explanation.

Here's to an uneventful weekend and a reassuring appointment with the TAC master on Monday!

19 weeks and concerned ... tightening in pelvis

Yesterday, I published this post on Abbyloopers:

"Hi, Ladies,

I am hoping you can help put my mind at ease. I thought I was doing really well with this pregnancy that is obviously set-up to be anxiety-ridden. Dr. Davis placed my pre-pregnancy TAC and now I am 19 weeks. I am seeing the local perinatal group that delivered my 24 weeker because to be honest, there are few options. I had a scan yesterday and my cervix was 3.3. I told the doc that I felt tightening in my pelvis. He asked if it had a beginning, middle and end. I said no, it was more just a constant tightening. He said that is not PTL/contractions and probably just my bowels.

I am also taking P17 shots weekly and on Wednesdays find I tend to get crampy as the solution seems to "wear off" so to speak. The doc said it was okay to take Prometrium before my next shot is due if it makes me feel better physically/emotionally.

Anyway, the Prometrium seemed to work and my tightening subsided last night. I got my shot this morning. Now, my lower left back hurts and the tightening is back. I called and made an appointment to see Dr. Davis on Monday but it's Thursday and I'm worried.

Should I call my local group and demand to be hooked up to a monitor to see if I'm having contractions? My local doc said it's nothing to be concerned about if the cervix doesn't change but I want to avoid that, right? I feel stuck right now. I think *woman from group*, you had home monitoring, and I requested it. I was told no, they don't do it anymore. *Woman from group's baby* is not even three, right? Things couldn't have changed that much in such a short period of time.

I did have contractions with my daughter that I did not feel, but were detected by the fetal monitor once I was on Trendellenburg because my membranes were bulging.

What should I do???

Thanks for your help!"

This pretty much sums up the past 18 hours or so. Things started to creep up on me while my little girl was napping yesterday. I was really scared that I was having contractions and made an appointment to see Dr. Davis who will put my mind at ease, I'm sure. Or if there is something wrong, will get to the bottom of it instead of brushing me off.

The tightening/back pain continued into the evening and by 9:00, I called my local group. Thankfully, Dr. C was on-call and told me I could go to L&D if that would make me more comfortable. He felt it was just stretching/round ligament pain. It's funny because both Hubby and my mom said the same thing. As for holding off on going to the hospital, Dr. C said to take a couple of Tylenol and apply warm compresses. The Tylenol thankfully worked and I was able to fall asleep. It must be exactly what Dr. C thought because at 3:00 A.M., when the Tylenol wore off, I was immediately awakened with severe pain. I took two more and went back to bed.

I'm glad I found a way to control the pain and discomfort. I'm not crazy to hear Dr. C say this could last until 24-25 weeks - my danger zone. Having this coupled with the stress of my last pregnancy experience is no picnic. One or the other would be plenty, both just compounds things.

Thursday, October 9, 2008

19 Weeks!

Kim came this morning and injected my fourth shot! Wow, I can't believe I've had four already. Today also marks week 19, almost to the half-way mark of a traditional pregnancy. I have a feeling my half-way mark has passed already and assuming my half-way point was 17 weeks or so, I'm extremely happy with that!

Yesterday I did experience tightening and took a Prometrium in the afternoon. I took another one before bed as I can take them every 8 hours. While in bed, I asked Hubby to feel my stomach, comparing it to the directions and guidelines illustrated on the sheet Dr. G gave me about PTL. Hubby confirmed that my tummy was soft and that no, I was not tight and therefore in his Daddy-opinion, not having contractions. I slept quite well last night and the tightening subsided. I think that's pointing in the direction that perhaps the Prometrium is working. I also took one this morning with my prenatal and so far today, have had zero issues. I think next week I will start my Wednesday with a Prometrium as to see if tanking up on the med in advance of the tightening will eliminate it altogether.

Perhaps later today I will have Hubby take some more flattering photos of my pregnant tummy just to show my progress. The ones previously posted marking each week is something we started from the get-go of my first pregnancy. It's funny, the week I missed one was the week things took a turn. It is my Thursday night ritual to sport my lovely purple plaid pajama bottoms and stretchy black tank top. The pictures are taken at the end of the day when my contacts are out and my face washed. Basically, I'm ready to fall into bed. I'll see what we can come up with that might be a little more becoming.

Wednesday, October 8, 2008

I Almost Forgot - Laugh Out Loud Funny...

And also pretty gross when you think about it!

Quick back story: about a week ago, I took Little Miss to the pediatrician because she was complaining that her "hiney hurts". They decided to run a urine culture so we sat on the potty and attempted the cup first. It was a no-go. So they bagged her. I was not going to cath her so thankfully the bag worked as she went in the bag while sitting on the potty. And thankfully the dip and culture were negative. The doctor chalked it up to being a potty-training two-year old who is all-too aware of certain body parts and their functions.

Fast forward to today: taking the opportunity to make everything a learning experience and only because the Miss had been through the same thing only the week before, when she asked, "what's Mommy doing" as I was leaving my own urine sample for the nurse today, I thought I might as well elaborate by reminding her that we tried to get her to do the same thing last week at her doctor and that it was Mommy's turn to go pee-pee in a cup.

She never took her eyes off me and as I placed the cup on the sink, innocently replied, "apple juice". I couldn't help but crack up but realize yes, it's pretty gross too. What is it they say, "out of the mouths of babes"?

Still Holding at 3.3

I saw Dr. G again today with Missy Girl in tow. We were coming from Kindermusik so it had been an early morning full of activity. She did absolutely fabulous! She was so excited to hear her baby brother's "thump, thump heart". She held Mommy's hand during my exam and held up like a champ, especially considering we had about a half-hour wait before being seen.

Dr. G checked my cervix which is holding firm at 3.3. I expressed concern about pelvic tightening and he assured me that contractions will have a beginning, middle and end. What I am experiencing is really one big tight ball. He also gave me a "cheat sheet" on the warning signs of PTL and how to understand and track contractions. It's funny, I never got this information last time.

Anyway, he was quite thorough, asking if I had any additional questions. He ended the visit by checking Baby Boy's heartbeat which is strong at 144 bpm. My Girl loves to hear the baby's heart beating and just lights up with excitement.

I reconfirmed that they were unable to get a Thimerosal-free flu shot and Dr. G suggested I call my primary care. I told him I did with no luck but that the pediatrician has them. He did not try to push me into receiving one of theirs. I was quite surprised and relieved that my wishes were respected. I am really trying to like him. Everyone who does tells me he has a good heart. I want so much to believe this. It's just a little hard when I feel he may have had something to do with pushing me into early labor with my nut. More on that as I start to enter what I call my "danger zone".

My friend, April, informed me last night that the health department has flu shots that are Thimerosal-free. I just scheduled my shot for Friday morning. It is a $20 co-pay, so at least I'm saving $30 as the pediatrician wanted to charge me $50. It is amazing the resources out there if you just look hard enough. Missy Girl has received a tremendous amount of resources and even though we have top-notch insurance, help with monthly co-pays for durable medical goods and formula when she required high-calorie Neosure after I finished pumping/breast feeding is/was very helpful. We pay taxes and don't feel funny taking what is available. I just wish there was better communication so ALL people who qualify for such services can utilize them.

Also, since I was feeling pelvic tightness and in following Dr. G's okay to "experiment" with Prometrium, I took a 200 mg pill this afternoon when we got home. For some reason, they make me feel drunk. But guess what? My tightening is subsiding. And yes, I've been pumping fluids all day. In fact, Dr. C was in the office today and upon my third trip to the ladies room in less than an hour, offered to watch my nut while she sat in her stroller. How nice of him! The last time they spent that much time together, he was in the process of delivering her 1 lb 6 oz body through my c-section. I really like him.

My next appointment is my 20-week anatomy scan. I am really looking forward to seeing my boy in great detail. Daddy is going to be there for that scan too! Now I just need to find childcare for my girl who has a full day of therapy. Hmmmm, I best get working on that!

Tuesday, October 7, 2008

More Than A Little Frustrated...

Last Friday, Nurse Barb was extremely anxious to give me a flu shot she so readily had on hand in her little refrigerator. When I expressed my concern about the Thimerosal, she quickly replied that she felt all shots were Thimerosal-free. Based on my experience with my nut, I know that is not the case. My pediatrician always advertises that their shots are Thimerosal-free. At the time, I decided not to challenge Barb. I had my girl with me and just wanted to escape before we moved to melt-down mode, which a two-year old can do without warning.

I called for Barb yesterday and learned she was out of the office. So first thing this morning, I called back. I told her I was ready to get my flu shot but needed one that was Thimerosal-free. What a difference a few days makes: her story somehow changed. Perhaps she did a little research. Perhaps she knew all along. I don't know, but the bottom line is, they can't get Thimerosal-free shots without ordering them a year in advance - or so they claim...

Frustrated, I called my primary care. No Thimerosal-free shots there. So I called my pediatrician. Of course they have them, but will they give one to me? After inquiring with the doctor, Maria called me back. Of course they will give me one - for $50.

My shot (as well as my nut's) is scheduled for next Wednesday. Tomorrow I see my perinatal group and will ask one more time, this time, I'll ask the doc himself, why they can't get the Thimerosal-free shots. I know the answer I will get will be quoted directly from the American College of Obstetricians and Gynecologists which is "The flu vaccination (injection) is both safe and effective for pregnant women and offers some immunity to their infants as well. Some pregnant women may be concerned about the safety of the flu vaccine because some contain thimerosal, a mercury-containing antibacterial compound. ACOG supports the recommendations and findings of the federal Advisory Committee on Immunization Practices, which found that there is no evidence showing that thimerosal is a danger to the health of the pregnant woman or her fetus. Thimerosal-free flu vaccines are available, but they tend to be more expensive."

I suppose with this ACOG recommendation, it will be pointless for me to submit my $50 receipt to Baby Blue Prints for my out-of-pocket Thimerosal-free flu vaccine. Peace of mind is priceless but boy, can it add up!

Monday, October 6, 2008

Just Some Numbers

I got a call on Friday from Genzyme, the company that formulates the results of the sequential screening. The second leg of the test was a recent addition as it was not offered to me during my first pregnancy. The woman who called told me this test is more sensitive than the first trimester screen alone.

My results were as follows:

1 in 9,100 for Downs
1 in 10,000 for Trisomy 18
1 in 6,000 for Neural Tube Defect

We are thankful that so far the baby and the pregnancy look healthy. I am just nine days away from my 20 week scan and pray that everything continues to look as good as it has.

Friday, October 3, 2008

Another Cervical Check

Today was my first appointment solo with my girl in tow. She was very well-behaved and snacked on pretzel sticks and mini muffins the entire time. Since it was just the two of us, and I was a little nervous what would happen if she started to get antsy.

She enjoyed listening to her baby brother's heartbeat on the doppler and now says, "Baby's heart thump, thump". For all she's been through as a micropreemie, she is an excellent patient herself, always following doctors' orders. She is the best little "sitter" when they listen to her lungs and since she has those preemie lungs, listening to her takes much longer than it would to listen to a "typical" child. She allows her ears to be looked at without putting up a fuss, and my favorite, is always ready to stick out her tongue and say, "Ahhh". But, she really doesn't like when anyone touches her mommy in a medical situation. So today, when it came time for my exam, she whimpered calling for me and wanting to hold my hand. It was nice to have the comfort of my Little Nut. She's so good at that!

My uterus is continuing to grow nicely and is slowly creeping up my mid-section. My cervix is measuring 3.3, right where it was last week. My TAC is nice and visible and is clearly, at this point, doing its job. Even with fundal pressure, my cervix is looking fabulous! Oh, and I gained a pound since my last appointment. Good news!

I proposed the idea of taking Prometrium (oral Progesterone) every Wednesday as it seems I am crampy just before my next P17 injection along with Thursdays after my shot - almost like the solution has "worn-off" before my next shot and by the time I do get my next one, it takes about a day to work into my system again. The doc said it won't change the outcome and I replied that I really just want to treat the symptom because the cramping is causing my mind to wander to places I prefer to stay away from. He claims that there is no harm that can be done by increased Progesterone and that I will be an experiment of sorts, that I can report my findings to them each week. So come Wednesday, I will begin my little test.

Finally, I am due for my flu shot and Nurse Barbara was ready to give it to me this morning. I freaked out! I have yet to finish my research on flu shots during pregnancy. I know that pregnant woman are in the high-risk category when it comes to influenza. Trying to convince me to get the shot today, Dr. G told me that pregnant women die from the flu. Lovely. I realize the flu is a big killer period. But I still have unanswered questions that require more reading on my part. For example, is there an increased risk of food allergies in the baby when the mother receives a flu shot during the pregnancy? What about the risk of Thimerosal? Will I get a Thimerosal-free injection? Nurse Barb seemed to think all shots were Thimerosal-free but couldn't guarantee that was what she was about to draw up in her needle. I explained that since I am due back in less than one week, and since it's early October, I am more than happy to wait and get the shot next time. I just need to ease my concerns a little before pulling the trigger or shall I say pushing the plunger.

Thursday, October 2, 2008

18 Weeks and Nameless?

As I sit here typing my 18 week update, this little guy is boxing the heck out the front wall of my abdomen. He has three distinct periods throughout the day in which he becomes active or maybe I should say when I notice his activity. Which now that I think about it, always happens when I sit down to rest or when I'm driving in the car. It has now gotten to the point where Daddy can feel the bumps and pokes and it has become somewhat of a routine or ritual for Daddy to connect with his son before we turn in for the night.

This week's shot is tending to burn a little more than my previous two. I am not complaining because it's really nothing in the scheme of things. I just wanted to mention it.

I started to experience back pain earlier this week. Towards the end of the day, my back would just start to ache. Of course the thought of pre-term labor entered my mind so Tuesday night I took one Tylenol before bed. That alleviated my discomfort. My non-medical opinion is that I'm starting to get bigger and I think it's causing a strain on my already weak back muscles.

Speaking of getting bigger, I am! It's actually very exciting! Yesterday, two people asked me when I was due and one other person asked if I was expecting. I must admit that the way I am carrying totally makes me look pregnant! It's so nice! I look pregnant! With Missy, I was just a big round blob, full in my face, hips, behind, all around. This time, while I'm sure my face is fuller and my hips and behind bigger, all that I notice is my big round tummy. Oh yes, and those close to me like to remind me how my boobs have just grown. My neighbor joked with me that I was either expecting or the recipient of implants.

Having a baby brother join our family is something we talk about many times each and every day. It has become routine for Missy to understand or at least act like she understands that there is a baby brother in Mommy's tummy. Yesterday, upon waking up, she came into our room and wanted to "nuggle Mommy" who was still lounging in bed. She climbed up and snuggled right in to me, causing me to comment that baby brother is getting crushed. To that she piped up with "Baby Ethan". Now there are some families that allow their children to determine the name of the new baby. Ethan is a lovely name and actually could work well with our last name. But Ethan also happens to be the name of Missy's little friend's new baby brother. That is where this whole Ethan kick began. The more I think about it, the more I like it but I am all about originality and when we were expecting Missy, when a name we liked was snagged by friends or neighbors, we immediately struck it from the list. We don't want to look like copy-cats.

So this poor baby boy is still nameless according to his parents. According to his big sissy, his name is Ethan. We have a few names we like but nothing (expect the one name that our family has poo-poo'd if not downright made fun of it) jumps out at us as the "one". With Missy, I just knew and to this day, when I see her name written I think it's just so pretty and I absolutely love it! It's time to get giddy about a boy name...

Here is a little clip of my girl saying she loves her baby brother. The part where she requests, "open" refers to the panel on my pants that she would like me to pull down. It was a little hard to finagle one-handed and as you will hear, I had trouble putting her request into words. But the whole point of this is hearing my nut say, "I love you baby brother."


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