Henry Edward is One Week Old!

It is hard to believe that one week has passed already. This experience has been amazing!

Recovery from my c-section has been going well. I feel terrible that I have been unable to lift My Girl but with squatting down, can offer her full body hugs. This recovery has been much easier than my first c-section and my TAC placement.


Henry is settling in nicely and has already made a visit to the pediatrician. He is down to 5 1/2 lbs but is eating like a champ! We appreciate and cherish all of his abilities - such as the fact that he not only knows how to coordinate sucking, swallowing and breathing, but he is doing all of this while exclusively breastfeeding. We are hopeful for a good weight gain so the breastfeeding can continue.

Another thing to note, is that Mister Henry, born at 6 lbs 3 oz, was 4.5 times the size of his Big Sister.

Here is a little video about our birth experience. Enjoy!

The Details...

I went to bed early on Saturday night and was awakened by a strange sensation in my lower pelvis. It was a burning feeling that ran straight across. I had taken it easy all day Saturday, working on a special book/album tracking my pregnancy. I noticed that I had urgency and frequency symptoms associated with a urinary tract infection so when I woke that night figured I might have a full blown infection.

Attempting to fall back to sleep, my thoughts were restless, I tossed and turned and when I sat up and looked at the clock's display reading 2:01, I knew today was the day. I woke up Hubby who suggested round ligament pain. Poor guy. I knew he wanted his sleep but this was different. It was time to call the doc and go to the hospital.

We started with a phone call to my brother, thinking it would be easier for him to crash on my couch than to wake up my mother. Little did we know he was in NYC for the weekend and so we moved on to dialing my mom. She was over in record time. In the meantime, I had gathered a few items, the camera being one of them, and called the service letting them know there was no reason for a call back, I was just going over to the hospital.

This time I took a wheelchair ride up to L&D. I was put in room #7 which is the same number assigned to My Girl's first NICU spot two and half years ago. My view was the same as hers, overlooking St. Charles Seminary. Already comfort! Hubby snapped a couple of photos.

I left a urine sample, hoping that would reveal the cause of my discomfort. I was then hooked up to the monitors. I was contracting. Big mounds of contractions were filling the screen and I could feel the gradual build up, peek and dissolution of the sensation. Hmmm, not sure I ever had "real" contractions before. In fact, it was questionable as to if these were "real" contractions as "real" contractions cause cervical change. I was given three shots of Terbutaline and consented to Dr. Einhorn examining my cervix, which remained closed and unchanged from her last check two weeks prior.

Between each Terbutaline shot (they were spaced about 20 minutes apart) my contractions would reduce to irritability and then bam I would have a strong one. The fact that my contractions were not going away was concerning and even if there was no cervical change, it was still advised that I not contract against my TAC.

Dr. Manko took over the shift and told me if things didn't improve within an hour, it was "game over". I liked her decisiveness and take-charge manner as she was very matter-of-fact as to what to do. She was exactly what I needed.

Hubby and I knew it was time and started making phone calls. We learned who was on in the NICU and while we trust and love everyone on the unit were excited to hear that accompanying Dr. Guida, was Nurse Practitioner, Cindy Cox. She was at Our Girl's birth and it was so special to have her at Baby Boy's birth too.

The resident who was on happened to be the same one I had the week prior when I visited L&D. (He wanted to do an internal and I wanted a transvaginal ultrasound.) It was nice to see a familiar face and I think by standing our ground, while we disagreed with each other, have a mutual respect for where the other person is coming from.

Dr. Manko confirmed that today was the day and so the ball started rolling. I was happy to learn that my urine was negative for infection and at least it wasn't that that put me into labor.

I walked myself back to the OR. This was the first of many, many discrepancies between my two birth experiences. I was prepped, got my spinal and Hubby joined me. I was nervous but who wouldn't be?

In a very slow, methodical nature, my c-section took place. There was a calm over the room, a calm that was very much absent from the rushed and frantic birth of My Girl.

Tears overwhelmed me and I sobbed uncontrollably as at 11:38 AM, our Baby Boy came into this world crying and kicking. I was so proud that my 35w 3d Baby Boy weighed in at 6 lbs 3 oz!



Hubby got to cut the cord and held our bundle swaddled in blankets while I was closed up. He was breathing on his own! His apgars were 8 and 9.

He's Here!

Baby Brother arrived on Sunday, February 1, 2009 at 11:38 AM. At 35 weeks 3 days gestation, he weighed in at a whopping 6 pounds 3 ounces! What a shock when he tipped the scales at such an amazing weight! He is still nameless and is in the NICU working on his nippling. He is in an open crib with no respiratory support, IVs or feeding tubes. We are working on breastfeeding as well. He looks so much like his Daddy!

He is doing so well and we are so proud of him! I will post photos and more details later on. I am feeling really good and have been up and around rather quickly.

Mom of 24 weeker AND 35 weeker!!!

35 Weeks!

What a big day! First of all, I'm now 35 weeks and second, I received my last P17 injection this morning! I never thought I would get through all 20 shots and here I am, all finished!

I saw Dr. Davis this afternoon. We really didn't have much to discuss and my cervix wasn't even evaluated. My fluid level is holding steady at 10.5 and my NST was good - baby was reactive and no contractions were detected.

Concerned about my increased irritability, I asked Dr. Davis how I would know if I was going into labor. He said whenever I'm unsure just go to the hospital like I did over the weekend. He said I might go back six times between now and my scheduled c-section and that it is okay to be evaluated and sent home.

Baby Boy remains breech, frank breech to be exact. It seems like he's been in this position for as long as I've been evaluated. Of course this brings with it new worries for me such as his hips and possible need for braces or physical therapy after birth. But it's nothing we can't handle.

Oh, and he may just have a name. We are keeping it under wraps...

Moving Right Along

Yesterday was another big milestone for me personally - at 34w 5d, Baby Boy has officially had an additional 10 weeks in utero than his Big Sissy.

My lung maturity amnio is just two weeks away and based on the time of day right now, in two weeks, it will be over (unless the doc is backed up). I was told they can get a feel for the results based on how the sample looks. Hopefully this doc will give us his off-the-cuff opinion.

The Terbutaline has been working, for the most part. With taking it every 8 hours, I felt a surge of symptoms six hours into my pill. Additionally, at about the same time, I developed chest pressure and shortness of breath. I was confused because I know Terbutaline is an asthma medication. This prompted a call to the service last night. The covering doc felt that my asthma symptoms are worse than I thought and that the Terbutaline was working on both my asthma and my uterine irritability. I was told to increase the Terbutaline to every six hours and have been doing so for three doses now. So far, so good.

Changes

It seems as though the increased Procardia was not working well enough to eliminate or even reduce my escalating uterine irritability. I called my group and was squeezed in this morning. I saw Dr. Einhorn who was very matter of fact that I stop the Procardia and very reassuring that I am at a great point in my pregnancy. She decided to prescribe Terbutaline which I am now taking three times daily as it seemed to work really well when I went to L&D on Saturday. I took my first dose this afternoon at 2:30 and have been on my sofa ever since. I have noticed a significant decrease in my symptoms. I'm still trying to decipher the side effects as I feel a little dizzy and very tired - both may be a good thing as if my irritability symptoms subside, I may be very temped to pick up the activity again. Being dizzy and tired may keep me from overdoing things.

Thankfully, my mother has My Girl as she is probably the most strenuous part of my day. She is heavy at 27+ pounds and I still carry her on occasion and snuggle her before nap and bed. She's quite the lovey and I can't resist!

I will admit my emotions are running high, probably the highest so far during my pregnancy. I am beginning to worry that Hubby could miss the delivery, if God-forbid they have to do an emergency c-section. Starting today, every Monday afternoon/evening, Hubby is in Baltimore for his new program. He so much deserves to experience this birth and I don't know what I would do if he wasn't there.

Additionally, I am just torn. When my irritability is bad, I want so much to just deliver as I am extremely fearful of rupturing my uterus. Then, moments like now, when my irritability is at bay, I want to make my c-section date of February 12. I want so much to experience a "term" delivery especially after having a 24-weeker. How amazing is that? From micro-preemie to term? I want that so very much, not just for me, not just for my husband and not just for Baby Boy, but for other women out there who are nervous to take the plunge into a pregnancy after a preemie.

My lung maturity amnio is just 16 days away and I pray that Baby Boy's lungs are mature! I will be counting down the days but as I've mentioned before, feel like I'm at a great point in my pregnancy at 34w 4d. Tomorrow I will be 10 weeks beyond where My Girl was born. I no longer qualify for steroids to develop the baby's lungs, nor do I qualify for tocolysis to stop active labor - those two milestones are just amazing to have achieved.

Additionally, there were two things that were holding me back from being fully ready to deliver and those personal milestones have been met. The first was the arrival of the gifts Baby Brother will be giving his Big Sister. Baby Bop and BJ arrived in the mail on Saturday. Boy, were they hard to find! Riff came from Toys R Us but the other two had to be flown in from Hong Kong.

The second was a portrait of my most pregnant tummy. The sweetest part of this photo is Our Girl's hand because it was her birth experience that had the greatest "hand" in Baby Brother's pregnancy success.

Here is Our Girl. Our former 24-weeker, once 1lb 6oz. She turned 2 1/2 yesterday and we are so proud of her! Her feisty nature and willingness to fight her way through her 105 day NICU stay is still evident in the precious little girl she is today. Last night, while playing on the playground at the local mall, she fell backward from a climbing apparatus when she missed a step. She wasn't hurt and I was probably more traumatized than she was. I screamed and Hubby raced to pick her up, carrying her over to me. I snuggled her and she told me, "Mommy, I try again." I just love this child!

Labor and Delivery

This morning, of all mornings, I had a terrible pain in my left side, higher up, in-line with my belly button that radiated around to my back. Hubby left to go to orientation for his new program, My Girl was scheduled for soccer at 9 A.M. and I had a long list of things to do including pampering myself with a wax and trip to the salon.

My brother was scheduled to take My Girl to soccer since adult participation is required and I very well can't run around after a ball, pain or no pain. My mother was then scheduled to take My Girl for a day of fun with Grammy, culminating in dinner for all once Hubby returned from school.

Well, the plans changed - My Girl spent the ENTIRE day with Uncle Justin and by entire, I mean 9 - 5 and my mom drove me to the hospital where we hung out on L&D until about 2:00.

Dr. Barsoum was on-call and when I described my symptoms felt it was better to be safe than sorry. L & D knew I was coming and after leaving a urine sample was hooked up to the monitors. My pain had subsided and had I not called the doctor, probably would have brushed it off and stayed home, carrying on about my long to do list. Thankfully, that didn't happen.

At first nothing showed up except uterine irritability. The male resident came in and wanted to check my cervix. We got into a discussion about it and I requested a Transvaginal Ultrasound which he completely disagreed with. He said he would talk to my doc and if she felt a Transvaginal Ultrasound was indicated, she could perform it herself, but he refused. That's fine because I refused his internal.

He returned with the machine and informed me that Dr. Barsoum would be stopping by to perform the ultrasound. In the mean time, my very nice nurse decided to move the TOCO monitor around as I was complaining of discomfort. A couple of contractions were detected.

When Dr. Barsoum called to say that her rounds were taking longer than usual and that she was still coming, the nurse told her about my uterine activity. At that moment, Dr. Barsoum ordered a shot of Terbutaline which I received in my arm. Thankfully, I didn't experience the heart palpitations I was warned could potentially occur. And after the injection, I noticed my underlying cramping diminished significantly (the painful sensations were on top of this crampy feeling). My TOCO strip post Terbutaline now resembled the strips I've been producing weekly when I see Dr. Davis during my NSTs - basically nothing.

Dr. Barsoum checked my cervix which with four different measurements averaged a length of about 2. She sent me home with an increase in my Procardia from 20 mg every 8 hours to 20 mg every 6 hours. And she told me to take it easy. Something I sort of do and sort of don't do.

My mother and I stopped for lunch (which I have to admit, my appetite is lacking). We made a few other stops before heading home (I needed a Crucifix for Baby Boy's room and I got a pedicure - think of me what you will).

There is a difference between being up, on my feet and relaxing with my feet up. My irritability has certainly increased in the past 24 hours and I wonder if this is the beginning of the process.

I feel good being 34w 2d, just two hours away from 34w 3d. There is part of me that is so scared to labor that I would almost prefer my membranes rupture as a way to tell me okay, this is it for real. Having to decipher on my own, what is worthy of a call and what isn't, is a bit much for someone like me who worries about every single twinge.

I learned late last night when I picked up a voice mail that my c-section is officially scheduled for February 12. That's just 19 days away. So at some point between right now and February 12, Baby Boy will be here... oh, and he still needs a name...

34 Weeks!

34 weeks feels so good!

Today was a busy day with two appointments. The first appointment was a consult for a local amnio. I made the appointment before Dr. Davis indicated he wanted to perform the procedure. Dr. Donnenfeld, who has an affiliation with my old group but doesn't deliver, recognized my husband. Dr. Donnenfeld only saw me for a brief moment the weekend I was in Trendelenburg with bulging membranes back in July 2006. He is a very nice man and asked about Our Girl and how she was doing. It is a simple question that to me, gives a quick peek into the heart of these very specialized doctors. It is nice to be able to distinguish which physicians truly care. Dr. Donnenfeld does.

It was decided based on his medical opinion and scheduling, to perform my amnio on Wednesday, February 11 at 36w 6d. Prior to scheduling, I wanted to meet with my new group to confirm their availability for my c-section. I was also torn about having Dr. Davis perform the amnio. I expressed this to Dr. Donnenfeld, who personally knows Dr. Davis.

My personal comfort, as much as I love Dr. Davis, is to be closer to home. There is just something about being far from home that causes me much anxiety lately. I think for my own inner peace, I need to have my amnio in PA. I hope Dr. Davis understands.

My second appointment was another weekly appointment with my new group. Dr. Porcelain is one of the last physicians I had yet to meet. She, too, personally knows Dr. Davis. She confirmed my need for the TAC and also inquired as to the health and development of My Girl.

It looks like if all goes well, my c-section will be scheduled for Thursday, February 12 at exactly 37 weeks gestation, full-term!

Wow! It's crazy to think that in exactly three weeks from this moment, assuming Baby Boy's lungs are mature, I will have delivered and will be recovering in the hospital with my healthy baby next to me - as in - rooming in! Nuts, just nuts!

Baby Boy was just evaluated for growth on Tuesday and is measuring just fine. I'm glad I have this knowledge as I've failed to gain much weight over the past two weeks. It's been something along the lines of 1/2 lb. My uterus is measuring on-target and his heart rate is within normal limits - all good things.

Since I had appointments today, I thought it would be easier to have the nurse administer my 19th P17 shot instead of having Kim restructure her morning on account of me. Oh, boy! Kim is so gentle and truly takes her time to make sure the experience is a comfy one. The nurse at the doctors' office, while very nice, stated she was very busy. She said they usually have the shots prepared ahead of time but since I usually get my shot at home, this wasn't possible. Anyway, I leaned over the exam table (doing my best to let my leg and behind relax) and with the preface that she had to be quick and a reminder of just how thick the solution is, got a fast jab in the backside (no z-tracking here) with a two-second push of the plunger. Let me just say, it was the most painful shot of this sort I've ever had! Holy cow! They have never hurt this bad and I am sitting with a heating pad as I type. But in the scheme of things, it's really not that big a deal.

So tomorrow, my plan is to make sure I get myself on the schedule for my amnio and confirm the time for my c-section.

While Hubby and I are both very happy with where I am, it would be nice to make it to 37 weeks to be able to achieve a term pregnancy after a micro-preemie. February 12 is not set in stone and I wouldn't be surprised (at least I'm prepared not to be too surprised) if Baby Boy makes his appearance before hand.

Here's to celebrating 34 weeks!

33 Weeks 5 Days - Nine Extra Weeks!!!

As of today, I am the most pregnant I've ever been by a whopping nine weeks! At this gestation in my first pregnancy, My Girl was already alive for 63 days. She had just tipped the scales at 3 lbs and began sprinting on the nasal cannula. In fact, at a corrected or gestational age of 33w 5d, I held my daughter on my shoulder for the very first time (all other holding sessions were either Kangaroo Care/Skin-to-Skin or swaddling) sans vent or CPAP. The photo below depicts a NICU mood as I am watching the monitors to make sure My Girl is able to keep her sats up while in my arms for the first time on cannula, not to mention making sure she is able to handle the position of being on my shoulder.



33w 5d has been a much different experience with Baby Boy. For one, he is still inside, where he belongs. Today his measurements calculated a weight of approximately 4.5 lbs - that's My Girl at the same age PLUS what she weighed at birth (1 lb 6 oz). I've said it before and I'll say it again, it's amazing how much a baby can grow when it doesn't have to focus on staying alive in the process.

My fluid was around 10 today, a little less than last week but still acceptable. My cervix is still closed and shows no signs of funnelling even with fundal pressure. My lower uterine segment was once again evaluated by Dr. Davis himself and confirmed to be fully intact with no visible signs of thinning or separation.

Today Dr. Davis mentioned scheduling my amnio. I was under the impression this would be done at the hospital where I intend to deliver. In fact, I have a consult scheduled for Thursday. Dr. Davis assured me that in the 25 years he has been doing amnios for lung development (which he performs quite regularly) he has never had an issue with nicking the cord, which was my main concern. In fact, he said that other doctors will refer tough amnio situations to him, and said although he can't walk and chew gum at the same time, is really good at navigating a needle into really small spaces.

I asked what were to happen if my membranes ruptured or I went into labor as a result of the amnio. I was surprised to learn he would let me drive back to PA to get to my hospital. Hubby is not so comfy with this idea and I have a feeling if either were to happen, I'd be delivering with Dr. Davis right then and there.

So it looks like we are tentatively scheduled for my amnio in three weeks at 36w 5d gestation. Dr. Davis informed me that he felt Baby Boy's lungs had a 10% chance of being mature enough for delivery but based on the values would be able to predict when he would be mature enough to deliver, waiting anywhere from one to two weeks. So much for the plan I had of delivering at 37w on February 12, 2009!

My plan is still to meet with the local doc as he is specialized in genetics and I have some questions about evaluating the amnio sample for some blood clotting disorders my husband is a carrier of. I already called my pediatric hematologist only to get the run-around from the woman who answered the phone. The doc, if I could have gotten to him directly, would have answered my questions. Why do so many doctors have bitchy "gate-keepers"?

Finally, I met the woman (and her husband) Dr. Davis asked me to call last week. She had her TAC surgery yesterday and looks like she's making a fabulous recovery! She is currently 10 weeks pregnant and I wish her another uneventful 27+ weeks! It is amazing what the TAC can do and I look forward to following her pregnancy.

And the fFN is...

Negative! I know I said I wasn't going to put any stock in the test, well maybe more so if it came back positive - but the fact that my fFN was NEGATIVE means that there is a really good chance I will NOT go into labor in the next two weeks. This information does wonders for the curious mind of a micro-preemie mom who is just waiting for something to go wrong at any moment.

In the spirit of honesty, my renewed fear is uterine rupture, which everyone has told me is very unlikely. But, coupled with the "unlikely" nature that I'd deliver my daughter at 24 weeks gestation, it's a bit hard to totally dismiss the advice. Especially considering that I am feeling so many tugs, pulls, pressure and other sensations that cause my mind to take a walk down the road of "what if". I see Dr. Davis tomorrow and my lower uterine segment will once again be evaluated for signs of thinning.

Some good news in the name of TAC advocacy - I learned last night from my in-laws that there was a story on their local news about the TAC. Here is the link: http://www.wptv.com/content/health/mb/story/Procedure-to-prevent-miscarriage/2MOthnLvvkeqpPdgN7kdIA.cspx

I have been unable to find the actual news broadcast but there is a written report.

Coincidentally, or perhaps it was the same report, there was another story on a news station in LA. Here is the link:
http://abclocal.go.com/kabc/story?section=news/health&id=6608988

The more we can spread the word about the TAC, the better! Women need to know there are other options out there beyond TVC. Here's to helping save the lives of precious babies and saving families the heartache of a loss or the terror of having a micro-preemie!

Discomfort and Discharge

Last night was a rough night with tremendous pelvic pressure. I just couldn't get comfy and come morning, my symptoms were still lingering. In fact when I got up with My Girl, I experienced a streak of discharge falling into my pajamas and down my leg. It was reminiscent of the morning at 24w 1d with My Girl that caused me to go to the doctor to learn my membranes were bulging.

Today was a scheduled appointment with my new group so instead of calling and trying be seen sooner, I just waited until my 1:45 time slot, taking the morning to push through my discomfort and clean my toilets, pick-up my house, do laundry, make a casserole for dinner and start a crock pot of soup for the weekend. Call it nesting, perhaps.

My mom came over to be with My Girl who is under the weather with an ear infection, runny nose and cough. She is just not herself and with her asthma it's just too cold to take her out - my car read 17 degrees this afternoon. Anyway, she is holding her own and not requiring any oxygen and we hope it remains this way.

I haven't had much of an appetite all day but when I met Hubby at his office felt like a Dunkin Donuts hot chocolate and munchkins, which I ate on the way to my appointment.

Dr. Einhorn is the third doctor I've met from my new group. She was just as nice, kind and understanding as the first two docs I met. It is so refreshing to see a woman! After much talking about my symptoms and after she reassured me that it was okay to examine me, I consented to a fFN swab and an internal. Yes, my symptoms were that bad that I really wanted to know the "status" of things. I was almost certain this baby was on his way today. Also, I've once again encountered that each OB has their own philosophy and that no two docs will agree on anything. There is just something about the way this doctor delivered the information and explained things that made me feel comfy, even though it was probably (well, I know it is) not what Dr. Davis would have suggested or done.

In order to perform the fFN swab, the doctor had to place a speculum. She evaluated my cervix visually first confirming it was closed and that yes, I did have a tremendous amount of what looked like normal pregnancy discharge. It is not amniotic fluid nor does it look like I have an infection. Good news so far.

She took the swab which I need to prepare myself if it's positive, doesn't mean there is anything to worry about. A negative result almost guarantees that I will not deliver in the next two weeks. The swab is being sent to the lab and it's likely that the results may not be ready before the close of business today.

She then did an internal (again, Dr. Davis would probably not agree with it but I just need to know what's happening!). My cervix is closed and long, although she admitted that it does feel different with a TAC in place. The baby can be felt low in my pelvis so she feels he has started to drop, possibly causing the great pressure and discomfort I am having.

The group is on-call this weekend and she told me if anything changes: bleeding, increased discharge, rupture of membranes, contractions, just an off-feeling, to call and go to L&D. She also wants me to take it easy and reduce my activity, being sure to hydrate well.

Oh, I should mention prior to my exam, she prefaced things with, "if you are at all dilated, you will be having your c-section today." She then went on to reassure us that the difference between a 24 weeker and a 33 weeker is night and day. Something we know, but will admit it's nice to hear and we will never tire of the positive thoughts.

As we were leaving the office, Dr. Barsoum, the first doc I met from the group popped her head into the room to say that she had a lengthy conversation with Dr. Davis just the day before. She wants me to schedule my c-section which once I meet with the doc about the amnio next week, will be able to put it on the calendar. Hubby and I marveled at the idea that in exactly four weeks from today, assuming Baby Boy's lungs are mature, I will be sitting in my hospital bed recovering from my surgery with our son in his open crib next to me. Crazy! It's just crazy! We're so close to reaching our goal of full-term!!!

So, I left the office feeling much better than when I had arrived, mentally speaking. Tonight I am off to book club and tomorrow I am going for a facial (thanks to my mother-in-law). I reason with myself that those are not stressful activities and I should be okay to pull them off.

Here's to charging forward!

33 Weeks!

Today I got what I can't believe is my 18th P17 shot! Only two more to go!

Hooray for 33 weeks!!!

Eight Weeks Longer... (So Far!)

Yesterday I celebrated 32w 5d! This means that Baby Brother has officially had an additional eight weeks in utero than his Big Sister did - and we're still cooking!

I saw Dr. Davis yesterday for my weekly scans and testing. My fluid level is remaining fairly consistent at 11.24. My cervix is continuing to shorten (as part of the normal pregnancy process) and is now measuring with a total length of 2.4 and a functional length of 2.1. The important thing is that it remains closed, which thankfully, it is.

Dr. Davis and I discussed the plan for scheduling my c-section and it was decided (which we knew this part all along) that if active labor starts at any point in time and can't be stopped, I will be taken in for delivery. If by 37 weeks (which is four weeks away from tomorrow!) I have not gone into labor, then an amnio should be performed to confirm Baby Boy's lung maturity. Dr. Davis feels I should deliver at 37 weeks if Baby Boy's lungs are mature as opposed to pushing it and waiting for labor to begin on its own.

The question of confirming lung maturity was addressed and I explained our position in our willingness to deal with transitional breathing issues if need be. Dr. Davis explained that this is common thinking for parents of preemies who have been through the NICU experience. What Dr. Davis continued to explain, that no one else has (although I think the new doc I saw last week alluded to this fact) is that near term babies have different issues with regards to respiratory status. He said that if a near term baby goes into Respiratory Distress and begins to experience Bronchial Spasms (both things we dealt with with Our Girl) their bodies respond by going into something called "Persistent Fetal Circulation". My understanding of this is that the blood does not circulate through the lungs once the baby is born and this causes major issues in oxygen saturation, persistent pulmonary hypertension and possibly death.

My next question was about complications from an amnio - that if Baby Boy's lungs are not developed but my membranes rupture, I go into labor or the umbilical cord is compromised, then what? Dr. Davis explained that all of those involve "stress" different from "distress" which works in aiding lung development.

So yesterday, Dr. Davis hit home our need to stay with the initial plan of confirming that Baby Boy's lungs are developed enough for him to enter this world by having the amnio prior to my scheduled c-section at 37 weeks.

With 33 weeks at the door in less than 12 hours, meeting our Little Boy is just four weeks away! I can't believe we are coming in on the home-stretch!

And speaking of home-stretch, I feel as though I am stretched to capacity. My maternity shirts are no longer fully covering my large tummy and last week my flush belly button officially began its journey towards becoming a full-fledged outie.

Finally, Dr. Davis asked me to call one of his patients who is scheduled for her TAC surgery on Monday. We spoke last night and I wish her well as she undergoes this life-changing, life-saving procedure. To anyone out there who has experienced a loss or early birth due to IC, PLEASE, PLEASE, PLEASE consider the TAC! Dr. Davis is an amazing doctor and person and I know I wouldn't be this far into this pregnancy without him and my TAC!

Oh, and since we've really moved into baby-prep mode, Our Girl is so fascinated with all the baby things we've pulled out that were once hers. She is also even more excited about Baby Brother's upcoming arrival and asks several times throughout the day when Baby Brother will come play with his toys. When the dogs bark and she thinks someone is here, she now says, "Baby Brother here, Mommy?"

Some Funny Feelings...

Yesterday in the late morning, I started to have some not-quite-right feelings/sensations. These feelings have continued as I have intermittent low abdominal cramping and lower back pain along with a feeling of heaviness and pressure. I have a slight increase in discharge but nothing too much and certainly no bleeding, otherwise I would have called the doctor or gone to the hospital. I am not having contractions although as my next dose of Procardia is coming due, I feel an increase in my uterine irritability, causing me to take my next pill anywhere from 30-60 minutes ahead of schedule.

The more days I clock in this pregnancy, the less-worried I am over things such as this. I informed my husband of my discomfort and he too feels the same way. Although my real reason for telling him was to enlighten him to the fact that I suppose things could change at any moment and we may end up needing to get to the hospital.

I have taken it easy today, only driving to school to pick up My Girl. Thankfully Hubby is flexible enough to meet me there, run in, get her and put her in the car for me. She was a true dream today and in spite of the coughing incident that caused her to throw up in her bed, cutting nap time short and requiring stripping of the bed and a bath for her, we had a lovely day together, snuggling in my bed as we "rested" (no nap). I even commented to Hubby that Our Girl seems just a little more mature today, like she's just growing up.

Tonight Hubby came home from work on the early side so we headed to the basement to pull out all the baby things we'll be needing in a few weeks: car seat, bouncy seat, swing, pack-n-play, etc., etc. This really sparked a heightened interest in Baby Brother for Our Girl. She is running around the house saying, "Baby Brother is coming!" In fact, a car pulled up out front and she asked, "Baby Brother in the car, Mommy?"

32 Weeks!!!

Wow, how exciting that within five weeks Baby Boy could be here! As I mentioned in my last post, I am getting a little nervous and therefore today became a day to prioritize, make lists, organize and basically try to get as ready as I can for our new arrival.

One very important thing we have yet to determine is a name. This poor boy is nameless as we lovingly refer to him as "Baby Brother". I never thought it would be me but I think we may end up needing to meet him before we settle on what to call him. Our Girl was named at 18 weeks gestation so this is a very different experience for us.

Kim stopped by to administer my 17th P17 shot. She came with her daughter, Melissa (we share the same name), who is my girl scout cookie source (can't wait until those Caramel Delights arrive!). Additionally, I just hired my first Mother's Helper as Melissa will be coming over every Tuesday afternoon starting at the end of the month to play with My Girl for an hour just before dinner time.

Something I neglected to mention in my last post was that the new doctor I saw yesterday from my new group, was just as nice as the first new doc I saw on Christmas Eve. As she sat and completed missing information in my chart, she asked about My Girl by name, which very much impressed me. Clearly the other doctor wrote My Girl's name in the chart and this doctor used it! This is something my old group never did and they delivered her.

Speaking of my old group, I received a formal letter in the mail today stating they were officially discontinuing their relationship with me. Goodness, I feel like I got more time and attention as I exited the practice than when I was an actual patient.

I took My Girl to the pediatrician today as she has had red cheeks since Sunday night and she's a little cranky. I thought perhaps she had Fifth Disease and just wanted to be certain. Turns out the doctor thinks it's the remaining two upper two-year molars making their way through her gums. For some reason I thought they had already erupted but clearly I was mistaken. Anyway, while at the doctors' office, I asked for the peds opinion on 37 versus 39 weekers. (It's really amazing that this is my issue at this point, isn't it?) She basically said it depends on the child and that she has 36 weekers that do amazingly well and 38 weekers that don't quite have it together yet. My latest concern is difficulty latching and breastfeeding, which the doc assured me, with proper attention and focus, can be overcome. So it looks like at this point, I will see what the specialist advises.

Here's to 32 weeks!!! And counting...

Getting Close and Getting Nervous!

I saw my new group today. I am attempting to cycle through all the docs so I can get to know each one in the event they perform my delivery. They are still awaiting records from both Dr. Davis and my old group so first thing tomorrow, I will be on the phone trying to coordinate all that.

Nervousness is starting to set in for me. The doctor I met with today wants me to meet with the doctor who would perform my amnio. It seems to be the consensus among practitioners to deliver me earlier (37 weeks) as opposed to later (39 weeks) due to my possible risk of rupture. This has always been in the back of my mind and now that I know my cervix is holding up just fine, taken the lead as one of my third trimester worries.

The point of the consult with the perinatologist who would perform my amnio is to confirm that I even need an amnio or if my risk outweighs the risk of the baby having potentially immature lungs. This may sound horrible but I expressed to the doctor that as the mother of a 24 weeker, I think I can handle a 37 weeker with transitional breathing issues. I have experienced prenatal steroids, the oscillator, surfactant, the conventional vent, chest x-rays, more steroids, C-PAP, nasal cannula, home O2 and asthma.

Timely as it may be, World News on ABC just ran a story tonight about this very topic: elective c-sections being performed prior to 39 weeks and the issues present in those babies. http://abcnews.go.com/Health/WomensHealth/story?id=6595888&page=1 Hubby and I both watched it and came to the conclusion that I am NOT one of those women who is having an elective c-section. My c-section is medically necessary as my TAC prevents me from having a vaginal delivery, not to mention the fact that I should not experience active labor. Additionally, I have other possible risk factors that I think tip the scales in favor of an earlier delivery (37 weeks) without my needing to feel bad or guilty about it.

So, all the being said, the fact that my amnio could be just five weeks away is starting to make me a little nervous! This baby will be here before we know it and I am starting to wonder how ready I am...

Needless to say, I have many phone calls to make tomorrow: tracking down records, scheduling with the perinatologist, etc.

Tomorrow, I am officially 32 weeks! This puts me in a whole new category as if Baby Boy arrived between 32 and 34 weeks, he would be classified as "moderately preterm" as defined by the March of Dimes. We are out of the woods on "very preterm" and "micro-preemie" and oh yeah, that level III NICU, no longer necessary (assuming we are healthy in every other way!).

Another Moved-Up Appointment

My appointment with Dr. Davis was scheduled for today, Tuesday. But, considering the events or shall I say lack-of events, as in a major slow down in Baby movements, I called to push my appointment up a day.

Sunday night was a difficult night for me. I had terrible left-sided pain that radiated to my lower back. I chalked it up to GI stuff as pregnancy causes a major halt in my digestion process. Gotta love Miralax! I couldn't get comfy and in my bouts of tossing and turning, noticed that Baby Boy was not moving in his normal fashion. I woke early Monday morning still noticing there was no movement. I hopped in the shower thinking that would help and nothing. I sat back in bed and had Hubby feel too. We pushed and poked and still nothing. I ate a bowl of cereal and drank a glass of juice thinking that should do it and yet nothing happened.

I called Lisa to see if they could accommodate an after lunch appointment as My Girl already had a scheduled-just-moments-before ENT appointment to have her newly swollen tonsils evaluated. Lisa was just as nice as always, informing me they were crazy booked both Monday and Tuesday and if I didn't mind waiting, come on over between 1 and 1:30. Mind waiting? Heck no, I'm used to it by now and was actually looking forward to it with a fresh book in my hands.

I was relieved to see Baby Boy's heartbeat on the ultrasound monitor. And with the probing of the transducer across my abdomen, Baby Boy decided to push back - finally! My fluid level continues to increase and was 11.6. My cervix was 2.7.

During my NST, Baby Boy must have been recharged from his long slumber as he was bouncing off my uterine walls! He had great accelerations in his heart rate and we both got a glowing report.

My visit with Dr. Davis was just a thorough as ever. He addressed my concerns about the following:

1. I mentioned that with My Girl, my membranes were exposed for five days, never rupturing. I asked if this means I have "strong" membranes and if this is even something that exists. He assured me that yes, there is in fact something to be said for bulging membranes that didn't rupture which leads him to believe I produce strong membranes.

This "history" was the build up to my real question about the chances of rupturing membranes in this pregnancy. I realize Dr. Davis can't predict the future but I did walk away with the reassurance that I am probably at a lesser risk for rupture since My Girl's membranes, under way extreme circumstances, stayed intact.

2. The other part to my membrane question was that in the event of rupture, does the TAC reduce the risk for a prolapsed cord. The answer to that was yes.

3. I also inquired about Fetal Fibronectin (fFN) testing http://www.marchofdimes.com/professionals/14332_1149.asp and whether or not it was something that we should consider. It was discussed that because of my tendency to worry, if I got a positive test back, I could very easily worry for no good reason. This test is best when it provides negative results, meaning delivery within a two week period is unlikely. I agree with Dr. Davis but still felt the need to ask.

4. My cervical length has decreased to a functional length of 2.7. This decrease in length is a normal part of pregnancy, which Dr. Davis explained is why the TAC is placed around the cervix and not sewn directly into the cervix. My TAC is still doing its job: my cervix is still closed with no funnelling.

5. Unfounded are my fears of uterine rupture. My mind can't seem to keep away from the fact that although my 24 week c-section was performed as a low-transverse incision (the preferable way but not likely with such an extreme premature birth), I was still cut at 24 weeks, way before my uterus had a chance to really expand. I am much larger now than I ever was with My Girl and that scares me. Dr. Davis took the time to perform another ultrasound, personally confirming there is no sign of uterine thinning or separation at my previous scar.

So yesterday was yet another of the many great visits I have had with Dr. Davis. I don't know where I would be without him. He puts my mind at ease and never undermines any of my concerns. Today I am officially seven weeks beyond where My Girl was born! Wow, seven extra weeks!!!

Another Phone Call...

Today we got another phone call from my old group. This time, it turned out it was Dr. C himself. Hubby answered it and when I realized who was on the other end was dancing around waving my arms in an "I'm not here" fashion. Turns out the doctor didn't even ask to speak with me.

I love my husband as he is truly one-of-a-kind and there is really nothing I would change about him ... except in this situation I wish he'd really stand up for me, tell the doctor a thing or two and demand that I receive a personal apology. But my hubby is just plain old mister nice guy and I suppose if he had the quality I am seeking for the satisfaction of telling off the old group, he wouldn't be the man I love nor the fabulous father he is to our daughter. That being said, I wouldn't change him or trade him for anything.

So the call was to supposedly confirm that I was not delivering with the group so my file could be closed out, whatever that means. From what Hubby told me there was no "we're really sorry about the way the last visit went" or "we're really sorry to be losing a patient" tone to the call. It was very matter-of-fact.

I realize this issue still gets me hot. I re-read part of my blog and around 19 weeks posted how I was unhappy but felt it was too far into the pregnancy to make a change. Ha, look where I am now, finding a group. Which by the way, I feel very good about and realize that I should have done this much earlier.

My goal is to have a safe delivery of a healthy baby. And once I settle in at home with my two children, I will start writing letters and making phone calls. There is no need to get myself all worked up right now with Baby Boy still cooking inside. Besides, I have too many other more important things to worry about. But I refuse to let this go unaddressed. They have not heard the last of me.

My advocacy of the TAC hasn't penetrated my old group yet, and this is not uncommon. I just read an Abbyloopers post from a woman who went to multiple docs, all pushing for a TVC. My hope is that my group, this woman's contacts and all the other naysayers will some day come to realize the life-saving benefits of this otherwise simple procedure (it's simple to me when compared to 105 days in the NICU or losing a baby). When Dr. C is at the end of his career, I would love to get a phone call or a letter in the mail saying, "You were onto something. I should have listened and I'm sorry I didn't." We can all wish, can't we?

New Year, New Week!

So I realized my last post was my first post of the New Year and it was more of a complaining post than a happy post...

Here is my "real" first post of 2009!

There is much to celebrate this New Year's Day, the start of a "clean slate", a day to regroup, reorganize and prepare for the exciting things this New Year has to bring, the most obvious, a welcome addition to our family!

I have made it to 31 weeks! I am no longer at risk of having a 30-weeker and my countdown to term is now in the single digits! It is still crazy to think that Baby Boy will be here in a matter of weeks and I am feeling the crunch to prepare. Prepare, not only for him but my life and our lives in general as we become a family of four. Oh and did I mention that Hubby is starting a Masters program in a city about 1.5 - 2 hours away?

We are all cleaned up from Christmas, the trees dried mounds in our backyard awaiting pickup. One of my goals was to make it through the holidays, excited about their distraction from my nervousness associated with this pregnancy. It is hard to believe they have passed.

Kim came by this afternoon to administer my 16th P17 shot. I have only four shots remaining - I can count them on one hand.

Wow, I'm 31 weeks! How exciting! My next goal is to get to 32 weeks as Baby Boy would no longer need a level III NICU for his care. To me, that is a huge milestone and a great place to be! Although in reality, I would love to deliver no earlier than 34 weeks, so I suppose you could say that's the following milestone. The rest to me is gravy, especially when you look at our last experience.

My final words as we ring in the New Year are from one of our favorite Christmas songs - "... may your New Year dreams come true!"

Can You Believe It?!

I am all about reading between the lines and was absolutely stunned to receive a phone call from my old group yesterday. I saw their number on my caller ID and decided I didn't want to get myself worked up by taking the call so I let it go to voice mail. Typing this, I suppose it wasn't the call itself that stunned me, as I personally believe that the doctor should call and at least apologize for his behavior two weeks ago, it was more the nature of the call, hence my initial comment about reading between the lines.

The message from the nurse was to confirm that I no longer wanted to deliver with the group, that I was in fact moving to another group within the hospital.

Let's look at the events leading up to this and you tell me if you think the writing was on the wall or not:

1. My last visit to the office was a horrible experience. So horrible that I left in tears, neglecting to pick up my orders for testing at the local perinatal testing unit.

2. I was a "no-show" at my last two scheduled appointments with the group. (I know, it's terrible that I didn't have the courtesy to cancel, but I was awfully upset and well calling there was just not something I wanted to do. Again, I assumed they would "get the hint".)

3. On Christmas Eve my new group faxed over a request for records SIGNED by me!

Hmmmm, you think after all this I'm going to have you deliver me? A doctor and group who clearly don't value me as an educated patient committed to having a healthy, uneventful pregnancy? No, I'm sure they much prefer the patient I met in their office about a month ago who didn't know she was pregnant for 20 weeks, went on to have a micro-preemie with major complications (God bless the child) and now less than one year later and just a couple months of having her son home from the hospital, is pregnant again and not quite sure how it happened. Now I know why as soon as I started talking to this other mom they called my name and put me in a room to wait!

So the question is, do I call back or perhaps by ignoring the voice mail, they will get the hint. Maybe I'll just call the insurance company, who by the way, knew I was unhappy long ago and told me that anytime I wanted to switch care providers I was entitled to do so.