Pregnancy after Preemie

2010-03-29T13:05:00.006-04:00

Welcome to Pregnancy after Preemie, a blog I created to document and share my pregnancy journey after the birth of my daughter at 24 weeks gestation.

I no longer actively post on this blog, however invite you to read through past posts to learn more about my decision to have a pre-pregnancy Transabdominal Cerclage (TAC) placed along with the anxieties that riddled my second pregnancy (after giving birth to a micropreemie). I have documented my entire pregnancy and want the world to know that there is hope to carry near term after the birth of a very premature baby.

As an update to my story, my son Henry is now almost 14 months old. The experience of having a near-term preemie is vastly different from having a micropreemie. I was able to breastfeed Henry exclusively for the first six months of his life. I was able to continue breastfeeding until just recently, and enjoyed every moment of it!

Henry has met all of his milestones thus far without any interventions. He was walking by his first birthday and has opened my eyes to just how delayed my once 1lb 6 oz 24-weeker was.

I have recently launched a new website: http://www.thepreemielife.com/. Please stop by to visit!

Henry Edward is One Week Old!

2009-02-08T14:09:00.005-05:00

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...

2009-02-04T10:15:00.005-05:00

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!

2009-02-03T10:21:00.002-05:00

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!

2009-01-29T17:06:00.003-05:00

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

2009-01-28T11:11:00.003-05:00

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

2009-01-26T18:22:00.006-05:00

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

2009-01-24T21:19:00.002-05:00

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!

2009-01-22T22:03:00.002-05:00

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!!!

2009-01-20T17:04:00.005-05:00

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...

2009-01-19T17:28:00.004-05:00

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

2009-01-16T16:49:00.004-05:00

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!

2009-01-15T18:24:00.004-05:00

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!)

2009-01-14T14:42:00.004-05:00

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...

2009-01-12T15:50:00.007-05:00

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!!!

2009-01-08T17:17:00.004-05:00

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!

2009-01-07T20:48:00.003-05:00

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

2009-01-06T13:55:00.003-05:00

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...

2009-01-02T20:48:00.004-05:00

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!

2009-01-01T18:14:00.002-05:00

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?!

2009-01-01T10:02:00.002-05:00

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.

Yesterday's Appointment with Dr. Davis

2008-12-31T15:46:00.004-05:00

Yesterday I celebrated 30w 5d and Baby Boy has officially had the benefit of an additional six weeks in the womb compared to his sister born at 24w 5d.

At yesterday's appointment, Dr. Davis performed a growth scan and Baby Boy is measuring on target for his gestational age. His approximate weight is 3 lbs 6 oz, a whole two pounds heavier than his sister was at birth. Curious as to how much Our Girl weighed at this stage, I referred to her NICU calendar where I tracked something positive each and every day of her NICU stay. (I still keep a daily calendar of what I consider to be "milestones" or cute things she says or does. In fact, today is the last day of my second Hallmark calendar (started the day of discharge) and I need to decide if I will keep a third year of notes for her. Baby Boy of course will have at least as much as his sister... so I hope and plan to, anyway.)

So the NICU calendar indicated that 30w 5d was day 42 of our NICU stay. Our Girl had just self-extubated the day prior which happened to be Labor Day and was off the vent successfully the third and final try. She was on a CPAP of 7 or 8 and weighed 2 lbs 5 oz. Clearly, the hard work of surviving takes its toll on these micro preemies. Just baking away as nature planned, allows for crucial weight gain and development that is seriously thrown off course when these tiny babies are thrust into the world too soon. It is realizations and comparisons such as these that really break my heart. Although, if you watch the attached video of My Girl singing "Jingle Bells", my thought is that most people would never know her life began the way it did.

While Baby Boy's measurements all average out to his actual gestational age, his tummy was measuring on the small side. What I love about Dr. Davis' techs, is that they just do the testing necessary to confirm that all is okay. Yesterday, this meant that without instructions or asking permission, my tech went ahead and confirmed that blood flow was appropriate and that Baby Boy wasn't compromised in any fashion. This is very reassuring as I love the better safe than sorry approach to medical care and you can't check me or my baby enough! For this reason, I have decided to have Dr. Davis and his team continue to follow my pregnancy on a weekly basis, performing the necessary growth scans, AFIs, NSTs, cervical checks and lower uterine segment screening for any sign of thinning.

It is very true that although my whole day is consumed by a Dr. Davis visit, I have a routine down and the techs in the office all know me and my situation. I feel 100% confident and comfortable with the care I am receiving and with little time left in my pregnancy feel it's in every one's best interest to keep a good thing going.

In other news, my fluid level came up to 10.5 this week. Each week since I was flagged for potentially low levels, my fluid has increased. This is all reassuring. My NST was reactive as well although uterine irritability was detected but I suppose that is nothing new.

I felt bad when as Hubby and I entered Dr. Davis' office to talk, his phone rang and he was clearly discussing with the person on the other end that I was going to be one of his OB patients. Long story short, I explained that I am more comfy delivering closer to home and so our plan for the remainder of the pregnancy is that Dr. Davis will continue to follow me weekly (as mentioned above) and my new group will see me every other week and ultimately perform my amnio and delivery. Gosh, it feels like a weight has been lifted off my shoulders! I have it figured out!

Earlier today, I put a call into the new doc I met on Christmas Eve. She called me back this afternoon and I confirmed that I would love for them to take me on as a patient, all the while co-treating with Dr. Davis. It made me feel so good that she was excited to talk to Dr. Davis not only about my records, but also about Transabdominal Cerclage! She was thrilled to learn of another doctor who performs the surgery! Spread the word!!!

So while I was hesitant to put up two Christmas trees this year because I had visions of being on bed rest or worse, in the hospital or visiting Baby Boy in the NICU, I am happy to report that instead of all the negative thoughts, I am actually able to help Hubby take the trees down! I wouldn't be here, on the eve of the New Year, the eve of 31 weeks, on my feet, helping out without this TAC!!!

Merry Christmas!

2008-12-25T22:09:00.002-05:00

All I wanted for Christmas this year was to continue to remain pregnant with Baby Boy - and my Christmas wish came true! I am officially 30 weeks today and our Christmas couldn't have been merrier!
30 weeks is a huge milestone for me as I have never before started my weeks with a "3". In fact, this was such a big deal that I pulled out Hubby's birthday stuff from April when he, himself, turned a different kind of 30.

Kim was kind enough to stop by today to administer my 15th P17 shot. It is so hard to believe that I only have five left! This pregnancy is really flying by and if I don't have any issues arise, Baby Boy will be here in just about 7 weeks. Dr. Davis wants to schedule my c-section on the early side and I will be given the okay once Baby Boy's lung development is confirmed.

This leads me back to my on-going dilemma of where to deliver... yesterday, I met with a group of women doctors who could deliver me at Lankenau. Perhaps it's the fact that I met with a woman but the approach was so different from the old group of mine. I felt comfortable immediately. My heart is telling me to stay local, that it will be easier on Hubby, easier for my mom to visit and easier for Precious Miracle to meet her brother. I am familiar with not only the NICU team but also the hospital itself, I know the lactation consultants and feel confident in the hospital as a whole, which this new doc pointed out, you never know when you'll need a specialist. God-forbid something should happen during my surgery, she encouraged me to consider a place with top-notch medical professionals who could jump in at a moment's notice.

This doc is willing to see me and co-treat with Dr. Davis (no egos here!) and left me with the impression that she supports what I have done and her in own words, "there is no such thing as too much monitoring" supports my plan for care until delivery.

She was very flexible and offered, on her own, that I would be guaranteed to have one of the physicians in the group deliver me regardless if they are on-call or not. This was amazing comfort to me. She also put thought into my amnio (on the assumption we get to that point) indicating that she would like it done in the hospital just in case. She also said if I needed to deliver at Paoli for whatever reason (bad weather, couldn't get to Lankenau) that I go where I need to go, they will take care of everything else! What a refreshing bit of info whereas the old group made me feel like it was a mortal sin to visit another hospital.

And of course, maintaining just a small link to Precious Miracle, I learned that the resident who was part of her birth (she was actually the doc who discovered I was bleeding and got my c-section in motion) is now part of the group. I highly doubt she remembers me but I did stop her in the halls many months after Our Girl's birth to thank her.

Anyway, my heart feels like the decision has been made, not to mention the fact that Hubby is pretty adamant about my not delivering in Jersey. The comfort and peace in my heart is one of contentment, like I just know this is the right thing to do. I suppose my fear or concern is hurting Dr. Davis' feelings - I know, he's a professional and will understand, it's just so hard for me and as I've said before, he's the reason I am celebrating 30 weeks on Christmas Day 2008!

A Jersey Birth?

2008-12-23T22:54:00.004-05:00

I saw Dr. Davis today for my now weekly NSTs and AFIs. My fluid was just under 10 today and Dr. Davis is happy if it remains at this level for the remainder of my pregnancy. I asked the nurse if the testing was still necessary and she said once you start monitoring you don't stop until delivery. So, I am signed up for the next seven weeks or so. It's actually reassuring to know that I have a standing appointment each week.

Today marks 29w 5d, exactly five weeks from the gestation at which My Girl was born. I can't believe Baby Boy has been cooking for an extra five weeks! It is truly amazing!

Back to my appointment. I was scheduled for 10:30 this morning and didn't leave the hospital until 2:00. There was really no idle time as I brought my latest book and read a page at most. An ultrasound with Patty started things off. My fluid level was checked as was my uterus for any signs of thinning (this was my request as my latest concern is uterine rupture). Then my cervix was evaluated and thankfully it remains long and closed.

I went for my NST and Baby Boy was quite active. He had some really nice accelerations and no contractions were recorded. Although, I will state for the record, I had three horrible contractions last night that woke me out of sound sleep at 3:28 A.M. They were all within a 15-20 minute period. After speaking with the nurse it was determined that my full bladder could have had an influence on the uterine activity. Otherwise it sounds like the low pelvic pressure I am experiencing now on a daily basis is "normal" and par for the course.

From there I had a very long and very nice conversation with Dr. Davis. I brought my records from my old group (the ones I requested in the event of that feared snowstorm that would cause me to go to a closer hospital) and Dr. Davis did a complete exam. When I say complete, I do not mean an internal, but he weighed me, did a breast exam and measured my uterus, which for the record had never been done by my old group in spite of numbers being written into the appropriate column on the prenatal care worksheet. I am a bit concerned that these numbers were just "made up" as a tape was never taken to my abdomen nor was ultrasound used to determine the height of my uterus.

Dr. Davis then called for copies of my most recent pap test (which was completed prior to conception) and all my labs. He was working to set up my complete file as I am now one of his OB patients. He informed me that he only takes about 10 OB patients at a time and that within the past five years has only missed one birth and that's because he was in Houston at the time.

I feel quite flattered that I would be one of the women he selects/agrees to provide this kind of care for. I feel that he is very invested in this pregnancy, as if it were not for him, Baby Boy would not have been able to remain in the womb five weeks longer than his sister. I am 100% sure of this and therefore, have absolutely no regrets about having my pre-pregnancy TAC placed. I would do it over again in a heartbeat! So when my old group questions me, they do not make me feel bad at all. If only every decision I encountered was made as confidently as this.

Trying to figure out which of the several hospitals Dr. Davis works out of my delivery would occur in, I asked if I should schedule maternity tours to familiarize myself. Right then he escorted me out of his office and took me on a full tour of Labor and Delivery, the c-section rooms, the NICU, well baby nursery and post-partum, which is where I recovered from my TAC placement earlier in the year. While Dr. Davis himself is a wonderful physician and I trust him completely, the facility at South Jersey Regional Medical Center is not exactly one that gets me excited. I can't quite put my finger on it except to go back to my initial impression which holds true every time I drive up to the place: it looks like a prison.

The Antenatal Staff is wonderful but I can't be 100% certain the same is true for the staff in Labor and Delivery and my experience with post-partum was a little iffy. For example, the one nurse who gave me a medication to combat my itchiness that counteracted my pain meds, in spite of my asking for plain old Benadryl.

Anyway, this is the latest situation - that Dr. Davis is willing to deliver me. It feels only right to have him take us full circle in this process: from pre-conception TAC to actual delivery of our Baby Boy. I am still torn, however...

Doctor Update

2008-12-21T12:12:00.005-05:00

I spent Thursday and Friday researching different OBs in the area. I have decided that I don't want to drive into the city for care or delivery since I am already driving pretty far to see Dr. Davis. My search for a new doctor has been limited to the suburban hospitals, specifically Main Line Health.

There was one group that came highly recommended - as in everyone who commented on my run-in post, gave me the same name/group of docs. I have an appointment scheduled to meet one of the male doctors in January. They only deliver at Paoli and since Paoli only keeps babies born at 32 weeks gestation, I didn't think it was really necessary to push the issue and see the group sooner. I will be just a few days beyond 32 weeks when I have my consult.

I called around to a few other groups who insisted on knowing where I got my care to this point. It would have been easier for me to have just relocated to the area instead of leaving a local group. When I pushed the issue, I discovered that these other groups don't want to take anyone who is "high risk".

I made one other appointment with a group of women doctors who deliver at Lankenau. After speaking with three different people, one of the doctors personally called me to better understand my situation. She was very nice, explained they have had other patients with a Transabdominal Cerclage (TAC) and was curious to know who my surgeon was. Her big concern was sending me for testing as the MLH Perinatal Testing Centers are usually run by my old group. I assured this doctor that all my testing is able to be completed by Dr. Davis. She didn't seem to mind that I would also be followed by Dr. Davis. I meet this group on Christmas Eve.

So now I need to come up with a list of questions about philosophies and office procedures. For example, the Paoli group delivers their own patients as one of the five docs is always on-call. I am not sure the same is the case for the Lankenau group but I do know that Main Line Perinatal is not one of their covering offices.

The big thing that I go back and forth on is where do I want to deliver. Paoli is much closer to home and where Precious Miracle was discharged from. Lankenau is where Precious Miracle was born and spent the first 85 days of her 105 day NICU stay. Both have meaning, just in different ways.

29 Weeks!!!

2008-12-18T14:41:00.003-05:00

Thank you to all who responded to my last post. I am feeling better about things and now that My Girl is down for her afternoon nap, plan on calling a few OBs (all of which have been recommended) to see if I can't coordinate a new practice to take over my care. I am unable to set foot in my old practice let alone allow them to put their hands inside my abdomen, be the first human touch my baby receives and perform his circumcision. That's just plain old crazy!

I called Dr. Davis last night after I calmed down and told him what occurred yesterday. My big concern was his professional relationship with his out-of-state colleagues. I didn't want my situation to negatively impact his interaction with his medical peers.

He told me he is always available to give me care and whenever I need him, just call. The plan at this point remains what it was: that I will continue to see him weekly for monitoring. Obviously, we don't have a crystal ball to predict what the future holds. He assured me in the event of an emergency, wherever I end up will be required to provide me with care. All I can do is what I've done all along and that is to take things one day at a time. We don't know how far I will go with this pregnancy but I can say, I am very pleased with reaching 29 weeks! This in no way means I am ready to have Baby Boy anytime soon, I'm just in awe of reaching this point in my pregnancy.

I received my 14th P17 shot this morning, thank you, Kim!

And in other more positive, preparatory news, I ordered some bedding options from Restortation Hardware Baby on Monday. They are having some fabulous sales at this point and I got an additional 20% off. (As an aside I always check http://www.retailmenot.com/ for additional savings no matter where I shop.)

Other exciting news is that My Girl has successfully transitioned to her new "big girl room"! This has allowed me to mentally and emotionally get to a point where I am now ready to start laundering clothes and bedding while organizing other necessary baby items. We now have two "new" rooms off our second floor hall, the offical "big girl room" and "Baby Brother's room". My Girl has spent three very successful nights thus far in her new full-size bed, quite a difference from her toddler bed-crib conversion.

A Bad Day...

2008-12-17T15:30:00.004-05:00

Where do I begin? I had two appointments scheduled today to deal with issues surrounding both of my children. The first was a prenatal appointment and while I was planning on discussing some pretty significant concerns surrounding my care, felt it would go relatively well. The second appointment was the annual IFSP for My Girl's Early Intervention Services. This meeting was slated to be a challenge as I was prepared to "fight" to keep her SLT and OT services on a weekly basis. My preparedness was all backwards and I am sitting here still recovering from the hearty cry my first appointment of the day caused.

What I am about to write is my interpretation and take-away from my appointment this morning with my local group. I realize every story has two sides, that each party has their own reality and views any particular situation through their own personal lens. My personal documentation of today's events is in no way intended to defame or smear.

I will admit there was no rehearsal on my part nor did I have a list of notes with me to keep me on track. This meeting was sincerely a "heart-to-heart" and those were the words I used with Dr. C when he entered the room. My agenda, so to speak, was strictly to convey my concerns, fears and wishes as a patient in a thoughtful and sincere manner.

My first point was that it would mean a great deal to me if Dr. C was the physician who delivered my baby. I should have known when I got a lecture about how over-worked he feels that I should have packed up my stuff and left. I mean, how professional is it to unload the burden of your hectic work schedule on your patient? I learned he is on-call 50% of the time. He is scheduled to work the weekend before Christmas (although he mentioned he was traveling with his family this weekend too), the weekend after Christmas, New Year's Eve and New Year's Day. The only time off he is getting this year is Christmas Eve and Christmas Day. The practice is responsible for six hospitals, dealing with high-risk calls coming from the home base of Lankenau, sister hospitals, Paoli, Bryn Mawr, Riddle and two others, Pottstown and Montgomery. He needs to be on-call for transports and in fact, has women right now on antepartum who could deliver at a moment's notice. He even told me he is considering not delivering any longer, it's just too much.

Okay, well, sorry I asked. So the bottom line is unless my c-section is scheduled, there is a 50/50 chance that Dr. C will be the one on-call to deliver me.

The conversation transitioned to my amniotic fluid level and the non-stress tests that Dr. Davis feels should be preformed weekly. I explained that while I expressed concerns about my contractions and uterine irritability to Dr. G, I was always brushed off, given the same canned answer about more than five contractions in an hour. I explained to Dr. C that while I've really tried to like Dr. G, realizing he is regarded as a fine doctor and that I need to put my personal differences and opinions aside, always feeling as if I am being talked down to with a condescending tone is hard to take week after week. Not to mention the fact that I felt like my concerns were never properly acknowledged and always minimized.

Because of this, I made an appointment to be evaluated by Dr. Davis. His team happened to, as part of the normal protocol, scan my baby (which my local group hadn't done since 20 weeks) and check my fluid level. I explained that since this discovery of borderline fluid last week, I have increased my fluids and started the Procardia around the clock. This combination has helped curb my uterine irritability.

Somehow, the conversation turned to the fact that I was not recommended by my local group for a Transabdominal Cerclage (TAC). That I was spearheading my care, which is unheard of and not a good way for anyone to seek medical care. The doctor is the doctor, not the patient. The literature does not support a woman like me to have a TAC. Dr. C then indicated that I should have tried a TVC and if that failed, then consider something more drastic. I was flabbergasted! I pushed him back asking him if what he was saying was that I needed to have another micro-preemie or worse yet, lose a baby due to a failed transvaginal cerclage?! I reminded him that I sought other opinions and that Dr. Davis was not the only physician to confirm my lack of "stitchable cervix". In fact, Hubby later reminded me that it was Dr. C who gave me the name of the doc downtown who was ready to perform a TAC on me as well.

I told Dr. C that not once did he check me to confirm that a TVC would be feasible. He then went on as usual, quoting literature stating that there is no way to confirm cervical competency in a non-pregnant woman. At this point I mentioned my instinct, that I knew in my heart the only way to carry a pregnancy to term (or closer to term than last time) was with a TAC. Dr. C informed me that my instinct was worthless and the only reason Dr. Davis placed my TAC was because I was dealing with Post Traumatic Stress.

Basically, something that women on Abbyloppers do all the time, consult an MFM along with a primary OB/Peri, was seen as a personal slight against my local group. Dr. C indicated that the relationship should be based on trust to which I responded that it's a little hard to trust someone who I sought help from on a Tuesday only to learn on a Friday that my membranes were bulging. I told him that pregnancy for me is HELL, that I trust no one and nothing and that my faith in the TAC has only truly become concrete as I've seen each passing week, beginning with the week I delivered my daughter.

It looks like my group never supported me, never valued me as an educated patient involved in my own care. They were offended that I would continue to see Dr. Davis, that I would put two doctors against each other. I defended that by explaining to Dr. C that he and his own colleague can't even agree, that their differing opinions are as good as being seen by two independent practices right there.

For some reason, stupid me allowed Dr. C to finish the exam. I allowed him to check my fluid level, to check my cervix. He wrote me orders for weekly AFIs and NSTs. I cried the whole time. Dr. C tried to scare me into thinking it was unrealistic to rely on Dr. Davis to be available to deliver me. How ridiculous for me to call him when it's time and expect him to meet me at the hospital and perform my c-section. How ridiculous.

So while I didn't officially blow up, didn't storm out with my chart in hand, didn't stop the Director of Development on my way out as we passed in the hall (thankfully he was distracted and didn't notice me) I left with tears streaming down my face, confused and torn yet knowing in my heart it's time to find a new group if I want to deliver in the system.

My emotional ties to delivering at Lankenau are many. The most important thing for me is the NICU team. This is where My Girl was born and while I could go to the other three hospitals in the system and end up with the same neonatologists, the nurses would all be different. I wanted the comfort of familiarity in the event we ended up with a significant NICU stay. Thankfully, with each passing week, the level of care is slowly (in theory) diminishing. Once I get to 32 weeks, I will no longer require a level 3 nursery.

Last week upon leaving my appointment I ran into a woman from the Development Office. She told me to call when I am ready to deliver, that she would hook me up with the brand new, top notch suite on the new L&D floor. Ironically, it sounds like the room that the part of the NICU where My Girl spent her first months of life, overlooking the seminary: a view that brought us great comfort.

And finally, coming full circle, I really wanted to breastfeed Baby Boy in the Lactation Room off the NICU that is named for and dedicated in honor of My Girl.

Lankenau Hospital has always held a special place in our hearts. It is the place where Our Girl was born far too early, the place where her life was stabilized and the place where she fought so hard to live. It is the place that we are forever indebted too, the place where our charitable hearts are. We take pride in knowing that our story has been instrumental in assisting the hospital secure $1,250,000 in donations for the NICU. It's hard to leave this behind and deliver elsewhere.

I called my support mom, Lori, the woman who helped me through My Girl's birth. Her son was born 12 years ago at 23 weeks. Lori and I talk several times a week and she was just the person I needed to help me through today. She had me pull over as I was driving in hysterics. She calmly helped me through and eventually I stopped sobbing.

Tomorrow, once my head is a little less foggy, I need to reassess and decide what course I am going to take. Do I deliver with Dr. Davis, all the way in New Jersey? Do I stick with the group that clearly doesn't value me as a patient? Or do I find a new group in the system?

Monitoring, Monitoring and More Monitoring...

2008-12-16T19:16:00.004-05:00

Today I saw Dr. Davis. I probably should clarify what seeing Dr. Davis entails: first of all, unless there is an issue, I usually see one of the very skilled ultrasonographers in the Antenatal Testing Unit for any combination of studies including, fetal growth scans, cervical measurements and amniotic fluid level checks (AFI). The images are then transmitted via computer to his office and usually after a pretty long wait (I don't mind, he's worth the drive and every minute I've spent waiting in his cramped waiting room) he calls me back to talk. He reviews the images, takes his own measurements, answers my questions and never makes me feel rushed. The visits usually end with a hug and he walks me out to the desk with my chart and gives my follow-up instructions to Lisa, the scheduler.

All of Dr. Davis' techs are great and I like them all, having confidence in each of them. However, that being said, Patty is still my personal favorite as she was there at my preconception consult. She performed my scan today and I explained to her that I was concerned I didn't receive an accurate AFI on Friday. After a quick peek at Baby Boy, Patty moved on to assess my fluid level. There was a big black area that could have been mistaken for fluid (I really learn something new each time I get a scan) but once Patty turned the color on, highlighting what I imagine to be blood flow, it was determined that the big mass of black was not fluid but a lump of cord. This technique was not employed during my Friday scan when my AFI came back at 15.

Bottom line, my fluid is nine this week, up from last week's seven. This is an improvement but nothing like the 15-16 range which is considered "normal". After my ultrasound I was hooked up for a non-stress test (NST) where both the baby and I were being monitored: he for heart rate and me for contractions. It really was painful to hear the nurse say that Baby Boy is still real small and that it may be hard to pick up heart rate accelerations because he is still "neurologically immature". Janice is a very nice woman also and very knowledgeable, I might add. I explained to her how much it hurts to hear something like that as My Girl was born exactly four weeks earlier at 24w 5d gestation. Moments like these are really sad and painful reminders of just how much My Girl was gypped by not getting more time in the womb. It's an open wound for me.

Anyway, Baby Boy looked great and I informed everyone I saw that I've had a really good week. I then saw Dr. Davis who confirmed that things are looking good but it's in my best interest and my baby's to continue to monitor things with weekly AFIs and NSTs. I couldn't agree more when he commented about how much we've invested in this pregnancy (as does any expecting mom, I would hope) and that it would be a shame to have something that is presenting as a potential issue slide past us and become an issue such as growth restriction or fetal demise. He is being extra cautious with me and I really appreciate that approach!

So, this leads me to my big dilemma which I imagine more light will be shed upon tomorrow when I meet with Dr. C: do I drive all the way to South Jersey each week or will my local group be willing to support this aggressive approach to monitoring?

Hiccups and Other Twinges

2008-12-15T09:13:00.004-05:00

After my last pregnancy, women who didn't necessarily know my circumstances, would try to compare pregnant-mommy notes. For some reason, a popular topic was fetal hiccups. I was never really sure that I ever felt them with My Girl and now that I most certainly have felt them with My Boy, know that hiccups were something I never got to experience the first time around.

Baby Boy has had several bouts with the hiccups recently and there is no mistaking that the rhythmic bumps coming from my insides are just that. It's a strange feeling and I find myself counting them once I realize what they are.

Speaking of strange feelings, nothing compares to the twinges that occurred last night around my cervix. Baby Boy was sleeping soundly, as was I, until I needed to use the bathroom. Well, that was enough to wake him and keep him awake for a little playtime. My cervix was his trampoline and I swear he was either bouncing off my stitch with his feet (he's been breach) or he was strumming it like a guitar with his little hand. The sensations were so uncomfortable that I woke Hubby to let him know it felt like Baby Boy was about to burrow himself out of me. I tried changing my position several times but he was very determined to keep the fun going at my expense. It was so bad at certain points, I was prepared to move tomorrow's appointment up to today.

Otherwise, I've been feeling pretty good. In fact, I've once again pushed myself a little more than I should have this weekend, although the consequences of such have not been as debilitating as weeks' past. Saturday was another busy weekend day with yet one more visit with Santa Claus and dinner out for a friend's 30th. Yesterday was a down day though and offered some time to rest and rejuvenate as I prepare to tackle the week ahead.

28w 4d and counting...

Yesterday's Appointment

2008-12-13T14:14:00.006-05:00

I will admit that I was not looking forward to my appointment yesterday. It was scheduled with Dr. G and I called earlier in the week to see if it could be rescheduled with Dr. C but he was booked for the week. I feel like I've hardly seen Dr. C and feel like we need to have a heart-to-heart. I have decided after much thought that if he is unable to deliver me, I will do my best to get to Dr. Davis to have him perform my c-section. My hope is that this delivery does not occur on an emergent basis, that I am able to confirm Baby Boy's lungs are mature and then schedule my delivery from there. Dr. Davis is aware of my desire to deliver this baby as soon as he is ready, preferably not a moment sooner and not many moments later. I need to convey this to Dr. C and also inquire about his willingness to be available to deliver me regardless if he's on-call or not.

Anyway, back to yesterday. I am really trying to take it easy but felt it would be okay to meet two friends for lunch. My mother-in-law came over to watch My Girl and I left a couple hours in advance of my doctor's appointment. It was nice to have a meal with adult conversation without having to entertain, cut chicken fingers or make frequent trips to the restroom on the heels of the words, "I go potty poop".

In fact, I planned my time so well, I arrived about 1/2 hour early for my appointment. I had my book club book with me and was looking forward to "free-time" to just sit, relax and read.

I entered the office and checked in with the receptionist. I informed her that I had a scare on Saturday night with some contractions, bad weather, no child care and this panicked feeling that I would need to call an ambulance as Hubby would have to stay home with Our Girl and I most certainly couldn't drive myself, and therefore, for peace of mind, would like a copy of my chart as my local rescue organization is not going to drive me to a hospital almost an hour away when there are two, no three within a few minutes from my house. She informed me in her usual tone that my local hospital affiliated with the same health care system will not deliver me. I snipped back that I cannot labor and the worst case scenario would be that oh, yes the would have to deliver me and I'd like my chart on the off-chance this happened. She was non-committal, saying I'd have to speak with the doctor or nurse about it.

I decided not to argue and went to my usual seat in the waiting room, almost right in front of the desk and most certainly within ear-shot. The phone rang and her voice lowered and well, you know that feeling you have when you think some one's talking about you, well I had it. My first thought was that the doc was in the back of the office and that he heard me talking and called up to find out was going on. I decided to brush it off, I mean how paranoid can I be. And who really cares if they're talking about me. So I headed off to leave my routine urine sample.

When I came out of the restroom, I learned that my instinct was correct, I was the subject of this "secret" conversation. The receptionist informed me that Dr. G was running late as he had a "procedure" to do. He wanted her to call me and let me know he needed to push my appointment back. Well, here I was, 1/2 hour early for my 2:30. Having had lunch out and rush hour traffic not too far off, I really didn't feel like hanging around that long for I knew my symptoms of overdoing it would soon surface. Not to mention my book would be finished in no time and I hate to be idle.

Since I was just evaluated by Dr. Davis on Monday, I reasoned with myself in a matter of seconds that I could forgo the cervical exam. The main reason I was there was really to get my amniotic fluid level checked. I made my proposal: if the nurse is able to give me my progesterone shot and check my amniotic fluid level, I can skip my appointment with the doctor altogether. Well, I opened another can of worms by suggesting my fluid level be checked. After the perplexed look I received, I volunteered that I had visited my other doc, the doc who placed my stitch, and that because I was having contractions, I was thoroughly evaluated. My fluid level was low and after my week-long drinking binge, I was to have it rechecked.

Long story short, the nurse was able to do all of the above and even managed a quick weight check (oh gosh!) and a blood pressure reading as well. I sensed that I had overstepped by visiting Dr. Davis as she defensively inquired why they would check my fluid levels. Must I explain this again?

My fluid supposedly measured 15 but I really question the methodology used to obtain the measurement. I am not a doctor, nor am I a nurse or an ultrasounographer (although many of My Girl's physicians ask me what medical training I have) so I can't say for certain, but my hunch was that when she didn't know which buttons to press on the machine, my measurement might not be totally accurate. Based on my observations, reading and research, I would have taken measurements from different starting points too, again leading to questionable accuracy. But again, this is just my opinion and you know what they say about opinions...

I will keep sucking down the water and wait things out until Tuesday when I follow up with Dr. Davis again. I am feeling tons of movements from Baby Boy and apparently when there is dangerously low fluid, movements are very difficult to detect. His nudges, flips and kicks are very reassuring to me.

On another note, my glucose screen came back normal.

So, I didn't have a full appointment yesterday, which was probably a good thing. I am really not in the mood to defend myself as it will just get me worked up and that is not something my body needs nor does my baby's.

Finally, in my heightened emotional state, I couldn't help but wonder what "procedure" the doctor was detained with. My wandering mind settled upon the idea that there was a woman out there receiving at that very moment, a rescue transvaginal cerclage. My heart ached for her and her baby and the horrible thoughts that were most certainly dancing though her mind about the safety and well being of her unborn baby. It is moments like these (real or imagined) that I am really, really thankful for my Transabdominal Cerclage (TAC), for Dr. Davis and for my own desire to pursue something my heart was telling me was absolutely necessary in spite of other doctors telling me I was crazy.

Hubby and I were in awe of my reaching 28 weeks and my growing bump (dare I share these photos of my most pregnant tummy to date?). We both acknowledged that without my TAC, Baby Boy wouldn't have had a fighting chance. And he has this fighting chance thanks to his brave, strong and determined big sister who endured her own undeserved hell to help her sibling.

Hubby's view of his children at 28 weeks gestation:

Baby Boy 12/11/08

Our Girl 8/17/06

No Doubt About It!

2008-12-11T14:51:00.004-05:00

It seemed last week there was some confusion as to what gestation kicked off the final phase of pregnancy. Some said 27 weeks while others said 28. Well, here I am at 28 weeks, so it's official no matter how you look at it: I'm in the third trimester of my pregnancy! How good it feels to be this far along!

Since seeing Dr. Davis on Monday, I have been keeping a low-profile. I have relied heavily on Hubby, my mom and my mother-in-law. I have been drinking more than I ever imagined I could handle in hopes of an increased amniotic fluid level measurement on Friday (tomorrow).

It's amazing how much better I feel when I rest and how that can give me a false sense of my abilities. There is only so much sitting around one can do without feeling like a lazy lump. Yesterday while Hubby and My Girl were out, I took a shower, made the bed, put away two loads of laundry and picked up a bit. By the time I got back downstairs, I was ready to sit with my feet up again as my crampiness and heaviness returned.

At this point, I am doing a self-induced purge of my schedule, keeping only very necessary appointments and sending Hubby or one of the grandmothers to take care of the rest. Poor Hubby is going to have to suffer through the last Kindermusik class of the semester next week. I know he feels rather uncomfy being the only adult male in the room parading around in a circle and singing songs. Songs, I might add he knows all too well as we make a habit of listening to Kindermusik CDs while in the car. For some reason, he doesn't really look at this musical knowledge as an advantage.

In addition to my increased fluid intake and rest, I have also kept up with the Procardia around the clock. The only new sensation I am noticing is that I am hot most of the time. Since I typically run cold on the temperature scale, it is taking some getting used to as I don't want to freeze my family by turning our heat down. I have opted to dress in less layers instead.

I feel pretty good overall at 28 weeks. My legs are beginning to cramp at night which is not fun but soon enough, I fall asleep and forget all about it. Baby Boy is quite active at times which is very reassuring.

On a final note, My Girl had a GI consult today. She knew we were heading to the doctor and in the car (my mother drove) stated exactly that: "we're going to doctor" - I pushed her a bit and asked her what they were going to do at the doctor. "Doctor checks Baby Brother!" she declared with certainty. She continues to amaze me this 24 weeker of mine... even though it was her tummy that was getting checked today instead of mine.

Another Milestone?

2008-12-09T15:17:00.003-05:00

Hmmm, I wonder if my glucose screening counts as a pregnancy milestone. I pushed the test as late as I could (I was instructed to complete it before 28 weeks) and knowing it was "lurking" out there in the future as something to look forward to helped me get through the past week. You see, as gross as some women might find it, this was one of the many things I personally felt "robbed" of during my last pregnancy. On the scale of grief, the glucose test pales in comparison to the most important loss of My Girl not getting what she needed and was entitled to in the womb. But on the whole, having a premature baby is accompanied by many losses and this well-known drink the solution and have your blood drawn test was one of them.

This pregnancy is not intended to make up for those losses. That was never my or our intention - to right the wrong. But I do appreciate all the little things that most women might take for granted. Not saying they do, but they certainly might.

The test was not nearly as bad as it had been made out to be. I drank a bottle of lemon-lime solution, sat and worked on my Christmas cards, went back an hour later and had my blood drawn. It was as simple as that.

Low Fluid...

2008-12-08T22:10:00.002-05:00

Since I still didn't feel right yesterday and last night, I decided to call and see if Dr. Davis was able to see me today. Sure enough, he was and my mom and I drove to New Jersey for my 2:00 appointment.

I had Patty, a wonderful ultrasounographer who was there the day I had my Pre-TAC consult. Baby Boy looks good and is measuring right-on for his gestational age of 27w 4d. His arms and legs are long and measure ahead but with his smaller stomach measurements, he averages out appropriately. He also weighs about 2 lbs 6 oz which is a whole pound heavier than My Girl was at birth.

My cervix is still measuring long and closed which is good news. The bad news and perhaps the explanation for my recent uterine irritability is that I have low amniotic fluid. The good news is that so far, Baby Boy has been unaffected by this latest finding. His blood flow was checked and no other problems are on the radar.

I was also hooked up to the monitors today because of my low fluid level and my complaints of contractions. I had four episodes of minor contractions in a 45 minute period. The nurse who worked with me acknowledged that just because something might not always show up doesn't mean things are not happening - basically I can have undetectable contractions that are very much real to me. She confirmed what I have believed all along, that a person like me with a history of a 24 week birth, be closely monitored.

I am exhausted at the moment as my mother and I closed the place. At 6:50 I called Hubby to let him know we were just leaving the hospital. It was a very long day.

There is a relief to know that perhaps it's the low fluid level that is causing my discomfort. I am to drink a measured gallon (I do drink a lot anyway and stay away from caffeine) and follow up with my other group on Friday to have my level checked again. I am hopeful that by getting my fluid back up my uterine irritability will be eliminated.

On another note, Dr. Davis has ordered the Procardia around the clock. So basically I am taking 20mg three times a day. We'll see if this helps. He did give me the realistic expectation that it won't totally eliminate all the discomfort.

I knew something just wasn't quite right and now I know that my feelings were valid. There is something else going on and thankfully I now have the knowledge to attempt to fix it.

I Overdid It... Again

2008-12-07T20:49:00.006-05:00

It's probably not in my best interest (nor the baby's) to push myself but it happened again this weekend. It's really hard not to overdo at times as the doctors (all three that I see) have not ordered me to follow any limited activity or bed rest guidelines.

Yesterday we took Our Girl to a breakfast with Santa. I was on my feet in heels much longer than I thought I would be. You see instead of just having breakfast, there was a dee-jay with dancing (no, I didn't dance) and I couldn't help but line the edge of the dance floor with the other parents watching our adorable children dance their hearts out. Here is a little idea of the draw that kept me on my feet...

After the festivities were over, I dropped Hubby and My Girl at home (nap time!) and ran off to an open house at an elementary school we are considering for our children. Not having the opportunity to change, I was still wearing my uncomfy heels which proved a huge mistake. I ended up walking the campus, breaking to sit when I could, but all in all, I was on my feet for about two hours.

From there, I pumped gas (I filled up for less than $30 and I was VERY empty!) and came home to pick up Hubby and My Girl. We then ran out to get our Christmas cards at Costco, I stood in line to make a return and then it was to Walmart to grab some additional Christmas lights. Hubby took Our Nut out to the car and I waited in the check out line only to have the woman in front of me decide at the last minute to void her whole order and start over. Knowing my body could take no more, I stormed over to the Customer Service Desk and demanded to be rung up. Every time I enter a Walmart, I swear I will never go back and last night was no different.

By the time we started heading home, the light flurries turned into something a little more and our ride was quite eventful. I am one of those nervous drivers when it snows while Hubby tends to have a little more confidence in his ability to manage the car. Well we ended up detouring just two miles from home, skidded to the shoulder on a back country road and detouring again just a mere 1/2 mile from home. Let's just say the stress was probably not good for me as my finger nails clawed into the sides of the seat. Thankfully, we made it home safe and sound.

In anticipation of a rough night, I took two Procardia pills as soon as we got home. I was in bed by 9:00 and thought I was home free - until about 12:15. That's when the contractions began. My script is for (1) 10 mg Procardia pill every 8 hours - Dr. Gerson specifically told me when he wrote the script he was giving me a low dose because of my size. Dr. Carlson told me not to bother with the Procardia and Dr. Davis said to double the dose and take it every six hours. Reviewing the various directions my multiple doctors gave me, I decided that when I had five contractions in a forty-five minute period, I needed to take more Procardia.

My mind was racing. The first thought was that of course, I brought this on myself. How stupid of me! I was convinced I was a having a 27 weeker. The roads were too bad for me to drive myself to the hospital. I couldn't expect my mom to drive over on bad roads, plus that would take too long. I couldn't disturb my poor neighbors to come watch our sleeping child at now 1:00 in the morning. The only thing I could do was call an ambulance.

Hubby and I lay in bed, he watching the clock and me making an effort not to make too much noise with each painful contraction. The audible ones he tracked, the silent ones, he had no idea occurred. If they were less painful, maybe they weren't real. We did our best to fall back to sleep.

Thankfully we made it through the night - me and Baby Boy still as one. My contractions started again and I took two more Procardia. Then I called the service. It was Dr. G on-call and I decided to have him call me back. He did his usual "calm down" talk - no I wasn't crying, just methodically reading through my notes so I didn't forget to tell him anything. Basically, I went through my contraction and medication time line. He reminded me that I am small (funny he still considers me small considering I look like a blimp these days) and that I can overdose on Procardia. I explained that Dr. Davis gave me different instructions and Dr. G asked who my doctor was... Hmmm, did I strike a nerve? My local group knows I still see Dr. D so why should he be offended I'm following his orders too? I mean come on, he isn't even on the same page as his in-house colleague, something I've been meaning to discuss with them.

Anyway, he told me as my pregnancy progresses, my contractions and symptoms will change. Lovely. Why is this not a talk that is incorporated into an office visit, a sort of update on the warning signs to look out for?

Bottom line is that each night now (since I have been waking up with contractions too) at 6:00, I am to take two Procardia. My doses are to be no closer than six hours.

So while I've sort of known that an increased activity level tends to cause discomfort, when I rest up and feel good, I forget that part of the pregnancy. Then days like Saturday happen when I totally overdo it only to play catch up with a major dose of panic and worry to go with it.

My main concern is to keep Baby Boy cooking as long as I can. But, I will admit, it is really hard to "do the right thing" when I have My Girl right in front of me, needing her mommy.

My Definition of Success

2008-12-05T14:52:00.005-05:00

At 27 weeks 1 day in my last pregnancy, the equivalent of 17 days old, I was finally able to hold my baby for the first time. This perfectly illustrates why my definition of success is much more than achieving 27 weeks gestation. Granted, it is better than the 24w 5d my daughter got but still a devastating gestation to have a baby come into this world.

I think the scary part is that one might assume since Our Girl did so well having been born at 24w 5d, that Our Boy, with more time in the womb, would do just as well if not better. This mirrors a conversation I had yesterday with Dr. G that I don't feel it's possible that our family would be as blessed twice. I expressed my concerns that we are expecting a boy and that statistically, boys don't do as well as girls. The whole race factor comes into play too with African American babies having better statistics than Caucasian babies, with the "wimpy, white boy" at the very bottom of the charts.

Dr. G told me to disregard the stats, that a baby does as well as their genetics. This Baby Boy is of the same make-up as our Miracle Girl and that counts for something, at least this is the doctor's opinion. I am not willing to test his theory.

Our First Family Photo August 11, 2006

Third Trimester???

2008-12-04T21:57:00.004-05:00

Last night, I was counting down the hours to midnight in anticipation of the arrival of the long-awaited third trimester. I am officially 27 weeks today and with that, it was my understanding, came a new, never before entered (by me) marker of pregnancy. In spite of feeling a bit under the weather (sinus congestion), I was on a cloud, excited about this newly achieved personal milestone.

I had an afternoon appointment today for a cervical scan and shared my excitement with Nurse Barb, who probably didn't mean to, but totally burst my third trimester bubble, telling me it was common knowledge that the third trimester officially begins at 28 weeks. She casually told me, just one more week. I was devastated! Then Dr. Gerson entered the room...

Well, he just made my day and I have to say, today was my best visit to date! He agreed that the literature is conflicting stating that 27 weeks is listed in one source and 28 weeks in another. So, based on my source of the chart below (thanks, Jen!), I am officially in the third trimester and feel damn good about it!

My cervix continues to be long and closed and today, Dr. G told me he considers me a "success"! Well, it depends on how you look at it... I told him that to me, success is having my baby and holding him immediately after birth, something I didn't get to do with My Girl and something I know I wouldn't get to do with My Boy if he were born today at 27 weeks gestation. So to me, success has not yet been achieved, but with each passing day, becomes more and more likely.

Dr. G felt that based on my "success" I discontinue weekly cervical checks. Thankfully, he was receptive to the fact that I NEED these checks for peace of mind and since they are already scheduled through the end of the year, agreed that it was okay that I keep them on the calendar. Additionally, he said if I wanted to be seen, he would be more than happy to do so.

We then had a discussion about preemies and the NICU. He reminded me that survival starts at 23 weeks and is quite low. And with this low survival, comes high morbidity. He emphasized that I have reached the inverse of this and at 27 weeks, survival is high and morbidity is low (survival was quoted at 95%). It feels so good to be on the other side but I still know the potential road and complications that even a 27 weeker would face in the NICU. I opt to keep on cooking...

Decisions, Decisions...

2008-12-02T14:33:00.003-05:00

When it comes to Baby Boy, we are still up in the air on so many things. The first and probably most important is his name. Right now, I've been calling him "no-name" in an attempt to get Hubby to sit down and review names with me. Hubby likes what he likes and when I suggest a name as he dozes at night, he is quick to shrug it off. I feel that we can't and shouldn't commit to a name until we've thoroughly researched all the options. A name is so huge and I want to make sure I have no regrets.

The other big decision is the bedding. To re-do the existing bumper would be cost-prohibitive so to make a new one, utilizing the same chocolate velvet fabric (purchased new) and a corresponding "boy" fabric is $350. I didn't think that was terrible, especially in comparison to what we spent for everything needed for Missy. I just emailed my friend to find out what is reasonable to spend on baby bedding. I googled the one and only ensemble I like from Pottery Barn Kids and it looks like that could be $350+. Granted, it's the full set, quilt, bumper, dust ruffle, sheet, etc., whereas otherwise, I would be just getting a bumper.

It is amazing that I am 26w 5d! At this point in my last pregnancy, Missy was two weeks old already and I still hadn't held her yet. This is such a better place to be and we are so thankful.

Over the Hump

2008-11-28T21:50:00.002-05:00

My P17 shot was given today as opposed to my usual day of Thursday. I was supposed to get the shot at my Wednesday appointment but since that was moved to Tuesday, I decided not to have the nurse administer the injection. So that brought me to today and Kim was kind enough to stop over on her way home from work. I truly didn't have the heart to bug her on Thanksgiving.

I am officially over the hump with more shots behind me than ahead of me. It is a nice place to be yet at the same time, a reminder that this baby will be here in about 10 weeks (assuming all goes well). I wonder how ready I am...

On another note, my crampiness and heaviness is very much attributed to my activity level. When I sit with my feet up, I feel minimal discomfort. When I become active, taking on my stairs, lifting My Girl or as we did tonight, go to the mall for photos, visit with Santa and walk a bit, I feel horrible! Needless to say I'm in quite a bit of discomfort. This is a clear indication that I need to start taking it easy as up until now, I have not really restricted much of my daily routine. Now is the time to start. The only thing I want for Christmas this year is to be pregnant and to help that wish come true, I need to take it easy.

Thankful for 26 weeks and So Much More!!!

2008-11-27T15:46:00.005-05:00

At this point in my pregnancy, I look at the passing of each week as comfort that I won't have a baby classified as having been born at that week's gestation. It is a direct link back to my thoughts about "weekers", a word I never knew existed until My Girl was born. Anyway, it is with great relief that I know Baby Boy will not be born classified as a "25-weeker" although now that I am 26 weeks, worry that could be our mark. I am so fearful because I know what a 26 weeker looks like in the NICU, the complications they face after birth and the potential complications they can face down the road. It is very scary.

Compounding things is the fact that I am really not feeling 100%. My low back aches, I feel pressure and heaviness in my lower pelvis and prefer to be sitting with my feet up as opposed to being active in my household and life. Thankfully, my mother and hubby have taken the lead with Thanksgiving: my mom, dropping off the prepped turkey and most sides - ready for the oven, and hubby taking care of all the other details of the day. I don't know what I would do without such a multi-talented husband who is not afraid of domesticity.

I find myself pushing the fluids and taking my Procardia and Omega 3's with the hope that my symptoms will subside. I am clearly getting big and wonder how much of this is "normal" pregnancy stuff related to growing and stretching as suggested by both my doctor and experienced friends. I don't want to complain because ultimately, I want a full-term, healthy baby, but if this is "normal" pregnancy stuff (which I sure hope it is) I am a big wimp!

Turning to the holiday, it is nice that on this day of Thanksgiving, our reflections of how blessed we are as a family are the same as the reflections that occur on any other day of the year. Yes, this is a special day but the words I shared with My Girl as I tucked her into bed tonight were no more profound as a result. I felt a bit of shock in this, thinking there must be more, but at the same time, take comfort in the fact that our prayers of thanks are genuine and that it doesn't take a day that comes along once a year to figure out just how blessed we are.

Happy Thanksgiving from our family to yours!

I Just Couldn't Wait

2008-11-25T14:34:00.004-05:00

My appointment for this week was scheduled for tomorrow but based on the way I was feeling, called this morning to move it up.

Yesterday afternoon the "cervical sensations" increased and I just didn't feel right. After a dinner of leftovers, I was in bed by 8:00. I felt horrible when Hubby asked if I wanted to say goodnight to My Girl as I knew she would request, "Mommy nuggle". I turned him down. Knowing I wasn't physically up for snuggling, and not wanting to turn My Girl down directly, unsure of who would be more upset by it, me or her, I kept myself out of sight.

I was solo this morning as Hubby had a meeting downtown. His influence on our school-day morning routine is quite helpful and I was sure wishing I had his help today, but as it turned out, we managed just fine. I wasn't too concerned about getting My Girl in the car as she is usually very excited to go to school. But when I walked out to the garage and saw this, I was concerned I might have more of a fight on my hands.

Thankfully, she was a dream and we sang and swayed to Christmas carols the whole ride.

After I played photographer for the class, I hobbled out to the car, knowing I needed to call my doctor. There are no office hours on Tuesdays and I was actually hoping they would let me go to a closer hospital for a quick ultrasound. But, as Nurse Barb put it, "in the event we need to admit you, you need to come here."

Thankfully they were able to see me, in spite of having no office hours. For some reason, it makes me feel bad when I can't make it to my next scheduled appointment. I just wish I could feel "normal" as the "typical" pregnant person isn't seen nearly as often as I am nor does the average TAC patient go for weekly scans. I think most tend to go every other week. There is absolutely no way that I could do that.

Between obtaining my ticket at the parking garage and paying my $3 to raise the gate, I was there for less than an hour. It was fabulous in terms of convenience. I was even able to pick up My Girl at school, allowing Hubby to stay at his conference instead of leaving early because I was stuck at the hospital.

My visit went well in the fact that my cervix measured longer today than Dr. C has ever measured it - not that much longer, but enough for him to comment and enough for me to feel good that it has not budged during all this discomfort I have been feeling.

The cause of my discomfort was once again attributed to my growing uterus and the fact that this is not my first pregnancy. Then why does it hurt so much? So much so that I'm afraid to move? I felt like I was doing so well, that this past week was very uneventful, that I actually felt good, "normal" for a change. It was nice to not feel the need to call the doctor at all.

Dr. C was pleasant as was Nurse Barb. I walked out of the office with an order for blood glucose testing, something I didn't get to do the first time around. It needs to be completed before 28 weeks.

So here I am, reclining in bed, watching my stomach move about as Baby Boy decides to change position. Oh how I love to feel him moving inside...it sure beats the alternative.

My Girl at 25w 5d

Reflecting

2008-11-24T15:18:00.004-05:00

It dawned on me yesterday that at this point in my first pregnancy, I was home from the hospital (discharged on a Saturday 25w 2d) without my baby. What a welcome change to still be pregnant today, 25w 4d which is eerily similar (number wise) to 24w 5d. I've been somewhat suspicious today especially considering the indescribable flutters and sensations I feel very low in my pelvis. It's almost as though my stitch is vibrating.

The good news is that I have no contractions and haven't for days. In fact, this past weekend, I've felt fairly well, with minimal complaints. Well, except for yesterday, Baby Boy was on the quiet side and I voiced my concern to hubby. I did all the things I anticipated the docs would have told me to do: I drank some juice, sat quietly for a bit, reclined on my left side. The baby's movements were very subtle until later in the evening. He was pretty much active for the better part of the night, interfering with my ability to get comfy and fall asleep myself. But the good news is he's fine.

Today I did some clothes shopping for Baby Boy. It has been very difficult for me to find boy clothes I like. Additionally, I struggled with the size. Hubby was a 10.5 lb baby. There are moments I feel quiet confident, as does Dr. C, that I'll get pretty close to term. Then there are moments when I feel like 34 weeks would be great. Dr. Davis has me concerned about my small uterus and the implications relative to a term pregnancy. This issue is in addition to my cervical issues. So do I buy newborn size or do I go with 3 months? The six month size would have been what my hubby needed after birth with a range beginning at 12 lbs. I really don't think my body will be able to sustain a 10 lb baby, nor an 8 lb baby for that matter. Only time will tell, and one would think I have learned my lesson the first time around that I am very far from being in control of things. It's a personality thing, I suppose.

The other baby-related task we conquered this weekend, well, maybe I should say that I conquered, was selecting a swatch for bedding. I am just waiting to find out if it's cheaper to re-work My Girl's bumper, reupholstering one side and removing the ruffle, or if I should just get new. I don't want Baby Boy to feel slighted that he didn't get the dream nursery like his sister. I know he doesn't care and I know in the scheme of life it doesn't matter but on a certain level of siblings, it matters to me. There is so much that Sissy has (photos, keepsakes, albums, journals, a lactation room at the hospital named after her, influence on my license plate: NICU MOM) that I want to make sure this baby feels special too.

Never Thought I Would Ever...

2008-11-21T19:05:00.004-05:00

It's been confirmed by my own admission that this is an anxiety-ridden pregnancy. For obvious reasons, I am scared to death that this baby is going to make an early appearance much in the way his big sister did. Preemie moms can probably identify with this emotion and fear. Being beyond the point at which My Girl was born feels bittersweet. There are so many feelings about what she didn't get, what she was short-changed by being plucked from my body because it was pushing her out otherwise. Yet I am so thankful that My Boy is still inside, where he belongs, safe and sound and protected, allowed to grow and develop as every baby should. But I don't want to get ahead of myself. Even though I am beyond the dreaded 24w 5d, there is still the fear that My Boy will arrive before his time and while there is no way he will be born a 24 weeker like his sissy, there is a chance he could be a 25 weeker. That being said, on the flip side, I have also confirmed by my own admission that I have done everything possible to ensure this pregnancy results in a delivery as close to term as possible.

Where am I going with this? Well, today I did something I never thought I would ever do... and that was cancel an appointment at my local perinatal office. It occurred to me this morning that I was just evaluated by Dr. Davis on Tuesday. Nothing has changed, I have no symptoms of anything so why would I need to be seen today, Friday, just three days later?

I bring this up because this is a huge mental and emotional milestone for me. My fear is no longer ruling as strong as it once did and I can only wonder if I am, dare I say, "relaxing" into this pregnancy, if only just the slightest touch.

25 Weeks!

2008-11-20T15:45:00.001-05:00

Wow! I have never before been 25 weeks pregnant! It amazes me to say that considering I have a beautiful two-year old. It really defies all sense of "normal" as was reflected in the perplexed look on another mom's face at duPont earlier today. She couldn't believe that I had My Girl before I was "this pregnant", and questioned how they keep 1 lb babies alive.

I am relieved to report that my contractions have subsided. I have been extremely tired lately and my energy has been low, so perhaps it is tied to the fact that I have not been doing much in recent days. My tummy is growing and even Hubby commented about "how big" I look. Getting big was something I longed to achieve last pregnancy - and there is no way I would ever turn that down this time, nor would I complain about it. So bring on the big tummy!

My 10th Progesterone shot was administered today and I am officially half way through my injections! I just called for a refill and will pick up my new batch of supplies tomorrow. Wow, the weeks have just flown by to this point. I started the P17 at 16 weeks.

Just a few final thoughts on my previous pregnancy reflections:

Prior to being admitted to the hospital on bed rest, I always took off my wedding rings each night before bed and never showered with them on. Afraid to remove them in the hospital for fear of losing them, I kept them on. Yes, Hubby or someone could have taken them home, but the strong symbolism of wearing my rings through what could have been a marriage-wrecking situation but thankfully (I had no doubts) was a marriage-strengthening situation, was very important to me. And while yes, my rings are just things, they were blessed by our priest and are a "sacramentals", a part of our lives as husband and wife. The comfort that reaching my left thumb across to feel the rings brought me was priceless. My rings have not left my finger since. And while it's been conditioned, if you ask My Girl what my rings mean, she will tell you herself that "Mommy married to Daddy".
Magnesium sulfate was used to stop my contractions (contractions I had no idea I was having, by the way). It was given by IV and I was closely monitored, having my reflexes and respiration checked quite frequently. Little did I know at the time, but the "mag sulfate" as it's often referred, made me hot, hot, hot. I am a person that normally runs cold, IE: socks to bed in the summer, with the windows open and no air on, cold. Well, the mag sulfate caused me to be so hot that the thermostat in my room was turned as low as it could go. My poor hubby ended up with a head cold (I know, temperature doesn't cause colds, germs cause colds). Additionally, it had affects on my speech and I came to find out that I was very whiny, sounding as though I was intoxicated. So I suppose my point on this is that while I knew I was in shock, I have to wonder how much this particular medication altered what was left of my mental state.
The language of the NICU was something we had to learn in crash-course fashion. I should have known when I learned that babies born before term are identified as "weekers". It shocked me, the first time I heard our unborn daughter referred to as a "24 weeker". The word weeker, flagged by spell check, has become an integral part of our "preemie world" as have many other acronyms, abbreviations and medical slang.

24 Weeks 5 Days!!!

2008-11-18T20:45:00.004-05:00

It's official! I am the most pregnant I've ever been! On Tuesday, July 25, 2006 at 8:41 A.M., our Precious Miracle was born at 24w 5d gestation weighing 1 lb 6 oz and measuring 13 1/4" long.

The morning of her birth, I woke with horrible contractions. I didn't want to say anything for fear they would make me deliver but the feeling was unbearable and I just knew something was happening. The resident, Dr. Mori, came in to check me and when I saw her blood-covered glove emerge from underneath my sheet, knew it was time.

Hubby, set to host an important work function later in the day, immediately got on the phone informing our mothers I was headed in for a c-section. I have never seen anyone jump into gear as quickly as my medical team did that morning and before I could even really consent to what was happening, found myself in the middle of a cold OR, shivering, crying and praying. The poor nurse who held me in position for my spinal comforted me in ways she'll never know as I longed for her to promise my baby would be okay. I disconnected from my body even more than I already had, feeling nothing, completely numb on all levels.

Hubby was brought in to be by my side at some point, but my perception of time was non-existent. I distinctly remember hearing Dr. Carlson demand, "scalpel". I give him tremendous credit for delivering our micro-preemie safely, while dissecting my lower uterine segment with a low-transverse cut. It wouldn't be until many, many months later, if not over a year plus, that I realized the full impact this much-preferred cut would have on my future pregnancy. All OB/MFM/Perinatal specialists who hear that I have this type of incision are just astounded. I am grateful for Dr. C's patience and skill.

My Girl's birth was so not the way I -we - had planned. It was supposed to be captured on video, set to the words of , "This Magic Moment". Instead of being magical, it was horrific, filled with so many unknowns that until recently, have just shaken themselves out, with a few remaining to unfold.

I didn't see my daughter when she was born, didn't hear her cry either. Hubby recalls seeing her tiny body with tooth-pick like limbs being carried to a warmer bed. He chose to look away, not noticing if she was vented immediately. I just prayed and prayed.

I will admit that once while on bed rest and once during her delivery, my body felt a calm sweep over with the feeling that everything was going to be okay. That's all I wanted was a healthy little girl, unaffected by her extreme prematurity, to grow up "big, strong, happy and healthy, from head to toe, inside and out, with an intelligent mind, good social skills, able-bodied, all her senses and a kind, loving, compassionate, understanding, giving heart." From that moment on, those were the words I prayed for my little girl. I prayed them each day in the NICU over her isolette and to this very day, pray them with her every single night before she goes to bed. Only now with my additional "Mommy knowledge" have added "good processing skills and good communication skills". Baby Boy already has the same prayer prayed for him.

The Chief Neonatologist was present for my delivery and while he has become someone very dear to us, at the time of birth, challenged us on the way we spell Precious Miracle's name. It's not like she has a real different name as it's a classic name that ranked in the 120's in terms of popularity. Although we were told she was the first with her name to ever be admitted to that particular NICU. I don't like trendy... that's why Baby Boy is still nameless, although I think we're getting there.

Anyway, I remember nothing of closing me up, nothing of recovery. I do remember the whirlwind of being wheeled into the NICU on my post surgical bed to see my baby for the first time. I couldn't touch her, as her tiny body was hooked up the oscillator, a high-frequency ventilator that jiggled her tiny, little body. Her skin was transparent, her eyes covered over , her body nestled in a "snuggle nest" on a gel heating pad, covered with a plastic tent within the confines of her Giraffe Bed, her home for the next three weeks plus. Probes and sensors were stuck and attached to her body along with tubes coming from her umbilical line. She was hooked up to monitors that beeped and flashed. It was sensory overload and the voice of our nurse, explaining things as I looked with glazed-over eyes, droned out to a hum. My tiny baby girl did not deserve this start in life. It wasn't her fault, it was me who failed her. I failed my baby.

So today, at 24w 5d, more pregnant than ever before, I am grateful that my cervix is holding strong at 3.2 and that I am able to be up and about, to snuggle my not-so little-anymore once micro-preemie who makes my life complete.

The sadness is that I know what 24w 5d looks like on the outside:

My Girl 24w 5d

The happiness, for the first time, I know what 24w 5d looks like on the inside, the way a pregnancy is "supposed to be":

My Boy 24w 5d

And the gratitude I feel for the man who helped me get to this point:

Dr. George Davis helping me celebrate 24w 5d!

And just an update on Baby Boy, according to today's scan, he's measuring 1 lb 9 oz. My fluid level is good and he's growing as he should. My cervix is long and closed and for that I am extremely pleased!

Busy Weeks?

2008-11-17T21:10:00.004-05:00

I think I may have figured out why, for two weekends in a row, I've felt the need to take it easy, confining myself to my bed. Today being Monday, my usual routine kicks into gear. Luckily Mondays and Tuesdays are school days for the Miss. Gosh, I love Mondays and Tuesdays. Hubby and Darling Daughter leave for school around 8:20 and from there I catch up on things, such as emails and what I refer to as "lite" housework. I take a leisurely shower, throw in a load of laundry and then before I know it, it's time to pick up My Nut.

I usually pack a lunch for My Girl to eat on the way home. Today was a 1/2 of peanut butter and jelly sandwich on whole wheat bread, a big cup of milk and American cheese, with pretzel chips for "dessert". She is usually starving when I pick her up at school and if I don't have a lunch packed, usually pull through the Burger King drive-thru for chicken tenders. I know, not the best choice but if I don't present her with the promise of food on the way out the classroom door, she'll ask me for chicken.

Anyway, the point of feeding her in the car is number one, she's hungry and number two, it's the only way to keep her awake until we get home. There are days when she dozes, mid-bite, and I do my best to wake her up by pointing out the cows or horses out to pasture. Sometimes it works and sometimes it doesn't. Then my plan turns into a wish for an easy transfer to nap.

Most days, I am very lucky. She is awake when we get home, we do a potty visit before nap, I change her into other clothes (clothes after three hours of preschool are just plain gross) and do a full facial and digital wipe-down. We read a couple of books, "The Mommy Book" and "Corduroy" still top the list, snuggle and she asks for her "bed". I tuck her in, always blessing her and head off to enjoy three peaceful hours: after I use the bathroom, walk the dogs, finish the laundry, make some lunch and catch up on emails.

My plan is to structure most of my mornings in the fashion of either school, Kindermusik, therapy or playdates, so I can achieve the 1:00 free-time a great nap affords me. On the days when we have Musik class, I am running from here to there as my OB appointments sometimes follow our dismissal by the mere skin of my teeth.

I find myself very active once nap is over, making dinner, entertaining My Girl, dressing her, dressing her and dressing her, as for some reason we need to totally strip to use the potty (not sure how socks interfere with one's ability to pee and poop but oh well) and cleaning up once more. I find myself up and down the stairs, although it has gotten to the point where if My Girl wants something, I make her go upstairs to her room to get it herself. But, nonetheless, there are always reasons why I need to race up or race down, the most common being I forgot something in my failed attempt at being efficient.

So by the end of the night, such as now, after I've already laid out her clothes for the next day and prepared just as much as I can for a fairly easy morning, including picking up my entire house, I am feeling very fatigued, tight and crampy with an occasional contraction.

Perhaps my very long-winded point is that my days are crazy and by the time the weekend rolls around my body just needs a break. Thankfully, I have a fabulous Hubby who can make that happen. And speaking of Hubby, he does bath almost every night (with the exception of the nights My Girl and I shower together), puts PJs on and does the majority of the bedtime routine. Although lately, I must confess, we've been in a bit of a "Mommy" zone and poor Daddy gets cried to the curb.

One of the great things about my TAC (best is getting to term!) is that for obvious reasons, I am way busier this pregnancy than I was last pregnancy. If with my limited activity last time, I only got to 24w 5d (tomorrow), I can only imagine when my body would have failed me this time around had I not had my pre-pregnancy TAC placed. It is an amazing thing and for a busy mom like me, couldn't imagine this pregnancy without it.

Tomorrow will be a difficult day for me, there is no question. I have a plan on how to best make it through, to memorialize it, if you will. And I will admit, the cathartic experience of purging my memory, especially Friday, the day of my hospital admission, has proved to be an amazing relief and even more beneficial than I once hoped or even thought it could be.

A Lazy Sunday

2008-11-16T15:20:00.005-05:00

I started contracting last night and called the doctor. The doc on call confessed, that although he respects the other docs in the practice, tends to disagree on some things and that it won't be uncommon for me to hear different advice from members of the same group. I appreciate the honesty, have already observed this disconnect and heard the same from friends whose pregnancies were also followed by the practice. But come on... in a high-risk specialty, why can't they have some cohesive plan of treatment for their patients?

Ever watch the show, "Deliver Me" on Discovery Health? The three doctors in that practice consult often on their very high-risk patients. Someone in my shoes needs to know the plan, have the docs know the plan and not be the one left to decipher which doc to listen to this time. And in this situation, to listen to is equivalent to placing my unwavering trust in.

Bottom line is, if I have less than five contractions in an hour, I'm thought to be just fine. I would love to hear those same words from the other doc I see. I don't want to be paranoid but can't help but wish I had the opportunity to speak with him about my recent pains and tightening.

So here I am on this Sunday afternoon, still in my pajamas, in bed, catching up on computer stuff and watching lame TV. Hubby has been Super-Daddy as he was up with The Nut before 8:00, leaving me to sleep peacefully until I was delivered a pancake breakfast in bed. He then let me doze again while setting up the "Bounce House" in the basement playroom to tire out Our Girl. Feeling like I was missing out, decided to venture out of bed and downstairs. Glad I did, for this is what I saw...

Not only was my Girl in the Bounce House, but Hubby was too. What a dad, huh?

Listening to my body, I headed back up to my bed after capturing some photos. I just don't feel right and although I've only had two contractions so far today, feel a constant tightening sensation across my lower pelvis.

Since I didn't get much time today with My Girl, opted to snuggle and read "Corduroy" before nap time. Then I went down for a quiet lunch with Hubby, thinking that perhaps I could take on the day and attend the Southern Living Party I RSVP'd to last week. Well, once again, my body gave way and I found myself craving the comfort (physical and mental) only my bed could provide.

Supper Dad morphed into Super Hubby as he cleaned our entire downstairs. Super Dad/Hubby, my Super Man, did it all with a smile, never once complaining that I have done absolutely nothing today with the exception of complain.

I know it's wishful thinking to call the service and learn that magically another doc is on-call. I don't want to miss anything but have to force myself to wonder how much of this is brought on by the fact that at this stage in my last pregnancy, I was just two days away from delivery. That this very moment I was in my hospital bed having my hair washed by my mother and nurse beauty team. And that the same duo shaved my legs when they finished massaging my scalp.

Blessings...

2008-11-15T17:17:00.006-05:00

At this point in my last pregnancy, we had already met with the NICU team again. Karen, a Nurse Practitioner, came in with a preemie-size diaper. Her son was a preemie, not a micro-preemie, but a preemie. I really liked Karen, especially as we settled into the NICU as she took me around to see "Feeder-Growers" who were once as tiny as our girl. But that's getting ahead of things here. I liked Karen from the start. What I didn't like was her reference to "how cute" the preemie diaper was. Here I was, a mom doing my best to keep my too-soon-to-be-born baby inside. The last thing I wanted was a reminder of how tiny she would be. And no baby deserves to be born that small. Cute, maybe in doll terms, on a sunny, happy day in a life that wasn't my own.

Karen's talk (diaper aside) was more uplifting than the doctor's. She had a son who was born in the 30's (weeks) and she described him as a "monkey". I needed positive stories. I remember one of my nurses, Maria, had a 28 weeker who was a senior in high school. She showed me her picture and she looked so "normal". That's all we wanted was "normal". A normal pregnancy, a normal baby, a normal experience.

My doctors came in and decided to pull my food again, thinking that I was on the verge of being delivered. They really didn't know what was going to happen. One doctor in particular wanted me to pick a day and time to deliver. He was concerned what could happen in the event things tuned into a very emergent situation. He didn't want to have to "filet my uterus". Fabulous words, huh? I called him on it at my post-partum appointment. He admitted that those words weren't the best choice. I suppose he gets credit for honesty. But his concern about our choice to deliver was very serious.

Hubby and I consulted with our families and a past client who was an OB/GYN. Hubby called him and updated him on our situation. He advised us not to deliver our baby unless absolutely necessary. Those were words we needed to hear from a medical professional as in our hearts, we could not force our daughter into this world and live with that decision. It was not our decision to make but God's.

We then requested another visit from the NICU team. This time Cindy Cox, another Nurse Practitioner came in. Cindy is a no-nonsense woman who lives her career of neonatology. I am so happy that she ended up being part of Precious Miracle's birth team and was there during our delivery, but again, I get ahead of myself. The point is that Cindy is someone we came to adore and still do.

She told us that every day a baby is in the womb, is equal to three days in the NICU. She was adamant that we leave our baby where she was. I was not leaking fluids as my membranes had not ruptured so it is my impression looking back that no one thought our daughter was in great danger. There were no signs of infection either. Thank God.

On this Saturday night, 24w 2d or July 22, 2006, Hubby and I were torn and scared. We held out hope that perhaps I might be able to pull off weeks and months of bed rest. I remember trying to will that to happen, as I met with anesthesia once more and learned that this doctor was headed for vacation the next day. I remember so much wanting to wait for his return, saying, "I'll still be here, in this bed, when you get back." But based on the tone and opinion of my doctors, we knew it was probably a long shot.

My sister-in-law, on the eve of her summer vacation, contacted our priest, picked him up and drove him about half an hour to the hospital. Our families gathered around my bed, my mother, uncle, two brothers, brother's girlfriend, Hubby's parents, sister-in-law and Father Paschal. Even my nurse, a devout Catholic, asked if she could be present for this blessing as Hubby held my hand and we bowed our heads in prayer for our daughter. The prayers were powerful, tears were shed and a miracle happened in my hospital room that night, of that, I am most certain.

We asked our families for privacy as I had to ask Father the question that was lingering in my mind... the what if. I didn't even have to come out with it, as Father Paschal intuitively assured me, "it's a life, respect the life".

Moving to present day, 24w 2d, I couldn't let today escape without Baby Boy receiving his very own special blessing from this very holy man. I emailed Father Paschal weeks ago in anticipation of this emotional day.

I thought the blessing itself would evoke raw emotions for me, but his words were much different this time. He prayed for our unborn son and for a healthy pregnancy that will end in God's time. It was those words, "God's time" that caught my attention and reminded me of what I've known deep down, all along: this is in God's hands. We've turned it over, even from the start, that if we were meant to have another child we would. Clearly God has blessed us with a son and we need to trust that He is in control. For it has become apparent to me, after much discernment, that Precious Miracle is who she was always destined to be in the eyes of God. And while He held her in the palm of his hand for many months while in the NICU, this Baby Boy is created in His image and likeness. And the words of Father Paschal's prayer, while different, they are no less powerful, no less meaningful. Here's to a man who is so very special to our family, a man so very special in the lives of our children.

Emotions Running High

2008-11-14T13:45:00.004-05:00

It has been an emotional 24 hours. Maybe it's the pregnancy hormones, perhaps it is my reflection on where we were in Precious Miracle's pregnancy, or the rush of feeling Prematurity Awareness Day brought upon me, but learning that one of Precious Miracle's classmates was diagnosed with Lymphoma sent me into a crying frenzy last night that I just couldn't shake.

Reading posts on Abbyloppers and catching a glimpse of a Today Show story about a little girl who suffered a terrible shaking at the hands of her nanny, leaving her brain damaged, caused an instantaneous flow of tears. Maybe those tears are for me, not me now, but the person I was when I was 24w 1d pregnant with My Girl. Maybe those tears are for the families, currently living something awful. Maybe those tears are for thanksgiving, the daily prayer offered to God that my daughter has grown into the amazing little person she is today in spite of the crazy odds stacked against her. I think the tears are for all.

It is days like this that I choose to remember in the midst of patience-trying moments. Hubby is the same way. It is days like this that put it all into perspective: what matters and what doesn't. And when I go upstairs for the third time after putting My Girl to nap only to discover her standing on the other side of the gate totally naked, room scattered about, I can only smile, thankful and so blessed that she is alive and able to do such things. The spilled milk on my couch, crayon on the wall, slow housing market, what does it matter? I have my family and for that I am forever grateful.

Today, 24w 1d, or Friday, July 21, 2006, I woke as though it were any other ordinary morning. I sat at my kitchen island and had a bowl of cereal. The act of standing up forever changed my life, for as I pushed the chair away with my rising body, felt something drip onto my upper left thigh. Quick to examine the wet substance, I knew I needed to call the doctor. I explained to Nurse Barb that blood-tinged mucus had fallen out onto my leg. She told me to come in to the office.

What was wrong with me? I showered, took my time getting dressed and got in the car. I hopped on the turnpike, driving myself to my own hospital admission. I remember arriving at the doctors' office and using the restroom before my exam. How lucky I was that My Girl didn't fall out at that moment. I went back to the same ultrasound room I use for my current pregnancy's weekly scans. Dr. G did a regular ultrasound and we saw the heartbeat. He then went to examine my cervix and inserted a speculum. His monotone words that followed are forever part of my being, "Your membranes are budging. You are not leaving this hospital until you deliver, could be 12 hours, 12 days or 12 weeks."

That moment I went into shock. I needed this baby. I wanted this baby. I loved this baby and she had to survive. I knew pregnancy lasted 40 weeks for a reason and here I was just a day beyond 24, that's just over half way. What was happening? What did this mean? My mind went into a tailspin as I recalled that my pregnancy book at home indicated that my baby was now, "viable". Viable, I had no idea what that meant in terms of all the intervention required. I would soon learn.

I called Hubby and just blubbered into the phone. I don't know what I said or what he said. Nurse Barb said to get dressed. I was afraid to stand up. She came back with a wheel chair and out the back entrance of the office she took me, clutching my tissue and wishing I would wake up from this nightmare. Through the back halls of the hospital we went until we finally came to an elevator. To my left and behind me, tucked behind a wing-wall of sorts, was the Morgue. I lost it. Crazy thoughts about my unborn daughter ending up in there circled my mind. What do you do when a baby dies? Do you have a funeral? Oh, God, NO! Sitting at home was a personalized burp cloth I ordered on sale at Pottery Barn Kids. Hubby and I were set on her name weeks ago. She had a name, she was my baby and I needed her to live. I began praying, over and over and over and over. Between my Hail Mary's I started reciting the words to Diana Ross' song, "I'm Coming Out". It was a song that when I heard it during my pregnancy, associated it with the day my daughter was going to be born - a now's the time kinda thing. It was just not supposed to be this day, but a day more than 15 weeks away. But as strange as it was, I hung onto the words, finding comfort in various lines that I repeated over and over, again between Hail Mary's. (Her NICU video is actually set to that song. There is a link in my post dated November 12.)

"There's a new me coming out, And I just had to live, And I wanna give, I'm completely positive. I think this time around I am gonna do it, Like you never do it, Like you never knew it, Ooh, I'll make it through" ... "I've got to show the world, All that I wanna be, And all my abilities, There's so much more to me. Somehow I have to make them, Just understand I got it well in hand And, oh, how I've planned. I'm spreadin' love, There's no need to fear..."

The Antepartum unit I was originally slated for was full so I was wheeled to Labor and Delivery. They needed to get a room ready and in the mean time, had me get on a gurney in the hall. My right side was against the wall. Nurse Barb left me and a new nurse came over. I was shaking at this point. Shaking, praying and reciting my song. I told the nurse I had the urge to pee but did not want to use a bedpan. My fear was the action of doing so would cause my baby to dislodge. It was a strong feeling I had that I needed a catheter. An IV was started and I was moved to what I was hoping was my home for the next 15 weeks. I was prepared to do whatever I had to do to keep my baby inside where she belonged.

I was hooked up to monitors and learned that I was having contractions. I was given magnesium sulfate to stop the contractions, received my first steroid shot to boost my baby's lung development and also antibiotics, if I'm not mistaken. My bed was placed in a Trendelenburg position, meaning my feet were higher than my head. My catheter was placed and somehow in the midst of all this, I changed into a hospital gown.

The fog began. I don't remember when Hubby arrived but know he didn't leave me waiting long. Other family members came by including my mom, Hubby's mom and my brother. It was not how I planned on asking him, but in that moment seemed necessary to let him know we would like him to be God-Father of our child.

My room was a circus of medical professionals. I didn't know my group all that well and ended up meeting new people who appeared stumped as to what to do with me. A doctor from the NICU came in to let us know what we were facing. He determined that our daughter was 24w 1d from my last menstrual period and seemed quite relieved that I was 24 weeks and not 23. He went through a whole list of terrifying words, explaining the risks that could potentially affect our baby. Hubby and I sobbed as we had no choice but to listen:

"Bleeding in the brain, mental retardation, cerebral palsy, blindness, deafness, digestive issues, inability to oxygenate, feeding problems, chronic lung disease, long-term breathing issues requiring permanent ventilation, learning disabilities, infections, the need for blood transfusions, asthma and a 50% chance of death." We were told there was a chance that our daughter could be non-functioning, unable to walk and talk. It was just the most devastating words you could ever imagine having to take in.

Hearing the seriousness of all that was said, I felt I needed to cling to one thing, that it would be impossible to escape this with nothing. I wanted asthma. I wanted my unborn daughter to have asthma and I prayed to God, right then and there to give my baby girl asthma and only asthma. My mom has asthma and my baby can live with asthma too. God, please give us asthma.

The visions that entered my mind are too painful to articulate. Hubby and I just sobbed together. This was a defining moment in our marriage, in our relationship. We clung to each other and from that moment forward, our relationship strengthened in ways only a life-altering situation such as this can cause.

The doctors sent in the anesthesiologist for a consult. They wanted to be prepared in the event I needed an emergency c-section. I don't think I've mentioned previously, but my daughter's feet were hanging through my cervix and into the birth canal. She was classified as a "footling breech" and therefore, would require a Cesarean delivery.

Since the doctors were unsure how things would play out or even how they wanted to proceed, I was restricted to IV fluids one minute and then offered a tray of food the next. There was not a great deal of consistency with the orders as each doctor had their own take on the situation.

My wonderful husband didn't leave my side. My brother stopped at our house to collect my glasses and contact supplies. I also had him get my rosary beads that had once been my maternal grandmothers, whose name is my daughter's middle name (and mine too). My brother found my car in the parking garage and took it home. My uncle took our dogs. The family pulled together. Hubby called some friends who spread the word that we needed prayers. The prayers poured in and while we had yet to know, a miracle was in the works.

24 Weeks!

2008-11-13T13:42:00.004-05:00

Here I am at 24 weeks and feeling quite nervous, emotional and thankful. The eve of 24 weeks in my first pregnancy brought with it a night of darkness as our power had still not been restored. Hubby and I ended up spending the night at my mom's. It was there, during dinner, that My Girl, still in my womb, was very active. I commented that if felt like, "she's kicking my cervix" - now what in the world does that feel like? As a first time expectant mom, those were the words I used to describe the sensation.

Shortly after dinner, I decided it was time to start the the over-the-counter yeast infection treatment the doctor suggested. I made the observation to my mother before heading off to bed that, "it won't stay in" ... "it just keeps sliding out"... "as if it's being pushed" - it was the suppository I was referring to. Hmmm, hindsight once again...

The next day (equated to today, 24 weeks exactly and a Thursday) we had the promise from the electric company that our power would be restored. In anticipation of this, I decided it was a good idea to clean out my spoiled refrigerator. With no power for almost 48 hours, everything had to go. So I grabbed a heavy-duty black garbage bag and started filling it up. This is one of those moments I regret. For the final days of my pregnancy, the thought that slinging that bag over my shoulder, lugging it through my kitchen to the garage and heaving into the super-big garbage can, haunted me as though my actions caused my baby to literally fall out of me. In retrospect, with a calm, level head, I know that it was not the cause. My cervical issues were becoming worse throughout the week and while this action may have accelerated things, it didn't bring them on.

I do recall after taking care of my rotting food, that I felt the need to "nest". I was organizing and cleaning things that ordinarily would not have gotten my attention. Little did I know what the next morning would bring...

Back to present day, 24 weeks with Baby Boy. The thankfulness comes with the recognition that I am at a different place this time around. I had an appointment yesterday with Dr. C and my cervix remains long and closed. I am almost 100% certain that if my cervix were evaluated in the same manner as it was yesterday at 24 weeks during my first pregnancy, the observations would be quite different. I am grateful for the peace of mind seeing an unchanged cervix over the past eight weeks brings.

My appointment yesterday was a good one. I got to enjoy another solo trip to the Perinatal office. My blood pressure remains low and there was actually no weight gain for me this week. Funny, considering all those donuts I indulged on earlier in the week.

When Dr. C came in, I told him that I experienced some contractions the night before. Yes, I was certain, these were actual uterine-tightening contractions. They occurred as I was settling into bed and there were only a few of them. He asked how active the baby was at the time. I explained that he was very active, moving in his own distinct "rolling" fashion. I confessed that his movements are somewhat concerning to me as the sensation is a strange one. And along with the strange sensations comes an active imagination that he is somehow burrowing his way through my c-section. Dr. C explained how rigorous movements on behalf of Baby Boy can cause my uterus to contract as he moves it from its natural state of rest. It made sense.

The part that I really appreciated was the fact that instead of telling me no way Baby is coming through my lower uterine segment, he SHOWED me! He took his time to view the lower part of my uterus before checking my cervical length. He also printed some photos for me of head-down Baby Boy sucking on his toes.

We discussed the Procardia and decided that since it wasn't eliminating my "crampy" feeling, I should just stop taking it. It seems as though what I am experiencing could be chalked up to "normal pregnancy stuff" but he agreed, because of my history, that we can't be too lax in that assumption. He explained how weekly appointments is pretty hard-core monitoring and it is unlikely anything will slip by unnoticed. It was also agreed that since my irritability isn't causing any cervical changes, unless the sensations I feel change or get much worse, it is safe to say that they are benign. Now if I can just remind myself of this in the midst of an "episode", I'll be just fine.

So today at 24 weeks, I got my 9th Progesterone shot. As Kim was drawing up the solution, she reminded me that I will need more as there is only enough for one more injection. I told her that it is a mental thing and that I cannot order more until what I have is used up. I know it's superstitious of me but I just can't help it.

My emotions have been at their height this week, something I hope will subside in the near future. Tomorrow will be especially difficult as that was the day I began my hospital bed rest. Actually, the next five days are all significant days in the birth story of My Girl. I plan on connecting with them emotionally as best I can in hopes of easing some of the raw pain still felt when I think back to that time in our lives.

Prematurity Awareness Day 2008

2008-11-12T08:38:00.012-05:00

November is Prematurity Awareness Month and today is Prematurity Awareness Day. One in eight babies is born premature (before 37 weeks gestation), that's 520,000 babies each year, or 1,400 babies and families affected by prematurity today alone.

To give an idea of just how much more awareness needs to be raised about prematurity, just think of all the breast cancer information out there. According to the National Government, in 2006, an estimated 213,000 women were diagnosed. Why is there such a disconnect? While I believe breast cancer awareness is just as important - I think most people know that October was Breast Cancer Awareness Month, why is prematurity still in the dark? These babies are our future!

With Precious Miracle always under foot, I never turn the news on, as I feel it's inappropriate to expose my child to adult topics. Although she is not really paying attention, I never know what day that will change. So today, while in the car alone, I listened to NPR and was just astounded by a report about premature birth. I have been waiting all day for there to be great recognition of the epidemic but it's not fair for me to really comment on the media's focus since I really haven't checked, read, listened to or watched any reliable news sources. That is with the exception of NPR. The report mentioned that my state, Pennsylvania, received a grade of "D" by the March of Dimes. This is the same grade as was given to the nation as a whole.

What infuriated me, was the "expert" from an insurance company who spoke of the ways women can reduce their risk of premature birth. The top of her list was dental care. For the average person listening to this report, the tone was that if you follow some very simple things, you will avoid preterm birth. It also insinuated that those who have experienced preterm birth didn't take care of themselves. WRONG, WRONG, WRONG! And right here, right now, I plan to argue her points as it is not a "catch-all".

First of all, I go for dental cleanings and exams every six months. In fact, my last cleaning was this past Monday morning. I have healthy teeth and gums, brush with a Sonicare toothbrush and floss as regularly as I can. I still had a micro-preemie.

Her second point was prenatal care, which begins before you get pregnant, a means of preparing your body for the upcoming job of carrying the pregnancy. Well, let me say that since before Hubby and I even met, I was taking the recommended daily dose of folic acid. Talk about prepared, I most certainly was. Prior to our planning on starting our family, I stopped all prescription medications over the period of several months, had a pre-conception visit with my current group, went for blood work to confirm that I was not at risk for having a child with Cystic Fibrosis, confirmed that I was not a carrier for Factor V Leiden, a blood clotting disorder my husband has, and other genetic concerns that my doctor suggested I check just to be safe. It was all pretty standard from what I was told, with the exception of the Factor V. As soon as I found out I was pregnant, I called to schedule my first prenatal appointment and never missed an office visit or scan. Still my daughter arrived at 24 weeks.

The next points were regarding smoking and drinking. First of all, I've never smoked. Second of all, Hubby and I are not big drinkers. I totally eliminated even the occasional glass of wine in the months before we conceived, and never took a sip of anything alcoholic during my six months of pregnancy. My Girl still came early.

The report made some additional points about making women aware of the signs of preterm labor. This I agree with. However, I think more listening needs to occur on behalf of the physicians and the literature for expectant parents needs to be very explicit in terms of what the signs are without the caveat that it's most likely "normal".

Moreover, I feel that the various causes beyond the points mentioned in the report, be better addressed and as a sufferer of cervical insufficiency, feel better screening tools should be implemented to potentially diagnose cervical issues in advance of the point of no return.

The March of Dimes has a "Petition for Preemies" and I am proud to say that I've electronically signed it. One of the key components of this Petition according to the March of Dimes website is the following:

"We urge the federal government to increase support for prematurity-related research and data collection as recommended by the Institute of Medicine and the Surgeon General’s Conference on the Prevention of Preterm Birth, to:
(a) identify the causes of premature birth;
(b) test strategies for prevention;
(c) improve the care, treatment and outcomes of preterm infants;
(d) and better define and track the problem of premature birth."

I am encouraging everyone to take a moment to support this very important cause. There was a widget I attempted to include below but after numerous attempts, kept getting an error message. So instead, please visit, http://www.marchofdimes.com/padpetition/index.aspx?a=1&z=1&c=1&l=en. It means a great deal not only to my family but to all the families affected by prematurity.

Furthermore, Johnsons Baby Products will donate 10 cents to the March of Dimes for every product purchased during the months of November and December.

Finally, here is a video I made documenting our prematurity journey. It can provide a little insight as to what the NICU road looks like. And, if you watch it, I'm sure you can see why we are so anxious to carry this Baby Boy to term. Just click this link.
http://www.youtube.com/watch?v=oaGOkjGWBGw

Comparision: 23w 5d

2008-11-11T15:11:00.010-05:00

Starting off with this pregnancy, at 23w 5d, I feel fine. My uterine irritability subsided greatly and I feel like a different person today. Was it the fluids? The added rest? Who knows, but whatever it was, I'll take feeling good over feeling bad any day.

At 23w 5d in my last pregnancy (a Tuesday), I was seen in the doctors' office because I thought I had a yeast infection. Dr. G did an internal (notice they are NOT allowed at all during this pregnancy) and told me my cervix was fine and while he saw only the slightest trace of yeast under the microscope, for my comfort, told me to treat with an over-the-counter. It seems as though my physical symptoms of discomfort were far greater than any proof that I had a raging yeast infection.

I know now (again that whole hindsight being 20/20) that I should have asked for, if not demanded, a transvaginal ultrasound to check for any funnelling and to measure my cervical length. I had learned during my anatomy scan at around 18 weeks that my cervix was 2.5, "on the short side" said Dr. C. That was the other thing I hadn't a clue about, and I was too ignorant to know the potential implications which for me, turned out to be a harsh reality.

So I left my appointment and carried on about my day, ending with dinner with Hubby's family, although my mother-in-law was absent that night. We were just about to order when a storm rolled in and the power was lost. The emergency lights came on and the sirens were sounding. I remember there being a discussion about what appliances were able to run in spite of the lack of electricity. Somehow, we were convinced to stay and ate our meals.

On the way home, Hubby and I stopped at CVS and picked up an over-the-counter yeast infection treatment. I can't recall if when we arrived at home the power was already out or if it went out later in the night, but I did not use the suppository that evening.

Since it was July, the lack of power caused us to open our windows and we joked that if our basement was finished, we would find ourselves sleeping down there because it was usually much cooler. We moved from our bed to the sofa, thinking that since heat rises, perhaps it will be cooler in the family room. I remember being unable to sleep and just sweating while trying to get comfy on the sofa. Hubby gave me the sofa and took the love seat, that I remember distinctly. Before long, I was in the powder room, wondering if perhaps the food I ate that night at dinner was spoiled or not fully cooked. Candles were flickering and the flashlight was used to aid in helping me see as I suffered from upset stomach at both ends. Hubby was untouched by this "bug" I thought I somehow picked up, fearful of food poisoning.

It was a rough night and thankfully (again no idea what was happening at the time) my Precious Little Girl did not slip out during those hot, dark hours. Gosh, that image and possibility really haunts me at times. That is when I know that God was looking out for me, Hubby and our Precious Miracle. When I hear stories of home births, my thoughts immediately rush to that night and the what-ifs that thankfully, never were. Because our power was out, we had no home phone, only our cell phones, which at the time, got horrible reception while inside our house. Again, just the thought makes me shudder with fear.

So here I am after My Nut's bedtime, finishing a post I began during her nap time. My diminished uterine irritability has turned into a couple of contractions, which were corroborated by Hubby feeling my uterus with me.

Not So Sure...

2008-11-10T14:42:00.007-05:00

It turns out my symptoms as of Thursday have not exactly subsided. In fact, I wonder if they are not worse or maybe I'm just more aware of them. I started the Procardia Thursday night, thinking it would be a magic fix for my increased uterine irritability, but no such luck. Dr. G told me he was giving me a low dose due to my size and I truly wonder if it was increased, if I would feel a difference.

Anyway, I felt ambitious on Friday (which makes me nervous, that whole "nesting" phenomenon) and organized our entire master bedroom closet while cleaning out the remains of the guest room. I made dinner and went to book club. Come Saturday, I was up at 7ish with My Nut as I let Hubby sleep (he ALWAYS lets me sleep so I thought it was nice to reciprocate). She and I made pancakes upon her "I help cook" suggestion. The furniture guys arrived with the new "Big-Girl" furniture and I hopped in the shower only to discover my plans for mattress shopping and miscellaneous bedding related stuff would have to be put on hold. I could hardly finish my shower and ended up crawling into bed on a self-prescribed order for mid-day rest.

I was suffering from pelvic pressure that just felt abnormal along with some mild cramping. After a brief nap (I actually dozed) and some peanut butter crackers and apple juice, I felt better. I knew it was in my best interest not to push it so I made phone calls after seeing a Macy's commercial and comparison shopped for a mattress directly from my own. As an aside, it is amazing the deals you can get! Never take the price anyone quotes as the final number. Hubby went out to pick up the mattress along with those other items typically selected by the woman.

I took it easy for the rest of the day and had a really difficult night with what feels like the return of Fibromyalgia symptoms, affecting my hip and knee joints, the same trigger points as previous flare ups.

Sunday was a lazy day too and my plans to food shop today were overturned by my own instinct coupled with Hubby's encouragement to let him do it. So off I went to Dunkin' Donuts for a hot chocolate and, since I had a coupon for "buy 6, get 6", a box of one dozen donuts, five of which have been eaten by me with the help of Baby Boy.

Thankfully, Missy went down for her afternoon nap (after a busy morning at school) and I am lounging in bed, afraid to take on the steps, walk the dogs or do anything else that is potentially strenuous. I am drinking tons of fluids and just feel crazy pressure that is keeping me off my feet, again at my own discretion. I am very curious as to what this week's appointment brings in terms of a change in care or recommendations.

Finally, in terms of the pregnancy comparison game I started playing yesterday, since there is nothing specific to report on this day, 23w 4d in my last pregnancy, I thought I would share what turned out to be my last preggo photo the first time around. It was taken at 23w 0d. Oh, yeah, and once again my whole disclaimer on the fact that these photos were never intended for public consumption... I will be the first to admit that I look horrible!

Quick commentary: First of all, I feel like I look like Homer Simpson. It is clear that I am "rounder" with my girl than with my boy, specifically my face and backside. My boobs were also bigger with my girl than they are with my boy and I broke out much more with my girl too.

23w od with Baby Girl

23w 0d with Baby Boy

I'm Bound to Compare...

2008-11-09T10:29:00.004-05:00

Thanks to my mother-in-law, who brought me a journal the day after Precious Miracle was born, I have hand-written entries from each of our NICU days, chronicling the disbelief and shock I felt after our girl was born and the desperate hope and faith that I had that she would not only pull through her early birth but also thrive. It also documents the love Hubby and I had for her from the day the stick indicated we were going to be parents. My journaling continued through homecoming and it's interesting to look back on the things I have written.

It was always written with a positive tone, even through the documented tears, to convey to my little girl as she reads it in the future, that we NEVER gave up hope, that we knew in our hearts she was going to make it and be just fine. The thing my journal never captured fully, were the days and emotions leading up to My Nut's early birth. That was just too painful to write out and too difficult to live through again, at that time. In fact, aside from a glossed over account documented in short essays I have written, there is no hard core documentation of exactly what we went through and the details of those horrific days. Yes, horrific is the only way to describe it, a word I would never, ever think to pen in a journal created specifically for my girl's eyes.

And so, here I am at 23w 3d, the same gestation when things took a turn in my first pregnancy. It is hard not to compare where I was last time as I pray desperately for a different outcome, an outcome that does not involve 105 days in the NICU, but a plump, full-term baby that is placed in our arms immediately after birth, a baby that is not left behind in an isolette: a real take-home baby.

Pardon the cliche, but hindsight is 20/20, especially in a first pregnancy. Gosh, if I only knew then what I know now...

The other thing I should mention, which makes it even more emotionally taxing, is that my last menstrual period with Precious Miracle fell on Thursday. The same is the case with Baby Boy. So basically, my dates line up the same in terms of the day of the week. Every Thursday, I celebrate a new week as was the case the first time around. So 23w 3d for Baby Boy is a Sunday, just like it was with Precious Miracle. Perhaps it wouldn't be so significant to me if the days themselves were staggered. But, things happen for a reason, and I am seizing the opportunity for therapeutic gain by writing what I've never written.

Okay, so it was confirmed that 23w 3d with Precious Miracle was also a Sunday. Hubby had an open house that day and someone wanted to show one of his listings. I was scheduled to meet an agent with her clients at 2:00. Well, earlier in the day, I passed a big chunk of mucus. I called the doctor on call (not 100% sure who but almost certain it wasn't either of the two who follow me now) who told me to drink fluids and rest on the couch, that there is increased discharge in pregnancy and what I am feeling is "normal".

So, I pumped the water non-stop and since I was just opening a door, felt it was okay to meet the agent, I'm normal, right? So I arrived at the house, turned on the lights and sat on the living room sofa, with a view of the street and waited for the woman to arrive. The sofa was white and I remember thinking, gosh, would we have to buy these people a new sofa if I delivered my baby right here or would a cleaning suffice? But it matches the love seat and chair so we if had to buy a new sofa, we would probably need to buy them a whole new living room set. Crazy thoughts started to pop in my head as I was physically beginning to feel worse.

The sellers were of an ethnicity in which a special clock above their mantle chimed a prayer, a very loud prayer, that scared the daylights out of me. The shock my body felt as I was startled out of my seat, I was convinced, was enough to send me into labor.

I remember feeling hungry for a BLT and wanted so much to go to the deli to pick one up but didn't want to stand on my feet anymore than I had to. The woman who was supposed to arrive at 2:00 never did and after spending two hours worrying between games of solitaire on my Treo, felt it was time to leave. I normally wouldn't have waited that long - maybe a half hour at the most but I was just out of it. I remember joking with my husband that I could have sat my own open house that day sitting there idle from 2-4 PM.

That's really all I remember from the day. The big part for me was feeling like I was going to have my baby on the white sofa of my husband's client. That, I suppose, was a premonition that something was bound to go wrong. Now, had I known that I just passed my mucus plug, I most certainly would have been at the hospital and not sitting in some strange living room. But, here is where I always go with this: perhaps had I sought intervention that day, the doctors could have monkeyed around causing my daughter to be born earlier than her 24w 5d and her outcome may not have been what it turned out to be.

Today is Precious Miracle's two-year adjusted birthday. We stopped adjusting back in July when she actually turned two but here she is on what, according to 40 weeks, would have been her second birthday, going potty all by herself. And when I say all by herself, I mean just that. Hubby and I are instructed to get out of the bathroom as the door closes and she gets on the potty and goes. When she's done, she exclaims, "I did it!" and requests an M&M for her efforts. We couldn't be more blessed than we are right now and for that we are extremely grateful. Focusing on the miraculous child we have is the only way to ease the pain of her early days.

Homecoming Anniversary

2008-11-07T23:21:00.002-05:00

Today marks the two year anniversary of the NICU graduation of our Precious Miracle. It is truly amazing to reflect on where we've been and the people we were on that long-awaited discharge day. After 105 days in the NICU, the last thing on our minds was growing our family and here, just two years later, we are 23w 1d with our little boy.

I suppose you can say that time heals but I really think it has more to do with the amazing little person our daughter has become, full of love and life. She has beaten the many odds stacked against her and to look at her, one would never know the rough start she had to endure. Our once 1lb 6oz peanut discharged at 6lbs 4 oz and has grown into a 27 1/2 lb preschooler. She is truly a miracle - there is no other way to explain it and we thank God everyday for blessing us with the most precious and awesome gift of our daughter.

23 Weeks and Feeling It!

2008-11-06T20:48:00.005-05:00

My appointment this week was originally scheduled for tomorrow but after a very, very restless night, full of menstrual-like cramping, I called the office this morning to see if I could be seen today. Dr. G saw me at 5:00. I'm glad I moved the appointment up as I took it easy today, doing absolutely nothing and drinking a ton of fluids. There was no change in my symptoms and I needed to know that my cervix was still long and closed in order to sleep well tonight.

On my way into the hospital, I ran into one of Precious Miracle's Neonatologists. He told me he just heard this week that we were expecting and wished not to see me anytime soon. I told him that I'm optimistic we'll just plan a visit, without taking up residence in the unit. Let's hope!

It was nice being in the office in the evening hours. There was a different, relaxed feeling that I prefer to the hustle and bustle of daytime. Plus, I was alone, which makes the visit that much more relaxing for me. I enjoyed some time to read my book while waiting to be seen and didn't really care how late the appointment ran. It was nice to just have some time.

I am gaining weight nicely and adequately for where I am in my pregnancy. My blood pressure continues to be low and the baby's heart beat quite a lovely sound. Although as he is growing and becoming more active, I feel I need that less. It is still nice to hear the sound and I will never refuse to hear it. It's just amazing what an active baby can do for your comfort. And, speaking of his activity, he is getting bigger as I am feeling simultaneous movements on totally opposite sides of my abdomen, what I imagine to be an arm and a leg. I know I've said it before but just to reiterate, he is such a more docile mover than Miss Girl was. I really think it's an indication as to his personality as My Girl's movements in the womb mirror the child she is today.

Back to my visit: since today was my shot day, Nurse Barb gave me my injection. It was, as usual, no biggie. Then Dr. G checked my cervix. Nice and long and closed, even with fundal pressure. The measurements very similar to those of last week - 3.3 to 3.4.

Dr. G then proposed that I start on a low-dose of Procardia, a medication used to stop uterine contractions. Procardia specifically is listed as a med used for uterine irritability too. According to Dr. G and various research I have done, no serious newborn side effects have been noted. However, it is listed as a Category C drug and its use as a tocolytic agent is off-label.

I was appreciative that the office could squeeze me in today and that Dr. G recognized my cramping is much worse this week. My guess is that since there is no cervical change, and now that I'm approaching viability, we want to stop any irritability from causing changes, thus nipping it (or attempting to nip it) with oral tocolysis. For this I am extremely grateful.

Finally, on my out of the hospital tonight, I ran into the parking attendant who was on most nights, two years ago, when we would leave the NICU. She remembered me, asked about my baby, acknowledged my pregnancy and also recalled that I gave her a Christmas gift that year. She wanted to personally pay for my parking tonight, and I insisted that she not. It was a very thoughtful gesture as was her asking about our Girl each night we would leave the hospital. She is one of the many people who touched our lives during that difficult time.

Hubby's Got His Superstitions Too

2008-11-05T22:17:00.003-05:00

So, it turns out I'm not the only one... And this fact leads me to assume that I can't be that crazy to be somewhat superstitions about this pregnancy. Hubby is clearly feeling it too and he is pretty level-headed. That has to tell you something about the experience we have been through with our Darling Daughter.

In anticipation of moving our girl to her new big-girl room (the furniture arrives Saturday morning!) we have been clearing out the guest room. It became a dumping grounds of sorts because when Missy transitioned into her toddler bed (she climbed out of her crib way sooner than we thought she would) back on July 1, we moved all the stuff she could get into with her new-found freedom out of her room.

So where does the superstition come into play? Well, among the many items in this former guest room was our bassinet. I can't remember exactly when we purchased it, but I do recall finding the specific bassinet I desired and going to Pottery Barn Kids to pick it up. We had to take it out of the box to fit it in the car as we weren't exactly child-friendly at the time. It sat assembled (not much to putting the bassinet on the stand now is there?) at the foot of our bed well before I gave birth to Missy at 24 weeks. It sat during her entire NICU stay, empty, waiting for her to fill it. It was a tough reminder every single time we entered our room. To move it was out of the question as leaving it there was our comfort that she would some day be joining us at home.

Tonight as part of my organizing, Missy and I wheeled the bassinet into the master bedroom, leaving in its proper place at the foot of the bed. We talked about Baby Brother and how in her words, "Baby Brother sleeps in there."

We went about the rest of our evening routine and Missy was soon in bed. Hubby and I caught up with each other in the bathroom as I was taking out my lenses. I showed him my growing bump and commented that I am going to be 23 weeks tomorrow. "I know," he acknowledged. He is always so good at keeping track of things. He then went on to inquire about my plans for the bassinet, indicating that he would feel more comfortable not having it in the room until the baby is born and home.

I felt it too, that pang of emotion. I guess I was just trying to push through it, figuring with enough time, the intensity of the feeling would diminish. I felt that I could go back to a state of neutrality about the bassinet and what it symbolized.

Hubby and I have a good relationship. We respect each other and the feelings that may be too much to feel at times. The bassinet is no longer at the foot of the bed. I guess I should admit there is a bit of relief in that for me too.

Happy Halloween!

2008-10-31T13:58:00.008-04:00

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

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

2008-10-30T11:41:00.003-04:00

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!

Today's Appointment

2008-10-28T15:22:00.002-04:00

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

2008-10-28T08:00:00.003-04:00

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.

Did I Over-Do It?

2008-10-27T22:06:00.002-04:00

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...

Other Medical News...

2008-10-25T13:21:00.002-04:00

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.

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

2008-10-23T16:34:00.005-04:00

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

The Dancing Dr. Carlson

2008-10-22T15:36:00.002-04:00

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.

On My Mind and Feeling Guilty

2008-10-21T10:20:00.005-04:00

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.)

Bladder Woes and Bedding

2008-10-19T19:53:00.004-04:00

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.

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

2008-10-16T14:38:00.003-04:00

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.

Wow!

2008-10-13T21:19:00.004-04:00

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.

My First Trip to L&D...

2008-10-11T13:42:00.003-04:00

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!

Can I Get My Story Straight?

2008-10-10T19:16:00.004-04:00

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

2008-10-10T17:34:00.002-04:00

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

2008-10-10T09:54:00.003-04:00

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.

19 Weeks!

2008-10-09T11:54:00.003-04:00

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.

I Almost Forgot - Laugh Out Loud Funny...

2008-10-08T15:57:00.003-04:00

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

2008-10-08T14:11:00.005-04:00

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!

More Than A Little Frustrated...

2008-10-07T15:30:00.003-04:00

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!

Just Some Numbers

2008-10-06T21:06:00.002-04:00

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.

Another Cervical Check

2008-10-03T11:49:00.005-04:00

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.

18 Weeks and Nameless?

2008-10-02T13:35:00.006-04:00

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."

Labs Today

2008-09-30T20:17:00.002-04:00

When I had my first trimester screening done by my local group back in August, I was given a lab slip for another blood draw to be completed between September 18 and October 2. The tech told me to do it closer to the 18th of September so I would get the results sooner. By the way, this test is for neural tube defects.

I marked my calendar and placed my prominently marked lab slip in my day book weeks ago, thinking, yep, I'll be there on the 18th. Well, here I am just two days before the test "expires" having my blood drawn.

Distractions, distractions. Such is life with a two year old. And it's even worse with a sick two year old who was born a micropreemie. By the way, she is back to her old happy self and thankfully, Hubby and I escaped getting sick ourselves. Oh, and flu shots are lined up...times three!

17 Weeks!

2008-09-25T15:13:00.003-04:00

Here I am at 17 weeks. There is really not much to report... I got my second Progesterone shot this morning, thank you, Kim! And like last week, it was a piece of cake. The shot was injected into my left side this week and I will say, I had some minor bleeding at the injection site but other than that, feel fine. I did spend some time sitting on the heating pad which I think is helpful in reducing any potential discomfort.

I created a little shot countdown that I posted on the right side of my blog. The first thing my husband said to me when he found out Kim came this morning was two down, 18 to go. It seems funny to me to count my shots down, for each week that passes, we are that much closer to meeting our little boy. And I know I've said it before, and I have no problem saying it again, I am in no rush for this pregnancy to be over!

Plans are all well and good, but as I realized with my first pregnancy experience, plans go out the window real fast. Nonetheless, I still can't help but play out in my mind the way things "should" go:

My hope is that I am still pregnant at 36 weeks, that PTL (pre-term labor) doesn't strike or that I don't fall victim to pPROM (pre-term, premature rupture of membranes). 37 weeks is considered term and I would feel more comfortable scheduling my c-section based on that milestone because of my own crazy fear of uterine rupture. But given the fact that we are expecting a baby boy, and boy lungs don't mature as quickly as girl lungs, I think it's best to plan on having an amnio to confirm his lung development is mature enough for delivery.

So what was the point of all this? Assuming I get to successfully cross off each one of those remaining 18 syringes, my next hurdle becomes dealing with an amnio... why does that cart always get in the way of that horse?

Catching Up and Hoping I Don't Get It!

2008-09-24T15:19:00.005-04:00

My Sweet Little Miss came down with her first cold of the season on Sunday. It must have been brewing for a few days as the end of last week, I was mom to a very unhappy and miserable little girl. We thought it was just a phase but Sunday morning, she woke with a runny nose and by afternoon, she had a low-grade temp. By Sunday night we were on O2 and by Monday, sitting in the pulmonologist's office learning she had a raging ear infection. So much for the oozing that ear tubes are supposed to provide you with when an infection is running rampant. I have no idea how long the infection was brewing but it was long enough to wreck havoc on her respiratory status and her asthma flared up, requiring a couple days worth of oxygen therapy. We will probably continue it for the next couple of nights just to be on the safe side. Thankfully, her fever is gone and she is satting fine during the day.

Now I am fighting something as my throat is scratchy. I hope that's the extent of it.

Yesterday, Little Miss and I spent most of the day in bed, just hanging out and watching TV. Oh, how I hate to admit that but when you are a two-year old tethered to a tank, there are few options. Anyway, in the midst of checking my email, I noticed that something had leaked. It was clear fluid, no mucus or anything and no, I didn't cough or sneeze and nothing about caring for a sick child is funny. So as far as leaking pee, I don't think that was it. But there was something and that something remained unknown. I told my friend and ran it by my husband, who both insisted that I place a call to the doc. They were at lunch (a long one at that) and by the time I remembered to call back, the office had closed.

I knew there was absolutely nothing they could do if I was leaking amniotic fluid. I know if much of anything happens at this point, there is nothing that can be done. The baby is all of 6 oz (hard to believe Precious Miracle was just a whopping pound more at birth) and at almost 17 weeks, not yet viable. It breaks my heart to think that way but I have realized that I can control what I can and what I can't is really out of my hands. Why worry, why obsess? I have done absolutely everything I can to make sure this pregnancy goes to term. I cannot second-guess and question that nor can I spend my day thinking about everything that could go wrong. I chose to move on.

What made it easy to move on was knowing that I had an appointment to be seen by my local group this morning. I told the nurse what happened with the leakage of something and she said, we'll just do a quick test for amniotic fluid. Well, by the time the doc walked in, that was out the window, as he claimed if it was fluid, it would not have been a one-time thing. Back to that whole trust issue...

So why didn't I just demand the test, just to put my mind at ease? Perhaps because I just didn't want to know. Maybe that is my whole approach to this pregnancy. A do all you can, close your eyes and pray that everything works out okay approach? A don't go looking for issues if they can't be fixed approach? Denial? Detachment? Not yet sure.

Back to the appointment: all looks good! I gained two pounds, yippee! No more anorexic momma here! My cervix is measuring 3.3 cm and with fundal pressure, remains long and closed! And my uterus is right on target in terms of size and the baby had a good heart rate of 145. Oh, and he is very active!

I also asked Dr. G (as Dr. C requested) what his thoughts were about bed rest. He said nope, not necessary. Thank goodness! Now, there is always the caveat that if God-forbid, something should be identified, I will climb into bed in a heartbeat and stay there until this little guy is ready to be born.

Oh and the other difference between the two docs, Dr. G wants to start weekly checks now as opposed to week 20. I'm okay with that.

Finally, I just want to add that since Missy has been sick lately, she has been very clingy and needing lots of cuddles. We have spent the past few days practically attached to each other as Daddy can't even hold her nebulizer. Everything is, "No, Mommy do it!" Anyway, when she snuggles into my tummy, putting a little bit of pressure on my growing bump, the little guy gets all charged up, moving around and around. Now if he could only see the stickers that decorate my stomach from time to time, courtesy of Big Sissy... we'll just take a picture and show him in six months from now.

Another Call to the Doc...

2008-09-20T15:24:00.003-04:00

Okay, back to the spirit of honest reporting. This morning I passed some mucus - enough to show my husband and enough that led us both to decide it was worth a call to the doctor. Dr. C was on-call and offered to see me, but felt that as my pregnancy progresses and in light of my TAC, mucus-like discharge will only be on the rise.

It is hard not to reflect on my first pregnancy when on the Sunday prior to learning my membranes were bulging, I passed something that hindsight tells me was my mucus plug.

This time around many thoughts went through my head. If it was my mucus plug, would I be placed on bed rest, started on antibiotics and told to just wait? If I started contractions or active labor, or if infection were to occur, I would have no choice but to have a c-section and deliver. You see the TAC is so great, you can't deliver vaginally. There is enough room for an early miscarriage (up until about 14 weeks) to pass but beyond that, a Cesarean must be performed.

Dr. C is really starting to know me well. He said if I am going to obsess about what happened, then my peace of mind is his peace of mind and he would like me to come in to be evaluated. He also stated again that there is a very low threshold for admitting me this pregnancy. Then he brought up what I feel like is his favorite topic: bed rest. He admits he's very conservative and that the literature really doesn't support it as a prophylactic measure but still feels I should, perhaps at 20 weeks, go on limited activity.

Dr. Davis told me aside from bungee jumping and sky diving, I can carry on with life as usual. I told Dr. C that this bed rest issue seems to be the biggest discrepancy between the two practitioners. He wants me to run it by Dr. G who I plan on seeing Wednesday.

Getting another opinion from my perinatal group is not the same as getting another opinion from a TAC surgeon. They see these high-risk patients day in and day out. They know the limitations and successes of their work and I am positive they would not advocate for no bed rest if in reality all of us TAC mommies should be reclining for the remainder of our pregnancies.

This reminds me of something else Dr. C said today. He said he does NOT look at me as just a regular pregnant woman. I'm glad to know his opinion of me as a patient and truly appreciate the fact that he takes the time to have these conversations with me, especially on a Saturday morning. I also appreciate that he knows exactly who I am when I call and that I can be an active participant in my care, sharing my opinions with him. That whole relationship as equal partners in my care is working! I am very thrilled that this has been achieved!

The conversation ended with the plan that if anything changes, I will call. If I have any bleeding, watery discharge (leaking membranes), severe cramping or contractions I will go in to be evaluated.

In the mean time, I have been hydrating very well. And, in the spirit of confidence in my doctor and confidence in my intuition, walked around a tree house exhibit with the rest of my family. So far, so good... just don't share this with my doc!

No Words To Eat...

2008-09-20T14:41:00.004-04:00

There is no change of heart for me regarding my first Progesterone shot. The crampy feeling I had in my muscle was virtually gone by the time I finished with the heating pad. Upon assessing my injection site later in the day, I could feel only the slightest little bump - about one-half the size of a pea - when I flexed my muscle. Not bad.

I will admit I am now wondering what other side-effects I may have developed as a result of the shot. I've been so focused on injection site issues, that I neglected to even ponder other consequences that could potentially cause trouble.

For example, late afternoon on Thursday, Missy and I met Daddy at a golf-outing dinner. I was so mentally out of it, I could hardly carry on a decent conversation let alone deal with the fussiness of my two-year old. Fatigue also set in pretty strong and I couldn't wait to get home to my bed. Thankfully I followed Hubby home but will admit, I was driving on reserves - no actually fumes. I was that tired.

Looks like the fatigue was not an isolated incident as that has been my M.O. for the past two days: tired, just plain tired.

Then yesterday, I felt a faint pressure across the lower part of my forehead. I showered before bed, thinking that would help eliminate an escalating headache. But I was wrong. I had a terrible night of sleep as my headache quickly moved across the entire back of my head. This is a very different type of headache than I usually experience with my migraines, which I am thankful to report, disappear when I am pregnant. I did break down and take a Tylenol this morning and went back to bed with the heating pad. My first Tylenol during this pregnancy.

It is hard to function in a mental fog. Pregnancy tends to bring on that mushy brain anyway, and now I feel as though I have been dumbed-down even more. With my Prometrium pills, I would sense a feeling of intoxication with my afternoon/early evening dose. It was very short-lived but intense. While this current feeling has less intensity, it is constant. I wonder how long it will take to get used to my new, yet temporary, mental state.

Welcome CarePage Readers!

2008-09-17T20:23:00.008-04:00

It’s official, Little Miss is going to be a big sister to a very lucky little brother! We discovered on Saturday, June 21 that we are expecting our second child. I am 16 weeks today and I suppose you could say the cat is finally out of the bag.

We initially thought it was going to be a long, long road: a road filled with much nervousness and anxiety, but it is really amazing how quickly time has flown by. I can't believe I'm 16 weeks already. I realize I still have many weeks to go and I have not entered what I consider to be my "danger zone" yet. Thankfully, I have my darling daughter to keep me grounded and focused. Without her, I don’t know how I would make it through this high-risk pregnancy.

It was extremely important for us that Missy Girl not be an only child. We so desperately want her to share her life with a sibling. For those surprised that we might attempt another pregnancy, here is how we got to where we are today:

We (more I) did a tremendous amount of research into why our little girl arrived at 24 weeks. I met with many specialists, talked with numerous physicians, connected with other preemie parents and joined online support groups for women like me: women who suffer from cervical insufficiency. It turns out that I have an anatomically short cervix. Basically, I don’t have much of one.

There were a couple of opinions on how to handle a second pregnancy. Most physicians, even the group that followed my first pregnancy, suggested a transvaginal cerclage (TVC) be placed around 14 weeks. This is cervical stitch in which they “sew” your cervix closed through a vaginal approach. It is amazing to me the number of “experts” who recommended this course of treatment without even knowing if I had enough cervix to stitch. There is much risk of cervical tearing, funneling and other complications that would require bed rest. Prior to even knowing my cervical status, I knew in my heart this was NOT the prophylactic option for me. Not to mention the risk to our unborn baby as the doctors are “fooling around in there” possibly nicking the fetal membranes. By the way, I don't have enough cervix to stitch so had I gone with this option who knows what would have happened.

There IS another option out there that most physicians felt was too radical a step: the placement of a Transabdominal Cerclage (TAC). In fact, none of the physicians who suggested a TVC even mentioned the TAC. And when I did, the feedback we received was to try the TVC first and if that fails, then move on to something more aggressive.

We wanted to do all that we possibly could do to ensure a successful and healthy pregnancy from the start and were not prepared to lose a child just to prove to the doctors something more ambitious should have been done. There is a such thing as instinct and my heart was really pushing me on this one.

All the research and discussion ultimately led to my pre-pregnancy placement of a Transabdominal Cerclage (TAC) on March 10, 2008. I found a fabulous MFM (Maternal Fetal Medicine) in South Jersey who is the board doctor of an online group called “Abbyloopers”. This board advocates for TACs, and after reading how many women have lost babies due to failed TVCs, our decision was confirmed. By the way, of the three physicians that I spoke to about performing the TAC surgery, they all agreed that I was a candidate.

Essentially, Dr. Davis (MFM) went through my c-section and placed a mersilene band (polyester fiber) internally around my cervix just below the uterine artery. While mine was done pre-pregnancy, it can also be done in the first trimester. Hubby and I were not willing to add additional risks to our future baby and knew pre-pregnancy placement was the option for us.

I was in the hospital for two days and had to take it easy for a couple weeks after surgery. The success rate, when done properly, is extremely high, much higher than that of TVC. We absolutely lucked out. Not only did we come across a physician who is expert in the field of TACs (he performs at least three per week and women travel all the way from the west coast and internationally), but he is only 2 hours away and has agreed to monitor this pregnancy as much or as little as I would like.

I am also being followed locally by the same group that handled my first pregnancy. They are treating me with kid gloves this time around and I must say that I am much more educated in obstetrical care than I ever imagined I would be. It is fair to say that I am confident in my ability to not only direct my care but also demand or deny specific care and challenge anyone who disagrees with me. We are sticking with this group because they are the only suburban high-risk group and, in the event our baby needs NICU care, we want only the same fabulous physicians and nurses who took care of our baby girl to take care of our baby boy.

I started this blog back in January documenting our decision to grow our family, followed by my search for the best surgeon. From there I chronicle my journey through surgery, recovery and finally learning that we are expecting. (Previous posts are archived on the right side of the blog.)

This blog is public and my intention is to spread the word about pregnancy after prematurity and Transabdominal Cerclage. I have been brutally honest in my posts and hope to encourage other women suffering from cervical insufficiency to investigate Transabdominal Cerclage. As you can see, due to the public nature of this forum, I have elected to keep the names of my darling husband and daughter private.

I update this blog often as I chronicle the daily ups, downs and milestones of this pregnancy. I am not currently aware of a feature that notifies readers of updates (please, someone correct me if I'm wrong!) so I advise bookmarking this site or adding it to your favorites if you are interested in following our story. Also, please, please, please feel free to direct anyone to this blog who may benefit from reading our story.

One Shot Down at 16 Weeks

2008-09-17T20:23:00.006-04:00

My neighbor Kim, who is a nurse, was kind enough to come over this morning at 9:00 A.M. to give me my first of twenty prescribed 17P shots. She could sense my nervousness through my emails alone as we went back and forth on timing. Initially we were going to do 11 but I thought Hubby should be here to help massage my injection site.

I am so glad we had a professional do this! Thank you, Kim! Just watching her draw up the solution into the syringe was enough to let me know we are not equipped to do this ourselves. I would be standing over my poor husband's shoulder second guessing if he did it right. Yes, second guessing him with all the medical training I've had which is zero.

My behind was iced to the point where it turned red. Kim had me lay on the couch to better relax my muscle. She gave me the necessary warning and I must admit, I was pleasantly surprised! The needle stick itself was just that, a slight stick. The solution didn't burn going in but towards the end of the shot, I could feel a "build-up" of sorts. I suppose that was the accumulation of the Progesterone in my muscle. I had slight cramping and tightening in my muscle but nothing major.

Missy had speech therapy in the basement playroom and was thankfully occupied while I warmed the injection site with a heating pad. Hubby didn't even have to massage anything!

I am so glad it's over with as the build-up and anxiety leading up to the shot was much worse than the actual experience. It was so nice to be pleasantly surprised.

So for all the women out there anticipating a painful Progesterone shot, it's really no big deal! Let's hope I don't eat my words later today. I'll let you know if I have a change of heart...

Getting a Little Nervous

2008-09-17T20:23:00.003-04:00

My very first Progesterone shot is scheduled for tomorrow. I am getting nervous, especially after seeing the size of the needle. It's 21 or 22 gauge and it looks like a whopper! I keep reminding myself I would much rather endure a painful stick each week than be sitting with my baby in the NICU. My friend Wendy put it well. She said every shot I do is one less. That is so very true, there is an end in sight.

I have scoured the Internet looking for tips from other women on how best to prepare. My shots are ordered weekly so I will alternate sides each week. Otherwise, I think my plan is this: I will ice my behind (it's an intramuscular shot), warm the solution in the syringe (I read it doesn't change the makeup of the medication), bite the bullet and have it injected, then apply moist heat while my husband massages the injection site. I've decided to do it early in the day so I can use my muscle and hope it works the solution through better. I've read horror stories of women who have injected prior to bed only to wake up at 2:00 in the morning with terrible pain.

I go through all this strategizing and then I think of all that Missy endured through her 105 day hospitalization, her post NICU admissions for asthma and her two seasons of Synagis. I have absolutely no right to be such a wimp about this. Bring it on!

Enough Already!

2008-09-16T09:30:00.003-04:00

I am two days away from 16 weeks and I had another round of vomiting this morning. What gives? Why is this pregnancy making me so sick? Typically morning sickness is over at this stage. But no, here I am feeling so sick to my stomach. I actually took my temperature to make sure it wasn't something else. I really shouldn't complain because in the end, all we want is a healthy baby and I will hang upside-down by my toe nails if that's what it takes. Believe me, I would. But when everyone I talk to says it should be over by now, I can't help but anticipate that good days are around the corner. It's one long block and the corner is nowhere in sight!

Time

2008-09-15T14:19:00.003-04:00

This week - week 15, marks the point at which the remainder of this pregnancy is exactly what my entire pregnancy was with Missy. Actually, at this point (15w 4d), assuming I get to term, I have 24w 3d left. A mere two days shy of the entire 24w 5d she got in the womb. And, technically, I am more than 1/3 of the way through this pregnancy. It is absolutely flying by - not something I really hoped for. Yes, it makes the worry less (I honestly could be much more of a wreck than I currently am) but the reality is, this baby boy will be here before we know it. Am I ready to be the mother of two??

I've said it before and I'll say it again, my pregnancy with Missy felt like every minute, every second was excruciating. Now, I blink and a whole week goes by. Did I somehow wish her early birth? Yes, we were anxious to meet her and I couldn't wait to hold her and I can only wonder if that contributed to things. That is my irrational brain at work. The reality is that no, it didn't. But I can't help but ponder...

My stomach is clearly upset. I would really like to settle for a happy medium. My previous issue is currently no longer as whatever I eat quickly ends up going through my entire system. I really have to be careful that this latest inconvenience doesn't end up interfering with what was starting to look the return of a semi-normal appetite.

A Confusing Night

2008-09-14T21:15:00.003-04:00

Before I get into the events of this evening which involved a phone call to my practitioner, I want to mention that we went shopping as a family for maternity clothes this afternoon. I ended up getting some fall/early winter staples that much resemble my usual wardrobe: ribbed turtlenecks. I tried to mix it up but that's just not possible. Additionally, I was afraid to purchase too much as Mimi has a "store credit only" return policy. And with my history I feel I never know when things could possibly change. My hope is that I have enough to get me comfortably through fall - if fall would ever arrive - it was 92 degrees today.

After my mini shopping spree, we went to my mom's for dinner. That's when the tightening in my pelvis/abdomen started. About every twenty minutes or so, I would feel this tightening/cramping sensation that would peak and then slowly dissipate. Both hubby and mom were feeling my stomach to see if they could sense the same tightening outside as I did somewhere on the inside. Nope, I felt the same. As one came on during dinner, it was determined that I needed to call the doctor.

So, on this Sunday evening, I learned Dr. G was on-call. He called me back and we had a nice conversation. Nice in the fact that he acknowledged that this pregnancy is going to be very stressful and that each twinge and pain will be assessed very critically. Nice in the fact that he encouraged me to call anytime something doesn't seem right - that they, my group, should be the ones to determine if it's worthy of concern or not.

The part that leaves me confused and troubled is this: Dr. G said what I described sounds like contractions. However, he also said that contractions don't start at this gestation 15.5-16 weeks of pregnancy. He claims I am having uterine cramping. I asked about Braxton Hicks and he said no, not Braxton Hicks either. This makes me wonder - last time I saw Dr. Davis, they saw Braxton Hicks during my scan. Dr. Davis also said that the uterus contracts from the very beginning of pregnancy. Perhaps I misunderstood contraction versus cramping. Who knows but it's moments like this that make me really question and that is not good. I need to have faith in my group. Faith in my local group.

We left for home and I had another episode in the car and then again about 30 minutes later at home as I was getting ready to read to my Little Nut. It took quite awhile longer but eventually my issue became clear. I must have some type of GI thing.

Hubby commented that I must have what he had on Friday night. Which at the time, I asked him if he thought it was something that was going to work through the household. Luckily his was a one-time trip to the bathroom. Thankfully, my cramping has stopped and I feel better. I can't help but think this could be the precursor to labor as the Tuesday night before I found out my membranes were bulging, I was so sick in the bathroom, cleaning the pipes from both ends. That was with Missy's pregnancy - my only other experience on which to draw from. Oh, and I hope this stops here. I cannot imagine an upset stomach while potty training. We've been three weeks diaper-free and I can only imagine an event like this would cause a dreaded setback.

No Infection!

2008-09-12T16:19:00.002-04:00

My local group was able to squeeze me in for a quick check this morning at 9:00. I saw the same doctor who told me my membranes were bulging and that "you are not leaving the hospital until you deliver. Could be 12 hours, 12 days or 12 weeks". (By the way, it was a Friday that all this happened.) Needless to say, I was a little nervous about seeing him. I have friends who love him and I have friends who feel anything but love for him. Trying to make a positive relationship out of this, I tried to give him a new chance at becoming a doctor I like. Remember, he could very easily be the person who delivers me this time around.

Back to today. He was thorough, and I felt I was treated with kid gloves. Even though I was squeezed into the schedule, I didn't feel rushed as I asked him the outstanding question about prophylactic antibiotics. He took the time to give me an answer I felt satisfied with, especially after discussions with other physicians, that there is no evidence-based information that treating prophylactically does anything except create resistance to treatment in the future.

So back to my supposed infection. Turns out I have irritation and it is recommended that the next time I have an ultrasound we use a covering that does not contain latex. I never thought of myself as someone with a latex allergy but I will take this precaution in the future.

15 Weeks!

2008-09-11T20:35:00.002-04:00

Here I am at 15 weeks. There is not much to report from yesterday except that Daddy got to feel the little guy moving a tiny bit last night. No, it wasn't gas, it was clearly the baby moving around inside his warm and cozy quarters.

It looks like I am unsure if I have an infection so I am going to my local group to get checked. Initially, Nurse Barb said I didn't need to be seen, that something would just be prescribed. That was not okay with me. If I don't know for certain that something is going on, let alone what, if anything it is, then how will they know what to give me? If it isn't an infection, I think I am having a reaction to the covering or gel that is used for the transvaginal ultrasounds. Their coverings are different from the ones they use at Dr. Davis' office, which so far, haven't given me any issues. Yesterday was my first transvaginal scan with the local group this time around. I really hope it's nothing but I need to be 100% sure.

A View of My TAC

2008-09-10T13:33:00.006-04:00

I had an appointment with Dr. C this morning. It was a regular appointment so I hopped on the scale - and according to their records, I have neither lost nor gained. My weight is exactly what it was on July 30th when I had my first appointment. I was happy to know that based on the same scale as six weeks prior, my weight did not go down. My blood pressure was taken and thankfully, it is where I am used to it hovering: 90/50. We also heard the baby's heartbeat on the doppler: 153 bpm. It was picked up very easily and there is no better sound in the world.

Dr. C then did a cervical scan. It was a landmark day as he saw my TAC for the very first time. He then went on to evaluate my cervix. He came up with over 3 cm of cervical length. I am not so sure how I feel about this as Dr. Davis claims that the cervix does not get longer but that the lower uterine segment can often be mistaken as cervix. Dr. Davis consistently measures my cervix at 2.5 cm with a functional length of 2.4.

The events of today took me back to my almost 18 week anatomy scan with Missy when I was told my cervical length was 2.5 cm and that it was the "low end of normal" but still "ok". If there is a tendency to overestimate, chances are it wasn't 2.5 cm. If a proper measurement was achieved, would other measures have been taken that could have prevented her premature birth? Thoughts such as these are a vicious cycle as I remind myself often that Missy is who she was destined to be. Perhaps had they been wise to my cervical issues and attempted a transvaginal cerclage, my membranes would have ruptured. When I look back at it all, especially considering just how well this child is doing, I can only feel blessed and thankful that everything went exactly as it did.

So the question becomes, why do I keep questioning this group? Is it because I blame them? Is it because the same room where my exam was held today was the exact same room where I was told my membranes were bulging? Is it because they were not advocates of the TAC? Is it because I trust Dr. Davis more?

I really like Dr. C. I do. He treats me with respect (now that we've moved past our differences in treatment options and I took charge of my care) and was very thorough prior to the start of today's exam asking very telling questions about discharge, fluid leakage, back pain, etc. I felt he was extremely methodical and cautious with my c-section the first time around, doing all he could to ensure I didn't have other issues down the road. I trust his skill in that fashion and would really prefer that he deliver this baby over anyone else.

My main concern is funnelling, which in my understanding, is easily identified. I am certain that this phenomenon would be picked up by anyone qualified to do a transvaginal ultrasound. I am really tempted to stop driving to see Dr. Davis and in fact am really close to canceling my appointment for Tuesday. Yes, it's nice to see the baby but the reality is he's moving and I feel it. Perhaps not everyday but just when I realize it has been a while, he gives me a nice nudge. And yes, it was confirmed that Missy is going to have a baby brother! We are excited to be expecting a baby boy for a number of reasons, one of which I already addressed (although the name thing is back in the air again). I'm sure I'll address the other reasons in later posts.

On another note, it looks like my placenta previa has reduced itself to "marginal" and Dr. C is confident it will continue to move away from my cervix. He too said not to be alarmed as I am having a c-section anyway. The good news he pointed out was that it's posterior, meaning the placenta is on the back of my uterus as opposed to the front of my uterus. Adhering to the front can cause a whole new set of issues which it looks like, thankfully, I'll be able to avoid.

All in all, today was a good visit. I got a call from the pharmacy that my progesterone was filled. Hubby just needs to stop by and pick it up along with my syringes. Then we need to submit for reimbursement - fun.

We are also debating whether or not to go back to the doctors office so hubby can learn how to inject my medication. That would entail going at 16 weeks for a lesson and then going back at 17 weeks to confirm he can administer the shot properly. I am really nervous about him doing it for some reason although there is absolutely no need to be.

My nausea returned for the better part of the morning as I hadn't felt as sick for a few days now. I'm hopeful this will pass very soon - why does it seem like I am always saying that?

Insurance Woes!

2008-09-05T16:41:00.003-04:00

After spending over three hours on the phone with my insurance company over the past few weeks, I received conflicting information which basically made my visit to my primary care yesterday a waste of time. It turns out that BCBS changed their policy in the midst of my conversations about P17 and home health care coverage.

The same woman from Baby Blue Prints that I dealt with during my first pregnancy called me this morning (after I spent 1.5 hours on the phone with member services) to let me know that I must pay for the injectible out of pocket and have my husband, friend, neighbor, etc. learn how to inject this viscous solution into the muscle of my behind on a weekly basis. I was told this after reading a horror story of a woman who received her injections incorrectly and ended up with a terrible infection. Infections and pregnancy don't mix. Why chance it, or so I thought - give me a nurse to shoot me up with progesterone each week. My husband sure can't stomach that and I can't very well aim for my tush with any accuracy, especially as I get bigger and bigger.

My frustrations came out on this woman as I ranted and raved over the fact that my breast pump rental (a one year rental) was not covered by my insurance when in reality is should have been. Having a 24 weeker in the hospital for 105 days and then bringing home an oxygen-dependant baby who doesn't have the strength to breastfeed each feeding, is defined as a very legitimate reason to have a hospital-grade breast pump. Yes, I am proud to say, that Missy Girl got one year of breast milk and was eventually (with the help of a handy invention called a nipple shield) able to take some of her feedings each day at the breast.

The point of this whole tirade was to illustrate to the woman that I don't trust the insurance company to reimburse me.

It looks like all the work my new primary did was for naught. My visit yesterday was for nothing - although I have the wonderful knowledge that I'm anorexic - remember it's lack of appetite, not some purposeful avoidance of food.

I see Dr. C next week at which point I am going to request that they attempt to get me a home health nurse. Yes, come 20 weeks, I will be seen weekly, and could probably get my shots then. Yes, I have friends who are all too familiar with these injections who have offered to teach proper technique to hubby. And yes, I have two neighbors who are nurses and have offered to help me out. But really, how do you repay someone for coming over once a week (for what should be a 20 week treatment) to stick a needle in your bottom? Would it be more comfy to get my shot at home - absolutely! Abbyloopers members have given me the plan: warm the vial in my bra, try to find the smallest gauge needle that will work, ice my behind until numb, take the shot, massage with heat and just stay in bed! Oh, and alternate sides each week.

This is far from over!

Second Trimester!!

2008-09-04T21:03:00.002-04:00

I am officially in the second trimester and feel extremely hopeful that my sickness will go away once and for all!

My new primary care is in the process of working on ordering my progesterone shots and home health care nurse who will administer the shots each week. This new doctor, who is fresh out of med school, I might add, called me anorexic when I told her how sick I was and how it is very hard for me to eat as I have aversions to almost everything lately. She really made me mad! After doing some research, I discovered that she is correct. There are two different terms: anorexia nervosa which is a purposeful disorder and just plain anorexia which is defined as "a medical symptom of reduced appetite" http://en.wikipedia.org/wiki/Anorexia_nervosa.

So it looks like I have a clinical diagnosis of anorexia or reduced appetite. Why does is sound more terrible than that? Like I am a pregnant woman purposefully starving myself?

Moving along, I have started to develop what feels like carpel tunnel in my left wrist. I am not left handed and notice it mostly when I am driving. It's pretty uncomfortable but nothing major - just another difference between my two pregnancies.

Which by the way, assuming this child is a boy, I take back my previous comment about needing to come up with a name. You see, even before we knew that Precious Miracle was a girl, we decided that if she ended up being a boy, we would have named him after my deceased father, Karl John, calling him Jack after my husband's deceased maternal grandfather. Yes, I know Jack is a relatively common name and I personally prefer names that are less-common. But the family connection is so strong, in our opinion, it overrides the fact that more than likely, he won't be the only Jack in his class. We are feeling somewhat confident that Missy will be the only one with her name in school - at least that's how it is this year for two-year old preschool! But back to Jack - it's such a strong name. Missy actually says, "Baby Jack in tummy" and gives him kisses.

I suppose the reason for the comment in my previous post was because I just want to be sure that's the name we are going to go with. There are some other names we like, for example, Henry and no, we would NOT call him Hank. That's about as far as we've been able to get. We have a girl name all picked out but these boys names are tough! The other part of this is that it is very emotional to commemorate or memorialize two very important people in our lives. My father passed away when I was six and my husband never met his grandfather, someone, who if my husband had an opportunity to meet, would in a heartbeat. I know it will be just as emotional for my mother, my two brothers (both younger than I), my husband's mother and his grandmother.

The other thing that I'm sure my father-in-law is secretly wishing for, especially considering the baby is due right around his birthday, is for us to name the baby III. My husband (obviously a Jr.), has a unique name himself and found it difficult growing up with a name that people always did and continue to butcher. He is pretty adamant about NOT naming this baby III. The only proposal I have - a gamble of sorts, is that if this child happens to stay in until March 4th(Grandpa's birthday) then by all means, we should name him III. I say this knowing that in all likelihood, this child will be out around Groundhog Day. If he makes it to March 4th, that in itself, would be amazing!

High Risk Times Two??

2008-09-02T22:08:00.003-04:00

No, not two babies but ANOTHER pregnancy complication has come up. Dr. Davis said not to worry about it, but it's hard not to. It turns out I have placenta previa, where the placenta has formed covering my cervix. It sounds like it could still move up but at almost 14 weeks, I am not really sure. The bottom line is that Dr. Davis feels my TAC is holding things together nicely. However, placenta previa can cause bleeding which would make me FREAK out! And it turns out this bleeding, heavy bleeding I might add, usually comes towards the end of the second trimester and into the third. My understanding (which could be wrong) is that it's best to deliver by c-section, which I have to do anyway.

I'm praying that all goes well! The baby is growing like a weed, measuring ahead of LMP gestational age. It is very active! Preferring to bounce around and suck his/her thumb. I'm gonna go with him because all signs with this pregnancy are pointing to a him. Now if we can just come up with a name...

Also, during my ultrasound today, braxton hicks contractions were very evident. Fabulous! Dr. Davis assured me, even prior to this confirmation, that uterine contractions begin very, very early in pregnancy. I am two weeks and just about a day away from getting my first P17 shot. Let's hope all goes well with that pharmacy order and that my new primary care gets it right.

And yes, I've lost about 4-6 lbs so far during this pregnancy. Not the case with Little Miss as I was getting quite plump all the way around with her. Again, I was told not to worry. It turns out sickness can cause weight loss in the first trimester. Let's hope I gain a healthy amount of weight for the remainder - 26 weeks - of the pregnancy. Dr. Davis equated the baby to a parasite - the best parasite - a parasite that will suck every last drop of whatever it needs out of me. I'm sure sucking the life out of a sauerkraut hot dog is extremely healthy, but since I really can't eat anything, my craving had to be satisfied - finally, tonight was the night. But I had two and now I feel sick so I doubt I'll crave another hot dog anytime soon.

Finally, did I mention that placenta previa by itself puts me at high risk? What does this make me, high-high risk??

A Flutter!

2008-08-31T22:28:00.004-04:00

Last night as I was in bed watching TV before lights out, I felt the very first flutters! I am absolutely sure that is was the baby as the sensation immediately took me back to my experience with Missy. It is unmistakable and I so wish my husband could feel it. I felt the baby moving today too and I am so excited that he/she is letting me know that everything is okay in there.

13w 2d gestation - first flutters!!!

Oh, and just for documentation purposes, I threw up again today. My nausea has returned to a certain degree but I would say my main issue is the fact that I look forward to certain foods and then when I have them, can't eat them. They are not cravings, just mental preparations for the upcoming menu. For the record, my cravings have been decaf carmel macchiato (finally got one today!) and a Johnnie's Dog House sauerkraut dog (I know, I know) which I will have to get tomorrow - they BETTER be open - as I missed them today by about 45 minutes. At least these are the latest which could change at any given moment.

Boy, would I love a hotdog right now! I can't wait! Oh, and a milkshake - vanilla! Perfection!

Finally, as far as the shopping thing, we never went. It was crazy to think it wasn't going to be a madhouse on Labor Day weekend. We did the Carters bit but left out of frustration!

To Shop or Not to Shop?

2008-08-30T12:53:00.004-04:00

Today we are headed to the outlets to get some new clothes for Missy for the fall. At 25 months, less than 22 months adjusted, we are working on potty training and so far, she's been hugely successful! I couldn't be more proud. This transition to big-girl underwear is a sad one for a mom who just adores onesies. Although it appears onesies stop at size 24 months, I feel we could have milked them for at least another 6 months or so. So now it is off to buy undershirts and tops that need to be tucked in. Yikes!

Since Labor Day is just around the corner, it occurred to me that the only pair of fitting maternity pants I have will need to be retired. They are white! I love them! They were a carry-over from Missy's pregnancy as I have not made any baby/pregnancy related purchases at all.

The thought hit me that I could run into the one maternity store in the strip (not sure what store it is even) and check it out. But my nerves are getting the best of me. I don't want to be superstitious, but I can't help but flash back to the days immediately after Missy's early birth when my online Gap order arrived in the mail. It was a new swim suit, maternity undergarments and other fun fashions for my upcoming fall as a supposed to be pregnant woman.

It was a miserable day when I had to return the clothes at my nearest Gap store. I was full of ammunition if ANYONE dare challenged my return. I was so ready to bite the head off anyone who even so much as gave me a funny look. I can still feel the emotion brewing inside.

Oh, you know, I take back the part about not buying anything for baby. While shopping for a shower gift for my friend back in June, I came across this adorable navy overall set (yes, boy) with corresponding white onesie. I bought it, knowing the Gap would take it back within 90 days if the baby happened to be a girl, not if God-forbid anything happened to the baby. Then I purchased a bunch of matching girl things at Talbots Kids. Now that return may be a little trickier as Tablots Kids is going out of business - darn! So, I suppose, that is progress. Maybe I just answered my own question. I suppose I'll go and see what I can find...

Turning 13 Weeks in the ER

2008-08-28T18:42:00.006-04:00

The point of this blog is to share my high-risk pregnancy experience. And while what I'm about to write is quite embarrassing, it is my pregnancy experience and to ignore the events of the past 24 hours would prove dishonest to myself, my readers and ultimately to my baby who will learn about the months leading up to his/her birth through this documentation.

So here goes...

Last night I was watching TV in bed laying on my right side. At 10:50, I attempted to turn over and felt this sudden excruciating pain along my lower right side. It took my breath away and in spite of many position changes did not relent. Hubby and I went through all the potential things it could be: my appendix - wouldn't I be sick, throwing up?, constipation - no, constipation just doesn't cause extreme pain, does it?, my placenta tore/uterus ruptured/active labor - wouldn't I have bleeding? Everything we read online and in books said to call your practitioner. I just couldn't bring myself to do it at now well after midnight.

I held on a little longer and then decided it was best I go to the ER. The pain was a definite 10! I didn't want to wake my mom and felt funny calling a neighbor to sit with the Miss so I drove myself.

The drive wasn't so bad but my emotions got the best of me as I couldn't help crying as I explained I was just 13 weeks and had extreme sudden onset abdominal pain.

It turns out the ultrasound tech had to be called in from home. They ran labs both blood and urine in the meantime. I was offered IV narcotics many times but declined them as to not risk harming the baby. I did request some IV Zofran as I was on the verge of throwing up.

They ordered a complete abdominal ultrasound and the tech started with the study of my gallbladder and kidneys. All I wanted to see was the flicker of my baby's beating heart! It was the longest 15 minutes as I waited for the focus to turn to the baby.

I learned quite a few things. During my last ultrasound at 12 weeks exactly, the baby was measured by crown-rump length. At 13 weeks, the baby was too big for this measurement and so the head was measured along with the leg. The baby measured 13w 5d with a heart rate of 161. I was so excited to see that the baby was well! It was moving and bouncing all around. I was also saddened to know that Little Miss might not have been 24w 5d at birth because her measurements were always behind my LMP gestational age. Not to mention the whole HCG issue too. Hubby and I talked about it when I arrived home and are reminded just how blessed we are to have a thriving and healthy 2 year-old micropreemie.

My tech endeared herself to me as she felt it was bowel all the way. She had been diagnosed with Crohn's Disease during one of her pregnancies and was very sympathetic to my bowel struggles thus far. She was able to connect my extreme pain with the movement of the transducer over my large intestines. There was an amazing sense of relief to know that it wasn't anything with the baby, my uterus, placenta, etc. Basically the pregnancy was healthy! My digestive system, on the other hand, needed some major help!

Once this was determined, I just wanted to get home. It seemed like my discharge took longer than the workup. Why is that when I was one of two people in the place? Anyway, I convinced the doctor to order me a colonoscopy prep kit. I need a major dose of colon blow to get rid of the "back-up". I am well beyond Milk of Mag and Colace, thank you very much. Additionally, I got an order for Miralax too and left for home at 4:00 A.M.

Too exhausted to go out of my way to stop at the 24 hour pharmacy, I went home for a big gulp of MOM, hoping it would start to work before I got the big guns down. I attempted to get some sleep but the pain was just too intense. Between my husband and my mother, by 10:00 I got my hands on the stuff that is so far, cleaning me out. It was recommended by my peri's office. Yes, I broke down and called to let them know my situation. After I hung up with the nurse, she called me back to tell me to skip the prep kit and drink a half bottle of Mag Citrate. It's this lemon-flavored stuff that within 1/2 hour, started working. The cramps were unbearable and my poor husband stood while I sat (yes, there) so I could hold his hand.

So here I am, feeling better. Not 100% by any means, but better. My stomach is so sore. It still hurts to move and certain positions are still too painful. But I do feel an improvement. I slept from about 1:00 - 5:00 and basically took no solids by mouth for almost 24 hours. I just didn't feel up to eating.

I am clearly losing weight this pregnancy. Probably the nausea from my morning sickness (the vomiting for the most part has thankfully subsided), and my food aversions are causing this. I am curious as to what the doc has to say about it.

Here is this week's photo along with a photo of me at 13 weeks with the Missy. I clearly look different. We are preparing for a boy!

13 weeks preggo with Little Miss Girl

Good News!

2008-08-26T11:26:00.003-04:00

Genzyme called this morning and said that we are in the lowest risk category at 1 in 10,000 for both Downs and Trisomy 18. All we want is a healthy baby and child so this is good news. Dr. Davis' office came back with the same numbers. I know there is always a chance they made a mistake but I'm going to revel in the good news anyway.