Mag is weaning, Ultrasound BPP results

Yesterday has been both a really good day, and also one that has a bit of the scariest for me so far. Right now, I feel like I live between extremes of feeling extremely happy and optimistic - and at other times I feel like I go through things I find I have a very difficult time handling.

Positive things first: My magnesium is being weaned off! Then they will restart my procardia an hour later and watch my contractions. If things are stable, I'll be allowed to eat some real food and get up to go to the bathroom - very good things indeed! Pudding and graham crackers here I come :-) Also, once the Mag is off my nausea and vomiting usually greatly improve and I won't have the blurred vision. My husband will also be a much happier camper with the Mag off as well because I'll actually allow him to turn the temperature in the room up a degree or two since I won't feel so hot from the inside out. Triple treat- truly a good thing!

Things that have hit me like a brick wall: I was catching a moment of actually resting comfortably when I heard the fetal heartbeat rhythm slow down a bit. After awhile it returned to it's previous rate. My husband didn't even notice. The volume was turned way down on the monitor just for this very reason - so that we don't cringe over every blip or time that the baby moves and goes off the monitor for a moment or two as all babies being monitored around the clock do. But my ears are so tuned in to noticing little changes even at low volumes after all of the hours of working up in labor and delivery, or in the operating room with the anesthesia machine that it sounded like a freakin fog horn was blaring a warning signal. Someone just have well screamed in my ear that Brynn was having a decel.

Decels are drops in the baby's heart rate, and an important thing to look at when they occur is whether the monitor was accidentally picking up the mother's heart rate instead of baby's (which is naturally much lower). Also, when the decel occurs is important, how low the heartrate drops (whether it drops from 140 beats down to 90 or 140 beats down to 60) and how long the heartrate stays low before returning to the normal higher rate (indicating the recovery). For instance does the heartrate stay low for a second or two, or does it stay low for much longer can indicate the baby's response to stressful situations. I knew that within a moment or two there would be a couple of nurses in my room to respond to this decel that I heard. Sure enough the door opened, lights got flipped on, and they began looking at the monitor strip and other things. Brynn then decided to do this twice more in the moments that followed. I now felt sick to my stomach, and was trying to explain what was happening to my husband without sending him into a worry frenzy. Often these decels can mean nothing serious so I was struggling to believe that this was the case for us. I actually had heard her do this the day prior once or twice - but they had been for very short periods and I didn't even mention these times because I was trying to believe that they didn't really exist.

Regardless, the OB resident that works with my doctor was paged. He soon came in and assessed the strip himself and reassured me that he was going to continue keeping a close eye on things and notify my OB also. Also, the day before on ultrasound it had looked like Brynn had the umbilical cord close to her hand which would explain the occasional short decels. But these decels were occurring very frequently now they wanted to do another ultrasound and a biophysical profile to see again if anything showed up. My dreams of a shower were beginning to look farther away!

Despite all of the drama, I am feeling a little better about things. Brynn seems to be having less of these decels, and the BPP turned out great. Our little girl scored a 8 out of 8 - a perfect score. Way to go girl! Surely enough, not only is her umbilical cord near her hand - Brynn seems to have the cord wrapped under her arm and she is nestling it like a security blanket. Just like a toddler sleeps with their favorite blanket - Brynn is has her cord under her arm and nestled up against her cheek - silly girl. Plus once again - icky uterus of mine has everything more cramped with less room for everything and Brynn has much easier access to her cord than most other babies. This was not something I had even thought of before.

Basically - this just means continued close monitoring. But as much as I'm trying to stay really light hearted and positive if I am truly honest I have to admit that my worrying consumes me at moments. I know that our girl is fine right now, things are moving forward in a positive way - and I am so grateful. But as Meredith said - the worrying that involves matters like the baby's safety can't even be compared to the worry I've felt about problems with my uterus or premature birth or things I've dealt with before.

Just wanted to say thank you again for all of your kindness and checking in to see how things are going. I truly am overwhelmed that so many people have been kind enough to leave a nice comment or words of encouragement. Just wish I could return the favor because it has made all of this so much easier. The moments I spend reading a nice comment are the moments when I have a smile on my face these days - so thank you.

Mag round 2 - UPDATED

(UPDATED - Just wanted to say I am enjoying some clear liquids now which is makes today a very good day!) Sorry - haven't been able to update because things have been a little too crazy over the last few days and poor wireless Internet. Thank you so much for checking in and keeping us all in you thoughts and prayers. They admitted me Thursday and that night started trying to stop contractions. They were coming every 1-2 minutes. Trying to avoid putting me on Mag again - they tried some more indocin and nitroglycerin (an old time fix) which I knew would had a feeling would not work and did not stop them. I never seem to respond to terbutaline well, and I had already had quite a bit of procardia that wasn't cutting it either. Contractions really were the only issue at first. My spotting and bleeding was due to the intensity of the contractions pulling on the cerclage - but I was not fully dilating yet. They kept checking things to see if there was any way to leave the cerclage in to delay possibly the inevitable breaking of my water and fully dilating that would possibly occur once they removed it. They feel since because my cervix is so far effaced (thinned) that once the cerclage is out, I'll fully dilate shortly after. Brynn still is small and just over 2 pounds so they really want to give her as much time as possible - plus delaying any birth before term is reached is always the goal. Also, due to the unicornuate uterus - carrying as far as possible is vital for fate of future pregnancies. So of course by the early hours of Friday morning they opted to restart me on a Mag Sulfate drip.

Contractions have been pretty intense often - kind of crazy that you can contract to the point of bring tears to your eyes, but not be fully dilating. My OB said that it's just another part of having the wacky unicornuate uterus. It contracts like crazy, and very intensely - but because it's abnormally shaped and so small it's also very ineffective at producing effective results (dilation.) In this case - I'm delighted it's not very effective :-) Not all unicornuates act this way - but I guess I have "an angry uterus" as it's been called several times this week. Hmm - any suggestions that I can offer it to be less angry, other than Mag? I'm all ears. Great thing is that as much as Mag sucks - it takes the contractions down so I can actually sleep and not be as uncomfortable. I won't go into too much detail, pretty much everything I mentioned before has been a repeat performance on the Mag- they give you the loading dose and then maintenance one and titrate it to your contractions. They really don't want you to get out of bed to go to the bathroom, or take a shower and you can't eat food due to all of the side effects. But for the last couple of days my contractions have been controlled on the Mag, they have been able to leave my cerclage in, and we are still pregnant! So yes the same hungry, stinky Sara is still here hanging out longing for some real food, a toilet and the shower - but all in all life is very good right now. We have been blessed with more time. I just somehow think that Brynn must have a little guardian angel with her because she seems to always get through any bumps in the road. We got to catch a glimpse of her on the ultrasound almost everyday so far and she has gained a few ounces so we're making some great ground and moving forward. We love you little girl!

I'll try to update more later - we're supposed to have another BPP (biophysical profile) study of Brynn again to see how she's hanging in there as well. Hopefully she'll pass with flying colors and get an 8 out off 8 if that is how they score it. On a much lighter note - my husband was the first to notice that my nurse yesterday looked just like Rachel Ray. After a few moments we realized that not only did she look like her, she had all the same mannerisms and expressions as well. I fully expected her to turn around and tell me that she was going to turn off my Mag drip and we were going to see if a little EVOO would help my contractions instead! (I told you the Mag makes me loopy and goofy, lol! But at least she was cracking me up :-)

My husband and my mom are still kind of my mini heroes because they have helped take such good care of me. My mom and dad have been watching Neela our doggie at their house and I know she's getting lots of belly rubs, treats and walks around the clock. My dad even sleeps every night on the couch with her! I feel blessed to have great doctors, and I am thankful for all of your kind words and prayers. All of that is why we've still been able to hang in through all of this and move forward. Just wish I could give everyone a little hug!

(Sorry again for the long radio silence - I will honestly try to post sooner next time - my husband has been just staying the night and showering here and the internet stinks in labor and delivery. It works in antepartum, but it's not really easy to drag the laptop over to another unit I'm not staying on. I'll have someone else update next time - I promise. But thanks for hanging with me none the less :-)

Back to the hospital - hopefully not Mag round 2

Well, same old story as last time. Contractions really picked up despite procardia extra dose. I also got some terrible lower back pain, cramping all of the sudden and pressure down below. By the time I paged my OB, I've started having spotting also. I'm headed in to labor and delivery to see what the game plan is and what's going on. Please keep your fingers crossed for us - as always. I know our little girl will be okay if this is her day - but some extra time is always a blessing towards some added health and less NICU time. Plus I really don't want to even thing of doing Mag Sulfate for days again - but whatever we have to do of course I will gladly do. Wish us luck.

Dealing with life pre pregnancy

Have you ever had a day where you felt like you did a whole bunch of housekeeping - without picking up a dust rag or vacuum? Today was one of those days. Saying that is kind of ironic because my day actually started out with the arrival of our cleaning lady bright and early who actually did do her fair share of dusting and vacuuming - but me myself...well no dusting or vacuuming was on the agenda. I know I've said it before, but months ago I never would think I actually miss using my yellow Dyson, but I do. Watching someone else spend some "quality one on one time" with my favorite cleaning appliance is kind of like having to watch you husband in bed with another woman, LOL! Yes I'm a sicko - but you all know that by now. For some reason I find vacuuming relaxing - and I miss our time we spent together before bedrest, hehe! Despite the fact that our cleaning lady got to spend the time with my dyson - I still think I came out on top in the end because I used her as a captive audience who couldn't leave for several hours and I talked her ear off to help keep me company and pass the time.

Also while she was working and my dog brought her toy after toy - I was able to get a whole bunch of stuff done for work. Although I haven't been able to work since May, I've been trying to keep up on any paperwork or housekeeping type stuff so that my transition back after my maternity time is a smooth one. It seems like I've been off of work for so long it's sometimes hard to remember that until my OB found out that my cervix was shortening and that I needed the cerclage I was working my normal long shifts doing cases. Life was so different than it is now. When I look at what a day was like back at the beginning of May to what one looks like now - it is actually hard to find many similarities. It's like it's the two different lives of two different people. And yet in just a few short months - the life that was mine at the beginning of May, I'm going to have to jump back into again. Sure we'll have a little girl then - but I'll also need to jump back into our previous life a bit as well. That is a very strange and bizarre thought to me these days.

So long story short - it has come time where I need to reapply for privileges at our hospital. It's something we have to do every two years. Basically because the CRNAs are not employed by the hospital like all other areas of nursing are - we have to apply for the right to practice at the hospital I work at. Instead we are part of a corporation through the anesthesia department - and every two years we have to go through a re-credentialing process. For some reason if the anesthesia department (comprised of anesthesiologists and fellow nurse anesthetists) was not happy with your practice over the last two years - they kind of have the right not to renew your privileges and to "let you go." without having to go through the typical hospital chain of command that was more familiar to me when I worked as an ICU nurse or other areas. Re-credentialing just really involves a lot of paperwork and I'm proud to say I think I'm finally done with it all as of today! I have privileges to practice at two hospitals - but the process is basically the same. So hopefully when the time comes for me to return in the months ahead - everything will be all lined up and ready to go.

Later in the day I went to my appointment and it went great! Cervix is unchanged from discharge of the hospital - way to go previous problem child :-) NST went good too - not too many contractions and our little girl behaved nicely again as well. The seat was still sort of warm from the woman before me which kind of was a bit odd - but then again anytime a pregnant woman near term has her butt in one spot for over a half hour - I guess it's reasonable to think it might stay warm for awhile, LOL! Poor woman following my NST probably got a warm one for her sitting pleasure as well. We also had a growth scan of our little Spot as well which was the best part of the day. She was measuring in the 10-15 percentile but weighed in around 2 pounds 4 oz. She broke the 2 pound mark and that was so good to hear! I'll try to scan some photos later from the DVD to post tomorrow if my husband has time to help me with them. (the one above is the only print out one - but the girl was nice enough to flip it over to 3D for a few moments). The whole time I kept seeing her try to stick something in her mouth to suck on, and I figured it was her hand at a weird angle. But then the ultrasound tech said, "Look, your daughter is quite the flexible one. She's bending her leg up and has her foot in her mouth." No wonder I kept feeling a lot of odd movements lately - Brynn seems to have turned into a foot sucker! When she takes it out of her mouth it rubber bands and snaps back to a straight position which seems to result in a strong THUMP feeling back again against my abdomen. I've been feeling that a lot the last week - and now part of the mystery THUMP is solved.

The whole time I was watching the ultrasound I felt all sappy and emotional. I felt guilty for my "poor me" feelings that I have been focusing on over the last few days a bit more than normal. Well, I think the thing I need to remember when I'm having one of my "moments" was best said by Barefoot Suzie on her blog this week. Not sure where she found the quote herself, but how true is this?

“being pregnant is the only chance we will ever get to help God with a miracle”

-author unknown

There is a miracle growing inside me, and if I would have known that we would have had this chance a year ago when we were having failed IUI after failed IUI - I would have agreed to do anything to have any shot at being a part of such a miracle. Bedrest or anything else - I would have agreed to it. So now I need to remember that. Now we have that chance, while so many others are still struggling to have their own chance with that - I need to remember how fortunate we are. Seeing her on the ultrasound gave me the little physical reminder of that miracle. Foot sucking and all - our little girl has gone from our tiny "Spot" to our 2 pound "THUMPer." That is a miracle if I've ever known one.

Doggie Litter

Just a quick question for anyone...does anyone else have a doggie who uses a litter box? Neela uses one by Purina called Second Nature. I was wondering if there are any other brands on the market for dogs? The one she uses is made for dogs - and dog litter is very different than cat litter. Just wondering if there is another brand as well - I do love the Second Nature line, but I've never seen any others to use.

29 week housekeeping

I'm pleased to bring you a very boring post. Week 29 has started out very quietly - and if it were to end that way, then it would be a very perfect week! My week began with an uneventful appointment at the OB and for awhile as I sat in the waiting room surrounded by other round bellies and some not so round bellies I almost forgot the events of the past two weeks. Things just seemed so routine, and it suddenly hit me how much I appreciated the calmness of it all. One of the nurses whom I've really grown to love called my name and I obediently followed her to complete the pregnant woman appointment dance: give a pee sample - try not to pee on my hand, weigh in, blood pressure, answering questions about feeling fetal movement - and so we completed the little ritual. Next I plopped down and got comfortable for my NST - during which our little girl behaved very nicely. My dear old uterus also behaved nicely and I only had 3 contractions during the monitoring. Once seeing my OB we did a bit of housekeeping stuff that we had needed to do for the last two weeks, but hadn't really done since I had been at the hospital during that time. We went over the results of my glucose test, which I passed with a result of 83 for the one hour test- YAY! He glanced through my latest CBC and other results - noting that my liver function tests looked fine (only done since I'm on the Procardia) and that my Hbg/Hct was fine and I'm not anemic - double YAY! I kind of already knew that this stuff looked okay since they had drawn a lot of lab work while I was admitted recently - but it was still nice to see that these from a few weeks ago were within normal range as well. We also went over some questions I had about doing the cord blood that I had decided we wanted to do during the delivery. I've had the kit sitting at home for a few weeks, but I still had a few questions regarding the process that he answered for me today as well.

Tomorrow I have another NST, ultrasound for growth scan, and a cervix measurement which I'm hoping will go as boring as the first appointment for the week went. Despite me feeling like I was in a bit of a funk on the weekend - my mood seems to have lifted quite a bit since then. I'm not sure if it's me getting to catch the fall season premiere of three of our favorite shows last night - ahh the sweet relief of decent TV at last - or the fact that we're 29 weeks and I'm still home, but whatever it is I'll take it. I find myself fluctuating between feeling really happy and excited about the weeks ahead, and on the other hand feeling like time is suddenly standing still. I kind of talked with Meredith about this - and hopefully she doesn't mind me sharing her thoughts - but sometimes I feel exactly what she posted about the other day. I think she said it a lot better than I can, or at least put more openly and honestly than I would put it.

But for whatever reason mingled in all the jumble of emotions in my head I also feel very at peace with things in my head. I think maybe I'm finally seeing the end in sight? I have worried about things that are out of my control for so long and I've just reached the point where I'm finally realizing that what is going to happen is going to happen. I'm tired of worrying and trying to control things I have no control over. We're at a point where if things happened, there may be many days - even weeks of NICU time, but things would still move forward and life would go on, whether I worry about them or not. And you know what the really cool thing is? Not only will life move forward and go on....but life going forward is going to be VERY good. No matter what happens now- that life is going to involve our little girl - and that will be a very good life indeed.

Almost 29 weeks, my family and friends have been busy

I'm happy to say that I have spent the whole weekend snuggled at home on my couch and out of the hospital! My dog has been by my side and my husband and I watched some movies; life seemed kind of "normal" whatever the heck that means these days. We watched Baby Mama and Made of Honor which helped pass the time, and I found out that my dog learned a new trick since I've been away from home at the hospital lately. Well, Neela got sick and tired of hearing how impressive "hands free" cell phone use in cars has become, or "hands free" navigation systems are - especially since that's the area of engineering that my husband works on (interior electronics). Our dog decided that she could demonstrate her ability to have "paws free" eating of her favorite Kong treats. My husband caught her demonstrating her new tech skills of this "paws free" action.

I can't wait for the new fall seasons to start tomorrow, some of our favorites are on including How I Met your Mother, Big Bang Theory, and Heros. My husband loves Big Bang Theory especially - maybe it's because he identifies with it a little too well, LOL! Then on Tuesday I can't wait to send my husband out to rent the Sex and the City Movie as well. I couldn't get out to catch it at the theatre this summer with being on bedrest, so I've been dying to catch it on DVD when it came out - and Tuesday is the big day.
When I got home from the hospital and walked by the back room that is slowly becoming our nursery I kind of stopped and didn't recognize things. Things looked a lot different than how I had left them. Friends, family, and some of the CRNAs I work with have been sending stuff over or giving us things over the recent days and I was both touched and shocked to have actual packages in our house.


My mom had gotten busy in the room while I was not able to be doing things, and had made some progress with laundering and putting things away, or just separating things to be put away later.



On the pregnancy front, tomorrow is 29 weeks and I'm elated. I'm still taking my procardia every 4 hours and it seems to be doing the trick with holding the contractions at an okay level. I've only gotten woken up a couple of times in the night by them - but most of the time I've been able to catch some decent sleep over the last few days. I find when I actually get sleep it does a lot for my state of mind. Tomorrow I have an appointment with my OB, and another NST.

I am so grateful for all of the support that we have gotten from people - whether it be in the form of phone calls, emails, letters via snail mail (personally might be my favorite these days?), and the generosity through things for Brynn. Some moments though for some reason I still find myself in a funk because there is so much I want to be doing, but I know I can't right now. I feel like internally my nesting instinct is going in overdrive and there is this crazy pregnancy / new mom to be motivation bursting out at the seems with no current outlet. Sometimes I have to admit it can be a bit frustrating to not be able to prepare for her arrival like I want to (or always dreamed of doing), but I know that to think that way is kind of a waste of energy. The things that matter most right now are going just the way they should be. Brynn is healthy, and I'm at home. There really isn't much more time to even feel this way because I know she'll be here before we know it, and I'll finally get to see the face I've waited so long to gaze at. I just feel like I'm lying if I say that those feelings of wishing that things had gone slightly different don't pop up every now and then. But the important thing is that for the time being I need to keep letting things go for right now, let others do things as much as it drives me crazy not to be doing them, and just let our daughter continue to grow. Although most of the time I feel like I'm kind of useless as far as productivity - I guess I'm doing the one thing that I can't let others do right now, and that's keep our little girl safe inside for as long as possible. And I hope that this doesn't make me sound ungrateful for everything that has been done for us - because I wouldn't have traded that for anything in the world, not even a "normal" or uneventful pregnancy. We have been touched by so many people, and I'll never forget that.