Mara Loves Her Little Sister

Last night after Micah went to bed and my sister-in-law went home for the night, Mara climbed into my bed (where I’m appropriately stationed on “bed”rest). Daniel was working late, so it was Mara and Mommy time.

We read three books. After we were done, she asked, “Mommy, now can I read a book to the little sister?”

So she re-“read” Just Going to the Dentist to her little sister. She has so many of her books mostly memorized, and only occasionally she would stop and ask, “What does this page say?” I’d give her a few words to trigger the memory.

It was kind of humorous to me that she wanted to read a book on going to the dentist to a baby that’s not even born yet.

But at the same time, it was sooo precious. I wanted to run downstairs and grab my camera so I could remember it always. Of course, I couldn’t, and frankly that would have ruined the moment anyway. So instead I just sat there, taking it in: My three-year-old, red-haired girl sitting there in her brown-with-white-polka-dot-kitty-sleeper, legs crossed, reading a book to her little sister, before she was even born.

It was a special moment.

Tonight I was sitting on the couch after dinner, and Mara asked, “Can I give the little sister a hug?” She threw her arms around my middle and planted a huge kiss on my belly. “I gave her a BIIIIIG hug and I KISSED her!” she exclaimed.

I can tell she’s smitten already. And that makes me really happy.

31 Week Update

Well, I have officially made it to 31 weeks! While we’re hoping for several more, I can’t say how grateful I am to be this far along.

On Monday I had my after-discharge-from-the-hospital-checkup with Dr. C. I’ve only seen him once before, and I have to say it was like seeing a completely different doctor. I don’t know if I caught him on a terribly busy day the first time or what, but he hardly looked up from my chart–he stood against the counter facing the wall, and in the two minutes he spent with me, I think he turned slightly toward me a total of 3 times (one of those to listen to the heartbeat).

This time he was amazing! Very thorough. Super friendly. Telling me “we’re here 24-7 and I want you to call anytime you have a concern!”

After getting out of the hospital, I did have a couple concerns.

Disclaimer: If you’re a guy or if you hate it when women discuss pregnancy stuff openly, this post isn’t for you. You should definitely skip the rest of this post. It is just TMI and will probably gross you out. It would have definitely grossed me out before children! But I’m here on bedrest, blogging–about bedrest. So (Warning!) there may be a few posts like this over the next few weeks.

I keep googling “procardia side effects” and “17p hydroxyprogesterone side effects” and “labor after progesterone shots” and “pregnancy after preemie” to learn about other women’s experiences, so I figure maybe someday, it may actually interest (and possibly even benefit?) someone in the same circumstance. I don’t know. But I hope so!

As I was saying . . .

First, on Saturday, I had a bit of “bloody show.” Not a huge amount, but what I remembered early on the morning that Micah was born (when I was over 5 cm dilated), which made me a little nervous. My contractions were not increasing though, in either intensity or frequency (as they were when Micah came). So I decided labor couldn’t really be progressing and maybe it was due to my cervical exam on Thursday.

Second, in the early hours of Monday morning, I woke up with severe nausea and diarrhea. It was horrible. I never actually threw up, but I was sitting there on the toilet heaving and holding the trash can because the nausea was so strong. None of my family was sick; and we had all eaten the same things on Sunday, so I ruled out food poisoning and stomach flu. I’d been struggling with the opposite problem (constipation) because of my progesterone, so this experience was definitely “something different.” I couldn’t sleep for about two hours. Again, my contractions were pretty normal (for me): several each hour, but nothing increasing in intensity or frequency. After about two hours, I felt well enough to go back to sleep. So I decided to wait and tell the doctor in the morning. But this was another symptom that was similar to the morning-of-delivery with both Mara and Micah.

As far as the nausea and diarrhea, Dr. C laughed when I said I was on both progesterone and procardia. He said, “You’re on progesterone and procardia?? That’ll mess you up!”

Thanks, Doc.

Then he added, after the constipation, this must be a welcome change, right?! Riiiight! (Hear my sarcasm, PLEASE!)

He said between pregnancy and medications, he would guess my body is just a bit out of sorts, trying to figure all this out. I can accept that I’m definitely out of sorts these days.

Little Boo’s head is still down (still pulling for a VBAC!!) and Dr. C said the “station” was -2, up from -1, which the resident told me last week. Isn’t it supposed to go the other direction? I guess that’s good news. The baby is now farther away from delivery (yay!).  I don’t know if that tells me anything at all, or just that the whole cervical exam is pretty subjective.

Dr. C said I was still at 1 cm, which was very encouraging! It seems unreal to me, during every cervical exam, when they say “1 cm” because as many contractions as I have had every day for almost two months, it seems like we would definitely be seeing some dilation going on! (Not that I’m complaining!–Just surprisedevery time!) The real test will be next week–the week I was 3 cm with Micah. . . if I am still 1 cm, then all the progesterone, procardia and bedrest will really be paying off!

Dr. C did say however, “I wouldn’t say you’re 100% effaced, but once you start dilating, you’re pretty much effaced.” (How do you translate that comment into a percentage? I took it to mean I’m almost completely effaced.) Which indicated some progress since last week at Thursday’s cervical exam when I asked about effacement, and the resident said, “Nope, you’re still nice and long.” The change in effacement could explain my concern about the “show.”

Dr. C said the 1 cm was what he was most concerned about at this point. No dilation since I left the hospital. So they will see me every week from here on out, and they’ll be doing a cervical exam each time.

Like all the obs, he said I need to be looking for “something different” and calling if I have any concerns, because I’m already experiencing such frequent contractions that I can’t really use that to determine when to go to the hospital.

“I imagine you’ll be making a couple more trips up to the hospital before you actually deliver,” he added.

While that’s not particularly encouraging, at least we know: they’re expecting to see a lot of me!

I’m still left with the daily dilemmas of bedrest: How many contractions is too many? How close together is too close? And: was that just a side effect of a medication? or was that something different”?

Time will tell. For now, we are taking one day at a time.

Thankful to be at week 31 and counting . . .

That Little Voice on “Fight For Preemies Day”

FightForPreemiesNovember is Prematurity Awareness Month. Did you know that? Today, November 17, it’s Fight for Preemies Day. After one baby born at 32 weeks, we are fighting for this next one! I’m at 24-1/2 weeks now.

My case manager called this afternoon–she is so perfect for me! I need her in my life! She always says, “I’m not telling you this to frighten you–I just want you to be aware.”

And for me, that awareness is exactly what I need.

She called today to follow up on Monday’s ultrasound. She too was perplexed by the cervical length from the ultrasound.

A little background: My initial ultrasound showed a cervical length of 3.4. The next ultrasound: 3.1. We were hoping it would remain around 3 cm, with the weekly progesterone shots I’m taking. But yesterday’s ultrasound showed 3.9, although the tech seemed to second-guess herself several times during the ultrasound, and later told me one thing and then changed her mind, which raised questions for me about the accuracy of the measurement. When I asked her, “Is that typical? To go from 3.4, to 3.1, back up to 3.9?”

She didn’t offer any explanation, she just said, “Oh absolutely! Absolutely it could do that!”

I was about to ask her if she could double-check. But then I realized that when I asked if she could tell me if she was still seeing “girl parts,” she had responded, “Was it a girl last time? . . . Well, then it hasn’t changed.” :-/ So I decided not to bother asking her to re-measure, and just to discuss it with the Ob.

Of course, when she called the high-risk specialist (on the phone), and said, “She’s a 3.9” (without mentioning my prior measurements), he thought that sounded great.

Monica, my case manager, said that she does see those kind of variations, but typically they are due either to a difference in the way the techs measure or an inaccuracy in measurement.

“Unfortunately,” Monica said, “this raises more questions, than it answers and just leaves you with more anxiety, since you’re still experiencing contractions.” That said, she added, “I do think it’s probably safe to say: it’s likely that you are still a 3, although I doubt you are actually a 3.9, so we are probably not dealing with cervical incompetency. It’s probably more an issue of an irritable uterus. The question now is: How much irritability does your uterus withstand, before it becomes preterm labor?”

She told me that the 17p progesterone is supposed to relax the uterus so it doesn’t contract at all, and there is no way to gauge how many more contractions I might be having at this point, if I were not on the progesterone.

She raised an interesting point. She said with contractions this early in pregnancy, we are not looking for all the traditional labor signs that you would look for at the end of pregnancy. She said if I experience more than four contractions within an hour (and they do not subside with rest and hydration), I need to be on the phone with my Ob. Some women who have delivered babies previously assume, since they’re not in “hard labor” or having difficult or very close contractions, that the baby is alright. That’s not the case. Her point was that the baby weighs about 1 lb., 12 ozs. at this point. I’ve delivered two babies already. She said at this stage of pregnancy, you don’t have to be dilated 10 cm to deliver–this baby could easily come at 4 or 5 cm because of its size. She said if I am dilated at all, even 2-3 cm at week 24, I would be likely hospitalized (unlike with Micah, who was larger when I was at 3 cm, and I was allowed to be home on bedrest until 4 cm).

She said, “I’m going to call you next week before Thanksgiving, and I know you’ll have family in town. But I just want to be that little voice in the back of your mind saying ‘Take it easy. You don’t want to be on bedrest or hospitalized.'”

I needed to hear that perspective. It really didn’t frighten me at all. But the awareness is something I need! And I appreciate that “little voice.” Little Boo, someday, will appreciate that little voice–after she is born healthy at full-term, right?!

That brings me back to Fight for Preemies Day, which is all about awareness!

One of my favorite blogs is The Spors Are Multiplying about Maddie, a 28-weeker who spent 10 weeks in NICU and unfortunately passed away at 17 months due to complications of her prematurity. Her mother is pregnant–due in February–and they are obviously monitoring “Binky’s” pregnancy very closely. Today’s post was about Fight for Preemies Day, written by a mom who through deep grief has learned all too well the need for awareness. . .

Fox News ran a story today about March of Dimes’ work to prevent preterm birth. It’s the story of Joshua Hoffman, who was born four months premature, weighing 1 lb. 11 ozs. His family is the 2010 National Ambassador Family for March of Dimes. Joshua’s mom successfully delivered her second son full-term, with the help of my favorite weekly shot–you guessed it, 17p hydroxyprogesterone! That was encouraging to me as well.

I never ever imagined I would have a preemie–even after two of my best friends–bridesmaids in my wedding–had preemies. It just seems like something that happens to “someone else.” Thankfully, my little 32-weeker (who incidentally was throwing my little decorative pumpkins over the back of the couch tonight and crawling off the couch to go get them and do it again) seems to be completely normal now, free of any long-term developmental problems or needs for surgery or special treatment! We named him “Micah”–which means “Who is like our God?!” We praise Him for His goodness!

So! On this day, take a moment. Be aware. Fight for Preemies.

The Test Will Be Monday

I have been taking 17p hydroxyprogesterone shots to prevent preterm labor for four weeks now–one month! My husband continues such stellar shot administration that I have begun to question whether his true calling may not be in I.T. after all–maybe it’s the medical profession! In fact, maybe I’ll just let him deliver this next baby! 😉 (I say that entirely to incite a reaction from him! Neither of us wants him delivering the baby!) On Monday I will have another ultrasound to see if the progesterone is doing its job.

My case manager called me this afternoon. It’s always helpful to talk with her, because she gives me specific goals related to my condition. Sometimes it’s challenging when you meet a new doctor with every visit, and have to bring them up to speed on your whole pregnancy history and then listen to their one-time assessment. I know you rotate through all the doctors, because you never know who will be on call to actually deliver your child, but it certainly is helpful to have one person following me throughout the entire pregnancy. Thank you, Monica!

Basically she’s hoping we will still see a cervical length of 3 or greater than 3. (The 1st ultrasound showed a cervical length of 3.4, the 2nd ultrasound showed 3.1.) The goal is for the progesterone shots to keep that number steady around 3. If that’s the case, she believes the high risk specialists will be pleased and say ‘continue with the progesterone, no more ultrasounds for now, unless you’re having a significant increase in contractions or some other cause for concern.’ However, if we see the cervical length dropping to, say, 2.5, I will be put on bedrest. (Sometimes I think she throws statements like that around, just to remind me if I don’t watch it, I could be on bedrest again soon.) Even 2.8 she said would not be a healthy sign, because it would show that I am “progressing,” in a way that we don’t want me to “progress” until much much further in the pregnancy!

She continually encourages me to “take it easy” now whenever I can, by limiting anything I know will  cause cramping/contractions, so I don’t find myself “taking it easy permanently” on bedrest, till the baby comes. (And we all know how I feel about that!)

So now I have something specific to look for in next Monday’s ultrasound . . .

Tonight I will be vaccinated against H1N1, the legendary swine flu of 2009. When Daniel gets home from work, I will be driving up to Willow Grove for my shot.

I have such mixed feelings about it. I’ve never even had a flu shot–for the typical “seasonal flu”–in my life! And I just don’t know what to think–with good friends on both sides of the debate–and medical people on both sides too. A bit disconcerting, I have to admit!

Last year my son, who was born almost 2 months premature, had the RSV shots (monthly) and the seasonal flu shot as well. Our whole family got sick five times last winter: three rounds of the respiratory flu and two bouts with the stomach bug. Micah was by far the healthiest one of us–the one who had the slightest touch of sickness each time and the one who bounced back the quickest. So either he is Mr. Incredible (which is a real possibility), or there’s something to be said for the flu shot (at least, last year’s flu shot!).

Since the kids and I are in the “high risk” category for H1N1, we had been thinking we might all get the shots this year. Then last week I received a letter from my hospital: since I am 24 weeks pregnant, I’m in the high risk category and the shot is being administered at the hospital with which my Ob is affiliated.

We decided I should go for it.

Our pediatrician’s office is not in favor of the H1N1 shot for children and is not administering it. So that still leaves us with the burden of deciding what to do about the kids . . .

I’m SOOO open to feedback right now! And I’ll keep you posted on how my shot goes tonight.

My Littlest Daughter . . .

My littlest daughter is 23 weeks along now. I mentioned to Daniel that, at 23 weeks, babies actually have a 10-20% chance of surviving outside the womb.

Daniel looked a little stunned. “Well, that’s depressing,” he said.

I thought it was kind of amazing–just from the standpoint that, if something happened and she was born, she now actually has a chance of surviving! (Some friends of ours lost a baby at 20 weeks. He was due the day Mara was born, and of course, at 20 weeks there was just no hope for the baby–nothing they could do.)

In addition, our baby’s chances of survival outside the womb increase almost exponentially over the next few weeks.–Those are the statistics that Daniel finds encouraging!

As for Little Boo herself: she must be an optimist.

During the ultrasound, she gave this very clear “thumbs-up,” and our tech captured the delightful moment for us.

ThumbsUpFromLittleBoo

I’ve been wanting to post this picture for a couple weeks now and haven’t gotten around to it. You can see the “thumbs-up” on the right, and that’s her foot on the left.

(Have I mentioned that I love baby feet too?!)

I’ll get to see them again on November 16. For now, I just feel them kicking.