Category: Progesterone Shots

My Due Date Buddy

Posted on by Becky

I have a good friend, Donna, who unfortunately lives in South Carolina while I live here. But she grew up about 45 minutes from here, and that is only the beginning of our similarities!

Donna and I were in college together. Started the same year. Sat out of college to work our second year. Returned to college the same year. Worked as RA’s together in our college dorm. While she was interior design and I was accounting/journalism, we bonded through our RA experiences. We graduated the same time. Went to the same church in South Carolina for about seven years after college. We were in each other’s weddings. In fact, in addition to being a bridesmaid, she also did my flowers–my wedding bouquet and the topper for our wedding cake! All that to say, she’s a dear, dear friend.

She knows a thing or two about preemies and bedrest as well. In 2003, her son was born premature (due to PPROM) at 31 weeks. He spent five weeks in the NICU, although today he is perfectly healthy, and you’d never guess! In 2006, she was on bedrest with her second pregnancy because of preterm labor. I was with her in the hospital when she went into active labor at 34 weeks (her husband, a pilot, was out of town). Somehow with medications, they held off her labor until exactly 37 weeks, when she delivered her second son full-term!

Here’s where our stories merge again. On baby #3, she is (like me) . . .

  • Having a girl this time
  • Having a lot of contractions, especially anytime she is going out shopping or on her feet for long periods of time
  • Spending a lot of time with the Maternal Fetal Medicine people
  • Having a lot of similar tests: like FFN (like me, still coming back negative so far) and ultrasounds monitoring the baby and her cervical changes
  • Rejoicing in similarities: our same-day ultrasounds a week ago Thursday, indicated weight estimates of 3 lbs. 13 ozs (my girl) and 3 lbs. 10 ozs. (her girl)
  • Puzzling over similarities (like awhile back, when both of our cervical lengths went up from 3.1 to 3.9! How weird and crazy is that?!)
  • Struggling with the same question of when to call the doctor when you have contractions all the time? and what is that illusive “something different” that they keep telling us we’re looking for?
  • And, craziest of all, she is due the same day I am! (Although neither of us have plans to actually deliver in March, we will both be happy if our girls wait until at least February.)

Unbelievable!

When we first discussed our pregnancies, I quipped, “We should have a race to see who can keep the baby inside the longest!”

She said, “Yes, but what would the prize be?”

I couldn’t believe she had to ask. Incredulous, I replied: “Being the mom without the NICU baby!!!!” But on further reflection, I thought, “That’s really unfair to the other mom, who honestly would have no way of keeping her baby out of the NICU.”

Unlike me, Donna is not on bedrest, which both of us consider absolutely miraculous, given her history with her previous two pregnancies. I fully expected her to “beat me” to bedrest! She also is not on progesterone or procardia this time, as she prefers more natural methods whenever possible. She is also (unlike me) hoping to deliver with a midwife, if all goes well.

Donna called me again Friday morning after her latest materal fetal medicine appointment.

I can’t explain how much I enjoy talking to her about our pregnancies.

Donna understands the difficulty of caring for toddlers and the struggles of maintaining a house while on bedrest. She did that with her second pregnancy. She understands the challenges and risks a NICU baby (and NICU parents) are facing. But she’s come through and she’s seen God’s grace in her own life and the life of her family. And she always points me back to Him. There’s no sense of pity or despair: it’s just where we’re at right now. Right now, there are very few people I can talk with that way!

It’s kind of like when I was studying for the CPA exam:

There were people who pitied me and said ‘oh I’ve heard how terrrrrrible that exam is! Good luck studying, and I hope you ever get your life back since no one people actually passes it the first time.’  (Oh the drama.)

Then there were people who had no clue what the exam was like, and would say things like ‘yeah, I’m thinking of starting a lemonade stand, so I’m studying too.’ Okay, no one actually said that, but my point is their comments told you they had absolutely no idea what was involved in becoming a CPA!

But when I talked to my peers (those taking the review course two nights a week from July – November, while working crazy hours starting out at the CPA firm, those spending most every weeknight and most of their weekends studying instead of hanging out with college friends), those were the people I could really talk to. Half of the conversations (that I had with everyone else) went unsaid, because I didn’t have to explain–we were in it together. And they understood.

So when Donna and I talk, we understand because we’ve both been there, and we both could potentially be facing many of the same circumstances all over again.

We share test results, and we don’t have to explain what the test is for or what the results mean, because we both have them. We compare notes from our appointments. We laugh over our husbands’ responses to everything going on. Together we are thankful for husbands that provide for us, care for us, jump right in to help whenever the contractions get more intense–and sometimes even protect us from ourselves (Donna’s husband told her a few weeks ago, ‘if the doctor doesn’t put you on bedrest, I will.’).

It’s always such an encouragement to talk to someone whose been there, and is walking much the same path right now, looking to God for His grace and strength each step of the way!

Next call: Monday morning, after my appointment. Can’t wait!

31 Week Update

Posted on by Becky

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 surprised—every 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”

Posted on by Becky

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

Posted on by Becky

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.