Showing posts with label Pre-term labor. Show all posts
Showing posts with label Pre-term labor. Show all posts

19 April 2011

I have now joined Team...

BLUE!!!!

Baby Boy was born at 1:10 am on Sunday, April 17, 2011. I managed to get him to 34 weeks 1 day gestation, and he weighed in at birth at a whopping 6 lbs, 10.6 oz, and he was 19 1/4 inches long. He's now in the NICU, working on his breathing, and will probably be there for a week or so. Each day is touch and go because his lungs are a bit underdeveloped (despite the steroid shots I was given). At present his doctor is concerned he might have a leak in his lungs, because he is breathing really hard. They will x-ray his chest again this afternoon to see how things are going, but it sounds like all we can do at this point is wait and see.

His birth was, in the end, extremely quick. I remember the doctors who delivered him debating afterward whether they really could put down as record that pushing took only 10 minutes. It definitely was something precipitous like that. But let me back up a bit...

Saturday afternoon, as I mentioned in my last update, the doctors started me on pitocin to regularize my contractions, with the hope that they would become more productive, and start me into active labor. My hope was that this could get my water to break on its own. Well, truthfully, I had hoped to be able to move around a bit and use some of my natural birthing class techniques to get active labor started, but since I was put on the pitocin I couldn't move around (at least I think that's why --- so much of this is a blur, bear with me!). My doctors were sympathetic to my desire to have as little intervention as possible, but the nature of our situation threw most of those desires out the window, understandably. We needed to get the baby out as efficiently as possible.

We had a big discussion about breaking my water. The doctors wanted to break my waters early on in the afternoon, and I really didn't want them to. In retrospect, I think the toughest part about how the delivery proceeded was the inner conflict I felt over wanting to advocate for as few interventions as possible, all the while worrying that by doing so I was getting in the way of what was safest for the baby. But I suppose it was somewhat needless worry, in that, if push came to shove and the baby was in danger, the doctors would do what was necessary.

So we talked about doing an amniotomy, and my doctors agreed to give the pitocin some time to work, and we'd evaluate as we went along. Fair enough.

[Side note: the doctors who delivered me were not my regular doctors, rather a resident of the hospital and the on-call OB who tag teams with my doctors' obstetric practice. Both were great; in fact, the entire team who's helped me since Thursday afternoon has been wonderful.]

They started the pitocin at a very low dose and gradually increased it. I started feeling contractions, and they got progressively closer together, but they were mild, like menstrual cramps, the kind you notice and you feel kind of crampy, but they aren't very distracting. I was able to carry on conversations, check email, entertain visitors (DH's dad, sister and brother-in-law came by to see us after the shower was over), and even attempt to nap. While this was all great and wonderful (I kept wondering if I was going to luck out and have a really mild labor overall, or whether karma was going to come and kick me in the ass at some point), it wasn't helping much. The contractions were regular, about 2-3 min apart, but I wasn't getting anywhere. I maybe went to about 7 cm over the course of several hours.

Just before midnight, DH and I started to drift off to sleep; or rather, DH was already nodding off and I decided to make a concerted effort to get some rest myself, figuring that we were being left alone for a while. Well, shortly after midnight, and basically just long enough later that I felt as if I had been awaken from a really decent sleep zone, my doctors came into the room and announced that it was time to break my water. Seriously it felt like they marched in to make the grand announcement. I'll admit though, by this time, despite the fact that I would rather have napped for a little while, I wasn't opposed to getting the show on the road. So I agreed (not that I think I had much say in the matter) and then the party really got started.

They broke my water and it seemed like within only a few short minutes everything changed. Full force contractions started almost instantaneously, and they were brutal. It was so sudden a shift in intensity that I was really caught off guard. Night and day doesn't even cover it. Yup, it was bad.

But, thank goodness it was short. As I'm adjusting to these new ferocious contractions, I kind of panicked that there was no way I could stand many of them... I had no transition, no time to get used to contractions gradually increasing in intensity and pain (was this the effect of all the pitocin without the buffer of the amniotic sac?)... I just wanted to escape my body. My husband DH was great as he coached me through them, all the while I was desperately trying to figure out whether I wanted an epidural... another one of those moments of inner conflict. In theory I really didn't want an epidural, but this pain was more than I had anticipated, so I considered it. The doctors couldn't tell how long I'd need to push, and I worried that I wouldn't be able to handle this type of pain for long. They told me that if I wanted an epi, it was now or never.

I was still debating the epi issue, and about to concede, when I started to feel like I had to poop really bad (sorry, but you know this is going to be full of TMI, lol). Hearing this the resident suggested trying to push for a couple of contractions. I said okay, and we tried. The amazing thing was that the contractions hurt much less when I was pushing, they still hurt like the devil, but within a more manageable realm, if that makes any sense.

After a couple of pushes, the resident checked me and said, okay, you're at about 9 1/2 now... this is it! The NICU team rushed in to get ready to take the baby (they probably were there already but it all seemed to happen at once), the other doctor was there too -- it was chaos and I can't remember all the folks who were there, but I know they were scrambling to get my legs in the stirrups and then they're telling me to push, sometimes up to three times per contraction, and I felt like I couldn't breathe, and couldn't get coordinated in taking breaths and where to hold my legs and pushing my chin to chest and... I was a discombobulated mess and had my eyes closed the whole time... but apparently I got something right, because after only a handful of contractions, I felt this burn, and a whoosh, and then, it was over. And then something was screaming like a banshee down near my feet. Oh, it's my son!

Well, I didn't know it was my son until they brought him up to my chest a moment later and I could see his whole body. Yup, it's a boy all right, and man, was he upset (who can blame him, he just got evicted from a cosy home some 6 weeks early)!

I got to have a brief moment of skin-to-skin contact with him before they whisked him away to the NICU (Daddy/DH went with him), and that was great. But they had already cut the cord so we weren't able to delay the clamping as we'd hoped (and no one had asked us about it before hand --- our birth plan was still in draft form as we thought we a bit more time). Ah well, there wasn't much time for much discussion of anything, and really, the important part is that my baby got out safely.

I won't lie though, I'm super glad there wasn't even time for me to agree to the epidural. The anesthesiologist wouldn't have been able to get my consent and set up in time for me to get it (and the contractions were so close together I can't imagine how they would have managed to keep me still enough). So yeah, if there's one part of my birth plan I'm glad I got to stick to, it was that I managed to deliver without pain meds. Yup, certified masochist here... but seriously, pushing was better than just sitting through the contractions, so I lucked out in that I didn't have much time to wait before I could push. I ended up tearing, so I have stitches, but that happened so fast too that I didn't notice it (other than the general burn of pushing Baby Boy out).

All in all, it was quite the roller coaster ride. I'll have to write the analysis later. They're kicking me out of the hospital today, and I have to navigate this weird space of going home without my baby. But it's indescribable, this feeling of fascinating and wonder at the fact that there is now a little boy in the world who wasn't here two days ago, and that I am his mommy.

And here he is, at about 17 hours old:


16 April 2011

Looks like it's time...

Group B Strep test came back positive, so it's time to get the baby out. I'm on penicillin, and they've started me on pitocin to get the contractions coming at a regular pace. Then I'll probably get my water broken. Not too keen on that, but not sure if I'll have a chance to try to break my waters myself.

So the next couple of hours will just be focused on getting me to a regular pattern. Then they'll check me and see what's next. But we're all hoping baby gets here quickly.

Over and out. Gonna try to rest for a bit. I'll update when I can.

15 April 2011

Evening check-in

Not quite an update, because not much has happened.

I got my second steroid shot at about 6:15 this evening. I've felt slight contractions throughout the afternoon and evening, but never spaced less than 10 minutes apart.

So we wait. I am hoping that I am "safe'" for the night, because I need to get some rest. Only slept about 3 hours last night, and today was busy with updates and phone calls from family making their way here for tomorrow's shower.

We'll see.

April showers bring May babies? If we're very lucky... :(

Soooooo.... um, yeah. icon_rolleyes.gif I'm actually writing this from a hospital bed. I went to my OB appointment yesterday at 1:40 pm, waited for what seemed like hours on the table for my OB to see me, and finally had one of my shortest appointments on record. I was scheduled for another fFN test and my Group B strep test (lovely), and so my OB did those first. I told her how I've been wondering if the baby has dropped or majorly shifted or something, because I've noticed a lot more pressure whenever I am on my feet. She said the baby might have, but let's take a look. The verdict:

4 centimetres dilated --- WTF??? (or What the Faggioli/Farina/Fruitcake)

And with that, I was packed up and sent to L&D. My OB was convinced that I was going into labor. YIKES!

I get to the hospital and for the first time, my visit did not end in the triage area. They did my intake, vitals etc., strapped me to the monitors that showed I was contracting but with no consistency, but they also had me sign a delivery consent form and went through all the steps to admit me to labor and delivery. Then I got set up in an L&D room, and got an IV where they started me on fluids and then soon after magnesium sulfate. They gave me the first of two steroid shots, and I've had 3 doses of procardia so far.

So what is actually going on? It's anybody's guess. Actually my day nurse, who I just met a short while ago, had the smartest answer I've heard so far. It's probably my fibroids, which have been remarkably quiet and stable on the whole, having a passive aggressive hissy fit (my words, unfortunately; would have loved it if she'd said that herself, lol). The nurse called them "muscle hogs," and they obviously are feeling like they need some attention. No one's ever mentioned the fibroids as a cause before... they've only said, oh you've got an irritable ute... yah, but WHY??? Okay, the fibroids make sense. Granted they may not be the reason, but it's something I can wrap my head around, and also explains why it's all fuss but no action except the dilation.

In about an hour my MFM doctor will be making the rounds, so I'll know better what happens from here after then. But from the looks of it, I may be here for a little while. And yeah, that may mean through Saturday. My shower is Saturday... BOOO HISSS FRIGAFRACKAFOOOOOOO! icon_angry.gif

Okay, got that out.

Of COURSE, I'm not going anywhere if it will hurt baby's chances of hatching at full term (and at this point I don't think my doc will let me anyway; at this point I'm not even sure if she'll let me go home before I deliver)... but geez, really??? Now??? Well, I was the one who pushed for the weekly exam this week, and not a two-weeker as my OB had originally suggested, because I wanted to make sure I was okay to go to my shower, but I certainly didn't expect events to go as they have. And probably good that I did push for the visit, because then I might have gone another week (or not) and not known... eek!

Well, the nice thing is that I will have lots of visitors this weekend, as the family (and friends) are pouring in from all over the East Coast to celebrate. I think we will set up Skype or something for those who can't/don't come to the hospital.

They all do say that if I deliver even now, baby will be fine... passed all the major milestones (or just about to this weekend), so there is some comfort there, but just WOW.

Operation Keep Baby Cookin' continues...

NEWSFLASH: They'll be moving me to an antepartum rooms (much better bed they say) sometime today. Gertrude is just being super irritable I guess because there are five tenants (baby + four fibroids). And I'm off the magnesium sulfate drip (yay) AND I've been given clear liquids... jello, juice, ginger ale, tea... woo hoo!

30 March 2011

Triple Thumbs Up!

Yay!
Yay!
Yay!

This morning's weekly OB appointment (31 weeks) went really well; in fact, it was the most encouraging one I've had in a while. Have I mentioned that I <3 my doctors? I bumped into all three of them today, and they all said hi and chatted for a minute. My case must be some bit of a topic of conversation because they instantly remembered me, LOL. I seem to be that way with medical staff; I have to go to them frequently enough that I become a household name. Dismaying but comforting at the same time.

So here's the good news:

#1. My cervix measures the same as last time, no further dilation - woo hoo!

#2. I passed the 3-hour glucose test - thank you! thank you!

#3. I can go to my work shower tomorrow - hooray! hooray! hooray!

and an anticlimactic #4. I didn't miss the UPS truck... I'm expecting a t-shirt from Cafe Press that I was hoping to wear to the shower tomorrow, and was worried that it would come during the time I had to leave home for the appointment. But there was no yellow sticky on the door, and online it still says that the package is "out for delivery," so I just have to wait for it to arrive...

Is it nap time yet? All that excitement this morning is making me sleepy...

27 March 2011

Operation Keep Baby Cookin' - Part V

All right, I think this post will finally catch me up to the present, as far as updates go...

Friday, March 25: 30-week OB appointment with Dr. Y (though technically I turned 31 weeks the following day; my appointment days got messed up by the trip to L&D on the 8th).

I told the nurse that I was due to have a fetal fibronectin test done, along with a cervical check, per instructions of the perinatologist. She got the fFN test out for the doctor, but turns out Dr. Y didn't do it, because she said it was too soon. My last fFN was done on March 15, and so two weeks wouldn't be until the 29th (this coming Tuesday). Ah well (though I'm wondering if this stricture had more to do with insurance than the test itself).

Anyway, Dr. Y did check my cervix, and found that it's further dilated than last time, at about 2 cm. Oh dear. Doc decided to put me on the fetal monitor again, to check whether I was actively contracting. I wasn't, but my uterus was definitely irritable, showing small peaks and valleys on the graph.

So guess where I went next? Yup, Dr. Y sent me over to L&D for monitoring (I confess I stopped at McDonald's on the way because I knew they wouldn't let me eat once I got there). But here I go, yet again (this is the fourth time now). I'm glad they want to be careful and all, but geez. I mean, this time, one of the nurses and the resident remembered me, and I them. Well, I suppose it can't hurt to build up a rapport for when it really counts.

I spent a couple of hours there, hooked up to the monitors. I'd brought a couple of books, including, this time, The Womanly Art of Breastfeeding, but found it was too heavy to prop up or rest on my belly, so I turned on the TV instead, and watched the first hour or so of Unbreakable (M. Night Shyamalan's 2000 flick starring Bruce Willis and Samuel L. Jackson).

Eventually, the resident came back in and checked the graphs -- nothing of note save a bit more irritability. She also did another manual cervical check -- still holding at between 1-2 cm dilated (whew!). Then she did a biophysical profile on the baby via ultrasound, and it only took her about 10 minutes to see all the signs she was looking for. Yay for baby!

After running her findings by my OB, the resident discharged me back to "house arrest," telling me that my OB wanted to see me in a couple of days. Well, I already had an appointment set for Wednesday, was that soon enough? Yup, that would be fine.

Wednesday will be telling, as I expect to find out (at least) three things:

1. Did I pass the 3-hour glucose tolerance test?

2. Do I have another two-week reprieve from pre-term delivery (will this next fFN come back negative too)?

3. Can I attend the baby shower the folks at work are throwing for me and two others this coming Thursday?

I hope the answer to all three questions is YES! Wish me luck!!!

18 March 2011

Operation Keep Baby Cookin' - Part I

Sorry, I know I am long overdue for an update here, and a lot has been going on. So here goes:

On March 8, I had my 28-week growth ultrasound with the Maternal-Fetal Medicine specialist (or perinatologist; MFM or peri for short). Baby looked great; measured 3 lbs, 6 oz (still 70th percentile), all anatomy seemed to be as it should be, and amniotic fluid level was fine. Unfortunately Little Oatmeal decided to be a stinker and hid his or her face as if s/he was running from the paparazzi, and so we got no good pics (and I was really hoping to see those chubby cheeks again, ah well). However, the tech managed to get this shot (I guess she felt bad for us and wanted us to have some memento):



No surprise this kid will have big feet (seeing as how I wear a size 13N and DH's feet are bigger than mine), but I do hope there was some magnification in that image, or I might have as much trouble getting the feet out as the head, LOL.

When the ultrasound was over, the doctor asked me how things were going. I mentioned that I was feeling some cramps down low, and had been since the evening before. On Monday, March 7, DH and I had gone for our last childbirth education class at the hospital, which included a tour of the maternity ward. While walking around, I'd noticed a lot of pressure and menstrual-like cramps at my bikini line, but hadn't thought much about them, since they were very similar to cramps I'd had a month ago, which had been attributed to round ligament pain (granted I'd ended up going to L&D for them, but they hadn't been contractions). When I got home from the class, it was late enough that I figured I'd just drink a ton of water and go to bed, since those had been the instructions last time. Well, the cramps never really subsided and even woke me up during the night, so I knew I should mention them at the appointment the next morning.

Little did I know, I was not crying "Wolf!" this time (wasn't last time either, as it was the OB on-call who told me to go to L&D to get checked out, but it was still hard to know if I was overreacting or if this was something serious). Since the cramps weren't letting up (and such cramps are a possible sign of preterm labor) my peri decided it was worth taking a look and doing a fetal fibronectin (fFN) test to see if anything was really going on. So he took the fFN swab, did a manual check on my cervix (the first time I'd ever had a male doctor, which was a little weird at first, especially with DH in the room too), and also had the tech measure my cervix with an internal ultrasound.

The verdict: my cervix was high and closed (good), but had shortened to 1.8 cm (not so good; ironically, this was downplayed a bit by the peri, as he only commented that this was "shorter than I like to see"). And off I went to L&D to get monitored for contractions. Oh wait, before I got carted off to perinatal triage (they sent for a wheel chair for me, even), the doc gave me the fFN test tube and told me to hand it directly to the nurse that admits me (we'd get the results faster that way). He also said that, provided the fFN test comes back negative and the monitoring goes well, I should go home, not go back to work for a week, and instead I was to "act like a slug, akin to the morning after partying too hard at college." Then I should come back in and have my cervix measured again.

So off to L&D I went, and they hooked me up to the monitors. DH actually had to leave to go to his hernia surgery follow-up appointment (everything looks great, thank goodness), so I spent some time connecting with work to let them know I was not going to be in this afternoon after all. About an hour into monitoring, the nurse came in carrying some tubes and bags and a syringe and said, "We're going to put an IV in, because you're having contractions." What??? I AM??? Whoa. I couldn't feel them at all; yet, apparently, they were coming every 4 minutes. "But these are Braxton-Hicks, then, right?", I asked. "Nope," the nurse said, "they're the real thing."

So when DH called to check on me, and I told him what was up, we both freaked out a bit (well me more than him, I think). He wondered if he should just get something quick to eat (it was lunch time), or go home, gobble some leftovers, and grab our hospital bag. Thing is, we don't have a hospital bag packed yet! I was only 28 weeks... figured I had at least another 8-9 weeks before needing to get that ready. I started to lose it: "I don't want a March baby... I want a May one!" But DH, ever relaxed under pressure, said, "Why not? We'll manage, whatever happens." I still felt like 28 weeks was way too soon to be going into labor, but knowing that DH was on an even keel helped calm me down quite a bit.

A little later, DH arrived, and we got the fFN test results back: NEGATIVE. Woo hoo hoo and then some; this meant it would be extremely unlikely that I would go into labor within the next two weeks!

Contractions started to settle down too. They were still happening, but had spread out to about 6 minutes apart. I asked why I was having real contractions, but yet they weren't doing anything. The resident OB said, "Some women just have them." Later the nurse said that "for some reason, your uterus is just irritated." Ah, an irritable ute. I've heard of those, but never knew what they were. Now I do. Introducing: Gertrude the Irritable.

They said I could go home, and that I should make an appointment to see my regular OB on Thursday or Friday, and then come back to the peri the following Tuesday.

And so began my week of modified bed rest. Or so I thought.

To be continued...

07 February 2011

My trip to L&D yesterday

I called my OB's office yesterday morning and spoke with the Doc on call. Told her my symptom, and that I wasn't sure if this was something to be concerned about, and was surprised that she told me to go get checked out, "to be on the safe side." My cramps are definitely a potential symptom of pre-term labor, though they can be attributed to other issues.

So, DH and I made a visit to our hospital's Perinatal Assessment & Treatment (PET) Unit (aka the triage or intake section of the Labor & Delivery/Maternity Ward) yesterday afternoon. They strapped me to a fetal monitor, and another one that detected contractions. Heartbeats and uterus were observed for about an hour, and luckily nothing of concern was found; baby's heart rate was comfortably variable, averaging about 158 bpm, and I wasn't anywhere near contracting. Cervical check showed that my cervix is high and thick and shut up like Fort Knox (or should I say "like a medieval fortress," to go along with the AMA theme, LOL?).

Then what's with all these cramps, you say? Well, the resident said it was most likely round ligament pain, or else it could be my fibroids acting up. I'd rather it be RLP, but I do go for a growth ultrasound tomorrow morning, so that should help determine whether my fibroids are behaving themselves.

The resident discharged me, telling me that pretty much, all looks normal, and I can take Tylenol to relieve the pain, but to come back if the symptoms persist or worsen, or if I don't feel the baby move. I felt the baby move a bit last night, but s/he's been quiet today so I'm trying not to get anxious, as the cramps haven't really let up... and of course I forgot to bring my Tylenol with me to work. :(

06 February 2011

Cramps? :(

For a while now, I've felt tightness in my lower abdomen at times, which seemed to correlate with sitting for "too long." The length of time varied, and might have had as much to do with the pants (and underpants) I was wearing as anything else -- if the pants cut into my belly at all, I'm sure that hastened the discomfort. Usually this tightness has gone away after moving around or shifting positions (leaning back, etc.), or both.

Well, last night, the tightness changed a bit. Instead of just tightness, I was really feeling cramps, like when I get my period. Lasted a couple of hours and didn't really let up until after I fell asleep.

I have this sheet given to me by my doctors on signs of preterm labor. One of the symptoms is:

Menstrual-Like Cramping: Cramps low or near your pelvic bone, like before or during your period. Cramping may come and go or be constant.

Ugh. I'm only experiencing this one symptom, so I'm not sure if this is normal or a warning sign. Guess it's time to call the doctor, just to be on the safe side. I have my next growth ultrasound at the perinatologist's on Tuesday, but I don't think I should wait until then. It's all fine and dandy that I've reached the viability stage of my pregnancy (24 weeks), but I do not want my baby born too soon!

By the way, I feel the baby kick and can tell s/he is getting stronger... so it's reassuring to feel those pops and punches while all this stuff is going on.