I'm now on heparin because the doc increased me to level 2 bed rest. No walking except to pee. Not standing for showers, just sitting! Oh well. I am supposed to spend all day in bed, but I'm allowed a couple wheelchair rides a day to the family lounge or the patio if its nice out.
Have to wear a pad tobight so they can see what goes on with the discharge.
Two empty bed on the ward but there's a high chance that someone'll end up in here with me. I have all the curtains open, but they'll get closed if someone has to room in here.
I better catch some sleep, the next dose of adalat is at 430am complete with baby check.
Tomorrows April Fool's. No body better fool me, and I promise not to make any jokes about Ellie and I. Not a laughing matter!
Bonne nuit <3
Thursday, March 31, 2011
1030pm
Gaaaah. I had a huge long post and it effing deleted.
900pm Thursday
It has been a long, long day. But, most definitely a hopeful one. The contractions seem to have petered out, and I hope that they stay gone when the nifedipine wears off. I have two more doses, 6am and 6pm tomorrow, so Saturday will be the 'big' deal day.
Meeting either tonight with the neonatologist or tomorrow.
Had my second round of steroids (yay) and another adalat. Also had to get a gbs swab done which was NOT how I remember it with Jake. "This might feel a bit uncomfortable"... thanks :s
Jason came to visit me for a while and brought licorice and a good bath towel. I still have my hep lock in, but am not attached to iv at present which is nice. Would be a good time to shower.
There's a sink in the main part of the room which I can use to wash my hair and stuff if I don't feel like having a real shower.
My night nurse came in, did a quick baby check, did a me check (vitals are all good for now). She gave me a little booklet about antepartum self-medicating, and the drs have me on materna, colace and a frozen fruit jelly three times a day. I also noticed they've got me on a high fibre diet. I guess being on bed rest and only getting up to pee is enough inactivity to mess with bowels. I hope having to share a bathroom doesn't activate my "scared to poop in public washroom" phobia... yuck.
There's a nice little family lounge for when my mom and Jake come visit tomorrow. Gives us some privacy without disturbing my roomie. I have no one at the moment, but they said that could definitely change by morning.
I am supposed to call the nurse when I go pee to show them the "plug" loss... she seemed convinced it was impossible for me to be losing plug. Hmph!!! I know my body.
Looking forward to morning, will be 29w3d! We met with the neo three weeks ago! Time flies.
Ooh, I get a snack! Apparently the dietician can come meet with me tomorrow about a regular evening snack. That would be awesome. Service is top notch.
I'm curious to see what the recreational therapy sessions involve. They're twice a week... also mommy's group on sundays. Fun times. If I have to be here next week, I'm all about another massage therapy session!
Mmm... cheese and crackers and an apple :) yum!
Okay, I think I'm going to wind down for the night and sleep if I can. Day 2 of hospital stay round 2, no baby, no sign of baby, fantastic.
Meeting either tonight with the neonatologist or tomorrow.
Had my second round of steroids (yay) and another adalat. Also had to get a gbs swab done which was NOT how I remember it with Jake. "This might feel a bit uncomfortable"... thanks :s
Jason came to visit me for a while and brought licorice and a good bath towel. I still have my hep lock in, but am not attached to iv at present which is nice. Would be a good time to shower.
There's a sink in the main part of the room which I can use to wash my hair and stuff if I don't feel like having a real shower.
My night nurse came in, did a quick baby check, did a me check (vitals are all good for now). She gave me a little booklet about antepartum self-medicating, and the drs have me on materna, colace and a frozen fruit jelly three times a day. I also noticed they've got me on a high fibre diet. I guess being on bed rest and only getting up to pee is enough inactivity to mess with bowels. I hope having to share a bathroom doesn't activate my "scared to poop in public washroom" phobia... yuck.
There's a nice little family lounge for when my mom and Jake come visit tomorrow. Gives us some privacy without disturbing my roomie. I have no one at the moment, but they said that could definitely change by morning.
I am supposed to call the nurse when I go pee to show them the "plug" loss... she seemed convinced it was impossible for me to be losing plug. Hmph!!! I know my body.
Looking forward to morning, will be 29w3d! We met with the neo three weeks ago! Time flies.
Ooh, I get a snack! Apparently the dietician can come meet with me tomorrow about a regular evening snack. That would be awesome. Service is top notch.
I'm curious to see what the recreational therapy sessions involve. They're twice a week... also mommy's group on sundays. Fun times. If I have to be here next week, I'm all about another massage therapy session!
Mmm... cheese and crackers and an apple :) yum!
Okay, I think I'm going to wind down for the night and sleep if I can. Day 2 of hospital stay round 2, no baby, no sign of baby, fantastic.
Thursday Dinner
500 update
She GREW!!! They did my growth scan today. 1000grams and holding steady at the 2nd percentile. For the first time she grew day for day (13 in 13!!) I am so proud of her.
Cervix is long and normal, not sure why they didn't do fundal pressure...or hang out to see if it changes at all over time. Fluid was great, flow was good. Happy mommy :) if my mucous plug would kindly stop dropping chunks, Id be thrilled.
Best part of my day was getting to be a guinea pig for a massage therapist in training! AMAZING!!! My back and legs feel amazing. Thanks Gail, for looking into that for me!
My roommate is GONE thank goodness. They were revolting. Burping, farting, parents using the bathroom then not closing the door or turning off the fan when they were done. It's quiet now!
Watching educational tv for free... all about pumping boobs! Pretty cool program. Wonder what else they have on queue. Ooh... breastfeeding preemies! Cuuuute.
My mom brought some yogurt drinks, chocolates and an apple. Jason's bringing me a towel so I can have a good shower.
Today has been lovely.
1150am update
I am all settled in my shared room. Clearly this area of the hospital hasn't been rejuvinated. The doppler machine is on wheels and has wood paneling... the bathroom is orange and rust and old. My neighbour is 21 weeks, I heard them say she is going home though. I am having a vag scan at some point today. Another HUGE chunk of plug fell out onto the toilet *gag*.
My parents brought me coffee and a bagel and magazines. I am sooooo tired and my backache is intensifying but no palpable contractions.
You know what irks me about sharing a room? The lack of common courtesy. It says on the bathroom door "patient use ONLY". Her mom was in there stinking it up for 20 minutes. Are you fucking kidding me?????
Sorry, a little aggravated today.
Lack of sleep!
I asked if my ultrasound was going to be any time soon. No idea. As an inpatient they fit me in around outpatient appointments. I want to know what my cervix is doing. I want to know NOW.
Ah... girl next door got a cerclage. She's complaining about bed rest and wanted to get up and walk. She's crazy. Ugh.
I think it's nap time. I hope lunch comes soon.
My parents brought me coffee and a bagel and magazines. I am sooooo tired and my backache is intensifying but no palpable contractions.
You know what irks me about sharing a room? The lack of common courtesy. It says on the bathroom door "patient use ONLY". Her mom was in there stinking it up for 20 minutes. Are you fucking kidding me?????
Sorry, a little aggravated today.
Lack of sleep!
I asked if my ultrasound was going to be any time soon. No idea. As an inpatient they fit me in around outpatient appointments. I want to know what my cervix is doing. I want to know NOW.
Ah... girl next door got a cerclage. She's complaining about bed rest and wanted to get up and walk. She's crazy. Ugh.
I think it's nap time. I hope lunch comes soon.
845am Thursday
I get to go upstairs!!
As long as the contractions stay away then I get to be upstairs. The dr reiterated that I can only be on procardia for 48 hours so who knows what will happen after that. She said at 29 weeks with steroids on board Ellie will be fine. Maybe my body will get the message not to have her yet?
She said that the bleeding is their main concern, and now I am at a higher risk of more bleeding and premature rupture of membranes (pprom), 72 hours from my last bleed is my earliest discharge home. That's three days from now, and honestly, id much rather be here if the contractions start after the procardia ends than at home.
It is almost 9am, my parents are coming at 1030. Better make myself comfy!
As long as the contractions stay away then I get to be upstairs. The dr reiterated that I can only be on procardia for 48 hours so who knows what will happen after that. She said at 29 weeks with steroids on board Ellie will be fine. Maybe my body will get the message not to have her yet?
She said that the bleeding is their main concern, and now I am at a higher risk of more bleeding and premature rupture of membranes (pprom), 72 hours from my last bleed is my earliest discharge home. That's three days from now, and honestly, id much rather be here if the contractions start after the procardia ends than at home.
It is almost 9am, my parents are coming at 1030. Better make myself comfy!
Thursday, March 31, 2011
Someone came in two hours after my last procardia, I guess because I passed out from exhaustion! And since Ellie was doing well and the contractions are like 3 an hour (I was having them every 3-4 minutes yesterday) they took off the monitor and I got to sleep a bit. I think I got 4 hours total last night.
My iv site hurts, I think that I must have slept on it weird.
Reallllllllllly hoping that my internal check this morning (I think...) shows no change from yesterday and I can move upstairs today to a more cushy room. I could care less about tv, I just don't like knowing I am in *this* bed because I am delivery risk.
Still waiting until tomorrow for our growth scan, I believe. They made no mention of it happening today.
I think E turned again. I was so uncomfortable for a while there without the monitor. It was brutal. O think she is lying transverse with her head on my left.
It is official, I have now had more ultraswounds than I can count. Over 20, and I am still in for plenty more, provided she isn't here soon.
Last time I got up to pee, there was whatever was left of my plug, in huge nasty chunks. My prayers for today are: -that she's still great on the nst
-that my cervix is closed
-that I don't have her today and,
-that the steroids work!
My iv site hurts, I think that I must have slept on it weird.
Reallllllllllly hoping that my internal check this morning (I think...) shows no change from yesterday and I can move upstairs today to a more cushy room. I could care less about tv, I just don't like knowing I am in *this* bed because I am delivery risk.
Still waiting until tomorrow for our growth scan, I believe. They made no mention of it happening today.
I think E turned again. I was so uncomfortable for a while there without the monitor. It was brutal. O think she is lying transverse with her head on my left.
It is official, I have now had more ultraswounds than I can count. Over 20, and I am still in for plenty more, provided she isn't here soon.
Last time I got up to pee, there was whatever was left of my plug, in huge nasty chunks. My prayers for today are: -that she's still great on the nst
-that my cervix is closed
-that I don't have her today and,
-that the steroids work!
Middle of the night
Apparently I don't get to sleep tonight. Ugh. I'm tired! I rolled over and she had a decel then they couldn't find her again and I almost freaked. Thabk goodness for portable ultrasounds. Hmmm... procardia in 2 hours. Might attempt a snooze.
Worked for an hour!! Tjey took me off the nst to get an hour nap in. Back on the monitor again because her baseline is at 110 bpm which is the very low end of what they consider normal. Had a higher dose of procardia at 3, now its almost 4. I am starving.
Worked for an hour!! Tjey took me off the nst to get an hour nap in. Back on the monitor again because her baseline is at 110 bpm which is the very low end of what they consider normal. Had a higher dose of procardia at 3, now its almost 4. I am starving.
Wednesday, March 30, 2011
1030pm update
I heard a lady getting her pubes shaved for a c-section. Now I hear one going "ah,ah,ah,ah,ah..." contractions slowed considerably and bleeding has turned into huge chunks of mucous plug. So gross. Vitals check at 1130pm. Then another procardia (nifedipine) at 300am. That stuff makes me HOT!! I have a make shift fan and a bag of ice. The procardia also raises Ellie's heart rate (her baseline right now is 15bpm higher than usual) and lowers my bp.
Had to take off my support stocking because I'm retaining water and they hurt.
Second dose of steroids around 6pm tomorrow...
Shitty. I wish I hadn't gone for that echo today, maybe id still be happily hanging out with my parents!
Had to take off my support stocking because I'm retaining water and they hurt.
Second dose of steroids around 6pm tomorrow...
Shitty. I wish I hadn't gone for that echo today, maybe id still be happily hanging out with my parents!
L n D update 830pm
Okay, I have no idea how that posted but right now it's 830pm and I am stoned thanks to the nifedipine. I feel a little ridiculous, but it has substantially slowed the contractions.
Am dilated some and the bleeding is still there when I get up to pee, so, I get to wear the SEXIEST mesh panties you've ever seen.
I honestly think she will be here this weekend. But I hope I am wrong.
My head hurts :(
There is a lady in the room beside me with a term iugr baby who isn't handling the thought of a csection well.
Ellie is footling breech at the moment, sure beats transverse. They told me that if she starts going into distress with the contractions they will do a csection and they might have to do a classical section which isn't good for having future babies, NOT like we ever plan on that.
Jay brought me dinner that mom made. It was awesome... so tired, so hot. I just wish I knew when and !
Am dilated some and the bleeding is still there when I get up to pee, so, I get to wear the SEXIEST mesh panties you've ever seen.
I honestly think she will be here this weekend. But I hope I am wrong.
My head hurts :(
There is a lady in the room beside me with a term iugr baby who isn't handling the thought of a csection well.
Ellie is footling breech at the moment, sure beats transverse. They told me that if she starts going into distress with the contractions they will do a csection and they might have to do a classical section which isn't good for having future babies, NOT like we ever plan on that.
Jay brought me dinner that mom made. It was awesome... so tired, so hot. I just wish I knew when and !
Wednesday, March 30, 2011
I am exhausted!!
This morning I has to go downtown for an ech cardiogram. I went in trhe wrong entrance and ended up having to walk all the way to the other side of the hospital. When I got there, I realised I didn't have the requisition with me. I asked the receptionist if I was in the right spot, but I wasn't on her list. I told her I was there for an echo and she looked at me fuuny. She said "an ecg?" To which I replied "I guess so…". She took down my particulars, sent me into a room, where they plastered me with stickers and covered me in leads. That was an electrocardiogram, NOT an echo, and I am glad I knew the difference. When the ecg was done, I left in search of the right office. I backtracked to the first entrance, made my way to the cardiology dept. They had me on file, but I had to go BACK to where I had the ecg, and instead of turning right, I had to turn left. OMG. I thought I was going to pass out from the exertion.
Finally found the right place! The echo took over an hour. The tech needed the doctor to com in an do some measurements. Apparently being very thin interferes with their ability to take good shots. It HURT!!!
My ribs and left boob feel bruised. The doc said "well... your test is 'okaaay', we'll send this up to the cardiologist and they'll contact your doctor. Okay? I guess it is better than bad, but normally all my tests come back Great!
We can only wait to see what they say on Friday.
I bussed home, which was another adventure, and now nothing at all is going to unglue me from my chaise longue! Nothing!!
Tomorrow I have the bloodwork and holter monitor fitting. Can't wait for Friday to get here already.
Tuesday, March 29, 2011
29 week u/s
My afi/doppler today was pretty okay. *plenty* of fluid, of course she was transverse. Last time she was transverse she had lots of fluid! Her s/d ratio was 3.95 which is alright, although the resistance index was high at 0.79. I know the number should be going down every week and it isn't. Will talk to the doctor on Friday about what they expect to see.
Going to have a quick nap, before company comes to dinner.
Feeling blessed to be at 29 weeks and still holding steady.
Going to have a quick nap, before company comes to dinner.
Feeling blessed to be at 29 weeks and still holding steady.
Tuesday, March 29, 2011
I am definitely not used to waiting until the afternoon to have my appointments. It throws my schedule out the window!
This morning I slept in until 8:30, then got up and made scones with strawberry jam. Yesterday, I was feeling awful and stir-crazy, so I went to the grocery store with my mom. I bought the ingredients for rice krispie squares (which I made last night!), for scones- complete with devon cream, black licorice and syrup waffles. I joked with my mom at the check-out that I really shouldn't go shopping when I have cravings, the cashier looked at me funny... like she couldn't tell I was pregnant. I told mom she needs to buy me some form fitting shirts! At 7 months, it shouldn't be an is she/isn't she pregnant question!
Soo... this morning I baked and stuffed myself with heart-attack inducing clotted cream. Yum!
Had a shower, now I am waiting for my boys to come over for lunch. I miss them!
This morning I slept in until 8:30, then got up and made scones with strawberry jam. Yesterday, I was feeling awful and stir-crazy, so I went to the grocery store with my mom. I bought the ingredients for rice krispie squares (which I made last night!), for scones- complete with devon cream, black licorice and syrup waffles. I joked with my mom at the check-out that I really shouldn't go shopping when I have cravings, the cashier looked at me funny... like she couldn't tell I was pregnant. I told mom she needs to buy me some form fitting shirts! At 7 months, it shouldn't be an is she/isn't she pregnant question!
Soo... this morning I baked and stuffed myself with heart-attack inducing clotted cream. Yum!
Had a shower, now I am waiting for my boys to come over for lunch. I miss them!
I need to buy a v-brace. Google it... it is horrid. HORRID. My girl parts are suffering from the horrible side-effect of bed rest. Thank god jason isn't allowed near there. He would FREAKKKKKK.
My godfather and his girlfriend are coming to dinner tonight. He's never met jake, I haven't seen him since our wedding. My mom is cooking, it smells delicious.
I wish I could nap right now, but there's a lady here going through the house with my dad figuring out how to pack and move everything.
Fun.
Monday, March 28, 2011
So many appointments!
I didn't want to miss getting my appointments for this week and with everything else I have to squish into my schedule, I decided to call the booking girl at the mfm office. I think she was annoyed by my impatience, so she sent me a list of appointments through to the end of april!! I was so surprised. Ugh, I honestly prefer a week by week approach, it isn't quite as daunting. This week I have appointments EVERY day. 30 appts in the next 32 days.
Shitty. My dad says that at least they won't miss anything.
Friday is what I am focused on now. I did a little researching, and I am hoping that little e sticks to a curve and weighs in at 1080gr at the very least. Anything more than that is awesome progress.
This week is going to fly by. Have my afi/doppler tomorrow, an echocardiogram on Wednesday, an ekg, bloodwork and the fitting for my holter monitor and nst on Thursday, then growth scan, mfm appt and holter follow up on Friday. Busy!!
29 weeks tomorrow :)
monday, march 28, 2011
The end of March is near. I can't believe it.
Yesterday I went home for the night to get a couple things done and give my parents the night off. I love going home and I realllllly wish that I could have stayed. But, nope, back at my parents first thing this morning to resume my reclining position on the chaise lounge in the sun room. It broke my heart to leave my sleeping boys at home, knowing J would be upset to find me gone when he woke up. Sigh... it is so hard.
I will be 29 weeks tomorrow. Still going strong and holding steady. Physically, I am achy but I feel fine. Emotionally, however, I am a wreck. I think my lack of control over the situation, and the guilt I feel for being needy and not being able to give J what he needs or really be there for my husband is wreaking havoc on my emotional well-being. I definitely find myself depressed more often that not. It is difficult to see the light at the end if this tunnel. I know Ellie worth it, I don't question that, but I am really concerned how *I* am going to be when this all plays out.
DH keeps telling me that he thinks I look beautiful and that he thinks I'm amazing for growing a baby. I feel gross. I don't think I'm amazing, I think it is pretty lame I can't just perform like I did with J. Ugh.
Just had my nst. Little miss was hiding for a while, but they did eventually track her down. She was great. Don't know when my hospital appointments are this week. They haven't let me know yet but I do know my nsts are Thursday and Saturday.
Hungry... going to go eat :)
Yesterday I went home for the night to get a couple things done and give my parents the night off. I love going home and I realllllly wish that I could have stayed. But, nope, back at my parents first thing this morning to resume my reclining position on the chaise lounge in the sun room. It broke my heart to leave my sleeping boys at home, knowing J would be upset to find me gone when he woke up. Sigh... it is so hard.
I will be 29 weeks tomorrow. Still going strong and holding steady. Physically, I am achy but I feel fine. Emotionally, however, I am a wreck. I think my lack of control over the situation, and the guilt I feel for being needy and not being able to give J what he needs or really be there for my husband is wreaking havoc on my emotional well-being. I definitely find myself depressed more often that not. It is difficult to see the light at the end if this tunnel. I know Ellie worth it, I don't question that, but I am really concerned how *I* am going to be when this all plays out.
DH keeps telling me that he thinks I look beautiful and that he thinks I'm amazing for growing a baby. I feel gross. I don't think I'm amazing, I think it is pretty lame I can't just perform like I did with J. Ugh.
Just had my nst. Little miss was hiding for a while, but they did eventually track her down. She was great. Don't know when my hospital appointments are this week. They haven't let me know yet but I do know my nsts are Thursday and Saturday.
Hungry... going to go eat :)
Friday, March 25, 2011
Dr. P redeemed herself. I was really happy with her approach today. She started off saying she was thrilled to see thast I am still pregnant. :) me too!
Little miss was okay this morning. Good afi and dopplers, but took a bit of time to get moving on the monitor. The nst took 45 minutes.
I had pretty low bp today 83/58, and I've had a few palpitations and feel dizzy almost all the time. They're sending me for an ekg, an ecg at St. Paul's, a hematology profile and 24 hour holster monitoring. Joy.
Dr. P said it was great things are stable but agreed with the home care because things can change really quickly.
The med student gave me a hard time about losing weight, but the dr said it was likely due to muscle loss. Fantastic.
Little miss was okay this morning. Good afi and dopplers, but took a bit of time to get moving on the monitor. The nst took 45 minutes.
I had pretty low bp today 83/58, and I've had a few palpitations and feel dizzy almost all the time. They're sending me for an ekg, an ecg at St. Paul's, a hematology profile and 24 hour holster monitoring. Joy.
Dr. P said it was great things are stable but agreed with the home care because things can change really quickly.
The med student gave me a hard time about losing weight, but the dr said it was likely due to muscle loss. Fantastic.
Thursday, March 24, 2011
Bad Mommy
I broke the rules today, and ended up going home, for the night because I just couldn't take being at my parents' anymore, AND I really, desperately wanted to be sure all my orders were taken care of before my appointment tomorrow.
Call me crazy, but my gut tells me that this is going to be the last time I'm allowed home until after Ellie is born. I'm scared.
I have been feeling like absolute CRAP today. My NST was great, Ellie gave the best tracing she's given so far, but I have a weird feeling that something isn't quite right. Maybe it's just me, I've been having dizzy spells and I'm exhausted. But, I wouldn't be surprised if they tell me tomorrow that my fluid levels have gone down again. God, I wish I'd asked what they were last Friday. The nurse today seemed nonplussed that the levels had dropped by 50%. She said that they can vary a lot. I haven't been able to find anything to back up her claim. I'm scared that it's gone down, I know I have until 5cm before I have to worry, so I'm hoping we're still hanging out around 10!!
here's a chart of weights. My peanut was 860grams on Friday, which puts her right at the -22% weight deviation. I remember seeing that number on the chart, 22%. Equates to 2.3% for size overall. Not a big girl... I know babies over 1500 grams do really well, so that means she's got to get to 32 weeks, IF she doesn't keep falling off the damn curve.
26+0 30 + 0 34 + 0 38 + 0 40 + 0 42 + 0 Gestational Age
950 1600 2380 3200 3600 3900 Expected weight
740 1250 1850 2500 2800 3100 -22% weight deviation » 2 SD
620 1050 1550 2100 2320 2550 -35% weight deviation » 3 SD
Tonight I feel sick about the situation. Again. Some days I'm great, but today is not one of those days. of course, it's late (11pm) and I have to be ready to leave for the hospital at 7:15am.
All my orders are done, all i have to think about now is having a baby.
Your thoughts and prayers are always most welcome.
<3
Call me crazy, but my gut tells me that this is going to be the last time I'm allowed home until after Ellie is born. I'm scared.
I have been feeling like absolute CRAP today. My NST was great, Ellie gave the best tracing she's given so far, but I have a weird feeling that something isn't quite right. Maybe it's just me, I've been having dizzy spells and I'm exhausted. But, I wouldn't be surprised if they tell me tomorrow that my fluid levels have gone down again. God, I wish I'd asked what they were last Friday. The nurse today seemed nonplussed that the levels had dropped by 50%. She said that they can vary a lot. I haven't been able to find anything to back up her claim. I'm scared that it's gone down, I know I have until 5cm before I have to worry, so I'm hoping we're still hanging out around 10!!
here's a chart of weights. My peanut was 860grams on Friday, which puts her right at the -22% weight deviation. I remember seeing that number on the chart, 22%. Equates to 2.3% for size overall. Not a big girl... I know babies over 1500 grams do really well, so that means she's got to get to 32 weeks, IF she doesn't keep falling off the damn curve.
26+0 30 + 0 34 + 0 38 + 0 40 + 0 42 + 0 Gestational Age
950 1600 2380 3200 3600 3900 Expected weight
740 1250 1850 2500 2800 3100 -22% weight deviation » 2 SD
620 1050 1550 2100 2320 2550 -35% weight deviation » 3 SD
Tonight I feel sick about the situation. Again. Some days I'm great, but today is not one of those days. of course, it's late (11pm) and I have to be ready to leave for the hospital at 7:15am.
All my orders are done, all i have to think about now is having a baby.
Your thoughts and prayers are always most welcome.
<3
Wednesday, March 23, 2011
wednesday, march 23, 2011
Another day down.
I am exhausted, my head hurts and I have to get up early so this one is going to be short.
Last night was brutal. By the time I was able to rip myself away from my phone, it was late. Go figre the moment I shut my eyes I heard "Mama? Mama?" Calling from the room next to mine. Not wanting my jet lagged dad to wake, I went to get Jake and he spent the night snuggling me. For the first half hour I loved every second... then I wanted to sleep and his mama need got a little aggravating. HE slept well. I did not.
I was expecting a late morning visit from a friend, to follow my scheduled nurse nst visit. I had planned to ask permission to go home for one night to tie up all my loose ends. Timing would have been great, my mil has tomorrow off and already agreed to have jake tonight and tomorrow night. Ah, but the powers that be crushed those plans... the nurse called to say tomorrow is slow for them so they are coming mid-day. Argh!! No big deal, just frustrating.
My visit with rachel was lovely. Then I spent ten minutes snuggling my hubby before he went to work. Ellie was quiet today and took 3 hours to give me 6 kicks this morning.this afternoon she perked up though. Seriously hope she's good for the nst tomorrow... I need stuff from home! People are waiting on tracking info and I want to see for sure everything has been taken care of. If Friday means even more intensive monitoring, I'll take it. I just want ONE day at home!
I am exhausted, my head hurts and I have to get up early so this one is going to be short.
Last night was brutal. By the time I was able to rip myself away from my phone, it was late. Go figre the moment I shut my eyes I heard "Mama? Mama?" Calling from the room next to mine. Not wanting my jet lagged dad to wake, I went to get Jake and he spent the night snuggling me. For the first half hour I loved every second... then I wanted to sleep and his mama need got a little aggravating. HE slept well. I did not.
I was expecting a late morning visit from a friend, to follow my scheduled nurse nst visit. I had planned to ask permission to go home for one night to tie up all my loose ends. Timing would have been great, my mil has tomorrow off and already agreed to have jake tonight and tomorrow night. Ah, but the powers that be crushed those plans... the nurse called to say tomorrow is slow for them so they are coming mid-day. Argh!! No big deal, just frustrating.
My visit with rachel was lovely. Then I spent ten minutes snuggling my hubby before he went to work. Ellie was quiet today and took 3 hours to give me 6 kicks this morning.this afternoon she perked up though. Seriously hope she's good for the nst tomorrow... I need stuff from home! People are waiting on tracking info and I want to see for sure everything has been taken care of. If Friday means even more intensive monitoring, I'll take it. I just want ONE day at home!
Tuesday, March 22, 2011
tuesday,march 22,2011
I feel gross today. I didn't sleep well because my hips hurt and my knees hurt. Because my joints were sore, I found myself tossing and turning almost the whole night through. Every time I rolled over - which was a lot- I had braxton hicks contractions. Totally unpleasant.
When I got up in the morning I looked in the mirror. My belly looked strange and small, ha, smaller than usual. I asked my mom if she saw a difference and she agreed it was noticeable. I had a little freak out that maybe my fluid went down, but my mom talked me out of stressing.
Had an afi and doppler check anyway this morning! The first thing the tech said was "wow, she's breech! Has she always been breech?" Nope! At my appointment on Friday she had her head so far into my pelvis they couldn't get a decent cervical shot! I am pretty sure based on where they found her heartbeat yesterday that she was still head down, so maybe all those cramps last night were from her turning. Little monkey.
I asked for the afi number this time. It was 108mm. I can't for the life of me remember what it was before, so I plan on asking the nurse tomorrow. I know afi levels generally stay constant and mine haven't (not really surprising, since this little one often likes to buck the trend). From what I could tell, dopplers were still stable too, hovering around the 90th percentile on most readings.
My daddy is coming home this afternoon, and staying home for almost a month! So happy to see him. It gives my mom a bit of a break when J gets crazy.
DH works tonight so he's napping, as is J, who is gearing up for a night of catching up with Morfar. I can't wait to see how my dad is with him. Its only been 10 weeks since they saw each other, but I know J has changed :)
Another nst in the morning... ah, the things I look forward to.
When I got up in the morning I looked in the mirror. My belly looked strange and small, ha, smaller than usual. I asked my mom if she saw a difference and she agreed it was noticeable. I had a little freak out that maybe my fluid went down, but my mom talked me out of stressing.
Had an afi and doppler check anyway this morning! The first thing the tech said was "wow, she's breech! Has she always been breech?" Nope! At my appointment on Friday she had her head so far into my pelvis they couldn't get a decent cervical shot! I am pretty sure based on where they found her heartbeat yesterday that she was still head down, so maybe all those cramps last night were from her turning. Little monkey.
I asked for the afi number this time. It was 108mm. I can't for the life of me remember what it was before, so I plan on asking the nurse tomorrow. I know afi levels generally stay constant and mine haven't (not really surprising, since this little one often likes to buck the trend). From what I could tell, dopplers were still stable too, hovering around the 90th percentile on most readings.
My daddy is coming home this afternoon, and staying home for almost a month! So happy to see him. It gives my mom a bit of a break when J gets crazy.
DH works tonight so he's napping, as is J, who is gearing up for a night of catching up with Morfar. I can't wait to see how my dad is with him. Its only been 10 weeks since they saw each other, but I know J has changed :)
Another nst in the morning... ah, the things I look forward to.
Monday, March 21, 2011
monday, march 21. 2011
Today was my grandmotherls birthday. Always think of her on this day, and this year - sent up a wish for her to look out for us and our tiny peanut.
Today I had my nst visit. Beth came over which was so nice :) little e didn't exactly cooperate with the nst which was lame. Took an hour to get a decent reading. I asked about the results of fridays afi index... it went from the 80th percentile to 30th in a week. Ughhhh. Why can't things just stay STABLE?! Is that so much to ask for?
28 weeks tomorrow, though. Six weeks since this all got complicated. Nervous about my afi tomorrow... if the fluid goes down more it could mean her lidneys are shunting blood away from them to the brain. Not pleasant.
Will update tomorrow!
Today I had my nst visit. Beth came over which was so nice :) little e didn't exactly cooperate with the nst which was lame. Took an hour to get a decent reading. I asked about the results of fridays afi index... it went from the 80th percentile to 30th in a week. Ughhhh. Why can't things just stay STABLE?! Is that so much to ask for?
28 weeks tomorrow, though. Six weeks since this all got complicated. Nervous about my afi tomorrow... if the fluid goes down more it could mean her lidneys are shunting blood away from them to the brain. Not pleasant.
Will update tomorrow!
Friday, March 18, 2011
Friday, March 18th, 2011
Trouble. This girl is trouble.
My ultrasound was alright, I could tell that fluid levels were fine (around 10cm) and dopplers looked awesome and normal. Then, she didn't cooperate with the NST, and it took an hour to get her to perform for us, but in the last five minutes they saw the accelerations they wanted.
I decided to get lunch in between my NST and MFM appointments, because last time I had to wait forever to be seen. The nurse did my weight (up 20lbs since the beginning...*gasp*) and urine (negative on protein and glucose). Then I went to the clinic room. R, the mfm nurse came in and did my vitals. Blood pressure was lower than normal 90/65, when I average 110/70, but hey! at least it's not going up. Fundal height was measuring three weeks behind, but there is no surprise there. My gd test came back normal, yay!
We chatted a bit about my history, and then the doctor came in. Ah, another amazing doctor! I wish they all were so nice, and that they all cared as much. My faith has been restored.
Ellie's growth trajectory is not keeping up with the normal curve. Most of her measurements are okay, but her abdominal circumference keeps dropping.
BPD was 1%
HC was 15% (or maybe it was 11... I can't remember)
AC was 2%
FL was 11%
She's measuring over 2.3 weeks behind, whereas at our last growth appointment she was 1.9 weeks behind. Still, she did grow some. They estimate her weight to be 800 grams, which isn't actually that bad, apparently. The doctor said that as long as she keeps eking out some growth, and AFI, dopplers and NSTs are stable, she stays in. She stressed that Ellie herself is still very premature, and would most likely only do as well as a 25 weeker at this point, so I'm going to do everything I can to make sure that she stays in. She said it would be unlikely to make it past 32 weeks, but we're going to do everything we can to get to that point. She said that it is highly unlikely that she will catch up at this point, based on three growth scans showing a lagging trend. If she gets to 36 weeks (the absolute max they will let us go) she'll be under 5lbs. Tiny!
Because my parents live very close to the hospital (thank goodness), they decided not to admit me, instead they put me into their antenatal homecare program. Mondays, Wednesdays and Saturdays a nurse will come to the house to do NSTs. Then Tuesdays and Fridays I will have AFI and doppler scans done at the hospital. Every other Friday I will also have all the growth measurements done.
They gave me my activity level guide:
-minimum of 8 hours rest at night, 3x3hours (9 hours total) periods of lying on side or sitting/reclining as tolerated
-Walking for short periods only (less than ten minutes, eg. to the Gift shop, caferia - Ha, that's kind of funny)
-no stairs ->sort of complicated in a house with lots of stairs.
- Active toddler should have alternate caregiver during visits, except for short periods.
-Yes to shower/bath and, prescribed bed rest activities.
*I am so, so glad I can have the antenatal home care, I think I'd lose my mind if I had to be back in the hospital, especially since they want me to get to 32 weeks. Crazy thinking that it's only a month away.
So, some good, and some not great. I hope she doesn't fall further behind in the weeks to come!
My ultrasound was alright, I could tell that fluid levels were fine (around 10cm) and dopplers looked awesome and normal. Then, she didn't cooperate with the NST, and it took an hour to get her to perform for us, but in the last five minutes they saw the accelerations they wanted.
I decided to get lunch in between my NST and MFM appointments, because last time I had to wait forever to be seen. The nurse did my weight (up 20lbs since the beginning...*gasp*) and urine (negative on protein and glucose). Then I went to the clinic room. R, the mfm nurse came in and did my vitals. Blood pressure was lower than normal 90/65, when I average 110/70, but hey! at least it's not going up. Fundal height was measuring three weeks behind, but there is no surprise there. My gd test came back normal, yay!
We chatted a bit about my history, and then the doctor came in. Ah, another amazing doctor! I wish they all were so nice, and that they all cared as much. My faith has been restored.
Ellie's growth trajectory is not keeping up with the normal curve. Most of her measurements are okay, but her abdominal circumference keeps dropping.
BPD was 1%
HC was 15% (or maybe it was 11... I can't remember)
AC was 2%
FL was 11%
She's measuring over 2.3 weeks behind, whereas at our last growth appointment she was 1.9 weeks behind. Still, she did grow some. They estimate her weight to be 800 grams, which isn't actually that bad, apparently. The doctor said that as long as she keeps eking out some growth, and AFI, dopplers and NSTs are stable, she stays in. She stressed that Ellie herself is still very premature, and would most likely only do as well as a 25 weeker at this point, so I'm going to do everything I can to make sure that she stays in. She said it would be unlikely to make it past 32 weeks, but we're going to do everything we can to get to that point. She said that it is highly unlikely that she will catch up at this point, based on three growth scans showing a lagging trend. If she gets to 36 weeks (the absolute max they will let us go) she'll be under 5lbs. Tiny!
Because my parents live very close to the hospital (thank goodness), they decided not to admit me, instead they put me into their antenatal homecare program. Mondays, Wednesdays and Saturdays a nurse will come to the house to do NSTs. Then Tuesdays and Fridays I will have AFI and doppler scans done at the hospital. Every other Friday I will also have all the growth measurements done.
They gave me my activity level guide:
-minimum of 8 hours rest at night, 3x3hours (9 hours total) periods of lying on side or sitting/reclining as tolerated
-Walking for short periods only (less than ten minutes, eg. to the Gift shop, caferia - Ha, that's kind of funny)
-no stairs ->sort of complicated in a house with lots of stairs.
- Active toddler should have alternate caregiver during visits, except for short periods.
-Yes to shower/bath and, prescribed bed rest activities.
*I am so, so glad I can have the antenatal home care, I think I'd lose my mind if I had to be back in the hospital, especially since they want me to get to 32 weeks. Crazy thinking that it's only a month away.
So, some good, and some not great. I hope she doesn't fall further behind in the weeks to come!
Wednesday, March 16, 2011
Wednesday, March 16, 2011
yesterday was a whole world of frustration, all over again.
I had to have my 2 hour glucose tolerance test, which meant I had to be at the hospital at 7am! With the time change, it was really dark, and I don't like driving in the dark, much less in the pouring (sideways!) rain. But, I made it.
The butchered my veins, I'm a completely bruised mess. i really hope I don't need any blood tests in the next couple of days because they won't be able to find anything through all the bruising, on either arm. Really, though, not a big deal. I'm 100% sure I don't have gestational diabetes.
After the two hours of sitting around being completely bored, I grabbed a bite to eat and headed to my nst. It wasn't great. Right at the beginning there were some accelerations, but then nothing. She would move, and her heart rate would drop. Then she had a nap, then she woke up, would move some more and her heart rate would drop again. The nurse that does fetal monitoring noticed enough of a difference from Friday's test, to call the mfm, who was too busy to come down. So, she called another doctor, who wouldn't even listen to my history (she actually interrupted the nurse!!) and said that at 27 weeks the rest was fine enough, she's too young to get a good read. The nurse showed her the test from Friday, the doctor didn't care. She told me to do kick counts, and that's it.
Well, kick counts I've been doing, and she regularly goes a couple to three hours without moving. Then, she'll kick up a storm for a bit, and then go back to the hours of not moving.
Stressful. The doctors these past few appointments have been so uncaring, and rushed, and I sincerely feel as though they could care less about Ellie and I. I know Friday isn't far, it's only two sleeps away, but I'm worried about all those tests on Friday. I think I'm going to call them today for an extra NST. To get a reactive one like we had on Friday would really calm my nerves.
Better get dressed and head over there :)
UPDATE:
I drove in to the fetal assessment clinic at the hospital. I tried calling the mfm clinic ahead of time, but couldn't get through to anyone all morning. Hmph!
I was the only patient there in the assessment area, it was a quiet morning (usually 20-25 babies are born there every day). They definitely were not half as skilled at performing nsts on people, much less women with tiny bellies! Took the nurse ten minutes to get everything in place, and Ellie didn't really want to cooperate. In the end, she gave an awesome strip, which eased my mind like you wouldn't believe. I know that it doesn't mean everything is wonderful or anything in there, but at least she's doing a lot better than she sounded the other day.
Then, I waited for the on call mfm to come look at the strip and let me go home. He took a while, (turns out he was reading my file all the way through- impressive!) and when he came around, he said he wanted me to go for an afi/dopplers scan before he felt comfortable letting me go home. Even though the nst from this morning was really good, the one from yesterday wasn't, so he felt it warranted a follow-up. Ah, where was he yesterday?
So, I waited for about an hour before the u/s, and the tech I got was a bit of a weido. Seriously, he talked non-stop about everything. I don't think he has any sort of filter. Good thing it was just stuff about his schooling (all the places he's dropped out of), his wife's spending issues, and other stuff I pretty much tuned out. AFI was really good, again. And, the dopplers from today were great. The resistance decreased, and it was contant the whole time. The doctor did say that the flow can be really variable, and that they will recheck it all again on Friday (nst, afi, dopplers) when they do the growth check. I asked if it was possible that the test from last Friday was wrong, and that maybe there wasn't absent flow. He said no, and that usually it doesn't get better, but that it's really intermittent, mostly positive, occasionally going absent depending on the baby's position. Still, I felt really relieved to have had someone actually take the time to familiarize himself with my file, and listen to me. He cared. It was a nice change from Friday and Tuesday.
Fingers crossed that by some miracle Ellie will have grown a whole bunch by Friday. I have to explain my crazy weight gain somehow!
Oh yeah... I parked on the main street outside of the hospital, because I didn't want to spend $15 to park in the parking lot. Well, you can't park on the street after 3:00. I left the hospital at 3:20, to see my car in the process of being hoisted onto a tow truck. OMG. I didn't even think about it, and broke into a sprint so they wouldn't take my car to the impound lot. The guy was really nice and gave me the car back, probably because I burst into tears when I got there and realized that I had just run a pretty far distance when I'm supposed to be on bed rest. It was crazy. I got a $50 fine for parking in a "no-stopping" zone after 3pm. Great. lesson learned, next time I'm getting my mom to drop me off at the hospital. No contractions or anything post-sprint, although I was so out of breath I had to stop my car when I got to a side street, and rest for about ten minutes. Ellie's been moving a bunch since then.
Ah, what a day.
I had to have my 2 hour glucose tolerance test, which meant I had to be at the hospital at 7am! With the time change, it was really dark, and I don't like driving in the dark, much less in the pouring (sideways!) rain. But, I made it.
The butchered my veins, I'm a completely bruised mess. i really hope I don't need any blood tests in the next couple of days because they won't be able to find anything through all the bruising, on either arm. Really, though, not a big deal. I'm 100% sure I don't have gestational diabetes.
After the two hours of sitting around being completely bored, I grabbed a bite to eat and headed to my nst. It wasn't great. Right at the beginning there were some accelerations, but then nothing. She would move, and her heart rate would drop. Then she had a nap, then she woke up, would move some more and her heart rate would drop again. The nurse that does fetal monitoring noticed enough of a difference from Friday's test, to call the mfm, who was too busy to come down. So, she called another doctor, who wouldn't even listen to my history (she actually interrupted the nurse!!) and said that at 27 weeks the rest was fine enough, she's too young to get a good read. The nurse showed her the test from Friday, the doctor didn't care. She told me to do kick counts, and that's it.
Well, kick counts I've been doing, and she regularly goes a couple to three hours without moving. Then, she'll kick up a storm for a bit, and then go back to the hours of not moving.
Stressful. The doctors these past few appointments have been so uncaring, and rushed, and I sincerely feel as though they could care less about Ellie and I. I know Friday isn't far, it's only two sleeps away, but I'm worried about all those tests on Friday. I think I'm going to call them today for an extra NST. To get a reactive one like we had on Friday would really calm my nerves.
Better get dressed and head over there :)
UPDATE:
I drove in to the fetal assessment clinic at the hospital. I tried calling the mfm clinic ahead of time, but couldn't get through to anyone all morning. Hmph!
I was the only patient there in the assessment area, it was a quiet morning (usually 20-25 babies are born there every day). They definitely were not half as skilled at performing nsts on people, much less women with tiny bellies! Took the nurse ten minutes to get everything in place, and Ellie didn't really want to cooperate. In the end, she gave an awesome strip, which eased my mind like you wouldn't believe. I know that it doesn't mean everything is wonderful or anything in there, but at least she's doing a lot better than she sounded the other day.
Then, I waited for the on call mfm to come look at the strip and let me go home. He took a while, (turns out he was reading my file all the way through- impressive!) and when he came around, he said he wanted me to go for an afi/dopplers scan before he felt comfortable letting me go home. Even though the nst from this morning was really good, the one from yesterday wasn't, so he felt it warranted a follow-up. Ah, where was he yesterday?
So, I waited for about an hour before the u/s, and the tech I got was a bit of a weido. Seriously, he talked non-stop about everything. I don't think he has any sort of filter. Good thing it was just stuff about his schooling (all the places he's dropped out of), his wife's spending issues, and other stuff I pretty much tuned out. AFI was really good, again. And, the dopplers from today were great. The resistance decreased, and it was contant the whole time. The doctor did say that the flow can be really variable, and that they will recheck it all again on Friday (nst, afi, dopplers) when they do the growth check. I asked if it was possible that the test from last Friday was wrong, and that maybe there wasn't absent flow. He said no, and that usually it doesn't get better, but that it's really intermittent, mostly positive, occasionally going absent depending on the baby's position. Still, I felt really relieved to have had someone actually take the time to familiarize himself with my file, and listen to me. He cared. It was a nice change from Friday and Tuesday.
Fingers crossed that by some miracle Ellie will have grown a whole bunch by Friday. I have to explain my crazy weight gain somehow!
Oh yeah... I parked on the main street outside of the hospital, because I didn't want to spend $15 to park in the parking lot. Well, you can't park on the street after 3:00. I left the hospital at 3:20, to see my car in the process of being hoisted onto a tow truck. OMG. I didn't even think about it, and broke into a sprint so they wouldn't take my car to the impound lot. The guy was really nice and gave me the car back, probably because I burst into tears when I got there and realized that I had just run a pretty far distance when I'm supposed to be on bed rest. It was crazy. I got a $50 fine for parking in a "no-stopping" zone after 3pm. Great. lesson learned, next time I'm getting my mom to drop me off at the hospital. No contractions or anything post-sprint, although I was so out of breath I had to stop my car when I got to a side street, and rest for about ten minutes. Ellie's been moving a bunch since then.
Ah, what a day.
Sunday, March 13, 2011
Frustrated
I've been thinking a lot about Friday. I really should have asked more questions. I plan on calling the clinic first thing in the morning tomorrow to ask about getting a doppler scan done before Friday.
I know that the doctor I saw on Friday thought my condition was stable, but really, when there was evidence of absent end diastolic flow, from all I've been able to find, they SHOULD be monitoring me more closely.
I would be heartbroken if I waited til Friday, and found out that something was really wrong, that could have been caught sooner, only wasn't because this one doctor decided I was stable enough to wait a week. I keep thinking about the peri that did the ultrasound and how she said that I should be rescanned by Monday at the latest. "It's not an indication for delivery, but it is an indication we should be following you a lot more closely than we have been".
I think it's time to advocate for myself and for my peanut. Argh, why do doctors have to be so aggravating at times?!
I know that the doctor I saw on Friday thought my condition was stable, but really, when there was evidence of absent end diastolic flow, from all I've been able to find, they SHOULD be monitoring me more closely.
I would be heartbroken if I waited til Friday, and found out that something was really wrong, that could have been caught sooner, only wasn't because this one doctor decided I was stable enough to wait a week. I keep thinking about the peri that did the ultrasound and how she said that I should be rescanned by Monday at the latest. "It's not an indication for delivery, but it is an indication we should be following you a lot more closely than we have been".
I think it's time to advocate for myself and for my peanut. Argh, why do doctors have to be so aggravating at times?!
Sunday, March 13, 2011
We slept in this morning, thanks to my little munchkin :) He only woke us up because he wanted the step stool on the other side of his baby gate!
We got up, came downstairs (I live on the couch during the day), and Jason started on breakfast. I turned on the tv... we forgot about daylight savings!!!! So, I've been up for a little over an hour, and it's already 11:34am! Oops.
It's miserable outside today, I'm definitely ready for spring. Coming home from my mom's the other day, we were greeted by baby daffodils in my front planter. Last year, I planted a ton of bulbs in all my pots out front, and they are coming back :) Love that I don't have to do anything, and they still look beautiful. We didn't put our patio furniture cushions away over the winter. I have a feeling that when life is back to "normal" that's going to be on my list of summer preparations. The fabric store should be getting in the summer's vinyl prints, so maybe I can find something nice to recover them with. We have some pompus grass out back, that should have been cut back, but wasn't, and looks pretty pathetic. Maybe when the weather improves, Jason can get out and deal with it.
We had dinner with my sister-in-law last night. I honestly can't remember the last time we saw eachother. She looks amazing!! She's 30 weeks next week, and absolutely blooming. I can't wait to be an Auntie, for real! That's my little niece in there.
I'm 26w5d today! Wow :) Only 9 more days until I reach 28 weeks.
We got up, came downstairs (I live on the couch during the day), and Jason started on breakfast. I turned on the tv... we forgot about daylight savings!!!! So, I've been up for a little over an hour, and it's already 11:34am! Oops.
It's miserable outside today, I'm definitely ready for spring. Coming home from my mom's the other day, we were greeted by baby daffodils in my front planter. Last year, I planted a ton of bulbs in all my pots out front, and they are coming back :) Love that I don't have to do anything, and they still look beautiful. We didn't put our patio furniture cushions away over the winter. I have a feeling that when life is back to "normal" that's going to be on my list of summer preparations. The fabric store should be getting in the summer's vinyl prints, so maybe I can find something nice to recover them with. We have some pompus grass out back, that should have been cut back, but wasn't, and looks pretty pathetic. Maybe when the weather improves, Jason can get out and deal with it.
We had dinner with my sister-in-law last night. I honestly can't remember the last time we saw eachother. She looks amazing!! She's 30 weeks next week, and absolutely blooming. I can't wait to be an Auntie, for real! That's my little niece in there.
I'm 26w5d today! Wow :) Only 9 more days until I reach 28 weeks.
Saturday, March 12, 2011
Saturday, March 12, 2011
Here's a little breakdown of what they test for weekly, it's from www.fetal.com
Fetal Surveillance
Unless delivery occurs, once treatment begins the fetus must undergo surveillance. The purpose of this is to identify further progression of the disease process that would jeopardize the fetus to a point that it would be better to be delivered than to remain in utero. There are four testing modalities, each of which addresses different aspects of surveillance, which are helpful. Most physicians agree that a combination of tests are better than an isolated test.
Non-Stress Test (I have two of these a week, at present)
This is one of the first tests used in the surveillance of IUGR fetuses and the simplest to perform. The physician uses a heart rate monitor to determine changes in the fetal heart rate with fetal movement. If the heart rate increases more than 15 beats for more than 15 seconds (at my current gestation, they look for an increase of 10 beats for more than 10 seconds), this is considered to be a reactive test. If the heart rate does not accelerate, remains flat, or decreases, then this is an abnormal test. The problem with this test is that it changes late in the course of the disease and does not identify a fetus with IUGR. When patients are diagnosed with IUGR and require continuous monitoring, the fetal heart rate tracing may be useful in detecting fetal distress.
Amniotic Fluid Index
The physician measures the vertical depth of four pockets of amniotic fluid to obtain a total amniotic fluid index. This method allows for comparison of changes in amniotic fluid with time. In the normal fetus the amniotic fluid index remains relatively constant. In the fetus with IUGR, it may decrease slowly, or decrease abruptly with time. A decrease in amniotic fluid may occur before there are changes in the non-stress test. The current recommendations are that if the amniotic fluid index decreases below 8 after 35 weeks, then delivery should be considered.(at yesterday's scan, I think my AFI was around 15, which is really good)
The following is an example of a fetus at risk for IUGR in which the amniotic fluid index was measured but the nurses and physician did not understand the principles of an abnormal reading. The fetus was allowed to remain in utero and developed cerebral palsy from oxygen deprivation. The family sued the hospital and the physician and was awarded 9.7 million dollars which was the largest malpractice award in the state of Utah.
This is the amniotic fluid index in the above case. The blue represents the normal range.
At 35 weeks the fluid measurement was 16. Four days later it dropped to 6.3. This sudden drop
was ignored by the nurses and physician caring for the patient. A few days later
the fetus was damaged because the umbilical cord was compressed, resulting in cerebral palsy.
Doppler of the Umbilical Artery
In a previous section I discussed Doppler evaluation of the umbilical artery. When IUGR is diagnosed, the value of sequential studies of the umbilical artery Doppler waveform is to determine if the Resistance Index is increasing or decreasing. If it is increasing, then this signifies a deteriorating condition. The following graph illustrates these principles.
This is a graphical display of the Resistance Index measurement of the umbilical artery
Doppler waveform If the measurement increases, this indicates the fetus is at increased risk
for adverse outcome.
Biophysical Profile (not sure if this is what they do on my Fridays, it's possible, although they haven't mentioned it)
This test combines the non-stress test and the amniotic fluid index with fetal movement, breathing, and muscle tone. If each of the tests are normal they are given a score of 2. If abnormal, a score of 0. If the score is 6 or less, this suggests the fetus is at risk for adverse outcome. While the biophysical profile is a useful test, when it becomes abnormal the fetus may have already suffered some damage.
Fetal Surveillance
Unless delivery occurs, once treatment begins the fetus must undergo surveillance. The purpose of this is to identify further progression of the disease process that would jeopardize the fetus to a point that it would be better to be delivered than to remain in utero. There are four testing modalities, each of which addresses different aspects of surveillance, which are helpful. Most physicians agree that a combination of tests are better than an isolated test.
Non-Stress Test (I have two of these a week, at present)
This is one of the first tests used in the surveillance of IUGR fetuses and the simplest to perform. The physician uses a heart rate monitor to determine changes in the fetal heart rate with fetal movement. If the heart rate increases more than 15 beats for more than 15 seconds (at my current gestation, they look for an increase of 10 beats for more than 10 seconds), this is considered to be a reactive test. If the heart rate does not accelerate, remains flat, or decreases, then this is an abnormal test. The problem with this test is that it changes late in the course of the disease and does not identify a fetus with IUGR. When patients are diagnosed with IUGR and require continuous monitoring, the fetal heart rate tracing may be useful in detecting fetal distress.
Amniotic Fluid Index
The physician measures the vertical depth of four pockets of amniotic fluid to obtain a total amniotic fluid index. This method allows for comparison of changes in amniotic fluid with time. In the normal fetus the amniotic fluid index remains relatively constant. In the fetus with IUGR, it may decrease slowly, or decrease abruptly with time. A decrease in amniotic fluid may occur before there are changes in the non-stress test. The current recommendations are that if the amniotic fluid index decreases below 8 after 35 weeks, then delivery should be considered.(at yesterday's scan, I think my AFI was around 15, which is really good)
The following is an example of a fetus at risk for IUGR in which the amniotic fluid index was measured but the nurses and physician did not understand the principles of an abnormal reading. The fetus was allowed to remain in utero and developed cerebral palsy from oxygen deprivation. The family sued the hospital and the physician and was awarded 9.7 million dollars which was the largest malpractice award in the state of Utah.
This is the amniotic fluid index in the above case. The blue represents the normal range.
At 35 weeks the fluid measurement was 16. Four days later it dropped to 6.3. This sudden drop
was ignored by the nurses and physician caring for the patient. A few days later
the fetus was damaged because the umbilical cord was compressed, resulting in cerebral palsy.
Doppler of the Umbilical Artery
In a previous section I discussed Doppler evaluation of the umbilical artery. When IUGR is diagnosed, the value of sequential studies of the umbilical artery Doppler waveform is to determine if the Resistance Index is increasing or decreasing. If it is increasing, then this signifies a deteriorating condition. The following graph illustrates these principles.
This is a graphical display of the Resistance Index measurement of the umbilical artery
Doppler waveform If the measurement increases, this indicates the fetus is at increased risk
for adverse outcome.
Biophysical Profile (not sure if this is what they do on my Fridays, it's possible, although they haven't mentioned it)
This test combines the non-stress test and the amniotic fluid index with fetal movement, breathing, and muscle tone. If each of the tests are normal they are given a score of 2. If abnormal, a score of 0. If the score is 6 or less, this suggests the fetus is at risk for adverse outcome. While the biophysical profile is a useful test, when it becomes abnormal the fetus may have already suffered some damage.
Friday, March 11, 2011
Appointment Update
What an emotional day today has been.
I got to my ultrasound appointment early, and they saw me pretty much right away. I was happy to see that the AFI was normal (yay), but got a little worried when the tech fell silent and focused on taking doppler measurements. She didn't say a thing about any of the measurements. After she was done, she went to consult with the reporting doctor, and took a long while before they both came back. Turns out the tech got some good shots of intermittent absent end diastolic flow. Meaning, the blood flow stops sporradically in the diastolic phase. When she went back to check, it was okay, but the pictures showed that it *does* happen. She said, it's not a reason to have her be born yet, even reverse diastolic flow isn't an immediate indicator of delivery, but that it does mean I need to be followed a lot more closely. She said she thought I should be rescanned tomorrow, and possibly admitted, but depending on the mfm I met with (as they all have very different opinions) might suggest a rescan on Sunday or Monday.
My NST was good. The fetal monitoring RN was awesome.
Then, I waited TWO hours for my mfm appointment. I was supposed to be seen at eleven, she didn't show up until 1!! I heard her complain about being hungry, and said to the nurse that I could wait until after she'd had lunch. OMG, the mfm was horrendous. I did not like her even one bit. After I'm done here, I'm calling the receptionist to request never to been seen by her again. She was awful. She came in, barely apologized for the wait, sat down and asked the basics (baby moving? spotting? contractions?) then went on to say "in my interpretation, your ultrasound results are stable. Your AFI is normal, as are some of your other dopplers". She pretty much stopped talking about that, and switched to talking about a gestational diabetes requisition (which I don't really want to have done) and my need to have it done before they can administer steroids. Jane says that the steroids can skew the results of the gd screen. She said "we'll follow you until 32 weeks and then you can go back to Richmond". Then she asked very quickly if I had any questions, and before I had a chance to think, she was gone. Five minutes later, the nurse came in, handed me the requisition for the gd test, and escorted me out. Are you effing kidding me?! One doctor says my condition warrants close monitoring, the other doesn't seem to give a rat's ass about me. Thanks for the service.
I didn't have too long to stew in my anger, because our meeting with the neonatologist was at 1:30pm. Wow, Dr. A was just the most amazing person I've met thus far. She was so, so nice to Jason and I. She talked about babies being born at 26 weeks, 27 weeks, 28 weeks, and a little about 29 weekers and up. Pretty much, if Ellie has to be born, she will make it. The NICU is so well equipped, they can handle just about anything thrown at them. She explained all the procedures they do to the newborns, all the monitors, all the tests. She was very open about it all, and didn't overwhelm us with information, just provided us with what we need to know for now.
She also took us on a tour of the NICU nursery, which was completely different than I had imagined. She showed us three babies (and thank you to the parents of those babies for letting us look!!). The first, was a 2 day old, 28 weeker who was born at 800grams. 200 grams bigger than Ellie, but so, so, sooooo tiny. Absolutely beautiful, perfectly formed, just micro-tiny. Then we saw a 23 weeker, who had been there a long time, but was nice and big and fat :) Adorable! And so amazing that he'd made it so far. Last, they showed us a 2 day old 31-weeker, a lot bigger than what Ellie would be if she stays on her curve, still so incredible tiny. Jason and I were in awe, and we left feeling comfortable, and no longer scared at the idea of having a preemie. She will be extraordinarily well looked after if she is born early. I have zero intention of allowing my care to be transferred to Richmond at 32 weeks, eff that idea. I'm staying in Vancouver, that is where I am having my baby.
We got home, and I called Jane to vent about the MFM. She suggested I call the ob-scan department to see if I could get the name of the doctor that did the scan, in the hopes of speaking with her about the drastic difference of opinion. Either that, or call the receptionist at the MFM desk and ask for a second opinion, explaining that I was very confused after my awful appointment.
Dr. P might be the more knowledgeable one, maybe her assessment is the correct one, and there's nothing to worry about between now and next week, but I'm not convinced. I think I'm going to think about it for a bit before deciding what to do.
I got to my ultrasound appointment early, and they saw me pretty much right away. I was happy to see that the AFI was normal (yay), but got a little worried when the tech fell silent and focused on taking doppler measurements. She didn't say a thing about any of the measurements. After she was done, she went to consult with the reporting doctor, and took a long while before they both came back. Turns out the tech got some good shots of intermittent absent end diastolic flow. Meaning, the blood flow stops sporradically in the diastolic phase. When she went back to check, it was okay, but the pictures showed that it *does* happen. She said, it's not a reason to have her be born yet, even reverse diastolic flow isn't an immediate indicator of delivery, but that it does mean I need to be followed a lot more closely. She said she thought I should be rescanned tomorrow, and possibly admitted, but depending on the mfm I met with (as they all have very different opinions) might suggest a rescan on Sunday or Monday.
My NST was good. The fetal monitoring RN was awesome.
Then, I waited TWO hours for my mfm appointment. I was supposed to be seen at eleven, she didn't show up until 1!! I heard her complain about being hungry, and said to the nurse that I could wait until after she'd had lunch. OMG, the mfm was horrendous. I did not like her even one bit. After I'm done here, I'm calling the receptionist to request never to been seen by her again. She was awful. She came in, barely apologized for the wait, sat down and asked the basics (baby moving? spotting? contractions?) then went on to say "in my interpretation, your ultrasound results are stable. Your AFI is normal, as are some of your other dopplers". She pretty much stopped talking about that, and switched to talking about a gestational diabetes requisition (which I don't really want to have done) and my need to have it done before they can administer steroids. Jane says that the steroids can skew the results of the gd screen. She said "we'll follow you until 32 weeks and then you can go back to Richmond". Then she asked very quickly if I had any questions, and before I had a chance to think, she was gone. Five minutes later, the nurse came in, handed me the requisition for the gd test, and escorted me out. Are you effing kidding me?! One doctor says my condition warrants close monitoring, the other doesn't seem to give a rat's ass about me. Thanks for the service.
I didn't have too long to stew in my anger, because our meeting with the neonatologist was at 1:30pm. Wow, Dr. A was just the most amazing person I've met thus far. She was so, so nice to Jason and I. She talked about babies being born at 26 weeks, 27 weeks, 28 weeks, and a little about 29 weekers and up. Pretty much, if Ellie has to be born, she will make it. The NICU is so well equipped, they can handle just about anything thrown at them. She explained all the procedures they do to the newborns, all the monitors, all the tests. She was very open about it all, and didn't overwhelm us with information, just provided us with what we need to know for now.
She also took us on a tour of the NICU nursery, which was completely different than I had imagined. She showed us three babies (and thank you to the parents of those babies for letting us look!!). The first, was a 2 day old, 28 weeker who was born at 800grams. 200 grams bigger than Ellie, but so, so, sooooo tiny. Absolutely beautiful, perfectly formed, just micro-tiny. Then we saw a 23 weeker, who had been there a long time, but was nice and big and fat :) Adorable! And so amazing that he'd made it so far. Last, they showed us a 2 day old 31-weeker, a lot bigger than what Ellie would be if she stays on her curve, still so incredible tiny. Jason and I were in awe, and we left feeling comfortable, and no longer scared at the idea of having a preemie. She will be extraordinarily well looked after if she is born early. I have zero intention of allowing my care to be transferred to Richmond at 32 weeks, eff that idea. I'm staying in Vancouver, that is where I am having my baby.
We got home, and I called Jane to vent about the MFM. She suggested I call the ob-scan department to see if I could get the name of the doctor that did the scan, in the hopes of speaking with her about the drastic difference of opinion. Either that, or call the receptionist at the MFM desk and ask for a second opinion, explaining that I was very confused after my awful appointment.
Dr. P might be the more knowledgeable one, maybe her assessment is the correct one, and there's nothing to worry about between now and next week, but I'm not convinced. I think I'm going to think about it for a bit before deciding what to do.
Friday, March 11, 2011
Not good...
Intermittent absent end diastolic flow. I have to come back tomorrow for a repeat scan, and they suggested that I will be admitted for much closer monitoring.
I had a decent NST. Waiting on the MFM appointment, and then the neonatologist consult. I am really hoping I don't get admitted today, tomorrow I can deal with. I still have loose ends to wrap up at home.
Eek.
Intermittent absent end diastolic flow. I have to come back tomorrow for a repeat scan, and they suggested that I will be admitted for much closer monitoring.
I had a decent NST. Waiting on the MFM appointment, and then the neonatologist consult. I am really hoping I don't get admitted today, tomorrow I can deal with. I still have loose ends to wrap up at home.
Eek.
Thursday, March 10, 2011
So scared. Thursday, March 10, 2011
I am so nervous about tomorrow that I'm nauseated, and shaky. That's not good...
Part of me, some weird part of my brain, is trying to convince the rest of me that things are going to be just fine tomorrow. But the rest of me, well, isn't so sure.
I am literally sick with worry.
I've gone into all my past appointments very optimistic, and left disappointed and confused. Each time I've gone in thinking "everything's going to have sorted itself out, she's going to have grown, they'll scale back their monitoring", and every time it seems I find myself facing increasing monitoring, and bleaker outlooks.
I'm so afraid that tomorrow she'll have absent end diastolic flow. I am SO afraid.
To make it worse, I'm going to my ultrasound, non-stress test, and mfm appointment alone. DH is with J until lunch time, when my mother-in-law is going to take J, so DH can join me for the "important" neonatologist consult appointment.
Please, please, please, please let there be positive flow. Please, if I never ask for anything else in my life, please let my little girl be okay.
Part of me, some weird part of my brain, is trying to convince the rest of me that things are going to be just fine tomorrow. But the rest of me, well, isn't so sure.
I am literally sick with worry.
I've gone into all my past appointments very optimistic, and left disappointed and confused. Each time I've gone in thinking "everything's going to have sorted itself out, she's going to have grown, they'll scale back their monitoring", and every time it seems I find myself facing increasing monitoring, and bleaker outlooks.
I'm so afraid that tomorrow she'll have absent end diastolic flow. I am SO afraid.
To make it worse, I'm going to my ultrasound, non-stress test, and mfm appointment alone. DH is with J until lunch time, when my mother-in-law is going to take J, so DH can join me for the "important" neonatologist consult appointment.
Please, please, please, please let there be positive flow. Please, if I never ask for anything else in my life, please let my little girl be okay.
Tuesday, March 8, 2011
Tuesday, March 8, 2011
You know what really isn't pleasant? Showing up for your first NST (Fetal assessment), and having the person administering the test exclaim that you're being seen a LOT more frequently than most people. Then, having that person look at your chart, and non-challantly say "ooh, that's why". My chart says that I'm high risk due to IUGR.
Thanks, Lady.
Little Miss did just fine on her NST, although she wasn't as reactive as they would have liked, eventually she started kicking up a storm, and they got adequate results. Apparently they don't like to do NST assesments prior to 28 weeks, but I guess they make special exceptions.
Here's my patient itinerary, for the next couple weeks:
Friday, March 11, 2011
9:30 U/S AFI Doppler - 15 minutes
10:00 Fetal NST F/UP- 45 minutes
11:00 MFM F/UP- 30 minutes
13:30 NICU Consult - 60 minutes
Tuesday, March 15, 2011
9:15 Fetal NST F/UP - 45 minutes
Friday, March 18, 2011
9:00 U/S Clinic OB Scan- 45 minutes
10:00 Fetal NST F/UP- 45 minutes
11:00 MFM F/UP- 30 minutes
I know the schedule can change at any time depending on how things go at each appointment, but it sure does amount to a lot of time spent at that hospital.
Our NICU consult is with Dr. A, a neonatologist, who happens to have a phD in ethical issues in neonatal decision-making. A lot of the reading I've done seems to indicate a high likelihood of morbidity (long term health problems) in iugr babies, and our plan of action might be different once we get a chance to talk with this Dr.
I'm glad they give us an hour, I am already planning out all the questions I can think of at the moment.
I had another look at my S/D ratios from last week, and two weeks prior. The resistance levels are definitely increasing, so I'm hoping that by some miracle they go down by Friday, or that they at least stay positive, and not absent-end, or reverse flow. From the research papers I've been glued to, she needs to make it to 28 weeks, regardless of weight, and she needs to do that before her flow goes absent. Only two more weeks.
14 days. If she can get to 31 weeks, she's golden, that's only 5 weeks away.
Thanks, Lady.
Little Miss did just fine on her NST, although she wasn't as reactive as they would have liked, eventually she started kicking up a storm, and they got adequate results. Apparently they don't like to do NST assesments prior to 28 weeks, but I guess they make special exceptions.
Here's my patient itinerary, for the next couple weeks:
Friday, March 11, 2011
9:30 U/S AFI Doppler - 15 minutes
10:00 Fetal NST F/UP- 45 minutes
11:00 MFM F/UP- 30 minutes
13:30 NICU Consult - 60 minutes
Tuesday, March 15, 2011
9:15 Fetal NST F/UP - 45 minutes
Friday, March 18, 2011
9:00 U/S Clinic OB Scan- 45 minutes
10:00 Fetal NST F/UP- 45 minutes
11:00 MFM F/UP- 30 minutes
I know the schedule can change at any time depending on how things go at each appointment, but it sure does amount to a lot of time spent at that hospital.
Our NICU consult is with Dr. A, a neonatologist, who happens to have a phD in ethical issues in neonatal decision-making. A lot of the reading I've done seems to indicate a high likelihood of morbidity (long term health problems) in iugr babies, and our plan of action might be different once we get a chance to talk with this Dr.
I'm glad they give us an hour, I am already planning out all the questions I can think of at the moment.
I had another look at my S/D ratios from last week, and two weeks prior. The resistance levels are definitely increasing, so I'm hoping that by some miracle they go down by Friday, or that they at least stay positive, and not absent-end, or reverse flow. From the research papers I've been glued to, she needs to make it to 28 weeks, regardless of weight, and she needs to do that before her flow goes absent. Only two more weeks.
14 days. If she can get to 31 weeks, she's golden, that's only 5 weeks away.
Monday, March 7, 2011
Monday, March 7, 2011
Today was beautiful outside, and I had a looooong nap lying on the chaise longue in my parents' sun room. It was delightful.
Tomorrow is my first (of this pregnancy) non-stress test, and my first at Women's. I know that usually they only take 20-40 minutes or so, and are more boring than anything else.
I haven't noticed Ellie moving as much recently, and I'm hoping that's just because I've been preoccupied. Friday cannot come soon enough.
Now I'm praying that we make it to 28 weeks with good blood flow, at the very, very least.
Tomorrow is my first (of this pregnancy) non-stress test, and my first at Women's. I know that usually they only take 20-40 minutes or so, and are more boring than anything else.
I haven't noticed Ellie moving as much recently, and I'm hoping that's just because I've been preoccupied. Friday cannot come soon enough.
Now I'm praying that we make it to 28 weeks with good blood flow, at the very, very least.
Saturday, March 5, 2011
Saturday, March 5, 2011
I'm so tired. Physically exhausted, and mentally drained. I think I read too much into everything, but honestly, when I think about it, I have a really bad feeling about how this is all going to work out.
It's almost impossible to find any useful information on Dr.Google. I was looking for a chart to convert weight and growth percentiles to actual measurements. I know that Ellie was measuring 23w3-4d yesterday, and her weight was in the 4th percentile.
In my head, all I can think of is what that pediatrician said. Babies born over 750grams do a lot better than babies who are born weighing less than that. According to one calculator, the 4th percentile, at 25 weeks is almost 450grams. According to another, it's 627 grams. That's a huge difference. I think I should really take a pad and pencil with me next appointment so that I can write all this down!
According to one website: Due to many recent advances, more than 90% of premature babies who weigh 800 grams or more (a little less than 2 pounds) survive. Those who weigh more than 500 grams (a little more than 1 pound) have a more than 60% chance of survival, although their chances of complications are greater.
No wonder the mfm yesterday was talking about E not having reached viability. Sure, her lungs and brains are (hopefully, probably) more developed than a 24 weeker, but the rest of her is too small to even stand a chance.
I feel sick to my stomach thinking about it. People keep asking me how I'm doing, you know, mentally. I'm a fucking disaster. Of course, I don't say that. I say I'm doing the best I can (which I am) and whatever happens, happens. I'm not bonding with my baby, I refuse to do anything in her nursery. I won't finish her bedding, I don't want to paint, I don't want to buy clothes, or accessories, or anything else, until she's OUT and she's fighting. I just don't think I can handle it. As it is, every time I walk by her room - which at the moment is overflowing with her brother's outgrown baby clothes- I want to cry.
So, how long is it going to take her to gain that weight?! HOW LONG? Will she gain it before the flow from her to me stops?
For the record, perinatology.com is a good resource.
http://www.baby2see.com/medical/charts.html is a little confusing, and gives lower scores.
It's almost impossible to find any useful information on Dr.Google. I was looking for a chart to convert weight and growth percentiles to actual measurements. I know that Ellie was measuring 23w3-4d yesterday, and her weight was in the 4th percentile.
In my head, all I can think of is what that pediatrician said. Babies born over 750grams do a lot better than babies who are born weighing less than that. According to one calculator, the 4th percentile, at 25 weeks is almost 450grams. According to another, it's 627 grams. That's a huge difference. I think I should really take a pad and pencil with me next appointment so that I can write all this down!
According to one website: Due to many recent advances, more than 90% of premature babies who weigh 800 grams or more (a little less than 2 pounds) survive. Those who weigh more than 500 grams (a little more than 1 pound) have a more than 60% chance of survival, although their chances of complications are greater.
No wonder the mfm yesterday was talking about E not having reached viability. Sure, her lungs and brains are (hopefully, probably) more developed than a 24 weeker, but the rest of her is too small to even stand a chance.
I feel sick to my stomach thinking about it. People keep asking me how I'm doing, you know, mentally. I'm a fucking disaster. Of course, I don't say that. I say I'm doing the best I can (which I am) and whatever happens, happens. I'm not bonding with my baby, I refuse to do anything in her nursery. I won't finish her bedding, I don't want to paint, I don't want to buy clothes, or accessories, or anything else, until she's OUT and she's fighting. I just don't think I can handle it. As it is, every time I walk by her room - which at the moment is overflowing with her brother's outgrown baby clothes- I want to cry.
So, how long is it going to take her to gain that weight?! HOW LONG? Will she gain it before the flow from her to me stops?
For the record, perinatology.com is a good resource.
http://www.baby2see.com/medical/charts.html is a little confusing, and gives lower scores.
Friday, March 4, 2011
Stupid Google
I'm doing a really, really good job of freaking myself out over the cord flow study from today. Bad things happen when you combine a little knowledge and the internet.
In my case, I know that two weeks ago, my S/D ratio was 4.1, this week it was over 5. The Resistance index last scan was 0.80, and this time it's 0.83, which means it's increasing.
When she was talking about the S/D ratio, she said, as long as there is a number, that's all we have to worry about for now, so I started thinking, how do you not get a number? Well, that's easy, if there's no diastolic flow, you don't get a number, instead they call it Absent flow.
Ah, the things I get to worry about until next Friday. JOY.
In my case, I know that two weeks ago, my S/D ratio was 4.1, this week it was over 5. The Resistance index last scan was 0.80, and this time it's 0.83, which means it's increasing.
When she was talking about the S/D ratio, she said, as long as there is a number, that's all we have to worry about for now, so I started thinking, how do you not get a number? Well, that's easy, if there's no diastolic flow, you don't get a number, instead they call it Absent flow.
Ah, the things I get to worry about until next Friday. JOY.
Friday, March 4, 2011
Well, I guess it was okay!
She grew 10 days worth in 16 days, which is acceptable. At least she grew!!
According to them, I'm 25w3d, and she's measuring 23w3d, so two weeks behind. Her measurements were:
BPD <1% (she said not to worry about this number, it only indicates head shape or something...)
HC 18%
AC 4%
FL 8%
They said she's showing signs of head sparing, which is good, and wasn't there last scan. Cord blood flow resistance was higher than last scan, but still okay. My cervix was NORMAL!
The mfm today talked about viability. According to her, it's more based on the baby's size than the actual number of weeks you are gestating at. Ellie is 4 "days" away from viability, but given that she's growing at 62.5%, it will take her closer to a week to reach that magical weight.
So, starting on Tuesday, I'm to go in for twice weekly NST monitoring (looks like Tuesdays and Fridays), and then weekly ultrasounds. Every Friday, they'll look at her amniotic fluid levels (which were a little lower than last scan) and the cord flow . Every other Friday they will be looking at growth, since you need about two weeks between growth scans to be able to tell anything significant.
Depending on how things go, they will either increase the frequency of the monitoring, or decrease it. I don't need to tell you which one I'm hoping for!! Every Friday, after my u/s, I'll meet with the mfm docs, and go over the reports for the week.
She drew out a diagram of what they look for when they do the cord doppler studies. She showed normal, absent, and reverse. We're still normal, but I could definitely tell a difference between this one and the one two weeks ago. It's getting a lot closer to absent...
She talked steroids again. Mentioned that they like to administer them at least 48 hours prior to the birth, and not more than 2 weeks out. She said this week since things were still okay, we'd hold off, but that they'll talk about it again at every appointment.
I asked if I would have to have a c-section if they decide she would do better on the outside, in the nicu (which I'm touring on Friday). She said that if I have to have Ellie because my placenta gives out, then yes, I probably will have to have a section. I'm starting to prepare myself for that. I know all that matters is that our little peanut comes out alright. Today, she was presenting frank breech, with her feet above her head, which was pretty funny to see
So, that's my update. I'm still on bed rest, since it's clearly working. They are going to keep me on bed rest until Ellie reaches 32 weeks (who knows how far along that means I will have to be!)
Thanks for all the support
She grew 10 days worth in 16 days, which is acceptable. At least she grew!!
According to them, I'm 25w3d, and she's measuring 23w3d, so two weeks behind. Her measurements were:
BPD <1% (she said not to worry about this number, it only indicates head shape or something...)
HC 18%
AC 4%
FL 8%
They said she's showing signs of head sparing, which is good, and wasn't there last scan. Cord blood flow resistance was higher than last scan, but still okay. My cervix was NORMAL!
The mfm today talked about viability. According to her, it's more based on the baby's size than the actual number of weeks you are gestating at. Ellie is 4 "days" away from viability, but given that she's growing at 62.5%, it will take her closer to a week to reach that magical weight.
So, starting on Tuesday, I'm to go in for twice weekly NST monitoring (looks like Tuesdays and Fridays), and then weekly ultrasounds. Every Friday, they'll look at her amniotic fluid levels (which were a little lower than last scan) and the cord flow . Every other Friday they will be looking at growth, since you need about two weeks between growth scans to be able to tell anything significant.
Depending on how things go, they will either increase the frequency of the monitoring, or decrease it. I don't need to tell you which one I'm hoping for!! Every Friday, after my u/s, I'll meet with the mfm docs, and go over the reports for the week.
She drew out a diagram of what they look for when they do the cord doppler studies. She showed normal, absent, and reverse. We're still normal, but I could definitely tell a difference between this one and the one two weeks ago. It's getting a lot closer to absent...
She talked steroids again. Mentioned that they like to administer them at least 48 hours prior to the birth, and not more than 2 weeks out. She said this week since things were still okay, we'd hold off, but that they'll talk about it again at every appointment.
I asked if I would have to have a c-section if they decide she would do better on the outside, in the nicu (which I'm touring on Friday). She said that if I have to have Ellie because my placenta gives out, then yes, I probably will have to have a section. I'm starting to prepare myself for that. I know all that matters is that our little peanut comes out alright. Today, she was presenting frank breech, with her feet above her head, which was pretty funny to see
So, that's my update. I'm still on bed rest, since it's clearly working. They are going to keep me on bed rest until Ellie reaches 32 weeks (who knows how far along that means I will have to be!)
Thanks for all the support
Thursday, March 3, 2011
More blood work...
I had completely forgotten that I was supposed to get bloodwork done before my appointment tomorrow. They faxed the requistion a week ago, but I just remembered. I got there at 3:57pm... they close at 4:00!!! So, I got my tests done, no idea when they are going to be back. According to the requisition, they were testing for toxoplasmosis IgM and IgG.
When I got there, the nurse (who is the same one who did ALL my beta draws from the beginning til like 10 weeks) looked up the requisition, and said, "Oh, prenatal? Have you had any other tests done?" I told her that I was 25 weeks, and that my baby wasn't growing enough so they were trying to rule out infection. She looked at me, sort of shocked, and said, "Ah, that makes sense, you're TINY for 25 weeks". Thanks a whole effing lot. I really wish that my outings were more pleasant than just going out for ultrasounds, bloodwork and appointments. Really!!!
Toxoplasmosis is that cat-related disease. EWW. I hate cats. I am pretty sure that it's going to come back negative, but they're just trying to rule out all the reasons that Ellie is little.
Maybe she's grown, tomorrow is coming up quickly, I just want to get it all over with.
When I got there, the nurse (who is the same one who did ALL my beta draws from the beginning til like 10 weeks) looked up the requisition, and said, "Oh, prenatal? Have you had any other tests done?" I told her that I was 25 weeks, and that my baby wasn't growing enough so they were trying to rule out infection. She looked at me, sort of shocked, and said, "Ah, that makes sense, you're TINY for 25 weeks". Thanks a whole effing lot. I really wish that my outings were more pleasant than just going out for ultrasounds, bloodwork and appointments. Really!!!
Toxoplasmosis is that cat-related disease. EWW. I hate cats. I am pretty sure that it's going to come back negative, but they're just trying to rule out all the reasons that Ellie is little.
Maybe she's grown, tomorrow is coming up quickly, I just want to get it all over with.
Tuesday, March 1, 2011
tuesday, march 1, 2011
I haven't posted in days! - forgot my laptop at home and my parents' computer is on the wrong floor and frustratingly slow. - have been keeping busy' trying not to worry about my next appoitment -on Friday, if you were wondering. My mom has been so, so great. She has so many activities planned for jake, that he naps for hours daily. I am feeling the effects of being primarily sedentary. I have gained weight, although I'm certain it is well within the realm of where I should be, it is difficult getting flabby at the same time. My hips are ridiculously sore. Both of them!! I find it brutal getting up to waddle tot the washroom, and then nearly cry when I have to sit down again. Today, I thought about having a bath to ease the discomfort, but the thought of getting into the bath was enough to scare me oyt of the idea...
It is Wednesday tomorrow... we are going home tomorrow evening. I have more work to organize. I love going home, but my stress level definitely rises. I am completely anxious about my ultrasound and appointment on Friday.
It is Wednesday tomorrow... we are going home tomorrow evening. I have more work to organize. I love going home, but my stress level definitely rises. I am completely anxious about my ultrasound and appointment on Friday.
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