Middle of the night pumping sessions make me sad my girl can't come home with us. They also make me just a little annoyed, since apparently my breasts are rather demanding in the milking schedule. I know, I know, moms of newborns aren't supposed to sleep, but I was a bit hopeful I'd at least be well rested when she did come home!

St Paul's

So... we went to st paul's today to check out their nicu, since at rounds today the doctors agreed they were going to start the process of her transfer. I understand it is a space issue and Ellie is definitely not as sick as the other babies in the nicu. But, st pauls nicu is full. They have 9 beds and the nurse we talked to said they are so understaffed they aren't taking new patients. Fantastic... it is really a good idea to tell the parents of a child that is probably going to be transfered to your unit that there isn't enough staff.
To say this stresses me, is an understatement. Plus, it is 20 a day to park, and the bus takes 35 minutes. Sigh... I wish she could just stay at Childrens.

This time last week, I was feeling the effects of the magnesium sulfate, and laughing at my little contractions.
Now, I am sitting in the pump room, attached to a double pump, wondering where the last week went. My baby girl will be a week old tonight. I can stop putting green dots on the bottles I make.
She is back to her birthweight today, exactly. She is off ivs.
They stopped the bili lights and will recheck levels in 48 hours.
She didsnt want to be held today, she desatted to 73 :(
She seems prone to ab episodes after feeds, and needed o2 while I was out with the boys. I think it is to do with her intake... they increased feeds so quickly. Hope it doesn't continue.
Olga, my awesome roomie with the kidney infection delivered this week! I was surprised to see her here. Her girl is in intermediate care. We were due 10 days apart... Ellie due after. What a difference it makes being born at 34 vs 32 weeks. Her baby breastfeeds... I got mechanically milked.
Ah well...

Wednesday, april 27, 2011

Kim drove me in again this morning. Until my parents get settled it is nice being able to come in without throwing Jakob's schedule out the window.
I am sleepy today, sort of like Ellie is :) her sats are lower than usual today, not sure if it is because of the increase in feeds + hmf or position, or what. She doesn't want to be handled today.
Jake and I are going to go out for lunch. Haven't been alone with my little man in far too long. Honestly, I am a little nervous.
Ellie had a good night. She gained 60grams over yesterday, which is awesome. Even if she makes it to 1500g before next week, they will still transfer us, so I just need to plan for that.

Blue bird

The docs today talked again about moving to st pauls next week. I called their nicu to set up a tour. They're nice, but boy do I pray she just grows.
She has to make it to 1500 g by 14 days. This morning she was 1306 (08?)g, so 200 grams to go in 9 days. If she were really gaining well they might move her to intermediate care. Poor peanut, it is so hard to gain when you have absolutely no fat stores.

I got to hold her for three hours. Three hours of mommy/baby time. Ellie's nurse today suggested wrapping her to me, with two squares of fabric. It worked SO well, both squares get folded into triangles, and the ends get tied together. The pointy part of the triangle gets tucked up under her. Her sats were low, at 80 right before I held her, and went up to 95-98 while I was holding her. I could have sat there all day long, except that my breasts started protesting. Ugh, I can't go longer than 3 hours without a pumping session. I spend a lot of time in the pump room. My little freezer box is full, and my big freezer box is started. I am going to be adding 5-6 bottles to the big box daily. It's going to fill up quickly.

I talked to the social worker today about parking. It costs $15 a DAY to park here. While I was on bedrest, my insurance covered one car a day, with in and out priviledges. Now that she's here, it doesn't. How does that make sense?! I asked if they gave discounts or anything, because one week is going to cost over a hundred dollars! Jason makes "too much". Nevermind that our mortgage is based on a dual income of $40k more than we're making, and that we can barely pay our bills... we make too much to qualify for help. It's so frustrating. Jason didn't come in today. I got a ride in with my mil on her way in to work, and will get a ride home with her this afternoon.

My parents are away tomorrow, back on Thursday, and I think we're going to start staying there. I wish it were easier to figure this all out. I really wish someone could just write down where I'm supposed to be and what I'm supposed to do, but I'm a big girl, I should be able to figure it out myself.

Tough morning.

Ellie had a few apnea and bradycardia episodes this morning which are nerve wracking, and it took EIGHT tries to get an iv started. They're accelerating her feeds because they can't count on the iv. She is up to 10ml feeds, 11 at noon, the 12 this evening. If she can get to 14mls they'll discontinue the iv. Full feeds are at 17ml.
She's off the bili lights, but will probably have to go back on tomorrow.
I asked about when she gets to be in an open crib... 1500grams. She was 1306g today, up 8g since yesterday.
She's starting on fortifiers tomorrow, that makes me really nervous!

pictures are coming... soon!

It`s hard to find time to get everything updated! I have a bunch of pictures just waiting to be uploaded and organized. I`ll try to get that done this week.

Just got her birth announcements ordered. I can`t wait to get them!!

Little Ellie is doing really well. Her bilirubin levels were pretty high this morning, so she's now sun tanning under the blue lights, rocking her little shades. She really doesn't like being under the lights, her sats are the lowest they've been (88), but they go all the way to 100 when I hold her. She dropped weight again last night, but now she's up to 7ml feeds every 2 hours, and tolerating feeds fantastically. She will reach full feeds hopefully in a week from now.
There was no residual food to test before her last feed - all digested!!!
She had a few ab episodes today, but self-recovered.
I got to change her diaper twice (one was a poop!!!), take her temp, wash her face. I felt like her mommy for real.
They're talking about transfering her to st. Paul's in a week because she doesn't need a level three nicu. If there's room in intermediate care at childrens she might get to stay, but right now they're planning to transfer her on May 2nd. I have mixed feelings about that.
Grandpa, grandma, auntie cindy and Jakob all visited today.
My milk is IN. I have already filled my small freezer box at the hospital, and I'm working on her big freezer box. Art home, I keep everything I pump at night. She's going to be set when she comes home.
I hope she grows quickly. I want her to come home soon.

Sunday, april 24, 2011

Wow. The past two days have gone by in a blur. It is Ellie's third day of life today, the most amazing Easter gift.

Yesterday mroning was incredibly hard for me. I slept through a pumping wake-up call, and didn't wake up til 830am, two and a half hours after I was supposed to take my bottles down to the nicu. I had a complete breakdown, and cried for an hour. When I got over it, I pumped, then spent the day downstairs. I got to hold her again, for an hour. Jay came during that time to pack my things in preparation for discharge.
Around noon, my good friend Ali came to take pictures of Ellie. The photos are amazing, so beautiful. Tonight I am going to put together her birth announcement. I can't wait!
I spent a lot of time in the pump room, pumping and chatting with some long time nicu parents. It is a strange place, the pump room. We are all there, being milked likw cows, so we can feed our tiny babies. The other parents really are so nice, warm and welcoming. Above all, they are tremendously supportive.
In the afterboon, I left the hospital for the first time since March 30th. Jay held one of my hands, Jakob the other. We were all sad to leave our little Ellie there.
We went to my parents for dinner, then jason and I went back for a last pump and Daddy's first snuggle. Then, we picked up our boy and went HOME. Home... amazing. We all slept in our bed, and I got up every three hours to pump. Pump, pump, pump! Thanks Ali for lending me your pump, and for the incredible cookies!!
I slept so amazingly well last night, despite the pumping sessions.
We woke up early today, dropped Jake at the inlaws, then headed in to the hospital. Ellie had a great night! She is such a good girl. - pumped, then snuggled her for an hour. We put her in a pink onesie from home. The doctor today said she can discontinue antibiotics, and increase feeds to 4ml every 2 hours! Oh, and she is gaining again!!! Yesterday she was down to 1315g and today she was 1348g. Good girl :)
We left at noon, to pick up a gift for my sil's baby shower. I was rewally emotional at the shower. I miss being pregnant. I wish I could have been pregnant for longer :(
We are on our way back to the hospital now. Just pulling into the lot. Going to visit for a bit, and go home for easter dinner. Will post pictures tonight.
Thanks again for all your thoughts and prayers.

I got to hold her!

I finally got to hold her!!! AND change her diaper, and get her dressed for the first time. Smallest onesie I've ever seen was still way too big.

She's amazing

I can't believe how amazing Ellie is. What I feel for her is absolutely overwhelming.

We spent so long thinking that she wasn't going to make it, and that we were going to lose her. I never really bonded with her while I was pregnant, mostly because I was terrified of what would happen if things didn't work out. I felt guilt about not bonding. I was worried for nothing, I am absolutely head over heels in love with her.

Okay... I have a few minutes to kill between pumping and going down to HOLD her, so here's my birth story.

On Wednesday afternoon, just after lunch, I started having contractions. They were pretty unpleasant, and happening often enough that I had to tell my nurse. After monitoring me for a while up on Evergreen, they decided to send me downstairs for continuous monitoring in labor and delivery. I spent all of Wednesday night attached to the monitor.

On Thursday morning, having contracted almost all night long, and after having a bit of a temperature, and a bit of weird blood cultures, the doctors decided that it was probably a good idea to get the show on the road. Because I had pPROMd they didn't do any vaginal exams at the beginning, they just went by my last ultrasound. The doc brought in a bedside ultrasound machine, to confirm that she was still cephalic, and to make sure that blood flow was good enough that she could handle labor. When they decided we were good to go, they hooked me up to magnesium sulfate, and to some hefty antibiotics. The mag made me feel hot, flushed and totally stoned, but I was lucky that I didn't have any bad side effects.

Around 1:30pm they started my on oxytocin. We started really slowly, at 1miu/minute, increasing by 1-2miu/min every 30 minutes. Beth showed up around 2pm for moral support, and Jason came sometime after that. For the next several hours, we just hung out, making bets on when she would be born. There was speculation among the care team that I would go really quickly, given my history with Jakob.

Contractions took a long, long time to get going solidly. They'd start, get regular, and just before the next oxy increase, they would fizzle out. This kept going until I got to 35miu/min around 11:30pm. At that point, the doctor decided to check me to see what progress we were making. I was dilated to 3cm, and almost fully effaced. So, a lot of progress, but at the same time, it usually takes an hour to dilate 1cm. We were all betting for the wee hours of the morning, I thought she would be here around 6am!

The doc used an amniohook to break whatever was left (not much) of my waters. The check was uncomfortable, and the contractions after that got to be really uncomfortable, so I asked for an epidural. I didn't want to go through the same pain as with Jakob, and I wanted to be as calm as possible, so the anesthetist came around 11:45pm. She was AWESOME, and the epidural went in no problem. After that kicked in, I was in heaven. I couldn't feel the contractions at all.

They decided to leave me at the 35miu/min oxy rate, because my body was producing some great contractions. It was totally strange not being able to feel them at all. Just before 2am, the baby started having decels with contractions, and the nurse I had (who was covering my nurse's break) was having a hard time getting a good trace with the abdominal monitor. She paged the doctor, who came and put an electrode on Ellie's head! It was crazy, I didn't even know that was possible. In two hours, I had go to a 5cm, so par for the course, at 1 cm an hour.

We decided to settle down for a good snooze, Jason was sleeping on a mattress on the floor, and Beth was reading a magazine.

Just after the doctor left, my good nurse came to give me an "in and out" catheter, since I didn't feel like getting up to pee. My legs were wobbly. While she was talking to me about the catheter process, we noticed the baby's heart rate decelerating again with contractions. She said "okay, well, I'll get this done, then I'll call the doctor, because you might be making progress if she's having these decels". I said that was fine. Just as she was leaving to get the supplies, she reminded me to tell her if I felt any pressure. As soon as she said "pressure", I was struck with an overwhelming urge to poop. "Oh my god, there's pressure! There's pressure! HOLY CRAP THERE'S PRESSURE!!" She quickly checked me, and said "Ah! There's the head!!" She paged the doctors, who came scrambling in, not really believing I could already be ready, as I yelled at Jason to call for my mom to come. He had no idea what was happening (he was really asleep). I told him to tell her to HURRRRRY or she was going to miss it. The doctors took the electrode off her head, and told me to push when I felt a contraction. I told them i didn't want my mom to miss it, I wasn't pushing. Jason decided to go see if he could find her, and left!! I yelled at Beth to go get him, because then HE would miss it too! Jason called my mom at 2:04am. At 2:08am, I couldn't hold the pushing urge any longer, and with one not very big push, our sweet baby girl came screaming into the world.

They put her on my tummy for two seconds, then rushed her to the resus room, where I could hear her crying away. She was pink and great. Her apgars were 9/9! She weighed 1374gram (3lbs even) and is 15.5inches long. Jason looked in at me and said "I'm going with her!" Love in his eyes already, that baby girl wasn't getting out of his sight!

The doctors worked on me for a bit, my placenta was delivered (it looked totally battered), and my uterus shrunk back down to size realllly quickly. Quick as it all happened, it was over, and it was just Beth and I in the room. It was totally surreal.

My mom came in a few minutes later, disappointed she missed it, but there's nothing I could have done. We all honestly thought it would be hours longer, but there she was, ready to rock our worlds. Mom went to the NICU to see Ellie with Jason, and Beth stayed a little with me.

After a while, they unhooked me from the monitors, got me up to pee, and then I got to see her. Wow.

She was on CPAP for a while, but they weaned her off it earlier today, and now she's doing great, breathing room air. She's had two meals (if you can count a couple cc's a meal!), and at 8pm I get to go down and HOLD HER!!

She's absolutely adorable, and such a miracle. I can't believe we made it.

**will update the rest of the pictures when I am back from my visit with her!

930am Friday

I got into my post partum room around 430am then sorted out by the nurses, changed and medicated. I pumped and got 30ml on the first try!!
Just went down to see her. She's so tiny. 1374g. Don't know length still, Jason didn't remember what they told him.
Ellie is on cpap with room air, doing great, so they're going to try to wean her off that. Sounds like she struggled a bit with that earlier today. She is being primed for feeding, has peed lots and I can't wait to see her again.
Need to have another nap. I am sooo tired. Tired makes me really cranky with people :(
Going to ask jay to get the laptop so I can load pics and update more regularly than I can on my phone!

Ellie Marianna Kimberly

She's here!! It was a whirlwind. I was 5cm, then they wanted to put in a catheter and all of a sudden there was so much pressure. Jay called my mom (she didn't make it) docs got set up, and one push later she was born. She cried right away!! And is totally amazing. They checked her over, bundled her up and let me hold her. I am so in love.
No tears, no bruising...
No idea what she weighs or how long she is, she's in the nicu with her daddy and mormor.
I have my daughter. Wow.

106am

A little drama over here. Doesn't help that I don't care for my current nurse at all.
Ellie now has an electrode attached to her head to monitor her heart rate. Attached to her head!!!
I am 5 centimeters dilated now :) making progress. If only the epidural machine would stop beeping i'd be happy.
At a centimeter an hour, she should be here around 6am. Cool beans. Hope her heart rate stays good and we don't need a section.
Thoughts and prayers always appreciated.

1230 Friday

I was 3cm at last check, and fully effaced. Contractions were every 2 minutes and killing me. I opted for the epidural. Never been so happy about a decision before. It is amaaaaazing. No pain and the actual process of getting it wasn't scary at all. Love my anesthetist. Beth is amazing... she was my epidural support person :)
Gonna snooze and hopefully wake up on my daughter's birthday.

820pm

Still no baby :) at 23miu/min of oxy. No idea what is going to happen.

650

What's taking so long? Lol... contractions every 2 minutes. Not bad at all compared with what I went through with Jakob.

Doc doesn't want to check me for progress until I'm having a harder time dealing. I feel a lot of pressure in my bum when I contract (and I took care of bathroom things, so it isn't that)

Baby is still doing well.

Hope we meet her tonight!

525pm

Now on 14milliunits/min of oxy. Some pretty good contractions are happening. Ellie's been havin some dips but nothing too bad. They might not increase the dose for a while... still leaking like crazy.
Talked to the nurse about an epidural and Jason turned yellow...all the color literally drained out just TALKING about it. Egads... I don't know how he's going to do.
I'm having ice and juice. I am starving!! I want either white spot when she's out, or Denny's. Depends on when she arrives!!
I'll get reassessed at 20milliunits per minute (in 75 minutes) to see what's going on.
Feel some pressure down low, but fairly sure I actually have to poop!

308pm

Oxytocin isn't so bad!! Beth and jay are here. Contractions every 3-5 minutes... no pain, yet.

Increasing the oxy every 30min by 2mils.

1230

I'm hiiiiiiigh. Mag sulfate is brutal. Can't do anything but giggle. Nap time.

It's go time, people!

The decision has been made, there's room in the nicu, little Ellie is on her way!

I am about to be started on mag sulfate for her brain (shown to significantly reduce cerebral palsy) then a slow start of oxytocin. At high risk iof an abruption, so we're going slowly.

Omg. I am going to have this baby!!

10am

I am in a bad mood.

I can't even explain why, I don't think I know why. All I want is for Jason to be here, and he isn't. There are decisions being made that can seriously affect *our* daughter, and I am left having to make those decisions on my own.

My mom wants to come see me when she's done moving, but honestly, if jay isn't here, id rather be on my own.

Jason called, he wasn't exactly leaping to come spend the day with me. He might come out after Jakob's nap.

I want to go home.

930

My nurse said my cbc came back normal, but when u/s called to say they're ready for my usual afi/doppler scan, my doctor told the nurse he didn't want me to go. It's a huge guessing game. I wish I knew what they were talking about. I know they won't decide without me, but I would love to be there while they discuss the pros and cons of everything.

I am tired.

900 update

One of the residents just came in for a quick check-in. They're waiting on my bloodwork to come back. Seems like I am high on their priority list and the docs have been having quite the debate discussing the pros and cons of delivering vs not delivering. Nothing is clearcut with me. I have a little bit of a fever, my past blood counts have been a little wonky. My belly hurts, ellie is little, I'm at a high risk of abrupting and I pprom'd. They know I'm worried about E getting an infection, especially after Gideon passed away.
Right now they're consulting with eachother, but also want to consult with the night team (inductions take a while!) To make sure that the night on-call doctors are on the same page as the daytime ones.
Part of me thinks that today is going to be induction day, and tomorrow is going to be her birthday. We'll have to see what they think.
I'm scared a bit, trying to be as rational as possible. Getting to term is impossible, getting to 34 weeks without infection is improbable.
More waiting!

740am thursday

I spent all night attached to this effing monitor. Every part of me hurts from having to lie on my back, and they wouldn't give me anything to help me sleep.
I did get to eat some toast at midnight... plain, white, buttered toast. It was surprisingly delicious.

The contractions are still niggly, and for a while in the night I had a fever. Not so much now, but my uterus hurts. It is achy.

Dr. D who was on overnight said she's going to consult with Dr. Lim who is on today. Depending on the two of them, they'll either continue monitoring me up in evergreen for further signs of infection, or they'll start me on antibiotics for chorioamnionitis and start proper induction meds.

I am 32w2d today. After 32 weeks, you don't need the mag sulfate, so I am happy about that.

Dr. D said that chorio is really bad for baby. They used to wait until the mom showed more signs, but research has shown delivering in the sub-clinical stage is way, way better for tiny babies. You don't want a preemie with chorio.

So, waiting on "the word"... will post with more details as they come.

915pm Update

I am beyond starving... I could eat just about anything!!!

But, instead of eating, or being in my cushy room on Evergreen, I'm lying here, staring at a wall... this is that wall!

I could watch the monitor, but that gives me a crick in my neck.

Contractions have fizzled out, so waiting on a cervical check to show no change since last check, and then I can eat again.

Big revelation for the day is that I actually tested gbs NEGATIVE. Someone must have written down the wrong info, because the test report showed it was negative. That's good, not that it makes a difference since I already started the penicillin protocol.

I have no idea how I'm going to sleep tonight. Maybe I'll luck out and get sent back upstairs!! I hope that's what happens. I hope.

I hate continuous monitoring.

430pm update

Vaginal exam (sterile speculum) showed my cervix is closed... "well, I don't see any hair!"

Still contracting, but since there's no change that's really good. They talked about starting me on magnesium sulfate, but want to wait until it's a sure thing she's coming.

Waiting on a cbc to come back. If my wbc are elevated, they'll induce me tonight. Hope the antibiotics are working!! It looks like I will be down in delivery overnight.

Contractions aren't quite as painful as before. If they induce me, I'm for certain getting drugs. I know I can't handle the pain.

So... we wait!

Ouch.

I've been having cramps since 1230. They hurt and are sort of registering on the monitor. I'm back in delivery just waiting to see what happens. Things settle while lying down but as soon as I get up (and the baby puts pressure on my cervix) it hurts like a mofo. Sweat inducing pain!
I think its just another false alarm... but holy shit do they ever hurt. Almost feels like the worst diahrea pains you can imagine, but nothing to go with them. TMI, my bathroom time has been just fine, went totally normally today.
Ellie looks great on the monitor! That's awesome. They started another iv, and I'm back on the nothing by mouth routine until this settles. Hope it settles... I don't care so much for a 4/20 birthday!
They're starting me on peniciilin, not sure why exactly. They still need to double check her position and stuff and I guess they might do a vaginal exam, although if this is a false alarm, they don't like to do it with pPROMs.
Will keep you posted.

Tuesday, April 19, 2011

Today was exhausting. We had a nice visit for Jason's birthday, and a nice dinner, but it was entirely too much. It's stressful when your child blatantly refuses to listen to you :( Plus, family visits tend to be stressful. Sigh...

I sincerely hope tonight is not the night she decides to come. So far, so good. My mil is going out to Langley, because my sil isn't feeling well at all, and probably shouldn't be alone. That means, if I happen to go into labor, Jason will have to bring Jakob to the hospital. UGH.

My parents are moving tomorrow... all in all, it's just not a good time. At the same time, I've been here for three weeks. I haven't seen the outside of this hospital in 21 days. TWENTY ONE DAYS.
I'm starting to lose my mind, just a little. I have no idea how I'm going to adapt to being home again, thinking about it terrifies me. I haven't had to do "everything" in so, so long, the thought of having to do anything is really intimidating. Maybe I'm just being a whiner.

The worst part of all this, is not knowing when labour is going to start, or how it's going to go. Statistically speaking, somewhere between 50-80% of women who pPROM go into labour within a week. That gives me 4 more days to see if I fall into the majority. Nothing seems to fall into the majority for this pregnancy, so I guess we'll see. The most inconvenient time would be tomorrow night, after my parents have spent a whole day moving, Jay's tired with Jakob, and there's a car appointment, and more moving early on Thursday morning. 96 hours in, I wouldn't be surprised if that's when it happens.

I'm terrified of the pain. I have been thinking about it, and I honestly don't think I want to even attempt a med-free delivery. Because of the high risk of fetal distress due to my crappy placenta, they will probably have to prep me for a c-section anyway, so bring on the epidural. I know it's not the greatest, but I don't want the pain. Selfish, yes, but I've been through so much, and I'm so tired, and feeling so weak that I don't think I can handle the combination of pain and effort it takes to push out the baby. I can do the pushing if I don't have the pain... hoping that I can still feel enough to push properly.

I'm scared of what might happen when she's born. Will she cry? Will she be okay? I know she's 32 weeks, I know we have the steroids, but still, she's 8 weeks early. That's so early.

Sigh. Not having a great evening.

32 weeks on the dot

Well... here's my 32 week picture! Compared with 21 weeks and 26 weeks. I can't believe there's been hardly any change whatsoever. 11 weeks between the first and third picture, that's almost 3 months!! I really wish I'd taken a picture before my water broke, I was a lot bigger.

I'm up 23lbs from my starting weight, which is pretty decent. My boobs have grown quite substantially, as have my love handles, hips and thighs. Hey, it has to go somewhere! At least I know I have some stores for when I start breastfeeding :)

I can't sleep

I couldn't fall asleep last night, for the life of me, and when I finally did (I started imagining Ellie being born, and it worked to get me dreaming), I was so hot, that I woke up. I've been up since 4am, and I'm hungry, and tired, but every time I try to sleep things like sewing ideas pop into my head.

Bad! I've been so, so good at not thinking about work. I miss it, yes, but when ideas start taking over my brain, such that I can't sleep, and end up suffering. It's all because I checked in on Etsy, and someone who bought a set a while back was asking to add a couple more items. My brain is so quick to revert back to that!

Today is my amazing, incredible, wonderful husband's 29th birthday! Happy Birthday, Jason! I love you!!

Provided the littlest lady in our family doesn't choose today to grace us with her presence, we're having a party this evening in the lounge! My mom is bringing the main food (tourtierre), and salads, my mil is bringing everything else (table cloths, plates, utensils, balloons, CAKE!) I am so looking forward to it.

I am not looking forward to my brother going back to London. :( I'm really sad about that. He was only here for a week, and I know he'll be back in the summer, but I wish he didn't have to go back. I wish my parents didn't have to go back, I think my dad is leaving just after Easter. Sigh... these past two and a half months have been awesome, in that I've had my family around. I knew I missed them, but I didn't realize how much until they were home again.

Home... I'm never going to see the inside of my parents' home again :( The big move is tomorrow and Thursday. I think it's almost better that way, it's such an emotional thing, having your parents sell your childhood home. So many memories.

Hubby just got mad at me for being awake and not resting :) I love him. Going to call for my antibiotics in about half an hour, then I plan on sleeping the morning away.

Diaper cake for Amber's Baby Shower

Since I can't go, I wanted to at least contribute to my sister-in-law's baby shower. I made her this diaper cake, which I hope she loves. I had such a fun time making it, I am seriously considering selling them locally as a subsection of SusieCues!

Things you shouldn't be able to do when 8 months pregnant

1. Reach your toes comfortably, as in just as you could not being pregnant, to give yourself a full pedicure.

2. Shave your legs with no issues

3. Groom your girl parts just by looking down, no mirror involved (and yes, it's a colossal overshare, I feel like a million bucks being able to be clean, especially given the constant state of leakage)

4. Bed over to pick things up off the floor

5. Sleep on your back, or belly with no issue

6. Get away with non-maternity clothes!

Tomorrow, when Jason brings the camera, I'll take my 32 week belly shot. It's a bit unreal. This belly is quite literally all baby, all 3 pounds of her... and a little, tiny, itty bitty amount of fluid!

I just had a really, reallly good chat with the mfm today. God, I wish he were my doctor! I can't remember who it was, but someone I know recommended him, and boy were they every right. He took so much time talking to me about all my concerns, and the best part was that Jason was here for it.

Wow, okay, let's see if I can remember everything.

The plan of action currently is to see me get through to Thursday or Friday. If I get that far without an infection or labor starting, then they'll come up with a long term (ish) plan. Because I don't just have pPROM, and I don't just have IUGR, and I don't just have a chronic abruption, I have all three, he believes that I wouldn't fall under the normal management for any of those conditions (usually trying to make it to 34 weeks or higher). He said, there's a case to be made for bailing out early, say on the weekend, before 33 weeks, especially if I say that's what I want. I told him how concerned I am about infection, and about everything really, and he said that depending on the mfm I get, I might "have to twist some arms" but I can probably talk myself into being induced before 34 weeks. It was easy to see that is what I was getting at, and he supports it. That said, he did mention that some mfms are more aggressive, trying to make you stay pregnant as long as possible, others bail at the first sign of trouble. The third group, is somewhere in the middle, and that's where he said he is. "You've got the liberals, conservatives and ndp".

So, we're "roided up", and will keep monitoring me daily. We'll bail at the first sign of trouble, and he said that it's really likely she'll decide to come on her own before they have to decide what to do with us.

At 32 weeks, we're looking at 3 weeks of NICU time, at 34 weeks, only 1, but that time is negligble, especially given the survival rate of babies between 31-34 weeks is the same. If I go to 34 weeks, he said it would be no problem to continue antibiotics until Ellie is born (thank you Panda for that suggestion, I appreciate it!).

So, delivery seems likely this week, especially if I can advocate for Ellie and I. He said it's so hard to know what to do, since there isn't adequate research on any of this, and I'm a unique case. Normally you don't get all the complications I have at the same time. Even if it was just an issue of pPROM, the research isn't clear cut, which is why so many doctors have such varying opinions on treatment options.

My last IV antibiotics are finishing up. I'll get the IV taken out, and then start on orals after that. I cannot wait to have a shower, you have NO idea how excited I am to get clean.

Good Midday

Gail's had Jakob all morning, which is amazing. They went to play gym, then swimming, and then came to see me!

I've been feeling really hot, so my nurse brought me a fan! It is amazing. I hope that I am not getting a fever :S That would not be good at all. Fever = infection = indication for delivery.

I'm waiting on a visit from the mfm on call today. I already met with the med student, who was awesome, but she wasn't sure on some things, like indications for delivery (other than for infection, and fetal distresst), etc...

I am seriously concerned about infection, as I've mentioned before. Even more than I was before, because I found out that little Gideon, who's mama pPROM'd at 21w6d, and delivered at 25w6d, lost his battle due to infection at 17 days old :(

I also found out that one of my friends on the ward had to have her twins a couple days ago, and the little one didn't make it. And, another mama on the ward just had a stillbirth. These losses sure don't do much to reassure me that everything is going to be okay.

From the literature I've read, once you reach 32 weeks, if fetal lung maturity can be confirmed (they do this by testing a pool of amniotic fluid in the vagina) delivery can happen. I'd almost rather go that route, we're 32 weeks tomorrow. I am so, completely consumed by fear that she might get an infection if we try to wait until 34 weeks. There's no benefit to her staying in, if her lungs are mature, and we've had the two rounds of steroids. Because I am gbs positive, despite the antibiotics, our risk of chorioamnionitis increases... the chance of us getting it increases every day we go without inducing or my going into labor on my own. I don't really like the idea of waiting two more weeks. I don't know that what I think will have any impact on what they decide. But we'll see what the doctor says.

Here's one research document I found about management of pPROM at this point in pregnancy:

pPROM Near Term (at 32–36 Weeks' Gestation)

When pPROM occurs at 32–33 weeks, fetal pulmonary maturity assessment from a vaginal pool specimen should be obtained if feasible (see later). Amniocentesis by a skilled clinician should be considered if there is inadequate vaginal fluid for pulmonary maturity testing. The infant with documented lung maturity at 32–36 weeks' gestation is at low risk for major morbidities related to preterm birth.⁴⁷ Alternatively, conservative management of pPROM near term will increase latency only briefly (36 vs. 14 hours, p < 0.001), increases the risk of amnionitis (27.7 vs. 10.9%, p = 0.06), and places the fetus at risk for occult cord compression with prolonged oligohydramnios. Because there is little neonatal benefit to be gained by brief pregnancy prolongation when fetal pulmonary maturity is evident with pPROM after 32 weeks, and the risk of amnionitis increases with conservative management, expeditious delivery is recommended.

When fetal pulmonary maturity assessment is unavailable or if fetal pulmonary immaturity is suspected through testing after pPROM at 32 or 33 weeks' gestation, there may be a significant risk of complications related to pulmonary immaturity and other gestational age-dependent morbidity. Unfortunately, there are no studies involving only this specific population on which to base management. Cox and coinvestigators evaluated 129 women undergoing immediate delivery or conservative management after pPROM at 30–33 weeks and 6 days' gestation,⁴⁸ and found only a brief increase in latency (59 vs. 100% delivered at 48 hours, p < 0.001), a significant increase in amnionitis (15 vs. 2%, p = 0.009), and no reduction in infant morbidity with conservative management. This population had a significant risk of RDS (35%), one stillbirth caused by suspected cord compression with conservative management and three neonatal deaths (2 sepsis, 1 pulmonary hypoplasia) with immediate delivery. However, antenatal steroids were not administered to reduce the risk of RDS, and this study was performed before antibiotics for pregnancy prolongation and group B streptococcus prophylaxis were routinely administered. While this study suggested that immediate delivery might reduce fetal exposure to intrauterine infection and avoid loss caused by cord compression, it confirms the risk for neonatal morbidity in the infant delivered at 30–33 weeks. If amniotic fluid is unavailable for testing or immature at 32 or 33 weeks, conservative treatment with close fetal monitoring, adjunctive antibiotic therapy, and induction of fetal pulmonary maturation should be considered. Alternatively, if these measures to reduce gestational age-dependent and infectious morbidity are not attempted, such patients may be better served by expeditious delivery.

It is important to reiterate that all three prospective studies evaluating pPROM near term have found significant increases in perinatal infection and only brief pregnancy prolongation with conservative management. As such, expeditious delivery should be considered unless the fetus is considered to be at significant risk for gestational age-dependent morbidity and efforts to suppress infection and enhance fetal maturity are undertaken.

AFI and Dopplers

I just had my afi and dopplers done. AFI on Thursday, was 200mm overall. Today, it was 4mm. The largest pocket she measured was 1.7mm. No wonder little Ellie isn't moving. Poor peanut. It also explains why I'm hardly leaking anymore. I do every couple of hours, just a bit, enough to need to wear a pad all the time, but it seems everything she outputs just leaks right on out :(

Her dopplers were still "good", as in positive flowing. Super high resistance (96th percentile), but still good. I wonder how the umbilical cord does dry out when there's hardly any water... The images were super blurry too, I guess having lots of fluid makes for clearly pictures. I am a bit scared, no, I am really scared. I drank SO much water this morning, hoping to have it make a difference. The tech even looked in Ellie's bladder, to see if there was more about to come out. Nope.

How is it that all these rare things keep happening to me?! I know most of them are linked. The SCH, the chronic abruption, the iugr, and now pPROM, but it doesn't seem fair.

Because the largest pocket they found was 1.7mm, that puts us in the "mild" oligohydramnios (fancy word for not enough fluid) category, which is better than severe. It seems like everywhere I can find says trying to make it to 34 weeks, as long as she's still okay, and as long as I'm still okay. I had nightmares of her dying last night, obviously I need to watch what sort of articles I read before bed.

Tomorrow is Jason's birthday. Looks like if I want to participate in the party (the grandmothers are planning a party in the lounge here), I'm going to have to do so from my bed. Thank goodness it rolls.

Monday, April 18, 2011

Ow... they didn't dilute my most recent erythromycin, so typing is limited until it ends... ughhhhh.

Last night was okay, except that I woke up because she *wasn't* moving. Usually she moves so much at night, and last night, she hardly moved, at all. I called in the nurses in the wee hours, when she hadn't moved in two hours. They checked her heartrate, still good. Nurse said "some babies know they have to stop moving when the fluid gets too low, she's conserving her energy." I am scheduled for an early nst this morning, and that ultrasound today sometime, where we'll see how little fluid there is. I'm drinking a ton of water.

Okay, time out from typing, hurts too much.

So many goodies!

this is my care basket from Angie. So amazing...

I don't need the extra stress, thanks

Some people have unrealistic expectations. My parents are moving this week, and as I have mentioned before, they are giving us a lot of furniture. The "plan" before I was admitted to hospital bedrest, was for us to clear out and sell the unwanted furniture, and have everything organized before the movers bring the furniture.

With the amount Jason's been working, he's exhausted. He's working nights, and especially on dirty deltas (4pm-4am) gets off work, goes home, goes to sleep, wakes up, eats breakfast and goes back to work. On deltas, I know we won't see him, and that's just the way it is.

On the days where Jay's not working, he's looking after Jakob, and trying to keep things in check. Jakob is an easy child, but it's never, ever easy acting as single parent. Especially when Jakob's routine routinely gets messed with. Put someone who is readjusting to normal sleeping together with a confused toddler, and it's a little chaotic.

My mom thinks that Jason should have figured out all the furniture on his own, while juggling Jakob, or maybe on a day where he's working. Are you kidding me? She definitely doesn't understand what it's like for him. Jay is not a multitasker.

She wants me to get on his case about a million household chores. I flat out told her no. I will never, ever comment on something I haven't seen myself. Who gives a crap if there are a few wet diapers in the garbage? She wants me to add many things to his to-do list. I refuse, because I know how long that list already is. I see the guy a couple times a week, I am not going to ruin my time with him by nagging him about things that don't affect me. I know Jakob is well looked after, that is all that matters.

Then, she got mad at me for not thanking her for all the work she did today at the house. For starters, I was never consulted on any of this. Instead of being sold, most of my furniture was donated to the thrift shop, including a dining set with chairs I know I could have sold for $500. I'm just a little bit choked about that. She cleaned, that's great, I'm thankful, but she expects me, after belittling my husband, to grovel at her feet in thanks.

Argh.

Then, I was pretty much yelling at her, and told her that there's NOTHING I can do from here. Helllooooo, I'm stuck in a fucking hospital, with fluid leaking out of my crotch, trying NOT to have a baby, and you want me to stress out about household chores? Get your priorities right.

She changed the topic to me, naturally. Have I showered today? No, I'm still on IV, it's not convenient. I'm off IV tomorrow evening, then I'll have a shower. Well, have I at least cleaned myself? WTF?? What am I, ten?? NONE of your business, at all. Then she was mad about my level of hygiene, when she doesn't know a thing about it. She doesn't know that I am insanely obsessive about washing my hands, and I use my peri bottle religiously every time I'm up. My sheets and underwear are changed twice a day. Eff off. I reminded her that I'm only allowed on my feet to use the toilet, because if she didn't remember, SHE was the one who was upset that my water broke, and that Ellie might be born mid-move. Sorry, I'll talk to my amniotic sac about that colossal mis-communication.

I was yelling, again...

Then, she says "well, it will all be easier when you're home". Are you kidding me?! No it won't be easier! I will have to ferry myself to the hospital multiple times a day, to be with my daughter, to feed her. "Well, who's going to look after Jakob?" I AM. "you're not going to be able to manage two kids you know..."

GAHHHHHH.

No faith, she has no faith in me whatsoever.

I'm doing my best in this shit-storm. It's actually okay for me to let things go, and not have everything be perfect all the flipping time.

:S

Ouch!

Got my last dose of steroids, and this time it hurt as bad as the first shot in round 1. I believe it depends entirely on the nurse administering the shot. Ow, ow, ow!

Just painted my nails an amazing red. OPI "I'm not really a waitress". Love it!

Watching the hockey game, it's not all that impressive at the moment. Eating popcorn helps :)

I don't think it's going to be tonight, barely anything contraction wise. This is good.

4:40pm

Finished my crochet hat! I really like how it turned out :)

Still soooo tired. I think it's time for another nap. I hope this isn't my body prepping for labor!

1:15pm

Go figure, my nst happened just as they were dropping off lunch. Argh! So, I got to wait an extra hour before lunch. Ellie was good on her nst, so I am happy about that. She has to stay happy in there.

Ultrasound tomorrow sometime to check fluid and doppler. HOPE the fluid situation isn't too bad. The gushing has slowed to a trickle, so I wouldn't be surprised if now it's just leaking what she pees out. Amniotic fluid is a mystery.

My room was cleaned by the most talkative cleaning lady I have ever met. She was very nice, and very encouraging, and told me to look into buying doll clothes for Ellie. She said at 3lbs, even preemie clothes are most likely to be too big. Crazy, but a really good suggestion.

So, amniotic fluid has a definite aroma. I wonder if when outsiders come into my room, they notice. I notice, and I'm sitting here. It's not really a gross smell, I don't know, it's hard to describe. It's one ingredient short of being the new baby smell. The ingredient that's missing, is obviously the baby.

I am dying to have a shower. I will ask to be unhooked from my iv this afternoon, in the gap between ampicillin and erythromycin. I told one of the nurses (the one that successfully started my iv on the FIRST try yesterday. Way to go, Lisa!), that the erythromycin hurts like a mofo while it drips. She said they can dilute it to make the hurt go away. I wish I'd asked earlier! My nurse gave me a hard time for not saying anything, and I told her that I try very hard not to be that patient. You know, the one who complains about every.little.thing?

I am convinced they think I won't tell them if I start contracting. For those of you who don't know, my labor with Jakob was induced at 41w3d. They gave me a cervidil insert at 8pm on Wednesday. On Thursday, at 8am, my water broke. I had, what I would call, Braxton Hicks contractions irregularly from then until maybe 3 or 4. I'd been checked, and while I was a great deal effaced, I was barely making any dilating progress. They thought a change of scenery would be good for me, and issued a day pass so we could walk in the park. On the elevator ride down, contractions started one after another, lasting forever. I was delirious with pain, and it took us 15 minutes or so to get back to the room. I insisted they check me, and I was pretty much ready to start pushing. From 0 to go-time in barely any time at all.

My nurses seem to think things will go a lot fast this time. I'm not actually counting on that, since in case you hadn't noticed, this pregnancy has been the polar opposite to my pregnancy with Jake. They are so worried I won't tell them in time. Trust me, I will tell you. Just like I told you when my water broke.

Ah, they mean well.

11:45am Update

I slept all morning, it was glorious. I was so tired, I didn't give a hoot that the bed is wet, and I've somehow managed to override that "peeing-your-pants" feeling I've been trained to respond to since I was a toddler. Of course, I haven't actually peed myself, I promise.

I'm currently looking up different styles of Depends underwear. Fantastic, adult diapers! I'm thinking I need the Maximum Absorbency option, and I want ones that don't look like freaking kids' diapers. Pull-ups! After all, I am a big kid now!

I'm hungry. I don't know if it's because I skipped dinner last night - my water broke right when it was delivered, and until they had me set up on iv and checked out and everything, I wasn't allowed to eat. It tasted revolting when it was cold! I did have my evening snack, it was decent. And, I've had breakfast, but I.AM.HUNGRY. If getting to the box of treats beside my bed didn't involve unplugging my iv, and doing an awkward waddle to the other side of the bed, I'd be stuffing my face with popcorn and licorice, mmmm, or maybe the butter cookies that are calling my name (thanks again, Angie!)

But, I'm lazy as you wouldn't believe, and I have no intention of getting up to get treats when lunch is just a few minutes away.

9am update

I'm supposed to lie on my side all day with sitting allowed for meals. Allowed to get up and pee.
Daily nsts still and a full bpp reassess tomorrow. Doc thinks tonight, tomorrow or Tuesday it will likely happen. Iugr is their main focus again, tied with checking for infection.
My arm kills when the meds go through. Ugggh.

Sunday, April 17, 2011

it's 7:29am, and I managed to get a couple hours of sleep in. Of course, after my last flood, it took a while for me to fall asleep, and just as I did, it was time for a baby check, and iv bag shift.

Then, I fell asleep again, and at 7 something, the iv monitor started alarming, so I had to wake up, call the nurse, and have her fiddle with it. I waddled to the bathroom (because that's all you can do when you're wearing a pad the size of a canoe), hoping that maybe the leaking would have stopped. Nope, ha, not a freaking chance.

The exciting part for me, is that I pPROM'd 14.5 hours ago, and I'm still not having anything in the form of even half-regular contractions. With Jake, my membranes ruptured at 8am, and he was born at 7:01pm, after 4 or so hours of labor and pushing. Way to stay put little Peanut.

I read that the amniotic fluid completely replaces itself every three hours. NO WONDER I am leaking forever.

No family visits today, they're all at our house in Ladner, finally (several weeks too late) getting rid of the old furniture, to make room for the new furniture we've inherited from my parents' move! This is the week everything happens, and do I ever wish someone would paint the nursery, just the nursery, before everything gets put in there. Will have to add that to the "Honey-Do" list.

They gave me another one of those freakishly, horribly, drawn hospital brochures, this time on ruptured membranes. Will photograph it later to post, but really, really, they should probably not include graphics that make a mom want to freak out even more at a stressful situation.

All my nurses are surprised with how calm I have been over the past couple weeks, but since yesterday especially. What else am I supposed to do? Stress isn't good for the baby, there's nothing I can do to change ANY of this, it's completely out of my control. I am okay with that. hmmm... I wonder if being here, and learning how to not be in control, is going to affect things like the fear I have traveling as a passenger in cars, or airplanes (obviously I'd be a passenger there, last time I checked I didn't know how to fly a plane!)

I am tired. Tonight I am most definitely asking for sleeping pills. I remember quite clearly, back when Jake was born, telling Jason that my only regret was not having taken a sleeping pill the night I was induced. I could sure use the sleep, especially with a baby coming soon (or in the next 16 days)

Holy shit. 16 days, MAX!!

251am

I fell asleep only to wake up two minutes later to have to change my pad and blue pad again. Again!!!

Seriously. Eff this.

It just keeps flowing...

2:28am, and I have just had my bed made by my lovely nurse. I tried sleeping, but woke up when I realized I was leaking at every.single.breath! I guess lying flat allows the fluid to pool in my lady cave and it filled up. There was a monsoon when I sat up. Soaked through the pad, the blue soaker, two protective sheets AND the sheet, all the way into the mattress. Not just a little either. The spot on the mattress is a good two foot circle. How is that even possible???????

So, new sheets, new pads, new everything. She said the flow should slow down, it can't go on like this forever. Ellie would have to pee more than a full grown male to keep this up.

Two weeks of this?? I'm asking for sleeping pills tomorrow!!

Where is it all coming from?!?!

How is it possible to leak SO much fluid?! I've gone through almost a pack of pads (there are 14 in a pack) since 5pm. that's like, almost 3 an hour. The last time I got up to pee, the amount that came out burst the dam of the pad, and there's a trail from my bed, to the washroom of amniotic fluid. SO GROSS. It went all down my legs, soaked the mesh panties... I've given up on panties for tonight, I'm happily sitting on my blue soaker pad. I still can't believe this happened.

I know on Thursday, I had an AFI of over 20cm. My guess is that it's WAY less than that now. I most definitely do not look 8 months pregnant. No way. I hope to take a belly picture tomorrow, right now it's too complicated, and I'm not wearing pants!!

I wonder which day it will be. Will my little girl share her daddy's birthday on the 19th? Or will she share Auntie Andrea's birthday on the 20th? Or will she hold out for May??
So many unknowns. I really, really hope we don't end up with an infection. That is the scariest thing I can imagine.

9:30om Update

Erythromycin makes my arm hurt. I am freaking boiling, and every time I get up to pee, I'm not sure how long to stay there. Really, I could stay there forever, there is so much amniotic fluid leaking out. SO much.

I'm supposed to watch to make sure it doesn't change color, smell, or consistency. I have to let them know how many pads I go through, if it turns pink, or if contractions pick up. I know there's a strong likelihood she'll be here in the next 48 hours. But, if she isn't here, then chances are she'll stay in a while longer.

Wow, I am so hot. All I'm wearing is a hideous hospital gown, and I'm back into the sexy mesh panties. I'm supposed to spend the night butt naked (just butt, I can wear a top) and sleep on a blue absorbent pad. OMG, the stress of this makes me want to throw up, I am so nervous!

The thought behind sleeping on a pad, is that there's better airflow, and it's cooler, so that infection doesn't set in.

Holy crap, I just sneezed, and I'm sure the pad I just put on, is full. FML.

I'm watching Celtic Thunder. Love it.

pPROM at 31w4d

So, I'm here, chilling with a painful iv in. Getting ampicillan, a broad spectrum antibiotic to kill anything that might consider giving us an infection. I got a "rescue round" of steroids, since it's been 2 weeks since our last dose, and we're under 32 weeks. When the ampicilllan is done, they'll give me another type of antibiotic, and if I don't go into labor in the next 48 hours, I'll start oral antibiotics.

My doctor today said that 70% of pPROMs (premature preterm rupture of membranes) end up delivering within 7 days. 30% go longer. Because they've ruptured, the absolute end date is now May 3rd, 34w0d. I will be induced if we make it that far, because, as luck would have it, she was head down when my water broke.

I'll be honest, I'm shit scared.

Even if she stays in, how much can she grow with less than ideal conditions?? She's so little. This sucks.

YIKES!!

MY WATER FREAKING BROKE!!! (edited to clean up the language a bit... I fully intend on printing this all for Ellie, she doesn't need to know her mommy has a bit of a foul mouth at times like these)

I was visiting with Steven and Debbie, and when I got up to see them out, it felt like I peed myself. Walking back to my room, little gushes... told my nurse. Yep, the strip turned bright blue! Looks like my water broke. Don't quite know how this is happening.

Don't quite know what it all means. Might go a while? Might have her tonight? HOLY SHIT PEOPLE... I'm not ready for this.

Saturday, April 16, 2011

Another weekend, here already. We're half way through April! How is that even possible?

Yesterday was amazing. I had a bunch of visitors, and the day flew by. I had an amazing visit from Angie, who brought me 12 books, and a bunch of incredible goodies. We had a great visit, and the evening literally flew by!

I'm currently in the middle of reading It Sucked and then I Cried by Heather Armstrong, the lady behind dooce.com Loving it. Seriously, though, I could have written most of it (at least up til the 2 month-old phase, where I'm currently at in the book) myself! It's funny, it's sad, it's awesome. I plan to finish it this evening, after I've had a chance to visit with friends from Squamish, and after my mom comes by.

I think I'm going to pull a number out of a hat to decide which book I'll read next. Thank you so much, Angie!!

Jason was by for a bit today, before work. This morning, after breakfast, I fell back asleep (probably due to the fact that I was glued to the book until after midnight), and had the most annoying dreams! I've probably read one too many romance novels over the past couple weeks, and since I've been on pelvic rest (read, no sex) for an eternity, these books have done nothing but frustrate the heck out of me. One of the dreams I had, put Jason in my hospital room overnight. I told him that the nurses said it was okay for us to, you know, do it. Well, he didn't take much convincing, and half way through, right at the point where I was getting all worked up, the nurse came in and started yelling at us. Jay was so mad that I'd lied about being allowed to be frisky, that he left without saying a word. Then I woke up. Ugh!! I was so upset that he was mad at me, I reached for my phone, and then I realized that it was all a dream. Obviously I didn't try to seduce my husband in my hospital room, with nurses coming in and out of the room as they please. When I saw him today, I told him about the dream, and then nearly cried when it dawned on me that we're not going to be able to be "intimate" until this little creature is OUT, and I'm healed, and she can be put down for long enough... that seems like a lifetime away.

Jason hasn't seen me naked in almost 9 weeks, not since I got put on bed rest, and moved in with the parentals. Let's just say that there have been changes in the size of certain body parts. My ass, for one, has most definitely grown, thanks to my 6 meals a day, and you know, the whole not being allowed to walk around thing. I know he loved me through my massive weight gain with Jakob, and he was surprisingly not turned off by the pizza-dough tummy that was the aftermath of birthing an 8lb baby. My boobs were massive, and enough of a distraction. But, and this is what I've been thinking about a lot recently, when I was pregnant with Jakob, he saw me every single day. When you see someone daily, you really don't notice the day-to-day changes that happen. Sure, you would probably notice a change, say if your partner got a haircut, or something like that, but it's not like you would wake up the next morning to something like a 15lbs weight gain. (Of course, the morning my milk came in, that was noticeable...) Anyway, back to my point, Jason will not have seen me in my birthday suit since I was still skinny, with a little baby belly. Fast-forward to when Ellie is born, and I'm home, and he sees my "new" post-baby body, and I'm moderately concerned the change is going to make him want to rip out his eyeballs, lest he never want to touch me again. In all seriousness, he's probably going to be so excited he can finally have sex again, that he won't care, but I CARE. My body is most definitely not going to be anything he expects to see...

Some days it's really freaking hard to be a female and see your body undergo all these massive changes. Sure, my weight gain this time has been in check, and is totally reasonable. I don't have any new stretch marks, and I'm not swollen like a marshmallow. But, all the changes are enough for me to notice, and if I could, trust me, I'd be out jogging, or something (probably not jogging, actually, the thought of jogging at the moment sort of makes me want to vomit). I would be okay with at least walking!

Sigh.

Friday, April 15, 2011

I miss my husband. I miss him a LOT.

He was just here for an hour or so, and had to leave to go to work. His visit seemed to last three seconds. But, while he was here, he got to meet one of my doctors, watch Ellie kick the daylights out of my innards, and listen to her on the monitor. He gave me a back rub, and we snuggled. Ah, I wish I could go home.

While he was here, the doctor said, for the millionth time (but the first time he's heard it) "If you can go 48 hours with no bleeding, we can send you home". After she left, he asked me if that meant home home. It doesn't. It means going back to my parents, back into the home-care program for visits three times a week, and twice weekly nsts in hospital. Same as before. The only problem with that, is my parents are moving this coming week, and everything is going to be in limbo during that time. Also, they told me the 48 hour thing when I got here in the beginning. Fifteen days and the longest I've gone is 18 hours. The end of that time marked by the biggest bleed I've had since I got here. Another big bleed would land me back in hospital, probably back downstairs, back to the bottom of the pile. Once your bed is gone, you have to start over again, and I'd probably be in a double room again, which I could NOT handle.

I wish I'd spent more time outside today. It looked so nice out, but it was cold this morning, and now it's cloudy. I wish the window in my room opened. It's weird that none of them do, not even a little bit. The window is really dirty, too, which is aggravating. I really like clean windows.

It's amazing how quiet this room is. When the door is shut, all you hear is the low mumble of people's voices. It's nice to be able to block it out. Sure, there are times where I feel more social, and I keep it open, but for the most part, I'm enjoying the peace and the quiet.

:)

Statistics

What are the chances three people out of the 14 of us here on the ward would have the same due date? At recreational therapy this morning I found out I have the same due date as two other ladies here! Bizarre.

Busy afternoon today. I have Gabriela and Alexandra coming after lunch, Gail after swimming, Jay on his way to work, Mom and Jake after they visit Vera, then Angie is coming around dinner and theeeen there's the hockey game!

Creepy Face On U/S Picture

She's looking straight out... you can see her eye perfectly, there on the left. That black circular space at the top, with the little white vertical line in the middle, is her brain! And, she's got some chubby cheeks!!

Again, she grew!

I already forgot most of the measurements. Her hc was 285mm, ac was 239mm, fl was 57?? I can't remember that one. Bpd was 73 or something like that. Overall weight guess was 1300 grams. Thanks mostly to a huge head and leg spurt :)
S/D was 4.5 and RI was 0.80.

Just saw my doc going to do an amnio. She said shed come talk to me when they get the report :)

Yay, Little Ellie, for growing!!!

Thursday, April 14, 2011

Having a lazy day. I've been watching tv all morning, it's a bit of a problem. Good thing I won't pay to keep it going, otherwise I would get sucked in and lose my daily routine.

I slept so well last night. The air isn't quite as dry in here as it was in the other room, and this bed is better designed! The other one folded right in the middle, and when you have long likes like I do, that makes it nearly impossible to straighten out said legs. This bed, has the fold at the 3/4 mark, fabulous, and the mattress is better.

The perks keep coming! Because I'm in a private room, the Bright Start Bundle people came by with a form for me to fill out. They bill my extended health the cost of the private room. Whatever my insurance doesn't cover, Women's pays for. I end up getting:

• Private or semi-private room
• Daily parking pass with in-and-out privileges
• Telephone and cable TV, including the most popular sports, news, movie and entertainment channels
• A coupon from our cafeteria
• Baby photography offer

Wow! I have to ask how the parking works, because that in itself is an incredible plus. My parents have spent soooo much money coming to see me, just on parking. I'm really excited. Of course, I'd much rather go home, but little things like this sure do make hospital life a lot better. And, I get to watch hockey :)

Still waiting for my ultrasound. A little anxious about it, can't wait to see how much she's grown, and how big she is. It's exciting to think that maybe she'll have grown a whole bunch. She certainly feels a lot bigger.

I'll update when I've had the scan!

New Room!

I am so excited. My room is awesome. I'll add pictures later, but it is amazing having my own toilet and bathtub, and door I can close, and window I can look out from!

Bonus, it's the first night of playoff hockey, and the TV was still paid for! So, I get to watch myself some hockey. I just wish I had some sort of junk food to eat while I watch. Mmmm... chocolate covered pretzels, or pizza, or candy, or something other than the banana that's staring at me. I don't really care for bananas at all.

While everyone (Jason, Jakob, my parents, my brother, my in-laws, grandpa and Amber) are out for a nice dinner, I'm cozy in my bed, trying to get the contractions that have been nagging me all afternoon, to go away so that I can focus on hockey. This might be the only game I get to see while I'm in here, I can't see myself paying $11 each game day.

Okay, it's starting :)

410pm Wednesday

Finally... the nurse came in to tell me another patient transfered to RCH and that means a bed is free. An hour or two until the room is cleaned and then I will finallllllllly have my own space. Privacy!! No more asking if I can use the toilet or have shower. Thank goodness.
Today is been really good, though, no bleeding today. Watch, they'll move me to a single room and two days later they'll send me home. Ah. Wishful thinking probably... at least its a step in the right direction. I'm happy.

1130am Wednesday

Just had my nst. Not as good as yesterday, but still good, and she moved lots so that is reassuring.

Wonder what it would tale to have things settle down so I can go home...

Wednesday, April 13, 2011

It's official, I've been here for TWO WEEKS.

I really don't sleep well when there's someone else in the room. The iv pump "snores", the nurses come in a lot more frequently, and I wake up at every little sound. Today, I'm tired.

The doctor came in early today, just for a status check. Still passing small clots, so they're thinking that the bleeding is fairly constant, it's just pooling, and when I get up to move around, or go to the washroom, gravity takes over and it comes out. NSTs whenever I want, as long as they are daily. Ellie is really good in the afternoon, so I'm aiming for afternoons, when she's active. My nurse told me to call her when I feel her grooving.

For the past almost week now, room 11, a private room, has been sitting vacant. My doctor asked the charge nurse about that this morning. Apparently, it's being held for someone coming in on Friday. Really? What's so wrong with that patient that they aren't here NOW? If their condition is so serious that they need to have their own room, shouldn't they be here already?

I don't know how long this roommate is going to be here. She's nice, but she keeps the curtains closed, and the blinds to outside shuttered. It's dark in here. Last night, I could hear her in a lot of pain, but she didn't call a nurse until an hour after she started moaning and sighing. I was on the brink of calling them myself. If I could sleep with earplugs in, that would be terrific, but I can't stand the feeling.

My mom said that if I get a single room, she'll have her hairdresser come in and give me a hair cut! Nothing drastic, I just need the ends cleaned up, and a little shaping. Still growing it as long as it will go without looking silly.

I wish I could have a long shower. But, I'm limited by my bed rest activity level, and the guilt that comes with sharing a room with someone who has to pee, a lot. I wish it were tomorrow already.

I've been on bed rest for 63 days, and I've been here for 14 days. I think they'll induce me the week of May 10-17, so that's only another 27-35 days. The end is in sight, there is a light at the end of this long tunnel.

So much monitoring!

So, in addition to daily monitoring with the nsts, they've written orders for the baby to be checked on every 4-6 hours! That means I have to wake up in the middle of the night for a listen! Insane.

Good... I guess... but that's a whole lot of monitoring!

So I don't lose track of the data

Last growth scan, Ellie was 2w6d behind, I think...? Yeah, that sounds right, she measured 26w4d at 29w3d. In preparing myself for next time, I've written down the numbers that are relevant for my next scan.

If she's still about 3 weeks behind, we'd assume that at 31w3d, she'll measure equivalent to 28w3d.
Those measurements are:
BPD 73.5mm
HC 266mm
AC 250.5mm
FL 54.5mm
EFW 1294g

Measurements for a normally grown baby at 31w3d are:
BPD 80.5mm
HC 286mm
AC 277.5mm
FL 60.5mm
EFW 1852g

For umbilical artery flow, the average S/D ratio is 2.79. The 95th percentile S/D ratio is 3.85, RI is 0.75 and PI is 1.25.

I can't remember what I wrote before for weight goals, but I'm hoping that she weighs in around 1450g. It's super high, but that would keep her on her projected growth curve. I'll be happy if she makes it to 1294g, though. As long as we're not falling behind. It's only 260grams, that's totally doable. She can do it.

Partial Placental Abruption Picture

This is what it looks like!

Daily NSTs

Yup, they're daily now. Ellie was sooo good today. The further along she gets the better her strips get. My nurse today was awesome, and even gave me a piece for the baby book! The top line is her heart rate. The bottom monitors contractions. They happen a lot, irritable uterus! As long as they stay infrequent and not painful, it's all good.

1:40pm Tuesday

I have had a really great day, so far.

Alexandre and my dad came by just before 10 this morning. I had managed to find time to wash my hair, so I didn't look like a total grease ball. My little brother told me I don't look any bigger than I did the last time he saw me, which is pretty true. They visited for about 45 minutes, which was lovely.

Theresa from Recreational Therapy came in just after they left to let me know she was going to set up a sewing machine for me! It was like angels singing, you have no idea how excited I was to have the chance to really SEW! I spent a couple hours in the lounge, ironing and sewing. I made two really awesome blankets. One with the light pink minky dot, with Bella/Cozy Madison fabric. The other, is this lovely aqua fabric, with pink birds, I LOVE it, and paired it with a light aqua minky. Both were done with cotton borders, they turned out great. I sewed a couple bibs for some of the other ladies, because I wasn't overly interested in making cards or embossing. I was so happy.

Just as I was finishing the ends on the last bib, my boys walked in!! They didn't even let me know they were coming, but I was thrilled at the surprise visit. Jakob was so cute. The first thing he told me was "Mommy, I stepped in dog poop!" Hahaha, gross. He was so chatty. They stayed for almost two hours, while I had my lunch, and he told me all about everything he's been doing. It was so nice to have them here with me.

After they left, I had a visit from my doctor. I am not a high-priority patient, but she is pushing for me to get a private room. I think I'm second in line, though, because there's some chick in the room beside me who is sick and needs to be isolated as to avoid making the rest of us sick. There are no beds available, other than the one beside me, and I'm waiting on a roommate today, I think she's got kidney stones or something like that. The doctor said I have to go 48-72 hours with no bleeding, and since that hasn't happened since I've come, they can't even give me an estimation of when I might possibly get to go home. That's okay, I am used to it here. Depending on how my bloodwork from the other day was, I might start on iron supplements, since I've been losing blood, and will only lose more when I actually had her. She said that there's no reason at the moment why they would deliver her, unless I was "bleeding to death" (yikes) or Ellie were in severe distress. They want me to give her every chance at growing they can. The doctor was looking over my sewing, and admiring my blankets :)

My roomie is really, really nice! Ah, love it.

On Friday, at our next recreational therapy, they're going to be making fleece quilts. I get to do all the sewing! I suggested to the lady in charge that instead of sewing everything, maybe I can sew the panels (the other patients will cut out the fabric they want, and pin it the way they want it laid out) and then finish them as a no-sew blanket, where you make cuts at regular intervals, then tie the fabric together. I think the ladies would feel like they actually did something more than just cutting out the fabric. It's nice to feel productive.

I have two burp cloths cut out (rectangular, not the same shape as the one I did before), a blanket for Amber, another blanket for Ellie (her stroller blanket), a blanket for the twin bed in her room (it's going to be big!) and another couple of blankets. Busy! Because I've been able to sew them on the machine, I can totally sell them in my shop. I really love the way they look with the border. I am going to ask Jay to bring in my SusieCues labels, so they can be sewn on properly. I think I'm also going to ask for some of the extra minky, so the ladies can use it for their crafts. I have so much extra fabric, it would be nice to have it go to some place worthwhile!

My mom is coming by in an hour or so, which will be nice. I wish I were allowed to get up and walk, but I've been told that I'm only allowed to go to and from the lounge in a wheelchair, three times a day, and my showers are to be limited to 5 minutes. FIVE? Ah, that's lame. No baths, since my membranes are exposed. I hope the bleeding settles so that I can get back to my level 3 bed rest.

Tuesday, April 12, 2011- 31 weeks!!!

Happy Week Milestone to Me!!

My nurse woke me up this morning at 8, for a baby check. She is super friendly. She sat down and chatted with me about a lot of things, like my bleeding, which she says the doctor has on my chart as a Chronic Abruption. The theory goes something along the lines of, there's a spot on my placenta that likes to lift away. Who know why it did in the first place, but things like moving quickly, or Ellie kicking it in just the right way start it off again. The most reassuring thing anyone has told me this whole time, is that if Ellie is still moving, and I can feel her, when the bleeding happens, it's going to be okay. Babies in distress don't move, they do everything they can to conserve energy. How come no one told me that two weeks ago?

Today is an appointment free day. I have an NST tomorrow, and on Friday, and my big scan on Thursday. Unless the bleeding picks up, which would warrant another NST, I`m good to just chill today. No word on if there`s going to be a new roommate today

Alexandre is coming to see me today!!! I haven't seen him since our trip to Mexico, and I'm really excited to see him. I'm not sure if mom will come with him, or not. I think Jason was planning on bringing Jakob by at some point today, also.

I'm tired again, I think I might have a mini nap, and then get on with my day. The most exciting thing I have planned is a shower.

10pm Monday

Tomorrow is 31 weeks. I am absolutely amazed we've made it this far, there have been many times where I've been fairly certain Little Ellie would be born, but here we are, still together, I am still pregnant.

One thing stuck with me from my chat with the doctor this morning. They still consider her a symmetrical iugr baby. I've been trying to figure out what the ratio is for symmetrical vs asymmetrical, but all I've been able to figure out is that symmetrical usually starts sooner, asymmetrical starts after 30 something weeks.
Traditionally divided into in:
Type I symmetrical 20%
Type II asymmetrical 80%
Symmetrical is the one that's linked primarily to chromosomal abnormalities. High s/d doppler ratios, especially over 30 weeks are linked to both IUGR and chromosomal abnormalities. I really wish we'd had some sort of testing done earlier on, just to know what we're up against, if there's something.

Sometimes I wish I could just ask all my questions, and get all the answers, but the doctors here are busy, and they're rushed, and I feel like unless there's something urgent, I can most likely find out the answers myself. I know that babies with karyotypical anomalies are usually REALLY small, like 0.1percentile, so we're a lot bigger than that, which I'm going to take as a positive.

In the research I've done, it makes a lot of sense to deliver at 35 weeks. Chances are that there's still going to be reduced flow, as there is now. If it goes absent, they'll deliver her at 33 weeks, if it reverses, well, then it'd be go time, whenever that happens. The doctors want to control labor and delivery from start to finish, because IUGR babies do not handle labor well.

They check her heart rate four times a day. If there's any indication on any of those checks (if it's either hovering below 120bpm, or above 160bpm) that something isn't right, they'll do an nst, if that's abnormal, they'll do a biophysical profile and then go from there.

Ah, I'm done for the night with baby checks. Little Miss was not happy to be dopplered this evening, she kept kicking it away :) Fiesty little muffin.

In our weight range, until we reach next Tuesday, according to one place, the action plan should be, at minimum:
US: weekly
Doppler: AED administer steroids, especially < 28 weeks followed by NST and Doppler daily and BPP twice weekly.
Reverse diastolic flow, late deceleration and pulsative venous flow: C/S
*We have two ultrasounds weekly, but and NSTs thrice weekly, they haven't been doing actual BPPs (biophysical profile) since flow and AFI levels have been good (ish).

and after 32 weeks:
US: weekly
Oligo & reverse diastolic flow:C/S
AED: daily CTG, Doppler, weekly BPP, if deterioration, C/S

Survivability is amazing from this point on. The steroids boost her by about a week, although her small size cancels it out. She's got as good a chance of surviving intact as any full term baby would have.

I'm going to go to sleep knowing that she's going to be fine. I want her to stay in for as long as possible, but if she wants to come out, we will most definitely welcome her with open arms.

I can't wait to see how much she weighs on Thursday.
She went from 680g at 25 weeks to 860g at 27 weeks to 1030 at 29 weeks. Up 350g
in 4 weeks. Babies at the 10th percentile would have grown 493g,"Normal" babies would have grown 594g in that time, and BIG babies (at the 90th percentile) would have grown 695g.

Since we're going to hope she sticks with at least the growth expected of a baby at the 10th percentile, the expected growth from 29 to 31 weeks is 308grams. If she were a real go-getter, and aimed for what the average baby gains, the expected gain would be 372g. I'm not even going to hope for what a big baby would gain (436g, if you were wondering).

I'm hoping very much that when I ask on Thursday, how much she weighs, they'll give me a number higher than 1340g. 1340... that's what we need to stick to our curve, it's doable! To clear us of IUGR, she would have to weigh-in at 1454g.

I honestly have no idea what to expect, so I'm going to leave it until Thursday :)

Bonne nuit.

7:30pm Monday

Wow, that was a trip. I really don't like feeling stoned/high.

I watched a really funny episode of Family Guy, so that was rather enjoyable. I really want to have a shower, but I was just up to go pee again, and I'm still bleeding, not a lot, but enough to make me want to stay in bed. Uggggh... it's pretty scary to see.

I'd say most of the time, the bleeding I've had over the past two weeks has been between spotting and a really light period. Usually, it's light red, sometimes it's bright red, most of the time it's pink and mucousy. How's all that for too much information? :) Today, it's red, dark red. Definitely fresh. I passed a couple more clots, so I think I'm going to lie low. I wish I knew for certain where it was coming from. Does it stem from my cervix dilating, or is a little part of my placenta lifting up, or is it more serious? No one can tell me though, it's just a waiting game.

Waiting, waiting, waiting. It's amazing though. I've learned a lot over the past couple months, learned to destress, learned not to let the little things get to me. I have time these days to look at the walls and think about whatever I want to think about, not when my next deadline is due, or when I have to get my next shipment out. I don't have to think about bills, or groceries, I don't have to think about much. That part I like.

Thank you, Codeine

I started having a bad head ache again this afternoon, probably due to the stress of everything. This time I didn't hesitate to ask, and ended up being given a T3. Ah, blessed codeine, and it's pain killing properties. I'm high as a kite, and I only had one!!

Hmmm... now to find something entertaining to watch :)

A Rather Eventful Midday

I was thrilled this morning when there was no bleeding. Just "normal" pregnancy discharge. However, I wasn't feeling so great, and I was really crampy. I had a good non-stress test, lunch and then I decided to have a nap. I've been so sleepy today.

I felt the need to pee, so I got up, went to the washroom, looked down and nearly died. There was so much blood! I passed a clot the size of a toonie, and turned the whole toilet bowl red. Not only that, it ran down my legs, and onto my pants, and onto the floor. I buzzed the nurse from in the bathroom, and she came to see me. Got me set up with a new pad, hooked me back up to the nst for a while just to make sure that Ellie was okay. They ordered bloodwork on me, and the nurse checked my pad every five minutes for the next hour.

I got sent down the hall for a speculum exam. It was hideously uncomfortable. She stuck gauze up there to soak up the bleeding to get a better look of things. Last speculum exam (which tells you much less than a digital vaginal exam) showed me closed. Today it showed me over a centimeter dilated. I know that I can stretch out to about a 4cm. The cramping stopped after I started bleeding, so they think that my lack of bleeding overnight and this morning was because it was causing the clot, and when my uterus finally got irritated enough with it, it ejected it, causing the cramping and bleeding. YUCK.

I had my AFI/doppler scan a bit after that, which was fine. Baby looks good. She took a couple pictures of my cervix from the abdominal view, my amniotic sac is clearly hanging out inside my cervix. Lovely.

They aren't going to be talking about moving me again until three days from now. I'm scheduled for my growth scan on Thursday, I can't wait for Thursday.

While I was having my scan, Gail asked me if I wanted Ellie out at 32 weeks, or if I wanted her to stay in until 35 weeks (which is when I'm fairly sure they will induce me, if what the doctor today said carries any weight). As hard as it is to imagine being cooped up in here for the next 4 weeks, I'd rather that, than having her stuck in the NICU for who knows how long, and my having to run back and forth between home and here several times a day. No thanks, I'd just like her to stay in, we're together, I don't have to worry about anything, this is definitely the place for us.

Jason came to visit for a couple hours. God, I miss him so much. I think it's possible I might actually miss him more than I miss Jakob. Does that make me horrible? Jason is the most loving man I've ever met. Before all this, every night he was home, he would rub my back for an hour, or brush my hair, or rub my feet. We snuggle during movies, and hug many times a day. I am seriously missing the lack of physical contact. If I get my own room, I think he's going to have a sleepover, just so I can be cuddled all night long. I know lots of the other ladies here have someone overnight with them.

Gail's on her way back, so I'll go. Will post if there's any change with the bleeding/situation.

I LOVE my Nurses

I just heard my nurse arguing with the OB, that LADNER is *not* part of the Fraser Valley. She said that I should be here, and not in Surrey.

She also said "Room 12 (that's me) deserves a private room before anyone else". I love her.

I might get one today... and I'm not going to Surrey, they're going to have to handcuff me to the ambulance if they think I'm going to Surrey.

Feeling really crampy today, it sucks.

11:30am Monday

Um, WTF? They're out there in the nurses station talking about sending me to SURREY!!! Are you kidding me???
#1. Surrey is FAR from home. Ladner is not the same thing as Langley, morons.
#2. My whole support network is based out of Vancouver. My parents just rented an apartment in Vancouver, so that I can be close to the hospital if I get back to home-care.
#3. I don't know anyone in Surrey, I don't have an OB out there, and my midwife doesn't have privileges out there.
#4. WHY?!
Wow, I just looked at the clock, 11:04am on 11/04/11. Strange :)
Quite simply, I am not going. If they tell me I have to go, I'm not going. The stupid (they tend to run that way around here) medical student, who is on her first day of rotations, is horrible at hiding that they want me out of here. Where do you live? Ladner, but I moved to Vancouver when I started having pregnancy problems. Where were you going to deliver before this? At home, with a midwife. Where did you deliver your son? Richmond, it was horrible. Where are you pre-registered? Here... Oh. That's right. When I got classified as high-risk, I was transferred to Vancouver, to the MFMS, I pre-registered here, because they seemed to think it unlikely for me to make it to 32 weeks, and Richmond only takes normally grown 32-weekers, not little ones with IUGR. God, what's wrong with some people?
I told the nurse doing my nst this morning, that it was pretty obvious they wanted me to get out of here asap. She said, the Obs tend to be like that, some of their patients live on the ward the whole time, when they should and could go home, but the MFM patients who actually need to be here, get shafted based on office politics. It costs $2000 a day to be here. I'm not the one asking to stay. The student works with the OB, so she's on the OBs side of this battle. My doctor, you know, the high risk maternal fetal medicine specialist, told me I have to go 72 hours with no bleeding. I AM TRYING. It's no like I have control over my cervix or placenta.
Sometimes I just want to run away. I just want to go home.