It's been 39 days since we thought I was going to deliver a 24-weeker, 40 days since we found out we had lost a 24-weeker the day before. It still is an odd situation, but I feel like the focus on the living has to take over. Not that I want to discount the loss of try to gloss over it, but the 39 days that we have kept Chiron out of the NICU somehow is feeling more significant and with each passing day I expect this to get more so.
37 of those days have been in-patient bedrest and included fun with preterm labor, BRB [yes, they have an acronym for bright red bleeding], magnesium sulfate, contractions and more, but it's really been surprisingly easy. It's the "new normal". Do what needs to be done.
Another 39 days and we would be 35 weeks. Not trying to put the cart in front of the horse, but I'm cautiously optimistic.
Tuesday, December 21, 2010
Sunday, December 19, 2010
My iPhone is sentient
Was having some trouble tonight where the answer to "what's wrong" was "nothing more or less than the universe." I know I do not have the luxury to stay in this state, stress makes contractions worse and can push me back over the line to preterm labor, so I decided to turn on the iPod on phone as something different than what I've been doing in the five weeks I've been here.
The answer from the iPod was Lifehouse's Broken. http://www.azlyrics.com/lyrics/lifehouse/broken.html
Thank you sentient iPhone. Bonus that makes it even more perfect: up until two days ago when I had one of the nurses change the battery, my wall clock was losing two minutes a day...
The answer from the iPod was Lifehouse's Broken. http://www.azlyrics.com/lyrics/lifehouse/broken.html
Thank you sentient iPhone. Bonus that makes it even more perfect: up until two days ago when I had one of the nurses change the battery, my wall clock was losing two minutes a day...
Where is the line of a sibling?
In my mind, Trajan still has two siblings. But, where is the line? While I think I would acknowledge a miscarriage, they would have a different category in my mind than siblings I think. I don't know if it would be because we didn't know gender or because they were early enough to not have to be delivered or because a death certificate was not needed or what.
Random thought one: needing a death certificate when there will never be a birth certificate.
Random thought number two: I am still much better at "he and she" or "A and B". I don't do names. I know I should, but I don't.
I think part of what helps to make it perfectly clear to me that they had a sibling is these two shared a womb. Wombmates used to be one of the jokes that amused me. Chiron remains a twin on all the hospital forms rather than a singleton. It's just he's our single twin. At the beginning of this pregnancy, I commented that I'd never really thought of the word singleton. Before all "this" happened, I'd never thought of a single twin.
I don't know what the point of this is. I was just thinking about the info sheet they have you fill out in the obstetricians which is number of pregnancies, number of life births, number of still births etc. and it now makes more sense why they have to have each explicit category.
I do think Aurelia is their sister, but I imagine my answer to the question in passing, rather than detailed conversation, of how many children we have will be two. Sometimes it's easier to take the slight pang in the heart than to open up the guard on it all.
Random thought one: needing a death certificate when there will never be a birth certificate.
Random thought number two: I am still much better at "he and she" or "A and B". I don't do names. I know I should, but I don't.
I think part of what helps to make it perfectly clear to me that they had a sibling is these two shared a womb. Wombmates used to be one of the jokes that amused me. Chiron remains a twin on all the hospital forms rather than a singleton. It's just he's our single twin. At the beginning of this pregnancy, I commented that I'd never really thought of the word singleton. Before all "this" happened, I'd never thought of a single twin.
I don't know what the point of this is. I was just thinking about the info sheet they have you fill out in the obstetricians which is number of pregnancies, number of life births, number of still births etc. and it now makes more sense why they have to have each explicit category.
I do think Aurelia is their sister, but I imagine my answer to the question in passing, rather than detailed conversation, of how many children we have will be two. Sometimes it's easier to take the slight pang in the heart than to open up the guard on it all.
Friday, December 10, 2010
Optimism
Feeling rather optimistic. Should be careful with that, but it definitely is a nice feeling.
Thursday, December 9, 2010
Brief Positives!
Well, had an ultrasound and all was as good as could be and in one case better than we would have expected! Chiron is a healthy 1.2 kilograms of baby (2.64 pounds of 2 pounds, 10 ounces) with the right amount of fluid and excellent cardiac activity. He looks great! And I have continued with GAINING cervix. Yes, I never thought I'd find a cervix so interesting, but I do. Dilation is closing down and cervix is now up to around 3.7 centimeters. This is huge for those of you who haven't also developed an obsession with cervices (p.s. is that the correct pluralization?).
Said do need to stick with strictest bedrest and that does most likely mean to stay in the hospital, but deferring that decision until Monday when MY doctor is back. Wahahahaha.
Flying high right now ;-)
Said do need to stick with strictest bedrest and that does most likely mean to stay in the hospital, but deferring that decision until Monday when MY doctor is back. Wahahahaha.
Flying high right now ;-)
Hostile Intrauterine Environment
I'm supposed to be on a google ban, but took a break from it just to read a literature review to give myself some context. Thought this phrased it well: we are balancing the risks of a hostile intrauterine environment to the risks of prematurity. I have known friends who had incompetent cervix and I always hated the name because of incompetent. I think I may feel the same about hostile. I'd be better with compromised or something like that... Hostile sounds intentional.
And now I've got a work project in, so I can happily be distracted! I am so thankful for internet, VPN, printers and work that can be managed with a little flexibility from all involved remotely. I am pretty sure I'd go crazy if I was here with nothing to do!
And now I've got a work project in, so I can happily be distracted! I am so thankful for internet, VPN, printers and work that can be managed with a little flexibility from all involved remotely. I am pretty sure I'd go crazy if I was here with nothing to do!
That's not me!
Ok, I'm betting any doctor can get the patients confused, but the doctor covering keeps saying things that are the exact OPPOSITE of what is true and it's making me nervous. 1. she said they were going to stop my saline lock because I had bad veins. Nope, I'm an easy stick. Multiple nurses have commented that it's nice that I have such good veins. Plebotomists (how does one spell that) at the blood centers love me. They got all four sticks for the three-hour glucose tolerance test in the same arm with fast, easy sticks. So, that's not me. 2. I'm anemic, but she said she was going to stick with the once-a-day iron instead of three-a-day like we'd been doing because I got too constipated. Nope. Not a problem. 3. She said that cephalosporins are not a beta-lactam. I gave on that one, but she said my assignment was to look it up and yes it is as the other doctor had said. 4. I did not have a cesarean section with Trajan. 5. My gallbladder is fine.
Arggggghhhhhhhh
Arggggghhhhhhhh
The plan...
I keep getting asked by people, including the nurses, "what is the plan?"
Frankly, I don't know. I knew what the plan was at 24 weeks when the delivery of Aurelia and most likely both of them was imminent. I don't really know the plan now that we are at 28 weeks and stable. I know it is still a balancing game of risks: balancing between the risks to Chiron in his current environment and of being delivered premature, the risk to my body of keeping them in versus the risk to Chiron of being delivered, the risk of different delivery methods and more.
My best understanding? As long as I continue to pass my workups to show that I am not developing preeclampsia or DIC and Chiron continues to show great fetal heart patterns on the daily nonstress tests, we will stay in a holding pattern as long as I avoid returning to preterm labor. Originally, the perinatologist had sounded like this would be the case until 32 weeks, but I'm hoping that we are now looking to stay in the holding pattern a few more weeks beyond that. Consider this the all is good part of the plan.
Now, if all is good workup wise but I do go into preterm labor, I believe the plan is to deliver Aurelia, the presenting Twin A, vaginally. They will then cut the cord from her body as close to her as possible, place the cord back up in the uterus leaving the placenta inside and attached and then administer magnesium sulfate and hope that it stops the labor process and that my body even closes up the cervix some. If this works, we will be in another holding pattern, but one that does not have the potential to go as long in all likelihood.
If anything is not good workup wise, I believe the answer is delivery then of both babies. The only solutions for preeclampsia and DIC are the removal of the underlying condition. While I think DIC is technically only due to the intrauterine demise of the cotwin, my understanding is it is such a serious condition that they would go ahead and deliver both twins because of the risk to maternal life is too great.
I think I've come to understand that if anything is going wrong, we are likely to go with a c-section, but there is still the possibility of delivering both vaginally, even possibly days or weeks apart.
What's funny is that even a month ago, having to have a c-section was near the top of my fears lists. Never had a problem with it and was completely on board as medically necessary, but definitely not comfortable. Now it doesn't even hit the radar. And that's with knowing some of the situations make the necessity of an emergency c-section with the older, more dramatic abdominal surgery possible.
I'm trying not to put too much faith and hope into any thought, but my actual OB is back Monday and she is much more comfortable with questions and discussing possibilities even when they don't know the answer than the covering doctor, so I'm hoping I have a better answer for the plan than these current guesses after I talked to her. I know I shouldn't set too much faith in anything changing in my understanding or anything once she's back, but I can't help but feel like it will be a relief to have the doctor that I like, that delivered my son, that communicates in a way that I understand and who puts up with my inanities without even blinking.
Frankly, I don't know. I knew what the plan was at 24 weeks when the delivery of Aurelia and most likely both of them was imminent. I don't really know the plan now that we are at 28 weeks and stable. I know it is still a balancing game of risks: balancing between the risks to Chiron in his current environment and of being delivered premature, the risk to my body of keeping them in versus the risk to Chiron of being delivered, the risk of different delivery methods and more.
My best understanding? As long as I continue to pass my workups to show that I am not developing preeclampsia or DIC and Chiron continues to show great fetal heart patterns on the daily nonstress tests, we will stay in a holding pattern as long as I avoid returning to preterm labor. Originally, the perinatologist had sounded like this would be the case until 32 weeks, but I'm hoping that we are now looking to stay in the holding pattern a few more weeks beyond that. Consider this the all is good part of the plan.
Now, if all is good workup wise but I do go into preterm labor, I believe the plan is to deliver Aurelia, the presenting Twin A, vaginally. They will then cut the cord from her body as close to her as possible, place the cord back up in the uterus leaving the placenta inside and attached and then administer magnesium sulfate and hope that it stops the labor process and that my body even closes up the cervix some. If this works, we will be in another holding pattern, but one that does not have the potential to go as long in all likelihood.
If anything is not good workup wise, I believe the answer is delivery then of both babies. The only solutions for preeclampsia and DIC are the removal of the underlying condition. While I think DIC is technically only due to the intrauterine demise of the cotwin, my understanding is it is such a serious condition that they would go ahead and deliver both twins because of the risk to maternal life is too great.
I think I've come to understand that if anything is going wrong, we are likely to go with a c-section, but there is still the possibility of delivering both vaginally, even possibly days or weeks apart.
What's funny is that even a month ago, having to have a c-section was near the top of my fears lists. Never had a problem with it and was completely on board as medically necessary, but definitely not comfortable. Now it doesn't even hit the radar. And that's with knowing some of the situations make the necessity of an emergency c-section with the older, more dramatic abdominal surgery possible.
I'm trying not to put too much faith and hope into any thought, but my actual OB is back Monday and she is much more comfortable with questions and discussing possibilities even when they don't know the answer than the covering doctor, so I'm hoping I have a better answer for the plan than these current guesses after I talked to her. I know I shouldn't set too much faith in anything changing in my understanding or anything once she's back, but I can't help but feel like it will be a relief to have the doctor that I like, that delivered my son, that communicates in a way that I understand and who puts up with my inanities without even blinking.
Selfishness, balance and ideal?
So, I caught myself thinking positively towards a scenario that I know
I know intellectually that I want the ideal situation. Ideal in this case means not developing a problem coagulating my blood called DIC. I think this means disseminated intravascular coagulation, but in a passing comment with a nurse the nickname of Death is Coming came up and that is not soothing. My levels are still within normal, but they do drop from week to week, so we want to keep this possible condition at bay as long as possible, like into February. Ideal also means keeping both babies in until again, sometime in February.
It is a must riskier proposition to deliver Twin A, Aurelia, and then stop labor. It does help diminish the risk of DIC almost entirely, but it will create an additional potential source of infection. It does seem like everything they do they mention the infection risk, but in this case they would deliver her, put her cord back up inside and then administer magnesium sulfate again, so I can where the clear infection risk would come from because something that had been on the outside would be placed back in the uterus.
So, while I see the advantages of the ideal and intellectually am rooting for it, I do appreciate some of the selfish advantages to the second plan. I think my degree of selfishness is such that I'm definitely not rooting for this course, but if it does happen, I will seem gold in the lining. Note: these advantages are mainly truly selfish. First, the day I deliver her and she officially becomes a stillborn (rather than a stillfetus?) would not be his birthday. Second, it may already be too late, but they said the earlier I delivered her, the more she would look like a small but perfect baby and with the passage of time, the more she will come to resemble more just tissue. Again, this is just selfish. I can no longer help her in any way. In some warped way I view the longer we can hold her in as a last gift to the brother she will never know.
I guess this is just my confession. I know intellectually that Chiron's entire life hangs in the balance and the quality of it is improved by every single day that things remain calm, I avoid preterm labor and I don't develop conditions of DIC or preeclampsia, but sometimes I just want some resolution for Aurelia.
I know intellectually that I want the ideal situation. Ideal in this case means not developing a problem coagulating my blood called DIC. I think this means disseminated intravascular coagulation, but in a passing comment with a nurse the nickname of Death is Coming came up and that is not soothing. My levels are still within normal, but they do drop from week to week, so we want to keep this possible condition at bay as long as possible, like into February. Ideal also means keeping both babies in until again, sometime in February.
It is a must riskier proposition to deliver Twin A, Aurelia, and then stop labor. It does help diminish the risk of DIC almost entirely, but it will create an additional potential source of infection. It does seem like everything they do they mention the infection risk, but in this case they would deliver her, put her cord back up inside and then administer magnesium sulfate again, so I can where the clear infection risk would come from because something that had been on the outside would be placed back in the uterus.
So, while I see the advantages of the ideal and intellectually am rooting for it, I do appreciate some of the selfish advantages to the second plan. I think my degree of selfishness is such that I'm definitely not rooting for this course, but if it does happen, I will seem gold in the lining. Note: these advantages are mainly truly selfish. First, the day I deliver her and she officially becomes a stillborn (rather than a stillfetus?) would not be his birthday. Second, it may already be too late, but they said the earlier I delivered her, the more she would look like a small but perfect baby and with the passage of time, the more she will come to resemble more just tissue. Again, this is just selfish. I can no longer help her in any way. In some warped way I view the longer we can hold her in as a last gift to the brother she will never know.
I guess this is just my confession. I know intellectually that Chiron's entire life hangs in the balance and the quality of it is improved by every single day that things remain calm, I avoid preterm labor and I don't develop conditions of DIC or preeclampsia, but sometimes I just want some resolution for Aurelia.
Wednesday, December 8, 2010
Delay...
Sigh. Other people must have things going on and not find the idea of a cervix length check to be as riveting as I do. Ok, that in itself is a little disturbing. They moved Chiron's growth and my cervix length ultrasounds to tomorrow instead of today. So, don't have any news yet. But as I've told several people, in our situation no news is about the best possible news.
I'm still on the recommended Google ban that Paul proposed four weeks ago. This is good, because even some of the random facts I run across provide enough fodder for my mind. Boys apparently don't do as well in the NICU as girls?!?
I have no idea how to spell ay-yum, but I mean a yoga type sound that in my mind is coupled with pressing fingertips together. Calm, cool, collected and continuing to deal with reality and find the best course available to us.
I've had amazing quantities of work projects today (i.e. I started at 4:30 am and still am working with things) and I'm as always grateful for VPN, internet, printers, and plenty of work to keep my mind from going crazy.
Ramble over. In the words of Trajan, "grow, grow, grow."
I'm still on the recommended Google ban that Paul proposed four weeks ago. This is good, because even some of the random facts I run across provide enough fodder for my mind. Boys apparently don't do as well in the NICU as girls?!?
I have no idea how to spell ay-yum, but I mean a yoga type sound that in my mind is coupled with pressing fingertips together. Calm, cool, collected and continuing to deal with reality and find the best course available to us.
I've had amazing quantities of work projects today (i.e. I started at 4:30 am and still am working with things) and I'm as always grateful for VPN, internet, printers, and plenty of work to keep my mind from going crazy.
Ramble over. In the words of Trajan, "grow, grow, grow."
Tuesday, December 7, 2010
New Normal
It's odd that having no news is such good news. It's a wonderful thing to go a day with no change in status, I think more of less boring the nurses. Such an odd reality to be in, but one that I hope gets drawn out. Tomorrow is an ultrasound both for growth and for cervix length. And then Thursday is officially third trimester. It's been a couple days shy of four weeks since this whole thing started and doesn't seem like it's possible that it's just now third trimester, but that's pregnancy math for you.
I also have to make myself get some more work done for work tonight or tomorrow because I just haven't been able to get my butt in gear. I have a printer in the hospital room along with 4g internet and helpful coworkers and I don't have anything better to do, I just haven't been able to motivate myself. I know from experience that the time goes much faster and better when I do stay on work stuff, so I'll make a concerted effort starting with the post-Trajan visit/dinner time before bed.
I also have to make myself get some more work done for work tonight or tomorrow because I just haven't been able to get my butt in gear. I have a printer in the hospital room along with 4g internet and helpful coworkers and I don't have anything better to do, I just haven't been able to motivate myself. I know from experience that the time goes much faster and better when I do stay on work stuff, so I'll make a concerted effort starting with the post-Trajan visit/dinner time before bed.
Saturday, December 4, 2010
Jury Duty
Oddly, it seems like the minute logistics are more difficult/annoying than the big things. Got a jury summons. Now, I can claim a medical exemption by faxing documentation stating that I have a serious medical condition which would make it difficult or impossible for me to serve, but it still has to be done. I've done the online part of it, but I have to figure out who through the doctor's office does this. I'm thinking that calling Dr. Nash's nurse on Monday is probably the most efficient method since she is talented and helpful and excellent and most good things in the world.
Just argh.
Just argh.
Monday, November 29, 2010
Questions
Weihs doesn't like questions and while I got to see Nash this morning because she was covering part of Thanksgiving, figured it wasn't good to harass someone who is really on maternity leave. Dr. Nash will be back on a normal schedule December 13 apparently, so hopefully I can harass then.
- What happens with a fetal demise with a singleton? What's the body's response? How is this regulated?
- Why do I suddenly not need the vitamin D and iron? My blood work better?
- How does this delivering, knotting and shoving cord back up plan work if we do try to deliver just Aurelia?
- Is the infection risk basically from breakdown and decay?
- Why the coagulation blood work?
- How do we deliver them? Early? Later? If we are trying to deliver both, how will this happen? I know this is not a certain thing, but what are the ranges of possibilities?
- What is the ideal end game?
- What are the contractions/irritability? Dr. Yium made the most sense with a passing comment that I had a uterine irritant. Is that right?
- Basically, what are we doing? What are we watching for? What is the range of expectations?
- Does both moving so much lower mean anything?
- The sort of downward pressure sensation is just due to position moving?
- What the hell is a contraction?
- What's superstition and what's real? Lie only on side? Flood with liquids or just reasonable? Ambien more worthwhile for the benefits of sleep versus the risks?
The longest wake ever
That's what I feel like one aspect of this situation is. Not supposed to grieve, not supposed to stress, not supposed to worry though. It's a state of limbo that I'm not sure the mind is meant to handle. On one level I get that there is only one of them that I can do anything for and that's how I operate for decisions and intellectual thought, but I just can't get myself behind it 100%.
I'm taking it out on my hospital breakfast this morning by shunning it.
I'm taking it out on my hospital breakfast this morning by shunning it.
Tuesday, November 23, 2010
Dead Baby Blogs
I probably need to go back in and fill in the details, but that's not what I'm thinking of tonight. I wrote a pretty good story of what happened the first night in the hospital and I'll probably process updating that at some point, but not tonight.
Tonight what is on my mind is the phrase "dead baby blogs". It's something I came across occasionally in reading blogs, never really thought about, but apparently was aware enough that it pops into my head. However, I don't think I could write one. It's not that she wasn't real, but she never completely was. I don't know what I'm trying to communicate there. I know I prefer to only refer to her as she. Use her proper name, Aurelia, instead of pronouns raises my stress level dramatically. Maybe part of the reason why I feel I can't focus on the loss aspect is that her little brother is still trucking along, galloping like a good centaur. Maybe part of it is because I am hoping to carry her dead body inside me for up to three months. Maybe part of it is knowing I am not supposed to be stressed for Chiron's sake. I can not do anything more for Aurelia. Period. There is nothing. Thus the decisions seem easy to me.
I'm not heartless, it's not that I don't care. I only knew her from ultrasounds, yet there were guesses as to her temperament, primarily centered around her interactions, to dub them politely, with her brother. She was the older one in our earliest ultrasound and now she will forever be Chiron's big sister, it's just we will never get to know her.
I don't know why I'm writing this, but these are the thoughts for the night. Just because you never fully were doesn't mean we didn't love you and don't miss you.
I hate umbilical cords on some level. Uterine replicator for safety please.
Tonight what is on my mind is the phrase "dead baby blogs". It's something I came across occasionally in reading blogs, never really thought about, but apparently was aware enough that it pops into my head. However, I don't think I could write one. It's not that she wasn't real, but she never completely was. I don't know what I'm trying to communicate there. I know I prefer to only refer to her as she. Use her proper name, Aurelia, instead of pronouns raises my stress level dramatically. Maybe part of the reason why I feel I can't focus on the loss aspect is that her little brother is still trucking along, galloping like a good centaur. Maybe part of it is because I am hoping to carry her dead body inside me for up to three months. Maybe part of it is knowing I am not supposed to be stressed for Chiron's sake. I can not do anything more for Aurelia. Period. There is nothing. Thus the decisions seem easy to me.
I'm not heartless, it's not that I don't care. I only knew her from ultrasounds, yet there were guesses as to her temperament, primarily centered around her interactions, to dub them politely, with her brother. She was the older one in our earliest ultrasound and now she will forever be Chiron's big sister, it's just we will never get to know her.
I don't know why I'm writing this, but these are the thoughts for the night. Just because you never fully were doesn't mean we didn't love you and don't miss you.
I hate umbilical cords on some level. Uterine replicator for safety please.
Sunday, November 14, 2010
It all changed
This is something I wrote on my iphone keyboard while lying in a labor and delivery room during my last few hours of mag.
I find myself not fitting into any category. Can't really neatly fit the experience into blanks.
I had a normal growth scan and preterm labor session scheduled at the perinatologist for Thursday, November 11. I had some contractions Tuesday night and so they moved both up to Wednesday just to check what was going on. 24 week growth scan on both babies was great with good movement, size, blood flow and all of that. They also did my first cervix length ultrasound and the praise couldn't have been stronger, 4.38 centimeters.
Since I had just had the ultrasound, I didn't have a manual cervix exam for my preterm labor appointment. Just said I was doing well and discussed a work project that might be causing stress ad was encouraged to just relax about it. She said that my reduced and split work schedule with doing a fair bit from home was looking excellent and to keep it up. I was showing no indicators of any preterm labor risks or anything like that. Blood pressure and urine great. The week before I had had a manual exam and my cervix was fully closed with even the "exterior" kind of closed which is really impressive in someone with an older child apparently.
Unfortunately, I really feel like I had a mentality shift after this appointment. They were both described as great and viable and all of that and I'd received such overwhelming praise of my cervix. Since preterm labor was really the only concern that was on my radar at this point, I really felt much more like they were real. I'd had trouble getting my mind around the concept of "there's two of them", but I was finally definitely there.
Friday morning was a school holiday for our three-year-old. We'd decided he would go to a drop-in day care place that he loves for part of the day at least since we were trying to be conservative on hours for work and the Thanksgiving holiday was coming up anyway. Problem: appointment with the OB was at 8:15 in central Austin and the center opens at 8:00 in north Austin. We had just had the appointment on Wednesday, so for the first time ever, I went off to the OB by myself. Even stopped and got a rooibos latte to drink after the appointment since they come so hot and these appointments are so quick. Left it in the car and have not seen it again.
My doctor, Dr. Nash, had had a baby about two weeks before and so I was seeing a "random" doctor. The resident studying with random doctor came in and we chatted and she took fundal height and blood pressure and complimented the fact that I could still sit up on my own. Then Dr. Weihs, I think that was her name, came in and started giving me the gestational diabetes test stuff and then was wrapping up with a quick ultrasound to get heartbeats. Didn't get one on A, but said something to the effect of will try the easier one first and went and got our boy's heartbeat. Then she spent ten excruciating minutes watching our girl not finding a heartbeat. Then she stated that she believed something catastrophic had happened, but she wanted me to go to the perinatoogist for confirmation.
I was by myself in the "wrong" side of the office with doctors and staff I did not know. Bless Dr. Weihs, she had the brilliant idea to get "my" nurse over from the other side. Not only that, but Rachael, my normal doctor's nurse knew that I was not really ok despite my control, and abandoned everything to drive me to the perinatologist where she stayed not just until my husband could make it, but until we were done. And she had a doctor's appointment of her own this made her late to.
Met the third peri of the office for the first time and he concurred that she had suffered a fetal demise. He said he couldn't see any cause for why this would be and that he'd looked through the report from two days before and everything still looked the same except she was no longer living. The OB had sounded pretty concerned about preterm labor or otherwise losing our son as well, but the peri sounded much more promising. We left very emotionally uncertain.
That night, I felt good physically. I described myself as aware of my uterus, but not contracting. I did well emotionally across the afternoon, but lost it a bit that night. I knew I was supposed to avoid stress for the sake of Chriron, our boy, but this made processing the loss of Aurelia much harder.
By ten Saturday morning, I was having regular cramping feelings. Talked to Rachael a couple a couple times and she had me come in, even if it was just for my sanity. They found I was having contraction as well as being dilated to one centimeter, so they immediately gave me a first steroid shot and started me on a 48-hour initial course of magnesium sulfate. Saw both the on-call OB and the on-call peri, who was the same one we had seen the day before. They talked through the possibilities of keeping both in, that they would try to stop labor more after I did deliver Aurelia if I did since she is the presenting baby and what would happen if we delivered both.
Chiron was placed on continuous monitoring and they left the sound on his machine to help soothe us. That gallop really helped through the first few hours or so when I went from sort-of contracting to full contractions about every four minutes. This was several hours in the mag and nurses stated talking up the try to deliver one plan more. They sent a neonatologist down to talk to us about generalities and DNR orders. Then things calmed down. Not sure how or why and haven't seen any doctor since then, but I know this can be nothing but good. I'm not trying to see anything more into it than buying Chiron a better chance of getting his full 48 hours of steroid treatment, but do hope we talk to an ob or peri in the morning.
I am still having at least three contractions an hour based on the monitors, but even fewer that are noticeable. No one has asked me about pain meds in hours and I again view this as a sign in the right direction! I'm definitely not trying to lose myself to optimism, since I'm pretty fact based, but seeing the good helps. I know I'm on a mag drip, but I'm hoping for the little guy. I do experience significantly increased uterine irritability if I go over about an hour to pee, but doing that is helping and is completely doable.
My eyes are having real trouble focusing because of the mag, so sorry for typos and wrong word choices.
Right now, my goal is making it to shift change. Shift change equals having made it through another 12 hours. Shift change equals one whole half a day's growth. Shift change in this case equals morning and people awake and food trays even if they are just liquids. They've only talked me through Monday midday, so I don't know what will come, but all I know is I will do what I can and know I can do nothing else.
I find myself not fitting into any category. Can't really neatly fit the experience into blanks.
I had a normal growth scan and preterm labor session scheduled at the perinatologist for Thursday, November 11. I had some contractions Tuesday night and so they moved both up to Wednesday just to check what was going on. 24 week growth scan on both babies was great with good movement, size, blood flow and all of that. They also did my first cervix length ultrasound and the praise couldn't have been stronger, 4.38 centimeters.
Since I had just had the ultrasound, I didn't have a manual cervix exam for my preterm labor appointment. Just said I was doing well and discussed a work project that might be causing stress ad was encouraged to just relax about it. She said that my reduced and split work schedule with doing a fair bit from home was looking excellent and to keep it up. I was showing no indicators of any preterm labor risks or anything like that. Blood pressure and urine great. The week before I had had a manual exam and my cervix was fully closed with even the "exterior" kind of closed which is really impressive in someone with an older child apparently.
Unfortunately, I really feel like I had a mentality shift after this appointment. They were both described as great and viable and all of that and I'd received such overwhelming praise of my cervix. Since preterm labor was really the only concern that was on my radar at this point, I really felt much more like they were real. I'd had trouble getting my mind around the concept of "there's two of them", but I was finally definitely there.
Friday morning was a school holiday for our three-year-old. We'd decided he would go to a drop-in day care place that he loves for part of the day at least since we were trying to be conservative on hours for work and the Thanksgiving holiday was coming up anyway. Problem: appointment with the OB was at 8:15 in central Austin and the center opens at 8:00 in north Austin. We had just had the appointment on Wednesday, so for the first time ever, I went off to the OB by myself. Even stopped and got a rooibos latte to drink after the appointment since they come so hot and these appointments are so quick. Left it in the car and have not seen it again.
My doctor, Dr. Nash, had had a baby about two weeks before and so I was seeing a "random" doctor. The resident studying with random doctor came in and we chatted and she took fundal height and blood pressure and complimented the fact that I could still sit up on my own. Then Dr. Weihs, I think that was her name, came in and started giving me the gestational diabetes test stuff and then was wrapping up with a quick ultrasound to get heartbeats. Didn't get one on A, but said something to the effect of will try the easier one first and went and got our boy's heartbeat. Then she spent ten excruciating minutes watching our girl not finding a heartbeat. Then she stated that she believed something catastrophic had happened, but she wanted me to go to the perinatoogist for confirmation.
I was by myself in the "wrong" side of the office with doctors and staff I did not know. Bless Dr. Weihs, she had the brilliant idea to get "my" nurse over from the other side. Not only that, but Rachael, my normal doctor's nurse knew that I was not really ok despite my control, and abandoned everything to drive me to the perinatologist where she stayed not just until my husband could make it, but until we were done. And she had a doctor's appointment of her own this made her late to.
Met the third peri of the office for the first time and he concurred that she had suffered a fetal demise. He said he couldn't see any cause for why this would be and that he'd looked through the report from two days before and everything still looked the same except she was no longer living. The OB had sounded pretty concerned about preterm labor or otherwise losing our son as well, but the peri sounded much more promising. We left very emotionally uncertain.
That night, I felt good physically. I described myself as aware of my uterus, but not contracting. I did well emotionally across the afternoon, but lost it a bit that night. I knew I was supposed to avoid stress for the sake of Chriron, our boy, but this made processing the loss of Aurelia much harder.
By ten Saturday morning, I was having regular cramping feelings. Talked to Rachael a couple a couple times and she had me come in, even if it was just for my sanity. They found I was having contraction as well as being dilated to one centimeter, so they immediately gave me a first steroid shot and started me on a 48-hour initial course of magnesium sulfate. Saw both the on-call OB and the on-call peri, who was the same one we had seen the day before. They talked through the possibilities of keeping both in, that they would try to stop labor more after I did deliver Aurelia if I did since she is the presenting baby and what would happen if we delivered both.
Chiron was placed on continuous monitoring and they left the sound on his machine to help soothe us. That gallop really helped through the first few hours or so when I went from sort-of contracting to full contractions about every four minutes. This was several hours in the mag and nurses stated talking up the try to deliver one plan more. They sent a neonatologist down to talk to us about generalities and DNR orders. Then things calmed down. Not sure how or why and haven't seen any doctor since then, but I know this can be nothing but good. I'm not trying to see anything more into it than buying Chiron a better chance of getting his full 48 hours of steroid treatment, but do hope we talk to an ob or peri in the morning.
I am still having at least three contractions an hour based on the monitors, but even fewer that are noticeable. No one has asked me about pain meds in hours and I again view this as a sign in the right direction! I'm definitely not trying to lose myself to optimism, since I'm pretty fact based, but seeing the good helps. I know I'm on a mag drip, but I'm hoping for the little guy. I do experience significantly increased uterine irritability if I go over about an hour to pee, but doing that is helping and is completely doable.
My eyes are having real trouble focusing because of the mag, so sorry for typos and wrong word choices.
Right now, my goal is making it to shift change. Shift change equals having made it through another 12 hours. Shift change equals one whole half a day's growth. Shift change in this case equals morning and people awake and food trays even if they are just liquids. They've only talked me through Monday midday, so I don't know what will come, but all I know is I will do what I can and know I can do nothing else.
Friday, September 17, 2010
What is a due date, really?
Well, we have once again changed due dates. We are back in the range of the first due date and calling it March 4, 2010 now. So, I'm back up to 16 weeks!
Had another ultrasound yesterday and BOTH of them had their legs not just closed, but crossed! They would move them around, but not uncross them, so we still don't know what they are. We have ultrasounds on October 14 and then on October 15, so we should know by the end of that week I think! Then starting with October 28, we go to the perinatologist's office every week for a preterm labor prevention program.
After they both wouldn't show their goods I started entertaining the idea of waiting to find out, but when I mentioned this to Paul he looked at me like I was crazy, so I imagine we will not be doing that!
Had another ultrasound yesterday and BOTH of them had their legs not just closed, but crossed! They would move them around, but not uncross them, so we still don't know what they are. We have ultrasounds on October 14 and then on October 15, so we should know by the end of that week I think! Then starting with October 28, we go to the perinatologist's office every week for a preterm labor prevention program.
After they both wouldn't show their goods I started entertaining the idea of waiting to find out, but when I mentioned this to Paul he looked at me like I was crazy, so I imagine we will not be doing that!
Wednesday, September 1, 2010
What KIND of Twins are they??
First off, while people have asked us if they are natural, I think that's not a very useful word to use. I have no idea what an artifical twin would be. They are however, spontaneous.
In terms of the question of monozygotic, aka identical, or dizygotic, aka fraternal, the answer currently is we don't really know. They each have their own placenta, but this is true for 30% of monozygotic twins as well as all fraternal twins. However, since eggplant has measured slightly smaller than heart on every single scan, my thought is they are likely dizygotic.
The shorthand summary I've worked out of mono vs. di is:
If they are in the same sac, they are identical. If they are boy/girl, they are fraternal. Everything else could go either way though there may be indicators towards one type or the other. Also, if they have different blood types, they are fraternal, but this won't be known until after they are born. The true gold standard to test is a zygosity test.
In terms of the question of monozygotic, aka identical, or dizygotic, aka fraternal, the answer currently is we don't really know. They each have their own placenta, but this is true for 30% of monozygotic twins as well as all fraternal twins. However, since eggplant has measured slightly smaller than heart on every single scan, my thought is they are likely dizygotic.
The shorthand summary I've worked out of mono vs. di is:
If they are in the same sac, they are identical. If they are boy/girl, they are fraternal. Everything else could go either way though there may be indicators towards one type or the other. Also, if they have different blood types, they are fraternal, but this won't be known until after they are born. The true gold standard to test is a zygosity test.
Heart and Eggplant
Well, while we were sent home with a picture of two sacs at the last appointment, Dr. Nash did not use the word twins except for asking if twins ran in our family. In fact, as a follow-up to my question of “isn’t there such a thing as vanishing twin syndrome,” she said that there definitely are two sacs with something in each now, but she’d give it 30% odds that there would still be two in two weeks. I think she might have been trying to help me gradually adapt to the idea, because I never found any stat that low online.
So, when she walked in to our appointment two weeks later, she skipped all the small chat and said, “well, I’m wanting to know how many are in there and I’m sure y’all are, so let’s get to it.” And lo and behold:
Heart and eggplant! Both with good heartbeats. Heart is A and eggplant is B!
So, when she walked in to our appointment two weeks later, she skipped all the small chat and said, “well, I’m wanting to know how many are in there and I’m sure y’all are, so let’s get to it.” And lo and behold:
Heart and eggplant! Both with good heartbeats. Heart is A and eggplant is B!
She also changed our due date at this appointment to March 10 from March 2. But, since she also told us the latest we would go is 38 weeks, we actually moved up over a week total.
We also got individual shots of each, but apparently I'm not good enough at knowing how to use the blogpost thing to show both... Oh well
July 8, 2010
We go in for our first 6 week appointment. Everything looks good on the physical exam, so move on to the ultrasound. Dr. Nash looks around for a bit and then looks up and asks, “do twins run in your family?” Umm, what? Was the quietest I’ve ever been in her office!
Paul took it like a trooper while I stayed in a state of shock. That is until we were driving to work and he asked if I realized this meant that we would have to name two resulting in a screamed profanity.
Two huh? That’s a surprise.
We go in for our first 6 week appointment. Everything looks good on the physical exam, so move on to the ultrasound. Dr. Nash looks around for a bit and then looks up and asks, “do twins run in your family?” Umm, what? Was the quietest I’ve ever been in her office!
Paul took it like a trooper while I stayed in a state of shock. That is until we were driving to work and he asked if I realized this meant that we would have to name two resulting in a screamed profanity.
Two huh? That’s a surprise.
Reconstruction by key dates:
So, the timing of this pregnancy was not coincidental. I work as an actuary and recently finished up my exam requirements to move from an Associate of the Society of Actuaries to a Fellow. Yes, an FSA. Seldom has so much effort been expended to turn an A into an F. [That’s a bad actuarial joke, so feel free to not even get it.]
I thought an interesting way to get myself thinking through what I should be recording/blogging/etc. would be to reconstruct the key dates that have gotten us to where we are today.
April 30, 2010 – took CSP-RU exam and felt pretty good about it. Knew I completely aced the non-accounting questions and thought I may have figured out one of the accounting questions completely and hopefully at least got points on each.
May 11, 2010 – took EA-2B exam and rocked it.
May 12, 2010 – talked through performance on the exams and decided we were comfortable going ahead and moving towards getting pregnant even though we didn’t have my results on the exams yet. Theory was since I was confident I had passed EA-2B, the worst case scenario was that I would have to take CSP-RU again. Since it wouldn’t be offered again until the end of April 2011, assuming I got pregnant quickly, I shouldn’t have difficulty taking it as I’d still be on partial maternity leave.
May 15, 2010 – completed FE module. Assuming I had passed both exams, getting this module in before May 30 meant that I would be grandfathered into the older FSA requirements and not have to do a third content FSA content module.
May 28, 2010 – LMP
June 7, 2010 – Appointment with OB. Out of curiosity, I started tracking basal temperatures and monitoring for LH spikes over the winter/spring months. This had not produced any useful patterns. She said that even though we hadn’t been trying, we should go ahead and do some lab work at the start of my next cycle because I had good data and it wasn’t promising.
June 9, 2010 – got my first ever positive ovulation test. Proceeded to do two more in quick succession to make sure it wasn’t a mistake. Gone by just a couple hours later, so was not optimistic.
June 23, 2010 – positive pregnancy test! Do NOT believe those valid 6 days before silliness. Also, make sure and give test enough time to get a result before just tossing it. And thanks to Anita for confirming that a pale positive is still a positive!
July 8, 2010 – twins. Except that word really wasn’t used. March 2, 2011 due date.
July 22, 2010 – still twins, but now the word twins is used for sure! Back up to a March 10, 2011 due date
July 24, 2010 – buy a new bedroom set.
August 19, 2010 – still twins and they look much more baby like on ultrasound. Their size is closer to the March 2, 2011 due date, but apparently we are sticking with March 10.
August 23, 2010 – first perinatologist appointment. Both babies ace their Down’s screening. Perinatologist says March 2 date seems more likely. There’s a third space and an ovarian cyst, but definitely no triplet. I know we would have dealt, but I must confess that I was joyful at there not being a triplet. Triplets is just such a harder and risker ballgame.
Ok, so this post is really for me to keep things straight. Hopefully it gives me motivation to write out more of the story coming up...
I thought an interesting way to get myself thinking through what I should be recording/blogging/etc. would be to reconstruct the key dates that have gotten us to where we are today.
April 30, 2010 – took CSP-RU exam and felt pretty good about it. Knew I completely aced the non-accounting questions and thought I may have figured out one of the accounting questions completely and hopefully at least got points on each.
May 11, 2010 – took EA-2B exam and rocked it.
May 12, 2010 – talked through performance on the exams and decided we were comfortable going ahead and moving towards getting pregnant even though we didn’t have my results on the exams yet. Theory was since I was confident I had passed EA-2B, the worst case scenario was that I would have to take CSP-RU again. Since it wouldn’t be offered again until the end of April 2011, assuming I got pregnant quickly, I shouldn’t have difficulty taking it as I’d still be on partial maternity leave.
May 15, 2010 – completed FE module. Assuming I had passed both exams, getting this module in before May 30 meant that I would be grandfathered into the older FSA requirements and not have to do a third content FSA content module.
May 28, 2010 – LMP
June 7, 2010 – Appointment with OB. Out of curiosity, I started tracking basal temperatures and monitoring for LH spikes over the winter/spring months. This had not produced any useful patterns. She said that even though we hadn’t been trying, we should go ahead and do some lab work at the start of my next cycle because I had good data and it wasn’t promising.
June 9, 2010 – got my first ever positive ovulation test. Proceeded to do two more in quick succession to make sure it wasn’t a mistake. Gone by just a couple hours later, so was not optimistic.
June 23, 2010 – positive pregnancy test! Do NOT believe those valid 6 days before silliness. Also, make sure and give test enough time to get a result before just tossing it. And thanks to Anita for confirming that a pale positive is still a positive!
July 8, 2010 – twins. Except that word really wasn’t used. March 2, 2011 due date.
July 22, 2010 – still twins, but now the word twins is used for sure! Back up to a March 10, 2011 due date
July 24, 2010 – buy a new bedroom set.
August 19, 2010 – still twins and they look much more baby like on ultrasound. Their size is closer to the March 2, 2011 due date, but apparently we are sticking with March 10.
August 23, 2010 – first perinatologist appointment. Both babies ace their Down’s screening. Perinatologist says March 2 date seems more likely. There’s a third space and an ovarian cyst, but definitely no triplet. I know we would have dealt, but I must confess that I was joyful at there not being a triplet. Triplets is just such a harder and risker ballgame.
Ok, so this post is really for me to keep things straight. Hopefully it gives me motivation to write out more of the story coming up...
Tuesday, August 10, 2010
Inspired, but no motivation
So, I've been inspired recently by some awesome friends who chronicle life and their children and the things that happen. However, all I currently want to do is take a nap. Thus I have compromised. I'm writing something, but don't have pictures or an organized path to follow.
I was looking for a blog title and the two thoughts that have been most in my mind in the last couple weeks are Life Happens and Just Another Day in Paradise. Obviously such obvious blog titles aren't available, but I had a thought that friends have frequently used terms such as Wiley World and Decided that Wileydise was an interesting play on paradise. Now, it's not something anyone will ever remember, but it will do for now.
I should ask Paul how I can put a blog up on a domain since he got me www.elizabethwiley.com since he's awesome.
But for now, know that Life Happens and It's Just Another Day in Paradise and smile.
I was looking for a blog title and the two thoughts that have been most in my mind in the last couple weeks are Life Happens and Just Another Day in Paradise. Obviously such obvious blog titles aren't available, but I had a thought that friends have frequently used terms such as Wiley World and Decided that Wileydise was an interesting play on paradise. Now, it's not something anyone will ever remember, but it will do for now.
I should ask Paul how I can put a blog up on a domain since he got me www.elizabethwiley.com since he's awesome.
But for now, know that Life Happens and It's Just Another Day in Paradise and smile.
Subscribe to:
Posts (Atom)