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.

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