No news is the best kind of news, right? Still hanging out at the Seton Spa and Resort, but am now ensconced in stable antepartum care. I saw my OB this morning and the plan is to evaluate Thursday. I was supposed to have my weekly growth/modified BPP scan today, but the perinatologist shifted it to tomorrow. If that is good, plus I look good on a cervical exam which my OB does on Thursday and I can commit that I can adhere to real bedrest at home, then I will be discharged Thursday. If any of these three conditions are not true, then I stay here.
Right now I'm trying to keep an open mind to either outcome. Being honest, I'd rather be at home. I really think between having Paul and Poppins, I should be able to be a good bedrester (and my mom is here for right now, but she has responsibilities out of town, so trying to plan without relying on her) and this would let me see the boys. And bedrest is much better with dogs than without!
There are nice features of hospital bedrest as well though. In particular, visitors! I think people are more comfortable dropping by the hospital than a house, so I get to see more folks which definitely helps the mood.
I luckily am able to work full-time from either the hospital or the house which I think is crucial to my good spirits. The house is a mile from the office while the hospital is 15 minutes or so, so the house would be a little more convenient to the poor soul whose job includes running me files, but she is a very good sport, so I'm sure she's happy to do either way. I am not having Paul bring my hospital printer up here to get setup in advance of Thursday. If they keep me Thursday, then I'll have him set it up.
It's odd being back in antepartum because I know the nurses and staff so well, but it is a nice familiarity and there is real sanity benefit in getting an NST every day and fetal heart tones every night.
It should be obvious from these last few paragraphs that I have no clear preference between being kept for the duration and being discharged. I think the real truth is I'm on board with whatever the OB and the perinatologist believe is best for the girls. If I could keep them out of the NICU for one week by being in a bed with my head slanted towards for the floor for a month, that would be more than a fair trade. Seriously, it is so much easier to be the patient than to watch your child as the tiny patient. Any hour we can decrease their stay in the NICU by is honestly an hour that's not just better for them, but for our entire family. So, stay put girls.
The boys basically come here to eat and read books. And Trajan likes to adjust all the bed buttons. And there's unlimited pudding. What's not to like?
Monday, April 30, 2012
No news news
Saturday, April 28, 2012
All is good...
I really thought I posted something two days ago, but it turns out that perhaps I'm not the best phone blogger while on mag and I didn't put anything. So, the short version of it is that we are all doing well. Chiron has less fluid draining from his ears, Trajan apparently is the toughest, most resilient fella on the planet and was completely unfazed by the anaesthesia, the surgery, the pain, the hospital or anything. And the girls are both kicking butt and I'm getting the word "stable" applied to me.
Longer version:
Bless the commenter who pointed out that I should get a book about getting the tonsils/adenoids out and talk about it with Trajan. I did and the book said to think about your kid and the degree to tell him or her and I made the decision that he was the type who wanted to know everything that we knew included how he was be gassed, the kinds of tools that they would use to cut, that it would hurt, etc. He took one of his stuffed animals with him to the surgery, baby jaguar, and this friend also got to go back with him to surgery (since he needed his tonsils/adenoids out) and I'm told that Trajan did a fantastic job talking baby jaguar through what was going to happen.
This is his surly, presurgery pictury and I don't actually know the story on what the face is for. He LOVES the hospital socks. That's baby jaguar beside him. They happily went back through the doors to surgery by themselves, so we were two for two this week for our kids happily heading back with nurses they didn't know for surger :-).
This is his first post-surgery shot. He came up from the anaesthesia like a trooper (unlike little brother who fought the world like a tiger and was completely disoriented). He was in love with these rainbow popsicles. This is immediately after surgery, so he's still pretty high on the meds, but looking great and already explaining that it just feels like he's got a booboo in his throat and that getting your tonsils out is a good thing.
Pretty much immediately after that my mom (who went with Paul for part of the day, Paul stayed the whole day and night) asked Trajan if he wanted some quiet time. Trajan agreed and even put the nap mask on and was back asleep in less than a minute. When he woke up from this nap, he apparently seemed pretty much completely recovered. So, apparently my apprehension was all for nothing and I should have stuck with the half of me that knows my kid and is frankly time and again amazed by him. Trajan really is a superhero to me.
Just another example of him explaining things to baby jaguar. The IV is how you let your blood drink, pretty cool, huh, baby jaguar? Kid thought that getting to sleep at the surgery center was an awesome treat/trip reward. And then was discharged the next morning with no events!
Little brother has so far been to see me both days and I dub him my cutest visitor to date:
They both came yesterday and I'm going to need to get things set up with books and toys and all again to make this place a fun visiting spot. I'm highly confident I know what to do to make Trajan have a positive experience with my being here, but I'm much less confident with Chiron. Any tips to make a very attachd toddler understand visiting his mom in bed would be appreciated. So far, he's been very happy to just lay in bed with me, snuggle, read, talk and be. But I also think that he has a little stomach bug that may be slowing him down.
Trajan is still wearing his surgery socks and his arm band and really enjoyed realizing that I had a hospital band too!
I think my dad probably has some pictures of the boys visiting yesterday when they came with Poppins and my parents, but I was much more focused on enjoying them and the like, so all I've got is that shot that shows he has a band too :-).
I'll have an update on me and the girls sometime in the next few days, but I think I may wait until Tuesday when it sounds like we are going to have more of a conversation about "the plan". I was just moved from L&D to stable antepartum and am set up there. This gets me a real bed instead of a delivery bed, the right to short showers and the ability to wear clothes instead of a gown. It also shifts the girls to getting monitored once a day with an NST rather than the continuous or hourly monitoring that we've been doing.
I did have a conversation with a neonatologist the other day and it went pretty well. There actually have been some substantial improvements in just the 16 months since Chiron was born. Still hoping to go much longer, but it's a much rosier picture than the conversation I had at 24 weeks with a neonatologist last time.
Anything you want to know about the uterus of doom? About the girls? They've been doing great on monitoring, actually achieving 10 by 10 accels pretty often which is fantastic for 25 weekers and are doing everything we could ask of them.
That's my ramble, what should I update?
Longer version:
Bless the commenter who pointed out that I should get a book about getting the tonsils/adenoids out and talk about it with Trajan. I did and the book said to think about your kid and the degree to tell him or her and I made the decision that he was the type who wanted to know everything that we knew included how he was be gassed, the kinds of tools that they would use to cut, that it would hurt, etc. He took one of his stuffed animals with him to the surgery, baby jaguar, and this friend also got to go back with him to surgery (since he needed his tonsils/adenoids out) and I'm told that Trajan did a fantastic job talking baby jaguar through what was going to happen.
This is his surly, presurgery pictury and I don't actually know the story on what the face is for. He LOVES the hospital socks. That's baby jaguar beside him. They happily went back through the doors to surgery by themselves, so we were two for two this week for our kids happily heading back with nurses they didn't know for surger :-).
This is his first post-surgery shot. He came up from the anaesthesia like a trooper (unlike little brother who fought the world like a tiger and was completely disoriented). He was in love with these rainbow popsicles. This is immediately after surgery, so he's still pretty high on the meds, but looking great and already explaining that it just feels like he's got a booboo in his throat and that getting your tonsils out is a good thing.
Pretty much immediately after that my mom (who went with Paul for part of the day, Paul stayed the whole day and night) asked Trajan if he wanted some quiet time. Trajan agreed and even put the nap mask on and was back asleep in less than a minute. When he woke up from this nap, he apparently seemed pretty much completely recovered. So, apparently my apprehension was all for nothing and I should have stuck with the half of me that knows my kid and is frankly time and again amazed by him. Trajan really is a superhero to me.
Just another example of him explaining things to baby jaguar. The IV is how you let your blood drink, pretty cool, huh, baby jaguar? Kid thought that getting to sleep at the surgery center was an awesome treat/trip reward. And then was discharged the next morning with no events!
Little brother has so far been to see me both days and I dub him my cutest visitor to date:
They both came yesterday and I'm going to need to get things set up with books and toys and all again to make this place a fun visiting spot. I'm highly confident I know what to do to make Trajan have a positive experience with my being here, but I'm much less confident with Chiron. Any tips to make a very attachd toddler understand visiting his mom in bed would be appreciated. So far, he's been very happy to just lay in bed with me, snuggle, read, talk and be. But I also think that he has a little stomach bug that may be slowing him down.
Trajan is still wearing his surgery socks and his arm band and really enjoyed realizing that I had a hospital band too!
I think my dad probably has some pictures of the boys visiting yesterday when they came with Poppins and my parents, but I was much more focused on enjoying them and the like, so all I've got is that shot that shows he has a band too :-).
I'll have an update on me and the girls sometime in the next few days, but I think I may wait until Tuesday when it sounds like we are going to have more of a conversation about "the plan". I was just moved from L&D to stable antepartum and am set up there. This gets me a real bed instead of a delivery bed, the right to short showers and the ability to wear clothes instead of a gown. It also shifts the girls to getting monitored once a day with an NST rather than the continuous or hourly monitoring that we've been doing.
I did have a conversation with a neonatologist the other day and it went pretty well. There actually have been some substantial improvements in just the 16 months since Chiron was born. Still hoping to go much longer, but it's a much rosier picture than the conversation I had at 24 weeks with a neonatologist last time.
Anything you want to know about the uterus of doom? About the girls? They've been doing great on monitoring, actually achieving 10 by 10 accels pretty often which is fantastic for 25 weekers and are doing everything we could ask of them.
That's my ramble, what should I update?
Labels:
cervix,
hospital,
preterm labor clinic,
round three,
trajan,
twins
Thursday, April 26, 2012
Deja vu, but not
Some aspects of deja vu, but more not than are.
Last afternoon just at the time I was leaving work, I started feeling some cramping. Nothing big, but just enough from keeping me from standing quite all the way up (and for clarity, by late afternoon I mean Monday). Continued on into the evening, but I was originally thinking GI. Went to sleep, but was getting woken up by ten or so with them and so finally talked with the oncall doc that night at one. When she asked what was wrong, my first answer was raving paranoia. We decided she was fine with a plan where I tried to go to sleep and if I could, I'd check in in the morning. Made it to sleep by four, so did so.
Called in and "my nurse" (I'm oddly possessive) went ahead and scheduled me with the same OB who I saw last time while "my OB" (see?) was out on maternity. It was nice because of both familiarity and the fact that she's one of my favorite three of the seven (yes, I've had them all more than once now. I would like to take a moment to point out that I saw two others OBs at all throughout the entire pregnancy and delivery with Trajan and they were both post partum).
She said I was dilated fingertip whereas notes indicates I was completely closed Monday and that I was 30% effaced and soft. Not a big deal and itself, but enough to earn the monitor in office. Which in turn showed enough contractions to earn some monitoring at the hospital. Urgent enough to not go pick anything up or anything, but calm enough that I could drive myself over the two blocks.
She came over at lunch time and said that it did look like I has some irritability going on with contractions every 4-6, but didn't look like a steady pattern of true preterm labor. And she asked if I was good with staying through the afternoon and she'd discharge me at 5:30 or 6.
I actually calmed down during the afternoon contraction wise, so was looking good when she came in at 5:30. Then she did a cervical check. I was a full one and she switched language from discharge to steroids, mag and notifying the nicu.
To be clear, one centimeter in itself is not a big deal, particularly being multiparrous, I think it was the pattern of change plus the 29-weeker that makes it more of a deal. I will try to confirm that with my OB tomorrow.
Good news: mag isn't phasing me at all this time. Last time, on the initial magging at least, I had trouble focusing my eyeballs. No issue this time.
Good news 2: I'm confident with the procedures around here and how to say go to the bathroom disconnecting the three monitors, unplugging IV, unclipping blood pressure cuff, etc.
Good news 3: having the doc that I had today means no foley catheter. She feels it is more an infection risk than any possible advantage, thus the peeing.
Great news: they're both alive. This OB is the one I dub smart but without any much bedside manner and she declared early in the process of starting the mag that we made it further this time. I may have rolled my eyes (yes, 25 beats the hell out of 24, but it's still not what I'd want at all), but I think she missed the greater point, they're both alive. See those two fetal heartbeat lines in the image? Woot!
Crappy news: Trajan is still having his tonsils and adenoids out tomorrow. This honestly makes me almost feel sick. I have always been with him for everything medical and this is going to be hard and I can not be there for him. I couldn't take him on our planned special grocery store tonight. I can't help him come out from anaesthesia. I can't discuss vomiting possibilities with the anaesthesiologist pre surgery. I can't help console him through the first few days. I can't work at getting him to drink sufficient quantities. I can't be there.
My parents are in town, Paul is off and we have Poppins for the weekdays. I know the boys will be fine and don't need me, but that logical thought doesn't help much.
His checkin time is 8:45 this morning, four hours.
New bag of mag going on. Should see my OB sometime in the next day.
- Posted using BlogPress from my iPhone
Monday, April 23, 2012
New Territory
So, I wrote the title for this about a week and a half ago, but haven't updated anything. Not because anything is wrong, but just been too frantic with work getting things done to have any time between work and the boys and life.
All is good.
On the girls' front, I actually ended up calling my OB's nurse the next morning and talking to her about the preterm clinic. And totally lost the capacity to speak without crying which is something that happens to me about once every half-dozen years. Luckily, she's a very patient and kind soul and waited me out and helped me get the whole story out. The end result was that she talked with the OB and they declared that I didn't have to go to preterm clinic anymore. However, by that point I'd come to the conclusion that anyone could say something stupid and perhaps I should give her another chance. So I went ahead and went the next Monday morning and it was fine. I figure that it makes more sense to follow the recommended protocol as long as it isn't causing me to stress out unnecessarily. Went again today and I would actually go so far as to say that it was a positive experience with the preterm nurse, so hopefully things will stay that way.
With my flipout I actually ended up seeing my OB last Thursday where she patiently dealt with me 25 item long list of questions that I'd developed as part of my flipout. This was not the first time I'd done this to her, but the first time she saw it printed out instead of just on my phone or laptop screen. I kind of thought maybe we'd just get through a few of them and save the rest for next time, but she actually did the whole dang list!
She also talked with the perinatologist and got me set up for weekly ultrasounds with the perinatologist who strikes me as the best. Until 28 weeks, he is just going to assess their amniotic fluid, look at their heartbeat patterns and generally assess their movement. Then, starting at 28 weeks he will do a BPP each week. And at some point NSTs get added in.
While there is definitely a risk of recurrence in stillbirth due to cord accidents, I'm pretty sure they are doing most of this extra monitoring to keep me sane more than because they think it will make a difference in the girls' outcome. Honestly, I'm ok with that.
Here's their heads this morning. We are definitely in new territory as we are past the point of the demise in the last pregnancy. ALso, these girls move around a LOT. At 20 weeks, they were stacked both transverse with the right one lower. Then at 24 weeks, they had switched and the left one was presenting and she was vertex along the left side of my uterus with the right one stretched across the top transverse with her head to the right. And then a week later, the right one was back to being presenting and she is breech on the right side of the uterus with the left one transverse across the top of the uterus! It's anybody's guess where they are going to end up!
All is good.
On the girls' front, I actually ended up calling my OB's nurse the next morning and talking to her about the preterm clinic. And totally lost the capacity to speak without crying which is something that happens to me about once every half-dozen years. Luckily, she's a very patient and kind soul and waited me out and helped me get the whole story out. The end result was that she talked with the OB and they declared that I didn't have to go to preterm clinic anymore. However, by that point I'd come to the conclusion that anyone could say something stupid and perhaps I should give her another chance. So I went ahead and went the next Monday morning and it was fine. I figure that it makes more sense to follow the recommended protocol as long as it isn't causing me to stress out unnecessarily. Went again today and I would actually go so far as to say that it was a positive experience with the preterm nurse, so hopefully things will stay that way.
With my flipout I actually ended up seeing my OB last Thursday where she patiently dealt with me 25 item long list of questions that I'd developed as part of my flipout. This was not the first time I'd done this to her, but the first time she saw it printed out instead of just on my phone or laptop screen. I kind of thought maybe we'd just get through a few of them and save the rest for next time, but she actually did the whole dang list!
She also talked with the perinatologist and got me set up for weekly ultrasounds with the perinatologist who strikes me as the best. Until 28 weeks, he is just going to assess their amniotic fluid, look at their heartbeat patterns and generally assess their movement. Then, starting at 28 weeks he will do a BPP each week. And at some point NSTs get added in.
While there is definitely a risk of recurrence in stillbirth due to cord accidents, I'm pretty sure they are doing most of this extra monitoring to keep me sane more than because they think it will make a difference in the girls' outcome. Honestly, I'm ok with that.
Here's their heads this morning. We are definitely in new territory as we are past the point of the demise in the last pregnancy. ALso, these girls move around a LOT. At 20 weeks, they were stacked both transverse with the right one lower. Then at 24 weeks, they had switched and the left one was presenting and she was vertex along the left side of my uterus with the right one stretched across the top transverse with her head to the right. And then a week later, the right one was back to being presenting and she is breech on the right side of the uterus with the left one transverse across the top of the uterus! It's anybody's guess where they are going to end up!
We dropped our boys' 0-12 month clothing off with friends yesterday, it was impressive. Still pretty amazed by that purchase.
On the boys' front, it's surgery week. Chiron is getting tubes tomorrow and then Trajan is getting his tonsillectomy/adenoidectomy on Thursday.
Chiron is still adorable:
Trajan was an adorable ringbearer:
Poppins is still going great. I had a great time chaperoning Trajan's field trip a few weeks ago and CHiron went to his first birthday party for one of his friends.
Life is good, and perhaps now that I've acknowledged I've failed to write about all kinds of things, I'll get back on an updating schedule. I think it was largely trying to get work ready for me to be out for both surgeries that was kicking me backside, but I do still have a lot of work for the next few weeks, so it's entirely possible that I'll fail as an updater.
Random note: we have now had 19 or 20 ultrasounds this pregnancy and I'm not even remembering to take pictures of all the shots we get, much less upload them. How's that for crazy?
In conclusion, I'm sticking with the idea I opened with, all is good.
Friday, April 13, 2012
And I lost it...
So, I've held it together very well. Hell, I'm not even sure I'd say I've been holding it together, because it's been pretty easy. I'm rational. I understand things happen. And that doesn't mean it will happen again. So, I've been very fine. I've taken to thinking of these two as going to be here at some point. I've entertained the idea that it will be via the NICU possibly, but really expecting them by 37-40 weeks as a part of our day-to-day life.
Then I lost it.
I don't know if it's being at the same gestational age or realizing that I'm going to have to go for the longest stretch in the history of this entire pregnancy without an ultrasound or the preterm labor nurse upsetting me, but I've lost it. It was definitely the preterm labor nurse as the trigger, but I don't want to put it all on her.
How do I know I lost it? I called my OB's nurse this morning to confirm that something the preterm labor nurse said I didn't need to worry about and I ended up where I could barely (if that) talk because I was crying and just had lost control. I'm sitting here typing with tears running down my face. Thus, I say I've lost it.
To backtrack: yesterday I had an appointment with the preterm labor nurse and then an OB appointment. The preterm labor appointment was in the morning and went great in terms of the babies and my status as a pregnant person. Both had good heartbeats. Blood pressure was good. Cervix is long and closed, yeah! OB appointment also went well with both looking good on the quickie ultrasound and she also checked out my cervix and agreed it looked great. Four cervical checks in 88 hours, I declare my cervix to be pageant queen popular. Everything medical and related to this pregnancy at both appointments could not have been improved upon.
So, why the crazy? Well, the preterm nurse took me back to last time. I had an appointment with the perinatologist and her scheduled for a Thursday, but after feeling jumangi drums and just so much absurd amounts of motion that it distressed me, they had me come in Wednesday to check them out. They did the 24 week anatomy growth scan (24 weeks would be Friday) and everything looked great. Viable and perfect were words used. Yeah, ain't that almost funny?
She brought up this appointment and what I had felt and brought up that this was likely Aurelia doing her best to try to get oxygen. The nurse even said to communicate "hey mom, I'm not getting air." Yup, said that to me.
Yeah, that's a kick in the ass. But you know what, there's nothing we could have done differently. There's nothing we could have done to help her. And if I'm being completely honest, the outcome of two 24&0 weekers one of whom has been experiencing oxygen deprivation likely would not have been a better outcome than where we have ended up. But still, having someone say that yes, that meant something was wrong and I was the only one capable of getting the message makes me sick. And now I'm supposed to be watching for fetal thrashing?
I meant to ask the OB about it yesterday and we got to the point of saying that the preterm labor nurse had upset me (though I kept it completely together with her oddly), but got distracted and never got into why. Go attention deficit.
Also, the OB had convinced me early on this pregnancy that we weren't certain this was a cord accident. And this I think helped with my piece, because cord accidents are one of the causes of stillbirth that has recurrence where many stillbirth causes are flukes. So, now I'm back to that worry about the recurrence rate.
Oddly, I just realized that I never changed the little summary box of "our world" that's in the border of the blog page to not say cord accident when the OB convinced me that the neonatal nurse practitioner told me it as a certain cause to make me feel better, but they couldn't be certain. I will say that cord compressions definitely fit well with the symptoms and the experience of her motion.
And I'm feeling much better post this rant/ramble and a conversation with my OB's nurse, who is an amazingly patient and kind soul, this morning.
I have the 24 week anatomy/growth scan with these two on Monday and then I will see the preterm lady again. And then I enter my new distress as the OB set my next appointment for four weeks and the perinatologist will set my next appointment for four weeks, so I will have to go almost four weeks without seeing them on an ultrasound when I haven't gone even two weeks so far this pregnancy. The preterm labor clinic will do the Doppler, but even she has said that she's not 100% certain she's identifying them separately. It may seem odd, but the idea of possibly not knowing one is dead for weeks is almost more upsetting than the idea of one being dead. So, I anticipate some basketcaseness for the next four weeks.
I'm not ok, but I'll make it.
Afterthought: I am very lucky that I'm signed up to work pizza Friday at Trajan's school today. Two hours of serving up pizza and fruit and talking and playing with three lunches of kids and the world is always a better place. I'm still convinced I'm pretty blessed and lucky, even if I'm a bit crazy today.
Then I lost it.
I don't know if it's being at the same gestational age or realizing that I'm going to have to go for the longest stretch in the history of this entire pregnancy without an ultrasound or the preterm labor nurse upsetting me, but I've lost it. It was definitely the preterm labor nurse as the trigger, but I don't want to put it all on her.
How do I know I lost it? I called my OB's nurse this morning to confirm that something the preterm labor nurse said I didn't need to worry about and I ended up where I could barely (if that) talk because I was crying and just had lost control. I'm sitting here typing with tears running down my face. Thus, I say I've lost it.
To backtrack: yesterday I had an appointment with the preterm labor nurse and then an OB appointment. The preterm labor appointment was in the morning and went great in terms of the babies and my status as a pregnant person. Both had good heartbeats. Blood pressure was good. Cervix is long and closed, yeah! OB appointment also went well with both looking good on the quickie ultrasound and she also checked out my cervix and agreed it looked great. Four cervical checks in 88 hours, I declare my cervix to be pageant queen popular. Everything medical and related to this pregnancy at both appointments could not have been improved upon.
So, why the crazy? Well, the preterm nurse took me back to last time. I had an appointment with the perinatologist and her scheduled for a Thursday, but after feeling jumangi drums and just so much absurd amounts of motion that it distressed me, they had me come in Wednesday to check them out. They did the 24 week anatomy growth scan (24 weeks would be Friday) and everything looked great. Viable and perfect were words used. Yeah, ain't that almost funny?
She brought up this appointment and what I had felt and brought up that this was likely Aurelia doing her best to try to get oxygen. The nurse even said to communicate "hey mom, I'm not getting air." Yup, said that to me.
Yeah, that's a kick in the ass. But you know what, there's nothing we could have done differently. There's nothing we could have done to help her. And if I'm being completely honest, the outcome of two 24&0 weekers one of whom has been experiencing oxygen deprivation likely would not have been a better outcome than where we have ended up. But still, having someone say that yes, that meant something was wrong and I was the only one capable of getting the message makes me sick. And now I'm supposed to be watching for fetal thrashing?
I meant to ask the OB about it yesterday and we got to the point of saying that the preterm labor nurse had upset me (though I kept it completely together with her oddly), but got distracted and never got into why. Go attention deficit.
Also, the OB had convinced me early on this pregnancy that we weren't certain this was a cord accident. And this I think helped with my piece, because cord accidents are one of the causes of stillbirth that has recurrence where many stillbirth causes are flukes. So, now I'm back to that worry about the recurrence rate.
Oddly, I just realized that I never changed the little summary box of "our world" that's in the border of the blog page to not say cord accident when the OB convinced me that the neonatal nurse practitioner told me it as a certain cause to make me feel better, but they couldn't be certain. I will say that cord compressions definitely fit well with the symptoms and the experience of her motion.
And I'm feeling much better post this rant/ramble and a conversation with my OB's nurse, who is an amazingly patient and kind soul, this morning.
I have the 24 week anatomy/growth scan with these two on Monday and then I will see the preterm lady again. And then I enter my new distress as the OB set my next appointment for four weeks and the perinatologist will set my next appointment for four weeks, so I will have to go almost four weeks without seeing them on an ultrasound when I haven't gone even two weeks so far this pregnancy. The preterm labor clinic will do the Doppler, but even she has said that she's not 100% certain she's identifying them separately. It may seem odd, but the idea of possibly not knowing one is dead for weeks is almost more upsetting than the idea of one being dead. So, I anticipate some basketcaseness for the next four weeks.
I'm not ok, but I'll make it.
Afterthought: I am very lucky that I'm signed up to work pizza Friday at Trajan's school today. Two hours of serving up pizza and fruit and talking and playing with three lunches of kids and the world is always a better place. I'm still convinced I'm pretty blessed and lucky, even if I'm a bit crazy today.
Labels:
aurelia,
pregnancy,
preterm labor clinic,
round three,
the demise
Thursday, April 12, 2012
What autocorrect says about me
Some mistypings and the word it chooses seem revealing:
Trying to type on --> OB
Trying to type you --> uti
Trying to type of --> OG
Trying to type one --> OB's
Trying to type next --> NEC
Trying to type we --> ER
Just my little amusement today.
Trying to type on --> OB
Trying to type you --> uti
Trying to type of --> OG
Trying to type one --> OB's
Trying to type next --> NEC
Trying to type we --> ER
Just my little amusement today.
Monday, April 9, 2012
Thursday, April 5, 2012
Preterm Labor Clinic Begins...
My OB's practice sends their twin pregnancies to the preterm labor clinic at the perinatologist starting at 22 weeks. I did it last time, but only made it to three visits before "it all changed." Had the first appointment for this go round today and it went well. Was greeted with a deja vu comment.
I'm up 15 pounds now, which is less than they'd ideally want, but is enough that she isn't worried and says to just to keep up working on it! I'm 22 weeks and I'm measuring 31 weeks based on fundal height which interestingly is the exact same measurement that I got last time at 22 weeks with her!
We talked through all the activity guidelines and reviewed preterm labor symptoms. She wants me to work towards working part of each day from the house sooner rather than later, so I need to get my technological ducks in a row. She also wants me to really minimize my carrying of Chiron as much as possible. Don't need to eliminate entirely, but cut back as much as I can.
After the discussion, she had me leave a urine sample and then she measured the fundal height, listened to the heartbeats with a Doppler and then did an internal exam. My urine was excellent, an odd phrase to hear, but I'll definitely take it. And that coupled with a 120/60 blood pressure (which I think is great for me in a OB/perinatologist setting at this point) indicates all is well on the preeclampsia type front. Righty had a heartbeat at about 150 while Lefty was around 160. And my cervix is still very long, she said she would believe it's still around the 5 cm that it was the last time we measured, and the inner part is completely closed. The outer is open, but that's just because I've had a kid before.
The only thing she absolutely ruled out is that she says I am NOT to be the one to stay with Trajan for getting the tonsils out. She says that that would be a perfect storm nightmare to cause preterm labor. She actually had her son's out at the exact same place with the same surgeon a few months before and she adamantly said no. I can be there during the day for the procedure and all that, but I need to leave for the evening hours. I'll need to talk with Paul (he has a webcast at work this morning), but I imagine this isn't really an issue and he can just stay with him. She also recommended that we do get the alcohol-free version of the pain meds for a reason I hadn't thought of. It burns less when they swallow it, so kids are more willing to take it, so it's less likely that we will fall behind his pain and have issues with that.
Everyone I talk to is making me more and more nervous (not sure that's the exact right word) about getting the tonsils/adenoids out and the degree of discomfort, pain and just plain suffering Trajan will experience with it. I'm cautiously optimistic that at 4.5 he is much more capable of reasoning and discussing than most of the kids who are at 3 and so perhaps that will help.
Look for another ENT update this afternoon or tomorrow on the Chiron front! (and no, that isn't really an exclamation point of excitement, but it's kind of like the theory of you either have to laugh or cry. I am going with laughing and living. And glad that Poppins is in place so both of us have been able to work this time).
And to finish up the preterm labor thoughts, I will see her weekly until 37 weeks or things hit the fan. She is looking for continued weight gain, clean urine, good heartbeats, cervix staying long and closed and me reporting that I'm cutting back more and more on activities.
She gave me a sheet just like last time that outlines the key dates (I'd already converted my old one, but just for fun, here they are:)
And one last thought. I was wrong about something. I'd written before I got pregnant that the reason that I wouldn't ride this ride of pregnancy again for a round three is that my sanity couldn't handle it if something went wrong and in particular if we last another baby. It turns out that I'm pretty sure that that is not true. I obviously am not rooting for it, but I have had time to really think about what that would be like and I think I can say with pretty high confidence that I would make it. That I would process it, work through it and come through it still me, just a little bit different. I am strong enough. This may seem a warped thought, but knowing it helps me.
I'm up 15 pounds now, which is less than they'd ideally want, but is enough that she isn't worried and says to just to keep up working on it! I'm 22 weeks and I'm measuring 31 weeks based on fundal height which interestingly is the exact same measurement that I got last time at 22 weeks with her!
We talked through all the activity guidelines and reviewed preterm labor symptoms. She wants me to work towards working part of each day from the house sooner rather than later, so I need to get my technological ducks in a row. She also wants me to really minimize my carrying of Chiron as much as possible. Don't need to eliminate entirely, but cut back as much as I can.
After the discussion, she had me leave a urine sample and then she measured the fundal height, listened to the heartbeats with a Doppler and then did an internal exam. My urine was excellent, an odd phrase to hear, but I'll definitely take it. And that coupled with a 120/60 blood pressure (which I think is great for me in a OB/perinatologist setting at this point) indicates all is well on the preeclampsia type front. Righty had a heartbeat at about 150 while Lefty was around 160. And my cervix is still very long, she said she would believe it's still around the 5 cm that it was the last time we measured, and the inner part is completely closed. The outer is open, but that's just because I've had a kid before.
The only thing she absolutely ruled out is that she says I am NOT to be the one to stay with Trajan for getting the tonsils out. She says that that would be a perfect storm nightmare to cause preterm labor. She actually had her son's out at the exact same place with the same surgeon a few months before and she adamantly said no. I can be there during the day for the procedure and all that, but I need to leave for the evening hours. I'll need to talk with Paul (he has a webcast at work this morning), but I imagine this isn't really an issue and he can just stay with him. She also recommended that we do get the alcohol-free version of the pain meds for a reason I hadn't thought of. It burns less when they swallow it, so kids are more willing to take it, so it's less likely that we will fall behind his pain and have issues with that.
Everyone I talk to is making me more and more nervous (not sure that's the exact right word) about getting the tonsils/adenoids out and the degree of discomfort, pain and just plain suffering Trajan will experience with it. I'm cautiously optimistic that at 4.5 he is much more capable of reasoning and discussing than most of the kids who are at 3 and so perhaps that will help.
Look for another ENT update this afternoon or tomorrow on the Chiron front! (and no, that isn't really an exclamation point of excitement, but it's kind of like the theory of you either have to laugh or cry. I am going with laughing and living. And glad that Poppins is in place so both of us have been able to work this time).
And to finish up the preterm labor thoughts, I will see her weekly until 37 weeks or things hit the fan. She is looking for continued weight gain, clean urine, good heartbeats, cervix staying long and closed and me reporting that I'm cutting back more and more on activities.
She gave me a sheet just like last time that outlines the key dates (I'd already converted my old one, but just for fun, here they are:)
- April 4 - 22 weeks : Need to be resting a minimum of 1 hour midday and 2 hours early evening and begin decreasing all activities at home and work.
- May 16 - 28 weeks: Uterus will be full-term size and contractions more common. Need to work a maximum of 4 hours a day in office (if no appreciable work at home). Can work more hours from a reclined position. Minimum rest intervals of 2 hours midday and 2 hours early evening. Curtail activities much further
- June 13 - 32 weeks: "Big Goal to Pass" aka it's all bonus from here. Moms can tolerate very little activity and no activities of any type should be undertaken lasting over 2 hours. Work should solely be from home and a reclined position. (She said I could run up and get stuff, putter around the office for possible an hour a day depending how I'm tolerating)
- June 27: 34 weeks: Will not need steroids to mature babies' lungs, will not give medications to stop labor and babies likely in NICU about 2 weeks
- July 11: 36 weeks: Typically no NICU time
- July 18: 37 weeks: Ideal delivery timing
And one last thought. I was wrong about something. I'd written before I got pregnant that the reason that I wouldn't ride this ride of pregnancy again for a round three is that my sanity couldn't handle it if something went wrong and in particular if we last another baby. It turns out that I'm pretty sure that that is not true. I obviously am not rooting for it, but I have had time to really think about what that would be like and I think I can say with pretty high confidence that I would make it. That I would process it, work through it and come through it still me, just a little bit different. I am strong enough. This may seem a warped thought, but knowing it helps me.
Monday, April 2, 2012
Damn, fun with tonsils and adenoids
So, I was figuring I'd write a quick little post of the boys' getting haircuts yesterday, but instead it's surgery. Yes, for my kid who has had two fevers in his life and one stomach bug, because apparently life is too boring :-).
I'd made him an appointment with the ENT because his dentist had recommended that we have him evaluated by an ENT due to his mouth breathing, growing overbite and large tonsils. I really kind of expected the ENT to possibly scoff at us a little for being there and at most recommend a wait and see approach. Nope, not at all. He was in the room maybe three minutes and had asked Trajan some questions, looked in his throat and observed him and then asked me if I wanted the bad news then or in a few minutes. I voted for then and he said, "he's going to need both the adenoids and the tonsils out."
Apparently he pretty clearly has some obstruction due to his lymphatic tissue. The ENT said that it's not at all the size of the tonsils that makes him go to removal, but more the mouth breathing that is pretty much obligate. Apparently some notes in his chart from the allergist also supported the idea. He said that if we wanted, we could first schedule him for an overnight sleep study to document that he is having breathing events, but that he could pretty much guarantee that with Trajan a study would find episodes and that sleep studies are not a fun walk in the park either.
I'd already checked in with our primary and she sounded like removing them could be reasonable and did support that the ENT is a good one, so I figure let's do it.
He sent the nurse in to schedule it and her first comment was, "looking at you, I'm thinking we need to schedule this sooner or later. Do you have a couple weeks left?" Seriously woman, I'm 22 weeks. I realize I'm a bit large for 22 weeks, but I sure as heck don't look like 37 or anything! I for some reason have harsher standards for medical professionals. However, I did agree that sooner is better than later. Both because our world will get more crazy and because the younger you are, the easier this procedure is supposed to be. But he's ringbearing in a wedding on April 21, so we scheduled for April 26 as they apparently only do them on Thursdays.
It's a one-night stay and then lots of fun with fluids and soft things! They said that some kids are back out playing by the time they are discharged, but some take as long as 7-10 days. He has the week of the surgery off, so will hopefully just miss part of the next week of school. We are also hopeful that he will be better enough by the next the week that he may still need to lounge and "take it easy" (i'm translating to be allowed to watch unlimited tv and drink and eat things with lots of sugar), but will be good enough that he'll be okay staying with Poppins during the day.
The ENT said that most kids who present like him become much happier and are much better behavior-wise after the procedure as they aren't getting particularly restful sleep. As he's a generally pretty good and easy kid, I'm thinking this could make him absurdly easy if it's true! ;-) That said, he does definitely have his moments (Mr. Hyde) where it's like he's a completely different kid. It's probably being overly optimistic to think that this will help that, but a girl can dream, right?
The ENT also said that at this age no myofunctional or speech therapy will be necessary. He should simply revert to breathing through his nose as soon as the swelling has gone down since that is the body's "natural way". He mentioned the same thing the dentist did about this making oral surgery as a teen less likely and having been through that fun of having both jaws broken and being in the hospital five or six days, I think if there's a CHANCE this will allow him to escape that, it's worth it. I also still have no feeling in my chin or lower lip, so more reason to avoid that much more substantial surgery.
He sort of knows it is coming, but we will need to definitely have a discussion with him to make sure he knows what to expect. I'm thinking I can couple it with a special grocery trip to pick out things to eat and drink post-surgery. Any other tips, anyone?
I'd made him an appointment with the ENT because his dentist had recommended that we have him evaluated by an ENT due to his mouth breathing, growing overbite and large tonsils. I really kind of expected the ENT to possibly scoff at us a little for being there and at most recommend a wait and see approach. Nope, not at all. He was in the room maybe three minutes and had asked Trajan some questions, looked in his throat and observed him and then asked me if I wanted the bad news then or in a few minutes. I voted for then and he said, "he's going to need both the adenoids and the tonsils out."
Apparently he pretty clearly has some obstruction due to his lymphatic tissue. The ENT said that it's not at all the size of the tonsils that makes him go to removal, but more the mouth breathing that is pretty much obligate. Apparently some notes in his chart from the allergist also supported the idea. He said that if we wanted, we could first schedule him for an overnight sleep study to document that he is having breathing events, but that he could pretty much guarantee that with Trajan a study would find episodes and that sleep studies are not a fun walk in the park either.
I'd already checked in with our primary and she sounded like removing them could be reasonable and did support that the ENT is a good one, so I figure let's do it.
He sent the nurse in to schedule it and her first comment was, "looking at you, I'm thinking we need to schedule this sooner or later. Do you have a couple weeks left?" Seriously woman, I'm 22 weeks. I realize I'm a bit large for 22 weeks, but I sure as heck don't look like 37 or anything! I for some reason have harsher standards for medical professionals. However, I did agree that sooner is better than later. Both because our world will get more crazy and because the younger you are, the easier this procedure is supposed to be. But he's ringbearing in a wedding on April 21, so we scheduled for April 26 as they apparently only do them on Thursdays.
It's a one-night stay and then lots of fun with fluids and soft things! They said that some kids are back out playing by the time they are discharged, but some take as long as 7-10 days. He has the week of the surgery off, so will hopefully just miss part of the next week of school. We are also hopeful that he will be better enough by the next the week that he may still need to lounge and "take it easy" (i'm translating to be allowed to watch unlimited tv and drink and eat things with lots of sugar), but will be good enough that he'll be okay staying with Poppins during the day.
The ENT said that most kids who present like him become much happier and are much better behavior-wise after the procedure as they aren't getting particularly restful sleep. As he's a generally pretty good and easy kid, I'm thinking this could make him absurdly easy if it's true! ;-) That said, he does definitely have his moments (Mr. Hyde) where it's like he's a completely different kid. It's probably being overly optimistic to think that this will help that, but a girl can dream, right?
The ENT also said that at this age no myofunctional or speech therapy will be necessary. He should simply revert to breathing through his nose as soon as the swelling has gone down since that is the body's "natural way". He mentioned the same thing the dentist did about this making oral surgery as a teen less likely and having been through that fun of having both jaws broken and being in the hospital five or six days, I think if there's a CHANCE this will allow him to escape that, it's worth it. I also still have no feeling in my chin or lower lip, so more reason to avoid that much more substantial surgery.
He sort of knows it is coming, but we will need to definitely have a discussion with him to make sure he knows what to expect. I'm thinking I can couple it with a special grocery trip to pick out things to eat and drink post-surgery. Any other tips, anyone?
Farm Day!
Some friends of ours have a horse farm and we went out this weekend. Trajan is a huge fan, but we actually haven't been out in something like a year?!?
I was smart and on the way there we went by our local and awesome kids shoe store and got Chiron his first pair of shoes explicitly purchased for him. He likes them! He generally just had a great time of it, walking and meeting animals and people and just enjoying life. And nature is pretty cool.
We took Gretchen, the younger dog with us and she proved again that she really is a champion farm dog. No leash needed, gives horses an appropriate amount of space, doesn't overreact to noises and things and just generally has a great day of it.
We did see another aspect of her role as a farm dog and that was as a little boy supervisor. Wherever Trajan roamed, there she'd be:
Those two dots to the left of the tree in the center are Trajan and Gretchen :-). He yelled back at about this point "I found a lot more nature!"
Since it had been a year and a half or so since we had been out there, Trajan was impressively older in terms of doing things. It's funny how it's the little things that surprise you at times. The fact that without seeing anyone do it he knew how to climb up a fence and hang on it just kind of startled me:
He also went riding. In the past, he's mainly ridden the little pony (with the exception of the one time he insisted on riding a big one and so we put him up on a Grand Prix horse. He promptly declared he was good with Tex, the pony then), but we actually started him out with a medium sized horse this time.
He got her from the pasture, led her into the barn and crossties, helped some with brushing her down and waited while her tack was put on. I insisted that he learn some, so he learned the word mane and frog. Then it was out to the mounting block to learn how to mount and then to the ring.
(Someday I will figure out a way to put pictures together so they don't eat up space like they do if uploaded individually, but also aren't cut off like they are when I make collages now).
For some reason the other videos I shot are showing up sideways despite the fact that I held the phone the same way, so who knows. This video is of him on the flat. He also worked on going over some poles and a low oxer. Those went well. Then somehow the brilliant idea occurred to have him go over a flower box jump. Well, this resulted in a real jump and perhaps a bit of an agitated buck. Kid is super athletic though and though he went flying in the air, he kept his hands on her and stayed pretty aligned with the horse. Our friend who owns the farm and was in the ring with him sort of caught him in the air and between them he was right back in the saddle on the other side. He thought this was amusing rather than traumatic, so that was good!
After we played around the farm some more, we ended up back in the barn and he went for a quick bareback ride around the farm on the pony. That's him on Tex in the last picture in the collage. Perhaps the post fascinating part of that is the crazy cat they have at the farm! He's about one and so we hadn't met him before. When we got there, I forgot to remind Trajan of the rule that he is allowed to roam pretty much anywhere on the farm, but he shouldn't go in the barn without an adult. So, I ended up following him (with Gretchen) of course into the barn early on and we found this cat. Who started to play with Gretchen and followed us down to where we were sitting waiting for our friends. And proceeded to play and romp with Gretchen.
I'm bringing the cat, Kitty Boy, up because when Trajan was out on his bareback ride, the cat followed them along and kept divebombing the pony!
How wacky is that?!?
Trajan also rode his Daddy:
Chiron was so tired by the end of the day, he'd had about an hour long nap on the way there and when we first got there, that he literally fell asleep in our friend's daughter's arms, something he hasn't done in months.
And stayed awake being passed between a number of people and then being placed into his carseat. Even when our friend's daughter's eight pound Yorkie ran across him in the carseat, he stayed asleep!
Good day had by all!
I was smart and on the way there we went by our local and awesome kids shoe store and got Chiron his first pair of shoes explicitly purchased for him. He likes them! He generally just had a great time of it, walking and meeting animals and people and just enjoying life. And nature is pretty cool.
We took Gretchen, the younger dog with us and she proved again that she really is a champion farm dog. No leash needed, gives horses an appropriate amount of space, doesn't overreact to noises and things and just generally has a great day of it.
We did see another aspect of her role as a farm dog and that was as a little boy supervisor. Wherever Trajan roamed, there she'd be:
Those two dots to the left of the tree in the center are Trajan and Gretchen :-). He yelled back at about this point "I found a lot more nature!"
Since it had been a year and a half or so since we had been out there, Trajan was impressively older in terms of doing things. It's funny how it's the little things that surprise you at times. The fact that without seeing anyone do it he knew how to climb up a fence and hang on it just kind of startled me:
He also went riding. In the past, he's mainly ridden the little pony (with the exception of the one time he insisted on riding a big one and so we put him up on a Grand Prix horse. He promptly declared he was good with Tex, the pony then), but we actually started him out with a medium sized horse this time.
He got her from the pasture, led her into the barn and crossties, helped some with brushing her down and waited while her tack was put on. I insisted that he learn some, so he learned the word mane and frog. Then it was out to the mounting block to learn how to mount and then to the ring.
(Someday I will figure out a way to put pictures together so they don't eat up space like they do if uploaded individually, but also aren't cut off like they are when I make collages now).
After we played around the farm some more, we ended up back in the barn and he went for a quick bareback ride around the farm on the pony. That's him on Tex in the last picture in the collage. Perhaps the post fascinating part of that is the crazy cat they have at the farm! He's about one and so we hadn't met him before. When we got there, I forgot to remind Trajan of the rule that he is allowed to roam pretty much anywhere on the farm, but he shouldn't go in the barn without an adult. So, I ended up following him (with Gretchen) of course into the barn early on and we found this cat. Who started to play with Gretchen and followed us down to where we were sitting waiting for our friends. And proceeded to play and romp with Gretchen.
I'm bringing the cat, Kitty Boy, up because when Trajan was out on his bareback ride, the cat followed them along and kept divebombing the pony!
How wacky is that?!?
Trajan also rode his Daddy:
Chiron was so tired by the end of the day, he'd had about an hour long nap on the way there and when we first got there, that he literally fell asleep in our friend's daughter's arms, something he hasn't done in months.
And stayed awake being passed between a number of people and then being placed into his carseat. Even when our friend's daughter's eight pound Yorkie ran across him in the carseat, he stayed asleep!
Good day had by all!
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