Wednesday, May 23, 2012

Someone tell me to shut my trap

Apparently I did not learn a life lesson from this post.  Note that it was written on 12/21 and Chiron was born 12/23.

My putting into writing that she had had no more decels and just some slightly extended variances may have been a bad idea.  I'm not really very superstitious by nature, but both L&D and the NICU kinda make me so.

So, can you guess what happened between the last post and now?  More variances plus a couple decels.  They were V's, not W's, which I'm reassured is very good and she recovered on her own each time and is still achieving accelerations and the like, but NOT what we are looking for.   She got down to about 90 from 150 or 160 and then recovered back to 150 or 160 over a couple minute period on one of them and I didn't get the specific numbers on any others.

Her line does look crazy compared to her sister's. 

Nothing has changed, just the clock to feel confident that her positioning has resolved itself and she is not at risk has reset.  Nothing to be alarmed about.  Nothing to overreact to, but seriously?  Just STOP doing that, little miss lefty.

I am finding it much harder to actually work while monitoring, so I'm going to celebrate the positive side and declare this an opportunity to nearly guilt-free work on getting caught up on my blog reading!

Thank you all for keeping track of us and sharing your thoughts and jokes and experiences.  Really does mean the world.

Oh, and Tanika, the uterus of bitching is totally behaving, so I think we may need to get a nickname for little miss attention magnet...

In which I ruminate...

I just turned off the alarm for the maternal heartbeat on my monitor.  It's limits are set at 50 and 120 and I go up into the 120s pretty frequently, typically this is when talking to someone, and so it was a bit annoying.  It's probably a bad sign that I'm more familiar with the machines around here than some of the nurses.  I thought about changing the upper limit, but figured just turning it off would make for a simpler return to standard state, though I believe it does reset anytime it is unplugged as well.

Why I think this fact is worthy of sharing with you, I don't really know, but eh, I never claimed to make sense! And perhaps an even better question is why I think I need to share a picture of the monitor, but I do:
And in the style of live blogging, the whole story changes!  The pulse ox cord apparently had some issues.  I do like that none of us yesterday or last night thought to actually look at the clock and take my puse, we just accepted the 120s to 150s.  My nurse today, who is a favorite and definitely one of the most competent, looked at me and declared that my pulse was not that high, took it by hand and changed out the part. 

See, isn't my life fascinating?

I have decided that the L&D floor is a time distortion field.  Came in for three hours, stayed for 10 days.  Right now, I'm still here from my two hours of monitoring Monday night.  There had been some talk about letting me go this morning, but while there haven't been any deceleration events (which are apparently measured in minutes), there were more variables and with greater drops than the current on-call OB (who is the doctor I had for four weeks while mine was on maternity leave last time) is comfortable with.  She sounded like she wasn't concerned per se, but isn't feeling sufficiently comfortable with Lefty's strips yet.  It's now a different on-call doctor, my OB doesn't work Tuesday or Wednesday as she has three small children of her own, but today's doctor said that the next one may discharge me after 6am tomorrow

I know I'd mentioned that I found the changes in the NICU in the last 17 months kind of fascinating when the neonatologist came down to talk, but I've also discovered another interesting change in the obstetrics side of things.  Last time, they didn't repeat steroids.  In the last few months, they've aparently had their thinking come around to be more like a decade ago and they do repeat if it's been around four weeks or so and they think there's a reasonable chance of delivery in the next week or so (this time they were thinking possible c-section for distress instead of PTL.  read as NOT MY FAULT for once).  So, I had two more doses of Betamethasone Sodium Phosphate with Betamethasone Acetate Monday night and last night.  It's possible they will do one more round if I were to go into labor or we were removing the babies for distreen reasons between about 32 and 34 weeks.

By the way, random note, but these shots are much more pleasant in the bum than in the thigh.  Four of my six doses ever have been thigh and I highly recommend taking this route.

I am on continuous monitoring until we are assured about Lefty's strips and I'm oddly proud of my ability to come and manage.  Many people have a lot of trouble because you can't really get much continuous sleep as anytime a baby comes off the monitor, the nurses have to come in and put them back on.  I am apparently very good at noticing them come in, confirming that they don't need me to reposition and then go back to sleep while they are moving straps and monitors and all of that.  Having a real bed instead of the transformer delivery bed also makes a huge difference.  When they were talking about running continuous monitoring, I in my own mind thought that I could probably only make it about 100 hours before I started to lose it, but I really don't think this is the case.  I think I can stay on as long as necessary without too many issues.

Cool rag doll look!
Biggest problem is needing to keep the pulse ox on 24 hours a day as it makes it much harder to work on things for work or even play around on the computer/phone.  However, one of the nurses said I could move it to my thumb and this makes the typing MUCH easier as I just use my right thumb exclusively fore the space bar and all is good.

In my last thought, girls are 29 weeks now. Officially non-micros no matter what happens now!  Still voting for them to stay put, but we are really coming along in terms of intraventricular (IVH) and NEC risks now.  AND, they are big enough to serve as a tray when I have to eat lying down to keep them on the monitor:

So, I think the summary version is that we are still here in the hospital, but all three of us seem to be doing pretty well.  And no reason at this time to expect anything drastic to change.

Oh, and their last possible date is set, July 19.  And since they did finally change from shoulder presentation presenting/transverse upper, to breech/transverse, looks like definitely going to be the c-section route.

Monday, May 21, 2012

See this angelic face?

She was misbehaving on her NST, so we are over at L&D for some monitoring. She was having relative bradycardia events, dropping into upper 90s/lower 100s. Both girls got perfect 8s on their BPPs, but the perinatologist sent me over to L&D to monitor for a while longer to make sure that the bradycardia events stop.

Strip is looking pretty good so far at L&D though, so hopefully just here for a couple hours. He said if the events didn't reoccur that they would let me go, but if they do reoccur, we are going to need continuous monitoring.

He did some extra visualization and studying of her cord (that's Lefty) and it is actually positioned really well, so hopefully is just a fluky, benign thing.

The perinatologist was also able to confirm that my feeling that fetal motion was different this morning is due to repositioning as I theorized.

Being honest, I did get a little toward panic during the NST while the tech was noticing the bradycardias, but the perinatologist was very reassuring with his ultrasound examinations and doing this extra monitoring is really helping me to feel confident.

So, think behaving thoughts their way and if so, I'll update you with fun baby tiedye tomorrow from the house instead of medical!

And here's evidence of the girls conspiring:

UPDATE: well, they decided to do two more rounds of steroids since it's been four weeks and so here for 48 hours. But strips are looking good.

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Tuesday, May 15, 2012

Overachieving Fetuses

I'm not sure my brain is qualified to keep track of what I've updated here versus Facebook versus what I've told people.  But it does look like we are due for an update here.

With the exception of one 12-hour stint in L&D Sunday night/Monday morning, I've been successfully serving my bedrest at home.  That was the product of a flareup of the uterus of bitching.  I started contracting Sunday afternoon every 6-7 minutes which increased to every 5-6 minutes after a couple hours.  They were only about 40-45 seconds in duration, so it seemed very unlikely that they were causing cervical change, but since we are still pretty early gestationally and they were regular, they had me come in to get checked and run additional IV fluids on top of my water chugging.

Thought 1 from that 12-hour visit: I was dubbed level-headed and rational for the fact that I took myself.  My logic was that I was pretty sure that I was not having cervix changing contractions, it was bed time and it's much easier to deal with one of your parents leaving at bed time than both and barring an immediate emergency c-section, even in the worst case scenario we should have at least 2.5 hours of warning, so Paul could get up to the hospital.  The nurse said that most moms are too flipped out to think about what will be best for their existing children, so apparently I'm calm as a cucumber.

Thought 2 from that 12-hour visit: if you let them give you 5 of Ambien, you can actually get some sleep on the L&D side!

Thought 3 from that 12-hour visit: I think I've come to an understanding of my uterus of bitching.  It basically responds to anything being off or stressful on my body as a system by contracting.  The actual cervix changing ones from a couple weeks ago I really think were just because of the cold I had.  It does seem like a rational response from the body: body under stress, want to reduce stress, evict occupants.  The destabilizing factor this time is a bit more embarrassing.  I think I had a little constipation going on and that was enough to make my uterus declare that this wasn't what it signed up for and it was going to make things simpler!  So, I think the grand conclusion is that I just need to keep things easy on my body and the uterus of bitching will keep its trap shut aka not contracting.

Got discharged at 5:30 am, so was able to hit my normal Monday morning perinatology appointment.  The preterm nurse was out of town, so I didn't have to see her and went straight to the perinatologist which was very nice!  This was our first week of doing biophysical profiles.  The peri was willing to accept my statement that both achieved 15 by 15 accels during monitoring the night before, so we skipped the NST and just did the ultrasound part of it.  Both got 8 out of 8, but it took quite a while to get Lefty to show her breathing practice.

My favorite ultrasound picture of this appointment was Righty's hand and Lefty's feet together:

Also got a shot of someone's tongue:
 And someone yawning:

Because of the time waiting to get Lefty to show off her breathing, we also get profiles and face-on views of both babies.  And confirmed they are both still girls!

Also confirmed that I don't have the gestational diabetes!  But my vitamin D and calcium levels are low despite the supplementation, so we are stepping them up even more by tripling my vitamin D.  No changes are necessary to my calcium amounts because the theory is that getting the vitamin D levels up will increase my uptake of what I am taking.  And I need to take a belly shot as requested, but here's one from last weekend for now:

And this picture of Chiron sitting on Trajan amuses me and so I am passing it on:

Oh yeah, why did I call them overachieving fetuses?  Well, biophysical profiles don't normally start until 32 weeks and they both got perfect scores at this 28 week appointment and also achieved accelerations of 15 by 15 (meaning 15 beats for 15 seconds) which also isn't normally looked for until 32 weeks.  So, they are overachieving fetuses.  Good girls!

And in one last celebration, hitting 28 weeks will mean that they while they may still end up being preemies, they will not be micropreemies!  And even if they were born in the next few days (not the plan), they should be able to skip the Giraffe incubator phase in the NICU.  So again, go girls!

Tuesday, May 8, 2012


You know how sometimes a word pops into your head?  Well, this happened to me the other day with the word mensch and I've decided to run with it.  I looked it up to check that my meaning was right and it was "a decent, upright, mature, and responsible person."  It's Yiddish, so I have no idea where I came across it, but I think it's a great summation of my goal in terms of my attitude and actions.

Rather than whining at restrictions, I think it's best that I be a responsible adult who can balance the needs of multiple people and timeframes and gets the significance of avoiding as much NICU time as humanly possible at essentially any cost.

I was discharged Friday and all is going really quite well with home bedrest.  Paul and my parents got me set up with a minifridge and a microwave upstairs and stocked with food, cutlery, drinks and more.  I've also got a serious number and variety of pillows to arrange different positions.  Add that I was planner and last pregnancy had purchased a hospital bedside table and a lap table in preparation (before everything changed), and I'm in great shape.  I've got a printer set up here and a friend who works at my office brought me out some things I need, so I'm in shape working as well.

Having Poppins definitely helps as she and Chiron are here throughout the day.  They go for walks and to the park and to the grocery store, but it really results in about two hours being the longest duration I go without Paul or Poppins being here.  Add friends who have helped with all kinds of things and life is pretty good!  It's also nice because Chiron stops by a couple times a day and plays which really brightens the day and being home allows me to read to Trajan before bed like normal which I couldn't do from the hospital.  And I've got pretty cute coworkers here:
Besides helping with boys, being home allows me to be useful as I can go through the mail and sort things that have been pulled out for goodwill including getting them entered into itsdeductible and lots of little things like that.  Feel much less useless.

On the girls front, all is looking well.  I should confess that I was secretly hoping/expecting that when I went to the preterm nurse Monday she would say that she thought the covering OB was in error and I hadn't had any cervical change, but she if anything actually identified more cervical change dubbing me one-plus, 30-50% effaced and soft where I had been completely closed when I had seen her before going into the hospital.  Since the covering OB had done a cervical exam at 8 am and then 5:30 pm of the same day, it was probably a silly hope, but oh well.

The good news is that I still have 4.4 cm of cervix which is enough cervix for two pregnancies and close enough to the 4.9 value in the hospital last Wednesday.  That and both girls aced their modified BPP, so we are really in good shape.  The perinatologist did think that I needed to stay on as complete a bedrest as possible as I was contracting some while I was there and if just medical trips are enough to make irritable, running around free could equal instability.  He also didn't like that preterm labor nurse noticed some pink blood after the cervical exam, but since I haven't seen any after, I'm going to go with that was just due to the exam.

We got a profile of Righty who is back to being the presenting baby.  She is vertex in the center/left (name is based on her placenta) and then Lefty is sprawled transverse up in my ribcage.  Note: I am not 8 weeks currently as the ultrasound is labelled.  8, 27, what's the real difference, huh?

 I thought I'd fixed the orientation in iPhoto, but apparently not... oh well!

The one thing I really miss from the hospital (well, besides some nice and amusing nurses) is the monitoring.  Seeing those lines a couple times a day just is nice:
BUT, these faces are nicer:

I'm blaming the Chiron bias here on the fact that he's much more cooperative than the others.

But in tying back to my mensch theme, yesterday one of the techs at the perinatologist said something that startled me, but also made me glad: "you're always in such a good mood and kind.  You're our best patient."  And this is a woman who has seen me at one of the worst moments in my life.  This made me glad.  Because really the best we can do is live our lives :-).  What will be will be, I'm here to celebrate it and optimize it!

Thursday, May 3, 2012

24 hours

If I can be good for 24 hours, discharge shall be mine, wahahahaha.  By good, I mean that I have to stop bleeding and have no new bleeding, contract minimally on the monitor and I guess feel like I'm good and stable?  We are theorizing that the bleeding was only due to a cervical ultrasound yesterday and so we went ahead and did a cervical exam today so I can have a calm cervix and get discharged.

I'm supposed to be good because my OB is leaving town and won't be back until Monday night and we established that I have a history of misbehaving when she is out (read maternity leave for her in version 2010).  However, I argued that one event doesn't make a history!  And so I can define a new trend.

I really think I am comfortable with the discharge.  I don't feel like I'm in preterm labor.  I feel like I have a pissy uterus that likes to express its displeasure with the world when anything doesn't quite go its way.  But I think it's bark is likely much worse than it's bite.  So maybe it's not a uterus of doom?  Maybe it's just a uterus of bitching?

I'm supposed to be very limited in what I do at home.  No lifting the boys in any time or condition.  No stairs just for giggles.  No housework.  The oddest explicitly stated limited that she gave me was "no shopping".  I'm taking this as meaning physically shopping, so don't worry dear friend Amazon! I can shower, bathe, go to the bathroom and go to doctor's appointments though and continue working from home similar to how I do in the hospital (and since the house is a mile from the office, this is MUCH easier if I need files or anything to be brought to me).  

I think I forgot to mention here that in celebration of finishing mag I bought a stroller the other day!  We have settled on a two-stroller solution to our stroller logistics and I purchased stroller number one.  This is a Baby Jogger City Select with the second seat.  I was feeling enthusiastic enough that I ordered the glider board thing as well.  This stroller will take both of the Chicco Keyfit 30s, but I haven't ordered the adaptor bars yet.  My theory for ordering this stroller now is multifaceted.  One, it allows us to sell the Bugaboo and it's accoutrements on Craigslist while still allowing Poppins and Chiron to get out.  Two, the weight limit on this stroller actually still includes Trajan, so he who has never really used a stroller much can get to play with it this summer and get that out of his system some before it gets into real use.  Three, the 2012s are out and have been out for a while and the 2011s haven't dropped in price and since there were so few changes to the 2012 model, they probably won't anyway, so it made sense to be the stroller to buy.

If you're curious, the second part of our stroller logistics solution that we have settled on is a Valco Trimode Twin with a Joey Seat for Chiron.  The BJCS will be more for Paul and I (who can sling or Ergo a third if necessary) and in the car while the Valco is mainly for leaving at the house and for Poppins to utilize.  The model years on the Valco don't seem to be updated and I want to get more on top of it's product line development and history before I buy one.  Also, the colors are giving me pause.  I think we'd probably do best with just the Raven, but it doesn't seem to exist, so maybe the Arctic?

Have we noticed the leaps of faith I've taken?  We are employing an entire person, I bought a stroller and we have girl clothing in our garage up to 3T.  We also now have three crib mattresses and are moving towards figuring out bunk beds for Trajan so we can turn his full-size bed back into a crib.

And in other news, my subtle pity party has ended as scheduled this morning and I'm back on board conquering the world and generally being competent and in charge.  It was a subtle pity party, but it still feels good to be over.

And for some random pictures because I think they are fun:

Chiron on the way to storytime with nanny yesterday in a picture she texted me:
The awesome alligator that one of my friend's fiance's crocheted and she brought to me.  He does amazing work!
My bed stuck up high by the exuberant Trajan.  He really does enjoy the hospital bed.
And my view, because well, ain't it awesome?

So, the conclusion is that my uterus and my cervix are both whiners and like to vent their agitation frequently, but they keep doing what they are supposed to do despite being big pansies.  Keep it up guys.

Wednesday, May 2, 2012

Am I irrational/insensitive?

I think I may be not seeing some other side of the coin, so here's wondering if there's something I'm not seeing and someone can make me see straight.

Context: Trajan had tonsils and adenoids out almost a week ago. He's been a complete trooper, but like clockwork, he started complaining yesterday of pain. They'd told us to expect this because of the cauterization. Paul also had vasectomy yesterday afternoon and I'm still living at the Seton Resort and Spa.

School has been giving Trajan his ibuprofen doses during the day, but they forgot the four pm yesterday, so he took some around six. He then woke up at midnight calling and asking for his ibuprofen and again at five thirty. He went back to sleep after each dose.

Here's the part where I'm guessing that maybe I'm just not seeing things from Paul's view and so need some help. Paul was irritated at Trajan for not wanting to take his antibiotics this morning. Then he went into a rant (to me, NOT where Trajan could hear) about being upset with Trajan for waking him up. My thought is Trajan did exactly what he should do and shouldn't have just laid there hurting.

I gave sympathy for it not being fun and being annoying to be woken up and acknowledged that Paul would rather sleep through the night, but in my mind, that's just a part of life. And getting upset about it does no good. And that he'd be MUCH better off to accept the reality he's in and optimize instead of getting mad at the kid.

Well, this upset him and he declared that I was saying that he didn't have a right to feel how he felt about things. This isn't really what I meant, I more just meant that feeling or doing something that has no possible positive outcome just doesn't make sense to him.

And then I said that I honestly didn't have empathy for him for having to wake up twice in the night to give ibuprofen. That I could agree that it wasn't fun and would be better to not, but that that honestly wasn't even TOUCHING on the list of things I'm currently concerned or worried about.

Also, what's sleeping through the night?!?

Somebody help me see the other side so I can understand better instead of just muttering things under my breath (at myself) about petulant child. Because I know he is Not. He loves those kids and does what is necessary and it just confuses the hell out of my brain that he seems to embrace the martyr aspects.

Help please!

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