32 weeks, 3 days: On becoming an inmate

February 3, 2014 § 37 Comments

I’ve written update posts several times, but before I’ve been able to finish any of them and press GO, something changes and makes it no longer relevant.

Let me try to give you all a bit of a timeline. Last Tuesday, when I was 30+4, our baby boy’s growth had majorly slowed. He was sitting somewhere around the 10th percentile after measuring solidly in the average range on previous scans. To try to figure out what was going on, the MFM performed an umbilical artery doppler assessment. The purpose of this is to look at the blood flow through the umbilical artery during peak diastole (when the heart is at its’ most relaxed). Flow in the umbilical arteries ought be in the forward direction. If the placental resistance increased for some reason, the diastolic flow may reduce, then become absent and finally go into reverse. Below is what you might see on the ultrasound screen when there is “healthy” flow. See how the tops of the valleys between the peaks are well above the line? This is essentially what our girl’s looks like.

umb-3a

My understanding is that toward the end of all of all pregnancies, the placenta matures and doesn’t function as efficiently. This is supposed to happen slowly over time and to not cause problems (and is also one of the reasons they talk of induction post-due date). But our boy’s placenta seems to be deciding to quit early. I grew it wonky, and it’s making its’ displeasure known. The image below will help explain.

326-4_default

Umbilical artery Doppler velocimetry: (1) normal pattern; (2) reduced end diastolic flow; (3) absent end diastolic flow; (4) reverse end diastolic flow

The top line is normal. A week and a half ago, when we discovered that there was a problem, there was reduced end diastolic flow that was also intermittently absent. So, the space between the valley and the line was small, and every once in awhile, there would be a big gap where there was no valley showing at all. This got me on schedule of biophysical profiles (BPPs) and umbilical artery dopplers twice a week with MFM. Three days later it looked the same. No change was good.

The following Tuesday when I was 31+4, I saw my OB first thing in the morning. This was to be followed by a MFM appointment. I don’t think I had quite wrapped my head around the seriousness of the situation until my OB told me that he was going to do a quick ultrasound even though they were doing one down the hall at the MFM appointment in a couple of hours. I must’ve had a quizzical look on my face, because he then said, I’m doing this because if your baby has died, I want it to be me who tells you, not an ultrasound technician you have never met. I know this probably sounds incredibly insensitive. Heartless even. But I appreciated it. Immensely. He knew that there was no other reason to justify his looking, and he knew that I would know this. But he wanted to look anyway because it was important to him, and so he just decided to go ahead and tell me why instead of just making something up. Or saying nothing and leaving me wonderingknowing.

Incredibly, he later came to my MFM appointment. There we all learned that the flow had changed to continuously absent end diastolic flow (#3 in above image). The two doctors looked at each other, had a brief discussion right there in front of me, and I was admitted to the hospital in order to “tighten the safety net.” I was shocked. My OB had warned the week before that it could happen any time, but it still hit my like a truck. I cannot describe the fear we felt. Not only did it mean very likely early delivery of both babies and all of the risks and complications that come with that, but I also jumped to all of the worst case scenarios for our boy, like death. Or neurological and/or developmental problems from being deprived during such an important stage of growth.

I was allowed to go home and pack my bag and say goodbye to the dogs. And, guys, I cried the entire time.

I won’t be going home again until I am a mother.

I’ve been in the hospital for 7 days now. I was given the steroid shots on Tuesday and Wednesday to help speed fetal lung development, and I learned that the doctors thought it was likely that I would likely need to deliver within the week. In that picture included above, you deliver when you see #4. Reverse end diastolic flow. Now that I am in the hospital, my two a week BPPs and umbilical artery dopplers get increased to three a week. They also do fetal non-stress tests (NST) three times a day at 6 am, 2pm, and 10pm. For these I get monitors put on that are kind of like our home dopplers, and reactivity of heart rate to movement is measured for 20 minutes. You also deliver if there is a problem seen on one of these tests. So the level of monitoring is outrageous. But it’s allowing me to sleep at night.

It had been pretty quiet around labor and delivery the last few days, then last night and this morning things have really picked up. You could see the stress on the nurses faces. I am one of a number of “ante’s,” who are meant to be here long term. Everyone else rotates. They come in, labor, have their babies, and then move upstairs to the mother and baby unit. They try to stick the ante’s on one hallway so it’s quieter for us. I met one of them yesterday for the first time when we were both getting ourselves some orange juice. She said she’d been here two weeks already. She barely looked pregnant at all and I thought, I hope she has a long, long while left. When I woke up this morning to The Artsy Engineer bringing me blueberry pancakes and tea before heading to work (a variation of which he has done every day to prevent me from eating too much horrible hospital food), he told me that there was a labor bed outside of her door. All morning, doctors’ and nurses’ voices have floated past my door and into hers. And I can hear her crying. And tomorrow she’ll be gone. Hopefully with a small but healthy baby to visit in the NICU.

I’m also on strict bedrest, which is very interesting. I sit. ALL DAY I sit. I can get up for the bathroom and to take a shower. And every once in awhile to walk to the ice machine in the hall right outside my room to fill up my own water because dear god is it hard to let others do things as simple as this for you all day. The nurses come in once an hour to check on me during the day and every two hours at night.

My new digs.

My new digs. See the bassinet? It made me cry every time I looked at it during the first few days, knowing that my babies will not be with me when they first enter the outside world.

But you know what guys? It’s helping.

I had been warned that this sort of issue doesn’t really improve. It just gets worse (slowly or not so slowly) and then you have to deliver. But something is seriously, really really helping. Since I got here, I’ve had two additional ultrasounds. Both have continued to show reduced end diastolic flow (but not continuously absent and not even intermittently absent). This is EXCELLENT. The babies both continue to pass their BPPs (which is where they look at movement and heart rate and attempts at practice breathing using ultrasound). And I’ve been told repeatedly that our babies look great (even for their gestational age!) on the 3x/day non-stress tests. That our boy “does not look like a baby with cord blood problems.” So they both seem to be healthy and doing developmentally appropriate things in there, and no one is distressed. No one is distressed. On Friday, my MFM said that if he were a betting man, all of these things would lead him to place his bet on our being table to talk in weeks until delivery rather than in days until delivery. It still seems doubtful that I will make it much past 34, which is about a week and a half away at this point.

But man. I’m so so close, sisterfriends.

So I will continue to relax my ass off in this hospital bed for as long as I can if it means these babies can use the incubator on the inside of me instead of the incubators on the outside of me.

I can’t wait to meet them, but my body will miss them when they come.

Advertisements

§ 37 Responses to 32 weeks, 3 days: On becoming an inmate

  • J o s e y says:

    Wow, I’m so happy for you and scared for you and all over the place in my thoughts right now. No wonder you’ve had a hard time pushing POST on anything this past week! Praying that you are “easily” able to get to 34w+ before delivering!!

  • Amber says:

    I’m so glad your little guy is still hanging out and doing okay so far. I spent 6 days in antepartum and delivered at 33w,2d. I’m glad they are monitoring things closely. As much as it sucks to be stuck in a hospital bed, it’s the very best and safest place you could be for your babies. I’m so happy to get an update and know tha you are all okay. Keep us posted!

  • I’ve been following your journey for a long time but this is my first post. Oh my gosh, Lentil. The past couple of weeks must have been so scary for you. I’m very relieved that you have such good care and that they were/are able to monitor you and the babies so closely. And it’s awesome that things have improved since you entered the hospital. I’m sending lots of positive thoughts your way.

  • Amanda says:

    Wow! It sounds like you’ve been on quite the roller coaster! But it sounds like you’re receiving excellent care and that your doctors are taking good care of you! Hoping you can eek out a few more days and get to 34 weeks! Hang in there! We’re all excited for you!

  • I’m so glad to hear he’s doing better. Being an inmate sucks… but you get to meet your babies soon. SO SOON! That is amazing. I am so excited for you, my friend. And it sounds like you’re in very good hands. Yay. Keep us posted.

  • notpregnantandpissed says:

    Wow! Crazy. I’m so glad babies are looking good! I’m sorry you have to be couped up in a hospital bed for what hopefully will be weeks! Boring!!! I always think staying in bed for days sounds amazing but then when you actually get the chance to do just that (usually a terrible flu) in reality it becomes horribly uncomfortable! There isn’t enough good TV or good books to keep you occupied I bet. Wish we could all come visit you! Good luck friend, I’m betting you and babies will do perfectly!!

  • Kimberly says:

    So glad you are relaxing and they are doing well! Hope you can make it another week or so. Keep us updated, even if there are no changes – we will all be thinking about you a lot!!

  • Emily says:

    Oh man, so many changes in such a short time! It sounds like things are going as well as can be for the situation, so I will hope that it continues on a good road for you. I’m a NICU RN, so if you have any premature baby questions, let me know! I’m sure you’re spending lots of your abundance of free time researching, but I’m here for ya if there is something your research can’t track down 🙂
    Take care!

  • Kitten says:

    So scary! I’m glad you and the babies are doing well and are being closely monitored. Even if you have to deliver sooner rather than later, those babies are going to be just fine.

  • pajamamommas says:

    So glad to hear that the babe is doing better.
    For what it’s worth, my little brother was born at 29 weeks, and is now 6 feet tall and starting graduate school! And that was 30+years ago.
    Hope you’re finding things to do to entertain yourself. Bedrest (especially when there’s nothing to do but sit around and worry) sounds exhausting!

  • Meredith says:

    Thinking of you. Glad you’re in the hospital – the safest place all three of you can be right now – especially with all of the ongoing monitoring. Keeping my fingers crossed they stay in you as long as possible – hope you get to 34 weeks. Just think, you get to meet them so soon!

  • Can’t believe you are so close!! I am really happy to hear things are looking pretty good for you and the babies. I’m glad you are getting top notch care and the babies have stayed put for a few more weeks.

  • Megan says:

    I hope your little ones continue to stay in and that the cord issue doesn’t get worse for at least a little while longer!! Good luck!!

  • Flicka Mawa says:

    Lentil, I’ve been thinking about you since the last post. I’m not sure what I can say except that I wish you the best and know you will do everything possible to get these babies off to the best start. It sounds like you have great care and super support from the Artsy Engineer. Hang in there.

    Before you know it, you will be a mom. My little one is 3 weeks 4 days so I’m still caring for a newborn and I have to say, it’s an amazing experience. You will love it!

  • sarah says:

    So I could get all meta and liberal art-ay here and wax philosophical about how the warden has become the inmate (kidding!)…. but honestly, I’m just so happy you’re feeling better and your boy is staying strong. Can’t imagine how unsettling this all is but I am sending crazy positive vibes and hoping those two kiddos stay put for as long as they can. Can’t wait to see those babies in the bassinet with their happy parents. XOXO

  • 2dognite says:

    My coworker just delivered twins – a boy and a girl – at 34 weeks. Baby girl was 4 lbs 10 oz and baby boy was 5 pounds. They’re under observation at the NICU but doing beautifully. It sounds like you’re in great shape to deliver equally healthy, if a little early, babies. Hang in there, you’re doing an amazing job. And, I hear that blueberry pancakes are strongly correlated with third trimester fetal growth. Fact.

  • Steph Mignon says:

    Wow, what an intense and scary whirlwind! I teared up when I pictured you saying goodbye to your first babies, your dogs. But I am so so sooooo glad to hear that being on bed rest in the hospital is helping. I will pray and hope and cross everything that you all make it to 34 weeks or longer! I cannot believe that I am only 1.5 week behind you in baby growing land. It’s CRAZY that one way or another, early or late or just on time, the chances are good that we’ll both my moms soon. WOW. And pass me some pancake. Those sound amazing right now.

  • julieb79 says:

    I am so relieved to hear that the little guy is hanging in there and you are being watched around the clock to make extra sure. I’m sure it has been super scary and no fun and now very boring, but at least the prognosis is good and everyone will more than likely be just fine!

    So crazy to think that we met (virtually) about a year ago, and here we are, both about to deliver! I’m 40w4d, waiting for my dude to decide it’s time to come play outside. Excited and a bit terrified, just like I’m sure you’re feeling! I hope I go first and your babes get to stay inside a bit longer. : )

    • We must have a baby by now! I’ve been thinking about you like crazy over the last week. I wish I could go follow you somewhere. This year-long friendship is feeling a bit one sided. All I do is talk about myself. : )

      • julieb79 says:

        Aw, I think of you often too! I can PM you my FB or Google+ info via FF if you frequent either of those social media sites. We do indeed have a baby now. Erik James arrived via unplanned c-section (long, traumatic story but I’m getting over it now) at 3:14am on 2/5/14, weighing in at a whopping 8lbs 12oz and 21 inches long. He is awesome and my AE and I are loving our new roles as mom and dad. I posted a pic in our old FF group. I hate that you’re being pulled in a tug-of-war between whoever is on the current shift… hopefully your new plan will work out well and you’ll get to deliver later rather than sooner. I’m sorry this has been such an ordeal for you, but you’ll be amazed at how fast the love for those two little inmates will heal your psyche once they’re paroled and snuggleable.

  • Jenn says:

    I’ve been thinking about you a lot lately. So glad you posted and updated us all. Happy to hear the lil man is doing well! Embrace the bed rest and sleep now, before the lil ones arrive. Praying for you to make it to, or past, 34 weeks! Many hugs to all of you!!! You are a powerful mama and everything is going to turn out wonderfully! XXXX

  • Aramis says:

    Thank you so much for the update! I have to admit I’ve been super worried about you and the inmates (hah! now you’re all inmates!) since your last post. I’m so glad that they’re monitoring you so closely, and that despite everything the babies are continuing to look good. Hang in there mama! You are so close!

  • Daryl says:

    I’m sure it’s super boring, but I’m so glad the bed rest seems to be helping your little guy! Here’s hoping for another couple of weeks of boring to get your little ones to at least 34 weeks!

  • Jenna says:

    I am so happy to hear you and your babes are being well taken care of. This makes me want to rush out and buy you a care package to keep you sane while you are on bed rest! Hang in there!

  • I’m sorry i haven’t commented on your last couple updates… but rest assured I have read them, and I have thought of you often. I am glad things are stable, because I have been so worried for you and your tiny little family.
    It’s amazing, isn’t it, how priorities can change on a dime? How you’d trade your entire graduate education to ensure your babies are born healthy and safe? Be prepared, sisterfriend, for your entire universe to blow up. For your hormones to rage, your boobs to swell, and your heart to explode with love. While I wish you could get to fullterm, you, in all reality, will not. So instead, I wish for you to soak in every last pregnant second, and prepare your heart. Cry, and ponder, and for the love of all things sacred, SLEEP. (seriously, sleep… because you may never sleep again!)
    I will anxiously await a birth story 🙂

  • Oh I have been dying for an update. Thank you for posting. I’m sorry you’re stuck there but glad you have such an amazing medical team. Wishing you more time to cook those babies and peace while you do it. Hoping you have some good books! I just read the two by Liane Moriarty which are great and distracting. Really enjoyed The Impossible Knife of Memory by Laurie Anderson too. Now I’m on Want Not which is good if a little more dense. Keep us posted!

  • jesselyn6585 says:

    Oh Lentil! So many emotions run through me as I read this. I’m so concerned for baby boy and you. And so happy that things are going better. I will keep my everything crossed that you make it to at least 34 weeks! Sending love, patience, serenity, and grow vibes to the babies.

  • redbluebird says:

    Oh gosh! How stressful this must all be! I can’t imagine spending all your time in the hospital is fun, but I’m very glad you are there so they can keep an eye on you and your little inmates. It sounds like the husband is taking good care of you three as well.
    I’ll be thinking of you! Can’t wait to hear about those sweet babies of yours!

  • Happy to hear of all the great care you are getting and that the stress is not too bad. Hang in there.

  • I don’t know what the deal is but I seem to be literally blubbering over here non-stop, reading your post—I just felt your words so strongly, felt a piece of your fear, the intense, beautiful, sad, scary emotions you have been going through. I want that boy to make it as if he were related to me.
    For you to have come so far, so smoothly, to this tightrope end of the line! And then to tiptoe on over to an area where no one, miraculously, is distressed! Ahhhhhhh. It’s just so much to take in. Life!
    It’s alllll going to be okay. Yes.
    Please know that I am thinking about you and your little babies every day. The bassinet made me cry, too. It’s all so wondrous and terrifying and amazing. You’re almost there. Peace, love, and light to you and yours. xoxox

  • K&A says:

    Oh my goodness! What a roller coaster. I am so glad that you are resting, safe and in good care. It seems things never go as planned, but all is working together for good. I am thinking about you and the babies. Wishing you all the best for a safe and healthy delivery…whenever it is RIGHT for it to happen! Hugs!

  • nonsequiturchica says:

    Whoa! Keep us posted! I’m glad that all of that rest seems to be helping!

  • missymakes says:

    Oh – thank god things stabilized for you. Hospital bed rest sucks. I only made it a handful of days before my girls decided the time had come, but all that sitting was brutal. I spent a ridiculous amount of time raising/lowering the head and foot of the bed trying to relieve the pain or numbness in my butt. LOL. But it’s totally worth it. Even though I’ll admit that having babies in NICU isn’t as bad as I imagined, I’d have done anything to be able to hold them longer right after delivery, to be able to nurse them right away, to be able to take them home with me. You’re doing great, mama – keep it up!

  • petersentn says:

    I’m so glad things have stabilized a bit! I can’t imagine how scary all of this must be. Praying and hoping those two little ones stay happy and healthy INSIDE as long as possible. I was on bed rest for 5 days after IVF, and thought I was going to go stir crazy. It’s not as easy as you might think, is it? Of course, the good thing is you know that what you re doing is helping your kiddos have the best possible experience/chance when they decide it’s time to meet you. Thinking of you!

  • Oh Lentil! I’m glad for the update and that things are going as well as possible in this situation. I’m hoping you’ll sitting there bored as possible for weeks! Hang in there, we’re all pulling for you and both your little ones.

  • […] the last time I updated, things have fluctuated considerably. A few days after I wrote that post, they sent me home to […]

Help a sister out?

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

What’s this?

You are currently reading 32 weeks, 3 days: On becoming an inmate at lamenting the lentil.

meta

%d bloggers like this: