(28w5d, Hospital Day 13)
Quite the rollercoaster we have going on here.
Looks like this actually may go on for a bit longer than we would have guessed a few days ago.
My blood pressure has stabilized on the medication and my blood work is rock solid.
Go figure.
I am feeling good, and as the babies looked stellar on monitoring this morning, I am expecting to still be tucked into my comfy antepartum bed tomorrow (and maybe the day after *gasp* should I dare hope???).
The babies appear to be growing well and estimates put them around 1 kilo (2.0-2.5 lbs). Their kicking has gotten stronger and I periodically find a foot or hand sticking straight out of my belly.
One important thing about making it until tomorrow is that I will receive another steroid dose. Recently research has shown that a "booster" steroid injection (given if the woman hasn't delivered 2 weeks after the initial steroid doses) can improve outcomes. Right on. We will take any help we can get at this point.
btw... I did get a big smile from Dr. Peri for getting to 28 weeks. But he said he wouldn't be REALLY happy unless I get to 29 weeks. Talk about moving my cheese :).
(at 29 weeks not only is survivability >95%, but the rates of retinopathy and brain bleeds decrease significantly. Sign me up!)
I have survived to gestate another day...
P.S. I have great nurses! Last week I had J three days in a row. Then she was off for three days and when she returned two days ago (the day after things looked like they were tanking), she walked into my room first thing in the morning and asked, "Who broke my patient????". Well, it appears she got me "fixed" again :-).
Thursday, August 7, 2008
Wednesday, August 6, 2008
Too Much Of A (Not So) Good Thing
(28w4d, Hospital Day 12)
I remain on the antepartum unit.
And the triplets remain inside Womb-Thing.
But OOOOOEEEEEE, was it a close one this morning.
My repeat 24 hour urine showed severe proteinuria (7gm) which was approximately 20 times worse than when I was admitted last week. Dr. M walked in this morning clearly stating he was looking for a reason to deliver me today. If he found one other reason besides the proteinuria, it would be Happy Birthday to the triplets. The only reason I have yet to go under the knife is that everything else is stable.
So stable the doctors seem a bit perplexed.
Clearly they don't know me well :-). I am not known for following the "expected" path.
With proteinuria this severe developing over such a short time, I would be expected have much more edema, worsening kidney function and worsening blood pressure along with possibly worsening liver function and decreased platelets. But... ummmm... I don't.
My systolic blood pressure remains in the 150's on the labetalol.
And the babies? They are thriving like champs. They look good on monitoring and on ultrasound all three have great amniotic levels (if low, it would indicate the placentas were not perfusing properly).
So where are we?
As soon as my blood pressure creeps back up into the 160's, the babies show any evidence of distress, or my morning labs show dropping platelets or worsening liver or kidney function... the jig is up.
Everyday counts!
I remain on the antepartum unit.
And the triplets remain inside Womb-Thing.
But OOOOOEEEEEE, was it a close one this morning.
My repeat 24 hour urine showed severe proteinuria (7gm) which was approximately 20 times worse than when I was admitted last week. Dr. M walked in this morning clearly stating he was looking for a reason to deliver me today. If he found one other reason besides the proteinuria, it would be Happy Birthday to the triplets. The only reason I have yet to go under the knife is that everything else is stable.
So stable the doctors seem a bit perplexed.
Clearly they don't know me well :-). I am not known for following the "expected" path.
With proteinuria this severe developing over such a short time, I would be expected have much more edema, worsening kidney function and worsening blood pressure along with possibly worsening liver function and decreased platelets. But... ummmm... I don't.
My systolic blood pressure remains in the 150's on the labetalol.
And the babies? They are thriving like champs. They look good on monitoring and on ultrasound all three have great amniotic levels (if low, it would indicate the placentas were not perfusing properly).
So where are we?
As soon as my blood pressure creeps back up into the 160's, the babies show any evidence of distress, or my morning labs show dropping platelets or worsening liver or kidney function... the jig is up.
Everyday counts!
Tuesday, August 5, 2008
High Pressure Situation
(28w3d, Hospital Day 11)
Looks like we will be meeting our babies.
Soon.
My blood pressure started inching up about 24 hours ago and by early yesterday evening I was regularly hitting 170s/100. Not exactly what we were hoping for. Stat labs (amazingly!) weren't bad... only mildly sub par kidney function. Oh, and 3+ protein on urine dipstick. Since my platelets, liver and uric acid were cooperative, they agreed to treat my blood pressure with labetalol (at least temporarily) while a 24 hour urine is repeated and labs could be done again this morning. The NICU was put on alert, and a delivery for tomorrow was expected.
But then my labs were stable this morning.
And my pressure has shown some improvement on the labetalol(at least it has returned back below the "danger zone").
So I am in a holding pattern.
Whether or not I will be delivered will literally be a day-by-day decision from now on.
Obviously we would like to keep them in as long as possible, but I appreciate that the doctors are concerned about my health. As Dr. M said yesterday, "Taking the babies a day or two early at this point won't make an enormous difference for them, but taking them a day or two late could have huge consequences for you." Point well taken.
Feeling not so much like my fab self today, so signing off for nap time, but will try to update daily.
Looks like we will be meeting our babies.
Soon.
My blood pressure started inching up about 24 hours ago and by early yesterday evening I was regularly hitting 170s/100. Not exactly what we were hoping for. Stat labs (amazingly!) weren't bad... only mildly sub par kidney function. Oh, and 3+ protein on urine dipstick. Since my platelets, liver and uric acid were cooperative, they agreed to treat my blood pressure with labetalol (at least temporarily) while a 24 hour urine is repeated and labs could be done again this morning. The NICU was put on alert, and a delivery for tomorrow was expected.
But then my labs were stable this morning.
And my pressure has shown some improvement on the labetalol(at least it has returned back below the "danger zone").
So I am in a holding pattern.
Whether or not I will be delivered will literally be a day-by-day decision from now on.
Obviously we would like to keep them in as long as possible, but I appreciate that the doctors are concerned about my health. As Dr. M said yesterday, "Taking the babies a day or two early at this point won't make an enormous difference for them, but taking them a day or two late could have huge consequences for you." Point well taken.
Feeling not so much like my fab self today, so signing off for nap time, but will try to update daily.
Monday, August 4, 2008
A Day In The Life
(28w2d, Hospital Day 10)
My life right now is very exciting (*snort*)
5:30-6:00 am Wake up on my own or by someone in a white coat shoving a large needle in my arm (you know, either way... whatever); medications. Start watching local, national and international news.
6:00-7:00 am more news watching, occasionally punctuated by a text to Matt and periodic quick naps; shift change
8:00 am Breakfast arrives (hey, these are big events one looks forward to with baited breath and an empty stomach); medications
9:00-11:00 am (approx) monitoring starts. Four monitors, one belly, 2 hrs laying flat. Need I say more? Watching TV. Occasional discussion with nurse and housekeeper regarding Oprah's topic of the day.
11:00 am (if I am lucky... if the Wiggly Ones don't cooperate, make that 11:30) the highlight of my pitifully simple day.... SHOWER!
11:30 am I pour my non-makeup-ed, non-blow-dried but now squeaky clean body back into my bed with crisp new sheets; medications
12:00 am Lunch. No really... nothing like food to break up the monotony
1:00-5:00 pm Nap on and off (which I desperately need), watch TV, read, chat up the nurses, return phone calls and snack
5:00 pm Dinner arrives, but as I have most likely eaten a snack or two, I hold the tray to be warmed later when Matt arrives
5:30-6:00pm Matt calls to say he is on his way to the hospital. What do I want to eat?; medications
6:30 ish pm Matt arrives and we get some time to chat
7:00 pm Shift change
9:00 pm Another round of monitoring; medications
10:00-11:00 pm Matt heads home
11:00 pm - 5:30 am Episodes of deep sleep (thank you, A.mbien!) punctuated by bathroom breaks (think hourly...), blood pressure measurements and medications (midnight and 4am).
Major Decisions I Make Every Day
Forget the life-or-death decisions I used to make in the hospital. This is where the REAL decisions are made:
1) What time do I want my monitoring done in the morning? What time at night?
2) When do I want my shower?
3) What will I eat for a snack in the afternoon?
4) What do I want to order off the menu for tomorrow?
But the most important recurrent, vital decision that I make on a daily basis?
5) Now that I am back in bed from the bathroom... do I want to lay down on my left or right side????? I have to admit this one sometimes stumps me sometimes for a few minutes :-).
So there you have it. A day in my life.
Don't get me wrong, I'm not complaining.
Although a bit monotonous, it is the life of a human incubator.
And every day they spent in THIS incubator is 2-3 days they won't spend in the NICU incubator.
Still hoping this life-distilled-down-to-basics schedule continues for at least another week or two.
My life right now is very exciting (*snort*)
5:30-6:00 am Wake up on my own or by someone in a white coat shoving a large needle in my arm (you know, either way... whatever); medications. Start watching local, national and international news.
6:00-7:00 am more news watching, occasionally punctuated by a text to Matt and periodic quick naps; shift change
8:00 am Breakfast arrives (hey, these are big events one looks forward to with baited breath and an empty stomach); medications
9:00-11:00 am (approx) monitoring starts. Four monitors, one belly, 2 hrs laying flat. Need I say more? Watching TV. Occasional discussion with nurse and housekeeper regarding Oprah's topic of the day.
11:00 am (if I am lucky... if the Wiggly Ones don't cooperate, make that 11:30) the highlight of my pitifully simple day.... SHOWER!
11:30 am I pour my non-makeup-ed, non-blow-dried but now squeaky clean body back into my bed with crisp new sheets; medications
12:00 am Lunch. No really... nothing like food to break up the monotony
1:00-5:00 pm Nap on and off (which I desperately need), watch TV, read, chat up the nurses, return phone calls and snack
5:00 pm Dinner arrives, but as I have most likely eaten a snack or two, I hold the tray to be warmed later when Matt arrives
5:30-6:00pm Matt calls to say he is on his way to the hospital. What do I want to eat?; medications
6:30 ish pm Matt arrives and we get some time to chat
7:00 pm Shift change
9:00 pm Another round of monitoring; medications
10:00-11:00 pm Matt heads home
11:00 pm - 5:30 am Episodes of deep sleep (thank you, A.mbien!) punctuated by bathroom breaks (think hourly...), blood pressure measurements and medications (midnight and 4am).
Major Decisions I Make Every Day
Forget the life-or-death decisions I used to make in the hospital. This is where the REAL decisions are made:
1) What time do I want my monitoring done in the morning? What time at night?
2) When do I want my shower?
3) What will I eat for a snack in the afternoon?
4) What do I want to order off the menu for tomorrow?
But the most important recurrent, vital decision that I make on a daily basis?
5) Now that I am back in bed from the bathroom... do I want to lay down on my left or right side????? I have to admit this one sometimes stumps me sometimes for a few minutes :-).
So there you have it. A day in my life.
Don't get me wrong, I'm not complaining.
Although a bit monotonous, it is the life of a human incubator.
And every day they spent in THIS incubator is 2-3 days they won't spend in the NICU incubator.
Still hoping this life-distilled-down-to-basics schedule continues for at least another week or two.
Sunday, August 3, 2008
Of (False) Decels and Nannies
(28w1d)
So as my recent frequency of posting may tend to indicate, two things have changed.
1) I have successfully discerned the best way to use the internet here at the hospital
2) I now feel well enough most days to jot a little post down
Get this...
As of this morning, my liver and kidney functions have completely normalized.
Even my uric acid is "normal", just a little higher than they would want.
The doctors seem a bit perplexed.
Apparently they often see a slight improvement after hospitalization and steroid administration. But to have everything normalize and remain stable for a week is... well... quite unusual. I gather they didn't get the memo that I don't exactly follow the expected route of... well... ANYTHING when it comes to this pregnancy.
What a fabulous way to buck the trend!
During monitoring this morning, there was some concern that Alpha was having decels (a substantial decrease in her heart rate which can indicate low oxygen/distress). But because she wasn't showing up well, it was unclear if they were true decels or just artifact from the monitoring.
Dr W showed up and was concerned enough to pull out the ultrasound machine. Apparently if the decels are "true", Alpha will be sluggish due to the build up of lactic acid. He needed to count her movements. From the minute the ultrasound probe hit my belly the screen was filled up by a whirling dervish. Make that three of them.
They usually spend 30 minutes counting fetal movements.
All three of mine passed in the first minute :-).
Dr. W believes the tracing pattern is due to Alpha's position (VERY low and near my large vessels), and her... ummm.... maniacal activity:-)
Phew!
One more bullet dodged.
In other news... it appears that Matt and I will certainly be getting at least some sleep once all the babies are home.
No, dear readers, I am not in the throes of acute hospital-induced delirium.
No, my friends... we have found a night nanny!
She is about 60 years old and has extensive experience taking care of multiples.
And likes working at night.
Could we be any luckier?
Skipping a feeding or two a night (at least five nights a week) should do me wonders.
That's all for now...
One more day down!
So as my recent frequency of posting may tend to indicate, two things have changed.
1) I have successfully discerned the best way to use the internet here at the hospital
2) I now feel well enough most days to jot a little post down
Get this...
As of this morning, my liver and kidney functions have completely normalized.
Even my uric acid is "normal", just a little higher than they would want.
The doctors seem a bit perplexed.
Apparently they often see a slight improvement after hospitalization and steroid administration. But to have everything normalize and remain stable for a week is... well... quite unusual. I gather they didn't get the memo that I don't exactly follow the expected route of... well... ANYTHING when it comes to this pregnancy.
What a fabulous way to buck the trend!
During monitoring this morning, there was some concern that Alpha was having decels (a substantial decrease in her heart rate which can indicate low oxygen/distress). But because she wasn't showing up well, it was unclear if they were true decels or just artifact from the monitoring.
Dr W showed up and was concerned enough to pull out the ultrasound machine. Apparently if the decels are "true", Alpha will be sluggish due to the build up of lactic acid. He needed to count her movements. From the minute the ultrasound probe hit my belly the screen was filled up by a whirling dervish. Make that three of them.
They usually spend 30 minutes counting fetal movements.
All three of mine passed in the first minute :-).
Dr. W believes the tracing pattern is due to Alpha's position (VERY low and near my large vessels), and her... ummm.... maniacal activity:-)
Phew!
One more bullet dodged.
In other news... it appears that Matt and I will certainly be getting at least some sleep once all the babies are home.
No, dear readers, I am not in the throes of acute hospital-induced delirium.
No, my friends... we have found a night nanny!
She is about 60 years old and has extensive experience taking care of multiples.
And likes working at night.
Could we be any luckier?
Skipping a feeding or two a night (at least five nights a week) should do me wonders.
That's all for now...
One more day down!
Saturday, August 2, 2008
Let Me See Those Pearly Whites
(28w0d, Hospital Day 8)
First of all, I feel like I am back in Mrs. J.orgenson's third grade class.
When Dr. W (a partner of Dr. Peri) showed up yesterday and said all of the partners (apparently they discuss treatment plans on Dr. Peri's hospitalized patients as a group every day) are not only pleasantly surprised that I made it this long, but also impressed that things actually looked better for me yesterday than at any point since I was admitted, I couldn't help but be proud (as if my falling liver tests are a direct result of good study habits.)
Well stick a gold star on my forehead :-).
Today is 28 weeks!
We made it!
Slap me silly and call me Martha.
Let's see.
I'm most definitely going to celebrate.
Hmmmm......
Maybe by eating one extra baked goody? (*gasp*)
Or, if I am feeling truly rebellious, making my way OUTSIDE my room down two doors to get some cranberry juice (think T.he V.illage, T.ruman Show, etc). Yep, a wild child, I am :-).
Ooooo, ooooo, I know (hand waving wildly waiting for teacher to call on me), Stuffed crust pizza for dinner? (Now we're talking!)
Matt is running a few errands for me today... Among other things... new shampoo and conditioner. MOUTHWASH (ahhhhh.... I can't wait!) and he will be bringing my shaving supplies from home as another week like this and S.asquatch won't have anything on me.
The Mother of All Headaches is gone.
Completely.
Ahhhhhh. Can't tell you how NOT sorry I am about this.
One never truly appreciates the lack of one's head being split in two by a hatchet until... well... it stops.
This also marks the beginning of hospital week 2.
All sorts of things to celebrate today!
I can tell the babies are growing because of how they move (well, and I suppose the fact I am teetering on the edge of belly button out-y-ness is also a clue). And I'm not talking about the 6-footed, 6-handed, log-rolling frenzy that often erupts when monitoring starts. No, I'm talking about the occasional foot that stretches out the top of my uterus. This conscious stretching activity is new. Estimates roughly put them at approximately 2 lbs right now if we are lucky (soaking wet, of course). New goal? 2.5 lbs... no, make that 3 lbs... it is O.lympic season, might as well dream big, no?
It is an awful good thing I made it this far.
See, I have an ulterior motive.
Dr. Peri should be in on Moday.
And I am SOOOOOO waiting to give him a bad time about putting me in the hospital and then leaving the country the next day to go SCUBA DIVING... WITHOUT TELLING ME. I am so going to raz him.
Besides, he has been telling me for several weeks that he won't be smiling until we get to 28 weeks.
Where is that smile, Dr. Peri???????
Now clawing our way towards 29 weeks...
First of all, I feel like I am back in Mrs. J.orgenson's third grade class.
When Dr. W (a partner of Dr. Peri) showed up yesterday and said all of the partners (apparently they discuss treatment plans on Dr. Peri's hospitalized patients as a group every day) are not only pleasantly surprised that I made it this long, but also impressed that things actually looked better for me yesterday than at any point since I was admitted, I couldn't help but be proud (as if my falling liver tests are a direct result of good study habits.)
Well stick a gold star on my forehead :-).
Today is 28 weeks!
We made it!
Slap me silly and call me Martha.
Let's see.
I'm most definitely going to celebrate.
Hmmmm......
Maybe by eating one extra baked goody? (*gasp*)
Or, if I am feeling truly rebellious, making my way OUTSIDE my room down two doors to get some cranberry juice (think T.he V.illage, T.ruman Show, etc). Yep, a wild child, I am :-).
Ooooo, ooooo, I know (hand waving wildly waiting for teacher to call on me), Stuffed crust pizza for dinner? (Now we're talking!)
Matt is running a few errands for me today... Among other things... new shampoo and conditioner. MOUTHWASH (ahhhhh.... I can't wait!) and he will be bringing my shaving supplies from home as another week like this and S.asquatch won't have anything on me.
The Mother of All Headaches is gone.
Completely.
Ahhhhhh. Can't tell you how NOT sorry I am about this.
One never truly appreciates the lack of one's head being split in two by a hatchet until... well... it stops.
This also marks the beginning of hospital week 2.
All sorts of things to celebrate today!
I can tell the babies are growing because of how they move (well, and I suppose the fact I am teetering on the edge of belly button out-y-ness is also a clue). And I'm not talking about the 6-footed, 6-handed, log-rolling frenzy that often erupts when monitoring starts. No, I'm talking about the occasional foot that stretches out the top of my uterus. This conscious stretching activity is new. Estimates roughly put them at approximately 2 lbs right now if we are lucky (soaking wet, of course). New goal? 2.5 lbs... no, make that 3 lbs... it is O.lympic season, might as well dream big, no?
It is an awful good thing I made it this far.
See, I have an ulterior motive.
Dr. Peri should be in on Moday.
And I am SOOOOOO waiting to give him a bad time about putting me in the hospital and then leaving the country the next day to go SCUBA DIVING... WITHOUT TELLING ME. I am so going to raz him.
Besides, he has been telling me for several weeks that he won't be smiling until we get to 28 weeks.
Where is that smile, Dr. Peri???????
Now clawing our way towards 29 weeks...
Friday, August 1, 2008
A Pain In The... Head
(27w6d)
... But also a pain in my always-ample-now-jumbo-jet-sized tush.
Technically and geographically the pain is actually above my shoulders.
Yes, I had a migraine starting yesterday morning.
No, not just a run-of-the-mill migraine.
No, as S.addam H.ussein would have said-- the Mother of All Migraines.
As my normal pre-pregnancy migraine medication (which, btw works so well that I would kiss the feet of the researcher that developed it... No really, I would... barefoot...) is off limits for now I am left with older meds that have luckily worked wonders during my pregnancy... until now.
Not exactly great timing as those in the know will understand that a persistent headache resistant to treatment is an indication for delivery in preeclamptics.
Even at 27w6d.
As a bonus... such a severe headache is bound to make one's blood pressure... well... less than desirable.
Fabulous.
I eventually took four doses of the older medication with very little effect.
Not reassuring.
And even I started becoming concerned since this was so unusual.
After being called a "ticking time bomb" (tick, tock, tick, tock) by Dr. Peri's partner ("Don't even consider thinking about being able to leave this hospital until you deliver these babies" he warned me), he threw the proverbial pregnancy-friendly pharmacy book at me in an attempt to prove this was actually a migraine-run-amok and not my neurologic system preparing for mass destruction.
Eventually it worked.
Hallelujah!
And I got a full three hours sleep (something I fully intend to rectify this afternoon by turning off my phone and turning my TV to the golf channel.
As of this morning, I am the proud owner of a respectable (ummm... at least for Pregnancy-Induced Hypertension standards) blood pressure, decent labs and an after-severe-migraine fog.
Besides feeling like I have been run over by a M.ack truck (fighting a migraine for 12 hours will do that to a person), I am feeling good today.
And I couldn't be happier.
Talk about a rollercoaster!
So far August (at least the first 12 hours of it) is treating me very, very well.
Oh, I almost forgot. A family friend sent over their caterer to bring me dinner a few nights ago. Complete with a cloth napkin, placemat and table cloth. Pink and yellow lentil soup (Yum!), salad, salmon with risotto and roasted beets were served. A great surprise, tres generous and tres tasty!
P.S. In case you aren't aware (not that you would like to be... ) one of the benefits of an ever-growing front section is that even the most generous back side begins to look... well, relatively flat. Believe me.
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