I stayed at the hospital last night, and neither Sarah nor I got a lot of sleep. As the day went on today, however, things got better and better. Here's a summary of what's gone on the past couple of days.
Tuesday - Doctors' appointments (with a heaping of stress), followed by a admission to the hospital and a steroid shot for the babies lungs.
Tuesday Night - Move from Labor and Delivery bed to an antepartum bed. I go home.
Tuesday/Wednesday overnight - An increase in contractions, a side effect of the steroid. The contraction inhibitor isn't doing enough to slow them down. Sarah is moved back to Labor and Delivery and put on magnesium sulfate to curb the contractions.
Wednesday - Anxiety and steroid shot still contributing to contractions. Terbutaline is discontinued, magnesium sulfate is maintained. The nurse's description on the side effects of magnesium sulfate ("like a bad case of the flu") turn out to be correct. After going into work for a bit to get some things in order, I headed back to the hospital, where I stayed overnight. In the early evening Sarah received the second steroid shot.
Thursday - Magnesium sulfate is discontinued at Noon. Sarah is able to eat lunch at 2 PM (albeit very little). The contractions slow to the point that they cease the continuous monitoring of the fetal heartbeats and uterine contractions. Symptoms continue to ease to the point that Sarah is moved back to an antepartum room, where monitoring will be performed on an "as needed" basis. Sarah will sleep the sleep of the medicated and I will sleep in my own bed, rather then on the bench in the L&D room like I did last night.
Best Case Scenario - Contractions are minimal and infrequent, no side effects of medications persist, and Sarah is allowed to go home Friday evening. A slightly more realistic but still optimistic scenario has this playing out on Saturday morning instead.
So, we will wait, and hope, and pray for the best. We'd really like to get to at least 32 weeks and would feel better about 34, as the time in the NICU decreases with every hour preterm labor is delayed. The docs will aggressively suppress labor until 34 weeks, at which point they will try to delay it, but will take measures that are less heroic than those taken at an earlier point in the pregnancy. Our nurse from the last couple of days is off tomorrow, so she told us she didn't want to see us again for a few weeks, but when we do come in, to makes sure we find her. We will do our best.
Oh! I almost forgot. Sarah is feeling much better, and would welcome phone calls and perhaps even a visit. Just be sure to call ahead to see if she's up to it. Thanks again for all your thoughts and prayers. We really appreciate it.
Pregnancy Ticker
Thursday, November 1, 2007
Wednesday, October 31, 2007
No Visitors for Now
I went by the hospital for a couple of hours mid-day today to check up on Sarah. She is really starting to feel the effects of the magnesium sulfate and would prefer not to have visitors for the time being, as she is very uncomfortable and not as clear-headed as she'd like. They're taking good care of her and keeping an eye on everything, so I'll have more to report when I get home tonight after going to the hospital after work.
The Home Stretch?
Whilst I was asleep last night more exciting stuff happened. Sarah was continuing to experience contractions, among other symptoms, and they moved her back to labor and delivery and put her on magnesium sulfate to inhibit the contractions. This drug is more effective than the other, but it has many unpleasant side effects. Sarah will be confined to the bed until at least tomorrow (Thursday, Nov. 1) morning, and might not leave it until the babies are born. The chances of Sarah coming home before the babies are born really aren't that good anymore, unless there is a significant change, which is unlikely. The doc came by and said his goal is to delay delivery until 32 weeks, and he is optimistic that we can make it that far, with treatment.
While I will be able to take off work for a month (thanks to leave donated to me by generous coworkers), the doc said to expect the babies to be in the NICU until they reach 36 weeks in gestational age, which is 5 weeks from tomorrow. This will make things a little tight, but I may have received some donations that I don't yet know about, so there may be more.
So here we go. Hopefully we can meet or beat the doctor's goal of 32 weeks, but if we don't we know the babies are in good hands. Please continue to remember us in your prayers during this exciting but stressful time.
While I will be able to take off work for a month (thanks to leave donated to me by generous coworkers), the doc said to expect the babies to be in the NICU until they reach 36 weeks in gestational age, which is 5 weeks from tomorrow. This will make things a little tight, but I may have received some donations that I don't yet know about, so there may be more.
So here we go. Hopefully we can meet or beat the doctor's goal of 32 weeks, but if we don't we know the babies are in good hands. Please continue to remember us in your prayers during this exciting but stressful time.
Tuesday, October 30, 2007
OK, I Admit It
So today was eventful, to say the least. We had an appointment at 2:30 with our high risk doc, complete with a consult with a geneticist. After that, we were to go to our regular OB fresh from our results with the high risk guys. Here's what really happened.
We get to the high risk doc at 2, 30 minutes early. At around 2:45 they tell us that the docs have had an emergency and were delayed. They also told us that there were two people ahead of us, at 30 minutes each. We were a bit worried, because our regular OB appt was at 3:45, and they go home at 4. So, after talking to both offices, we went to our regular OB first, at 3:10, having been told we had 30 minutes. We rushed over, and they rushed us in, no waiting. ---{we interrupt this compelling narrative to bring you these pertinent medical findings...SARAH's gestational diabetes test was negative, and her belly is similar to that of someone 38 weeks pregnant with a singleton...we now return you to the stirring play-by-play}--- While Sarah was finishing up and making our next appointment with our regular OB, I headed straight back to the high risk OBs, which are literally down the hall, to let them know we were done. This is were it gets fun. The girl at the desk tells us that they called our name, and we weren't there, so we would have to reschedule. Yes, this is the same girl who told us we had 30 minutes, something she denied ever saying. So I'm mad. I'm so mad that I walk out of the office, down the hall, count to 30, and go back in to reschedule. Shortly thereafter, Sarah catches up and is told we have to reschedule. She gets as mad as I was, but she has more hormones running through her than I do. Suffice it to say that voices were raised, denials were made, and tears were shed. Not the sad kind, the angry kind. Eventually, word comes in from much higher up than the front desk girl, and they work us in. ---{more medical information...the babies are roughly 3.5 lbs each and are still similar in size...EMMA's head pushes both on SARAH's bladder and cervix, explaining a lot of phenomena SARAH has experienced...SARAH's cervical length is roughly 0.4 cm, and a week ago she was 1.5 cm dilated...and don't tell me you don't do the metric system; the measurements are no more arbitrary than imperial measurements...if it helps, there are ~2.5 cm per inch and a quart and a liter are roughly the same size...we now join your story in progress}--- Our doc, who is very nice and helpful, is not comforted that Sarah has not yet had a steroid shot, in light of the medical findings. ---{blah blah blah medical blah blah blah...severely premature infants may have underdeveloped lungs, because they are not yet producing their own surfactant...this can lead directly to Respiratory Distress Syndrome, also called hyaline membrane disease, in the neonate...to try to reduce the risk of this outcome, pregnant mothers with threatened premature delivery prior to 34 weeks are often administered at least one course of glucocorticoids, a steroid that crosses the placental barrier and stimulates growth in the lungs of the fetus}--- So, it turns out that, rather than being turned away for another appointment, Sarah was admitted to the hospital overnight for administration of steroid shots, one tonight and one 24 hours later. They will monitor her tonight, as steroids can sometimes cause labor ---{hey! medical stuff is my job!}--- although the doc doesn't expect that to happen. He was encouraged that our fetal fibronectin test last week came up negative, and expects Sarah to be released tomorrow evening. Since we finish up 31 weeks tomorrow, my goal of 33 weeks looks better and better. We are much more at ease now that the steroids are being administered so we can get the babies out of the NICU as soon as possible after they're born. Just to be safe, though, tomorrow I'm bringing her seasons 2 and 3 of Veronica Mars and a portable DVD player, in case she has to stay an extra day.
---{LATE BREAKING NEWS!...SARAH just called from the hospital...they moved her to an antepartum room...the nurse told her that around the time her anti-contraction medicine was wearing off she was experiencing 8 contractions an hour...SARAH felt she was having 2 per hour during this time...our girl has a high "contraction" threshold}---
So, we're in the home stretch. It appears that 2 weeks is on the outside of what we have to go, but we'll take everything we can get. The babies start putting on that cute baby fat that keeps them warm from here on out, and that's very important. Every day we can delay their delivery will help, so please continue to keep us in your prayers.
We get to the high risk doc at 2, 30 minutes early. At around 2:45 they tell us that the docs have had an emergency and were delayed. They also told us that there were two people ahead of us, at 30 minutes each. We were a bit worried, because our regular OB appt was at 3:45, and they go home at 4. So, after talking to both offices, we went to our regular OB first, at 3:10, having been told we had 30 minutes. We rushed over, and they rushed us in, no waiting. ---{we interrupt this compelling narrative to bring you these pertinent medical findings...SARAH's gestational diabetes test was negative, and her belly is similar to that of someone 38 weeks pregnant with a singleton...we now return you to the stirring play-by-play}--- While Sarah was finishing up and making our next appointment with our regular OB, I headed straight back to the high risk OBs, which are literally down the hall, to let them know we were done. This is were it gets fun. The girl at the desk tells us that they called our name, and we weren't there, so we would have to reschedule. Yes, this is the same girl who told us we had 30 minutes, something she denied ever saying. So I'm mad. I'm so mad that I walk out of the office, down the hall, count to 30, and go back in to reschedule. Shortly thereafter, Sarah catches up and is told we have to reschedule. She gets as mad as I was, but she has more hormones running through her than I do. Suffice it to say that voices were raised, denials were made, and tears were shed. Not the sad kind, the angry kind. Eventually, word comes in from much higher up than the front desk girl, and they work us in. ---{more medical information...the babies are roughly 3.5 lbs each and are still similar in size...EMMA's head pushes both on SARAH's bladder and cervix, explaining a lot of phenomena SARAH has experienced...SARAH's cervical length is roughly 0.4 cm, and a week ago she was 1.5 cm dilated...and don't tell me you don't do the metric system; the measurements are no more arbitrary than imperial measurements...if it helps, there are ~2.5 cm per inch and a quart and a liter are roughly the same size...we now join your story in progress}--- Our doc, who is very nice and helpful, is not comforted that Sarah has not yet had a steroid shot, in light of the medical findings. ---{blah blah blah medical blah blah blah...severely premature infants may have underdeveloped lungs, because they are not yet producing their own surfactant...this can lead directly to Respiratory Distress Syndrome, also called hyaline membrane disease, in the neonate...to try to reduce the risk of this outcome, pregnant mothers with threatened premature delivery prior to 34 weeks are often administered at least one course of glucocorticoids, a steroid that crosses the placental barrier and stimulates growth in the lungs of the fetus}--- So, it turns out that, rather than being turned away for another appointment, Sarah was admitted to the hospital overnight for administration of steroid shots, one tonight and one 24 hours later. They will monitor her tonight, as steroids can sometimes cause labor ---{hey! medical stuff is my job!}--- although the doc doesn't expect that to happen. He was encouraged that our fetal fibronectin test last week came up negative, and expects Sarah to be released tomorrow evening. Since we finish up 31 weeks tomorrow, my goal of 33 weeks looks better and better. We are much more at ease now that the steroids are being administered so we can get the babies out of the NICU as soon as possible after they're born. Just to be safe, though, tomorrow I'm bringing her seasons 2 and 3 of Veronica Mars and a portable DVD player, in case she has to stay an extra day.
---{LATE BREAKING NEWS!...SARAH just called from the hospital...they moved her to an antepartum room...the nurse told her that around the time her anti-contraction medicine was wearing off she was experiencing 8 contractions an hour...SARAH felt she was having 2 per hour during this time...our girl has a high "contraction" threshold}---
So, we're in the home stretch. It appears that 2 weeks is on the outside of what we have to go, but we'll take everything we can get. The babies start putting on that cute baby fat that keeps them warm from here on out, and that's very important. Every day we can delay their delivery will help, so please continue to keep us in your prayers.
Monday, October 29, 2007
Homestarloween Costumes
We have 3(!) appointments with doctors tomorrow, so we should have lots to post tomorrow night.
In the meantime, most of you know that I am a huge Homestar Runner fan. Every year the cartoon features a Halloween toon, in which all the characters are in costume. Even funnier, however, are the instances in which Strong Bad (the antagonist and "criminal element" of the toons) makes fun of real people who dress up as Homestar Runner characters for All Hallows Eve. Pure comic gold. I can't wait to see this year's installment.
In the meantime, most of you know that I am a huge Homestar Runner fan. Every year the cartoon features a Halloween toon, in which all the characters are in costume. Even funnier, however, are the instances in which Strong Bad (the antagonist and "criminal element" of the toons) makes fun of real people who dress up as Homestar Runner characters for All Hallows Eve. Pure comic gold. I can't wait to see this year's installment.
Thursday, October 25, 2007
29.5 Week Belly Shot
Before our late run to Labor and Delivery Triage on Monday night, we made sure to take a belly shot, just in case. Here you have it, 29.5 weeks pregnant with twins. I think she carries if off very well. The lack of focus is my fault. I have a new camera and I haven't quite gotten the focus down just yet.
Tuesday, October 23, 2007
Once More, With Feeling
Monday night we made our third trip thus far to Labor and Delivery Triage (but only our first in 3 weeks!). Sarah wasn't having more contractions than usual, but they were more painful. She hasn't been sleeping well, thanks to all this, which compounded the issue. So, we went in and they monitored the babies' heartbeats. They also tested for fetal fibronectin and checked for dilation. The fetal fibronectin test was negative, which was encouraging, because 97% of the time that means there will be no delivery for the next 7-10 days. Obviously this isn't infallible, but it is encouraging. We're at 1.5 cm dilated, which is more than we'd like, but isn't catastrophic by any means.
They prescribed terbutaline to reduce the amount of contractions, since it worked so well in triage. It has to be taken every 4-6 hours, but should allow Sarah to achieve more restful sleep and relaxation, which are also very good. So it looks pretty solid that we'll make 30 weeks, if not 31. I'm still shooting for 33, but we'll take our victories as they come. Please continue to remember us in your prayers, we really appreciate them.
One other good thing came out of the trip last night. We have made great headway on packing our "gotta go" bags. Sarah worked up a list, and I had started getting things together the past few days, but last night we scrambled around for 30 minutes getting some essentials together in preparation for delivery, just in case last night was the night. Now we're going to keep those bags pretty much as they are and maybe add a few things to them.
Lastly, a special thanks to the friends and family who have cooked us meals and helped around the house. Since Sarah is at fairly complete bedrest, these kindnesses have been greatly appreciated.
They prescribed terbutaline to reduce the amount of contractions, since it worked so well in triage. It has to be taken every 4-6 hours, but should allow Sarah to achieve more restful sleep and relaxation, which are also very good. So it looks pretty solid that we'll make 30 weeks, if not 31. I'm still shooting for 33, but we'll take our victories as they come. Please continue to remember us in your prayers, we really appreciate them.
One other good thing came out of the trip last night. We have made great headway on packing our "gotta go" bags. Sarah worked up a list, and I had started getting things together the past few days, but last night we scrambled around for 30 minutes getting some essentials together in preparation for delivery, just in case last night was the night. Now we're going to keep those bags pretty much as they are and maybe add a few things to them.
Lastly, a special thanks to the friends and family who have cooked us meals and helped around the house. Since Sarah is at fairly complete bedrest, these kindnesses have been greatly appreciated.
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