Just a quick update on our little man. Fortunately for him, he isn't staying too little. Of course as mom I'd love him to be my little baby forever, but the fact that he is healthy and growing and thriving after his explosive early entrance into the world also makes my heart melt. His last appointment was for his 4 month well check. He is slowly creeping closer to the "standard" growth charts. His length actually made it near the 3rd percentile. When plotted on his preemie chart he is holding his curve and remains around the 60th percentile for weight but it isn't enough to make the "standard" charts just yet. He either has been having growth spurts of late, or just misses mommy. That boy normally likes to eat, but brought it to a whole new level the first week or so I was back at work and continues to ramp it up every couple of days. Either way, he is putting on some pounds, adding to his roll count on his little legs, and of course there are those cheeks.
So far though we haven't had any major concerns. That doesn't mean I'm not hyper vigilant anymore about protecting him. After all I do cringe every time another little one gets close to his face for fear he will catch somethings. I also recruit my pediatric Physical Therapy sister to do an evaluation every so often, but overall I think I'm doing okay at letting him be a regular little baby.
We've even been at the germ factory (read: daycare) for almost two months now, and so far so good. Of course I can't help think about all the flu and RSV and common cold viruses lurking around every corner there, but if I've learned one thing is that I have no control over the timing of any of this. So he has started attending germ camp at the same time as virus season explodes.
WASH YOUR HANDS PEOPLE! (That is just a PSA as a health care worker I felt the need to throw out there and in no way is a reflection on our daycare itself. Our daycare is actually quite awesome as germ centers go.)
So anyway, Will is now almost five months old adjusted. I sometimes for a minute forget that he is really only three months adjusted; when I think about it I am that much more amazed at him. He has been cooing and started giggling. He is more alert, watches his sister be goofy and is starting to reach for toys. His smile in the morning is the best reason to be up and always gets me going (until the coffee kicks in). It helps that his smile also has a way of causing amnesia from the lack of sleep he caused the night before! It would be nice to have some consistent sleep, but knowing how he is growing makes the ongoing middle of the night feedings (sometimes every three hours) rewarding by the light of day. I haven't been tracking his milestones per se since it doesn't feel like the best measure of how he is doing. Obviously he is behind for a five month old, and we are supposed to adjust based on his due date so he should be at a three month old level. I am roughly aware of what he should be doing of course, but as long as he continues to make progress I am happy to let him just do that.
And that is just what he is doing!
Sunday, December 1, 2013
Tuesday, October 22, 2013
The Voices We Hear
Our house is a crowed, noisy place lately. Most of that is having a three month old who has found his own voice, plus a three year old in general who really like to talk. And talk. And talk. And sing. And talk. She uses up so much oxygen with the nonstop talking/singing/talking that I am exhausted just listening to it (or sometimes zoned out pretending to listen to it...until she pauses for me to answer and I'm utterly confused)!
But apparently we have some other little "friends" who come and go as they please. Let me introduce Cindy, Honey and Jha Jhu (or is it Xia Xou? Could be either based on how Lydia pronounces it). These are my daughter's imaginary friends, or as we say at home "the voices in her head." Sometimes they all come to play, sometimes just Cindy. Frequently either Cindy tattles on Lydia, or Lydia tattles on Cindy, and I am surprised they keep "playing" together with how much they seem to argue. Supposedly imaginary friends are a sign of creativity and broad thinking (at least that is what the parenting articles say). Fingers crossed that is really the case, because some days I think my daughter hears a few too many voices. If it weren't an age appropriate milestone I would be more concerned so we will have to wait and see how long this little friends stick around. It is quite entertaining to listen to her full conversations. She has them out loud and sometimes we hear what all parties have to say (2, 3 or 4 players including herself). Sometimes she only voices her role, but with sufficient pauses to allow others their turn to "speak." We are definitely at that stage where I'm not sure if she is telling me about a real person/event or a complete fabrication. My guess is her stories are often a combination of the two.
Now I readily admit having an imaginary friend as a youngster myself. I don't personally remember her that well, but my mom likes to tell the stories. I like to think I am a good judge of character, so she must have been nice. The only "thing that makes you go hmmmmmm" to admit is my little friend was also named Honey. So either Honey is back, ageless and helping my daughter in and out of trouble, or she had a little Honey of her own. You decide if its cute or creepy.
Maybe I should invite my Honey back? Perhaps then someone might be listening to me instead of talking to myself so often. I'll have to decide which of those leads me farther down the path to crazy-town. Lydia sure is having fun with hers
But apparently we have some other little "friends" who come and go as they please. Let me introduce Cindy, Honey and Jha Jhu (or is it Xia Xou? Could be either based on how Lydia pronounces it). These are my daughter's imaginary friends, or as we say at home "the voices in her head." Sometimes they all come to play, sometimes just Cindy. Frequently either Cindy tattles on Lydia, or Lydia tattles on Cindy, and I am surprised they keep "playing" together with how much they seem to argue. Supposedly imaginary friends are a sign of creativity and broad thinking (at least that is what the parenting articles say). Fingers crossed that is really the case, because some days I think my daughter hears a few too many voices. If it weren't an age appropriate milestone I would be more concerned so we will have to wait and see how long this little friends stick around. It is quite entertaining to listen to her full conversations. She has them out loud and sometimes we hear what all parties have to say (2, 3 or 4 players including herself). Sometimes she only voices her role, but with sufficient pauses to allow others their turn to "speak." We are definitely at that stage where I'm not sure if she is telling me about a real person/event or a complete fabrication. My guess is her stories are often a combination of the two.
Now I readily admit having an imaginary friend as a youngster myself. I don't personally remember her that well, but my mom likes to tell the stories. I like to think I am a good judge of character, so she must have been nice. The only "thing that makes you go hmmmmmm" to admit is my little friend was also named Honey. So either Honey is back, ageless and helping my daughter in and out of trouble, or she had a little Honey of her own. You decide if its cute or creepy.
Maybe I should invite my Honey back? Perhaps then someone might be listening to me instead of talking to myself so often. I'll have to decide which of those leads me farther down the path to crazy-town. Lydia sure is having fun with hers
Monday, September 16, 2013
Back to Work Countdown
It is hard to believe that I go back to work next month, in just 3 weeks actually. It doesn't feel like Will is old enough, but I realize plenty of mom's have to go back when their little ones are only 6 weeks old. I can't imagine that and am beyond thankful for having stored up so much vacation time over the years, as well as such an understanding employment situation that is allowing me the full 3 months. Since everything with Will is based on "adjusted age" he won't actually start in daycare until a couple weeks after I go back to work when he is adjusted to 8 weeks old (HUGE thanks to Grammy and Papa for that help).
The paperwork for infants in daycare is pretty detailed and rightfully so in order to pass along things like what is upsetting or soothing, what schedule the baby follows, eating and sleeping habits etc. Around the last month before going back to work with Lydia I started tracking her patterns to see if she was developing her own schedule, so I plan to start that with Will. I may be surprised when I actually track it, but I think he is still emerging from newborn patterns so I am delaying some of that paperwork. What is clear now is he likes to eat and gives no warning before announcing he is hungry. He likes his nuk and his swing and doesn't like his vitamins. He tends to urp a lot, but otherwise we just go with the flow.
Lydia probably won't even notice my going back to work. She has been going to "school" several days a week even on my leave and always has fun, although lately she has been asking in the mornings if today is a stay home day. I haven't figured out yet if she is hoping for a yes or no answer. She is very excited though to bring Will to school with her and show him the baby room.
Besides the heartache of leaving the kids again (for me, not them) I am slightly anxious that the right brain cells won't turn on again. I haven't been at work since the first week of May, when I left rather abruptly and landed myself in the hospital. Not that the idea of adult conversation and not being puked on isn't appealing, I just hope I can get back into the swing of things without too many bumps. I'm sure my coworkers and my patients hope so too!
The paperwork for infants in daycare is pretty detailed and rightfully so in order to pass along things like what is upsetting or soothing, what schedule the baby follows, eating and sleeping habits etc. Around the last month before going back to work with Lydia I started tracking her patterns to see if she was developing her own schedule, so I plan to start that with Will. I may be surprised when I actually track it, but I think he is still emerging from newborn patterns so I am delaying some of that paperwork. What is clear now is he likes to eat and gives no warning before announcing he is hungry. He likes his nuk and his swing and doesn't like his vitamins. He tends to urp a lot, but otherwise we just go with the flow.
Lydia probably won't even notice my going back to work. She has been going to "school" several days a week even on my leave and always has fun, although lately she has been asking in the mornings if today is a stay home day. I haven't figured out yet if she is hoping for a yes or no answer. She is very excited though to bring Will to school with her and show him the baby room.
Besides the heartache of leaving the kids again (for me, not them) I am slightly anxious that the right brain cells won't turn on again. I haven't been at work since the first week of May, when I left rather abruptly and landed myself in the hospital. Not that the idea of adult conversation and not being puked on isn't appealing, I just hope I can get back into the swing of things without too many bumps. I'm sure my coworkers and my patients hope so too!
Wonderful State of Chaos
The past weeks have flown past since Will came home! A few people recently asked if I was still keeping up this blog, and I realized I have started various entries multiple times, only to get sidetracked with spit up or diapers or Lydia's imagination. It is a wonderful state of chaos. Lydia continues to be sweetly devoted to her little brother, and he is growing and thriving. Since really he was just due a couple weeks ago, he is essentially still a newborn in most of what he does. Basically that is eating, sleeping and filling diapers. Add in a hefty dose of puking and our day is complete! I think I get puked on more in a day than I get to shower in a week, so we're working on reversing the shower to laundry ratio too.
Will had been doing well enough at our last check up that we no longer have to fortify/supplement his milk, and he caught on like a pro to nursing. Our lactation consultant told me we were her heroes since apparently most preemies/moms don't get to the point of exclusively breast feeding for a number of reasons. While it is a personal decision for everyone, it is important to me and I am proud of us for sticking with it. He doesn't have a formal weight check again until later this month, so I attempted a crude weight at home with him last week, and he was up to a nice 10.5 lbs!
Will had been doing well enough at our last check up that we no longer have to fortify/supplement his milk, and he caught on like a pro to nursing. Our lactation consultant told me we were her heroes since apparently most preemies/moms don't get to the point of exclusively breast feeding for a number of reasons. While it is a personal decision for everyone, it is important to me and I am proud of us for sticking with it. He doesn't have a formal weight check again until later this month, so I attempted a crude weight at home with him last week, and he was up to a nice 10.5 lbs!
Lately he has started having more awake moments, and I believe even a few real smiles which has been a treat to see. Lydia loves to help with tummy time, laying down on the blanket in front of him saying "look at me Will, look at your big sister" and gets genuinely excited when he picks his head up to do so! I admit to asking myself everyday how long I have until this gentle sibling love is replaced with rivalry or jealously or something else, and continue to be amazed at how lucky we are.
Tuesday, July 30, 2013
Facts & Figures & Dates and such
Since staying warm and growing are Will's two biggest tasks right now, we have close follow up with his pediatritian starting right away today, just 48 hrs after being discharged. While all newborns get their first checkup early on, Will will have mainly 2 appointments a week for at least a while to make sure he continues to gain weight appropriately as we adjust his feeding schedule between nursing, fortifying his bottles and overall volume, along with his work of maintaining his temperature.
Reviewing where he's been so far:
Reviewing where he's been so far:
- US all along estimated him large for age ~ at 32 weeks was estimated at 5 lb 1 oz - which was 95% for his gestational age, or average for a 35 weeker
- Born at 32 weeks 2 days weighing 5lb 5oz and 18 inches long - still 95%. His head circumference was up there as well, albeit proportionately
- Initial weight loss (as expected) down to 4lb 13oz but after a week old & no significant gains for a couple days after that, added a fortifier to his breast milk
- Weight steadily went onward and upward from there ~ on the day of discharge up to 6lb 4oz and length up to 19 inches
- First outpatient visit after 48 hrs home weighs in at 6 lbs 8 oz
Sunday, July 28, 2013
We're Home! Adventures of the first Night
Well, last night was the big day. After his small setback, Will perked up again with good eating and good temps. His team had re-planned for discharge Saturday, but until it actually got here I wasn't going to count on it. This time I feel ready though. Not that I'm any less terrified than I was when we talked discharge last time, but I feel ready. Which I suppose is good since we are all home now!
We told Lydia that her baby was coming home, and while initially confused (after all, someone in this family has been living at the hospital for the last three months) she kept asking about him through out the day. We had originally planned on dropping her off with friends to play while we went to pick up Will, but then she was so interested I thought she might feel better about coming along. So we gave her the option, and while letting a two year old make her own decisions might not be frequently recommended, she was certain about this one: she was going to come along to the hospital! And she was so excited when we got there. Her expressions were great when he squeaked, she asked to hold him and feed him and help with his car seat. When we eventually wrangled everyone into the car and back home, she wouldn't go to bed without giving him hugs and kisses. So far today he was the first thing she wanted to see this morning; "I have to tell him good morning." She didn't want to leave "her baby" to come shopping with mom, and she absolutely has to help with every diaper change - at least we have someone willing to run them to the garbage!
Charlie has been good at welcoming his new little friend as well. He loves to sniff baby's heads, and this has been no different. But mostly I think he is curious as to who caused all the ruckus that got him kicked out of the master bedroom (besides mommy). He's been good though, even when Lydia tells him "no Charlie, that's my baby" when he comes in to see what is going on.
So now we have the first night down. It was interesting coming home in the evening ~ not that I think we'd have slept more regardless ~ but the first few hours were just about getting settled, picking what routine we'd try first, and realizing there is no point in planning more than three hours in advance! There are two big variables so far compared to when we brought Lydia home. One - I seemed to have gotten some viral thing a few days ago that wish as I might isn't allergies, so I have to wear a mask when handling Will and really have to minimize that as much as possible for a few days (booooo, plus doesn't help help the little sleep I would otherwise get). Two is that Will isn't mature enough to exclusively breast feed (as expected) so we have the potential triple threat of nurse/bottle/pump for each feeding. Since Lydia was only nursing, that was pretty much a one (wo-)man job; not this go around.
As we settled in to bed for 'the night' Chris says make sure to wake me up. For those who don't know, a freight train could come through our room in the middle of the night and if it didn't physically contact Chris he may not wake up ~ so listening for/hearing baby sounds is all me. At this point we are still on a bit of scheduled cares so involves minimally an alarm every 3 1/2 hrs if Will doesn't get us up sooner. Two hours after Chris uttered those fateful words, I was standing over him with Will and a bottle trying all I could to bring him to consciousness. The first understandable words I heard out of him (after a lot of grunting and mumbling) were "oh, you have him right there" and then a blank stare. So this was our pattern every three hours for the rest of the night. We could switch roles, but I don't think Chris would do as well pumping. Plus I love seeing my two main guys just hanging in the middle of the night.
So far, so good. Each set of cares still involves monitoring Will's temperature. And it figures for the little guy that is temperature sensitive he'd come home on a July day that got as cold as into the 50's and raining overnight ~ so he's been bundled up. I find it a little ironic that Lydia came almost a week late in October and went home on an abnormally warm day ~ sunny in the low 80's; Will arrives 2 months early and comes home in the rain on a 50 degree July evening. But we are ALL home!
We told Lydia that her baby was coming home, and while initially confused (after all, someone in this family has been living at the hospital for the last three months) she kept asking about him through out the day. We had originally planned on dropping her off with friends to play while we went to pick up Will, but then she was so interested I thought she might feel better about coming along. So we gave her the option, and while letting a two year old make her own decisions might not be frequently recommended, she was certain about this one: she was going to come along to the hospital! And she was so excited when we got there. Her expressions were great when he squeaked, she asked to hold him and feed him and help with his car seat. When we eventually wrangled everyone into the car and back home, she wouldn't go to bed without giving him hugs and kisses. So far today he was the first thing she wanted to see this morning; "I have to tell him good morning." She didn't want to leave "her baby" to come shopping with mom, and she absolutely has to help with every diaper change - at least we have someone willing to run them to the garbage!
Charlie has been good at welcoming his new little friend as well. He loves to sniff baby's heads, and this has been no different. But mostly I think he is curious as to who caused all the ruckus that got him kicked out of the master bedroom (besides mommy). He's been good though, even when Lydia tells him "no Charlie, that's my baby" when he comes in to see what is going on.
So now we have the first night down. It was interesting coming home in the evening ~ not that I think we'd have slept more regardless ~ but the first few hours were just about getting settled, picking what routine we'd try first, and realizing there is no point in planning more than three hours in advance! There are two big variables so far compared to when we brought Lydia home. One - I seemed to have gotten some viral thing a few days ago that wish as I might isn't allergies, so I have to wear a mask when handling Will and really have to minimize that as much as possible for a few days (booooo, plus doesn't help help the little sleep I would otherwise get). Two is that Will isn't mature enough to exclusively breast feed (as expected) so we have the potential triple threat of nurse/bottle/pump for each feeding. Since Lydia was only nursing, that was pretty much a one (wo-)man job; not this go around.
As we settled in to bed for 'the night' Chris says make sure to wake me up. For those who don't know, a freight train could come through our room in the middle of the night and if it didn't physically contact Chris he may not wake up ~ so listening for/hearing baby sounds is all me. At this point we are still on a bit of scheduled cares so involves minimally an alarm every 3 1/2 hrs if Will doesn't get us up sooner. Two hours after Chris uttered those fateful words, I was standing over him with Will and a bottle trying all I could to bring him to consciousness. The first understandable words I heard out of him (after a lot of grunting and mumbling) were "oh, you have him right there" and then a blank stare. So this was our pattern every three hours for the rest of the night. We could switch roles, but I don't think Chris would do as well pumping. Plus I love seeing my two main guys just hanging in the middle of the night.
So far, so good. Each set of cares still involves monitoring Will's temperature. And it figures for the little guy that is temperature sensitive he'd come home on a July day that got as cold as into the 50's and raining overnight ~ so he's been bundled up. I find it a little ironic that Lydia came almost a week late in October and went home on an abnormally warm day ~ sunny in the low 80's; Will arrives 2 months early and comes home in the rain on a 50 degree July evening. But we are ALL home!
Thursday, July 25, 2013
So Close, Small Setback
Week 3: Will is growing, up to 6 lbs today. He's had a lot going on this past week. After a very brief but much needed respite to the north woods last weekend, we returned Sunday night to our strong boy doing exceptionally well. He nursed great, almost an entire feeding and wowed the staff the entire 48 hrs we were away. On Monday the team decided after some discussion that he was close enough on his oral feeds that he could trial having his NG tube (feeding tube) removed and see how he does. So instead of getting a fixed amount on a scheduled basis, he would transition to ad lib feeds, with a goal amount to accomplish in a 12 and 24 hr window. The first day he of course impressed everyone and exceeded his goals. In fact he looked so good they started talking about discharging him at the end of the week, maybe as early as Thursday!
Now we have been anxious for him to come home of course. But honestly hadn't done enough at home for him to be there yet. Between months of bed rest, and then spending days in the NICU it all of a sudden felt like we had a LOT to do. So we went into overdrive with laundry & cleaning (along with a lot of help). I stayed the night here on Tuesday to get into the "real" rhythm of around the clock cares/pumping/naps etc. We were excited, but I'd be lying if I said we weren't nervous...maybe even terrified a bit.
Will had his own agenda, as usual. The entire day he didn't feed as well, although seemed to perk up in the late afternoon. But then overnight his body temperature was abnormally lower, he was exceptionally sleepy and again did not eat well. He was having more episodes of low oxygen levels. He didn't quite make his 12hr volume goal and that was with a lot of effort on every one's part. I was exhausted from only 3 hrs of sleep - which was divided into separate 1 hour intervals, and especially concerned that he was not his usual self. His night nurse agreed as she has taken care of him before, and we asked the doctors to take a look at him early Wed morning. It all could be a simple point of Will reminding us he is only 35 weeks gestational age, and is tiring from the work of eating all on his own and just being premature. However with the constellation of things happening at once his team was concerned he may have some kind of infection causing all these changes.
At this point discharge was put on hold along with the "little things" he needed to do before leaving (car seat test, hearing screen, heart screen). Labs were checked and while some were reassuring, not all were normal. By now Chris had sent me home for some real sleep (defined as anything longer than 1 hour) which was needed, because all I could do was cry and worry. Will was started on antibiotics, planned for at least 48 hrs or as the culture results dictate. Unfortunately that meant restarting an IV, or in Will's case they tried. And tried and tried. He was a tricky one at delivery too I was told. After more pokes than Chris likely told me about, they still weren't able to get his IV in so had to give him IM shots for the antibiotics. Another ouch! But necessary. He got an additional two shots 12 hrs later, and then last night they were successful with another forehead IV to finish his antibiotics.
Luckily he has perked up a little more in the last 12hrs, so is taking enough of his feeds yet that he so far doesn't need his feeding tube replaced. His body temp and color are much better. He is still sleepier than before, but appropriately mad when they poke his heal and likely needing a little extra time to recover from all the activity. Cultures are negative so far.
We may not end up knowing for sure what caused his little set back, but I am happy he already looks better. It could have been a start infection that we won't pick up on tests but the antibiotics are kicking in. It could have been just too much work to eat & gain weight & maintain his temp & coordinate breathing only 24 hrs after asking him to do it all on his own for a guy who wasn't supposed to be born yet! Or a combination of those things. Today the team thinks his trying & failing to maintain his temperature at least was part of it, and he had a cold shock as it were. The rooms were noticeably cooler that night (happens in every hospital I've been in with weather changes - building is too big to keep up) and he wasn't in a footed sleeper but a short-all with socks under his blankets. This effort took so much out of him that the other points suffered. At least now we know he may be more temperature sensitive and can plan accordingly for home.
So today things look back on track. His other tests are being set up to finish in the next few days. If he keeps improving again, we are so close to all going home. But we are still terrified!
Now we have been anxious for him to come home of course. But honestly hadn't done enough at home for him to be there yet. Between months of bed rest, and then spending days in the NICU it all of a sudden felt like we had a LOT to do. So we went into overdrive with laundry & cleaning (along with a lot of help). I stayed the night here on Tuesday to get into the "real" rhythm of around the clock cares/pumping/naps etc. We were excited, but I'd be lying if I said we weren't nervous...maybe even terrified a bit.
Will had his own agenda, as usual. The entire day he didn't feed as well, although seemed to perk up in the late afternoon. But then overnight his body temperature was abnormally lower, he was exceptionally sleepy and again did not eat well. He was having more episodes of low oxygen levels. He didn't quite make his 12hr volume goal and that was with a lot of effort on every one's part. I was exhausted from only 3 hrs of sleep - which was divided into separate 1 hour intervals, and especially concerned that he was not his usual self. His night nurse agreed as she has taken care of him before, and we asked the doctors to take a look at him early Wed morning. It all could be a simple point of Will reminding us he is only 35 weeks gestational age, and is tiring from the work of eating all on his own and just being premature. However with the constellation of things happening at once his team was concerned he may have some kind of infection causing all these changes.
At this point discharge was put on hold along with the "little things" he needed to do before leaving (car seat test, hearing screen, heart screen). Labs were checked and while some were reassuring, not all were normal. By now Chris had sent me home for some real sleep (defined as anything longer than 1 hour) which was needed, because all I could do was cry and worry. Will was started on antibiotics, planned for at least 48 hrs or as the culture results dictate. Unfortunately that meant restarting an IV, or in Will's case they tried. And tried and tried. He was a tricky one at delivery too I was told. After more pokes than Chris likely told me about, they still weren't able to get his IV in so had to give him IM shots for the antibiotics. Another ouch! But necessary. He got an additional two shots 12 hrs later, and then last night they were successful with another forehead IV to finish his antibiotics.
Luckily he has perked up a little more in the last 12hrs, so is taking enough of his feeds yet that he so far doesn't need his feeding tube replaced. His body temp and color are much better. He is still sleepier than before, but appropriately mad when they poke his heal and likely needing a little extra time to recover from all the activity. Cultures are negative so far.
We may not end up knowing for sure what caused his little set back, but I am happy he already looks better. It could have been a start infection that we won't pick up on tests but the antibiotics are kicking in. It could have been just too much work to eat & gain weight & maintain his temp & coordinate breathing only 24 hrs after asking him to do it all on his own for a guy who wasn't supposed to be born yet! Or a combination of those things. Today the team thinks his trying & failing to maintain his temperature at least was part of it, and he had a cold shock as it were. The rooms were noticeably cooler that night (happens in every hospital I've been in with weather changes - building is too big to keep up) and he wasn't in a footed sleeper but a short-all with socks under his blankets. This effort took so much out of him that the other points suffered. At least now we know he may be more temperature sensitive and can plan accordingly for home.
So today things look back on track. His other tests are being set up to finish in the next few days. If he keeps improving again, we are so close to all going home. But we are still terrified!
Tuesday, July 23, 2013
Myths and Reality
If there is one thing I feel the need to clear up, it is the commonly stated but vastly mythological concept of "at least you can get some rest while he's in the NICU." Yes, in theory we could leave our miracle man here with his medical team, and know his cares are being handled. In theory my only task could be to pump every three hours, and some might argue that I don't have to do that. However we see things quite differently. It is so important to us to be involved in Will's cares every day; both because we are his parents, and so that we are comfortable/familiar with his needs and ready (as we can be) to take him home when that time comes. Even though he can't nurse regularly, I can at least provide expressed milk so he gets all the immunities and nutrition from that. I realize that is a very personal choice for mom's ~ and for me it is extremely important.
So "resting up" while Will is in the NICU is not a reality. It involves all the expected sleepless nights of a newborn, plus the logistics of being in a hospital and traveling back and forth. His cares are every three hours and generally take 30-60 minutes to do. Then I pump every 3 hours which also takes 30-40 min in total. This leaves little time between each set of events to nap/eat/shower/etc. And this is the routine that will continue when he comes home, probably even less organized since we won't have the nurses help, but we will have Lydia's!
It is true that at least we aren't first time parents. However, the details involved are so different this go around that sometimes I feel like I am a new parent. Last time the "schedule" was much simpler; eat, poop, nap and repeat. Now we have many more steps involved. Granted there isn't too much extra to pooping, but napping involves the constant worry that his oxygen levels are going to drop. Eating includes mixing fortifier to milk, giving bottle and/or nurse, pumping, and the dishes that involves each time so we are ready for the next one, and also the worry that his oxygen levels are dropping while he is eating. We have been told several dozen times that all newborns do that to some degree as they learn to get their eating/breathing patterns organized, just usually aren't monitored so parents aren't as aware. But after spending 3 weeks in the NICU, and hearing the dinging and alarming of the monitors in my head long after I've left, or in my sleep, or in the car, or filling any quiet space I might have...it goes without saying that concern is ever present.
So yes, we are overjoyed that Will is doing so well. This is certainly not intended to be a complaint or a rant or anything negative at all. Instead a brief writing about the daily experiences which are our reality.
One other item of clarification, is the confounding factor that I am still healing physically, emotionally and mentally. We are healing from the entire process of not having anything straightforward or normal about our pregnancy, delivery, or newborn experience. And admittedly there is some grief there ~ as wonderful as things are progressing, it was never pictured this way. Just because I know how lucky and blessed we are, doesn't negate the dreams of a "normal" experience. Most times I don't give it another thought, this is just the experience we are having. But that doesn't change the fact that this isn't the route we had hoped for, and underneath it all the grief and sadness are still there. They are both fading and being drowned out by the new realities of our days...we just need some time to allow those feeling their due and eventually be over.
So "resting up" while Will is in the NICU is not a reality. It involves all the expected sleepless nights of a newborn, plus the logistics of being in a hospital and traveling back and forth. His cares are every three hours and generally take 30-60 minutes to do. Then I pump every 3 hours which also takes 30-40 min in total. This leaves little time between each set of events to nap/eat/shower/etc. And this is the routine that will continue when he comes home, probably even less organized since we won't have the nurses help, but we will have Lydia's!
It is true that at least we aren't first time parents. However, the details involved are so different this go around that sometimes I feel like I am a new parent. Last time the "schedule" was much simpler; eat, poop, nap and repeat. Now we have many more steps involved. Granted there isn't too much extra to pooping, but napping involves the constant worry that his oxygen levels are going to drop. Eating includes mixing fortifier to milk, giving bottle and/or nurse, pumping, and the dishes that involves each time so we are ready for the next one, and also the worry that his oxygen levels are dropping while he is eating. We have been told several dozen times that all newborns do that to some degree as they learn to get their eating/breathing patterns organized, just usually aren't monitored so parents aren't as aware. But after spending 3 weeks in the NICU, and hearing the dinging and alarming of the monitors in my head long after I've left, or in my sleep, or in the car, or filling any quiet space I might have...it goes without saying that concern is ever present.
So yes, we are overjoyed that Will is doing so well. This is certainly not intended to be a complaint or a rant or anything negative at all. Instead a brief writing about the daily experiences which are our reality.
One other item of clarification, is the confounding factor that I am still healing physically, emotionally and mentally. We are healing from the entire process of not having anything straightforward or normal about our pregnancy, delivery, or newborn experience. And admittedly there is some grief there ~ as wonderful as things are progressing, it was never pictured this way. Just because I know how lucky and blessed we are, doesn't negate the dreams of a "normal" experience. Most times I don't give it another thought, this is just the experience we are having. But that doesn't change the fact that this isn't the route we had hoped for, and underneath it all the grief and sadness are still there. They are both fading and being drowned out by the new realities of our days...we just need some time to allow those feeling their due and eventually be over.
Friday, July 19, 2013
A Second Week of Progress
It is a little funny to think we are now in the window that we had last settled on scheduling my C section; and I say window because we had a lot of discussion about picking a date in the 34-36 week gestational time frame. Way back when it was officially confirmed that I had a complete placenta previa, the plan was to schedule a C section at 37, maybe 38 weeks. Then with my progression/admission/bleeds we were considering 36 weeks, and last were talking 34-35 weeks in the hopes of doing this delivery in a scheduled manner before being faced with an emergency situation. I may have mentioned that during those most recent planning talks I felt less and less like I was going to make it to either of those dates as well; of course we didn't.
Two weeks ago I was 32 wks and 2 days pregnant when we welcomed baby Will 8 weeks early. Since that time he has impressed everyone who has met him, and melted our hearts. His arrival has given Lydia yet another opportunity to melt our hearts as well. Last night she was listing all the things she was going to teach him since she is the big sister: throw a ball, go on the potty, sing and dance, wear princess dresses, color, play with Charlie...and the list went on. She came to visit him again, and now that he is out of his isolette and minimal "things" on his face I think she can really see him for the little baby he is. She was talking to him and he was squeaking back which she thought was very exciting. I'm pretty sure he was actually squeaking because his next feeding was due in the following 10 minutes, but I also thought that was exciting.
So what has Will accomplished in his second week of life? He has moved to an open air crib and maintaining his body temp (with the assist of some layers of clothes/hat). He has started to "nipple" meaning he takes at least part of most of his feeding either by bottle or nursing. So far he is in the 50% range that way, and gets the rest still through his tube. Once he is able to consistently due over 80% by bottle or nursing then he gets the tube out; if he keeps gaining weight after that, then they start talking about home. So far he is back up to birth weight almost exactly at the two week mark. He still has some episodes where his oxygen levels drop, but these are infrequent and short lived. He corrects himself consistently, and the are as often a result of squirming, grunting, enjoying his bottle to fast or generally just working something out. He is off the caffeine entirely as well. And of course has a million girlfriends up here on the nursing staff.
The most common phrase in the NICU is "each baby is so different, they call the shots." This is the answer to any question you might think to ask. How soon will he learn to nipple? How long will it take to get up to 80% feeds by mouth? How often does the tube have to go back in? How long will the low oxygen events last? How will he do transitioning between bottle and nursing? Insert the same answer to each question.
So now we wait for him to keep gaining weight and learning to eat. His first few days he went from 10% to 30% to 60% of his feeds by mouth. Apparently that was beyond impressive enough that we have been cautioned several times he isn't likely to keep that pace. More likely these next few days will level off, or even go backward a little bit simply because it takes so much energy for these little ones to learn this skill. Remember usually babies grow into it while mom's still pregnant; Will needs to learn it on the fly. So we wait for him to decide his course. And as long as he stays healthy, we've got time.
Two weeks ago I was 32 wks and 2 days pregnant when we welcomed baby Will 8 weeks early. Since that time he has impressed everyone who has met him, and melted our hearts. His arrival has given Lydia yet another opportunity to melt our hearts as well. Last night she was listing all the things she was going to teach him since she is the big sister: throw a ball, go on the potty, sing and dance, wear princess dresses, color, play with Charlie...and the list went on. She came to visit him again, and now that he is out of his isolette and minimal "things" on his face I think she can really see him for the little baby he is. She was talking to him and he was squeaking back which she thought was very exciting. I'm pretty sure he was actually squeaking because his next feeding was due in the following 10 minutes, but I also thought that was exciting.
So what has Will accomplished in his second week of life? He has moved to an open air crib and maintaining his body temp (with the assist of some layers of clothes/hat). He has started to "nipple" meaning he takes at least part of most of his feeding either by bottle or nursing. So far he is in the 50% range that way, and gets the rest still through his tube. Once he is able to consistently due over 80% by bottle or nursing then he gets the tube out; if he keeps gaining weight after that, then they start talking about home. So far he is back up to birth weight almost exactly at the two week mark. He still has some episodes where his oxygen levels drop, but these are infrequent and short lived. He corrects himself consistently, and the are as often a result of squirming, grunting, enjoying his bottle to fast or generally just working something out. He is off the caffeine entirely as well. And of course has a million girlfriends up here on the nursing staff.
The most common phrase in the NICU is "each baby is so different, they call the shots." This is the answer to any question you might think to ask. How soon will he learn to nipple? How long will it take to get up to 80% feeds by mouth? How often does the tube have to go back in? How long will the low oxygen events last? How will he do transitioning between bottle and nursing? Insert the same answer to each question.
So now we wait for him to keep gaining weight and learning to eat. His first few days he went from 10% to 30% to 60% of his feeds by mouth. Apparently that was beyond impressive enough that we have been cautioned several times he isn't likely to keep that pace. More likely these next few days will level off, or even go backward a little bit simply because it takes so much energy for these little ones to learn this skill. Remember usually babies grow into it while mom's still pregnant; Will needs to learn it on the fly. So we wait for him to decide his course. And as long as he stays healthy, we've got time.
Friday, July 12, 2013
First week acheivements & new goals
Yesterday was Will's one week birthday, which is hard to believe. I've adjusted to being home but really still being in the hospital for most the day. Today I finally feel somewhat functional, generally more comfortable and increasingly independent which are all great things. I am of course still weak and tired and generally have a LONG way to go given what the bed rest for so long did to my body, but at least the acute pain from surgery is significantly better. I have had so much swelling from all the fluid they gave me during surgery that my legs themselves are so heavy I get tired just moving them, but I trust my joints/bones will reappear in the next few weeks. My mind and emotions have been all over the place, plenty of days I still break into tears. Some times there is a reason, most times there isn't ~ other than lack of sleep, hormones, worry, joy and all the other abstract things floating around in my head. My personal goals for the immediate future are to walk more, nap more, start slowly working on getting my strength back, tackle a load of laundry or two and mostly just enjoy my family.
My achievements and goals are nothing though compared to Will's. He has had such a week, and improved so much. Every day the team cautions us that it wouldn't be uncommon for him to "not fully tolerate" whatever advancement they plan, but that he's doing well enough it is worth the challenge. And while I know it wouldn't be a failure if he needed some supports back, I can proudly say that so far he hasn't! His wean from the respiratory support went superbly, and for the last 36+ hours he has been breathing entirely on his own without even extra oxygen. He hasn't had any more "spells" in over 48 hrs. His caffeine treatments stopped yesterday, and that will remain in his system for about another 5 days, then we will really see what he does on his own. They are increasing his feeds steadily & he is peeing and pooping like crazy so his GI tract is working great. He still needs to start gaining a little more weight, and since he was a big guy to start with they feel he could use some extra calories so are going to fortify the breast milk for a few days. Hopefully his weight will pick up more, because he is also starting to be alert enough and show feeding cues that we might be able to start formally nursing in the next few days. They start with "nuzzles" to make sure he'll tolerate being at the breast, because at this age he could expend as many calories nursing as he gets while nursing. But all are steps in the right direction. He is getting better at regulating his own body temperature so they are turning down the isolette temps and getting him dressed/swaddled in more layers which is all progress toward being in an open crib. His goals are similar to mine ~ eat, sleep, get stronger ~ but so much more important and impressive!
Hopefully he will continue to make strides in the upcoming weeks, and if all goes well we might be able to have him home by the end of the month. It is a wish I entertain briefly, but have to wait and see. His team said at this point he is basically calling the shots and making the plans, we are all just along for the ride.
My achievements and goals are nothing though compared to Will's. He has had such a week, and improved so much. Every day the team cautions us that it wouldn't be uncommon for him to "not fully tolerate" whatever advancement they plan, but that he's doing well enough it is worth the challenge. And while I know it wouldn't be a failure if he needed some supports back, I can proudly say that so far he hasn't! His wean from the respiratory support went superbly, and for the last 36+ hours he has been breathing entirely on his own without even extra oxygen. He hasn't had any more "spells" in over 48 hrs. His caffeine treatments stopped yesterday, and that will remain in his system for about another 5 days, then we will really see what he does on his own. They are increasing his feeds steadily & he is peeing and pooping like crazy so his GI tract is working great. He still needs to start gaining a little more weight, and since he was a big guy to start with they feel he could use some extra calories so are going to fortify the breast milk for a few days. Hopefully his weight will pick up more, because he is also starting to be alert enough and show feeding cues that we might be able to start formally nursing in the next few days. They start with "nuzzles" to make sure he'll tolerate being at the breast, because at this age he could expend as many calories nursing as he gets while nursing. But all are steps in the right direction. He is getting better at regulating his own body temperature so they are turning down the isolette temps and getting him dressed/swaddled in more layers which is all progress toward being in an open crib. His goals are similar to mine ~ eat, sleep, get stronger ~ but so much more important and impressive!
Hopefully he will continue to make strides in the upcoming weeks, and if all goes well we might be able to have him home by the end of the month. It is a wish I entertain briefly, but have to wait and see. His team said at this point he is basically calling the shots and making the plans, we are all just along for the ride.
The Big Sister
What does Lydia think of all this? Honestly most times I have no idea what she is thinking in general, but so far she seems amazed by her baby brother. I'm sure it is confusing that for so long we talked to her about mommy is in the hospital so the baby can grow bigger and stronger, and now he is "out" and mommy is home. But baby still isn't, and mommy still can't do a lot. She seems to expect things back to normal now that "baby is out" which is understandable. At least daily she asks "mommy can you carry me now?" And although she looks said when we say not yet, she also seems to accept that answer. We've told her mommy's new ouchie needs to get better first, and she either asks to see it several times a day, or asks if its getting better yet.
As for her focus on Will, she has been up to visit him a few times, but one can imagine the threshold for a 2 1/2 year old for being still and quiet ~ so the visits are brief. I can't wait for her to see him again now that he has less lines/iv's etc attached to him as he really does look more like a little baby. She asks to touch his hands whenever she is hear, and has been so good about a gentle little hold. She got this toy dinosaur/lizard thing she wants to show him, and reads books to Will. She shows genuine concern when he squeaks or cries, saying "its okay don't cry, you need a lovey. I will get you a lovey" and hopped off the couch to walk out. I asked what she was doing and she replies very matter of fact "well I'm going to the lovey store for my baby." I just melted.
She does ask about him sometimes at home, but I think she is still in her routine enough that since he isn't there yet she isn't sure what to expect. The first couple days we were sharing a twin room with another baby whose family was from farther away, so when we'd go visit Will there was another baby boy in the room. Being the little lover that she is, Lydia has mentally adopted him as "her baby" too, and has asked about Alex almost as much. When he was moved to another room she wanted to go find him. Hopefully when we do bring Will home, she will be content enough with just one baby brother.
The hospital has become so routine for her, she actually asked to go play there the other night. She said she wants to play the games in mommy's room, and when we explained that mommy doesn't have a room there anymore, she suggested that daddy go away and he should stay at the hospital. Apparently if we take turns being there and she can come play then it's all okay. At least we know my being gone so long wasn't terribly traumatic for her!
In the next few weeks we will bring her up more to visit of course. I'll ask her to help get his room ready, and she gets a big girl bed so "her baby" can have the crib. So far she is on board for that transition. She is such a loving and empathetic girl that I can't imagine she won't be happy when Will comes home, but like I said before sometimes I have no idea what is going on in that girls head. She is amazing to me.
As for her focus on Will, she has been up to visit him a few times, but one can imagine the threshold for a 2 1/2 year old for being still and quiet ~ so the visits are brief. I can't wait for her to see him again now that he has less lines/iv's etc attached to him as he really does look more like a little baby. She asks to touch his hands whenever she is hear, and has been so good about a gentle little hold. She got this toy dinosaur/lizard thing she wants to show him, and reads books to Will. She shows genuine concern when he squeaks or cries, saying "its okay don't cry, you need a lovey. I will get you a lovey" and hopped off the couch to walk out. I asked what she was doing and she replies very matter of fact "well I'm going to the lovey store for my baby." I just melted.
She does ask about him sometimes at home, but I think she is still in her routine enough that since he isn't there yet she isn't sure what to expect. The first couple days we were sharing a twin room with another baby whose family was from farther away, so when we'd go visit Will there was another baby boy in the room. Being the little lover that she is, Lydia has mentally adopted him as "her baby" too, and has asked about Alex almost as much. When he was moved to another room she wanted to go find him. Hopefully when we do bring Will home, she will be content enough with just one baby brother.
The hospital has become so routine for her, she actually asked to go play there the other night. She said she wants to play the games in mommy's room, and when we explained that mommy doesn't have a room there anymore, she suggested that daddy go away and he should stay at the hospital. Apparently if we take turns being there and she can come play then it's all okay. At least we know my being gone so long wasn't terribly traumatic for her!
In the next few weeks we will bring her up more to visit of course. I'll ask her to help get his room ready, and she gets a big girl bed so "her baby" can have the crib. So far she is on board for that transition. She is such a loving and empathetic girl that I can't imagine she won't be happy when Will comes home, but like I said before sometimes I have no idea what is going on in that girls head. She is amazing to me.
Tuesday, July 9, 2013
Preemie issues ~ "Spells" and other things
"He's a big guy"
" He's a good size"
"He seems long"
These are the most common variations of the theme surrounding our new man. Every conversation with every staff member (nursing, aides, docs, RT) somehow includes a comment on William's over achieving dimensions. At 5lb 5 oz and 18in at birth, that put him into the 95% for a 32 wk baby, and is more average for 34-35 wks. Even with the expected weight loss that all babies have, he still is 5lb even today. Will has been getting some protein and sugar through his IV, but the majority of his nutrition is through a feeding tube. He is too young to have developed the suck/swallow/breathe coordination needed for breast/bottle feeding, but has tolerated his tube feeding well. I have been pumping every three hours since about 6 hours after delivery; he started on a preemie formula but now is getting all breast milk which I consider a personal victory. He feeds so well though that they have been increasing how much he gets every day ~ so good for him, but now I need to keep up! The only minor downside to his, as his nurses have pointed out, is that when looking at him he appears older than he is, and therefore ends up creating higher expectations than we should have for him. This is especially important since he hasn't had any other extra problems really, his is just doing what a 32 wk born preemie will do!
In general since being born Will's biggest issue has been needing respiratory support, which is one of those things expected for being born at this gestational age. Initially he was on only CPAP and they increased the settings once on that. However his first full night he had a number of "spells." These spells are events where his heart rate and then oxygen levels drop below specific criteria, and we are told are not uncommon when born at 32 wks. Some babies come out of these spells on their own, others need external stimulation to do so. Will was needing enough extra help to break the spells that they changed him to additional ventilator support. He didn't need an invasive breathing tube put into his lungs, but was able to get the extra support and breaths delivered through his cannula. They also started giving him caffeine thru the IV ~ yes, the same ingredient in the much needed coffee that gets me going in the morning. As a stimulant, it helps preemies "remember" to breathe, making the spells less frequent and less severe. I guess I don't need to worry about having my coffee while pumping/nursing with this one! Fortunately in all this he didn't require much if any extra oxygen delivery, and has not yet needed surfactant, which are both good signs. The spells have gotten less frequent and he has been able to pull himself out of them more often than not over the past day. Today they plan to cut back the ventilator support and get back to standard CPAP; if this goes well they will continue to cut back the breathing supports over the next few days.
Another common preemie issue is jaundice. Initially his bilirubin wasn't too high, but it kept trending up so he was put on a bili-blanket. It seemed to make him uncomfortable, mainly because in order to work has to have access to the skin, so all his little blankets and supports and cushioning had to be moved/repositioned. He is also such a squirmy guy that he kept knocking his eye protection off. Fortunately his labs improved in 24 hours and we were able to remove that again today. Almost right after the bili-blanket was removed he settled down into a quiet, calm, very relaxed state which was comforting to see.
At this point we have pretty much traded one hospital room for another. Everyone in the NICU is very welcoming, the rooms are private and have sleeper couches/rockers etc, and parents are encouraged to participate in as many of the cares as we are able. So I still get to check temperatures, change diapers, and help with dressing. I was able to hold him in "K care" (kangaroo care) twice, but we had to put this on hold when his vent settings and bili light were active; we hope to resume K care again tomorrow. So far I am spending nights at home, but will likely spend some with Will especially as he gets closer to coming home and I get to take over more of his needs. His care team has been wonderful, involving us where they can, answering questions, and speaking directly with us on rounds and in making plans so we are always updated and clear on what is happening and what is expected.
The neonatologist today said it well in that "he is a preemie, and we have to remember to allow him to act like one." Today we would have completed 33 weeks pregnant; instead Will 5 days old. And I have been grateful for every one of them!
" He's a good size"
"He seems long"
These are the most common variations of the theme surrounding our new man. Every conversation with every staff member (nursing, aides, docs, RT) somehow includes a comment on William's over achieving dimensions. At 5lb 5 oz and 18in at birth, that put him into the 95% for a 32 wk baby, and is more average for 34-35 wks. Even with the expected weight loss that all babies have, he still is 5lb even today. Will has been getting some protein and sugar through his IV, but the majority of his nutrition is through a feeding tube. He is too young to have developed the suck/swallow/breathe coordination needed for breast/bottle feeding, but has tolerated his tube feeding well. I have been pumping every three hours since about 6 hours after delivery; he started on a preemie formula but now is getting all breast milk which I consider a personal victory. He feeds so well though that they have been increasing how much he gets every day ~ so good for him, but now I need to keep up! The only minor downside to his, as his nurses have pointed out, is that when looking at him he appears older than he is, and therefore ends up creating higher expectations than we should have for him. This is especially important since he hasn't had any other extra problems really, his is just doing what a 32 wk born preemie will do!
In general since being born Will's biggest issue has been needing respiratory support, which is one of those things expected for being born at this gestational age. Initially he was on only CPAP and they increased the settings once on that. However his first full night he had a number of "spells." These spells are events where his heart rate and then oxygen levels drop below specific criteria, and we are told are not uncommon when born at 32 wks. Some babies come out of these spells on their own, others need external stimulation to do so. Will was needing enough extra help to break the spells that they changed him to additional ventilator support. He didn't need an invasive breathing tube put into his lungs, but was able to get the extra support and breaths delivered through his cannula. They also started giving him caffeine thru the IV ~ yes, the same ingredient in the much needed coffee that gets me going in the morning. As a stimulant, it helps preemies "remember" to breathe, making the spells less frequent and less severe. I guess I don't need to worry about having my coffee while pumping/nursing with this one! Fortunately in all this he didn't require much if any extra oxygen delivery, and has not yet needed surfactant, which are both good signs. The spells have gotten less frequent and he has been able to pull himself out of them more often than not over the past day. Today they plan to cut back the ventilator support and get back to standard CPAP; if this goes well they will continue to cut back the breathing supports over the next few days.
Another common preemie issue is jaundice. Initially his bilirubin wasn't too high, but it kept trending up so he was put on a bili-blanket. It seemed to make him uncomfortable, mainly because in order to work has to have access to the skin, so all his little blankets and supports and cushioning had to be moved/repositioned. He is also such a squirmy guy that he kept knocking his eye protection off. Fortunately his labs improved in 24 hours and we were able to remove that again today. Almost right after the bili-blanket was removed he settled down into a quiet, calm, very relaxed state which was comforting to see.
At this point we have pretty much traded one hospital room for another. Everyone in the NICU is very welcoming, the rooms are private and have sleeper couches/rockers etc, and parents are encouraged to participate in as many of the cares as we are able. So I still get to check temperatures, change diapers, and help with dressing. I was able to hold him in "K care" (kangaroo care) twice, but we had to put this on hold when his vent settings and bili light were active; we hope to resume K care again tomorrow. So far I am spending nights at home, but will likely spend some with Will especially as he gets closer to coming home and I get to take over more of his needs. His care team has been wonderful, involving us where they can, answering questions, and speaking directly with us on rounds and in making plans so we are always updated and clear on what is happening and what is expected.
The neonatologist today said it well in that "he is a preemie, and we have to remember to allow him to act like one." Today we would have completed 33 weeks pregnant; instead Will 5 days old. And I have been grateful for every one of them!
Monday, July 8, 2013
Best of the alternatives
The 24hrs of July 4th-5th are hazy. What started as a laid back holiday and mini picnic in the room obviously ended with quite a bang! And the main thing is that Will is here, and doing well for being born at just 32 weeks.
I am also so thankful that all the planning for "worst case scenario" was in place but ultimately not needed. It made for a crowded OR ~ Chris counted 23 people in the room at one point ~ but fortunately we could say "thanks but no thanks" to a number of them. So of all the ways this delivery could have gone, other than early it really went the best way possible. I was able to have just the spinal anesthesia instead of needing general and being completely out; it was important to me that I be emotionally and mentally present for everything going on. They did do a larger vertical incision (instead of the common low horizontal one) at the request of the Gyn-Onc team; this was part of the "just in case" process that if I would have needed an emergency hysterectomy as well would have given the best/fastest access.
My blood pressure was low at baseline, so didn't have a lot of room to move but was being monitored closely. I got terribly nauseous several times from the low pressures, medications and all the "sensations" of the procedure itself. For not being able to feel pain, it was the most uncomfortable yet indescribable feeling. They warn that you'll feel "pressure" or "tugging." I'm not sure what I felt but it was something! I was tempted to watch a few times since I could see everything reflected in one of the lights if I wanted to, but decided against that for the most part. Although I may have watched more than Chris did ~ we haven't clarified that yet!
More importantly the placenta delivered as normally as could be expected. The entire surgery of course had some urgency besides the bleeding from the previa, the rest of my placenta lay anterior so had to be cut through to get to Will. This puts a time crunch on getting him out since his lifeline is cut just to get to him. Although I have gotten pretty anemic no transfusions needed, just some good makeup tricks to put some color back in my complexion. I'm still waiting for pathology results on the placenta but my OB said everything looked normal. They were great about updating me over the curtain as things were happening. I know that when things get too quiet it means there might be trouble, so the updates were reassuring.
Now it is on to recovery, which I am actively learning required more than I anticipated!
I am also so thankful that all the planning for "worst case scenario" was in place but ultimately not needed. It made for a crowded OR ~ Chris counted 23 people in the room at one point ~ but fortunately we could say "thanks but no thanks" to a number of them. So of all the ways this delivery could have gone, other than early it really went the best way possible. I was able to have just the spinal anesthesia instead of needing general and being completely out; it was important to me that I be emotionally and mentally present for everything going on. They did do a larger vertical incision (instead of the common low horizontal one) at the request of the Gyn-Onc team; this was part of the "just in case" process that if I would have needed an emergency hysterectomy as well would have given the best/fastest access.
My blood pressure was low at baseline, so didn't have a lot of room to move but was being monitored closely. I got terribly nauseous several times from the low pressures, medications and all the "sensations" of the procedure itself. For not being able to feel pain, it was the most uncomfortable yet indescribable feeling. They warn that you'll feel "pressure" or "tugging." I'm not sure what I felt but it was something! I was tempted to watch a few times since I could see everything reflected in one of the lights if I wanted to, but decided against that for the most part. Although I may have watched more than Chris did ~ we haven't clarified that yet!
More importantly the placenta delivered as normally as could be expected. The entire surgery of course had some urgency besides the bleeding from the previa, the rest of my placenta lay anterior so had to be cut through to get to Will. This puts a time crunch on getting him out since his lifeline is cut just to get to him. Although I have gotten pretty anemic no transfusions needed, just some good makeup tricks to put some color back in my complexion. I'm still waiting for pathology results on the placenta but my OB said everything looked normal. They were great about updating me over the curtain as things were happening. I know that when things get too quiet it means there might be trouble, so the updates were reassuring.
Now it is on to recovery, which I am actively learning required more than I anticipated!
Sunday, July 7, 2013
Recovery
I don't know what I expected, but this wasn't quite it. The last few days have made it obvious that I hadn't given much thought to recovering from surgery.
Certainly I thought a lot about Will's arrival ~ when would it be? would it be controlled or emergency? would Chris make it on time if he wasn't here? would I need transfusions or a hysterectomy? And of course I thought plenty about how Will would do related to all these same questions. What will the NICU experience be like? Will he be stable? What can I do to make his chances for success better?
But I apparently never thought much about recovering from the C section itself. I knew I would have less strength and stamina after being on bed rest for so long, and that is no surprise. Perhaps I was unprepared because of stories related from friends who have had C sections and preferred that option. Or the cliché of "to posh to push" suggesting a C section would be easier? Either way my body has been loud and clear the past few nights ~ hello lady, you had surgery, sit down and rest and take some meds! I'm not complaining, just adjusting. And things are definitely getting better as I am scaling back on types and amounts of meds.
I'm trying to let the positive reinforcement do some good. I'm not sure if the nurses and staff are just trying to convince me, or if I really look like I feel better than I do, but either way I'll take it.
Certainly I thought a lot about Will's arrival ~ when would it be? would it be controlled or emergency? would Chris make it on time if he wasn't here? would I need transfusions or a hysterectomy? And of course I thought plenty about how Will would do related to all these same questions. What will the NICU experience be like? Will he be stable? What can I do to make his chances for success better?
But I apparently never thought much about recovering from the C section itself. I knew I would have less strength and stamina after being on bed rest for so long, and that is no surprise. Perhaps I was unprepared because of stories related from friends who have had C sections and preferred that option. Or the cliché of "to posh to push" suggesting a C section would be easier? Either way my body has been loud and clear the past few nights ~ hello lady, you had surgery, sit down and rest and take some meds! I'm not complaining, just adjusting. And things are definitely getting better as I am scaling back on types and amounts of meds.
I'm trying to let the positive reinforcement do some good. I'm not sure if the nurses and staff are just trying to convince me, or if I really look like I feel better than I do, but either way I'll take it.
Fireworks (part 2) - He's Here!
There was something different about this one. I had almost gotten used to the little bleeds - random episodes (which for me were always overnight) that required some extra monitoring, sometimes extra medications, consideration for transfusion or other interventions that proved time and again why I was living in the hospital. But this past week has felt different ~ more unsettled, more episodes of contractions or bleeding. Generally these didn't even happen together, and this is the time for Braxton Hicks to show up; baby looked great on every monitoring event we did. And the doctors were technically more surprised on the nights I had no events than the nights I had small ones, which in a weird way was reassuring. But still it felt different.
At 10:15 on the 4th of July I was dozing off, waiting for my nurse to do night assessments and listening to the neighborhood fireworks. Oh, and I started bleeding again; but this started different. Usually when these happened I would only wake Chris (always happened at night!) if they escalated the plan for monitoring or moved me to the L&D floor "just to be safe." My nurse happened to come in just as I was going to call for her, so instead I let Chris know. Just felt like this wouldn't turn out to be one of those wait and see nights. I could tell right away the bleeding was more significant and steady; the fact that the number of nurses in my room kept steadily increasing was a sign as well. Oh, and that the doctors showed up at my bedside 10 min later rather than the usual phone consult for my usual behavior. The conversation with Chris went from "hey something is happening" to "give a heads up to our dear friends re: staying with Lydia if needed" to "come ASAP" in the same amount of time it took to type that.
Fortunately this wasn't technically a "crash C section" nor was I really hemorrhaging ~ but it was obvious this wasn't going to stop soon. I was on the monitors by 10:20 and down to the L&D floor by 10:30. Contractions started then and continuously became stronger and real, and with each contraction the bleeding picked up. It looked like this was as controlled a situation as we were going to get, and the decision was made by 10:40 that we were delivering this baby in short order. Quick paperwork, lab draws, baby blue scrubs for Chris, re-consulting with the NICU and GYN-ONC surgical team, meeting with anesthesia, and in-bed scrub down while wheeling to the OR quickly followed. They had Chris wait on a very lonely looking chair just outside the OR while they finished getting me prepped. I just kept hoping he wasn't having PTSD from our first semi-traumatic delivery while sitting out there alone in the hall (except for everyone rushing past to get into my OR room). Luckily things were "stable enough" I could start with a spinal so I didn't have to be put to sleep unless "things progressed." These terms are all nebulous enough to be reassuring...at least for those who don't already speak medical.
Spinal in and working (thank goodness too because contractions at this point were true labor pain intensity); Chris invited into the room & sitting by my head (reminds me what great eyes he has when that's all I can see of his face); the NICU team arrived and ready and GYN/ONC on standby & we are ready to begin. One of the highlights is that even my regular OB was out of the call schedule for the week, she came in to assist her partner for my surgery anyway. Her dedication to getting us through this with our sanity and health has been awesome.
I'm not sure exactly when surgery started, but I know that at 11:25 on July 4th our big little man entered the world! William Oliver let out a squeaky cry to announce his own arrival, all 5lb 5oz and 18 in of him. It was the best sound, and I cried to celebrate it ~ we both kept this going for a bit. He went straight over to the NICU team, and once assessed and well enough, took a pit stop in his isolette at the head of my bed for a glimpse before heading up to the NICU with his proud daddy in tow.
Of course they aren't done with me yet, but that is for another post. What is important now is that Will is here, so far doing relatively well considering he was only 32 wks + 2 d, and we love him terribly. Each day since his birth has been another adventure, one we expect to continue for a lifetime. But now we take it day by day, and pray he continues to be the strong little miracle we know.
At 10:15 on the 4th of July I was dozing off, waiting for my nurse to do night assessments and listening to the neighborhood fireworks. Oh, and I started bleeding again; but this started different. Usually when these happened I would only wake Chris (always happened at night!) if they escalated the plan for monitoring or moved me to the L&D floor "just to be safe." My nurse happened to come in just as I was going to call for her, so instead I let Chris know. Just felt like this wouldn't turn out to be one of those wait and see nights. I could tell right away the bleeding was more significant and steady; the fact that the number of nurses in my room kept steadily increasing was a sign as well. Oh, and that the doctors showed up at my bedside 10 min later rather than the usual phone consult for my usual behavior. The conversation with Chris went from "hey something is happening" to "give a heads up to our dear friends re: staying with Lydia if needed" to "come ASAP" in the same amount of time it took to type that.
Fortunately this wasn't technically a "crash C section" nor was I really hemorrhaging ~ but it was obvious this wasn't going to stop soon. I was on the monitors by 10:20 and down to the L&D floor by 10:30. Contractions started then and continuously became stronger and real, and with each contraction the bleeding picked up. It looked like this was as controlled a situation as we were going to get, and the decision was made by 10:40 that we were delivering this baby in short order. Quick paperwork, lab draws, baby blue scrubs for Chris, re-consulting with the NICU and GYN-ONC surgical team, meeting with anesthesia, and in-bed scrub down while wheeling to the OR quickly followed. They had Chris wait on a very lonely looking chair just outside the OR while they finished getting me prepped. I just kept hoping he wasn't having PTSD from our first semi-traumatic delivery while sitting out there alone in the hall (except for everyone rushing past to get into my OR room). Luckily things were "stable enough" I could start with a spinal so I didn't have to be put to sleep unless "things progressed." These terms are all nebulous enough to be reassuring...at least for those who don't already speak medical.
Spinal in and working (thank goodness too because contractions at this point were true labor pain intensity); Chris invited into the room & sitting by my head (reminds me what great eyes he has when that's all I can see of his face); the NICU team arrived and ready and GYN/ONC on standby & we are ready to begin. One of the highlights is that even my regular OB was out of the call schedule for the week, she came in to assist her partner for my surgery anyway. Her dedication to getting us through this with our sanity and health has been awesome.
I'm not sure exactly when surgery started, but I know that at 11:25 on July 4th our big little man entered the world! William Oliver let out a squeaky cry to announce his own arrival, all 5lb 5oz and 18 in of him. It was the best sound, and I cried to celebrate it ~ we both kept this going for a bit. He went straight over to the NICU team, and once assessed and well enough, took a pit stop in his isolette at the head of my bed for a glimpse before heading up to the NICU with his proud daddy in tow.
Of course they aren't done with me yet, but that is for another post. What is important now is that Will is here, so far doing relatively well considering he was only 32 wks + 2 d, and we love him terribly. Each day since his birth has been another adventure, one we expect to continue for a lifetime. But now we take it day by day, and pray he continues to be the strong little miracle we know.
Friday, July 5, 2013
32 weeks and Fireworks (part 1)
Well this post has needed some revisions, and additions since it was started (see Fireworks part 2 to follow). A couple days ago I was planning to update with our newest information and associated updated timeline ~
Our growth scan/US for 32 wks was done 7/1, and keeping up with previous measurements this little one was no longer so little ~ at least for gestational age. Major bone lengths, head and abdominal girth were all closer to an average for 34 wks. We were guessing what the weight would be; 4 1/4 lbs? 4 1/2? Either of those are well ahead of average. You can imagine my reaction when she told us an estimated 5 lbs 1 oz! Good thing we're planning a C section - a full term baby would be at least 10 lbs at this rate!
Next, we finally had a C section date set, following some discussion in deciding the best timing in the 34-36 week window. The dilemma being both to give baby longer to mature and in trying to not push our luck with my bleeding events; all with a lot of professional opinions out there but no solid data to guide the choice one way or another. Ultimately we settled on a date and I knew no matter what, I was looking at 3 more weeks at the most. It felt good to have that "one last goal" in place, although with all the back and forth I wondered if it would matter.
The past week somehow I had been feeling different. I can't say how, just know I had this feeling I wasn't going to get much farther. I was certainly getting much bigger though! And with this last growth spurt came more frequent "minor" bleeds, expected really for this phase of baby and uterus growth. No matter how expected though, it still makes for sleepless nights and drowsy days. My pattern has been nighttime events all along, and each time is harder to fall back asleep as I can't help but wonder if it is done or if this is going to turn into "the big one."
On July 4th my always entertaining husband suggests the middle name "Pendence" ~ which I was more confused by than anything. We had already narrowed a list of middle names, and I had no idea where this was coming from...until he also says we'd have to change the first name to "Indy" if it was going to work. Ha ha, always the joker! Of course I was clear that was not going to happen, besides the only way that would work would be to have this baby on that same day. So instead we had our hospital provided "picnic" lunch (another long stay patient perk) complete with table cloth and picnic basket & all took naps at various points in the day. We said our good nights as usual, and Chris headed out to tuck Lydia in at home after she gave baby hugs. (This has been the cutest thing, as she hugs my belly, gives kisses and talks directly to my belly button as if it is a direct portal to communicate with "her baby").
Another evening, ready to tuck in and just waiting for my nurse to do her nighttime assessment. We always plan for that between 10-10:30 so that I can have the "do not disturb" status then until 6:30 am unless I need something ~ just another perk! And then promptly at 10:15 my nurse arrived, as did more bleeding. Which became more bleeding...and more nurses, and the start to our very own fireworks extravaganza! This July 4th birthday suddenly felt not just possible, but likely.
Our growth scan/US for 32 wks was done 7/1, and keeping up with previous measurements this little one was no longer so little ~ at least for gestational age. Major bone lengths, head and abdominal girth were all closer to an average for 34 wks. We were guessing what the weight would be; 4 1/4 lbs? 4 1/2? Either of those are well ahead of average. You can imagine my reaction when she told us an estimated 5 lbs 1 oz! Good thing we're planning a C section - a full term baby would be at least 10 lbs at this rate!
Next, we finally had a C section date set, following some discussion in deciding the best timing in the 34-36 week window. The dilemma being both to give baby longer to mature and in trying to not push our luck with my bleeding events; all with a lot of professional opinions out there but no solid data to guide the choice one way or another. Ultimately we settled on a date and I knew no matter what, I was looking at 3 more weeks at the most. It felt good to have that "one last goal" in place, although with all the back and forth I wondered if it would matter.
The past week somehow I had been feeling different. I can't say how, just know I had this feeling I wasn't going to get much farther. I was certainly getting much bigger though! And with this last growth spurt came more frequent "minor" bleeds, expected really for this phase of baby and uterus growth. No matter how expected though, it still makes for sleepless nights and drowsy days. My pattern has been nighttime events all along, and each time is harder to fall back asleep as I can't help but wonder if it is done or if this is going to turn into "the big one."
On July 4th my always entertaining husband suggests the middle name "Pendence" ~ which I was more confused by than anything. We had already narrowed a list of middle names, and I had no idea where this was coming from...until he also says we'd have to change the first name to "Indy" if it was going to work. Ha ha, always the joker! Of course I was clear that was not going to happen, besides the only way that would work would be to have this baby on that same day. So instead we had our hospital provided "picnic" lunch (another long stay patient perk) complete with table cloth and picnic basket & all took naps at various points in the day. We said our good nights as usual, and Chris headed out to tuck Lydia in at home after she gave baby hugs. (This has been the cutest thing, as she hugs my belly, gives kisses and talks directly to my belly button as if it is a direct portal to communicate with "her baby").
Another evening, ready to tuck in and just waiting for my nurse to do her nighttime assessment. We always plan for that between 10-10:30 so that I can have the "do not disturb" status then until 6:30 am unless I need something ~ just another perk! And then promptly at 10:15 my nurse arrived, as did more bleeding. Which became more bleeding...and more nurses, and the start to our very own fireworks extravaganza! This July 4th birthday suddenly felt not just possible, but likely.
Sunday, June 23, 2013
Into the 30's
So, what is new? Nothing really, which in my confined little world is a good thing. Today is 30 weeks and 5 days along, and being in the 30's feels so much better than having been in the 20's. Hard to believe I've been inpatient for 6 of the last 7 weeks and doing the bed rest routine that entire 7 weeks. I've had a few more "minor" episodes of bleeding since the last post, each time confirming why I am here. They've become routine enough that they almost don't bother me. Of course there is always still the lingering question of when one of them will be significant enough to demand additional interventions, or even delivery. But I stay thankful for everyday that we stay pregnant.
Having said that, the most concrete evidence of all this time passing is that I feel huge. This kiddo has been measuring ahead on each evaluation, and the last few days I'm feeling it! And talk about activity, there is plenty of muscle building going on in there with the work out this one is constantly doing. Doing the monitoring is one of my favorite parts of the day, listening to the heartbeat going up and down and watching all the activity tracked out in little dots. Of course I can also watch all the activity directly on my abdomen too, no subtlety there anymore! I just hope this one figures out daytime/nighttime more accurately before the big arrival, because is certainly a night owl so far. Between frequent bathroom trips and then constant kicks to the bladder/ribs sleeping is a bit of a luxury already.
Lydia asks almost every day if /when "her" baby is coming, to which I respond not yet. And she follows with pretty soon? Fortunately her concept of time isn't terribly accurate yet, so I still hope that no matter what time this baby comes, to her this entire time will seem short lived.
Keeping our fingers crossed with each day that will total another week and then another month. We are knocking on the door to 31 weeks, with the next big step really being 32. Then on to 34, and hopefully 36!
Having said that, the most concrete evidence of all this time passing is that I feel huge. This kiddo has been measuring ahead on each evaluation, and the last few days I'm feeling it! And talk about activity, there is plenty of muscle building going on in there with the work out this one is constantly doing. Doing the monitoring is one of my favorite parts of the day, listening to the heartbeat going up and down and watching all the activity tracked out in little dots. Of course I can also watch all the activity directly on my abdomen too, no subtlety there anymore! I just hope this one figures out daytime/nighttime more accurately before the big arrival, because is certainly a night owl so far. Between frequent bathroom trips and then constant kicks to the bladder/ribs sleeping is a bit of a luxury already.
Lydia asks almost every day if /when "her" baby is coming, to which I respond not yet. And she follows with pretty soon? Fortunately her concept of time isn't terribly accurate yet, so I still hope that no matter what time this baby comes, to her this entire time will seem short lived.
Keeping our fingers crossed with each day that will total another week and then another month. We are knocking on the door to 31 weeks, with the next big step really being 32. Then on to 34, and hopefully 36!
Thursday, June 6, 2013
Another event: not IF but when
This past weekend brought another bit of perspective. Everything really is relative - the term "bed rest" in general, along with monitoring, next step, next bleed, all of it. Over the weekend I had another bleed, which considering this is now technically the 4th I would think we could get used to this. However every event has its own circumstances, and this last time wasn't as brief as the prior ones had been.
It all started the same, but since it continued much longer I was moved to the Labor & Delivery floor for continuous fetal monitoring, frequent lab checks and more medications. I got another round of steroids to help the baby's lungs mature, and this time I got a magnesium infusion. Initially this was started in case I would have to deliver, as it has been shown to help stabilize the baby's neurological status. However it was then continued longer because I also started showing contractions on the monitor, and traditionally the magnesium has been used to help relax the uterus. The thought in my case is the blood was irritating enough to the uterus to cause the contractions. Fortunately that subsided as well. The medications were no stroll in the park, and left me actually feeling "unwell" and dependent on cares for the first time I've been in here. I couldn't eat for two days, both wasn't allowed and didn't feel like it. I was apparently pretty close to getting blood transfusion too, but then the bleeding slowed enough they decided to hold off. Overall the entire 3ish days are kind of a haze, between the lack of sleep, medication side effects and general anxiety over what is next.
Tuesday turned out to be our magic day, as the bleeding subsided and we hit the 28 wk milestone. I was able to move back into my "long term" room, and am slowly getting back on my feet so to speak. Really I'm just going one day at a time initially being allowed out of bed to the bathroom, then a sitting shower today, being able to skip the middle of the night checks to catch up on sleep. I'm back in my own clothes and allowed to eat with an appetite coming back.
All of this was more assurance that this pattern will in fact continue; I will have more bleeds, need more monitoring, more treatments, etc. That much is clear. The big unknown is when the next one will be, how long it will last, and most importantly will it lead to delivering this little bean? Each time we hear there are a number of interventions to take before delivery since the longer we stay pregnant the better. It is a little unsettling because some of the staff seem to have slightly different thresholds for what that next step might be, and a different tolerance for how much "watching and waiting" they will tolerate. Obviously I personally would rather wait as long as possible even if that means blood transfusions, more infusions, monitoring and less sleep. But for now we wait, hoping the next event is some time away and that it will be a minor one, but knowing it is coming none the less.
It all started the same, but since it continued much longer I was moved to the Labor & Delivery floor for continuous fetal monitoring, frequent lab checks and more medications. I got another round of steroids to help the baby's lungs mature, and this time I got a magnesium infusion. Initially this was started in case I would have to deliver, as it has been shown to help stabilize the baby's neurological status. However it was then continued longer because I also started showing contractions on the monitor, and traditionally the magnesium has been used to help relax the uterus. The thought in my case is the blood was irritating enough to the uterus to cause the contractions. Fortunately that subsided as well. The medications were no stroll in the park, and left me actually feeling "unwell" and dependent on cares for the first time I've been in here. I couldn't eat for two days, both wasn't allowed and didn't feel like it. I was apparently pretty close to getting blood transfusion too, but then the bleeding slowed enough they decided to hold off. Overall the entire 3ish days are kind of a haze, between the lack of sleep, medication side effects and general anxiety over what is next.
Tuesday turned out to be our magic day, as the bleeding subsided and we hit the 28 wk milestone. I was able to move back into my "long term" room, and am slowly getting back on my feet so to speak. Really I'm just going one day at a time initially being allowed out of bed to the bathroom, then a sitting shower today, being able to skip the middle of the night checks to catch up on sleep. I'm back in my own clothes and allowed to eat with an appetite coming back.
All of this was more assurance that this pattern will in fact continue; I will have more bleeds, need more monitoring, more treatments, etc. That much is clear. The big unknown is when the next one will be, how long it will last, and most importantly will it lead to delivering this little bean? Each time we hear there are a number of interventions to take before delivery since the longer we stay pregnant the better. It is a little unsettling because some of the staff seem to have slightly different thresholds for what that next step might be, and a different tolerance for how much "watching and waiting" they will tolerate. Obviously I personally would rather wait as long as possible even if that means blood transfusions, more infusions, monitoring and less sleep. But for now we wait, hoping the next event is some time away and that it will be a minor one, but knowing it is coming none the less.
Saturday, June 1, 2013
The Lucky Room & Long Stay Privileges
As further evidence that I'm not going anywhere, I was able to switch rooms into a bigger/better layout. I know first hand what that means for inpatients from my own work. It's always the same, big room switch = long stay expected. I have however had a number of nursing staff and even housekeeping comment on how this is also the lucky room. And I also know first hand that some rooms do seem to have either good or bad vibes associated with them - so perception or reality, I'll take it! It makes sleep overs easier, and keeps Lydia out of medical equipment (mostly).
Then exhibit #2 is the visit from the nurse educator, which was basically an orientation of sorts to all things special for the long stay patients. Some are simple things like access to the "activity cart" with miscellaneous movies, books, crafts, games, etc. There is an expanded menu & take out binder, parking passes, family dining passes. She encouraged me to make the room as homelike as I wanted - bring pictures, artwork, of course my own clothes & bedding. Surprisingly I learned Charlie can come visit since his immunizations are up to date, provided he's had a bath. I can even bring a mini-fridge in if I want since I can't walk down to the "nourishment room" and then am not dependent on cafeteria delivery hours. She gave me hints to areas of the hospital that aren't in use during evenings & weekends so we can head over there for a change of scenery & more space now that I have wheelchair privileges. My OB cut back on monitoring overnight enough that I officially am a "do not disturb" between 11p-7a ~ another long stay patient privilege. Of course if I need anything they are in here in a flash and that goes away if anything clinically changes, but at least I have the option of uninterrupted sleep for now.
I have been readmitted now a week (again), and am trying to pretend I have some kind of schedule. It does help and was advice from a friend with her own bed rest experience. I am just starting to be able to "sleep in" which really means waking up at 6:30-7 instead of 5:15, but then there is less time to fill during the day. Weekdays all run together - wake up, breakfast, news, Today Show or GMA, get hooked up to monitor, maybe watch Kelly & Michael, local news, shower, lunch, "project time" ie - read books, do puzzles, blog, email, pay bills, make phone calls, play games (I had a few more options when I was home, but from here that is about it), maybe nap, then dinner, more TV or movies or reading, more news, then sleep. Any visits that happen are a welcome break in the day. There are apparently 5 or 6 other antepartum patients right now as well; supposedly they give us the option to all be wheeled to the lounge once or twice a week as a sort of support group. Since so far I haven't met any of them yet I have no idea how long they are all expected to be here, or if I will end up seeing a number of them come and go home during my stay. For today I am looking forward to a nice long visit with Chris & Lydia, and a wheel chair trip for a change of scenery, maybe even fresh air in the courtyard. If I'm lucky tomorrow will be more of the same before the weekday "schedule" starts again.
.
Then exhibit #2 is the visit from the nurse educator, which was basically an orientation of sorts to all things special for the long stay patients. Some are simple things like access to the "activity cart" with miscellaneous movies, books, crafts, games, etc. There is an expanded menu & take out binder, parking passes, family dining passes. She encouraged me to make the room as homelike as I wanted - bring pictures, artwork, of course my own clothes & bedding. Surprisingly I learned Charlie can come visit since his immunizations are up to date, provided he's had a bath. I can even bring a mini-fridge in if I want since I can't walk down to the "nourishment room" and then am not dependent on cafeteria delivery hours. She gave me hints to areas of the hospital that aren't in use during evenings & weekends so we can head over there for a change of scenery & more space now that I have wheelchair privileges. My OB cut back on monitoring overnight enough that I officially am a "do not disturb" between 11p-7a ~ another long stay patient privilege. Of course if I need anything they are in here in a flash and that goes away if anything clinically changes, but at least I have the option of uninterrupted sleep for now.
I have been readmitted now a week (again), and am trying to pretend I have some kind of schedule. It does help and was advice from a friend with her own bed rest experience. I am just starting to be able to "sleep in" which really means waking up at 6:30-7 instead of 5:15, but then there is less time to fill during the day. Weekdays all run together - wake up, breakfast, news, Today Show or GMA, get hooked up to monitor, maybe watch Kelly & Michael, local news, shower, lunch, "project time" ie - read books, do puzzles, blog, email, pay bills, make phone calls, play games (I had a few more options when I was home, but from here that is about it), maybe nap, then dinner, more TV or movies or reading, more news, then sleep. Any visits that happen are a welcome break in the day. There are apparently 5 or 6 other antepartum patients right now as well; supposedly they give us the option to all be wheeled to the lounge once or twice a week as a sort of support group. Since so far I haven't met any of them yet I have no idea how long they are all expected to be here, or if I will end up seeing a number of them come and go home during my stay. For today I am looking forward to a nice long visit with Chris & Lydia, and a wheel chair trip for a change of scenery, maybe even fresh air in the courtyard. If I'm lucky tomorrow will be more of the same before the weekday "schedule" starts again.
.
The Good & Bad days
Some days are better than others which probably goes without saying.
On bad days, I alternate between concerns for my husband also being now a single dad, for our daughter's routine being disrupted and for mommy not being there, and of course for our baby, the little bundle that is moving and growing and thriving but needs to stay put for much longer. I am so sad about all the things I am missing in their lives & outside these walls. Then I feel guilty because those are selfish feelings when I know that being here gives baby the best options if needing to come early or preventing baby from doing so. It is the most mentally exhausting thing I have done. Some days I find I can accept it all and am in good spirits, other days I spend crying. Plenty of days have a mix of both. On bad days I shed a lot of tears, sometimes it seems for no reason and every reason all at once. It feels surreal like this is all a bad dream, I can't possibly really be stuck in these four walls for a couple more months when I've only survived just over 2 weeks so far! The days blend together and I wonder how I will function back in life again, especially considering when I get discharged it may very well be with a newborn! A lot of days I feel like I'm just getting bigger and weaker and dumber all at once. How am I going to be there for my family when I haven't physically done anything for months? And how am I going to function when I go back to work (both physically and mentally), which will probably have to be much earlier than planned since I am using so much of my leave before the baby is even here?
Then on good days I am at peace with this disruption since it really is the biggest reminder of how far we've come. I am pregnant, simple as that. Although we know getting here really wasn't that simple, but here I am none the less. If this is what it takes to stay that way, then this is what we do. The reality is I would do this all over again as much as needed for our little one. I recognize how fortunate I am to have such supportive family, friends & coworkers. I am thankful for the luck of living close enough for daily visits from my husband and daughter. I truly appreciate the visits and calls from friends that go a long way in breaking up the day. I give thanks for the meals prepared for Chris & Lydia in my abscence and for the little treats or flowers or cards that are sent. Each message is a bright spot in my day and an awesome reminder of how much we are loved.
Thursday, May 30, 2013
Bedrest - technicalities of how we got here
I realized after reading the last entry that I didn't really explain why or how we ended up on bed rest, or in the hospital for that matter. I was going to post this after getting home, but now I'm back in the hospital again so figured I'd complete the (hopefully concise) summary. If medical details aren't your thing you may want to skim this one. Either way, I'm inpatient again and likely here to stay for a while.
To review, I was told we had a "low lying" placenta @ 16wks when we ended up in the ER with bleeding; was given light duty/activity restrictions. The intermittent spotting continued until about 20 wks. Then we had our formal high detail anatomy scan and confirmed a complete placenta previa. Since the spotting had essentially stopped at that point we continued with the light duty/pelvic rest.
Skip ahead to 24 weeks when without warning I had "significant" bleeding, which fortunately resolved relatively quickly. But considering how early this still was, the chance for it to start up again and the timing of monitoring & interventions for both me and baby, I was kept in the hospital for a full week. The first few days were a flurry of studies, meds, labs and consults as we went through the entire run down of the plan for worst case scenario which involved all the details of having to deliver at 24 weeks. I underwent a series of ultrasounds, an MRI to look closer at the placenta since the possibility of having placenta accreta (besides the known previa) not only is increased in my case, but also raises some of the risk factors surrounding delivery. Fortunately there was no evidence of that on the MRI, although no imaging study is perfect. I also received steroid injections to help the baby. Consults were with the NICU team, high risk Maternal-Fetal medicine specialists and gyn-onc surgeons (who apparently are backup in surgical cases that are "complex" which includes a potential hysterectomy at delivery in the setting of hemorrhage and disrupted anatomy due to enlarged uterus/blood vessels). Physical therapy gave me options to do while on bed rest for hopefully the following 14 wks. So like I said a flurry of information, prompting the needed emotional outlet of my last post.
Since everything stayed quiet during that week, I live quite close to the hospital, and am deemed a reliably compliant patient, they let me home on bed rest. I was home for 9 days and just getting mentally adjusted to home bed rest (ie - leaving the dishes/laundry/chores, adjusting to what I couldn't do with the family etc) when I had another "real" bleed, bringing us back to the hospital. Fortunately that episode also stopped, but now I expect to be hospitalized until I deliver. I am 27w 2d today. Short term goal has been getting to 28 wks, with the ultimate goal of getting to 36-38 wks for a scheduled C section. Of course a part of me hopes I have a chance to get home again for some time, but each day I accept a bit more that isn't going to happen.
To review, I was told we had a "low lying" placenta @ 16wks when we ended up in the ER with bleeding; was given light duty/activity restrictions. The intermittent spotting continued until about 20 wks. Then we had our formal high detail anatomy scan and confirmed a complete placenta previa. Since the spotting had essentially stopped at that point we continued with the light duty/pelvic rest.
Skip ahead to 24 weeks when without warning I had "significant" bleeding, which fortunately resolved relatively quickly. But considering how early this still was, the chance for it to start up again and the timing of monitoring & interventions for both me and baby, I was kept in the hospital for a full week. The first few days were a flurry of studies, meds, labs and consults as we went through the entire run down of the plan for worst case scenario which involved all the details of having to deliver at 24 weeks. I underwent a series of ultrasounds, an MRI to look closer at the placenta since the possibility of having placenta accreta (besides the known previa) not only is increased in my case, but also raises some of the risk factors surrounding delivery. Fortunately there was no evidence of that on the MRI, although no imaging study is perfect. I also received steroid injections to help the baby. Consults were with the NICU team, high risk Maternal-Fetal medicine specialists and gyn-onc surgeons (who apparently are backup in surgical cases that are "complex" which includes a potential hysterectomy at delivery in the setting of hemorrhage and disrupted anatomy due to enlarged uterus/blood vessels). Physical therapy gave me options to do while on bed rest for hopefully the following 14 wks. So like I said a flurry of information, prompting the needed emotional outlet of my last post.
Since everything stayed quiet during that week, I live quite close to the hospital, and am deemed a reliably compliant patient, they let me home on bed rest. I was home for 9 days and just getting mentally adjusted to home bed rest (ie - leaving the dishes/laundry/chores, adjusting to what I couldn't do with the family etc) when I had another "real" bleed, bringing us back to the hospital. Fortunately that episode also stopped, but now I expect to be hospitalized until I deliver. I am 27w 2d today. Short term goal has been getting to 28 wks, with the ultimate goal of getting to 36-38 wks for a scheduled C section. Of course a part of me hopes I have a chance to get home again for some time, but each day I accept a bit more that isn't going to happen.
Monday, May 13, 2013
Bedrest -"doing nothing really is doing a lot"
You'd think this post would just flow between the combination of new information and time on my hands. However for some reason it seems hard to put together. Maybe that's because I'm still processing it differently every day. The short story is I landed myself & baby bean in the hospital for the past 5 1/2 days, and now am officially on bed rest for the duration of this pregnancy. It has been quite the emotional flurry, changing from one moment to the next.
Now the long version...and I warn this may get really long.
I don't know why I'm at all surprised about being on bed rest now, especially with all the information & research we had done through this entire process. I knew well the potential added complexities of a post-Asherman's pregnancy. I even new early on that we may have placenta issues, and have already been compliant with my light duty restrictions. My OB even warned me she would have a low threshold for more conservative recommendations. Somehow though actually facing the reality of real bed rest is a daunting & overwhelming thing.
Initially I worried about work - that I might not be able to go back, trying to brainstorm ways to be fully sedentary but still useful from home, getting scheduling taken care of both because it is my responsibility and because I felt bad about potentially leaving my coworkers short so abruptly. Then I worried about Lydia - that she would be getting cheated from her usual routines of trips to Minocqua, the park, the zoo, having mommy at swimming and gymnastics. That kid is a crazy one though, and so far she thinks it is fun to visit mommy at the hospital and even have a sleep over on the weekend. Now I worry about my superman husband - who overnight has become full time dad & mom, while working & maintaining the house. People have been so kind in asking what they can do for me - really it will be what can people do for him! I know he can do it all, and will do so quite well, but he shouldn't have to. Then there are the relatively little worries, like how will I keep up my strength? How will I not be bored? Will I be able to pick up back at work after such a long time out? Will disability be another headache?
And of course I worry about this baby - not quite 2 lbs and too little for us to meet yet. It is one of those things I'm glad I never had need to know before, but in a short time we've learned a lot about what it means for this kiddo if delivery comes early. And how different that information is from just one week to the next at this point. When I got admitted we were 24wk 1d along - so 24wk 6d today, and making it into that next week is huge. Making into each of "the next week" is huge right now, so much that my short term goal is to keep cooking until 28 wks. The next goal will be 30wk, then 32 and so on. It also helps breakdown the calendar, when looking at bed rest in a couple weeks increments instead of 3 months, even though the ultimate goal is the same. There is no doubt this kid is a tough one, after all we've been through, to even get pregnant, to be at this point, is all part of an enormous miracle.
It was actually my OB who told me I have to remember that doing nothing right now really is doing a lot. That statement has become a bit of a mantra. I otherwise feel physically fine so far, and if I only think of that it seems silly to not be able to help with chores, go to work, etc. I'm making lists of questions to ask - can I do this or that? Not because I would push it, but because I need to know specifics. Being such a planner, this
I've had a few comments about how bed rest for a couple days would be nice. I won't lie, the first few days gave me more time to get some things taken care of than I'd had in months. Mornings aren't rushed & I've definitely caught up on news. So far I'm still awake early since that is what I'm used to, but literally get breakfast in bed (and lunch and dinner...). Someone else cleaned my bathroom and made my bed. So I won't argue with the sentiment that "a couple days of bed rest" would be nice - but this isn't just a couple days. Already this morning I woke up at 5:15, desperately wanting to sleep longer both because I'm allowed and because then the day isn't as long. I woke up bored. My highlight today has been being on the fetal monitor (the best white noise a person could ask for), planning my shower and when/what to order for meals! Yikes, I'm going to need some new distractions.
Now the long version...and I warn this may get really long.
I don't know why I'm at all surprised about being on bed rest now, especially with all the information & research we had done through this entire process. I knew well the potential added complexities of a post-Asherman's pregnancy. I even new early on that we may have placenta issues, and have already been compliant with my light duty restrictions. My OB even warned me she would have a low threshold for more conservative recommendations. Somehow though actually facing the reality of real bed rest is a daunting & overwhelming thing.
Initially I worried about work - that I might not be able to go back, trying to brainstorm ways to be fully sedentary but still useful from home, getting scheduling taken care of both because it is my responsibility and because I felt bad about potentially leaving my coworkers short so abruptly. Then I worried about Lydia - that she would be getting cheated from her usual routines of trips to Minocqua, the park, the zoo, having mommy at swimming and gymnastics. That kid is a crazy one though, and so far she thinks it is fun to visit mommy at the hospital and even have a sleep over on the weekend. Now I worry about my superman husband - who overnight has become full time dad & mom, while working & maintaining the house. People have been so kind in asking what they can do for me - really it will be what can people do for him! I know he can do it all, and will do so quite well, but he shouldn't have to. Then there are the relatively little worries, like how will I keep up my strength? How will I not be bored? Will I be able to pick up back at work after such a long time out? Will disability be another headache?
And of course I worry about this baby - not quite 2 lbs and too little for us to meet yet. It is one of those things I'm glad I never had need to know before, but in a short time we've learned a lot about what it means for this kiddo if delivery comes early. And how different that information is from just one week to the next at this point. When I got admitted we were 24wk 1d along - so 24wk 6d today, and making it into that next week is huge. Making into each of "the next week" is huge right now, so much that my short term goal is to keep cooking until 28 wks. The next goal will be 30wk, then 32 and so on. It also helps breakdown the calendar, when looking at bed rest in a couple weeks increments instead of 3 months, even though the ultimate goal is the same. There is no doubt this kid is a tough one, after all we've been through, to even get pregnant, to be at this point, is all part of an enormous miracle.
It was actually my OB who told me I have to remember that doing nothing right now really is doing a lot. That statement has become a bit of a mantra. I otherwise feel physically fine so far, and if I only think of that it seems silly to not be able to help with chores, go to work, etc. I'm making lists of questions to ask - can I do this or that? Not because I would push it, but because I need to know specifics. Being such a planner, this
I've had a few comments about how bed rest for a couple days would be nice. I won't lie, the first few days gave me more time to get some things taken care of than I'd had in months. Mornings aren't rushed & I've definitely caught up on news. So far I'm still awake early since that is what I'm used to, but literally get breakfast in bed (and lunch and dinner...). Someone else cleaned my bathroom and made my bed. So I won't argue with the sentiment that "a couple days of bed rest" would be nice - but this isn't just a couple days. Already this morning I woke up at 5:15, desperately wanting to sleep longer both because I'm allowed and because then the day isn't as long. I woke up bored. My highlight today has been being on the fetal monitor (the best white noise a person could ask for), planning my shower and when/what to order for meals! Yikes, I'm going to need some new distractions.
Wednesday, April 24, 2013
More restrictions & More milestones
After a brief but warm trip to Florida I came home with great expectations for our 20 week US. Knowing the placenta issues we were monitoring but also that the spotting seemed to be better had me hopeful things would be resolved. It turns out I'm not that lucky. So after taking a few days to feel sorry for myself, I realize we are at some big milestones!
Don't get me wrong I am ecstatic that the baby is perfect (of course), apparently I am the problem. More specifically that pesky placenta is the problem. Turns out I do have a complete previa; likely related to all things dating back from tricky delivery and Asherman's related. So now what? Well, fortunately I've already incorporated most of the activity restrictions that are just now indefinite. Perhaps I will still end up on bed rest, only time will tell. On my optimistic days I think it could still technically resolve, however unlikely in my case. But overall instead of worrying about that I am preventatively collecting book titles, movies, TV/radio series etc that come recommended as a back up plan in case I can not avoid it. I figure I never otherwise have the time for those extra things, so if I am prepared maybe I won't need it? Probably the hardest disappointment is that I can't spend my summer floating on the lake as I had planned, the bleeding risks/urgency are too high for me to be in the middle of nowhere. I admit to taking a day or so to feel sorry for myself, but really then I realized I could go to Florida because at that point it was considered too early for much interventions - now we are far enough along that both our outcomes are able to be managed more aggressively which is oddly comforting. And since at one point in time we thought we'd never get here, so what if I spend the summer sitting in a kiddie pool with a 2 year old? Or in the basement with the AC on high? I have more options than I once ever thought possible. So now I sit at 22 weeks (supposedly with the bean now the size of a papaya) un-planning the next few months, and really am fine with it. We'll know more at 32 weeks when we peek again.
Of course how can someone not look forward to more and detailed pictures of the baby at any point! That is really the highlight of the 20 week US. It really is amazing every time, and amusing this time as well since the little bean apparently didn't want to sit still for most of it. I thought I was crazy for thinking I could feel this one since week 15, but the US just confirmed that I'm not crazy (at least about this) - we actually have a little jumping bean. A perfect in every way, healthy, active & measuring all in the "normal" ranges jumping bean.
Additional fun is that Lydia has moved on from discussing her "baby sister and a fairy" to her baby sister and brother. No, let me be clear, we are not having twins. But somewhere apparently she has decided a baby brother instead of a fairy would be okay. She enthusiastically tells everyone that she has baby toys - for baby sister and brother. She plays her/him music, kisses him/her (right on my belly button so it can get inside), and is trying to decide if she thinks she should share her room/crib or if the baby should have her/his own since "babies cry a lot."
Don't get me wrong I am ecstatic that the baby is perfect (of course), apparently I am the problem. More specifically that pesky placenta is the problem. Turns out I do have a complete previa; likely related to all things dating back from tricky delivery and Asherman's related. So now what? Well, fortunately I've already incorporated most of the activity restrictions that are just now indefinite. Perhaps I will still end up on bed rest, only time will tell. On my optimistic days I think it could still technically resolve, however unlikely in my case. But overall instead of worrying about that I am preventatively collecting book titles, movies, TV/radio series etc that come recommended as a back up plan in case I can not avoid it. I figure I never otherwise have the time for those extra things, so if I am prepared maybe I won't need it? Probably the hardest disappointment is that I can't spend my summer floating on the lake as I had planned, the bleeding risks/urgency are too high for me to be in the middle of nowhere. I admit to taking a day or so to feel sorry for myself, but really then I realized I could go to Florida because at that point it was considered too early for much interventions - now we are far enough along that both our outcomes are able to be managed more aggressively which is oddly comforting. And since at one point in time we thought we'd never get here, so what if I spend the summer sitting in a kiddie pool with a 2 year old? Or in the basement with the AC on high? I have more options than I once ever thought possible. So now I sit at 22 weeks (supposedly with the bean now the size of a papaya) un-planning the next few months, and really am fine with it. We'll know more at 32 weeks when we peek again.
Of course how can someone not look forward to more and detailed pictures of the baby at any point! That is really the highlight of the 20 week US. It really is amazing every time, and amusing this time as well since the little bean apparently didn't want to sit still for most of it. I thought I was crazy for thinking I could feel this one since week 15, but the US just confirmed that I'm not crazy (at least about this) - we actually have a little jumping bean. A perfect in every way, healthy, active & measuring all in the "normal" ranges jumping bean.
Additional fun is that Lydia has moved on from discussing her "baby sister and a fairy" to her baby sister and brother. No, let me be clear, we are not having twins. But somewhere apparently she has decided a baby brother instead of a fairy would be okay. She enthusiastically tells everyone that she has baby toys - for baby sister and brother. She plays her/him music, kisses him/her (right on my belly button so it can get inside), and is trying to decide if she thinks she should share her room/crib or if the baby should have her/his own since "babies cry a lot."
Friday, March 29, 2013
Slowing it down
These last couple weeks have brought a bump in the road. Not terrible, and at this time so far so good, but a need for me to slow things down. The short story is it turns out I still have a "low lying placenta." We knew at our very first viability scan at seven weeks that the placenta was low, but at that point apparently a lot of them are, and as the baby/uterus grows, the placenta placement moves on up with it. I did have spotting early because of this and at least the physicians weren't surprised. My personal feelings at that time were another matter, but it resolved. Until last week when it started up again and was a new issue. Second trimester bleeding is abnormal - everything says so - to call right away. We went in and quickly the nurse found the bean's little heart beat and all was fine. Then we had even more bleeding, got sent to the ER, where again tests all looked good. This time we had another full US, which showed the placenta to still be "low lying." This pattern of events has bought me some activity restrictions at least until we are 20 weeks along. But again the bean looks good which is the ultimate goal.
So now what? It is nerve racking because every day now I have at least some anxiety over this. We had a great discussion with our OB last week about the whole thing. Basically we won't know for some time yet if the placenta will continue to move up or if it has just implanted low and will stay there. Hence the 20 week mark - which is when we have a detailed scan to look more closely at a number of things including the placenta. We will never know if this implantation is somehow related to my Asherman's and the never quite normal lining, or just dumb luck. It is estimated that 1 in 200 pregnancies have placenta previa - but they won't classify if I have this or to what degree formally until that magic 20 week appointment. In trying to ease my anxiety she said to consider it a good day when there is no spotting, but not to be surprised if there is some. And somehow that actually is helpful. As long as the bean stays well, we'll deal with it.
The hardest part to "no heavy lifting" means I'm not supposed to pick up Lydia. Her favorite game lately has been running to me to pick her up and rescue her from the dinosaur (her daddy) while he chases us around the kitchen. Then there is bedtime, which used to be a snuggle fest while I'd carry her upstairs. Now we've modified things to hold hands and run from the dinosaur or show me how big she is that she can reach the hand railing and walk up to bed herself. Some days I do hope she won't think she's "too big" for me to carry by the time I am able to again! Exercise is its own adjustment - I can walk and do "minor low impact things" but no weights/running which has been my mainstay. I never would have guessed how much sanity those runs gave me until being told I can't do them. Maybe it will help my post-partum workout motivation then?Thankfully my job isn't really anything that qualifies as heavy duty, at least not physically, so no changes there. It is mostly the things you don't think about, a lot of things weigh more than 10 lbs when you aren't supposed to be carrying it. I think I even have to empty out some of my purse!
On the up side the focus of slowing down does make me realize how frantic my days sometimes are, and really don't need to be that way. A month ago I would try to fit something in to every minute of the day, thinking I had to use each moment to be productive. Now if I find I have a 45 minute window, I'll take a nap or relax a bit rather than attempt 3 loads of laundry and vacuum the entire house. And wouldn't you know it - the world is still turning and we are still happy. So here's to hoping I can take remember this lesson when it isn't imposed upon me!
So now what? It is nerve racking because every day now I have at least some anxiety over this. We had a great discussion with our OB last week about the whole thing. Basically we won't know for some time yet if the placenta will continue to move up or if it has just implanted low and will stay there. Hence the 20 week mark - which is when we have a detailed scan to look more closely at a number of things including the placenta. We will never know if this implantation is somehow related to my Asherman's and the never quite normal lining, or just dumb luck. It is estimated that 1 in 200 pregnancies have placenta previa - but they won't classify if I have this or to what degree formally until that magic 20 week appointment. In trying to ease my anxiety she said to consider it a good day when there is no spotting, but not to be surprised if there is some. And somehow that actually is helpful. As long as the bean stays well, we'll deal with it.
The hardest part to "no heavy lifting" means I'm not supposed to pick up Lydia. Her favorite game lately has been running to me to pick her up and rescue her from the dinosaur (her daddy) while he chases us around the kitchen. Then there is bedtime, which used to be a snuggle fest while I'd carry her upstairs. Now we've modified things to hold hands and run from the dinosaur or show me how big she is that she can reach the hand railing and walk up to bed herself. Some days I do hope she won't think she's "too big" for me to carry by the time I am able to again! Exercise is its own adjustment - I can walk and do "minor low impact things" but no weights/running which has been my mainstay. I never would have guessed how much sanity those runs gave me until being told I can't do them. Maybe it will help my post-partum workout motivation then?Thankfully my job isn't really anything that qualifies as heavy duty, at least not physically, so no changes there. It is mostly the things you don't think about, a lot of things weigh more than 10 lbs when you aren't supposed to be carrying it. I think I even have to empty out some of my purse!
On the up side the focus of slowing down does make me realize how frantic my days sometimes are, and really don't need to be that way. A month ago I would try to fit something in to every minute of the day, thinking I had to use each moment to be productive. Now if I find I have a 45 minute window, I'll take a nap or relax a bit rather than attempt 3 loads of laundry and vacuum the entire house. And wouldn't you know it - the world is still turning and we are still happy. So here's to hoping I can take remember this lesson when it isn't imposed upon me!
Saturday, March 9, 2013
Another day in the life...
It is too quiet today. The lovely chaos that is my home is too quiet with no one there. I have to work, so the hubby took the monster (Lydia) and the dog with him for some quality grandparent time and will cap it off with Lydia's favorite event these days - a birthday party. She loves to sing Happy Birthday, loves to pretend to give presents, and of course loves to pretend to eat cake. Lets face it, she just loves cake. So the fact that she gets to do it all for real this weekend it so exciting & the anticipation has been building all week! But it means my house is too quiet. I probably should be productive after work since we have the usual never ending list of "to-do's" but instead I think early to bed is more in my future. I guess that counts as being productive since taking a nap is always on my list as well and that never happens!
Lydia has been in a music class for the last three months which is finishing in the next few weeks. Unfortunately I can't re-enroll her yet because of our work schedules and she is going to miss it so much. That little one has her daddy's dance moves too ~ for those of you who have witnessed that umm, situation, you can only imagine! Her enthusiasm is contagious too, also just like her daddy. Is is through the Music Together program, so we have some home materials and a CD, which I anticipate will be highly requested during the dance parties we routinely have in the living room. All are welcome to join, they happen almost daily. Although be warned at least half the time a dinosaur or ghost shows up and we have to run and hide, or run and chase, or just run in circles. Never a dull time. If you aren't careful though Lydia just might put you in time out.
So far things are well with us. Testing is all looking good, appointments are on track. I am in that great stage which explains why they create those T-shirts that say "I'm not fat, I'm pregnant" ~ makes me consider wearing one. We've been mentioning a little more to Lydia, just to see what she does/thinks/understands. Still not sure how much comprehension is there, but she brings the subject up on her own enough. Last week I was buckling her into her car seat and she says "Mommy where is baby sister?" So I answered that the baby would grow in mommy's belly until he/she was big enough to be with us at home. One of her favorite books right now is "God Gave Us You" (search Amazon ~ it is a super sweet book) in which a mama bear tells the story of little cub growing inside her until being born. We read it almost every night, and mama bear's belly gets "bigger and bigger and bigger" as little cub grows until she wants out. Again, not sure how much she really gets, but the other day she did tell me "Mama you have a baby brother in your belly" and proceeds to lift up my shirt to look for him/her and poke at my not fat but pregnant belly!
News of our baby bean is spreading. It is funny the comments we get especially from people who don't/wouldn't have known our whole story. I try not to make much of it, because how would they have known? But I do take that chance to put a little education out there especially since anyone around us may be quietly bearing their own burdens. The most innocent statements can be received very differently depending on your situation. I've gotten lots of things, but my personal favorite so far is the apparent conclusion that we've chosen perfect timing. The conversation is usually something like this:
Lydia has been in a music class for the last three months which is finishing in the next few weeks. Unfortunately I can't re-enroll her yet because of our work schedules and she is going to miss it so much. That little one has her daddy's dance moves too ~ for those of you who have witnessed that umm, situation, you can only imagine! Her enthusiasm is contagious too, also just like her daddy. Is is through the Music Together program, so we have some home materials and a CD, which I anticipate will be highly requested during the dance parties we routinely have in the living room. All are welcome to join, they happen almost daily. Although be warned at least half the time a dinosaur or ghost shows up and we have to run and hide, or run and chase, or just run in circles. Never a dull time. If you aren't careful though Lydia just might put you in time out.
So far things are well with us. Testing is all looking good, appointments are on track. I am in that great stage which explains why they create those T-shirts that say "I'm not fat, I'm pregnant" ~ makes me consider wearing one. We've been mentioning a little more to Lydia, just to see what she does/thinks/understands. Still not sure how much comprehension is there, but she brings the subject up on her own enough. Last week I was buckling her into her car seat and she says "Mommy where is baby sister?" So I answered that the baby would grow in mommy's belly until he/she was big enough to be with us at home. One of her favorite books right now is "God Gave Us You" (search Amazon ~ it is a super sweet book) in which a mama bear tells the story of little cub growing inside her until being born. We read it almost every night, and mama bear's belly gets "bigger and bigger and bigger" as little cub grows until she wants out. Again, not sure how much she really gets, but the other day she did tell me "Mama you have a baby brother in your belly" and proceeds to lift up my shirt to look for him/her and poke at my not fat but pregnant belly!
News of our baby bean is spreading. It is funny the comments we get especially from people who don't/wouldn't have known our whole story. I try not to make much of it, because how would they have known? But I do take that chance to put a little education out there especially since anyone around us may be quietly bearing their own burdens. The most innocent statements can be received very differently depending on your situation. I've gotten lots of things, but my personal favorite so far is the apparent conclusion that we've chosen perfect timing. The conversation is usually something like this:
"hey, heard you were pregnant, congrats"
"thanks, we are really beyond excited"
"and your daughter is what, 2 now?"
"yep, 2 going on 13"
"oh, that is just perfect timing for #2 - she'll be a great big sister"
"well, ah, ok - she sure will"
sometimes I'll add "actually it got complicated/ timing wasn't in our control/plan/etc" if I think they are receptive to some more information and go from there.
It does make me glad to have started this blog for yet another reason. It has helped us sort through so many things when there is no blueprint for guidance. It has provided a distraction, a reason to research, a way to share without coming emotionally undone repeatedly and a way to educate. It can be a reference and now a source of hope for fellow women with AS. I knew nothing of Asherman's before it happened to us, and it continues to be under recognized and under appreciated by not only the general population, but by medical professionals in general even in the OB/GYN specialty. So if this blog continues to help spread some knowledge and awareness in even the most diluted way, I consider that a small accomplishment.
Friday, February 22, 2013
More Waiting - to week 12
It feels a little odd to be waiting this long between appointments. And that "long" is only a month - but for the better part of the last year plus, my schedule has involved more frequent visits/phone calls/tests than even that. So this last month between weeks 8 and now (12 +!) has seemed to go on forever. We slowly let a handful more people in on our news. The great delay in telling others has a multitude of reasons. I'm paranoid at times still - and was afraid to say too much until after our appointment today. Of course there are also the appropriate chains that news of this sort needs to go through - and hold ups on sharing in one place limits our ability to share with others. Then there are friends/loved ones that have their own struggles - some with fertility, some with other matters - that make this an even more sensitive bit of information. The last thing I want to do is have our joys cause anyone else heartbreak. And I know it can happen - I know it isn't personal, I know it isn't intended - but I've seen both sides of it, and it is delicate. Finally, as much as our Asherman's struggles are documented here, part of me has wanted to own this pregnancy as just ours for a while. We felt the same on that with our first pregnancy - she was our secret for about this length of time as well.
But today feels more like a sharing day. We had our 12 week appointment along with a First Trimester Screen (I am of "advanced maternal age" afterall) - and all looked good again today. A strong little heart beat, a wave from five little fingers, a beautiful tiny profile. The placenta looks good so far - implanted in a different spot than last time (hopefully less likely to cause problems than if it was in a similar location) and no longer low. It is a good day, so we are starting that cascade of information and letting it spread as it will!
Next we wait for the blood work from the screening tests today, and wait for the next appointment. I can stop window shopping for maternity clothes, and start actually picking up a few more pieces (needed since I borrowed so much last time!). We haven't really said too much to Lydia - I don't think she understands things yet other than mommy being tired all the time - although she still mentions the "baby sister and a fairy" request. So maybe she's on to us more than we know; at least on occasion she'll say baby brother too, so hopefully she's not too picky!
But today feels more like a sharing day. We had our 12 week appointment along with a First Trimester Screen (I am of "advanced maternal age" afterall) - and all looked good again today. A strong little heart beat, a wave from five little fingers, a beautiful tiny profile. The placenta looks good so far - implanted in a different spot than last time (hopefully less likely to cause problems than if it was in a similar location) and no longer low. It is a good day, so we are starting that cascade of information and letting it spread as it will!
Next we wait for the blood work from the screening tests today, and wait for the next appointment. I can stop window shopping for maternity clothes, and start actually picking up a few more pieces (needed since I borrowed so much last time!). We haven't really said too much to Lydia - I don't think she understands things yet other than mommy being tired all the time - although she still mentions the "baby sister and a fairy" request. So maybe she's on to us more than we know; at least on occasion she'll say baby brother too, so hopefully she's not too picky!
Sunday, February 3, 2013
A baby sister(?) and a Fairy
Thank you for the quiet understanding of those few with whom we've shared our fabulous news so far. I've gotten over the not planning ahead, to the point that weeks are marked out on the calendar, some travel plans are being reconsidered, and I'm daydreaming about floating - big and swollen - in the lake for at least part of the summer. Now I just get anxious as the next appointments come around the corner. I have no reason to suspect anything is wrong, and most of the time I don't think there is, but this nagging little worrier in me craves the confirmation that things are fine with this bean so much more than I did with the peanut. I miss the blissful ignorance of that pregnancy. And I do realize my reference pool is completely skewed since all the women on the AS support page ended up there out of terrible circumstances - so really I need to pull back from that a little bit every so often.
The fun and amazing and heart warming things I get to focus on now are plentiful. I think often about the intuition of children - how instead of wishing for tacos on a star one night my niece wished for a baby for Lydia; how on the way to music class last week Lydia tells me she wants a baby sister and a fairy. Hopefully she'll be okay with a baby brother if that is what's in store, especially since I can't do anything about the fairy. But watching her play with her little friends makes me that much more excited to have a sibling on the way for her. And she has all sorts of things to tell this little bean - stories about animals and snowmobiling and friends and great adventures. Her enthusiasm for pretty much everything is endearing and inspiring. Of course sometimes she is a stubborn, crazy little maniac - but she is two!
The fun and amazing and heart warming things I get to focus on now are plentiful. I think often about the intuition of children - how instead of wishing for tacos on a star one night my niece wished for a baby for Lydia; how on the way to music class last week Lydia tells me she wants a baby sister and a fairy. Hopefully she'll be okay with a baby brother if that is what's in store, especially since I can't do anything about the fairy. But watching her play with her little friends makes me that much more excited to have a sibling on the way for her. And she has all sorts of things to tell this little bean - stories about animals and snowmobiling and friends and great adventures. Her enthusiasm for pretty much everything is endearing and inspiring. Of course sometimes she is a stubborn, crazy little maniac - but she is two!
Sunday, January 20, 2013
The US - week 7 (and 8!)
Week 7:
Today was the biggest day we've had in quite a while. Dropped Lydia off at school, headed over the doctor's office for our US...and first laid eyes on our little bean! I really trully did finally exhale completely - and cried tears of joy and hope and excitement. We heard the hearbeat, listened to it over and over. The visit probably could have been half the time it was, but we kept looking and listening. Heartbeat in the 130's; the miscarriage risk drops to less than 5% with a heartbeat over 100 at this point. All we needed to hear for now though was that heartbeat. And with the information from today, we are officially released from the "specialty" office to go see our "regular" OB.
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Week 8:
We recently met our new OB, and she is wonderful. In fact the entire office was wonderful. I was not looking forward to having to start over, re-explain and recount our story - but I didn't need to. It was obvious both the physician and her nursing staff were already familiar with our history, and had spoken with Drs. Pritts/Olive's office. They took time to go through everything about my history, our first pregnancy, the labor and delivery, the follow up, and the entire Asherman's story. We laid out some plans for monitoring, issues to address along the way, thoughts about delivery and went over every question/concern I could think of. I have every faith that we are in confident, capable and caring hands. And the fact that we got another peak at the bean was a bonus, still with a strong little heartbeat. So now we wait a little more - another appointment and screening tests and US in a month or so. It was interesting to learn some of the recommendations that have changed even since our last pregnangy - and how they apply to me even independent of Asherman's Syndrome. I am 35 for this pregnancy, so automatically labeled "higher risk", which frankly I expected - but my PCOS requires some extra/early screening for fun things like gestational diabetes too. Ah well, I will endure any number of tests and appointments and studies and the like. Afterall, someone once told us we wouldn't ever get pregnant again, so it all seems like speed bumps after the detour we took!
I do feel strongly still that the right physician with the right expertise/skill set has made all the difference for us, and it still frustrates me that my last "expert" tried to refer us across the state, then across the country for another opinion. Had I not done the research myself we would not have found Dr. Olive. So in a not too obnoxious way, I would like to update that previous provider on our progress. I'm thinking an appropriately worded letter will bring him up to speed - what I haven't decided yet is if I should mail it or wait until I'm big enought to waddle in there and drop it off myself. Suggestions?
Today was the biggest day we've had in quite a while. Dropped Lydia off at school, headed over the doctor's office for our US...and first laid eyes on our little bean! I really trully did finally exhale completely - and cried tears of joy and hope and excitement. We heard the hearbeat, listened to it over and over. The visit probably could have been half the time it was, but we kept looking and listening. Heartbeat in the 130's; the miscarriage risk drops to less than 5% with a heartbeat over 100 at this point. All we needed to hear for now though was that heartbeat. And with the information from today, we are officially released from the "specialty" office to go see our "regular" OB.
----------------------------------
Week 8:
We recently met our new OB, and she is wonderful. In fact the entire office was wonderful. I was not looking forward to having to start over, re-explain and recount our story - but I didn't need to. It was obvious both the physician and her nursing staff were already familiar with our history, and had spoken with Drs. Pritts/Olive's office. They took time to go through everything about my history, our first pregnancy, the labor and delivery, the follow up, and the entire Asherman's story. We laid out some plans for monitoring, issues to address along the way, thoughts about delivery and went over every question/concern I could think of. I have every faith that we are in confident, capable and caring hands. And the fact that we got another peak at the bean was a bonus, still with a strong little heartbeat. So now we wait a little more - another appointment and screening tests and US in a month or so. It was interesting to learn some of the recommendations that have changed even since our last pregnangy - and how they apply to me even independent of Asherman's Syndrome. I am 35 for this pregnancy, so automatically labeled "higher risk", which frankly I expected - but my PCOS requires some extra/early screening for fun things like gestational diabetes too. Ah well, I will endure any number of tests and appointments and studies and the like. Afterall, someone once told us we wouldn't ever get pregnant again, so it all seems like speed bumps after the detour we took!
I do feel strongly still that the right physician with the right expertise/skill set has made all the difference for us, and it still frustrates me that my last "expert" tried to refer us across the state, then across the country for another opinion. Had I not done the research myself we would not have found Dr. Olive. So in a not too obnoxious way, I would like to update that previous provider on our progress. I'm thinking an appropriately worded letter will bring him up to speed - what I haven't decided yet is if I should mail it or wait until I'm big enought to waddle in there and drop it off myself. Suggestions?
Sunday, January 6, 2013
Early ups and Downs
Jan 2013 -
The week 7 US can't get here soon enough. Every day I'm equally ecstatic and anxious about what might happen next. I don't want to think past the next day, can't make plans or mark my calendar too far in advance - all for fear of those things being a reminder in the future if something goes wrong. It is the best news we could have asked for - yet I'm having some battling emotions. Partly I'm trying to protect myself from heartbreak - and to do that I can't plan ahead, I can't fully acknowledge this based on the lab work. The more I let my guard down the harder it would be to handle a miscarriage. I also know the fact that we even got pregnant should be good news in itself - it is a small step of success in the big picture. I know even without my history that early miscarriage is a reality up to 20% of the time. But this isn't about what I know, and is of little conselation in this moment. So I try to stay busy, and distracted mostly, until the US day comes.
Of course at the same time I'm taking care of myself as best I can, trying to relax, get some sleep, go for walks. Simply turning off the brain is a skill I've yet to master. And I realize how naive I was with our first pregnancy - in a good way I think. Going through this blog helps me put some things in perspective even if it isn't going anywhere quite yet. Sometimes I think I should just go back to posting as I write, as I feel. Afterall, we've already shared some strong thoughts and feelings about our course. Then again, I created this blog for myself in the first place, and for now I need to own this information fully. I need to be able to worry about my own thoughts/feelings/emotions on the subject, on the outcomes, without worrying about others. It is not a worry about being judged - more that seeing family/friends having concern, worry, sadness - makes it harder for me to focus on my own feelings/healing/strength. And that is (maybe selfish) approach I have to take right now. The risks are all still there - I read them over and over as I learned them. However I'm getting closer to being able to not dwell on them. We have an excellent doctor and team; he's referred us to an OB that does high risk as well and comes highly recommended. So if he trusts her then so do I - we would never have gotten here had I not trusted him in the first place!
With much anticipation, we now just await the US which somehow is finally around the corner. Wish us luck!
The week 7 US can't get here soon enough. Every day I'm equally ecstatic and anxious about what might happen next. I don't want to think past the next day, can't make plans or mark my calendar too far in advance - all for fear of those things being a reminder in the future if something goes wrong. It is the best news we could have asked for - yet I'm having some battling emotions. Partly I'm trying to protect myself from heartbreak - and to do that I can't plan ahead, I can't fully acknowledge this based on the lab work. The more I let my guard down the harder it would be to handle a miscarriage. I also know the fact that we even got pregnant should be good news in itself - it is a small step of success in the big picture. I know even without my history that early miscarriage is a reality up to 20% of the time. But this isn't about what I know, and is of little conselation in this moment. So I try to stay busy, and distracted mostly, until the US day comes.
Of course at the same time I'm taking care of myself as best I can, trying to relax, get some sleep, go for walks. Simply turning off the brain is a skill I've yet to master. And I realize how naive I was with our first pregnancy - in a good way I think. Going through this blog helps me put some things in perspective even if it isn't going anywhere quite yet. Sometimes I think I should just go back to posting as I write, as I feel. Afterall, we've already shared some strong thoughts and feelings about our course. Then again, I created this blog for myself in the first place, and for now I need to own this information fully. I need to be able to worry about my own thoughts/feelings/emotions on the subject, on the outcomes, without worrying about others. It is not a worry about being judged - more that seeing family/friends having concern, worry, sadness - makes it harder for me to focus on my own feelings/healing/strength. And that is (maybe selfish) approach I have to take right now. The risks are all still there - I read them over and over as I learned them. However I'm getting closer to being able to not dwell on them. We have an excellent doctor and team; he's referred us to an OB that does high risk as well and comes highly recommended. So if he trusts her then so do I - we would never have gotten here had I not trusted him in the first place!
With much anticipation, we now just await the US which somehow is finally around the corner. Wish us luck!
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