Thursday, September 27, 2012

Nothing To See Here

Well, the contractions continue to drive me a wee bit batty.

These contractions are the type that take my breath away and make me start to do the pant-pant-pant breathing that I was taught in a birthing class four years ago.  They come very regularly, with increasing frequency and pain, for nearly an hour. . . sometimes even an hour.  Then, juuuuuust as I am about to call L&D and head in, they stop. 

Then, within an hour or two at the most, they start again.  Lather, rinse, and repeat.

They happen when I am laying down.  They wake me up from a dead sleep.  They happen when I am sitting.  They happen when I am driving.  They happen when I am eating. The only thing that seems to stop them, or at least really lessen the discomfort, is taking a warm bath.  Of course, the fact that they stop/slow down and that a bath takes them away indicates that they are simply false labor.

But I am gonna be honest.  They don't feel "false" and they are driving me nutty.  I remember this with Emma, too, and she didn't end up coming before the scheduled c-section, so now I am wondering if after all of the platelet issues, might we actually go to 10-11-12?  That is only two weeks from today.  If we do go that far, I will have enough short term disability from the c-section and then two weeks of saved vacation to make it to Christmas, which would be WONDERFUL.  My company gives us the week of Christmas off, so I wouldn't have to be back until after the New Year. 

I know, I know.  All of the wondering and speculating will get me nowhere and fast.  He will come when he is ready, or at 39 weeks, on my scheduled c-section date. 

But. . . these contractions, they get inside my head and start messing with me good.  I went to the grocery store today and they were coming so fast and furious that I left half my list unshopped for, checked out quickly, and went home.  I unloaded the groceries, keeping an eye on the clock, as they came 3 minutes apart for forty five minutes.  And then?  The dastardly buggers stopped.  They are back now, as I type this, but not so fast and furious (maybe ten minutes apart) and I don't think they mean business.

Oh, well.  At least I got the ice cream before I abandoned the shopping trip.

Tuesday, September 25, 2012


I had my 37 week appointment today.  My platelets were the highest they have been in several weeks at 99k.  No rhyme or reason to this, other than with thrombocytopenia of pregnancy, they tend to bounce in the 90 - 100k range.  This trend increases the likelihood that I will be awake for the c-section, so I am glad for it.

I had been having some pretty painful (having to breathe through them) contractions throughout the day, so it was good timing to have an appointment.  The NP checked me and I am 3 cm dilated!  Now, a woman can walk around for weeks this dilated, so it doesn't necessarily mean anything.  However, while she was examining me, I had three more contractions (about five minutes apart).  She told me to go home, monitor the situation, and if the contraction pattern continues, she wants me back in L&D for monitoring tonight. 

So. . . it could be baby time pretty soon here!

Or, the contractions, which have slowed down in the past hour, could continue to slow down and nothing could come of it.  But in any case, the countdown is on!

Sunday, September 23, 2012

Full. Term

Well, we made it.  I am 37 weeks pregnant as of today. Any day past this is gravy.

I am very pleased that my body (platelets) have held out this long.

People, I am HUGE.

None of my maternity shirts fit.  Shirts that fit at term with Will and Emma will just not go the distance this time.  I managed to escape without stretch marks with Will and Emma.  My belly looks as if it has been clawed by a wild bear this time 'round.

It is all worth it, of course.  But I am relieved to be in the definitive home stretch.  I am eager to meet this little guy and get the "two to three" transition underway.

Another week would be ideal, but I am also ready.  Car seat is in the car, nursery is set up, my parents are packed and on notice to head up at my call. 

Of course, there is also the quite ironic possibility that we will make it til my scheduled c-section date of 10-11-12.  I have a feeling Andrew is gonna keep us on our toes from the beginning, so we'll see.

Wednesday, September 19, 2012

Wrap It Up

I had my 36th week OB appointment yesterday.  Andrew sounds great!  His heartrate was a lovely 140 and he kicked soundly at the doppler several times while we laughed at him.  I am measuring a full two weeks ahead (big boy!!) and he is definitely an active little guy.

Dr. S feels confident that my platelets will hang out in the 80,000 and above range and told me we could go to weekly blood draws.  If I am still pregnant the week of my scheduled c-section, he will want to do them every other day.  He didn't seem that concerned about the platelet issue, but he was concerned about the 2+ protein in my urine and some other pre-eclampsia symptoms.  I have developed these issues in my previous pregnancies, so this isn't unexpected. 

My blood pressure, which has been running in the 110/60 range was up slightly to 130/70.  I also have italian bread loaves where my feet used to be and my fingers have started swelling.  I have been having mild headaches and my nanny noticed on Friday that my face seemed a bit swollen.  Dr. S agreed.

He asked me if I was in a place with work where I could stop with relatively little stress.  I said that I could definitely be done with my work in the field and then take a few days to wrap things up from an administrative standpoint.  He said that it would be best if I could do the administrative work from bed.  He made it clear that he wasn't putting me on bedrest, per se, but that if my BP and swelling isn't down by the next time he sees me, he likely will.  They moved next week's appointment to this Friday, so I feel as if the clock is ticking on getting work things wrapped up and done.

While it will definitely be nice to be off of work for a little bit before the baby comes, it definitely makes me nervous to be taking so much time off of work.  I won't be taking a long maternity leave (eight weeks of STD from the c-section, plus the two weeks of vacation I have saved), but if I go to October 11, this adds another three weeks on to that.  And remember that I am not eligible for FMLA because I will not have been with my company for a year until October 24.  I don't think anyone is giving my job away while I am gone, but it is still a little scary to be taking "unprotected" leave.

But I also don't really feel as if I have much of a choice at this point.  I am definitely not feeling great, and I have noticed this feeling getting much worse these past few days.  I am hoping that resting up a bit more will help and, in the scheme of life, three weeks of work here and there really isn't that big of a deal.  The most important thing right now is getting this baby baked and here safely.

Monday, September 17, 2012

Chugging Along

My platelet count continues to hover in the acceptable range.  I go in every Monday and Thursday for my draw and then keep a watchful eye on my phone until Dr. S's nurse calls to give me the results.  Other than that, things just keep moving along.

I turned 36 weeks pregnant yesterday.  Holy moly, that seems amazing to me.  I feel like it was just yesterday that I was noticing my pregnancy symptoms and saying to M, "I think I might be pregnant."

And now, here we are, practically on the brink of number three!

Yesterday, I was hauling my whale-like self up the stairs, out of breath and physically exhausted by the time I reached the top.  I thought to myself, "It's almost over."

And then I realized. . . No, it isn't.

I will have three kids and an entirely new level of exhaustion in but a matter of weeks.

I guess I have logically known this baby is coming for quite some time, but it was that moment yesterday that it really seemed to hit home.

I am a bit (more than a bit) scared, if the truth be told.  But I was super-duper scared when I was pregnant with Emma, and that turned out okay (actually, more than okay, I'd like to think).  It IS more work having more than one, so I am assuming my workload will increase again, but I just have to hope it is doable.  I see mothers doing it every single day, so I know it is possible.

And it doesn't really matter, because. . . it won't be long now.

Monday, September 10, 2012

Back To Our Regularly Scheduled Programming

My platelets did not go back up, they basically stayed the same at 90,000.  This was enough to make my OB comfortable with the fact that this is a true diagnosis of pregnancy thrombocytopenia, a completely harmless condition related to pregancy which will resolve in the days after delivery.  Women with this condition rarely have counts that go below 80,000, which means that I will not be at any risk for complications during the c-section.

I will still have to likely be put under a general, but he did tell me that some of the anesthesiologists will agree to do a spinal if the patient has a long record of platelet counts that never show that drop beneath 80,000.  He said he would talk with the providers and see, but no guarantees.

I was discharged on normal activity with the expectation that I will have bloodwork every Monday and Thursday until Andrew arrives.  If the counts ever get below 70,000, I will be readmitted and we will proceed in the direction of a c-section, especially if it is after 36 weeks.

It was weird to leave the hospital.  The last few days have been a rollercoaster.  From the crazy call from the nurse telling me to scoot to the hospital, to the low count on Saturday, to the contractions yesterday. . . . we went from discussing the logistics of a pre-mature baby and coordinating my post-op recovery to . . . Back to our regularly scheduled program as if it all never happened.  My hormones probably didn't help, either.

You know that feeling you have when you leave the hospital with your newborn?  How nothing really matters outside of the realm of feeding, diapering, calming, and bonding with your new baby?  Time and date doesn't matter, it all kind of stops?  I felt that way when we were leaving the hospital, only there was no baby, and no real reason for the suspension of reality.  It took me a bit of time to acclimate.

I still feel tired (exhaustion is a side effect of the thrombocytopenia), but my swelling is completely gone and my feet look normal.  I am continuing to have semi-regular contractions, but they build to a crescendo and stop just as I am about to call triage.

The kids were so happy to see me and I to see them.  It was good to get home, even better to climb into my own comfortable bed.  I will enjoy tonight, with no midnight blood draws, followed by 4 AM vitals.  But I will miss having no choice but to lounge around and have someone bring me food on a regular schedule!

And no later than one month from tomorrow, platelet count regardless, Andrew will be joining us!

Sunday, September 9, 2012

Good Thing

I did not get discharged as I was hoping.  My OB was not at the hospital today and the rounding OB was clearly did not want to be the one to discharge me.  Honestly, I don't think they really know what to do with me, and the concern is that with my platelets kind of being all over the place, then they could just as easily go down as up. 

After the OB left the room, more excitement started.  I have been having BH contractions for quite some time so I wasn't too alarmed when I was told that I had contractions on the monitors these past couple of days.

Today, however, my nurse came in after about 45 minutes on the monitors and informed me that my contractions were now only 5 minutes apart. I was noticing them, too, at least more than I had been in previous monitorings.  She alerted the on-call doctor who ordered another hour of monitoring and no more food just in case things got started and it was baby time.  I had a couple of super strong, painful contractions that I actually had to breathe through, and then things seemed to calm down.  I was still having contractions, but they were spacing out and losing intensity.


So, I guess it was a good thing I was here, because had I been home, I likely would have gone to L&D.  At least I was here already.

So, next steps will be determined by tomorrow's platelet count.  I will see my OB when he rounds in the morning.  My loose understanding is that, at this point, if my count stays the same or goes up, I will get to go home.  If it goes down, I will have to stay here. 

And so we wait.

Up, Up, and (Hopefully) Away

Okay, so it turns out that this Jean Barlow (I couldn't even definitely google who that is, so I am not going to link to anyone) person knows what they are talking about.

I didn't sleep much last night and the sleep I did get was peppered with dreams about emergency c-sections and NICU stays.

At midnight, the way-too-cheerful-for-it-being-midnight lab guy (who also looks exactly like Ken Jeong from The Hangover) came into my room and took blood, so when my nurse peeked her head in at 5 AM, I knew she would know my latest counts.  She didn't keep me in suspense and told me that they had risen. . . to 96,000.  What a roller coaster!!

ANY rise is good and this was a pretty substantial jump.  We are waiting for the on-call doctor to do her rounds and let us know the game plan.  With this rise in my count, I think the official diagnosis is likely to be plain ol' thrombocytopenia of pregnancy, which means my counts should stay about 70,000 and out of the we need to deliver prior to term range.  Which also means. . . fingers crossed. . . I should be able to be discharged. 

I am sure frequent (daily?) draws will be in my future and I am also pretty certain I will not be allowed to be awake for my section, BUT if Andrew can bake a couple more weeks and avoid NICU time, I am not so worried about the general part. 

But, again?  Who knows?  I think it will likely be a let's wait and see approach from here on out, but at least things do not seem quite so dire today. 

Saturday, September 8, 2012

The 90%

"90% of what you worry about never happens" - Jean Barlow

I am a worry wart.  Always have been, always likely will be.  It's just in my Type A nature to think of everything that could possibly go wrong and then attempt to control it or at least have a plan to deal with the outcome.  I am not necessarily proud of this part of my personality and I do believe my life would be easier without it, but after 33 years of life on this planet, I have come to the realization that this is part of me and fighting it is of little use.

So as you can imagine, I have been abusing the good Doctor Google all day.  My platelet count this morning came back at 81,000.  This wasn't the greatest of news. Although a count of 81,000 in and of itself isn't dangerous, it is showing a trend we were all hoping not to see.  So I have been googling things like "average NICU stay for a baby born at 35 weeks" and "how to prepare for your c-section under general anesthesia".

Basically, I will stay hopsitalized until my platelet levels either A) rise or B) fall to 50,000 or below.  If they rise, I can go home, though no one has said if going home means to regular activity, bed rest, or what.  If they fall to 50,000 or below, it's Baby Time, ready or not.

I am decidedly NOT ready.

Well.  I guess that isn't true.  We are "ready" in that the nursery furniture is up, the curtains are hung, diapers are in the holder, tiny onesies are folded, and jammies lay in wait.  But I still haven't found my breastpump and the car seat isn't installed (both minor things to deal with, really).  We had over a month until my scheduled c-section, after all, and I felt as if we were in pretty decent shape.  Also, my OB has been pretty calm about this whole thing and I didn't really think it would get to this early delivery business.  So I am not mentally prepared to be potentially giving birth in a matter of days, nor I am prepared to think about the reality of a premature baby.

Now every nurse that comes in grimly looks over my file.  I have asked their opinions on whether or not they believe the counts will spontaneously rise, and they all just shake their heads and say it would be surprising to them if I was still pregnant by the end of this week. 

The end of this week would be great because if we can just get to 36 weeks, then a lot changes in the protocol.  A 35-weeker has a mandatory 24-hour NICU stay at my hospital and average length of stay for that gestation is seven days in the United States.  A 36-weeker is evaluated at birth and can either go for a short observation after some skin-to-skin contact or possibly even have no NICU time whatsoever.  It is all very baby-specific, of course, but the statistics (of which I have never been a fan) improve greatly for outcomes at that 36-week mark.  I think that is what we are all aiming for at this point.  That is a week away.  If my platelets continue to drop at the rate they have been (10,000 in the last day and a half), then we have three days. . . but this isn't an exact science, so it could be more. . . or less.  Since nobody knows, I just worry.

I will not be able to be awake for the c-section unless some crazy increase in my platelets bring them back up to over 100,000.  Even then, it would still be up to the anesthesiologists, and most of them will not do a spinal if the count has recently been under 90,000, no matter what it currently is at, because it can all change so quickly.  It is likely I will need several hours to recover and even if Andrew doesn't have NICU time, I will not be able to do skin to skin and nurse him as I did Emma in recovery.  I am saddened by this, though I realize there is no other option.  I try to remind myself that Will and I didn't have a ton of bonding time until about 5 hours post birth and that was the first time he attempted nursing, too, and we had no issues with bonding or feeding.  It still makes me sad.

I had forgotten what this helpless feeling is like.  This feeling that your body, which is supposed to be the safest of havens for nurturing a baby, is failing you and failing miserably.  It is not a good feeling. 

I do have lots to be thankful for.  I am getting excellent care.  The nurses on the antepartum unit are AWESOME.  Seriously, they bend over backwards for me.  I was just delivered a snack of graham crackers and milk and a sodoku book the nurse thought I might enjoy.  She also rearranged my pillows and turned the lights on for me.  Each nurse has been so caring and kind in their own way.

The kids are with the Gramma and also getting great care.  They were able to visit tonight and thought my bed that went up and down was very neat and Will enjoyed using the bathroom so much that he used it twice.  They sat on my bed and shared my dinner tray with me and then we watched videos of them when they were newborns.  My room also has a beautiful water view and there is an aircraft carrier in port right now, so he was fascinated by watching it.

Also, I was so very tired these past few weeks that it is nice to have nothing to really DO besides just lay here.  It is a wee bit frustrating in some aspects, as there is so much that I would like to do as far as getting ready for baby, but I have made a list and lovely friends and family are working on checking off my to dos.  A day of watching t.v., napping, reading, catching up on my blog friends, writing a post, and eating would have sounded like heaven if you'd asked me just a couple of days ago.  So I should really not look a gift horse in the mouth.

But I am still a wee bit nervous and hoping that my platelet counts miraculously rise tomorrow morning.  I'll keep you posted.

Friday, September 7, 2012

How Low Can She Go

I had my routine 34 week appointment on Tuesday and Dr. S and I discussed my platelet count.

It has been pretty stable since 24 weeks, but it's always been low.  Even in the first trimester, it was under the normal level of 150,000, but since it was not dropping further, he wasn't concerned.

However, my last CBC (looking at my iron levels), revealed that it had dropped to 105,000, so he wanted to keep an eye on it.  I had my blood drawn Tuesday and didn't hear anything, so I figured all was a-okay.

I got a call yesterday from the nurse.  My platelets had dropped to 95,000.  Anything below 100,000 requires further investigation, just to rule out pre-eclampsia and HELLP, or any other more serious cause.  More than likely, what I have is called thrombocytopenia of pregnancy.  And, in and of itself, it really isn't dangerous and will resolve immediately after delivery.  The only problem is when it does drop below 100,000, then you have to worry about if it is something more sinister.  And if you can rule something more sinister, then you have to worry about your platelet levels being high enough for your scheduled c-section. 

They had me go in for STAT bloodwork this morning.  I went in, had the bloodwork done, and then went on my merry way.  At 11, my doctor's office called me with the news that my platelets had dropped even further.  I asked the nurse the next step and was a bit surprised when she told me that Dr. S wanted to admit me immediately.  I asked if I could finish my work for the day and she said no, to come immediately and that I could only stop to pack a back if I could do it quickly (less than 20 minutes). 

Of course, having two small children and their care to think of, this was a bit more complicated.  My parents were out of town and out of touch (not answering their cell).  My MIL didn't answer her phone.  It took about an hour of calling to finally get my MIL on the phone and she promised to head on down.  We had our nanny, of course, but she had a doctor's appointment to get to and had planned to leave early, so she wasn't an option as of mid-afternoon.  M left work and joined me at the hospital where admitting me took a long time.  The doctor came in and let me know the plan was to take a lot of blood and run a lot of tests and to keep me here until they have a reason for the decreasing platelets and know it is stopping; at least a day or two.  So, we won't really know much until the labs come back tomorrow.

In the meantime. . . here we are.  I am 34 weeks, 5 days pregnant and hoping to keep this baby boy baking for at least two more weeks.  He looks great on the monitors, and I know a 34-weeker is child's play compared to what most deal with here in the blogosphere, so I am trying to remain calm and "enjoy" my visit to the ante partum unit.  It really should be every pregnant woman's dream:  food delivered bedside, unlimited t.v., a bed that raises up and down and that I don't have to share, and the kids kept safely with my mother-in-law.  Yep, that's what this is, a nice little rest before Andrew arrives and rocks our world.