Only the sixth?

Today I'll openly admit I've hit the "oh my gosh I'm so bored that I've even run out of internet to browse" stage of bed rest. Believe it or not I've managed to be fairly content so far (6+ weeks) but - today - I was trying to figure out what day it was and I was updating my time sheet with the few hours of work I've been able to do while laying on my side and I realized that March has only been happening for 6 days and here I was thinking it had to atleast be near the middle. Who knew that revelation would be enough to bum me out!?

I am feeling both relieved to be "so far" into my pregnancy, and thus a bit cavalier about the whole thing, and freaked out that my baby, who is probably just a little over three pounds, is millimeters away from entering the world. (Don't worry though, the blessed fFn test says I have another 1.5 weeks at least). The combination means I take longer showers than I was when I was 24-28 weeks, but feel guilty about it the whole time.

And we still don't have a name - chances are the baby will be born at 41 weeks and we will still have to narrow the list down - we are a deadline driven couple.

Anyhoo - if you are a local blog reader I'll go ahead and ask if you have 2-3 books that you'd describe as "compelling*" that I could borrow?

*Compelling: (adj.) Thought-provoking and well wrtitten. May include emotion but not in a manipulative manner. See "worth my oddles and oodles of time to read".

Me and A-Rod

If it weren't for ethnicity, career, salary, and number of times testifying before Congress me and A-Rod would be besties...

Aaron has informed me that discussing cervii is not necessarily a polite conversation - but - such is my life at the moment, my apologies...

Turns out mine got shorter as is now "80% effaced" or about .5 cm long. That is a drop of a centimeter in 5 days. Still, there is not much they can do to stop anything, particularly because I'm not generally contracting (a few scares here and there but nothing that lasts). The one thing they can and did do was start me on the steroid shot that helps the baby's lungs (and I think brain as well) mature a bit faster. We think this made a big difference with Tessa, and this time we will likely get the full 48 hours that they like to have before delivery (and hopefully more) in addition to the additional month (or more) that we currently have on where Tessa was.

Anyway, thats just the latest.

28 weeks + 1 week

28 weeks
When I first went into labor with Tessa and before everyone realized that we would be lucky to get 48 hours till her birth the doctors told me that they were going to try and get me to 28 weeks. I didn't make it there until 2 years later...but YEAH for that.

So - here is what I look like at 28-ish weeks - and YEAH (did I already say that?)

29 weeks
Oh - and - btw - I was in the hospital for observation for a few hours Monday morning. I was having contractions 6-10 minutes apart from 3-9 am. No change in my cervix though so I got an IV then home I came. The contractions are pretty much non-existant now so - whew. I'm taking this as a subtle reminder to keep taking it easy and not get to cavalier about this whole thing. As glad as I am to be at 29 weeks (YEAH) it is still way to early to have a baby...plus we haven't picked a name yet.

26 weeks

I'm 26 weeks (Tessa was born at 26 weeks, 2days) and my ultrasound today showed that there was just slightly more shortening of the cervix* than 2 weeks ago. Yes - it is still shorter, but not "imminent delivery" short.

I feel totally relieved. I've been trying not to act nervous but I spent all last night dreaming about being in the hospital about to deliver a 2nd baby at 26 weeks. Subconscious anxiety strikes again.

I have a maternity shirt that says "Coming this SPRING" and apparently that is 6 weeks away. I wear it a lot.

I hope the baby can read.

*It is now 1.7 cm long if you are THAT curious.

Nothing New

I just thought I'd post real quickly that there is nothing new to report. I've been taking it easy all week thanks to Aaron and friends who have been helping out. I won't have another ultrasound until February 2nd (one of my favorite holidays - btw) so until then I'm just being super cautious (hence a short post with no pictures before I scurry back to bed).

An (un)Eventful Weekend

Friday night was Aaron and my date night.

We got a babysitter, spent time together laughing and talking and I got breakfast in bed the next morning.

Unfortunately my primping for this outing involved a regularly scheduled ultrasound that showed my cervix had shortened by 30% in 2 weeks. And the location was L&D triage at Brigham and Women's hospital.

After seeing that my cervix had shortened the doctor suggested a cerclage (stitch through the cervix) to prevent any dilation. Aaron came home, we dropped Tessa off at some friends house and off we went. Ultimately the doctors at the hospital decided not to do the cerclage because I was so close to "viability"* and they didn't want to cause any PTL (Pre-Term Labor).

My cervix was measured at 2cm long, which isn't SUPER short, just shorter than it "should" be. I was not contracting. So they finally decided just to admit me for observation - hence the breakfast in bed (you'll notice the bed in the picture above is a twin size...never a good sign.)

Nevertheless, I wasn't kidding about date night. I was actually very surprised at how calm I felt during this whole thing (ie my intuition told me I was not going to have a baby that weekend), and so Aaron and I sat in our little room and joked and laughed and "how was your day?-d" from about 9 until midnight. Around midnight Aaron headed home and I sat waiting for a room.

I ended up staying in the hospital until Sunday afternoon. A test and an ultrasound gave us strong indications that I wasn't about to deliver. The test** they did was negative, and if it is negative gives someone a 95-99% certainty that they aren't going to deliver within 2 weeks. The ultrasound was much better than the one on Friday, whether that had to do with an actually growth in my cervical legnth, or a different person and machine doing the measuring I don't know. I am now home on bedrest and looking toward 26 weeks...and beyond (in Buzz Lightyear voice.)

*Viability is considered 24 weeks (though that is stretching to 23 weeks in some cases). That is when the baby has a fighting chance of surviving outside the womb and most hospitals will consider resessitation, before that some will not. At 23 weeks a baby has a 20% of survival, at 25 weeks it is 65%, and at 26 weeks (when Tessa was born) it is 75%. Though full-term is our ultimate goal, afte 30 weeks babies have a 90-95% survival rate.

**The test is called a Fetal Fibronectin or fFN test. See this link on the March of Dimes website for more info because I can't explain it to you.

Random notes:
I am recovering from a cold (I know you know because I've been complaining about it all week) and so was coughing up a storm the whole time I was in the hospital. A normal person would just suffer through it, but I had nurses checking on me every 4 hours so they listened to my lungs and "prescribed" things like saline spray and cough drops (both over the counter medicines that I'm sure I/my insurance paid an arm for).

Tessa loved her weekend with Daddy. They came to visit me on Saturday, she loved the bed with the moveable head and foot buttons and then when it was time to go she gave me a big hug, a kiss, waved bye-bye and headed down the hall.

I took the chance to visit the NICU. This is a different hospital than the one we delivered Tessa at and I was feeling very sad not to have access to the nurses who I'd consider friends and missing the familiarity of the surroundings. The NICU tour was helpful in at least making me feel comfortable with the level of care a preemie would get (still hoping to avoid it though). However, I haven't been in a NICU since we left with Tessa and it was HARD to go back. The babies are so tiny and the feelings are still very fresh.

I was looking forward to hearing how Aaron was 15 minutes late for church on his first morning ever of being in charge of getting out the door (I even had a spy in place who was going to keep an eye on him). Yes, I know that is a snarky thing to think...but don't worry, he miscalculated and thought he needed to leave by 8:00, when it is really by 8:30...and so he was there 10 minutes early. Darn...seriously.

We had a major snow storm Saturday and Sunday. The roads were so bad Aaron almost left me at the hospital until Monday! I realized that I'm really working this whole "mothering" thing. I haven't had to shovel in three winters. Winter 07 - pregnant, winter 08 - taking care of a baby, winter 09 - pregnant (which leads me to believe that winter 10 I'll be off the hook as well!)

I almost forgot...

...to do a last minute reminder about Team Tessa and the March for Babies, there is still time to donate.

But even more important I'd like to thank those who have already donated! I really do feel like the March of Dimes has made a difference in the care of preemies.

In fact years ago my Mother helped in some March of Dimes fund raisers. This was 17+ years ago. Well, 17 years ago the treatment for a baby born at Tessa's gestation was to put them in an incubator pumped full of oxygen and "see what happened." I know this because a nurse in the NICU had a baby born at 27 weeks gestation and that very very miraculously survived when it wasn't expected that she would. The research that made so many medical advances in the mean time was partially funded by my Mom's efforts. She never had any premature babies, in fact hers where either at, or beyond term, and I know that asking people for money, even for a good cause, was quite out of her comfort zone, however she did and made such a difference.

So once again, thank you to all who have donated!

Team Tessa

So many people supported us a year ago when Tessa was born and we continue to be grateful for the care shown by each and every person.

I hope then, that its not to presumptuous of me, this year, on Tessa's 1st birthday, to ask for your support in the March of Dimes - March for Babies.

I plan to participate in the walk held

Saturday, April 26, 2008
at 12:30 pm
in Lowell, MA.

Why am I doing this? It is because among the many people that supported us at the birth of Tessa was the Walk of Dimes organization.

Every year, half a million babies in the U.S. are born prematurely. Premature birth is the leading cause of newborn death and many life long disabilities. The funds we raised in March for Babies supports research that saves babies' lives.

Over the years there has been a lot of improvement in the care for premature babies. Not too long ago Tessa may not have made it and so we are grateful for every advance.

In addition to funding research March of Dimes provides in hospital support to families. Our hospitals March of Dimes rep was literally beside me many days providing support, and sometimes just company.

I am grateful for both the large scale work of the March of Dimes and the personal care they gave to my family.

Click here to support my walk by donating, or if you are local consider joining me (and Tessa) in the April March for Babies!!

BBB Charity Report This link has information on how the March of Dimes spends their money and reports that in 2005 they funded 517 research grants for prematurity and birth defects.

"So what exactly happened?" - the short version

I woke up Monday morning with a backache that came and went. I went into the hospital thinking I would get sent home to rest. Luckily, they checked my cervix right before they sent me home and it was dialated to a 3/4.

So into Boston I went, they gave me steroid shots to mature the baby's lungs and 36 hours later, with no epidural, I delivered our 2lb 3oz. baby girl.

The first pictures of her are so hard to look at...and at the same time I can see that it is the same little girl I snuggle with now. I could tell her personality from the very first day.

"So what exactly happened?" - The (really) Long Version

About 5:15 am the next morning (Monday, February 11th) I woke Aaron up.

Me: Honey, I've been having some back aches and the doctor says I should go to the hospital to be checked...its probably nothing, do you want to come with me?

Him: Do I need to?

Me: Well, its probably nothing but I'll leave it up to you.

Him: Well, my battery still isn't recharged so I'll stay here.

Me: Well, its probably nothing but if you wanted to come you could.

Him: Let me know how it goes.

Me: Its probably nothing...but if it IS something you wouldn't have a car.

Him: I'll get dressed.

So off we went. The whole time I'm expecting a rather embarrassing experience where something totally obvious and benign is happening and I'm sent home"to rest."

-----

At the hospital they took a bunch of swabs to test for various things then put me on a fetal heart-rate and contraction monitor for an hour. Aaron and I napped...the shifts changed...the new midwife came in. I had only had one contraction that showed up on the monitor...with a bunch of other "irritable uterine" contractions. It appeared everything was alright but just before they sent me home the midwife checked my cervix...

...which was dialated to a 3-4cm.

Everything sped up after that.

"We're sending you to Boston."

"We're giving you a shot to mature the baby's lungs."

"We are going to try to get you to 28 weeks, its better if you can get that far."

"This drug we're giving you to slow the contractions will make you very hot."

I only knew a 3-4 cm dilation was bad because just that week I had gotten brave enough to read the "Labor and Delivery" section of my pregnancy books. Aaron only new it was bad because I burst into hysterical tears.

It was such a blessing to have the specific midwife on call at the time. I had never met her before but it turns out that the past year she had given birth at 28weeks and she handled Aaron and I perfectly. She calmed me down as much as possible, told Aaron a little bit of what to expect (still with the hope I would be on bed rest for awhile) and then when he asked me what I wanted him to bring from home she gave him a list of insightful things like "toothbrush" and "change of clothes." That was beyond what I could think of at the time.

After the ambulance delivered me to the hospital in Boston (Tufts - New England Medical Center) I was set up in a delivery room. Aaron showed up an hour and a half later after stopping to get stuff at the house. (It all went by really quick...but I was so anxious and glad when he made it. After that I pretty much didn't let him leave unless he was hunting down a nurse to turn off the incessant beeping from various machines).

(BTW - My first ambulance ride solved the age old question about what route is fastest to Boston. IF it is during the day (not rush hour) then taking Route 1 is faster then taking 93. However, if you are an ambulance there is no toll...but if you are a car then there is a $3.00 toll... so take that into consideration.)

While Aaron was getting to the hospital he made the necessary phone calls to friends and family. When people (i.e. my Mom and Mindy) saw my number show up on the caller ID and heard Aaron's voice they immediately knew something was wrong.

Aaron made those calls because we needed their prayers and we asked the people we called to spread the word. I don't know everyone who prayed for us, but we felt the effects of and are beyond grateful for, each prayer given. In my past, when I would ask people what I could do to help, and they said "Pray" I thought they were just being polite by not asking for help. Now I know that in a situation like this...they mean it! The prayers offered for a loved one, and for a stranger, have a definite power behind them.

I was also given a blessing, the words of which I can't remember. I do however remember the feeling of calm and reassurance I felt and which was so important that day, and the weeks to come. A few days later, when we were facing the first of our parenting challenges, I wrote myself a little reminder about those feelings so that I could remember them when I was no longer feeling calm.

-----

By 2:30 that afternoon I had dilated to 6cm and the contractions where irregular but speeding up. They took me off the magnesium sulfate because it wasn't working and they wanted to avoid potential side effects. Ironically, the contractions slowed down after that.

A Neonatalogist came by to talk to us about what the baby's prognosis would be if she were born at that gestation (26 weeks). He was another bright spot in the experience. He was very honest yet hopeful and gave us a lot of confidence. He was also just plain nice.

Unfortunatly, in the middle of our discussion I thought my water had broken and I was really panicked. The OB staff (it is a teaching hospital so there is always 3x as many people as really need to be there) came in and it was determined that I had a "partial placental abruption" which means that the placenta had partially detatched from the uterine wall...I won't go into too many details but that was indicated by a lot of blood. This may be why I started contracting, the blood had pooled behind the placenta, or it could have been as a result of the contracting. No real answer.

The baby warmer was all set up and we all were waiting for the immenint delivery. We hoped I could go till 8:30 that night so that the steroid shots would have at least 12 hours to work...the ideal would be 48 hours but it was just too much to hope for that.

That night was very short and very long. At some point I was measured at 9cm dialated. I felt like delivery would happend with in the hour...all night.

Yet when the day nurse started her shift the next day...there I was. So she gave me the 2nd dose of the steriod. Literally, every minute counted as it worked on the baby's lungs. In fact she gave it to me about 1/2 hour early because I was so close to delivering.

Then the day shift ended and back to the night shift...who was also surpised to still see me there.
And then finally, exactly 36 hours after the first steroid shot was given, I delivered our baby.

She cried.

I was so afraid she wouldn't cry. She cried and wiggled...the neonatalogist kept exclaiming gleefully how much she was moving around. We had made it.

I'm not sure why but I had known that the baby was safe inside of me, and after meeting the neonatalogists, that she would be well taken care of when she arrived, I was most scared of the delivery.

The nurses showed her too me once they had taken their first assessment (by the way, apgar of 6 at one minute and 7 and five minutes) they showed her to me, all bundled up in a blanket, then they wisked her away to the NICU and the waiting hands of the nurses who we are terribly indebted to.

Well, here is the part that is perhaps too honest. After they took the baby to the NICU they got me cleaned up and took me to a recovery room. I hadn't had any real sleep. or anything to eat, for over 48 hours. I was very excited to have some pizza Aaron had stashed for me in the fridge and then he left in time to catch the last train and I fell sound asleep. The too honest part? Well, I can't remember perfectly but as I sit here tonight I don't remember thinking too much about that little baby in the NICU. Afterall, I wasn't expecting to be a Mommy for another three months at least, the whole thing had been so unexpected (as I'm sure it generally is) and I was oh so tired.

However as I slept soundly, on a mattress about 4,000x more comfortable than the L&D bed, I had my first mommy moment. Sometime in the middle of the night a white coated woman woke me up to have me sign a permission form to give the baby a blood transfusion.

Who was I to give this permission? What made me all of a sudden someone's mother?

In the morning when I woke up I was gripped with fear. While I had been in the hospital there had been a big snow/ice storm and the temperature was in the single digits when Aaron left the night before...what if he didn't make it home!! In a panic I text messaged him to see if he was awake, and alive. It was 5:30. He called me immediately. HE has woken up gripped with fear, what if something had happened to the baby over night? He didn't have the hospital's phone number so he couldn't check. Well, he was safe, I was safe, the baby was safe.

It was Valentine's Day.

Laughter or Fettucini

Was it the dinner we ate Sunday? The fact that we laughed the entire evening? There has to be something that caused the pre-term labor, but we'll probably never know what. I've narrowed it down to those possibilities, and only these.