The Light at the End of the Tunnel

It was all worth it...

Finally Out of the Danger Zone

You may remember that I had to be induced early to deliver Alexander because of pregnancy-induced hypertension...well it has finally resolved. My last blood pressure reading was back in the normal range. Thanks goodness! I have been on nifedical for the last few months to control my blood pressure. My OB took me off of it on Tuesday to see what the reading would be off the medication. If it was still high, then I would be diagnosed with chronic hypertension. I was very nervous! I am now so relieved! :) I am happy to be off that medication too, as it was starting to make me a bit dizzy. Phew!

The Boys' New Blog

I have decided (with input from some of you of course!) to continue blogging about the boys' adventures. In one blog. The Second Whorl is dedicated to my journey through being pregnant after having a preemie. Alden's Story is about the preemie experience. My third blog is Jessi Stitches which, up until now, had been dedicated to my knitting projects will become more of a general blog about my life balancing parenting, craftiness, and other pursuits requiring high levels of creativity. This new and improved blog is the result of being inspired by other local bloggers such as Mom in Madison and Clean. I warn you: these blogs are addicting. I can only hope to be as inspiring.

My question to you:

What should the new blog be called? Keep it as Jessi Stitches? What about...

Madtown Mama
A Plus (Get it?)
Double A (Smirk)

Other ideas? Please help. My creativity is getting off to a slow start. I still have postpartum fuzzies... and I am going to use that excuse for a long time...

The first weeks at home...

Sorry for the lack of posts!

We have been home since August 2nd, and have been quite exhausted. Alex completely has his days and nights mixed up, expecting us to party with him from about 10pm-4am. The last two nights have been better, waking up for shorter time periods to feed and going back to sleep. Giving me more sleep. I was getting a bit delusional trying to function on 2-3 hours of sleep per day for nearly two weeks.

Some of you know that as we were being discharged from the NICU on the 2nd, we received news of some concerning spots on Alex's recent MRI. The neurologist was on vacation all last week, so we could not get a solid interpretation. We were extremely anxious about this. Yesterday we received the best news possible from his neurologist: Alex's brain seems totally healthy and normal. The 4 little specks are areas of restricted water flow in the brain, but they are so extremely small that they should not have any residual effect for Alex. In fact, there could be many babes who have this after birth, and you would never know it without an MRI. The neurologist was so unconcerned that he completely discharged Alex from his services, without even needing to see him for a follow-up. We were extremely relieved.

Alex is also breastfeeding better every day. I can't describe how wonderful it is to finally carry on with life and just relax and enjoy my little one. We have had way too many scares in the past almost 3 weeks. I am happy to report that the adventure of being pregnant after having a preemie has concluded with a happy ending.

I will post more pictures when I get to it! I know I have been awful with keeping up on posts. I have had many questions as well as to whether this blog will be devoted to Alex's early years, as I did with "Alden's Story." I haven't decided yet. Alden's Story is really about the first few years of parenting a preemie, and this blog has really been focused on being pregnant after having a preemie. I might throw Alex into Alden's blog... We shall see!

Occiput Posterior (aka: The Dreaded OP)

Here is a link about why my labor was so terrible.

Apparently, I am one of very few nut-jobs who refuse any sort of medication to get through an OP delivery. Seems we were also very lucky to avoid a cesarian or vacuum delivery.

Feeding

Still in the NICU, although the only thing keeping him here is getting his feeding volumes up. It is common with brain bleeds, no matter how small, to affect a baby's stamina. Especially with breastfeeding. He is very effective at breastfeeding, but just stops too soon. We are weighing him before and after each feeding. If he needs to take in more, Dave finger-feeds him (a tube of breastmilk taped to his finger. When Alex sucks, Dave gives him milk with a plunger.) Finger feeding is like bottle feeding: easy for Alex, but no nipple confusion. Alex is taking in more milk from me every day, so I don't anticipate we will be here for much longer, hopefully.

Welcome Alexander!

Just a quick update for now... still in the hospital! I will post pictures later...

I was induced on July 27th at 8:30 AM. I had terrible back labor for 9 hours, 4 1/2 of which was just trying to push him out. He got stuck on my pelvic bone and came out with a giant hematoma on his head. He had strange symptoms that suggested trouble with his brain right away, so was sent to the NICU for monitoring. In the NICU, he had a giant seizure. He was given medication for the seizure, as well as antibiotics for possible meningitis. We were terrified of that as well as the possibility of a genetic seizure disorder.

Today, we received the best news possible: he has a small brain bleed in the right frontal lobe caused by the traumatic birth, and which will most likely be reabsorbed with no long term consequences.

Alex will be monitored with head ultrasounds for the next week to make sure the bleed is reabsorbed and doesn't get larger. I will stay here at the hospital with him to work on breastfeeding, and just being his Mommy. We can't wait to take him home!

Dear Baby Boo (aka Thumper),

Time has flown by for all of us. As much as I enjoy having you in my belly, I know that you will be here, in my arms, soon. Emotions are washing over me like waves. I am thankful for all of the love and support from our friends and family. I've been reading a lot to keep myself inspired for your birth. We do have a real name ready for you (although we can't share it yet); it is a strong name, like you. Your older brother felt you kick for the first time today. He was so proud, he kissed you through my belly. We have all of your clothes washed and ready, your bed is next to ours...we are ready for you, Boo. We are ready to celebrate your birthday!

Love,
Mom

Vent

I never thought I would have a "normal" pregnancy. I knew I would be worried a lot, have to take a lot of supplements and medication, possibly endure bed rest, be financially and emotionally ready for anything and everything. But I wasn't prepared for making it to full term, and still being miserable. I really thought that making it to full term, I would be elated with joy. I was, for a minute. But now, instead, I have to still endure strict bed rest and now have the fear of developing pre-eclampsia. I have to look forward to laboring and delivering lying down again. I have to worry about going on magnesium sulfate again immediately after delivery. I might, therefore, not be able to hold my baby right away and start bonding and breastfeeding, as I imagined I would. This is all exhausting to think about, as I have nothing else to do in bed. It's wearing me down.

Still on bed rest...

Just got back from my appointment! I actually had to go see my OB at the hospital in triage, because everyone decided to go into labor today and she couldn't make it into the clinic. No changes. All my labs were normal, and Thumper was happily thumping away on the monitor with a strong heartbeat. My BP is still high sitting, but normal lying down, so I am on bed rest until Tuesday when I will be induced. If I don't deliver before then! I had a few doozie contractions this morning, and lots of pelvic pressure.

I found out that I will have to labor and deliver lying down again. I had to do this for Alden because he was so premature. Now it is because of my high blood pressure. I am not looking forward to that! I am sending myself vibes for a fast labor.

Update - visit to OB today

It was reassuring to see my regular OB today, and I am now back home on bedrest. My bp was still high at 140/70, but not as bad as last week. I has an NST and AFI, and passed those. She checked my cervix, and I am 3 cm dilated and 80% effaced. My cervix is so ripe, that I could go into labor on my own at any time! The plan is to see her again on Thursday for another bp, NST, AFI, and blood and urine labs. If everything still looks good, then I get to stay pregnant until next Tuesday at the latest. Then she will induce me, because that's when she is on-call and she doesn't want me to be pregnant past 39 weeks. I will be 38 weeks and 3 days then. So baby will definitely be here within the next week! :)

We made it to full term!!!

Happy 37 weeks!



I realize this is not the most flattering picture of me, but I just have to document the day. I am big and tired and in bed all day - so big that you can barely see Alden in the picture! I literally got up for a minute, took the picture, and went right back to bed.

My 24-hour urinalysis came back negative for a significant amount of protein. So still no preeclampsia, which is a relief. I see my OB on Monday, and will discuss my risk for developing preeclampsia. I am so scared of preeclampsia, that if my risk is really high I might just consent to being induced. When I read that some women with preeclampsia need to be treated with magnesium sulfate immediately after delivering, my heart dropped. I simply can not go through that sheer hell again. I am pretty scared. The good news is that I have complete trust in my OB. I will do anything to avoid being "magged" again.

Gestational Hypertension

Well, my BP was high again today while sitting, and normal lying on my side. All of my labs are still normal, so I have gestational hypertension and not preeclampsia. I am still home on bedrest and seeing my OB (who is back from vaycay on Monday!) every 2-3 days. I would love to stay pregnant for as long as possible, but I also take comfort in the fact that I will be 37 weeks tomorrow.

Mama's Eye View

Almost 37 weeks!

Back On Bed Rest!

At my OB visit today, my blood pressure was 144/88! Lying down, it went back to 120/70. My blood and urine labs were normal, but I am back on bed rest for at least the next few days. My bp will be rechecked on Friday and Monday. I am so bummed! To make it more stressful for me, my regular OB is on vacation this week, so I had to see one of her partners, who doesn't have the best communication style. I therefore learned all about the worst case scenario of possibly having preeclampsia and if I do have that, needing to be induced, etc. I am not currently diagnosed with preeclampsia because of my normal labs, but I will be monitored super closely from now on.

I wasn't even allowed the extra shot of progesterone, because of the possibility of needing to be induced within the next week if I develop preeclampsia. I was shocked.

I have been in tears today, totally freaked out and stressed. : (

Rethinking the Definition of Term Pregnancy

So this article freaked me out today:

Rethinking the Definition of "Term Pregnancy"

Click on the title to read the abstract. Basically, according to new research, "term pregnancy" should reference women who are 39-40 weeks pregnant. 37-38 weeks should be considered "early term." Early term infants are at higher risk for things like chronic respiratory disease and learning problems. And I thought getting to 37 weeks was enough! Of course, early term infants are at less risk for these things than preterm infants (less than 37 weeks gestation)... but still...

Well, when I reach 37 weeks on Saturday - you know I will be celebrating! It is still full-term to me, and SO much better than 26 weeks!

36 Weeks!!!

I can't believe we made it this far - one more week until this babe is full-term! :) I am feeling really good. Just easily tired from activity and trying to build up my strength, which has diminished after six weeks of bedrest. I still contract often, but that is considered normal at this point, as long as the contractions aren't painful. I am guessing this babe to be about six pounds now, which is average. Alden was about five pounds and still in the NICU when he was adjusted to 36 weeks gestation. It takes a lot more effort and struggle for a baby to grow outside the womb. We know exactly what a 36-weeker looks like. I still remember thinking that our five pound boy looked HUGE! Thumper is most likely already about three times Alden's birth weight and has had ten more weeks in utero. We feel extremely lucky.

Go all the way, Baby!

Today was going to be my last shot. My 20th! But I saw a little left in vial and asked if it would be OK to get just one more next week -- the nurse looked at me funny and said it would be fine, but most women can't wait to be done with the shots! She also said that if I want to "go all the way with the pregnancy," then that's the way to do it. I said, let's schedule that appointment! I am now labeled "hard core." The shots aren't that bad, really. If one more will buy me an extra week, it is VERY worth it!

Happy Independence Day!

35 weeks = No more bed rest = Happy Independence Day to me! :D



I actually left the house to go see the fireworks yesterday - that's the longest I have been outside for the last six weeks. It feels great to rejoin the world!

2 more days...!!!

In two days, I will be 35 weeks and then my bedrest restriction will be gone! Woo-hoo! My OB still wants me to take it VERY easy, however. No going back to work or to much household cleaning/cooking...darn. :) I can try to walk a block, though, as long as contractions don't start up. If I start to feel a lot of contractions, I have to rest again. Wish me luck!

I'm glad we got a pic of Alden showing his baby some lovin'! He often brings me water in bed and pulls the blanket up over his baby brother/sister...he's very excited!




We lack full-length mirrors in our home - so you can imagine my shock at how big I really am! WOW!


As my Mom was taking this photo she exclaimed, "You're as big as a watermelon!"

34 weeks!!!

We are now in the "golden zone." If Baby Boo is born now, he/she would do very well and not be at risk for long-term preemie complications.

PHEW!!!

So far, this babe has had about eight more weeks in utero than his/her big brother. Pretty amazing.

Next milestone is 35 weeks - then Thumper could possibly come home with us and avoid the NICU - wouldn't that be something?

Since we know Thumper was about 3 lbs at 29 weeks, I would guess Thumper to be about 5 lbs now. Baby is getting big and strong - those kicks are mighty powerful! Not just little "thumps" anymore, that's for sure!

Five weeks of bedrest, one more to go. Then I can really celebrate "Independence Day." But, to tell the truth, I'm going to continue to take it really easy until I reach the 37 week milestone. I am feeling contractions every time I get up, so I'm not taking any chances. Why risk it when we've come so far?

Terbutaline

Many women are still prescribed Terbutaline to prevent preterm labor. I asked my OB about it, and she refused to prescribe it for me. Now I know why! This is good info for anyone trying to prevent preterm labor:


TERBUTALINE
Terbutaline Sulfate, sold under the brand names Brethine and Bricanyl, is an asthma medication that has come to be used on an "off-label" basis to treat preterm labor. Premature labor occurs in nearly 20 percent of all pregnancies in the United States and an estimated 1 million women annually are treated with Terbutaline or similar drugs to halt early contractions. The use of Terbutaline for this purpose is not an approved use by the Food and Drug Administration ("FDA"). As early as 1997 the FDA issued its first warning concerning the potential dangers associated with the use of this drug for the treatment and prevention of preterm labor. As noted by the FDA, "The approved labeling for terbutaline...states that the drug should not be used for management of preterm labor."

Supporting the reasons for not using Terbutaline to manage preterm labor, studies have revealed a link between the use of terbutaline during pregnancy and an increased risk of brain damage and cognitive deficits. These conditions manifest themselves at infancy, continue through adolescence and cause permanent disabilities. A study conducted at Duke University showed that the use of terbutaline may leave the brains of children susceptible to other chemicals present in the environment. The researchers suggest that such an exposure predispose newborns and infants to fall victim to particular ailments and medical conditions in the future.

Consistent with the findings of the Duke University study, the National Asthma Education and Prevention Program has recommended that Terbutaline no longer be given to women with mild intermittent asthma while they are pregnant. The reason for this recommendation was that drugs such as Terbutaline, when administered to pregnant women, also penetrate to the fetus where they affect brain development.

Even the American College of Obstetrics and Gynecology ("ACOG") warns against the use of terbutaline to prevent preterm labor, when they stated in a Technical Bulletin to it's members that "no studies have convincingly demonstrated an improvement in survival or any index of long-term neonatal outcome with the use of tocolytic (Terbutaline) therapy. On the other hand, the potential damages of tocolytic therapy to the mother and the neonate are well documented."

Here is also a link to the FDA warning dated November 13 1997
http://www.fda.gov/medwatch/SAFETY/1997/terbut.htm

No more cervical lengths

I saw my regular OB again today, because I didn't like that my Perinatologist doesn't want to see me anymore and I was thinking that I wanted another cervical length. Well, my OB (and my hubby) talked me out of it because:
1. A shorter cervix would freak me out
2. If my cervix shortened, there would be nothing more she would do, especially since I am nearing a very low-risk zone of 34 weeks and beyond (the "golden zone" as my OB likes to call it).
3. No one knows what a short cervix at this point means. Research has only looked at cervical lengths from 24-28 weeks as far as predicting anything. No one seems to care about a cervical length at 32+ weeks.

So that's it for cervical lengths. I won't be checked again for dilation until 36 weeks. I was 1-2 cm dilated at 29 weeks, who knows what it will be like at 36 (fingers crossed I make it to 36)!

My blood pressure and Thumper's heart rate were both fine. Thumper is head-down and measuring exactly 33 weeks. I, on the other hand, have gained 3 lbs in one week! Bedrest is taking its toll. Time to decrease the ice cream consumption. Maybe one small bowl every OTHER day, haha!

33 Weeks!

I can't tell you how happy I am to be still here and pregnant at 33 weeks! That's seven more weeks than Alden got. Alden was 2 lbs, 2 oz when he was born, and this babe is probably already a little more than twice that. Seven more weeks to go until 40 weeks!

I definitely breathe a little easier with each passing week. At 34 weeks, Thumper will be at no risk for any life long preemie problems. At 35 weeks, Thumper will be a "take home baby," meaning no NICU time. And 37 weeks, of course, is full term.

We are so close!

32 weeks, 3 days OB visit

No new concerns. I will stay on bedrest until about 35 weeks. At 35 weeks, most babies don't need to see the NICU - that would be wonderful! :)

Since the high risk clinic doesn't want to see me anymore, I will start seeing my regular OB weekly. Mostly for my mental health, as I have gotten used to being reassured on a weekly basis! We might take a peek at my cervix next week with my OB's ultrasound machine, which is much more basic than at the high risk clinic, but can still get a length.

My 17th shot is tomorrow and then only 3 left to go! :)

31 weeks, 5 days pics

I love my belly...


I love my linea nigra...



I love my baby...


I really am on bedrest, and only stomp about the yard for photo shoots! :)

Belly Pic!

This is from last week...

Shortened Cervix

Well, my cervix has shortened to 2.7 cm, and the Perinatologist could care less. In fact, she doesn't want to see me anymore. The reason is that I will be 32 weeks pregnant on Saturday, and 32 weekers do just about as well as full-term babes. But I care! If Thumper were to be born now, he/she would still have to be in the NICU for about a month, and I really don't want that. The Peri also said that having a shorter cervix might not mean anything, as many women have a cervix that starts to shorten around this time, and still carry to full-term. I guess I was just really hoping to still have a nice, long one that isn't dilating. I was 1-2 cm 2 weeks ago, and I have no idea if that has changed. I'm still hoping to hold on for another 5 weeks!

Anyways, here are the last of the ultrasound pics of Thumper. 31 weeks, 4 days gestation...

30 weeks, 4 days: OB visit

My OB is now very optimistic, once again, about my ability to make it full-term! I have been having a few contractions here and there, but nothing significant (knock-on-wood!). Mostly just when I am up and about for too long. I am taking nifedipine 1-2 times a day when I feel more contractions than I would like, which helps a lot. My OB says that current research shows that nifedipine isn't really effective in prolonging pregnancy once the steroid shots are in (that 48-hour stint I went through last week). But nifedipine also can't hurt anything, and if it is good for my mental health to not be feeling contractions, all the better. I'll probably continue to take it until I am 36 weeks along. That's when I will feel the most comfortable.

So today I am allowed to sit up with my feet up. I no longer have to lie flat, on one hip all day. My hips will be happy. If all is well at 32 weeks, I can do light things around the house, but continuing to monitor the effects on my contractions. She also said that, if all is well, I can come off of bed rest around 34 weeks. But if I am still feeling contractions, then I will probably want to continue to take it easy. I am no risk-taker!

My blood pressure and fetal heart tones are good. I am measuring 30 weeks, exactly. I have lost a pound, which I cannot imagine. I am a complete sloth and eating a ton - how can I have LOST weight? I should have some ice cream tonight - it's so important right now! :)

15 progesterone shots down, only 5 left to go! Hooray!

In the 30s!

Today I am 30 weeks pregnant. I have never been 30-something-weeks along, and I am SO happy to have made it this far!

Bedrest is hard, but I can tell how necessary it is. My uterus is definitely more sensitive and "jumpy" since my hospital visit last Sunday. I contract every time I get up. The contractions could be normal and harmless - but I'm not taking any chances!

I forgot to mention that we asked for Thumper's weight at our last ultrasound on Wednesday. 3 lbs! A very good weight for a 29 weeker! :)

Preggo pic

Upon realizing that I didn't have a single picture of my pregnant self, my Mom took this the day I turned 29 weeks pregnant. Also the day before I was hospitalized for preterm labor. Maybe when I am allowed to be upright again, I will be able to get more pictures. I'm just glad to have this at all!

Bedrest

I am home now on bedrest. This is because of the fact that I am 1-2 cm dilated, and we don't know if I have been this way for a long time, or if it is the result of all the painful contractions I had on Sunday. My OB is being very conservative because of my history delivering so early - and I don't blame her! Bedrest is very strict until I am about 32 weeks along. That means I am to lie in bed or lie on the couch, I can get up only to use the bathroom, take a shower, get a snack. That's it. If, at 32 weeks, my cervix is still lovely and I'm not contracting too much, then bedrest can be modified to include some more activity. If everything is perfect by 34 weeks, I might be able to rejoin the world. That will be on June 26th - a long time from now. This is going to be quite the adventure! I just feel so lucky to still be pregnant.

To Hell and Back: Still Pregnant!

We have, so far, received the best news we could have hoped for. I am still very pregnant and it looks like I will be discharged from the hospital tomorrow morning!

I do not wish magnesium sulfate on anyone. Some women don't experience all the side effects, while others are tormented with them all. I was the unlucky latter. It was truly a nightmare for me and the family, but we are so very thankful that we made it though, slowed down my contractions, and baby got the two needed steroid shots over the 48 hour period. The shots are needed to speed up baby lung development, should Thumper be born too soon. I had also gotten the shots for Alden last time, but didn't need to be on Magnesium Sulfate to stop preterm labor, because I was able to use a much nicer drug that can only be used until the 27th week gestation. Too far along for that now!

I am still in the hospital tonight, and will meet with my OB tomorrow morning to determine the final plan of care. After we made it through the mag sulfate, I had a cervical ultrasound which showed - amazingly - that my cervix looks NORMAL at 3.5 cm! I cried many tears of joy at that. The Perinatologist who reviewed the u/s also said that many women are 1-2 cm dilated throughout much of their second pregnancy. She also said that with an amazingly long cervix like this at 29 1/2 weeks, I have only about a 1% chance of delivering before 34 weeks gestation. Simply unbelievable. I cried many tears of joy when I heard that.

We met briefly with the Senior Resident here, who said that I will be discharged tomorrow morning. Possibly on home bedrest, but also possibly back to work, if my OB deems work is a place that won't cause my uterus to contract too much. Although many women contract normally throughout their 3rd trimester, it is so hard to say with my history what is normal for me.

There is no way I could have gone through Hell and back without the incredible support of Dave, Alden, and our families. Alden is doing great visiting me in the hospital. Asking really good questions, and painting pictures for all of us at his daycare. He knows that I am getting better, but doesn't know that it has anything to do with Thumper, which I think is best.

Thanks for all of your support. We'll keep you updated!

In Hospital

Real quick: I was admitted at 8am for preterm labor. Cervix is still long, but dilated 1-2 cm. Contracting a ton, but no more cervical changes so far. I am on bedrest and a nasty iv med called magnesium sulfate. Makes me feel crappy. I got the first dose of a steroid shot to speed up development of babe's lungs. I need two over a period of 48 hours to be really effective. I'm sure you can all imagine how we feel. We are hoping for the best. What is the best? I am on mag for 2 more days to speed up the lungs. Then stay in hospital and watched for 4-5 more days then sent home on strict bedrest until 34 weeks. Then I can do whatever. We are praying for that...

28 weeks, 5 days

My OB visit went well today. She said that my visits are getting more and more "normal." She also said that I would be cursing her at 41 weeks! Alden's early birth is being seen now as a "fluke" and most likely the result of a sub-clinical infection. Sort of bittersweet knowing that. Nothing anatomically wrong with me, but still so sad that Alden had to endure the result of a little infection. I just feel so lucky that he wasn't damaged by bacteria!

No welt after the shot this time. So weird. Doesn't seem like I am allergic to it after all. Still taking it one week at a time!

Nesting

Hubby pointed out that I have started to "nest." I hope that doesn't mean that baby is coming too soon! I have the dresser and changing table all set in our room. I even stocked the dresser with green and yellow clothes. A bag of blue clothes are standing by, just in case. I swept and mopped and dusted. I am obsessed over what cloth diapers to buy. All sorts of baby items are coming down from the attic. I am getting so excited to set everything up - but at the same time, I hope my "nesting" instinct isn't predicting an early birth. It's hard not to be wary at all times.

Happy Third Trimester!

28 weeks today! We are very excited to be in the third trimester for the first time! :) I need to get some preggo pics soon. I am the biggest I have ever been, and it is so awesome!

Welt

It appeared today at the injection site. Too weird. I just hope it doesn't mean I am developing an allergy. Just another normal roller-coaster day!

More Good News

My shot today, given by the experienced high risk clinic nurse, was considerably less painful. Did not even form a little welt. Hmmmm... I'm beginning to think that my original theory about last week's welt was correct: it was the nurse's poor technique, NOT an allergic reaction.

Anyways, my cervix is still strong and long. The perinatologist said again today that she thinks my risk of delivering prematurely is pretty low. Still higher than the general population because of my history, but lower than the docs originally thought. I have a good chance of actually making it another 10 weeks! Woo-hoo!!!

Here is a pic to melt your heart. Or crack you up. Here is a very bendy baby, smelling his/her toes:

Good news

I don't have gestational diabetes! Woo-hoo! I celebrated by eating some of the yummy oatmeal-peanut butter-chocolate chip cookies I made yesterday. Guilt free! Thumper also celebrated by doing cartwheels after we ate the cookies.

Rough day

Had my glucose tolerance test this morning. 4 blood draws over a period of 3 hours. I won't know the results until tomorrow. I did find a meta-analysis from 2008 that states women who receive 17P are more at risk for developing gestational diabetes. So at least I know that if I do have it, it isn't because of ME, or my genetics or diet. It is because of the 17P. Would have been nice if someone at the clinic informed me of that.

What really upset me today is that I had a localized welt, for the first time in 11 weeks, from the shot I received last week. I assumed that it was because the nurse administered it too fast, but wanted to get checked out while I was there, since it wasn't totally gone. It was determined that it is an allergic reaction of sorts. I was told by my doc's nurse that I could go ahead and try the shot again on Wednesday, but to bring Benadryl just in case it happens again, and I will have to wait and be "watched" for an hour to see if I get the welt again. I was fine with that, until the nurse said, "And if it happens again, you will probably have to stop the 17P." At which time I totally freak, since I strongly feel that the shots are keeping Thumper baking inside and not outside of me.

I go through the rest of the day crying on and off, until I decide to call my doctor and ask to speak to her myself. I am so glad I did that. She said that we would NOT just stop the 17P. She would consult best practice with the pharmacist, and most likely recommend that I take either Benadryl or prednisone before I get the weekly shot. I would rather not take prednisone, but it sure beats stopping 17P - which I consider life-saving for Thumper. It really upsets me when I encounter a nurse who should know better: don't just say things off the top of your head if it isn't a doctor's order!!

Hopefully, the welt was a one-time-thing.

I will update on Wednesday.

27 weeks!

Every day now is like a "first pregnancy" experience for me. I've never been 27 weeks pregnant. I've never been this big! Next week, I will be in the third trimester for the first time.

My OB says she is more convinced that Alden's early birth was a "fluke." Perhaps a sub-clinical infection (one that can't be detected without an amniocentesis). She thinks I could even possibly make it to full-term! Another first for me. I have no idea what it would be like to deliver a large baby.

We are interviewing two doulas next week - I'm excited!

When Alden was about 27 weeks, we could hold him for the first time and start to take care of him. I can't help but flash back to the NICU with every milestone I reach. How I do love to watch Thumper thump around inside me! His/her kicks are so strong, I can watch my belly move - another first for me.

Failed 1-hour glucose

Must have been that Einstein's bagel with cream cheese I had this morning. I scored a 139, and the limit is 135 - so barely over. Now I have to go in on Monday for a 3-hour glucose test. Ugh. And to think: I was EXCITED to take the glucose screen, because I never was able to in my last pregnancy! The nurse said that many women fail if they have a lot of carbs the morning of the test. Now I know. I just hope that I don't have gestational diabetes! That would be crazy. Other than that, things are normal.

Also, I have more shots behind me (so to speak), than I have yet to endure. 11 shots down, only 9 to go! This is also a reminder that Thumper (if all goes well) could be here in just about 10 weeks. Are we ready???

26 weeks, 1 day gestation

Alden was born at 26 weeks, 1 day gestation. My labor would have started around 7:30 last night, and continued for 24 hours. After 11 days of hospitalized bedrest. I am a bit teary today. I am so thankful that Thumper is still thumping away inside me, and I am allowed to just go about my normal, everyday life. We have two birthday parties to attend today, ironically.

We hopefully still have many weeks ahead of us. It is terrifying and amazing to still try and grasp the concept that a little two pound infant can not only prematurely enter the world now, but survive and thrive. I am all too aware that Alden is a miracle - many babes born around this time have life-long disabilities. We are so very blessed.

Every passing day will be a blessing to this baby. And, really, it is all thanks to Alden. If he didn't go through what he did, we would never know how to prevent a premature delivery for Thumper. Alden is our little hero.

Sadly, we all know what 26 weeks, 1 day gestation looks like outside of my womb:

Double-digits!!

Only 99 days to go! Woo-hoo!!!

All is Well

I had another ultrasound of my cervix today, and it is still holding strong, long, and closed. Yippee!! I am also halfway done with my 17P shots - 10 shots, 10 to go. They are not nearly as painful as I feared. Bring on the next 10!

So far, I think the nifedipine is helping. I am still feeling some contractions, but none that are clustered together (knock-on-wood! I am becoming quite superstitious and don't want to jinx myself!)

No good pics to show today, really. The umbilical cord was right in front of Thumper's face. The tech said that as Thumper gets bigger, there will be less and less space, and it will be more difficult to get a good portrait. Oh well, a small price to pay for growing a big, full-term baby!

24 weeks, 4 days check-up

Everything still looks good! Cervix is still hanging out at 3.7 cm.

I have had an emotional week. I think just being sick has left me tired and teary - but I also might be having a bit of PTSD. Also having a bunch of contractions Monday morning and Tuesday night didn't help my mental state. Thankfully, the contractions don't seem to be affecting my cervix!

Three years ago, I was admitted to the hospital at 24 weeks, 5 days gestation. My cervix was mostly gone, fingertip dilated, and my bag of waters was pouching through. I was hospitalized for 11 days before I delivered. I am SO relieved that things are different this time! I am not even on bedrest (knock-on-wood!). For some reason, I was sure I would be on bedrest by this point. I am starting to feel more optimistic!

My doctor today said that many women contract just as much as me throughout their entire pregnancy, and still deliver full term. But she can't say for sure that my contractions didn't cause a change in my cervix last time with Alden. So, to be on the safe side and for my mental health, she is putting me on around-the-clock nifedipine to decrease my contractions. I will most likely still contract, but shouldn't have anymore contractions clustered together (like the 4 in 30 minutes I had on Monday, etc). So hopefully that works!

24 weeks today

This is a milestone, because it I went into preterm labor today, the doc in L & D would try like all heck to stop my labor. Thumper is considered "viable" today, which means that he/she could potentially survive if born today. Before "viability," docs don't use prescription medication to try to stop the labor, because they are usually pessimistic that it would be useless. Anyway, I have mixed feelings about being 24 weeks, because even though Thumper is "viable," Thumper would have some serious disabilities if if she/he was born today.

My next milestone is 26 weeks, 2 days - I will be the most pregnant I have ever been!

After that, the next milestone is 28 weeks. If my cervix still looks fabulous at 28 weeks, my risk of delivering before 35 weeks goes down to 10%. That would be awesome.

I am feeling great contraction-wise (knock-on-wood), but this could be a very emotional next couple of weeks. I was hospitalized with my first at 24 weeks, 5 days.

I am feeling not-so-great sick-wise. I have a nasty upper respiratory cold. Ugggh.

23 weeks, 4 days Ultrasound

I have a "perfect" beautiful, long cervix! Yaaay! The high risk doc said that I have reached a milestone. I am in the time period where if I have a lovely cervix, my chances of delivering prematurely decrease. Research also shows that if my cervix is still gorgeous at 28 weeks, my risk of delivering prematurely decreases again dramatically. Let's all pray for that!! With Alden, my cervix certainly wasn't lovely at 24 weeks -- it was barely there at all. I am so thankful that we are in a different place this time around!

Another bonus of cervical lengths every two weeks: pics of Thumper!



A little smile...

22 weeks, 4 days Check-up

All is well. I am actually measuring at 24 and 1/2 weeks! My weight is good - this could be a big baby! Wouldn't that be a change? I asked for my cervix to be checked again today. Not because I was particularly concerned, just for general peace of mind. It was 3.7 - perfect. I haven't had too many contractions since last Tuesday. My Mom came to visit this weekend, while Hubby and Son went to visit other family. I was spoiled rotten, and my uterus loved it. I had maybe just one contraction the entire 3 days. I also got my first pregnancy massage ever - I think I'm going to have to find a way to get that more often! Aaaahhh...

Feeling Thumper

I've felt Thumper's thump since about 16 weeks. Last night, Hubby felt his strong little babe for the first time! 22 weeks, 2 days to be exact!

Phew!

I got good news at my 2 week cervical length check at the high risk clinic! My cervix is now 3.6 cm (it was 3.3, I think, 2 weeks ago)! The technician said that the difference could be just due to different techs doing the measurement. I don't care - I'll take it!

I was greatly relieved because I had cluster contactions again Monday night. My OB is on Spring break, so I had to talk to one of her partner's nurses Tuesday morning, who was also really good. That is just such a good clinic. She said that I could take 400-800 mg of ibuprofen that day, but no more. And I couldn't take ibuprofen for more than 3 days. It's supposed to be a temporary fix for cluster contractions in mid-pregnancy. It did the trick! I also rested at home and drank gallons of fluids. I felt much better.

I can't think of anything that would have "brought it on" Monday night. My OB did say that it is really normal for many women to have braxton hicks starting around this time. I was also told that with Alden, but it didn't turn out to be benign contractions in that case. So it is really hard to know if my contractions are safe or not, and I am just so happy, again, that I am being taken VERY seriously this time, watched like a hawk, and the clinic's doors are open any time I want to get checked out. Like I said: PHEW!

Another perk of going to the high risk clinic for cervical lengths every 2 weeks: 4D ultrasound pics!! Here's the latest of Thumper (taking a rare moment to sleep!), 21 weeks, 4 days today. Heart rate: 150. Hubby said that it looks like Thumper is crying in this pic - must be the amniotic fluid, because on the screen, we watched him/her smiling in his/her sleep...

Physical Assessment Guidelines to Establish Risk

Here is a good link, that really explains preterm labor and defines high risk. It also points to the evidence behind doing routine cervical checks. It gives me hope!

http://emedicine.medscape.com/article/260998-overview

Here is an exerpt:

Physical assessment guidelines to establish risk

Previous preterm deliveries, including autopsy reports and medical records, if appropriate and available, should be reviewed. Social stressors (including housing and food availability), social support in the family, financial stability, domestic violence, drug abuse involving the patient or her family, and death or serious illness in a close family member should be assessed.

The integrity of the cervix and the extent of any prior injury to the cervix may be assessed by speculum and digital examination. The presence of asymptomatic bacteriuria, STD, and symptomatic BV may be investigated.

In some patients, formal cervical length assessment may be of use in risk assessment.
Cervical length during prenatal care, particularly at 24-28 weeks’ gestation, has been demonstrated to be the most sensitive prenatal predictor of preterm birth between both high- and low-risk women. In a mixed high- and low-risk population of singleton pregnancies, transvaginal ultrasound-measured cervical length at 24 weeks was highly correlated with the risk of spontaneous preterm delivery before 35 weeks.6 The relative risk of preterm delivery among women with a cervix 25 mm or shorter at 24 weeks was 6.2. Furthermore, at 28 weeks, a short cervix (≤25 mm) was associated with a 9.6 relative risk of preterm delivery. Cervical length 25 mm or shorter at 28 weeks had a 49% sensitivity for prediction of preterm delivery at less than 35 weeks, a value markedly greater than that of cervical funneling.

Among high-risk women with a history of one or more spontaneous preterm births (excluding those with multiple gestation, uterine anomalies, and prior cervical surgeries), 20% of patients demonstrated a cervical length shorter than 25 mm by transvaginal ultrasonography at 22-25 weeks.7 Among these patients with a short cervix and one previous preterm birth, 37.5% delivered at less than 35 weeks. In contrast, patients with a cervical length longer than 25 mm had a preterm rate (<35 wk) of only 10.6%. Cervical length has similarly been demonstrated as the optimal predictor of preterm delivery in low-risk women. In an assessment of low-risk women, short cervical length at 24-28 weeks was detected in 8.5% of women.8 These patients demonstrated a relative risk of 6.9 for preterm delivery at less than 35 weeks. As compared with fetal fibronectin or Bishop score, cervical length demonstrated the greatest sensitivity (39%), with a specificity of 92.5% and a negative predictive value of 98%.

In addition to the 24-28 week assessment, evidence shows the value of early midtrimester cervical length measurement. Studies of Owen et al from the Maternal Fetal Medicine Units Network10 demonstrate the value of cervical length measurements between 16 weeks and 23 weeks and 6 days. Serial transvaginal ultrasonographic cervical length measurements in a high-risk population demonstrated that a cervix shorter than 25 mm resulted in a relative risk of 4.5 for spontaneous preterm birth at less than 35 weeks, with a 69% sensitivity, 80% specificity, 55% positive predictive value, and 88% negative predictive value. As the NIH Maternal Fetal Medicine Units Network is initiating a study of progesterone treatment for patients with a short cervix in the early midtrimester, a program of routine cervical length screening may soon be justified.

Among patients with a short cervix, education should be provided concerning the signs and symptoms of preterm labor, especially as the pregnancy approaches potential viability. Prenatal visits/contacts may be scheduled at more frequent intervals to increase patient interaction with the care provider, especially between 20 and 34 weeks’ gestation, which may decrease the rate of extreme preterm birth.4

Rough night...

Last night I had about 7 contractions in 4 hours, and some more this morning. Alden and I are sick with colds, and were up coughing all night. I also started to freak about my contractions, so ended up with very little sleep. About 6 contractions/24 hours has been the norm for me - not 7 in 4 hours! Luckily, my amazing OB agreed to see me first thing this AM. It is her "on-call" day, so she doesn't even have patient appointments scheduled, but she saw me and did a cervical u/s. My cervix still looks long and closed, with no funneling. I am so relieved! My blood pressure was also great, and Thumper was kicking away at the doppler again, with a heartrate of 152. She told me to call anytime, even if I just need a peace of mind - and she wasn't kidding! I was also instructed to take some Robitussin tonight. I will have a much more enjoyable weekend now. I can't describe enough what a difference it make for me, mentally, to feel so well cared for.

21 weeks tomorrow!

20 week anatomy scan and cervical length

19 weeks, 6 days today, to be exact! We saw our beautiful, 12 ounce babe for the first time today. The Perinatologist also said our little girl/boy is beautiful - the opinion was shared by all. Everything looked perfect, including my cervix - thank goodness! I was greatly relieved, because Thursday was a little rough for me. After a Wednesday with lots of walking, stair-climbing, and playing on a playground with my 3 year old, I was feeling more contractions than I liked. They were still not frequent or regular - I just HATE feeling them at all. I feel much better after taking it easy yesterday and today. The good news also helps. I am learning my limits!

We had the technician write the gender in a little baby card that we are keeping sealed, unless I have to go on bedrest... then we would find out! I have to admit it is difficult to not just rip it open...!

OK, now for the show!

Blowing a bubble?!




Another profile...




Hi there!




A secret smile...

18 week check

18 weeks, 4 days today. So far, so good! Heart rate was 160. Baby was kicking the heart Doppler so much, that it was difficult for the nurse to read it! My new name for this babe is "Thumper." I am feeling him/her kick all day - does Thumper ever sleep?

I am still having infrequent, irregular contractions. My OB is not worried - this can be completely normal for some women. To ease my mind, she did a cervical ultrasound, and my cervix is nice and long at a little over 4 cm. Phew!

Another shot today. 17 more to go!

Our full anatomy scan is next Friday! We are SO excited!

16 week check

16 weeks, 5 days today - to be exact!

My appt yesterday went very well. The 17P shots from Wedgewood pharmacy arrived to my door without any glitches, and my insurance is covering it (reimbursing me) as a matter-of-course. It worked out perfectly. Phew! I brought it to the clinic, and nurse injected it for me with minimal pain. So far, so good. Just 19 more weekly shots to go.

I have started to notice a few contractions here and there. Dr. Wiedel stated that while it is a bit early to feel them, it is still within the normal range. It is good that I am feeling no pain, just tightening. Although, I didn't feel any pain with Alden either. So the main thing I have to notice is if they are frequent and regular (2 contractions every hour, for example). Mine are not. I am feeling 1 or 2 in the morning, 1-2 in the PM, 1-2 at night. They are still very random and not frequent. She said that if I start to be concerned, at any point I can come in to have a cervical u/s check. She did one today (I have them every 2 weeks now with the OB), and my cervix is still perfect at a little over 4 cm. I will start to have the cervical checks every 2 weeks at my high risk Perinatologist's clinic starting at 20 weeks. If there is any sign of change, the Peri would take the lead on course of action - whether it would be bed rest, medication, cervical cerclage, etc.

I heard the heartbeat yesterday as well. About 159 bpm. It was strong, like a horse's gallop.

The Elusive 17P Shot

Just a quick update on the recent drama. Last Thursday, I received a phone call from one of my doctor's nurses (I'll call her Wicked Nurse)who states that they can't give me 17P at their clinic because the manufacturer only makes it with latex stoppers. I'm allergic. She refers me to a home health service which gives latex-free injections. And if my insurance won't cover it? Oh well! "We'll just continue to monitor you closely." I DON'T THINK SO! I honestly don't know if I would have risked getting pregnant again if the only thing that could be done for me is "close monitoring." I went into full blown panic mode - especially when my insurance denied the service. Then on Monday (the same day as my son's eye surgery) a different nurse (Good Nurse)called to inform me that she called basically all the clinics and pharmacies in Wisconsin to try to find a 17P source that is latex-free with no luck. Also, I am apparently the first and only high risk preggo to also have a latex allergy. Totally ludicrous, I say. But she goes on to inform me that she started to call pharmacies in other states, and found one who will provide 17P latex-free, and will ship it to me tomorrow. My plan is to pay the expense out-of-pocket for one month, and guilt-trip my insurance (do you want to pay $1 million to the NICU, or $300 to the pharmacy?) into reimbursing me and covering the remainder of my shots (I need 20. One a week starting at 16 weeks). So that is the plan. I am apparently foraging the way for future Wisconsin high risk preggos who can't stand latex. Lucky me.

12 week check

12 weeks, 4 days today...

I heard the heartbeat - 164 bpm! I was not expecting to be able to hear it so soon, it was a wonderful treat. Everything is great so far. I just love the clinic. I feel listened to, and all of my questions and concerns are taken seriously.

We discussed the plan again. At my 16 week check, I will start the p17 shots. I will then continue to get the shot every week until at least 34-35 weeks. I can continue until 37 weeks, if I want, which I might. I will also see Dr. Wiedel every two weeks starting at 16 weeks. My first ultrasound will happen at 20 weeks, with cervical check ultrasounds every 2 weeks after that. We are so excited for 20 weeks! And no, we do not want to find out if baby is a girl or boy at that time. We will only find out if I have to be put on bedrest. I believe it will help me to focus on "the light at the end of the tunnel," if I have to ever go through that.

We are hoping for a long, boring, uneventful pregnancy!

First Visit

Sorry it has taken me awhile to post about my first visit, but I have been waiting for DH to help me scan the u/s (see below!). I couldn't see the midwives again, because I am now high risk. I didn't like that there are 10 of them anyways - I never saw the same provider twice. Also, I wasn't too impressed with my experience with the UW-Clinic MDs while I was in the hospitalized with Alden. There were, again, too many and none of them seemed to know what they were talking about. So I switched to Associated Physicians. A smaller practice (5 OBs - hopefully I will get to meet them all!). One of whom was referred to me by a nurse/preemie Mom. She was referred to the MD by another MD/preemie mom.

Dr. Weidel seems fabulous. She took a lot of time with me answering my questions and talking about the plan. She did the ultrasound herself. Basically, I am going to start the progesterone shots at 16 weeks, as well as a small bit of Prozac to build it up in my system so when I hit 20 weeks, I won't be at as high risk for PTSD. Both she and the perinatologist are concerned about the effect of stress/anxiety on this pregnancy. I too am concerned about getting anxious when I hit the same time period (20-26 weeks) when things went downhill in my last pregnancy. Dr. Weidel is also going to prescribe something in case I have an anxiety attack during that time. She anticipates me not needing those meds once I hit about 28-30 weeks, and I agree. We will celebrate then. Also, I am going to see her every 1-2 weeks starting at 16 weeks. I will start to see the perinatologist at 20 weeks. The Peri will do an ultrasound every 2 weeks until baby is here, to measure my cervix. At the first sign of any change, they will pull me off work. I will either be on bedrest at home, or in the hospital, depending on the severity of the change, and on whether or not I can truly rest at home.

So that's the plan for now! I am seeing her again when I am 12 weeks.

Here's our little bean! At the time, measuring 8 weeks, 3 days. Thanks to charting my cycle, I was right on for when I conceived! Heart-rate, cervical length, and everything else looked great.