Day 4

The difference between Daria and her sister is uncanny - you can't even say they're related, they look so differently!

Pictures!

Hello everyone!

I'm very sorry for the delay in getting pictures and details 'out there'. Unfortunately Daria is a pumpkin head - no lie, 36 cm. head circumference! She dislocated my tailbone and gave me a 3rd degree tear so I've been too uncomfortable to sit for too long and I've got some serious edema going on in my feet (can't even wear flip flops) so even standing is painful.

But - she's wonderful. We went home on Thursday, she's officially a 'take home kid' and she's eating magnificently. It's really nice to have a baby that will actually feed at the breast this time. She's only lost weight until discharge - going from 7.14 to 7.6 and has been gaining really well since. I imagine when she gets weighed on Wednesday that she'll be above her birth weight. Even better was that her bilirubin levels were great and we haven't had to do lights or anything out of the ordinary.

It was a little surreal to go through Arianna's baby clothes and realize that much of the clothes she wore for her first 6 months are actually going to be too small for her sister. Otherwise she's a great little lady and we're truely blessed to have her in our lives - I'm so in love with her chubby cheeks!

With big sister Arianna, who is so in love with her 'baby'

Announcing...

Daria Michelle
Born 8/19/2008 @ 6:03pm
7 lbs, 14 oz.

Pictures to follow!

In the Hospital

I've been admitted to the hospital with labor. News to follow!

hmm?

So I'm going on 4 hours of one constant contraction and (TMI) I know I lost my plug (again) this afternoon, so I'm definitely more dilated.

In some way I hope this is it - I'm really tired of being constantly nauseous right now...

I'm going to sit on the ball for a little while and see how everything goes.

Monday Update

So I went to my OBs office for a 10:15 appointment and we're making some (very slow) progress. I'm 100% effaced, kid is fully engaged (don't know the station) and I'm now 1.5 cm dilated... so 1/2 cm. I'll take it - its better than nothing! I scored a 9 on my bishop scale (which is the 'how good is this person for an induction' rating) and a 9 is good - so if they could/would induce, I'd be golden... but my hospital doesn't do any kind of induction until 39 weeks.

So, encouraged by the appointment, I decided to go walking at the mall. I walked for nearly an hour and stopped to get some sorbet (shhh... don't tell my doc). I've had what feels like one solid contraction since then, not painful but overall tightness that just won't give up - I hope that's a good sign!

I'm really tired now so I'm going to go lay down and take a nap and hope these continue on their own.

Monday...

Well, we didn't have to go to the hospital last night. I managed to sleep, which was needed. I was up probably every 2 hours or so but was able to 'switch sides' and get back to sleep, which was good.

No regular contractions yet today, just a few big doozies, but I have an appointment with one of the OBs in my office at 10:15 AM today - so I'm hopeful that there has been some progress since Saturday, and if not I hope she's willing to 'help things along'. I'm really frustrated - I wish I hadn't agreed to the terb shot.

Hubby was in a car accident on his way home Friday so we're down to one car this week - thankfully he works close to home. We drove up to my parents home to pick up Arianna and drop her off at daycare - I'm hoping we won't need to go to the hospital today because she was really distraught when we left her this morning. You could tell she really missed us and kept asking to go home.

So I'm just waiting at this point - feeling really nauseous this morning for some reason so I won't be going for a long walk before my appointment. Its supposed to be really hot today so if I haven't progressed enough to go to the hospital I'll probably just go to the mall and walk around for a while...

Another update

So its about quarter of 8 PM and my contractions are picking up again and they're definitely different from yesterday - I don't get much warning before the peak it happens very suddenly and there's stabbing pain with it so I hope that stabbing pain is in my cervix, meaning its breaking up the scar tissue!

Hubby and I haven't done much of anything today - he still feels yucky and I'm just exhausted so we've been vegging around the house trying to rest (I did manage about 5 hours of sleep all day but the only thing I've managed to eat was 3/4 of a strawberry poppy seed salad from Panera Bread and a yogurt smoothie from Dunkin Donuts). I spent about 30 min. on the birthing ball and we went for a short walk around the neighborhood. I think it took the terb about 12 hours to wear off because the contrax didn't come back regularly until after 4 PM - that stuff works fast, let me tell you! I was having contrax every min. on the strip and then they gave me the terb and it QUICKLY slowed to every 10 min. It was amazing how fast it worked.

After I do this update I'm going to get back on the birth ball for a little while and see if do these psuedo squats will help spread my hips and allow my cervix to break up. We'll probably be back at the ER again tonight but I won't be calling Tina until I get an exam and can be sure I'm progressing some. If the exam at the hospital is uneventful we'll head home and I'll make an appointment to see my OB tomorrow and see if she'll break up my scar tissue for me. The big reason the doc in the ER wouldn't do it fully is that I'm only 36 weeks so not technically full term. The doc that was covering my group was really busy last night (full moon has some truth in it!) so he didn't get to come down to the ER but I know if he could have he would have helped break it up - he told me so when I saw him on Thursday.

So that's it for now. Arianna is being an angel for grandma and grandpa and they're happy to keep her for another night - we'll pick her up in the morning so she can go to daycare and give grandpa a break (who is just newly laid off and has an abundance of free time).

25weeks: My hubby says the same thing. Pregnancy is very morbid, you get very excited about seeing a woman in pain "Ya, Jen is miserable, that's awesome!" LOL!

My frustrating Saturday

My parents came to the house at 5 and took Arianna to spend the night with them - I knew we'd be going to the hospital at some point that night.

I decided to labor at home until I 'couldn't take it anymore' - a sign that the contractions were strong enough to put me in active labor. I sat on the birthing ball for a while, took a nice bath for a while and DH and I took a nice walk around the neighborhood. After my bath about 8 PM the contractions had slowed to a crawl so I figured we were 'done' for the night. DH had food poisoning from a cookout we'd gone to that day so he was throwing up all over the place and by 9 the contractions had me really tired so I just looked at him and said "let's go to bed as we may be up early". He surprisingly agreed.

I woke up at 10:40 with lots of pain - I was really feeling it now and had a hard time talking through it - surely this was it! I got hubby up and called my doula and started packing the car/getting dressed.

We got to the ER at 11:50 and true 'full moon' fashion it was packed. I got through registration and triage and sat down. Hubby was still not feeling good but I needed to walk around with Tina (my doula) so he stayed with our bags while we walked the halls for about 15 min. They called us back and got me into a room to get the baby monitored and get an exam. Boy do contractions hurt when you have to lay down through them - I don't know why women do that without an epidural! I ended up standing next to the bed for a long time doing the strip because it really hurt to lay on my back. Then the resident/attending came in to give me my exam. Apparantly my doula knew her very well and was excited she would be the one doing my exam because she could 'fast track' me upstairs to L&D if needed.

I was 100% effaced, which was AWESOME, but only 1 cm. dilated (not awesome). So she told me to get up and walk around for two hours and see if that helps any. The scar tissue from the cerclage was going to make dilation pretty impossible - she even tried to break it up for me (ouch!!).

So I diligently followed orders - lots of walking with Tina and lots of contractions - eventually they were right on top of each other with no break in between and it was really frustrating but, if I do say so myself, I did very well despite no pain meds. They were really strong now and Tina said I should get examined because she could tell by the change in contractions that I'm further along.

4 AM I get another exam and there is no freakin' change. Not even a half a centimeter! I couldn't believe it! The the worst news came in.

They have no beds. With contractions showing up on the monitor at every minute or less they couldn't just send me home but they had no where to put me but in the ER on the WORST BEDS IN EXISTANCE and I really couldn't stay laying down - really, back labor sucks when you have to stay on your back.

So they gave me terbutaline and sent me home... after I'd labor hard for more than 24 hours they were giving me drugs to stop all my hard work and sending me home simply because they don't have a bed. WTF?!!

So its noon now, we're finally up and I'm eating something for the first time in 24 hours (I don't get hungry in labor) and incredibly upset about the turn in events. The worst is that I know we'll be back there again tonight playing this dance again... I have to go through those contractions again and hope they have a room for and hope that I get a sympathetic doc who will break up my scar tissue allowing my cervix to open up. All the docs I've seen have said the same thing - once the scar tissue breaks up I'll go from 1 - 6 fairly quickly. I like the sound of that, just wished it would happen sooner than later.

I kinda wish my doctor was on last night - when she took out my cerclage on Friday we talked about the size of the baby and what my cervix looked like and she told me to 'do everything I can' to get this kid out now... so that's what I'm trying to do. Just wish that I didn't have to seemingly fight them on it.

ooh ooh!

I'm having contractions about 2 - 4 minutes apart. We're going to time for an hour before we make 'the call' but its looking promising!

Wish me luck!

Cerclage Removal!

I can't believe I made it to the point of actually having it removed... this is surreal to me.

Anyway, in a little under 10 hours I'll be stitch free! Although, theoretically, I could dilate and go into labor immediately, the OB I saw today said in his 30 years he has never seen anyone go into labor the day the stitch is removed, so chances are good I'll be home after a few hours of monitoring.

But... if I'm lucky enough to be the exception I'll have hubby post a quick update here before he jets off to the hospital to meet me.

I can't tell you all enough how wonderful you have all been with your comments and emails - I am very blessed to have such caring people wondering about me.

I can't believe the end is in sight now (hopefully) and hope that my story has been inspiring and helpful to you.

36 weeks!

It's a funny thing being pregnant again after having a preemie - especially sub 30 weeks. If you're fortunate enough, like me, to make it to (almost) full term you'll experience a strange emotion... the "I never expected to make it this far and now I feel overdue" emotion.

I guess mine is compounded, unfortunately...

Ended up in the ER last night due to lack of movement - which never happens, this kid is VERY active... s/he didn't do well on the NST at first and then they gave me apple juice and pretzels and flipped me all over - then s/he got marginally better, but I still hadn't felt a kick in HOURS... very scary.

Today I had my regularly scheduled NST and still hadn't felt so much as a hiccup... low and behold I get on the NST and s/he decides to hold a dance party. The NST was incredible - beyond perfect wave form. I cried happy tears...

Then I had an U/S. I'm really start to hate these... my AFI is 26 and baby is still in the 97th percentile - now 7 lbs. 12 oz. I'm 36 weeks... it could be off by as much as 10% at this point, which is about a lb. in either direction - so s/he could be as big as 8.5 lbs. or as small as 6.10... still really big for this point.

In essence s/he is measuring 3 weeks ahead - so 39 weeks. Add in the abundant fluid and I'm big... really freaking big and uncomfortable! I can fully appreciate why so many women complain about the end of pregnancy. It used to make me really mad when I'd hear women complain because I had wished to have been able to experience it with Arianna, but now I understand and will never chastise a full term pregnant mom again! Seriously, there isn't anything that doesn't hurt right now. My feet are huge and rolling over in bed brings me to tears... and lack of sleep? I can't even call 'no sleep' lack of sleep, because that implies there is actually SOME sleeping going on.

They won't induce at my office, instead at 40 weeks they'll give me the option of a c-section. He says because my fasting numbers have been so hard to control (now under control with 30 u of insulin) and this kid has been measuring steady at 97th percentile for 3 months, the u/s is probably pretty accurate - this kid is just plain big.

On top of that he said in his 30 years of being an OB he's never seen anyone dilate into labor once the cerclage is removed (which I know is rare, just wishful thinking on my part I guess) and furthermore, since I've been funneled to the stitch for so long (thus creating alot of pressure on the stitch), I will have alot of scar tissue that will make dilation difficult, if not impossible.

Everything about this kids position is perfect for 'natural child birth'- which is what I've paid alot of money to a doula to help me with. I've been preparing myself for this for months and I'm so excited to get the birth I want... but now I'm looking at the very real possibility of a c-section and that is very scary to me. I'm really disappointed. I know in the grand scheme of things having a full term healthy kid is so much more important but I was hoping the actual birthing experience could be close to what I wanted this time. *sigh*

And although I'm only 36 weeks I said a silent prayer - that this weekend I go into labor naturally and have a healthy baby. I'm beyond dreading a c-section. No, I'm not as foolish as some to actually TRY and induce labor but I wouldn't mind it happening on its on at this point. I can only pray...

How exciting!

Well, today has been an eventful day!

I had a non-stress test (kid was amazing - never seen my tummy move so much when s/he kicks) and my u/s was great - my AFI went down 10 points! WOo HoO!

Baby is measuring in at full term - 37w5d and weighs 6 lbs. 10 oz. I can't believe it! Wow!

Best news of all - we scheduled my cerclage removal. Because I'm already so thinned out I bet the kid is coming when the cerclage is out! Of course, I could go weeks without it too... that would stink!

So next Friday at 9 AM I'll be at the hospital having it removed... and maybe, just maybe, we'll have our new little one too! I can only hope that being 36 weeks and a few days is enough time to avoid the NICU and allow him/her to come home with us - how amazing would that be? A take home kid - WOW!

Maternity Photos

I had some professional maternity pictures done at 32 weeks and got them back today. Unfortunately I had to fix them... alot. I'm, by no means, a professional photographer but the photos I received today weren't professional quality. My skin color was actually GREEN in the outdoor pictures and the black and white photos were horribly blown out - so much so you still can't see any of the detail in Arianna's dress. I'm pretty disappointed overall, but it is what it is and the only thing I can do is not refer the photographer to anyone else.

At least I have the memories!

34 weeks

Well, I'm here and miserable! LOL

I swear, I'm going to go insane here in bed but I'm too scared to get up! For the last two days when ever I stand or sit I get massive pressure really low and huge contractions. It used to be that I wouldn't get any when lying down but now I do - I get alot of contractions. At my last ultrasound I had very little cervix left and I really don't see myself lasting the week, but making it to 35 would be wonderful... I just don't see it happening. I'm in alot of pain...

I had such a strange bunch of appointments Friday. I had my first NST which was kinda neat - dozen or so contractions but I felt all of them and they weren't regular so no worry there. I then had an ultrasound to check fluids and my CL. Then saw the OB and finally got my 17P shot.

We're doubling my insulin at night, which I expected.

My fluid is still high but not as dangerous high as it was last time.

The OB (one I don't normally see) tried to tell me there was no cervical funnel... funny, but I saw it on the u/s. She tried to tell me, that's just a pocket of fluid... um, ya, in the funnel of my almost non-existant cervix. I decided I don't like her and am going to try to avoid appointments with her.

So in light of the less than stellar appointment I went to Babies R Us Friday afternoon and purchasing 2 going home layette sets (one boy, one girl) - we'll get to see which one I get to use ;)

Sad...

I'm bored...
and overwhelmed with everything that needs to be done that I refuse to let myself do (cleaning the house for one).

If I spend too much time out of bed I get cramps and contractions but staying in bed is painful too - laying on my side is really painful to my hips and laying on my back is out of the question at this point.

Today our refrigerator decided to break. Shawn had taken Arianna to the playground and all I wanted was something to drink but I came out to a kitchen slowly drowining in melted ice from my freezer. I wasn't about to leave it there! So I got towels and did alot of bending down and picking up and then had to call a repair guy and spend even more time out of bed.

I feel like crying alot of the time. Everything is just so overwhelming, even when Arianna comes into the room to spend time with me she'll want me to help her up onto the bed (when she's perfectly able to climb up herself, of course) and I'll just cry because I can't get up. She'll want out and I have to scream for hubby and that scares her too. Then there's the eye rolls from hubby when I ask him to do something as simple as get me a drink - does he think I like this??! I hate being so dependent on people!!

I saw my OB yesterday - would you believe they're not going to give me the steroid shots?!!! I don't qualify for them anymore at 34 weeks but I'm obviously in danger of delivering soon and I have gestational diabetes which slows lung maturity. Its pretty doubtful I'll make full term so why not give me the shots?

This makes me cry too.

This pregnancy is really overwhelming right now and I don't have anybody to really talk to about it - so I'll just vent here for all of you to read.

Thanks for the sympathetic 'eyes'!

Still here at 33 weeks!

Hi everyone,

Sorry for not updating sooner and sorry for worrying people so much that they had to email - I hope to be better in the next few weeks. My only excuse is its really hard to type while laying down.

Things aren't much better than they were 2 weeks ago - I'm still on bedrest at home and my asthma is still really bad.

I'm on enough prednisone to kill a cat right now. Its not really helping so we added 3, yes 3, different inhalers. I'm at the highest advair, flovent and albuterol. All things that aren't great with Long QT Syndrome but I actually haven't been having any weird symptoms with all this medicine so I must really need it!

The prednisone, unfortunately, has raised my blood sugars so I'm considered a gestational diabetic and have to test my blood sugar 5 times a day and follow a special diet - do you know how hard that is to do when your on bed rest? Sigh...

My cervix has shortened a lot in the last 2 weeks also - its at 1.7 now and the OB I saw on Tuesday said they may take out my cerclage on Friday to avoid ripping through my cervix. I think this is jumping the gun - I'm not having contractions and as far as I know I'm not dilating (didn't get a manual exam this week) so why take it out? If I have shortened more I may ask for hospital bedrest because its obvious that bedrest at home isn't working too well... I'll also be asking for steroid shots regardless of tomorrows appointment. Since I've got gestational diabetes lung maturity is slowed even more and I'm at risk of delivering soon so I'd hope they'd be open to giving the baby a little boost with one round of steroids.

On the bright side this kid is still huge - 97th percentile and 5.5 lbs. already at only 32 weeks! Part of me is happy that I won't see full term because natural delivery will be really hard with a 9 lb. kid. I'll need recovery from bedrest and adding recovery from a c-section (because the kid is so big) will be awful.

So that's my update - not great, but I'm still here and baby is still baking away (oh ya, and not breech anymore! ya!)

31 weeks

Well, here I am at 31 weeks - this is great!

Good news: Had another negative FFN this week and my 5th to last 17P shot - I'm positive I'll see 33 weeks now - wow! My cervix is still funneled, still 2.5 and still finger tip dilated, but no change so that's good.

Bad news: My asthma is OUT OF CONTROL. The last time my asthma was this bad I was hospitalized for 3 days.

I finally saw OB medicine yesterday which was none too soon. She is very concerned about my horrible peak flow readings (as am I) and doubly concerned that my breathing gets even worse when I'm laying down (and particularly on my right side). I have to spend the majority of my day laying down so this is a real problem. When doing a quick exam she heard some extra heart sounds that may or may not be related to where I am in my pregnancy (blood volume is at its highest right now), so she ordered an echo cardiogram for next Friday to check for pregnancy associated cardiomyopathy.

CAN I CATCH A BREAK PLEASE?! SERIOUSLY!!

I'm on 2 weeks of prednisone and albuterol via nebulizer around the clock (despite my not to be taking it with my Long QT Syndrome) until things get better but I'm not very hopeful. I haven't slept well in 3 days now because I'm gasping and coughing. This is terrifying. I never expected it to get this bad. She's trying to get some answers from my cardiologist regarding which steroidal inhaler I can use because the pulmicort I've been on for a 12 years isn't even touching it now. The problem is that most of the steroidals that I should be using have a component to them that is bad for folks with Long QT Syndrome.

As she put it, I have the ultimate protection, my defibrillator so I need to get my breathing under control and if that means using stuff that is contra-indicated, then so be it. I'm reasonably well protected and its more important for me and baby that I nip this in the bud.

She'll check back in on me on Monday to see if the prednisone is helping - if not I'll be looking at some hospital time and IV steroids. G R E A T!

This is the pits!

But on the bright side, pregnancy is going well so I'll look at the positives for now...

Jinx!

I wrote my last post about an hour before I left the office for the weekend.

We were getting our house exterminated for carpenter ants and I was getting home about 30 minutes earlier than my husband and the exterminator so I could make sure everything was all set to pack up and wrangle the cats into carriers - hubby knew I wasn't doing any of the actual work, just getting everything lined up for him to do it. Well, I get home and the exterminator was there early and already putting the chemicals on the outside of the house! He arrived early so he could start his vacation early - so I had to run in and wrangle the cats and do EVERYTHING before hubby and my mom arrived to help. It was alot of work and I was stupid for doing it...

We got out of the house with the cats on time and I drove hubby back to his office so he could leave his car at the house when he was in NC... so I've got the cats in the back of the car for the next 4 hours and 3 adults crammed into my corolla (oh ya, with a carseat taking up a seat...). I dropped off hubby and was already having lots of contractions. Thankfully I had an appointment for my 17P shot so my mom and I drove there. She was coming with me so that she could stay in the cats while the car was running with the AC on. I had 3 hours between taking him back to work and picking him up to the airport and OF COURSE I would spend that at the office... I got my shot and an exam.

I'm 1/2 - 1 cm. dilated and contracting. I'm on bedrest at home now and had to go to the hospital Thursday night for an ultrasound and meds to stop any contractions ( I had 3-4 dozen of very painful contractions over the course of 4 hours). I got there about 6 PM after picking up Arianna at daycare, dropping off the cats at the house and driving up to my parents (only to turn around and go back to the hospital) I was super worried 'this was it' when I got to the hospital
but thankfully my u/s was the same as earlier in the week and the contractions had stopped by the time I got on the monitors...

The the doctor came in and gave me some 'perspective'. She yelled at me for 10 minutes...

I guess I needed to hear it - as I vented to her about everything I have to do at home with my 2 year old she counter-acted with "You have a husband and family and friends to help, you have more important things to do right now and that is stay in bed... allow other people to do everything, you do nothing but lay in bed"

I stayed with my parents and they put Arianna in a diaper all weekend... it was really hard to 'allow that' considering how hard we've worked on potty training (successfully!) for more than a month.

This is going to be really hard so expect to read lots of venting here!

30 Weeks!!

I can't believe I'm in the 30's now! This is AWESOME!

This week I had another OB appointment and u/s. My cervix is still funneled and a little bit shorter at 2.4 cm and it looks like the 'Y' shape I was worried about - meaning its starting to dilate too. Not enough to be worried about, yet. I have another appointment next week and will ask for a dilation check to be sure.

I'm having ALOT of trouble with my asthma lately - to the point where I'm taking my inhaler frequently throughout the day. I'm actually really worried about it. The hospital I will deliver at doesn't do anything BUT OB related stuff. The hospital next to it can handle my Long QT Syndrome (which limits the meds I can take for my asthma) and asthma but hasn't done anything OB related in 50 years... I'm supposed to see OB medicine which is the branch between the two hospitals but at yesterday's appointment they were running so far behind that they had me reschedule my appointment, so I have no OB medicine doc right now.

Add to that the fact that I'm 'moving in' with my parents this weekend because my husband is going to NC for the weekend - and that moves me more than an hour from the hospitals! So, if I have trouble, and I probably will, I think I'll make the trek up to Brigham and Women's hospital in Boston which has a great cardiology deparmtent and OB department and can handle my asthma with my 2 high risk factors. This will create a problem with getting records to my doctors but I don't really care - the 'tangled web' of hospitals down here is a bit too much to deal with right now and I don't want to have to wait for hours at one of the hospitals down here while OB medicine figures out what they're doing...

My ffn is still valid for another week (its predicts 10 to 14 days out), so I'm still pregnant for at least another week! woo hoo!

Next weekend I'm getting professional maternity pictures done and will post them for everyone to see!

Have a great 4th of July!!

Good News!

I had another ultrasound and FFN test today. Baby is still huge but fluid level is very normal. Cervical length is holding strong at 2.6 cm, so I can rest easy for the weekend! My FFN test came back negative - this means I'll see the 30s... I can't believe it! I'll be able to say "I'm 3x weeks pregnant"... unbelievable!

So much for that...

So today I'm my most pregnant - this was my first milestone and I'm very happy.

Now the bad news:

Yesterday I had an ultrasound (my first in 4 weeks) to check the baby's size and my cervical length. My doctor is concerned because I'm HUGE... when I say huge, I mean really big - as in full term big. As it turns out this kid is in the 90th percentile and I have an 'overabundance of amniotic fluid' - both of which put pressure on my cervix... which is now funneling and short at 2.5 cm - a loss of nearly a cm in a month. I've had an increase in discharge that I chalked up to advancing pregnancy but now realize its my cervix thinning...g.r.e.a.t.

I failed my 1 hour like I thought I would and have to take the 3 hour this weekend. A big kid and overabundance of amnio fluid are signs of gestational diabetes - so I bet I have it. My father has Type II so its not like I don't have risk factors for it.

Arianna was born at this point in my pregnancy and weighed 2 lbs. 15 oz... this kid, at the same gestation, is weighing in at 3 lbs. 9 oz! I'm paying $1000 for a doula and watch, I'll end up with a c-section because the kid is too big... oh ya, and breech... fun times.

On the bright side my OB and I agreed that the reason Arianna was born early was cervical incompetance so getting the cerclage was the single best thing I've done this pregnancy. The 17P shots are a close second because they've been shown to strengthen weak cervix. We also agreed that even if I pass the 3 hour on Saturday I should plan on following a low carb diet because this kid is just WAY too big and if it continues I'll be looking at a 9 lb baby. I won't lie to you that if I go full term I'm VERY scared of delivery. I hired a doula to do it 'all natural' and I'm scared that the size of the baby will make that very hard.

I have another ultrasound on Friday to check the cervical funnel - if it shortens more I'm on bedrest. It would be very hard to do bedrest at home with the amount of work required around the house and potty training a 2-year old and it sounds odd to request it but I'll be asking for hospital bedrest. Although I haven't been having any contractions a funnel/short cervix brings it on and I'd rather be in the hospital if that happens so it can be stopped immediately.

I just need 6 more weeks to feel comfortable... I can do that in the hospital; I know I can, I know I can...

I've made it this far - that's a reason to celebrate but I want my 'take home kid' and I don't care if I have to hang from my toenails to get it!

28 weeks...

Yesterday I was 28/3 - the day I went into labor with Arianna so I'm a little teary eyed yesterday and today. At 5 o'clock I was driving to the ER with DH thinking they'd just give me some meds and send me home. The nice nurse in the ER had me give a UA sample and get changed and no sooner did I get back to the bed the resident checked me and told me I was 'paper thin' effaced at 100% and 4 cm. I wasn't going to leave the hospital and she would be born very soon. For some strange reason I was more excited than not and when the resident tried to calm me down I stupidly said "I was born really early and I'm fine... she'll be fine too". I've learned so much since that day.

I was wheeled up to L&D and they immediately gave me the first steroid shot and it seems that the exam the resident gave me really sent me into full labor - the pain was UNBEARABLE! Within an hour I had an epidural and the onslaught of Social workers/NICU staff/Nurses/OB Medicine and OB staff would infiltrate my room throwing all sorts of info at us but I was too scared to really listen.

She was born at 6:43 AM on 28/5 - so if I can make it to 28/5 and still be pregnant I've reached my first goal - to make it past where she was born.

I have a growth u/s and meeting with my doc tomorrow afternoon - I am very optimistic everything will be fine but still have my fingers crossed, just in case.

Third Trimester!!

I did it - I made it to the 3rd trimester. Only 12 days until I can say I'm my most pregnant. I can't believe how time has FLOWN! Wow!

I was just sending an email to my husband today saying how I'm glad we'll have all our debts (minus my 2006 Toyota) paid off next month so we can actually have some money to buy baby things because we haven't purchased ANYTHING yet. I feel bad in a way. At this point in my first pregnancy we had finished the nursery and had lots of baby things. This baby is already second best and s/he isn't even here yet!

Oh well - its more important that we pay off our debts so I can stay home with minimal stress when the baby arrives.

I had my 1 hour gestational diabetes test this morning - I hate that test, its so pointless. I'm sure I'll fail it again like I did with Arianna and I'm really not looking forward to doing the 3 hour. I didn't get to do the 3 hour with her because she was born the day I was scheduled to take it - oh well! I was good and watched my diet closely for 3 days prior to the test so I hope it makes a difference. I only failed my 1 hour by a few points last time but had a huge carb loaded breakfast before hand. This time I enjoyed a yogurt and water so I hope it makes the difference!

I had my 17P shot and they're getting so much more tolerable now - maybe its because I'm more vocal about how they should administer the shots or just that I'm used to them, but either way its good. Only 8 more shots! WOo HoO!

I have an appointment on Tuesday and then we make a plan for the rest of the pregnancy. Since I'm in the 3rd trimester I'm out of the 'incompetant cervix' danger zone and if my cervical length is favorable we can pretty much rest assured it won't be the reason I deliver early if I do.

On the bright side I haven't had any contractions (that I feel anyway) in 2 weeks - how odd considering how the weeks previously had gone. I'm not complaining, its the best news I could report. I'm so optimistic right now. As long as Tuesday's appointment goes well my anxiety level will drop through the floor because I'm doing really well now! Who'd-a-thunk it? :)

WOW!

I know I've been here before but I still can't believe it - next week I'm in the third trimester! WOW! I'm so happy to have made it this far without bedrest or intervention!

26 Weeks!

It's been a milestone week!

I'm now under 100 days and I have had more 17P shots than I have left (10 shots so far, only 9 left now). Things are going really well (knock on wood). I haven't had ANY contractions in over a week and although my hips still ache all the time, I can deal with that if I'm not having contractions. Maybe we've 'turned a corner' and things will be nice and quiet from now on?

I have my 1-hour glucose test next Friday. I failed this by 5 points in my first pregnancy and was scheduled for my 3-hour the day Arianna was born. It was a big source of stress for me and I really want to avoid that this time so I'm going to be really diligent about watching what I eat next week so I don't consume too many carbs or whatever and hope for the best! My OB is concerned that I'll fail it again - I'm measuring 3 weeks ahead already so she wouldn't be surprised if I had gestational diabetes. I sure hope I don't though - I don't want the added stress!

It's been weird the last 2 weeks for me. I have no appetite - I haven't been hungry and nothing sounds good. I don't know if I've got a cold or not but my asthma has been pretty out of control - which is very rare for me. I had alot of trouble with my asthma early in my first pregnancy but it was gone by the second trimester. This time it didn't peak until the end of the second trimester! Due to being pregnant and due to my heart condition I'm very limited in what I can take and that's scary to me. I really hope doubling up on my steroids will help soon because being pregnant makes you out of breathe anyway!

I'm going to do something I said I would never do this weekend - I'm putting on a bathing suit and going to a public beach! Put out the beached whale signs! I have no clue how I'm going to shave my legs and bikini area, I can barely see my feet! But it's going to be 95 degrees this weekend and my husband is in NJ for a 'guys weekend' and I'm sure not going to be chasing after a toddler when its THAT hot outside all by myself- I've recruited my mom and hope the two of us can wrangle a two year old who loves the water!

Another mini-milestone

I'm under 100 days left - woo hoo! Double digits!

That requires cake and ice cream doesn't it?

NICU Levels

I thought this was very interesting... in case anyone is looking for a chart on how the AAP (American Academy of Pediatrics) grades their NICUs:

Consistancy...

I can't tell you how upset and relieved I am right now.

I went to see my regular OB yesterday, the one who really knows me, and she did an exam and I had an ultrasound. Not only is my cervical length the same it was on Tuesday (3.3 cm) but I'm not soft and certainly NOT dilated. She can't explain why the resident told me I was... but that's why she's my doctor and the resident isn't.

I went to the hospital for reassurance on the increased amount of pressure/pain in my hips and instead left thinking I was going to have another 28 weeker. I have Symphysis Pubis Dysfunction which basically means my hips feel like they're on fire all the time - most likely my hips are out of alignment due to some injuries I suffered while skydiving (bad landings on my butt, nearly breaking my tail bone etc.) - so for the remainder of my pregnancy I will have severe hip pain and it will mostly likely get worse. How fair is this? How fair is it that I'm already neurotic about every twinge and have to deal with this? It's not fair but lots of people deal with stuff that isn't 'fair' in life and I just have to suck it up. At least I have a name for it now and know that I'm not really crazy - this really is painful and there isn't much they can do.

So, not only am I not helping my neurotic/paranoid high risk pregnancy thoughts, but the hospital didn't help either. My doctor was really nice about all of this and simply said "I'll see you next week but you're doing really good, there isn't anything happening right now out of the ordinary"... she, thankfully didn't say "try to not worry" because I think she knows that's impossible.

Thanks again for the kind thoughts everyone - they seem to do the trick because, once again, it was a false alarm :)

25 weeks

I narrowly averted getting admitted to L&D last night. My hips were absolutely killing me - walking hurt, sitting hurt and I was getting contractions. I took 10 mg. of nifedipine but after an hour nothing seemed to help my hip pain so I went to the ER.

My cervix is 'soft' and finger tip dilated... and I'm officially freaking out. I had a negative on my fFN test. I have an appointment with my doctor at 11:15 today. Tuesday I had an ultrasound and was 3.3 cm which was a loss of 1/2 cm. in one week. Things are happening fast now and the doctor covering for mine said he was very worried about me tearing through my cerclage. The resident I saw at first talked about steroid shots....

I just started crying - how did I go from 3 cm and everything great to them talking about steroid and admitting me?!

Bedrest is a given, I started that as soon as I got home and I'm fortunate that my work will allow me to work from home.

I'm getting scared now - I'm only 25 weeks. Even the resident didn't express confidence I'd last another 10. Although no contractions showed up on the strip it wasn't all quiet so they think I'm 'irritable'... and I didn't feel any of it.

ugh - Please keep me in your good thoughts today. I hope to update this afternoon!

Percentiles of Sonographic Cervical Length

Please click the picture to see the bigger version

Ya... I'm below the 10th percentile right now. I'm very glad I have a cerclage!

Great new come-back

This story comes from a new-preemie mom and I thought she created a great story!

So a mom at the playground approaches me to ask how old my 29 week preemie is.

"3 weeks?" she guesses.

"No, 3 months." I reply.

I sit and wait for the normal look of confusion that comes over people's faces when I tell them my preemie's age. It is quite humorous. I think they wonder if I have forgotten my own baby's age.

The look appears and then I go into the whole explaination of his age, birth weight, NICU stay, blah, blah blah.

Then she looks at me through her Dolce sunglasses and asks me what has to be the most retarded question I have ever heard.

"So when do you celebrate his birthday?"

"On the day he was born."

"Even though he was early?"

"Yes, most people celebrate their birthday according to the day they were born." I am really irritated at this point by now.

"Oh, I suppose that makes sense."

Oh my God, is this conversation really happening?

Then she procedes to go on and on about her baby was a larger weight when he was born than my baby is now.

I just wanted to look at her and say " Congratulations! I guess you get the loose cooch award for the day!"

Ok, I can't stop laughing - I wish I could have used that one of the multi-tude of times comments were made about Arianna's size...

I just can't respond...

I belong to a message board for women due at the same time as me - September. Earlier this week, unfortunately, a mom gave birth to a little girl at 24 weeks. I can't imagine being in her shoes and my heart really goes out to her, she will have a long/hard road in the NICU and beyond.

I can't respond to the messages of support - I feel badly about not being able to reach out to her but the majority of the other posts are "my cousins friends sisters finance's brother's wife had a little girl at 23 weeks last year - she's 12 months now and TOTALLY PERFECT! No problems at all!" (really, at a year old you can say that?) or "My sister and I were born at 29 weeks 30 years ago and we're totally fine now" (Can you really compare 29 weeks to 24 weeks?), and the most hurtful "Preemie's do so well now - they just need time to grow outside for a while and she'll be just fine!"... ya, that's what my daughter NEEDED... she needed to be outside of me in order to grow.

So how do I respond with "I'm very sorry you are in this position - your NICU rollercoaster will be very hard and you can expect lots of ups and downs. You'll have a big learning curve but don't underestimate how well your daughter can do or even if she falls in with the normal course of a 24 weeker and has trouble for a while. I wish you the best and feel free to email me if you want to talk"... I did and immediately got pelted with all sorts of messages from others saying I was being too negative blah blah blah.

It's amazing how prematurity wears such rose colored glasses to the general public... well, no its not really amazing in a good way.

Seeing pictures of her little girl - with a preemie diaper up to her armpits despite an umbilical line - make me so sad for all preemies. Who's life needs to start being poked, prodded and having a tube shoved down your throat? I cried seeing her pictures. I'm so very scared of putting another baby through that but its practically out of my control and thats even more scary.

24 weeks

Today marks 'viability'. I'm trying to not celebrate making this point because it was never my goal. My goal is to make it further than I did with my first pregnancy and we're still 4 weeks 6 days from that. But at least I know that bean baby could arrive now and we may bring a baby home.

I'm doing well - no repeats of last week (knock on wood) and I'm still as active as I have been. I'm measuring big and carrying pretty high so I'm out of breath alot and even now, just sitting here, I'm out of breath and its really annoying. I hope its just the position bean baby is in today.

Otherwise everything is progressing just fine and I get to complain about normal pregnancy stuff... so I'll start that here for levity.

* Whose stupid idea were maternity jeans? Seriously - the stretchy band is either too low causing your pants to FALL OFF when you bend over or the band is high causing the top of the jean material to totally dig into your stomach making you look 'fat' when you sit down! I'm sick and tired of them but its all I have minus one dress and one black skirt - so I'll be investing in some skirts and summer dresses tomorrow because they're much more comfortable and cute than jeans/pants.

* I didn't have a foot swelling problem with #1 but boy oh boy do I have it now! I haven't been able to wear sneakers for a good month now and I need a pedicure! My heels are nasty. To save money I usually do it myself but its SO hard to bend down to do it now and there is no way I'm letting hubby near my feet (he's a little 'rough'). Spend the money on a pedicure or pay off the car before kid comes so I can stay home in the fall? Hmm... I think I'll invest in lotion and wear socks to bed.

* Bloody noses - I'm really sick and tired of waking up with one EVERY DAY, not to mention that my nose is ALWAYS stuffed up. I've been using a nasonex nasal spray for months now but its not really being very affective anymore. At this point in pregnancy #1 my nose wasn't bothering me at all - what's up?

* Weight gain. I've stopped looking at the scale because I know it ain't pretty. I tell the nurse every week "I'm closing my eyes, tell me if there's a problem, otherwise I don't want to know". I did this with Arianna too and by the time she was born I was up 30 lbs. I probably am this time too :(

I guess I'll just have to suffer through it - and its worth it if I get to term.

Meeting with my doula this weekend and I'm very excited! I hope everyone has a great long weekend!

Thank you!

Thank you so much for your good thoughts - they must have worked!

I'm very glad my doctor is conservative. I had my ultrasound yesterday - baby is great, and big! S/he is already 1.5 lbs. I can't believe that! She checked my cervix by abdominal ultrasound and didn't tell me the results - said she wanted to do a vaginal ultrasound instead. That had me worried but I didn't have to be. She later told me she wanted to do the vaginal ultrasound because she didn't believe that my cervix could be 'that good' on an abdominal ultrasound.

My cervix is measuring 3.8 - I have a 'wonder cervix!'. That's a fabulous measurement and I'm so happy!

Yesterday afternoon my OB called me after getting the preliminary report from the ultrasound I had earlier in the day. Since my cervical length is 3.8 she doesn't want to see me before my next appointment in 2 weeks - which I'm ok with. I have an ultrasound to check length again next week.

I've been getting lots of cluster contractions which are almost never painful but concerning because I get LOTS of them - Thursday, Friday and Saturday I had lots but nothing since then and my cervical length is still really good - awesome in fact. Its a mystery. Last Friday this was my contraction counts:

10:21
10:32
1:01
1:16
1:25
1:28
1:30
1:34... and nothing for the rest of the day.

Saturday DH and I went up to NH for a convention and I had dozens on the way there. Then Sunday the 3 of us went to the zoo and walked around ALOT, I had not one contraction the entire time!

I talked to her about going on nifedipine around-the-clock and she doesn't think its necessary. I agree. At this point my cervix isn't being affected by the contractions and it may just be what my body does when pregnant now. Lots of women have many BH like contractions and go on to have full term pregnancies.

She gave the option of long term nifedipine (procardia) up to me. I don't think I want to take any medication if it's not necessary right now. We're going to continue to closely monitor everything and watch out for pre-term labor problems but right now I don't think I'll take the nifedipine long term. I can still take one if I get alot of contractions in a short period of time but that's it.

I'm surprisingly OK with all of this - but more importantly I'm ECSTATIC at how well my cervix is holding up despite the contractions. I am crediting the 17P shots and early cerclage with how well this is all going.

This weekend I have my first meeting with my new doula and I've drafted up a birth plan - how odd to be thinking of normal pregnancy stuff now. I remember at this point in my pregnancy with Arianna I was all about researching breastfeeding... so much for that. I tried for 6 long months to get Arianna to breastfeed and had to give up and ya know what - she was just fine with me pumping for 13 months! So I'm not stressing about that stuff now - now I just want to make it to 'take home' gestation.

Yesterday I called my mom to update her on my appointments and she told me "your brother was born at 34 weeks and was only in the hospital for 2 weeks!". I kinda snapped at her - "No, this one is coming home with me!"... I felt kinda bad but I don't think she understands how scared I am of leaving the hospital without my baby. I pray every day to reach 8/8/08 - 35 weeks and a great shot of going home with me.

Prayers today please

So this morning I had my bi-weekly appointment and was told two things:

1. I'm measuring pretty big (which I knew because I'm HUGE right now) - 26 weeks, when I'm only 23 - good if I have a preemie.

2. She thinks my cervix has done some serious shortening based on a manual exam so I have an 'emergency ultrasound' at 11 o'clock today. I'm still closed and the cerclage is still tight, so that's good news. I'm only in the office for about an hour and then off to the appontment. I really wish there were more ultrasound tech's so I could have gotten the ultrasound at my 8 AM appointment! So I'm really nervous now but can only pray for the best. I had felt I'd 'dropped' on Saturday, I was suddenly carrying really low and my mind was RACING with bad thoughts but I really didn't want to pay ANOTHER $100 ER copay and wait there for hours, so I just laid in bed all afternoon/evening. Despite contracting all day thursdya, friday and saturday...Sunday everything was good - not one contractions! Wierd!

So I'll ask you to all keep me in your good thoughts today and I hope to update when my appointment is over.

Physical Assessment guidelines to establish risk

Hi everyone,

I came across a study on pre-term labor that you will probably find really interesting and encouraging:

http://www.emedicine.com/med/topic3245.htm

Physical assessment guidelines to establish risk

The obstetrician should review previous preterm deliveries, including autopsy reports and medical records, if appropriate and available. 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. 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. 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.7 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%.
Whereas cervical length assessment by digital exam is a semisubjective measurement, a recent study has demonstrated the value of an objective cervico-portio length measurement using Cerivlenz, an intravaginal measuring device.8 These manually obtained cervical length measurements appear to be reproducible, accurate, and predictive of a short cervical length by transvaginal ultrasonography. Therefore, Cerivlenz may represent a low-cost, objective screening tool to identify at-risk patients for preterm delivery.

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 Network 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.

22 Weeks!

Another week down and it was pretty uneventful, thank goodness. I didn't have any repeats of the 'Tuesday night contraction-fest' and got my 17P shot.

I have to vent about these shots - I don't know if its the nurse giving it to me or what but they really hurt. I have several black and blue marks on my butt and it takes 4 or 5 days for the HUGE welt to go away after I get the shot. The injection site is really itchy for a few days and it hurts to sit down. I'm getting really tired of it and I still have a long way to go! I don't know what to do to make it better because everyone else I talk to who gets these shots says they aren't that bad... what the heck is my problem then??!

Otherwise things are going well. Last night baby decided to hang out using my uterus as a hammock and it was really really uncomfortable - I ended up going to bed early because laying down on my side was the only thing that made me slightly comfortable. Not only that but s/he was still hanging out that way at 3 AM when I got up to use the bathroom! Luckily by the time I got up s/he had shifted a bit and it wasn't so bad. By the time I got to work bean baby was 'head up' and an hour later 'head down'... s/he must love moving around so much! I don't remember Arianna moving around like this at all!

I don't have another appointment until next Monday and I hope everything is still going well then! I'm coming up on 'viability' and that's super scary for me - baby is only a little over a pound right now! I'm not going to worry about that too much though - we're going to go much farther than last time. I dream of a take-home baby all the time, so it must be a sign! :-)

21 weeks

I'm getting big... and I'm letting myself enjoy it this time! I hope to post photos soon!

Last night was Tuesday and was the first, in the previous 3, that didn't end with me in the ER with contractions - it was such a nice change. Last Thursday I saw my OB and got my 17P injection and convinced her to give me procardia to help with the contractions so I didn't waste my time in the ER until 4 AM again. She agreed! I did end up taking one on Saturday when I got 6 contractions in about 10 minutes, but I haven't had anything since, which has been wonderful.

I saw my OB again on Monday where she did a cervical check and we talked for a bit. My cervix is SUPER HIGH (she actually had a really hard time reaching it) and long and closed which is the best news I could have heard. She told me she understands why I'm nervous and nothing besides getting through the next 2 months will help but she said she thinks its in my best interest to see her every 2 weeks instead of every week because she feels its too much stress for me. She wants me to keep my feet up when I'm home and continue to drink lots of fluids. Baby is very active now and I get kicked so much more than I did with Arianna - I bet this one will be the one that keeps me awake at night. Everything is going really well despite the contractions and I just need to focus on the positives.

I still can't believe that in one month the baby could be born alive - not that I want that but still, its scary close. We have nothing done in preparation. Last weekend we got some used furniture from my coworker to replace all the furniture Arianna will be losing to the baby but its all stacked up in the room that will be the baby's room which still has a ton of crap in it that needs to be moved out. I doubt we'll get it done before the baby arrives, even if its full term. H/She will sleep in a bassinet in our room until 15 lbs. anyway, so they won't need a bedroom for a while. I'll just need a big basket for clothes for now.

I hope everyone is enjoying the sunshine out there - today is a beautiful day as was yesterday. I love spring/summer in New England!

20 Weeks!!!!!!!!!

I can't believe this time has come! I'm half way today - when did that happen?! When did 5 months go by?! Seriously...

I've had a rough week with lots of contractions that mess with my head but the 17P shots must be working wonders on my cervix because the contractions don't seem to yet be causing problems - I'm so thankful for that.

I have another appointment on Wednesday and can only hope that my cervix is still behaving. I'm still debating to push for Procardia to help with the contractions but since they aren't doing anything at this point, I'm ok with waiting it out.

We signed the contract for our birth doula today and sent her a check for her deposit. I'm optomistic that we'll make it to full term and have a normal delivery but I also know that at any moment it can change - so we have a doula lined up, for now so that my labor and delivery experience will be better than my first pregnancy. I really felt like a caged animal being poked at and it was really scary and I think it made me ask for the epidural super early and as a result I was tied to a bed with way too much time to obsess about what was happening - it was the worst experience and I hope we don't have to repeat it.

Did you know?

Numerous clinical studies have found that a doula’s presence at birth

• tends to result in shorter labors with fewer complications
• reduces negative feelings about one’s childbirth experience
• reduces the need for pitocin (a labor-inducing drug), forceps or vacuum extraction and cesareans
• reduces the mother’s request for pain medication and/or epidurals

These are all good things in my mind so we're going to try one and see. We met with Tina, our doula, about 3 weeks ago and felt very comfortable with her. She also runs some of the child birth education classes that are given at the hospital we'll deliver, and that made us even more comfortable with the decision.

We've even decided on names now that we're half way: Christopher Michael for a boy and Madelyn for a girl (undecided middle name right now).

Next step is cleaning out the bed room that will serve as his/her bedroom - that's a huge task in and of itself!

19 weeks

I'm nearly at the half way point... Friday marks 20 weeks and its not very fun.

I enjoyed 2 hours of near constant contractions last night - since they didn't hurt, I didn't bother calling my doctor (since I knew I'd waste a trip to the ER anyway) and just drank lots of water and put my feet up. Eventually they stopped. Today started out fine but I was still getting crampy about once an hour or so. I left work after 1 PM to go to the office to get an U/S and see one of the doctors. Everything looks good on U/S - 3.8 cm which is great. If these contractions keep it up I'll be requesting procardia soon as eventually these will thin my cervix and I don't want to wait for that to start happening before we do something.

So ya, my stress level is through the roof right now - but what's new?

#1...

I'm sure this won't be the first time, but it was a shame it had to happen at only 18 weeks 3 days.

I ended up at the Emergency Room on Monday night about 8 PM. After I got home from work my round ligament pain (which has been REALLY bad) was worse than usual. After dinner I decided to lie down for a while.

After laying down for a few minutes the same round ligament pain was occuring, but I wasn't moving - which made me think it wasn't round ligament pain. I haven't felt the baby move much because I have an anterior placenta so even movements confuse me - I didn't get many with my first pregnancy because of the same reason so even, what could be, normal movements confuse me. So I decided to call my doctors office. The OB on call quickly called me back and I was very frank about my situation telling her I didn't think it was something serious and wanted to know what I should do.

She told me to play it safe and come in to the ER to get checked out.

I know, at 18 weeks there is nothing they can or will do and that scares me. We were all sitting in Arianna's room when I took the call and after I hung up the phone I just started bawling - something I haven't done in a long time. Arianna was so confused - she kept yelling 'mama! mama!' and trying to get close to me. I couldn't help but look at her and think of how lucky we are to have her - I picked her up and gave her a big hug when she said 'all done crying?'... and I laughed and said 'yes, all done crying'. She's so precious.

I then tried to call my parents - I wanted someone to come by and stay with her while we left. It was close to her bed time so it would be easy for someone to stay at the house - I was pretty confident we wouldn't be at the ER long. Well... no answer at my parents house, no answer on moms cell, no answer on dads cell, no answer on my brothers cell - but his girlfriend answered so I asked her if she could come down to the house and watch her while I went to the hospital. She was a wreck, even more so than me I think! She ended up calling the VFW post where my brother tends bar and my dad was with him and told them of the situation - my dad was more than just a little rude with her and I felt bad, she was only trying to help.

So a little after 7:30 my parents showed up at my house and took Arianna home with them and Shawn and I drove down to Providence to the ER.

We were very lucky there were only two other parties waiting - both women were obviously very full term and then there was me, who just looks fat rather than pregnant. I got in very quickly and the on call doctor and my nurse were very nice. She gave me a quick exam and said my cerclage looked wonderful and I was still long and closed (music to my ears!) and then we struggled to find bean baby on the doppler - we found him/her after a few tense minutes. I must have a tilted uterus - I didn't know it would STILL be so hard to pick him/her up at this stage but the nurse wasn't surprised.

Then they did a test to see if I had a urinary tract infection (which was negative) and sent us home. I was hoping the UA came back showing an infection so that it was easily explained but instead I got - everything is normal, its just round ligament pain, get a maternity belt.

I don't feel bad about going in but I have found I'm much more anxious now. I stayed home from work on Tuesday and felt really good so I'm hoping that my ultrasound on the 21st shows that my cervix is still behaving (fingers crossed)!

I did something really stupid tonight...

I went to a website for women with incompetent cervix and looked at the pictures of the babies that died due to mom's IC - many of them from 17 - 24 weeks.

I'll stop bawling eventually... really.

Its so horrible that this has to happen. Its so horrible that anyone has to deal with that. I'll be saying an extra prayer for them tonight and kissing my angel baby (now a toddler!) before I go to bed.

Sigh of...

...relief.

Had my 18 week ultrasound today - Bean baby is doing awesome! Currently weighs in at 8 oz and is developing fine.

Best news was my cervical length - 3.6! :) This is still great, they don't worry until you're under 3.0. The only thought still crossing my mind is that this is slightly shorter than when I was pregnant with Arianna - at 20 weeks I was 4.0 with her, but the discrepancy can be for a number of reasons including new ultrasound equipment (I had the same tech this time as with Arianna so I don't want to say it could have been the tech... even though it could have been).

So I can exhale for another 2 weeks... phew.

Rant...

Ok, you get to listen to me rant for a little while - hope you don't mind!

I'm in pain, every freakin' day. They call it normal 'round ligament pain' but I call it torture! Sitting hurts, standing hurts, bending over hurts, getting up from the floor hurts. But mentally it hurts too because I'm in the danger zone now - 18 weeks and every single ache and pain sends my mind racing! Is this a contraction? Is the fullness I'm feeling because I'm funneled to the cerclage?

I knew that this pregnancy wouldn't be 'fun' but I was really hoping to keep my exposure a little bit more. I feel like crying. Monday I was sitting on the floor reading books to Arianna (her favorite thing!) and when we were done I tried getting up and my left hip sort of locked up on me and I couldn't get up. It was so painful, for only a few seconds, that I was too scared to move. I screamed and then just started crying - not because it hurt after the initial pain but because I was so scared. I hate being scared that I could lose this pregnancy at any moment - I have no reason to really be worried, so far everything is fine! I'm doing this to myself!

We have our 'big ultrasound' tomorrow. Will finding out the sex help me bond better with my baby? I really want to be surprised on delivery day but will knowing help me have a more 'normal' pregnancy? I'm starting to feel kicks now (despite my anterior placenta) and its very reassuring but I question even those movements - the baby rolls over, is that minute amount of pressure a contraction?

I don't know what will help my anxiety. Therapy? Drugs? No, I won't be taking any medication to help this. I've been through much worse in my life and didn't need medication - I can get through this without causing potential harm to my baby. But maybe its time for therapy again...

Tocolysis in women with preterm labor between 32 0/7 and 34 6/7 weeks of gestation: a randomized controlled pilot study

Link to article

OBJECTIVE: The purpose of this study was to determine whether intravenous magnesium sulfate (MgSO(4)) followed by oral nifidepine tocolysis in women with preterm labor between 32 0/7 and 34 6/7 weeks' gestation reduces neonatal hospital stay.

STUDY DESIGN: Fifty-four women between 32 0/7 and 34 6/7 weeks with preterm labor were randomized to receive either MgSO(4) and oral nifidepine (n = 24) or no tocolysis (n = 30). All women received betamethasone and prophylactic antibiotics. The primary outcome was total neonatal hospital stay. Data were analyzed using Chi-square and Mann Whitney U test.

RESULTS: The 2 groups had similar mean cervical dilation and gestational age at enrollment. There were no statistically significant differences in total neonatal hospital stay (5.8 +/- 7.2 days; median of 3 days in the no tocolysis vs. 7.5 +/- 8.6 days; median of 3 days in the tocolysis group), rate of preterm delivery (57% vs. 75%) or need for oxygen supplementation (7% vs. 21%, p < 0.23). The neonatal complications were similar in each group.

CONCLUSION: Tocolysis after 32 weeks gestation does not reduce neonatal hospital stay.

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I am very disheartened to read this. I wouldn't be surprised to learn that some women have not been offered tocolysis because 'it won't do any good anyway'.

Very sad.

17 weeks

I went away on a retreat with some friends this weekend, but before I left I went to my doctors office to get my first 17P injection. I had to see a doctor, which surprised me because I thought all my appointments were supposed to be with the same doctor to avoid mis communication etc. It was Dr. Brodsky who was the admitting doctor the day I went into labor with Arianna - she's not my favorite because of her rather crass bedside manner but she was pleasant and the appointment went well because I got to hear the bean baby on doppler for the first time!! It was a great sound!

The appointment was super quick and then I had to wait around for almost 45 minutes for my shot. I only went to this appointment for the shot so I was really annoyed that I was there for more than an hour - really annoyed because one of my friends was waiting for me to get home so we could drive to our retreat. I'll have to ask at my appointment this week if I really need to see a doctor and then wait around for an available nurse to give me the injection. I was really hoping to avoid weekly appointments this pregnancy!

I'm not going to lie - the shot hurt! My butt was sore all weekend! But if it works I'm not going to complain! I have another shot this week on the other side so now both butt cheeks can be sore, ya!

This week we have our structural ultrasound when they could tell us the gender - but we're not going to find out this time, we'll let it be a surprise. The most important part of this appointment is that I will find out what my current cervical length is - I haven't had a trans-vaginal ultrasound to check its length since before my cerclage was placed; my doctor has just been doing manual exams so I'm anxious to hear that NOTHING has changed. I had no change in my cervical length until after 20 weeks with Arianna (my last ultrasound was at 20 weeks) and I'm hoping for the same here. I'll be talking to my doctor about starting Vitamin C this week to help ward off pPROM which has a high occurrence when cervical funneling is present (as is typical from this point on in IC patients with and without a cerclage)

I'm starting to get more anxious as the time goes by because I feel so much more sore in my hips than I remember being with Arianna. On top of that I'm getting HORRIBLE leg cramps at night
and feel so old! I'm praying really hard for good news this week and would appreciate any good thoughts from my readers!

Week 16

I'm officially 4 months along! Wow - time is really flying.

I had an appointment last Monday - the day after we came back from our cruise. My cerclage looks good but we still can't find the baby on doppler. Some of this may be because of my anterior placenta but most likely it is due to low fluid around the baby! I was really bad about staying hydrated while we were on vacation and the day we flew back we were delayed 5 hours and I don't think I drank more than 24 oz. of fluid ALL day - really bad!

So I got yelled at... justifyably so. I have to be better about drinking fluids - I knew this and just because I was on vacation doesn't mean I can stop being pregnant for a week. Since that appointment I've been really good so I hope it made a difference!

I have my 'big ultrasound' on 4/10 - we could find out the sex then, but we're going to be surprised on delivery day! They'll also check my cervical length then (and hope for LONG). I have my next high risk appointment for 4/11. I also start my 17P shots on Friday - not looking forward to getting stuck with a needle every week but if it works, I won't complain!

I'm starting to get uncomfortable standing too long or laying on my back - I'm sure I'm in for even more fun as time goes by...

Week 13

I made it to the second trimester. Now if I can just get into the 3rd trimester (after 28 weeks) I'll be super happy!

Last night we took Arianna to a toddler gymnastics class. It involved parental participation. When I arrived I asked the perky young girl at the desk what was expected of parents and she glanced at me and all she could say was "well everyone needs exercise, you'll be doing everything the kids do!". I was taken aback a bit. I'll admit I hate this stage of pregnancy; where you don't look pregnant, just fat. (I guess it didn't help that all I was wearing was a bulky sweatshirt huh?) So I spun around to my hubby and said loudly "Well, since I'M PREGNANT and can't lift more than 20 lbs. you'll have to help her". I was a bit upset about the comment. I ended up doing much more than I should have and paid for it dearly when I got home - my hips were VERY sore.

Today I went to run some errands at lunch. I wanted to get some last minute things for our upcoming cruise vacation. I walked around two stores and stopped to get some lunch. My hips are STILL hurting me. I want to take it easy this weekend but we have so much to do! Arianna's birthday party is tomorrow and we have to pack for leaving for our cruise next weekend. I don't see how I'm going to be able to 'take it easy'.

On the plus side I had my post-op appointment yesterday and it went well. They still can't pick up Bean baby on the doppler so I got another quick ultrasound. This time Bean was sleeping quietly.

My biggest complaint with my OB group is that with my pregnancy with Arianna I was 'watched' for problems. There are 12 doctors and twice as many secretaries in this group and they all had different ideas on what to watch for. I was told I would have weekly ultrasounds until 24 weeks by one doctor and then the next would say everything was fine. I didn't get the treatment I hoped for and was hurt by it when Arianna came so early. I decided to stay with this group because they have admitting privileges at the hospital and are one of the few high risk groups and I had hopes that things would be better if I started to demand more.

Well as it turns out, now that I have a cerclage I'm high risk (duh!). So I'm in their high risk protocol now. I got a call from a nice lady earlier this week. She is the high risk secretary - yes, there is one dedicated to gals like me. She told me that from here on out I would see the same doctor every two weeks and would only deal with her for scheduling. My prayers have been answered! I'm very happy to FINALLY be getting the treatment I want.

Anyway, I decided to pick the doctor that put in my cerclage as the one that will follow me - we have a good rapport and I like her. I see her again in 3 weeks and then every 2 weeks after that until delivery (hopefully about 38 weeks). She said she does a mix of manual exam of the cervix (with her hand) and trans-vaginal ultrasounds to measure the length. I'm not exactly thrilled at the thought of having something poking at my cervix and cerclage too often but I trust she knows what she's doing. My next ultrasound is at 18 weeks but I see Dr. Cavanaugh at 16 weeks. We'll discuss starting 17P shots then also.

I have a new concern. I was doing some research into the drugs used to stop pre-term labor and found that I supposedly can't take them with the heart condition I have (Long QT Syndrome) . This obviously isn't great news but I also understand that managing pre-term labor with underlying conditions is all about managing risk - is it more risky to give drugs to stop pre-term labor to mom or more risk to baby due to early arrival. My cardiologist is fine with all the drugs used to stop pre-term labor but I know OB-Gyn's can get a little weary about that. This group is well aware of my heart condition so its not news to them but I am going to talk about my concern with these medications at my next appointment. I'm worried they're going to send me to Maternal Fetal Medicine - which is a separate group I saw last time. It turns out my heart condition was not at all a concern during my pregnancy and I went to WAY too many useless appointments (they wanted to see me weekly!). I really don't want to go back to weekly appointments with them in addition to the appointments I'll have with my high risk OB... so I've got my fingers crossed.

I doubt you'll hear anymore from me this week. We leave next Friday for a week in the Caribbean (Jealous yet? I know I am! hehe). I hope its a relaxing, uneventful vacation and that the only news I come back with is how gorgeous my tan is!

We're on lockdown!

My cerclage surgery was last Friday, everything went well in that aspect. I don't have any cramping and only a little bleeding. The spinal was really surreal - I'm watching them lifting my legs into the stirrups and no feeling A THING - it was wierd.

The worst part of the day, and why I'm very lucky to have had the cerclage at all, is that I got my daughters stomach flu that morning. As of 9 PM I'd vomitted 10 times. 5 of which was from the drive to the hospital until I was in the operating room. 1 of which was in the middle of surgery! I notified my doctor of the virus I had and she wanted to go ahead with it as I wasn't running a fever or anything - this TOTALLY surprised me. They gave me nearly 20 mg. of Zofran through my IV and I was still vomitting. Of course, I wasn't allowed to eat anything because of the surgery so it was mostly dry heaving. Try doing that on your back... it sucked big time. They gave me an u/s as soon as the surgery was done and it was a little sad to see the baby had moved to the very other side of my uterus from my cervix - it must have 'needed' to move from all the 'work' they were doing down there. I hope s/he is ok now!

I lingered around the house all weekend (doctors orders) trying to recoup after all the vomitting but it was not easy. It's hard for me to not have control - so it was hard to see the table a mess, my daughter still in PJs and dishes in the sink. If I get put on bedrest there is going to be ALOT of tension between hubby and I when it comes to the house work...

I have my post-op appointment tomorrow and hopefully everything looks good. I didn't get ANY antibiotics (IV or take home) and I'm worried about infection. I'm on pelvic rest for the remainder of the pregnancy now (no sex, poor hubby!) and have to refrain from picking up anything over 20 lbs. Arianna weighs in at 22 and is a very needy kid, so this won't be easy - she already screams at daycare when I won't pick her up immediately... and its hard on me, I want to pick her up!

So the new bean baby is on lockdown - ordered not to come out for AT least another 24 weeks!

NT Scan

I had my NT scan yesterday and I must say - it was the best ultrasound I've ever had! My doctors office scans stink. I've actually gone to appointments for cervical checks where they don't even show me the baby. This u/s was done at the hospital and it was incredible - she showed me everything and took me on a baby tour. This one moves around so much more than any scan I had with Arianna. Bad news is that I have an anterior placenta so I won't feel any movement until much later, but I doubt I'll have problems with previa as its high - but everything looks marvelous so I'm very happy about that. I left with two sets of pictures and its amazing how clear they are - this one has the same nose as Arianna (which is very different than mine or my husbands - its actually cute). I was there for about 20 minutes and left with 2 sets of 4 pictures - one for hubby and I (no fighting! haha). I was so happy I had it done.

I'll have pictures to post soon - I just have to find a reliable scanner!

Next up - 3 days until my cerclage! I'm nervous with anticipation!

Week 11

Week 11 is already here - where has the time gone?! Things are better, overall with my morning sickness but still not perfect. I find that most of the time I eat stuff, thinking I want it, only to find it tastes horrible and then I feel sick. Not fun. But I'll take that over all day nausea!

I find the hormones are totally wrecking with my patience. Last night we went to dinner (cause the thought of cooking was gross to me) at a local restaurant and ordered Arianna's macaroni and cheese immediately. Of course, she finished her food before ours arrived and wanted to get down and run around. Um... no. So she whined and cried which of course set me off cause I can't stand the thought of other people staring at us wondering why we took such an unruly child to dinner. So we spent dinner hurriedly trying to eat our food and keep her entertained. It didn't work and we ended up leaving before we were done. I was so made at her for being such a brat! Why? Its perfectly normal for her age to have acted like that. It seems the new baby is already zapping my patience!

The next week is my last week of freedom - things will definitely change after my cerclage. I'll be doing my own sort of modified bed rest and will be relying on family/friends to help me more. I think things will still be hectic until after we come back from vacation but then its 'feet up' for me!