my blood sugars have been much harder to manage this pregnancy compared to when I was pregnant with Corynn. With her, I had no trouble controlling them with diet and I could even occasionally take a little extra bite of something yummy and it wouldn't really affect my sugar. I only took 2.5 mg of glyburide at night with her because my fasting sugars would occasionally be over 90, but that's it.
This time having two placentas is making it impossible to control. I take 7.5mg glyburide at morning AND night. I have been so strict and eating even less carbs than they say I can have just to try and keep my blood sugar down below 120 (two hours after meals) but my sugars are STILL high.
For example: I have to have a snack with protein and up to 20g of carbs right before bed to hold my sugar stable through the night so that I don't get low and in response my liver would release glucose stores thinking I'm starving which would make my fasting sugar high. Lately my fastings have been high so the other night I had two hard boiled eggs and a glass of milk for my snack and my fasting was 102 the next morning!! With Corynn I would only have a high morning sugar like that if I tried to cheat and have 1/2 cup of ice cream with pb for my bedtime snack.
This is insane! So then I had a sausage biscuit from mcdonalds for breakfast. This has always been one of my favorite diabetes friendly things to eat. It's yummy, has plenty of filling protein and only 34g of carbs (I'm allowed 45 in a meal). Well two hours after eating that my sugar was a whopping 152!! So I skipped my morning snack to try and get it back down and for lunch I only had a half turkey sandwich with ONE slice of bread (18g carbs) because a few days ago my full turkey sandwich (36g) gave me a sugar of 121 which isn't horrible but the fact that it was even over the line was so stupid! So after my no snack and half lunch, my sugar finally came down to 97 and then I was STARVING and inhaled a hamburger like a starved orphan.
I called my OB yesterday to tell her that I don't know what to do anymore. I'm already cutting out carbs that I'm supposed to be eating and I'm really hungry all the time yet my sugars are still high.
The other night I had green beans and cooked tofu for dinner. NO CARBS. Well, I think tofu has like 6grams, but it's basically no carbs and I didn't even check two hours later bc I figured it would be fine. I did however check it four hours after because I was going to have my bedtime snack and it was 116! This would be a great number for the two hour mark but FOUR HOURS??!! Makes me wonder what it actually was at the two hour mark.
So my OB called back and said she is not comfortable increasing my medication dose anymore without perinatal approval. She is sending me for a consult with them because we're really out of options. She doesn't want me to restrict my carbs anymore because I need to be eating SOME carbs for energy or I'll start producing ketones which is not good for the babies.
I am very frustrated because I feel like no matter how hard I'm trying, I'm harming my babies. Diabetes is a well known cause of a prematurely aging placenta like Owen has. I feel like it's my fault yet there's nothing else I can do. I hope the perinatologist has some insight.
Thursday, July 26, 2012
Tuesday, July 24, 2012
no news is good news
had my weekly ultrasound. These are so good for my mental health. They keep me satisfied for about 3-4 days and then I start getting antsy for another one.
Owens placenta is still looking very aged (grade 3) but so far is functioning great. Both passed their bios and cord flows looked great. Really nothing new to share.
Eden was head down but it doesn't really matter because Owen is still breech and he has to be head down to deliver vaginally because he's first. Bad boy.
My contractions had been feeling lower and more intense so I asked my doctor to check my cervix and I'm still at 2cm. My contractions are only like maybe two an hour while on the procardia so this is keeping me from dilating further.
32 weeks tomorrow and I'm ready to be done. I'm ready to have them here and stop worrying about them.
My sugars have been getting hard to control again. Two placentas is killing me! I already eat less carbs than I'm allowed and my sugars are still high, so my doc increased my dose of glyburide again.
That's about all. Pretty low key appointment.
Owens placenta is still looking very aged (grade 3) but so far is functioning great. Both passed their bios and cord flows looked great. Really nothing new to share.
Eden was head down but it doesn't really matter because Owen is still breech and he has to be head down to deliver vaginally because he's first. Bad boy.
My contractions had been feeling lower and more intense so I asked my doctor to check my cervix and I'm still at 2cm. My contractions are only like maybe two an hour while on the procardia so this is keeping me from dilating further.
32 weeks tomorrow and I'm ready to be done. I'm ready to have them here and stop worrying about them.
My sugars have been getting hard to control again. Two placentas is killing me! I already eat less carbs than I'm allowed and my sugars are still high, so my doc increased my dose of glyburide again.
That's about all. Pretty low key appointment.
Monday, July 23, 2012
THE NURSERY!
Yesterday I finally got to see the nursery for the first time. I hadn't wanted to put any effort into doing a nursery myself because I was afraid it would crush me if something bad happened to the babies, so my mom wanted to do one for me.
At first I didn't want to see it until the babies came home from the hospital and if something happened to them, I wanted it all taken down so I would never have to look at it. But then I started thinking about it and realized that if something tragic were to happen, having not seen the nursery would not help my grieving. In fact, it might make it worse in a way by just trying to ignore it and not confronting it. I would still always have known there was a nursery that I never saw and then I think I would regret never having seen it or enjoyed it.
So, I decided I wanted to see it once my mom was finished and that day was yesterday!
It is so beautiful. The cribs are back to back and have their names on them.. Owens has a blue background and Edens has a coral background and they both have a sunshine and either starfish or flowers around their name. The whole room is done in a beach theme which I LOVE. The furniture is white and the walls are a very light beige and cream to look like sand and the curtains are roman shades that kind of look like burlap (but isn't) and are pulled up with thin rope and starfish hanging from them. There is a lamp with sea shells inside. The sheets and bumpers are white but the bed skirts are blue for the "water". Owen has a blue Whale in his bed and my mom is making a coral seahorse for Eden's bed.
There are three paintings on the wall of little kids playing in the sand at the beach. Two girls and a boy.
I sat in the room pretty much all day. I started slowly organizing drawers and the closet, although I couldn't do much because of my bed rest, so there's still a lot of organizing to be done.
I was so happy but of course couldn't shake the feeling of anxiety and slight sadness. Every time I start to get anything ready for the babies, I have this struggle with being happy vs cautious and sad. I hate it. I just felt kind of down all day. I would sit in the room and stare at everything and just hope that the babies survive and that I will get to use the nursery. I'm so so so so afraid I won't bring them home to that room and then I'll have to come home to it and take it all down. These feelings just get in the way of me being truly happy.
I love the room, but I want my babies here so I can stop worrying about them!
At first I didn't want to see it until the babies came home from the hospital and if something happened to them, I wanted it all taken down so I would never have to look at it. But then I started thinking about it and realized that if something tragic were to happen, having not seen the nursery would not help my grieving. In fact, it might make it worse in a way by just trying to ignore it and not confronting it. I would still always have known there was a nursery that I never saw and then I think I would regret never having seen it or enjoyed it.
So, I decided I wanted to see it once my mom was finished and that day was yesterday!
It is so beautiful. The cribs are back to back and have their names on them.. Owens has a blue background and Edens has a coral background and they both have a sunshine and either starfish or flowers around their name. The whole room is done in a beach theme which I LOVE. The furniture is white and the walls are a very light beige and cream to look like sand and the curtains are roman shades that kind of look like burlap (but isn't) and are pulled up with thin rope and starfish hanging from them. There is a lamp with sea shells inside. The sheets and bumpers are white but the bed skirts are blue for the "water". Owen has a blue Whale in his bed and my mom is making a coral seahorse for Eden's bed.
There are three paintings on the wall of little kids playing in the sand at the beach. Two girls and a boy.
I sat in the room pretty much all day. I started slowly organizing drawers and the closet, although I couldn't do much because of my bed rest, so there's still a lot of organizing to be done.
I was so happy but of course couldn't shake the feeling of anxiety and slight sadness. Every time I start to get anything ready for the babies, I have this struggle with being happy vs cautious and sad. I hate it. I just felt kind of down all day. I would sit in the room and stare at everything and just hope that the babies survive and that I will get to use the nursery. I'm so so so so afraid I won't bring them home to that room and then I'll have to come home to it and take it all down. These feelings just get in the way of me being truly happy.
I love the room, but I want my babies here so I can stop worrying about them!
Thursday, July 19, 2012
31 week update
So, I got it clarified... the perinatologist had only written a recommendation to my OB to "follow up in two weeks" with an ultrasound. She did not specify that growth needed to be checked or that I should have it checked every two weeks, that is just how I understood it.
My OB emphasized that growth measurements are so small that looking at a change any more often than every four weeks will not give you good accurate information. So, we will only measure growth monthly. Looking at placentas and cord flow IS in fact a part of a biophysical profile scan, so we will be checking on that weekly. I was satisfied that at least this would be looked at frequently.
This time both babies were moving around and doing breathing exercises right away and passed their bios within the first minute. Edens placenta doesn't look too bad but Owens is pretty bad. It's a grade 3 now and looks really calcified, but both of their cord flows were 2.6-2.8 this time which is totally normal thanks to my bed rest . I was VERY happy about this! The US tech explained that they would never deliver early based solely on a calcified placenta. She said they look at how well the placenta is functioning to make that decision and the best indicators of that are cord flow (S/D ratio), amniotic fluid level and growth and if all of those things are fine, there is no need to worry. She said she's seen really calcified placentas produce huge healthy babies and seen really perfect looking placentas produce tiny growth restricted babies. She said a calcified placenta by itself is really nothing to worry too much about.
And then I saw my OB and she told me all the same things and said that with the way the babies are looking, we will still plan on going to the full 38 weeks. She said at this point she has no real reason to take them early. We will of course reevaluate on a weekly basis, but for now we're saying 38 weeks. She doesn't think I'll make it that far and thinks I'll go into labor on my own before that. But honestly, I disagree with her.
If I had to guess, I will NOT go on my own despite all this preterm labor/ dilation drama. We did this same thing with Corynn. At 35 weeks I was having regular "contractions" and dilated to 2.5cm and 80% effaced. I lost my mucus plug the next day. I continued to dilate about 1cm a week as well as have regular braxton hicks contractions. My doctor said every week that I would go into labor any day. I NEVER did. I made it to 39 weeks and was induced at 5cm 100%. Who knows how long I would've gone on my own before going into labor!
Of course this time this same thing started to happen at 28 weeks so it was a little more worrisome and we needed to take it seriously and treat it as pre term labor even if it wasn't the real thing. I honestly think that this is just what I do... I have a lot of regular braxton hicks weeks and weeks before I were to go into labor and my cervix dilates easily so these BH cause me to start slowly dilating, but it doesn't mean anything "real" is going to happen. And now I'm on medication to stop my BH contractions so I REALLY don't think I will go into labor on my own. Plus the bed rest I'm sure prevents me from rapidly dilating.
My doctor didn't check my cervix yesterday. She said she'll only check it if I start having more contractions again. No need to stir things up at this point now that everything is calmed down.
Both babies are still breech this week. I think it's getting pretty crowded in there because their movements are pretty small now and my doctor decided to go ahead and schedule me for a csection on September 4th so that we can get a 'good O.R. time" (good for her I think).This is pending the peri's approval because Shawnee mission has a strict policy of not delivering before 38 weeks for twins and 39 weeks for a single. I will be 37wk 6days on Sep 4th, and I asked "would they seriously care about a one day difference?" and she said that yes they are kind of nazis about it and won't allow anything any earlier without an emergent reason or perinatal approval. My doctor ONLY delivers at Shawnee Mission on Tuesdays, so if we don't do it that day, I'll have to wait until Sep 11 when I'll be one day away from 39 weeks. Ugh, pleas NO! My belly will be measuring at 48 weeks by then. Hopefully the peri approves Sep 4th.
As far as CS vs induction she said we can always cancel the csection if they flip head down again but for now she's thinking that may not happen. Oh well, at this point I don't really care how they get here. Of course I would prefer a vaginal delivery but it's not that big of a deal to me. I've accepted the high possibility of a csection.
At 34 weeks I will switch to more of a modified bed rest and at 35 or 36 weeks we will start weaning me off of the pericardia and after that point we just let things happen naturally. But I would be willing to put money on it that NOTHING will happen.
In other news, I have had very little weight gain due to my GD diet. At 24 weeks I had gained 12 lb and then it pretty much came to a halt. At my 29 week appointment I had gained 1 more lb for a total of 13lb. But this past week I had said to Erik that I felt like I was gaining weight. I started getting puffy and swollen an my clothes just felt tighter. Sure enough I gained 6lb in TWO weeks time! This is the biggest most rapid pregnancy weight gain I've ever had. I couldn't believe it because I feel so freaking hungry all the time and never get to eat anything yummy, so I know the weight gain can't be from too many calories. My doctor just said that this is the time for the most rapid growth and weight gain of the babies and in addition to two heavy babies, I'm starting to retain fluid. My lips and nose look puffy and if I stand for more than about 5 minutes or even have my feet dangling instead of elevated, they start to puff up, swell, throb and turn a blotchy purplish red color and I develop some lovely cankles. I never really had this too bad with Corynn, so this is new for me. My stretch marks are also starting to hurt and itch and burn and my skin is really shiny and stretched looking and starting to crack and flake.
Back to the subject of diabetes, my doctor said that the fact that I have to be so strict with my diet or my sugars will go crazy high is a good sign that the placentas are functioning well. She said that if they start crapping out that they will secrete less hormones (that bind to my insulin receptor sites) and I would notice a change in my sugars. They would start to be much lower and I would be able to eat more carbs without consequence. So this makes me feel pretty comfortable because I can NOT budge with my carbs right now and this info gives me something to work with to feel like I have some way of monitoring them in between appointments.
I never feel like they move enough and have started getting my doppler out again and doing my own home non-stress tests. I did tell my doctor that I don't feel like they move enough, although they do move and she said it's fine as long as they're moving and reminded/ reassured me that they just don't have much space. I'm always amazed that they pass their bios so well because I'm such a worried wreck that I'm always convinced something is wrong, but then every week I'm reassured that they are just fine. I'm so grateful for weekly ultrasounds to take my anxiety down a notch.
My OB emphasized that growth measurements are so small that looking at a change any more often than every four weeks will not give you good accurate information. So, we will only measure growth monthly. Looking at placentas and cord flow IS in fact a part of a biophysical profile scan, so we will be checking on that weekly. I was satisfied that at least this would be looked at frequently.
This time both babies were moving around and doing breathing exercises right away and passed their bios within the first minute. Edens placenta doesn't look too bad but Owens is pretty bad. It's a grade 3 now and looks really calcified, but both of their cord flows were 2.6-2.8 this time which is totally normal thanks to my bed rest . I was VERY happy about this! The US tech explained that they would never deliver early based solely on a calcified placenta. She said they look at how well the placenta is functioning to make that decision and the best indicators of that are cord flow (S/D ratio), amniotic fluid level and growth and if all of those things are fine, there is no need to worry. She said she's seen really calcified placentas produce huge healthy babies and seen really perfect looking placentas produce tiny growth restricted babies. She said a calcified placenta by itself is really nothing to worry too much about.
And then I saw my OB and she told me all the same things and said that with the way the babies are looking, we will still plan on going to the full 38 weeks. She said at this point she has no real reason to take them early. We will of course reevaluate on a weekly basis, but for now we're saying 38 weeks. She doesn't think I'll make it that far and thinks I'll go into labor on my own before that. But honestly, I disagree with her.
If I had to guess, I will NOT go on my own despite all this preterm labor/ dilation drama. We did this same thing with Corynn. At 35 weeks I was having regular "contractions" and dilated to 2.5cm and 80% effaced. I lost my mucus plug the next day. I continued to dilate about 1cm a week as well as have regular braxton hicks contractions. My doctor said every week that I would go into labor any day. I NEVER did. I made it to 39 weeks and was induced at 5cm 100%. Who knows how long I would've gone on my own before going into labor!
Of course this time this same thing started to happen at 28 weeks so it was a little more worrisome and we needed to take it seriously and treat it as pre term labor even if it wasn't the real thing. I honestly think that this is just what I do... I have a lot of regular braxton hicks weeks and weeks before I were to go into labor and my cervix dilates easily so these BH cause me to start slowly dilating, but it doesn't mean anything "real" is going to happen. And now I'm on medication to stop my BH contractions so I REALLY don't think I will go into labor on my own. Plus the bed rest I'm sure prevents me from rapidly dilating.
My doctor didn't check my cervix yesterday. She said she'll only check it if I start having more contractions again. No need to stir things up at this point now that everything is calmed down.
Both babies are still breech this week. I think it's getting pretty crowded in there because their movements are pretty small now and my doctor decided to go ahead and schedule me for a csection on September 4th so that we can get a 'good O.R. time" (good for her I think).This is pending the peri's approval because Shawnee mission has a strict policy of not delivering before 38 weeks for twins and 39 weeks for a single. I will be 37wk 6days on Sep 4th, and I asked "would they seriously care about a one day difference?" and she said that yes they are kind of nazis about it and won't allow anything any earlier without an emergent reason or perinatal approval. My doctor ONLY delivers at Shawnee Mission on Tuesdays, so if we don't do it that day, I'll have to wait until Sep 11 when I'll be one day away from 39 weeks. Ugh, pleas NO! My belly will be measuring at 48 weeks by then. Hopefully the peri approves Sep 4th.
As far as CS vs induction she said we can always cancel the csection if they flip head down again but for now she's thinking that may not happen. Oh well, at this point I don't really care how they get here. Of course I would prefer a vaginal delivery but it's not that big of a deal to me. I've accepted the high possibility of a csection.
At 34 weeks I will switch to more of a modified bed rest and at 35 or 36 weeks we will start weaning me off of the pericardia and after that point we just let things happen naturally. But I would be willing to put money on it that NOTHING will happen.
In other news, I have had very little weight gain due to my GD diet. At 24 weeks I had gained 12 lb and then it pretty much came to a halt. At my 29 week appointment I had gained 1 more lb for a total of 13lb. But this past week I had said to Erik that I felt like I was gaining weight. I started getting puffy and swollen an my clothes just felt tighter. Sure enough I gained 6lb in TWO weeks time! This is the biggest most rapid pregnancy weight gain I've ever had. I couldn't believe it because I feel so freaking hungry all the time and never get to eat anything yummy, so I know the weight gain can't be from too many calories. My doctor just said that this is the time for the most rapid growth and weight gain of the babies and in addition to two heavy babies, I'm starting to retain fluid. My lips and nose look puffy and if I stand for more than about 5 minutes or even have my feet dangling instead of elevated, they start to puff up, swell, throb and turn a blotchy purplish red color and I develop some lovely cankles. I never really had this too bad with Corynn, so this is new for me. My stretch marks are also starting to hurt and itch and burn and my skin is really shiny and stretched looking and starting to crack and flake.
Back to the subject of diabetes, my doctor said that the fact that I have to be so strict with my diet or my sugars will go crazy high is a good sign that the placentas are functioning well. She said that if they start crapping out that they will secrete less hormones (that bind to my insulin receptor sites) and I would notice a change in my sugars. They would start to be much lower and I would be able to eat more carbs without consequence. So this makes me feel pretty comfortable because I can NOT budge with my carbs right now and this info gives me something to work with to feel like I have some way of monitoring them in between appointments.
I never feel like they move enough and have started getting my doppler out again and doing my own home non-stress tests. I did tell my doctor that I don't feel like they move enough, although they do move and she said it's fine as long as they're moving and reminded/ reassured me that they just don't have much space. I'm always amazed that they pass their bios so well because I'm such a worried wreck that I'm always convinced something is wrong, but then every week I'm reassured that they are just fine. I'm so grateful for weekly ultrasounds to take my anxiety down a notch.
Friday, July 13, 2012
30 week ultrasound
We made it to the 30's!!! Feeling very good about this. Now I have two week goals from here out: 32 is better than 30 and 34 is better than 32 and 36 is better than 34 and after that I'm good to go.
I had an ultrasound on Wednesday that I thought was supposed to be a biophysical and growth check because the peri had said we needed to check out growth every two weeks due to the placenta and cord issues. When I got in there the US tech only had me down for a bio. For those who don't know, this looks at heart rate, amniotic fluid level, gross and fine movements and practice breathing that the baby should be doing. They give the baby a score and I'm not sure how the points are broken down but each baby has to get 8 out of 8 or further monitoring and intervention is needed if they don't. Last week at 29 weeks I had to ask the US tech to look at the placentas and cord flow and tell her why I was concerned about it. My OB had been on vacation the previous two weeks while I was in the hospital and had just gotten back that day so I just figured she hadn't seen my report yet and didn't order anything extra in the ultrasound.
So then I had my appt with her and discussed what the perinatologist had said and I thought we were on the same page as far as concern level goes because she talked about delivery at 34 weeks.
But then this week the US tech once again only had me down for a bio. I told her the peri wanted to look at growth every two weeks and the on call OB in the hospital said we would look at placentas and cords weekly.
Well this week the tech said normally they do growth monthly because two weeks won't show much change and that my doctor hadn't ordered to look at those things but she would do it just this one time for me.
I was very frustrated with this because I'm getting different messages from different doctors. I was looking at my appt schedule and after next week, I didn't have any US ordered until 34 weeks. Ummmm how are we supposed to decide if it's necessary to deliver at 34 weeks if we don't have any US to check on things up to that point?! I called the peri to see if I was supposed to follow up with her and the nurse said that no, they had just sent recommendations to my OB and that I would just continue to see her and that's who I should speak with.
So I called my OB and they got me scheduled for weekly bios but said once again that growth will only be checked monthly but that they would review the notes from the peri and see exactly what her recommendation was and may or may not change the orders based on the report. Ugh. Then I asked about the placentas and cords and the nurse said "I thought that was part of a bio anyway". Well, I have no idea but it sure seemed like I had to really convince the techs to look at those things. I asked if she could please make sure of this and if not, make sure it is ordered for my remaining ultrasounds.
I don't know if I'm just overreacting or what, but I get the feeling my OB is not taking this issue as seriously as myself or the peri. The peri acted like it was definitely something to pay close attention to and I sure as hell want to check it out every week. Heck, I'd prefer to check on it every day if I could.
We'll see what happens next week and see how big of a fit I'll have to throw. Hopefully they'll get it together and just do what I'm asking.
But for this week their growth had greatly improved! Owen was 3lb 5oz/ 58th percentile and Eden was 3lb 3oz/ 54th percentile. Last week they were in the 44th and 40th percentiles so all this bed rest has given them a lot more energy to draw from and they grew like crazy!
Eden passed her bio right away but it took Owen awhile because he was not moving or doing practice breathing at all. The tech kept pushing on my belly trying to wake him up but he was not budging. It was starting to freak me out but then finally at the end and passed his test.
Owens placenta is looking very old and calcified but his cord flow was fine.
Edens placenta looked only slightly aged but her cord flow was mildly concerning. They measure the systolic to diastolic ratio and like to see it be less than three. The tech measured it three different times and got 3.1-3.7 but then came back at the end and was able to get two more readings of 2.8. She went to tell the OB (not mine) about it and after a minute she came back in and said that the doctor was ok with those numbers because she passed her bio, her growth is good and we did get a reading below 3 so the higher readings could have just been her position or activity level at the time.
I'm glad the doctor wasn't concerned but at the same time I'm freaking worried out of my mind and kind of wish someone with authority would be to. In a way I wish I could just be monitored continuously in the hospital until they're born. I'm so afraid I'm going to lose one or both of them because of lack of attention.
I've had thoughts cross my mind that it would be better to just deliver early and get them out here where we can have more control and for a second I thought about taking myself off bed rest and just allowing myself to go into labor. But I would feel horrible if something happened to them due to prematurity. My biggest concern at this gestation would be NEC (a life threatening intestinal infection) I just don't know what to think. My main motivation for staying on bed rest is for their cord flow and growth. I want to give them everything I have. My concern for preterm labor, although important is less of a factor in my mind. At this point if they're born early I will feel like it's because it was the best thing for them.
I feel so fortunate for every day that I wake up and still feel them moving. I feel like I'm just waiting for something horrible to happen and I keep wanting to control the situation in some way but the only thing I can really do is give the control to God and keep praying.
The other thing bed rest has done was amazingly allowed Owen to disengage his head from the birth canal. His head was no longer resting on my cervix which everyone thought was impossible because of how low he was but because I've been laying down and never standing, he was able to come back out. This is great because it means I probably am not anymore dilated and decreases my chance of preterm labor.
The bad side is that he is now breech again AND his sister decided to follow him and they are BOTH breech. Little turds. This is ok for now, but they better get their heads back down where they belong for delivery.
I had an ultrasound on Wednesday that I thought was supposed to be a biophysical and growth check because the peri had said we needed to check out growth every two weeks due to the placenta and cord issues. When I got in there the US tech only had me down for a bio. For those who don't know, this looks at heart rate, amniotic fluid level, gross and fine movements and practice breathing that the baby should be doing. They give the baby a score and I'm not sure how the points are broken down but each baby has to get 8 out of 8 or further monitoring and intervention is needed if they don't. Last week at 29 weeks I had to ask the US tech to look at the placentas and cord flow and tell her why I was concerned about it. My OB had been on vacation the previous two weeks while I was in the hospital and had just gotten back that day so I just figured she hadn't seen my report yet and didn't order anything extra in the ultrasound.
So then I had my appt with her and discussed what the perinatologist had said and I thought we were on the same page as far as concern level goes because she talked about delivery at 34 weeks.
But then this week the US tech once again only had me down for a bio. I told her the peri wanted to look at growth every two weeks and the on call OB in the hospital said we would look at placentas and cords weekly.
Well this week the tech said normally they do growth monthly because two weeks won't show much change and that my doctor hadn't ordered to look at those things but she would do it just this one time for me.
I was very frustrated with this because I'm getting different messages from different doctors. I was looking at my appt schedule and after next week, I didn't have any US ordered until 34 weeks. Ummmm how are we supposed to decide if it's necessary to deliver at 34 weeks if we don't have any US to check on things up to that point?! I called the peri to see if I was supposed to follow up with her and the nurse said that no, they had just sent recommendations to my OB and that I would just continue to see her and that's who I should speak with.
So I called my OB and they got me scheduled for weekly bios but said once again that growth will only be checked monthly but that they would review the notes from the peri and see exactly what her recommendation was and may or may not change the orders based on the report. Ugh. Then I asked about the placentas and cords and the nurse said "I thought that was part of a bio anyway". Well, I have no idea but it sure seemed like I had to really convince the techs to look at those things. I asked if she could please make sure of this and if not, make sure it is ordered for my remaining ultrasounds.
I don't know if I'm just overreacting or what, but I get the feeling my OB is not taking this issue as seriously as myself or the peri. The peri acted like it was definitely something to pay close attention to and I sure as hell want to check it out every week. Heck, I'd prefer to check on it every day if I could.
We'll see what happens next week and see how big of a fit I'll have to throw. Hopefully they'll get it together and just do what I'm asking.
But for this week their growth had greatly improved! Owen was 3lb 5oz/ 58th percentile and Eden was 3lb 3oz/ 54th percentile. Last week they were in the 44th and 40th percentiles so all this bed rest has given them a lot more energy to draw from and they grew like crazy!
Eden passed her bio right away but it took Owen awhile because he was not moving or doing practice breathing at all. The tech kept pushing on my belly trying to wake him up but he was not budging. It was starting to freak me out but then finally at the end and passed his test.
Owens placenta is looking very old and calcified but his cord flow was fine.
Edens placenta looked only slightly aged but her cord flow was mildly concerning. They measure the systolic to diastolic ratio and like to see it be less than three. The tech measured it three different times and got 3.1-3.7 but then came back at the end and was able to get two more readings of 2.8. She went to tell the OB (not mine) about it and after a minute she came back in and said that the doctor was ok with those numbers because she passed her bio, her growth is good and we did get a reading below 3 so the higher readings could have just been her position or activity level at the time.
I'm glad the doctor wasn't concerned but at the same time I'm freaking worried out of my mind and kind of wish someone with authority would be to. In a way I wish I could just be monitored continuously in the hospital until they're born. I'm so afraid I'm going to lose one or both of them because of lack of attention.
I've had thoughts cross my mind that it would be better to just deliver early and get them out here where we can have more control and for a second I thought about taking myself off bed rest and just allowing myself to go into labor. But I would feel horrible if something happened to them due to prematurity. My biggest concern at this gestation would be NEC (a life threatening intestinal infection) I just don't know what to think. My main motivation for staying on bed rest is for their cord flow and growth. I want to give them everything I have. My concern for preterm labor, although important is less of a factor in my mind. At this point if they're born early I will feel like it's because it was the best thing for them.
I feel so fortunate for every day that I wake up and still feel them moving. I feel like I'm just waiting for something horrible to happen and I keep wanting to control the situation in some way but the only thing I can really do is give the control to God and keep praying.
The other thing bed rest has done was amazingly allowed Owen to disengage his head from the birth canal. His head was no longer resting on my cervix which everyone thought was impossible because of how low he was but because I've been laying down and never standing, he was able to come back out. This is great because it means I probably am not anymore dilated and decreases my chance of preterm labor.
The bad side is that he is now breech again AND his sister decided to follow him and they are BOTH breech. Little turds. This is ok for now, but they better get their heads back down where they belong for delivery.
Monday, July 9, 2012
baby sprinkle and rest
Saturday was my baby sprinkle thrown by my younger sister Jannel. I was so excited to celebrate these lives. It really had nothing to do with getting gifts. The only thing I really needed was new cloth diapers and I got a TON so that's great, but what I really wanted was just to have family there to celebrate these miracles inside me. That morning I felt the babies moving and just thought to myself "we made it to the sprinkle". I was just so amazed and grateful that they were still alive at 29.3 weeks. When my sister and I decided on July 7 way back in like Feb or March I remember thinking "if we make it that far". And we did! I'm so grateful to still be pregnant with TWO living babies!
Everything was done in blue and pink and was so picture perfect like a scene right out of pinterest!
I was so glad my doctor let me go. I sat the whole time and had people bring me my food, drink and gifts. It was great to get out of my house and my same old recliner I ALWAYS sit in. I decided to stay at my moms for several hours after the sprinkle was over just so I could talk to some people for awhile and have a change of scenery from my living room. It was really nice, but by the end of the night I was very uncomfortable and couldn't seem to get comfortable in any of their furniture so I was ready to get back to my recliner and was starting to get some contractions so I took a prn muscle relaxer as well. Being up and moving even just a little bit kinda made me appreciate the bed rest status because I had kind of forgotten how much pain I was in trying to simply walk around. As bored as I get, I realize how wonderful the rest is and how much my body needs it. I'm very grateful to not be working right now. I need the time off WAY more right now than I will after the babies are born. I really only need about six weeks for full recovery after babies anyway and the rest of maternity leave is just fun time with my babies. I remember thinking after six weeks with Corynn that there really wasn't any reason I COULDN'T work, I just liked being home with my baby for a few more weeks.
Whereas right now I CAN'T work. Right now is when I really am "disabled" and NEED that short term disability check.
Another thing I noticed the day of the sprinkles was that the babies didn't move much. They moved enough to let me know everything was ok but they were small rare movements. They move WAY more when I'm home kicked back in my recliner. The day the perinatologist saw the problem with Eden's cord and placenta she said the best thing for it would be strict bed rest to keep my pressure down and allow them optimal flow and they can get all the energy they need because I'm not using it to move around and man, I could really tell the difference on saturday! Sunday they were back to moving around like crazy.
I feel a greater need to be on strict bed rest for this reason than I do for the preterm labor. Not that I'm not worried about preterm labor, but I'm more worried about simply keeping them alive.
Everything was done in blue and pink and was so picture perfect like a scene right out of pinterest!
I was so glad my doctor let me go. I sat the whole time and had people bring me my food, drink and gifts. It was great to get out of my house and my same old recliner I ALWAYS sit in. I decided to stay at my moms for several hours after the sprinkle was over just so I could talk to some people for awhile and have a change of scenery from my living room. It was really nice, but by the end of the night I was very uncomfortable and couldn't seem to get comfortable in any of their furniture so I was ready to get back to my recliner and was starting to get some contractions so I took a prn muscle relaxer as well. Being up and moving even just a little bit kinda made me appreciate the bed rest status because I had kind of forgotten how much pain I was in trying to simply walk around. As bored as I get, I realize how wonderful the rest is and how much my body needs it. I'm very grateful to not be working right now. I need the time off WAY more right now than I will after the babies are born. I really only need about six weeks for full recovery after babies anyway and the rest of maternity leave is just fun time with my babies. I remember thinking after six weeks with Corynn that there really wasn't any reason I COULDN'T work, I just liked being home with my baby for a few more weeks.
Whereas right now I CAN'T work. Right now is when I really am "disabled" and NEED that short term disability check.
Another thing I noticed the day of the sprinkles was that the babies didn't move much. They moved enough to let me know everything was ok but they were small rare movements. They move WAY more when I'm home kicked back in my recliner. The day the perinatologist saw the problem with Eden's cord and placenta she said the best thing for it would be strict bed rest to keep my pressure down and allow them optimal flow and they can get all the energy they need because I'm not using it to move around and man, I could really tell the difference on saturday! Sunday they were back to moving around like crazy.
I feel a greater need to be on strict bed rest for this reason than I do for the preterm labor. Not that I'm not worried about preterm labor, but I'm more worried about simply keeping them alive.
Tuesday, July 3, 2012
aging placentas
had an ultrasound and OB appointment today. Both placentas now appear to be aging/ calcifying, actually Owen's looks more aged than Eden's BUT both of their cord flows looked normal today!! That made me very happy. They both were doing a lot of practice breathing and moving.
Based on the way my placentas looked, my doctor is thinking that we will deliver them at 34 weeks. While I don't want them to have any NICU time, I know they will need a short stay if born at 34 weeks and I'm ok with that if it's what's safest and the alternative is death from non- functioning placentas! I think especially knowing ahead of time that that's what's going to happen, I can prepare myself for not having them in my room with me and giving up on that idea.
Good news is that both babies are now head down so hopefully they stay that way and I won't need a csection!!
My doctor checked me again and was blown away by how much pressure Owen was putting on my cervix and how far down his head was. She said "I'm pretty sure you're still 2cm, but I'm not gonna do a thorough check because he's so low, I'm afraid I'm going to stir something up". She emphasized that I need to stay off my feet and be on strict bed rest as much as possible but did give me permission for the baby sprinkle on saturday :-)
Based on the way my placentas looked, my doctor is thinking that we will deliver them at 34 weeks. While I don't want them to have any NICU time, I know they will need a short stay if born at 34 weeks and I'm ok with that if it's what's safest and the alternative is death from non- functioning placentas! I think especially knowing ahead of time that that's what's going to happen, I can prepare myself for not having them in my room with me and giving up on that idea.
Good news is that both babies are now head down so hopefully they stay that way and I won't need a csection!!
My doctor checked me again and was blown away by how much pressure Owen was putting on my cervix and how far down his head was. She said "I'm pretty sure you're still 2cm, but I'm not gonna do a thorough check because he's so low, I'm afraid I'm going to stir something up". She emphasized that I need to stay off my feet and be on strict bed rest as much as possible but did give me permission for the baby sprinkle on saturday :-)
L&D 5
yesterday afternoon I lost a bunch of nasty bloody mucus plug so I called my OB just to let her know what was happening and she decided I should go back to L&D just to check my cervix and make sure I wasn't dilating more. I wasn't!! Still 2cm.
So they were just gonna watch me on the monitor for a bit and send me home. Thanks to the pericardia, I only had a contraction about every 15-20 minutes! Just as they were going to release me I had a contraction that made Owens heart rate drop to 80, so they decided to keep me another hour to watch him. He didn't do it again but it still made me very nervous. The nurse was like "oh he probably just pinched his cord" and I'm thinking that is the worst thing she could say to me. People treat cord compression like it's no big thing, and I guess maybe it's not most of the time but when you've lost a baby to a cord accident, ANY cord compression is a major deal!
I went home after a couple hours
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