At this point I am getting wheeled over to a room in Labor and Delivery, wouldn't you know it was the same one I delivered Audra in! I am so very thankful that I had done my reading on preterm labor treatments, NICUs, etc. earlier on in pregnancy. I was able to understand why the doctor was pursuing this course of action, but none of my reading had been too recent enough that I was freaking out or anything, because if you do look up what the treatment/side effects can entail, it isn't pretty and could be very anxiety inducing. I was also take this moment to say that God clearly had a hand in my calmness, because I'm just not that calm of a person. Even though very few people knew what was going on at this point we were being covered in prayer.
I understand that there are less intense therapies to treat preterm labor, but am so happy that my Dr. simply told me what she was going to do instead of allowing me to waffle around on the idea that I could take a more cautious approach. I was very quickly hooked up to an IV for fluids, a bag of magnesium sulfate, and given the first dose of a steroid shot (at a bit before 4 PM) that is used to help mature babies' lungs in utero by triggering the production of surfactant.
Surfactant is pretty much a lubricant for the lungs. It is produced naturally by babies, but not generally until a bit later in gestation. *Literally every.single.day.in utero has huge benefits for babies, so while 32 weeks and 3 days may not seem too different than 34 or 35 weeks, it has a HUGE impact on "outside baby readiness". I randomly heard that every day inside the uterus is along the lines of 4 days in the NICU.* Triggering the natural production of surfactant earlier through use of the steroids is used to helps premature infants have less respiratory distress because the air sacs in the lungs are able to do their jobs without sticking to other lung tissue, causing or furthering respiratory distress in the wee one. Since coming home I have also found that some studies indicate that this shot may also reduce risk of brain hemorrhage, which is very commonly seen in premature babes, and of course is a major concern. In order for the steroid to work, Mom must get 2 doses of it - best spaced at 24 hrs apart - so this also relates to why my preterm labor was treated very aggressively even though, in the world of preterm delivery I was further along than many. A large part of the labor delay was in order to give those boys enough time to receive the benefits of the steroid shots so that whenever they do decide to arrive (a day from now or a month from now...who knows?) they will be as prepared as can be to breathe with the least amount of assistance. Medical technology is truly a miracle, but being hooked up to breathing apparatus', etc. increases risk of infection. So - we are really hoping that Baby Boys will come out with lungs slathered in surfactant, wailing, and ready to make me very tired from all of their crying.
Okay - does that cover the steroid shots? It wasn't pleasant, but it was also very much nothing compared to some of the other "lovely" experiences, and honestly - I'd take yucky shots over intense, un-medicated labor any day. Oh, and the benefits speak for themselves so it really was not an issue. We were all just intensely relieved that we were (eventually) able to get the full treatment to the boys. At this point, if I went into labor, they wouldn't stop it because a) the boys got such an awesome benefit from this treatment and b) please, if my labor is bound and determined to start there isn't anything left that wasn't done to my body to keep it from doing so.
Quick notes:
1. I HATE IVs. I had a really good one done, since it was in for about 3 days and I didn't actually attempt to tear it out, but I still suuuuuper hate getting fluids through it and puffy and itchy and gross.
2. I totally understand why they exist, and was pretty psyched that I got a Prilosec drip to help ease the nasty heartburn that came along as a result of things like: laying down for 3 days straight, having you body pumped so full of fluids that it rapidly grows your ever-massive uterus straight into your ribcage (not that there was so much space left anyway), not being able to eat or drink for 3 days...yeah - we'll get to that., having heavy meds pumped into you over the course of 2 of those days that has a knack for making people feel like they are on fire.
3. I really don't mind blood draws. Seeing as they were happening round the clock to make sure I was in the therapeutic range for the meds, but not getting overdosed, these were the least of my concerns and I'm glad I'm not a needle-hater. This whole experience would have been much more traumatic.
Next up: The "Mag Bag" or "Dreaded Mag" aka Magnesium Sulfate...this beauty is going to get a post of it's own.
Thursday, October 6, 2011
Wednesday, October 5, 2011
PreTerm Labor Experience Part 1: How did I get here?
Well, I know that many of you will have gathered bits and pieces of this post via facebook updates, emails, and texts, but I did want to detail the past 5 days or so anyway since that is the whole point of this blogging adventure. Also, while I do want to provide a bunch of information, I will be leaving some of the gorier details out..and off the internet. There are just some things about this experience that I do not feel need to be broadcast.
Friday Sept. 30, 4:30 AM - I wake up and am feeling yucky and crampy. I lay there for a few hours before letting Steve know that I will NOT be taking to Audra to school in the morning since I hope to catch a few more hours of sleep which thankfully does come. A few days prior, The Mr. had randomly chosen to take the day off in order to get a few things done around the house so he was able to get Audra to school after all. He spent the day running around being productive as scheduled, while I lay in the basement still feeling crampy and gross and generally sorry for myself (and him) that I was not being helpful. Around 5 that evening I finally hauled myself off the couch in order to go pick up Audra from school. During the car ride and pick-up process, I had a bunch of contractions. Mind you - I've been feeling contractions regularly for months, but these were very regular and in combination with feeling "off" I decided to keep taking it easy and go lay back down. Dehydration can be a common cause of contractions and I hadn't had nearly enough to drink during the day since I wasn't doing much, so I chalked it up to pregnancy discomforts and not being hydrated, got annoyed by timing contractions that were regular, but not intensifying, and decided to get some sleep figuring that would take care of things.
Saturday Oct. 1 AM - Steve once again was up with Audra before me and I had gotten some truly excellent sleep for the first time in a loooong time and was quite groggy. Audra hung out with me on the couch while Steve got ready for a haircut that morning. In truly Schwendy fashion, our toilet backed up into our tub and through our ceiling for the 2nd time in a week after being "fixed" on Monday AND we discovered we may have had something similar to apower surge (just was told by the technicians it was probably a lightening strike) over night, so none of our internet/AV/TV equipment was working which I had been attempting in order to occupy the little lady so that I could help Steve gather towels/buckets/etc. All of this before 9 AM when Steve has to be downtown in 20 min. Also around this point, I realized I was still feeling crampy, although I wasn't feeling too many contractions. This was really not a good time to have concerns, but then again I am a good little student of the internet and it told me that experiencing any changes was worth at least a call to the OB answering service. I let Steve know as he ran out the door that I'd be calling, but not to think too much of it. I also took this time to call my Mom so that I had someone to remain accountable to, since I really didn't want to call on the weekend over nothing and also to share our "funny" morning tale. Mom did a very good job of making sure that I would call soon, and to let her know what they said.
I went ahead and called the help line and gave the basic overview to the woman who answered and was told a doctor would call me back in about 10 minutes or so. Sure enough, I got a call from the OB on call from my practice soon after and I went through the basics with her: crampy, some contractions, but better than the day before and nothing intensifying. At some point she realized I was a twin pregnancy (the answering service had not informed her of that fact) and she told me to get my butt to Labor and Delivery. I told her my butt had a 3 year old at home and a husband who was out, but would be in when I could be. Thankfully Steve's appointment was finished and I was able walk out of the house as he was walking in. I kissed Audra quickly and I took my phone and computer just in case I needed to wait around, but was hoping to be back by 1:15 to watch Audra so that Steve could get our cat to the vet for her yearly appointment. Also, good friends of ours were hosting a party that evening and I was very much looking forward to parking myself on their couch and having people bring me plates of food, but off I drove.
We live appx. 2-4 minutes from the ER depending on how you hit the lights and what entrance you use, so I was at the hospital in no time. Walked in, chatted with the ER receptionist about how twin pregnancies are super hard and nothing to envy and then walked up to L&D. They took me into triage and hooked me up to the contraction monitors and reviewed information and just hung out for about 45 minutes until the Dr. could come by and see what was going on. During this whole time I only had one contraction and was feeling much better so I was excited to get the show on the road and get back home. After a bit, the Dr. did come by to do a fetal fibronectin (fFn) test. I figured she might as well do something while I was there. This is not a definitive test. Basically, it is very accurate at determining that you are NOT going to go into labor in the next week or so when negative, and then if positive, alerts you that you have a 50/50ish chance of going into labor in that same time period. All signs were showing that after an hour I'd get a negative result and could break free.
The next hour was spent occupying myself on the phone, but also noticing that I was feeling crampy, nauseated, and that I thought I was feeling contractions again. During this hour the L&D nurse also began talking less to me and making lots of hash marks on the contraction readouts. Still, she was pleased that the boys heartrates were looking great, and of course Baby B was doing his thing rocking and rolling around so that they had to keep adjusting the straps to find his heartrate. Imagine my surprise when the nurse let me know that they had (very quickly) gotten the results back that the fFn test was positive. The doctor told me to go use the bathroom since I had been hooked up for a while, and that we'd talk after that. I heard, "You are gonna hate me, but your boys are gonna looooove you". as I made my way over. At this point (around 1:30) I realized I was not going to be going home, but was more curious to know what they had in mind.
Friday Sept. 30, 4:30 AM - I wake up and am feeling yucky and crampy. I lay there for a few hours before letting Steve know that I will NOT be taking to Audra to school in the morning since I hope to catch a few more hours of sleep which thankfully does come. A few days prior, The Mr. had randomly chosen to take the day off in order to get a few things done around the house so he was able to get Audra to school after all. He spent the day running around being productive as scheduled, while I lay in the basement still feeling crampy and gross and generally sorry for myself (and him) that I was not being helpful. Around 5 that evening I finally hauled myself off the couch in order to go pick up Audra from school. During the car ride and pick-up process, I had a bunch of contractions. Mind you - I've been feeling contractions regularly for months, but these were very regular and in combination with feeling "off" I decided to keep taking it easy and go lay back down. Dehydration can be a common cause of contractions and I hadn't had nearly enough to drink during the day since I wasn't doing much, so I chalked it up to pregnancy discomforts and not being hydrated, got annoyed by timing contractions that were regular, but not intensifying, and decided to get some sleep figuring that would take care of things.
Saturday Oct. 1 AM - Steve once again was up with Audra before me and I had gotten some truly excellent sleep for the first time in a loooong time and was quite groggy. Audra hung out with me on the couch while Steve got ready for a haircut that morning. In truly Schwendy fashion, our toilet backed up into our tub and through our ceiling for the 2nd time in a week after being "fixed" on Monday AND we discovered we may have had something similar to a
I went ahead and called the help line and gave the basic overview to the woman who answered and was told a doctor would call me back in about 10 minutes or so. Sure enough, I got a call from the OB on call from my practice soon after and I went through the basics with her: crampy, some contractions, but better than the day before and nothing intensifying. At some point she realized I was a twin pregnancy (the answering service had not informed her of that fact) and she told me to get my butt to Labor and Delivery. I told her my butt had a 3 year old at home and a husband who was out, but would be in when I could be. Thankfully Steve's appointment was finished and I was able walk out of the house as he was walking in. I kissed Audra quickly and I took my phone and computer just in case I needed to wait around, but was hoping to be back by 1:15 to watch Audra so that Steve could get our cat to the vet for her yearly appointment. Also, good friends of ours were hosting a party that evening and I was very much looking forward to parking myself on their couch and having people bring me plates of food, but off I drove.
We live appx. 2-4 minutes from the ER depending on how you hit the lights and what entrance you use, so I was at the hospital in no time. Walked in, chatted with the ER receptionist about how twin pregnancies are super hard and nothing to envy and then walked up to L&D. They took me into triage and hooked me up to the contraction monitors and reviewed information and just hung out for about 45 minutes until the Dr. could come by and see what was going on. During this whole time I only had one contraction and was feeling much better so I was excited to get the show on the road and get back home. After a bit, the Dr. did come by to do a fetal fibronectin (fFn) test. I figured she might as well do something while I was there. This is not a definitive test. Basically, it is very accurate at determining that you are NOT going to go into labor in the next week or so when negative, and then if positive, alerts you that you have a 50/50ish chance of going into labor in that same time period. All signs were showing that after an hour I'd get a negative result and could break free.
The next hour was spent occupying myself on the phone, but also noticing that I was feeling crampy, nauseated, and that I thought I was feeling contractions again. During this hour the L&D nurse also began talking less to me and making lots of hash marks on the contraction readouts. Still, she was pleased that the boys heartrates were looking great, and of course Baby B was doing his thing rocking and rolling around so that they had to keep adjusting the straps to find his heartrate. Imagine my surprise when the nurse let me know that they had (very quickly) gotten the results back that the fFn test was positive. The doctor told me to go use the bathroom since I had been hooked up for a while, and that we'd talk after that. I heard, "You are gonna hate me, but your boys are gonna looooove you". as I made my way over. At this point (around 1:30) I realized I was not going to be going home, but was more curious to know what they had in mind.
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