Sorry it's taken me so long to post... I'm in the hospital, hence the reason for no updates in the last few weeks. Thanks to everyone who has been checking in and expressed concern.
So, how did I get here? Well...
On Sunday, December 2o...
I lost part of my mucus plug in the Kohl's restroom... at least at the time I thought that's what it might be. I saw something come out and, as sick as this sounds, reached in after it in the toilet in order to try and figure out what in the heck it was. It was tinged a darker blood color and very stretchy, but wasn't even the size of a quarter. Instantly, I had this sinking feeling that is what it could be from what I'd read, so I finished my Christmas shopping and went home. I was in no pain and wasn't having any major contractions... just a few small ones before bed which were alleviated by drinking water and resting on my side. Jay, who was many states away at the time (training for his new job), and I decided that it would be ok to wait and call the doctor the next morning.
Monday, December 21
When I called my OB I was told "if it was your mucus plug, that's not what we want to see at 21 weeks". So, that afternoon, I headed out to get checked at the OB's office. One internal check and an ultrasound cervical length check later, I found out I was fully effaced (no cervical length) and funneling (or dilating from the inside out). Honestly, if it wasn't for me going in that day, I think we would have likely lost our babies within a few days.
Thank goodness my mom had her womanly intuitions turned on that day. Before I left the office, I e-mailed her to let her know I was going in to get looked at, but that I was calm and would call her later with an update. As I'm sitting on the exam table, in walks my mom - is this woman amazing or what. God was speaking to her that day and I am so very thankful for that. She deserves so much credit for helping me keep my sanity through the crazy journey that would lie ahead over the next few days.
There in the office we were told to drive straight to St. John's Mercy Hospital to see the high risk doctors. I was instructed to essentially stop walking immediately... between this and the scariest ultrasound of my cervix I'd ever seen (the sonographer actually showed me the bag of water protruding into my cervical canal and said that the good thing was that it had burst!), I knew things were dire.
A St. John's they began admitting me and discovered I was contracting every minute and didn't know it. Tthey shot me with terbutaline, which made my heart race, but took care of the contractions for awhile. I was then paid a visit by doctor Gilbert Webb, one of the perinatologists here at the hospital. He said that the best, real hope at this point would be to do a emergency/rescue cerclage in order to try and tie my cervix shut. He warned it could throw me into preterm labor afterwards, due to the irritation after surgery, and that there was a chance that baby A's bag water could rupture since it was bulging into the cervical canal where he would be working. He assured me he would do everything possible to make sure that wouldn't happen, but there were no guarantees. After the rest of the surgery prep was complete, I was wheeled down in a bed, feeling somewhat alone, but knowing God was present. I prayed with all my might that he would protect the three of us - the life of our babies was in his hands, just as it was when we underwent IVF when to conceive them. What a miracle it was for us to get pregnant - I knew God still had great plans for these two precious babies.
The surgery itself went as good as we could have wanted. The cerclage was in place and the membranes did not rupture. The only traumatic part was when they put me under; apparently sensors to the breathing part of my brain went off before my consciousness did and I felt, for a few seconds, like I was suffocating. The weirdest and most frightening experience I've felt before during a procedure.
Tues-Wed, December 22 &23
The second biggest hurdle was to stop the contractions brought about by the surgery and to pray the babies' bags of waters would stay intact... I tested positive for the fetal fibronectin test on the 21st, which further indicated that the area around the babies in my uterus may be slightly compromised. Following surgery they put me on an IV of magnesium sulfate and clear fluids; it ended up taking three concentrated loading doses, a maintenance dose and about a day and a half until the contractions were somewhat stable. I thank God it worked, though mag certainly isn't a pretty drug. Initially, I went from feeling like I had the worse fever ever to a loopy state where I could only open my eyes half way. Put anything in me, even water, and the projectile vomiting would begin. My least favorite part was when I was still contracting after all the extra doses and was told by one of the doctors "we're doing all we can. It's up to your body now." This scared me to my core.
On Wednesday, things finally settled down and I felt a huge sigh of relief. I wanted things to be "normal" again so badly and believed at that moment we were on the uphill climb. As they were taking me off mag, they put me on a pill called indocin - another strong anti-contraction medication that they can only give for 48 hours max, otherwise it isn't good for the babies' hearts. Early that afternoon, a wheelchair ride showed up at my bedside and whisked me away downstairs to the perinatal center for a growth ultrasound and first cervical check since the surgery. With my Mom by my side, we learned the cerclage was tightly in place and my cervical length was now at 1.6 cm, rather than 0, prior to the surgery. All great news!! Also, the fluid around the babies was perfect and the babies were both measuring good for their gestational age. Technically, I was 21w5d - baby boy was 22w2d weighing in at 1lb 2oz and baby girl was 21w2d and weighed 1lb. I was thrilled to hear they had both topped 1lb already!! I was wheeled back up to my room with two pics of our perfect little babies, never more proud to be their mommy.
I hadn't been back in my room for long at all and in walks the nurse, announcing they were removing the catheter and sending me to antepartum. In retrospect, this really was probably done a bit too soon, but at the time, although I physically felt rushed, it also seemed like I was moving into a "safer" place; surely I wouldn't be moved unless things we're going well. Again, another ounce of hope was felt. The new room also meant I could shower for the first time since the 21st (eeeeww) and pee on my own (it's the little things ;-P). "Normal" didn't seem too far off.
Best of all, Jay was flying back into town that night! I missed him so much and really needed to have him home. Bad. He made it in late that night, flowers in hand and the biggest, warmest kiss ever. It was perfect.
Thursday, December 23
In the morning I was given my last dose of indocin and by evening I began procartia - another anti-contraction med that I would stay on long term. Had a great day catching up with Jay and an even better night after a movie and hospital bed snuggles :-)
Friday, December 25 - ChristmasDay
I wish I could say the good times just kept on rollin', but they did not. I woke up about a half hour before my procartia was due... at first the contractions were somewhat spaced out. I tried not to worry, keeping in mind that the nurses said the hour surrounding med time could be when I might contract more. At 9am, I downed my pill and waited. Just to be safe, I decided to time them. For the next hour they kept on, increasing in frequency and strength. By 10, we called the nurse and requested to be put on the toco machine to monitor the contractions. Just as I had been noting, they were coming every 2-4 minutes... around 10:45 I had my first mildly painful contraction, so we called the nurse back in.
Before I knew it, she was calling the doc, giving me a shot of terbutaline and by noon I was being transferred by bed back to labor and delivery. This was the first time Jay was experiencing anything first-hand. I think even the nurse detected the stress in the room; I'll never forget when she said "Dad, are you going to be ok?" I was impressed with how much he rose to the occasion, asking me to take deep breathes in and exhale out and pulling a chair right up next to my bedside, trying to keep me calm. I'm positive he was a driving force in me holding it together over the next 48 hours. I am so thankful God orchestrated him being there during my weakest hour.
Once again, the IV and cath were put back in and we began again with the same meds. By the afternoon on the 26th, the contractions settle, but they kept me on mag longer this time while they added in the indocin.
Sunday & Monday, December 27 & 28
On the 27th, I took my last dose of indocin and waited to hear about what they would do differently with my protocol this next time around. Dr. Webb agreed that perhaps the procartia- only regime they had me on before might not be enough, and that we may try something more aggressive, like adding the terbutaline pill into the mix. We felt good about this move and were more at ease with the new plan. Even still, I broke down that night. I knew I shouldn't cry and carry on, but I couldn't help myself. I had bottled up so much and just needed to get it out. I needed to be able to verbalize how fearful I was and to just vent that I was so sick and tired of things being so darn complicated. Most of all, I needed to make sure Jay and I were on the same page. I knew he was being thrown so much and that, while it was difficult for him to focus, I needed him to badly because no one else could maake me feel secure like he could. After a long, tearful talk, I mustered up some more courage and asked him to go home and stay with the dogs that night. They had been alone for so many nights and I knew they needed it. In the darkness that night I cried out to God, pleading with him "God, you gave me life and then you gave me these babies. Please don't take them away. Heal me now and protect them. I won't lose them now! I can't!" I was on the brink of being more mad at God than I'd ever been. I felt guilty afterwards, but I was desperate.
Come Monday, things seemed, for awhile, to go downhill. For one, I slept like total crap the night before. Labor and delivery isn't meant for sleeping apparently, yet that's where they put you when things are unstable and you need to be more closely monitored. Between alarms going off in the room, the blood pressure cuff going off every hour and squeezing so hard my hand would tingle, someone coming in to give a med or check something or the night nurses carrying on like fools at the nurses station right outside my door, I got zero sleep. When Jay came back the next morning, he was so mad he wasn't there to help quiet things down.
The biggest issue was when the third-year resident paid me a visit. Rather than read my file, she asked me for my entire history. From the start I was worried. Worried that the "plan" Dr. Webb had set forth, at least we were under the impression he had, no longer existed. I shared this plan with the resident, letting her know our concern was with when we transferred to procartia last time around. She left the room and returned a short time later to inform us that the had spoken with Dr. Bartlesmyer (whom we had never even met before) and he didn't think the terbutaline pill was the way to go due to recent studies. Instead, I would be put back on the same dose of Procartia only. [Insert freak out here]
I was livid. Scared. Confused. What had happened? Who was this person who was making the calls now? Didn't he know how critical this was? To make matters worse, the nurse came in and announced she was turning off the mag. I couldn't take it and sobbed uncontrollably. I told the resident this made no practical sense to me given it didn't work last time and that I was NOT happy. I could feel the warrior coming out in me. It was fight or flight that day. I felt as though the life of our babies depended on it. I was told Dr. B would be stopping by later in the afternoon; that moment couldn't come soon enough.
In the meantime, I called my mom. Told her the whole story and put her on standby in case we needed another mad momma at the plate. I also called my OB's office, hoping for an opinion since he knows the high risk doctors here, both personally and professionally. Then, I had my first meal in days, fed to me by Jay :-) I needed my energy to get through the day in one piece. We prayed God would take care of our babies and that he would direct the doctors to make the right decisions. Beyond that, and staying calm, there wasn't much else we could do.
When Dr. B finally arrived, it was obvious he knew how upset and concerned we were. He sat down and explained that there were very recent studies that show possible negative impacts on baby's hearts and that the negatives might outweigh the positives. I was surprised to hear that he actually preferred to have me repeat this same protocol (mag, indocin) time and time again if needed, as long as there is no sign of infection. I was glad that this was in the cards, as there are really not very many meds they can give to try and stop preterm labor.
Tuesday, December 29
On Tuesday, after lying on my back since the 24th, I once again regained a few basic freedoms, all of which had to do with being able to visit the bathroom. I never thought this would be something I'd miss. I neglected to mention that during these five days, I was dying to wash my hair. Between an angel nurse and my husband, they somehow managed to get the job done with me lying in bed! I felt so refreshed! Tuesday was also the day I was moved back to Antepartum, hopeful this time it was for good.
Thursday, December 31
We rang in the new year celebrating my first contraction-free toco strip. This, compliments of a little extra assistance from another dose of indocin. No matter the method, it felt good to pass
"the test". Especially in the beginning, I took my twice-a-day monitoring SUPER serious. No laughter was permitted, moving or sometimes even talking - nothing that would impact the results. As silly as it might sound I needed to pass. I needed to know things were on the mend and reassurance that they weren't spiraling out of control yet again.
Tuesday, January 5
And pass I did! From the 31st to the 5th, things were great. Contractions were never more than 2-3 in an hour, sometimes none at all! On the 3rd, I had my second cervical check and there was no negative change! In fact, last check it measured 1.6 and now it was around 2.4! Amazing!! On the 5th though, when doing my AM toco, I was contracting every 3-5 min in the first 20 minutes. The nurse practitioner stopped by and told the nurses to give me an extra 1x dose of procartia as a 'boost'. Sure enough, it calmed things down in no time. Thankfully. Later, the nurse came back to inform me they weren't actually "supposed" to give that to me. She said there was a previous note in my file that said "no additional tocolytics to be given unless there is cervical change." I was a little unnerved by this because of the sheer fact that I was still so early in weeks and that once there is cervical change, you often can't regain ground. All I could do at this point was trust we wouldn't cross this bridge and move forward.
During this time Jay had to go back out of town for his job. His leaving this time was even more difficult than the first. He is my rock and him leaving felt like things might all just fall apart. I sobbed and the sweet nurses did their best to make it better. I knew deep, deep down that I would make it... never letting myself think about the "what ifs" in a worse-case scenario. My mind couldn't handle that event either way.
As of today, Monday, January 18th...
I'm so extremely proud to report we are 25 weeks and 3 days. God is hearing each and every prayer that goes up!! Thank you from the bottom of our hearts to all who've been praying. For almost two weeks now things have been "stable". Contractions are typically pretty sporadic, with an occasional active time (2-3 in 30 minutes) here and there.
During the babies last growth ultrasound at 24w6d, baby boy weighed 1lb 11oz and baby girl was 1lb 7oz. Eating all this hospital food really is worth it after all :) It may be too early to tell, but if the most recent profile pic is accurate (may be a stretch here), by my account, baby boy may have his daddy's jaw structure. In any case, my face lights up just thinking of the possibility that there's a mini-Jay in there.
When this all began, we were shooting for viability of 24 weeks. A fighting chance is all I wanted. Even though things looked grim, I kept repeating "With God, all things are possible." He has gotten us this far already and it gives me so much hope for the future. Now, my sights are set on 28 weeks when, statistically, things are given a far better chance. Even then, I know that we certainly are already defying what's in a textbook and am quite sure this journey is far from over. For now, we'll continue to do what we've been doing for the past month - taking it one day at a time, being sure to be thankful for each and every passing minute.
