Friday, November 20, 2009

Morning Update

So, I just recently woke up. And by that, of course, I mean I gave up on trying to sleep anymore. Labor beds are really uncomfortable! I always forget that. I actually slept okay and didn't have to take anything to sleep like my doctor thought I might. I just woke up. A lot. And had to roll over. A lot. Which is not so easy when you're trying to keep your baby on the monitor so you do freak out and think she died. Ready for an update?

I had a long chat with my doctor last night, and he had had another long chat with the Perinatologist. My OB is Doctor G (Mara and I like to call him that because he's very hip and cool. And if you knew him right now you would be busting a gut laughing. No no, I make fun of him all of the time, but he is a great doctor and this will be the third of my babies he's delivered. He is both very conservative, in that he'll stick me in the hospital at the drop of a hat to ensure the baby's safety, and very liberal in that during labor and delivery he'll pretty much let me do what I want as far as pushing, laboring, etc. goes. Or, you know, as much as I can do when I'm hooked up to an IV and monitors.

Anyway, they talked (The Peri is Dr. F). Basically, the Fetal Fibronectin test is looking for something called...wait for it....Fetal Fibronectin. Yeah, so simple it's confusing. Fetal Fibronectin is kind of like a glue that holds the amniotic sac to the uterine wall, and if it's present when they swab for it, it means that glue is starting to break down, which means that your body is preparing for labor. If the test is negative for the substance, you have almost no chance of going into labor within the next two weeks. With a positive result, things are more iffy, and it basically is telling us that contractions are going to cause a lot more change in my cervix at this point than they would if the "glue" was not starting to break down. Not sure if that made any sense. Sorry!

So in any case, it's not a guarantee I'll go into labor, but it's a good indicator that my body is going there again. Especially when you throw my history of three 34-35 week babies in there, and recall that my last baby was actually my earliest baby. My body just seems to jump into gear faster and faster. As my nurse last night said, "You're going the wrong way!" Don't I know it.

Wow, got off track. All that considered, Doctor F thinks I have about a 60% chance of delivering in the next two weeks. I'm 31 weeks 2 days right now, and the positive test came in yesterday. We spent lots of time talking about why my membranes have ruptured without being in active labor so many times. I had always thought the pre term contractions/dilation and my water breaking were kind of unrelated, and Doctor G explained how by my cervix dilating early every time, it opens the amniotic sac up to the elements, if you will, and that can lead to it infection or to weakening early and breaking before you're in active labor, or any labor at all.. That made it all make SO MUCH more sense to me! I could never figure out why I had so many seemingly unrelated issues going on. I mean, when everyone tells you no ones water breaks in real life and that's all on the movies and then it happens to you three times in a row, you start to feel kind of weird about it all. I know it's the most dramatic way to know that bahy's coming, but seriously!

So, it's likely my membranes will rupture again. If that's the case and it happens after 32 weeks 0 days (Five days away), he will not do anything to stop labor. Although he does keep women in the hospital with ruptured membranes for days or weeks at a time if it's called for, he feels that after 32 weeks she's going to do better out than in in that case, especially considering the risks of infection and prolapsed cord, and our history with Eli.

If my water doesn't break, then we will try to hold labor off until 34 or possibly 35 weeks, and I'm not sure what means may be necessary (Not magnesium, please not magnesium!) If she is not here within the next two weeks and my Fetal Fibronectin test is still positive, we will repeat the betamethasone steroids and see when she decides to make her appearance.

I will say that I've been on the monitors since 5:30 yesterday afternoon and I don't think any of us realized how often I was actually having irritability and contractions. The irritability is happening every minute or so, and I'm having a few "real" contractions an hour. I put the real in quotations because although they are lasting 30 seconds to a minute, they feel very mild and I barely notice them. My cervix will get checked later today and if there is no change from yesterday, I will be able to go home this evening after my second shot.

After Doctor G left, one of my very favorite NICU nurses ever came by. She said she checks the board for my name every night and finally saw it last night. She was Seth's regular night nurse and her daughter and Ava play on the same soccer team, so we have  become friends. She hung out and chatted for a while, and she said that she and all the nurses are up to speed and ready for the baby whenever she decides to come. She also said "I cannot believe you made it this long!" which cracked me up. The whole staff fell in love with Seth and I know this new baby will be in amazing hands with them, because it's become very clear that I won't be able to be with her every second (literally) like I was with Seth. But there's nothing better than knowing who is taking care of your baby, and this NICU is amazing. It's a level 3 and the only reason I would have to worry about the baby getting transferred is if she needed surgery, which is unlikely at this gestation. Plus, it's a mile from home, which is so, so nice.

So, I'm feeling better this morning. I have kind of come to terms with it all, and am embracing the fact that we have a great hospital and NICU here, so whatever happens, she and I will get great care.

I'm going to order breakfast now. Unfortunately, I don't think they'll let me have a grilled cheese. So uncool.
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