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36 weeks

18 May

Holy cacao. We made it. It feels a little bit like reaching the finish line, though I know we still have miles to go before we’re both truly healthy and safe. But 36 is still huge. For us, it’s the second to last week turnover we’ll see, and it means that, come hell or high water, we WILL be meeting Turtle in 10 days or less.

Being on bedrest in a hospital is a funny thing. In one way, it’s every paranoid pregnant infertile’s dream. Imagine having a nurse just the push of a button away for every strange twinge and ache. Imagine having your vitals taken every four hours, including hearing baby’s heartbeat. Imagine daily NSTs to know if baby is okay and if you’re contracting.

On the other hand, your world is very, very small. Little things become huge things, like the personality of your nurse on duty and the way she does things. You get particular about the way your curtain is drawn, the angle of your bed, how high your window shade it. It’s like being in a very nice, caring jail, or getting locked in a hotel room (yet others can come and go).

Thank you all for your comments on my last post. It’s hard to believe the ride we’ve been on, and while I’ll never say anything like it’s unfair that we’ve had to deal with so much, I am starting to seriously struggle with those who not only get pregnant without difficulty, but who then go on to have perfectly easy pregnancies and deliveries and take their babies home from the hospital a few days later. I know their are much tougher roads than ours, which is why I’ll never talk about fairness. But there are also plainly much smoother ones, and I wouldn’t mind being on one of those.

But we’re not. We’re here and this is happening. I still can’t believe it, even as I feel his round head push up against the top of my belly for the millionth time, that there’s really a live human baby in my belly that’s going to come out and then be my baby forever. And when you put it that way, how can you not feel anything but lucky, how can these two weeks not feel like anything more than a blip on a radar screen.

Complications

15 May

Well, I’m not really sure where to start. How about the present: I’m currently sitting in my home. My new home, that is, at the hospital. I’ll be living here until Turtle is delivered, which hopefully will be two weeks from yesterday but could really be any time.

Yesterday I was diagnosed with preeclampsia. The day before I left my house thinking I was just going in for a quick check up and would then head to work. But an unexpected high blood pressure reading and the presence of protein in my urine meant a trip to triage at the hospital. From there they admitted me for a 24 hour urine collection and monitoring. The results were high enough to diagnose me with preeclampsia and tether me to the hospital for the rest of my pregnancy.

I know it’s good I’m here. I know it’s the safest possible place for me to be. Still I’m struggling with dealing with yet another complication. I never thought to fear for my own health with this pregnancy. I was worried about Turtle. His bowel dilations and potential blockages due to the gastroschisis. Not me. I’m struggling with having to spend the first two weeks of my precious maternity leave just hanging out in the hospital. I’ve never spent a night in a hospital, much less lived in one.

So that’s that. My parents are driving up today, which will allow my husband to spend the nights with me here. It’s been lonely without him the last two nights and I cried like a baby before he left last night. I miss my dog. I miss my life… Before it all got so complicated and scary.

34 weeks

4 May

This is an insane milestone to me. Every week now feels like a triumph. We’re two weeks away now from totally safe to deliver, and three away from full term. But even if we had to deliver now, I feel he would be okay. And that’s a crazy thing.

Two days ago, I started feeling some things that made me nervous. Turtle had hiccups already three times by lunch time and I was feeling really crampy in my lower belly and in my back. I didn’t think I was going into labor but I was scared something was going really wrong with his gastroschisis, which was causing him to reflux and my amniotic fluid to skyrocket, hence the cramping.

So, I left work early, DH left work early, and we returned to my MFM OB’s office for the second time in four days. All was fine. Turtle’s dilations looked stable (from Monday) and my amniotic fluid actually went down a little, back into less worrisome range. A transvaginal showed my cervix at 2.4, which is pretty much right on track for where I’m at. It was tight and closed during my first ever internal exam (ow ow ow!) (and also, done by the u/s tech?). The NST looked fine. I did have a few light contractions I couldn’t feel but they said those could have been triggered by the internal exam.

So all was basically fine, and I might have been feeling a little silly about the whole thing but the trip was so worth it because we got the best ever 3D picture of Turtle. It almost felt like we were meeting him for the first time. I’m telling you guys, we were in awe and we can’t stop starting at his beautiful face. And his chubby cheeks! And his kissable little lips! This is prenatal bonding on steroids, and now I’m feeling just so in love with the little man in my belly and beyond excited to meet him (posting to the Turtle page for those who are curious).

This weekend, we are packing hospital bags. I need to go out and buy granny panties, a nightgown, a maxi dress, and some toiletries. Once we get them together I’ll be sure to post our packing list. I also drafted a c-section birth plan (did I mention, Turtle is still breech?) that I want our doula to review before our appointments on Monday. Once that’s finalized, I’ll probably share it as well, if peeps are interested.

Won’t be long now. Not long at all.

(ps. Thanks all for your super kind words on my last couple of posts. It’s been one of the rockier weeks but we’re hanging in there!)

Week by week

29 Apr

Week by week. That’s how we’re taking things at this point, according to Dr. Kind this morning.

At our weekly ultrasound, the dilations have continued to grow (many are over 3 cm now) and alarmingly, to me at least, my amniotic fluid has shot up. We had been hearing the fluid level was normal for weeks now and had been taking that as a good sign. Today it was 27, definitely out of the normal range.

What does this mean? Well it seems his bowel is getting sicker, perhaps ceasing to function as well. There could also be a blockage developing, which would prevent the fluid from going through his system, thus increasing the amount.

It means Dr. Cohen wants to talk to Dr. S, our surgeon at Children’s. It means that 37, possibly even 36 weeks, could be out the window. It means they’re really starting to weigh what will be more beneficial for the baby: more time in the womb vs. getting the healing process started. It means that at any one of these weekly appointments, they could decide to pull the plug.

Turtle is still in a breech position right now, which is making the possibility of a c-section all the more real each day. After the appointment, DH and I decided that it’s definitely time to pack the hospital bags, and I’ll probably want to start working on a c-section birth plan as soon as possible.

At this point, I honestly don’t know what to feel. We’ve had to be so flexible in terms of when and how this baby will come out that this really just feels like a little bend in an ever shortening road. What feels easiest is to take myself out of the equation altogether and figure, whatever the doctors think is best, is what I’m on board with.

Do I want to deliver before 36 weeks? In my ideal world, no. I want him to stay in as long as he needs, I want him to emerge as big and strong as possible. But this clearly isn’t my ideal world in any fashion, and if taking him out earlier is what’s best for him, let’s go for that. Do I want a c-section? Ideally no, but if it’s best for him, I’m all for it.

All I want is a healthy baby. And as things start to get more serious with his condition, everything else just feels like noise and clutter next to that goal. So for now we continue to wait and watch, we continue to take everything as it comes, we continue to cling fiercely to the hope that everything will be okay in the end.

Processing

24 Apr

I’m still trying to process the results of our appointments on Monday, hence the delay in my posting.

The good news is, Turtle is still growing right on track (even a little ahead). His dilations have not grown very much. His bowel is still moving, still appears to be alive. My amniotic fluid level is still good. He seems to be getting enough oxygen and he passed the non-stress test with flying colors. And my blood pressure is great. That’s the good stuff.

The less good is that he’s still in a breech position and we learned that with his condition, he cannot be delivered vaginally if he’s breech, nor should we attempt a version. We also learned, after a couple weeks of getting ourselves a little psyched up at the prospect of a natural birth, that Dr. Kind will want him to come out when we hit full term (37 weeks). His reasoning is, he’s full term, he’s big enough, let’s get him out and deal with the gastroschisis.

We were a bit surprised to hear this, as all along he had been saying that he wanted to get to “at least 36 weeks if not much more.” I’m not sure what changed, since he even said something along those lines at our last appointment two weeks prior. It could be the fact that he still has these bigger dilations that aren’t going down.

Either way, that means a scheduled cesarean if he remains breech, or a scheduled induction if he turns. Now lately I’ve been feeling very much like I don’t want a c-section at all. Like the very thought scared me, of lying on that table, belly sliced open, and not getting all the hormonal and emotional benefits of a natural birth. It seemed like it would make the journey that much harder, emotionally, when he is taken away.

However, I’m not thrilled at the idea of an induction either, as I’ve been reading so much about how the contractions are more painful, how you’re tied to your IV, how sometimes it fails, how it leads to more interventions and can end up leading to a c-section anyways. I don’t know why I was thinking I might be able to go into labor on my own but it’s pretty clear that unless my body magically kicks into labor fairly early, that won’t be the case.

At first this felt very devastating. Dr. Caring, while understanding that this is not the birth we wanted, went ahead and reserved OR space for us on May 28th (37w3d), which felt very scary and real indeed (that’s less than five weeks away!). The more I’ve thought about it though, the less sure I feel about anything.

I’m thinking maybe it is a good idea to take him out at that time, maybe he’s safer here in the outside world than risking fetal death (this is a fear of mine, though not directly related to anything in particular, other than once hearing that the risk of this is slightly increased – very slightly – with gastroschisis). I’m thinking maybe a scheduled c-section isn’t that bad. It definitely appeals to the planner in me. And I’ve heard that going in for a scheduled c-section can mean a better recovery, vs. being induced then ending up with a c-section anyways due to stress on the baby, not dilating quickly enough, etc. I’ve heard too that a c-section recovery isn’t necessarily that bad.

So now I’m really confused. I don’t know what to hope for anymore. I know whatever the experience ends up being is secondary to whatever is best for Turtle. I’m trying to focus on that. But do I want him to turn and then open up the possibility of an induction, which scares me? (Scared of the painful contractions, scared of maybe having to get an epidural, scared of being hooked up to all the machines, scared of ending up in the operating room anyways after all.) Or do I want him to stay breech and go with the scheduled c-section, which also scares me?

Do we stick with our doula, if it’s looking like we’ll be having a scheduled c-section? Knowing she will NOT be able to accompany me into the operating room? Is it worth the cost of her full fee if she’s not providing actual labor support or should we come up with some hybrid fee for prenatal (and perhaps postnatal as well) counseling? We are meeting with her this weekend to discuss these things.

So yeah, I’m confused. And I hate not knowing what’s coming. But in some ways it is nice to know that sometime during the last week of May is most likely when Turtle will be here. And then the healing can begin.

ps. New updates on the Turtle page, including (giant) belly shot from today!

A day.

9 Apr

So yesterday was a day. Extremely long, exhausting, informative, terrifying, mystifying and at times even relaxing, sweet and exciting.

We started at our high-risk OB’s office for another routine ultrasound. In this ultrasound, we learned that Turtle has turned from transverse to breech. I am really hoping he will continue the cycle and get (and stay) head down soon. Overall, his size and weight looked good. The weight estimate was 4 lbs. 3 oz. but this is likely skewed by the fact that his belly is measuring 2-4 weeks ahead due to the dilated portions of his bowel. His abdomen is currently in the 97% percentile.

My amniotic fluid looked good, 11.1 cm pockets of fluid (normal = 5-20). This is important because high amniotic fluid can indicate a blockage in Turtle’s bowel. The dilations are still around 2.5 cm. Up slightly but still in the same neighborhood. Overall though, Dr. Kind was pleased with Turtle’s overall growth and size for this stage and by the fact that the dilations seemed to have stabilized for now.

Next up was my delivery OB. These appointments seem a little bit pointless as all they do is record my weight and listen to the heartbeat (which we always have just seen on ultrasound downstairs). If I have a question, I ask her but otherwise they are incredibly short meetings. Still, I really like my delivery OB (I am HOPING she is the one who delivers us) and enjoy these meetings with her.

Then we had a short break before our 1 pm ultrasound at Children’s, so we hunted down a grilled cheese food truck we’ve been dying to try. We ate like little piggies and enjoyed the first really nice day in Boston so far this spring.

At Children’s, the ultrasound was about the same news. In this one, they got an amniotic fluid measurement of 15.6, which they said it changes depending on how the baby is positioned. Turtle’s femur and humerus bones are both measuring ahead (the humerus is quite a few weeks ahead at 33w1d) which we liked to see. In this ultrasound we got to watch the loops of bowel as they moved around inside his belly. We were told his movement is a good sign of activity (and not dead bowel) which is great. They showed the blood flow activity in color on the portion of the bowel outside his belly and there appeared to be blood flow there as well, which is again, good news. We want healthy bowel to put back in and get working ASAP!

Next up, meeting with our surgeon (well the one assigned to our case, he won’t necessarily be Turtle’s actual surgeon). We really like this guy. He is calm, confident, very smart and such a good listener. He said this issue of having some dilated loops of bowel is common with gastroschisis. The amniotic fluid level indicates that there’s not a complete blockage (though there still could be some level of blockage). He reminded us once again of our worse case scenario: a blockage that cannot be repaired because the bowel is too inflamed. In this case, they put the broken bowel back inside, close him up, wait MONTHS until it has healed, then take it out, repair the blockagae, close him up again and THEN begin the process of getting his bowel working and accepting and processing food again. Oh how I hope this isn’t the case for us.

Still, Turtle’s bowel is not the most dilated they’ve seen. At this point, there’s nothing that can be done but to watch and wait and see how it looks when he is born. The surgeons from Children’s will come over to Beth Israel and be present at the delivery and they will determine, bedside, whether it will be possible to repair and close immediately or whether a silo will need to be placed. They often do the surgery within 4-6 hours of birth as this is the best time to work with the bowel and assess it.

Something we learned: if they close him in the first 24 hours, we’re only looking at about a week in the NICU. If they place a silo, it’s more like 2 weeks or more. We were under the impression that we were looking at 7-10 days either way. More NICU time does not excite me one bit.

Which brings me to the next line item of the day, a tour of the NICU at Children’s and the regular floor. Well, I’m skipping the meeting with the lactation consultant, which actually was very interesting but likely something for another day. Nothing can prepare you to be in a NICU if you’ve never been in one, especially not the one at the top children’s hospital in the country. It’s like a spaceship in there, more medical machinery than you can imagine, and nestled in these giant spaceship apparatuses, the tiniest little babies. They seemed so alone in there. My first reaction when I walked in was, holy shit I’m going to lose it.

But I didn’t want to cry. Not when this was a place where people were trying so hard to bring some good and healing to these precious lives. It’s not supposed to be a sad place. It’s a magical place. It’s a place where the marvels of modern medicine work their hardest to heal the tiniest lives. It was HARD to imagine my son spending time in that place. Hard to imagine myself there day in, day out. It’s very cramped with machinery and hardly a comfortable place to sit and be with your baby. But, it is where he will be and I will get used to it.

When he’s in the NICU, we are allowed to stay in a dormitory-style room within the hospital. Once he is released from the NICU though, he will go to the regular floor, where rooms are shared and there’s only one reclining chair for one parent to stay overnight. We are still trying to figure out how we will work this, with DH being back at work and us not wanting to spend every night for two months sleeping apart. We’re hoping to work out a rotation schedule with my parents who will be here to help us out. If possible, we’d like him to never be alone. The regular floor is much busier, with fewer nurses per patient. You have to stay on top of the staff to get what you need done. And he will hardly be able to advocate for himself.

No, SOMEONE must be there. It’s going to be rough though and I worry about how much DH and I will miss each other and how we will be able to support each other through this tough time if we’re spending so much of it apart. Anyone with any experience in this arena, please reach out and let me know what some viable options might be for us.

After that, we had a few hours to kill, so we went and walked around our old neighborhood in Brookline, got coffee, sat in a courtyard and talked about how surreal this all still is on some level and how that’s probably protecting us in some ways. We had dinner at one of our favorite old places. Then it was back to hospital land for our 7:30 pm tour at BIDMC.

I have to say, I thought this would be my favorite part of the day, the “normal” part, but I actually hated it. Aside from being EXHAUSTED by this point, with horrifically swollen feet and feeling the urge to pee constantly, I didn’t like being grouped in with all the people who were getting their normal birthing experience. It was especially painful to hear about how mother and baby are never separated, except for maybe an hour or two. Knowing I will be in a different building, away from my baby for days. Hearing about what you do when you get discharged and are taking baby home, knowing we won’t be discharge from this hospital to go home two days after he’s born like most people. I’ve really started to come to terms with our lot in this pregnancy, but it didn’t help to have it laid out so plainly before us just how different of an experience we’ll be having. Plus it was like 20 pregnant ladies together in one place – not something an infertile is used to.

Anyways, I got home, showered and fell promptly to sleep. I’m still tired today! But glad it’s over, glad it wasn’t so bad, glad we learned more, and glad especially that the end is in sight. Whatever will be will be, I just want him to get here!

ps. If you made it to the bottom of this post, I applaud you. I know it was a long one but I had to get it all down. Might be too “in the weeds” for a lot of you readers and I apologize if that’s the case!

Showered with love

6 Apr

I have some major catching up to do around these parts! Today marks the big 3-0 and it’s such a surreal milestone to reach. Even as late as the second trimester, part of me didn’t really believe we’d ever see 30 weeks pregnant. It’s definitely starting to feel like the tail end of this pregnancy has arrived and Turtle’s arrival is imminent.

Now that we’re getting close, I have some major fears around his birth and the early months of his life that I’m having to face head on. One of the things we’re doing to deal with this is looking into hiring a doula (special thanks to Belle for her encouragement in this area), which I will blog about soon. We’re still in the early days of talking to people, figuring out the financials and seeing if there’s a good fit out there for us.

First though, I want to thank everyone for your support after my last post. It really helped me through a very tough few days where I’d find myself breaking down for no apparent reason. Eventually though, the shock of hearing statements like “if your baby is born premature he won’t survive” wore off and I’m thankful that I was able to enjoy Turtle’s baby shower thrown lovingly by my parents at our house. Friends and family came to Boston from D.C., NYC, and Philly to celebrate Turtle and it was really just lovely.

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On Monday, we have a full day of appointments with both OBs and our surgeon at Children’s. We’re having two ultrasounds and touring both hospitals. No matter what information we learn, we know it will be a “wake up call” day. A day that makes it all feel very real and very close. That’s going to be great in some ways and hard in others but either way, the time has come to face what’s ahead of us head on.

I’ll be back sometime after that to let you know how it went.