Tuesday, June 29, 2010

26 Weeks!

Well, the good news keeps coming. Sunday I was officially 26 weeks, which is fabulous! Monday was a big day, full of tests for the baby and I. I'm happy to report that we BOTH passed them all!! They are going to be monitoring him more closely now, so they started with a baseline biophysical profile checking several things like breathing, movement, and fluid. {Which is now to 14 by the way!} He has to meet certain requirements within a designated amount of time in relation to his gestational age. He had up to 90 minutes... he passed in about 5 minutes, so that was wonderful! The next test for him was being on the fetal heart monitor for 20 minutes, and once again, he passed in that first time block and therefore was able to come off of the monitor. They call it a non stress test and will do that one every day, and apart from that, as long as he continues to pass it daily, they won't need to do any further monitoring. Not bad for a lil' one who has faced many challenges with " the cards" stacked against him already in life! The test I passed was my glucose tolerance test... guess I can keep having those desserts! haha I have to say, I really look forward to Thursday lunches... hamburger, fries, and a lemon bar! Spoken like a true pregnant girl huh? Actually, I guess that's a fairly normal meal. My affinity for that good ole' American standard bursting with saturated fat has never wavered. I'll let you know if I start indulging stranger variations like ice cream and pickles or chocolate covered cheese balls... any takers?

Today, Stella is coming for another visit, and will be here until Sunday! I'm so excited to have extra time with her. It's been extremely painful to be away from her and from Ryan, but I'm really thankful for the time we get as well as how incredible our family has been through all this. My mom is staying in St. Louis full time with me and has done so much to make me feel at home in my hospital room and to keep my spirits lifted. Meanwhile, Grammy Jean and my Dad have been keeping Stella while Ryan works. I'd say she's had a great summer so far, lots of play time and cousin time, which is her favorite, she just LOVES her cousins!

No doubt, your prayers and messages are continuing to strengthen us! I think often of Psalm 139:13-14 which has always been a favorite. "For You created my inmost being; You knit me together in my mother's womb. I praise You because I am fearfully and wonderfully made. Your works are wonderful; I know it full well."

With love,

Thursday, June 24, 2010

Hospital, day 18 - 25 1/2 weeks!!

Sorry I've kept you waiting longer for this post. I was waiting for something interesting or exciting, and I sure do have some incredible news!!! Yesterday morning I went for another ultrasound/growth scan... now, I was NOT prepared for the outcome. Brace yourself... my fluid level was 12.9!!!!!!! AND, the tech said that is a NORMAL level! What?!?!? Really?!?!? What?!?!? I've referenced in the past the "deepest vertical pocket" measurement, and my mom asked her about that and her response was, "We don't measure the deepest vertical pocket when the fluid is adequate." I'm simply amazed. I have definitely noticed changes over the last couple weeks in the hospital in that my belly, and lets face it, the rest of me, has really grown. This must be due in part at least to more fluid accumulating and his growth... it could also be from the desserts that come with every meal(I keep "forgetting" to tell them not to include them) When Ryan visited he said, "You look a lot more pregnant now!" They estimate baby's weight at 2 lbs and in the 70th percentile. The doctors were very pleased, not jumping for joy by any means because they still consider me "ruptured" and at risk. They still talk about how we won't know any damage to his lungs that the low fluid may have caused until birth, however, I just don't think the ultrasound could have brought better news! To hear the words normal... that's not an adjective that has been used in any description of my pregnancy since this all began. I'm so excited to share this with you. I believe our prayers are being heard and answered! We'll keep taking things slowly and cautiously, but will continue believing that the impossible is possible. Thank you for continuing to be on this journey with us!

With love,

A peak at his sweet face... hard see it through the chord.

Just a lil' reminder.

Stella's visit last weekend.

Monday, June 14, 2010

Hospital Day 8 - 24 + Weeks

Another goal met! Yesterday, Sunday, I was 24 weeks, which is considered a sort of turning point. Medically speaking, our baby has hit viability! I knew I'd become fonder of that term eventually. I was so excited for yesterday, mainly because Ryan and Stella were coming to visit and a busy day was planned. They arrived at 9am, and I couldn't have been happier to see them! Stella immediately crawled in bed with me to snuggle, wrapped her little arms around me and said, "mmmmm, I love you Mommy." Ryan's birthday was Friday, and I had gotten him cards from both of us, so we sort of celebrated his birthday... not the best party, but better than nothing. The nurses started my first steroid injection, and I received the 24 hr follow up one this morning. They also started round of IV antibiotics or the "cocktail" that based on studies is believed to promote latency in this situation... meaning helping my body hang in there carrying baby longer. They hope the steroids will help his lung development. Some doctors give another round between 28-30 weeks, but I don't know if they will do that in my situation because the baby has already undergone an amount of stress existing with such low fluid for so long. Guess, we'll see when I get there! :-) Ryan and I met with one of the Neonatologists and she spent a good hour with us, further explaining things and getting to know us. That afternoon, we went on a tour of the NICU. Wow, so many mixed feelings from that. I had such varying emotions as we entered the areas with all the babies. They currently have 72 babies!!!! It is obviously a state of the art facility and seeing everything they have to offer was comforting... knowing we have access to the best. But, bottom line, I hate that we're here, yet, I love that we're here. Classic glass half empty vs half full. The charge nurse, Martha, was great, she just celebrated her 36th year on staff. She showed us a tiny baby girl who was just born a couple days ago at 26 weeks and weighed 1 lb 15 oz... Of course, I've never seen such a sight. I couldn't see much of her body, because of the way they had her wrapped and covered, but I could see part of her belly with the iv lines and her TINY legs and feet... smaller than the smallest baby doll Stella has. Looked like she was fairing well, but on a lot of support, which is to be expected at that gestation and size.

Ryan and Stella had to leave around 5pm to get back on the road, so it was a short trip, and it was terrible saying goodbye. My dad will be bringing her back up to St. Louis with him on Thursday, and she will stay until Sunday. Ryan will join us Saturday after work, so we'll have more time than this past weekend. All in all, my first week of hospitalization is completed, so one down, ten to go if I make it to 34 weeks!!! How's that for a countdown!

A friend's pastor visited the other day and shared one of my favorite passages from the Bible, an excerpt from Paul's letter to the Ephesians, that continues to remind me how the love of Christ enfolds us and the arms of God surround us. "For this reason I kneel before the Father, from whom his whole family in heaven and on earth derives its name. I pray that out of his glorious riches he may strengthen you with power through his Spirit in your inner being, so that Christ may dwell in your hearts through faith. And I pray that you, being rooted and established in love, may have power, together with all the saints, to grasp how wide and long and high and deep is the love of Christ, and to know this love that surpasses knowledge—that you may be filled to the measure of all the fullness of God. Now to him who is able to do immeasurably more than all we ask or imagine, according to his power that is at work within us, to him be glory in the church and in Christ Jesus throughout all generations, for ever and ever! Amen. Ephesians 3:14-20

With Love,

Tuesday, June 8, 2010

Hospital Day 2 - 23+ Weeks

Well, for now, I have taken up residence at Barnes-Jewish Hospital in St. Louis. I felt great relief that my admission day finally arrived, and we have made it to another milestone. We checked in yesterday morning around 11am, and it was a good, but taxing day with evaluations, consultations, exams, and more consultations. It's obvious to me that I am in great and capable hands here. I saw a wonderful team of doctors, who covered as much as possible. I know I've explained this, but the fact that I have made it 7+ weeks with ruptured membranes is amazing, but a double edged sword. It's incredibly encouraging that I could continue to carry, yet a matter of great concern of the dangers it poses to me and the baby should a problem arise. The doctors are guarded as they repeatedly describe the detriment to baby when there is little to no amniotic fluid. I won't list all the horrible complications they have described beyond saying that a 23 week old baby has a 1-6 chance of surviving... and in my case, being ruptured it's much worse. The primary concern being pulminary hypoplasia which is incomplete development of the lungs. I'm not trying to dwell on the negative, just continuing to be aware of what's "probable" so that you know how to pray specifically for us and our baby. I did however feel a bit more encouraged today after speaking with the Neonatologist and another main attending that I hadn't met yet. He said "You've already beaten the 'odds' by making it this far." My blood pressure ran low all night, but has come up today. Seems its likely a result of inactivity and bed rest.

The "plan" or next goal right now is to make it to 24 weeks, which will be on Sunday. At that point I will receive a steroid injection to aid his lung development and a round of IV and oral antibiotics. We had to weigh the timing of the steroid injections. Generally, they like to do the injection within 7-10days of delivery for the most benefit, however, in this precarious situation, not knowing when that will be, they feel there is very strong evidence that this will be a great benefit to him, even if I'm able to carry much longer. The 23rd week is still a very "gray period" of pre-viability where they don't have much to go on that says it would be significant in aiding or increasing his life expectancy or survival if I were to deliver this week. Here's where our faith comes in once again... faith, that we've made the best and right decision to wait until Sunday for the steroids. Hope, that remaining fluid, no matter how small is ENOUGH for his precious lung development, and enough to prevent chord prolapse, chord compression, or limb deformity. Amazing the role even ONE more week plays in this. For now, they will continue to monitor me and baby's heart tones, and I will continue to pray, hope and try and remain as positive as I can... catching up on some sleep would be nice too!

So, all in all, it's been a good couple of days all things considered. My parents and Stella helped me get all settled in. We're making the room as "homey" as possible. My mom will be staying in town most of the time to be available and keep me company. Ryan will continue to work and keep things as normal as possible for Stella... normal that is, given the situation. He'll bring her up on Saturdays after work and stay till Sunday evening. We'll work out other arrangements for visits with her during the week as well, so that I can be with her more than just on the weekends. I just don't think I could handle only seeing her on weekends.

What I'll miss about bedrest at home.... There is a song that I have begun listening to and thinking about repeatedly. It's called "You Are My Strength." I remember when I picked this song out to have my worship team learn, and how at the time, though I loved it, I had no idea the significance, meaning, and impact it would have for me. Here a link where you can hear it... hope it will be uplifting to you as well. http://www.youtube.com/watch?v=aGMOKBki56k
You are my strength, strength like no other
Strength like no other reaches to me
You are my hope, hope like no other

Hope like no other, reaches to me

In the fullness of Your grace
In the power of Your Name,
You lift me up... You lift me up

Unfailing love, stronger than mountains
Deeper than oceans, reaches to me
You're love oh, Lord, reaches to the heavens
You're faithfulness reaches to the skies
By Reuben Morgan © 2007 Reuben Morgan/Hillsong Publishing)Adm in the US & Canada by Integrity’s Hosanna! Music)ASCAP

With love,

Thursday, June 3, 2010

Appointment with Maternal Fetal Medicine

Yesterday was a big day, and left us with more decisions to make, so I didn't have much remaining energy last night to update. We had our ultrasound and consultation at Barnes Hospital in St. Louis. I was beyond relieved when yesterday morning finally came, especially after the incredibly long and stressful night I had with about two hours of sleep, due to my anxiety over those last 24 hours standing between us and the appointment.

Now for some results... My cumulative amniotic fluid level was 7.34, which was an increase from 4.5 when I was in the hospital. Considering I continue to loose fluid, I am encouraged that more is still being produced and accumulating. The normal range is 9-22, 9 of course being very "low normal", so 7.34 gives me hope that we just might be able to inch our way into the territory of "normal" even if it is lower than desired. The tech noticed the baby's abdomen rising and falling and she explained that the baby is practicing breathing. Now, it doesn't mean that the lungs are forming, but she said it's a good sign! Another pleasant surprise came when she told me she estimated him to weigh 1 lb 5 oz!! I was so happy to hear that! Two weeks ago in the hospital they said he was about 13 oz, so to hear he has gained that much to me is just awesome. She made some other remarks like, "that's a pretty spine", and another measurement or shape in the spine that indicates spinal bifida which looked good, and she said, "now, that's what we like to see."... more sighs and smiles from Ryan and I.

Next was our appointment with Dr. Rampesad, who Ryan and I really liked! She was very patient and attentive to my endless questions, spending over an hour with us. She had lots of medical history questions for us, and then gave me all the time I needed to explain what we've been through. Most of the info she offered were things we've already been told. She reinforced concern over infection, especially with someone like me who had a rupture so early, and explained again why they have to deliver when there is even evidence of infection because it can be deadly to baby and to me. She also spent more time with us explaining concerns for placenta abruption, which is where the placenta suddenly tears away from the uterine wall, causing extreme bleeding, and happens more often in cases of premature rupture. That would be another emergency c-section situation, where they would do everything to stabilize us both. So, you can see why they choose to hospitalize women in cases where either happens, and why every week further is so vital for baby. On June 13th, I will be 24wks, which is what they consider viable, and his chances of survival are 50%. She has given us the choice of going into the hospital at 23 or 24 weeks. In the research I've done, SOME women opt to stay home for longer and mange there, but because I've been ruptured since 16wks and we are 2 hours from the hospital, we've decided that I will go in at 23wks. So, as of now, Monday is the day. The best case scenario is that I'm able to carry until 34 wks, at which point the risks of the baby remaining in the womb outweigh the benefits, and he will be delivered.

I have such mixed feelings as this separation from Stella and Ryan will be so incredibly difficult, but I believe I will feel safer knowing that I am in the best place to receive immediate care if an emergency should arise. Though I want and pray to carry for as long as possible and have worried all along about so much, I am thinking now of the emotional and physical toll a prolonged hospital stay could take. But, we feel immeasurably blessed that we are surrounded and supported by such incredible family and loved ones, who are willing to drop anything and give so much to help us. I've had this verse in my mind for several days, "Yet those who wait for the LORD Will gain new strength; They will mount up with wings like eagles, They will run and not get tired, They will walk and not become weary." ~ Isaiah 40:31 Now, I don't see any running or much walking in my near future, but I think you can catch the meaning. :-) Waiting is wearisome, tiring, and I don't think I even know emotionally the extent of what I'm facing, but I do trust that as I wait, I will gain new strength to press on and stay strong.

With love,