Daniel update

I just went to see my son (that feels weird saying the word for the first time) and he is off CPAP!! He was awake and we had a beautiful brief visit. He is gorgeous, so tiny and perfect. I got to touch his little head. Bliss!

War picture no 2

Some of the 12 attempts at starting an IV.

War pictures

Arterial line site (they had to poke a lot to get it in).

Day 2 post partum

I am still in the high risk ward today but am finally starting to feel more normal. I am still on magnesium. They were supposed to stop it last night but instead had to bump up the dose to double because I was twitchy and hyperreflexive. I only started to decrease my reflexes today so the magnesium got decreased again. As long as I am on magnesium I am stuck in bed and have a catheter. Cannot stand well or even sit too long or else I pass out. And, most importantly, I cannot go and see Daniel except for whenever the nurses take me in a wheelchair. Except sitting in a wheelchair makes me pass out so it is a brief brief visit, if at all.

I am making three drops of colostrum at each pumping session. It does not seem like making milk is my body's highest priority right now. Recovering from the preeclampsia/csection/hysterectomy/hemorrhage/electrolyte abnormalities is a bigger priority. Oh well. I will continue to pump and hope for the best.

Addendum

Oh yeah, forgot to mention that I had a placenta accreta (glued to the uterus) and ended up losing the uterus along with 1.5 liters of blood (normal csection loss is 0.5 liters). I did not get a transfusion though. I guess this is the end of baby making for me!

Sent from my iPhone

Just visited him.

He has mild RDS but is improving. Probably tomorrow they will try him on room air.

Here he is!

Had baby Daniel

Emergency csection last night at 1 am. Had severe headache, vomiting, protein 9 g/day, etc. I had brain edema. Worst agony as far as headaches go. Daniel is in the NICU and had CPAP, probably still does, but improving. They are starting tube feedings. I get to see him soon. I am in the high risk area on magnesium and a ton of labetalol but my headache is gone, BP 140/82 and am feeling sooooo goooood!

32w5d quick update

Blood pressure out of control at the moment, 174/108 last night, got the Nifedipine 5 mg bite and swallow, and that brought it down momentarily, then they increased my long acting meds and added some more, but this morning I am at 168/100.  Marginally better.  I think I need more drugs, I just don't know how many more drugs there are left in the magic hat for me.  I am on Adalat XL 30 mg twice a day (maximum dose), Labetalol 200 mg three times a day (there is room to go up to 400 mg three times a day), and there is a third medication called Aldomet that they might try, but it is not as effective.

I am hoping so much to get to Monday or Tuesday, not only because I will be 33 weeks by then, but also because my husband is stuck working in our home town and cannot find coverage to get out.  Since his is an essential service, he has to stay, and I dearly would like him to be here and see his son being born.  Hopefully it will happen.

I don't sleep almost at all.  I am going to ask for some Ativan tonight, otherwise it will be my third night in a row of three hours sleep total.  I spent my nights doing relaxation exercises, and meditating.  It is very relaxing, but it is not sleep unfortunately.  I just hover above entering sleep for long hours, and almost cannot tell if I am awake or not, but it is not as restful as real sleep would be.

I miss my baby...

This is what I am missing the most in the mornings. 

I am pretty, oh so pretty!

This is what I mean by dependent facial edema.  I obviously slept on my right side.  Even my lips look huge!  The dilemma this morning was whether make up is worth it at this point.  I think make up is always worth it unless you can't see your eyelashes, then it is a waste of mascara :)

I think I got admitted at a good moment, because not only is my swelling epic, but my blood pressures are just not budging, despite the meds.  This morning it was 155/102.  The labetalol is not touching me.  I am guessing they will probably increase it today. 

I had such a hard time falling asleep!  The edema in the legs is giving me the restless legs feeling, and it took hours to finally fall asleep at 1:30, only to wake up again at 4 am for vitals.  Even in the middle of the night, while asleep, my BP was 144/90.  I think the high pressures make me a bit insomniac.  

I miss Emma's lovely smile in the mornings when she wakes up next to me.  Sweet little girl! 

hospitalized again

I got admitted again today.  I think the doctor on call was thinking of just giving me some blood pressure meds and sending me home, but I asked her to rather keep me, because I am starting to feel unwell.  Swelling is much worse, and I am now getting corneal edema when I wake up, making my vision in the one eye (on the side I sleep on) blurry for about an hour or two.  I also felt very shaky and puky today, so I was not comfortable going home.  It is not just a blood pressure issue.  My proteinuria is getting a lot worse as well.  I think I need to be watched a bit since I feel like I am getting worse.

The doctor in the assessment room thought I am lucky if I make it to 34 weeks.  I am 32w3d today.  Let's see.  I tend to agree with her, and will do my best to last that long, but it seems that no matter what I am doing in terms of resting and keeping salt levels down, the proteinuria is worsening.  My sodium level is quite low as it is, well below the normal limits, so I have to take some salt in, otherwise it will drop too much and I will have to have an IV, which in any case I might end up with sometime in the next week.

I don't know yet if I can get released home again, perhaps if I stabilize, but I think they are going to keep me for at least a few days.  Or until they decide to do the C section.

32w2d, worsening again

My BP is now reaching 156/98 and I even had a 158/102 last night.  Evenings are definitely worse, daytime better.  The proteinuria is now at +3.  Things are going down the hill from where I am sitting.  The home care nurse thinks I am lucky if I make it through the week.  I am still hoping for two weeks, but that is a long shot.  I am meditating every day, especially in the evenings, and it helps a bit with the blood pressure, but I am not expecting it to slow down the progression of the disease of course.  Even meditation has its limits :)

I am trying to decide whether the term "unlucky" really applies to me as far as pregnancies.  I mean we have infertility, incompetent cervix, a propensity for post partum hemorrhaging, and now preeclampsia.  Despite all these issues, I got pregnant three times, got one baby out alive, and have every hope to get the second one out as well, even though not fully baked, but at least at a reasonable gestational age.  What is luck?  Is it what you are given genetically, or what you are given to compensate for the genetic and health lacunae?  I have a wonderful family that looks after Emma better than I can at the moment, and I access to one of the best health systems in the world, not to mention that I am going to deliver a top notch hospital that is well equipped and experienced in looking after women and babies like me and Daniel.  Is that luck?  Being somewhere else, at a different time, I would have never had babies.

That being said, if the OB runs into any trouble at all, I give him my wholehearted blessing to take out my uterus...

update, 32w1d

I saw the locum OB today, a different one that I have never met before.  She said that it looks like things are worsening, but not enough yet to put me on medication.  My blood pressure did get a bit worse over the past two days, and my proteinuria went from PCR 60 on Thursday to 160 today.  Otherwise, the labs are not showing anything else too worrisome, so I am to stay put and probably see somebody at the end of the week, with bloodwork on Thursday again.  The AFI and cord doppler studies are normal, so baby Daniel is doing well.  It is just me that is slowly deteriorating at this point.

I am very afraid of placental abruption.  I have a morbid fear of it.  I know it only happens in about 4% of preeclampsia patients, but I am torturing myself imagining one every night before bed.  I wonder why my brain decided that is a good idea?  to keep me in bed?  to keep me on my toes?  There usually is a good reason why we have a certain fear.  Hopefully it will stay as only a fear.

bedrest and beyond

I will try to write something different today than the usual updates on my blood pressure, which by the way is subtly worsening (the diastolic is about 90-93 constantly now).  Hoping for the weekend to not bring it to 100, which is my clue to go to the assessment room.  I also have steady trace to +1 proteinuria, but I don't think that impresses any of the doctors at this point.  We know I have preeclampsia, proteinuria is part of it.

I am feeling well, and starting to adapt to the bed rest and to the entire situation so far.  I was not expecting preeclampsia in the least during this pregnancy.  If anything should have gone wrongly, I would have bet on structural issues, like the cervix, or the uterus.  However, it seems that, as usual, life throws me the unexpected curveballs...

How do I feel about it?  I am of course worried about the baby, and about myself, but overall feel that we are in good hands, and trusting both my luck so far, and the caregivers, and most importably God, who let me keep my uterus despite the massive hemorrhage after Emma's birth.  There had to have been some reason why that happened, namely to have Daniel.  I am cautious with the optimism, but at this point I really think that baby Daniel will make it out alive.

Bed rest is hard, but it becomes easier with each passing day.   The days are starting to shape into a rhythm of waking up, having breakfast, reading to Emma, meditating for an hour to nature sounds, having lunch, sleeping in the afternoon, lounging outside on a long chair while Emma is playing with the dog, then watching some movies or reading a book, reading to Emma again and sleeping with her.  I feel fulfilled if I focus on the things that I can do.  Because I am horizontal almost all the time, these things do not include drawing or writing or knitting, but they can include spending time with my mind, feeling the presence of God, feeling His love (which I have not focused on so deeply in a long time) and, lest I seem to be too much into spiritual development, rotting my brain by watching Netflix (I am into Bones at the moment).

I am noticing that I don't have the struggle for identity that I had during the first bed rest time with Adrian.  I was, back then, fighting to become a mother.  This time I already am a mother, and I am fighting for Daniel to grow and have the best chances at a healthy life he can have.  Emma makes me feel peaceful during this situation.  Having her close reminds me of what a beautiful gift I have been given once, and very likely will be given again.  I don't question whether I will ever be a mother, I already am one.  Daniel is here now, inside of me.  Emma is here now,  growing into a beautiful, smart young lady, and I feel like a very lucky woman.

Funny enough, I don't spend any time thinking about why me, why do all these things seem to happen to me while other women have multiple pregnancies without any issues.  I simply don't think that way anymore. I got asked that many times by people, and I just felt my brain telling me that going down that line of questioning will not get me peace, or happiness, or answers, so rather not go there.  That is what I have learned along the years:  don't go there, it won't lead to gold.  The real treasure is in focusing on the love and people and care that are around me now, in seeing that, rather than the funny curveball obstacles along the way.

31w4d

Yesterday the nurses were trying to tell me that my blood pressure is good enough for me to get up more.  One of them made me feel neurotic indeed for lying here all day long.  So, I got up for lunch a bit, and for dinner for two hours.  It was my mother's birthday, so we celebrated, and had a "hot pot" which is a soup in which you boil various small cuts of fish, seafood, meat and vegetables.  It was lovely, but afterwards I laid down for two hours, and even after that my BP was 144/98.  The high diastolic made my whole body feel like it was vibrating, a most unpleasant feeling.

I think today I am going to be a lot more strict, like my instincts tell me to.  I was up to the lab to get my blood work, and I also had the nurse come over for the NST (which baby passed), and I am now waiting for the results.  My BP has been 85-91 diastolic, so not too bad, and I think it will continue to lower if I behave, or at least not increase.  I have trace proteinuria again, nothing to be excited about, but another step back.  I wonder if this illness will be full of steps forward/steps back, or if it will suddenly start to worsen.  Only time can tell.

It is HARD sitting here and waiting for something bad to happen.  The most helpful thing so far is to know that I am almost 32 weeks (and think that I will make it to 32 weeks at least), and also I find it encouraging to read other women's blogs who were on bed rest for various other reasons.  I have not found many who are doing preeclampsia bed rest, most of the preeclampsia stories out there on the internet are precipitous stories of suddenly getting ill, and finding out that delivery is imminent.  Perhaps that would have been me if my OB were not very observant.

PS. my labs are back.  All normal except for the proteinuria, PCR of 60 which is considered +1 on a dipstick.  Not too bad, but worse than it was (my last PCR was 8).  Proteinuria by itself is not a reason to panic though, just something to watch as part of the bigger picture.  By the way, normal PCR is 0-22 at Women's hospital.

31w3d

My blood pressure tends to increase to 144/93 max when I get out of bed, even for brief stuff like eating, and so I probably should avoid doing those things.  It does go back down to normal values like even 116/78 after resting again for a few hours, but I want to be very careful this week, as my short term goal is to get the pregnancy to 32 weeks.  If I can, then my new goal will be 34 weeks.  I think if I reach that, then I should consider myself lucky.  Today I had trace protein on a concentrated specimen, but I redid it on a regular urine and it was negative.  I think the nurse meant for me to test on a regular sample.

The Antepartum Home Care nurse came by yesterday, and she likes to talk a lot!  She brings my BP up just with her non stop talking.  I think she might settle once she becomes comfortable with me.  I am so thankful for this wonderful program, as they are coming by twice a week to do NST's at home, and they call me daily, as well as provide the BP cuff and the dipsticks, and follow my blood work.  They also call the doctor if anything goes sour.  It is great to be enrolled in this program, and I cannot believe how lucky I am to have such good medical care so far.

Today I am alone with Emma for a few hours, and making heavy use of Netflix to entertain her from the supine position.  She enjoys Diego, so I am in luck, but I have to admit that part of me is feeling guilty about my daughter's brain taking in so much TV!  She does not want to read books, and I am not about to pressure her into any activities right now.  My focus is so much on baby Daniel that I am not too concerned about anything regarding Emma, I think whatever happens in the next five weeks can be rectified later when I can get back to teaching her stuff.

So, overall, I am spending my day lying in bed and thinking about life, or browsing the internet.  The goal for today is to find a good book to read.  I am also learning Aperture, the photo editing program. The first few days on bed rest are the hardest, because the situation is still pretty volatile and it is hard to focus enough on any activities not related to the pregnancy to enjoy them.  One cannot get lost in a book or a movie because the brain keeps on worrying and processing "what if's".  However, after a few days, things settle and I am hoping that I can find a rhythm to allow the days to pass smoothly.

Today is my mother's birthday, so we are going to have a little party tonight.  I am probably going to lie in bed, but it is still nice to see my family celebrating and enjoying good food.

31w2d

I am doing my first day of bed rest at home.  It is only ten in the morning, but I am soooo sleepy!  And I am trying to keep some regular nap time from 1-3 pm, so I am struggling to stay awake.  So far my BP has been 128/81, urine negative or trace, I cannot really tell, and the weight at 205 lb.  One whole day to lie here and worry, hurray!

home today

They let me go home because the blood pressure has stabilized below 140/90 and the proteinuria is stable, at the moment almost non existent.  It was +1 and now it is zero.  I know that this disease will come back, but hopefully as the one nurse said to me I can "sneak in the pregnancy" unnoticed.  I don't think anybody believes that I will make it to term, but then again everything is possible and why not let things be.

Wish me luck and I will keep updating.

update from the hospital

Yesterday I did not pee almost at all.  400 ml was all I made in almost 20 h.  So they threatened me with an IV, and I started drinking massive amounts of water, I drank about a litre per hour for three or four hours.  It took a while for things to start working, but they finally did, and towards evening I was putting out a normal amount of urine.  I was so dehydrated from the stress of admission that my sense of thirst had completely gone out the window.

I am doing much better, BP 130/80, has stabilized over the past day or so, and I have not gained any further edema.  The baby looks good, and if tomorrow's ultrasound shows good cord flow, then I might get to go home and continue on bed rest there.  I only have mild proteinuria, and mildly elevated BP, but I do feel that I was starting to turn sour, so it is a good thing that they admitted me and stabilized me.  I am a lot more relaxed when I am in the hospital and taken care of.  I have also had some time to think about my priorities right now:  this pregnancy is the first priority, it has to be.  It is a much more fragile situation than anything else going on, and it is only for a limited further six weeks or so.  Emma is very well looked after by my mother, so I can relax about mothering her right now and focus on myself and the gestation.

I am meditating for about half an hour twice a day, and hopefully that helps to keep the blood pressure down as well.  I don't get up that much, just for bathroom, and for about one hour per day total with walking to the water cooler, and stretching my legs.  I plan on continuing that as much as I can at home.

Every day that we gain is a bonus, but I feel that we will make it for a whole other week.  I have a good feeling about it.

I landed up in hospital

This was quite an eventful time for me.  I saw the OB on Wednesday, and my weight had increased 9 lb, blood pressure 140/92, no proteinuria.  I then went back to see him again on Friday, and I had gained a further 8 lb, with same BP readings, but +1 protein.  He sent me straight to the hospital for admission, and here I am, an inpatient again, sooner than I had expected.

The labs showed that my platelets decreased slightly from 164 to 146, and the uric acid went up from 345 to 370.  No protein was present on the urine PCR (yeah, they have urine PCR here, fancy stuff).  I am now doing a 24 hour urine to confirm, but the dipstick upon admission was also negative, so I am thinking that the OB's receptionist over interpreted it or something.

The BP in hospital ranged from 158/89 (when I just got into my room) to 135/90 most often.  I think that they will start me on labetalol.  The baby looks great, the NST was fabulous, and I am getting an ultrasound on Monday.  I did freak them out though because they gave me steroids, and I am now so full of beans that I am typing at 100 words per minute!!!  Mind you, I have only slept for three hours last night, so I am pretty sure I am typing nonsense.

I miss Emma so much...  My mom is bringing her tonight, and we talked about bringing her every evening for 1-2 hours.  I am going to read to her, and maybe draw/colour if mom brings some books. I got to sing her good night songs over the phone and she fell asleep, it was so sweet!  I don't think she can tolerate more than a relatively brief visit daily, she needs to be outside in fresh air, playing with the dog, not in a hospital room with me.  And seeing me every day should give her (and me) reassurance that we are alright.  Last night, when it was time to leave, she started pulling on my hand and saying "mommy let's go, let's go with the grey car to bua's house (bua is the name she gave my mom)".   I cried a bit thinking about this, how eager she was to direct me home with her... but I remembered that I am here in a big part to protect her from losing her mother.

I was going to fight this admission somewhat, because I saw no reason to manage me as an outpatient, except that of course with the labs being somewhat worse, I guess that I would have been wrong.  I need to be here for now, until we figure out what is going on.  HELLP kills, I am well aware of that, and I am fortunate enough to be under surveillance.

The care that I am getting here is excellent.  The OB's are taking things seriously, I am frequently monitored, and there is a tertiary NICU available if I should deliver right in the hospital.  I am in the best place possible.  Not to mention that they have free wireless internet :)

Will update when I have something new to say.  If you are so inclined, pray for me and for the baby.  Thank you!

30w3d update, Hypertension

My blood pressure was a lot higher today at the OB's office, 135/96 once, and 130/90 the second time.  Enough to buy me a blood test and a warning that I'd better rest in bed for the rest of the gestation.  It's not like I am a model of activity anyway, but it looks like I have to adopt the sick position for the next six weeks, if indeed I make it that far.  It would not be the first time, I say.

I have no proteinuria, and my bloodwork turned out fine (here in Vancouver you can find out the results at the same time as your doctor by checking online).  The swelling however is really noticeable, and I have gone up 9 lb in two weeks, which is about 7 lb more than usual so far.  I am seeing the OB again on Friday, and I am guessing that if the BP does not come down, I am going to end up on meds and with three times a week visits to the hospital for non stress tests.

In the meantime, I am trying to finish knitting a blanket made of white alpaca wool that I have started during Emma's gestation but only got to halfway.  Perhaps this baby will get to enjoy it.  Emma just came by as I was typing just now and pulled out one of the needles (losing about fifty stitches) and exclaiming "big crayon"!  Gotta love her.

swelling, swelling

Whoa, I have gained 6 lb this week, and yes, I am aware that the week is not even over yet.  In four days, I should specify, my weight has gone up by 6 lb.  I am now 200 lb, the weight I was aiming for at delivery.

I am very sure that it is all fluid.  I track my calories religiously on myfitnesspal and I have not gone over 2300 calories, in fact I have stayed around 1800 calories on most days, except on the days when I swim half an hour, then I add an extra 200-300 calories if I am very hungry.  Also, my carb intake is around 45%, which is very decent.

Today I woke up with my fingers the size of sausages.  I cannot make a fist at all.  I have not looked at my feet yet, but I can thankfully open my eyes, though I am puffy.  This weekend I am supposed to have my beautiful maternity photographs done, sigh...Hopefully she is decent with photoshop.

I have noticed that being in the water helps a lot, and I take Emma to the pool for two hours at a time, as well as swim for half an hour a few times a week.  I only do about 800 m front crawl, and have been planning to slowly increase by 50m per week until I reach 1 km, then perhaps stay there for the duration of the pregnancy. I really need to spend as much time as possible in the water, something about the hydrostatic pressure (and lack of gravity?) is very helpful with this swelling.  I now recall why I was such an avid swimmer during my last pregnancy :), then I had the time to do 1.5 to 2 km in a leisurely fashion almost every day.

My BP is still good, 110/84 or so.  I have an old dipstick and did a urine protein, but not having the box anymore I cannot really tell what the colour should be, I just watched the square that I know corresponds to the protein to see if there are any big changes.  There were no big changes, so I am not thinking that I am spilling massive amounts of protein.

Don't know what is happening with the fluid retention, but I am really hoping it will stabilize.  As it is, I am heading towards 210 lb at delivery if I don't gain any more fluid.  A lot more than I was hoping for, but so be it.  Healthy baby boy at the end, fingers crossed.

29 week update

I really need to post more often.  Too many things happen within one week to really be able to write about in just one post.  First of all, I got a call last week from the OB's office to go and repeat partially the ultrasound because they saw "some abnormality" on the fetal spine.  Gulp!  I called the receptionist back and made her read to me the ultrasound, she did not know where to start, but I realized it was a skin structure, probably a skin tag, that worried them.  I then went to see the OB as I had a scheduled appointment the next day anyway, and read the report myself, which said that on one of the views the skin tag looked like it was there, at the base of the spine, but on the other views it was not, so most likely it could be artefact (in other words, not real).  I was a bit stressed at that appointment, and my blood pressure was higher than normal, 110/85.  He repeated it a few times, and the diastolic (second number) stayed highish, at 85.  My prior BP measurements showed a diastolic of 70-75.  This is definitely not good news.

I have repeated my BP during the week with my home monitor, and it is around 79-88, most often around 82-84 during the day, and lower if I rest, especially lying down.  If it reaches 90 or over consistently I will have to be on medication.  I did not have proteinuria, and what makes this whole thing so bizarre is that this is my second pregnancy with the same partner, hence the risk of developing a hypertensive disorder is very low in general.  Apparently beware, when something rare can happen, it will happen to me.

I had the followup ultrasound today, and the neuro radiologist herself scanned me and showed me the whole spine.  There is no skin tag, no tethering, nothing to note other than a very normal looking baby. She did say that the anterior uterine wall looked very thin, but not in the lower segment, rather in the uterine body.  My prior tear due to the cerclage and the c section cut are both in the lower segment, and that is where the weak spot of the uterus is if anything should happen.  Hopefully there will never be any labour and hence no opportunity for a catastrophe like a uterine tear.

I am worried, of course, because I am now in the third trimester, and things can go more wrong around now.  I am worried about the blood pressure increase and the swelling of my hands and face that I woke up with today (swelling likely due to too much salt on Sunday at church lunch).  I am also worried about the uterine integrity and prior injury and hence relative weakness.  But despite this worry, I am also preparing for a baby.

I am getting my maternity photo session done this weekend, and also the baby shower is this weekend. I am so excited about seeing newborn cute clothes and having a newborn glued to me again.  It will be blissful.