Preterm Labor

My body mistakenly took all that "practice" for being the real thing! I'm now typing from bed. A place I plan on becoming far too familiar with the next few months. We'll get more into how that came about later. Let me begin where I left off...

I took advantage of the the time I took off from work. Being on restrictions to 8 hour days meant when I came home, I was on my butt until shower/bed time. My legs were typically swollen and felt tight by that point anyway. So, not much complaining from me, but it made getting housework done seem impossible. I had to squeeze everything in on my days off it seemed. Since I had 10 days off, I could finally stretch out the squeezing. I felt less like I was trying to make fresh squeezed lemonade for a convention center and more like I could sip lemonade that was made just for me.

And I did. I sipped carefully, however. I was still contracting, but I felt more confident in my body and that my "belly tightening" was just Braxton Hicks (practice), and not the real thing.

I cleaned. Oh I cleaned. I had this overwhelming feeling like things needed to be clean. I mean CLEAN. Like you would feel comfortable eating off of the floor while lying there naked. Not that most people would feel comfortable doing that in any situation, but I felt the urge to try and make it that kind of environment per se. 

I scrubbed probably 1,000 sq ft of baseboards with paper towels for 3 days until I dwindled my fingernails down to brittle nubs. I vacuumed every possible square inch that was within my sight/reach. Every little speck of dust was foreign enemy #1 and had to be captivated within the vortex confines of the super storm created by my Kenmore vacuum cleaner. While my fancy smancy Dyson vacuum is much lighter and more versatile for preggers over here, it sucks! Actually, it doesn't suck. It doesn't seem to suck at all, and that is exactly why it is retired to an upstairs closet. Rant for another day. Back to nesting. I scrubbed every spot on the cabinets, under them, between them, in them. It brought me great satisfaction to work and see my progression. It also brought great amounts of contractions. It was ok, though. It was all just practice.

So I thought.

I wasn't even finished. I had a lot more baseboards to clean, rooms to straighten and organize. I wanted to finally finish our house. Yes, we have lived here for over 3 years, and it isn't "finished." I still have rooms that need to be furnished, painted, and decorated. I was grabbing paint swatches from home improvement stores like crazy, taking measurements, making plans, and even getting a major living room renovation quote from a local contractor!

Out of our entire house, our master bedroom is the only thing completed. That means it is completely furnished, painted, and decorated the way we want and are happy with. The downstairs guest bathroom is a close second, requiring only new towels. The office only has a small ways to go, just needing some window treatments, tidying up, and wall hangings (always a pain). And we are very close to completing the nursery (cue lots of excitement in that phrase!). 

That was another project we embellished on while I was off. Starting the nursery. We ran with an adult African Safari theme. And when I say "adult," I don't mean naked African women are plastering the walls. I just mean not a cartoony version of safari animals. My dad painted the walls a beautiful color somewhere between orange and copper. It's name (tea room) isn't revealing, but it's hue is quite fitting. And I'm pretty sure Kirkland's was running low on inventory by the time we left their store. It's not finished, but a great start to our imaginations! The most unfortunate part is that I won't be able to participate in finishing it. And the entirety of the rest of this blog is why.   

It seems like my blogs are always weekly doctor updates. I get tired of that sometimes. I get tired of re-reading about doctors and appointments with them. But let's face it, that's my life right now and this blog is my journal. Anyway, on to the ultrasound. 

My step dad was present for the ultrasound. The coolest part about that was that he had never seen an ultrasound performed! So, he got to see the baby moving and kicking. Little man even waved for us. The tech tried some 3D imagery, but it just didn't turn out well. The little guy had his face buried in the placenta, but it was exciting nonetheless to be apart of something that was a first for my step dad!

Then, all the crappy questions came, "Have you been having any tummy tightening or feeling a little crampy lately? Any bleeding?" Ah Hell. I knew what those questions meant as I had a little fear that my contractions could have been making changes in my cervix. And apparently, they had. It was confirmed. My cervix was getting shorter. The stupid thing was < 1 percentile for my gestation. I didn't even know that was a category?

The cervix is the last barrier between baby and the world. It's like a sponge. It's strong but weak in the same sense. It responds to pressure, and contractions force quite a bit of pressure on it (think of squeezing that sponge). The cervix shortens (effaces) and eventually begins to open (dilate).

Mine is shortening prematurely. I wasn't told I was dilating, thus I assume I am not at this time. It is about 50% effaced, though. It's acting like that sponge. With contractions, it shortens to 75% and begins to open internally (dilation in labor is opening externally). Opening internally is what typically causes the water to break. Yikes! When relaxed, it goes back to 50% and closes. They call this a dynamic cervix. This happened right before my eyes on the ultrasound screen. It's a scary sight. It is essentially preterm labor.

I was placed on a toco monitor in the OB's office to monitor my contractions. There were tons! I couldn't even feel half of them. They lasted about 20 seconds, but were fairly close together. My OB labeled this with an interesting name. An "irritable uterus." Really? And what exactly does that thing have to be irritable about?

One theory is a previous D&C (dilation & curettage). When I delivered my daughter, the placenta was retained. Meaning it wouldn't deliver properly. Delivery of the placenta is crucial to stop hemorrhage. Thus, I hemorrhaged to a point of almost going into hypovolemic shock (my BP was 70/30). My doctor had no choice but to do a curettage (use of a sharp tool to scrape the uterine lining) on the placenta. The procedure has its risks. The risks were not greater than me bleeding to death, though! After I recovered and was fully healed, I had a diagnostic procedure done to determine if I had any damage or scar tissue from the curettage. Everything looked great. So, I'm ruling that theory out on my own. 

Another theory could have something to do with little Brussel Sprout's passing back in the 1st trimester. The twin could be releasing chemicals telling the uterus to abort it. Why now and not sooner? I don't know.

So, here I am on bed rest.

Theoretically, gravity places more pressure on the cervix causing it to thin and open faster. Thus, lying flat takes gravity out of the equation. It isn't a proven method, but accepted widely enough to be an intervention. My contractions do lessen when I lie down. They also come on hard as soon as I stand. It's one of those things I can "why me?" myself about all day. I could soak in self demise and boo hoo about my "luck." Yes, I wish I could finish my nesting, grocery shop, even work. But what it boils down to is that this is what I have to do to give my little guy as much of a fighting chance at life as possible. So, that's what I'm doing. Simple as that. As well as taking a blood pressure medication twice a day (to control contractibility of the uterus) and progesterone nightly. I'm going to lose muscle mass and tone, probably just a small amount of bone density loss, increase my risk of blood clots, and severely hinder my activity tolerance by the time he is born. I finally see what it is to be a mom and sacrifice anything in this world for your little one. Josh and I are ewwing and awwing and just laughing at every little movement we feel together. We are cherishing the moments and basking in them with hopes that they won't be ending any time soon. I can't count the tears that I've shed at the thought of him lying lifeless in a NICU incubator on a ventilator right now. As active as he is, it's crushing to even imagine.

I leave you with something I found comforting....

This was my favorite painting we picked out to hang in the nursery. After looking closely at this picture I took, I realized the cub is in our crib (seen in the reflection of the glass) and sleeping while mom watches over him. It gave me chills.

Letter to Baby

Dear Son,

Today marks a big day! We are 24 weeks pregnant, and professionals say this is a point of viability. It means that there would be a "chance" of survival if you were born right now. I'd like to keep you around a little longer, though. We don't want to "chance" anything with you!

Your daddy and I have been working on your room, finally. I hope you like it! Daddy liked the idea of an African Safari. So, we ran with it! We decided on a real safari theme as opposed to the more cartoony version. I can't wait to teach you how to say the names of the animals. I sat in the floor in your room rubbing my belly and imagined holding you in my arms soon. I can't wait for that moment. You mean so much to me. I'm not sure you'll ever fully comprehend until you have a little one of your own someday, but it's amazing!

I can't wait for you to meet your daddy, too! He loves you so much already. He holds my belly and gives you lots of kisses. He tells you he loves you and calls you "little buddy" all of the time. You are getting so much bigger and stronger! It blows daddy's mind how hard you can kick him already. He smiles and laughs and says, "Oh man!" when he feels your roundhouses. Something about his touch calms you. When you are rambunctious and kicking up a storm, daddy can place his hand on my belly and you calm right down. I look forward to this magical touch after you are born!

I stare at your ultrasound pictures trying to fathom what you will look like. I dream of you often, too. I can't tell you enough how much you have consumed my world already. You are and always will be my everything. We are so blessed to get to watch you grow on ultrasounds. We can't wait to watch you grow up right in front of us! Daddy is going to seem like a pretty tough guy on you sometimes when you get older, but he already has so much love for you that it gets him pretty choked up sometimes.

We look forward to your much anticipated arrival in a few short months (no sooner, please!).

Love always,
Mommy

24 weeks

Viability!!! We have arrived.

 Total weight gain thus far: 18 lbs

Baby's weight: 1 lb 9 oz

 

 

And so the practice begins

Last week, I worked 14 hrs the day before taking 10 days off. I know! I know! I'm on restrictions to 8hr days. I only worked on my feet for 7 hrs though, then 7 hrs sitting with my feet up at a computer. It would have been no different if I had gone home and sat to watch TV. In my defense.

That night, when I got in the shower, my belly got really hard and tight. Little guy seemed to be all balled up. Then, he spread back out and relaxed through the warm shower. When I crawled in bed, he did it again! His jabs and kicks are getting much stronger, so it was no surprise that he was having such an impact on my belly by balling up. I've even seen him kick me!

The next day, I did nothing! And I mean nothing... Zilch, nada, nothing! It was day 1 of 10 days off. I couldn't have been more relaxed and happy to sleep in and awake just to sit on my butt and do nothing. But little guy had other plans for me. He started balling up again. A lot! I started to think something might be wrong with him, or maybe it wasn't him at all. But why in the world would my belly be tightening so much?

Go ahead and google belly tightening. A very scary word pops up consistently.

CONTRACTIONS

Duh! Contractions are uterine muscle fibers tightening. How did I not put two and two together? Seems as though I may still have some innocence left in this game.

"I've been having contractions!" I thought to myself ever so slightly panicked. I'm well aware of Braxton Hicks contractions, but never having them, I have no idea what to expect. I couldn't time the contractions, and they were painless and irregular. But they continued...

I had a little issue with blood sugar that day, too I believe. I'm not used to doing "nothing." I sipped my water bottle, that I carry around religiously. I ate a bowl of dry cereal (the milk was bad, waaayyyy bad). And I spent the morning on Craigslist and other websites gathering items needed for the nursery. At some point, I realized I was hungry and it had been more than 5 hours since I had eaten anything. When I got up to go get something to eat, I didn't feel so hot. I was shaking and dizzy. Oops. Blood sugar must have gotten a little low. Ate a granola bar while I had some mashed potatoes warming up. Still felt bad. Ate mashed potatoes, well inhaled them. Not better. Ate a candy bar. Nothing. Filled up my trusty water bottle and went to lay down. I was having contractions during that time, as well. I have no idea how many or how close together, though. I was so fuzzy-headed. I fell asleep for a couple of hours.

When I awoke, I had a contraction here and there. I was worried. Really worried. I was only 22 weeks 6 days. Keep in mind, a small chance of survival outside the womb begins at 24 weeks. Since they were so irregular and painless, I halfway chalked it up to Braxton Hicks and decided to call OB if I was still having them by noon the next day.

The next day: still sporadically occurring. At this point, I was so paranoid that I thought I was having them all of the time. I would poke different spots of my belly to determine if I thought it was hard. I was doing this CONSTANTLY. In nursing school, a wonderful OB instructor taught us how to differentiate between mild, moderate, and severe contractions. Mild feels like the tip of your nose, moderate feels like your chin, and severe feels like your forehead. She always said, don't be ashamed to feel the moms' bellies with one hand while touching your nose, chin, and forehead with the other. They may look at you like your crazy, but it works. So, here I am, mashing my belly with my two fingers on my left hand and touching my nose, chin, and forehead over and over again with my index finger on my right hand. Crazy? Yeah, I'm sure I looked plenty psychotic seeing as I was doing this obsessively and unaware in public. It completely took away from me being able to even feel the contractions. My belly would start to get hard and I would start poking it. Poke. Poke. Poke. Poke. To the point I couldn't even tell when it was hard and when it wasn't. Delirium maybe? I can actually time a contraction from start to finish now, as long as I don't touch! I just concentrate on what I am feeling in my body, and not with my hands (took a few days to learn that, though). This is a first for me, what can I say?

I stopped putting it off. I called my OB. She reassured me that it sounded like Braxton Hicks contractions. She told me to drink 2-3 liters of water a day, keep my bladder empty (as a full bladder tends to cause contractions, ah ha!), and if I am noticing the contractions when active, to rest. She said if they became predictable and I was able to time them or if I had more than 4 in an hour, to call back and she would have me go into L&D and get checked out. She said to think of the Braxton Hicks contractions as my uterus practicing for the big day. Cute. Practice. Ok, I can do that, but when does this practice become real and how can I tell? Apparently, consistency, predictability, and an increase in frequency and strength are key notes here. Admittedly, I definitely had more than 4 in an hour the day before, but they were extremely inconsistent and never strengthened.

I am still having them today (23 weeks 4 days). I have several a day. I don't like this practice. I feel a little panicked inside when I start to feel my belly hardening, or even when I think it is but isn't. I go see the Peri for an ultrasound and OB for the glucose test and routine OB stuff both on Monday (a long 5 days away). My fear? That these contractions are making small changes in my cervix preceding an early labor (wwaaaayyyy too early). I'm also afraid of being out on bedrest. I have so much to do at work, and we just got started on the nursery. I will do what it takes, but it wouldn't hurt my feelings to just be normal for once. I'm so mad at my body! What makes it think "practice" is warranted this early?! My body couldn't start practicing after the third trimester or later?! We have to work together here! This baby has to stay with us until at LEAST 37 weeks! I want to hold my son and for him to be with us so bad, but not quite this soon. Just a few more months my little man. Hang in there.

A Real Face (3D ultrasound)

On small occasions, we get to try the 3D ultrasound! Our Perinatologist suggested the tech try this time, since everything looked so good. She figured maybe we could get a good face shot for keepsake. But he would NOT be still. He just has to be still for a few seconds, so the computer can process the still image. Nope, wasn't happening. She tried several times before deciding to try and switch over to 4D to get a good shot. And it worked! Here's the very first glance at our son's face:

His eyes are still fused shut this early. The Peri said his features may change a bit as he is just starting to accumulate fat on his body, and he still has a ways to go. His cute little upper lip makes him look like one of the Simpsons characters. Just adorable. Based on his measurements, he is measuring 1 week ahead and weighing in at one whole pound now! Amazing! We are so blessed.