My last post was a little more than two weeks ago before the first fetal fibronectin test. And, we had a busy 24 hours right after that…
The last Monday in March was my 24 week visit with Dr Hartman. He did the fFN and some ultrasounds and things went smoothly. The babies looked healthy, the fluids were equal, and there were no signs of concern. We discussed the number of contractions I had been having since there seemed to be more over the past week or so. He said to continue with the six hours laying down and then taking it easy the rest of the day, and call him if there are more than 12 contractions in a day. We made an appointment to see him in two weeks, he gave me the yummy orange glucose drink to check my blood sugar tolerance at the next appointment, and we were out the door in less than 30 minutes.
The surprise came late that night after I had put Brooklyn to bed and Jerry and I were watching the news in the back room. I randomly saw the little red flashing light on the phone charger indicating there was a message. So, at about 10:30 we got up to go to bed, and I casually picked up the phone to listen to the message. It was from a cell phone number I didn’t recognize. Then I found myself listening to Dr Hartman’s voice. He says, “Katy, it’s Hartman. Your test has come back positive. It’s concerning enough to me that I think you should go to labor and delivery at the hospital and get the steroid shots to develop the babies’ lungs and have them monitor you for a while. Preferably you should do this tonight. If you can’t tonight, then first thing in the morning.” He went on to explain his reasoning, the 20% chance of delivery vs. his reassurance that my cervix is perfect with no other signs of ensuing labor, and the importance of having the steroids “on board” as soon as possible if the test was correct in predicting an early delivery. Oh my….at that moment I thought my biggest nightmare was coming true. I immediately felt that adrenaline surge begin to rush through my body and felt shaky, nervous, sick to my stomach, worried, and of course, emotional. My first thought was ‘these babies are not ready to be born. They are barely past the viable age for survival outside the womb. And, there is no way we are ready to deal with such sick and tiny babies in the NICU.’ My next thoughts turned to Brooklyn. She was asleep all cozy in her bed. We couldn’t leave her in the middle of the night. She would freak out if she woke up and someone else was here while mom and dad were at the hospital. So many thoughts were running through my head. Then I said to Jerry, “I have to call my mom.” I was a little panicky, but Jerry in his usual calm and collect manner helped me think through things and make a plan.
We decided to go in that night. Dr Hartman doesn’t get too excited about too many things. So, when he said it was concerning to him, I thought it was probably best we go in soon. But, it was pretty late. I really didn’t want to call and wake anyone up to come stay with Brooklyn, but that was the only logical choice. My mom had offered to come up, but that’s an hour drive. We called Jerry’s mom and she was happy to come help. I know we woke her from a solemn slumber, but she acted like it was no problem at all to come to our rescue. I’m sure it took her a day or two to recover from a wild night at our house, but we were so grateful she was close and able to be with Brooklyn. We didn’t know how long we would be gone. It was reassuring to know that Brooklyn was in good hands with someone who loved her. I changed back into some clothes, brushed my teeth, grabbed my contacts and phone charger, and went into Brooklyn’s room to kiss her good bye. I was way sad to leave her not knowing what the next few hours would entail. Was I going to get to come home? Would I be checking into the hospital for the next few months? I was scared and nervous not just for me and the babies, but also for her and the questions she may have if things changed drastically overnight, all while she was asleep. But, Grandma was there and so we left.
Our insurance coverage is at Ogden Regional Hospital. It would be nice to deliver at McKay-Dee where I work and know the policies, procedures, and people, but not this time. It was unusual to drive to a different place. I had done my labor and delivery clinical rotations at Ogden Regional 10 years ago, but hadn’t been back since. It felt weird. On our way into the elevator a lady with some McDonald’s food in her hand said, “Are you going to have a baby tonight!?” My belly may look like I’m ready to deliver, but I said back, “Hopefully not tonight. These babies are not ready to be born yet!” By now it was almost 11:30 in the night. We checked in and pleaded our case to the clerk and then to the nurse, and waited for them to take us back to a room. Admitting came up to take all our information… so they can bill us of course…and a CNA took me to a room. I had to change into a hospital gown and everything, which proved to be a little much in my opinion for what ended up happening, but I was obedient. They asked me a bunch of questions and put me on the monitors. However, they had a really hard time getting the babies to stay on the monitors. They brought in the ultrasound machine and located each of the heartbeats, but still had a hard time keeping them on the other machine consistently. They were also monitoring me for contractions. They brought Jerry into the room, and after several minutes of frustration, the nurse gave up and said she was going to go call the doctor for orders. I felt bad. I know how frustrating it is to be given a new patient in the middle of the night when you have a million other things to do. I’ve said it before and I’ll say it again, it’s not easy being the patient. By now it was at least midnight and everyone was tired. Jerry tried to get me to close my eyes and go to sleep…ya right J The nurse came back in and Dr Hartman said it was ok to not monitor the babies tonight but keep me on the monitor for an hour and give the first betamethasone (steroid) shot now and a second one in 12 hours. Yay, more shots in the bum! I thought by now I was pretty good at tolerating shots, but man did that one hurt! I swear she hit a nerve or something ‘cause my leg jumped, the muscles cramped up, and it bruised and burned. I forgave the poor girl ‘cause I know I’ve hurt a few patients in my career, but that was not nice! After the shot, it was basically time to wait for an hour and monitor for contractions. Well, just like when you take your deathly ill child to the doctor and they have a miraculous recovery in the waiting room and look and act totally normal when the doc comes in to see you…ya, you know how that works…well I didn’t have any contractions. Of course, I was lying in the bed doing nothing, too. Dr Hartman said that with minimal contracting I could either choose to stay for the 12 hours until the next shot or go home and come back for the other one and be monitored again. Easily decided, we left the hospital about 1:30am and were to return again at noon. I crawled into bed with mixed feelings and emotions. It seemed like a lot of trouble, stress, and worry in the middle of the night for a few hours of nothing, really. I was slightly frustrated with the situation, but mostly grateful that things seemed to be ok. We had done what we could with the information we had. Dr Hartman was going to call in the morning and we would move on from there.
I was happy to be home when Brooklyn woke up. We told her some of what had happened while she was sleeping and as I predicted, she was very surprised. Even for her it was a little of a reality check. I took her to school, got ready for the day, and headed back to the hospital. I am appreciating more and more the fact that Brooklyn is older and in school. So much of this whole experience has included doctor visits and things that are during the day while she is in school. I can’t imagine how difficult it would be to have a toddler or baby at home and constantly be needing a babysitter. I really think it’s an unexpected blessing that has made all this possible and somewhat less stressful.
Jerry met me at the hospital. Again, we checked in and waited. While waiting we contemplated the cost of such admissions. I assumed it would be an outpatient fee since it’s (hopefully) such a short time frame, but you never know what insurance companies are willing to cover. Again the CNA took me to a room and had Jerry wait. While they were getting me hooked up to the monitors and such, Dr Hartman called my cell phone which was in my purse with Jerry. He gave Jerry all the new instructions: absolutely no less than six hours of bed rest and light activity otherwise, continue to monitor contractions at home, plan for possibly starting to see him on a weekly basis, and the next two weeks are a critical time to stay down and calm. As he said the night before, I needed the second betamethasone shot, and if there are minimal contractions after at least an hour of monitoring and the babies look good, then I can go home. This time the nurse was the charge nurse for the day, and I was impressed with her. The shot was much better this time, and she got the babies on the monitor first try. This time, with both the babies on the monitor along with the toco (to monitor contractions) she was able to do what’s called a non-stress test. This basically monitors the babies’ heart rates and responses to contractions, movement, and ‘stress.’ Of course I again didn’t have hardly any contractions, but the nurse was very impressed with the babies’ heart rates. She said they were responding very appropriately, even more maturely than their actual age, and looked picture perfect. I think she was probably trying to reassure us, but nevertheless it was good news. After about two hours and a Subway sandwich, we were able to go home.
Again, I had mixed feelings. It seemed like a lot of trouble. But, there is also no extent to which you’ll go for the health and safety of your children and loved ones. I trusted that the doctor was using his best judgment and experience to make the best decisions, too. He made it clear that although the test is not fool-proof, it is an indicator of delivery, and we aren’t ready for that. I honestly think he was surprised that it came back positive—as was I—and it made him nervous. He doesn’t want these babies to come any sooner than we do, so together we are doing what we can to be prepared and prevent an early delivery. So, I see it as a lesson in making the best decisions you can with the information you have. Not always can we predict the future, and not always are we right. But, we must be proactive for those ‘just in case’ moments when we don’t have room for regrets. Obviously I haven’t had the babies yet, and we made it through those two weeks. I’ve never been so worn out from so much lying around! It’s amazing how tired you get after doing nothing all day J But, as Jerry keeps reminding me, the little things we do now, and the more obedient we are to the doctor’s orders, may very well be the deciding factors in when these babies are born. It’s a small moment in time to make sacrifices. But, we cannot afford to cut corners now for our own convenience at the expense of a premature delivery for the babies we’ve waited so long for.
That being said, bed rest is the new norm at our house. Even Brooklyn is asking how many hours I’ve been down and tells me when it’s time to go back to the couch. I’m pretty sure the couch is getting a well-worn spot, too. It’s surprising how much planning and effort it takes to make sure I get in all six hours. Regular life things take up a surprising amount of time! Last week my mom came up to rescue me. She brought dinner, made more dinners and treats, did an amazing amount of house cleaning—including toilets and windows, did laundry, gave Brooklyn a piano lesson, taught us how to crochet, and even made time for some fun...all while I was lying on the couch. She was amazing. My natural personality is to feel guilty, and I did, but I’m definitely learning how to let things go and allow others to do what I normally do. (At least a little bit.) Again, I am so humbled and grateful for all the love and help.
Yesterday we saw Dr Hartman for the two week appointment after our little ‘scare.’ It was the 26 week mark. I passed the glucose tolerance test. We discussed the positive fFN test, the hospital events and shots, and a plan for the next few weeks. Although the first test was positive, subsequent tests may be negative. Again he gave us the options of repeating the fFN test every two weeks or having an ultrasound every week. The fFN may be more reassuring and definitive, but may also cause more stress and worry. In Hartman’s own words, “If you are afraid of failing a test, then don’t take the test.” I asked if our treatment and future plans will change depending on what we choose, and he said ‘no.’ So, although a weekly visit to the doc is a pain, we decided to do the ultrasounds instead of the fFN. We can always do the test if warranted, but either way our plan of care doesn’t change and we’ll continue with what we’ve been doing. I’ve noticed my contractions are way less when I am down. So, I am seeing the purpose of the rest. All the ultrasounds that day were good. He measured both babies; their heads, legs, abdomens, and the fluids. They are both measuring right on time and about two pounds each. They’ve moved a little bit. The boy (baby A) is head down on my right side, and the girl (baby B) is breech with bum down more on my left side. So, basically they’re kicking each other in the head. Typical brother and sister J Hartman is pleased so far with the way things look. He said we really couldn’t ask for better progress.
I think the boy is consistently more active than the girl, but it may be just the way they are positioned. Sometimes they get really crazy. I still love to feel them move. Brooklyn likes to feel them too. The other night I was laying by her at bedtime and someone was really going crazy. I put her hand on my belly and she got to feel someone playing a little ‘punching bag.’ She thought that was pretty cool. She always comes up to pat my belly or talk to them and say hi. Yesterday after I told her whose head was where, she gave them each a kiss. Its fun to see her become more and more excited. She is also such a big helper. She’s doing so much without complaining. Jerry is also taking on new roles. He’s a master grocery shopper now, and keeps telling me to make him a list of things I need him to do. He’s so supportive. It’s taking a whole family to get these babies safely here. And, actually time is going faster and faster as I think how soon the summer will be here!
