Monthly Archives: December 2012

Day 17 Update

29 Saturday Dec 2012

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On Christmas Eve, I got the news that baby B was so stable I would only need ultrasounds on Mon, Wed, and Fri. That was some of the most reassuring news I had gotten since I arrived in the hospital 17 days ago. While the doctors are confident at some point the condition would get worse, they didn’t feel it was going to happen real soon.

To my surprise and ultrasound tech stopped my room earlier today. For a moment I was questioning what day it was. It is easy to loose track in here. But, then I recalled I did in fact have an ultrasound yesterday and it is Saturday. I told her I was surprised to see her and asked had the orders changed? She said officially, no, but she had to come up here to scan another lady and was told to scan me while she was here.

I am a firm believer that things don’t just happen by chance, and that everything happens for a reason.

Every ultrasound makes me nervous. In the back of mind I am always wondering is this going to be the one. The bad reading. The one that determines if I have to deliver the babies. She began the scan- heart rates look good, fluid levels look good, they are very active, all good signs and consistent with all my other scans. Then she asks, ” I thought baby B was the one with absent flow, I must have mis-read your chart.” I confirmed baby B is the one that has been absent. She scans over to baby B, then back to baby A, back to B and back to A once more. While she was scanning, the only thing she said was hmm.

Hmmm, really, not the reassuring comment I was looking for. She finished the scan and told me that it seems both babies now have absent flow. I asked if baby A’s was intermittent or completely absent because yesterday it was normal? To me it seems like a big jump to go from normal to absent bypassing the intermittent phase. But, she confirmed it is completely absent. Both babies scanned exactly the same.

So, now I sit and wait for both the specialist and my doctor to come see me later today and give me their thoughts on the new situation. I know it doesn’t mean delivery, at least not today. Neither baby showed any sign of reversing or any signs of distress. But, I can’t help but feel a bit uneasy. I really need them to hang on for 2 more weeks so I reach the 28 week mark.

Absent End Diastolic Blood Flow

26 Wednesday Dec 2012

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I have spent 14 days on hospital bed rest now. And, I can honestly say I have only had one bad day since my hospital stay began. I have tried to remain focused on the babies, but day 8 sucked. It dawned on me that I had been here for over a week. It was only days until Christmas; the time of year I would typically be running all over town finding the perfect last minute gift or at least at home enjoying my Christmas decorations. But, instead I was stuck in a hospital bed; all of my independence gone. My breaking point was when they came to change my IV site (they relocate the IV every 3 days) and decided to put it in the bend of my elbow. I had already had it in my hand, my wrist, and my forearm, so elbow was next. The problem with that spot is it doesn’t feel like you can bend your arm. Luckily, the next day the IV came out. They can always put it back if I need it in the future. Since day 8, I have new level of acceptance for being here.

On Christmas Eve, the labor and delivery ward was very slow, so the nurses decided to take Chris and me on a tour. First stop the NICU. While I know there is little doubt that the babies would end up there, I was surprised to find out the nurses all knew who I was, how far along I am and that I am carrying twins. They took us straight over to the” Giraffe” which is an enclosed incubator that they use on extreme preemies. They explained all that it did as well as other equipment that might be hooked up to the babies. Numerous times while discussing processes and procedures they used the term extreme preemies which lead me to ask, what causes a preemie to be classified as extreme? The answer: a baby born on or before 28 weeks or that weighs less than 2.2 lbs.

The next stop on our tour was the mom and baby ward, followed by the operating room. There is a specific OR designated for multiples. They explained in the room each baby would have a nurse as well as the neonatologist, the doctor would have a scrub nurse or 2, of course the doctor, I would have a nurse, the anesthesiologist, Chris and me. That is way more people than I thought would be in the room during my c-section, not that that is a bad thing.

On Christmas, we talked to a lot of family and friends. There were 3 questions that were asked most frequently. 1) How do I feel? Minus being a little stiff from being in bed so much, I feel perfectly fine. 2) Do you really have stay in the hospital until you have the babies? That is a very understandable question considering my “twin due date” isn’t until March 10th. Yes, I will not be going home until after the babies have arrived and the closer to March to better! 3) Why are you in hospital? I have a condition called Absent End Diastolic Blood Flow. It isn’t the easiest condition to explain, but I found an explanation online from a nurse at the Texas Children’s Fetal Center that explains it much better than I can.

“The blood flow in our bodies continues to move forward when our heart is not beating (Diastolic). The placenta works like a pumping mechanism. It provides a closed loop circulation between the baby and the placenta…used blood moves from the baby to the placenta, it then picks up nutrients and is cleaned and then returns to the baby. Doctors look at 3 measurements in a fetus to determine fetal well being… the cord Doppler’s are one of those measurements. When their heart beats and there is a balance of pressure between the baby and the placenta on relaxation of diastolic, blood continues to move forward, when the placenta is working really hard to get that blood flow back to the baby it may appear absent in forward flow. It should be considered a yellow flag… it is concerning but just needs to be watched. When it reverses it is a red flag and is very concerning.”

My Doppler readings on baby B have varied between intermittent absences and absent (mostly absent, but no reversing). I have learned they measure in 3 places along the cord; at the placenta, mid way, and close to the babies’ abdomen. They also check for other signs that would indicate baby B isn’t getting everything he needs. They look for activity level. My babies have no issues there; they are very active babies. They look for amniotic fluid levels, again no issues. And, they frequently monitor the babies’ heart rates. Both babies’ heart rates are in the 150s and 160s. All in all, I have very healthy babies. They just need to continue to cook for a bit longer!

Home Away From Home

15 Saturday Dec 2012

Posted by in Hope, Pregnancy, RAINBOW BABY

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Every pregnancy comes with milestones; hearing the baby’s heart beat, the end of the first trimester, feeling the first kick and so on. I have been anxiously awaiting yet another milestone- twenty four weeks. Twenty four weeks hold a lot of significance for me. It is the point in pregnancy in which medical science has determined a baby can survive outside the womb. In high risk pregnancies, you will hear it referred to as V-day or the point of viability. But for me, it is also when I lost Ansley.

This pregnancy has not been an easy one for me. I haven’t enjoyed it the way most expecting mother do. I haven’t started working on the nursery or shopping for the babies. We haven’t picked out names, or talked about plans for the future. Chris and I decided early on once we hit 24 weeks, we would get started on planning for the babies. But the idea of planning and verbalizing hopes and dreams before that point was too scary.

Today, I am 24 weeks. This day comes a relief and a reminder. Each day from this point forward is a new day, one I didn’t experience in my pregnancy with Ansley. A painful, yet comforting thought all at the same time.

I know this pregnancy will have a better outcome. I have said all along they are watching me closely. Closely, took on a whole new meaning Wednesday evening. Twelve, Twelve, Twelve, the day I was put on hospital bed rest for the remainder of the pregnancy.

I will spend, what hopefully will be, a very long time in this hospital room. My current goal is 28 weeks, January 12th to be exact, but I am pulling for something closer to Valentine day. Christmas will be a little different this year, as will New Year’s, I will miss seeing my dog, sleeping in my bed, and enjoying the outside. But, in the grand scheme of things, all minor sacrifices in hopes of having 2 healthy baby boys.

The reason for the hospital bed rest is a little thing called intermittent absent diastolic blood flow. What that means is when my heart is pumping, baby is getting blood and when my heart is at rest (in-between beats) the blood should continue to flow through the umbilical cord to the baby. But, sometimes, for some reason, it cuts out for a second. While this sounds problematic, it really isn’t. I have a very minor case which isn’t affecting the baby in any way. But, with my history, my doctors decided it wasn’t worth taking the chance. HELLP syndrome is linked to a weak placenta and this condition is also linked to a weak placenta. In the event it gets worse, and turns into reverse blood flow, it could cause some distress to baby. The level of distress would determine if we would have to deliver, so that the baby could get the medial intervention needed. There is equally as likely of a chance that it will not get worse or it could possibly resolve all together. There are a lot of unknowns, so we are taking the better safe than sorry approach.

The other benefit to being in the hospital is the frequent testing for me. When I developed HELLP syndrome, it came on quickly and without normal symptoms. This time, should I start to develop Pre-Eclampsia or HELLP, we would know very early.

Much Ado About Nothing

06 Thursday Dec 2012

Posted by in Pregnancy, RAINBOW BABY, Uncategorized

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I know I am probably in trouble with a few of my friends and family members for neglecting to share a little detail about my week.  My intentions were good, no need to alarm anyone, but it is amazing how “things” have a way of getting out.  (For the record, we did tell our parents.)

On Tuesday, I had my routine visit with the specialist.  I thought the visit was going very well.  During the growth scan, they were able to see everything that was not clear a month ago.  The babies were incredibly active.  In fact, it was as if we were watching a WWE wrestling match.  Ahhh, the things I have to look forward to with two boys.  They are at it already!

The ultrasound tech wrapped up and soon thereafter the doctor entered the room.  She said they were able to see pretty much everything they needed to; but, at the end of the scan they used the Doppler to check the blood flow through the placenta, to the umbilical cord, thus to the babies.  Baby A had normal blood flow, but with Baby B they couldn’t find what they were looking for. They referred to this as absent blood flow.  Clearly, it wasn’t totally absent since the baby had a good heart beat, but it was reason to cause concern.  She said that, coupled with my occasional shortness of breath, was leading her to think she might need to send me to the hospital for more tests.  She told me she was waiting on my primary OB to call her back to get her opinion.

Just then the nurse let her know my doctor was on the line for her.  I looked at Chris and said, “looks like we are going to the hospital.”  I knew my doctor, who has been very cautious with me, would not bat an eyelash at sending me.

Sure enough, moments later I got my confirmation.  The only way they could get the tests they want and get them in the timeframe they needed, was to admit me.  So off to the hospital we went.

It was a little creepy when they opted to put us in the exact same room I was in with Ansley, but a room is just a room.  When the nurse staff realized it was the same room, they quickly offered to change my room.  At the end of the day, they all look the same.

Over the next 30 hours, I had countless tests run, including another ultrasound looking at blood flow.  The second ultrasound offered much better results and every test they ran on me came back problem free!

Both babies are on the small side, especially Baby B, so they are going to continue to watch me closely. They also decided it was time for official bed rest not just work from home status.  Guess I will be doing my Christmas shopping online.  But, all in all, the trip to the hospital confirmed so far everything is looking good.