Sunday, early evening we ( Noel, Aubrey, Nick, Nikki, Caroline and myself) got back from San Antonio. Aubrey and Noel had driven together and had unloaded a lot of gifts for us in the spare room. Aubrey had to get home because she had an interview the next day, and Noel stayed at the house and waited for the rest of us. Nikki and Caroline took off shortly after we unloaded the car. Nick went to one of our favorite places, Velvet Taco and picked up dinner for the three of us. We ate dinner and then Noel headed home.
We found out a short time later that our good friends Whitney and Clay had just had their son, Gunner. Nick and I were trying to decide on when a good time to go visit them would be. Gunner had decided to make his debut 5 weeks early! Little did we know we would get to see them all sooner than we thought !
Nick and I vegged out in front of the TV for a while and then I asked him if we could please unpack. Nick will stay packed for a few days while I want to start washing my clothes and have everything in its spot the minute I get back from being out of town. Luckily he was on board. We unpacked and started a load of laundry.
Call it intuition, but I told Nick I felt like I needed to pack a hospital bag "just in case". So I took one of the bags that we had used in San Antonio and threw a few things in there. I threw in some pajamas, t-shirts, panties and my overnight bag. I remember thinking to myself that packing my bag would be my project for this week.
We retired to the couch once again and began watching Big Brother. Aubrey got us into it last season and now I love watching it! Anyway, while we were relaxing, I noticed that I was contracting. The longer I sat there, the stronger they became. I started looking at the clock in an effort to see how far apart they were. I didn't say anything for a while and had Nick bring me a few bottles of water. I chugged the first 2 bottles and then sipped on the 3rd. I finally spoke up and told Nick that I had been contracting every 5 minutes for the last 30 minutes. We decided that we would wait it out a little longer before calling the doctor. As the hour ticked on, the contractions stayed steady at every 5 minutes. I called my doctor and he told me to take a warm bath and some Tylenol. I did as I was told and the contractions spaced out to every 10-15 minutes. Nick and I got into bed thinking it was just a little scare. Within 10 minutes of laying in bed, the contractions picked up again and were once again every 5 minutes. We waited 30 more minutes and then called Dr. G back. He said to go ahead and go in to get checked out. By this time it was a little after midnight. When Dr. G told me to come in, I lost it. I had just turned to 24.0 at midnight (it was now Monday). All I could think about was, what if they have to deliver me. It's too early. There is a strong possibility that my sweet baby boys that we had worked so hard for and that are so loved, may not make it. I may be delivering and coming home without my loves. I was a mess. Nick did his best to calm me down. He kept telling me that this could be a false alarm and we would be right back here in our bed in just a few hours. As much as I hoped and prayed that he was right, I knew in my heart of hearts that this was real.
We got to the hospital around 1230 on June 30. I signed in and was taken to a room by my nurse, Leslie S. I changed into my hospital gown, left a urine sample, filled out paperwork, and answered my admission questions. I was placed on the monitor. Both babies were very cooperative ( praise The Lord) and my toco ( contraction monitor) showed that I was contracting not only every 5 minutes, but every minute- I just wasn't feeling the little contractions.
I tried to blur this for HIPPA purposes. In between the red lines are the babies heart rates and the bottom wave like pattern are my contractions.
Dr. C came in, did a fetal fibronectin (fFN), a test that can tell us if I am going to deliver in the next 2 weeks. She then checked my cervix. I was dilated 1 cm. I knew my fate at that point and Dr. C confirmed what I suspected. She looked at me with the sweetest eyes and said, "Tiff, we are going to have to mag you". I nodded my head "yes" and said, "I know. Do what you have to do". Dr. C and Leslie left the room and I explained to Nick what was about to happen. I told him that "mag" (magnesium sulfate) is a smooth muscle relaxer that is given to stop preterm labor ( it is also used with high blood pressure). I explained that I would get two steroid shots called betamethasone to help with the babies lung maturity. I tried to warn him that the mag would make me really hot and sleepy and that I would probably be really out of it. I would more than likely slur my words. I would also have to have my blood drawn every 4 hours and I would have a catheter because they would be keeping a close eye on my kidneys. I also told him I would be on antibiotics as a prophylactic treatment. Nick was great. He asked appropriate questions and was so attentive to me.
Leslie came in a few minutes later and attempted to start my IV. She missed the first time and then ended up going in the same vein the second time. She got my mag started. I got a 6 gram loading dose that was administered over 20 minutes. I may be the only person in history who was begging for my catheter. I was so hot and nauseated and I really needed to use the restroom. Leslie was kind enough to use lidocaine jelly but I honestly don't think that it would have made a difference for me. It was uncomfortable but not terrible. She then started me on my antibiotics. I was to receive Ampicillin 2 grams every 6 hours. She then started my maintenance dose of mag ( 3 grams an hour). Within a few minutes I was already starting to feel a little bit better. I was given my steroid shot after having my hinny numbed with some ice. By this time it was a little after 2 in the morning. I told Nick that we should try to sleep and that I would call my mom first thing in the morning. I didn't want her to rush up to Dallas in the middle of the night, especially since she had had guests all weekend and at the time, we were stable.
At 6, I called my mom and explained to her what was going on. She was not too thrilled with me that I had not called her sooner, but I explained to her that I did not want her rushing up here sleep deprived and if she didn't come, I didn't want her up all night worrying when there was nothing that she could do. She then asked me if it was because of all the activity this past weekend at my shower. I told her I didn't think that had anything to do with it. My uterus just decided that it wanted to contract. I also explained what a fFN was and told her that it had come back negative, meaning the likelihood of delivering in the next 2 week was slim to none. I think this gave her some peace of mind. I know it did for me. Mom wanted to come up right away but I told her we were fine. She told me that she and my dad would be driving up first thing Friday morning. Sounded like a plan to me !!!!
My best friend Jenny was my nurse Monday. She also had a natural patient and was a busy lady most of the morning tending to her. I was turned over to my sweet friend Leah, who has always placed her hands on my belly and blessed the boys anytime we have worked together. She was able to get me into the normal hospital bed Jenny had ordered for me (as opposed to a labor and delivery bed which breaks apart). She was also able to move me to a different room with a window since I was more than likely going to be indoors for quite a while.
Everything is kind of a blur but I remember complaining that I really, really, REALLY wanted to wash my hair. I had not washed my hair since Friday ( it was now Monday) and it was bothering me. Shawna was in charge that day and I mentioned it when she was in the room. She went up to AP (antepartum) and got me a shower chair. Leah and Nick assisted me to the bathroom and Nick washed my hair and helped me bathe myself. That was something I didn't think would happen until we were old and gray. I changed into a new gown and felt like a new woman ( well as much as you can on mag)!
Me and Leah
When it was time to draw my mag level for the third time, I was done. The first blood draw was by the phlebotomist and she completely blew my vein. My mag level was high, 7.6, but they kept me at 3 grams. Jenny got my second one no problem. My mag level was high once again and I wasn't really able to focus on anything, so they turned my mag down to 2 grams/hr. By my third one, I had no veins. Poor Leah tried twice. Once in my hand and once in my foot (Per my request) with no luck. I asked her if she would have anesthesia come place a saline lock and I could just be a nurse draw from here on out. Sweet Dr. Gerard came in and even he had a challenging time placing my saline lock. Normally we try to avoid the AC (antecubital- the bend of your elbow) but that was all I had. Thankfully he got it and it made life so much easier - at least for me ;). Leah was able to draw from the saline lock and my level was once again high. I believe it was 6.8. They turned my mag down to 1.5 grams/ hour.
When Jenny was finished with her delivery and lunch she came back and took over again. At this point, with the mag being lower, I was a lot more alert. I was also I aware that I was contracting more. Unfortunately that meant that the mag had to be turned back up. So Jenny turned it back up to 2 grams/hour.
I remember Jenny being in the room and I remember looking over at my fetal monitor strip and seeing that the babies were having what we refer to as late decelerations in their heart rates. This is not a good thing and means that the placenta is not being supplied with the appropriate amount of oxygen to supply the babies with everything that they need. I turned onto my left side to help perfuse my placenta with more oxygen. Jenny told me that this had been going on for a while and I remember begging God to make the lates go away. I know that there is only so much time that we can allow this to happen. I prayed for peace and for the health of the boys as well as for myself. That I would give it all up to Him.
With the mag back up to 2 grams/ hour, me on my left side ( and multiple prayers), the lates resolved (praise The Lord ) and we were watching the hours slowly pass by. I drifted in and out of sleep as did Nick.
Jenny volunteered to go by the house and grab some things for us and she offered to bring me a plug in for the room to make it more like home. I'm so grateful for this and Nick was able to stay with me.
Leslie J ( LJ) was my nurse that evening. She is one of my favorite people and I was so glad to see her face! I had not had anything to eat in over 24 hours and quite frankly had never really been hungry. They had been bringing me clear liquid trays all day and I would have a sip of broth or a bite of jello here and there but nothing sounded or tasted good. For some reason that evening I suddenly wanted ice cream. Nick went with Clay to have dinner and he brought me back a little container of blue bell vanilla ice cream. I was so excited. I ate half of it and was full. It may have been the best ice cream I have ever had.
We had a few visitors that evening. I wish I could remember it all but it's all so hazy to me. I remember Clay stopping by after they ate dinner, and I believe our friends Eric and Katie swung by too. Nick's brother Brent ( my BIL) and Aubrey ( SIL) stopped by after visiting Clay, Whitney and Gunner. I believe that's all who visited the first night.
Later that evening, my restless leg started to kick in. Mind you I have now been in bed for almost 24 solid hours. I began crying because it was so bad. Sweet LJ tried a lot of different tricks. She went and got me SCD pumps for my legs which just ended up irritating me even more so we ditched that idea. Then she came up with a plan that truly made my night. You see, every time I start to get uncomfortable at home, I always take a bath which seems to help for a little while. Since that was not an option due to the mag, LJ did the next best thing. She went and got a basin, filled it with hot water and brought it into the room. She then got me up out of bed and sat me in a chair. She took me off the monitors and let me sit in the chair with my feet soaking in the water. This was exactly what I needed. A little break from the monitors and relief for my restless leg. She truly went above and beyond. I hope she knows how truly grateful I am for this.
Obviously she could not have me off the monitors for very long which I know and understand. We got everything in place and I once again got situated in bed. After that it was lights out. Nick was exhausted and so was I. I remember LJ coming in and doing my mag checks, replacing empty bags, and drawing my mag levels, but I was pretty zonked in between. The only time I really woke up was for my second dose of steroids. Ouch!
Around 6, I was awake for my mag check and blood draw so I texted Jenny and asked her to please bring us a Starbucks. My good friend Whitney G snuck in on her way to work and brought us all kinds of goodies. She brought central market muffins which I fed to Nick, Jenny and Dr. G, magazines, flowers and my favorite mango habanero frozen yogurt from Yummilicious. I was a little out of it when she stopped by but it was so good to see her and so thoughtful of her.
Jenny brought me my favorite, a tall skinny vanilla latte and Nick had his plain jane cup-o-joe. I literally sipped on my latte for hours. That is so not normal for me! Jenny was able to spend some time with us that morning which is very unusual in that it was July 1. Anyone in the medical profession knows that this is a stressful day for every hospital because it is the day that we get our new interns. When you work in labor and delivery it is also stressful because July, August and September tend to be our best months and our new residents are trying to learn the ropes. I'm pretty sure they were told not to come check on me because I had nothing but upper level residents all day.
Throughout the day we had multiple people come in and out as they were coming to visit Clay, Whitney and Gunner. It was so nice to see so many friends and know that they were thinking of us and praying for us. Everyone was so thoughtful bringing us flowers and magazines and entertaining us for a while.
As 1400 (2 pm ) was approaching, I was getting anxious. My mag was to be turned off at 2!!!! It couldn't come soon enough. About an hour before the mag was turned off, I was given a medicine called Nifedipine which helps my uterus to not contract. We were so excited when the mag was turned off but no one was more excited than this lady !!!!
Mag is off!
I was finally able to eat. Of all the things I could have chosen, I asked Nick to go get me a grilled cheese sandwich and "lots of pickles" from the cafeteria. He got me that along with some chicken noodle soup and some more blue bell :). I ate half of my sandwich, a lot of pickles and some soup. Nick put the ice cream in the freezer for later. I was beginning to feel a lot more like myself.
The plan was that the MFM doctor would come by for an ultrasound and they would watch me on labor and delivery for a while to make sure that my uterus was behaving. I would go to AP (antepartum) later in the evening.
Around 5, one of the MFM doctors, Dr. Magee came in to do an ultrasound. He never said a word about the EIF on baby A. I honestly don't think he even saw it. Nick and I were both looking for it and didn't see it either. He did however find that both the boys had something called polyhydraminos (also called poly). Poly is defined as excessive accumulation of amniotic fluid which could have been part of the reason that I was contracting. It can sometimes cause an over distention of the uterus. Poly is difficult to assess in twins but from what I understand they like the pocket that they measure to be below 9 and both of the boys had a little above 9. Dr. Magee wanted to check a blood sugar so Jenny went and got the glucometer. My blood sugar was 140. This is not abnormal due to the fact that I had just received steroids and had just finished eating.
It was shift change before we knew it and sweet Erin became my nurse. I got up, showered, and noticed that my left leg was super swollen. My right leg looked completely normal but the left leg looked like it belonged to another person!!! Erin measured it with a measuring tape that we usually use to see how long the babies are. My left leg was significantly bigger. I did not have any pain in my calf and my calf was normal size so I didn't think it was a DVT but it freaked me out. Erin ended up paging Dr. G to come check on me. He came in and evaluated me and told me it was probably just fluid accumulation from laying on my left side for so long and It should go away as I urinate all the extra fluid off. I was relieved to hear this but still freaking out internally. I have never seen this from any of my patients before. I would be the oddball!
Multiple friends stopped by. Nikki came and brought me a bunch of my favorite things. She knows me so well! Brent, Aubrey, and Noel came too. Aubs brought me Dasani ( the hospital water is disgusting but I love the ice!) and some snacks as well. We sat around and chatted for a while as I waited for my AP room to become available. When it was ready, Erin brought us a cart that we loaded up! We said good bye and good night to everyone and headed to AP.
Janet was my nurse on AP. We got settled into our much smaller room and got ready for bed. We were both exhausted. Nick had had a couch to sleep on in labor and delivery and now he was downgraded to a chair. Luckily the man can sleep anywhere and doesn't really complain.
There was not a whole lot of sleeping going on, at least not for me. I could not get comfortable to save my life and it felt like every time I finally did fall asleep, someone was coming in to check on me or to take my blood pressure and give me my nifedipine which I was getting every 6 hours. I was tired and frustrated but I knew everyone was just trying to do their job.
The next morning, I got up around 6:30 and went to the break room and made a pot of coffee. I then walked back into the nurses station and chatted with all the girls - oh and they gave me a bag of my favorite creamers for my coffee. :).
Beth was my nurse that day which is crazy because I delivered her little girl a few years ago. It was coming back full circle! I asked her if I could be put on the monitor and get that done with first thing in the morning. Most people on AP want to sleep so monitoring does not start for forever. Not for me!! I wanted it done before I started contracting again. I had started to notice that about an hour before my nifedipine was due, I would begin contracting quite a bit.
Nutrition dropped off a menu and luckily I am familiar with everything and asked if I could please have the alternative menu. This lets you pick from more of a variety of foods because hospital food is just that - hospital food. I also found out by talking with my sweet friend Lauri who had been on AP for a long time with her kiddo, that it's all one charge so I may as well order enough food to feed Nick too.
The day was spent with what felt like a hundred people coming in and out. There was occupational therapy, nutrition, physical therapy - you name it, they probably stopped by. I was getting very overwhelmed and frustrated because these were all people I have worked with multiple times before and no one seemed to recognize me. I finally just started saying no thank you to stuff and asked if people would please stop coming by. I was done. All I wanted to do was write my thank you notes for my shower the weekend before in peace and quiet.
Nick went home and grabbed a few things that I had asked for and some stuff that he needed. One great thing I had gotten from the many people who had been in throughout the day was to get in a routine and make your bed daily. I am a HUGE proponent of making your bed. In fact I always tell Nick that if my bed is not made, I have a bad day. It's true for me anyway! So I asked Nick to bring a Tech blanket we have and that was going to be my bedspread. I also had him bring some of my snacks I like and some additional toiletries.
That evening, a few more friends stopped by. Clay, Whitney and baby Gunner had to stay because Gunner had jaundice and needed to be under the lights so that meant more visitors for us too which I loved. As it got later, Nick and Clay decided that they wanted to play cards so they met up in the conference room and hung out. Nick needed that and I was very thankful their family was there even though I knew they would rather be at home.
Jackie was my nurse tonight and I absolutely adore her. I asked for ambien and slept a little bit more than I had the night before. I was still woken up for blood pressures and nifedipine, but it was better.
I got up around 6:30 and made another pot of coffee and came back to my room. Much to my surprise, the tech was there telling me to empty my bladder because I was going to have a sono. I had been told my sonos were going to be Tuesdays and Fridays but since the next day was Friday and a holiday (4th of July ), they were going to do it today.
I emptied my bladder, woke Nick up, and got in the wheelchair to go to the sono room. Dr. Yost was there with her NP, Alan. I got undressed because they wanted to do a cervical length as well. During the sono, the fluid was about the same around the babies so I was still poly. She checked my cervical length and it was still good- 3 cm when I wasn't contracting and when Dr. Yost applied a TON of pressure, it only went down to 2.7. Because there was still additional fluid and the babies, Dr. Yost wants my blood sugars checked fasting, and. 2 hours post perennial (after meals). We skipped the fasting one for today since I had already had some coffee with creamer and fruit.
We returned to the room and I had a mini breakdown. I had been hoping and praying that the poly would be gone and I really did not want to have to have my finger pricked 4 times a day. The needles the hospital uses hurt ! It's not like the glucometer you can buy at the store that barely pricks you. Nick was great and he was able to calm me down. I know it's not the end of the world and I will do anything to make sure the boys are ok. I just needed a moment.
People continued to try to come in and I finally asked Beth, who was my nurse again, to please tell them to not come in. I told her that if I wanted to do anything, I'd let them know. Especially since we had a lot of visitors throughout the day. Beth completely understood and no one came in after that..
Nick went to the gym and home to work for a little while . I had my second d-stick (glucose check ) 2 hours after lunch. It was 79. My first d -stick after breakfast had been 85. So far so good !!!
Dr. G came by after his office and let me know that Dr. E would be on for the weekend and would be rounding on me. Dr. G was off for the Fourth of July. I asked him how long I would have to get my blood sugar checked and he told me at least through the weekend. Boo.
Nick and I went and visited with Clay, Whitney and Baby Gunner. Whitney was a gestational diabetic while pregnant and had her glucometer with her. She let me borrow her machine because the part you stick with doesn't hurt nearly as bad as the hospital one does. I can't even begin to tell you how thankful I am for this !
- Posted using BlogPress from my iPad
No comments:
Post a Comment