Thursday, October 28, 2010

11 Day Update

Today we took Halcyone to the pediatrician for her 1 week follow-up appointment. As Tom put it, this was more of an assurance check for the parents than a check-up for Haly! She has gained back most of the weight she lost after birth. She started at 4lb 10oz, dropped to 4lb 4oz, and is now at 4lb 9.5oz! Her doctor said this is good progress. We had to get another blood test done and got a little education on dealing with diaper rash. Other than that, nothing big happened.

The past few days have been so good, being back at home and having a little freedom. I can do so much more now that I'm not on bed rest! It was great to be able to vacuum, clean the bathroom, and make dinner this week. I've also ventured out to Target and the grocery store with Haly.

A few things Haly has done this week:
  • watched her first movie: Iron Man 2
  • rolled from back to tummy
  • got a mohawk, styled by Daddy
  • did not eat bacon, even though Daddy talked to her about it
  • went shopping at Babies R Us
  • went to church
Below are a few picture we've taken over the past few days. Hope you enjoy them!

Saturday, October 23, 2010

Here's How it Went Down

After being told on Friday that they were going to try to keep Haly growing on the inside for at least another week, the plan changed on Saturday morning. The hospital needed me to meet 2 risk conditions to consider sooner induction. I had high blood pressure that was somewhat manageable with medications, but was still feeling awful, and was having a hard time sleeping because of all the extra fluid in my neck. By this time I almost couldn't walk because all the fluid in my legs and feet meant I almost couldn't bend my ankles or knees. On Saturday morning I reviewed my insulin usage and discovered that it had been cut in half for the previous 2 days... not a good sign. This is generally an indication that the placenta is starting to shut down and stop feeding the baby as it should. When Dr. de Regt came in to check on things that morning and found out about the insulin usage, she said we needed to start an induction in half an hour.

I was moved across the hall from a smaller room to a labor and delivery room. The nurse started my IV with fluid, petocin, and magnesium at about noon. The contraction monitor started showing that I was having contractions, but I was unable to feel them. Every half hour they would dial up the petocin dose. Dr. de Regt came to check on me and suggested breaking my water at 7pm. Tom and I them started a movie, but about half an hour in my contractions were becoming pretty uncomfortable and I couldn't concentrate. Instead we went for a little walk. While it was probably helpful, it wasn't any more comfortable!

Back in our room I spent the next few hours sitting in a big purple easy chair, working through the contractions as they got more intense. It helped to have a cheery nurse who was talking with Tom about people they both knew from school. Having something to listen to with my eyes closed seemed to make the time go by faster.

Eventually I thought I couldn't handle the contractions any more and started trying to talk both myself and Tom into asking for an epidural. I didn't really want one because I knew it would be much healthier for Halcyone if I didn't get one, and the recovery would be better for me as well. I was under the impression from our birth class that if I didn't start getting sick and being unable to communicate or think well that I wasn't approaching the transition stage (8-10cm of 10 total). I wasn't feeling sick and I was still very able to answer questions and think through what I was doing, especially regaurding my insulin pump. (I opted to continue using my insulin pump instead of getting insulin through an IV for labor because I was more confident in my ability to control my blood sugar than someone who doesn't live with diabetes every day.) I thought this meant that I was no where near the peak of what the pain could be. The nurse checked my cervix and said I was at about 8cm. Tom suggested using a small amount of narcotic instead of an epidural. This worked enough to very slightly dull the pain that I didn't feel quite like I was dying every 2 minutes.

Up to this point Tom had been reminding me or checking my blood sugar every hour. So far things were going really well. My numbers were staying around 90-110. I kept cutting back my insulin rate each hour as well and was being allowed to drink juice if I felt like the number was falling too quickly. I had also been allowed to eat lunch and drink a Jamba Juice that afternoon, something I had been told would likely not happen. Apparently doctors don't like it when you have that much food in your stomach. I knew I wanted to eat because I would need the energy. The doctor told us that labor burns 1000 calories an hour and is comparable to running a marathon!

It was probably less than an hour to get from 8 to 10cm, but the last bit was hard to get through because it felt like I needed to push Haly out already. About 2am Sunday morning the nurse verified that I'd reached 10cm, they wheeled me to the operating room where Dr. de Regt was waiting. Apparently it is hospital policy that anyone at 35 weeks of gestational age or less has to deliver in the OR. They would have more room for Haly's team of doctors to evaluate her and be in the right location if at any point she became stressed and needed to be delivered via c-section. The OR was so cold and bright compared to the labor and delivery room... 63 degrees! The nurse told me they keep it that cold to keep germs from growing.

After slightly more than 2 hours of pushing Halcyone arrived! Her heartrate never got unhappy during pushing, something that seemed to surprise the doctor. The doctor let me hold her for a minute before her team of NICU help took her across the room for evaluation. Her APGAR score was initially an 8, but went up to a 9 at 5 minutes. The doctors were expecting her to need oxygen or some other sort of continued NICU care for a few weeks because she arrived 5 weeks early, but she didn't! Tom went up to NICU with Haly for her required 4 hour evaluation. He fed her a couple bottles, talked with her, and helped her get her blood sugar and PKU checks.

My doctor stitched me up and finally got my bleeding to slow down, then sent me back to my labor and delivery room. Our doula stayed with me until my mom arrived. I slept for about 50 minutes. Tom got to come back down to our room with Halcyone after 4 and a half hours. When he gave her to me she smiled when she heard my voice and we finally got a nice snuggle.

I had to stay on my petocin and magnesium IV for another 24 hours to control my blood pressure. It seemed to have stabilized, so I was discharged on Tuesday. By Friday my blood pressure was running high again, so a visit to my doctor was in order. She prescribed more medications and said to call in over the weekend if it didn't get better.

Haly's blood work showed that she had a high bilirubin level on Monday, so we ended up in the pediatric unit with her under the bili lights for about 30 hours. It was so hard to see her sad and crying but not be allowed to pick her up. We discovered she's a baby who loves to be held and suggled with. We got to take her out for about 20 minutes of feeding time every 3 hours.Haly got to leave the bili lights at 2am on Wednesday. She had a follow up blood test that allowed her to be discharged around noon on Wednesday. Along the way they discovered that one of her neutrophil/white blood cell count was super low. This meant that she was at high risk of infection. A follow-up blood test on Thursday showed that these cells had tripled. She's still pretty susceptible to bacterial infections, but at least getting better at fighting them! We had to borrow a friend's car seat that can safely hold a smaller baby than ours, but Haly passed her car seat test and we were on our way home!

It's been so nice to be at home! I realized that yesterday was the first day I've driven or made dinner in a long time! It feels so good to not be on bedrest anymore. We're both loving taking care of Haly and spending lots of time cuddling her. We thank God for her health and life all the time. She's just perfect for our family.

Tuesday, October 19, 2010

Halcyone Has Arrived!

Halcyone Marie
Born Sunday 10.17.10, 4:16AM
4 lb 10 oz, 18.5 inches

Saturday, October 16, 2010

The latest from Floor 2

It seems we are in residence at Evergreen until Halcyone arrives!

On Thursday, Stacy and Haly had a checkup.  Because Stacy's blood pressure has been climbing again, the doctors decided to keep them for monitoring.  As Stacy got settled, I retrieved the luggage packed for just such an occasion and we turned in for the night.

After a good rest, today was quite busy.  A number of care providers came and went: Maternal-Fetal doctor, Primary doctor, NICU charge nurse, Diabetes care specialist, Dietitian, and Social worker (I am probably forgetting a few...).  The most eventful thing that happened was the removal of Stacy's cerclage.  It's always exciting when a doctor says "This should be easy. Hopefully we wont need an epidural!" before you are even in labor.  Thankfully it was indeed easily removed with relatively no residual pain.  During the down time between visits from staff and family, Stacy was able to sleep a bit too!

Over the past day and a half, the doctors have gone back and forth about what course to take.  As of dinner time, we were told that the current plan was to induce bright and early in the morning, pending test results.  After the tests came in at 10PM, there was a new plan: Because Stacy and Haly are doing so well, considering, we will not be inducing tomorrow unless something exciting (read: Bad) happens.  We don't know if this mean that Sunday is a go for sure, or if we are just on a day-to day basis.  More on this as we learn of it...

Perhaps the best part of this visit has been the diabetes care. Between Stacy's diligent glucose management (much helped by assistants Dexcom and Ping), and a new draft hospital protocol, the doctor's orders allow her full management of her own care.  In the past we have had to deal with everything from being awoken every hour (or less) for a glucose check that was unnecessary due to the Dexcom, to arguing with nurses about how much insulin Stacy needs at any particular moment (not comfortable when the dose they are insisting on would cause harm).  This time she has been able carry out her own diabetes management: allowing the nurses to focus on Haly and blood pressures and Stacy to sleep/rest peacefully.  We may need to change plans quickly depending on the direction labor takes, but for now, the freedom the new policy allows has been FANTASTIC! (Can you tell I'm enthused about it?)

So, Stacy is asleep: resting up for what has been a, and undoubtedly will become more, busy weekend, and I should do so as well!


Sunday, October 10, 2010

Haly and Me

Here we are at 34 weeks!

Friday, October 8, 2010

33, Going Much Better!

This past week has been a much better week baby-wise! I got to be home all week, with 3 doctor appointments.

The current set-up is to have a beginning of the week appointment with my delivery OB, Dr. Chien, who does a non-stress test to make sure Haly is doing well. Then at the end of the week I follow up at the Maternal Fetal Medicine clinic for an ultrasound, another non-stress test, and a doctor chat. This week I also had my third trimester eye check to make sure I'm not showing any signs of diabetic retinopathy, and I'm not! The doctors are now saying they will induce me at 37 weeks if Haly isn't here by then and that if I go into labor before then, they won't try to stop it again. I'm back on bed rest because my blood pressure is still being a little silly and to help minimize the foot swelling. So far it hasn't been bad. I've been working on a few sewing projects, the same knit sweater I've been plugging away at for the last 4 months, and putting together our baby announcements and Christmas cards. Below is a picture from today's ultrasound at 33 weeks, 6 days.

Last Saturday my cousins threw a fun baby shower for little Halcyone at my Mom's house. Haly is going to be one well-dressed little newborn! She also got her first doll from my Grandma.

Friday, October 1, 2010

What a Week 32 Has Been...

Last weekend marked the start of week 32 for baby Haly. It also became the start of a few multi-day hospital stays! On Thursday when I went in for my maternal-fetal-medicine appointment everything looked great except for my blood pressure, which was a little on the high side. The doctor I saw prescribed a medication to reduce both blood pressure and stop contractions that I may have. I started the medicine on Friday night and woke up Saturday with a horrendous headache and pain in my eyes that made it feel like they were going to explode. We called our doctor who said to go to the hospital and get checked out by labor and delivery since headache, eye pain, and my (still) high blood pressure are all signs of preeclampsia.

While I was in the triage area they hooked me up to a contraction and baby heartbeat monitor. Haly's heartbeat was happy, but at some point I started having contractions that I was not able to feel. They decided that since most of the blood pressure and anti-contraction medications are not great for a diabetic they would give me an IV drip of magnesium and start the 2-injection course of steroids to help develop Haly's lungs in case she came early. They also gave me morphine to help control my headache. That magnesium is some crazy stuff! They started me off on a big dose that helped get things under control, but also made me feel super warm and rubbery. I could hardly walk a couple steps without help for the next few hours and needed a fan blowing directly on my face from a foot away.

On Sunday morning I started having contractions again, although I was able to feel them a little this time. They decided to give me another bolus of magnesium and finish the lung steroids that afternoon. Because of the fuzziness the magnesium gave me, I can't remember exactly when, but at some point they became concerned about how dynamically Haly's heartbeat would change. They decided on Monday to keep me so they could continue monitoring her.

By Tuesday I was starting to feel a little more "normal" and they were happy with where my contractions were at, my blood pressure, and Haly's heartbeat. They let me go home! However, I started having regularly timed contractions that evening that were getting more intense and had to go back to the hospital. The contractions continued getting worse for about 7 hours. The doctor on call determined they weren't really doing anything and that it would be best if I could sleep. He gave me some sort of relaxing drug and morphine. I did sleep as the contractions started to ease up.

On Wednesday they did an ultrasound and decided they were right about the contractions not doing anything even though I was still having them. They put me on another form of the same medication for blood pressure and contractions that initially gave me the massive headache, but kept me to make sure I wouldn't react negatively.

On Thursday I got to go home again! That night was a success; far fewer contractions, lots more sleep, and better food! I'm back on bedrest to keep my "irritable uterus" happy. (Yes, that's really what they call it!)

Today I went in for a maternal-fetal-medicine check-up. Again, my blood pressure was a bit elevated, but everything else looked great! They asked me to increase my medication and keep checking blood pressures at home. Now we're hoping to get through the weekend without incident. One of my doctors said our goal should be to get Haly to at least 35 weeks. Below is one of the pictures from today's ultrasound. The tech says Haly has chubby cheeks and hair on her head! She's estimated to weigh about 4 pounds and 3 ounces. Thank you to everyone who has been helping us and praying for us!