Bed Rest - 29 weeks (The long version)

What a crazy few days! Seriously a week of roller-coaster emotions.

On Wednesday night, we had gone to the 4-d ultrasound. It was fun and really neat for Geoffrey to actually see the baby - it was the first time he really seemed to get it and connect it. You can see pictures at http://grantandbobbi.shutterfly.com/ or watch the 12 minute you-tube video here: You Tube ultrasound video

I was so excited to go to my Thursday doctor's appointment. I was anxious to see how everything was progressing - this pregnancy was feeling more and more real to me. I was also eager to really talk with Dr. Hargrove, my new OBGYN, and get a good feel for her. Plus, I had an ultrasound scheduled, which is always a nice treat.

I messed up my appointment times, though, and came in 30 minutes late, missing my ultrasound appointment. (I thought my appointments were at 4 and 4:30, they were actually at 3:30 and 4:00.) So I saw Dr. Hargrove first, before my ultrasound. I REALLY got a good vibe from her. She had read my file thoroughly and new all about my first pregnancy, and when I discussed my feelings on delivery she was very open and understanding. I got a wonderful warm feeling from her - and she is a hugger, too, which I of course LOVE.

I went in to do my ultrasound. The main purpose of this ultrasound was to see if my placenta hat moved - I had marginal placenta previa, which meant it was very near where my cervix would open. Right off of the bat, the cervix was 9mm away, which was excellent. She took a few more measurements and then said I could go empty my bladder (which I had been holding since 3:45 for my ultrasound!) When I came back in, she said she had noticed some cervix thinning and wanted to get a better look, so she did a vaginal ultrasound, and discovered that my cervix, which at this stage should be roughly 30mm (3 cm) was at5-6mm (1/2 a cm). Apparently this is not good.

She went to give the results to Dr. Hargrove, and came back to tell me that Dr. Hargrove was going to call Dr. Feldman and then come in to see me. They finished the regular ultrasound - which was all good news - plenty of fluids (14 mm, the goal is 10 - 15) and baby's measurements were all between 50-65% for the gestational age.

However, I could tell that something wasn't exactly right. FOr example, when she finished the ultrasound, the technitician told me to stay on the table - laying down - while I waited for the doctor. Still, as I sat there thinking, I figured that I would get some serious instructions, convince them I would be careful at work the next day, and come in for further testing the following week. Um... no.

Ultimately, it was a good thing that I missed my appointment time and saw Dr. Hargrove first - getting to meet her and have such a positive, reassuring conversation was a much better way to start our doctor-patient relationship then the next conversation would have been! (Plus, it was reassuring to here that she had consulted with Dr. Feldman as well.)

So, with my cervix being "shortened" the concern was of my going into early labor. So the office had already called Hoag, who was expecting me to check in - today. Straight from the doctor's office. I was to go on immediate hospital bed rest while they ran further tests and prepared for a possible premature delivery.

Dr. hargrove said that the good news was I was 28 weeks and six days, and the magic number is 29 weeks - that is good news for preemies. Also, all measurements were looking good and I hadn't had any bloody show or contractions and I was feeling good - although the hip and lowerback pain could be a symptom of the shortened cervix as they hips and back were helping to support the weight of the baby. Still, it was possible that I could be in the hospital until the baby was born, or at least until 35 weeks or so when preemie risk was pretty much not a worry.

In the hospital, I would recieve two steroid shots 24 hours apart, designed to boost the baby's lunch, intestine, and brain development in case of an early delivery.

In addition, I was to have another exam (FFN) that looks for a protein that becomes present in the vagina prior to labor. This test is only useful if the results are negative - if the protein is not present, then the likelyhood of my going into labor in the next two weeks are slim to none. If the results are positive, it is not particularly useful because that means I could go in to labor tomorrow, or in 11 weeks. It doesn't say much. They couldn't give this test for 24 hours, however, because of the vaginal ultrasound, which could inadvertently trigger some of the protein, so they need to give it some time to clear out.

I left the doctor's office a mess. I hadn't seen Geoffrey all day. I was going to the hospital - possibly until January. I hadn't been to the classroom since Tuesday because I had a training on Wednesday and Thursday, and I couldn't even make sub plans. I couldn't even say goodbye to my class. I called my dear friend Cathy, who scheduled a sub for me and wrote my sub plans. We stopped by home and I saw Geoffrey for about five minutes while we explained to Donna what was going on. Then we headed to the hospital.

The lady at the registration desk was very soothing, and as I was being registered, who should walk by but Dr. Feldman. Just seeing him made me feel better. He told me he would come visit me later. Once registered, I was wheeled down into my room where they asked more questions, got me changed into my lovely hospital gown, etc. I was checking in at a shift change so things were a little weird at first, but once the night nurse came in and started explaining things, it got better.

I was given my steroid shot.

Dr. Feldman stopped by. He explained that the last patient he had that had this discovered it at 25 weeks. SHe stayed hospitilized until 32 weeks and then went home and delivered at 39 weeks. He reexplained about the steroid shot and asked how I was feeling, and said that he would be in the hospital the next day and would stop by to see me. (o:

I was put on a monitor to check for contractions - this stayed on for my whole hospital stay except for my shower. They also did an hour of fetal monitoring, which looked great - the heartbeat is strong, lots of baby movement.

Grant went home during part of this to get me clean clothes, toothbrush, contact case, laptop, etc. Tammy came by to visit. Grant put Geoffrey to bed (we skyped goodnight) and then Donna stayed at the house for a while so that Grant could bring me that stuff and say goodnight before heading back home. Grant brought pictures and some of Geoffrey's art work to make my room super cheery.

I slept ok that night, but I was kind of stressed thinking about the implications of possibly being in the hospital until January and not being allowed to go back to the classroom at all. The mornign was the hardest - from 6 - 7:00 I was pretty darn gloomy.

Things started happening around 7:00. I called my mom and we talked for awhile - Dad came for a visit, followed by breakfast, a visit from the nurse, and then Dr. Hargrove came in.

Dr, Hargrove said Everything was looking as positive as could be. I had no contractions during the night, the babys monitoring was perfect, etc. I was now officially at 29 weeks. As far as sending me home for bed rest, she said if you ask 10 doctors about when to do it you will get 10 different answers, but she was feeling pretty confident. She said she could tell I was a good patient and would follow instrustions. Plus, having carried Geoffrey to full term I was a pretty low-risk patient. Regardless, I would NOT be returning to work, and would be on pretty strict bed rest until I got closer to full term. When I would go home would be determined later, after they could do more exams, which of course had to wait until 5 that evening due to when I had the ultrasound yesterday.

I was feeling better at this point. My biggest overall fear - the one I was trying to not focus on - was the safety of my baby, and although it seemed like it would not be the most ideal way to spend the next three months, it was very likely that I would be able to keep the baby cooking for a while if I followed instructions. All signs were pointing to a positive outcome. Ideally, I could do the bedrest at home, but even the hospital would be manageable (but hard on Geoffrey). I explained to her, from my perspective, that I would follow her instructions perfectly, and that Grant was a stay-at home dad so I would have help, and I think that my mental state would be better at home - if she was on the fence. (o:

Dr. Feldman popped by for a quick hello. He was also quite positive about how things were looking so far. He pointed out that had I not gotten that ultrasound, we might not have known about the thinning cervix - and I possibly could have not found out until 36 weeks when I went in for my vaginal exam and they thought I was just starting to dilate, which would be normal at that point. Some people just have thinner a thinner cervix. However, better safe than sorry, as since we do know about it, we certainly don't want to risk such a premature baby.

I made some calls and got the ball rolling on the district end - getting my principal to start working on getting me a good sub, taking care of my new disability leave, etc.

Delaine came by to visit, followed by Geoffrey and Grant, and that really raised my spirits.Geoffrey cuddled next to me and watched mickey mouse and we colored. Katherine came by as well, and she had printed out all of my disability paperwork and even filled out and stamped envelopes for me to mail the paperwork in. (blown away - I have the best friends ever!)

After everyone left, I was visited by Dr. ?, a doctor who works in the NICU. He will now be following along with my care as well, hopefully to prevent my baby from ever needing his services! I really like him, as well. Very friendly and positive. He reexplained everything about the steroid shot and the protein test I was getting later that evening. He also repeated alot about what dr. feldman had said - that especially because I had carried Geoffrey 41 1/2 weeks, it was likely that things would be fine - this is usually found in patients with a history of preterm labor, etc. He also said that research in this area is not very clear, but it just seems logical that taking extra weight off of a shortened cervix would be the smart thing to do, as the increased weight could cause it to thin further.

Geoffrey and Grant spent the night at Atlantis Park's JAck-o-Lantern Jamboree, and sent me lots of cute pics throughout the night. At 5, Dr. Hargrove came back and did the protein test, followed by a vaginal exam. She said it felt like a centimeter and felt good / strong, not like it was effacing, so that was promising.

News came back an hour later that the test was negative and that, assuming no contractions or change that night, I would be able to go home on Saturday on "moderate bed rest," which means that I can get up to pee and shower, and sit at the table for short periods to eat, but otherwise I was to be on the couch or the bed. No cooking, cleaning, shopping, etc. (Grant pointed out that this was my perfect scenario (o: And really not unusual for me - ha ha.) No picking up Geoffrey, etc. SO HAPPY!

Results continued to be positive. The baby's fetal monitoring was "beautiful," and there were no contractions that night. I also had another steroid shot.

Dr. Feldman came in the next morning and officially released me. He gave me instructions again on what they meant by modified bed rest, as did my nurse when she gave me my discharge paperwork. Grant and Geoffrey came to pick me up and I am home!

(By the way - my hospital stay was nice - I had my own room, very nice sized, identical to my recovery room from when Geoffrey was born. The nurses were wonderful. Grant and Geoff were allowed to visit whenever they wanted. I was on the fourth floor. Food was fine. It is just hard to get rest with people coming in and out, being hooked up to that monitor, etc. But I cant complain - Hoag is truly a fantastic hospital to be associated with.)

I will be visiting with Dr. Hargrove and Dr. Hayden on alternate weeks. Dr. Hayden will be doing ultrasounds to monitor for thinning cervix and signs of labor via ultrasound, as well as fetal monitoring, and Dr. HArgrove will continue to monitor as well with regular office visits.

Obviously as the weeks progress and I make it closer to full term, my restrictions will loosen up, but for now I am going to be pretty strict. They made it pretty clear that if I were to be readmitted to the hospital, I would be there until the baby was born. (In fact, as I was being wheeled out, one of the nurse's at the station commented, 'Wow! We;re discharging? That's unusual." I asked what she meant and she said that most of their patients, once there, were there to stay!

SO that's the news, I will keep you posted.