Laughing, Weeping, Living

Life happens. You laugh about it or cry about it, sometimes both.

7 Quick Takes: June 14

Linking up with Jen and all the other party people at Conversion Diary for the weekly quick takes. Go over there if you like to partay.

1. After spending the night in the hospital because my doctors take not the tiniest chance with the health of my unborn child, I am happy to be home for the weekend. Agnes was monitored constantly overnight, and she turned in a “reactive” performance on the heart rate. That was a good thing, too, because the follow-up BPP I did this morning only scored a 6 because Agnes refused to practice breathing during the 30 minute ultrasound. She still netted a score of 8 out of 10 with the reactive NST plus the BPP, so I was discharged with stern instructions to call immediately if anything worrisome happens over the weekend. As you can imagine, I was not a happy camper laying in that awful hospital bed with a sweaty, bedsheet-wrinkled backside, imagining myself beginning an induced labor on Monday morning after an entire weekend of laying in that awful hospital bed–paradoxically not being able to sleep–with a progressively more wrinkled and sweaty backside to keep me company. So I am very relieved to be home.

2. My hand is really sore where they inserted the XL size I.V. amidst great dramatics on my part. I asked, “do I really need to get the I.V.?” and the nurse said, “it’s in case you need an emergency c-section, but I guess you don’t have to have it in now.” And I said, “I’m confident Agnes will do great and nothing will happen, so I don’t think I’ll take the I.V.” And the nurse said she would let the attending resident physician know. Then the attending resident physician came into my room and told me all the patients get one and it’s not optional. Fine. Sheesh. And now my hand is really sore, right in the same place they will insert another XL size I.V. on Monday. Fun for me.

3. I made a lasagna for dinner tonight, which is what I had been planning to make last night. I really liked how it turned out; I followed the recipe on the side of the noodle box except I added a secret special ingredient: cauliflower! I had half a head in the fridge that I really wanted to use up, so I sliced off the florets only and cut them into teeny-tiny pieces. Then I mixed the cauliflower into the ricotta/egg/parmesan mixture thinking it would masquerade as cottage cheese curds. It worked out really well, though some of the vegetable pieces were a bit crunchy and tasted like cauliflower. I didn’t fool my mom, but she admitted that it “wasn’t too bad” which I choose to accept as positive feedback. If I do this again, I’ll cut the cauliflower even tinier so all the pieces soften and lose the crunch.

4. Two more days infant-free! Agnes will be born on Monday. I have a scheduled  appointment to start the labor induction at 8 a.m. How’s that for a start to the week? Actually I’m glad it’s an early start time. Hopefully I won’t be laboring into the night, and since drugs are assisting and this is my second childbirth, it could go fairly quickly. I think the doctors want a quick labor just so Agnes doesn’t have to cope with contractions over a long time frame. I would be cool with that, too!

5. Stephen is singing in his room. I put him down for the night about 30 minutes ago and he was quiet for a while, but he is clearly not asleep. It really sounds like singing. Or whimpering to a tune. Or something. Whatever, he’ll fall asleep eventually.

6. I bought off-brand oreo-type cookies at the grocery store on Tuesday because I was a pregnant lady craving oreos. I ate a few of them. Now the package is nearly empty! How did this happen? And I’m being serious here; I really did only eat a few of them–6 or 8 cookies, tops. What a world we live in, where a pregnant lady’s pregnancy-craving cookies just disappear…

7. I talked to one of my OB’s about Cytotec, and I guess I’ll trust the docs on this. She said they’ve been using it for years with no problems, and it works. Also that there are no methods that don’t have side effects. She told be about the alternatives to Cytotec, none of which sound as effective or easy or non-invasive. I have to trust the doctors to have my best interests and my baby’s best interests in mind. Maybe my cervix will have done enough effacing by then that Cytotec won’t be necessary, but if it is, I will use it.

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Live! From the Perinatal Ward

Yep. I’m back in the slammer. That is, the doc at Maternal Fetal Medicine sent me to Akron General Hospital for another overnight session of fetal monitoring.

Here’s how it happened:

I went to MFM for my ultrasound and NST appointment, and things were looking fine. Agnes is up to 4 lbs 12 oz which is AWESOME! If she can make it to Monday, she should be nearly 5 lbs for her birth day. The cord dopplers were a little elevated; the S/D ratios were just the tiniest bit above 4. Her ventricles were measuring fairly consistent with previous measurements. My amniotic fluid was a tiny bit less than it was on Monday. She even breathed during the BPP so the ultrasound tech didn’t have to sit around waiting for her to breathe. But, she didn’t move very much during the ultrasound, so she was docked a couple points on her score for not moving.

See, what I just learned today is the BPP/NST is scored out of 10 points, 2 points each for breathing, movement, fluid, tone, and a reactive NST. Well, Agnes has been scoring 8 out of 10 which is technically normal, but today because she was napping during the ultrasound or something, she scored 6 out of 10 which is cause for concern.  The doc sent me to the hospital for overnight monitoring, and there will be a retest for the BPP in the morning. If Agnes does okay overnight, and scores 8 on the BPP in the morning, we can go home for the weekend.

If Agnes does poorly overnight and scores less than 8 on the BPP in the morning, I may have to stay at the hospital over the weekend and deliver as scheduled on Monday. Or, depending on how poorly Agnes appears to be doing, she may be delivered before Monday.

I’ve spoken with a few doctors since being admitted, and everyone has a different story to tell. The OB from my practice tells me to stay positive and not worry too much about the worst case scenario. She says the specialists think a lot about the possible worst case outcomes so that they are prepared and can then provide the best case outcomes. On the other hand, the neonatologist tells me there will be a crowd of specialists in the next room when I deliver, and the moment Agnes is born they will swoop in and whisk her away to the NICU immediately where they will install an I.V. and keep her “as long as possible.” He also tells me she may have an intestinal blockage or maybe her esophagus doesn’t connect to her stomach, and that accounts for all the extra fluid. And that would require an operation. Thanks, doc, for that news which totally and completely new to me and really very serious. Why is this the first time I am hearing this, and how dare you patronize me by asking “did you expect her to receive routine newborn care?”

At least he did try to backpeddle a little and tell me their goal is to do the smallest program of care that is possible for Agnes’s case. That is only mildly reassuring after the rest of what he told me, but I guess I’ll take it.

So, yeah, I’m trying to stay positive despite what the doctors insist on telling me.

At this point, I’m just really frustrated and angry to be in the hospital so soon before I’m scheduled to return for the real deal. I almost wish Agnes could just be born now. I used to be the most adamant against c-section, but now I kind of want the whole ordeal to be over. Just knock me out and take my baby already. It’s the waiting that is the most stressful.

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No Changes to Report

I had one of my twice-weekly testing appointments today. It was one of my shorter visits to the Maternal Fetal Medicine clinic, lasting only about 75 minutes. The BPP ultrasound was a breeze this time since Agnes decided to cooperate and practice breathing right away. The tech only needs to watch about 30 seconds of breathing to count it as a “pass” for breathing, and usually Agnes holds out on us. Not today. My amniotic fluid is still really high, which I’m worried about, but no one else seems terribly concerned. The doppler results also looked about the same as they have been, so there are no real developments. The NST went pretty well, I guess. I was kind of sleepy so I stopped paying attention and read a Baby Talk magazine while Agnes’s heart thumped away. After a while the nurse came and unhooked me, so I guess the results were fine. Whatevs.

One week from today I will be giving birth. That is totally blowing my mind right now. I don’t really feel prepared since I haven’t practiced my deep breathing or pushing positions or anything. I did read the chapter on labor and delivery in the What to Expect book, and that helped a little. I’ve already been to the labor and delivery wing of the hospital so I feel pretty good about that. The rooms are nice LDR suites (labor, delivery, and recovery) with a bassinet so baby can room in. I wonder if that will be possible for me and Agnes? There is a NICU at Akron General which should be sufficient for Agnes if she needs intensive care. I think they only send serious case babies to Akron Children’s hospital and Agnes might not qualify as serious enough for that (I hope).

I’m trying to think about this as levelly as possible. We met with Fr. Sal about Agnes’s baptism, and we’re talking about where to put the bassinet in our bedroom, and thinking about installing the infant car seat. We’re trying not to think like she will be stuck in the hospital for a long time, or that something might be seriously wrong with her. I’m trying not to think about the horrible side effects of the drugs they will give me to induce labor. I’m trying not to think about the fairly high chances I might end up in the middle of an emergency caesarean.

Happy thoughts. Happy thoughts. Yay, new baby. Yay, new baby.

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The Best News!!!!

Today we met with the pediatric neurologist in addition to the usual round of tests. He had the best news to share with us:

One of the MRI scans.

One of the MRI scans.

Because of the way Agnes’s brain ventricles are enlarged, he is confident that her chances of developing normally and having no future brain problems are 99%. There are four ventricles in the brain, two in front and two in back. It is only the back two ventricles that are enlarged, and the doctor says this is why he is so confident Agnes will have no problems. The front part of the brain develops first in a fetus, and the back part doesn’t finish developing until practically the last week or two before birth. He says some babies have this problem with the extra fluid, and the swelling reduces on its own the closer the baby gets to birth, and even after birth. He is not concerned about Agnes firstly because the swelling in her brain ventricles is fairly minor, secondly because it is only the back ventricles that are swollen, and thirdly because the MRI scan shows Agnes has every little piece of brain accounted for in its proper place.

So, long story short, the doctor said it is 99% likely Agnes will not need a shunt or any other kind of surgery, and she has a 99% chance of developing normally.

Didn’t I say miracle a while back? Here is our miracle. This is certainly a wildly different story compared to when we first found out about the ventriculomegaly and heard what our docs in Albuquerque projected for Agnes’s condition.

There is Agnes's eye. You can see how the back part of the ventricle area is larger than the front.

There is Agnes’s eye. You can see how the back part of the ventricle area is larger than the front.

As for the ultrasound and NST, a few mixed results as always. The NST was non-reactive, but since this wasn’t a change from previous tests, no one was particularly concerned. The ultrasound did reveal that my amniotic fluid is way up since the last time, which seems like a cause for concern, but the perinatology doctor must not have thought so, because she didn’t even stop in to see me like she usually does when I go for these tests. The ultrasound also revealed that the ventricles are still holding at their measurements and at least not getting bigger; but they’re also not getting smaller (yet?). My ultrasound in a week will cover the growth measurements so I have to wait to know how much Agnes weighs at this point.

She is going to be a stinker for sure. She held her breath until the last possible minute during the BPP; the tech sat with the ultrasound wand waiting for baby breathing for nearly fifteen minutes before Agnes finally gave in. She also refused to react to the buzzer zaps today during the NST. But I felt her moving when we got in the car to leave for home. The little stinker. We’ll have to keep an eye on this one.

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Still Cozy At 35 Weeks

We had another NST and a BPP ultrasound today and the results were consistent with the previous tests. Agnes didn’t perform perfectly for the NST, but she also didn’t fail. I think at this point the doctors are just watching for any changes in the more negative direction; everyone seems resigned to the fact that Agnes’ NST will be non-reactive. However, one good thing that happened is I had several strong contractions while I was hooked up to the fetal monitor (wait, it’s good, I promise). The doctor said they were able to observe results as if they were conducting a contraction stress test, and Agnes reacted well during the contractions! Her heart rate didn’t slow down after each contraction, which would be an awful result. So, we’re hanging in there.

Some other faintly rosy findings at today’s test were the ventriculomegaly seems to have stopped becoming worse. Now, granted, Agnes’ head is super low down which makes it hard to get a clear enough picture for taking measurements. But the ventricles measured around 1.2 or 1.3 cm which is actually less than the largest measurement ever taken. I think one of them was up to 1.6 cm some time last month. So that’s good. Also, the amniotic fluid is still more than it was a couple weeks ago, but it isn’t more than it was just last Thursday. Also, the S/D ratios for the umbilical cord are currently holding near the top of the “normal” range of measurements, which is also good. Remember, this measures how hard the placenta is working to pump oxygenated blood and nutrients through the cord and into the baby. A measure of 4 is the top of the normal range. A number higher than 4 indicates the baby is maybe not getting enough oxygen and nutrition from the placenta. The doctors think an elevated S/D ratio is maybe the reason Agnes has intra-uterine growth restriction (IUGR).

They didn’t check Agnes for growth today, but she was approximately 3 lbs 14 oz on Thursday, so I would expect her to be really super close to the 4 lb mark by now.

She’s still moving a lot, but I’m starting to feel pretty horrible. I think the knowledge that she could be delivered any day is making it harder for me to deal with the aches and discomforts of late pregnancy. If I knew for sure I was still five weeks from delivery, I would have an easier time sucking it up and just dealing with it. But as it is, I feel really whiny and weak to deal with my body’s discomfort. Plus, I’m starting to have more contractions, which is related to the exorbitant amount of amniotic fluid I’m carrying with Agnes. The docs say a high volume of fluid can make the uterus more irritable and contract more. So, that’s nice to hear. Not.

Anyway, we’re still hanging tight, staying cozy, biding our time. The docs want to deliver Agnes at 37 weeks ideally, which would be the week of June 17. So, we’ll see if we can make it. At the rate things are going now, I think we will make it to 37 weeks unless:

-Agnes turns in a clearly and unarguably failing performance on an NST,

-or an ultrasound reveals she has stopped growing,

-or if I don’t feel her moving at least 10 times in an hour,

-or I go into labor naturally. If this happens, it’s bound to be dramatic with all that fluid. Yippee. I hope it doesn’t happen in the middle of the night at least. Please.

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Small Changes in Agnes’ Condition

Agnes had a check-up today consisting of an NST, a BPP ultrasound, and a growth ultrasound.

The NST was non-reactive yet again. Her heart rate barely accelerated at all even when the nurse zapped her with the buzzer. Agnes also hardly moved during the test, which is a bit unusual. She usually moves so much they have a hard time catching her heart beat on the monitor. But the results were not alarming enough to merit an early delivery. The doctor said a non-reactive NST is not unusual for babies with ventriculomegaly.

The BPP ultrasound was an easy pass for Agnes as usual. She demonstrated movement, breathing, good heart rate, etc. The S/D ratio in the umbilical cord was not a high reading today, so that’s good. However, the test did show an increase in amniotic fluid since the last time, which is kind of strange. I remember being told in Albuquerque that the fluid amount hardly ever increases as the pregnancy continues. The doctor here said the increase in fluid is worrisome since it may indicate Agnes is having trouble swallowing. Just like they are watching her heart rate behaviors, they will watch the fluid because the brain controls all those functions and now it’s starting to look like there are problems with the connection between brain and other areas.

The growth ultrasound revealed an increase of fluid in Agnes’ kidneys. It’s called renal hydro-something-or-other and it had appeared on a previous ultrasound, but today it was more pronounced.

The growth ultrasound also showed that Agnes’ weight is up to approximately 3 lbs 14 oz. This is an increase since the last time, but not by very much. She only gained 11 ounces in two weeks. Her size is still under the 10th percentile, but the doc didn’t say what her percentile is. She still has growth restriction (no surprise). The doctor concurs with my OB that there is most likely a genetic issue going on since there are noticeable problems across multiple systems. She asked me kind of wistfully, “you probably still don’t want to do an amniocentesis?” No, I really don’t. Maybe if they had tried hard to sell me on the benefits of an amnio several weeks ago I would have gone for it, but at this point Agnes could arrive next week so what’s the point of doing the amnio now? They can test her genes when she’s born probably easier and with a less risky method. Even if she does miraculously make it to the magic 37 weeks and I do the amnio now, it will give us a two week edge at most. Is that worth it? I don’t know.

All these results are less than encouraging for me and I really have to stretch to see the bright side:

a) at least they didn’t send me to labor and delivery today.

b) at least Agnes did grow since the last growth ultrasound two weeks ago.

c) at least her NST was borderline ooching to worrisome, rather than a total and utter failure.

d) at least she’s still alive in there.

 

Saint Agnes, pray for us.

Saint Maria Goretti, pray for us.

Mary Mother of God, pray for us.

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One More Day of Freedom

I was totally prepared to meet my baby today, but fortunately it was not to be.

I went to Akron General Hospital this morning for an NST (non-stress test) to check on Agnes. Her last couple NST’s have been borderline at best, so I wasn’t too hopeful about this one. We packed my hospital suitcase in the car just in case, left Stephen with my parents, and didn’t make any Memorial Day plans if you take my meaning.

As predicted, the NST was not stellar. Not terrible, but not really great either. At the Maternal Fetal Medicine clinic where I usually go to do the NST’s, they have this little buzzer wand they use to zap lazy babies to get them to move around. They can use it “up to three times” at the MFM clinic, and make a note on Agnes’ print out when they use the zapper. At the hospital, they have a zapper, too. And they’re not afraid to use it. I don’t know if the rules are just different down in OB E.R. Triage, or if the nurses just really really didn’t want to attend my labor and delivery on Memorial Day, or what, but those ladies just went nuts with the zapper. They were buzzing Agnes all over. And of course she moved; she was super pissed off. But still her heart rate readings weren’t perfect, mostly because she moved so much the monitor lost track of her heart and nothing was recorded.

So they did a Bio-physical profile (BPP) ultrasound. This is the one where they watch for fetal breathing, movement, amniotic fluid, and the like. Agnes has always done great at this test so I wasn’t too worried about it.

They ended up letting me go home because her NST results weren’t actually alarming, just not perfect, plus Agnes totally passed the BPP. Whew. So Agnes gets to stay put in her hot tub for a few more days at least. Let me just say at this juncture that a Flying Novena really works. This is a prayer trick Blessed Mother Theresa used when she had an emergency need. She would pray nine “Memorare” prayers in a row. I did this while I was lying there for the BPP, and now we’re at home with Agnes still cozy in her womb. Behold the power of prayer.

To celebrate my day of freedom, I came home and finished the laundry that’s been waiting. I’m glad I got to it because now all the cute newborn girl baby clothes I just bought with my mom are clean and ready. I also spent a good portion of the afternoon organizing the “guest room” to make way for baby care. I’ll be doing diaper changes in there during the nights, and Agnes will probably take naps in that room. She’ll be in a bassinet in my room at night for a few months at least, but I’ll probably nap her in the guest room. I feel a lot more prepared for her arrival now that I’ve had these past couple days to get organized. I even unearthed my breast pump. Grr. But I’ll probably need it, especially if she’s born really early and has to incubate in the NICU for a while.

Also to celebrate my day of freedom, I finally made gelato. At least, the first step. I cooked the custard and now it’s cooling in the fridge. All it needs is a spin in the ice cream machine tomorrow and it will be ready! I’m so stoked! And also as a side note, now that I’ve cooked my own gelato I will never begrudge the $5.00 price tag on a dish at a gelato store. It was hard to do just because you have to stand there stirring it almost constantly while it cooks up to 185 degrees. That process took nearly an hour. Sheesh, and now my back is killing me. I hope none of my doctors read my blog.

We’ll see what tomorrow brings. Hopefully it will be another day of smooth sailing!

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24 Hours of Fetal Monitoring

By guest blogger Jeremy Schwager (Judy’s Husband)

Judy asked me to post on her blog today because she is spending 24 hours or so hooked up to a fetal monitor. This makes it hard to type.

We went in to Akron Children’s hospital today to get an ultrasound, which is a twice weekly occurrence at this point in the pregnancy. We got some really nice photos of baby Agnes.

2013-05-21 19.56.46

3D Image

Unfortunately the fetal monitoring that they did on Judy didn’t go so well. The baby is really active and swims away every time any impertinent nurse ries to monitor her. We were especially unsuccessful today so the doctors feared the baby was in distress. The y can only keep a patient so long at the particular department of Children’s we were at  so they transferred us to Akron General where they could monitor at their leisure. Unfortunately this means the decided to take lots and lots of time. And they also decided that Judy should not eat because of a possible eminent birth by induction or c-section. The baby continued to be lackadaisical and resist monitoring. Mom and baby wer both understandably grumpy as this dragged on. This continued until about 3:30 when the doctors finally allowed Judy to eat. I went down stairs to Au Bon Pain and purchased a delicious turkey sandwich. After eating the turkey sandwich, Agnes became active (she was no longer starving) and doctors began to see the results they were looking for.

Judy is now resting comfortably in a brand new fetal monitoring unit in Akron General which just opened today. They don’t even have signs on the walls yet. She is in good spirits. Judy’s dad said her happiness is probably the best thing for the health of the baby. I agree!

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Little sign says “Fetal Monitoring Unit”

We got a visit from Fr. Sal at Holy Ghost Ukranian Catholic Church which was really nice. Especially since we only met him last Sunday.  He heard Judy’s confession and gave her communion. He said he would be happy to come for an emergency baptism if necessary as well.

Judy will probably be released tomorrow in the early afternoon. Please pray for Agnes and Judy.

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