Wednesday, December 30, 2009

C-section- Check!

My levels are continuing to stay stable and the babies are continuing to be happy and healthy in my belly. We are going to the hospital every other day for a biophysical u/s, NST and labs. I had a mini meltdown on Sunday at the hospital when the nurse did a pelvic exam because I have been experiencing a ton of pressure lately. She wanted to see if I was dilated more than the week before when my OB examined me. She said I was about the same and that I am feeling a lot of pressure because Baby A head is so far down low.

Baby A likes to continue to try and push down as far as he can and kick my bladder making it feel like I have to pee my pants. Baby B loves to be in my rib cage kicking and moving causing shortness of breath and pain. Every u/s we have both boys are kicking each other in the head and body since one is vertex and the other breech. It makes us laugh to see them in such tight quarters punching and shoving for more room:)

My OB agreed to deliver me earlier than my original c-section date of January 12 because of the cholestasis. Most women who have this condition are delivered between 36w-37w. I will 36w5d on January 6. We are hoping that being born at this gestation, along with receiving the betamethasone shots three weeks ago that they will not have to be in the NICU when they are born. It will also be fun to see how big they really are. We had a growth u/s one week ago and both babies were measuring right around 6lbs. Of course they are harder to measure as they get bigger, but we are hoping that both of them are at least 6lbs, if not more, when they are born.

Wow! I can't believe in just one short week I will be hopefully holding my two precious little angel boys in my arms! We are so excited and can't wait to finally lay our eyes on them.

Thursday, December 24, 2009

Home for the Holidays

I was discharged from the hospital one week ago today. I have continued to go to the hospital every day since then (except for Tuesday) as an outpatient for a biophysical u/s, NST, and labs. They are continuing to monitor me closely and I am thankful for the daily reassurances that my babies and I are doing good.

My liver enzyme levels have decreased every day. This is a surprise not only for me, but for my OB and the nurses at the hospital. I went from being told that I most likely would develop HELLP syndrome and have to deliver my babies far too soon to moving in the complete opposite direction. They did re-draw my bile acids to check for Cholestasis and they came back elevated this time. I now have an official diagnosis!:)

I will continue to go to the hospital every other day for an u/s, NST and lab work to to continue monitoring the babies and I. My OB is still prepared to deliver these babies at any time if anything doesn't look good. Yesterday we had an appt at our clinic with her and she did a pelvic exam. I am currently dilated to 1-2. In light of everything happening lately she did move up my c-section to January 6. I will be 36w5d. Although she did mention that I only have 50% chance of making it that long:) Baby A head is so far down and I have been having tons of pressure down low. My OB is on vacation next week, but she has really good partners who would be able to deliver for us. I was able to see one of her partners today at the hospital who has been following our case and she said that she would be honored to deliver our babies in our regular OBs absence.

So, I am officially home for the holidays. I don't have to be back at the hospital until Saturday. Today we are skipping our usual Christmas Eve plans. Tomorrow we are going to my parents house as usual with my sister and her family. It will be a low key day. And I am more than thrilled that I will be home to see the joy on Logan's face when he goes downstairs tomorrow morning and sees all of the gifts that Santa magically placed under the tree while he was peacefully sleeping in his own bed.

Now, I am off to lounge on the couch to fulfill my bed rest orders. Let's hope these babies don't get too feisty and kick open a sac of amniotic fluid in the next 36 hours. :)

Merry Christmas to all and to all a good night!

Thursday, December 17, 2009

At Home

Today we had an unexpected twist. For two days in a row my liver enzyme levels decreased. Not by a lot, but by enough for my OB to send me home! I was, and still am, completely shocked that I am able to write this post from the comforts of my living room at home:)

Last night I was out for an evening stroll around the maternity unit and I ran into my OB. She was leaving another patients' room. We started walking down the hallway together and she said, "you look really good". I had showered and gotten dressed in my own clothes, as I have done every day. I think she forgot what I normally look like since she does her rounds between 7-8am and I haven't been showered for the day yet.

I think her seeing me last night and seeing a drop in my liver enzyme levels was reassurance for her to let me come home. It hasn't hurt either that I still don't have any other symptoms, my edema in my legs is gone and my blood pressure continues to stay in the 110/60 range. I am still on bedrest at home and have to go to the hospital every day for a biophysical u/s, labs and an NST (monitoring of the babies). Of course, if my levels start to increase again I will be readmitted.

In the meantime I am enjoying being home with my boys and I had a wonderfully uninterrupted two hour nap this afternoon. DH is making steak tonight for dinner to celebrate. The best part of all, Logan was so happy that I was able to come home. He gave me so many hugs that I lost count and he told me,"Mommy, I am so happy you are home with me." Even though he was a trooper and adjusts well to new situations I started to notice yesterday that my stay at the hospital was beginning to take a toll on him.

Every day will still be a day by day situation. But, you never know, I might just make it to my original c-section date of January 12.

Wednesday, December 16, 2009

End in Sight

[side note: THANK YOU all for your wonderful comments and prayers. It is so nice to feel such wonderful support from all of you. There are a couple of you who don't comment very often and I so thank you for leaving a comment for me during this time. I am cheered to hear from you and you all are helping to lift my spirits each day. I wish you all a wonderful holiday season!]

My labs came back today and they have improved. My platelets are at 157,which is in the normal range, and my ALT and AST liver enzyme levels have improved a little bit also, but they are still out of the normal range. Both boys are continuing to pass each biophysical u/s with 8/8 and they are looking great on the NST monitor each time (they are monitored for one hour each shift). My blood pressure remains in the 110/60s range and my edema is pretty much gone. I no longer have tree stumps for legs and sausages for toes.:)

My OB came in this morning and called me a "Superstar". She said that I am trending in the opposite way that they expect me to. She also commended me on my positive attitude. Apparently she has never seen me sobbing after DH and Logan leave each day:)

We have talked a lot about trying to weigh my health with the health and well-being of the babies. She explained that even though the babies would most likely be okay if we delivered them today she knows that they are a lot better in my belly than being outside of my belly. She knows that we worked hard for these babies and the weight of something going wrong with them if she were to deliver them now is weighing heavily on her. She also is taking into consideration my mental/psychological health in the equation. She knows that it is difficult for me to sit here when I feel completely fine.

After talking about all of this I asked her what the threshold was for delivering these babies. Of course if I start to present more symptoms or the babies start to show signs of distress she will deliver them. If my levels continue to stay as they are she would like to see me get to 35w. She told me to mentally prepare for being here and then delivering at the end of next week. I told her that I didn't want my babies to have a Christmas Eve or Christmas Day birthday and that I would mentally prepare myself to deliver them the Monday following Christmas, but that I wanted to reevaluate next week. I can't tell you how pleased this makes me to have a real, confirmed date and an end in sight. The countdown is on...only 12 days to go!

She is also going to let me do more walking during the day. My previous orders allowed me to get up 1x/shift to walk around the maternity section. She is now going to let me walk 3x/shift. I also get to sit in the chair in my room for up to 30 minutes at a time. Oh, the small pleasures in life!:)

The best news of all perhaps is that as long as my levels continue to stay where they are and they are not declining, she is going to write a pass for me to leave the hospital for 2 hours on Monday night. Logan has his preschool Christmas program that evening and I really want to go. I am so excited that she would let me leave and be able to see my little angel singing his little heart out. It will also be nice to have a change of scenery and to enjoy some of the holiday season by seeing all of the Christmas decorations at the church.

For today, my spirits have been lifted a bit. I can now mentally prepare to be here for the next 12 days plus the 4 days after my c-section. This gives me something else to focus on. I have been thinking of Bri and Andy a lot. I am extremely afraid of becoming sick. Even though I am in the hospital and they are monitoring me closely, it is really difficult to not feel like a shoe is about to drop. And after 36 hours of labor and an emergency c-section with Logan I am really hoping to be somewhat coherent when these boys are born.

Tuesday, December 15, 2009

Still Here

I am still on hospital bed rest. The babies are continuing to look good on the NST and biophysicial u/s that I am doing daily. My liver enzyme levels are remaining steady and my platelets are hovering on the lower end of normal. The bottom normal parameter is 140, yesterday mine were 138 (just below normal) and today they were back up to 140.

I still don't have a diagnosis, but the feeling is that I will develop pre-eclampsia or HELLP. Either of these things can come on quickly and if they do, then I will deliver the babies. They don't want me going home either because they don't know what's wrong and they want to be able to act quickly if my numbers start to show the onset of one of these things or if any other symptoms present themselves.

My OB does not think I will leave until after I have these babies. Ideally she would like to see me get to at least 35w (which happens to be on Christmas day). We are just waiting day by day to see what happens with my labs and to make sure that the babies continue to be healthy inside of my belly and not under any stress. They are trying to balance my health with the health and well-being of the babies.

Meanwhile, my DH and Logan have been visiting me each day and I have had a couple of other visitors too. These visits are pretty much the highlight of my day:) I am still feeling 100% fine so I am definitely enjoying hanging out with people who stop by. DH is done working for the winter so this has been perfect timing in that he is able to be with Logan at home while I am here at the hospital. Although, when they leave in the evenings it is incredibly difficult to watch them walk away and leave me behind:(

This isn't quite what I had in mind when I found out that we were expecting twins. In the end, I know that this will all be worth it when I hold my two baby boys in my arms and this will turn into a distant memory.

Monday, December 14, 2009

Hospital Bedrest

Yesterday DH and I met with perinatalogist. He came highly recommended and has had the opportunity to train with the world expert on HELLP syndome. He was very thorough and asked me a lot of questions. He, too, does not know what is going on with me. Since I am only presenting one symptom (high liver enzyme levels), there is no way to diagnose me properly. He explained that he had a similar patient about six months ago. She stayed on hospital bedrest until about 37 weeks and then she developed pre-eclampsia.

He explained that he does not want me going home and continued to be monitored as an outpatient. He wants to be cautious with me and continue to monitor the babies and I while we remain in the hospital. He has ordered my liver enzyme levels to be drawn every day as well as a biophysical u/s of the babies to make sure they are not under stress. So far the babies are doing awesome and continuing to thrive in my belly.

They are trying to balance my health with the health of the babies. If I start to present any other symptoms or if the babies become stressed, they will deliver the babies. Right now we are just going day by day and hoping that things continue to go well and that I feel well so that the babies don't have to come too early.

As much as I agree with their decision to keep me here indefinitely, I am bummed. I want to be at home with my DH and Logan and I don't want to be constantly worried about this. It is scary not knowing what is happening inside of my body. I just hope in the end I have two healthy babies....and I hope their Mommy is equally as healthy.

Sunday, December 13, 2009

Admitted Again

Yesterday I came to the hospital to be monitored again. The babies are still looking wonderful, but my liver enzyme levels increased again. My OB admitted me back into the hospital and ordered some more labs and an u/s to view my liver and gall bladder. The only symptom I am experiencing is the increase in my liver enzyme levels. I feel completely fine and I have no other symptoms of pain or discomfort or anything. I have become quite the mystery:)

The u/s of my liver and gall bladder came back completely normal. I don't have gall stones and my liver is doing just fine. My urine came back better yesterday too. On Thursday when I started spilling protein into my urine the result was 50, yesterday it decreased to 30. My 24 hour urine from Thursday evening to Friday evening came back at 282 and anything under 300 for pregnant women is acceptable. My blood pressure has been really good too, usually somewhere around 110/65.

My OB told me that she wanted me to stay in the hospital overnight so that they could draw labs this morning and if my liver enzyme levels increased much more then I would have to deliver the babies this morning. They gave me an IV (ouch!) for the night to keep my hydrated and to help prep for the possible c-section this morning.

Since my levels decreased from yesterday to this morning, my OB is going to be bringing in a perinatologist to consult with. She went home last night and was trying to research more on my case and can't come up with a diagnosis that works or can't find any support for what is going on with me. Usually when your liver enzymes increase your platelets decrease and my platelets are within normal range.

Last night we also toured the NICU and found out a lot of info about what to expect if our babies have to be delivered. DH and I will be allowed in anytime, but each baby will only be allowed two visitors each day. Since we are having twins, we will be allowed to have four visitors each day, two for each baby.

One other thing that I found out is that my OB group was the same group that Bri had. When I talked to Andy last week he said that it took them awhile to diagnose Bri with HELLP because she did not have a typical presentation of the symptoms. I know and feel completely confidant in my OB and her group. They have come highly recommended to me by several physicians and a lot of the nurses here use them for their own personal OB care. I know that I am in good hands and it just may be that after what happened to Bri that they are being extra cautious with my situation, which I am completely fine with. Either way I am happy that they are monitoring me so closely.

Saturday, December 12, 2009

Medical Mystery

[side note: the babies are still doing absolutely wonderfully inside of my belly. I am doing much better now that I have slept in my own bed. Here are the details]

Yesterday morning we had a biophysical u/s at the hospital to check on the babies. Both were very active and passed the biophysical. Baby A was quite the stinker and didn't do his 30 seconds of practice breathing until the very last minute. He literally finished at 30 minutes and 24 seconds. But he did do it and both of them passed with 8/8. Here is the big news: they are little chunky monkeys for 33 weeks gestation! Here are their whopping weights:

Baby A: 4lb10oz, measured 34w1d
Baby B: 5lb7oz, measured 34w2d

They hooked me up to the NST monitor when I got back to my room and both babies were doing fabulously on that as well.

My OB came in at 10:30. She was really uncertain what is going on with me. She initially thought cholestasis (and I think still does) because of the itching I have had and slightly elevated liver enzyme levels. However, the bile acid test results came back from the Mayo Clinic and they were negative, which is not consistent with cholestasis. She did say that this is not an absolute test. She also was contemplating whether or not I am in the early stages of HELLP due to the protein leaking into my urine. She order more blood work to be drawn in the afternoon to monitor my liver levels and told me that she would make a decision by the afternoon and this would give her the day to think about what to do with me. The options being: let me go home and continue to closely monitor me OR deliver the babies in the morning after receiving the second shot of the betamethasone steroids for the babies lungs.

In the afternoon, the labs were drawn for my liver enzyme levels and they are remaining steady (compared to the same labs drawn on Wednesday and Thursday), which again is consistent with cholestasis. My 24 hour urine test came back elevated, but not severe (for my two Labor and Delivery Nurses I believe it was 282??, but not quite sure). My blood pressure was 108/61 and my reflexes were really good. And, perhaps most importantly, I feel great.

My OB came back in at 5:00 last night and told me that she is letting me go home. Thankfully, I am not "sick enough" to warrant having these babies right now. Because, of course, the only way for my symptoms to be treated is to deliver them. She is requiring me to come in to the hospital today and tomorrow to be monitored by NST, blood work, urine, etc to make sure that I am remaining steady and that there is not a drastic increase in my levels. If there is an increase, I will have my c-section and the babies will arrive. She told us that we will be going day-by-day and that she believes the babies will have to come by Christmas.

So, how do I feel? Physically, great, which is a huge relief. Just hearing the words HELLP after Bri died, was quite scary. But I know that I am in great hands and that we detected everything right away this week so I feel good just knowing that we are doing everything right. I have mixed feelings about the babies coming so early. I know that they will be in the NICU for a few weeks, but I also know they will be okay. They are great weights and they have the betamethasone shots so I feel good about that. In a way, I can't wait to meet these little guys. Of course, if I have the option to carry them for as long as possible, I will be glad to do it. But there is just the excitement of looking into your childes eyes and seeing what they look like. And, as much as I want to keep these babies in for as long as possible, I don't want to get sick and be incoherent when they are born. I don't want our families to have to worry about me and the babies.

We go back to the hospital today at 1:30 for monitoring. Hopefully everything continues to stay steady and the babies continue to thrive inside of my belly:)

Friday, December 11, 2009

In the Hospital

On Wednesday I went in for my OB appt. They took some more labs and everything looked good. My OB thought that I do indeed have cholestasis, but it is at a manageable level with weekly monitoring. I asked if it was necessary to get the steroid shots for the babies lungs and at that point she was not concerned as she felt I would not have to deliver until early January.

I had a regularly scheduled biophysical u/s, NST and OB appt on Thursday. The u/s went really well and both babies were given 8/8. The NST was good too. There were two decelerations in their heartbeats, but both of them were moving around like crazy and showing off:) When we met with my OB she was concerned about the decelerations, which they don't like to see. Since the cholestasis can cause fetal distress and the decelerations could be an indication of distress. She also mentioned that the amniotic fluid for Baby A was a little low, but still within normal range. Between the decelerations, decrease in amniotic fluid and cholestasis she found reason to admit me to the hospital to be monitored and to receive the betamethasone steroid shots for the babies lung maturity.

We were given permission to go home, pack and get back to the hospital. Thankfully Logan was with my dad for our appts so he was already in good hands.

When we got to the hospital they hooked me up to the monitor and both babies are doing wonderfully! We haven't seen any decelerations and both of them have been really active.

I, on the other hand, have started spilling proteins into my urine. I don't have pre-E, but they are watching me closely since my liver enzymes are also high and the bile fluids which typically go along with cholestasis. They are collecting my urine for 24 hours and then will retest it for protein output later today. I will also receive the second betamethasone shot today.

I also have a growth and biophysical u/s this morning along with more lab draws. I am feeling great other than being sleepy from sleepy on this hospital bed that feels like plywood:) I'll update more when I can.

Wednesday, December 9, 2009

Half Ass Results

I received a phone call from my OB today asking me to come into the clinic this afternoon. She received some of the results of my testing and wants to re-test me to get a clearer picture of what is happening.

She will not receive the bile acid results from Mayo Clinic until Friday or so, but she did receive my liver enzymes (from the HELLP panel) back and they are high. She also said my "alt" is high, but I have no clue what that is. She does not think I have HELLP, but wants me to have my blood pressure done today to make sure it is not elevating. She is also going to check my urine to make sure that protein is not spilling into it, which is a symptom of pre-E and HELLP. And she is going to re-test my liver enzymes to make sure they are not increasing too quickly.

She thinks that I may have a condition called cholestasis, but won't know for sure until she gets the bile acids results back from Mayo and views the information from my appt today. I have a Labor and Delivery nurse friend, who is also an IF'er, who explained that this condition can increase the chances of fetal distress, preterm labor, and worse case scenario, stillbirth. My OB told me today that if I do have this condition, and depending on the severity, that they may look at delivering the babies at 36-37 weeks.

Obviously this is not ideal. As much as I want to be done with this pregnancy, this is not at all what I was hoping would happen. I wanted a nice, clean way to evict them from my uterus, not a medical condition/scare that will leave me worrying about their health and survival.

Monday, December 7, 2009

Driving the Bitter Bus

[Disclaimer: this post is not blown with baby dust or sunshine. Although I am loving every minute of being pregnant, as I sit here today, I am done....I just want my babies in my arms. And please know and respect that this is my blog and my place to vent. My hormones are starting to get the best of me, so please don't take this personally.]

On Friday I went in for my weekly biophysical u/s and NST. They were both active, practice breathing, and the amniotic fluid was great. They scored 8/8 and passed with flying colors.

After my u/s I had my NST. Both boys were very active and passed within the allotted 20-30 minutes....until the very end. The nurse came to get the sheet to bring to the OB before she unhooked me from all of the monitors. When she came back she noticed that one of the babies heart rates did not "recover" as quickly as they like. She tore off the sheet from the machine again to have the OB look at it. The OB ordered me to stay on the monitors for another 20-30 minutes. When my time was up the nurse came in and said that everything looked good except that I had a contraction this time. I told her that I didn't feel a thing. She explained that it happened during a period of time that both babies were very active so she thought it was just my uterus contracting from all of the movement. She tore off the sheet to bring it to the OB and the OB was not concerned, whew! I was beginning to panic.

Over the weekend I started experiencing some very odd symptoms. On Friday and Saturday night I woke up in the middle of the night, out of a sound sleep. I was throwing up as I woke up. In real life, not in my dream. NOT pleasant. I also woke up both nights to ITCH. I am so stinkin' itchy. It's like I can't put on enough lotion and I can't scratch enough. NOT pleasant. My bowel movements also increased over the weekend too. It seems that every time I eat, I then need to head to the bathroom. NOT pleasant.

I called the on-call OB yesterday to explain my symptoms. The one that was the most worrisome to me was the itching. I have heard of this happening to pregnant women before and it can be serious. The on-call OB told me that she wanted me to be seen today because the cause could be my gall bladder or my liver.

When I went in today to see my OB, she ordered a few labs. One of them is to check to see if I have bile fluids (or something like that). She explained something about my gall bladder and I understood at the time what she was telling me, but I am too tired to remember right now. She also ordered a HELLP panel to be done to check my liver enzymes. She is also testing me for two other things. Again, can't remember enough to explain right now. Once I get the labs back I will have more information that I will hopefully remember. The only thing I clearly remember is that she told me she wants me to take Ben.a.dryl to help relieve the itching while I wait for the tests to come back (which have to go to the Mayo Clinic and they only run the labs on two days of each week).

And, here is my rant.

As much as I love being pregnant and having these babies in my belly, I want to be DONE. I am tired. No matter how much sleep I get. I am swollen. My toes look like sausages and my legs look like tree stumps. I am itchy. All.Over.My.Body. I am huge. Yes, I am ALL baby in my belly, but this also means that I am in a lot of pain in my belly and back. I have gained just over 40lbs, most of it being in my belly. And I am irritated over holiday functions that are yet to come. I want to go and have fun and enjoy my family and see the joy on Logan's face, but somehow I am just to frickin' tired to even want to go. I am pregnant with TWINS. When you look at me, you should see the THREE lives I am trying to maintain and grow. It is hard work, and although I love it, I also need you to understand that certain things are not convenient for me and thus, my family....because, you know, more than half of my family is IN MY BODY.

I am lucky, though. Lucky that I have not been placed on too many restrictions or bed rest. Lucky that things are going so well during this pregnancy so far. Lucky that if these boys were born today that they have a good chance of survival. Because even though my due date is not until January 12, I may not make it to that date. Lucky that my husband understands that things are difficult for me, even though everyone else expects me to continue on as if nothing else is going on. Lucky that I can put a happy face on and pretend that I am not completely miserable. Lucky that I can smile because my boys are still growing in my belly and not in an isolette in the NICU. Lucky that my son loves these babies as if they are already here.

As much as I want to be done with this pregnancy, in no way shape or form do I want these babies to be born any time soon. They need to stay in my belly for as long as possible. After all, this isn't about me or anyone else. This is about my two sons and their health and well-being. And, quite honestly, everything else is a far behind, not even close secondary.

Tuesday, December 1, 2009

Thanksgiving Post- A Little Late

A couple of weeks ago I put the tape of DH and my wedding into the tape player to view. I was cleaning out a drawer, came across it and after being crabby with DH earlier that morning, thought it would be fitting to put it in and be reminded of the love I have for him. As DH, Logan and I were watching I remembered that day and the joy and gratefulness I felt on that day. Not only for finding my DH and marrying him, but for those that surrounded us in love and joy that day.

That day was so special and so full of promise for us. I felt that the world was ours to take by the tail and do great things and have a wonderful life. As we were standing up on the altar we said our vows (which we still say to each other every once in a while on a whim). The priest asked us a few questions to which our response was supposed to be: "we will". As we were watching the edited version of our wedding it cut to this string of questions that the priest asked us. One of the questions being, "Will you lovingly accept all children given to you by God?" Over six years after our wedding day, just watching this simple question and moment on our wedding day took my breath away.

I immediately looked at DH and said, "Wow. If we would have only known at that time how important that question would play out in our life." Never in a million years on my wedding day did it even cross my mind that we would have problems conceiving a child and lovingly accept them into our home, our life and our hearts.

And, because I am a thinker, I thought of all of the others who have said the same or similar vows over the years who are still waiting to accept their children into their lives. The infertility sisters whom I have met online or have met face-to-face in real life. The ones still battling through the trenches to to expand and create their families. Why are some peoples wishes granted and not others? I'm serious....WHY? I sure wish that we had the answer to this question since I have been pondering it for so many years.

However thankful I am to have Logan, DH and these babies in my belly, I don't think it is fair. It's not fair that we are close to achieving our dream of expanding our family, while others sit silently in pain and anguish for the loss of their family-to-be. The wee little ones who were supposed to be. The embryos who never quite made into little angel babies to be placed in their arms. The loss of the family that they so desperately want.

So, yes, I am completely thankful and joyful at what lies ahead for DH, Logan and I. The little bundles who are growing in my belly and who are forever in my heart. I smile when they kick me at all hours and know that they are growing and thriving in my belly. I can't wait for the day that they are placed in my arms to love and kiss and hold.

But, to my fellow infertile friends who are still fighting the IF fight, you are not alone. I have not forgotten you or the pain you are experiencing. I mean, how does one forget such a hard time in their life?