Saturday, July 21, 2007

baby drama and baby mama drama.

Good lord. I couldn't make these things up if I wanted to........these little ones have given me a run for their money these past 31 weeks. Ok....here's the long version of the past week......it's a long one, sit down and grab a snack and drink.

One week ago, we returned home from an overnight stay at the hospital. I was home, on bedrest, behaving and minding my own business. Still trying to pass the darn kidney stone, which is no fun at all. Well, Sunday night/early Monday morning, each time I get up through the night to potty, I feel "full" in my upper belly, lower chest area with some pain all across that area. Thinking it's just from being on bed rest of some form or another for the past week or so....I continue on my exciting routine of bedrest and frequent potty breaks.

Monday I'm miserable......a person can only sleep so much in a twenty-four hour period. I remain uncomfortable and feel my breathing is wheezy, though my lung sounds are fairly normal (as best as I can tell by listening to them myself). Poor Chad returns home from work Monday night to me laying in the tub, crabby, miserable, and just plain pissy. Poor guy. He's a trooper, for sure. I'm not hungry, I'm not thirsty, yet know I need to eat and drink. I think I ate one entire PB&J sandwich and a few other small things the entire day, along with any amount of water I could tolerate. Drinking was a chore in itself, as my stomach felt squished like a pancake. On top of everything, I was not peeing much...thinking the darn stone was trying to make it's appearance.

Move ahead to 11:30pm Monday night. Up again to potty (this is happening at least every twenty to thirty minutes). I head back to bed, lay down, and feel like I'm literally being crushed. I can't breath, my heart rate is up, I can only take very shallow breaths, I'm basically freaking out at this moment. I attempt to take my blood pressure and best that I can tell it's 160ish over 80ish. It feels like the very worst panic attack one could ever have and felt bad sitting at the side of the bed, laying on a ton of pillows in bed, standing, walking...nothing helped. Not sure when I woke Chad.....but did at some point.

Finally at 12:30am, I'm feeling no different. I call my OB's answering service to let her know what's going on......she tells us to head into OB triage at the hospital.

We couldn't get to the hospital fast enough. Luckily is was the middle of the night and traffic was very light. Chad drops me off at the front entrance of the hospital while he parks. I slowly make my way to the OB unit. I know...I shouldn't have walked, but I couldn't wait.

They ask me what I came in for......"shortness of breath" was my response. I feel like an idiot telling them that was my reason.

Of course, my blood pressure was up once they took it, and I believe my oxygen saturation was also low, yet wasn't paying enough attention to the dings and rings at that time. The nurse midwife updated my OB and they decide to admit me.

After settling into my room, they take me downstairs for a chest x ray to rule out a pulmonary embolism. Unfortunately, one big risk of bedrest is clot formation in the leg, which travels to the lungs.

We return to my room where an IV is placed and labs are drawn. I attempt to settle for the night, which is quite difficult with the rapid shallow breaths and inability to lie at a comfortable angle in bed.

Fortunately, the babies are looking great on the fetal monitor. Both heart rates were responding appropriately, when they would stay still enough to catch their heart rate! Baby girl is an active one and VERY difficult to keep track of sometimes. It took a few hours for the nurse to even get a decent tracking on the little stinker! Baby boy was much easier to keep track of, though!

My OB arrives in the morning. She lets us know that she looked at the chest x-ray and my heart looks enlarged. They need to do further testing to rule out peripartum cardiomyopathy. I immediately get tearful. Of my ten years as a nurse, most of my practice has either been working in critical care or cardiovascular surgery. I know the implications. My first question is "is it reversible", which of course I know it isn't. A cardiology consult and an echocardiogram is ordered to rule out any immediate heart damage and rule out the chance that this is the correct diagnosis. My OB shares with us that if it indeed is cardiomyopathy, the babies will need to be delivered soon....like in the next day or two. She is going to ask the neonatologist on staff in the NICU to stop by and talk with us today and answer any questions for us.

Not sure at what point we head down for the echocardiogram.....Chad goes with and is able to come back into the room during the scan. Luckily it's fairly quick and we head back upstairs to wait.

At some point during the day, I receive two doses of Lasix to help remove some excess fluid build up. After the 10mg dose, I eliminate a liter or so of excess fluid. After a 20mg dose, I dump another two liters of fluid. Believe it or not, my breathing is a bit better!

The babies are monitored for a non-stress test three times a day, rather than continuously, since they are ornery and not willing to stay in one place at a time! Fetal placement was verified by ultrasound, just to get the best idea of where each was hanging out in my uterus. Baby boy was still head down, along my left side. At this time, baby girl is presenting, butt down, spine midline and belly out toward my right side. She's a mover and shaker for sure! Fortunately, they are looking great on the monitor and do not appear to be in any stress as this point.

The cardiology fellow stops by at some point Tuesday afternoon to obtain a history and physical on me. I don't think at this point they have the result of the echocardiogram. Around 4:30pm, the fellow returns with the staff cardiologist. Amazingly, it does not look like I have peripartum cardiomyopathy. What a relief.... The test did show that my right ventricular pressures were elevated. Reasons for this could either be prior damage to cause the increased values, or fluid volume overload. At this point I'm praying/hoping that it is caused by the fluid volume overload. The cardiologist recommends a repeat echocardiogram in a few weeks to ensure no changes are noted. He also recommends no further pregnancy. Luckily, Chad and I agree this is a good idea, considering the issues we've already had. Luckily we got the two for one deal with this one!

Chad and I are relieved, yet know we are not out of the woods, yet.

Wednesday, my blood pressures remain borderline and high at some points. My OB starts me on Procardia to help keep my blood pressure at a manageable level. I'm lucky enough to enjoy the lovely side effect of massive, drill through my skull headache and visual changes. About an hour after I take it, the visual changes start, followed by the headache. I'm told the side effects tone down after I build up tolerance...let's hope so. Today (Saturday) I took it at 7am or so, along with two Tylenol and went back to bed. Luckily I slept through it all!

At this point, there is a chance that I could go home on Thursday. We try not to get our hopes up too much. Good thing we didn't. Sometime through the night, the kidney stone type pain returns.......yep. The ugly bugger returns. Can you believe it? I didn't sleep much through the night at all.

Thursday morning, my OB orders a renal ultrasound to check for any stone evidence in my left kidney or bladder. According to the ultrasound report from the radiologist, there is no evidence of stones found at all, only some hydronephrosis. Apparently this is common in pregnancy. Bloody hell.....is it supposed to feel like a stone is passing through my ureter? Or is my baby boy clawing at my kidney and ureter........??? My OB reviews the renal ultrasound and is not fully convinced that there was no stone damage and feels I may have already passed it. The distal end of my left ureter is enlarged and angry. Thank goodness, I was beginning to wonder if I was just being a wuss and not able to handle normal pregnancy issues......

One more night in the hospital. At this point, Chad and I agree that we are not going to make any plans to go home and half way expect to stay here until the babies are delivered. Poor Chad has developed a cold. Fortunately, we both feel ok with him going home at night to sleep and even head to work to keep up with his projects. God knows one of us needs some sort of order! And I doubt I'll be getting it anytime soon!

Friday morning arrives. Chad arrives early in the morning in hopes of being around when my OB makes rounds. She asks if I want to go home! Hot damn, yes I do! As long as I behave at home, on bedrest, up for a maximum of ten minutes per hour, and grow these babies......yippee! We are both honesty surprised but very happy at this point. Chad heads off to work until I'm ready to break free. By 11am, I'm home, enjoying another Procardia headache, but I'm HOME! Chad gets me settled, fluffed and puffed and heads off to work.

I'm happy to say that it's Saturday night and I'm doing ok. Bedrest has been tolerable. We are in it for the long haul and pray we can make it as close to 36 weeks as possible. Please keep us in your thoughts.

Chad and I appreciate any and all offers for help. Please know we will let you know when we need something.

later,
Jennie

6 comments:

Ramie Ahlstrom said...

Holy schmoly girl. SO glad you and the babies are doing well......bedrest definitely sounds like a cake walk, when compared to things that could have been. I'm sending hugs and prayers. Take care of you and those little munchkins.

Ramie

Anonymous said...

((((Jennie)))))
You know I'm thinking of you and praying for you and those precious babies everyday. I'm only a phone call away if you need ANYTHING!!

Missy

Diana said...

Holy moly! Wow what a week - pretty scary stuff! I sure hope that the rest of your pregnancy goes much smoother and you are holding those babies soon!

Anonymous said...

A lot of things have changed in the world of peripartum cardiomyopathy. It is not bleak, as it once was. I know that it has been ruled out for now, but just in case there is a support site: http://www.amothersheart.org/members/index.php
We even have one of the authors of the PPCM article in the 2006 lancet to answer our questions: http://www.hefssa.org/content/downloads/2006_ppcm-lancet.pdf

BNP and hsCRP are good markers for anticipating PPCM.

Twin pregnancies are tough! Hang in there.

Best,

Anne, a PPCMer

Kath W said...

So glad it turned out not to be what they thought! I know you guys said you're done having more kids, but it took my breath away for a moment when the cardio guy said no more. : ( Prayers being said for a safe and boring rest of your pregnancy and delivery.

Anonymous said...

HI . I am glad that you are home ,.I know how twin prgnencies can be . I was on bed rest for my twin boys from 28 weeks until they reached 36 weeks. I unfortunately developed peripartum cardiomyopathy and am on my way to recovery . The treatment of ppcm has come a long way and there are many women who are getting full recovery .The key is early identification. I was so happy to read that your OB thought of that right off . Simple blood test like a BNP and hsCRP can help monitor your heart function and are excellent indicators of any potential problems . They are worth having even if yoou think "that couldnt happen to me " .information on ppcm can be found at www.amothersheart.com
Praying for you and the little ones and that 36 week mark