Since I have been admitted to the hospital on bedrest since December 7th, I am realizing how my thoughts can run rampant and think of all the worst possible scenarios. I have been so anxious about the "fear of pain" and the "fear of the unknown" for labor and delivery.
Today, I realized that my anxiety has improved so much. My nurse last night told me everyone who would be in the room at the time of my delivery. Two NICU teams, two respiratory therapists, two of my nurses, my doctor, and if I need a c-section, a scrub tech and a first assist. Hearing about all those people in one room would normally freak me out, but all of a sudden, I realized that most people in that room are for my babies. A sort of calm ran through me and I realized how grateful I am that there are medical people specializing in this field. I know there will be pain, but I am getting to that point where I just feel so blessed my babies have been overall doing so well during their fetal monitoring despite my PPROM. My perspective has changed so much, since my admittance at the hospital. I became a part of a PPROM facebook support group and so many women have stories where they ruptures before their baby's viability! I feel so blessed that my babies are viable and how well they are doing. If my rupture was inevitable, at least I was blessed enough that they were viable right? If I don't spin the story to seeing the glass as half full, I'll go into depression here at the hospital. Seeing these 4 walls everyday, eating hospital food, and not sleeping in my bed with my husband and dog can really eat at a person's positivity. I still have 4 more weeks, so I'll try to keep my chin up till then.
Monday, December 17, 2018
Thursday, December 13, 2018
29w5d: PPROM
It's been 6 days since I was diagnosed with PPROM (preterm premature rupture of membranes), and admitted to the hospital. I'm still in shock that this happened to me. Apparently PPROM occurs in only 3% of pregnancies and on Friday morning, I joined that small minority of pregnancies.
As I creep nearer and nearer to 34 weeks, I have been peppering the nurses with questions about the labor and delivery process. They have all been up front with me about how painful and messy it all is, and I appreciate their honesty. I do have a long history of severe anxiety though, and asked them about ways to cope with the "fear of pain." One of my nurses (Jill) told me to ask my doctor about nitrous oxide ("laughing gas"). She suggested this when I told her I was planning on having an epidural, but I was fearful of the pain that might come with an epidural. I discussed this with my doctor and he told me to request nitrous oxide before the epidural to relax me. He said the anesthesiologist wouldn't let me inhale the gas as the epidural was going in, but I am crossing my fingers the nitrous oxide will have a lasting effect through the epidural, to the point where my anxiety will be reduced. My nurses also told me they give Dilaudid for patients with contractions, but not dilated, and too soon for the epidural. I wanted to ask my doctor that question, but I was too embarrassed to ask. I understand women can get anxious before birth day, but I feel like I take it to a new level...
A typical day at the hospital consists of round the clock antibiotics. The first two days I was given lactated ringer solution fluids, ampicillin and magnesium. My nurses described magnesium as "flu in a bottle." It just makes you feel terrible and weak. I received two steroid injections and a Tdap injection. I stopped IVs Sunday and take oral medications only. I take oral antibiotics every 8 hours and a prenatal vitamin once daily. On an as needed basis, I take Pepcid, Colace, Diclegis, and at night, they offer Ambien. I felt guilty taking Ambien, but the doctor has OK'ed it and told me everyone on the floor takes it. It's so hard sleeping here, and it simultaneously helps with anxiousness. I suck up the guilt and try to remember the doctor OK'ed it. Twice a day, we do fetal monitoring and babies have been doing amazing. Other than one night with brief decelerations, which they checked on ultrasound, and they received a perfect 8/8 score. According to the tech and doctors, we cannot be sure which twin's sac ruptured, but it appears the girl's sac broke because she has the least fluid. They measure their fluid using the "deepest vertical pocket" of fluid and as long as it's over 2, it's fine. The boy's fluid measures 2.4 and the girl's fluid measures 2.1. In singleton pregnancies, they use the term AFI (amniotic fluid index), but not in twins normally. On ultrasound, it appears the girl twin is no longer twin B. She migrated down and is now twin A (closer to the cervix) and both twins are both head down. Every day, I do "leak" amniotic fluid and doctors tell me I will leak until I deliver, so I wear this embarrassing huge blue pad that makes me feel like I'm 90 years old. *sigh*
I had a few visitors today which was so nice. It made me feel human again. Everyone in my church has been extremely helpful from bringing my husband food to bringing me some sort of gift in the hospital. I still haven't announced my pregnancy officially yet on facebook, and only family and few friends know, so it's nice that the few that know, care. It helps me from stressing out and keeps my mind from wandering. I hope they continue to remember me the next 30 days.
As I creep nearer and nearer to 34 weeks, I have been peppering the nurses with questions about the labor and delivery process. They have all been up front with me about how painful and messy it all is, and I appreciate their honesty. I do have a long history of severe anxiety though, and asked them about ways to cope with the "fear of pain." One of my nurses (Jill) told me to ask my doctor about nitrous oxide ("laughing gas"). She suggested this when I told her I was planning on having an epidural, but I was fearful of the pain that might come with an epidural. I discussed this with my doctor and he told me to request nitrous oxide before the epidural to relax me. He said the anesthesiologist wouldn't let me inhale the gas as the epidural was going in, but I am crossing my fingers the nitrous oxide will have a lasting effect through the epidural, to the point where my anxiety will be reduced. My nurses also told me they give Dilaudid for patients with contractions, but not dilated, and too soon for the epidural. I wanted to ask my doctor that question, but I was too embarrassed to ask. I understand women can get anxious before birth day, but I feel like I take it to a new level...
A typical day at the hospital consists of round the clock antibiotics. The first two days I was given lactated ringer solution fluids, ampicillin and magnesium. My nurses described magnesium as "flu in a bottle." It just makes you feel terrible and weak. I received two steroid injections and a Tdap injection. I stopped IVs Sunday and take oral medications only. I take oral antibiotics every 8 hours and a prenatal vitamin once daily. On an as needed basis, I take Pepcid, Colace, Diclegis, and at night, they offer Ambien. I felt guilty taking Ambien, but the doctor has OK'ed it and told me everyone on the floor takes it. It's so hard sleeping here, and it simultaneously helps with anxiousness. I suck up the guilt and try to remember the doctor OK'ed it. Twice a day, we do fetal monitoring and babies have been doing amazing. Other than one night with brief decelerations, which they checked on ultrasound, and they received a perfect 8/8 score. According to the tech and doctors, we cannot be sure which twin's sac ruptured, but it appears the girl's sac broke because she has the least fluid. They measure their fluid using the "deepest vertical pocket" of fluid and as long as it's over 2, it's fine. The boy's fluid measures 2.4 and the girl's fluid measures 2.1. In singleton pregnancies, they use the term AFI (amniotic fluid index), but not in twins normally. On ultrasound, it appears the girl twin is no longer twin B. She migrated down and is now twin A (closer to the cervix) and both twins are both head down. Every day, I do "leak" amniotic fluid and doctors tell me I will leak until I deliver, so I wear this embarrassing huge blue pad that makes me feel like I'm 90 years old. *sigh*
I had a few visitors today which was so nice. It made me feel human again. Everyone in my church has been extremely helpful from bringing my husband food to bringing me some sort of gift in the hospital. I still haven't announced my pregnancy officially yet on facebook, and only family and few friends know, so it's nice that the few that know, care. It helps me from stressing out and keeps my mind from wandering. I hope they continue to remember me the next 30 days.
Monday, December 10, 2018
PPROM: Preterm premature rupture of the membranes at 28w6d
At around 6:30AM on Friday, December 7th, I started to feel a mild trickle of water in my PJs. At the time, I was lying down in bed, and cuddling with my pup, and my initial thought was, "Ive reached the incontinent stage." I noticed that it only trickled when I took a deep breath in, so didn't immediately attribute it to anything else. I laid there still for a few more minutes, but with each deep breath, I would feel that slow trickle. I got up to empty my bladder, and noticed my PJ's were soaked. I was alarmed, but still thought that it could still just be urine. I took my now wet PJ bottoms and did a load of laundry, and put on a new pair of PJ pants. I laid myself down again, and noticed the leak was not going away.
My husband had already left for work, so I tried calling him. He didn't answer, so I called the OB nurse my insurance offered for free 24/7. The nurse started asking me ridiculous questions, like if I felt a baby's leg in my vagina, or if I was having 'shock' symptoms. When I felt like she was just asking me generic questions, I told her I knew what I had to do and hung up. I texted my husband I thought my water had broken, and he called back within a few minutes. He rushed back home to take me to the hospital. I still didn't know if I believed that my water could have broken, and I still thought there was a chance I peed.
We entered the maternity section of the hospital, and I walked in hunched over and wet PJ pants. They directed me to registration. I had already sent in my registry papers by mail, so I was irritated when they said they didn't have them. I kept stalling the registry woman I was leaking and I was in pain, but she kept asking me about my social security and insurance, as I was leaking onto her chair, *sigh*. I took a deep breath and answered all of her never ending questions about my insurance and address, She had me walk myself through the triage doors and the nurses took over.
They immediately asked pertinent questions to my situation and the nurse got a sample of the fluid that was leaking to do a "fern" test. The "fern" test confirm is the fluid was amniotic fluid. A few minutes later, the nurse returned confirming that my water broke and that I was going to be admitted.
They kept me on fetal monitoring while I waited for an open room. I was having regular contractions every 10 minutes, but they were not intense. They started me on magnesium which reduced the frequency of the contractions. Magnesium deserves its own blog post, but I will summarize here. IV Magnesium is like the "flu in a bottle." It made my teeth chatter from chills, and the next minute, I was burning up. My muscles were so weak (it relaxes muscles to ease contractions), I could barely move on my own. It makes you light headed and gives you terrible headaches. All in the name of saving my babies and keeping them inutero, I endured for 48 hours on Magnesium. My doctors also told me it helps with cerebral safety for the babies should they delivery early.
Once admitted, they administered a steroid injection that is intramuscular. If you are at risk to deliver early, they will administer two steroid injections over the course of 48 hours to accelerate baby's lung development.
Their primary goal was to keep them inutero until Sunday. This would give the steroid injection enough time to work its magic on the babies' lungs. I've made it until Monday afternoon, and I hope many more afternoons until they induce me at 34 weeks. The longer they stay in the better!
I was cleared yesterday to shower, and cleared today to go outside in a wheelchair. I'm so excited for this! It's the little things I get to look forward to now. I will update later.
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