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.

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. 

Twin Pregnancy: 23 weeks + 2 days

Second trimester has been slightly easier than first trimester. Now, instead of my head in a toilet vomiting everything, I am able to eat most things (still can't eat spaghetti and some chicken ingredient foods).  In fact, I get sudden hunger pangs, where I go from zero to one hundred in a second, and I need something to eat right then. Luckily, since I can tolerate more foods, I have been eating more at home, and less out to eat. Which has saved us a lot of money. Now that I am seeing prices of baby items, I'm really trying to be more fiscally responsible with finances. 

I had acid reflux in the first trimester periodically, but now I have it nearly 24 hours a day. There's no "heartburn," but more like the sensation that food is stuck in the back of my throat. It doesn't go away with Zantac 150mg twice daily either. What I did find, was that milk of magnesia helped resolve that food-stuck in my throat sensation well. Only problem is, the taste milk of magnesia makes me nauseous. It also is effective with constipation and deemed okay for use in pregnancy. As my OB put it, "drink as much as you want. It's fine." With constipation being a common symptom in pregnancy, many women resort to milk of magnesia, as Colace (I found) was ineffective). Constipation effected me more in the first trimester. So far, I find if I drink at least 80oz of water daily, constipation relatively resolves itself. OB recommends a gallon a day, but between me peeing every 20 minutes, I don't think my body could physically tolerate any more water. Sometimes, I will come out of the restroom, only to go back 30 seconds later to pee again. Husband jokes he can't take me around any more to run simple errands, because I have to pee as soon as we walk in and then 10 minutes after. In order to help with the pressure on my bladder, I find myself having to take small steps and walk slowly. I'm sure I look ridiculous, along with my pregnancy waddle. 

The most painful symptom I have had, started yesterday. I think one or both of the babies have confused my cervix for a punching bag. I nearly cried last night they were so active. My mom is concerned they may be contractions, but at this time, they're irregular anyway.

The other day, I went to Costco, around lunch time, and I hadn't eat lunch yet. I went, not hungry for lunch yet and planning to eat once I got home. During this errand, in Costco, I started breaking out into a cold sweat, feeling lightheaded, and dizzy. I've been experiencing shortness of breath for the past few weeks, but my shortness of breath was even worse during this dizzy spell. The dizzy spell lasted an hour or more. I wasn't even hungry, so I wondered why I was experiencing these symptoms.  I called my mom to let her know to stay on the phone with me, in case anything happened, and I fainted. Thank goodness for moms. When I got home, I immediately downed a protein shake, and I felt much better. Now, I always try to eat before running an errand to avoid a scary dizzy spell. 

Just last week, we were at a huge public event where thousands of people attended. I had a sudden pang of bladder pressure and urge to pee. I held it for an hour, until we could find a restroom. Holding it started to become so painful. I found port-potties to use, with a huge line. I still can't believe I resorted to this, but I approached the he cop near it, and told him I needed to use the restroom right now. He said to stand in line. Without even trying, I broke down in tears, telling him my situation. He did probably what every chivalrous male would have done and got me to the front of the line. There were a lot of angry people, but I had heard, that holding your urine too long can cause contractions, and like I stated, it already had become very painful. I am so embarrassed to even admit that I did this though. Don't judge me to badly. 

With all these typical symptoms and my ever growing rounded belly, it was becoming difficult to hide this from family. We told my in-laws during a camping trip that I was pregnant (didn't tell them I was having twins though) at almost 15 weeks. We told my family I was pregnant with twins between 15 to 16 weeks. My grandma was ecstatic, calling me "her successor." She had fraternal twin girls, but has no idea we used IVF. At 20 weeks, my husband's side of the family and us, went on another camping trip, and for my husband's birthday, we told his side of the family we were having boy girl twins. We didn't do it in any cute sort of way, which I kind of regret, but my husband was bursting to tell them. They were shocked. Some inquired about IVF, but my husband denied it, I just don't need or want anyone's judgment to weigh on my pregnancy. I already have an extra 15 pounds on my belly, and don't need anyone else's judgement to weigh me down further. 

Kudos to anyone that is open and honest about their whole process though. 

At around 21 weeks, I found decent cribs at Walmart on sale, which I nabbed immediately, even though I had promised myself I would not buy anything until closer to 24 weeks. I am glad I didn't pass up the good deal though. We still need crib mattresses. Who knew a decent crib mattress could be so expensive! I am trying to do research on them. Speaking of research, I've been trying to learn everything I can about strollers. I ordered the City Select Lux yesterday, because it was on sale from normally an $829 price tag to $639. I may return it, if I find a used on for half that price though. $639 doesn't include the cost of two infant car seats and two adapters. 

I hope to write more frequently and am sad I haven't been writing as often as I would have liked. 

7w2d: Nausea without vomiting

Nausea without vomiting is an ICD10 code. It's also the definition of most of my days.

I am barely functioning at work when the nausea hits. I feel like I want to throw up and sometimes I feel the vomit coming up, but as gross as it sounds, I swallow it before it can make it out of my mouth. I don't want to be throwing up the Estradiol medications I am taking three times daily. IVF doc called me in Bonjesta after giving me six free tabs. At first it was helping, but has since stopped. It made me very drowsy, even the next morning. In a way, I am kind of glad it stopped working. Even with my insurance, it was $600 for 60 pills! That is robbery. Diclegis was not much cheaper at almost $400. I asked the doc for some Zofran prior to the frozen embryo transfer (FET), but he said there were too many side effects. My co-workers just keep telling me to "sneak" a zofran, because they all did it in their pregnancies, and they were fine. But I have always been one to listen to what my doctor tells me. I would feel guilty if something happened to my babies and I had taken zofran.

I also started having strange aversions to some foods. I don't want to look at fruit yogurt, chicken doesn't taste good, and mint ice cream looks disgusting. The only thing I want or can eat is at dinner time, at this one hole in the wall Mexican food place. I love their carne asada burritos. Except last night, it started tasting questionable to be too. I force myself to eat breakfast, since I wake up ravishing, but nothing sounds good. Eating breakfast sometimes helps the nausea subside slightly too.

I am still getting intermittent cramps, but they kind of feel like round ligament pains, just based on where the cramps are. It hurts when I sneeze or cough. I have never spotted or bled though.

I have never been prone to headaches, but I have been getting them more often. Not migrainous in nature, and not the worst headache of my life, but definitely there. I take Tylenol and a two to three sips of Pepsi sometimes to settle it.

Later this afternoon, I will have my second ultrasound with the IVF clinic. They had appointments early this morning, but I wanted husband to be there, in case it is bad news. I keep thinking of the worst. I can't help it. Today I am 7 weeks 2 days.

I am hoping for the best, because I haven't had any bleeding or discharge.

Is it this normal to be anxious about every ultrasound?