September 16: An Unexpected Journey

Tuesday morning, headache was back.  I had been up all night reading Sharp Objects by Gillian Flynn after having devoured Gone Girl over the weekend.  I finally get the hype now.  It's the train wreck you can't look away from and there's something seriously magnetic about the entirely messed up characters.  Nothing like a sordid thriller to take away pregnancy pains.  I read it between the hours of 10 pm and 4 am, it was so absorbing.  I'm sure the suspense helped my BP readings.  Little T seemed content to thump around all night as I read into the early hours of what would become her birthday. 

Rhett had stayed home with me both Friday and Monday through all the appointments/tests.  I hadn't been able to drive myself anywhere going on two weeks at that point so it was extra nice to have him around but I was feeling guilty about needing a murse (male nurse) to look after me.  Tuesday morning, I foolishly sent him to work saying I'd text immediately when test results were back.  Yeah...not one of my best judgement calls.  In retrospect, that was pretty dumb but who knew we'd be having a baby later that night?

I luckily logged onto the patient portal website through my OB office and saw that labs had come back late the previous night.  Wow, that was oddly fast.  It took me over three hours of cross referencing and over analyzing numbers to realize that these were FRIDAY'S results from the hospital.  D'oh!  Thought that was odd of LabCorp to be so prompt.  I then panicked and called the OB office saying I was waiting on results and could Dr. Convery please call to confirm she got them.  They had just come in that morning and would be reviewed shortly.  Many more hours of waiting, me feeling progressively crappier and crappier, barely getting out of bed and just short of blacking out, and finally my phone rings.  It's Dr. Convery.  Yes, I have been spilling protein in my urine and my blood work indicates renal distress.  It's definitely preeclampsia but it's atypical presentation.  She doesn't know quite how to proceed because she's never seen a case like me.  Obvious indication is delivery but she wants to consult with Dr. Garfinkel first.  She tells me to pack myself up for the hospital and she'll call me right back.

Wait...hospital?  Like this is go-time?  Fudge.  My husband is in Hoboken, my dog has no kennel reservations, I am alone and not driving.  I immediately text Rhett.

"Hi!  How soon can you get home?"

"I'll call you in five minutes."

Great.

Then I text my dad, hoping he's not in a meeting.  He is not and can be there in 30 minutes unless I need him sooner.  Yes, sooner.

Convery calls back.  Dr. Garfinkel wants you to go to the hospital so he can evaluate you himself.  He may be delivering you tonight so be prepared.  When is the last time you had something to eat or drink?  Good luck and let me know if anything changes.   

Holy shit.  A baby?  Tonight?  This baby.  She's possibly being born a month early and it's my fault because I developed this condition.  What if she's not ready?  I'm ready but is she?  I know they told me she was 6 lbs 14 oz last Wednesday but I didn't really believe that was accurate.  Thank goodness I shaved my legs but what about my cha-cha?  I think they do it if you haven't.  Oh my God, we're having a baby?  This is not what I planned.  I'm just so happy she's packed and I'm packed and I hope Rhett finished shoving things in his bag.  Oscar.  Oh man, let me call the kennel.  Rhett will have to take him.  I hope he can get home ASAP.  Cab?  Train direct to Morristown - oh good, he's calling me back.  

I fill my husband in on everything that's happened as my father pulls up, ready to drive me to L&D for the fifth time in a month.  This time, though, I have a feeling I won't be going home and when I do, it will be with our fundal bundle.  While not exactly the way I saw the drive to the hospital playing out, it was kind of nice to have my dad along for the ride.  After all, who better to have by your side than the man who was there for your own deeply dramatic, eventful birth?  Like mother, like daughter, I guess.  We made it to the hospital in a record 30 minutes, arriving shortly after 4:00 PM.

Sweet.  A preggo spot is open, which is oddly located further away from the entrance than the "parking for strollers" spots.  Whatever, stroller parents.  You have wheels.  Your legs aren't shaking because this is probably the last time you'll be walking for 48 hours.  Did I mention how incredibly strange it is to go from 0-60 in the span of two hours?

The Gathering Storm: September 10-14

First off, it's odd to think about all of the factors leading up to Tempest's birth in the past tense now that she's literally in front of me as I type this, peacefully cooing into my bosom.  (She doesn't mind the tapping of MacBook keys as long as there's milk in it for her.)

The combination of late pregnancy symptoms and the rate at which they escalated really did have the odds stacked against us of being full term but we were lucky enough to have a healthy, term-sized baby waiting impatiently to be helped out of my cozy womb.  This kid is amazing and yes, I am biased.

September 10 
With a tentative c-section date of September 23 on the calendar, our final MFM scan revealed that the previa had become a marginal previa which is categorized as being at least two cm from the cervix.  Are you serious?  Awesome...I guess?!  Now what?  The bugaboo which shadowed me the entire pregnancy defied the statistical odds and cleared itself of the birth canal just before 36 weeks, however the vascular cervix was still very much lighting up the screen and our dear daughter was confirmed breech.  C-section it would still be, though likely at term in another three weeks.  Ugh.
The bright spot of the appointment was a confirmed face sighting in utero and a generous tech who took some 3D shots of Tess.

Shockingly, this was an incredibly accurate preview.  A nice ending to an otherwise confusing/frustrating/happily resolved appointment.


September 12
By now I had been off procardia for three days though new symptoms unrelated to irritable uterus were cropping up.  I had sudden swelling of my left ankle and leg accompanied by constant calf pain that alarmed me enough to call the after hours number to check in.  The midwife answered and reassured me that edema of one leg can be common in the late third trimester because the uterus tilts to one side.  OK, but this was different and deep down I think I knew that so by the time we arrived to see Dr. Convery at what was supposed to be a typical wellness check the next morning, my suspicions had turned very serious overnight.  In addition to a general feeling of something being "off," I had been experiencing a headache and nausea unlike any I'd dealt with throughout pregnancy but the real clincher came when the nurse took my blood pressure - typically 100-110/70 like clockwork - and it first read 134/89.  Whaaaat?  I mean, sure, I was getting anxious now that our time frame was up in the air but not that anxious.  

She moved us to another room with a different cuff and took it again, asking questions about how I was feeling and taking me very seriously.  The reading was a bit lower this time, 128/89, but still a huge jump for me.  I knew it before she said it: could be early onset preeclampsia and the doctor would be in shortly to discuss.  Now true eclampsia is fairly infamous for killing the beloved Sybil Crawley on "Downton Abbey" but this is not 1920's England, thank goodness.  Today, preeclampsia, when discovered in time, does not yield high mortality rates.  It is fully treatable.  By delivery.  Yes, that's right: the only proven treatment for preeclampsia, which usually develops after 36 weeks, is giving birth typically by c-section to minimize risks to the mother and baby.      

Dr. Convery came in concerned and told me there was trace protein in my urine that day.  Never had that before.  She ordered a 24 hour urine collection test and blood panel but because it was Friday, I'd have to wait till Monday.  We were sent on our considerably less merry way to puzzle out how it was that I could have developed two rare and extremely serious complications in my first pregnancy that was otherwise as healthy as could be.

By 4 pm that day, I was on the phone with Dr. Convery describing what was one of the scariest days of my pregnant experience.  I felt like I was falling apart and I was worried for the baby.  I could barely breath, I was lightheaded, nauseous, aching, with my heart thumping out of my chest.  She said get to L&D ASAP to be evaluated and they would do some blood work there.  Another fun day of IVs at Morristown Medical Center maternity triage, this time with a Doppler of my legs to check for blood clots which I honestly don't remember having because they gave me some epic painkillers that made me feel like a drunk-ass sorority and we were finally discharged around 10 pm. .  I was ordered simply to rest and keep my feet elevated since my blood work came back at the limits of normal. 

Sunday, September 14 I did the 24 hour urine collection.  A 3-liter jug was almost not enough!  Dr. Convery was amused when I suggested as much in the office but clearly she doesn't know my champion bladder and the output it's capable of.  I just made the sample without going over, partially by holding my pee during the last few hours of collection.  On Monday morning, we dropped the sample at LabCorp and I did another blood panel.  Nothing to do but wait patiently for results.  I also had Rhett pick up a home BP cuff to keep an eye on my rising levels and rise they did.  I logged each and every measurement. 

On Monday, September 15 I felt sufficiently crummy but still had no hard evidence back from the lab work yet.  I instinctively knew, though, that my body was turning on me and I just hoped that some anomaly would crop up that my doctors would catch and be able to diagnose me with something tangible and treatable.  It was agony, waiting to hear, and my immense physical discomfort certainly didn't help.  The truth is no matter what the prognosis, I was simply ready to have this baby.  Turns out I'd get my wish faster than I had hoped.  

A Tempest

Gosh, I haven't written in well over a week but I have pretty much the best excuse in the world and her name is Tempest.

SURPRISE!

The next several posts will be dedicated to a retrospective look at the very unexpected birth of our daughter.  She's finally here!  I didn't even get to write my letter to her entitled "On the Eve of Your Birth" it happened so quickly.  Now she's snuggled in her daddy's arms in the nursery we worked so hard to make ready for her homecoming and not a day too soon. 

Tempest Felicity Caldwell Austell was born one week ago today at 9:27 PM on Tuesday, September 16.  She weighed 7 lbs, 3 oz ad was 20.5 inches long at birth.  For a 36-weeker, or "later preterm" baby she is practically perfect in every way, despite a mild case of jaundice which we're working at expunging from her system the old-fashioned way: got milk?

She arrived 3 weeks early due to a rather dramatic confluence of sudden medical factors -- would we have it any other way? -- so to say we never saw this coming is putting it mildly.  Neither of us ever thought in our wildest planning that our 5th trip to L&D would result in an actual baby.  But I'm getting ahead of myself.

Tess, as we've taken to calling her, deserves the chronicle of her birth I had planned to write so indulge me a bit.  Let's journey back two weeks and engage in a little story time.  I left you on the eve of our final MFM ultrasound, waiting for the final prognosis of placenta previa and an actual c-section date. 

Month 9

In another week, I'll technically be in the "4th trimester" or 10th month...which really is a crock, when you consider 9 months is plenty long to grow a baby.  I'm feeling every inch of this gestation, even if I am not yet the size of Wisconsin.  No one told me this monthly rodeo would stretch on into the the double digits.

*Bitchfest Alert* 

Remember that old running injury sustained during training for the Philly Half some 5 years ago?  Yeah, that's come back to bite me because of the added strain on my joints and ligaments.  Had to ice my damn meniscus yesterday, even though my activity is limited to walking Oscar and occasionally going up and down stairs!  The constant dueling Charlie Horses are fun, as is the vice in my cervix, not to mention the "throat snores" that leave me gasping for air and trying not to choke when I realize I'm crushing my poor, deflated lungs.  Realistically, I know that the final few weeks are uncomfortable for every pregnant women, well, ever, but never in a million years did I anticipate the endless stream of new symptoms/annoyances that pop up seemingly daily now.  I just did not think that it would be this acutely disruptive.  I'm an idiot, I guess. 

This procardia mess is like bringing on an octogenarian menopause (I'll spare you the numerous unpleasant side effects) and that's not making me a happy camper, either.  Is it better to risk crippling contractions several times a day or is it better to medicate, causing what is essentially one long, sustained contraction that turns my uterus into granite?  I'm so relieved to only be on this stuff for a week.  I have no qualms about stopping it and letting nature take its course, as directed by my doctor.  After 36 weeks the medication is no longer effective at preventing contractions and to that I say, fine.  Bring it on.

*End Bitchfest...for now*  I feel better already just letting it all out.

I suppose I'm particularly antsy ahead of tomorrow's MFM scan, not because of the baby but for my own peace of mind.  We're checking on the placenta and the cervix and whatever information that turns up is what we go with.  If there's one thing I can't stand it's not having a clear plan.  There are so many dang variables flying around that I have had to make do with having absolutely no control over anything at this point and that's not sitting well with me.  I think I have PTSD in this regard from the events of the past year-and-a-half and the IVF experience.  I never thought I'd be possibly two weeks out from delivery and not have a validated plan of action so depending on what we hear tomorrow, I'm really going to push for some specifics on Friday.  I've been patient.  I've not harassed my OB with minutia but now it's so close to Go Time that I really need more than a bunch of potential scenarios.  Though I don't subscribe to the Special Snowflake outlook on life, I realize this is not your typical pregnancy, nor is it your typical birth.  I actually am a unique case.  Go figure.

We have a "birth goals" sheet.  It's not one of those obnoxiously detailed Birth Plans that must be followed as closely as the Ten Commandments but it's an idea of what we're hoping can happen, should the situation warrant our requests.  I trust the medical professionals to provide the best care but I so want to watch the entire surgery.  If they can't lower the sheet, I hope I can get a mirror so I can view the procedure from first cut to last stitch.  When on earth am I going to get to witness my own surgery again?  That's my Number One item on the wish list. 

Whatever tomorrow brings, it will be more information than we currently have.  All this hurry-up-and-wait business is exhausting but my only job for the next few weeks is to remain calm, grow this baby as healthy as she can be, and try not to get upset about things I can't change.  Easier said than done when the new sleep schedule is basically 8:00-10:00 AM and 1:00-3:00 PM but at least classes are over, the bags are packed, the gear is ready to go, and now we wait as patiently as we can - which in my case, is not very.

Amusing things I've done before 4:00 AM

I've certainly had moments of wandering the halls like a restless phantom throughout this pregnancy but most notably in the last two weeks, I find it next to impossible to sleep past 3:00 AM.  So far, I've managed to avoid somnambulant fridge raiding but here's an amusing list of what I've tried (and failed) to accomplish:

• Writing a final paper
• Editing a final paper (not so much!)
• Composing long-overdue emails to friends
• Downward dog to move PB's head out of my right ribs -- girl, I ain't John Hurt.
• Catching up on YA novels I've been meaning to read for years, including most recently Walk Two Moons, Speak, The Perks of Being a Wallflower (ok, two of those were for class)
• Playing with the white noise generator.  Oscar prefers "babbling brook" but it gives me the urge to urinate even more frequently than every 5 minutes so I'm going to go with "thunderstorm" as the favorite.
• Trying one of those airplane neck pillows so my head doesn't loll around in case I doze off in the glider but instead, settling for restless PTSD after recalling some truly horrendous overnight flights using said pillow.  After about five minutes, I chuck it on the floor in exasperation. 
• Listening to David Bowie's Peter and the Wolf narration, which is the best approximation of Oscar attempting to stomp through the bushes on his morning walks ever set to music.  (He is the duck, of course.) 
• Drinking coconut water which, let's face it, taste like moldy dishtowel.  Never going to like this stuff.
• Attempting to get my wedding ring off before it's too late.  Failing.  Back into the ice bucket, this time trying the cling-wrap-trick-with-Palmolive.  Failing.  Lots of cursing.  Sonofabitch HURTS.  It is the only finger, naturally, that has decided to swell to twice its normal size.  My right hand, and feet and ankles, for that matter, are freakishly fine because of course they are.  I believe I have succeeded in spraining my ring finger so I'll be icing the shit out of that tomorrow morning and come 4:00 AM, trying the Crisco-and-tape method.  Pray for me. 
• Taking a bath
• Removing nail polish
• Meditating
• Screw it, it's been two hours: let's take another bath
• Loading our Netflix queue with movies I'll never watch
• Rereading this blog, started nearly a year ago, and marveling at how close we are to bringing our daughter home, despite the ongoing twists and turns which continue to throw us for some real loops.  Though 3+ weeks feels, at times, insurmountable, it really isn't so far away now.  Only 20-some nights of wee-morning activities to go!

September

Hallelujah!  September is finally here and my 20-something-day countdown has begun.  Labor Day came and went with no, uh, labor scares so that was an accomplishment.  Also, Bertucci's.  We have one close by.  Who KNEW? 

Hopefully the week is L&D free, though with this b.s. sauna-like heatwave, I'm not tempting fate by going outside more than Oscar absolutely needs.  On that note, our furry Romeo can't make it past his lady love Daisy's house without peeing on her wall or trying to leave her "presents" in the yard.  The two of them really need to get a room...

Maggie, the older wiser white dog, who has been cast in the role of "Nurse," sits with her back to these two crazy kids, rolling her eyes, not chaperoning very well at all.  I guess that makes me...Friar Lawrence?  I'm like, "Hey, yeah, great idea getting these two together!  This couldn't possibly end poorly."  And then our Juliet runs out into the street because she's 5 months old and can't quite control her floppy puppy body.  I do take secret pleasure in letting the young lovers mack it on "Friendly Neighbors'" front strip.  They are dog haters and generally unpleasant folk so it's their misfortune to live behind the nearest fire hydrant. 

We'll save the lovin' for when the sun goes down, to paraphrase Fleetwood Mac, and keep the A/C blasting this week.

Otherwise, my morning will be spent cursing the world's loudest lawn maintenance fleet as they blow the dirt and fallen leaves around unnecessarily while I finish up my final Linguistics project.  (I can't wait till they start coming during PB's nap time and I am out on the street raving at the heavens because she can't sleep through their racket.)  Maybe I'm just cranky because I woke up in the glider at 5:45 AM after less than 2 hours of sleep...I remember getting out of bed around 3:45 because I couldn't breathe propped up or lying on either side.  This is such a fun game!  Can't wait to see where I wake up tomorrow.

Waiting for the doctor to call at some point this week with intel about rescheduling the MFM scan next week but otherwise, today is my final day of working on anything Drexel related until January.  WOHOO!

Damn straight, Grandpa Joe. 







 

L&D: Round Two

Ever had one of those moments where you're convinced that you've finally figured it out and somehow, sheer mental preparation will beat whatever obstacle it is that you're up against -- only to be proven completely and utterly wrong by this hypothesis? 

It's what my teenagers call an "Epic Fail."  My uterus is failing me, epically, laughing all the way through my frequent warm baths, hot/cold compresses, stretches, and water chugging.

"Not so fast," it says.  "I did NOT ok a giant baby in there and I am not happy."

What. A. Bitch.  

Yesterday was actually not a terrible day in IU Land until about 1:30 PM.  That's when the Big Kahuna tried to surf a 30-footer and failed.  I knew something was just wrong.  For 90+ unrelenting minutes I could barely stand, my ribs and back were on fire, and this was just not a contraction I was willing to risk so I phoned it in.  Within 30 minutes, the doctor called back and I caught her up to speed on what has been happening since August 16.  She said it absolutely sounded like Braxton-Hicks/Irritable Uterus and not preterm labor (yes, thank you) but that to be sure there was nothing else going on I should always plan on heading to the hospital when they get that bad.  Oh, and probably this is the way my body just handles pregnancy. 

Protocol is:
1. Call it in to the OB
2. Wait for her to send you to L&D. 

Luckily my dad was available to drive me up to Morristown.  I don't think I could have driven myself in the end.  This is where I feel torn that we live two minutes from two good hospitals and 35 minutes from a great one but for my daughter, I won't settle for good, despite the inconvenience. 

It always feels like a defeat to show up at L&D, knowing deep down there's no baby coming imminently, and have people make a fuss over something that of course is going to dissipate by the time you actually get there 35 min later.  Same thing last week: I was on two separate monitors for a total of probably 2-3 hours and only saw minimal spikes in contractions.  What I have felt every day for the past week simply does not occur at the hospital and I'm absolutely not making it up.  It's frustrating as hell.  I don't want to be the "lady who cried preterm labor" but now that there's written record of my IU issues, I should probably relax.  No one is treating me any differently than other women who eventually get sent home from triage to wait it out.  I'm taking no chances with the previa and the other hot mess of my medical history.

Luckily, the nurse last night was incredibly compassionate and thorough.  She said she could absolutely trace the constant micro contractions on the monitor and that my uterus was definitely "angry about something."  Her theory is that because I'm in the home stretch and the uterus is almost at capacity, it is bumping up against all of my scar tissue and that's what sets it off.  Doesn't help that I have a super active baby rolling around all the time, aggravating it, but at least this doesn't seem to faze PB one bit.  Add endometriosis, adenomyosis, and placenta previa into the mix and this is not your typical pregnancy.  I asked if it would get worse before delivery day and she very sympathetically said, "probably."  She was a wonderful cheerleader, though, urging me to come in any time I felt like I felt earlier that day.  She said she's had patients who make routine visits to L&D just to get some relief for whatever it is they are experiencing and that she'd rather give me an IV of fluids every week for the next three weeks rather than have me stay home the one time it would have made all the difference to come in.  Sound advice.

Did I mention Morristown has the best nurses?

So she hooked me up to the IV, ordered by my third doc who happened to be on-call last night, because for some reason, even when you're not dehydrated, the influx of fluids calms the uterus down.  It seemed to take the edge off but I left the hospital with the same feeling of strong menstrual cramps that I came in with, dreading the night ahead but hoping for the best.

I was wiped by the time we got home at 8:30.  I haven't been able to nap during the days recently and I'm sure as hell not sleeping at night.  I dozed off around 10:00 and like clockwork, at 11:00 PM awoke to calf and back pain and a rock-hard uterus.  Eff. This.  Got up, did some school work, typed the first half of my final paper, read a bunch of home remedies for IU, and crawled back into bed sometime around 2:00 AM.  Woke up at 4:00, could not go back to sleep so I played the left-right-center game of how many pillows can you jam under your body in various positions to get comfy.  Answer: it doesn't matter!

Having educated myself about this still relatively little understood condition, I naturally have many questions for the doctor on Friday about what else I can be doing to make it through the next three weeks without totally losing my mind.  I made it clear when I called the other doctor yesterday that I am not a giant wuss.  I know from pain, having experienced 10 on a 1-10 scale last summer.  My worst contractions are about a 7, which is significant.  How do I avoid totally giving into them?  Can it be avoided?  How do I make sure I'm getting enough oxygen to the baby if I'm not moving around as much these days?  What should I be eating/drinking to lessen the contractions at night?  Also, let's pick a date.  Seriously.  I think having a plan in place will do wonders for my resolve getting through the remainder of this pregnancy.  I can handle anything as long as I know there's an end in sight and right now, it doesn't feel that way because there's nothing on my calendar yet.  This child needs a birthday!

Oh, and I learned a lot about Morristown policies regarding C-Sections from my nurse but that's another post for another day.  Fascinating stuff.