October 15th. Another really cool thing about this pg is that my libido has returned full-force! We were avoiding intercourse during the early weeks because of my risks for miscarriage, but it wasn�t long before I was actually ready for the �real thing� again. LOL! I haven�t asked the dr about it, but then again they did not put us on any restriction---that was self-imposed! So we are REALLY enjoying this part right now. ;) Truman thinks that means I am having a girl, but I really don�t know about that.
Funny thing is, last night I had a dream that I gave birth and it was a girl! I was so shocked, I had to look very closely to make sure it was indeed a girl, then I nearly passed out! LOL What a dream! It would be nice if it was true, but then I think that is probably too much to hope for. I don�t put a lot of stock in dreams---I dreamed many times that Jamie was a girl, but he was indeed a boy! So much for that theory! I have now dreamed once that this baby was a boy, and once that it was a girl. At least one thing is sure---it�s either one or the other! :)
October 17th. I went for my dr appt first thing at 8:45---it's nice to be the first appt---no waiting! LOL I saw the senior OB in the local practice---he's really nice. He hugged me when he came in, and shook Truman�s hand. He said how happy he was that I was pg again! He did not deliver Lucas, but he discharged me the next day, so he knows all about what happened. He had talked to the pathologist about Lucas before he came to see me that day, so he could talk with us about what had happened with the cord knot. I remember him saying, the good news was that the cord knot was so rare it shouldn't keep us from trying again if we wanted to! I was so glad he said that! I had first seen him 2 yrs ago, and he had refused to test my progesterone---I was miffed at the time, but the way he was about Lucas's loss convinced me he would take good care of me in another pg. And who knows---he may be the one on duty when my baby is delivered!
He immediately asked us if we wanted some fast reassurance about how our baby was doing! We both said yes, so he brought in a portable u/s machine and found the baby! The baby was moving around, but he would tell us what he could see---the face, the leg, the placenta, a bit of the umbilical cord, and of course the heart which was beating away (though we didn't get a rate, it looked good like before). He had already checked the results from my previous u/s and he was sure the baby was doing just great! I am starting to feel kicks, so that is always reassuring too. Today I even felt the baby kick against the transducer at one point! I thought we would listen to the hb with the Doppler but the mini u/s was a neat surprise!
Then the dr said, "What else can I do for you to help you feel more reassured about this pregnancy?" I told him I wanted to be seen every 2 weeks---a month is just too long between appts. So far I have seen either a high-risk dr or a local ob every two weeks, and that has been just right. My next high-risk visit is in one month though, so I asked to see a local dr in 2 wks----he readily agreed! He said he understood if we were nervous about a possible repeat of something like the cord knot Lucas had. I said that I wasn't spending much time thinking about that---I preferred to think positive! But I do like being reassured that the baby's heart is still beating and that it is growing well! He was happy to see that I was upbeat today.
We were home again almost before we knew it, and I did some work on the addition. The next day I did a no-no. I was cutting a notch in some vinyl siding and I slipped and cut my hand with the utility knife! It was bad enough that I had to go to the ER for some stitches and a tetanus shot. :P My hand was sore for a while, but I was able to continue work after a day or so.
I have been feeling the baby move more and more now. It�s usually when I am sitting at the computer or lying in bed. It�s really wonderful though! I have been craving a drink my family calls �haymakers�. It�s made with water, vinegar, sugar, and ground ginger. It�s very thirst-quenching in hot weather, but I think it also helps settle my stomach. I�ve been drinking it for weeks now and it�s the one thing I seem to �have to have�! I swear the baby likes it too, sometimes I feel a kick while I am drinking my haymakers. LOL I�ve heard that consuming vinegar during pregnancy will make your baby have lots of hair---so I wonder if the baby will be born with lots of hair or not!
October 31st. My 16 wk drs appt. Actually, I will be 16 wks tomorrow. I saw the same OB I was seeing for my last pg---this is my first appt with her for this pg, though I have seen 3 of her partners, plus the high risk drs. She was SO excited for us! We HEARD the baby's heart beat for the first time---so far we have only *seen* it on u/s. But I think there is nothing quite like *hearing* it! The Doppler she used did not have a number display, but the dr was satisfied that the baby's heart rate was nice and strong!
We talked a bit about whether or not I should use progesterone shots for prevention of preterm labor. A decision has not yet been made. The team of drs will discuss it when they meet on Thursday. She said they wouldn't start it until 20 wks anyway. I found that interesting---I read that the studies were done starting at 16 wks, and I know for sure my insurance will cover the shots starting at 16 wks, my case manager has told me that many times. My insurance highly recommends using the progesterone shots for women like me with risks for preterm labor. It appears to work for a high number of at-risk women, and the insurance would rather pay for prevention than pay for stints in the hospital trying to control PTL (like we did with my Jamie's pg).
The perinatologist also told me that if the shots don't work, at least they do not cause any harm, they are completely safe. But today, my OB said that there is thought to be a risk of increased hypospadias in male infants when the shots were used in pregnancy. Hypospadias is a birth defect where the hole is not located in the end of the penis like normal; instead it is in the side. It can be corrected with surgery, but still you wouldn't want to do something that caused such a defect! I need to do more research on this. Especially because I have had two boys with birth defects in their penises----*without* using progesterone shots! Ezra had the true hypospadias, but he died of other reasons before his could be corrected. Jamie did not have a true hypospadias, but about half of his foreskin was missing and what was left was irregular shaped (a defect that usually accompanies hypospadias). Jamie is circumcised so you would never know of his defect except I told you. If I had two boys with such defects without using progesterone, we already have increased risk for another similar defect, so I want to be sure of the information before we use the shots.
The prenatal nurse from my drs office called me to get particulars of my preterm labor experience, as well as the facts on my boys who had birth defects in their penises (one was not a true hypospadias). She said she was collecting information for the drs to review at their meeting on November 3. She would be letting me know what they decided. They did not seem too sure that the shots really do help prevent preterm labor, and if there is any risk in using them, we would want to be sure that the benefits do outweigh the risks.
I did some research on my own and I also contacted my case manager who had first told me to ask my drs about the progesterone shot for preventing preterm labor. I found a pediatrics article that cites the study linking progesterone use and increased risk of hypospadias. When my case manager called me back on Thursday, we discussed this in considerable depth. Here is basically what she told me:
First of all, she is a registered nurse, and between her and her co-workers, they have followed more than 100 high risk women who used the shots, and not one of them had a boy with hypospadias. Furthermore, of those 100+, only 2 women had preterm labor in spite of the shots---pretty good track record! So for most women, the shots DO appear to help.
Secondly, you have to read the hypospadias study carefully. There are several forms of progestin, and the ones used by women in the study were different forms of progestin, NOT the same as the form used in prevention of PTL. Also, the women in the study used progestin as part of fertility treatments and early pg support, and the time frame of use was 4 wks prior to conception until 14 wks after conception. The progestin shot given for preventing PTL is given LATER then this. So this form of progestin that I would need was NOT even considered in the study! Besides, the male (and female) genitals are completely formed at this point, so there is no longer a risk of hypospadias forming even if I did get the shots!
Now I want my case manager to tell my drs just what she told me! I don't know yet what they decided.
Tuesday, November 8, 2005. I woke up early this morning having some contractions. They were strong enough to make me sit up and take notice! They involved my whole belly getting really really hard for maybe 30 seconds. But the contractions never got closer than 20--30 mins apart. My drs have said to call if there are 6 in one hr. This was less than 3 in an hr. I got some juice, I also got some toast because I was hungry, and I went back to bed, with another glass of juice nearby. I then put on some progesterone cream and inserted a suppository. I stayed in bed all morning, and after maybe 2-3 hrs I had no more contractions at all. They never got close together or lasted very long, but they were surprisingly strong. I am only 17 wks pg.
I got up around 11 am, and got my younger son off to preschool (dh had took the older one to school earlier). I did a few things, but generally took it easy. Later in the afternoon, I had one more strong contraction, but I also had to pee pretty bad when it happened. I decided to call the drs office and ask for a nurse. I told her about the contractions I had in the morning, and said though I knew they wouldn't do anything now since they had stopped, but I wanted the dr to know it had occurred. She said she'd let the dr know, and he or she would call if they wanted to speak with me. She also said to drink plenty and take it easy.
Then Wednesday I called the prenatal coordinator, because I knew she had been involved in the drs meeting where they discussed whether I should get the shots (and she told me they did not yet reach a decision). I wanted her to tell the drs what happened when they meet again. She said they did not meet this week, but she would tell one of the drs what I told her about my contractions. She seemed worried that they felt that strong this early in pg.
Friday night the prenatal coordinator called me back to tell me that she had told the dr about it. Here is what the dr said: I should schedule an appt next week to talk about it and we can discuss benefit vs risk of the shots and I can tell her how I feel, whether I want to do the shots or not. However, they will NOT give them before 20 wks. I wonder why since the research was done from 16 wks on? My insurance will cover the shots from 16 wks on, but the dr says they cannot be given before 20 wks. I want to know the reason for this.
I have an u/s scheduled and an appt at DHMC with the high-risk OB, so I planned to talk with them about it. But I guess I need to speak with my local OB as well, since they would be the ones administering the shots if I get them.
The prenatal coordinator also told me that the dr said if I go into preterm labor at this point, "there is nothing they can do". What? They would not even try to stop it?? I am perplexed about this one.
Anyway, I have increased my dose of natural progesterone suppositories again---though my dr told me to wean off them, and supposedly I should have stopped them by now. The dr says they won't prevent PTL, they are the "wrong form" of progesterone to have any effect on that. I am not sure I believe that entirely. After all, there was a study done in Brazil using natural progesterone suppositories and they found it DID help prevent PTL, about the same as the progesterone shot! I am thinking I am not getting contractions now because I upped my dose of suppositories again! At least the contractions stopped after I used the progesterone the other morning!
I am feeling a bit like my drs aren't doing all they can for me---at least this one dr that the prenatal coordinator talked to for me. Like what did that comment mean---there is nothing they can do for contractions at this point? There are 4 drs that I see in the practice, and I can see anyone of them I choose. So far I have seen them all. I am seeing one of the others, not this one, in 2.5 wks.
I am glad my contractions stopped, and I am trying to be very aware in case they start again. I am taking my progesterone b/c I do think it helps. But I still wonder if I could be contracting small ones and not really be feeling it? I will bring it up at my next two appts, both next week and in 2.5 wks. At this rate I may have to go on self-imposed bedrest---seems a bit early and I still have so much to do on the house---but this baby is worth whatever it takes! But at the same time, I totally believe that "an ounce of prevention is worth a pound of cure!"
November 15th. My Level II u/s is scheduled for the 17th, but I just found out something very upsetting! I found out that they want me to go to a different dept for the u/s, instead of OB like we usually do. I was confused, so I called the secretary who had made the appts for me to find out what was going on.
They explained that they changed things, and they no longer do u/s in OB. That is the first I was told anything about it! They do all u/s downstairs now, like they used to yrs ago. The only problem is that when we last went "downstairs" for u/s (several yrs ago), we had the most HORRIBLE experiences. When the drs talked to me this yr about wanting me to have level 2 u/s done at that hospital, at first I was like "no way!" because of our previous bad experiences. They assured me that it would not happen again, because I would never have to go downstairs again! So I agreed to go there for several level 2 u/s this pregnancy.
Well, now they have changed where they do the u/s again. When I called today, the secretary said that they just do not have the option to do any upstairs in OB---all u/s HAVE to be done downstairs.
I am REALLY upset about this! I DO NOT want to go in those downstairs rooms again---it makes me sick to even think about it.
I called my local OB office, and had to leave a message. While I was writing this, the prenatal coordinator called me back. She made some calls. She cannot change what dept the hospital wants to do u/s in. BUT she can arrange to have me go to a *different* hospital for the Level 2 u/s. Obviously, it won't be done this week, and probably not next week what with the holiday. So maybe the following week when I am about 20 wks. But we will have to see what they can arrange for me.
Major UGH!
I did call my local OB again about the progesterone issue, but the earliest appt I can get to discuss it with the dr is Nov 28. I already have an appt scheduled for the 29th, so I will just talk to him about it then. This will be the man dr, not the lady dr who said �there is nothing they can do this early.�
November 16th. About 8:45 this morning, the phone rang---it was the secretary from the hospital. I was happily surprised that she called this early---they usually take a long time to arrange these appts. She had good news for me. She could get me an appt for 1:30 pm today at the DHMC clinic in Nashua, or at 1:00 pm next Wednesday the 23rd at the DHMC clinic in Manchester. Either hospital is at least 1.5 hrs away from my house. I would have loved to take the appt today, but knew it just wouldn�t work. It would be too hard to make arrangements for my children on such short notice---Eric was already at school, but would get home before we got home from the appt, and Jamie normally goes to school at 12 noon and I had no one to put him on the bus for me at that time. Plus Truman normally has to go to work at 2:30 pm, so he would have to take vacation time to drive me to the appt in his car (my car is broken down); but he has very little vacation time available and we are trying to save what time he does have for the baby�s birth.
I opted to take the appt for Wednesday Nov. 23rd. Truman does not have to work that day and the kids will be home from school that day for the Thanksgiving holidays. I don�t have to work that day for WIC either. We can make it a family trip, and it will be more relaxing since we won�t feel rushed to squeeze the appt in between everyone�s school bus times or work schedules! I know pre-holiday traffic may be insane, but we will have the extra time that may be necessary for the trip. We will be driving right by the Mall of NH, so if we want to we could even stop on our way home---we�ll see though.
I am much happier now that I have this arranged. The secretary even gave me the clinic�s phone number so I could call for directions (I haven�t been to the DHMC in Manchester before).
November 17th. We got to hear our baby's heartbeat again! Last week, baby was VERY active, but it's been much quieter this week. I am pretty sure I felt it move this morning, but I had to be lying very still, and even then I was wondering if I just imagined feeling it! So I called the nurse at my local drs office, and asked if I could come in for a quick listen to the HB (they have told me before that I can do this any time for reassurance, no appt necessary). She said sure to come on in. She found the HB really quickly, and the baby was kicking or punching at the Doppler. Heart rate was 160 to 163! Busy baby in there! We really enjoyed hearing it. :) I feel really happy right now!
She also mentioned that the drs want to do a swab for mycoplasma---it�s a bacteria that can cause contractions, preterm labor, and in some cases miscarriage. I think I have been tested for it yrs ago, but I guess it wouldn�t hurt to check again. She will ask the dr how soon he wants the test done, he may want it done before my next appt with him on the 29th. If so, she will call me and schedule for me to come in for that.
We went for our ultrasound November 23rd. Though it was a long drive to Manchester DHMC to have the Level II u/s, it was definitely worth it. We left early because the weather was supposed to be snowy, plus we wanted to allow for holiday traffic. We got there in plenty of time though, so we ate our packed lunch of sandwiches and apples. The waiting room was light and airy and generally nice. They even took us back for the u/s early! No 1.5 hr wait past our appt time! That was cool. And what a difference from the u/s dept in Lebanon DHMC that I never want to go back to!
The tech was nice. The baby was a little bit stubborn (like mama), and didn't want to turn enough so she could see the spine well, but they got most of what they wanted to see. We did NOT find out what the baby is (boy or girl) because it had its legs crossed! But that�s ok, I really did not want to find out! I did have fun making my friends think I had found out while they scrolled and scrolled through my email, only to read that the baby had its legs crossed! LOL But they also found out that the baby is HEALTHY! :)
I will have another Level II u/s done in 7 wks to track growth (because of my history). But today they said the baby was measuring beautifully---actually 3 days ahead of my dates. Which is a first for me!---Eric and Jamie always measured about 5-7 days behind, but they grew consistently so they don't worry about a few days difference. At the same time, it's amazing to me that this baby is bigger! And it's very reassuring. :) HB was 146 today. Baby has been active, but just kinda bumping around rather than kick-boxing.
The dr who came in was very nice. And I will probably see her at next u/s in 7 wks as well. I did ask her for her opinion on progesterone shots to prevent preterm labor, and she said that if I really want to have them, it may just help. She did want me to realize that the research is still quite new, so they cannot guarantee that there are absolutely no long-term side effects that show up 20 yrs later or something. But we do know that there are risks to a baby born too early, so preventing PTL if possible is certainly something worth trying. She will send her report to my local dr who I am seeing next week---I hope they will make a final decision by then about the shots. I have gotten conflicting info about when they will start them---anywhere from 16 to 24 wks! I will be 20 wks next week, and my local dr had said they start after 20 wks---I'll see if he says that again next week.
On the way home, we stopped at ToysRus and got a few things for the boys, including a new booster seat for Eric. He has outgrown the one with the internal harness, and we needed one that can be used with only the lap belt in our old car. We also found a couple small items for the double birthday party we are having this Saturday for both boys. They wanted Thomas party hats, but they were out of them, so then we stopped at iParty and got the hats and a really cool Thomas balloon that is actually shaped like a train! The traffic was heavy on the way home, but that is expected the night before Thanksgiving! But all in all, it was a great day, and it was nice not having to rush home to get anyone off to work or school. So it really worked out better than it would have to go to Lebanon last week!
Sunday, November 27th, we decided to go to Wal-Mart for a few things. By the end of our shopping, I was getting some contractions, so we hurried through check-out and headed straight home. The contractions continued, several were about 10 mins apart! YIKES! I drank all the water I had with me, and tried to relax, but I was scared. As soon as we got home, I went to bed and Truman got me a 16 oz glass of OJ. The baby was active, but the contractions continued---however they spaced to 20 minutes. I also took a dose of progesterone. After another hour and twenty minutes, and 4 more contractions, I decided to call the drs. As I figured, they told me to stay home, lie down, and drink fluids. But they also suggested a warm bath---so I did that. The contractions spaced to 40 minutes or more and finally stopped late in the evening. Phew! We got something to eat, and more to drink, and went to bed. But I called the nurse again the next morning as instructed.
I am a little upset that they keep saying that they *can�t do anything* to stop contractions before 20 wks! And even worse, they are calculating my due date to be a few days later than my u/s dating (and the date I calculate from my LMP), so they keep saying that I am not as far along as I say I am! The nurse even told me that this meant they can�t even start progesterone shots until NEXT week---if the dr oks them---while I think they should start this week. I calculate I will be 20 wks on Tuesday. It seems silly to get hung up on a due date which is only an estimated date for the baby to arrive, and babies rarely arrive on their due date anyway! BUT if the dating is interfering with my drs doing something about my contractions---THEN it bothers me! 20 weeks can�t come fast enough! I will talk to my dr at my next appt about all of this---I want some answers that I can live with!
November 29th. This morning I went for my 20 wk drs visit. I have finally gained some weight! I'm 130 with my shoes on! Must be all the yummy holiday food---LOL. BP was fine. I asked about giving a "clean catch" urine sample so they could check for bacteria that might have caused my contractions, and they thought that a good idea. Baby's HB was 150-160! I could feel the baby bumping around in there too. :)
There apparently was a little mix-up about the other culture I was supposed to have done. The prenatal nurse had called me about 10 days ago to tell me that the drs had decided to do this culture to check for something called mycoplasma. It's bacteria that can cause miscarriage and preterm labor. I was tested for it some yrs ago, and was negative. But the nurse said they wanted to do it again. But due to the holidays last week, they had no openings, so she said they could do it at my appt this week. I said something to the nurse today (different nurse) and she said she hadn't been told to set up for it. So she asked the dr. They checked in my chart---and discovered that someone had written "Mycoplasma? Yes or No." and the "yes" was circled. The nurse who called me thought it meant "yes, do the test." But the dr meant "yes, it's been done before!" I was like, "Oh! so you are not doing it again?" He said it's unlikely that the bacteria would appear now if it was not there a few yrs ago---it's not an easy-to-contract kind of bacteria. But then since I have had these not-yet-explained episodes of strong contractions, he said, "well, let�s just check again and be sure". I usually hate any kind of pelvic check, but this dr has the gentlest technique of any dr who I've ever met, so I hardly felt a thing. I did ask him how my cervix looked, since he was in there. He said it looked long and tightly closed---what a relief after those strong contractions the other day!
I talked with the dr at length about preterm labor and progesterone shots. He said that he cannot guarantee that the shots will prevent preterm labor for me. It appears to work for some people who have unexplained preterm labor, but it does NOT work 100% of the time. Also, they just don't know enough to say that there are no risks of side effects that might show up in our child yrs from now. However, progesterone does seem to be quite benign, so the risks are generally considered low if there are any. I said I had been doing some reading on the internet about using the P17 form that will be in the shots we are talking about using, and I felt that any theoretical risks were outweighed by the potential benefit of preventing PTL. I think that if we at least try the shots, then we are doing something. if it does not work for me and I have PTL anyway, then we know we at least tried. But I think that is better than sitting doing nothing at all. He was fine with that, and agreed to order the shots for me. And I can start them tomorrow (not wait until next week like the nurse had said yesterday!) After all, I am now 20 wks---I checked his wheel that was sitting on the counter while we waited, and it gave a due date of April 18th, though other wheels they have gave a due date of April 20th! I swear those wheels are NOT all the same and maybe not the most accurate either! LOL
I asked him why they had said they could not stop contractions before 20 wks. Basically, what that means is they cannot intervene with medication before 20 wks. We can do rest, fluids, warm baths, and all of that, but no drugs. Even if they did do medication earlier than this, there is not much likelihood that it would help. When a woman's uterus contracts, it is either Braxton Hicks or real labor. He said the only significant difference between BH and real labor contractions is that BH contractions are harmless and do not act upon the cervix to dilate it, while the real labor contractions actually dilate the cervix and result in delivery. The way the contractions feel is not a real indication of which kind they are. Women have dilated completely at 18 weeks or so, and never knew they were actually in labor. My contractions in the last few weeks were really strong and unmistakable, they even hurt---but they did not affect my cervix at all (THANKFULLY!) The dr said that if the contractions are going to result in a delivery, medication usually will not do more than delay things for about 48 hrs, if that. If the body is determined to deliver that baby, they have not found an effective way to prevent it indefinitely. But the advantage of delaying an inevitable preterm delivery for even 48 hrs is that it gives them time to do steroid injections to help the baby's lungs mature a bit before delivery. They just wouldn't give anti-labor drugs before 20 wks, and usually steroids are not used until after 23-24 wks which is considered the earliest viable gestation. If they can control the contractions for weeks and the cervix does not open, than they figure that the contractions were not real labor---but after 20 wks they WILL at least *try to control* the contractions with medication, whichever kind of contractions they are! I say "Good---they better!" I would not care to do nothing and find out the baby was being born too soon!
We talked about how I had strong contractions close together (6-7mins apart) in Jamie's pg at 28 wks. My cervix was also soft and just starting to open a little at that time. I had a different dr then (it was before we moved), and she put me in the hospital with meds and all. Then when she sent me home several days later, I was to stay on bedrest until I reached 35 wks! I had a total of 4 stints in the hospital with meds for this, because the contractions would start up again! I mean, she really took it seriously and used aggressive treatment, saying she wanted to prevent the baby coming too early if at all possible. My new dr is saying now that luckily, those contractions I had back then were not the real thing---if they were the real labor contractions, my dr would probably not have been able to get them to stop. He says that if my body had been determined to deliver then, it would have in spite of the meds. But knowing this, the drs still *have* to try everything possible to get the contractions under control, no one is going to sit there saying, "sorry, I can't do anything!" (after 20 wks at least). Thank goodness I am now far enough along that they will try whatever necessary to keep my contractions under control. But maybe it's a positive thing knowing that my uterus can contract a lot without it being real labor. I still think I'd rather play it safe and have them give treatment if necessary! And I am glad I will try the shots---it feels like the right thing to try, and I do hope it helps too.
He did say that in looking over my pg history to date, he has a hunch that maybe I have PTL due to placenta issues. Each new pregnancy has a new placenta, but overall, I have had small babies---which points to underlying placenta issues. We do know that I had severe placental insufficiency with my first baby Ezra, and he was way too small at birth; his placenta was studied in great detail after delivery, and the dr who did it has shared his files with my local drs. My two living kids, Eric and Jamie, were much better off, but when they were born they were still considered "small for gestational age". Eric's placenta was studied, but Jamie's was not. I don't remember being told that Eric's had any problems, but my dr now thinks there might have been a little issue of it no longer functioning at full capacity when Eric was suddenly born at 35 wks. Jamie's we can only guess at since they did not study it. I do know that when I had PTL with Jamie, my dr said I had a severe overgrowth of GBS, which could have been causing the PTL. With Lucas, there was some damage to the placenta---the high risk drs at DHMC say that was simply due to the cord knot restricting blood flow and creating back-up in the placenta. The local drs think it could be a much milder version of the placental insufficiency that Ezra's had. If there really is a connection between all my babies' placentas, that might help explain why I have issues with preterm labor---if the placenta isn't functioning fully, it may trigger my body to want to deliver early. This is still just theory---no one can say for sure.
I told the dr that the fact that I have Eric and Jamie tells me that I CAN deliver a live healthy baby, so I am focusing on that. If I did not believe I could do it again, I would not have kept on trying! He liked my positive attitude, and he said we would all hope for the best. He got a call to go to the L&D floor, so he had to hurry off. But I left the appt. feeling a lot better about my situation. The nurse is going to order the progesterone for the shots. I am waiting to hear that they have it all set for me, hopefully tomorrow. I am still taking it easy---no more working on the house addition. :)
December 7th. I�m not too happy right now. I just got a call from the nursing company. Apparently they are NOT able to make the necessary arrangements for me to get the P17 progesterone shots for prevention of preterm labor!
My insurance case manager had told me it was covered 100% under my home nursing care coverage. I told the dr this. But he tried to order the shots through a pharmacy, and the pharmacy said they could only charge it through my drug coverage, not my medical coverage. The problem with using my drug coverage is that we have a whopping monthly deductible, and I would rather avoid paying that if my medical insurance will cover the shots!
So I called my insurance case manager, and she called a nursing company called Matria that has branches all over the US. Matria has their own pharmacy and can provide the shots as well as have their nurses administer them. They also said that they do service my area. Good. So we got the doctor to send the prescription for the shots to Matria. A Matria nurse then called me for my information, including my medical insurance. I gave her my case manager's number so she could process the authorization quickly. My case manager called last night saying she had the authorization all done, and the Matria nurse would call me to arrange for someone to come out here to give me the shot each week.
I was supposed to hear from them today. By 3 pm I had not heard, so I called Matria. They called back later and told me that they cannot send a nurse out here on a weekly basis to give me my shot. They are trying to see if they can make other arrangements. If they can get my medical insurance to authorize covering just the shots (but not the visiting nurse), they might send the medication to my dr for his nurse to give me. I have no idea if my medical insurance will allow this or not. I called my case manager again, but had to leave a message. I am sure she will do what she can, but she has to be within what our medical policy dictates.
At this point, I am about ready to say "screw the shots". I have been asking about them for the last 5 weeks, and I am tired of all the run around---first to get a decision from my dr whether or not I can have them, and now trying to get it all arranged! Apparently, there is nothing simple about this! I am wondering if it is worth it! I would just continue my suppositories, except that I am almost out of them, and have no refills left. I don't know if I can get my dr to give me a new prescript for the suppositories---he has said that they are a different form of progesterone, and he really doesn't think they have any effect on preventing preterm labor. Maybe I should show him the articles I found about a study done using natural progesterone suppositories---they had much the same results as the study using the shots! I bet he will say that he wants to see the study repeated before he will believe it---he said that about the study using the P17 shots too! :P
And now I am also on "pelvic rest" too! :( The prenatal nurse called. She had asked me the other day if we were still having intercourse--I said yes, some. She asked if I had contractions after--I said, yes usually a couple. She talked to the dr and he said that because my contractions are a concern, we need to stop intercourse and anything that results in me having orgasm or contractions (ie, no nipple stimulation either). Wouldn't you know, this pg has been the best fun in that regard. But we must keep baby in until cooked enough, so we have to stop. Too bad I can't convince dh that he should stop his part too---it's no fun having to get him off if I can't too! :P
December 14th. My next prenatal check up. We got to the drs on time, but they were running very late---almost 1 hr behind. I had to pee so bad that I started getting contractions, so the nurse let me give my urine sample then go back to the waiting room. They finally got us into a room. Fortunately, my weight (131 �) and BP (124/68) were fine, and the baby�s heartbeat was great (150�s). By the time the dr even got to the room to see me, it was so late that it made us miss Jamie's bus. We tried to arrange to meet the bus in Keene, instead of going back home, but we missed that stop too. So we had to take Jamie to school. And we still had to get milk on the way home. With all this running around, my contractions just got worse---and they were 5-7 mins apart! As soon as I got home, I grabbed a snack and some water, and filled the bath with warm water. It seemed to help, and my contractions spaced out again. I continued getting a few, but not too frequent anymore, and certainly not regular. Dh was totally freaked and thought he should stay home from work. I told him that there was nothing for him to do besides worry if he stayed, and I made him go to work. I took my progesterone, and then I remembered a prescript the dr had given me previously to control contractions (I think it is a type of muscle relaxant), and took one according to directions. Yes, it must be a relaxant---I was soon feeling relaxed and sleepy! But it also gave me a head ache, so I took a nap.
I did call my insurance case manager again, to see if she can find any other nursing company that can give me the progesterone shots. She has worked on it for a while. The next day, she called back. She had finally found a local nursing company who could administer the shots if I got them through my drug coverage. But the additional benefit of making arrangements with this nursing company is that if I need bedrest, they can also come to the house to check me, and they can provide a terbuteline pump if that becomes necessary (I had to take terb during Jamie�s pg to control preterm labor). So now it is up to me to decide what I want to do about the shots.
It seems that for me to get the shots, I will just have to pay for the shots using my drug coverage�and the whopping deductible they require. That is what I wanted to avoid, but there is no local nursing company with the ability to provide the shots themselves and be reimbursed through my medical coverage. At this point, I might as well just keep taking the suppositories. It is true that I have to pay for them too; however, it is about half the cost per month. If I have to pay for progesterone, at least I can save myself from the black and blue of getting injections! LOL
I am almost out of my suppository prescription, with no refills left, so I asked the dr I saw on the 14th about getting it renewed. I have continued taking them while waiting for the shots to get arranged---and I really believe they help calm things down especially when I have an episode of contractions. She was very agreeable---no crap about the �suppositories don�t help prevent PTL� either---and she said to call her office with the info from my old prescript label and they could call the pharmacy to authorize refills.
Within a few days, the pharmacy was calling to say that they had my progesterone prescription ready for me---they compound them so it takes a few days to make them.
The two weeks just before Christmas. This time of year is bittersweet for me. I am happy to be expecting again, but at the same time I feel my losses keenly. I miss Lucas so very much! Plus Angel�s anniversary date is Dec. 10th. All my losses constantly remind me that nothing is guaranteed---it gives new meaning to �expecting�---like the new baby is something to hope for rather than feel certain of. I also get this feeling that healthy babies are what other people get, but not necessarily for me. Just like little girls are what other people get, but for some strange reason, I don�t. I really wish it wasn�t this way; this is one thing I would dearly love to be wrong about, actually two things! A healthy baby girl would be beyond my wildest dreams---I think I would faint in happiness!
Meanwhile, I will settle for a live baby, whatever else may happen---and at the same time I know that a live baby is not even guaranteed for me. L It�s great that *so far* everything is good with this baby, yet I still have that little nagging voice in my head that reminds me things can change at any minute. Sometimes I think of telling �so-and-so� that we are expecting again, then I remember that I told them last year, only to have to call them a week or two later and tell them our baby had died. That is NOT a pleasant situation to be in, so there are still plenty of people we have not told. Of course people we see regularly have been told---my belly is too big to hide anyway!
It�s hard to stay positive all the time, and some times I just need to cry. I also went ahead and packed my bags in case of an emergency trip to the hospital. For the most part, my contractions are not too frequent, but I feel that I can never be too careful!
I almost called the dr to ask them to just measure my belly size and see if it was still growing as expected. But I was rushing to get things ready for Christmas, and decided not to go through whatever rigmarole would be involved to get me squeezed into the drs already tight holiday schedule!
Besides, the baby---who I have nick-named Thumper--- continues to be very active, rolling, bumping, and thumping around in there. Thumper moves so much, I will hardly have to worry about kick-counts! They don�t make you do kick-counts until 28 wks, but this baby moves an awful lot more than 10 times in 2 hrs! I think it moves almost that much every hr of the day! Especially if I am sitting down, I will feel it move 4-5 times in just a few minutes, and then again a few minutes later. Feeling these movements is definitely comforting! So I continually remind myself to focus on this and not worry so much about the things I cannot control. After all, the outcome is in God�s hand, and if He wants us to keep this baby, He will make sure it�s ok!
On December 18th, I got a roll of film developed, and I was shocked when I saw the picture Truman had taken of my belly the night before! It looked nice and BIG! I also measured my waist, and was delighted to find that it measured 38 � inches already! That�s 1 � inches bigger than the biggest that I got with Lucas, so that�s reassuring too!
December 27th. Had my appt today---everything is good: BP fine, weight 134#'s, and baby's heart rate is still in the 150's! The dr also measured my fundal height, which I wanted him to do as reassurance that growth is still good---it's measuring almost a week ahead! That may be usual for some people, but my babies (and my fundal height) have all tended to measure a bit small, even with my healthy living kids---so as the dr put it, "this baby is well-grown!" :)
I told him I nearly called last week, wanting reassurance that baby is still growing---since I was feeling nervous that I was to the point where we found out Lucas was not growing well. But this baby is very active, bumping and thumping around in there, and I focused on that. I was still very glad to have him measure my fundal height today though! I felt so happy afterwards! I did not mention my dream about the baby dying on Christmas morning---I am sure that was just my over-active memories of Lucas running wild! Thumper is alive and well---and that is what matters!
The dr asked how my progesterone shots were going, but I had to tell him that we could not get it arranged without my paying mega-bucks for the medicine. I think I have explained before, but my medical coverage will pay for the both the shots and visiting nurse to give me the shots, IF the *visiting nurse* can also provide the medication. But most visiting nurse companies cannot provide this particular drug, and the one company that could said they would not send a nurse out this far on a weekly basis (their regional office is about 2 to 2.5 hrs away). if I pay for the shots through my drug coverage---which requires a whopping copay from me---then it doesn't matter what nurse gives the shots to me. BUT that copay is difficult for me to have to pay every month. So I told the dr that I was continuing on the suppositories, and his partner had refilled the supp. prescript for me (I still pay for the supps, but at less than half the cost). He was ok with that, but I think he was a little disappointed that we didn't get the shots arranged. And the more time that goes on before starting them, the less effective they will be---we both knew that.
I told him about my contractions getting 5 mins apart after leaving the drs office so late from my last appt---and all the rushing we had to do to get our youngest to school. I told him that once I got home, I got a tall glass of water, and then got in the warm bath to relax for a while. And I took a progesterone suppository, and rested a while---and the contractions finally stopped. He said I did all the right things, but of course if I could not get them to stop, then I should call.
I have another Level II u/s at the DHMC in Manchester in about 2 wks, and he wants to see me locally the week after.
Our New Years was a lovely quiet day. We stayed home, partly because I was having a fair amount of contractions. They were more of an annoyance than anything, because they generally were not close enough for me to need to call the dr. I guess it's part of my tummy getting bigger. Thumper is usually pretty active, thumping and bumping around in there.
The contractions continued for the next few days, but usually stayed at least 15-20 minutes apart. They didn�t last more than about 30 seconds each, but they did hurt. I often had to stop talking or whatever I was doing to breathe through them, and I was very uncomfortable. I still did not call, knowing the drs probably wouldn�t do anything unless they got closer together.
But by Tuesday night, January 3rd, after another quiet day at home, the contractions were closer together. I took a long warm bath, which usually will work to space them out, but after an hour in the bath, my contractions were still 5-10 mins apart. I was drinking water too, but that just made me have to pee more often and I always get contractions when I have to pee.
So I called the dr a little after 10 pm, and she called right back within 2 minutes! I told her I couldn't get my contractions to space out in spite of drinking water and taking a long bath. She suggested I take my progesterone then instead of waiting until I go to bed as I usually do. Then I asked her about Nifedipine---she had given me a prescript during Lucas's pg last yr, but though I got it filled, I had not taken any before he died. I then put the bottle in my freezer---you can keep drugs longer this way. I asked if I could take the Nifedipine for my contractions now---and she was quite pleased that I had it in the house! She told me how to take it---every 8 hrs, or less if the contractions stop.
I could tell the contractions were spacing out by the time Truman was home and we went to bed. I woke with a headache the next morning, a side effect of the drug. But I noticed I was having a few contractions, so I took another dose before I went to work---I usually work Wednesday mornings in the WIC office. Truman was taking my van to get the sliding door looked at---they said in 1/2 hr they would know why it wasn't working and what parts were needed to fix it. So Truman dropped me off at the WIC office and took my van to the GM garage. I told him to call me when they needed us to make a decision on fixing the door---this was supposed to be an estimate so we could decide. I also thought he would be back in an hour or so to pick me up.
Well, more than 2 hrs later, Truman had not called me, so I found a number for the GM garage and called them. Truman was still there and the van door was still being looked at. I told Truman that we had to make sure we had time to meet Jamie's preschool bus, and if the garage was running late on the van, he needed to call and make arrangements with the bus driver---we might have to meet him in Keene instead of at home. Well, Truman never called me back with an answer about how things were going. I was not feeling good, I was hungry with no snack, and my contractions were getting worse. Finally Truman came and got me---but he was with a man from the garage who said he would take us home since the van door was still being diagnosed! Well, we passed the preschool bus about 1-2 minutes away from our home, and that meant we had missed it. Meanwhile, my contractions were worse and worse, and every bump in the road was pure murder! I told Truman I needed to call the dr the minute we got home! I had left my cell phone at home thinking I would not need it---note to self: NEVER leave the house again without my cell phone!!!!
As soon as we got in the door, I called and told the nurse I was coming in to be checked---I was really worried about my contractions, and nothing seemed to help. She said they would take care of me. I grabbed my overnight bag, a list of phone numbers, and some crackers and a fresh water bottle. I gave Jamie a banana---we would take him with us to the drs and then see if we could take him to school later---but I was most worried about my contractions which were still 5-10 mins apart. Truman thought we should call Jamie's teacher, so I did. I also called the bus driver and apologized that we missed him. And then I called a friend of ours to see if she might be able to take care of our boys should I have to be admitted to the hospital---I left her a message to call us at the hospital when she got my message.
We got to the women's clinic at the hospital, and a nurse took us right into a room. A nurse midwife whom we hadn't met before came to see us (this was lunchtime for most of the staff, but she was on call). She was really nice and explained that she wanted to do a fetal fibronectin test and then have a quick check of my cervical length done with u/s. She also did the normal stuff---check BP, baby's HB (150-160), and she felt my cervix which was hard and closed! I was so relieved to know my cervix was not soft or dilating at all. She did the swab for the fibronectin test, and then they took me to the u/s room. The tech did a quick vaginal u/s to measure the length (thickness) of my cervix which looked nice and long! We could see the outline of the baby's rump, and the tech, goes, hey look, baby is "mooning us" LOL. I told her not to tell us the sex, and she said she couldn't see that much any way. :) Truman was disappointed, but I still want the surprise at delivery! :)
Well, after all this lovely reassurance, I was beginning to relax again, and the contractions seemed less bad. I think that my anxiety level had gotten so high, it could have been increasing my contractions---the staff said that sometimes happens. They put a rush on the fetal fibronectin test, so we would have results later in the day. Then the nurse midwife came in again---she had talked with one of the OB drs and they wanted to put me on the monitor for a while. So she took us over to L&D for that.
Jamie did really well, keeping himself occupied while all this was going on. Truman was freaking out---why is it that a 45 yr old man reverts to childhood in time of crisis??? While waiting for the nurse in L&D, we called Truman's work since it looked like he would not make it for his shift. The lady in HR is great and they are very understanding. He later talked to his boss who was quite concerned and said he would pray for us! Truman could use a sick day so he will still get paid for the time---but I really hope this doesn't happen again, b/c he won't have much time left to take off when the baby is born! Now that makes *me* feel guilty for making him miss work now!
We had not had a proper lunch and now it was like 2 pm, so we asked for some snacks or something---they sent up lunches for us! (salad, chips, milk, and pudding for dessert---and it really was yummy food, not horrid like some hospital food).
I was asked to give a clean-catch urine, which was no problem with all the water I was drinking! They took my vital signs and all that good stuff. And finally they hooked me up for monitoring. The baby was busily punching at the monitors, but it's heartrate sounded excellent, staying in the 150's. I still had some contractions, and they were strong enough to make me breathe through them, but they spaced out to 20 minutes or more apart. After another hr or so, they decided things looked good and stopped the monitoring. The fetal fibronectin test came back negative, which is the best news we could hope for---it means baby will NOT be arriving in the next 2 wks! If my contractions get bad again, they may do the test again in 2 wks. But we feel confident now that my uterus is just being annoyingly irritable!
Meanwhile, our friend had come to see us. She took Jamie with her and then she went to our house to meet Eric when he got off the school bus. I called the bus driver to let him know this was what I had arranged, and it was ok that someone else met my child. Then she took both kids to her house. After I was let out of the hospital, we went and got our van which had the door fixed by now, and then we went and picked up the boys---who did NOT want to leave our friends house, they were having too much fun! :)
I told Truman that since he was home, he should make supper. You'd think he could heat up some canned soup or make grilled cheese or something---but he insisted we go out to eat---that way neither of us has to cook! I love Friendly's so we went to Friendly's for supper. It was nice and we all enjoyed it. But I was glad to get home again, and soon we were off to bed! But what a day!
Thursday, the prenatal nurse called me. She said she had talked with the OB�s and though they would NOT out me on bedrest at this point, they wanted me restricted to light activity only. I am to rest as much as I can, and only do light housework etc. No lifting, no long walks (shopping trips), no extended time on my feet. They would like me to wait until I am further along to start reorganizing the room for the baby! They said these next few weeks are "critical". I asked about my job, and explained how I can usually work from home, making calls and mailing letters; but sometimes I need to go to the office for meetings and some of my pump loan paperwork---she didn't think that was a problem, because it's basically sitting at a desk to do that stuff; besides, it's nice to be able to leave the house once in a while! At least I am doing much better today---I was so reassured yesterday after being checked out, monitored, etc! And the contractions are much lighter today. :)
Saturday, we went to do a few errands and get some groceries. I was ok since we used the drive up at the bank and were not in the store for very long either. But when we got home, Truman piled all the food bags and boxes in the middle of the kitchen floor and I had to put it all away�especially the frozen stuff and the milk. I had to do a little rearranging in the refrigerator to make the gallons of milk fit, so I took out food for lunch. We were all hungry, and I needed to make a salad for lunch---the salad greens needed to be eaten as soon as possible. But before I could wash the greens, I needed to empty the sink of dirty dishes---and before I could put the dishes in the portable dishwasher, I needed to move the food in the middle of the floor by putting it all away! :P So it was at least an hour before I got all this done and we could eat. But I had been on my feet too long and the contractions began again! I HAD to go rest a while, but I was angry that Truman was not being more helpful---he was whining about how his knee hurt and how he never has a chance to relax! What a crock---he was sitting in his chair at least 45 minutes before I got through the mess in the kitchen! When I ask him to help me more, he has the worst attitude---full of complaining, whining, and selfishness! ARGH!
I did tell the chiropractor about my contractions, and she was shocked my OB had not put me on complete bedrest! She was very worried, and said that Truman needs to take over more of the cooking and cleaning and housework. She said this baby is a priority, and Truman needs to recognize that! I told her he just isn�t getting it when I try to tell him that---she said she will have a talk with him at our next appt! She knows all about his bad knee, but she thinks he should still help me more! I also plan to tell my OB that she needs to convince Truman to help me more.
Sunday I wanted to go to church, but Truman said I should stay home to rest. You know, he talks out of both sides of his mouth! It�s all about what suits him! He doesn�t want to go to church, so keeping me at home resting is a good excuse. But when I said we needed groceries, he�s all ready to take me shopping! And he ignores the fact that the second half of the shopping trip is dealing with the food once we get home! Putting the food away is NOT resting---it�s hard work!
It was also snowing, and Truman said he was worried about the roads. I decided not to argue about going to church, and I never even got out of my PJ�s! After breakfast, I lay back in bed again. The baby was kicking and moving all over, so I called the kids in to see and feel! Of course, when they put their hands on my belly, the baby didn�t oblige by kicking at them! They were disappointed, so I pulled up my gown, and pushed down the sheet just enough that only my bare belly was showing. Then I told them to watch my tummy. Soon enough, the baby gave a big kick---and the boys saw my stomach move! They LOVED it! They laughed and exclaimed over it as the baby kept moving around, kicking or punching in different places! It was really neat for them. :)
The Jamie lay down beside me to keep me company. He said something about the baby being a boy. I asked him if he wanted a boy, and he said yes. But I was puzzled---every night both boys pray for a baby girl! So I asked him why he wanted a boy now if he was praying for a girl? He looked confused, so I am not sure if he understands really. Then I said, �Well you have Eric for a brother, so wouldn�t it be nice to have a sister this time?� He grinned real big and said �Yes!� I still don�t know how much he understands, but he�s cute! LOL
