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year anniversary of our daughter's birth and death, we celebrate life by noting that we are expecting again, and currently through the first half of pregnancy already without problems. So far, everything is going as planned and yesterday, we were thrilled to see our precious daughter sucking her thumb during the sonogram. In late March 2005, we will be delivering our Emma by scheduled c-section at 37 weeks. We anticipate the blessing of watching this little girl grow into a beautiful young woman. Thanks again for the support, encouragement, and helpful information. I was so blessed by attending the gathering this summer and meeting people who share a common bond of this terrible disorder. There is great peace in feeling more acquainted with the symptoms of this disorder and realizing that we are not alone in this journey. May your good work continue. Hello to all whom I met at this summer's gathering.
The following is a series of emails from Donna, one of our members. It follows the progress of her second pregnancy from 31 weeks to delivery.
From Donna
dmmetler@bellsouth.net (Memphis, TN)
10/24 - Hi, everyone. This is Michael writing -- Donna's husband. But don't panic; Donna and Cuddles are OK.) Donna had a headache (with lots of pain and "spots" in her vision) and a high BP reading Friday evening. She's had headaches before -- but not like this one. And the BP was very high on the diastolic. She called the doctor and he suggested she go to the women's hospital to get things checked out. Going back there was very uncomfortable for both of us, since it's the same hospital where we lost Brian a couple years ago. But she started feeling better a few hours after we got there. To be safe, they kept her there for a 1-day observation period. And, during that she had a couple more headaches -- and very wide swings in BP. So they're keeping her for another day of observation. I hope she'll be coming home (with Cuddles still happily inside her) sometime Sunday. But we'll see what the doctor has to say tomorrow.
10/24 - This is Michael again. Donna and Cuddles are still in the hospital and still doing OK. However, they've decided to keep them in the hospital for observation until Cuddles is born. Since her due date isn't until Christmas-time, we're hoping that will be a while yet. And it could be. But we just don't know. (And, just in case, they administered two shots of steroids to speed up Cuddles' lung development.)
They're concerned about the headaches and BP swings (which continue -- though none have been as serious). And they want to make sure that, if something does go wrong, they're where they can take care of them both quickly. So they'll be in the hospital for the foreseeable future. Hopefully, we'll be able to get Internet access from the hospital room -- so Donna can go on-line and keep everyone informed (and be a little bit less bored). But we'll keep y'all posted one way or another.
10/28 - Well, the good news is that I may be going home sooner than expected. The bad news is the reason-while my OB has stated that he prefers to keep me on hospital monitoring, apparently Blue Cross/Blue Shield has decided I'm stable enough to go home, even with a history of things coming on rapidly and severely, without any real symptoms. At least part of the justification is that if things start to go bad, after all, they can deliver the baby now and she'll probably be OK-so even though I'm doing much better on hospital bed rest than I was on bed rest at home, which could make the difference between a baby who has to go through NICU and one who is near full-term, I guess the actuaries have decided that it's better to risk damage to Cuddles and/or me than to pay for it. So, at this point, it's up to my doctors to justify keeping me in-patient with BC/BS, or to send me home and monitor from there, until the next time something spikes. And I'm not sure exactly what happens financially if my OB decides that I should stay if BC/BS disagrees-and I'm not completely sure that I won't get a bill from these last couple of days, where BC/BS apparently didn't consider them justified. Mostly, I'm terrified-if my doctor had said on Monday "Your BP is down, tests are normal, I think the blood pressure surge was just a fluke", I would have felt good about going home and relieved about doing so. Now, though, even if he agrees that I'm stable, I know it's because the insurance is pushing it, which means that decisions about me and Cuddles are being made based on financial reasons from someone who doesn't really know me or my history, and doesn't care-and probably doesn't particularly care what the outcome of my pregnancy is as long as it doesn't cost them too much money. Anyway, I'll let everyone know how this turns out.
10/28 - OK-I've now talked to the case manager (about 3 times today now), who seems willing to work with me (and was much more reassuring than the one in the hospital, who seemed to have the "you can always come back if something goes wrong, and then the insurance will cover again" attitude)-my hospital stay has been approved through October 31, with another review after that, so we have a few more days to see if I either remain stable or if there's reason to extend. Whew!!
10/29 - Well, after all the insurance fuss, (with the result that my BP was higher yesterday than it had been since Monday), my perinatologist felt that it was about as well to go ahead and let me rest at home-although if it goes up much at all, I'm back in again (and then, it's likely that BC/BS won't fight quite as much). We did every test in the book today, and everything looks to be stable-Cuddles is up to 4 lbs 9 oz according to ultrasound, and is measuring between 32-34 weeks on everything, so she's doing great.
11/2 - 32 weeks - Except that my BP is now consistently high (and has been since about Sat), things are looking good. At this point, the BP by itself is not a reason to go back to the hospital-and is actually less of a concern because it's not swinging (in fact, there really was almost no change between at home, in the office, and back at home when previously there was an obvious jump). Slight protein, but not enough to be a concern, since some is normal by this point in pregnancy anyway. Heart rate and reactivity on the NST is fine, although it took about 30 minutes for Cuddles really to wake up and start being active. So, still home, still on bed rest, and still feeling like a beached whale.
11/5 - 32 weeks - Well, the second was actually first-we ended up going into L&D last night because I was having abdominal pains-and since epigastric pain is often the first sign of HELLP, that's not something I can ignore. It turns out that this was pretty typical false labor-just that I didn't feel it as a contraction pattern, and therefore didn't recognize it. Actually, it's a relief to go in, find out everything is completely normal, and go home-I've never before gone into L&D and NOT been admitted with some real concerns. Then, the biophysical profile and perinatal appointment. Basically, everything looks good, and while my BP is borderline high, it's not high enough to make it worth medicating-the medication would be more risky than the BP. In addition, taking it with me lying down gets me well into the
normal range-so right now bed rest alone is enough. He said that, while things can change, he's much less concerned with it being steady than he has been previously, because even though the BP on average is higher than it has been, it now appears to be stable. Still on bed rest, just because it seems to be helping, but the hope is that we'll make it through this final stretch without problems
11/9 - 33 weeks - If everything continues as it is, we're expecting to be having a baby in about a month, at 36-37 weeks. At this point, BP is still riding right around 90 diastolic most of the time, but we are seeing more numbers in the high 90's/low 100's-and if we get to the point where it is regularly up at that level, it's probably back to the hospital for more monitoring. We are also seeing some hyperreflexia and some extra fluid retention, but still insignificant protein-so pretty much, I'm sitting right on the edge of being pre-eclamptic-which has been the case for almost three months now. For that reason, I am staying on the phenobarbital-so we need to hope that Cuddles is not affected by it at delivery (he feels that needing to possibly withdraw Cuddles from the medication is less risky than the possibility of my going
out of control at this point) We also received the hospital bill from Baptist-9,384.00. Just the room alone is about $400 a day. Definitely very glad that the insurance company approved everything! Thanks for all the support so far-and thanks in advance for support over the next month.
11/12 - 33 week BPP - Almost 34, based on the U/S due date (which everyone BUT the perinatal center is using). Everything looks good. The blood pressure is slowly climbing, but there's no signs that its affecting the baby or the placenta, so we should be able to hang on a bit longer-hopefully, another 4 weeks or so. It's hard to believe I'm about a month from having a baby! I don't feel at all ready-this pregnancy has been such an endurance test that to have both care providers talking about delivery, and not premature delivery, is rather overwhelming. Although I must say I'm looking forward to getting to be a little less of a beached whale-and to losing some of the fluid retention so my fingers will work more normally (everything else is more generalized, since I've been on bed rest, but my hands are driving me crazy). The nursery theme items are on order from England-now we just need to get the rest of the nursery ready to put around them (to be occupied mostly by the cats, since the plan is to have the baby with me at first (and I suspect that with recovering from a C-section and waiting for my BP to go back to normal, it won't be really active). It's hard to nest when you're not supposed to move! It definitely takes some of the fun out of being pregnant. The name game still continues, although I think things are starting to settle where that is concerned. So, the countdown is on! The tentative date for the C-section is somewhere around December 11 or so, if things stay stable.
11/16 - 34 weeks - The operative word this week is more-more fluid retention, higher average blood pressure, and more protein-but nothing to the point where we need to worry about it, as long as there isn't a drastic change and the baby is doing well. He did request that they do a growth scan with the BPP this week, because I'm now puffy enough that it's getting hard to be sure how much is actually the baby and how much is just fluid weight. The itchy belly skin is simply stretching, easily irritated skin-not too surprising given that I've gained 8 lbs in the past week, and at least SOME of it is baby. So, beyond that, more lying around and waiting for December!
11/18 - 34 weeks BPP - In an interesting twist, my BP was significantly LOWER in the perinatologist's office than it has been at home-low enough that if it is changing that much, it's a concern. So, Tuesday (I have BOTH appointments scheduled on Tuesday, because of Thanksgiving), I'm going to bring in my monitor and make sure that it's still accurate-I certainly wouldn't complain if my BP was running lower than I'm getting at home. Other than that, everything looks normal and is doing fine.
11/23 - 35 weeks - We had a doubleheader today-because of the holiday, my usual Thursday appointment ended up being on Tuesday, which meant a lot of redundancy. And actually, that was probably a good thing, because "Cuddles" decided NOT to cooperate with the Non-stress test-she kept moving and as a result, the monitor kept losing her heartbeat. Fortunately, since we'd just done a BPP and she'd been fine there, no one panicked. Weight estimate at this point is 6.5 lbs-she's getting to be a big girl. Due date based on ultrasound is December 23, so she's on target. She's also fully dropped into position-which matters very little since I have to have a C-section anyway. Blood pressure was high in both offices, so it's likely my monitor isn't too far off accurate. We did change the batteries, since according to the nurse, low battery strength can cause problems with digital meters before the alert signal comes on, but in general, while we would like the BP to be lower, it's not a big problem with the baby doing so well as long as I feel OK. At this point, a bigger concern would be me going into labor, because the baby is in position and is getting up into the size range which could easily trigger it given that I'm physically small. Still retaining fluid (sigh), but at least SOME of the weight I'm putting on is baby! Protein is still good. So, overall, we're both in good shape. I'm hoping we (well, mostly Michael) can start getting the nursery together over the long weekend), except for the bedding and curtains, which are apparently coming by sea snail from the UK, given as long as they're taking. I have spent some time sorting clothes by size and getting everything ready on that front-although we still need to select a coming-home outfit (and hope it fits, since she's growing so quickly). Only a few weeks to go-and I must say I'm definitely ready to meet this little one face to face.
11/25 - (This is Michael again.) The new plan is to deliver Cuddles today.
Donna had several high blood pressure readings yesterday, so we took her to Baptist Women's Hospital again last night. Per their monitors, she was having contractions (which they gave her some drugs to try to suppress). She spent the night there -- and they have continued this morning. So the new plan is that Donna will have the C-section today. (That's a bit early -- but probably not so much as to be a problem.)
11/25 - Allison Joy (ak.a. Cuddles) was delivered by C-section this afternoon. Both she and Donna are doing fine. (But Donna's still on morphine for a while -- so she's kind of spacey.) The numbers:
She was born at 12:25pm Central
Weight: 6 pounds 12 oz
Length: 19 1/2 inches
Best of all, she was crying loudly right after delivery. And, though she's a bit early, she got to go to the regular nursery (not ICU). Both of them will be staying in the hospital for a few days (probably coming home Monday).
11/29 - We got home last night. So far, the biggest challenge is getting out of bed at 4:00 in the morning when the baby is crying and the pain medication has completely worn off. I definitely miss the hospital bed where it could do most of the work of sitting up for me!
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