Tuesday, October 2, 2012

Week 29 Hospitalization

So after six days of hospitalization, three extra sonograms, countless finger sticks and at least one too many hospital meals I am back at home. Given my last blog post I am sure that comes as a bit of a shock to some of you, but apparently things weren't going as smoothly as my appointment last Tuesday would have made me believe.  Let me explain:

Last Tuesday evening at 7 PM while helping HB sort things at our storage unit, I suddenly got a gush of bright red blood that scared the boohockey out of me. While starting the drive to our doctor in Fairfax I called my perinatologists and was promptly told to scrap the idea of driving an hour north and to get to the nearest hospital ASAP.  Pulling a tight right turn, HB got me to the Stafford Hospital within a few minutes and I was rushed to labor and delivery (L&D).

Upon getting to L&D, the nurses and doctor frantically hooked me up to the non-stress test monitors to check on the Baby and watch for contractions. Fortunately, the baby looked stable and unbothered by the excitement; unfortunately, I began preterm labor with regular, intense, every two minute contractions. They administered an antibiotic, the first dose of steroids to mature Baby's lungs if she would require delivery and an IV drip of 3 units magnesium sulfate to slow contractions. They did a sonogram to find where the bleed was coming from (the placenta), to see if the cervix was open or closed (partially open externally, long and closed internally) and to measure the amount of amniotic fluid (28 cm of fluid on the amniotic fluid index scale, shouldn't be more than 20 cm).

It was at this point that the OB on call explained that she and the Stafford Hospital were not equipped to handle a high risk case like this (yes, I found that scary) and that they would need to transfer me to either my hospital - Fairfax INOVA - or the local University of Mary Washington Hospital depending on how stable they could get me for ground transport. They needed my bleeding to lessen, my contractions to weaken and be less frequent - which eventually happened enough around 12 AM to allow for the shorter (aka less risky) transport to UMW Hospital.  So with every seven minute contractions and minor bleeding I was loaded into an ambulance and sent on to the next hospital.

For my first ambulance ride, I've got to say it was overwhelming and uncomfortable being the one strapped in to the speeding, bouncing (ouch!) vehicle that I usually watch go zipping by. But in 9 minutes and 42 seconds I was from one ER door to another and by 1 AM I was admitted to the L&D department at the local high risk hospital.

At UMW they gave me a second ultrasound, continued the magnesium for another three days, did continuous non-stress tests and administered the second round of steroids to mature Baby's lungs for delivery. I continued to have bleeding and slower, but regular contractions into Thursday morning and by Friday the bleeding subsided substantially and the contractions were sporadic enough for me to be transferred by ambulance again to Fairfax INOVA for longer term observation and care decisions.   GW helped the paramedics get me loaded up:

At the L&D triage at INOVA my doctors requested additional labs and a third ultrasound to actually diagnose the cause of the bleed and preterm labor. While I don't understand the medical nuances of the situation as well as I would like, essentially what happened is I somehow sustained an injury to the edge of the placenta that caused hemorrhaging and it was the bleeding that caused the preterm labor. In the sonogram the rupture seemed to be clotting (and Baby was "plugging" the area with her fingers - smart girl!) and the doctors expressed hope that by the following week I'd be able to go home.  They also said that throughout this whole ordeal Baby has looked stable and is extremely resilient, so despite my "irritable, sensitive uterus" (the doctor's words, not mine - fitting, eh?) she's been fine and that gives them comfort and confidence.

So on Friday night I was transferred from L&D to the High Risk Perinatal unit on the 6th floor of Fairfax INOVA. I was given daily non-stress tests and asked to begin kick counting for a general idea of fetal movement.  Baby continued to look beautiful on the monitors and responded promptly in her kick tests - which I thought was very agreeable of her.

And so begins the week 32 non-stress tests at week 29

Then, finally, yesterday morning the doctors announced that I could go home.  It's kind of bitter sweet to be back in my own space - I'm thrilled to be back with GW and to be causing less difficulty for my family, but I'd be lying if I said that being so far away from INOVA didn't scare me.  For the past many months I've been fearful of the day I might look down and see blood where it ought not be during pregnancy and last Tuesday the reality of what happened was far more terrifying than I could have even imagined (impressive, considering I'm a pessimistic worrier).   I'm definitely nervous that it will happen again and, considering I am still having sporadic contractions, I don't have much confidence that I'll make it to term (another seven weeks) let alone be clear of the NICU... I know God only gives us what we can handle and I managed to stay composed for the majority of the hospitalization (the paramedics actually asked what drugs I was on because they didn't believe I could be that calm on my own), but this has been a lot to take and I'm feeling far more delicate than I know how to deal with.

The doctors were quite murky in what they wanted me to do for the next several weeks, but I have a follow up appointment next Tuesday where I should have more comprehensive answers and new updates. I'm not exactly on bed rest, but I'm also not supposed to do much - and lifting is completely out.   For the time being I'm taking things easy and trying to prevent further muscle atrophy (lost 5 lbs in the past six days) by moving about the house.  I've got GW's halloween costume to make and a bunch more scrapbook pages for Baby because of this episode, so I think I'll be bonding with our couch.

Thanks to everyone who sent emails, text messages and flowers while I was in the hospital - your support means more than you know.

My source of hospital smiles.
What a good boy.

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