One flew over the cuckoo's nest

Things that are annoying me here in the hospital:

1. The annoying housekeeping woman. She comes in my room over half-a-dozen times a day: Empties trash - leaves. Later comes back cleans bathroom and floors - leaves. Later comes back to pick up the 'wet floor' sign - leaves. Later comes back several times a day to get gloves...as if there aren't gloves in other rooms? does she not have pockets to put gloves in? Dejame en paz!
2. The food/dietician. I mentioned the food in another post. Part of the problem with the food for me is that they have me on a diabetic diet (which, as you know, I'm vehemently protesting this diagnosis). The diet is a 2200 calorie diabetic diet which consists of three meals and 2 snacks. Supposedly this is supposed to add up to 2200 calories. I beg to differ. I asked to be weighed last week and discovered that I lost 4 pounds - on bed rest where I do nothing but eat and lay around! I've talked to the dietician and she offered absolutely no help on how to keep up calories on this diet. My snack choices are either a cup of cereal, or 1 3-pack of graham crackers, or an apple with cheese or peanut butter. The main meals are mainly concerned with carbs - vegetables and protein? Forget it. The eggs are fake and the vegetables and protein are not necessarily available with every meal and when veggies are on the menu they are they are absolutely disgustingly overcooked. The "tomato and lettuce" salad is always frozen. I finally asked one of the food service gals if they had hard boiled eggs and she brings me some when I ask. (As a side note, when the perinatal radiologist saw my hard boiled eggs, she said "oh good source of protein and the cholesterol is good for the baby"). The next time that dietician comes in she's going to hear it from me.
3. Dry as a desert. The air here is soooooooooooooo dry. They keep it dry to reduce bacteria. But because of this, I'm constantly congested and have a bloody nose.
4. The nurses won't keep my door closed/cracked. There is a lot of hallway noise and I like to keep it at bay by closing my door most of the way, but inevitably housekeeping (see #1) or a nurse will come in and leave it open.

As Time Goes By...

And no matter what the progress

Or what may yet be proved

The simple facts of life are such

They cannot be removed.

You must remember this

A kiss is just a kiss, a sigh is just a sigh.

The fundamental things apply

As time goes by.

Week 2 on bed rest (1 April):

wake up; go to bathroom; check sugar; eat; go to bathroom; lay on my left side - uncomfortable; sit up; lay reclined - back hurts; go to the bathroom (ahhhhhh feels good to stand up); lay down; turn on t.v. (nothing worth watching until 5pm); turn on radio; check sugar; look out window; eat; go to bathroom; lay down; sit up; read magazines; turn off radio; turn on tv - britcoms are on PBS!.......

and so it goes.

After a couple days of this, it gets kinda old. Surprisingly on weekends when all you want to do is veg-out, it all sounds so appealing.

Week 3 on bed rest (8 April)

On Friday April 7th (34 weeks), my doctor called me and informed me that my protein had gone up to 2.5 g. Previous readings were at less than 1 g. Based on those results, he was concerned that they would continue to exponentially climb. His recommendation was to be admitted (again) and run another 24 hour test to see what the next value would be, then based on that result he'd be able to determine what the trend is. We decided it was better for me to be in the hospital knowing that once I went in, I wouldn't be released until I deliver. So I got admitted that Friday. We were hoping this was an errant test and really did not want to deliver at 34 weeks. I took the next test and, SURPRISE SURPRISE, my protein had actually dropped to 1.4 g. So my protein was lower and my amniotic fluid was good. We continued with monitoring amniotic fluid and protein. The next round of tests weren't as good. My AFI dropped but the perinatal radiologist wasn't concerned as he saw a lot of fluid in one pocket. My protein crept up to 2 g though. My platelets, which were dropping, actually came back up. Later that week I had another AFI done and it continued to drop. So I did another protein test and based on those results we would have to make a decision about delivery (35 weeks).

In the meantime, my baby shower was now out of the question. And since I wasn't home, I really needed to feel prepared just in case we had to deliver early. We still needed to get a car seat (high priority), get the crib put together, wash the new baby clothes......I felt totally disorganized and it was driving me nuts!

Despite all of this, I'm glad to have such good friends and relatives that called or stopped by to visit! It's hard not to feel down and isolated when you're in the hospital and their support has been wonderful for me.



Week 4 on bed rest (15 April):

My next protein test results came in and, SURPRISE SURPRISE, it only increased to 2.1 g. My platelets increased even more and have been the highest they've been. Totally stumped. My doctor had already decided that he was going to start inducing Wednesday with cervical gels and deliver Thursday (36 weeks). His reasoning was 'why wait?' 36 week old babies are just as healthy and why wait for something to go wrong. That being said, he was willing to wait for the next AFI reading, if that was even lower I really would have no options but to deliver.

Now we were wondering what was causing my proteins to have gotten worse, better, then relatively stable. The difference was that protein in my diet had increased. Steven had been increasing the protein in my diet when I was home and when I was admitted, he brought me extra food to supplement since the hospital food is not very nutritious (doesn't that surprise you? You'd think as a hospital they'd have very nutritious meals but what I've determined is that they don't follow the nutritional guidelines for protein, vegetables, etc.... more on that later).

The perinatal radiologist came in to do my AFI and, SURPRISE SURPRISE, it increased - in fact almost doubled! Based on that and my other results she saw no reason to deliver me.... I bought another week which meant that as long as nothing went south I could deliver at 37 weeks rather than 36 which, according to my doctor, is considered 'term'. While it seems insignificant, at 37 weeks the baby has a better chance of not going to NICU, having developed the sucking reflex, and my body being more prepared.

So now I have a few more days left before we start the induction on next Wednesday/Thursday....

Sleep, perchance to dream...

ay, there's the rub

That's all I've been able to do for the last week.

Sunday, 25 March: This weekend I noticed my blood pressure starting to rise. Then Sunday while my father-in-law was over in the morning I felt something damp. I went to the bathroom and noticed a gooey glob on my leg. Mucous plug? I called Steven and had him look at it. At first he didn't think it was but after looking online it really sounded like my mucous plug. I called my doctor and left a message. The other doctor in the practice was on call and returned my call and asked me to stop into Alexandria while she was there for a couple hours.

We arrived at the hospital and I was hooked up to a fetal monitor, blood pressure cuff, had probably 6 vials of blood drawn, and had a fetal fibronectin test run. Dr Salgado came in and looked at my swelling and blood pressure readings. We waited for lab results to come back in. About 4 hours later, labs were in and there was an elevated reading in uric acid. We left with instructions for bed rest until Tuesday and follow up with my doctor on Monday.

Monday, 26 March: We went to the doctor's office and she did an exam to check my cervical length. She could only confirm feeling about 1.5cm of it which left her uncomfortable since I was 32 weeks. She sent me for an ultrasound to check cervical length and also gave me a container to do a 24 hour urine collection to test for protein in my urine.

We went straight from the doctor's to the ultrasound office. They confirmed my cervical length was about 2.2 (Dr Salgado wanted it to be 2.5). They also checked the baby, amniotic fluid, etc. Then they wanted to do a 3-D ultrasound - for reasons still unknown other than they got a new machine and wanted to use it. While I was checking out, my doctor's office called to discuss the results of my ultrasound. The nurse started in with going to see the Perinatal radiologist and steroids and on and on and on....Stop, wait, what? I handed the phone to Steven because I was too overwhelmed to talk. We went home and I laid in bed and collected my urine certain that this too would pass.

Tuesday, 27 March: I dropped off my specimen after lunch and was feeling pretty good. Not that I was feeling bad to begin with.

Wednesday, 28 March: Steven left to drop off some items at his dad's house and came home and immediately started looking up something in one of our reference books. I was on the phone with work at the time and when I hung up, he said "we're going to the hospital." I failed another test. My protein came back at 800mg. Normal range is like 300. They wanted me to go in for 24 hours. Ok.... take a shower, pack a bag, get something to eat. We arrived after 6pm. The nurses immediately talked about getting a steroid injection. Um no, not yet. Don't think it's necessary really. Again, I was hooked up to a fetal monitor, blood pressure cuff, had blood drawn, and had to do yet another 24 hour urine collection.

Thursday, 29 March: Dr Fracasso stopped in and thought I had taken the steroid shot. He agreed that it was my choice and gave me the impression that after 34 weeks it would be of no difference. I said "well I'm 33 weeks today." He deferred to the perinatal radiologist to get their opinion. About 2pm, I was getting a bit anxious and asked Steven to find out when I was supposed to see the radiologist. She happened to be at the nurses's station. Apparently no one informed her ahead of time that I had been waiting. She did an ultrasound on a portable machine and the baby looked good. I mentioned being borderline pre-eclampsia and she said 'No, you have pre-eclampsia'. She, too, assumed I had taken the steroid shot and when I said that I hadn't she really gave me her opinion. She just didn't see why I wouldn't want to do it as the benefits to the baby are certain. She mentioned something about staying in the hospital because with pre-eclampsia, there is a a risk of the placenta detaching from the uterine wall. I said there is no way I can stay in the hospital for 4 weeks and she said, very dryly, "yes you can and we've had some women in here even longer." and with that she left.

Later that evening I was called to see her again as she wanted to run one last test on ultrasound. She gave me literature on the steriods that I asked for and checked a value called "resistance indicator" which checks my blood vessels to the placenta. Again, I fail another test. Not by much, but I fail it. She emphasized again the steroids. I went back to my room and after talking to Steven, I called the nurse to administer the injection. Part of my hesitation on steroids was that I did not want to start a chain of events that would leave me without options. Steroids can cause increase in blood sugar levels, which then require insulin injections to offset the glucose levels. I also did not want doctors to have an "excuse" for delivering me early without any real medical necessity. But after weighing it all out, the benefits for the baby are most important.

Friday, 30 March: Dr Fracasso came in and we chatted about when I might be getting out. He felt chances were good that I might get out that night, but plan on Saturday. He mentioned something in passing about inducing me at 37 weeks via C-section.... hm, yet something else to discuss. I mentioned going back to work and he recommended not "burning the candle at both ends." My blood pressure had been stablized, at least while lying down, and my glucose levels never went off the charts for me to require insulin (can I mention again that I don't think I have gestational diabetes?). My 24 urine test came back elevated to 810 buy my doctor was not worried about the small change. Finally at 7pm, the nurse came in and gave me my discharge orders! Bed rest, may not return to work, and a ton of "signs" to look for.

This weekend: So now I'm setup in the office for close proximity to the bathroom (and not having to go up and down stairs from our bedroom loft). Steven has been doing a great job of trying to get chores done and make sure I drink water and stay fed.... he's a great guy. I love him.