Day 35: T-3

Wednesday, August 26, 2009

Yesterday was not a good day, hence no update. I wasnt even in my room.

At yesterday morning's 9am HB monitoring, Bobby's HB was 212. He is normally 130s-140s. A second nurse confirmed then the Resident, Dr N, was called. (Dr P was at a different hospital after visiting me for rounds in the morning- funny stories about him, actually...) She used 2 different u/s machines to confirm the HB. It was a blur of activity as they tried to get an IV and give me oxygen. Suddenly, I was told that I was being moved to Delivery and that Dr B had been called to discuss an emergency c-section. I called Peter and tried not to cry.

They moved me from Antepartum to Delivery and continued trying to get an IV while also trying to get the babies on the monitor. 6 sticks later, I had an IV in my arm (and my other arm is now just one bruise), oxygen, and a nurse monitoring Bobby and Maya. Maya was fine, but Bobby's heartbeat stayed in the 200s then would momentarily drop to the 150s then back to the 200s. It was terrifying as they were concerned he was in distress. Dr B called Dr C, the MFM doctor that we've been seeing, and they consulted. The wanted to avoid delivery if at all possible, so Dr C came and did an ultrasound on the high resolution equipment. By this point, Peter had arrived.

As we waited for Dr C. the u/s tech pulled the babies up and the first thing he said was "There's no fluid around the heart or lungs." This was great news. This means that Bobby's heart has not started going into failure. Once Dr C arrived, it was quiet for most of the scan. But he also had some better news. Bobby was not in distress. The upper part of the heart, the atria, are not beating regularly. In a normal heartbeat, you get atria-ventricle-pause-atria-ventricle-pause, etc. The atria contracts, then the ventricle contracts and relaxes, preparing for the next round. Hence the lub-dub sound you hear on a stethoscope. Bobby's atria is contracting twice. atria-ventricle-atria. atria-ventricle-atria. The ventricle is getting the sign to contract but it cant be cause it is relaxing and by the time it contracts again, the atria has contracted a second time. This is causing the arythmia and pushed his heart into overdrive. The overdrive is called SupraVentricular Tachycardia, or SVT. The concern is that SVT leads to heart failure if not treated. Since they cannot give Bobby treatment directly, the discussion became what to give me to try and help him while not hurting Maya (whose heartbeat is stable and regular). At first, the discussion was Digoxin, a cardiac medicine that would possibly lower his heartrate but also would require cardiac monitoring for me since my heart is normal and would be impacted by the medication. This is a common first line of defense because it is an older drug that, although a class C medication, has been used enough in pregnant women that no adverse effects have been shown (there just havent been studies conducted). Dr C decided to call Dr B, a pediatric and fetal cardiologist from Dupont in DE, to consult on what he had seen and heard from the monitors. Dr B will be arriving on Monday to do a echo on Bobby's heart and, in the meantime, suggested they start me on Propranolol, a beta blocker and also class C, since it would have the greatest impact only on my blood pressure and not my heart, and he feels might lower Bobby's heartrate. The idea is to lower his heartrate and then try to figure out what is causing the arythmia. Is it a heart defect that was missed on the MFM ultrasounds (although Dr C still couldnt see a problem even yesterday) or is it an unknown arythmia that will fix itself either in utero or upon birth, which can happen. Either way, their hope is that, even if the drugs dont work (and they have a plan to add drugs if that is the case, including adding the Digoxin to the Propanolol), they can buy us time to 28w and deliver then, versus delivering now. Not that we want a 28w delivery but we will take it if that means both of them are okay. The worry is that if they cant get Bobby's hearbeat to settle back down to normal and it does go into failure, that drugs wont work. And since we arent willing to let something happen to him for the sake of going longer into pregnancy, we've already made the choice that, at whatever time they see distress, we are opting to deliver both babies.

So, last night, we were in Delivery with the idea that we would be transferred back to APU, but they decided they'd do my monitoring, etc, over there and bring us back later. That monitoring showed that he was still in tachycardia (high HB), but that in addition to going back to normal ranges, he was droppping into subnormal (80s-100s) and then back up. The residents were called and they did an ultrasound in the room. He was still moving and happy but you could see his heart going fast then normalizing and then, it appeared, taking pauses in between beats (the low beats). They felt that there was really nothing they could do except watch and wait and hopef or the best, since he was normal or high much more than he was low. Of course, I had a good cry when it was just Peter and I, terrified that Bobby's heart was stopping and that he was trying to tell us something that we just couldnt understand. "Is he saying, "Mommy, help me," and I'm not?" I sobbed. Peter just held me and rocked me and, with every little cook of our baby boy's foot, told me to take heart that our son was okay.

We got back to our room around 10pm and were so tired. I woke a few times in the night (for the bathroom, to have my BP measured, to take my new med) and each time, I prayed and willed the babies to move, just to let me know they were okay. Maya was more than happy to oblidge when I rolled onto her side and she didnt like it, but Bobby was fairly quiet. I was terrified and ended up falling back into a restless sleep with my hand glued to his side of my belly.

This morning, as we were laying in bed, Peter told me he wasnt going to work today, that he wanted to make sure that things were stable before he even thought of leaving the hospital. I am so glad that he stayed. Bobby was more than happy to make me aware of his presence with kicks and rolls, along with Maya, and I felt better about his safety, and I actually took a peaceful nap. Dr B came in during this time and talked to Peter, and then my nurse came in to do monitoring. I explained about the irregular heartbeat and SVT, but she was nervous listening to his HB because she said that what she was seeing on the monitor wasnt matching what she heard. So, she called in the Nurse Practitioner, who did an ultrasound and confirmed that his heartbeat was stable with drop offs (but not surging). Still, she was concerned and called the Resident, Dr P. Dr P had seen me this morning on rounds and told me that, while he knew I was scared, he has seen fetal arythmias a lot and they usually resolve themselves... that Dr B from DE is an expert and will find any abnormalities but that he thinks things will be just fine... To try not to worry... (and, funny story, I dont know how he found out that I had been moved from APU yesterday but apparently he called Dr N and drilled her on what happened. Last night, she laughed and told us "I had to keep telling him that you were fine.") So, Dr P came in and listened and repeated the u/s. He was able to confirm that Bobby's HB was within normal ranges and dropping off with periodic highs (190s) that only lasted seconds. So this is actually better than last night. His heartbeat is still very irregular (i.e. arythmia) but the tachycardia aspect is diminishing. This could be because of a quick response to the medication (which has lowered my blood pressure to the point that my morning dose was skipped and I felt a little off kilter) or it could be that this was just a fluke thing. I'm hoping the latter and that the arythmia as well will clear up on its own. The CRNP wanted to move me from APU to L&D; Dr P doesnt. (He wouldnt be my Resident over there... Such a nice guy.) He also told the CRNP that if he could sit and get Bobby's HB on a solid strip for 15m (meaning they can see all the highs and lows and not just points blipping up on the print out), then the nurses can do. The CRNP argued with him for a bit but after a while said "You've proved your point." He also wants them to monitor the babies seperately since they know that Maya's heart is fine right now and that way there isnt dual lines on the print out. So, a nurse will sit with me for 15m of my monitoring to get a solid, 15m strip of Bobby's HB, highs, lows, and everything inbetween.

Emotionally, I am drained and am a nervous wreck. It's bad enough to not know "why" this happened; it's worse to feel like it is a wait and see. Hopefully, come Monday, we will have some answers when the pediatric/fetal cardiologist comes, but it is the waiting until Monday that is killing me. Will Bobby be okay until then? Everyone seems to say yes, but then there is the mini-freakout when they monitor him and the nurses see/hear the arythmia. I just want to know that he is safe and okay. I dont want them to go for monitoring one day and not find him. That is my huge fear right now. I realize that delivery at this point isn't a good thing and we are desperate to get to 28w... I just want to know that he is okay until then. When he moves, I am reassured; but when he doesn't, I panic.

A note about my blood sugar... Yesterday, after breakfast and lunch, my BS came back at 120 and 127 respectively. I was really pleased. After dinner (and my first dose of the pro...), it was 166. Even though I ate the same as I had for lunch. The meds screw with your blood sugar. This morning's fast: 135. So... even though diet actually DID help, I will have to go on insulin therapy to moderate my BS as a result of the meds to help Bobby's heart. I'm a walking pharmacy!

Prayers are much appreciated. I am hoping that I will have better news to report within the next week. I'm also having a MFM u/s on Friday, which I hope will give us some peace of mind as well. Right now, both babies are kicking and I am relieved to say that we are doing okay.

56 comments:

Molly said...

I am praying for you.

Kim said...

I seldom comment, but I am ALWAYS thinking of your family and sweet babies. BIG prayers and thoughts going out.

You may already know about this blog, but if not, check it out. Their baby, Stellan, also had SVT en utero and continues to deal with it now. It would be a great source of information and support for you.. the momma is super sweet!

http://www.mycharmingkids.net/

Krystal said...

My heart was racing the whole time I read this post... You, Peter and you sweet twins are in my prayers... I hope this settle down a little for you, so you and the babies can get some rest.

Much love,
(((HUGS)))
Krystal

Carrie said...

Oh my God, Michelle. I was thinking of you this morning and hoping all was well with you and the babies.

I cannot imagine how terrified you were yesterday, and are today. I am so sorry this is happening.

I am so thankful you are in the hospital and they caught this- I am sure the earlier they are able to stabilize Bobby's heart, the better. It seems like you are in SUCH good hands and they are doing everything they can to keep them in as long as they can and to heal Bobby.

It amazes me: you never say, "Why me?" and your attitude is such fierce protectiveness and love for your children. I am holding all of you very close in my heart and thoughts, hoping the arthimias are gone for good very soon.

Sending love and peace and a steady heart beat for B.

stumbull said...

Michele: I have never left you a message but I am always reading/following your blog. I am praying very very hard for you, Peter, Bobby and Maya! You are an inspiration to me and to I am sure more people than you know! I was so worried when you did not post yesterday I am glad that at least the worst did not happen although I know this is very frightening! I will continue to pray for you! Stay strong for all your little ones!

Barefoot said...

Oh, oh, oh -- I'm so sorry you had such a scary day yesterday. I am praying (for all of you) big time.

Anonymous said...

Hi, Sweetie!! Hugs and more hugs to you, Peter, and ALL the kids. Love, PJ

Catherine W said...

Oh Michele. I just don't have the words.

Hoping and praying for you and your precious family. I hope that Monday brings some answers for you.

Thinking of you all xx

Monique said...

Sending much love and prayers.

Bluebird said...

I'm so sorry for this new concern. You deserve a stress free pregnancy more than anyone :) I can only imagine that, if it were me, I'd be full of pouting about "what now."

I will continue to keep you and your babes in my thoughts and prayers. Hang in there, sweet girl.

Anonymous said...

Oh Michele, I am sitting here crying my eyes out reading this. I know how scared you are, the same thing happened with Julia before I delivered her. Just have faith and know that we are all out here cheering you, Peter and the babies on and praying for you all. I wanted to just give you these words of wisdom that might brighten up your mood....

The most beautiful people we have known are those who have known defeat, known suffering, known struggle, known loss, and have found their way out of the depths. These persons have an appreciation, a sensitivity, and an understanding of life that fills them with compassion, gentleness and a deep loving concern. Beautiful people do not just happen.”

Tons of hugs to all of you!
Megan

cheryllookingforward said...

I'm with everyone else, saying some prayers for you guys!

Suraita said...

Thinking of you and your family and sending prayers for all of you!

A n T said...

Praying for you and little Bobby's heart. Keep us posetd.

Just Breathe said...

Oh Michele, I can't believe it. I am sending prayers to God right now. I am praying for at least 28 weeks, Bobby's heart healing and going back to normal. Waiting until Monday is just not fair. I will be praying non-stop for you and the babies. I will pray that you will feel him moving all the time because I know that is the best feeling for you to have. Please keep us informed and I am so sorry for this added stress.
Take care and God Bless. ((HUGS))

sprogblogger said...

You're in my thoughts and prayers - hoping this is just a glitch that works itself out quickly. Take care of yourself.

Lachlan's Mum said...

That sounds so, so scary, Michele. I remember how scary it was when Lachlan's heart rate dropped and all of a sudden we had to do an emergency c-section. That time was just so terrifying. I really hope for you and your babies that Bobby's heart rate normalizes and that there are no more emergencies. Big ((Hugs)).

Anonymous said...

I was so nervous when you didn't update yesterday,I always check up on you every day, to see how you and the babies are doing. I am praying so much for you, Peter and the babies today, and especially Bobby's little heart. Many hugs to you, you are such a sweet and wonderful person and I admire you so much
-EH

Kate said...

When you didn't update I felt myself getting anxious. I'm so sorry you had such a hellish day. I can only imagine your feelings when they moved you towards the delivery room. *hugs* I'm so sorry. I am hoping and praying for Bobby. I pray he will be okay and that Monday will come as soon as it possibly can.

*hugs*

Donna said...

Just hoping and praying that everything will be OK and the babies get to stay inside a few more weeks!!

May said...

holy freakin' crap. Can you please catch a break here!?!

All fingers and toes crossed for a quick and easy resolution.

Busted Tube said...

I was worrying about you! I'm so glad the babies are still cooking for now and I hope things with Bobby's heart get better and better. What a stressful, scary day- I'm glad you're surrounded by caring doctors and your wonderful husband, I'm sure it has been a huge drain on your emotional reserves. Take care, I'll be thinking of you.

Anne said...

I am still praying for you and will have the prayer card you sent me in my purse for as long as it is needed there (maybe more than that too). I keep checking your blog even if it is the only one I have time to check. Love and hugs to you and the babies, Anne

B.A. Smith said...

Dear Michele, Please know that my prayers are with you. May God hold you in the palm of His hand.

mekate said...

Oh sweetie pie, what a shitty scary day. I am so sorry for all that you've been through and the waits the waits the waits between moments of reassurance. I cannot imagine how you feel, but I know I read and read and read and read with my heart in my throat, and hoped the whole time that you would say something like And all was well. I am hopeful that is true now or will be true soon. AND THAT YOU WILL KNOW IT.

Prayers and thoughts and love,
Kate

Kate said...

Hi Michele, thanks for your comment on my blog, I'm not sure you read the other posts before the one youc ommented on but wanted to let you know that I got a BFP yesterday. We'll see what happens but there is always hope.

Amanda said...

Praying for health and peace for you and health and longer gestation for the babies!!

Michele said...

Hi Michele,
I am not even sure how I found your blog except to say that God led me to it. I haven't been through all of what you are going through (but sadly, some)... but count me in as one who is praying for you, your husband and those beautiful babies. Blessings!!

Jimmie's Auntie Amber said...

Praying! I can't believe this. Seriously!!!!

Hope's Mama said...

Oh my goodness, my heart was certainly racing reading this Michele. Just hope little Bobby's heart can be ok. Strong and ok. Please hold on little Bobby.
Thinking of you and your family.

gwinne said...

Oh, Michelle. What a rough time. You and Peter and the babies are in my thoughts. I hope the specialist has good things to say.

Simbelmyne said...

Prayers and good energy.
I hope you have lots of reassurance today.

SMK said...

Michelle,

I pray for you and your babies every night. I am so sorry that you are suffering through all this. I am praying for you so that you have the strength to endure all of this. Give Bobby and Maya a big hug for me. I hope the specialist has great news for you. Thinking of you and your babies. Take care.

wifey said...

I am so so sorry to hear about this added stress for you. I don't pray much, but I will be praying for all of you!

Wishing you comfort and peace

Lisa said...

I was just going to tell you the same as commenter up above. You need to talk to Stellan's mom .

Sophie said...

Ack!!! What a horrible scary day for you yesterday!!! I am freaking out, so I can imagine how scared you must be! I'm so glad your hubby stayed with you today!

Sending you much well wishes and wagging my finger at your little boy and telling him to behave himself! No more of that please, Master Bobby, that's quite enough!

xx

Amanda said...

Just going to send some HUGE (((((HUGS))))) to you and DH!! And those precious babies.. that everything is ok and they hold a bit longer. Stay strong mama!!

Reba said...

I'm keeping all of you in my thoughts, especially little Bobby. Stay strong little one.

Mrs. Cline said...

Thinking of you and your sweet babies.

Hugs.

Natalie

k@lakly said...

Oh what a scary, scary day! I am so sorry you had so much stress and worry. I will keep a good, strong thought for Bobby and for his heart to heal itself very soon. I am so glad they are watching you and the twins so closely and that they are taking such good care of you. keeping everything crossed for 38 weeks:)!! Dream big, right!
Thinking of you mightily.
xxoo

Cassandra said...

Michelle,
I am so sorry that you are going through yet another difficulty. But, now that I'm in the hospital myself, it seems fortuitous that you are there (albeit for other, scary reasons) and that they can watch Bobby so closely. If you were a "normal" pregnant woman they would be doing a doppler every few weeks and would probably miss it altogether. The constant care and monitoring makes me a little afraid to leave the hospital if the time comes for me!

Hoping for the best for all of you.

bankshot said...

Oh that has got to be sooo hard!! I am so sorry!! I will be praying EXTRA hard for you and Bobby and Maya....

God bless!! ~michelle( yer preggo twin...lol ) SMILE as best you can!! :)

Annalien said...

O man, why can't things just go your way for a change! I will be praying.

momto558 said...

You and the babies are always in my thoughts & prayers.Hang in there...your doing a terrific job,mommy:)hugs,
Michele G.

Leah said...

Praying for you. I cannot even imagine how emotionally trained you are after this ordeal. Wow. I'm really praying that it was a complete fluke. Thinking of you!

sonja said...

Oh, Michele ... I am so sorry that this is happening! I will pray for Bobby's heart and for the doctors to figure out the best way to help Bobby that is also safest for you and Maya. I can't imagine how scared and exhausted from worry you must feel.

Praying hard for you.

*hug*

mekate said...

Thinking of you and worrying, because I'm like that.
Hoping all is ok.

Sending love and the best vibes possible for you and your family, in every way.

XOOX
Kate

Ms. J said...

Oh Sweetie, WHAT a day you and Maya and Bobby had! He is quite the attention-getter, eh?!

I think it's a good sign that they are not choosing to deliver . . . as you know every day there are still cookin' inside your oven is one day more that they grow and gain strength! You and the babies are getting excellent care and monitoring, and it's clear that if they are concerned that Bobby is in danger they will deliver immediately.

I think it's a healthy sign that the dr.'s are not always in agreement - it shows they are open to other opinions and are willing to duke it out a bit, until they are resolved in a course of treatment.

I can't imagine your stress level right now. Many extra prayers being sent your way!

Leah said...

You have got to go to www.mycharmingkids.net Her youngest son was diagnosed with SVT in utero and he is now like 7 months old or so and there has been ups and downs but the mom has such an awesome love of God. My prayers are with you and please check out that blog.

Marie W said...

Oh no Michele. Not the news anyone of us wanted to hear. I am praying for your peace and Bobby's heart to stabilize. We serve the GREATEST physician and all things are possible through him. Hugs to you and hubby.

Shinejil said...

I'll be praying for Bobby and hoping for the best.

projectkjetil said...

Sending prayers for a stable heartbeat and continued in-uteroness for both babies. Hoping hard that you can make it past the 28 week mark.

survivingbaby said...

Sending you lots and lots of love from NC...

AKD said...

Oh, Michele. It touches my heart that you made such a kind comment on my blog after such a hard couple of days. I am praying for you all - I actually have seen your posts on Babycenter's loss boards in addition to LFCA, and am just amazed at what a rock you are.

I have faith that your babies are going to be healthy and happy. God bless.

Tash said...

Michele, I'm sorry I'm so late to this news -- and YIKES, what a scary time. I'm grateful you're in such good, attentive hands. Thinking of you all, and hoping for a stable resolution. I keep thinking it really shouldn't be this hard, but look who's talking.

djsmom2007 said...

Praying for you all! I was going to tell you about Stellan, but saw that someone already did! The Blog World is amazing!