Day 42: T-10

Wednesday, September 2, 2009

To say that today felt like one of the seven layers of hell would be an understatement. Disclaimer: Both babies are currently kicking around on top of my cervix. This post might be scary but keep the disclaimer in mind.

This morning, after breakfast and all the fun blood sugar tests, etc, one of my favorite nurses (whose c-section is scheduled about a week before my cerclage removal) began the monitoring. Maya goes on. No problem. Bobby goes on. The monitor is flashing 70s. Low 70s. Mid 70s. Sometimes we get the 140s. Rarely the surge up to 170s. Mostly 70s. Now, sometimes the monitor flashes 70s and I can clearly count 140s-150s. The monitor isnt equipped to deal with abnormal HBs; it can only pick up what it hears, so sometimes it misses a lighter sound or, God forbid, it gets confused by hiccups. Always a fun time. But this morning, I couldnt hear a light beat. Just a slow, 70s HB. My nurse heard it too. We were both silent and then she said "This is different." I said "Yes; I"m not sure if it is good or bad." "Neither am I", she said as she pushed the nurse call button and asked the desk to send the CRNP in. She came and listened for a bit before getting the ultrasound machine. Sure enough, put him on and he's in the 130s-140s when they timed him (they still have to do it by hand for an average since the u/s machine gives you detailed stats when you select a specific range but not a long term range). But on the monitor he does NOT sound that way. So, the Resident, Dr K, is called in. She listens and she, too, cannot pick up a missing beat, yet she sees the beats on the u/s. So she calls Dr Bailey and Dr R, the MFM who is on for today (and incidentally is the BOSS; she is the Dept Head for all the hospitals in this network). They ask her to perform a BioPhysical Profile (BPP).

As you may remember, Bobby had a BPP performed last week. At this age, he is eligible for 8 points. There are 4 categories: amniotic fluid, tone, movement, and breathing. (At 28w, the twins are eligible for 10 points with a 5th category, the NST which will look for reactivity). Each category scores 2 points or 0 points. At this point, 8 is normal; 6 is okay; 4 and below are abnormal. Babies that score well typically have a positive 7 day outlook. Last week, Bobby scored an 8. So, today starts and the doctor comments that his amniotic fluid looked good and he was moving a lot, so 4 points right away. Then he starts moving his hands and sucking his thumb and flexing his legs; 2 more points for tone. And then the waiting. Because of his movements and placement, it took her forever (it seemed like) to get a good view of his diaphram, but finally, 2 points for breathing. Thank God. He scored 8/8 again. So, she said that this was good news and she would let the doctors know. That the HB charting in the 70s wasnt good (if it was indeed that low- even she admitted the machine could be wrong since his irregular beats could be throwing it off) but that, on u/s, he looked fine. That she would call Dr B and Dr R and pass on the results, but that Dr R wanted to come and talk to me later in the day.

I spent the morning in tears. I was on the monitor for almost 2 hours as they decided what to do (i.e. from the start of the monitor to the doc coming in to my doc and MFM being called and everyone deciding what to do). All I could hear was a slow HB and I kept thinking: Is this it? Is this how my son dies and I cant do a damn thing to stop it? You have to understand, it sounded bad. I mean, I can deal with seeing a 7o when I can count a 140bpm. I realize the machine is dumb and isnt a person. But seeing a 70 and counting a 70. It makes your stomach churn. Then, seeing him on ultrasound and seeing his heart beating irregularly but at a normal rate. It's a low then high then low then high pattern. Up, down, up, down. Which way??? As I lay in bed, listening, crying, all I could say, over and over again, was "I give this to you, Lord." I couldnt breathe and I was terrified and this was the only thought that came out of my head. I couldnt pray. I couldnt do anything. Except those words. And while I still cried, I started to feel both babies moving, as though they were saying, "Mommy, we are okay." The HBs were charting the same, Maya in the 150s and Bobby still sounding/looking like 70s, but they were moving and okay.

I felt better after the BPP because he scored so well and he looked fine. And so then, it was just waiting. At around 4:30, Dr R came in. I'd been told that she was blunt and straight forward, and to prepare myself. But that is what I prefer. Dont sugar coat it; I want the truth. I read and am well aware of how bad things can go; the last thing I need is someone trying to placate me.

So, she begins by telling me what a low heartrate in a baby shows. Anyone who has read up on bradycardia knows that a low heartrate isnt good, but there is something about an expert telling you that it means oxygen depravation that sends chills down your spine. But after we finish the primer on low fetal heartrate, she says, "but we know that isnt your baby's problem." Because they see movement and his BPP was excellent, because they know his cord isnt compressed, because he has hiccups (often) and is his breathing looks good, this isnt why his heartrate is showing low. It could be a machine malfunction due to the arrythymia or the machine could be halfcounting without showing a sign of that. Today, because no one could hear the added beat and it sounded like 70s, she said that the u/s was a better interpretation and that showed a normal heartbeat with an abnormal rythym- no different than before. She then did her own ultrasound and, amazing of all amazing, saw nothing. His heart was beating normally. Yes, the arrythymia was still there, but no surging, just a normal heartbeat with an irregular pattern. She even went so far as to say that the babies looked so similar she had a hard time telling them apart! (I told her to find the penis and she'd have no problem telling them apart, LOL). She said that, at this point, in her expert opinion, we are stable and that the moment that changes and he shows distress, they will deliver. That she feels they can catch whatever might come up because we are being monitored so frequently.

It was a relief. And then, tonight, while the monitor showed 70s, the nurse, Peter, and I all counted 140s-150s. He had the hiccups, which made the monitoring a fun time as well (and made counting a little challenge!) but overall, his HB stayed in the 140s-150s. It was so reassuring. And, of course, the movement. They are practicing their acrobats right now.

So, it's been a long day. I am so tired. Every day it seems is full of being pulled this way and that. One day of good monitoring followed by bad monitoring. It's just so hard sometimes. I tell myself nine and half more weeks (not even!) and then they will be here full term, safe, healthy... I just have to stay focused on that. I know I will miss feeling them inside terribly, but I will be grateful for the lack of worrying about monitors and nurses in here several times an hour sometimes and pokes and prods and wondering if there is fetal distress. That stuff, I wont miss one single bit.

Thanks for those prayers. They are keeping these two safe in the womb and giving their mama gray hair. But, after all, dark hair with a few streaks is pretty darn chic...

27 comments:

Lorza said...

Phew. I think I got a few grey hairs reading this!! I am glad the babies are doing okay. That is one frustrating part about nursing- machines are just machines. Blah!

I am praying for you and the babies!!!

PS What wonderful information you put on here. It is very educating!!!

Carrie said...

Oh my gosh! What a trying day you've all had. I am so grateful that Bobby continues to kick butt on his BPP's which we know are an EXCELLENT indication of fetal health. I am so sorry that you are going through this, but your doctors are ON it and seem to have a plan in place for all possible outcomes.

How frustrating that the monitoring is so unreliable. I really had no idea there could be that much error in a reading.

Thinking of you as always, wishing Bobby and Maya many more weeks snuggled inside. Isn't it too bad they can't give you a Valium for Pete's sake? I'd take one sometimes, too! ;)

Love,
Carrie

Jessica said...

*hugs* Michelle....you have been so strong through this and its a testament to what a great mom you will be. I am glad to hear that by the end of the day Bobby was ok. He is a fighter it sounds like. :)Hang in there.

Reba said...

how frustrating!! i'm just glad the babies are okay. thank you for the disclaimer, this would have been even more harrowing to read otherwise.

sprogblogger said...

What a scary day for all of you! Thinking of you so very hard, it feels weird that I can't just pop into the hospital to see how you're doing for myself. Hang in there. It sounds scary, but it also sure sounds like things are ok, it's just a wonky machine reading. You are all in my thoughts and prayers.

Just Breathe said...

So your going for the S & P look!
What a day you had, OMG. I am glad that everything seems to be running smoothly. You certainly know your stuff. Wow! I of course will continue to pray. God Bless.

April said...

I'm thinking nothing but the best for you and the babies (well, Peter too, but I counted him as part of the "you"). I 'check on you' often and always hope that it is good news to read. You are such excellent parents.

k@lakly said...

Thanks for the disclaimer, I would have been panicked otherwise. So glad they are watching so closely. Just a sidenote, I remember back after losing Caleb reading that hiccups can be a sign of distress and I think there are studies that link hiccups to stillbirth, so I am extra, extra glad that they are watching you so closely. I don't say this to worry you more, only because I know you will look into it and make sure the docs are watching him all the more closely, although I doubt he could get any better care than he is right now. You are all amazing.
9 and 1/2 more weeks, wow, you go girl!!!
xxoo

Krystal said...

Oh sweetie,
Im sending you tons of paryers and love.

Rest tonight you and the babies need it.

Tomorrow may possabily be a better day!

Nickie said...

I hope tomorrow is better for you and the babies. I know that God is with you, Peter, and them. Maybe when I get out of this hell hole of Colorado, I'll bring Joey and Ian to see y'all. Love you!

Catherine W said...

Oh my. Oh my gosh, no wonder you are feeling tired. How stressful and frightening my dear.

Yay for the BPPs. I hope it is not genuine bradys. I'm so glad that you can count higher than the monitor.

Nine and a half weeks, hang on in there Bobby and Maya. And of course mom and dad. I swear I have more gray hairs since the girls were born. xo

Cassandra said...

I'm sorry that you had such a rough day. I hope today is better.

Barbara said...

Nine and a half weeks! So soon. just hang on.

xxx

Leah said...

Ugh, what a long day! I can't even imagine how difficult this rollercoaster is for you. . . especially when you're so helpless. Just know there are so many people thinking and praying for you, your hubby, and those babies in your belly. Thinking of you.

Donna said...

What a day!!! You are supposed to be on bedREST - but you don't seem to be getting any...I'm glad everything seems to have resolved itself to some extent. You need a day of chic flick movies and trashy magazines to just mindlessly pass some time.

I hate to say it - but I think Bobby is going to be a handful...(and you probably won't be getting much rest for the next 18 years either!)

I'm so glad everything is still OK.

gwinne said...

Wow. What a scary day. Glad to hear it ended on a positive note.

A n T said...

Okay Bobby and Maya 9 more weeks! You can do it! Praying so hard for your babies Michelle!

Busted Tube said...

My goodness! These babies are certainly giving you good practice for their teenage years...
I'm so glad they continue to look good on the ultrasound and stay inside. Your doctors sound very, very skilled and also like they care about you and the babies on a very real and human level. Many good wishes to you and your family.

Molly said...

Oh my gosh, how scary for you. I'm so glad they are OK. It sounds like you are getting excellent care. As always you are in my prayers.

AKD said...

Oh, my goodness. What a stressful day - what a wonderful ending, but it had to send YOUR blood pressure through the roof with the waiting. I hope that tomorrow is a more relaxing day.

Missing Kasey said...

What a day! I am glad that it ended with reassurance! I know really reassurance wont be until those 2 cute little ones are in your arms screaming. Thinking of you and hold on Bobby and Maya -9 weeks ((Hugs))

Bluebird said...

Sounds exhausting :(

Mommy (You can call me OM) said...

I read this last night but I was unable to comment. I am thinking about you so much, Michele. I pray that all continues to go well, that you have no more scares, that all the scares were merely mechanical error, and that you are surrounded by positive people and lots of positive energy.

I really don't think I would be able to act as graciously as you if I had to be tortured by what may or may not be an inconsistent reading for Bobby's heart rate. Sometimes technology causes anxiety of its own.

Praying for you and wishing you peace, my friend.

mekate said...

Chic and courageous Momma! I swear this is more than I can imagine dealing with-- I am so glad he is ok! And you, my dear sweet Michele, I wish I could hold your worries for a while so you could rest a bit, but I am not sure I am strong enough.

Thinking of you and as each day passes, those little ones are getting stronger and stronger and each day counts-- so
congratulations on t-9 today!

warm wishes to you,
Kate

Linda said...

My heart goes out to you and your family! I pray that you will have a safe pregnancy and delivery this time! How great that you can be monitored so closely, what a blessing to know that they are being so closely attended too.

...It´s so easy to forget what a miracle it is to have a healthy baby, safely delivered into this world... I cried when I read your story about losing three babies.

Stay strong in the hospital while waiting to hold your healthy, strong babies in your arms!

djsmom2007 said...

May the Lord's peace and rest fill you, Peter, and your babies, Bobby & Maya! Keep fighting, you are almost there!

Linda said...

BTW, a little mental health tip, for staying sane in the hospital: DId you ever try knitting? Nothing can keep me so distracted from my worries as knitting, and time actually flies by when you´re knitting. (But then of course you may not have the strength to do it, nor the interest..)

But anyway, best wishes for the weekend for you, your husband and your babies! May you all get the rest you need!