Passive Superstition Be Gone

I think I have not been posting through a mix of passive superstition, by not typing things it is totally logical that I'm not tempting fate (right?), and honestly just not wanting to process some thoughts.  Neither of these was a conscious move, just kind of happened.  But I got forced to a few thoughts, including realizing that I wasn't writing anything for silly/nonexistent reasons, so here I am.

First thought: at some point in the last week or so, my expectation has changed from this could result in 0, 1 or 2 babies to there will be 2.  Yesterday morning, my OB was as usual sitting in the rocking chair beside my bed chatting and writing up my chart and when she finished she asked if I had anything else.  And then said that she thought there was something else and that I sometimes get a look where she knows I'm thinking something, but she just doesn't know what it was.  I felt oddly stressed, but couldn't identify what it was.  In thinking after, I think it really was just that I'd made the transition to expecting 2, and thus exposing myself.

That's my big thought.  Figure I should give a status update and summary now since I have been so non-communicative.  However, just like with Chiron/Aurelia, I've actually done a good job through Facebook and it's hard to keep straight what I've said where, so figure I'll just go general here.

Two new things were declared by the OBs this week: next baby who pulls a hijink is getting born at that time and bring her sister with her and we are staying through delivery.  Why, you ask?  Well, Monday when we actually were at the point of considering discharge in the next couple days, Righty aka baby A, started having late decels followed by tachycardia on our normal morning strip.  Initially responded with trying positional changes while a nurse got the oxygen setup in place.  Then she called the OB and had her look at the strip just to be sure she knew what was going on and the OB told the nurse that we were going to c-section them and to start an IV, get labs drawn and get me moving towards L&D.  Then in the thirty minutes all that was going on little miss behaved perfectly and so my OB backtracked and said we would do 24 hours of monitoring.  No more incidents occurred after that, so was shipped back to stable antepartum, but it was declared that these two were out of chances.

Background: at 25 weeks, I had a cold and my body started contracting/dilating in response to there is stress on the system, lets do something to simplify.  Stayed in-patient for ten days, things calmed down and was discharged to home bedrest at 26&2.  Then at 28&5 I was at the perinatologist for normal BPP and Lefty, aka baby B, was having variable decelerations and some moderate bradycardia on her NST.  He wasn't worried, but wanted to make sure that it stopped rather than continued and since it was 5 pm, sent me over to L&D for two hours of monitoring.  Instead of discharge after two hours, I instead got another 2 rounds of steroid shots and was admitted.  She continued having some of these events until the morning of 30&5 when there was some insane fetal motion and I again started having contractions.  Had dilated more and so went over to L&D.  By middle of the day, I was having beautiful, rhythmic contractions of mountains and values every 2.5 minutes and it looked like we were heading towards birth.  Then it just petered out.  Stayed in monitoring in L&D another day and a half and then back to stable antepartum.  Good news of that event was the huge motion was Lefty moving from transverse to breech and as a result seemed to have gotten her leg or whatever out of the cord loop and we haven't seen variables at all, much less bradycardia from her since.  Then on Monday, at 32&5 we had the late decels event with Righty.

So, now I'm back to hanging out in stable antepartum.  Looking pretty stable and while I have a couple rounds of regularish contractions a day, nothing significant.  Both babies are behaving on their strips and so we continue on.  The delivery date barring someone misbehaving ahead of then is July 19 at 37&1.  My OB, who you may remember is really amazing, competent and just a good human, just left my room and is heading out on vacation and will be out of town until July 2.  Of course, there will be other OBs on call and I know them all, but I am spoiled and really prefer MY OB, so think behaving thoughts through at least July 2. That would also get us to 34&5, which I would count as pretty awesome.

That's my ramble and now some random pictures because captions are fun.

Chiron playing around with one of the new strollers while hanging out at Trajan's swim lesson.

Trajan is by the rail waiting at swim.

Amusing nurses with hijinks and jocularity make the world better.

So do nurses drawing fun pictures.

And awesome coworkers who bring amusing things as well as folding zombies out of paper!

And grandparents who come into town and amuse boys and generally help.

As well as hold little boys with colds when the pass out.

Friends coming by, talking, bringing food, amusement and even making a five-foot tall kangaroo makes the world a lot better as well.

So do wonderful friends who I've actually never met in person who amuse me every single day on multiple occasions and have sent more surprises, notes and thoughts than I ever would have imagined.

Even being challenged to a massive hamburger eating contest is pretty cool.  And as a bonus, you see here the pictures that some amazing friends I work with thought to print and bring up (and some of the zombies!).

This little man loves wandering around the hospital on our 30-minute wheelchair privileges and is amazing us with all he's mastered.

This little man prefers to be silly and luckily there are some great nurses who go along with it!

These three are pretty awesome and photographic evidence that Trajan may come here to play iPad almost as much as to see me.

Happy, loving boys

Everyone

I don't have an innie or an outie now, I have a flattie.  Also, tell the kids at home not to pierce their belly button because even if it's only for two days due to some impulsivity and fun with roommates, it will stretch to impressive size as a scar.  And my first two skin marks ever appear below on diagonals on each side.

In which I ruminate...

I just turned off the alarm for the maternal heartbeat on my monitor.  It's limits are set at 50 and 120 and I go up into the 120s pretty frequently, typically this is when talking to someone, and so it was a bit annoying.  It's probably a bad sign that I'm more familiar with the machines around here than some of the nurses.  I thought about changing the upper limit, but figured just turning it off would make for a simpler return to standard state, though I believe it does reset anytime it is unplugged as well.

Why I think this fact is worthy of sharing with you, I don't really know, but eh, I never claimed to make sense! And perhaps an even better question is why I think I need to share a picture of the monitor, but I do:

And in the style of live blogging, the whole story changes!  The pulse ox cord apparently had some issues.  I do like that none of us yesterday or last night thought to actually look at the clock and take my puse, we just accepted the 120s to 150s.  My nurse today, who is a favorite and definitely one of the most competent, looked at me and declared that my pulse was not that high, took it by hand and changed out the part. 

See, isn't my life fascinating?
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I have decided that the L&D floor is a time distortion field.  Came in for three hours, stayed for 10 days.  Right now, I'm still here from my two hours of monitoring Monday night.  There had been some talk about letting me go this morning, but while there haven't been any deceleration events (which are apparently measured in minutes), there were more variables and with greater drops than the current on-call OB (who is the doctor I had for four weeks while mine was on maternity leave last time) is comfortable with.  She sounded like she wasn't concerned per se, but isn't feeling sufficiently comfortable with Lefty's strips yet.  It's now a different on-call doctor, my OB doesn't work Tuesday or Wednesday as she has three small children of her own, but today's doctor said that the next one may discharge me after 6am tomorrow
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I know I'd mentioned that I found the changes in the NICU in the last 17 months kind of fascinating when the neonatologist came down to talk, but I've also discovered another interesting change in the obstetrics side of things.  Last time, they didn't repeat steroids.  In the last few months, they've aparently had their thinking come around to be more like a decade ago and they do repeat if it's been around four weeks or so and they think there's a reasonable chance of delivery in the next week or so (this time they were thinking possible c-section for distress instead of PTL.  read as NOT MY FAULT for once).  So, I had two more doses of Betamethasone Sodium Phosphate with Betamethasone Acetate Monday night and last night.  It's possible they will do one more round if I were to go into labor or we were removing the babies for distreen reasons between about 32 and 34 weeks.

By the way, random note, but these shots are much more pleasant in the bum than in the thigh.  Four of my six doses ever have been thigh and I highly recommend taking this route.
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I am on continuous monitoring until we are assured about Lefty's strips and I'm oddly proud of my ability to come and manage.  Many people have a lot of trouble because you can't really get much continuous sleep as anytime a baby comes off the monitor, the nurses have to come in and put them back on.  I am apparently very good at noticing them come in, confirming that they don't need me to reposition and then go back to sleep while they are moving straps and monitors and all of that.  Having a real bed instead of the transformer delivery bed also makes a huge difference.  When they were talking about running continuous monitoring, I in my own mind thought that I could probably only make it about 100 hours before I started to lose it, but I really don't think this is the case.  I think I can stay on as long as necessary without too many issues.

Cool rag doll look!

Biggest problem is needing to keep the pulse ox on 24 hours a day as it makes it much harder to work on things for work or even play around on the computer/phone.  However, one of the nurses said I could move it to my thumb and this makes the typing MUCH easier as I just use my right thumb exclusively fore the space bar and all is good.
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In my last thought, girls are 29 weeks now. Officially non-micros no matter what happens now!  Still voting for them to stay put, but we are really coming along in terms of intraventricular (IVH) and NEC risks now.  AND, they are big enough to serve as a tray when I have to eat lying down to keep them on the monitor:

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So, I think the summary version is that we are still here in the hospital, but all three of us seem to be doing pretty well.  And no reason at this time to expect anything drastic to change.

Oh, and their last possible date is set, July 19.  And since they did finally change from shoulder presentation presenting/transverse upper, to breech/transverse, looks like definitely going to be the c-section route.

Unscheduled Fun with Doctors!

The theme of the last week or so was definitely unscheduled fun with doctors.  First, I had a cold that led to some asthma type symptoms that landed me at the allergist and on steroids and albuterol.  Doing much better now though and nicely recovered. 

Then, Chiron picked up the cold.  He went from fine when we dropped him off on Tuesday morning to not looking great when I picked him up at 5:15.  They said he'd been coughing and seemed a little under the weather, but weren't alarmed.  I figured it was a cold and we headed to pick up Trajan.  As we were waiting for Trajan, Chiron seemed to get worse by the minute, so I hurried him up and we headed home.  Decided to skip dinner for him and just head upstairs, get a temp, give him milk and put him to bed.  The temperature was 102.4, so I put in a call to the pediatrician to get them to call in some Albuterol preventatively.  Started feeding him and he started wheezing and coughing more.  He was deteriorating as I watched and so headed back downstairs to start packing to go to the ER.  While doing so, the pediatrician called and said to definitely take him in.

At this point he was wheezing loud enough that it sounded like a musical instrument.  Driving to the ER with the stereo all the way off listening to him to make sure he kept wheezing was one of the most terrifying experiences of my life.

He continued his life-long achievement of not having to triage in the ER by wheezing pretty severely at the checkin assessment.  His pulse ox wasn't bad at 96, but since I'm not above dropping the phrase "29-weeker" there, we got taken straight back.  They tested him for RSV and flu, but the doctor we saw says she refuses to give this information as it doesn't impact what they do and can get parents worked up.  I think I got a nurse to say both were negative, but I'm not 100% sure.  Things like that just annoy me.  If I am quoting you his H&H, I obviously have a bit more knowledge than average running around there and I promise not to overreact either way.  I just like information.

However, I still like this doctor because she said that she sees very little improvement with kids this young with albeterol because they don't have sufficient smooth muscle or something like that.  Since he had wheezing in the lower part of the lungs and crackling in the upper, she had an RT administer two nebs of albuterol over the time we were there and they both confirmed that it didn't seem to improve things.  As a result, she said that we definitely don't have to wake him up to do albuterol and can really think about not doing it at all.  As he screams and struggles throughout, this made me love her.

Isn't he the happiest looking fella (with the exception of the first picture)?  And this is hours after his bedtime.  I got him a 40-minute nap in the Ergo at one point, but that was it. 

He was having problems with his cough causing him to vomit, but I got very good at catching it in the emesis basin.  They got some Zofran into him though and that helped a lot and so we were able to get him started on oral steroids.  His fever came down with Motrin to 101 and so they discharged us with a prescription for four days of prednisone, a just in case albuterol prescription refill and instructions to monitor.

He stayed home with Paul the next day, but really was doing better by Thursday, so we sent him to the majority of a day of school.  And he's looking much better now.

Trajan's explanation of his medicine to one of his after-school counselors was kind of awesome.  He touched a bug and so his soldiers have to fight it and we are giving him medicine that gives his soldiers armor so they can kill the bugs easier!

Chiron stayed home this weekend while I ran Trajan up to my parents for spring break just to give him a little more time to recuperate, but I'm happy to say that he's looking great and has no fever nor any wheezing at all.

However, to continue the fun of unscheduled medical appointments, I had one of my own this morning.  Yesterday, I got back into town and walked down to the mailbox with Chiron.  Our mailbox is at the entry to the street in a cluster.  This was actually an auto-eliminate when we first started looking at houses, but our standards dropped and we live with it.  There was a package and so I carried it, the mail and Chiron back.  Within a few minutes of getting back I felt a gush type wet and I had had some sort of bleed.  I laid down while he napped and it completely stopped and there wasn't even the old blood within two hours, so I waited until this morning to call.  They had me come in just to check things.

The answer is it was almost certainly a placenta bleed from Righty.  Her placenta started as a partial previa and I think is now a marginal that we are hoping might make it all the way to no Type of previa at all by the end.  It was self-correcting and hasn't continued to bleed, so nothing too alarming.  Because of the bleed, she went ahead and did an internal exam and my cervix is not only long, but is still closed, which is definitely a very good thing.

Both babies looked good at this twelfth ultrasound, but Right had a much lower heartrate than Lefty when we looked on the ultrasound so she checked them on the Doppler.  Righty was easy to find and was in the 150s.  Lefty is harder since she has the anterior placenta, but we were able to get a reading through the placenta and it was in the 130s, so also a perfectly acceptable value.

She said to go ahead and add a 25-pound weight limit to my life as the only modification for now.  She also said she wanted me to keep my appointment for next week so she can do a one-week recheck.  I also see the perinatologist that day, so will definitely be checked!

And just for giggles, the dog who thinks she's a cat:

76-week medical streak broken!

After 76 straight weeks where I saw at least one doctor a week for either myself or the kids, the streak was broken last week!  For the first week since August 8-14, 2010, I did not see a single medical professional.  So it took one week shy of 18 months to get from the last week without a doctor to this one! 

I called it on Facebook a little early, about 4:30 Friday afternoon, and then came about as close to a major car accident as I've ever been in my life while driving to Dallas a couple hours later, so I decided to wait until the entire weekend was past to call it here.

This streak includes a week that I was in Toronto for work from Tuesday to Sunday.  I had figured earlier on that I must have not seen a doctor that week, but when I went back and reviewed (Google Calendar is definitely my friend), it turned out that Trajan's four-year-old well visit was that Monday!

Paul asked the question of when was the last MONTH that I didn't see a doctor with anyone and it's actually not much further back with the month of May 2010 being entirely medical visit free.  Note: the LMP for Chiron and Aurelia's pregnancy was May 28, 2010 and I don't think this is coincidental.

I had an OB appointment this morning (both babies looked great with good growth, movement, cardiac activity and all that.  Didn't get a shot this time.), so this week is already out for repeating the feat.  And next week I have an endocrinologist appointment with a perinatologist appointment the week after that.  I talked the OB into scheduling at 4 weeks instead of 2 or 3 though, so there is a potential that the week of February 26 to March 3 will be doctor-free! Hopefully so since March already has at least one appointment for each week spread across the three of us and since weekly appointments start for me at 20 weeks, that week is pretty much our only potential one between now and late summer.

As long as I'm throwing out numbers, I also think it's interesting that this total includes 112 in-patient days between us.

And to keep this from just being dorky numbers, here's the boys this weekend.  I had a board meeting in Dallas and so they came along to play with their cousins:

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We made him take off his shirt to eat a banana with some chocolate dip.

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He outate his five-year-old cousin, four-year-old brother and three-year-old cousin put together!

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Chiron and his great-grandfather

Cousins are exhausting.  And there was nothing playing, so I'm not sure why he had the headphones on.  And yes, the booster makes me a little nervous, but I've given in.

First Sick Day and Skin Testing

Chiron had his first fever last week and ended up staying home Thursday and Friday.  Considering he's over one, I think this is pretty impressive.  He started out with a 101.6 or so fever Wednesday night which continued into Thursday.  We were just watching it and going to go in for a quick check with the pediatrician Friday before the weekend, but it had jumped to 103.8 by afternoon before a Motrin dose and so they had us come in.  The pediatrician was saying that given the high level and his relative lack of reserves (code for underweight), they were going to do a urinalysis and we should probably do chest x-rays.  Then she looked in his ear and grinned.  Why?  He had his first ear infection and thus a clear cause for the fever!  So he's on amoxycillin and looking better!

His head really is huge!

Then yesterday he had skin testing for food allergies.  As expected, he did not react to any of them!  Coupled with his 0's on the blood RAST tests and the conclusion was that he can now eat everything but dairy and soy.  And since we are worrying about protein intolerance and digestion issues with them, we don't even have to be concerned about trace amounts of them!

We will likely try soy at two years.  She also decided that she will do his environmental skin testing early at 18 months.  And she wrote us a prescription for Pulmicort to try using to cut down on his Xopenex needs if he gets junky again.

His back wasn't allowed to touch anything once it was done, so he and I got creative to keep amused and even get a bottle eaten!

This adventure at the doctor did prove something to me: my normal workday is very easy on the body.  By the end of yesterday, I was feeling the heavy cervix/crampy abdomen feeling of a irritable uterus.  Not like contractions or preterm labor, just a bit of a protest of the body.  Could tell it was, because even grabbing and Chiron made it more intense.  But some water and some rest and all is back to good.  Glad my job is so easy on the body!

I was also starving after completing his appointment and so got two slices at a pizza place that has slices at lunch.  Each slice is huge, so I ate half of an 18 inch diameter pizza.  That's 127.2 square inches of pizza. 

And yes, I ate it all.

And yes, in calling last Thursday his first sick day I am completely glossing over the 59 days spent in the hospital. That's totally my perogative!