Thursday, May 19, 2011

Hope we get there

24 weeks + 5 days, 8 weeks post rupture, day 9 at my parent's place. I'm sticking with my ovulation date at this point. Screw doctor's dates.

Doctor's appointment today. Slept poorly last night at the prospect of leaving my safe little cocoon to go sit in a waiting room. I worry about what the doctor might say to crush our spirits a little more and I worry I'll leak a lot, or bring on cramps or labour being up and about. And the appointment was for 8 am so it means I have to get up early! I don't do well with early mornings.

Anyway, the appointment was first. Dr. S. could fill in for Eeyore in Winnie the Pooh if the job ever becomes available. He's such a downer. He basically said that while it was 'good' that I'd made 24 weeks (longer than last time), we are still looking at a very poor outcome because of how long my membranes have been ruptured. Yeah, thanks we know, Eeyore. I worry about this on a minute to minute basis, you don't have to remind me. Then we asked about getting me a private room at the hospital. He basically said that infection risk was not a good enough reason. When we told him I couldn't sleep due to the anxiety and stress of the situation and having a roommate made it worse, he said he'd ask the hospital administrator if 'anxiety' was a good enough reason, but that he wasn't very hopeful. So then I flat out said "well then I can't be hospitalized. It's just too stressful". I hope he understood how strongly I feel about this. It's pretty serious when your pregnant high risk, congenital cardiac patient is refusing hospitalization. Maybe he'll push on my behalf...being a well respected, high powered OB has got to be good for something.

Our alternative plan at this point is using my insurance to pay for a private duty nurse to come and stay with me during the day while I live at my parent's house. My mom has to go back to work next week and I'm afraid to be alone during the day. My doctor said he would sign any paperwork I need to get this in place if that's what I wanted but he didn't feel I 'needed a nurse'. He just said that I need someone there to be able to get me to hospital if need be. Uh, yeah, Dr. S. that's the point. Of course he'd be willing to hospitalize me with round the clock nursing care, who check me multiple times a day for fever, pain, cramping and check the baby's heart I don't really see how this is much different. Likely cheaper for the health care system. Go Emily, saving the province money!

I then had an ultrasound which actually was better than I expected. My AFI was at 6.1! This is low, but adequate for lung development. Flow through the umbilical cord is normal. Baby's measurements are all over the place, but I'm not really concerned about that since bloodflow is normal and adequate for growth, and I think there is a lot of measurement error with the AFI being low. Also, Acorn scored an 8/8 on the biophysical profile, including getting a 2 for 'breathing movements'. I know other pPROM moms have been told this is not an indicator of adequate lung development for breathing outside the womb but it does indicate that Acorn at least has enough room to allow chest expansion and has the neuromuscular control to coordinate his or her diaphragm. Good stuff I hope.

Then I had my glucose tolerance test. That drink isn't that bad. I don't know what everyone complains about.

For the finale, I also had my first steroid shot to assist with lung development. Worth it, but still, Ouch! My whole left gluteus maximus is now sore. Tomorrow I have to go back to get jabbed in the right buttock. Fun times.

I still don't know what we'd do about a C-section at this point. Currently the baby is breech and Dr. S. said that if we really wanted to 'go after this baby' a C-section would be the way to deliver...but he's not sure he would recommend it due to 'poor prognosis' at this point. I must agree. My gut says its not worth it...yet. But a few weeks down the line, if we get there, things might be different.

I really hope we get there. Please Acorn, keep hanging on! Mommy's doing her best to keep you safe.

Update to answer Melissa's question (comment #2): No there is no reason per say that I couldn't go many more weeks...but as Eeyore was saying, it was unlikely 8 weeks ago that I'd still be pregnant today, so any more time is 'pleasantly unexpected' medically. But if you check the pPROM boards on babycenter there are women out there who make it into the 30 week range who ruptured around the same time as I did, so it is technically possible. My cervix is maintaining (3.1 cm measured today), so infection and bleeding are our two major issues, other than having low fluid. Probably the same thing that caused your pPROM at 31 weeks was the same thing that threw you into premature labour (infection or incompetent cervix), but since it was likely my abnormal placenta that caused my pPROM, there is nothing that has (so far) caused labour to start. Things I'm doing to prevent labour is laying around to avoid pressure on the cervix, drinking massive amounts of fluids (4-5 L per day) to prevent dehydration and encourage amniotic fluid build-up. I wash my hands obsessively (before and after going to the bathroom), I take probiotics, extra Vitamin C, D, stool softeners, antibacterial wet wipes after bowel movements and a collagen drink once a day (strengthens tissues, including hopefully my amniotic sac). Hopefully something is helping...but I did almost none of this except the water and the laying around last time and I still lasted 10 weeks post rupture so who knows if this is just how my pPROMs go.


  1. I'm so happy you have made it this far and that things are at least stable. Keep it up! You and Acorn are doing so well. Screw Eeyore the doctor (I had one of those as well and just plain hate him). Getting a private duty nurse seems to be the best choice at this point - you can be comfortable in your parents' home and you don't have to eat icky hospital food.
    If hope is all we have, at least we can hope for the best!

  2. I haven't commented before but I've been reading for the last 6 weeks or so. I'm so impressed and proud of you for making it this far. I realize it still may not have a good outcome, but you are doing everything possible to be the best mommy you can in a truly shitty predicament.

    I think of you many times a day and am constantly checking back for an update. I do have a question. My water broke a little early, 31 weeks, but I had my son 2 hours later. So I don't have any experience in trying to keep a baby in after your membranes have ruptured. My question is , is there more of chance of going into labor as time goes by? Due to the baby getting bigger or any other reason? I knw it could happen any day. But if you've made it 8 weeks, is there a reason you wouldn't be able to go another 4 or 6 or even 8 weeks? Other than the obvious fluid leaking and risk of infection?

    Just curious. If this offends you in anyway, I'm sorry. You don't have to respond. Hoping beyond hope for your little acorn. Your AFI is great news!!

  3. Im still rooting for you and that sweet baby! That baby is a fighter, holding on that long:)
    Will the hospital not just give you a waiver to sign for a private room if you agree to pay the uncovered costs? I know on bedrest with my first pregnancy they gave me a waiver to sign for a private room....
    I hate that you even have to worry about it!!

  4. Acorn, your Mommy's doing a great, great job. Hang in there, little one. Every extra minute helps!

  5. i'm so glad you got some bits of good news today. i'm still hoping for you!

  6. I like the glucose test orange drink :)

    Glad today was a better day. Maybe you could fake some sort of mental health issue to get a private room???? lol

  7. Yay to being over 24 weeks. Hoping your octor gets you a private room. Think of you and Acorn lots even though I am not commenting on all your posts.

  8. You are doing such an awesome job at keeping little Acorn in! I'm constsntly amazed and floored all at the same time at how far you have come! I'm pretty sure that I have said this before but YOU ARE DOING THIS FOR THE REST OF US WHO COULDN'T and you are kicking butt and taking names! Keep up the great work!!

  9. I'm so glad that the ultrasound was good, there seems to be a lot of good signs there.

    Those steroid shots are very ouch-y. Well done for today's and good luck for tomorrow's.

    Hang on in there Acorn and Mommy xo

  10. Great great job all around. Promising ultrasound (at least in my opinion), and you sound like, overall, you are doing much better at your parents. Continue on doing what works best for you and Acorn. Hope that things can be worked out so that you get a private room at the hospital. When is the latest that the doctor wants you to start hospital bedrest (I assume it's your decision ultimately but I'm just wondering if Eeyore is stressing a no-later than date)?

    Still sending good vibes yours and Acorn's way!

  11. Such a rollercoaster you're on. So glad the news is mostly good in today's post. Constantly thinking of you and baby Acorn.

  12. you are doing a great job!

    and i'm gonna have to say that a c-section is worth is SO much better for preemies...seriously reduces the risk of a brain hemmorage. and the recovery isn't *that* bad...sure its harder than a vaginal delivery but worth it IMHO.

    i hope you see many, many more weeks of pregnancy!

  13. So glad to get this bit of news today! My thoughts get more positive by the day for you.. look at that fluid increase! Keep on keeping on!

  14. Many prayers and warm thoughts!!!

    And what a doctor downer! I remember my OB saying that the first 2 weeks were the roughest and that, as the weeks go on and the baby gets bigger, it actually gets a bit easier because the baby is able to 'plug up' the leak and more fluid can build. As the baby moves, of course, there is still leaking, but that it actually get get a little easier.

    You are doing a GREAT job, Emily! A GREAT GREAT GREAT JOB!!! I am so proud of you. You are an example of motherhood in all its ways and, no matter what, you've done a superb job. Hoping for a few more months pregnant!

  15. Sounds like a great u/s - I know this whole thing is saturated with problems, but I'd be hard-pressed not to take a bit of hope from the fluid and lung movement! And every moment he stays in there helps - I know you are scared about infection but hoping you can hang on a bit longer. Those downer docs can sometimes be the best ones, even if you have to brace yourself to talk to them. I was lucky that my doc had an awesome nurse who could make me feel much better about what the doc said.

    Hoping the private nurse thing works out, seems like if you can stay at your parent's home that would be best for your mental health at least!

  16. I think of you and Acorn so often... You are both doing such an inspiring job!

  17. Sounds like some good news!?

    I'm not too educated with all this as I had a "perfectly healthy" but not breathing baby. Hmph.

    As for the diabetes testing liquid: I'm seriously thinking it's just another thing pregnant women like to complain about because I never thought it was bad either. It was no big deal at all, really.

    Glad to hear baby is sticking around and doing his/her grow thing.

  18. Just noticed you updated to answer my question. Thank you for that! Yes, my pPROM was all tied into my preterm labor. My doctors disagree on whether or not I was in early labor before my water broke as I was having mild contractions and spotting the night before. My cervix however was long, thick, and closed so they did not consider me "in labor". But obviously something was going on. Water broke in the morning and I almost couldn't even get back to the hospital in time the contractions were so intense and close together. I still had one shoe on when e was born. We have no explanation. No sign of infection or anything. I consider it to be "spontaneous preterm labor" and not really a pPROM issue. I think it broke when it needed to same as when someone is full term. That baby was coming out that day no matter what. But it certainly pushed things into high gear.

    I'm 14 weeks pregnant now so all this has been examined by different docs recently.

    Anyway, enough about me. I'm so glad you got to the steroid shot stage and I'm hoping you can keep little Acorn in for awhile longer. Keep developing little lungs! You are doing fantastic!