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Archive for September, 2007

Weekend Wellness

Jessica here…still
How was my weekend you ask? It was fine. Full of romping, running, and enjoying the brisk early autumn weather… How was Karen’s weekend? It was fine… Full of contractions, kicks to her bladder, and most recently enjoying her newly itchy hands and feet! Ahh… The joys of pregnancy.

I have a SERIOUS case of writers block tonight, but need to get the info out to Karen’s pep squad! 🙂 So let me give it to you in bulleted form… OK?

  • Karen is still Pregnant.
  • The babies are all still doing well!
  • No we still don’t know what she’s having (but I have some SERIOUS hunches)
  • Her Doctor from this weekend scheduled her for a C-Section on Friday the 21st.
  • Karen didn’t agree with this idea and now we’re back to having no scheduled date.
  • Yom Kippur begins Friday at dusk.
  • On Saturday evening Karen developed intense itching in her hands and feet.
  • Her Doctor from this morning thinks the itching may be a pregnancy condition called Cholestasis.
  • They also think this may be what is causing the slightly elevated liver panels from last week.
  • This is not to say that the pre-eclampsia is still not an option.
  • Karen’s Blood Pressures have been good, but still elevated.
  • When I talked to her on Saturday she had a terrible headache…
  • On Sunday she felt and sounded much better…

That’s all I’ve got folks… I hope you’re all doing well and that you all enjoyed this awesome weather we had this weekend!! I’m absolutely worn out from running after the kids outside all weekend! Feel free to post in the comments if there’s something I missed, or if there’s questions you have, I’ve been keeping up with the comments… So I’ll see any questions ya’ll throw out there!

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Weekend Wellness

Jessica here…still
How was my weekend you ask? It was fine. Full of romping, running, and enjoying the brisk early autumn weather… How was Karen's weekend? It was fine… Full of contractions, kicks to her bladder, and most recently enjoying her newly itchy hands and feet! Ahh… The joys of pregnancy.

I have a SERIOUS case of writers block tonight, but need to get the info out to Karen's pep squad! 🙂 So let me give it to you in bulleted form… OK?

  • Karen is still Pregnant.
  • The babies are all still doing well!
  • No we still don't know what she's having (but I have some SERIOUS hunches)
  • Her Doctor from this weekend scheduled her for a C-Section on Friday the 21st.
  • Karen didn't agree with this idea and now we're back to having no scheduled date.
  • Yom Kippur begins Friday at dusk.
  • On Saturday evening Karen developed intense itching in her hands and feet.
  • Her Doctor from this morning thinks the itching may be a pregnancy condition called Cholestasis.
  • They also think this may be what is causing the slightly elevated liver panels from last week.
  • This is not to say that the pre-eclampsia is still not an option.
  • Karen's Blood Pressures have been good, but still elevated.
  • When I talked to her on Saturday she had a terrible headache…
  • On Sunday she felt and sounded much better…

That's all I've got folks… I hope you're all doing well and that you all enjoyed this awesome weather we had this weekend!! I'm absolutely worn out from running after the kids outside all weekend! Feel free to post in the comments if there's something I missed, or if there's questions you have, I've been keeping up with the comments… So I'll see any questions ya'll throw out there!

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Hospital, Day Two…

Jessica Again…
After talking with Karen a bit ago, I am convinced… Nothing phases her. Well nothing much at least. I’m pretty sure boredom might drive her batty before the contractions do… Crazy Karen 🙂

All is well in Karen’s gestating world. She’s still pregnant, and the trio is still doing well. Nothing too interesting to report, but I felt it necessary to update since I had in fact spoken to the Momma herself. As of about noonish today, things were on the up and up… The pre-eclampsia that we were so fearful of, it seems may be nothing more than a touch of high blood pressure and possibly just some ill related elevated bloodwork. It’s funny how that works… You get very pregnant and your body gets all crazy. So for right now, that diagnosis is on the back burner, hopefully not to be brought to the front burner anytime soon. If it IS brought to the front burner, the decision is that the babies will be delivered ASAP. ugh. As for the contractions, the Doctors have also decided that if there is still no sign of toxemia, then the Terbutaline can be started again. This is a wonderful decision, not only for the babes, but for Karen. It sounds as though last night was incredibly difficult… The contractions were laughing at the mere mention of the RN’s offers of percocet. In wonderful news however, today is a miraculous milestone of 32 weeks, woo hoo!! Let’s all do a little happy dance for this mile marker…

So the plan (as of noon) is this, the Doctor’s will sit on Karen, and not send her home. So many factors are (in my mind) weighing in on why they’re keeping her… The holidays, J being 4 years old and being home full time for the next few days, being 32 weeks pregnant with triplets, having a cervix less than 2cm, frequent contractions… Do I honestly need to continue this list? Honestly? I thought not…

Regardless, keep everyone in your thoughts… Obviously all the powerful thoughts are working! I also let her know about all of the AWESOME comments you’ve been leaving for her! Seth will share all the words of kindness when he gets to visit this afternoon… Keep it up fellow bloggers!!

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Jessica Here…
First off, let me reassure everyone and let you all know that Karen sounds perfectly fine, very calm, and very “Karen-like” 🙂 Any of us that know Karen in real life know her penchant for keeping cool in crazy situations… Hence her calm demeanor this evening!
Anyway, after talking to the Momma herself this evening, she’s doing well. They’ve admitted her because of her possible pre-eclamptic issues. The tests that were run a few days ago, showed slightly elevated liver enzymes which along with high blood pressure, usually indicate issues with pre-eclampsia. So, for right now, she’s there for observation purposes only… There are no definitive plans as to what they’re going to do right now. We chatted for a bit and she laid out the three distinct possibilities:
1. The MD’s come back tomorrow and decide on a delivery time. (eeek!)
2. The MD’s come in and decide that the pre-eclampsia is not progressing and send her on home.
3. The MD’s come in and decide to sit on her and the babes for the duration…
Tomorrow at twilight marks the start of one of the larger holidays for Karen and her Family, so of course, hanging at the hospital (while not fun) might be the most practical of the options… I’m really hoping they don’t just send her home… But hey, Doctor’s know best right?? 🙂 On that thread of thought also, the Terbutaline pump that Karen has been using to keep the contractions at bay? It has been discontinued… The Doctors see a connection between pre-eclampsia and terb, so no more of that for now! I was reassured to hear that she was still taking some Procardia, but was unfortunately a little uncomfortable regardless… On the upside, they’re 32 weeks tomorrow…
I’ll keep you all posted with information as it becomes available! Please keep them all in your thoughts!

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Hospital, Day Two…

Jessica Again…
After talking with Karen a bit ago, I am convinced… Nothing phases her. Well nothing much at least. I'm pretty sure boredom might drive her batty before the contractions do… Crazy Karen 🙂

All is well in Karen's gestating world. She's still pregnant, and the trio is still doing well. Nothing too interesting to report, but I felt it necessary to update since I had in fact spoken to the Momma herself. As of about noonish today, things were on the up and up… The pre-eclampsia that we were so fearful of, it seems may be nothing more than a touch of high blood pressure and possibly just some ill related elevated bloodwork. It's funny how that works… You get very pregnant and your body gets all crazy. So for right now, that diagnosis is on the back burner, hopefully not to be brought to the front burner anytime soon. If it IS brought to the front burner, the decision is that the babies will be delivered ASAP. ugh. As for the contractions, the Doctors have also decided that if there is still no sign of toxemia, then the Terbutaline can be started again. This is a wonderful decision, not only for the babes, but for Karen. It sounds as though last night was incredibly difficult… The contractions were laughing at the mere mention of the RN's offers of percocet. In wonderful news however, today is a miraculous milestone of 32 weeks, woo hoo!! Let's all do a little happy dance for this mile marker…

So the plan (as of noon) is this, the Doctor's will sit on Karen, and not send her home. So many factors are (in my mind) weighing in on why they're keeping her… The holidays, J being 4 years old and being home full time for the next few days, being 32 weeks pregnant with triplets, having a cervix less than 2cm, frequent contractions… Do I honestly need to continue this list? Honestly? I thought not…

Regardless, keep everyone in your thoughts… Obviously all the powerful thoughts are working! I also let her know about all of the AWESOME comments you've been leaving for her! Seth will share all the words of kindness when he gets to visit this afternoon… Keep it up fellow bloggers!!

Read Full Post »

Jessica Here…
First off, let me reassure everyone and let you all know that Karen sounds perfectly fine, very calm, and very "Karen-like" 🙂 Any of us that know Karen in real life know her penchant for keeping cool in crazy situations… Hence her calm demeanor this evening!
Anyway, after talking to the Momma herself this evening, she's doing well. They've admitted her because of her possible pre-eclamptic issues. The tests that were run a few days ago, showed slightly elevated liver enzymes which along with high blood pressure, usually indicate issues with pre-eclampsia. So, for right now, she's there for observation purposes only… There are no definitive plans as to what they're going to do right now. We chatted for a bit and she laid out the three distinct possibilities:
1. The MD's come back tomorrow and decide on a delivery time. (eeek!)
2. The MD's come in and decide that the pre-eclampsia is not progressing and send her on home.
3. The MD's come in and decide to sit on her and the babes for the duration…
Tomorrow at twilight marks the start of one of the larger holidays for Karen and her Family, so of course, hanging at the hospital (while not fun) might be the most practical of the options… I'm really hoping they don't just send her home… But hey, Doctor's know best right?? 🙂 On that thread of thought also, the Terbutaline pump that Karen has been using to keep the contractions at bay? It has been discontinued… The Doctors see a connection between pre-eclampsia and terb, so no more of that for now! I was reassured to hear that she was still taking some Procardia, but was unfortunately a little uncomfortable regardless… On the upside, they're 32 weeks tomorrow…
I'll keep you all posted with information as it becomes available! Please keep them all in your thoughts!

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So, my normal, non-pregnant blood pressure is about 110/65 or lower. During the first, oh, 29-30 weeks of this pregnancy, my blood pressure ran about 120/70-80. Totally fine and normal. I don’t remember exactly when my blood pressure shot up last week, but for the last week or so, my blood pressure readings have been, um, not so great. I take my blood pressure every morning (and now, often several times throughout the day as well, but I’m not typing out every single BP I’ve taken in the last week). Here’s what it’s looked like (do note that often I get a lower reading later in the day and I ALWAYS get a lower reading at the doctor’s office which makes NO SENSE):

9/5: 125/94 (In doctor’s office later, it was 120/84, I think)
9/6: 136/111
9/7: 128/90 (at doctor’s office it was 110/63… WTF??)
9/8: 106/85 (with Procardia in AM)
9/9: 121/103 (later 118/92)
9/10: 132/105 (later 146/90)
9/11: 123/105 (later 126/98)

I thought it was maybe my BP cuff that wasn’t working properly, but I’ve got two, and they come out with just about the same readings. (they are both electronic, one is fully-automatic, one is semi-automatic) Apparently, I’m just nice and calm in the doctor’s office. Normally, my BP shoots up in the doctor’s office. Go figure.

Anyway, my nurse at Matria, the traitor, called my doctor yesterday and again today with my BP readings. Sure enough, I got a call back this morning saying that there’s a pretty good possibility that they’ll decide at my appointment today to just admit me to the hospital for observation. Careful what you wish for, I suppose. I was JUST coming to believe that maybe it WOULD be better for me to just be at home during Rosh Hashana, since I could always just go to the hospital if I needed to (there’s absolutely nothing wrong with going to the hospital in a medical emergency on a Jewish holiday… it’s going for something routine and/or not necessarily emergency-status that’s a problem). So anyway, I was warned to pack a bag (it’s mostly packed anyway) and bring it with me. At least they warned me.

I’m 32 weeks tomorrow. Just 2 weeks to go. I said that to the sonographer/medical assistant person who called me with the news of possible hospitalization and she said, “2 more weeks? Well, we can hope…” UGH. But it’s all good. I’m seeing Dr. G. today. I totally trust his judgment. I have absolutely no reason to believe he would lead me astray. I do sort of wish Dr. P weren’t out of the office all this week. I find Dr. G. just as comforting as Dr. P., but there’s something in the back of my head wishing Dr. P. would be around, just in case. I’m not sure why. And it’s not like delivering triplets at 32 weeks is a bad thing. That’s the national average. It’s just sooner than I’d hoped. And anyway, I still really do believe that I’m going to hang in there until 34 weeks. I’m not sure WHY I believe that, but I really do.

So, yeah. I wouldn’t have been updating September 13-15 anyway, because of the holiday and Shabbos. So don’t be alarmed if I drop off the planet. If I do end up admitted, I’ll have either Jess or my husband update tonight. Okay? But even if I’m admitted, it’s likely just so they can keep a closer eye on me, which is fine. So don’t freak out if I disappear.

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So, my normal, non-pregnant blood pressure is about 110/65 or lower. During the first, oh, 29-30 weeks of this pregnancy, my blood pressure ran about 120/70-80. Totally fine and normal. I don't remember exactly when my blood pressure shot up last week, but for the last week or so, my blood pressure readings have been, um, not so great. I take my blood pressure every morning (and now, often several times throughout the day as well, but I'm not typing out every single BP I've taken in the last week). Here's what it's looked like (do note that often I get a lower reading later in the day and I ALWAYS get a lower reading at the doctor's office which makes NO SENSE):

9/5: 125/94 (In doctor's office later, it was 120/84, I think)
9/6: 136/111
9/7: 128/90 (at doctor's office it was 110/63… WTF??)
9/8: 106/85 (with Procardia in AM)
9/9: 121/103 (later 118/92)
9/10: 132/105 (later 146/90)
9/11: 123/105 (later 126/98)

I thought it was maybe my BP cuff that wasn't working properly, but I've got two, and they come out with just about the same readings. (they are both electronic, one is fully-automatic, one is semi-automatic) Apparently, I'm just nice and calm in the doctor's office. Normally, my BP shoots up in the doctor's office. Go figure.

Anyway, my nurse at Matria, the traitor, called my doctor yesterday and again today with my BP readings. Sure enough, I got a call back this morning saying that there's a pretty good possibility that they'll decide at my appointment today to just admit me to the hospital for observation. Careful what you wish for, I suppose. I was JUST coming to believe that maybe it WOULD be better for me to just be at home during Rosh Hashana, since I could always just go to the hospital if I needed to (there's absolutely nothing wrong with going to the hospital in a medical emergency on a Jewish holiday… it's going for something routine and/or not necessarily emergency-status that's a problem). So anyway, I was warned to pack a bag (it's mostly packed anyway) and bring it with me. At least they warned me.

I'm 32 weeks tomorrow. Just 2 weeks to go. I said that to the sonographer/medical assistant person who called me with the news of possible hospitalization and she said, "2 more weeks? Well, we can hope…" UGH. But it's all good. I'm seeing Dr. G. today. I totally trust his judgment. I have absolutely no reason to believe he would lead me astray. I do sort of wish Dr. P weren't out of the office all this week. I find Dr. G. just as comforting as Dr. P., but there's something in the back of my head wishing Dr. P. would be around, just in case. I'm not sure why. And it's not like delivering triplets at 32 weeks is a bad thing. That's the national average. It's just sooner than I'd hoped. And anyway, I still really do believe that I'm going to hang in there until 34 weeks. I'm not sure WHY I believe that, but I really do.

So, yeah. I wouldn't have been updating September 13-15 anyway, because of the holiday and Shabbos. So don't be alarmed if I drop off the planet. If I do end up admitted, I'll have either Jess or my husband update tonight. Okay? But even if I'm admitted, it's likely just so they can keep a closer eye on me, which is fine. So don't freak out if I disappear.

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Yesterday for hours I was having pretty uncomfortable contractions spaced exactly 5 minutes apart. Eventually they shifted to exactly 4 minutes apart. I wasn’t loving this development, but having a lot of contractions wasn’t the end of the world. After all, that’s what I DO, right? Yes, they were more uncomfortable than usual, but they weren’t alarmingly so, so I wasn’t sure whether it really mattered. I decided that I’d see if I could sleep through the night to decide how alarmed I should be. And that’s when the fun began. The contractions didn’t get better through the night, and I never did get more than about 20 minutes of sleep at a time, but there were only 2 stretches in the night where I even got that many. I spent the whole night trying to figure out when it was appropriate to call the doctor or at least call Matria. Calling at 2:30 seemed silly, I rationalized, since I’d be getting a bolus at 3am. At about 3:15, I fell asleep for 20 minutes, which seemed to me to suggest some improvement, so I figured calling wasn’t strictly necessary. By 4:30 I was in agony, so I considered calling and asking for an additional bolus, except that the auto-doses really weren’t doing much good, so why would I think another bolus would? By 5:30 I was in tears from the pain (as I had been intermittently through the night), but again, only half an hour away from a bolus, so calling seemed premature.

All night the contractions themselves were not only stronger and more regular than usual, but I had cramping so severe I expected to see blood every time I went to pee and pain into my back along with the cramping so strong that I would have sworn I had a kidney stone had it not been so definitely in sync with the contractions. Once I dragged myself out of bed at 6:30ish (with less than an hour total sleep to show for myself), I couldn’t quite figure out WHAT to do with myself. I still felt crappy, but at that point, I wasn’t feeling any worse than I’d felt all night, so I decided to wait to call Matria until it turned over from After-hours to the local center, so that I had a higher likelihood of talking with a nurse who knew me. At 8:30 I called over there and spoke with a nurse who, as it happened, I’d never spoken with before. She suggested giving myself an extra bolus, but also said that she’d recommend contacting the doctor, since this was a change from the norm for me. So she paged the doctor for me.

Dr. P. was on call, which surprised me, since he’s going to be away all this coming week, but that was good since I saw him twice this past week, so he knew what was going on with my medications, etc. He called me directly, rather than trying to relay everything through Matria, which I appreciated. He first told me to raise my basal rate on the terbutaline, and then said he could bring me into the hospital and get me onto a monitor and possibly mag sulfate if I wanted. Alternatively, this is about the last opportunity I’ve got to use Indocin (they won’t use it after 32 weeks), so since I haven’t been on it for a few weeks, and since historically it works well for me, that was my other choice. So I decided to try the Indocin again and he said if I wasn’t feeling better in several hours, I can always come in to the hospital. Fine and dandy, except today is my foster son’s 4th birthday party, so I’d like to avoid that if possible. Obviously, if I need to go, I need to go, and that’s all there is to it. However, if there’s any way to avoid it today, I’d like to. I do want at least my husband to be at the party, and I’d rather not go to the hospital alone (I’m not going to be at the party regardless).

So that’s what we agreed upon. And then… shortly after I talked to Dr. P., I pulled out my pump to give myself the extra dose that my nurse had suggested and I realized that the pouch that holds the pump was a little damp, as was the area around the pump where the tubing attaches to the syringe in the pump. How odd… And I peered closely at the tubing and watched it for a good long while. And I realized that absolutely NO medicine was going through that tubing. In fact, probasbly no medicine had been going through that tubing all night. And in retrospect, when I changed the syringe last night, I vaguely remember that ther was a subtle “crack” sound as I put the tubing on, and I DID check to see if anything looked cracked but didn’t see anything, so I’d sort of forgotten about it. Obviously, I didn’t look closely enough. Whoops. In the two months that I’ve had the pump, this is a first. Still, I feel foolish.

However, at least now I know that the terbutaline really IS serving a very important purpose. Because if that was just a tiny glimpse of 12 hours without terbutaline (bearing in mind that the half-life of terbutaline is, I think, 4-5 hours, so I theoretically still had terbutaline in my system that whole time, just less and less of it through the night, then boy, do I not want to know what life woud have been like without it all together. So as many contractions as I feel with the terbutaline… at least I now know that the Terbutaline DOES work. Really well. Sheesh!

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Yesterday for hours I was having pretty uncomfortable contractions spaced exactly 5 minutes apart. Eventually they shifted to exactly 4 minutes apart. I wasn't loving this development, but having a lot of contractions wasn't the end of the world. After all, that's what I DO, right? Yes, they were more uncomfortable than usual, but they weren't alarmingly so, so I wasn't sure whether it really mattered. I decided that I'd see if I could sleep through the night to decide how alarmed I should be. And that's when the fun began. The contractions didn't get better through the night, and I never did get more than about 20 minutes of sleep at a time, but there were only 2 stretches in the night where I even got that many. I spent the whole night trying to figure out when it was appropriate to call the doctor or at least call Matria. Calling at 2:30 seemed silly, I rationalized, since I'd be getting a bolus at 3am. At about 3:15, I fell asleep for 20 minutes, which seemed to me to suggest some improvement, so I figured calling wasn't strictly necessary. By 4:30 I was in agony, so I considered calling and asking for an additional bolus, except that the auto-doses really weren't doing much good, so why would I think another bolus would? By 5:30 I was in tears from the pain (as I had been intermittently through the night), but again, only half an hour away from a bolus, so calling seemed premature.

All night the contractions themselves were not only stronger and more regular than usual, but I had cramping so severe I expected to see blood every time I went to pee and pain into my back along with the cramping so strong that I would have sworn I had a kidney stone had it not been so definitely in sync with the contractions. Once I dragged myself out of bed at 6:30ish (with less than an hour total sleep to show for myself), I couldn't quite figure out WHAT to do with myself. I still felt crappy, but at that point, I wasn't feeling any worse than I'd felt all night, so I decided to wait to call Matria until it turned over from After-hours to the local center, so that I had a higher likelihood of talking with a nurse who knew me. At 8:30 I called over there and spoke with a nurse who, as it happened, I'd never spoken with before. She suggested giving myself an extra bolus, but also said that she'd recommend contacting the doctor, since this was a change from the norm for me. So she paged the doctor for me.

Dr. P. was on call, which surprised me, since he's going to be away all this coming week, but that was good since I saw him twice this past week, so he knew what was going on with my medications, etc. He called me directly, rather than trying to relay everything through Matria, which I appreciated. He first told me to raise my basal rate on the terbutaline, and then said he could bring me into the hospital and get me onto a monitor and possibly mag sulfate if I wanted. Alternatively, this is about the last opportunity I've got to use Indocin (they won't use it after 32 weeks), so since I haven't been on it for a few weeks, and since historically it works well for me, that was my other choice. So I decided to try the Indocin again and he said if I wasn't feeling better in several hours, I can always come in to the hospital. Fine and dandy, except today is my foster son's 4th birthday party, so I'd like to avoid that if possible. Obviously, if I need to go, I need to go, and that's all there is to it. However, if there's any way to avoid it today, I'd like to. I do want at least my husband to be at the party, and I'd rather not go to the hospital alone (I'm not going to be at the party regardless).

So that's what we agreed upon. And then… shortly after I talked to Dr. P., I pulled out my pump to give myself the extra dose that my nurse had suggested and I realized that the pouch that holds the pump was a little damp, as was the area around the pump where the tubing attaches to the syringe in the pump. How odd… And I peered closely at the tubing and watched it for a good long while. And I realized that absolutely NO medicine was going through that tubing. In fact, probasbly no medicine had been going through that tubing all night. And in retrospect, when I changed the syringe last night, I vaguely remember that ther was a subtle "crack" sound as I put the tubing on, and I DID check to see if anything looked cracked but didn't see anything, so I'd sort of forgotten about it. Obviously, I didn't look closely enough. Whoops. In the two months that I've had the pump, this is a first. Still, I feel foolish.

However, at least now I know that the terbutaline really IS serving a very important purpose. Because if that was just a tiny glimpse of 12 hours without terbutaline (bearing in mind that the half-life of terbutaline is, I think, 4-5 hours, so I theoretically still had terbutaline in my system that whole time, just less and less of it through the night, then boy, do I not want to know what life woud have been like without it all together. So as many contractions as I feel with the terbutaline… at least I now know that the Terbutaline DOES work. Really well. Sheesh!

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