Our son Magnus was born November 19, 2009 with a serious congenital heart defect, HLHS. I set up this blog to keep our family and friends updated on his condition, and to connect with other families dealing with HLHS.
I was very nervous that this morning's non-stress test could end up as another trip to labor and delivery, but it actually went pretty smoothly. They had me on the contraction monitor for about an hour and only registered one small contraction, which is nothing to worry about. My amniotic fluid levels still look good, and baby is still practice breathing. The one thing they said they were going to check with the doctor about is the fact that it took him a while to "become reactive," i.e. to get his heart rate up high enough above baseline. I think that might just be because he was a little sluggish this morning...perhaps he takes after his father, who really doesn't like to be awake before 11 a.m. They said they'd call me back if the doctor thought this was a legitimate reason for concern, but I'm feeling pretty good about how things went today.
So, this morning started with my first non-stress test. The good news about that is that the baby did great! His heart rate went up and down like it was supposed to, and he was practice breathing like a champ. I also got to see him sucking his thumb and looking super cute.
The bad news was that I was having contractions. Not big ones, I couldn't even really feel them, but they were happening pretty often. "More often than you should be right now," said the nurse. Given all my cervical woes, she decided to check my cervix, and found it to be "very short" and about 1 cm dilated. That in and of itself is not so unusual at this stage of pregnancy, but that is a change from the last time it was checked about 2 weeks ago, and between that and the contractions, they decided to send me over to Labor and Delivery again.
I called Iggy and he met me over there. They attached me to a fetal heart rate monitor and a contraction monitor. I kept having small contractions, and they seemed to be getting closer together. I think we were there for a couple of hours before we saw a doctor, one of the residents, and I tried to get as much information as I could out of her, but she basically told me that they were going to continue monitoring me, eventually do a pelvic exam, "and then we'll decide whether we're going to let you go home or whether you're going to stay and have your baby right now."
Eventually, the attending physician decided that I should be given a drug called terbutaline to see if it would stop the contractions. Luckily, the terbutaline worked great, and I immediately stopped contracting.
They kept me on the monitors for another couple of hours (and I had zero contractions in that time after getting the terbutaline, whereas before I was having them every few minutes) and then did another cervical check to see if the contractions I'd had earlier had resulted in any cervical changes. The doctor said he estimated that my cervix was 1 cm long and still 1 cm dilated, so basically unchanged as a result of the contractions I had today, which was great news.
The less great news is that terbutaline often only works for a few days to delay labor. That doesn't necessarily mean that I will go into labor later this week, but it's a bit more of a concern given the events of today.
So, I guess it's a good thing that I am having the twice-weekly non-stress tests from here on out, because I really didn't feel the contractions I was having this morning, and don't feel confident that I would be aware on my own if it happened again. I am also planning to make a renewed effort to take it easy...I have to admit that oxymoronically, I have been slacking off a bit in my taking it easy. It has not escaped my notice that both this trip to L & D and our last trip there happened during times of intense stress at work. I was supposed to do a really important experiment today, and two of my wonderful co-workers stepped up and took care of it for me, and I owe them big time. So, from here on out, a renewed commitment to relax and try not to get stressed out. Not so easy for me, but I'm going to try!
p.s. A couple of people wrote to me after my last entry to ask if we'd definitely decided on going with the hybrid procedure rather than the Norwood surgery. We haven't made a decision yet, and probably won't until after he's born, as his physical condition after birth may give us some insight into which is the better option.
Today Iggy and I met with the social worker in the Pediatric Cardiac ICU to take a tour of the unit (as well as the Neonatal ICU, which is where the baby will be immediately after he's born) and to get a little bit of a better idea of what to expect. The social worker was really nice and asked us some questions about how we were coping with things...her whole job is basically to provide emotional, and to some extent logistical, support for families of PCICU patients.
Seeing the PCICU was intense. It was pretty much what you would expect...lots of little kids and babies tethered to lots of big machines, and lots of nurses.
Our meeting today was pretty short. I was feeling really tired today and was thinking about some stressful stuff I have coming up at work this week, so I didn't have the presence of mind to ask as many questions as I probably should have. One illuminating thing the social worker did tell us was that of the kids who have undergone the hybrid procedure at UCSF, one was in the hospital for two months afterward, and another was in the hospital for seven months. That was pretty daunting, although she did say that the baby who was in the hospital for seven months was "doing great" now. I'm not sure what other issues these kids may have had, but it's definitely something I plan to bring up with the surgeon next time I talk to him. When we met with him before, he did say something about the hybrid procedure potentially involving a longer hospital stay, but seven months is just crazy.
Tomorrow I start going in for twice weekly non-stress testing. The fact that we have gotten to this point is something of an achievement, because the reason they are doing non-stress tests now is because our baby would now be viable if he had to be induced. The flip side of that is that more tests potentially mean that they could find problems which would make them want to induce. But hopefully they won't!
Our next big day of appointments is next Monday. We have a fetal echocardiogram, a growth ultrasound, and an OB appointment all scheduled for that day. Supposedly, this fetal echo should be able to give the doctors a better idea of what condition our son will be in immediately after he's born. I think it will also tell us whether we can just let him come when he's ready, or whether he'll need to be induced so that the necessary personnel can be ready for him if he's going to need immediate intervention after birth.
So, one way or another, we will be getting a lot of information this week. Here's hoping it's mostly good news.
Today we are 33 weeks along, which is 1 week away from what that neonatologist told us was "the edge of viability" and 4 weeks away from full-term. And I am feeling pretty good about our prospects of making it to full-term, or at least pretty close. I went to a work dinner last night, and the husband of one of my co-workers predicted that the baby would come on November 30th at 10:30 p.m. I'd be plenty happy with that, although my dad might be a bit miffed...his b'day is December 1st and he's been rooting for a 12/1 birth all along!
This was supposed to be a rare week with no medical appointments, but apparently that was not fated to be. On Sunday morning, Iggy woke up with a fever and was feeling pretty out of it. He seemed to get a little bit better on Monday (which is a good thing, because our basement flooded and he had to clean up and move a bunch of stuff out of the water), but by Monday night, his fever was 103F, which is when I started to worry that it might be the flu. This article about a formerly healthy pregnant woman who contracted H1N1 and subsequently spent 5 weeks in a coma and lost her baby didn't do much to ease my mind, either. I had a seasonal flu shot last month, but the H1N1 vaccine still isn't here.
So on Tuesday morning, I spoke with the advice nurse at my OB office. She spoke with both an obstetrician and a perinatologist (a high-risk OB) and both recommended that in addition to avoiding all physical contact with my ailing husband, I fill a prescription for Tamiflu. The OB suggested that I wait to see if I developed symptoms before taking the Tamiflu, whereas the perinatologist said I should take it immediately as a prophylaxis. I knew that Tamiflu hasn't been tested in pregnant women (though it has been tested in pregnant animals) but given the severity of H1N1, the CDC is recommending that pregnant women take it if they think they've been exposed to the flu. I was still on the fence, though, so yesterday, I filled the prescription but I didn't take it.
Then, before I went to bed last night, I took Iggy's temperature and it was up to 104.2F. I made him take some Tylenol and was hoping he'd feel better this morning, but his temperature was still 104.2 and he was having very bad asthma symptoms, so off we went to the ER. To make a long story somewhat more concise, the doctors there determined that he probably has the flu, told me that I definitely should take the Tamiflu, and sent us off with some steroids for his asthma and antibiotics in case he also has pneumonia. They also prescribed Tamiflu for him, though they said it's probably too late now to do any good. Reassuringly, his fever has come down a lot, and I'm hoping he'll be on the mend soon, and of course that I don't get sick, too. The "what ifs" are a little scary, but at the same time, I know that most pregnant women who do get H1N1 end up being fine.
So, here's hoping that week 34 will be a little less exciting.
We're just back from another round of cervical checking and OB-visiting and happily, things seem pretty much unchanged.
Our requisite scare of the day came when the ultrasound tech was unable to find my cervix and had to go get the radiologist so they could scan me together. This happened once before, as you may remember. Anyway, they finally did find it, and their verdict was that it was basically unchanged...same length and still closed, which is excellent.
The OB appointment we had directly afterwards took forever, but was pretty uneventful. Our OB decided that we are not going to do any more cervical length monitoring or fetal fibronectin testing from here on out, which is fine with me, because it just gives me more stress and they can't really do anything for me anyway.
So, the next steps are that at 34 weeks, I start doing non-stress testing, to make sure the baby is getting enough oxygen and everything, and then the following week I have another ultrasound to check the baby's growth, another OB appointment, and a follow-up fetal echocardiogram. That is a lot of appointments. Thank god I work right across the street!
Baby is still inside, and I'm still not feeling much indication that he wants to come out any time soon. Tonight is our first childbirth class. It's every Monday for the next 4 weeks, which will bring us right up to the cusp of 34 weeks.
So, things seem to be going OK. It's just really annoying not being able to lift anything heavy.