After a great appointment last Friday, I was hoping and praying that this would be the new trend and that both Weston and I would sail through our appointment on Tuesday. I invited my mother-in-law, Ruth Ann to the appointment because I thought it would be awesome for her to see her grandson and all his cuteness on the ultrasound. And God, in His infinite wisdom, knew that I needed her with me and that I needed my parents to be available at home.
Since Weston was a little stinker on Friday, I assumed he would behave the same on Tuesday. Surprisingly enough, he cooperated and stayed put, but his heart rate wasn't accelerating as much with activity. He was such a show off on Friday that they bumped up his requirements - now he needed to get his heart rate up 15 beats above his baseline for 15 seconds and we needed him to do this at least 2-3 times in a 20-40 minute period of time. The nurse was phenomenal and even tried a little Chris Brown music to jazz him up a little, but even LMAFO's "Party Rockin' in the House Tonight" just barely squeaked out 10 beats above his baseline for 10 seconds. He was still quite active and passed the non stress test just fine, but he just didn't perform as well as on Friday. And neither did my blood pressure... The nurse checked it several times and it was alarming... it was such a blur... but it was well over what I had ever anticipated... Ruth Ann's memory is probably better than mine, but I thought one reading was 166/122? And I think the lowest was maybe 147/110? Anyway, regards of the numbers... it was TOO HIGH! Grrr.... Now what?
We then headed over to check the amount of amniotic fluid via ultrasound. The sonographer was again wonderful and Ruth Ann got to see our little guy's profile, hands, and cute little toes. I love seeing this precious gift from God! My fluid levels were just fine and in fact rose just a smidgen from Friday which means that he's getting all the nutrition he needs.
The nurses collected a urine sample to check for protein (an indicator of preeclampsia) and fortunately, that continues to remain negative. A different nurse checked my blood pressure manually, and it was still in the 150s/100s. These appointments generally make me nervous only because I feel like a ticking time bomb... at any point, Dr. Harms could say, "Let's just cash in our chips."
When we had first talked about pregnancy induced hypertension two weeks ago, he was reluctant to start me on any type of blood pressure medication because the high blood pressure is a result of the pregnancy - and the only cure is delivery. Another concern is that if they did put me on medication - my blood pressure would most likely be around my baseline, but might mask some other symptoms of preeclampsia resulting in even further complications. I do recall him saying that he didn't like anything getting around 160/110 and that if Weston's health or my health was at risk, we'd need to change things up. So when Dr. Harms visited with us he said Weston looked healthy, but my health was at risk... and when words like "stroke" "seizures" and "organ failure" came out of his mouth, we knew that I was not about to "Pass Go and Collect 200 dollars." I was getting sent to "Jail." There would be no opportunity for me to run home and grab some toiletries - they were whisking me away immediately.
Little Amaya was on my mind because she was spending time with her cousins visiting from Colorado for Thanksgiving and knowing that I'd be stuck in a hospital bed for who knows how long, I was concerned about where she was going to go, who would pick her up, care for her, etc. So having my parents (who know her routines, etc.) at home was a huge answer to prayer. I didn't need to worry about her after all... and this little girl is so resilient and flexible - she's an absolute blessing. And having Ruth Ann with me to support, encourage, cry, and laugh with me was a tremendous gift.
They wheeled me over to triage just down the hall and got Weston hooked up on the monitor and got a few blood pressure readings - still high of course. I met with a mid-wife and the team agreed that I should be observed for at least 24 hours and that I would be admitted over to Labor and Delivery. LABOR AND DELIVERY?!?!? I'M NOT READY TO HAVE THIS GUY!!! The only reason I was being admitted there instead of the antepartum unit was because they were going to give me a medication to reduce my blood pressure through an IV and I needed to be on a cardiac monitor and Weston needed to be monitored closely as well during the administration. Plus, if my blood pressure didn't respond... or if I had any indications of severe preeclampsia... I would be set to deliver if need be.
My nurse was incredible - very attentive and CALM. Guess that's what you want from a Labor and Delivery nurse, huh? Anyway, she got me started on another 24 hour urine collection, had anesthesia get an IV in, blood work taken (OUCH!), seizure pads on my bed, hooked up to the cardiac monitor, and hooked little Weston to his monitor and gave me my first (and ONLY - PRAISE GOD) dose of IV Labetalol to try to bring my blood pressure down. My blood pressure was checked every 15 minutes for an hour or two - I even have the bruises to prove it - and then once it was stabilized (around 130s/80s) it was only checked every hour. Steve and Ruth Ann had a little lunch and we watched the movie "Finding Nemo." I met with about 10 different doctors - from Labor and Delivery, anesthesia, and high risk OB. Basically, it was a waiting game - wait to see if my blood pressure would stabilize with just one dose of Labetalol and then transition me to oral medication - wait for my blood results (platelets, liver function, and kidney function) - wait for the results of my 24 hour urine... I was also on the agenda to receive a steroid injection in the tush to help little Weston's lungs mature faster so that if he were born in the next 1-2 weeks, he'd have a better chance of breathing better.
Around dinner time, they gave me my first dose of ORAL Labetalol with hopes that this would continue to stabilize my blood pressure over night and I could continue taking it at home. My blood pressure really plummeted to 105/57. The nurse hooked Weston back up to make sure he was tolerating the decrease in the blood pressure, and he was very happy with not a care in the world. This little man is AMAZING! Nothing has really phased him yet and I hope that's going to be the trend!
They transitioned me over to the antepartum unit around 8pm since both Weston and I were stabilized and not requiring any more monitoring. My blood pressure would continue to be checked, but not nearly at the intense level as it was in Labor and Delivery. And I still enjoyed my nurses over there - in fact my overnight nurse was the mom of a colleague I used to work with in Dermatology - but the amount and level of care I received in antepartum was much, much different.
Amaya slept over at my parents and Steve kept me company in the hospital. We didn't sleep the greatest - maybe got about 3-4 hours of interrupted sleep. The steroid injection made me feel pretty wired and hyper so it was difficult to get much rest.
Wednesday morning, Steve went home to shower and eat breakfast and run a few errands before I was scheduled for my ultrasound. My blood pressure remained in the 130s/80s overnight and into the morning - still not at baseline, but at least out of the danger zone. Then the nursing assistant came to take me down for the ultrasound. Unfortunately, Steve wasn't back yet, but he managed to find me to see most of the ultrasound. They measured the amniotic fluid and that was continuing to look good. She checked out his heart, lungs, abdomen, head, feet, hands, and his "special parts." - Still a BOY! (Not that there was ever a question, but it's still reassuring!) The sonographer working with us was in training and was having a difficult time trying to get Weston to practice his breathing. She jiggled him and shook him, but he was just being stubborn. Her preceptor came in and eventually got a couple of snapshots of him breathing, but this kiddo was very close to flunking the test. She passed him because she got the results she needed - it just took a little longer than normal. The great news is that he is growing and weighs 3 pounds, 15oz (nearly 4 pounds!) He's on the chunkier end of the scale, so that was a HUGE relief!! He is our strong boy!
The remainder of the day was uneventful... my 24 hour urine collection wrapped up at noon... and all I was waiting for was one more steroid injection in the tush... a prescription for Labetalol... and dismissal! I always forget that it takes forever to get dismissed... we ended up leaving a little after 4pm. But, I was glad it took a little longer because the results of my urine came back and it was NORMAL! No PREECLAMPSIA!
So... the plan is... take my blood pressure pill twice a day... rest, rest, rest... monitor myself for any signs of preeclampsia... see Dr. Harms on Wednesday for another non stress test, ultrasound, and consultation. I will be 32 weeks on Wednesday and that was the first goal Dr. Harms told me to strive for - get to 32 weeks! So, hopefully nothing exciting happens in the next few days.
Thank you for all your prayers, encouragement, support - we feel very loved. We have so much to be thankful for. I miss all of you so much and it gets lonely during the day, so I appreciate the e-mails, texts, cards, and phone calls.