A Study in Bedrest Dementia

26 weeks, 1 day: I am still here. Not in the hospital, not any other terrible place. I am sorry that I have not updated before now--I need to figure out how to do posts from a Blackberry or something?

The lowdown on the medical situation: still on bedrest (REALLY REALLY BAD), total protein numbers have bounced around without any significant increase or decrease so far (REALLY REALLY GOOD), BP still too high and still increasing medication every week (REALLY REALLY ANNOYING--KIND OF LIKE THE ALL CAPS, EH?).

Baby No Name is hanging in there like a trooper. We have our second Level II ultrasound this Thursday to check on his growth and the placenta situation. I am hoping that he will be well over 2 pounds by then.

My OB (did I call her Dr. Thorough before?) is somewhat perplexed by my collection of problems, as it is apparently worse than chronic hypertension usually is but it's not (yet) progressing like pre-eclampsia usually does. So, it looks like we won't have a firm diagnosis until we look back at it from the other side. If you're wondering, the reason we care about the diagnosis is that it gives some indication of what might happen in the next weeks/months. But I don't think we're going to get that luxury.

The basic plan at this point is to try to keep me out of the hospital for as long as possible. Dr. Thorough guesstimates that hospitalized bedrest will likely be needed by 30 weeks. We are hoping to keep BNN cooking in there until at least 32 weeks, which will be around Thanksgiving. A 32 weeker will be in NICU for a while, but hopefully not more than a month and without major prematurity problems. I can still barely think about what all this may mean for the baby.

Ack.

I'm not going to lie to you--spirits are on the low side. I have been throwing myself pity parties with distressing frequency. I have started doing therapy sessions again by phone and that has helped some, although my therapist pointed out that I must have been a dictator in a former life to have all these hard lessons to learn about control.

No kidding. I get it already. I am really trying to stave off wallowing as it does no one any good, least of all me. I have not yet had much success finding peace with all of this, but I am still trying. I've got to figure out how to move past the anger and sadness and fear that my longed for, idealized, probably one and only pregnancy is turning out like this. That is really old news at this point but it is still so hard to let go of the bitterness about all the experiences we have been cheated out of. I can hardly bear the thought that my baby's precious first weeks will be spent in a plastic tub with tubes and needles and monitors sticking out all over. And I know that he will most likely be ok. But still........so hard to come to terms with that.

Anyway, I am still here, making like a bump on a log and trying to keep this baby cooking. And gladly accepting all calming thoughts that you can spare.

No One Said It Would Be Easy, Right?

If anyone is taking bets out there, we have officially crossed the magic protein line into pre-eclampsia. It is mild pre-e* but pre-e. So..........more testing and more waiting. There is not much to be done except try to keep it from getting worse for as long as possible. Which means strict, only-get-up-to-pee, bedrest.

This is much harder than it sounds. Much MUCH harder. Especially when your DH is essentially somewhat mistrustful of the medical profession and is not all convinced of the need for bedrest of this magnitude. And frankly, I wonder myself if Dr. Earnest is not going a bit overboard? It's hard to say. My Google M.D. says that bedrest is somewhat controversial in treating hyptertensive disorders in pregnancy, as the clinical studies only support a better outcome for the baby, not the mother. On the other hand, there is anecdotal evidence that it has helped some women prolong the progression of the disease. I think there really isn't a choice when it comes down to it--I have to know that I did everything I could, however futile it ends up to be. We don't have the luxury of a do-over if it turns out to be the wrong thing.

So.......the big challenge now, as seems to be so often the case, is to try to shoulder the load with some kind of dignity. I am finding this much easier said than done. Ha! Understatement of the year! It is so very hard for me--maybe not for everyone, but for me--to keep up with the emotional fallout of all this. I feel angry that this hell has to follow the hell of infertility, I feel abandoned by some of my friends and family, misunderstood by my husband, lonely, pitiful, eager to just DO something. For added drama, most of these emotions come in 10 minute revolving cycles throughout the day. And I thought Clomid was bad.

In any case, we will get through it. And--God willing and the creek don't rise--we'll have a healthy baby boy to show for it. That's a good goal, I think.


*If you're following along at home, the protein number went from 218 mg last week to 337 mg this week. Translation: 300 and up is mild, home bedrest pre-e; 1000 and up is hospitalized bedrest pre-e; 4000 and up is severe, delivery of baby now pre-e. The complicated part is that you can go from "mild" to "delivery" levels over months, or within days or even hours.

Tales from the Couch

First, thanks to all of you who have commented and emailed in recent weeks. I don't have to tell you how much it means to have that support from some of my favorite people.

To recap events since we last spoke, we had the perinatologist/maternal-fetal medicine specialist appointment last week. The good news is that the fancy ultrasound revealed Baby No Name to be wriggling away and in apparently fine health. We had the u/s at 22w3d and he measured an average of 23w2d--so the high BP hasn't caused any intrauterine growth restriction (IUGR) so far. IUGR is one of the main risks to the baby from my BP so they will be keeping a close eye on him by repeating the u/s every few weeks. It was such a tremendous relief to hear him described as "vigorous." Even more than hearing the heartbeat for the very first time. Little stinker seems to be a fighter. And, as of last week's Jug O' Pee protein test, I am still dodging pre-eclampsia. Hallelujah!

The bad news is--surprise!--my BP. We have tweaked the meds twice since I updated last and nothing seems to hold it down for more than a few days. This situation is driving me mad, as I just can't fathom why modern medicine can't get a handle on it. I have just finished my fourth week of bedrest with medication six times a day and I'm still spiking into the 170s/90s, with consistent pressures greater than 150/85. It makes me shudder to think what would happen if I was working?

Oh, and as of Friday's hospital visit, I have been diagnosed with something called "irritable uterus." Apparently, hypertension increases the risk of pre-term labor and, if I understood the nurse correctly, IU is some variety of pre-term labor. In any case, I have been having 5-8 contractions an hour, but they are not changing my cervix. They are tolerable as long as I don't move around much. So I'm on strict bedrest until told otherwise by the OB. I really have no idea what this new development means to the overall picture.

This is probably all way too much information, but I am not sure what pieces to leave out? Things have gotten a bit complicated and interconnected here in Mudland. I would like to put together a post about the emotional/homefront aspect of all of this, but that will have to wait. Headed back to the couch, with gratitude again for the lovely internets.

24 weeks on Monday.