Wish List: Crystal Ball

Where to begin? Well, my new home indefinitely is St. Mary's Hospital.

I was admitted early Wednesday morning (2am-ish) after I awoke to moderate pain on the left side of my belly, radiating through my left hip and lower back. That was followed by hemorrhaging...sounding fun, yet? Brad and I immediately called the on-call OB and made our way to the hospital. My mom graciously awoke to our emergency call and was at our house within 5 minutes to stay with Gavin, who slept peacefully through all of this. How cool to wake up and MaeMe is there!

So, it was determined that my crappy placenta (yes, I will call it this, because that is what it is) decided to tear away a bit from my uterus, causing the pain and bleeding. Fortunately, the bleeding stopped quickly. Brad and I stayed in the hospital through the day for observation with concern that further tearing or abruption could occur, but then were happy to be discharged home. I've blogged previously about my desire to not have to be in the hospital. Thursday afternoon, we were able to meet with Dr. Balaskas (MFM specialist) again.

Another ultrasound - confirmed a small separation of my placenta. Something like 9mm. Then we sat down to talk with Dr. B. We talked about the second opinion we had received the week before, our discussion with the neonatologist at Spectrum and also our discussion with the neonatologist at St. Mary's (who we saw at length on Wednesday during our stay). The last time we had met with Dr. B was when I was 22 weeks pregnant and at the time it was recommended that we take a non-agressive approach with baby.

Of course, I've blogged about the differing opinions and the difficulty (to put it lightly) in deciding which approach is "right". Brad and I have been giving this so much thought. As you can imagine, it has consumed our thinking as of late. If only we had a crystal ball so we could see the right decision, the outcome. But there isn't one. And none of our health care providers have one either, as much as I'm sure they would like a crystal ball as well.

We expressed our interest in more aggressive management, given there is a possibility that our daughter's lungs may be developing and given I'm now farther along in the pregnancy. Dr. B told us the decision is ours (that's what everyone has been telling us) and that he would follow our decision. He told us that there is no middle ground, however. I can not be managed out patient if we decide that we are going to try to give baby a chance at life. I would need to be admitted and monitored closely. There is concern that my placenta may tear away more or completely abrupt, which is an emergency (and highly fatal) for baby and for my own health, as the hemorrhaging would continue at a rapid pace until I delivered via C-section. I could lose a significant amount of blood.

It makes me cry just to type this - really a lot of things make me cry lately, sob in fact at times. Being away from home and my family and all of the things I love makes this decision so incredibly difficult. And to know that it could be weeks worth of confinement in the hopital. Such a double-edged sword - I don't want to be in for weeks, but at the same time I do, knowing that each and every day counts to get baby farther in gestation and reduce the risks of prematurity. There will always be a risk of lung development, regardless of gestation. Her lungs may just not have developed due to the low amniotic fluid. But all of the other prematurity risks (neurologic development, retinopathy, Cerebral Palsy risk, the list goes on) are lessened with lengthened gestation.

With great anxiety and no real sense of "this is the right thing to do", I was re-admitted to the hospital on Thursday evening. I now have a separate residence from my beautiful little boy and husband. I live in a 12 x 10 ish room on a floor full of women celebrating the birth of their children, probably most of them healthy. I have little to look forward to, hopefully a healthy baby as well, but so much uncertainty. All of this could be for nothing.

Starting at 10pm Thursday, I was on a 24 hour fetal monitor so that they could track baby's heart rate and assure I was not experiencing any contractions. Dr. B is looking for any decelerations in heart rate, which could indicate my placenta is not supplying enough oxygen to baby, which would have devistating outcomes, not just on survival but also disability and quality of life. Seems like so many people focus on survival but forget about quality of life. It's top of mind for me.

It was a very long 24 hours. All night, the nurse had to keep readjusting the monitor because baby girl decided it was a good time to be awake and active (which I love, don't get me wrong). I was awoken countless times with the beeping monitor. Really, I wasn't even awoken, I was already awake. So, very little sleep. Fortunately, she cooperated more on the monitor during the day. And best of all, her tracings looked good and I was able to come off the monitor last night around 10pm. And I got a great night's sleep, ahhhh. Now, I will be monitored in one hour periods a few times a day. I'm hooked up right now, in fact. Funny, baby girl has hiccups right now, so I'm just listening and feeling them. Soaking it in. I remember Gavin having hiccups inutero quite frequently.

My back is killing me from the 24 hour monitoring period. Once we found a position that was working for the monitoring, I was reluctant to move at all. Not to mention my hospital bed is nothing to write home about. Not comfortable. So, my tail bone and lower back took a beating.

I haven't seen my OB yet today, and Dr. B is supposed to be stopping by as well. I'm hoping that they will at least let me get out of bed a bit, even just to sit in a chair would be nice. I know I won't be able to run laps around the hospital floors or anything, but some ambulation would be nice. I've never been this un-fit in my life! That's one of the (many) difficult things about all of this - I feel perfectly healthy, yet I'm living in a hospital. People in hospitals look and feel sick, I don't. Well, I might look sick - I said previously, I haven't showered yet since being admitted.

I know that I need to work on improving my spirit about all of this. If I'm going to be here, I need to make the best of it. But I'm not there yet, I'm not happy. My nature is to be happy and positive, so I'm praying that I get a little of that back. I need to make a list of all of the good things, things to be grateful for.

I need to find some activities to fill my time. Brad and Gavin have been great about visiting. But I can't help but feel guilty that my two year old has to spend time here. He should be doing two year old things like playing at home and outside (though the weather hasn't been all that great - maybe that goes on my list "I'm not missing nice spring weather while here", yet at least). He shouldn't have to be in a room that has all of these tempting buttons and gadgets that he's not allowed to touch and doesn't understand why. Not to mention we're exposing him to hospital germs everytime he's here. We've been hand sanitizing a lot.

Another question that has been consuming Brad and me - is St. Mary's the right place to be? My OB office (Advantage Health) is affiliated with St. Mary's. They are providing excellent care, as is Dr. B who also is more strongly affiliated with St. Mary's than Spectrum, so I'm very reluctant to transition that to new providers.

But Spectrum has a larger NICU and they do more OB. Is quality of care determined by size? We asked a lot of questions to determine the best place to be. In the end, I'm feeling it is more important to be in a hospital with providers who know me and know our situation. As far as the NICU goes, I still have some hesitations, though the neonatologist here assures us that they can provide the same care that Spectrum provides. The only exception is that the pediatric specialists do not come to St. Mary's. Likely a moot point in our situation, given we shouldn't need any surgeries or procedures that they provide. And if we did need them, as long as baby girl is stable, she can be transferred to Spectrum (which can be risky in itself, particulary if she's not stable).

So, lots of new information. I'm sure I'll have more to follow. And lots of time of my hands to blog, given I'm just sitting here.

As always, thanks for the continued support and prayers. We need them, boy do we need them!