Tuesday May 12th - and how my life changed!

On Tuesday May 12th, I started my day working from home, before heading to a scheduled doctors appointment. The appointment was with the Pre-Term Labor department and it was for an education session with a nurse to teach me the signs of pre-term labor. Being pregnant with twins landed me automatic referral to the program at Kaiser which they have set up to educate and monitor "high risk" pregnancies. During the visit I met with RN Jill Bascom who sat me down in a little office room and started to go through the materials describing pre-term labor symptoms. Luckily I didn't have any of them...or at least that's what I thought. As we were sitting there, the RN looks at me (sitting 5 ft away) and says "I think you're having a contraction right now". To which I answered "really"? She points out how hard my belly is, I think to myself "this is how my belly has always felt for the last few weeks".

Luckily for me, this woman was observant and on the ball - she took me back into their little clinic area and hooked me up to some monitors. Long story short, I was contracting every 2 - 3 minutes and didn't even know it. I had always thought this stretching sensation was a little baby bum or head poking up in my belly. I thought a contraction was something that would be more painful, and would make more surface area of my abdomen hard, not just the baseball size shape that I felt when it was happening to me. I've learned a lot since May 12th!

Nurse Bascom tried to get me over to Labor & Delivery (i.e. the hospital), but I think they were full. Instead I got a quick appointment with an MD in their suite, he did a pelvic exam, determined that I wasn't dilated (good news), and prepared a FFN test (fetal fibronectin). He ALMOST tossed out the test after finding out via exam that I wasn't dilated because the risk of being in pre-term labor with no dilation is low (at least that's what I gathered). Thankfully he did decide to send it to the lab just to be sure. After that I went home.

As part of my pre-term labor education I was told that I need to lie down and monitor for contractions twice per day and call the hotline if I have more than 6/hour. So, I laid down that evening, and since I was still a complete novice, got done with the hour having no idea if I had one giant hour long contraction, or none, or something in between. I was not at all confident in my ability to know what the heck a contraction really was. So, I called the hotline. Long story short again, the nurse on the line there pretty much dismissed me and said if I wasn't feeling any that was good and to do it again in the morning. I was kind of ok with this because I had just been checked out by the doc and sent home, and had another appt scheduled for three days later (and I didn't feel bad/laboring in my mind). So that was the good news for 45 minutes until I got a phone call from another doctor who had received the results of the FFN test - it was positive, which is another indication of pre-term labor. She wanted me to go into the hospital to be monitored...oh and by the way the SF hospital is full, you have to go to Hayward (30min away).

No problemo - Matt and I stopped the oven warming up for a frozen pizza dinner, packed a few things and headed out. I called my boss to say I might not come in to work the next day or so (wish I had thought far enough to say "and maybe not for the next six months" haha).

Matt and I got to Hayward and I got all settled into my hospital gear. Got another pelvic exam from another doctor who found (or made!) me 1cm dilated. This was the worst exam I'd ever had in my life - quite painful and no gentleness involved. But anyway, I guess you don't go to the hospital for pleasant experiences. That doc ordered me on magnesium sulfate to slow the contractions, steroids to help the babies lungs mature in case they were to be delivered early, and an appt with the Perinatologist the next day. Matt left around 12:30am and I survived the night in the hospital. I had a few visitors the very next day and Matt came back in the afternoon to keep me company. Magnesium sulfate is no fun, leaves you hot and thirsty and kind of groggy. At 4pm the Perinatologist came in and did an ultrasound - the bad news was/is that my cervix was only 1.5cm thick...he typically likes to see 3.5cm on a twin mom at this stage. A pregnant cervix does not get thicker, so what damage is done, is done, and the hope is just to keep it, and the contractions from cascading me further into labor.

I spent two more days in the hospital and finally got released on Friday afternoon, after another ultrasound from the Perinatologist who got some better images and measured my cervix at more like 1.7cm (not that it grew, but maybe just a better angle?). He felt good that things weren't getting worse and my orders were to go home and be on strict bed rest (that means 22 hrs/day ladies and gentlemen!) with monitoring from the pre-term labor nurses who call me each day. I get to get up and go to the bathroom anytime, and get to make some quick (5min) meals and eat them, shower maybe every other day, and that's about it.

Since we've been home things have been sort of up and down. I'm better at knowing when I'm having contractions, yet there are other signs that I wonder about sometimes (is that low back ache from the way I'm sleeping? or is it yet another pre-term labor sign?). I pretty much quit work with about 0 hours notice (sorry guys - I promise I'll be back later this year) and have been working hard at just relaxing which is not as easy as it sounds when you also have to learn a million new things about your own body and how to read different signals it's giving you.

I would like to give a huge thank you and apology to all friends, family, co-workers who have sent their well wishes my way, who have visited, who have not visited (this is very much appreciated too!!), etc. It took me this long to get the energy to sit up with a laptop and type out my story for all to see...the whole two way communication thing is still a tiring thought, so if I ignore your call or say I don't want visitors, please don't take it personally. Call Matt or Emilie for updates on me, both have been fabulously helpful and are making my life much more pleasant. Hopefully if things ever get kind of regular or boring on bed-rest I will be more up for talking/writing/etc. For now though, I'm not bored at all, so don't worry about me.

Oh and for the "how did this happen" side of the story - I'm not sure there's a very clear answer. What I'm telling myself from what I've pieced together, is a few things 1) I have twins - which automatically is more of a burden on the body than a single baby, 2) I'm not exactly the largest woman on the block, the bigger you are the more adaptable your body/womb/etc is to handling the excess capacity, 3) I'm pretty active, it's not easy for me to be "somewhat relaxed" which is why bed rest is probably a good thing for me. Until Tuesday I was pretty much up and about (sitting/standing) all day long, with maybe just a little extra sleep each night. This is not exactly what my body needed I guess.

As for my pregnancy timeline, on May 12th I was at 26 weeks, which is just barely in to the "possibly viable" state for the babies, but definitely far from developed and ready to live on their own. Each day is a milestone at this point and probably every week they stay inside me for the next month is 3 - 4 weeks less in the NICU when they come out. We really want to get them as far as we can, especially past the 31 week mark (June 16), and even better if we can get to 34 weeks before delivering. More than that is great too but the long term issues get less and less the further you get into the 30-week zones.

Also, if anyone else is ever faced with bed rest, I highly recommend getting some cats and a great husband. The cats are GREAT at this bed rest thing and have been showing me just how to do it since the moment I got home and Matt had been a superstar in getting me what I need to be comfortable and trying on some new culinary skills to keep his wife and two boys fed, which is not easy despite only burning calrories laying down.

I'll post again when I'm up for it - in the meantime please leave comments on the blog or send me emails, I love to get both.