We had our MFM appointment on March 20th. I felt good. It was the first appointment that I went to feeling somewhat confident in this pregnancy. The office was really busy. The u/s tech finally called us back and I was thrilled to get a peek at the boys. We started the u/s with a quick check of my cervix. I knew the moment the image popped up on the screen that my whole world was about to change. I quickly glanced over at Kara but I'm not certain she was actually concerned at that point because she did not understand what we were looking at on the screen. So I remained quiet as the u/s tech started to take measurements of my cervix. Or more precisely ... what was left of my cervix. Only a month ago my cervix was measuring between 4cm - 4.6cm. It was now measuring 1.9cm. Not good. You could see Baby A's head right there ready for departure! Only 2cm separating my boys from the world! If the u/s tech put pressure on my abdomen my cervix all but disappeared into nothing. I finally got the nerve to say to the u/s tech, "It looks really short." and she responded, "Yes. It's short. But we will have to wait for the MFM to take a look at it." I knew it was not good but honestly I just assumed that this would be the beginning of bedrest for me. The u/s tech continued with the remainder of the u/s. Both boys looked awesome! It is getting crowded in my belly now so it is simply a tangle of arms and legs on the screen. I really had no idea what we were looking at! I could identify an arm, or a leg, or a belly, or a brain, but I never really had any idea if the appendage belonged to Baby A or Baby B! The good news ... Baby A is measuring at 2lb4oz and Baby B is measuring at 2lb5oz. The u/s tech finished with the u/s and had me get dressed to go get my blood pressure check and weight check. I then returned to the exam room to wait for the MFM. Kara and I waited about 15 minutes before the u/s tech returned to the room and indicated that the MFM wanted to put me on the contraction monitor for about 20 minutes to see if I was having any contractions. I knew I was having braxton hicks contractions but I did not believe I was having any real contractions. I was not concerned. I did not think anything would show up on the monitor. The nurse got me all hooked up and within minutes I could see a rather large contraction on the monitor. A couple of minutes later another contraction registered on the monitor. Hmm? I remember glancing at Kara and I think I said, "I'm really having contractions." It was at that moment the MFM entered the room (after only about 5 minutes of monitoring) and said, "I'm just going to cut to the chase. You are going upstairs to be admitted for a few days. You are having frequent contractions and your cervix is short. You are in preterm labor." It was at this moment my world crashed down around me. I surprisingly remained calm. The only question I asked the MFM was whether or not the boys could survive on the outside should they be born today. The MFM immediately indicated the that the boys could survive on the outside. This was all I needed to know at the moment. The next several hours are a blur.
We were upstairs on the high risk section of the L&D floor within minutes. I know that I made a point to not make eye contact with anyone as the nurse took us upstairs but Kara later indicated that we were getting a lot of concerned looks from the nurses in the MFM office. I'm glad I did not realize that at the time. I got assigned to a room and got undressed. It was bizarre to suddenly be in a hospital room and in a hospital bed. The chronological order of things gets really fuzzy at this point. I know I was starving! I remember the nurse asking me about what I ate for breakfast and I remember laughing when she replied, "I bet you wish you would have eaten more." The MFM resident entered my room within a few minutes and indicated the first thing they were going to do was my 1 hour glucose tolerance test. Because I would be receiving steroids to mature the boys lungs and brains my blood sugar number would naturally increase. I guess the steroids impact the pancreas in some manner. The MFM also indicated that I would be placed on Procardia to try and stop the contractions and in addition he wanted to do a few other tests to just make certain all was okay with the pregnancy. The nurse brought in the glucola drink within minutes. I had to drink it within a five minute time period. I think I downed the drink in under 60 seconds! What can I say? I was thirsty and hungry! The nurse continued to ask me a ton of admitting questions. At some point I told Kara it was okay to run home for a bit. We had an appointment scheduled with our lawyer for the afternoon that needed to be changed and I knew that the dogs would need to be let outside. So Kara left. The next thing I knew my room was full of people. There were three nurses in the room and two MFM residents. I suddenly felt like a piece of meat! I was being poked and prodded from every direction. All modesty was suddenly out the door! I don't remember much about the poking and prodding but I do remember being extremely frustrated with the MFM resident actually doing all the poking and prodding because she never once said a single word to me. Huh?? I know they did manually check my cervix (this is the third time during this pregnancy that I have had that done and I hate it every time) and it was firm and closed. This was great! Once the MFM residents left the room I was hooked up to the contraction monitor and both babies were hooked up to the monitors so their heart rates could be continuously monitored. The nurse then worked to get an IV set-up in my arm. Ouch. The nurse did a good job but do we want to talk about blood!! It went everywhere ... it was even up on the rails of the bed! The nurse was like, "Well you are definitely not dehydrated." They then just put me on some IV fluids and drew a bunch of bloodwork.
Here is a picture of my lifeline to the boys (aka. The IV) ...
The nurse also gave me my first steroid injection. Ouch. It was a big needle. And it hurt. I made them do the next steroid shot the following day in the other butt cheek because my butt was still sore 24 hours later! I felt immediate relief to know that the boys were getting the steroids. The MFM entered the room a bit later (probably about an hour) and announced, "You failed the one hour glucose tolerance test ... miserably." Joy! So I now also have gestational diabetes (perhaps). The MFM indicated that I would be treated as a gestational diabetes patient while in the hospital. This meant a restricted diet and testing my blood sugar five times a day. And then when I left the hospital I would monitor my blood sugar at home until I was able to get with the OB to do the three hour glucose tolerance test. My blood sugar number was 180. The passing number is 130. So ... I really, really failed the test! The nurse also gave me my first dose of procardia. And then we just waited. The next several hours were quiet. I was having a few contractions on the monitors but nothing out of the ordinary. I was probably only having 2 or 3 contractions an hour.
Kara managed to get hold of our lawyer and we made arrangements for the lawyer to come meet with us in the hospital that afternoon. Kara and I really needed to get a Medical POA and a Living Will in place especially because I suddenly found myself hospitalized. The Medical POA would allow Kara to make any medical decisions on my behalf should I become unable to do so and the Living Will is put in place to make certain no one keeps me hooked up to life support should all hell break loose. The lawyer arrived for the meeting sometime in the late afternoon. We had been meeting for only a few minutes when there was a knock on the door. It was a neonatologist from the NICU. Huh? Our lawyer kindly stepped out of the room for a few minutes and Kara and I spent the next 30 minutes discussing what would happen should the boys be born at 27 weeks. This is when I started to panic. I strangely did not cry during the discussion but I remember repeating over and over again in my head, "This is not happening. This is not happening." We were given a lot of information but basically it all came down to ... Yes. The boys could survive on the outside. There would be a lot of areas of concern (breathing, eating, bleeding in their brains, problems with their eyes) but each area would be tackled one day at a time. And that most 27 week preemies do eventually make it home. The time a preemie spends in the NICU is a marathon not a sprint. We also discussed feeding options for the boys. They would be able to receive my breast milk and the NICU would encourage pumping from the moment the boys are born. I would be able to store breast milk in the NICU. If my breast milk supply was low then the boys would receive donor breast milk. The NICU wants to avoid formula at all cost. This all made me very happy. The neonatologist kept asking us if we had any questions and to be honest I could not formulate a sentence. I was just in shock. Once our meeting finished with the neonatologist our lawyer came back into the room to finish our meeting. We briefly discussed the other legal documents we want to get in place. We signed the Medical POA and the Living Will and then concluded the meeting because I was becoming super overwhelmed! My brain was in shutdown mode.
The remainder of the day was fairly quiet. My contractions were minimal. My parents came over in the evening in order to let Kara be able to go home to tend to the animals. My mom helped me get settled for the evening and left around 9pm. I thought it was going to be a quiet night ...
Mary
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