Tag: pprom

5 Days Old

I wanted to come and write out my birth story and how that all happened and some of the moments of joy in the insanity. But as so often happens, events have overtaken things and last few days have been difficult. Cora, Twin A, just can’t seem to catch a break. Initially she was was doing well, but she has now been ventilated for several days, has had a lung collapse, and generally a tremendous amount of stress. We’re also in a bit of shock about other news we got about her, which I am not yet ready to talk about. I can’t wait until she is off some more of her tubes and I can hold her again. We keep thinking that maybe today will be the day, but so far we just don’t know.

Beautiful Beatrice, who was the twin who was ruptured for so long, is doing very well and when I called at 6 a.m., they said she’d had a great night. We anticipated her having lung problems due to PPROM, and she did at first, but she is holding her own and is breathing with just a little help, so we hope she keeps holding her own and wailing her little wee kitten cry at the nurses when she is annoyed.

What is tremendous is how much I love them both despite all the tubes and machines.

Birth

I wanted to let you know that the twins were born at exactly 30 weeks when they decided, rather quickly, that it was time to come. They are 3.6 and 2.9 pounds respectively – quite respectable weights for their age. Both seem pretty well all things considered although its very hard to see your babies so small and fragile and hooked up to so many machines, undergoing necessary but invasive procedures. It’s been very emotional. Yesterday I got some skin to skin with the bigger twin and even changed her diaper – big milestones around here. I’m also still in the hospital recovering from surgery, which is quite, well, different. More to follow soon.

Spruce Forest

This shawl was definitely my most ambitious project to date, and I think it would have taken me about a year if I hadn’t been on modified bedrest (took a quick break for some photos in the yard!) As it was, I finished it in a couple of weeks. Like my Levenwick and my Rockaway, this was a pattern put out by Brooklyn Tweed and has the evocative name of Spruce Forest. I tried this pattern about a year ago, but I didn’t have the skill level at the time, so it ended up frogged. Looking at the acres of fingering weight yarn I’ve accumulated, especially the spruce green one, I decided to give it another shot. I think the Lacy Socks were good preparation, because once I got through the first bit of it, I got the hang of it quickly, learned to “read” my stitches, and made relatively few mistakes. I put in lifelines every 20 rows or so but only had to frog back to them once.

Spruce Forest Shawl

I LOVE this garment! Why aren’t shawls more popular? I think I’m going to need at least one more… although I will do a slightly smaller, heavier-weight one. But this is going to be perfect for summer evenings, or for nursing in the summer time. (Ravelry project link here.)

And just for you guys, a nice big 28 and a half week belly shot! Everyone’s still hanging in there, and we’re trying to make every day count. I had a little scare earlier this week with one of my non-stress tests. Baby B had a long deceleration which alarmed the nurse, so I hung out in labour and delivery at the hospital for five hours while they did some monitoring. All seemed reasonably well, so they sent me home again. I think the stress kicked up a bunch of contractions (or maybe the contractions kicked up the decelerations), but I was very strict with my bedrest yesterday and things seemed to settle down again.

Spruce Forest Shawl

Labour and delivery is such a fascinating place – there are little tragedies and miracles happening all the time. The woman next to me was told her baby had intrauterine growth restriction – which is usually a sign the placenta is not working well and the babe will need to come early. Like me, she’d had a bad non-stress test so she was there for longer monitoring, and they urged her to come back the next day so they could keep an eye on things. Another woman came in laughing and smiling announcing she was in labour then stood there for ten minutes chatting with someone she’d run into. Listening, I wanted to pull back the curtain and say “Girl, you are NOT in labour! Go home because this baby is not coming until at least tomorrow.” I resisted the urge, but I think someone else eventually sent her home. There was another twin mom there too, but I couldn’t figure out what was going on with her. And then there’s me, applying more ultrasound gel to my belly, and quietly adjusting the settings on the monitor while untangling a big ball of yarn for my next project… a baby blanket.

Flowers

It’s very hard to be in that “nesting” stage of pregnancy and yet more or less bedridden. I am feeling far enough along now that I am starting to let myself think about all those things that were too hard a few weeks ago. Double strollers, decorating the bedrooms, knitting baby blankets. My doctor said if we get to 28 weeks, order flowers; if you get to 30 have cake and if you get to 34 time for bubbly! So we’re just a few days away from ordering flowers.

The babies are growing well too, if the last ultrasound was accurate. I can’t remember exactly what their weights were but at they said Baby A was around 1500 grams, which is over three pounds. And Baby B was around 1200, which is well into two-pound territory. All these numbers take on overwhelming importance to me because I am constantly calculating and recalibrating the premature birth statistics. I have no real baby in front of me to marvel over – just probabilities.

The odds get better but the symptoms of PPROM get scarier as time goes by. A week doesn’t often go by without some new and alarming physical symptom. I’m learning to take them more in stride. And when I get a bit panicked I call the nurse or the doctor. Having a non-stress test every couple of days eases my mind a lot too. I try to remind myself that in obstetrics, despite what you read, things rarely happen without any warning at all.

Despite the roller coaster, my stress level is much lower than it was two weeks ago. I’m not bursting into tears when the local botanical garden refuses to extend my membership (which I can’t use!) or sobbing randomly in the evening anymore. The doctor’s visits are far more optimistic. We’re starting to discuss the end-game here, which wasn’t always on the table earlier.

Cuddles

I watched a Netflix documentary last night called Little Man. I wouldn’t have been able to handle it much earlier, as it deals with the birth and treatment of a 25-week, one pound, growth restricted baby. But it certainly shows the kinds of moral hazards associated with resuscitating extraordinarily preterm babies. I don’t envy the jobs of neonatologists – all of us parents want miracles. But for now I’ll settle for at least three more days of being pregnant! And then two more weeks… And then Baby A flipping down so she’s not breech… and then, and then, and then.

One Day At a Time

Another week of PPROM, almost 25 weeks now. On the one hand, I’m breathing a little easier. On the other hand…

“At 25 weeks, we sometimes counsel not to resuscitate.”
“At 25 weeks, your chances of bringing home an intact child are less than 50%”
“A 25-week preemie can spend up to one year in the NICU.”
“The following factors can adversely impact the survival rate – multiples, uterine leaking.”
“Survival rates improve every day but the rate of brain injury doesn’t go down significantly until after 28 weeks.”

I like the approach where I am, which is very much about involving parents in all decision-making. “We will go on this journey together.” But sometimes I just don’t want the information. I can’t tour the NICU right now. Maybe in another week or so.

Now that I have reached the magical 24-week threshold I have a nurse who comes to monitor me every day. They tell me they see the pre-term labour people three times a week, but us PPROMers get a daily visit. I have a homework chart and I graph my temperatures. They listen to the babies every day. Every other day I get a non-stress test and spend 20 minutes watching the babies heartbeats rise up and down, watching for the appropriate accelerations when they move.

I wouldn’t say the rupture is getting better – I hoped it would, and that it would just heal up after a couple of weeks of rest. That hasn’t happened, and sometimes it seems worse. But they stay there still enough fluid around little Baby Girl B, so thus far it’s regenerating faster than I’m losing it.

24 Weeks

Not even sure who’s reading this but with some time on my hands, I thought I’d start writing again. I hit 24 weeks yesterday, which was a big milestone in PPROM terms because the babies are now viable. Unfortunately it’s not as simple as that, as 24-week babies face many, many struggles, but it’s the first hurdle.

It’s funny how different it feels to have a true “high-risk” pregnancy. I remember last time, with M, we had some scary ultrasound findings that sent us into a tailspin. This twin pregnancy has brought news of that magnitude almost every few weeks: multiple hematomas, early oligohydramnios, echogenic bowels indicating possible cystic fibrosis, massive growth disparity. All of those things resolved by about 18 weeks and I was about to “graduate” from the high risk program and then I hit the scariest – PPROM.

You know what’s crazy, is that it really isn’t that uncommon. At the hospital, currently my second home, I see women with even bigger problems than I – HIV pregnancies, fatal abnormalities, being on the brink of very preterm labour. On the day I sat waiting in labour and delivery to be assessed for PPROM, two women lost their babies. I’m glad that my first two pregnancies were easy, relatively speaking. I think it makes it a whole lot easier to go through this without being bitter about what I’m missing.

Also, for some strange reason I just feel more empowered in my care. The first time I questioned every minor test and agonised over it all. This time, you know what? I’m just going with the flow. I’m in some kind of weird limbo territory and I feel very comfortable leaving it in the hands of experts. Of course all the big stuff is discussed with me – I’m an active participant and I’ve never felt rushed by my caregivers in any way. But I don’t want to know everything – sometimes it’s just too much information.