Sunday, March 11, 2007

Weeks 33.5 Update

A lot and yet not a lot has happened in the last week and a half.

Had another ATU (monitoring) appointment on Friday, where I go to the hospital and the kid is checked out for a heartbeat, amniotic fluid update, and that sort of thing. A bio-physical profile.

I'd thought this would be a quick-ish visit, as the last two I've had have been. Mr. L. didn't come with me to this appointment (and I'm now having them weekly). I was hooked up to a machine that checked the kid's heart rate and lay back for 20 minutes, watching the monitor as I'd forgotten to bring something to read (and the tech seemed to "forget" that I requested a magazine from the waiting room to tide me over.)

The kid's heartrate started out in the 140s, bounced up to the 150s, and I even saw 170 here and there. "These are all normal," Tech said before she left the room.

At one point, I'd started to doze off, and noticed the kid's heart rate dropped some. 115. 98. 110. Maybe the kid is dozing off, too, I thought. The numbers jumped back up to the 140 range again.

Thirty-five minutes later, I'm wondering why no one has come in to disconnect me after twenty minutes. Since I'm wearing a monitor strapped to my belly that's connected to the machine, I can't really get up myself.

I didn't see a call button anywhere, nor did I remember the number of the main ATU office. I saw a phone, and reached over as best I could to grab it. I called my OB's assistant, who is in the same hospital in a different office, and who made all the ATU appointments for me.

"Hi, it's (Lyrehca) calling from the ATU unit," I told Assistant. "I'm here alone and I've been in a room for almost 40 minutes and they seem to have forgotten about me. Would you call the office and let them know?"

"Oh my God, I'll call them right now," she said.

I watched the clock, and thought, "if no one comes in in five minutes, I'll just disconnect myself from the machine. The heartrate numbers have been printing out on a sheet of paper, so it's not like I'll lose data if I disconnect myself."

Three minutes later, a different tech walked in.

"I thought you forgot about me," I told her.

"We didn't forget about you," she said. "We're down the hall watching your numbers and sometimes we get backed up with other patients."

"OK," I said. "Can I get back to work now?" This Friday was nearing the end of my deadline week and while I went into work early that day to get some stuff done before the 10am appointment, I wanted to get back.

"Oh, no, you're not going to work," she said. "The baby had a deceleration and we need to send you to Labor and Delivery for a few hours."


Apparently, the drop in the baby's heart rate, down to 98, is called a deceleration. It means that the kid's heart rate slowed down, and while it could mean something relatively harmless that the kid swam over and touched its own umbilical cord, it could also mean there was some other reason that was less than harmless. They wanted to watch me for a longer period of time in a bed in Labor and Delivery, where they had more beds, and that if they saw something distressing, they could delivery the baby early if they had to.

Um, huh?

"Are you kidding me? I might have to have the baby today?"

"It's possible, but it's also possible this is just a one-time thing. But we need to monitor you more closely to see if more decels are occuring."

I was a bit annoyed with this tech's matter of factness about this totally unexpected thing. I honestly felt like I was missing something.

"I don't even know where Labor and Delivery is. And does my OB know?"

"We just got off the phone with her. She's the one who is sending you there. It's on the tenth floor."

So I pulled out my cell and called both the OB and Mr. Lyrecha. The OB's assistant said she'd get the OB to call me right back, and called the Mister. He was alarmed.

"Should I come down to the hospital? Are you OK? Is the baby OK? What's happening?"

"Everything is fine," I said. "I'm just going to go to the Labor and Delivery floor and get checked out for another two hours or so. I feel fine, the baby is kicking a lot, and I will call you every hour with an update," I promised.

The the OB called me back, and explained that since I'm getting all this testing (weekly), that it's not uncommon to see something like this and that it could just be a one-time thing, but since I'm there, it was important to get further monitored for a few more hours. I mentioned my surprise again about expecting to just go back to work.

"You can return to work if you really want to, but you really should get checked out just to see what is going on."

So after I called my boss and told her what was going on (and she was very cool about saying "What can I do to make things move smoothly while you're out?" which I plan to say if I'm ever in a similar situation but reversed), I made my way up to the Labor and Delivery floor, where I'd never been before. (We have a hospital tour skedded in a few weeks). I was checked in, given a bracelet ("Are you admitting me?" I asked. "Not just yet, but this is standard procedure," I was told. "Do you have a pediatrician," I was asked. The Mister and I had just decided which of the two we interviewed we'll go with, so I gave that doc's name and practice. No idea what her phone number is.)

A nice calm nurse with curly blond hair came into the lobby to get me. Labor and Delivery has heavy locked doors and you have to be approved to even get past them. This reassured me for security reasons.

"I'm a little surprised I'm here," I told Calm Nurse. "I thought I'd be here for a quick 20 minute visit downstairs.

Calm Nurse repeated a lot of what I'd already heard, and led me to a hospital bed in the Recovery area. As in, the woman in the bed next to me had had a c-section that morning and was the proud mom of a new son.

I gave a urine sample, asked if I had to wear a Johnnie (thankfully, no), and got strapped to another heart rate machine. Calm Nurse told me she'd stay with me for a bit as she asked me medical history questions. Tonsils out? Yep. Wisdom teeth pulled? Yep, two. A few surgeries here and there, yes. Diabetes for 29 years, check. "Oh, you're type 1," she said. Oh yeah.

"But so far, the pregnancy's been uneventful, except for swollen ankles," I said. (My blood pressure both in the ATU and in L&D was normal, so still no sign of danger with the cankles.)

Calm Nurse was able to get me a stack of magazines to read (the new Marie Claire, nice) and when I tested my blood sugar and found it a bit low, she brought me some graham crackers and peanut butter and a nice big glass of ice water. It was just what I needed.

"It's like a restaurant here," I said. "A bit more like camping," she said, showing me a styrofoam cup filled with a scoop of peanut butter and a plastic spoon. I had two of the four packs graham crackers (20 grams of carbs) with a bit of peanut butter to treat a 64. A half hour later, when the 64 hadn't budged, I ate two more packs of grahams and left the unit around 120, which is a bit higher than I wanted to be, but at least out of a lowish zone.

And I alternated between skimming Marie Claire and keeping an eye on the monitor. Again, 150s and 160s on the heart rate. A jump up to 200 or so when I hoisted myself up to eat the graham crackers. Whenever I moved, the monitor would move slightly and sometimes it lost contact with the baby's heart rate for a few seconds. Always, a green, yellow or red light would indicate how strong a signal the machine would get from the baby. If the baby swam out of the way, it would lose contact with the machine and the numbers would disappear from the screen. This happened at one point and the number than came back was a 94. Oy.

After about an hour, the Calm Nurse came back and said she didn't see anything that was worrisome to her, and that the OB on call, who was in touch with my own OB, said I was free to go.

What about the 200 and the 94 reading?

"The 200, like the 94, was momentary, and likely happened when you reached for the food," she said. "This baby likes graham crackers and peanut butter. It was very active while you were eating."

"Good," I said. "I plan to eat a lot of both of them in my time." (I eat peanut butter every day for breakfast, and will miss it if I have to avoid giving it to the kid while breastfeeding. Not sure how that will play out.)

The 94 was accompanied by a time on the monitor where the numbers stopped recording for a few seconds, and the nurse told me she thought it was just because the baby had been moving around. A more gradual and longer drop in the heart rate would have indicated a more serious problem, but there was no sign of that.

I called Mr. L. and reported things. He was nervous, he told me. "The nurse I have here is very reassuring," I promised. "Do you want to talk to her?"

He declined, but continued to ask questions. After I hung up, Calm Nurse told me it was sweet he was asking so many questions. "He sounds like a great guy," she said. "He is," I said.

"You're free to go," she said again, and since I felt fine and the baby felt fine, I said I was going back to work. And after a lunch at the hospital and calling my mother (since Mr. L told me he'd told his sister about what happened, who then told her mother, which annoyed me, but I figured I'd need to let my mother know since we're nothing but not a worrisome bunch).

By then, I was calm and feeling like there was a lot of excitement over something that turned out to be nothing unusual. I can understand wanting to be safe rather than sorry, but honestly, how often do these decelerations happen in a non-diabetic pregnancy?

While that was probably the biggest news of the past week and a half, the previous week's ATU visit showed that the kid, at 32 weeks, was measuring about two weeks ahead, at around a 73 percentile. I was alarmed, since the kid had been closer to a 60th percentile four weeks before and wasn't quite so ahead.

"Is this because of the diabetes," I asked. "Am I dooming the kid to having a large abdomen and a lifetime of type 2 itself?"

I was reassured that a two-week ahead gain was considered normal, and if the kid was measuring ten weeks ahead at week 30, that was something to be more concerned about. Besides, the Mister and I are both tall, and as much as I hate it, we both have our share of abdomnal fat. The Mister is definitely apple-shaped, and the only time I've had a flat stomach was when I was five, prediagnosis with type 1. Still, it annoys me that the kid is measuring a few weeks ahead on a growth chart.

And in completely other yet still-baby-related news, we had several rooms in our house painted over the last week. This meant that I moved out to my parents' place for a week, which I must admit was a much closer commute to work, calmer (the phone never rang for me, I had a bathroom and bedroom all to myself, and would read a lot at night instead of dealing with the TV, the Mister's favorite leisuretime activity), and sort of mellow. While I saw the Mister on the weekend when we all went out for dinner, and talked to him several times a day, it was a bit like being on a working vacation.

Now I'm back home and while we have some great colors in a number of rooms now, we still need to put all the paraphernalia like bills and papers and tchotckes all back where they belong. Not quite as restful as it was being at my parents place.

And to top things off, some late-assigned freelance work means I need to do work (from home, but still work) later on today to get it all done by Monday. This is likely the last bit of freelance I'll take on for awhile, as I'd like to chill as much as possible at home before the kid's arrival. Decluttering papers on my own time, despite the lack of payment for it, is more appealing than freelance work. It's like the calm before the impending storm.

Oh, nearly forgot, but Scott at Scott's Web Log had tagged me for a meme about seven things. I've got a bit of Meme Fatigue, and frankly barely have time to post updates like this as it is. So while I'm always honored when someone cites me on their blog, forgive me for passing on it right now.


Chrissie in Belgium said...

My heart beat was zooming there for a while! I am so glad you are OK! Take care! Don't get overly ambitious and clean up everything after the painters too quickly. My heart is STILL in overdrive.... You know my daughter is expecting her third child ANY day now. I am already edgy!

Rachel said...

glad all is OK.

Being highly monitored has its annoyances, I guess, besides the time commitment required. A more "normal" pregnancy wouldn't require the monitoring and therefore, wouldn't know about a deceleration here and there.

MileMasterSarah said...

The last trimester of a pregnancy with a type 1 mom is simply a blur of appointments. I so remember those days! Don't be too alarmed about the weight. The doctor told me to expect a 9-1/2 lb baby with my son, and he weighed in at exactly 7 lbs. 2-1/2 lbs is quite a difference when you are in labor!

Megan said...

Wow! What a scare that must have been. I'm glad you and the baby are ok.

SaraS-P said...

What a relief that all seems ok!

Give that kiddo some PB and graham crackers!

Ottoette said...

Glad to hear from you and glad the decel amounted to nothing. Not long now!
Do you think I could go stay at your folks for a week, sounds like a lovely working vacation!

serenity said...

You sure know how to tell a story, woman - I was worried for a few long minutes. Happy to hear that you and Baby L are doing well.

Penny said...

I'm glad little baby L is doing OK.

Watson said...

Wow, that actually sounds pretty scary! How on earth were you able to stay so calm??

I'm so glad things are okay! And I just wish you all the best as these final weeks arrive


Bernard said...

I agree with Serenity, you tell a good story.

I'm glad to hear that both of you are well. I hope the time between now and delivery are uneventful.


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