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It's late, the house is quiet, and I thought I'd finally write as there is so much swimming around in my head tonight that I know if I don't get it out, I'll never be able to sleep. If I ramble, again, it's because it's late.
The past few days have been rough, to say the least. Yes, as my last post read, I was most definitely in a funk. First, a very close family member -- who I can't name since she forbade me to outright talk about her in public, but her name rhymes with "bomb" -- was admitted to the hospital a late last week with severe heart problems. We were all plenty worried since things were touch and go for a while ... it was made even more difficult to handle as we're so far away. They are in California and we're 3,000 miles away in New York. The feeling of helplessness is overwhelming. When someone you love is in so much pain, all you want to do is to be there with them to hold their hand or stroke their brow. As soon as I heard that they were in trouble, I called Dr. G to ask him if I could fly out there. At first he was going to let me go as long as I took precautions and made promises not to carry anything or exert myself. Then I had to go and open my big fat mouth and tell him that the sharp, stabbing pains I'd been having in my lower abdomen were getting stronger and more hurtful. Well, that did it. There was no way he was going to let me go anywhere at that point. Open mouth, insert foot.
In the end, I know he's right. After all, he did make me cancel the babymoon to New Orleans in early December because he said that was a critical time for me. And now it appears it's even more so.
Today started off well enough ... Wayne and I got the kids ready for school, we shared a nice breakfast, he kissed me on the lips, and sent me off to see Dr. G for another OB appointment. When I got there, I was already in enough of a mood that I told Gloria, his assistant, that I didn't want to know anymore how much I weighed. So, taking a page from a wise friend of mine, I got on the scale backward and held in my stomach. I don't know why I did that ... as if sucking in more air and tightening my muscles would make me weigh less. This pregnancy brain is getting to me.
Before Dr. G took the cervical length measurements with ultrasound, he swabbed my cervix for the fetal fibronectin (fFN) test. Fetal fibronectin is a protein that acts as a "glue" during pregnancy, attaching the amniotic sac to the lining of the uterus. Fetal fibronectin begins to break down and "leak" into the vaginal canal toward the end of pregnancy. A negative fFN test result means that you have a 99.5% chance of not giving birth within the next two weeks or so. However, a positive result is a clue that the "glue" has been disturbed and you're at risk of preterm labor within two to four weeks. I'll bet you a million dollars to guess the result that I got. You got it ... a big fat positive. Awesomeness. Dr. G called me while I was driving 3 teenage boys home from school. I should really apologize to those boys' parents for having a conversation with my doctor on speakerphone with them in the car, and perhaps giving them a lesson in the female anatomy. Hopefully there were enough Latin words thrown around that most of it went over their heads.
Now, I've read and been told by countless of well-meaning people that false positives are pretty common with an fFN test, but you know with the way my luck has been going lately ... I wouldn't hold my breath that the results are totally wrong. Seriously though ... NICU ... three times??? This baby can NOT come this early. I swear, I will ground him for LIFE if he does.
The up side is that my cervix is still pretty long ... at 24 weeks and 4 days it's still measuring 3.7 cm. (I think the average is 3.5 cm at this point.) It's still open a little more than halfway up but the internal and external os are still closed. I wish I had taken a photo of the sonogram with my phone camera. It's actually pretty cool ... it looks like a broken zipper. I've been told that it's a "dynamic cervix" which means that it changes length depending on pressure or whatever. However, because the range since I've been pregnant has been from almost 5 cm to 3.5 cm (which is still pretty long), he actually backtracked on his promise that I'd be on bed rest at first sight of a positive fFN sign and told me it's not "immediate".
However, as always with this man who I've come to know pretty well over the last 15 years, there's always a caveat ... it being the new MFM's opinion. Tomorrow (or today, rather, since it's now 1AM), I have a consult with Dr. R, the associate director of the OB/GYN Residency Program at NYU School of Medicine. Dr. G is obviously lining up the big guns since I also found out today that I'm only the SECOND percreta case he's seen in 20 years, the first when he was a resident. If Dr. R wants me on bed rest after all, then he'll defer to her and off I'll go.
In any case, Dr. R will be the gate-keeper of sorts, handling the various specialists who will be on hand during the delivery, along with setting me up with the MRI and steroid shots. It should be interesting. I know that I was going to have the steroid shots for the baby's lungs at some point, but I guess now with the fFN the way it is, I'll get them sooner, rather than later. If I remember correctly, I'll probably have to spend a night in L&D for that.
A few more interesting things to note, then I have to go to bed because it's taking a lot for me to be somewhat coherent now ...
1) Dr. G came out and agreed with me that last November's miscarriage was most probably a very early accreta. That explains the 10 weeks of bloodshed.
2) If I had been diagnosed in the first trimester with an accreta/percreta, then he and any colleagues he referred me to would most likely have recommended a termination of this pregnancy. He justified it by saying many pregnancies like mine never make it this far and almost always pose a life-threatening risk to the mother. But then he looked at me and shook his head, "But you probably wouldn't terminate, would you?" I replied, "Not after that last miscarriage. It almost killed me." (Emotionally, I mean. It was revealed from the genetic testing done on the tissue that the baby had been a girl. That's another story for another day.)
3) He said the sharp, stabbing pains are in the location of my bladder. You know what that means ... and it isn't good.
4) My contractions aren't as often as they had been, although when they do come, they're quite painful and last longer. I'd say that on a scale of one to 10 with the latter number measuring more pain, they're around 6 or 7 ... enough that I drop what I'm doing and can't talk while I'm having them. Sometimes I even have to hee-hee-hee through them. Dr. G tells me that Dr. R will probably recommend 17P again, but after that last episode, he's reluctant to go there with me again.
Oh, I almost forgot ... last night I had some really crazy dreams ... three to be exact. With the first one, I was in an elevator that could go anywhere in the world with just a press of a button. Somehow it could take me to Antarctica or London, but it could never send me home, no matter how many buttons or configurations of such I pressed. I was trapped and kept on traveling, never going home. The second dream, I was with a little girl and we boarded a subway train car that had two levels. She didn't want to climb the stairs to the second level, but I made her because it was brighter up there and the lower car was too dark and small. It didn't take long before I realized that the subway blew through my stop and kept going. I couldn't get off, even after pulling on the emergency brake. The train kept on going and going and going. I couldn't go home and the little girl was so scared.
In the third dream, I was driving a car in Manhattan and tried to turn onto West 34th Street to head to the West Side Highway to go home, only to face a gigantic warehouse with a garage door that was closing fast. I tried to step on the brakes to stop before the car hit the door, but it wasn't fast enough. The car slid into the dark garage where I spent some time trying to figure a way out. Eventually I succeeded (I forget how I did it, but I'm pretty sure I performed some MacGyver move) and started driving again. I decided to take 36th Street to the highway which should have been a safe bet, but instead it took me onto a road ramp high in the sky near an airport. While I saw people taking luggage out of cars and kissing each other goodbye, all the time I wondered how in the world did this pop up without me ever noticing it? I kept driving and driving but the ramp wouldn't stop ... I saw the same people rotating back as if on a merry-go round.
Wayne says I was crying in my sleep, saying I want to go home. I think it's pretty obvious that I'm worried and it's spilling over into my subconscious. Any psychology majors out there who can take a better shot of analyzing my dreams?
Okay, now I'm finally going to go to sleep ... I would say "going to bed," but ever since I got home, Wayne's banished me to the bedroom and wouldn't let me get up to do anything despite my protestations that I don't have to be on immediate bed rest yet. I spent the rest of the afternoon and evening in bed with the Weet, playing dinosaurs and singing songs from "Daniel the Tiger's Neighborhood." Then I had a few good cries because everything is still getting to me and I'm still trying to digest and understand what's going on with my mom, with me. There's too much to process.
Sometimes I don't think that most people get it. I wonder if, by some of the comments I've been getting, if they think when the baby comes out early, that he'll just be smaller and spend a little bit of time in the NICU to gain weight. If the fFN is on the money, that couldn't be further from the truth. If he comes this early, then it will be all kinds of bad ... so many bad things remembered from Josh and Spike that I can't even list them again. Then on top of that, I wonder if they realize that as soon as the baby is delivered, then that's when I'll go under the knife. That's when the fun begins for me and it won't stop until months later. (Dr. G told me it could take up to three months to recuperate, barring any unforeseen complications with my bladder. I can just see it now. Baby AND mommy are both wearing diapers.) Thank goodness for Wayne. He lets me cry as much as I want, tells me he's in it with me through thick and thin, and keeps handing me the Kleenex. I sure am in love with that man.
Thanks for reading my ramble ... I'll try to post earlier tomorrow, when I'm actually cogent, after I meet with Dr. R. It should be an interesting appointment. If you recall, the last time I met with Dr. P, the last MFM, I stood on Second Avenue crying on the phone with Wayne. Hopefully I'll get better news this time around.
xo,
L
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