NINE months!

My dear sweet Allessandra,

Where have 9 months gone? You are doing the most amazing things and while you are still behind a little bit in terms of development (to be completely expected, I mean, you were 9 weeks early)...I am reveling in each milestone and so proud of how far you have come.

In the last three months, we have watched your personality develop, watched you get stronger, and watched you fall more in love with your sisters. Here are a few of the highlights (mommy sure does love to keep tracks of these big days):

8/12...6 months. You can hold your left shin with your left hand while laying on your back.

8/13...6 months. Toes!!!! You can grab your toes with your left hand while you are laying on your back. Probably one of mommy's favorite moments is when all of my girls were able to grab their toes.

8/16...6 months, 1 week. You can roll from your back to your side.

8/20...6 months, 1 week. You blow raspberries, pretty much all.day.long. And mommy thinks you are pretty cute doing it!

8/28...6 months, 2 weeks. Mommy and you have some fun games. For one, you love to bury your little head in my shoulder and scream and then mommy gives you big side to side hug and yells "Aaaaahhhhhh!"

9/1...6 months, 3 weeks. If you have a toy in front of you, you can sit up pretty well...not 100%, but we are real close!

9/5...6 months, 4 weeks. Ah, you have rediscovered your voice...happy pterodactyl screams have returned!

9/12...7 months. You are sitting up by yourself!

9/19...7 months, 1 weeks. The babbling has begun! Ya-ya-ya-ya-ya and va-va-va-va-va are the first two syllables of choice!

9/22...7 months, 2 weeks. You are babbling da-da-da-da-da!

9/22...7 months, 2 weeks. You absolutely LOVE putting BOTH feet in your mouth. How on earth you do this is beyond me!

9/23...7 months, 2 weeks. You are rolling from your back to your tummy now!

9/30...7 months, 3 weeks. And now you are rolling from your tummy to your back! A complete roller!

9/30...7 months, 3 weeks. You find yourself hilarious...yes, you actually laugh at YOURSELF. It's the cutest sound.

10/1...7 months, 3 weeks. You are making this funny scrunched up face that mommy calls your "Scoongie face!"

10/5...7 months, 4 weeks. Another syllable...now you are babbling ba-ba-ba-ba-ba.

`10/7...7 months, 4 weeks. Finally! Ma-ma-ma-ma-ma is your babble of choice today.

10/14...8 months. So are so proud of yourself! You are clapping hand over hand and definitely love the praise.

10/15...8 months, 1 weeks. You understand (and do NOT like) "No, no!"

10/24...8 months, 2 weeks. You are starting to reach forward from a seated position to end up on your belly.

11/1...8 months, 3 weeks. Make that LUNGING forward from a seated position to end up on your belly!

As you can see it's been a busy 3 months and I have no doubt that the next 3 months are going to be JUST as busy! Your 9 month well-check is on the 20th, so we will see how that goes. We are excited to see how much you have grown physically and hopefully hear you are doing well despite that early start!

SIX months!

Dear Alle,
Happy 1/2 birthday my little one! Well, you really aren't all that little any more. Just a few weeks ago on July 22 when you were 5 months, 2 weeks old ACTUAL and 3 months, 1 week old ADJUSTED, you weighed in at 13 pounds, 4 ounces. You are growing like a weed flower and continue to change with each passing day. There seems to be new milestones met each week. Here are a few of my favorites:

7/14...For the past few days you have been feeding one last time before 9:00pm and sleeping until 7:30-8:00am. Um, are you really my child? Not only are you sleeping WELL through the night, but you just might possibly be the easiest of babies when it comes to putting you down for bedtime. Our nighttime routine is still flexible, but that will change when the girls start school in August and I will have time with you after they are asleep to bathe you, read to you, sing to you, and just plain snuggle you. Right now our nights are so late with summer time fun, late swims, late movies, late desserts...you get the picture, right? Right now, after your last feed and actually sometime toward the end of it, you become rather sleepy. You rub your eyes and your blinks become long and heavy. At this point I can lay you down in your cosleeper, give you your paci, lovie, and burp cloth and walk away, leaving you drifting off to sleep completely on your own. Really? Could it be any easier?

7/30 You have discovered your voice! Remember all that you would do with your lips and mouth only to say something so tiny, so short, and so soft? Well, those days are LONG gone. You have completey discoverd your voice and you sure do love hearing yourself talk...all. the. time.

8/1...While I'm not quite sure exactly when you started doing this, I know it was somewhere between 5-6 months actual and 3-4 months adjusted. When you are nursing, once you are somewhat satisfied you like to take an intermission, lay back, and chat with mama. I usually can't get a word in edge-wise and you take this prime opportunity when you have my undivided attention, to just plain smile, coo, and BABBLE. When you are finished talking, you simply roll back to your side and let me know our "chat" is over.

8/1...Tummy time has become fairly easy for you. You hold your hold at a beautiful 90 degree angle and prop yourself so sweetly up on your forearms, clasping your hands together.

8/5...Hhhhmmm, wait a minute? Who are YOU? You seem to be starting to show some hesitation and uncertainty towards people you have never met or don't see regularly.

Your official well-check is on 8/19 at almost 6.5 months. I can't wait to get the new stats and hear from your doctor just how fabulous you are doing!

All my love little one...

4 Month Well-Check

Stats

Weight: 11 pounds, 9 ounces @ 5th percentile

Length: 23 3/4 inches @ 18th percentile

Head Circumference: 38 centimeters/15 inches @ 3rd percentile

We are so excited and happy to report that you are ON all three charts for your ACTUAL age! In other words, you are growing just beautifully. Right up until the end of May you were gaining 1+ ounce per day, which was amazing, but in the last two weeks your growth rate has started to ease up a bit, which is completely normal. I guess you can't gain an ounce a day forever!

Development and Milestones

Today you are 4 months, 12 days old...so closer to 4.5 months actual and 2 months, 1 week adjusted. Of course you are a little behind in overall development, but that is to be expected since you were 9 weeks early. At the end of August you will have your first appointment at the High Risk Infant Clinic to be assessed for Early Intervention services. At that point in time you will be almost 4.5 months adjusted. The girls were assessed at 3 months adjusted, so in my mind it's a tad bit late, but we are hoping that your delays won't be as significant and that you may not even need therapy...fingers crossed my little one. Fingers crossed. 

You are completely socializing and vocalizing with smiles, ahboos, coos, gurgles, and giggles. Right now your favorite "word" is ah-bbbbbooooo and the correct pronunciation of that involves blowing a soft raspberry on the bbbbbooooo part. I say it. You say it. Too.Stinkin'.Cute. Most of the time you study our mouths so intensely, then move and contort your own tongue and mouth in every way possible only to eek out a teeny tiny little sound. But on occasion, you just about talk Mommy's ears off and I have yet to capture one of those perfect moments on video. I'm trying, but when I'm ready...you just smile and stick out your tongue. (Which by the way, you are a tongue-roller my dear. Just like Mommy and Mia).

Physically, you are doing so many great things. First off, you are trying to purposely bat at your hanging toys. How do we know? Well, when we hang Mr. Bumble Bee above your right arm, you fix your gaze on him, both arms somewhat quiver, and then slowly we see your right arm raise up to bat him. When we move Mr. Bumble Bee to the other side, you follow him intently with your eyes and once again, both arms somewhat hover until the left arm raises up to repeatedly hit the toy. It's so incredible to watch your little brain working overtime on what seem to be such simple tasks.

I'm also fairly certain you would happily eat your entire fist if you could. You've been working on getting fingers, a thumb, or the whole darn right hand in your mouth for the last two weeks. I do have to laugh though because in many of your attempts, you end up hitting yourself in head/face as you bring your hand to your mouth. 

You are starting to discover your legs and like to bounce up and down putting weight on them when we hold you and your feet are on our laps. Your head control is pretty much perfect and your doctor always comments on how great it is. Still, you do get the bobbles and Grandpa's nickname continues to be apropo ("Grandpa's Little Bobblehead).

Tummy time is becoming easier as you can pretty much prop your upper body up on your forearms, hold your head at an almost 90 degree angle and look left, right, and center. You aren't getting as frustrated either, which means you are getting used to torture tummy time. Phew.

Emotionally, you are a very securely attached baby and that's a for sure thing. You know who "Mama" is and look for me, follow me, and even whimper when I walk away or if you hear my voice. Still, you find complete comfort in the arms of most anybody, but especially Daddy, Grandma, Grandpa, and your sisters, who you adore, more than life itself.

Overall, you are such the happy, easy-going baby...so much so that when you are taking your morning nap for a few hours and Mommy is attending to the household duties and your sisters, I have actually at times forgotten you were even in the house. Your sisters weren't difficult babies by any means. In fact, they were very much like you, except for the tiny fact there were TWO of them which made it difficult by default no matter how easy each child was on her own. 

Really, your only fussing/whimpering/complaining comes when you are hungry and/or tired. And hey, who is NOT grumpy when they are hungry or tired? Just look at your mommy as a prime example of THAT. However, being held and walked around (in a state of constant motion while nosily peering over a shoulder at the world going by) is probably one of your favorite things to do and something that will typically make you happy no matter what you are fussing about...at least for long enough for someone to do something about it! 

On the sleep front, I truly cannot complain. You have been sleeping well and going 5+ hours between feeds since you were a little over 3 months old or 1 month adjusted. Now you will typically feed between 8:30 and 9:30pm, fall asleep immediately following, and sleep until about 4:00am. It's a really nice stretch of sleep for us all. Sometimes you will actually wake at 11:30pm to feed one more time and then go until about 6:00am before your next feed. And while I like that stretch of sleep a little more than the 10:00pm-4:00am stretch, really, I canNOT complain about your sleep habits.

Your morning nap is really the only consistent nap that has materialized in the last couple weeks. Every day you feed between 6:00-7:30am and then nap until late morning. This is your Boppy nap (and yes, I know that babies aren't supposed to sleep on, in, or between Boppy pillows, but you are not unsupervised at all...in fact, I am folding clothes, paying bills, or surfing the net right next to you). I lay you on your tummy with your arms over the top of the pillow and your little feet tucked under your body in the fetal position and you are happy as a clam. In fact, it's some of your best sleep. Yes, you are a tummy sleeper through and through, but we only allow that for naps (again, in complete supervision). At night you are swaddled as tight as possible and laid on your back. Although, it appears that your swaddling days are numbered since most times I find you like this:

You sleep right next to me, so I hear when you are starting to struggle and try to break loose. When that happens I just sit and watch and when you are finished releasing your inner Houdini, I move the blanket down to a safe position. What I don't like is that you spend hours on end trying to break free and while you never FULLY awake, it seems to me like that is a lot of restless sleep. It just might be time to start swaddling you with arms out and see how you do.

I could go on and on and ON about you and all of your amazingness (is that a word?), but I really do need to be ready for you when you wake up.

Lots of love and hugs and kisses and snuggles,

Mommy

FOUR months!

Dear sweet Allessandra,

It's so hard to believe that you have graced this earth for four whole months already. Yet in the same breath, the whole hospital-NICU experience seems a world away. Funny how the heart forgives and forgets sooo easily...oh wait, that's how we took that leap of faith to have you in the first place!

Now while you are actually 4 months old, you are only 8 weeks old corrected. We're gonna' have to do that whole actual/adjusted/corrected thing for a little while sweetie until you catch up completely. But not to worry, your big sisters caught up across the board developmentally just shy of their 3rd birthday. And today at almost 5 years old? You'd never even know their tiny beginnings.

You are absolutely in love with your play mat and thoroughly enjoy flirting with talking to and smiling at the animals hanging above you. You love all of your toys, but I think you are quite partial to Mr. Bumble Bee.

Your other favorite places to hang out are in the bouncy seat while Mommy pumps and loungin' in the Boppy.

You absolutely adore your sisters and love when they talk to you and give you snuggles. Grandma is your buddy and Grandpa is already giving you a bad time. Daddy tells me that you have late night chats and giggles after your mid-morning feed. And as for me? Well, it's pretty clear that you know who I am. We have LOTs of talks and cuddles throughout the day and honestly, I'm just trying so very hard to remember every little moment because I know how quickly it passes. I have no doubt if I blink too long I just might miss the rest of your first year.

Your other favorite place is Mommy's shoulder. You just love to be there, able to see the world while we walk around the house, the backyard, and the front yard. You are absolutely in awe of all that is around you and I can almost see those little neural connections being made when I look in your eyes.

I am also happy to share that you are nursing! While you are not an exclusively nursed baby, you are exclusively breastfed...only Mommy's milk for you! It just makes my heart beam knowing we are so very blessed to share this nursing relationship for however long it lasts. Already it is one of the most beautiful things I have ever experienced and I am so grateful that we worked so hard to get to this point.

On the flip side of that, I simply make too much milk for you and still have to pump 5 times a day right now, which has left our deep freezer filled to capactiy. Thankfully, it looks like Mommy will be a human milk donor soon enough and sick/premature babies will be able to benefit from all of the extra milk we have stored.

Your 4 month well-check isn't until the 20th and I'm not looking forward to the shots. I think we will spread them out again, giving you 1/2 of the shots this month and the other 1/2 next month. Our usual doctor is out of town, but you will see Dr. Sethi, who also happens to be our lactation consultant and she will be so happy to see how much you have grown, not to mention hear how great you are nursing!

And more than anything, I want you to know how completely loved you are. Daddy and I can't seem to get enough of you and your snuggles, sweet smiles, giggles, and coos. So many people thought we were crazy to try this again, but when I look at you I have no doubt in my mind you were absolutely meant to be the perfect addition to our family.

Love you soooooooooo much lil miss,
Mommy

Resurfacing, excuses, and the plan...

Yes, I'm coming up for air. It's only taken me the better part of 2 months, but I'm doing it...finally.

Does that mean everything has settled down around here? Oh no...it just simply means someone has the twins, Lil Miss is sleeping, I have pumped, and am still awake...shocking, I know.

The last two months have been filled with a LOT of stuff. When looking at my post queue on Blogger, there are several posts that have been started, only to never be reopened again. That's what happens when you try to compose something while pumping. I always have had good intentions with posting and keeping everyone apprised of the goings on around here. But then those darn feel good-and-relaxed hormones, oxytocin and prolactin, are released and put me right to sleep. Add to that an already extremely sleep deprived person and well my friends, you have a recipe for blogging disaster.

So there's my excuse and here's the plan. I simply MUST finish the blog posts I have started...how can I not mark her homecoming, her due date, some of our first outings, her return to the hospital, and my first Mother's Day with my three little girls? The posts will be there, eventually, I promise. Just be sure to back track from time to time and check!

Treading

It's kinda' how we feel right now...like we are treading water, just barely keeping our heads above the surface. To say we are "tired" is a bit of an understatement and doesn't really quite tap into just how sleep deprived we both are. 

And we don't even have Allessandra home with us.

But still, we are on a newborn schedule. I am pumping breastmilk every 2 1/2 to 3 hours. Considering it takes about 5 minutes to set up, 40 minutes to pump, then 5 minutes to clean up, it doesn't leave much time until we do it all over again. Add to that Robert's work schedule. Add to THAT, twice daily trips to and from Burbank for two 3+ hour visits. Add to THAT, juggling the girls. Trust me, it's exhausting. I know it's perfect preparation for Alle's eventual homecoming...but honestly, I really think it will be so much easier to just have her here and not 35 miles away.

As for our lil miss, Alle is doing fabulous...mostly. She is gaining weight like a champ and is now 5 pounds, 4 ounces (which was MY birth weight. It's hard to believe I came home at a super light 5 pounds after a 1 week NICU stay). Alle had been making BIG daily gains and then slowed down a bit this past weekend, gaining 10-15 grams a night, then staying the same weight for two days. On Tuesday morning, the nurse informed me that she suddenly gained a whopping 175 grams...um, that's like SIX ounees, IN ONE DAY! Something seemed off and to her nurse, Alle looked a little "puffy" in her legs, feet, and toes. I had noticed the same "puffiness" in her fingers (of all places) the day before, but didn't think much of it. In fact, I remember thinking how strange it was that her fingers looked so much like Mia's (long and skinny) and then suddenly overnight they were like Juliana's (short and not so skinny)...in a matter of a day. Turns out she had retained some fluid and yesterday, the doctor ordered 2 doses of a diuretic to help her pee off the excess.

As of this afternoon, she had done just that, and still managed to gain an ounce overnight. Her weight gain is certainly non-issue at this point and they will most likely  discontinue the use of the high calorie formula to fortify my breastmilk. Up until now Alle has received 3 parts breastmilk to 1 part formula for each feed and she will now receive 100% mommy's milk. 

She is still nippling twice a day, but we are seeing definite progress as she has typically taken 3/4 of her bottles in the last few days. In fact, today lil miss actually finished the WHOLE bottle, all 53cc, in under 20 minutes! It wasn't graceful mind you, and full of alarms in the beginning, and desats throughout, but she did it. Congratulations my dear Allessandra, mommy will now buy you a car seat since the prospect of a homecoming is becoming more and more real!

So in the next few weeks, we have tons to do, yet the obstacles to getting everything finished still lie in the way. Sadly, the only real way to tackle any of it is to not travel to the hospital to see her...and that is so hard to just not do. While we know Alle is under the best of care, it still tugs at our heartstrings to know she is away from us, all day, every day. It's been this way for 31 days now and I'm sure we have many more. 

Praying Allessandra comes home to us soon...

Status quo

Here we are, status quo, just kinda' doing the same ol', same ol' day after day. And while the monotony lacks much in the way of excitement, it sure does feel good for a change to not have the daily worries we did with the girls.

The only thing that really changes is Allessandra's weight...and it's going UP! She is now 4 pounds, 10 ounces and gaining each and every day. Her feeds are up to 47cc (a little over 1.5 ounces) over 30 minutes, every 3 hours. She is still having all her feeds via gavage, but we will attempt nippling from a bottle again tomorrow at 34wk3d (attempt #3 that is) and hopefully she will do well enough to be nippling once a day after that.

She is also becoming a quite mobile baby. With only the feeding tube (which is disconnected between feeds), two leeds (heartrate and respiratory rate), and her oxygen saturation sensor, she is fairly easy to disconnect, swaddle, and hold/walk with. It's not something WE are doing, traipsing around the NICU with our little girl, but something the nurses like to do with her. We think she likes it too. There is nothing more satisfying than walking in to scrub up and be startled when you turn around and the nurse has her all bundled up to say hi. A mobile baby, is a stable baby, a healthy baby. LOVE that.

As for this mama, I haven't seen my sweet girl for two days now. TWO days people. TWO. I managed to wake up with a lovely little cold bug Thursday morning and I 'm trying my darndest to just get well. Robert has been visiting at night, but mommy is strangely absent. After being will her each and every day for 223 days...hearing my voice, my heartbeat...I am suddenly gone. It hurts me to think about it and I sure hope she doesn't feel abandoned in any way. I know that's a bit extreme, but to be suddenly disconnected like this...hurts. I am making sure to send my fresh pumped breastmilk for her feeds so that she benefits from my antibodies to this lttle bug because I am sure I exposed her to it in the days leading up to Thursday. Nice mommy.

We are praying that Alle continues to do well and figures out this whole suck-swallow-breathe sequence...soon. She's got the "suck" part, but then just sits there with the milk in her mouth, holding her breath, trying to figure out what the heck to do with it. Once she swallows, she then has to catch her breath because she held it for so long. AND the vicious cycle starts all over again.

Here's hoping for a good bottlefeed report tomorrow!

Long overdue

An update on Miss Alle, that is.

(Come on, we are most certainly NOT talking about me and pregnancy. Seriously people. That's a good one. The word "overdue" and "me" will never be in the same sentence. EVER.)

I haven't really shared much about her progress on here and I feel horrible about that. I really need to be better about updates. Already, poor second, well third, child syndrome is in full effect.

Thankfully, there are a lot of good things to say and share. Having an almost 31 weeker with steroids given 12 days earlier is such a different ride than 27 week twins with steriods given nearly 3 weeks prior.

Shortly after her birth, they put her on the ventilator for a few hours to give her a dose of surfactant to help her lungs inflate properly. She then went to CPAP for a few hours...and then nasal cannula for a few hours. By the end of her first day of life, she was breathing room air with no assistance of any kind. Alle's respiratory rate was quite high however, which was probable cause for putting her back on the nasal cannula, but because her oxygen saturation rates were in the high 90s, they felt it really wasn't going to do anything to help. In fact, it might have caused some tummy issues by introducing air into her belly. So basically she was breathing pretty fast for her first week of life...but that has since improved dramatically.

Which is pretty typical of most things in preemie land...time typically takes care of most things.

Alle started feeding via gavage on day 2...just 3cc of breastmilk and once it was clear that she was tolerating it just fine, they advanced her feeds to be increased by 1 1/2cc every other feed. Before we knew it, she had reached the maximum for her weight with little to no residuals after each feed. Once she achieved that, a high calorie formula was added to the breastmilk so her feeds were in the ratio of 3 parts breastmilk to 1 part formula. Clearly it's helping her put on the weight! She is gaining 30-60 grams each day which is about 1-2 ounces a day.

On Thursday night, she reached the magic 1800 grams (about 4 pounds) when babies can typically begin to regulate their own body temperature. Before this, the isolette had been kept at a balmy 99 degrees so little one didn't have to burn calories just to stay warm. Now the top has been raised and she is in an open isolette, swaddled, and staying nice and toasty all on her own.

Probably her biggest issue to date has been some random episodes of bradycardia without apnea. Trust me, she has her share of typical preemie spells of apnea and bradycardia, but she also has some where her heartrate dramatically drops for a short period, while her respiratory rate and oxygen saturation remained unchanged. The intial thought was that it was a heart issue...an electrical/pump issue. An EKG was done and her heartrate patterns were recorded and saved each day for a while. Thankfuly the pediatric cardiologist didn't see anything abnormal in her EKG and believes that the issue is most likely related to reflux which might be causing a vagal response or hiccup in the heartrate. So while it's still not something we can for sure discount, we are praying that it's simply something she will outgrow. Since the EKG that was done about 2 weeks ago, we've already seen a big decrease in the amount of episodes she is having...again, time takes care of most things.

The final hurdle for our little Alle will be learning to feed via bottle and/or breast. The doctor ordered that she give it a go this past week, at just 33 weeks, 1 day. Typically, nippling isn't started until 34 weeks, but some babies are able to do it a little earlier than others. Well, as I expected, she had a really difficult time with it. Learning to coordinate sucking, swallowing, and breathing...is hard work. She's just not quite ready for it, but hopefully in a week's time she will be ready. They will start slow and advance more feeds to bottle/breast as she "gets it." Once she is taking all 8 feeds via bottle and/or breast, well, basically...she will be ready to go home!

Please pray that our sweet girl does well with nippling next week...that a week's time makes all the difference in the world for her. While her first attempt was pretty cute and the nurse, OT, and myself had a good laugh, deep down it breaks my heart to see just how HARD it really was for her. She was completely confused, overwhelmed, and exhausted...and I hate that. Had I been able to give her another month or more inside, it probably wouldn't even be an issue. [Enter preemie mommy guilt here].


Sigh.

All in all, she is doing fabulous. She needs only to feed and grow. I am sure she will be home in a month or so...which means we better get crackin' on getting this house baby ready.

Her story...

My last real update detailed the lovely antics of our little one in-utero. Was it a sign of something to come? Maybe? Maybe not.

2/5-2/6
Saturday and Sunday I felt some pretty intense pressure. That certainly was cause for concern since her dramatic deceleration in heartrate the day before. The strange thing was the pressure wasn't coming from down low, but rather on my sides. I thought for a moment she might be lying transverse (across the belly, head near the left horn of my uterus and feet/butt on the lower right), but had she really moved THAT much? I mean, this little one was a mover for certain, and the possibility was there.

2/7
Early Monday I spoke with my peri and he said he wouldn't be by to do the cervical length ultrasound until Tuesday night. He also planned to do a growth scan to make sure she was still on track in terms of development. I sent a text back to him, joking (kinda'), "Great...thanks again for everything. I'll do my best to stay pregnant another day!"

Little did I know staying pregnant would be harder than I thought.

Throughout the day on Monday I had some random cramps, not much that would make any normal preggo even flinch, but they definitely made me wonder if some uterine irritability was popping up.

Monday's night's monitoring session showed no contractions at all...some little bumps here and there that we had all chalked up to baby movement since my stay began at the end of January. In hindsight, those little blips just might have been uterine irritability/preterm labor all along.

2/8...
Tuesday morning's monitoring session was the a little more interesting...three good contractions within 40 minutes...3 good contractions that showed up clear as day on the tracing, but that I did NOT feel at all...a lovely genetic gift given to me by my mom, contractions you DON'T feel. Instead of taking me off the monitor at 6:40am, they said they would keep me on it until my OB came by. I did not know at the time that he was in fact called to come by ASAP by my nurses. Within 10 minutes he was there and the internal exam was NOT good. While the baby's weight was no longer pressing on my cervix, a little elbow or hand/arm was lodged inside of it, attempting to protrude through the cerclage. AND, I was dilated to 1cm, the bag of water and little body part buldging below the stitch.

He looked at me and said, "I think it's time my dear." Instantly the tears came and as hard as I tried to fight them back, they still streamed down my face. I begged him for another day, for more time for the baby, but he said, "You've done a great job. We've given the baby the steroids. You've given this baby 2 more weeks of growth inside. It will be fine, I promise you."

Still, I was terrified of the unknown. Frantically I called my husband (thankfully I had told him the night before to turn the ringer up which is usually OFF). I barely squeaked out, "You need to get here now. It's time." And what did my husband do? He hung up on me. I'm sure I sent him into a panic, first by waking him with a phone call and second by telling him we were having the baby. I called back and told him he needed to be there within the hour. Mind you, it's 7:00am, rush hour traffic, and we live 40 minutes from the hospital withOUT traffic. All of the antepartum/postparum nurses that had been caring for me during my stay assured me by the time the baby was actually delivered it would be an hour or more. They all knew that there was a good possibility that he wouldn't make it in time, but in trying to keep me calm they left that little detail out. At 7:25, he called saying the girls were taken care of and he was leaving the house.

For the next hour or so, I was being prepped. The NICU was alerted to the arrival of a 30 weeker within the hour and when NICU staff found out it was me, two of the night nurses came to see me in pre-op. When they found out Robert was en route, both decided to stay with me until he arrived. They had just come off their long 12 hour shift and still, they stayed by my side. I cannot say how much that meant to me and I'm not quite sure how I will ever really thank them for that. I also sent a frantic text to my dear friend Devon, fellow preemie mom and St. Jo's hospital regular...I knew she'd be able to talk me down from the roof. We had met in an online fertility community and then were brought closer together when by some amazing twist of fate, we both ended up pregnant at the same time...both delivering very early...at the SAME hospital...just weeks apart. I have no doubt God had his hands in that one...none whatsoever.

Thankfully, Devon was working that day...just across the street. She offered to come stay with me until Robert came and I wholeheartedly accepted...even saying that if he didn't make it, she would be his stand-in.

The anesthesiologist came in next and we reviewed my history of anesthesia, specifically spinal anesthesia and my horrible reactions to it. We came up with a plan that involved not including Morphine in the spinal, but rather giving it to me afterwards via a PSA, personal pump. He also gave me various anti-nausea medications before, during, and after delivery and over the next 24 hours.

It was now 8:25am and time for them to take me to the OR.

And Robert...was still not there. About 10 minutes away, he had decided to get off the freeway which was bumper to bumper, and take surface streets.

Devon went to get scrubbed in and suited up, just in case.

The spinal was painful...nothing like the one I didn't feel with the girls...but fairly smooth. My OB walked in the room and said, "Dad is here getting ready. Let's get started."

I think I exhaled for the first time at that moment.

The NICU team came in and said their hellos and again, it was so nice to have familiar faces around me. Just as my OB was beginning the c-section, Robert walked through the doors and of course, the tears came again.

A short minute or so later, at 8:54am, our little girl was born. Unlike her 27 week sisters, she did NOT come out crying or breathing. I kept asking if she was ok and no one seemed to answer. Robert just said they were working on her. Again I found myself holding my breath, waiting for something...anything. A very LONG minute later, I could hear her little cries from beneath the oxygen resuscitation bag.

And again, the tears came flooding.

The delivery of placenta, cleaning out of the uterus, replacement of body parts, and closing me up were nothing short of torture. Ah, the joys of a c-section. With the girls' it was a breeze. This time without Morphine on board, while not in pain per se, the pressure was overwhelming and left me cringing and writhing throughout the process. My OB also let us know it was in fact her elbow that was lodged in my cervix, which at the time of delivery had dilated to 3cm WITH the cerclage still in, and the stitch was now embedded in the tissue of my cervix. It most definitely was her time to come, as hard as that was, and still is, to accept.

Recovery was okay...not so great. I managed to have an untimely panic attack within the first 30 minutes, with horrible chest pains, shortness of breath, and overall discomfort. The pain was becoming unmanageable as well as we waited for the Morphine pump to be sent up from pharmacy. After a few hours and a steady flow of Morphine, I was feeling much better and was sent up to postpartum...once again, without a baby by my side.  It was the one thing I had longed for, hoped for, and prayed for in this pregnancy...over and over and over again.

But I guess it was not to be.

Little Alle came into this world, just as He had planned. She was the gift we had prayed for and with her came...

...a first trimester wrought with complications,

...a completely normal, uneventful, and quite enjoyable second trimester,

...a third trimester that would last just a few short weeks and one that would be spent mostly in the hospital on strict bedrest,

...a rather sudden and dramatic delivery,

...and the experience of having a preemie,

...all over again.

In the years to come, we will see what else this little one brings to our family, but we can undeniably say she has made our family complete. To look at that sweet little face and think that she was almost taken from us so early on is just unimaginable. I have no doubt in my mind that her story is, and will continue to be, an amazing one.

Our third blessing, our third miracle, our little Allessandra Hope...

Happy Birthday Little One

Our sweet little girl, Allessandra Hope, arrived February 8 at 8:54am. She weighed 3 pounds, 5 ounces and was 16 1/8 inches long.

It's been a little crazy and I'm sure once I am settled back at home I will be able to post more about her birth story and how amazing she is!

1 hour old...

 1 day old...1st feed of breastmilk and kangaroo care with Mommy

 1 day old...snug as a bug

 2 days old...more snuggle time with Mommy

2 days old...our sweet girl

Not yet

I didn't think I'd need to do an update so quickly, but my tweets are making people call, txt, and email...asking what is going on.

Friday night, I had my typical night monitoring session. They are about an hour long and serve as a non-stress test of the baby and a record of my uterine activity.

The baby's heartrate is monitored and a baseline is noted. Last night, baby was staying between 130-140 bpm. They want it to stay between 120-160 bpm, so it was very much within normal range. They then watch to see how the baby's heartrate responds to his/her movements. Baby Lewis typically has done really well during these monitoring sessions. S/he begins the intrauterine gymnastics routine and his/her heartrate rises and falls and recovers nicely.

But Friday night something happened.

The baby's heartrate was climbing with increased movement...and climbed quite high...into the 170s, 180s...which might have been fine if it recovered near the baseline, but it didn't. Instead it plummetted.

I like to listen to the baby's heartbeat, so they always keep the volume up for me. I heard it racing and then it slowing, to what seemed like a complete halt. I poked and prodded trying to get baby to respond, but nothing. Two nurses came running in, rolled me on my left side and put an oxygen mask over my face. One was tending to me and the other trying to get the baby back on the monitor. I asked how low the heartrate went, but they wouldn't tell me.

Baby did recover and over the next couple hours never had another episode like that, but it sure did make everyone take notice.

That night was a rough night of sleep. All night I tossed and turned. Every time I shifted position, I would push a little on baby's butt/back and wait for a response...just to be sure everything was still ok.

Saturday morning I woke up and Dr. P was definitely concerned about what had happened. His first question was, "Have you eaten or drank anything this morning?"

I hadn't...I had JUST woken up. And he was happy about that, "We might be having a baby today."

My heart dropped.

He did an internal exam, concerned that the baby had maybe dropped or settled lower in the birth canal compressing the cord, maybe the baby's bag was bulging, maybe that I was even dilated. Thankfully, none of these were found to be true. In fact, the baby has shifted position a bit and is no longer resting fully on my cervix.

And that is a GOOD thing.

Saturday morning I was monitored for 5 hours and then taken off. I will be monitored 2 times per 12 hour shift now, for 1-2 hours each time. It was going to be continuous, but during the 5 hours Saturday morning, the baby was perfect...leading my OB to believe it was in fact an isolated, random occurrence rather than something ongoing.

Still, it is very unsettling. I am not so worried about the daytime when I can personally monitor the baby's movements, count kicks, etc. It's night that worries me. But the good thing is I will be monitored twice, from 8-10 and then probably again 2-4. It means little sleep, but that's a small sacrifice for piece of mind.

This whole little event has thrown me for a loop. I've been so concerned about my body giving out before baby was ready, I've never really worried about the health of the baby because s/he has done so amazingly well despite everything. Now it just adds a layer of worry to it all...is the baby in any kind of distress in there?

This week is a big week...

Monday or Tuesday will be another ultrasound of my cervix and hopefully, baby too.


Wednesday is 31 weeks.


Thursday is 31wk1d...2 full weeks from hospitalization and steroids. If my doctors feel it necessary, we will do a course of rescue steroids sometime between 31wk1d and 32 weeks. That should carry us right up to 34 weeks when steroids are typically no longer administered.


Friday is 31wk2d...2 full weeks from the first fFN test which was negative. A repeat test will be done and we will see what it says.


Nothing would be better than to make it to Thursday/Friday when we can repeat the steroids and really provide the most protection possible for this baby.

But even if Baby Lewis comes tomorrow, we rest in knowing that we've already done everything possible to ensure the best outcome for baby and me.

30+2

So you can see I snuck a little post in there without giving it it's own day to sit on my blog. I had it finished early Thursday morning, but didn't want everyone to get all worried about me. I decided to wait until I posted an update to sneak it in there.

(And yes people, I really am ok emotionally. I won't say this isn't hard and that I'm not feeling those things...but it ebbs and flows. There are good days and bad days...and even good and bad parts of each day. I even saw the social worker today...and I guess I passed the test, answered the questions right, so they aren't all that worried about my mental state here).

Baby Lewis is doing well...being a little stinker on occasion during monitoring, but what do you really expect when my twice daily monitoring sessions tend to occur RIGHT after a meal and not to mention that s/he really isn't all that fond of the monitors poking him/her in the shoulder/back. Rather than sit nicely and just be, s/he would much rather try to kick, punch, hip check, and shoulder throw the monitor in attempts to get it off.

My OB was by this morning, as he is every morning bright and early, and okayed clothes and my IV be removed. After a shower, blow dry, and an actual shirt, bra, undies, and pants...I feel like a whole new mama. Nine days in a hospital gown, free as a bird mind you, is just so irritating. I change sides all day long and I would constantly argue with that darn thing, practically ripping it off from time to time.

I am feeling a little blech today. No contractions, but my uterus is sore and cranky. It's not showing up on the monitors but something is happening...most likely a growth spurt for baby and me. I full expect it to set things in motion at some point. I am certain that the contractions will eventually start and the IV will have to go back in and my clothes will be ditched, but even an afternoon of these luxuries is enough for me right now.

I plan to do a belly shot or two later. Want to make sure I capture 30 on film.

And really...that's all. Hoping and praying to make it through the weekend for another u/s on Monday. I really want to see what's going on down there and maybe even get to see how Baby Lewis is doing developmentally/growthwise.

Praying, praying, praying...

Guilt

I feel it on so many levels right now...

...and it just plain sucks.

A lovely little cold/flu bug is sweeping through the house and taking down victim after victim. Both girls are sick. Robert is fighting it. My mom is fighting it.

Sick = no visits. And that certainly is difficult on the psyche...remember, it's just me and my little "room with a view"...kinda'.

But what hurts even more is not being there to help. My little girls are waking up crying for mommy to make it all better, to snuggle them, to put a washcloth on their foreheads, to wipe their noses, to stroke their little heads, to hold them tight, to tell them it's going to be alright.

And I can't.

Ouch.

To top it off, Daddy and Grandma aren't feeling great. They are doing their best, which is an amazing job, but I know to say this is "hard" on them is an understatement right now. Oh and then there's that other little thing called "work" that both need to do on occasion as well.

Despite our world being turned upside-down...life is still moving at the same pace and my poor family is desperately trying to keep up...with all of this other stuff coming down upon them like a ton of bricks.

Part of me feels as if I have snuck away and am "oh so conveniently" side-stepping all of my duties as mommy and wife. I feel helpless, lazy, and useless. I am of no help to my family at home and as I sit here, my body is failing this baby as well.

The days are long and the nights are hard. I've done this before and I know a light lies somewhere ahead...I just don't see it yet. I feel caught in this quandary...wanting desperately for my body to hang on and give this little one more time inside so life on the outside won't be an even worse struggle.

Yet this horrible little part of me wants to go home against doctor's orders and take care of my family...even if it means the baby might be born far too soon.

And for that last thought, I feel a huge sense of guilt. Here I am, 30wk1d and I still have not truly become attached to this baby. It's not that I feel nothing...it's just that I don't feel something all of the time. It comes and goes...which is strange.

To this day I catch a glance of myself in the mirror and have to do a double-take...like whoa...who is that big ol' PREGNANT lady? Seriously, it's me? No way. We're gonna' have a BABY? You're joking, right?

I have no doubt in my mind that once this baby is here, she or he will be loved and cherished more than anything in this world...but until that moment is realized, I'll still be sitting here in disbelief.

I miss my family. I miss my home. I miss my doggies. I miss my bed. I miss my couch. I miss my food.

Yet, I know this is what I HAVE to do...and do it...I will.

Hotel Antepartum

Well, looks like this is home, for now. 

I saw my OB this morning and he said he decided not to do an internal until later this week. He does not want to disturb anything in there and since there really have been no physical changes or signs warranting "checking" my cervix, there simply isn't the need. In his words, we are day-to-day...but he is optimistic.

And he casually slipped out of the room, off to a surgery that was to happen in 3 minutes time. I wanted so badly to ask what "optimistic" meant in terms of days, but I know he can't answer that. No one can.

Today was very quiet and I didn't do much. Dozed off and on this morning....dozed off and on this afternoon. Visited with my sister-in-law on her lunch. Enjoyed an evening with the hubby, a shower (if you want to call it that...more like rinsing off with a waterpick), yummy Chinese take-out, and some mindless reality TV.

My monitoring sessions went well. Baby Lewis is very "reactive" with good accelerations and decelerations...and of course, lots of movement. S/he is not so fond of me laying on my back with the monitor pushing on his/her little back. His/her main goal seems to be how the heck can I kick this thing off of me or get away from it. Sadly, I think this little one is just too wedged in there--head down and butt stuck in that one horn--to really move anywhere else.

At the end of both sessions, I had one contraction. Kinda' like clockwork as my bladder fills up and I've just been on my back too long. If I am on my sides, I simply don't contract.

Tonight I also was visited by my peri who did a vaginal ultrasound to see where my cervix is at. Overall, the length of my cervix is much shorter...last Thursday it was 3.37cm and tonight it was 2.25cm. It could be a little longer, but it was a different ultrasound machine and he said he was being very conservative...not giving my cervix ANY benefit of the doubt.

And of course, it looked fine. No funneling. Which is what it appears to be doing while my uterus is at rest. But, then he pushed on my uterus and there it went...shrunk down to nothing, right to the stitch creating that lovely little funnel. There is still about 5mm from the stitch with a little bit below it.

The good thing is that it isn't any worse and that it most likely isn't like that ALL day long...just when I am contracting...which isn't very often and almost always the cause of a full bladder and not any kind of preterm labor.

Still, it was disappointing and my peri definitely shared his frustration with my cervix as a few expletives came out of his mouth. He's a good Christian man, but clearly he was genuinely upset. I assured him that where my cervix is concerned, all profanity is completely allowed and justified...if not expected.

We all laughed.

He is fairly certain that after he speaks with my OB, they will agree to keep me here, mostly because it is safer and my darn cervix is just so unpredictable. We live 40 minutes from the hospital and it's just not a risk they want to take right now.

There will be discussion as the days progress of 1) whether or not to repeat that fFN test after 2 full weeks, and 2) whether or not to repeat the steroids after 2 full weeks. It just depends on whether or not I am still pregnant at that time and whether or not either will make a difference.

We are all settling into this new normal. It's hard on everyone, but mostly Robert. Between work, the girls, the house, the dogs, and well, ME...he has a lot manage. Not to mention at some point he must be dealing with his own worries, doubts, frustrations, and fears. Yet, he is a truly remarkable man and is simply taking it all in stride. Family is making adjustments and helping out wherever possible and for that, we are so grateful. We all know it takes a village to raise a child...but when you're talking about me, it takes a village to keep me pregnant. Thank you to everyone for your support, prayers, and helping hands...we appreciate you all more than words could ever express.

On antepartum floor and still cookin'...

So here we are...made it to an antepartum room on the 4th floor. It is quite tiny, but I don't need much space. Clearly it isn't a room meant for someone who has just had a baby because it's quite tight...no room for a bassinet, not even a couch or pull-out chair for someone to stay overnight. After a little begging I was able to at least get a small chair in the room for the occasional guest which will work just fine. I haven't had more than one other person in here with me at a time, so I can't quite imagine tonight's visit with Robert AND the girls. :)

YET...I am soooooo looking forward to seeing their little faces and snuggling with them even if it's only for a short time.

We've been trying to do Face.Time whenever possible and that has helped them a bit...I think. I'm still not quite sure if it's helping me or making it harder. It's just so hard to lay here and wonder when will I be home again? Will it be this week? Will I still be pregnant? Will it be a month from now? And again, will I still be pregnant?

And yet no one knows. (But if you do by chance have an idea, a vision, a hunch, a crystal ball...I'm happy to hear what it is!)

My OB was here this morning and said he wouldn't torture me with an internal exam today. My peri will be here tomorrow for another ultrasound and I'm sure my OB will do an internal as well. With those two pieces of information we should have a better idea of what is going on and what to do next...if anything.

Right now, I'm just trying to lay as low as possible and keep the weight off my cervix and give that stitch a little relief from all that it's trying so desperately to hold in.

I have shower and bathroom privileges still, so that's a good sign.

Still no contractions or cramping.

Baby Lewis looks great on the monitors and is doing very well.

Nothing else to really report. My IV might be removed soon...it's just a hep-lock right now, ready and waiting should they need to administer meds quickly. But it's been in for a few days and it's time to either move it to a new site or just remove it altogether. I will receive my lovely support hose in the next few hours as well to help with the circulation in my legs since I have been off my feet since Thursday. At least it's not the leg squeezers just yet!

Apparently there are lot of us "sitters" here in L&D and Antepartum right now...a bunch of women trying desperately to give our little ones more time inside. I am a bit further along than most of them and I know that many are facing the possibility of delivering soon and facing long NICU times if their babies are born now and, God willing, survive. I offered to reach out to them via the nurses...I know how this goes and I know how hard it is. I'm not sure if anyone will feel like chatting over texts, but I just don't want anyone to feel alone in this waiting game...especially when it's something you've never been through. It is a feeling of uncertainty, fear, sadness, guilt, anxiety, and worry, like no other.

You feel as though the fate of your child rests in your hands, well, your body...which is failing...yet you have NO control over it. None. What. So. Ever.

Sure, you can pray, you can hope...but you can't will it. You can't close your eyes and clench your fists and make your cervix get longer. You can't make your bag of waters magically reseal if it has ruptured. You can't make your blood pressure go down just by practicing some deep breathing. And you cannot tell your uterus to stop contracting...though trust, me, you try. No matter the complication that has led you here, your body will do what it is programmed to do...for better or worse...to ultimately save your life.

I just hope and pray that these women, and myself, are able to give our little ones the time they need. And truthfully, prayers and positive thoughts are about all we can really ask for and offer each other.

The latest

I am happy to say that today is ending on a much better note than it started on.

When I woke up this morning, my OB greeted me with a rather somber tone...which is very unlike the man he is, typically upbeat, optimistic, old school, liberal, relaxed in his approach.

He sat down by my bed and said, "Baby is doing fabulous, thank heavens for that. Our goal here is to give you that steroid shot at noon, do the fFN test in the afternoon, and hope that we can squeeze 28 more hours out of this pregnancy."

As if that wasn't hard enough to swallow, his last sentence as he walked out the door was, "I'm not going to make any grim predictions...but I think we're looking at delivery soon, unless we see some dramatic changes for the better."

And that was that.

GULP.

The steroid shot came at noon and ouch, it's a doozy. It's not that I don't like shots, well, not like I really DO, but when you receive up to 4 shots per day for weeks on end...shots just aren't that big of a deal until someone different does it. I'm used to the quick dart method, but man, these nurses are not so into that. Instead, it's the slow push in method and I just about wanted to turn around and do it myself!

My uterus has thankfully been very quiet, but just before the shot, I had one really good contraction...one that was about a minute long and took my breath away. I received the shot about 10 minutes later and proceeded to have 3 more contractions spaced about 5 minutes apart. I was really worried it was the start of something, but a quick trip to the ladies room and a roll to the left side did the trick and kept things quiet for another 4 hours or so. It seems my body is having about 1 contraction have 2-4 hours which is not labor.

Still, they are watching and waiting.

Contractions are what typically cause the pressure that allows the cervix to change. In my case, my cervix is changing without the contractions. My OB said the pressure of the baby who is quickly running out of room in my heart-shaped uterus is causing the changes and contractions will only make it worse. Right now, Baby Lewis is head down and tucked in the left horn of my bicornuate uterus. S/he did manage to flip head down in the last couple weeks, so there is room...but the right side is still completely empty and unfortunately very difficult for the baby to get to.

A few hours after the shot I had the fetal FibroNectin test done...yeeeeOUCH. That's all I'm gonna' say people. Read up on the method used and you will understand WHY it hurts so much ladies. Fortunately, I won't have another for 2 weeks...if the negative result we received truly means that I will NOT go into labor in the next 2 weeks.

That is, unless I am in the 1% category for which the test is invalid.

Ha, ha, HA...right?

My OB stopped in a little later and said he was very pleased at the test result and plans to assess me tomorrow or Sunday via internal exam to see if there are any changes, for better or worse. Fortunately the nurse who did the fFN test noted she did not see any signs of blood, discharge, mucus plug, and my cervix was closed.

There is a chance that if the contractions stay away, I might be moved to the 4th floor Ante/Postpartum unit for monitoring...either for the duration of the pregnancy OR until things take a turn for the worse OR until things stabilize enough to send me home on strict bedrest.

My peri came by after my OB and said he wants to do another vaginal ultrasound on Monday or Tuesday to see what is going on from inside and do a growth scan of the baby to see where s/he is at in terms of development. He is thinking that will all of the information from the tests, internal exams, and ultrasounds, they will have a pretty good picture of what is going on and the course of action to take.

So it appears that I will be here until at least Monday, possibly Tuesday. But maybe, just maybe, HOME after that...if I am still pregnant. Which trust me, I so hope and pray to be.

Not being home is hard...harder for such different reasons than when I was in the hospital when I was pregnant with the girls. Back then I missed my doggies and my husband.

Now I miss all of that...and my girls. And while I know my doggies miss me, and so does my amazing husband, our girls are having a hard time. Bedtime is our thing...our time together.

We have a wonderful routine and it's something I think the girls and I look forward to each and every night. Daddy doesn't quite enjoy it as much as I do...but he's on the fast track now.

It starts with getting ready for bed, cleaning up, brushing hair, brushing teeth, then getting into bed. The girls choose 1-2 books each and we read for about 20 minutes. After reading is singing time...their favorite lullabies and other quiet songs. Then it's our prayers. And finally our whispered "I love you's" and "Goodnights." All the while, their little heads rest on each shoulder and I stroke their hair. After the goodnights, they will usually roll to the opposite side and doze off in a matter of minutes, as I rub their backs. It's our snuggle time. Our mommy/daughter time without any distractions...and though it's a process that takes a good 45 minutes from start to finish...

...I cherish it.

So far I've had two nights without it and how hard it is. It's different than going away for a night to a hotel...I'm in the hospital which comes with fears and unknowns. The girls don't understand why I cannot be at home...why I am not coming home today...why I have to stay. We try to explain, but ultimately, they just want me there and trust me...I want to be there more than anything.

But daddy is there and doing an amazing job. Tonight Juliana had a very hard time falling asleep, so they called me and together, daddy and I put her to sleep. We sang our songs (and of course, I couldn't get through the last sentence of "You Are My Sunshine" without bawling my eyes out and having to put the phone down. Daddy came to the rescue and together we talked her to sleep.

He is pretty incredible...which reminds me, it's time for my bedtime phone call...so he can talk me down and to sleep.

I will update more as I know it, but for now, keep the prayers, positive thoughts, and good vibes coming...clearly they are working and we are so incredibly grateful for the overwhelming support.

With much love...

The time has come...

Ah yes, the time has come. Today I was admitted to the hospital, most likely for the duration of the pregnancy with a teensy, eensy, weensy chance I might be able to go home on strict bedrest. But folks, the chance is REALLY slim.

At 28 weeks, last Thursday to be exact, I had a day of tons of irritability and about 3-4 contractions an hour. It eventually eased up, but it was a it unnerving. I spoke with my doctor that evening and if things didn't settle down, I was to head to the hospital, but if they DID, I was to come in to see him first thing in the morning. The next morning I went in and the appointment went well. All checked out okay (no ultrasound) and I was sent home with a prescription for a tocolytic medication to stop contractions...to take "as needed." Thankfully, I filled the prescription and haven't needed it.

And still don't, but.....

Today I had a cervix check...no ultrasound of the baby, just my cervix. Oh, my lovely DYNAMIC cervix. Well, if it was dynamic last time, today it was nothing short of a show stopper. Literally.

Let me explain this ultrasound. The left of the picture shows the babies head. Yes, baby is head down now which explains some increased pressure and why when I looked in the mirror yesterday I suddenly had a space between my belly and boobs that hasn't been there for a few weeks.

To the right of the head is a black area which is amniotic fluid and the bright white outline that is sitting so nicely in that large funnel is my bag of waters, membranes, sac, whatever you want to call it. Continue to the right and you will see a dark line with bright white at he top and bottom...that is the cerclage or the stitch and the bright white little lines are the knots. That is what is reinforcing my jacked up cervix and keeping it closed...for now. Continue to the right further and the cervix ends where the area becomes a little lighter in color.

I wish I had a picture of the first ultrasound and actually, I'll have to text my peri to email me a picture of it for comparison. When he initially measured my cervix today, it was measuring 3.37cm (up from last time) and there was NO funnel. Where the black area juts majorly in and to the right creating that V...it was NOT there. It was a straight, well slightly curved line near the baby's head. That is what a NORMAL cervix looks like...if it stays like that.

Just as he was gushing at how great it looked, he applied fundal pressure to mimic a contraction (pushing on my belly) and we watched the monitor as that curve became increasingly V shaped and kept getting larger and larger and larger as my cervix got shorter and shorter and shorter. It seemed to stop...right at the stitch. He said there was only about 5mm from the end of the funnel to the stitch.

Five millimeters people. That's NOTHING. From the stitch to the external os or opening, there is about 1.5cm. But the long and short of it (no pun intended), is that the stitch is holding my cervix together and keeping this baby in.

PERIOD.

My peri then looked defeated, disappointed, and concerned. Flashback to the first time we saw him for this pregnancy and things looked so dire...that I would have to take medications to induce the miscarriage of two babies and possibly lose my uterus to save my own life.

Trying to lighten the mood, he joked with my husband, "I guess I might owe you that coffee Robert." And of course, my husband started telling him how he likes it. You see, they have had a bet this whole pregnancy as to just how far I'd make it. My peri said all the way, my husband said, 30 weeks.

Thanks for the vote of confidence, honey.

My peri then recommended, oh so casually, too, that I head to the hospital to receive the steroid shots just in case I were to deliver soon. He called my OB and had me stop there first and my OB confirmed via internal manual exam that I needed to go to the hospital. He could feel the pressure of the baby's head sitting right on the cerclage/stitch.

So here we are. I am settled into a nice Labor and Delivery suite for the time being. I received the first of two betamethasone steroid shots at noon and another will be given to me at noon Friday. Each shot takes 24 hours to "do its thing"...help mature the baby's lungs. So after 48 hours, we have given this baby the most protection we can provide if she or he were to be delivered within the next week. The effects or benefits of the steroids do wane over time. In years past, doctors would give high-risk patients like me the shots every 2 weeks until delivery, but research demonstrated that could have serious long term effects...so that practice is not generally adhered to anymore.

I will also have an fFN test done tomorrow after the second steroid shot. This test helps predict the chance of preterm delivery within the next two weeks. There is some question as to whether or not it will give us any more information or alter the precautions already being taken, but they are going to do it anyway.

The good thing is I am not having any contractions...some irritability, but not contractions. That means no meds for those just yet. Right now I just have to stay horizontal to keep the weight off my cervix...get these shots on board...and pray.

The first night in the hospital is always the hardest (sad that I've done this enough to know). We are in a much better place this time around in terms of gestation.

And knowing how amazing my girls are...my 27 weekers...it does put my mind at ease...a little bit.


Still, it's hard to not feel the sense of failure...yet again. Trying to push those thoughts aside, but mommy guilt is ruthless.


Praying, praying, praying...


...that Baby Lewis continues to do well...


...that we are able to receive both shots and give them the time they need to work...


...that my dynamic cervix calms down a bit and stabilizes...


...that the contractions do not come...


...that my membranes do not rupture...


...that the fFN test is negative...


...that we can give this baby the gift of time (3 more weeks to be exact)...


...that Robert is able to hold down the fort at home...


...that my girls will adjust to mommy not being home...


...that they will rest well tonight, despite knowing how hard it is on them all...




Please God, give us more time...

More

Well, here we are...

...officially MORE pregnant than ever before.

Surprisingly, I find myself a little more on edge now. Maybe it's because it's unknown territory? Or maybe it's because I feel like now we're working on borrowed time?

Or maybe it's because I just don't know how far this will all go?

Crystal ball anyone?

Unfortunately, my cervix and uterus are the only ones that know the answer to that question.

Fingers crossed, prayers said, that we make it to our next doctors appointments at 29 weeks and my cervix and uterus are still playing nice.

Email from peri...

My peri emailed me back today with his thoughts on my cervical lengths on Thursday...

"I believe that what the ultrasound demonstrates is that your cervix is quite dynamic. However, with that being said, both the resting cervical length [of 3.27cm], as well as cervical length after fundal pressure [of 2.95cm], are still both normal, even if it is the low end of normal. The most reassuring sign from my perspective is the fact that there is still ample cervix above the level of the cerclage [that is, from the stitch to the internal os of the cervix which opens into the uterus]. I think you can maintain your current activity level and rest as often as you can as you have been doing. The decision regarding hospitalization will not be made strictly on the basis of cervical length, but will take into account membrane funneling. If we see membrane funneling close to or at the level of the cerclage then I would favor hospitalization. My hope is that this will not occur."


When he talks about membrane funneling, he is talking about the internal portion of the cervix from the internal os to the stitch/cerclage sewn around and through my cervix, opening up like a funnel or capital letter Y which would allow the amniotic membrane or bag of waters to sag into the funnel. 


At 24wk5d with the girls, my total cervical length was 1.8cm, but from the internal os to the stitch, it was only 2 measly millimeters and funneled pretty much right to the stitch. And there was Baby A's bag resting in the funnel...which is why I was hospitalized.  


Right now I am resting in knowing that he considers there to be "ample cervix" between the internal os and the cerclage and no funneling. Still, I don't think I am as optimistic as he is. I feel fairly confident we can make it to 30 weeks...I would be thrilled to make it to 32 weeks...and I would be absolutely over the moon to make it to 34 weeks. 


We just have to wait and see...

27 + 2

Well, here we are at 27 weeks, 2 days...the exact gestation Juliana and Mia were born at. Looking down at my belly, I can't quite fathom having this baby today...that something so small could survive and one day be all that my little girls are. Amazing.

Simply, amazing.

My OB appointment went well Wednesday. They gave me all of my test results right off the bat. I passed the 1 hour glucose challenge test (phew), but my iron levels are borderline low, and my rubella titer continues to decrease. So while I don't have to worry about the 3 hour glucose tolerance test, I do have to up my iron intake and will most likely receive a rubella booster shot after delivery.

Weight was just up a pound to 158, so 23 pounds gained in 27 weeks. Heartbeat sounded strong and in the usual 140s range. Blood pressure 100/60. Fundal height 27.5...so just right.

He shared with me that he and my peri are very happy with how I am doing and he even went so far as to say I'm doing "fabulous."

Um, "me", "fabulous", and "pregnancy" in the same breath? Seriously?

We also talked about when it would be time to call it game over if things continued to go well. His biggest concern is my uterus and the chance of rupture due to the prior c-section done at only 27 weeks, the c-section scar itself, and the fact my uterus is heart-shaped and cannot expand as completely as it should. In his game plan, we will do an amnio at 36 weeks and possibly deliver...that is, if I haven't delivered by then already. I don't think he really plans for me to go any further than that because the risk of rupture is too great.

My peri appointment went well yesterday as well, but has left me with questions. My cervix is measuring 3.27cm and then with fundal pressure applied (pushing on uterus to mimic a contraction), it goes down to 2.95cm. Now that's not a HUGE change, but it is a change...whereas before there were no changes with fundal pressure. Any measurement above 3cm is considered normal...so do I fret over the 5/100ths?

Of COURSE I do people!!!

I ended up emailing my peri an hour later and asked him to really share with me his thoughts on that change with fundal pressure applied and he hasn't gotten back to me just yet. I told him not to rush, so I'm sure I'll hear from him tomorrow.

From the research I have done, the cervix...well, a normal cervix...should measure between 3 and 4 cm before 28 weeks. After 28 weeks, it will slowly shorten on it's own in preparation for labor. Measurements below 2.5cm are cause for concern and biweekly measurements...which I'm already doing and we're not quite there yet. Measurements below 2.0cm are really worrisome and usually mean bedrest and weekly measurements. Measurements below 1.5cm mean hospital bedrest.

The good thing is that the cerclage acts as a reinforcement to my cervix. The portions of my cervix immediately above and below my cerclage are thicker due to the scarring that the cerclage causes...therefore, it is more difficult for them to change and soften.

Now despite my frets over the .5mm I am below 3cm, my peri assured me things look great and he is very pleased. In his own words, "This looks like a 39 week pregnancy." When I asked him about my uterus and the chance of rupture, he was not nearly as concerned as my OB...which did surprise me quite a bit. I am guessing my OB will be the one that is watching my uterus very carefully and not him.

The last tidbit of info is that my last 17p shot will be at 34wk4d...if we make it that far. I don't have any refills after that and the peri said that's close enough.

There you have it...consider yourself up-to-date on all things Baby Lewis! We do have a website for this little one (finally). I have actually had it since October, but just wasn't ready to take the leap of faith of sharing it at that point.

It is a work in progress...one that will be worked on heavily in the next week as I add scanned ultrasound pictures, ultrasound video clips, and more baby bump shots. The journal entries are the same as the ones here and I plan to continue posting the same entries on both the blog and website.

www.ourthreemiracles.com

Stream of consciousness...

25wk6d...we are very close to midnight, so I'm calling it that. :)

I have so much swirling and whirling around my brain tonight...so much, that I just need to let it out.

The house is quiet, very quiet, and Baby Lewis and I are relaxing on the couch. Between 9:30-10:30, it's this little one's awake time, and boy did I ever cherish the little gymnastics routine that went on tonight.

In the past 24 hours or so, I haven't felt a whole lot of movement...really, nothing. It was quite unnerving and I found myself taking back all of the comments I've made to myself over the last few weeks about wishing this little one would lay off my cervix and kick elsewhere. Trust me, today I would have gladly taken a swift kick ANYWHERE, just to know s/he was okay. I poked, I prodded, I drank juice, I ate sweets, I laid flat, I laid on my side.

But nothing.

Finally at dinner I had two little taps and breathed a sigh of relief, but I still wasn't satisified. I wanted that big wallop and thankfully, it came around 10:00 tonight.

Exhale.

As I put the girls to bed tonight, I found myself kissing their little faces and thinking, "How can it ever be better than this?" In my eyes, they are perfection...every square inch of their little bodies. Even with the few lasting effects of their prematurity...the ones that will always be...they are perfect.

Despite being born at 27 weeks...a gestation we are quickly approaching with this one still tucked safely inside, they are perfect.

They survived.

They are thriving.

I'm not sure what I will do if/when 27wk2d finds us still pregnant. I'm sure I will wake up giddy with excitement and exhale a big sigh of relief, yet again. And if we are blessed enough to make it to 28 weeks, who knows what kind of party we'll be having!

In some moments, like now, it all seems so attainable. Yet in others...like the last 24 hours...I wonder if this is it. It's such a mental battle.

Of course, everyone has their guesses as to when this baby will come. Many friends and family are saying 32-33 weeks. My peri is thinking all the way. My OB is a little more conservative and just keeps telling me to make it to 28 weeks (as if I have any say in that). My husband says 30 weeks and when I stop worrying about making it to that point, my body will just let go.

Um, thanks honey for the encouragement.

I wish I could say I have my own guesstimate, but I don't. Really, I don't. I am living day to day and praying constantly that we make it to the next. I know all too well from my own experience and that of close friends and even complete strangers in blogworld, that things can be more than fine one minute and take a dramatic turn the next.

And really because of that very fact, I cannot think very far ahead. People are asking when I will start getting everything ready...pulling down tubs, washing everything, taking inventory. I start thinking about what we need in terms of "stuff" and I just can't do it yet. I even have a website for this baby, similar to the one that girls had for my pregnancy with them and their first two years of life, but it remains unfinished and barely set up. In many ways, I don't think I will be ready to think about anything until we hit 27wk2d...28 weeks even. Of course, I'm sure once we do hit that mark (God willing), I will be a crazed maniac trying to pull it all together in the final hours. But that's just how it's going to have to be.

11 more sleeps til 27wk2d...

The happenings...

It's been a busy couple weeks with the holidays, which is why this update is a little late. The good news is that it has the most current information since I had two appointments this past week!

Before we get to where we are at TODAY, I do have to confess that I found myself in Labor & Delivery (L&D) last week after two days of constant irritability and contractions. Around 5pm on Tuesday, that was it. I made the call and the doctor on call (my OB's partner) said because we were 23wk6d, it was time--time to head to the hospital to see what was going on...because we now had "a viable pregnancy" and if I was starting preterm labor they could give me the steroid shots. And by viable, I mean we had reached a point where this little one, if born, would have a 50% chance at survival. From this point on, the rates go up with each passing day, which is why every day means so much to us.

After drinking about 32 ounces of water in an hour...and despite having to pee every 5 minutes as a result...we made it to the hospital and of course, the irritability and contractions stopped. My uterus was quiet as can be on the monitor and the only blips were caused by the baby's gymnastics routine taking place every 5 minutes. After an hour and a half of monitoring, I was sent home. Since then, I haven't had a day like that...which may be due in part to my upped fluid intake which clearly makes a BIG difference in how calm or irritated my uterus gets.

By the weeks end, I would hit 24wk3d and spend Christmas at home...my Christmas wish. We even ventured out to the children's mass at the parish where my brother in law is a priest. It was a wonderful Christmas spent with both of our families.

Monday came, as did 24wk5d, and I had a growth scan and a cervix check with the peri at his new office in Burbank. The new exam rooms are amazing. They are huge with a large LCD monitor mounted across from the exam table for the patient to view the ultrasound as it is happening, as opposed to having to share the monitor with the doctor as you crane your neck to the right.

Baby Lewis was looking great, measuring right on track in all areas. We even managed to get a few decent 3D shots of the baby, but trust me, my children clearly do not like their picture being taken while inutero...that is, until they are born and then they know they have no choice!

I was super concerned about my cervical length, especially since I had the trip to L&D the week before and a few REALLY busy, on-my-feet-WAY-more-than-I-should days with pre- and post-Christmas activities. Thankfully, it was measuring good...okay...normal. It was our shortest measurement yet at 3.3cm, but considering it has been 3.76cm, 3.8cm, 3.4cm, 3.62cm, and now 3.3cm, my peri is still very pleased with it. It's kinda' gone back and forth between 3.3 and 3.8...which is a 1/2 cm range, but it's still above 3cm and that's fantabulous for me. I confirmed with Dr. I the "threshold" we were looking for which would mean hospitalization and he said anything below 2cm. My next check will be at 27wk1d...1 day shy of the day I would deliver the girls and right now I am just praying to make it to that point without any drama.

Thursday I had an OB appointment at 25wk1d and it was the usual pee in a cup, measure the uterus, take vitals, weigh me...ahem...YIKES...and talk about my concerns. My fundal height is around 26 weeks, so I'm still measuring a week ahead. I am up to 157 lbs....with clothes, shoes, and a jacket on mind you! That puts me up 22 lbs. at 25 weeks. We then talked about "the plan" and I finally got confirmation that I will NOT be trying for a VBAC. My only option is a c-section for a couple reasons:

1) I have a cerclage in place and in order to try for a vaginal birth, that has to be removed first. The question is when do you remove it? For most normal women, you do that at 34 weeks and then have the baby 4-6 weeks later. Well, for me, trying to pinpoint when is the right time is not easy. Once you remove the cerclage, the possibility for introducing infection goes way up and my OB was honest with me...he said he really doesn't want to take any risks here.

2) The most significant reason is my uterus is bicornuate, or heart-shaped, and it will likely be maxed out and stretched to capacity much sooner than term. The longer we go, the greater the risk of my uterus rupturing which is bad, bad, BAD. On a similar note, going through labor, contractions, and pushing could also cause my uterus to rupture and then here we are needing to switch to an emergency c-section and facing a life-threatening scenario.

3) Another factor to consider is the area of my prior c-section scar. Because I delivered the girls so early, the incision scar will be stretched much further this time if we reach 34-36 weeks and that area will be the area that will be the thinnest. In fact, we will start monitoring the thickness of my uterus in various locations starting at 27 weeks to make sure the risk of rupture isn't already here.

4) Vaginal birth and preemies don't go well together and the stress of a vaginal birth can cause more trauma and complications for the baby. And trust me, it's all about getting this baby here as safely as possible.

I guess I'm okay with all of this...I mean, I never REALLY thought I'd have a vaginal birth this time around, so I don't feel like I'm missing out on anything. Well, I take that back...the part I am sad about missing out on is the mother/baby bonding that happens immediately after birth...if/when the baby is stable. For me, the after-effects of the spinal anesthesia are not-so-great and include nausea/vomiting for anywhere from 6-18 hours; horrible itching; and a spinning room. I am not so sure that I will be in any shape to spend time with this little one...IF s/he is stable.

I've long since given up on my "dream" of a natural, water-birth. Ha. Ha. HA. Having your children at 27 weeks via emergency c-section will quickly make you realize you do what you have to do to get the baby(s) OUT. Period. You set aside your wants and do what is necessary.

The real question that remains is WHEN. When will all of this happen? How far will we make it? And how will it all play out? 

All questions to which I have no answers or even clues to answers. Clinically, this 'looks' like a normal pregnancy NOW, even though it clearly didn't start off that way...one that would otherwise go to term. But we all know that my body and this baby may have an agenda all their own. Who knows if/when the preterm labor will start. Who knows if/when my cervix will give out. And who knows if/when some other complication might occur.

And who knows...we could very well have none of the above occur and just continue to be normal.

I suppose we will just have to wait and see.