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.