Friday at the Hospital or Let's Make a Day of It!
Hello and Good (Eastern) Friday to you all. Always, thank you for your prayers.
Rebecca had another decent night of sleep, waking up at 9:00ish today thanks to our Ambien connection. Feeling antsy, we left for our 11:40 appointment early because Rebecca needed to be some place not home (cooped-up fever). We stopped at Lamar's Donuts and enjoyed them while sitting on the sunny side of the patio.
We arrived for our appointment right on time, but had a twenty minute wait. The NST is supposed to last 20 minutes, 30 if the baby is a little uncooperative. We were there over an hour! The reason was Xavier was really not cooperating. His heart rate was strong and stayed around the mid 140s at the beginning, but he did not move around. His heart rate dropped around the mid 130s for a while, then up to 140 for a while, then down to the low 130s for a while. Well, you get the picture.
I used the time to schedule more ultrasound and NST appointments and to coordinate them so Rebecca did not have to spend the whole day in the hospital to get through her tests. This involved running back and forth between two wings as the departments cannot coordinate or communicate well in the scheduling area. I managed to get a good cluster of appointments set up through the end of May. I felt I accomplished a good task: Rebecca did not have to walk back and forth between wings and I got the schedule tight enough she would not have to be at the hospital longer than two hours on any day. It would be when I returned to the room the NST was being done in that I would learn either the irony or the futility of my efforts.
While I was away, Xavier began moving around a bit, which made things all the more interesting for the nurses trying to figure him out. The goal of the NST is to catch him moving (Rebecca presses a button and the ticker tape gets a mark showing the baby moved), then to see his heart rate rise (accelerate) by 10 bpm for 10 seconds, then return to its baseline. Xavier's chart today never gave a decent baseline for the nurses to look at, hence the hour-long test.
Not being able to baseline him got us sent over to L&D again where we got to undergo another three and a half hours of monitoring. (the area of L&D we were in is considered an emergency area, btw). Xavier's heart rate ranged from the low 130s to 150 and he moved around frequently. Rebecca did not have a button this time; we weren't recording his movement activity.
The ward was extremely busy today. One of the monitors in our room had a little pop-up message to the nurses encouraging them to be as speedy as possible in discharging patients. Rebecca and I hoped that would mean we would get out of there faster. Alas, no. After seven feet of chart cranked out of the monitor, we looked it over and saw nothing too different from two days ago when we had the privilege of being monitored in L&D. When, at last, the nurse came in and took the paper chart to examine with the resident doctor, we started packing to leave.
The nurse returned (her name is Diana and is one of the midwives at the hospital; an older woman with 20 years experience). The doctor found something in the chart that warranted further monitoring, another two hours of it. The issue was two or three decelerations (where the heart rate slows down significantly). We had several of these on Tuesday; in fact, they are what got us sent to L&D on Tuesday.
After that two hour stint, Diana rolled in a portable ultrasound station so she could measure the amnio levels. When she walked in, the monitoring machine hooked up to Rebecca was not emitting any paper tape (Diana purposefully turned it off two hours prior). She began fussing about it not having a paper record and made statements that suggested we might have to start over. I thought I was going to have to hold Rebecca down, perhaps hit her with a lithium dart. She was not happy about the idea of another two hours! Can't say I blame her. The monitoring is all recorded electronically, so the paper tape is only a backup device. We did not have to submit to another two hour monitoring period.
To measure Xavier's fluid, Diana chose the same four quadrant method that Pam, the mid wife nurse who saw us on Tuesday, had used. The results: Xavier's fluid level was about 9.2 cm, very close to Tuesday's measurement.
After further discussion with the resident doctor about the fluid measurements, we were released. Xavier is doing fine. On the way home through rush-hour traffic, we stopped off at a local eatery to sate a pregnancy need.
Xavier's face on May 3rd, 2013. His chin is to the left, top of his head to the right. Even though this image has him laying on his side, he really is upside down in the womb (head-down)
Week 30 Doppler Exam
Hello to you all.
Good news for Rebecca, she has gotten two nights of descent sleep thanks to her little Ambien helpers.
This afternoon we had our doppler exam. I am bummed this was not a growth exam; somewhere between last week and this week they changed the interval and failed to mention it to us (or we heard it and it went in one ear and out the other). As it stands now, growth exams are every three weeks, so next week's exam will be more comprehensive. I asked Tianne, our sonographer (whom we've had once before) if she would do a quick growth check anyway, but she did not. I even bribed her with a dollar. (if she would have done the measurement, I would gladly have negotiated a higher price :) ).
Tianne did cursory checks of the heart, the cranial arteries, the bladder and a few other items. She slipped the sensor a little and got a peak at mom's bladder today also :)
Xavier's heart rate was 149, which Tianne said was a good heart rate. His bladder was full (always good to see that!), but his amnio was lower than Tuesday. Though still a nice sized amount, most of his fluid was between his face and belly today.
His dopplers were a little worse than last Thursday, Dr Wheeler, a Partner at the hospital and someone we've not met before, came in to discuss the results. An older woman, her manner reminded me of a crusty country doctor who had seen it all. Sitting down, she told us the ratio might be OK for now, or we would be checking Rebecca in to the At-Risk Mothers ward, or we would be checking Rebecca in to the Labor and Delivery for delivery.
She wanted to see the amnio amounts for herself before deciding, but it seemed to me she was of the mind Rebecca needed to be checked in to the hospital for more frequent observation. She was surprised we were not having two NST appointments a week.
After measuring the fluid again and probing around, she did not like the high doppler measurements and low fluid level. I countered some of her thoughts, saying his amnio measures more today than last week(3.3 cm today!). Rebecca mentioned that his amnio has been much lower. She left the room and returned several minutes later. She went to study in greater detail Xavier's history.
When she returned, she was more comfortable seeing that Xavier has had a long history of low amnio. She did have us schedule NSTs twice a week and we have one tomorrow morning.
We got a few more pictures of Xavier, one of his face, and three others I can't remember what they are (one is of his arm), but none of these three are very recognizable. If we are interpreting the scale on the face image correctly, and if a baby at his developmental age maintains the same proportions as a new-born, then we estimate Xavier's length to be ten or eleven inches!
Of course, I will let you all know what tomorrow's NST results are. Thank you for your prayers. They have kept Rebecca from returning to the In-patient floor. Also, Rebecca and I think Xavier may have hit a growth spurt. Wouldn't that be something! Since we have another week to wait for growth measurements, we are encouraging Xavier to put on at least another three to four ounces, an impressive, but obtainable goal given his current growth rate.
Winter Storm Achilles
Hello to you all.
With a significant snow storm across the Denver-Metro area, we enjoyed a relaxing, non-eventful day. After yesterday's fun, today was a good day to rest. Rebecca felt good today, and experienced only slight swollenness.
Xavier has been active most of the day. Rebecca baked chocolate chip cookies this afternoon. After eating a couple, Xavier moved around quite a lot. The cookies were tasty.
We have a doppler and growth exam tomorrow. Rebecca's belly seems like it has grown notably larger over the last few days, and we are expecting to learn Xavier has grown faster than his past rate. Rebecca is pulling for 200 grams, which will put him at 824 grams or about 1 lb, 12 oz. I'm pulling for a full two pounds.
Always, thank you for your prayers.