&
Baby's Sudden Birth!
We had our next Level II u/s on January 11. The baby is now about 2 pounds 2 ounces! Still measuring a few days ahead. :) This is such a relief! I always get nervous before these appointments---things haven't always been good in past pgs, so it's nerve-racking until they tell us everything is good with this baby!
We went to Manchester again---that place is great! They take us in on time, or even a little early if they can. The tech was one of the same girls that did our last u/s (two of them did it last time, because one was a student). I told her NOT to tell me what the baby's gender was, even though Truman wanted to know. :) She was all done in like 20 minutes, then she got the high-risk dr who took a quick look too.
The dr was very pleased with how the baby is doing. She thinks it won't be necessary to do another Level II u/s, so my local drs can do an u/s locally if they want to. Because of my history, I usually have at least one more u/s after 30 wks, sometimes 2 more. One dr did say that it's important to make sure my baby doesn't drop off the growth curve near the end, so I am fairly certain they will check growth once more if not twice.
I told the dr we saw today about our scare last week with contractions, and she was glad to hear that the fetal fibronectin test was negative! She seemed happy with our current plan of action---I'm restricted to light activities and I have nifedipine to use as needed---and things seem relatively calm right now! We were done half an hour after we got taken in for the u/s!
Truman thought we should celebrate our good news with some sex when we got back home---what an @$$! He KNOWS I am on pelvic rest, so it means only he can have it (manually of course). I told him he is mean---it's like dangling Oreo cookies in front of his nose, but telling him he can't eat them because his cholesterol is very high! My libido has been very strong this pg, especially during the second trimester---BUT b/c of contractions I have to obey the drs orders on this one. It isn't easy, I feel like I am missing some real fun----BUT I will be good for the baby's sake. I have forced myself to think of it in terms of the baby's needs rather than what I feel like doing, and mostly I am ok with missing the fun. It would be much nicer though if Truman would just shut up already instead of trying to temp me to play hookey (or should I say nookie)! :P
I see my local dr next week for follow-up, and then I think I do the glucose test the week after---they usually do it at 28 wks here. I have been seeing a dr almost every week now, and have appts already scheduled for the next few weeks---so I guess I am now on weekly appts until the end.
January 16th. This morning we went to the chiropractor first, then I had a prenatal check-up. Our chiropractor is an awesome lady, and she is really convinced that regular adjustments will optimize the blood flow to the uterus and of course the baby! With my history of loss and small babies, that is just what I need---and with how good my baby is growing this pg, I would have to say I am convinced the chiropractor is right on this one! Besides, it's great getting my back into line again! :) Of course our insurance doesn't cover much of the chiropractic care, and has a limit on number of visits which we reached a LONG time ago---so the chiropractor is giving us a very reduced rate because she thinks it's so important I have the regular adjustments and she does not want our inability to pay to stand in the way.
After my chiropractor adjustment, I went to see my OB. There is actually a team of OB's and I schedule with whomever I can get the best time slot with. They are all great drs, so it doesn't really matter. But the last OB I saw had wanted me to schedule with a particular dr this time, to follow-up after my level II u/s last week. I hadn't seen this dr for maybe 2 months now, and she was so excited that things are going so well this pg! She hugged me tight and congratulated me on how well things are going! She said, "This looks like it's really turning out to be your best pregnancy!" I forgot to mention that maybe regular chiropractic care is also contributing to how well things are going. :) But whatever it is, this really is turning out to be my best pg so far! The baby is still measuring ahead (which is awesome), and so is my fundal height! The baby was busy moving around, but she got a good heartbeat, same as usual. My weight is 135 1/2 now, my BP was 120/70, and my urine test was perfect---no signs at all of Pre-E. I get to do the glucose test next week, and have my iron checked, but I haven't had problems with those before, so I'm not worried about it at all! :)
I told the dr that I still always need to hear them tell me that the baby is still growing. My worst fear is if it stopped growing for some reason, but I try to keep positive as much as I can. I constantly ask my hubby to tell me that my belly looks bigger---I'm sure I'm driving him nuts about it! The dr asked when my last u/s was, and I told her it was done last week in Manchester. She said, "oh, then the results are in the computer, I just need to look at them." We filled her in on what we knew. I also told her what the dr in Manchester had said last week, that I would not need another Level II, but they could do another u/s here towards the end of my pg. The dr today said they would probably do it between 32 and 36 wks, depending how my pg continues. I told her I really want to make 36 wks---I want my water birth! She goes, "Right!" and smiled---they must have "wants water birth" written in my chart by now, I say it every time! LOL
I just have one more major milestone to pass---the 28+ wk mark (when we lost our Ezra). But we aren't really too worried about that, this baby is already so much bigger than Ezra was. She saw the notes about my contractions and verified that I was taking the meds I have for it "as needed". She was so happy that things seem to be going well on the whole.
Before I left, I booked several appointments ahead so I could get the time slots I need. Then we went and got groceries. Shopping while pg is bad---LOL---I see food and I simply must buy it! We make a trip for milk and bread, but I come home with meat, fruit, eggs, cookies, pickles, and more. Not that it's all bad, but my freezer is so full of meat, frozen veggies, rolls, etc, we would really be ok NOT buying more of those things for a bit! But I just can't pass up good sale prices either----we got steamer clams for 99 cents a pound, and lamb shoulder chops for something like 1.09 a lb! I steamed the clams for lunch----yummmmmmmmm! :)
After my wonderful appointment on Monday morning, I was totally unprepared for what happened.
Julian Thomas Howard made his debut at 5:43 am on Tuesday morning January 17, 2006! He weighed 2 pounds 5 ounces, and is 14 1/2 inches long.
But let me back up and fill in some details. Truman had gotten home at 11:15 pm Monday night, and we ate some supper as usual before going to bed. A few minutes after midnight I was standing by my bed putting lotion on, when I felt something leaking. I was horrified to find I was suddenly standing in a pool of bright red blood. I panicked so bad it took me 4 tries to dial the hospital. Of course we were told to come to L&D immediately. I called a friend who agreed to meet us there and take our kids for the rest of the night.
When we got to the hospital, we tried the main entrance---we had not yet been told that after 8 pm, you have to go to the ER to get to L&D! There was a man inside the main entrance vacuuming the carpets, but he would not let us in. We were yelling through the glass that I had to get to L&D ASAP, and he said to go to the ER! We had grabbed a wheel-chair from the entrance, and Truman pushed me down to the ER entrance, where some staff showed us how to get to L&D from there.
We got up to L&D, and the dr came right away. She checked the baby first with a bedside u/s, and the baby looked just fine, plenty of fluid, plenty of movement, good heartbeat, etc. Then she checked me and found I was 3 cm dilated---and bleeding a fair amount. They monitored us for a while, as well as started IV drugs to stop my contractions which were now 6 mins apart. They also gave me a steroid shot for the baby’s lungs, just in case. But I continued bleeding worse and worse, and the contractions got stronger and closer in spite of the drugs. The contractions also hurt quite a bit now, and I could feel them wrap from back to front. I recognized this as real labor, and I tried my best to breathe through the pain. My OB called the high-risk dr at DHMC, and they debated transferring me---but they thought I was bleeding too badly for it to be safe making the trip, even in the helicopter! Around 4:30 they noticed the baby was having a few decelerations in heartrate, and the decision was made to do a C-section and take him out.
They could not tell for sure, but they highly suspected that my placenta was abrupting, and if we did not take the baby, we would lose him. I was so scared of the bleeding, I felt relieved that they made the decision to take the baby out, and I readily signed the consent form. A c-section is one of the last things I would care to go through, but I wanted my baby alive no matter what. He was big enough to survive in NICU, and that was his best chance.
At the same time, I was a little disappointed. I had really badly wanted a water-birth, and that obviously was not going to happen. In fact, the dr warned me that she might have to make a vertical incision, because they sometimes can't get a preemie out with just a lateral incision---if that was the case, I would have to have c-sections in any future deliveries. This makes me glad that I did get to have a water birth with Lucas, even though he was still born.
The thought also crossed my mind that now I have experienced every kind of birth, or at least it seems like almost every kind (except home-birth)! I had severe pre-eclampsia and a preterm vaginal birth with Ezra. I had an almost full-term vaginal birth with Eric, arriving at the hospital fully dilated; I had bad back labor with him, difficulty pushing, and I also tore badly. But I was able to hold Eric right away after he was born. I had an almost full-term vaginal birth with Jamie---after 8 wks on bedrest for preterm labor; Jamie was born easily in bed (no back labor and no tearing) after laboring in the Jacuzzi for a few hrs. But Jamie had to be rushed away because of difficulty breathing. With Lucas, I was induced; I had a fast and easy water-birth, but he was still-born (24.5 wks gestation). Now I was having an emergency C-section!
But then, I also knew that whatever the outcome, I would not be able to go through any more pregnancies---not after this latest and most serious complication! My pg history is pretty complex already with so many risks, and this was just the last straw. I told Truman I did not think I could ever do pregnancy again with this additional serious risk (once you have an abruption, you are at increased risk for it to happen again). I have been wanting 4 children for years, but I am grateful for the 2 we have at home, and hopefully this third baby makes it too! I reminded myself once again that we are in God’s hands, and if He wants us to raise this baby, then we will.
The nurse told me about the c-section procedure and what to expect (at least some of it), though I can't remember too many details of what she said. She inserted my catheter, but the dr said not to shave me. Truman had been with me the whole night. He helped me use the bedpan several times, and helped my nurse clean me up, and he even helped her when she put in my catheter before the surgery. The nurse also gave me some alka seltzer to drink, and that almost made me puke! Yuck!
I was taken to the OR to have my spinal inserted. Truman could not be in the OR while the spinal was inserted, but he came in soon after and remained with me through the surgery. I was not sure that I liked the idea of the spinal, but then maybe being awake for the c-section would be better than being put out completely. I have had general anesthesia for my gallbladder surgery 5 yrs ago, and I remember how hard it was to wake up from it. Since this was my baby's birth, I didn't want to miss much, so maybe being awake was really the best option.
The anesthesiologist was nice and gentle, and made a lot of effort to put me at ease. He told me each thing he was doing, and how it would feel. The scrubbing was really scratchy, the local burned briefly, the spinal medication felt cold, etc. After the spinal was done---he said I did very well, in spite of my worry that I would not be able to stay still enough---then they let Truman into the room. They put me on my back, and strapped down my hands. Good thing they did, I was shivering by this time. Soon, the medication had made me numb from my chest down. The dr came in, with my favorite midwife (Sarah) who was assisting her.
Suddenly I felt sick, and as much as I hate throwing up, I knew my sandwich from last night was about to re-appear. I had eaten with my husband like we normally did around 11:30 pm, and the bleeding started about 5 minutes after midnight. Once we got to the hospital, I was feeling nauseous, and wished I had not eaten, but who could have predicted this? My usual experience is that when I go into labor, my digestive system shuts down, and I can't eat anything---and I had felt like this most of the night as my contractions increased.
I said, “I feel sick,” and someone placed a small pan under the left side of my face where Truman held it for me. The anesthesiologist (I think) said something about my blood pressure falling and they gave me something. But I threw up anyway. It’s nasty to throw up while you are lying on your back! Truman has an iron stomach! I would never be able to hold a puke bucket for anyone except perhaps my kids---but he willingly held my pan while I puked several times.
I think it was around 5:30 that they started the section. They said I would feel lots of pressure. They were NOT kidding! It felt like they were rearranging all my organs as they pulled and pushed and tugged and shoved! Holy cow! What a weird feeling! Even worse, what they were doing was also putting pressure on my stomach, so I kept getting sick again! It was like they were pushing the undigested sandwich out of my stomach! Nasty, nasty, nasty! Truman continued to hold my pan under my face as I tried to turn my head enough so as not to choke on the vomit. One of the other people there (not sure who) took the pan away several times and gave us a new one for me to fill. I guess they are used to this, but it was about the worst part for me. I desperately wanted to brush my teeth, but of course I could not!
I don't think it was very easy for them to get our baby out. I found out later that they did have to make a T-shaped incision---the lateral one was not enough and they had to cut vertically as well. They said it was 5:43 when he was finally out, and the NICU team took him immediately to work on. They said we got him out just in time, as my placenta broke into pieces! (Note: we found out later that this was because the dr had to cut it to get to the baby.) He lost a lot of blood, and I surely lost some, though our baby was much worse off than me.
My dr had called the neonatal transport team before starting the c-section, and they came in the helicopter from DHMC, so they were standing by when our baby was born. They worked on him immediately, but it still took them a while to stabilize him. The baby was not able to breathe, and his heartrate was low. Though they transfused him and put him on a ventilator, he was still not doing as well as they wanted.
I heard the midwife say he was another BOY! And we quickly decided on a first name for him! We really did not have one, but we looked at each other, I said to Truman, “any ideas?” and he responded, "do you have any ideas?" Julian came to mind---it had been on the short list we considered for Lucas, and I had nothing against the name, just couldn't think of anything to go with it! I asked Truman what he thought of Julian, and he said, "I like it!" So we had a first name for our newest little boy! (It took us 3 days to come up with the middle name!)
After they sewed me up and put staples in my incision and whatever, they wheeled me into a recovery room. By this time I was getting a little feeling back, and I was also shaking uncontrollably. The shaking had started while I was still in the OR, but it just got worse and worse. I had to clench my teeth to keep them from rattling in my head, they were chattering so hard! My hands had been strapped down, but my arms were just banging around. Once in recovery, I was no longer strapped down, but I held my arms tight against me to try to control the shaking. My nurse was saying it was all normal, and I remember shaking after Eric was born, but this had to be fifty times worse! I shook for at least an hour and a half, and finally it subsided.
I was exhausted, and wanted to go to sleep, but so much was still going on. My body was waking up from the spinal and after a bit I could move my feet, then my legs, and so on. I think my butt was the last to wake up again! The nurse gave me some shots in my hip, and I didn't even feel the needle, though I got pretty big bruises by the next day. At first I could not feel it when they felt my uterus, but once the spinal wore completely off, that hurt the worst ever. It’s never been very comfortable to have my uterus palpated after a vaginal delivery, but after just having it cut open----MEGA-OUCH!
My dr came in to see me at one point, and gave me a hug. She said she had to go to another town to do clinics today, but maybe by late in the day she would have me transferred to DHMC as a patient, since our baby was being taken up there to the NICU. At that point I didn't really care what they decided---I was in such a daze. I did feel that they were taking the best care possible of us, and I was content with that. I was also very impressed by how good the communication was between my OB’s and the high-risk OB’s and other staff at DHMC!
My memory is a little confused about the order of things, but I do remember the anesthesiologist coming in to say good bye to me. His name was Marty and he had a shaved head with a little beard on his chin; he was nice and gentle and he gave me a hug while congratulating us on the birth of our son. I also remember a woman coming in to draw more blood from me. By that time, I had been stuck with so many needles, I had lost count! I know they were concerned about my blood loss, and that I might be anemic---but I think the results were a bit better than they had feared.
I also remember our pediatrician, Dr Silverstein, coming in. From what she knew, since they had given our baby Julian a blood transfusion and also put him on the ventilator, he was doing ok. They were now getting ready to transport him in the helicopter back to DHMC to the NICU. We were glad we had met our pediatrician prior to Julian's birth---I had taken the older boys to see her for their well-checkups in December, and it was nice we had a connection already.
Then the NP who headed up the transport team came in to see us. She said we needed to talk seriously. She said they had done some blood-gas tests on Julian, and the results were really not good at all. As she put it, babies with those numbers often did not survive. His heartbeat was very low at birth, and he needed a lot of blood immediately. They also put him on the ventilator because he was not breathing at all at birth. But she still had deep reservations whether he would be ok or not. I did understand that lack of oxygen even for short times can cause brain damage, but was she saying that for Julian it was even worse than that?? I thought for a minute that she was ready to sign his death-warrant, and I just couldn't take it all in!
I had this horrible feeling of de-ja vu! We had already buried (well actually cremated, but same difference) two preterm sons, and I could not believe that we might be doing it again---and so soon (we lost Lucas barely 9 months ago!) The NP offered to give Truman and me a few minutes to talk. I was crying by this time, and I felt like my brain couldn't function. I tried desperately to clear the cobwebs from my head, as I reminded myself that God was still in control no matter what happened to our baby. Truman was saying he believed Julian was a fighter, and we must give him every chance to live. I knew I BADLY wanted Julian to survive, but I also knew that the best thing for us is to yield to God’s will---a hard lesson I have learned through all our previous losses!
Nevertheless, the thought went through my mind: did I just go through this horrible C-section, trying to save our baby, only to lose him anyway?? What a cruel twist of fate!
I wanted to call our pastor (the associate pastor from our church), and Truman dialed the number (we had our address book with us). The pastor's wife answered and I was crying as I told her what had happened. The pastor was at a prayer meeting, but she would page him for us. She prayed for us, and just then the NP came back in to the room to talk with us again.
My OB was there and a nurse and I’m not sure who all. The NP asked if we knew what we wanted. I said that we were NOT ready for them to take Julian off any life-support. Truman chimed in that he wanted them to keep working with him, whatever he needed. I remember saying to my dr that it just isn't fair how there are people who don't want babies and throw them in the dumpster (that was actually in the news a while back), while we want more children and we have been through so much infertility and loss. My dr agreed how it really isn't fair at all!
I also said that I wanted to see Julian. Truman had seen him very briefly in the OR, but I had not. They agreed to wheel my bed into the room where Julian was, and they actually laid him (still hooked to life-support) on a heated blanket in the crook of my arm. I was crying, but I talked to him, telling him how much I loved him! They encouraged me to touch him, so I placed my finger in the palm of his hand. He instantly grasped it--and he stabilized completely! The staff was just amazed, and they all commented on how this just shows how much a baby needs his momma! The nurse took pictures, but we only had my 35 ml camera, and the film is not yet finished, so I don't have them developed yet.
Julian was then put in the helicopter and taken to DHMC. He has been stable ever since! The staff has been amazed how well he is doing after such a rough birth! Then they decided to transfer me to DHMC that same morning! I was taken by ambulance. Truman had to go in our vehicle, so he stopped at our house to pick up a few things we needed, including our digital camera, then he came to DHMC to be with me.
Our friend made arrangements for our kids for the day. We had called my parents to tell them what happened, so my mom caught the train from Philadelphia. Our pastor came briefly to see us, and he promised that people from our church would help out in any way they could. Someone picked up my mom at the train station, and took her to our house so she could take care of our kids. Someone else took care of the boys after school until my mom arrived Tuesday evening.
We finally got released from the hospital around 6 pm Friday night, January 20th. Julian is of course still in NICU, but doing well. We took mom and the boys with us to see Julian on Saturday. The boys had fun with Grandma, but are very happy that we are home again! I missed them, and they missed me too! They are also excited about their new baby brother! Eric still wants a sister, but we told him that unless we adopt, there won't be a sister! After having the placental abruption, on top of all my other pregnancy risks, we know we are not planning to have any more babies of our own! I just know I can't handle another pg after this. The abruption is by far the worst and scariest of everything I have gone through! Besides, since I had the section, I will not be able to have a vaginal delivery ever again, because of how they had to make the incision. The c-section was no walk in the park, let me tell ya! And the recovery time is so much longer than for a vaginal delivery.
January 22nd. I am healing from my c-section, but it has been pretty sore! I admit I am a wimp when it comes to pain! When we went to the store to get my prescriptions filled plus a couple other things, I got Truman to push me in one of those wheelchairs with a shopping basket on it. I miss having the hospital bed---it could raise me to a sitting position which makes it easier to get out of bed! LOL If you don't mind a little TMI, the worst thing was having my first BM---in spite of taking stool softeners, eating fiber-rich foods, and drinking water, that part was exceptionally difficult, I mean like the worst I can ever remember! And when I finally did go, Truman had to unplug the toilet because the hard stuff just wouldn't go down! Major UGH! (Of course, he knows just how to unplug the toilet because for some reason, it plugs from time to time no matter who uses it.) I still have red marks from the tape they had used to put the bandage on right after surgery---and my belly itches like the dickens! But despite the discomforts and pain, it's all worth it to know that Julian is safely here, even if he needs the time in NICU to grow before he can come home. The fact is he wouldn't be alive if they had waited much longer to take him out---BUT I am so happy we got him in time!
Wednesday, January 25th, we went to the hospital to get Truman's FMLA papers filled out and signed by the dr. They are a bit different than the ones I remembered getting before. We went to the ob/gyn clinic since my OB had said she would be willing to sign the papers for us. But the receptionist said that first the medical records office completes the papers, so the dr only has to add her sig. Ok, but then she said it could take a week for medical records to complete the papers! Not ok! We had had to wait for the papers to be mailed to us, then we had to carry them in to the drs office, and we did not have a week left to get the papers filed with the company's office out of state before the deadline for filing! We needed them done by Friday, so then we could get them faxed in to the office in time.
The receptionist said she'd call medical records and get them to do the papers today. Phew! My dr was in so they would ask her to sign. I also took the opportunity to see if I could get a new prescription of Percoset. My prescript had no refills, and I had run out---but no way am I healed enough to go without pain meds, thank you very much! So they got the dr to write a new prescript for me as well. As we were waiting to get our papers back (the ob was with a patient), the prenatal coordinator nurse came out of the back hall. When she saw us, she immediately came over and hugged us. Then she took us to her office, saying she had some time before her next patient. We talked about what had happened and how well Julian is doing. Then she went and told my OB that we were there---and she came to see us too! My OB had checked the computer and seen the notes that Julian was doing well.
Truman asked if the placenta report was done. It isn't. In fact, the pathologist decided to send it to the lab at DHMC in Lebanon for their opinion! They are not sure that I had an actual abruption, but then they aren't sure just what the problem is! There was evidence of some small blood clots and something they called thrombosis. I have been tested for clotting disorders, not once but three times, and most recently was last summer. The results were negative. However, I seem to have this common denominator of "placenta issues" in my pregnancies! It is quite mystifying, since each time has been a different thing that happened, yet it all point towards the placenta having something go wrong. There is no known diagnosis for whatever this is. My case history has all my drs---from the high risk maternal fetal medicine specialists to the reproductive endocrinologist, to my OBs---all are scratching their heads. They just don't have an answer for me about what causes all these things to happen in my pgs!
There were a couple things my OB clarified for us. She did make the incision that means I can't have any more vaginal deliveries. She first made a lateral incision, but then she had to make a vertical one too, so it looked like an upside-down T. She had warned me that they sometimes have to do this to get preemies out. Now, one of the nurses had said that the placenta came out in many pieces. My dr explained that this was because when she made the vertical part of the incision, my placenta was in the way of her getting to the baby---and she had to cut through the placenta, that's why it was in pieces. My amniotic bag was still intact, my water had not broken at all, and she had to cut open the bag. She was able to see that the fluid was not completely clear---it was greenish, but definitely NOT meconium. She thinks it means there had been some bleeding at an earlier time, and just like a bruise turns green when it heals, the blood can turn greenish. Her guess is that maybe the day a couple weeks before when I was having a lot of contractions, could I have had a small internal bleed that we had no way of knowing about??
We will all be interested in what the placenta report has to say once it is done. After talking with my OB, the prenatal nurse checked my weight (130 lbs), BP (120/70), and my incision (looked good).
Friday, I had my *scheduled* check-up with the prenatal nurse. I really needed her to fax some papers to Medicaid for me. Even though I had seen her briefly two days ago, she again checked my BP (94/70) and my incision (looks fine). She thinks I look very pale, so she is going to check my blood work that was done. It probably wouldn't hurt for me to take an iron pill, or maybe just my prenatals, since I did lose blood in the abruption/surgery. The nurse also got me a copy of the "parent notice" for Julian's Birth Certificate---the one that was supposedly mailed has not come to us yet. So now we can get the birth certificate from city hall---as soon as we have a chance. At least the parent notice is enough to add Julian to our children's insurance coverage, and the nurse faxed all our paperwork to my case worker for that. I’m glad that part is done!
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I am making a new page for Julian and his progress. I am continuing to recover from the C-section, and trying to catch up a little with all the normal stuff like paying bills etc. Truman's company somehow messed up and did not pay him his vacation/sick time for the 4 days he took off while I was in the hospital---as a result we were this close >< to bouncing checks, and I had to transfer some money from a savings account to cover, though I did not have enough money in the savings account to make the entire difference. UGH! But we called Truman's company, and they did determine that they had messed up, so they cut him a check manually for the 4 vacation/sick days. Phew! But I hardly have energy to deal with anything like this on top of the situation with Julian, and I was pretty upset about it. :(
Saturday, February 25th. It figures that the resident BFing Peer Counselor is suffering from breast pain! Last Monday I got a plugged duct---those things HURT, but thankfully it resolved the same day. Now I am 99% sure I have a yeast infection in the same breast. The symptoms fit. It hurts so bad to pump that breast. And the pain stays long after I'm done. :( Of course I know what to try, but I can't prescribe myself anything. And it's the weekend. :P
Sunday, February 26th. Now I'm not really sure what the problem is. It could be a mastitis inflammation (rather than an infection). I thought yeast first, because my nipple hurt (both during and long after pumping) and was bright pink, which is just like the time I had thrush with Jamie. But the next day, I had a large red streak from my nipple towards my underarm. The streak was very tender, but there was NOT a hard lump. I got out my Breastfeeding Book (Dr. Sears). He says that mastitis means an inflammation, and although often there is a bacterial infection causing the inflammation, IF there is no fever than it may just be an inflammation, not an infection. The nipple pain makes me think yeast, but the hot and tender red streak makes me think mastitis.
I called tonight, because it was hurting to pump so much, and the m/w who was on call gave me some suggestions. She thought it sounded like the beginning of mastitis, but because I had no flu-like symptoms (still don't) she thought I did not need to rush off and get antibiotics. But I did need help managing the pain! She suggested taking 800mg of ibuprofen every 8 hrs, AND a hot shower, letting the water run down my breasts as I massage them, then pump.
I know that it is very important to keep draining the breast! It's just that when it hurts that much, it's so hard to pump! The ibuprofen and the shower did help enough that I was able to pump. I also set the alarm and got up in the middle of the night to pump instead of letting my breasts wake me in the morning. It’s possible that I got too full the other morning and that triggered the inflammation. I am continuing with ibuprofen today, and I notice that when I forget it, pumping gets painful again! I have my pp checkup tomorrow morning, so I will tell my OB and see what she says. I don't know if it is possible to have both yeast and mastitis at the same time?? I've just never heard of it.....
February 28th. I went for my 6 wk post-partum check-up today. Boy that sounds so weird, when the other April ladies haven't even given birth yet! I took some pictures of Julian to show the dr. I couldn't believe it when she told me that her 10 yr old son is named Julian too! I had no idea!
I did mention my problems with breast pain, but it seems that it is resolving on it’s own. The OB agreed that we don’t want to take antibiotics unless necessary, because they can then allow yeast to get established. It would seem that I do not have a true infection of either sort, just an inflammation. And the ibuprofen helps manage the pain so I can pump to drain my breasts, which is key to resolving inflammation.
I talked it over with the OB (a partner of the OB who delivered Julian) and she agreed that I could wait a few months before making a final decision whether to get an IUD or not. I still have my diaphragm which I can use for now, and from past experience any chance of my getting pregnant in the next year is extremely low, as long as I am lactating. We should probably make a decision about the IUD before that, but the point is I do have some time, maybe 6 months anyway. I explained that I did not want the non-hormonal IUD, but I was worried about the small possibility of the progestin IUD impacting my milk supply. My past experience is that I need to wean to regain fertility, even after my baby is on solids and older than one yr. I plan to pump until Julian goes to breast, then BF up to 2 yrs. So we will see how it goes.
The Ob asked if we were planning to have more children. I said that it's a tough decision for us, and we want our options open for now. Since I had the abruption, another pregnancy may not be advisable, unless we can figure out WHY I had the abruption and whether anything can be done to prevent another. But I have always wanted 4 children, and we aren't ready to shut that door permanently. I'm 34, and I'd like to see how we feel about it in say 2 yrs. She was very understanding.
I did ask about the placenta report---she had to go look it up in the computer. This is one puzzle piece we have been looking for. The placenta was maturing too fast, and had infarctions in about 20% of it. Yes, it abrupted---pulled away from the uterine wall. But the hypermaturity and infarctions mean it was no longer functioning at full capacity, and was starting to shut down. This goes along with the theory one of my other OB's has that there seems to be some underlying reason that my placentas develop problems and shut down early, precipitating preterm labor and delivery. This seems to point to a "clotting disorder"---even the high-risk OB said that. BUT the strange thing is that three times I have tested negative for clotting disorders! The one thing I keep wondering about is that I have read that some women only show the clotting disorder antibodies while pregnant. I'm wondering why the high-risk OB of all people didn't say anything about this though, assuming it's true. My tests were always done between pregnancies, not during pregnancy. But could that be the missing link?? If we can prove I have a clotting disorder, they can treat it! But they won't treat for it unless there is proof I have a clotting disorder.
Anyway, right now I need to focus on Julian and give him my attention and energy. This whole NICU thing is getting old. It's stressful, all the traveling, and trying to make arrangements for the older kids so they have their schedules as normal as possible. I desperately want my baby home and settled in, but I know he has to be able to breathe well without any apnea first. Some days I just want to break down and cry, but I have to be strong and try to keep it altogether for my family's sake.
I do feel frustrated about several aspects of this situation---but maybe it's more hindsight than anything. I know that neither I nor any of my drs ever dreamed I would abrupt like that! But I am glad at the same time that they did send the placenta to the lab. I have also contacted the dr who studied the placenta from my first baby years ago. we've stayed in touch all these yrs (he's in Florida). I'm going to send him a copy of this placenta report, and I want to know his thoughts.
One of the hardest things for me is thinking that I may never be able to have the fourth child I've always dreamed about. But at the same time, I feel SO LUCKY to have the three I have. Julian is extra special because we went through so much to have him. I just want him home very soon, and I wish I could somehow make him breathe better and grow faster!
I hope to get my website completely updated again, but I kinda stalled on some of the things I want to write down the past week or so. I started writing, but it was so jumbled, it wasn't making a lot of sense. But maybe that's ok, I feel like my emotions are so jumbled anyway! At least this part of my journal is done, and I will work on Julian’s pages as I can, including putting up more pics.
