I am behind in updating here, but with good reason. After spending an uneventful weekend on home bed rest last weekend--including a monitoring session at the hospital with a good NST and decent blood pressures on Sunday--I was admitted to the hospital on Monday afternoon.
Ironically, I thought there wasn't really even much need for me to go in for a doctor's appointment that day. While at the hospital on Sunday morning for my NST, I'd had my blood pressure checked every 10 minutes, and each reading was under 140/90. Not great, but not in a dangerous range and better than some recent measurements I'd had.
Nonetheless, I followed my doctor's orders and went to the office on Monday afternoon. Where my blood pressure was 160/90 and I was immediately sent to the hospital and admitted for further monitoring and work-up.
I was freaked out about getting admitted. Worried about the babies, yes, and also just generally unsettled at the idea of having to be hospitalized. (Although I worked in hospitals as a nurse for seven years, I had never spent a night in one as a patient for any reason prior to Monday.) The last 36 hours or so have turned out to be not as bad as I feared they might.
When I was initially admitted, because my blood pressures were running so high, I was bolused with IV magnesium sulfate and started on a continuous mag drip. (I had also never had an IV before.) The mag made me feel extremely hot/flushed--I had my room's thermostat on 65 degrees and would have moved it lower if possible--and also gave me a headache, though I was fortunate to avoid the nausea/vomiting and other symptoms some women experience on mag. I hardly slept at all the first night; although the nurse was great about not disturbing me unduly, and I have a private room, between the unfamiliar environment, the uncomfortable bed, and the sound of two continuous fetal monitors, I was only able to sleep about three hours total. (Ugh.)
The first of two shots of betamethasone (a steroid given to help mature the babies' lungs) which I also got upon admission probably contributed to my restlessness and overheated feeling. (Though I will say that after 10 weeks of PIO shots, betamethasone was a piece of cake.)
At this point, the news is more encouraging than it was when I was admitted. (On Monday night, we weren't sure if I might have to be delivered within hours.) I had a repeat 24-hour urine collection which continues to show protein (1015), increased from my last 24-hour urine. . . but still in the "mild" and not the "severe" range. Most of my liver function tests look OK, and my platelet levels are normal. My resting blood pressures are running in the 130-140/80-90 range. (After any small exertion, though, they can shoot up to 160s/100s.) I've had a second betamethasone shot, and my blood sugars are a little elevated as a result but not to the point of requiring insulin.
On the plus side, my doctors are currently terming my preeclampsia "mild," which means there is no rush to deliver the babies. On the negative side, I will have to continue to remain in the hospital until I deliver, as the course of preeclampsia is so unpredictable and can quickly take a turn for the worse (as many of you reading likely already know). It's clear that my preeclampsia is progressing. . . . it just doesn't appear to be progressing too quickly at this point, thank goodness. Here's hoping that continues to be the case.
The best news of all is that the babies appear to be doing very well in spite of mom's problems. Their monitoring has all been excellent, to the point where my OB ordered me to be off fetal monitoring last night to get some rest; she didn't feel continuous monitoring was necessary through a second night, given their condition. They had a comprehensive ultrasound yesterday, including a growth scan and check of their amniotic fluid levels and cord vessel blood flow, and everything looked great. Their estimated weights are now 5 lb 7 oz (Twin A) and 5 lb 4 oz (Twin B), which I'm told is very good for twins at nearly 34 weeks gestation.
I was uncharacteristically weepy yesterday thinking about all that could go wrong, but knowing that the babies appear to be doing well and that my pre-e symptoms aren't getting worse has helped. (Getting nearly a full night's sleep last night and being allowed to shower and wash my hair this morning probably helped some, too. Sometimes it's the little things.)
So that's where things are. I am still hoping to make it to 36 weeks, although I realize that may not be realistic at this point. Every day I can keep these boys in utero is another day they won't have to spend in the NICU, so I'm just trying to get through one day at a time.
Today we plan to have a tour of the NICU and visit with one of the neonatologists to prepare for the possibility of our boys' needing that care. I also plan to ask to meet with a lactation consultant, as I think I may need some help and guidance in building my milk supply for them, especially if they are premature and require NICU care. (Difficulty coordinating breathing with sucking is one problem common to babies born at 34 weeks.)
I remind myself that this possibility--the need for advanced care--is why I chose this OB group and this hospital (which is reckoned to have the best NICU in the metro area, if not the entire region) and why I established care with the maternal/fetal medicine specialists associated with this hospital. I can't control how my body is responding, but I believe I have done all I can to optimize the outcome for our babies. . . . which, at the end of the day, is all any of us can do.
Now all I can do is hope for the best.
Keep us in your thoughts. Thanks.