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Archive for blood pressure

Birth Story, Part 3: Postpartum

By Goddess in Progress · Comments (4)·   August 12th, 2007

Within one short minute early last Friday morning, I suddenly went from pregnant to not. It would seem like such a monumental change should take place over a longer period of time, but as my husband would say (quoting from an episode of West Wing), pregnancy is a binary state. You either are, or you aren’t. And now, I’m not. Whew.

So, after the c-section, I was groggy but happy for a while. Since I had felt some pain during the surgery, I had been given a little extra dose of happy juice while they put me back together. They also used something called duramorph. Instead of having a morphine pump for pain after the surgery, they injected a long-lasting dose/form of morphine with the spinal. For a solid 24 hours, I can honestly say I felt no pain, and I noticed no negative side effects. For that period of time, they also gave me pitocin to help contract my enormous uterus and IV fluids. I had inflatable cuffs around my calves, not unlike alternating blood pressure cuffs, to keep circulation going and avoid blood clots. It was a little odd at first, but not terribly uncomfortable.

At this point, I hadn’t slept in a good 24 hours. But as there were new babies and it had reached somewhat reasonable hour of the morning, there were phone calls to be made. Excited grandparents were weepy, aunts and uncles (real and honorary) were cheering us on. I was sleepy, but the adrenaline (and frequent checks by the nurses) would keep me up for a while.

The first day saw me confined to bed, but no shortage of visitors. My dad arrived directly from a business meeting several hundred miles away by 2pm. Our only local relatives (my aunt and my sister-in-law) came by as well. I smiled sleepily at them and assured them I was feeling no pain. They got to go with the new daddy to see the babies in the nursery. I was jealous.

By Saturday morning I was unhooked from my various tubes and wires and was able to slowly start moving around. I finally was able to go to the nursery to see the babies for myself. It was really the first time I’d seen Daniel at all. My first thought was how small he looked. I knew he was bigger than Rebecca, so I figured he’d be huge. But no, he was a little six-pound newborn. It’s only after spending time with or holding his sister that he suddenly looks like a linebacker.

Since I knew I wanted to breastfeed the twins, and they were not really in a position to be directly nursing, I was started on the pump. You can’t help but moo the first few times you get your boobs into the suction cups. Though I likely wouldn’t produce much of anything at first, I was instructed to pump for 15 minutes, every three hours, to help my milk come in. Fun times.

Sunday I was able to walk to the nursery on my own and not require a wheelchair or assistance from the nurse. I started going more frequently, realizing I was welcome there, and tried to make it to as many feedings as I could. I learned what it took to “stay on top of the pain.” Motrin and Percoset became good friends. The pain was quite manageable, but my elevated blood pressure and swollen extremities would not abate. I was instructed, yet again, to spend more time on my left side, and keep drinking plenty of water. And here I had been so excited to finally sleep on my back again. Ah well.

In the meantime, we had scrapped our original plans of hubby spending nights with me in the hospital. Since the babies weren’t rooming in, we decided we’d both have a better shot at a good night’s sleep if he went home and took care of the dog and kept his snoring to himself. I’d not only be able to sleep instead of yelling at him to roll over every 10 minutes, but he’d be able to rest up instead of being on an uncomfortable cot, waking up every time the nurses came in. We both liked this plan.

Sunday night, as he got ready to go home, I got my first case of what I refer to as “the weepies.” Hormones combined with a huge emotional life change are a really special cocktail. I assured my husband I was just fine and insisted he get home and get some rest, and then proceeded to cry for 30 minutes. No particular reason. Just the weepies.

By the time Monday came around, I was feeling a lot more human again. I was more comfortably mobile, able to shower and wear something other than the hospital gown and a robe. As much as I missed being home, I was also getting anxious about being discharged. Not that I was concerned for my health, but rather because I wanted to keep being down the hall from the babies. Not across town lines. I was additionally stressed because the pumping was coming to absolutely nothing. Three solid days of dutifully pumping every three hours, and I had nada to show for it. I don’t mean “not much.” I mean nothing. Every time I went in to feed the babies, someone asked if I wanted to put one to breast, or if I had any pumped milk I wanted to feed them. I tried one of them at breast at least once a day, just for the sake of practice, but there was nothing for them to get.

Monday night, the weepies came on with a vengeance. I cried at the thought of leaving the babies at the hospital. I cried out of the guilt of having someone else take care of them, even if it wasn’t a matter of choice. I cried at the feeling of not being able to take care of them myself. I literally woke up three times during the night, bawling. Tuesday morning was no better. I had finally gotten a hold of myself when the nurse came in to take my blood pressure. Unsatisfied with the results, she told me to lay down and rest and she’d recheck me in half an hour. I once again burst into uncontrollable tears. I wanted to get to the nursery to be with my kids, and I had to lie down again for my stupid blood pressure. I was a wreck.

Just before I left for home that afternoon, I finally got my first measurable amount of breastmilk from the pump. I kid you not, it was two milliliters. Total. Both breasts combined. And I brought it right over to the nursery so someone could eat it. The nurses were great, and proudly combined it with formula so the babies could have it. We came back to the hospital a few hours after leaving to feed the babies, but I was running on empty. I couldn’t stop crying, no matter what. The kind SCN nurse insisted that it would be a good idea for me to just go home and rest, and I could come back in the morning.

It was nice to be home, but again, very mixed. After being unsure how “connected” I would feel to them since they were in the nursery all the time, the prospect of being further separated positively broke my heart. I ached from missing them. I couldn’t even look at the polaroid of the three of us from two days earlier without sobbing.

Wednesday and Thursday, however, were improvements. We were at the hospital for four feedings a day, and all the pumping was FINALLY starting to produce something. The first time I got a full ounce, I nearly jumped for joy. It wasn’t enough, but it was finally progress. The babies were doing well, and it looked like they would come home. I was having minimal pain from my incision, and was able to keep it at bay with only ibuprofen, maybe a single percoset at night.

And here I am, the end of day two with babies at home. My in-laws were here the last two days and were more helpful than I worried they’d be. It was good to have the extra set of hands. I still burst into tears with minimal provocation, but it’s getting better. My belly is a big, stretch-marked bowl of jelly and my feet and legs are still determinedly retaining lots of fluid, but I’m trying not to worry about it. The pumping is yielding 1.5-2.5 ounces at a time, which is enough to keep up with their current needs (doctor sent them home alternating breastmilk with high-calorie formula to help gain weight).

I’m pretty tired, and I haven’t got the foggiest idea what I’ll do when my husband goes back to work in a couple of weeks, but I can’t possibly think that far ahead. Tomorrow is our first full day by ourselves, so we’ll see how that goes. I think we’ll make it.

So, that’s the story. This is now, officially, a “mom of twins” blog. Hard to believe, but it’s really true. I have two babies. Yipes!

Comments (4)
Categories : Feeding, Hospital, Postpartum
Tags : blood pressure, Breastfeeding, c-section, emotional, Formula, NICU, pumping

Hospital day, 35w5d

By Goddess in Progress · Comments (2)·   August 1st, 2007

Still cooking, alas.

Today was plenty of good news for babies, which is of course a mixed blessing for me. I half hoped there would be some indication for delivery, since I’m so tired and uncomfortable, but it’s just not in the cards.

Babies looked great on the ultrasound. Crowded, of course, and I was quite correct that baby boy A is way low against my cervix now. But fluid levels were good, breathing movements and all of that were good. And, though it’s always possible the estimates are off, they seem to be growing quite well. Baby boy is estimated to be about 6lb7oz, and baby girl is all the way up at 5lb7oz. 12 pounds of baby in my belly… no wonder everything hurts.

Non-stress test was fine. As always, little girl decided it was a great time for a nap and we had to get out the buzzer, but after that she woke right up. My blood pressure was high, but not as bad as Monday (which was apparently as high as 150/100 at one point!), so my doctor (who was at the hospital, anyways) sent me home.

So, here I sit! Still really uncomfortable, but the contractions have gone away for the moment. Hopefully I’ll get in a good nap this afternoon, since I was not able to sleep well last night at all. If everything stays the same, I’m off to the OB on Friday for my pre-op appointment… Who knows, maybe I’ll make it to next Thursday, after all!

Comments (2)
Categories : Hospital, Pregnancy, Ultrasounds
Tags : blood pressure, discomfort, discordant growth, NST/BPP

I wasn’t all wrong

By Goddess in Progress · Comments (4)·   July 31st, 2007

Still pregnant!

But I wasn’t totally off the mark, as yesterday was a rather new and different day.

I called my OB’s office to report the new pressure I was having, mostly to ask if I should do anything or ask for anything special while I was already going to be at the hospital. My doctor wasn’t in, but my favorite doctor (ha!) from a few weeks ago called back and said I should come by the office after the NST for an exam, presumably to see if my cervix was dilating. Sounds like fun!

Off to the hospital. The BPP ultrasound went just fine, both babies dutifully practicing their breathing motions, still plenty of fluid, all of that good stuff. The non-stress test started rough, though. For some reason, little miss really likes to sleep during those, so it’s been taking a while to get her to be “reactive.” We keep ending up needing to zap her with the little buzzer or poke her to get the heartrate variation we want. Once we finally had the results we wanted, the nurse was almost ready to let me go when she realized she had never taken my blood pressure. And then it got interesting. I never heard the actual reading, but it was apparently high enough that they decided to keep me a bit longer for monitoring, especially since it was taken after an hour of me lying down. The on-call doctor ordered blood tests to see if I was developing preeclampsia. Basically, if the bloodwork didn’t come back with good results, it was going to be birthday time. Yikes! Thankfully, it all came back just fine, kidney and liver function were good. Four hours after the start of the NST, they sent me home. I had missed the opportunity to go in and get checked at the OB’s office, so I was instructed to call her in the morning.

Of course, as soon as I left, the back pain I had been experiencing in the uncomfortable hospital bed turned into pressure, and soon I was having regular cramping. By 7:30, it would start as a low back pain that wrapped around my lower belly like a really bad menstrual cramp. Hubby and I started timing them, and they were about 9-10 minutes apart, with sometimes a lesser aftershock at 4-5 minutes. I remembered my OB saying I should call anytime I had anything regular and painful, so call I did. The on-call doctor sent me back to L&D, so at nearly 11pm, off we went. The cramps indeed showed up as contractions on the monitor (it’s not all in my head), and babies were good and active, not distressed at all by these new developments. They were still relatively far apart and somewhat irregular, though. And when the nurse did my very first internal exam (short fingers! OW!!), we discovered I was not even a little bit dilated. The contractions, fun though they were, were not making changes in my cervix. So at about 1:00am, back home we went. I had been worried about a “false alarm,” but the nurse reassured me that I had done the right thing to call and come in, and not to worry about it.

Unfortunately, the contractions stuck around all night, ranging between 4 and 20 minutes apart. And these were not the painless braxton hicks I’ve had for the last many weeks. These hurt, enough that I had to really concentrate on breathing through them and not tensing up the rest of my body. Needless to say, it was an awful night’s sleep.

I talked to my OB this morning. I’d be lying if I said there wasn’t a big part of me that sort of hoped she’d tell me to head in and just deliver today. But as the contractions were still irregular and not close together, she wanted me to stick it out and wait at least for tomorrow’s growth check at the peri’s office. Much as I’d love to be done, the babies are still officially premature at this point, so we need a better reason than discomfort to justify delivering them. She was kind enough to say that she half hoped that tomorrow’s ultrasound would show slowed growth so I could get it over with, but in the meantime, the plan is to just kind of suck it up. (No, she obviously doesn’t want my babies to not grow well! She just understands how “done” I am…)

After a few more contractions this morning, they more or less petered out by about 11am. I’m still having some low back pain, but it’s definitely not the contractions I was having earlier. I’m resting and drinking my water like a good girl, and hopefully will get in a good nap to try to make up for last night.

Tomorrow at 11 is the big (final!) growth ultrasound, so we’ll see how it looks. If either of them has slowed down or stopped growing, it may very well be delivery time. If not, well, I get to keep on hanging out until I either go into labor on my own (which is feeling more likely!) or make it to August 9.

Things are getting interesting around here!

Comments (4)
Categories : Hospital, Pregnancy, Ultrasounds
Tags : blood draw, blood pressure, contractions, nonreactive, NST/BPP, preterm labor

Hospital day, 33w6d

By Goddess in Progress · Comments (1)·   July 19th, 2007

An interesting day, indeed, at the hospital. Today was a growth check with the ultrasound, in addition to the biophysical profile. Both babies passed the BPP, though we had to poke little boy to get him to wake up and move around for us. Weight estimates were encouraging, but interesting… Baby girl appears to have had a bit of a spurt and put on a full pound to reach 4lb4oz. Baby boy actually slowed down and gained only 10oz to reach 5lb3oz. Of course, these are estimates, and can arguably be further off the bigger (and more crowded) the babies get. But still, very encouraging that little miss continues to grow. An unusual twist, however, that her brother is slowing down. He also appears to have a bit less fluid than she does. As the peri said, it’s not as worrisome as it would be if little girl was the one with less fluid, but something to keep an eye on, nonetheless. Non-stress test was just fine, and as of next week, I’m going to actually go in TWICE every week. Good thing I’m done working!

The craziest part of the visit, however, was our discussion of when to deliver. First of all, if I go into labor spontaneously anytime tomorrow or later, they will not attempt to stop me. If it were to peter out on its own, they wouldn’t try to restart it, but they won’t stop me. OK. Wow. And then she said, “so, when do you think we should have these babies? I’m thinking 36-37 weeks.” Whoa!! Used to be 38, then 37-38… now 36? Holy crap! That’s two weeks!!

Basically, the plan is this: I’ll have my twice-per-week BPP and NST. If anything looks concerning, they might decide it’s a good day for a birthday. My next growth check will be in two weeks (August 1, to be precise). If either one of their growth has slowed or stopped? Birthday time. If growth is still good, they’ll schedule me for induction or c-section at right about 37 weeks.

WOW! I can barely wrap my mind around it. Three weeks at the most, possibly two or less. I’m pretty darn excited, but mostly it’s just not sinking in at all.

I’m off to my OB’s office shortly, where we definitely need to have a discussion about delivery method. Baby boy seems to have really taken over at the baby A position, and is head down, so vaginal delivery is an option on the table. We shall see.

Oh, and my blood pressure seemed to be creeping up at the NST today. We’ll see if that issue proves to be the dark horse that determines birthday time. I’ll update after the OB’s office if there are any interesting developments.

OB Update
After talking to my OB, she’s totally cool with me going directly for the c-section. She seemed to think it was probably a good idea in my case. If I change my mind and/or they both flip to vertex, I’m welcome to try for vaginal (if they don’t flip, then only if she’s the one on call, because she’ll do a breech extraction of twin B). But otherwise, she’s going to schedule my c-section for right about 37 weeks! To be moved up if things change, of course. Holy crap!!

Comments (1)
Categories : Hospital, OB Appointments, Pregnancy, Ultrasounds
Tags : blood pressure, c-section, discordant growth, NST/BPP, perinatologist, preterm labor
   

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