I'll Be Home For President's Day . . .

I was going to include all the technical info in this post and forego the pithy stuff altogether since that was the original intent of the blog and quite frankly, for a while there, I was all out of pith. 

But things are changing SOOOO quickly, that yesterday’s news is so, well, yesterday. 

Here’s what I thought wouldn’t change when I started writing this post just yesterday: I am in the hospital to stay until the twins are born.  This has put a funny spin on it because of course, I want to be pregnant as long as possible and so I am embracing the idea of a long hospital stay.

The Peas are doing really great.  In our bio-physical ultrasound yesterday (we will be doing 3 of these thorough ultrasounds a week now), they scored 8 out of 8.  I didn’t score so well.  The ultrasound showed lots of contractions and a little more dilation than Tuesday’s measurements.  Contractions are normal (at this stage they are just your Braxton Hicks variety) and twin moms experience more contractions than singles, but that’s still too much action for comfort.  Pair an “excited” uterus (as it is called) with an incompetent cervix and suddenly it’s like they’re the Keystone Cops of the Birth Canal, bumbling and stumbling and egging each other onward: the frequent muscle contractions of the uterus encourage the cervix to open which apparently is very exciting if you are a uterus.

So they put my uterus on downers (indocin – the opposite of pitocin) which will continue for another day.  This seems to have done the trick.  Twice a day the twins’ heartbeats and my uterine contractions are measured by ultrasound (without the visuals), and according to the last two readouts, my uterus is, like, totally stoned, dude.  It has literally flatlined.  Which is good because it means they will take out the magnesium sulfate IV, which means I get to take a shower.  God Bless Us, Every One!

So far we have had:

• Two steroid shots to help with lung development (betamethasone).  If I am still pregnant four weeks from now, they will give me two more.  (insert Barry Bonds placenta joke from Fat Shari post here)
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• Nearly three days of magnesium sulfate drip.  This is to stop contractions (the efficacy of which is disputed) and help reduce the incidence of cerebral palsy in preemies.  Side effects include: feeling warm (which means that my room must be an icebox), dizziness, weak legs, blurred vision, headaches, crankiness, and dangerous retention of liquids.  Luckily, all I feel is warmth (which could be my own sentiment) and crankiness (which could be attributed to not having showered in a while).
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• H1N1 vaccine, the mercury free variety
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• One pair anti-embolism stockings designed to help circulation by cutting it off.  Matt calls them “tourniquet socks.” 
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• Stool softener and lots of prune juice.  (Really, Janine, nobody wants to know about that one.  Nobody.)

Other fun stuff:

Twice a day for thirty minutes to an hour we get ultrasound readings of Peas and The Excited Uterus.  There are two ultrasound that look like “microphones,” one for each of the Peas and one “Toco” for me.  Mine is set at a frequency to pick up muscle contractions.  The Peas’ ‘phones pick up heartbeats and movements.  Because the Peas are still so tiny, this is quite tricky.  Sometimes both Pea microphones detect the same heartbeat, even though they (both sensors and peas) are on opposite sides of the belly.  The heartbeats are constantly fluctuating from 125 beats a minute to as much as 171 (although the tight range is closer to 135 – 150).  This fluctuation literally happens from beat to beat (partially a function, or dysfunction, rather, of the equipment.  It just can’t keep up.)  So while my heart beat readout reads like: 88 . . . 91 . . . 89…..The Peas are closer to: flicker, flicker, 141 . 125 . 131 . 151 . 144 . 122 flicker, flicker.

If the two ultrasound readings are consistently about two beats apart, then they are picking up the same heartbeat.  Sometimes—often times—one reading is completely blank.  Usually this means that the baby is moving, which is actually better than picking up a heartbeat, because if itsa movin’, itsa beatin’.  Doctors like it when the babies move a lot.  Nurses don’t.  It means that they still have to stick around, angling the sensor this way and that until Red Baby stops moving (it is ALWAYS the Red Baby, Baby B).  Further confirmation of babies’ movement is a fourth line on the readout and very often the blank spots on the heartbeat axis are complemented by thick black streaks representing Red Baby’s Dance Along the Uterine Wall. 

Three times a week (starting yesterday) I will go in for the ultra-deluxe bio-physical profile ultrasound.  This is the ultrasound where the twins get graded.  Umbilical cords are checked for crimping and bloodflow and that kind of thing.  On Thursdays they will also take a cervix measurement.  Shortening cervixes are signs of labor BUT sometimes the cervix can lengthen and shorten, widen and tighten.  This is called a “dynamic cervix,” and this is the outcome we are all hoping for.  (So much better than being “incompetent” or “insufficient”)  A dynamic cervix means that this week’s measurements are simply snapshots in the dance and now that the uterus is no longer excited, the cervix is just kinda dancing by herself in the corner, like me at my friend Amy’s wedding.  Or come to think of it, every wedding I ever went to before I met Matt.

Tuesday and Thursday are massage days and once a week a physical therapist is supposed to stop by to move my legs around so they don’t atrophy (tourniquet socks can only do so much for circulation).

Wednesday is support group day.  I haven’t been yet, but I think all the moms pregnant with 20-something weekers gather ‘round and either we feel sorry for ourselves or we walk away (roll away; I think we are all in wheelchairs) thinking, “Geez.  At least I don’t have it as bad as THAT poor nut.”  And I think we learn how to knit, too.  (I’m not joking about this.  One of the nurses feels very strongly about teaching American mothers the lost art of knitting and she figures that a captive audience is an easy target).

As far as stuff that won’t change, the doctor who is the head of the high risk pregnancy practice has stopped by this morning (Saturday, the day after Christmas) and doesn’t think I need three bio-physical ultrasounds a week.  He has cancelled this morning’s BPP (as we call them here on the inside) and prescribed a progesterone suppository to stop the cervix from dancing.  Oh, and he thinks that I could go home if I wanted. 

How’s that for a cliffhanger?

© 2010 Janine Kovac