There's A Plan

My how things change in a week.  The last week has been the craziest rollercoaster ride I've ever been on, and I'm pretty sure it's just the beginning.  Here is a brief timeline of events:

10/2 (Thurs) - Amanda is worried she is not feeling baby kick enough for 31 weeks of pregnancy.  She called her OB and she recommended that we go to the hospital for a non-stress test (NST), where they listen to the baby's heartbeat for 30-40 minutes to make sure it's doing what it's supposed to.  The test went fine, but the doctor on call suggested we go in the next day for an ultrasound instead of waiting another week for our scheduled appointment, mostly to ease our minds.

10/3  (Fri) - We went in for an ultrasound, one day before week 31 of pregnancy.  This is where our world was turned upside down (for now, we hope).  Our baby was measuring below the tenth percentile in size for her gestational age, and was diagnosed with Intrauterine Growth Restriction (IUGR).  She was not getting the nutrients she needed from the placenta, and would probably have to be delivered early.  How early, they weren't sure.  They want to leave her in as long as they can until we reach the point where she is better off coming out.  At this point we schedule ultrasound appointments for Monday, Wednesday, and Friday, and go home and cry.

10/4-5 (Sat-Sun) - We spend most of the weekend talking to friends and family, getting advice and support.  All of a sudden, everyone I know has had a preemie, was a preemie, or knows someone who just had a preemie.  It is the two longest days of our married lives, waiting for our Monday ultrasound.

10/6 (Mon)  - Amanda worked a half day in the morning, which was what she was scheduled for, and then we went for an afternoon ultrasound.  The dopplers we were most concerned with relating to blood flow from the placenta to the baby all look good, and we breathe a sigh of relief.  Dr. Walker tells us we are probably good for at least a week based on this, which was great news after a harrowing weekend of worry of what will be.  We decide to put Amanda on self-imposed bed rest, even though no one has told us to.  She does not work the rest of the week.

10/8 (Wed) - Another good set of tests, an ultrasound and another NST, and we are just hoping to get to 34 weeks before we have to deliver.  Amanda's blood pressure is up a little, but not alarmingly so.  The problem with the high BP is that Amanda could be developing preeclampsia, which is dangerous to both mother and baby.  Wednesday evening, Amanda's mom, Barbara, calls to let us know she has a flight the next day and will arrive around 2:30pm.

10/9 (Thurs) - We have scheduled a tour of the Neonatal Intensive Care Unit (NICU) for 11:00am.  This is where the baby will be after she is delivered, and will stay here until she comes home with us, and the tour is recommended by a few people so we have an idea what our baby will be facing, and to give us an idea of how she will be cared for.  I think we both just want to catch a glimpse of a preemie so we can see how small they are, but when you walk through the NICU they discourage "window shopping."

Our plan after the tour is to stop by our doctors office, have a quick NST to make sure everything is o.k., then pick up Barbara at the airport.  The NST went fine, but Manda's BP was high, 145/95.  It was at this point that the doctor said she wanted to admit us.  She asked us if we needed to go home, or if we were ready.  We'd been bringing our bags with us since Monday, so that was that, Manda was admitted around 3:00, and Barbara took a taxi to the hotel.

The idea was to give her medicine to get her blood pressure down, and she was given an IV with magnesium sulfate (mag).  The mag is great for lowering BP, but otherwise it's like "here, have the flu."  Manda was nauseous, hot, achy, and headachy.  Not much fun, but her blood pressure dropped to about 117/75 by the morning.  Now that we're in the hospital, they can monitor her more closely, but we are still anxious to know how long she'll be able to carry the baby before they think it's not safe.  If she was born today, her birthday would be 10/9/8.

10/10 (Fri) - In the morning Manda's BP is down to a comfortable level, so they lower the mag dosage and she begins to feel better.  Around 11:30, we have an ultrasound in the room, and again, everything looks good.  At this point, we know it's not going to get better.  The placenta does not regenerate itself, but nothing has gotten worse, so it's a good scan.  The plan is for our next scan to be Sunday, but Dr. thinks we are good until at least Monday, but probably not more than a week to ten days until we deliver.  We still want to get to 34 weeks, but I realize this is not in our control.  

That afternoon, Manda's 24 hour urine analysis comes back with a high amount of protein, another indication of preeclampsia.  Around 6:30-7:00, our nurse comes in and tells us Dr. Haynes, the doctor on call, will be in shortly to talk to us about "the plan."

"There's a plan?"

"Yes, there's a plan.  Dr. Haynes will be in soon to tell you about the plan."

"What's the plan?"

"They're going to deliver you tomorrow morning.  At 7:30"

"                  "

"Are you ok?"

Then the nurse explained what was going to happen in the morning, what I would do, where I'd go, what and when they would do throughout the procedure, a lot to take in, but we listened the best we could.  Our little girl would be delivered exactly at 32 weeks.  Then the doctor came in and went through the process and answered any questions we had, which were many.  There were so many people in and out of the room, it was hard to keep track of who was who and what they were doing and telling us.  We just kept thinking about 7:30.

10/11 (Sat) - Lily Maia Rogers was born at 8:21am, weighing 2lbs 6.3oz, 14.25 inches tall.  She was breathing on her own, which is great for 32 weeks, and hasn't needed any help yet.  She and mom both came through the c-section in great shape, although mom had a few more drugs afterwards.  After the drama of our last week, it was incredible to see Lily in person and felt like two tons off my shoulders when they told me she was o.k.  As every minute passed, I felt more and more assured that she would be fine, and when I finally got to hold her, about an hour later, it was the best feeling I could ever imagine.

Lily Maia Rogers 10/11/2008  8:29am

The rest of the day is kind of a blur for me, but I remember most of it being spent going back and forth between the nursery and Manda's room, checking in on Lily and giving Manda updates.  We wheeled Manda to the nursery around 9:00pm and for the first time, Mom, Dad, and Lily were together.

Lily Maia Rogers 10/11/2008  12:19pm

Lily will be in the NICU for a few weeks, and come home near her original due date of Dec 6, although many nurses have told us we could probably expect to bring her home anywhere from 1-3 weeks sooner.  Don't forget to breathe.