Stickin' it to the man...hey, I'm trying to come up with a silver lining

So it looks like I may be admitted to high risk maternity for the next week (or longer).  I spoke with my OB this morning, who made a special visit to the hospital to check on me, and he said that he would really prefer if I stay in the hospital for the next week because he, like me, would prefer that I not have the baby before 33 weeks.

I saw the high risk maternity team (minus the attending who was in the ultrasound lab) and they told me that I might be able to go home this weekend at the earliest.  They are going to do a test on me tomorrow morning called fetal fibronectin.  Essentially, fetal fibronectin is the glue that holds the amniotic sac to the uterus.  If they swab for fetal fibronectin and it comes back negative, that means that there is about a 2% chance of having the baby in the next 1-2 weeks.  If, however, the test comes back positive, it doesn't really mean a whole bunch of anything.  All that a positive test indicates is that the "glue" is starting to not hold as well.  This could mean that the baby could be born in the next 1-2 weeks, or it could mean that the baby will be born at term.  If the test comes back negative, they might send me this home this weekend as it would be unlikely that I would have the baby before 34 weeks.  If it comes back positive my OB will want to keep me here for at least a week to make sure that I can get as close to 34 or (even better) 35 weeks as possible.  Unfortunately, one week may turn into two weeks may turn into three weeks.

The silver lining to this cloud is that I get to stick it to the man.  I currently have two health insurance policies.  My primary insurance is Aetna.  I don't remember the exact coverage scheme, but I pay a certain percentage until I reach such-and-such amount of claims.  Then I reach something called a donut hole (unfortunately this donut hole is not nearly as wonderful and delicious as Tim-Bits from Tim Hortons).  While in the donut hole I am responsible for paying 100%.  Once I reach the other side of the donut hole my insurance will pay 100% for the rest of the coverage year.  I have totaled things up and it looked like (prior to this hospital admission) that we were going to reach the far end of the donut hole, but not quite get to the 100% coverage from Aetna.  Therefore, we decided to keep my OSU insurance.  The way that secondary health insurance works is that anything that the primary insurance doesn't pay gets kicked to secondary insurance before it gets kicked to the consumer.  The hope is that secondary insurance will cover part of the cost that normally goes to the consumer until we reach 100% coverage from Aetna.

Any of you who have heard me talk about OSU student health insurance know that I don't like it.  I purchased it because I had to have it during grad school (in fact, my former grad program paid 90% of my insurance payment each quarter, so back then I only had to pay $50 per quarter for health insurance...not a bad deal).  But now I pay full price, I have had them deny claims that they should have paid, and I had them cancel me as a client for a week during this pregnancy (before I was covered by Aetna, so I was insuranceless).

One small thing that brings me a twinge of joy throughout all of this is that OSU student health insurance is going to get a HUGE bill for this hospital visit.  Furthermore, we are going to reach the far end of the donut hole for Aetna, so we will have FREE healthcare coverage for the rest of the year!!!  I see in my future many check-ups and preventative care visits. :-)

My trip to the hospital

I am currently sitting in a hospital bed, hooked up to a contraction monitor and receiving IV fluids.  This is not really what I expected when I left to go to my OB appointment 14 hours ago.  I knew I had been experiencing some symptoms of pre-term labor, but I only had one time when I thought I might have been having braxton hicks contractions, and even then I wasn't sure.

My main symptoms have been menstrual-like cramps, low back pain (definitely not musculoskeletal - more like the pain you get when you have to poop, but you don't actually have to poop), and, for the past few days, a recurrence of nausea.  These symptoms seemed fairly benign, so I figured that I had been overreacting during the past couple of weeks when I had been telling people that I thought I might be having pre-term labor.  Sometimes people who are pregnant just cramp for no real good reason.  I mean, I am carrying a 4 pound baby (weight estimated from my ultrasound last night) in there after all.  It makes sense that things might get a bit crampy.  And low back pain?  All pregnant women get back pain.  Add in the fact that bowel habits aren't necessarily normal during pregnancy and you get a pretty good explanation for low back pain.  As for the nausea, this is not a new symptom for me.  I got a reprieve from nearly constant nausea and "sour" stomach starting at 26 weeks, but usually once or twice a week nausea would come back for a visit.  Three days in a row of nausea seemed a bit worse than it has been, but since when can you compare things to the "usual" in pregnancy?  Nothing is usual.

I told my doctor about my symptoms and he said that he wanted to do a cervical exam just to make sure that I wasn't dilating.  I had talked myself out of thinking I was having pre-term labor at that time, so I thought this was no big deal and I was going to get a normal report of no dilation or effacement.  However, when he checked me I found out that I was 1 cm dilated.  1 cm...that's only 10% of the way there.  I'm sure that's not a problem.  It's probably pretty normal to dilate just a little bit during early to mid third trimester.  He was a little bit concerned and told me my options.  He said that he wanted to send me to the hospital for 1-2 hours of monitoring just to see if I was having contractions (I told him I wasn't sure if I had been having them and he said that it is likely that I wouldn't be able to tell if I was).  He also said that he might put me on a calcium channel blocker just to calm things down in my uterus a little bit.  And if they found that I was contracting I might be put on bed rest.  Either way, I should take it easy for the rest of my pregnancy.

Keith and I went to the hospital.  Since I wasn't too concerned (I just thought we were heading to labor and delivery for a 3 hour detour of our normal day, and that we would be going to Bible study just a little bit late) we made a pit stop at Java City.  I wanted some milk because they told me that I would have to pee for another urinalysis, and I had to prime the tank.  I also hadn't eaten for a few hours, so we grabbed a couple of snack to sneak up to triage in case I felt the need for nourishment.

We went up to triage, we found out that when my doctor phoned over to labor and delivery that I would be coming he said I was 1-2 cm dilated.  Was he just telling us 1 cm so we wouldn't panic?  Or did things get exaggerated going through the grapevine?  We hung out for a little while as paperwork was being processed.  I gave my urine sample, I got hooked up to the fetal heart rate monitor and the contraction monitor (toco), and then waited for the next 1.5 hours as they collected data.  Thankfully, baby's heart rate is strong, baby is moving around a lot, and I maybe had one mini-contraction during the entire 1.5 hour stretch (the nurse told me it was a contraction...when I looked at the read-out it looked pretty unremarkable to me, but I suppose I should trust the judgment of a labor and delivery nurse over that of a myself, a medical dietetics graduate student).

Unfortunately, when the nurse checked me she said I was 3 cm dilated.  Here's the thing about checking dilation: it's all by feel.  It is not the most scientific measurement.  One persons 2 cm may be another persons 3 cm.  They train their fingers by reaching into circles of different sizes and learning by feel how far apart their fingers spread for each cm.  So the question at this point was if I was always 2 or 3 cm dilated, or was I progressing?  Had I started at 1 cm in the OB's office and now that I was at the hospital I was at 3?  Or was I always 3, the OB didn't want to alarm me so he told me 1 instead of 1 to 2, and then he measures differently than the nurse?  It was time to call in a third person to check my cervix.  Person number three is a resident in OB (he and Keith actually got to bond a bit talking about rotations that you have to do as a first year resident).  He checked my cervix and said he was pretty confident that I am 3 cm.

Because of the uncertainty of always being 3 cm or progressing from 1 to 3 cm at just 32 weeks pregnant they decided to admit me overnight.  There were several reasons for doing so.  First, they wanted to make sure that I wasn't contracting, so I have been hooked up to the toco for about 10 hours now.  Second, they want to make sure that I am 3 cm dilated today, and no more.  Third, they want to pump me full of several medications.  Since I have been here I received IV fluids (this is my first IV ever!), IV antibiotics (they don't test for Group B Strep until you are 35-36 weeks preggo, so they gave me abx as a precaution.  Also, if I have an asymptomatic UTI (the reason for the urinalysis), it could cause the cramping and dilation.  The antibiotic essentially could kill two birds with one stone, or if I don't have a UTI or GBS it could be yet another case of antibiotic overuse.  But I guess it is better to be safe than sorry when it is my baby's health that could be affected), calcium channel blockers (to calm down my uterus...however it hasn't felt calm over the past couple of hours), and a steroid shot (to help the baby's lungs finish developing so they are surfactant filled if baby happens to be born early).

I've got to say that I'm glad I have a husband who is a doctor at this hospital.  I have made sure to casually work into conversation with each and every one of my caregivers that he is a doctor here.  I want them to know that we are medically educated people and to talk to us like we understand, and I also want a little bit of the VIP treatment.  I have no shame in saying that, and from interning at this hospital I know that staff and family members of staff (especially family members of doctors) get a little extra TLC.  Also, he ran home to get some essential supplies and then came back and slept in my hospital room last night (even though it meant that he only got 4 hours of sleep).  It was nice because he was able to roll out of recliner (he slept in the chair in my room because he didn't want to bother with a cot), shave and brush his teeth, and then go straight to work just a couple of floors away from here.  When the doctors come to talk to me today or if any decisions need to be made, he told me to page him and he will come to see me to help me to sort through everything.  He also said when he gets a chance he is going to come to my room to do his charting.  He is a good one. :-)  I'm very glad to have such an amazing husband!

Hopefully things will go as planned, baby Vogt will stay in cookin' for another 5 weeks or so (or at least 2 or 3 more weeks when major milestones have been met by the fetus, like the ability to eat without a feeding tube and the ability to breathe without assistance), and I won't find out the gender of baby Vogt before I cut my cake open on Sunday.  Somehow I think that the cake cutting might be anti-climactic if we already have a baby born of a known gender...

Thankfulness and Respect

I know that it seems like I complain a lot about pregnancy on here.  Well, the reason for that is because those just happen to be the funny stories.  If I talked about all of the amazing parts about pregnancy I might be mesmerized, but I think most everyone else would be bored.

But I think that it is worth talking about from time to time (especially considering that we are heading into the season of thankfulness with Thanksgiving being just one month away).  First, I want to talk about respect.  Pregnancy is way harder than I ever thought it would be.  I have a ton of respect for every woman who has ever been pregnant.  It is kind of a constant physical battle.  While I had sympathy for pregnant women in the past, now I have empathy and will do everything I can to help them and make their lives easier.

Even though this has been one of the hardest things that I have ever done (and labor will catapult the difficulty into the stratosphere), it is worth it and I wouldn't trade any of it (except maybe the vomiting).  Every little battle I face I am fighting for my baby, confirming my love and showing myself that I can be a good mother.  I am also rewarded in small ways every day.  One of the greatest feelings that I have ever experienced is feeling my baby kick.  I stare at my belly every time I feel movement (which is making me less and less productive as the weeks go by and the baby kicks more and more).  I try to get Keith to stare too, but I realize that it is not as exciting to him.  As he has said, he doesn't get to feel the baby moving on the inside along with seeing the movement on the outside.  I know that not everyone gets to experience this, and I am so thankful that I am lucky enough to be able to feel my baby.  I am blessed.  And in less than 9 weeks (or so) I will get to hold my baby in my arms and feel it move around and kick on the outside.

what I most look forward to

Other than actually having a baby in my arms, what I most look forward to after childbirth is once again gaining the ability to sleep flat on my back or stomach.

Feeling first trimester preggers...again

I made a bit of a mistake today.  I was grocery shopping and came across gummy prenatal vitamins.  I have been taking gummy flintstone vitamins since my first trimester since prenatal vitamins made me throw up and chewable flintstone vitamins made me feel extremely nauseated.  I finally just accepted the fact that I would have to take gummy flintstone vitamins.

I have been doing really well with my gummy flintstone vitamins.  I only got super nauseated from them a couple of times (both times on an empty stomach), and for the last 10-15 weeks I have been able to take them on an empty stomach no problem!  It was with this logic, that gummy vitamins are safe, that I decided to purchase gummy prenatal vitamins at the store today.

Not all gummy vitamins are created equal, however.  Gummy flintstone vitamins actually don't have a very high vitamin content.  This is good and bad.  It is good because the vitamins were what was upsetting my stomach, so by taking much smaller doses throughout the day I was able to keep the vitamins down.  This is bad because the vitamins are low in vitamins, so in order to get in enough vitamins to match up to my prenatal vitamin I had to take 8 gummy vitamins in a day.  This rarely happened.  Furthermore, some vitamins in the flintstone gummies were at 50% of the RDA in just one gummy.  Other vitamins were at 12.5%.  So in order to get 100% of the vitamins at 12.5%, I would get 400% of the vitamins at 50%.  Anyone who knows about my thesis research would realize that this really bothers me - vitamins are not good at all levels.  We have 100% for a reason.  If you exceed that level by too much, the vitamins cause more harm than good, leading to bad diseases, organ damage, and sometimes death.  When I found the prenatal vitamins I was very happy to discover a mostly balanced vitamin profile.  In taking 2 gummy prenatals, I was able to get 50-100% of all of my major vitamins!  And the ones at 50% are vitamins like vitamin E (which most people do not need in supplement form) and the ones at 100% were vitamins like vitamin D (which most people need in supplements in order to meet the recommended intakes).  I was so happy to finally have a bottle of gummy vitamins with a decent vitamin profile, and I was happy to have prenatal vitamins that I would be able to take because they were gummy!

But I was wrong.  Unfortunately, within about 20 minutes of taking my new prenatal vitamins I began to feel nauseated.  It has now been 5 hours since I took my vitamins and I still feel as bad as when I first took them.  I think that I am perhaps not meant to take prenatal vitamins, and that I should try to continue through my last 9 weeks of pregnancy with Fred, Dino and Pebbles.

Gwesley

We finally decided on baby names and that it is time to share.  If we have a girl, she will be named Gwendolyn Aurelia.  If we have a boy, he will be named Wesley Rowan.  We love these names and spent hours looking through somewhere between 10 and 20 thousand names.  And in 2 1/2 weeks we will find out, at my baby shower, if we are having a little Gwen or a little Wes!  But, until then, we are having a "Gwes."

Let me introduce you to my friends Braxton and Hicks

I have been experiencing some pre-term labor.  Not that it is a big deal, as I'm pretty sure that most women experience it.  However, when it hits it interferes with my life in minor ways because I have to slow down and take better care of myself (our bodies have amazing ways of telling us when we are doing too much).

The main symptom that I have been experiencing is menstrual like cramps.  They started about 3 weeks ago on a day that I felt nauseated and allowed myself to become dehydrated.  The next time they struck was about a week or two later when I was out of the house for seven hours with no access to water.  Tonight I got really severe cramps again.  However, this time I had been laying in bed all day reading and typing for my thesis.  I had eaten two square meals already as well as one snack.  I had taken in 7 8-oz glasses of water and milk.  So for the life of me I have no idea why baby decided to revolt and cause sharp, rhythmic pain in my back and pelvis.  This time things were different than the last two times; the pain occurred every 5 to 10 minutes, or so, with no pain in between.  This has led me to believe that I may have experienced my first contractions (braxton-hicks, mind you, but contractions nonetheless).  But they didn't feel like what I thought contractions would feel like.  Because they felt different than I thought, it makes me think that I am reading too much into things.

But let's face it: it never hurts to take a break, drink a big glass of water and lay down for a little while.