Recovering well

I am recovering well, my throat is back to normal as is my voice! That was the most annoying feeling ever, together with those sore muscles in my neck. I still look a bit like a cocaine addict with my bruised elbows from the attempts to put a drain in my arm. I haven't had any significant bleeding and it looks like my breasts are taking the hormone bait and won't start lactating. A pity that I still have to lose those 5 to 6 kilo's, that was definitely not baby weight!

I found it remarkable that on Monday the midwife wasn't able to feel my womb, which means that it has already shrunk behind the pubic bone - I mean, it takes over 14 weeks to grow over the pubic bone, but within 2 days the whole thing is almost back to its original size. Looks like the doc has cleaned it out very well during my operation.

I have been fairly light-headed in the mornings the last couple of days, but I can feel that that is getting better too. Yesterday I did my first 'walk' to the letterbox around the corner, chaperoned by DH's mum, to post a letter and that went okay. Tonight DH and I will be going for a short stroll around the block. Can't wait to be on the golf course again to be honest

So what's left of this pregnancy? Not much, a tiny bit of ashes for us to receive, registration of the baby, and the results of the post-mortem on the baby and the placenta. In about 4-6 weeks time we'll be back at the hospital for a discussion of the outcomes, if any. In the meantime we have to be careful (if that's what we want...) as I can become pregnant again straight away!

Sore muscles

Every muscle in my body is protesting, like I've been rowing a regatta totally untrained. My whole back, front, neck and even jaw are stiff as hell!

And my throat is still very much irritated by that tube they put in at the operation, can hardly talk without coughing. Sound like an 80 year old heavy smoker.

And back home

We came home again this morning after a reasonable night sleep, where I again swam in my own sweat due to the hormones given to me the previous day.

In the middle of the night the midwife on call did some checks on me - blood pressure, temperature and blood loss - and after that we slept till 8 am. I have had no pain at all since the baby popped out, only a slightly bruised feeling in my tummy for which I'm taking some paracetamol.

At 9 our own midwife came by to check up on me once again. I also chose to take some hormone pills to prevent my breasts from lactating, as normally after delivering a baby within 3 days the milk will come in! Something else to think about.

The baby and placenta will be sent off to wton on Sunday, where the pathologist will perform research on it on monday. Transport of the baby will be done by a funeral company, all arranged for us by our midwife. After we've seen the baby we decided to let the cremation take place in wton, it was clear to us that this baby never could have survived, no need for us to hold a special service or whatever.

When we came home some truly beautiful flowers were waiting for us from my mum and DH's and my colleagues! Also DH's parents gave us a lovely piece of art; this piece attracted us when we first saw it one or two years ago and is a bit of a free interpretation of Noah's Ark. Very cute.

And last but not least: I am eligible for 14 weeks paid maternity leave, so won't be back at work till the end of February. Pure bliss! Time to get my head around things, to take it easy and to make plans for the future!

At the hospital

This post will be updated during the day, if I feel up to it :-)

8am: arrived at hospital and settled in to our room. Midwife is here too and together we go through the events of the day.

9am: midwife inserts 4 tablets vaginally, which should soften the cervix and dissolve a tube (?) in the cervix so that an opening will be established. Lying on the bed, not allowed to move around till tablets have had time to dissolve.

9.30am: midwife takes temperature and blood pressure. Temp is good, blood pressure is somewhat elevated. Light cramping really low, almost behind pubic hair has started.

9.45am: cramping continues, intensity has grown. Pills are definitely working and quite early according to midwife. DH is off to the hospital cafe for his first coffee of the day. He has installed himself with laptop in the granny chair.

10.30am: cramping continues, intensity is constant now and okay. Midwife is off to an appointment the next 45 mins and the first oral pill is scheduled for 12pm.

11.55am: cramping intensified and started to get very annoying, sharper and nauseating. Took two oral pills, which will kick in fairly quickly and make matters much worse. Also took two paracetamol to start with to take the edge off the contractions. A sick bag is close by.
Just ate a sandwich and half a banana. DH feels somewhat helpless, although he's a nice distraction.
Got a bedpan to use on the toilet to prevent baby and placenta from flushing through, as the need to poo can also be mixed up with the baby coming out. All very glamourous, not. Grrrrtttrrrrrrrrrrrrrrrrrrrrr.

15.45pm: baby delivered!!! Woohooo!! Now waiting for the placenta to arrive. Pain has subsided for now. A while ago I got a shot in the bum with anti-nausea and a pain killer, as the cramps were awful and I started vomiting. At 3pm I got another set of pills plus another pain killer and just when I started to wonder when the heck this would end I felt something coming through.
The cramps will be back soon for the placenta, but enjoying being pain free for now.

16.45pm: preparations are being made to help the placenta coming out. I've just got another 4 tablets inserted vaginally, which might start contractions again and force the placenta out. But in the meantime I'll also get a drip and am not allowed to eat or drink anything for the next 6 hours in case I need to be brought to theatre for a manual removal under general anaestatics.

17.20pm I'm being prepared for a little surgery to get the placenta out. The obstitrician had two attempts at putting a drip in my arm, but kept hitting a valve. The anasthesist was then called who succesfully put one in ny hand. I look like a casualty from war with all my bandages...!


9pm: we both have been dozing on the bed for the last couple of hours and are now listening to x-factor on the tv (no great reception so only sound on this channel).
The doc came by to obtain consent for my operation at 10pm. This can take up anything from 20 mins to whatever, depending on how firmly the placenta is still attached to the uterus. We'll be staying at the hospital overnight.

21.45pm They've taken me to theater where first the general anaestetic will be administered. The surgery should be done within 20 minutes, but afterwards they'll keep me another half an hour or so for observation. Afterwards they'll return me to our room where DH and I will spend the night.


11.15pm: i'm back!! Woke up crying from anaestatic, got a deja-vu from when I was little and had to get operations in my ears. Operation went really well, no complications, placenta came out easier than thought. Just a very itchy throat from a tube that went in there. But hurray for hospital staff, everyone is really very caring and approachable, this hasn't been a traumatic experience. Worst part were the contractions, but quite surprisingly easily forgotten as soon as pain is over - just like flying to Europe and touching down after 24 hrs in a plane. As soon as you've arrived you forgot about the ordeal. And hugs and love for DH of course, we were in this together and he was lovely :-)

Update after first pill

Had period-like cramps tonight, which stopped after a couple of hours. Other than that and a feisty headache the night went well.

DH is thinking of writing everyone who sent us their love and best of luck a personal message back, he's even getting a bit stressed about it, and I wish him all the best as that will be a day task up till x- mas. So I thought I better interfere here and save him.
Please do know that we love your support, but we can't possibly start a writing career just now. Keep those messages coming, or feed us some juicy stories or awful gossip for tomorrow, so that we have something to read during our mini-labour and delivery day.

The process has begun

Today at 4pm we went to the hospital for my first pill. The aim of this pill is to remove the placenta from the uterus, which takes two nights and one day.

We were shown our hospital room - I made a few pictures but haven't found out yet how to post these with my new blogger app on my phone. It just looks like a small hotel room with a queen size bed (a wooden frame!), a lazy granny chair and an ensuite bathroom with shower.

We spent the compulsory hour after taking the pill in our room, and as I was fine when the hour was over we went home again. I can expect symptoms ranging from nothing at all to cramping to severe abdominal pain, in which case I have to return to the hospital of course. Up to this point I'm just hungry all the time!

Kickstarting labour

This is how the next couple of days will look like:

• Tomorrow evening we'll go to the hospital here in Nelson, where I get the first of a series of pills. I have to stay there for 1 hour, so that they can check that there are no side-effects, as this pill apparently can make you feel sick.
  
• If everything goes well, then after that hour we can go home again, where we'll spend the night and the following day, doing nothing much.
• Then on Friday morning 8am we're expected back in the hospital, with a bag. I'll get an internal exam, and another dose of this hormone mixture (?), but now vaginally applied. Over the course of the morning I'll get a couple more pills to be taken orally, 4x the dose of the first one.
• At the same time contractions should begin and if everything goes well then early Friday afternoon the delivery side of things should be over. It might happen that the placenta doesn't want to come out, if that's the case they need to remove it surgically.
• We can stay at the hospital for as long as we like. If things drag on until the evening we can stay for the night, but most people opt to go home as soon as possible.
  
• We'll be there with the three of us: DH, myself and our midwife. Specialists are around in case there are complications. Pain relief is available, as much as I like as there is no baby to take into account.
  
• There is a separate area in the maternity ward for 'people like us', a bit like a hotel room with double bed, bit of a living area.
• I was really not looking forward to this part, but now that I know what I can expect I am starting to get quite curious actually.
  

Get your tissues out for the next part:

• do we want to hold the baby after delivery? Take pictures? We'll decide in the moment I think, that's fairly unthinkable at the moment.
• Then in Wton they want to research the baby and the placenta to find out the cause for all of this - why was the placenta not functioning? We'd like to know that too. So after the delivery everything will be sent off.
• We are required by law to register the baby and bury/cremate him, as he is over 20 weeks old. Another hurdle to get through at some stage. This freaked us out a bit as we don't want to make it bigger than it is really. But now we sort of have to. Then I found out that you can choose your own private place and bury the baby yourself without doing it through a funeral service with coffee and cake, which made this prospect a lot nicer. This is not our first priority, so more about that when the time is ripe.
  

My god, hear what we are talking about, it's sometimes ridiculous and we do laugh between the tissue moments too! It's not all drama.

The baby died

This morning the midwife came by for a routine visit, and after measuring blood pressure etc. she tried to find baby's heartbeat but was unable to locate it. Could have been nothing, but as baby's movements in the last two weeks were very few and sporadic, we all thought that this could be the end of it.

She arranged a scan for this afternoon, and as DH was in Wton for work I went with DH's mom. It became immediately clear that there was no movement or heartbeat and that baby was gone. Baby passing away is quite the shock as this is the end of the road we took almost 7 months ago, but it came not totally unexpected at the same time, and it possibly saves us from a truckload of trouble and very difficult decisions, so there's also quite some relief.

DH is arranging flights to get back from Wton tonight, so that we can have a conversation tomorrow with our midwife on the next steps, which will be labour and delivery to get the baby out. That'll be quite a painful process I imagine, literally and emotionally. Luckily that'll happen here in Nelson at the hospital, no need to go to Wton anymore. After that we'll start with a clean slate, and hopefully take that holiday we were planning to take as I think we could use it.

Still a mixed bag

Sorry for the delay in reporting the results of our scan yesterday, but I had some technical blog problems...

So we went to Wton for yet another scan and came back with mixed results. On a positive note baby has grown, especially his tummy this time. He has now an estimated weight of about 340 grams; he put on 80 grams in the last two weeks. And he is still alive.

But all this growth doesn't change the situation that he is way too small and that he's having a hard time in there. His organs can start deteriorating any time now if they haven't already, as he is conserving energy for his brains which can cause damage to his kidneys and liver to start with.

There is nothing that can be done at this stage, so we'll wait and see for another two weeks. If he then is close to 500 grams they'd like to get him out, although that is still open for discussion as the lead obstetrician doesn't think he'll survive the next two weeks, and if he does then he'll very likely won't survive after delivery.

So we''ll be back in Wellington in a fortnight, with a bag this time in case we decide to take the baby out if he's close to 500 grams. And that will be done through c-section, because there is no way they'll let these fragile babies go through the stress of labour and delivery. But it could also be that we then wait and see for another week, or two.

Nothing to report

We know, we have been quiet over the past week... But that's because we have visitors, work, and gorgeous weather to keep us entertained. Although it's actually drizzling now. Very good for the garden, as October was the driest October month ever. As you can see, nothing to report...

Check-up

Our midwife swung by yesterday for a catch-up and a check-up. Blood pressure was good (no white coat syndrome this time) and no protein in urine. Also the sample that had been sent to the lab 2 weeks ago was clear of protein too.

Pfew.

Again I was totally convinced that baby had died in utero as I hadn't felt him move for a day and just only now and then the day before. But the midwife found the heartbeat straight away, still a feisty 150bpm. And last night and this morning he was really wild, having a jolly good time keeping me awake.

Doing the maths

Folks who follow our other blog may remember a little incident with DH's kidneys when we were applying for our resident's visa a while ago. We had to undergo some medical check-ups and one of the things they checked was our urine.
Well, DH's results at the time came back abnormal, he was suffering from 'kidney failure', we were told by the Dr. That was the strangest thing ever: DH wasn't aware at all that he had troubles with his kidneys, the whole family got stressed, and besides that these results brought our stay in NZ in jeopardy.
These things always happen in the festive season, so in the middle of the X-mas holidays while we had friends staying with us he had to collect his urine in a huge container, can't remember if it was for 48 hours or a whole week :-)

Anyway, we got his results on a sheet of paper and as we are good with numbers and formulas (DH) and quite good at finding evidence from research on all sorts of things (me), combining these lovely skills you'll get us questioning medical results. In the case of DH's 'kidney failure' we found out that some moron had made a mistake with the very complicated formula and that DH never could have had these results. Only from the age of 86 years would it be possible. So no kidney failure for DH!

Now I'm going to translate this to our pregnancy - no miracle stories, I'm sorry, but still....
Again we found a mistake in the latest scan measurements, which has consequences for the use of the formula to estimate baby's weight, and which means the difference between showing a total standstill in growth or some growth, which in turn may mean the difference between actively interfering in the pregnancy or applying a 'wait and see' policy.

Interesting is some research into the formulas they use to estimate baby's weight. There are numerous formulas in use, and they all result in a different outcome. The perfect formula hasn't been found yet. We checked a few of those formulas with the measurements from our scans, taking the error out, and the most pessimistic formula tells us that baby is currently weighing 240 grams, and the one we like most is the formula saying that baby is 320 grams. The one they used at the hospital and has the measurement error in it says baby currently weighs 200 grams.

Estimating baby's weight is interesting, but also prone to inaccuracy as those formulas are based on average babies at the end of a normal pregnancy, so what we also did was plotting all our scan results thus far on fetal growth percentile charts. That makes visible whether there has been growth at all, and how baby is doing compared to the general average. See below for a chart related to the diameter of baby's head.

What we achieve with this? Hmm, not much really, but we feel a lot better informed, the picture is a bit less gloomy than it was, and it emphasised our decision to 'wait and see'. You never know.
And our midwife will slam the hospital around the ears because of the measurement error :-)

What the error was? Inaccurate use of cm's instead of mm's. Which made the circumference of the head 17.3 mm instead of 173 mm and thus a lot smaller than the diameter of the head, which was 50mm. And that is impossible.

Support

Hi there everybody! We have been flooded by messages of support from all you guys and we'd like you to know that that is heart warming and much appreciated!

After 'Weird Thursday' and 'Reality Friday' we are sort of back to normal again. And we have decided to let nature take its course as much as possible and not to interfere with actively terminating this pregnancy. If it is so bad as they say it is then baby won't make it till the end anyway. And that's just the way it is, although it's a strange situation to be in, like a cruel scale with on one end 'baby' and on the other hand 'no baby', what will it be?

We'll keep you posted.

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