A Family of Four!

Isla got to meet Isaac today!
Isaac's wonderful day nurse, Rhonna, arranged for Isaac to be off his monitors for a few minutes and Isla got to look through a window at Isaac.
Isla recognized Isaac from his pictures right away. She was very serious but very interested in him. She told Rhonna that Isaac needed a bandaid for a tiny scratch on his face and wanted to show Rhonna her bandaid on her own finger.

Isaac was very relaxed and happy. Rhonna unwrapped him and showed Isla his feet and hands. Isla was pretty impressed and a few times she double checked that I did have a baby in my tummy any more.

Thanks for all the e-mails, calls and texts! I'm sorry we haven't gotten back to anyone. I thought it would be easier for rest and recovery with Isaac in the NICU, but in reality it is translating to less rest. We go to the NICU every three hours for updates and nursing. Each visit takes 1 to 2 hours, meaning we get 1-2 hours of sleep / eating / vitals / medication / shower / etc. I've gotten about 7 hours of sleep since I woke up Friday morning.

Here's a quick Isaac update...
Isaac is still doing fantastic! He is a little jaundiced, but it doing his best to feed. We had one possible incidence of SVT lasting only a few seconds. I was patting his back to burp him at the time, so it is possible that the patting motion affected his monitor, however his heart rate hasn't gone up to 260's any other time we've done patted the monitor. He was also crying when it happened, so it may be related. Right now we are not concerned about it because it hasn't happened again.

The one scary thing is that he has been having some trouble with reflux causing him to repeatedly gasp for air until he turns blue and passes out. It has happened twice. They did an ultrasound of his brain today just to make sure it is not causing the issue. It hasn't happened since this morning, so that is great!

Word on the street is that we will both get to go home tomorrow!

PS - I did not have a c-section! The ER was for Isaac, not me, and he happily did not need any interventions. I'll post "the birth story" soon. Overall it was a fantastic experience!

PPS - All of my nurses and CCP's from 7th floor have been visiting me. It is wonderful to see them all again and show them pictures of Isaac. They all seem to genuinely care deeply about Isaac and his little heart. When I was pregnant with Isla I felt like there were angels watching over her. With Isaac those angels were (& are) physically present taking care of him. We are so blessed.

PPS - We met the daddy of Isaac's neighbor, who was born at 25 weeks when his wife's water broke due to placenta percreta - her plancenta grew through her uterus and into her fallopian tubes (This is super rare - placenta precreta occurs in 5% of all plaenta accretas, which occurs in 1 in 2,500 pregnancies). His daddy was excited because cried and started drinking milk for the first time today. He is an absolute miracle!

Birth Story

Here's the story of Isaac coming into the world... (in LOTS of detail - be warned of possible TMI and endless details...)

On Thursday we met with Isla and Isaac's pediatrician to go over Isaac's situation and have some testing ordered for Isla's heart, just as a precaution.

On Friday morning my mom, Isla and I loaded into the car to go to my biophysical profile appointment. The night before my mom made a giant Indian meal and I made caramels. I made plans with our friends to go to breakfast on Sunday and my mom got tickets for a play on Saturday. During previous appointments I'd felt nervous, but this time we were all feeling confident that all would be normal. (Andrew was not - he said that he looked in the mirror that morning and wondered if he'd be wearing his shirt in the birth pictures.)

I went in and had the non-stress test first. It was completely fine - Isaac was his most active and I did an interview with a med student for a research project on maternal understanding of prenatal care during the NST and got a 15$ Target card. Then I went in for the ultrasound. I was chatting it up with the tech and telling her that my fluid levels were usually a little low. I had enough ultrasounds at this point to know that they were even lower than usual, but I wasn't concerned. (Between 7 & 25 is considered normal, but if the levels are on the low end of normal they start paying more attention. They check the levels by dividing the belly into 4 quadrants and measuring the total in each. They also look for 2x2 sections of fluid, which is an indicator that everything is fine, even if the fluid is on the low end of normal.) The tech measured twice and told me she was getting 3 and she wanted me to go over to L&D for a more detailed ultrasound. I asked what typically happened in this situation. She said, "If it is really this low, they usually want to deliver, but who knows, maybe he'll pee on the way over and the level will be up."

I still wasn't worried, but things did seem a little surreal...maybe I'll have my baby today! I walked over and called my mom. I decided not to call Andrew until I knew for sure...it still mostly didn't seem real. My mom and Isla were getting smoothies at the cafe next to the hospital (the one we'd gone too when I was in the hospital in my wheel chair, IV and all - I wonder if that happens there a lot?) and we decided not to say anything to Isla until we knew.

I checked in to L&D and got my room L&D ER1 this time. I had the charge nurse and she was really nice. I'd never met her, but she knew who I was from seeing Isaac's monitor (pretty much everyone did - Isaac is famous!). Then the Dr. came in - it was Dr. A, a perinatology resident who had been working with us from the very first day arrived. I was so happy to see her! She completely knew the background and in the previous weeks, I'd already held her hand and cried, discussed my worst fears and basically bonded a ton, so there was no one I'd rather have walk in the door. She was really excited to see me too and brought in the ultrasound right away. She did it twice and said, "I don't know what they saw over there...I can't even get 1 (for fluid levels). Every cavity is filled with cord, not fluid." (The machines can detect blood flow and identify where the cord is, even if it isn't immediately visible.) Then she said something to the effect of, "Are you ready to have a baby!?!" YES!!!

Here's your medical vocab word for the day - "Oligohydramnios"
I don't know how to say it, but basically it means low amniotic fluid. There are lots of causes, but one of the most common in 3rd trimester is placental breakdown, meaning the placenta is no longer effective. It puts the baby at risk because the placenta isn't doing it's job and because without fluid the baby can compress his cord. In my case, with almost no fluid and being full term, delivery was the only option. (The low fluids explain why I was measuring on the small side.) I find it odd that the reason for the delivery came out of left field (just like everything in the 3rd trimester) and seemed unrelated to the heart issues.

Next Dr. A went over the delivery plan - induction. After checking my cervix - 50% effaced and 1 cm dilated! - she decided to go with straight pitocin, rather than use anything else. I was fine with this - with Isla I was at least 80% effaced, but not dilated and an induction with just pitocin worked fine.

I called Andrew and my mom and Isla and my mom came
I was supposed to have my first real appointment (i.e. in her office, not phone call or hospital visit) with my new high risk OB that afternoon, but obviously it was canceled.

My biggest concern at this point was that I forgot to put on deodorant in the morning. Obviously I forgot that labor was a gradual process because I was totally freaked that I would be in labor without deodorant on. Fortunately we had more than enough time to have Andrew bring deodorant. I called Andrew & my mom. My mom and Isla came to visit and walked with me over to my actual L&D room. I talked to Isla about what was going to happen and gave her a bunch of hugs and kisses. It was so hard to say good-bye to her. I didn't realize it, but in away it was saying good-bye to her babyhood. After Isaac came home she suddenly seemed so huge and capable.

Andrew went home (got my deodorant) and met my mom and packed quickly (We never did get that hospital bag pre-packed, but on the flip side I never totally unpacked from the first stay, and as my friend Carolyn pointed out, you can have a baby without a hospital bag.) I had lunch and relaxed and the nurse came in to start my IV and started the Pitocin around 3pm. Andrew arrived about an hour later and at this point I still didn't feel anything and I still didn't really feel like I was having a baby. I kept telling Andrew how unreal it all felt.

Around 5 pm... We're having a baby!!!

I needed A LOT of pitocin to get things going. They kept increasing it. With Isla we topped out at 24 and they had to turn it down because the contractions were getting too close together and turning into one big contraction. With Isaac they would get my contractions two minutes apart and then they would start to slow down to three unless they increased the pitocin. Like the initial contractions with Isla, the contractions were also very mild.

Around 5:30 pm...feeling great!

Around 8pm - Feeling a little less great...

Dr. A was off in the evening and Dr. R came on. I had always feared delivering with an unfamiliar Dr., but it turned out to be completely unfounded. Dr. R was awesome and actually spent more time in the room and checking in than by old OB had with Isla. She broke my water at 7:30 PM and I expected immediate pain (what happened in the same situation with Isla). There wasn't any water to come out, so it took a while and some testing to actually confirm it was broken. Maybe because there wasn't any water, it didn't immediately get super painful either, just gradually more intense. Breaking the water didn't actually speed up labor, so they kept upping the "pit."

I was worried that I would miss the chance for the epidural, but I didn't want to do the epidural until I was in enough pain that the epidural would be relatively painless. I have scoliosis, so the epidural is a little tricky - last time the anesthesiologist had to do it twice. I ended up getting it at 9:30 and I was really nervous because it was a younger looking Dr. and I knew I was at a teaching hospital and I had visions of paralysis. The Dr. was incredibly quick and confident and he had a resident observing who radiated "anesthesiologist calm" (I have a theory about people who become anesthesiologists.) in a kind of ancient medicine man kind of way and distracted me by showing me the giant rolls of tape they were going to use to keep it from falling out (my friend Gretchen had that happen to her.) I also prayed the entire time and it was incredibly calming.

At some point a NICU Dr. came in to review the delivery plan.

After lots and lots of pitocin I progressed to 5 cm, but I was still 50% effaced. The doctors increased the pitocin again (We topped out at 60 - almost 3 times as much as with Isla! Good thing I have absolutely no concerns about pitocin and its effects on me or the baby.) and I went from 5 to 10 cm and 50% to 100% effaced in 45 helacious minutes. This was really similar to my experience with Isla - uncontrolled shaking, lots of barfing and aspirating barf - just a lot faster. I was given oxygen to increase Isaac and my oxygen levels and it really helped me feel better, even though the mask smelled like the saran wrap the hospital uses to wrap their snacks in, which was gross. I had to be on my side for the entire labor and most of the delivery to maximize oxygen to Isaac and it made the epidural was weirdly stronger in my legs. Whichever leg I was lying on got extra numb and Andrew & the nurse had to help turn me over every 3o minutes or so to keep me from getting too numb.

When I was 5 cm Dr. R predicted that it would be a few hours, so she was surprised and happy that I progressed so fast. She came in to do some practice pushes and it was really discouraging. I realized how much the heart meds and bedrest had effected me and told Andrew and the nurse that I didn't think I could do it. They upped my epidural and had me "labor down" for 45 minutes. Basically relax and not push to see if the contractions would move the baby to a lower station. The one thing I really missed compared to my labor with Isla was having my i-pod. Andrew played some music on his phone, which was really nice.

A little past 10pm - getting some sleep.

1 am - it feels real now! Note the ice chips and barf cup beside...

After 45 minutes I tried pushing again and it was much more successful. Then the Dr. rushed in and asked me to stop pushing because the NICU team was in a C-section. (They must have a plan to address this! I'm sure this isn't the first time two high risk births were taking place simultaneously.) I waited again and then we got ready and moved over to the OR.

4:50 am - Let's have a baby!!!

Everything was hectic, crowded and fast from then on. Isaac's heart rate was dropping and was difficult to trace during pushing, so they had me push even when contractions were not occurring to speed up delivery. (Someone suggested an episiotomy to the OB and she said, "I am NOT doing an episiotomy!" THANK YOU!!!) At the very end they used a vacuum for the last few pushes. The Dr. started explaining the vacuum & I said, "It is fine. Just do it!"

Our, white blond, blue eyed (for the time being) little miracle arrived at 4:59 AM on Saturday 10-15-11. He weighed 6 lbs 3 oz and was 19 inches.

Isaac was screaming when he first arrived - music to my ears. He was placed on my stomach for a few seconds and then rushed away by the NICU team to the resuscitation room. Happily he did not need any resuscitating and after an initial evaluation and Andrew "re-cutting" the cord, he was brought in. Isaac's APGARs were 8 & 9! Both mark downs were for color.

Daddy cuts the cord at 5 Minutes old!

Holding him was instant love! I had no idea my heart could love another child as much as Isla and I'm so happy that it was instantaneous and complete. Isaac was crying a super soft cry and was very very pale and perfect. I held him and kissed him and we took some pictures. The NICU team stood around shuffling their feet and finally one of them told me they had to take him.

Meeting Mama at 8 minutes old!

Andrew asked if I wanted him to go with them and I said yes and then the doctors finished everything up and wheeled me back to the L&D room for recovery. At some point a NICU nurse came in to tell me that his heart was doing great. I rested and slept a little until Andrew came in and then we looked at pictures of Isaac, heard about what they did in the NICU (and the wonderful nurse who stepped in and took over after another nurse failed twice to start his IV.)
After rounds were over in the NICU we went in and I got to really spend time with our little man!

Isaac James - 1 hour old

9:17 AM - Visiting with Isaac

Isaac's 1st Bed

Our Son - Resting at 2pm

Getting an Echo at 3 pm - All is good!

Welcome Isaac James!

We are so excited to announce the birth of our son, Isaac James.

Born 10-15-11 at 4:59 AM
Length - 19 inches Weight- 6.2 poundsIsaac & his Mama are doing fantastic! Isaac was born in the OR in order to have immediate access to the NICU resuscitation room and NICU level monitoring. The resuscitation equipment was not needed and his initial monitoring looked perfect. Later at the NICU he had a 12 lead EKG. It was perfect and had no indications of Wolf Parkinson White - one of the more serious causes of fetal tachycardia. After a very quick visit with Mama, Isaac went with Daddy to the NICU for monitoring. Everything looks great - his heart rate is on the low side of normal with no signs of arrhythmia.
He has a small heart murmur that should disappear when the ductus closes completely (usually within 3 days), he is having some mild problems with profusion, and had a few issues with a vasovegal response when burping, which all sounds a little scary, but in the world of the NICU adds up to nothing to worry about and to an extremely healthy thriving baby.
He has had a preliminary echo that indicated a completely healthy normal heart (other than the ductus needing to fully close - which is normal for his age). He'll have another echo on Monday. Right now we are just waiting to see how he responds to the medication wearing off. There is nothing to indicate that his heart will return to SVT, AF & A-Fib. If all goes well, he will be released from the NICU to go home with us on Monday.
Isaac is eating like a champ and also has already found his thumb. He no longer needs the warmer and is able to regulate his own temperature. He is receiving outstanding care and is on constant telemetry, pulse ox and some other monitoring. Everyone in the NICU is super nice and we are already able to visit without being overwhelmed by all the machines and wires.
Isaac already loves his paci - here he is holding it all by himself during his echo.
It is hard to beleive that Isaac has been in our lives for less than 24 hours. We are already so in love with our little man! It feels like he has been in our hearts all along.

Happiness...

I just talked to Isla & told her I was coming home.
Me: Guess what Isla? I get to come home today. When you wake up from your nap, I'll be home!
I: I would love for you to come home after one last nap!
Me: Ok, well I'll be there when you wake up.
I: And will you play with me?
Me: Yes!
I: and read to me! ...and put me to bed!?!
Me: "Yes!"

Homeward Bound!

(a little Simon & Garfunkel nod...)

I am going home today!!! (For REAL!!!)

We had the fetal echo this morning. Everything looks perfect!!! Thank God!!!
Right now he is not having any valve regurgitation and the pericardial effusion (fluid around the heart - 1st stage of hydrops) is gone (I didn't mention that earlier because it was freaking me out a little too much to share.) This is great because it indicates that without the tachyarrhythmia his heart is healthy.

Isaac has only had a few minutes of SVT in the past 24 hours and the cardiologist and perinatologist are both thrilled.

I am going to continue to see Dr. R twice a week for non-stress tests and biophysical profiles and regular OB appointments.

Delivery will be planned as normal (and not next week - we'll just wait until he is ready). I am going to be on modified bedrest & on the heart medication, but I will be able to get up around the house...basically a little more active than I have been here, but not much.

The cardiologist said that Atrial Fibrillation and Atrial Flutter usually resolve with birth and SVT typically does too. The plan will be for Isaac to be observed a little longer than most babies without medication to see if his condition resolves. He will then see a cardiologist and has a good chance of having no issues at birth.

This is such a hugely different spot than we were in last weekend. Now that things are so good the Doctors are a little more honest about how scary things were last weekend. Apparently he was in tachycardia 45-50% of the weekend and everyone was sure we would be delivering this past week.

We are SO Happy & SO Thankful!!!

36-36

36 Weeks & 36 Days to Go!!!

I've been looking forward to typing this post from early on...
& I'll have a belly picture to add soon! (Here it is...)Today I am officially bored out of my mind... I took a little walk (down the hall, to the window that overlooks the helicopter pad and the water), read a bunch, ate too much food & See's (I'm going to be huge!), talked to the nurses, napped, looked out my window, did arm exercises, wrote the alphabet with my feet, wished more people would post on facebook & update their blogs on the weekends, wished TV wasn't so terrible on the weekends... Right now I'm watching "Pawn Stars."

Andrew & Isla visited & we played hide and go seek in the hospital room and my parents are on their way to visit (Did I tell you my Dad is visiting! It is so nice to have him here and Isla re-named her favorite stuffed animal "Grandpa" when my mom came without him.)
(Some hide & go seek...)


I had a bunch of contractions yesterday & Isaac's heart accelerated with each one, just as it should. The only problem... I couldn't even tell they were happening! My guess is that they aren't doing much. Today I've had tons of Braxton-Hicks - the first I've had since being in the hospital.

Isaac is doing absolutely amazing! He may have actually converted, because he hasn't had any tachycardia all day. It sounds like he still is having arryhthmias, but in the grand scheme of things, that is ok. He did A LOT of sleeping today. I think the poor little guy is probably exhausted from the past 3+??? weeks. This afternoon - during a time he usually has tachycardia - he was very very active, just like he is during tachycardia. His heart rate went up in the exact same patterns it follows in SVT, except it never got above 160! It was really reassuring to see.
(More hide & go seek...)

Still Looking Good!

Isaac just had his first tachycardia in the past few hours - & it only lasted for 3 minutes!
I think this is as close to cardioversion as we are going to get, but it is fantastic.
The medicine is doing its job almost too well...with my heart rate often in the 50's and Isaac's between 100 & 120 most of the time (normal range is 110-160), my guess is this is good balance.
The most exciting thing is watching Isaac's heart rate shoot up during his active times - it shoots up to the 140's!!!

I am hoping to go home very soon!!!

I'm handling the medication much better now. I still occasionally get sleepy, weak or nauseous and I still get random twinges of chest pain, but I have so much more energy. The loads of See's candy my family has given me has been excellent self medication.

Now that things are looking so much better, the calmness and confidence I felt at the beginning is slipping. (In the past 2 and a half weeks I've spent many a night watching the monitor as my baby's heart struggled away at ridiculously high rates and let the tears flow - while trying not to sob out loud so I wouldn't have to talk to the tele nurse, but also stay calm and breathe just in case my crying had an adverse effect on Isaac - BUT, for the most part I have felt, to quote one of my favorite songs, "peace like a river [...and] love like an ocean [for Andrew, Isla & sweet baby Isaac and everyone who has supported us] in my heart). Now that things are improving so much, my anxiety and fear and the weight of everything that has happened is creeping back in.

My wonderful sister told me not to waste my time worrying that I don't feel the way I think people think I should feel. (Did you follow that, b/c if you did, it is some very insightful wisdom.) I am trying to keep that in mind when I am flooded with dread or sadness that seems more appropriate for all the scary things that were happening last week.

I have a series of awesome nurses - Sara and Stephanie - two days & nights in a row! Today I found out that Sara went to school at Johns-Hopkins in the same class as my friend Nan's husband. How random (cool) is that!?!?

Also, dining forgot my sherbet (again) and Rose, one of the other nurses, called down & got me two sherbets. Now I have a stockpile of sherbet in my mini- fridge!

Fun adventures...

I have Sarah again as my RN.
Today she got a wheel chair and let me leave in the wheel chair with Andrew, Isla and my parents without a RN chaperone. :-) (Other than my mom.)

Isla rode in my lap and snuggled a bunch and we wheeled over to a cafe next to the hospital. Isla & I shared a smoothie and we had fun doing something normal.

At the cafe I ran into one of my tele nurses - her baby girl is due in early November - and we caught up.

What a fun day!!!

Happy October!

I can't sleep, so I've been watching the sunrise for the past 80 minutes, waiting for breakfast and hoping to take a shower as soon as possible.

Isaac has had less than 20 minutes of SVT in the past 24 hours!!!
A few minutes twice yesterday afternoon, a few minutes last night and a few minutes this morning!
I'm not willing to completely get excited yet, because we've been there - done that, however, this is the best 24 hours he has had since arriving at the hospital by a huge margin!

Thank you again for all the prayers, support and positive thoughts!!!

Day 18 & Great News!

I can't believe it has been 18 days!
I just had an ultrasound and it was the best ultrasound we've had!!!
Isaac had no valve regurgitation and no tachyarrhythmia during the ultrasound!
Also the amniotic fluid level was higher and closer to normal. This is the first normal ultrasound we've had.

The high heart rate seems limited almost entirely to night time and the length of time is shorter every night. Last night it lasted only 3 - 4 hours!!!

Right now he is transverse, but I can feel him flipping around, so that probably won't last long.

Although I would REALLY like to deliver next week & meet our baby boy, this might mean getting to go home and deliver closer to his due date, which is much better for him! I'm here until Monday, but if everything looks good I will probably get to go home.

I'm so thankful that he is doing so well!!!

By the way, my ride outside was wonderful!!! We went all the way around the hospital. Feeling the sun on my face was almost a religious experience. After going outside we toured around the hospital.

Inspiration!

I have an amazing RN today. She is Muslim and very spiritual. She brings a cloud of peace with her when she walks into the room. Totally what I need, since in my boredom I am googling the listeria outbreak and freaking out.

We were talking about prayer today and she shared how, for her, prayer so grounding for her and allows her to face challenges in life.
She said that the reason God wants us to pray is not for him (or her, if you are talking to Isla), but for us.

Isaac never reached cardioversion, but seems to have stabilized. He now has a 6-12 hour period of intermittent tachycarrhythmia (excessively high and irregular heartbeats) each day and is stable the rest of the day. The Dr. just came in and said, usually when a stable pattern is reached with medication it doesn't change, so hopefully he will tolerate this until delivery.

Oops - a few more nurses...
- Stella
- Kim
- Zaman

Already an expert...

One of the things I LOVE about my husband is his ability to become an expert in things overnight. His research skills are phenomenal and he has a great memory for detail! He already throws around medical terms with the ease of a resident.

Today the Dr. went over everything that is going on with Isaac.
On his last two ultrasounds he had all kinds of abnormal heart rhythms (arrhythmias) & today we discussed them in more detail. When I called Andrew to relay my discussion with the Dr. he knew the definition of all of them.

Here's what is going on with our little boy.
(Although Andrew might be able to better explain these things!)

- Tachyarrhythmia - An excessively rapid heartbeat accompanied by arrhythmia. (Arrhythmia is an irregularity in the force or rhythm of the heartbeat.) The issue with tachyarrhythmia is that it makes it heard for the heart to fill all the way, so less blood is pumped through and oxygenated.

- Fetal PACs (Premature Atrial Contractions) - premature heartbeats originating in the atria, but not in the sinoatrial node (the heart's built-in pacemaker). PACs can be symptomatic or asymptomatic. In Isaac the PACs seem to be triggering tachycardia, so they are symptomatic.

- Fetal SVT (Supra-ventricular Tachycardia) - an arrhythmia characterized by an excessively rapid heart-rate originating above the ventricular region with a 1:1 ratio - meaning the whole heart beats at the same high speed.

- Fetal Atrial Flutter - an arrhythmia characterized by an extremely high atrial rate with an Atrioventricular (AV) Block (this is actually a good thing - the AV node cannot conduct the high heart rate to the ventricles so the ventricles beat at a slower rate than the atria). In Isaac's case it appears to be a 2:1 ratio, with the atrium beating twice as fast as the ventricles, but the sonographer has not been able to measure the rate of the atria during some of the episodes.

- Fetal Atrial Fibrillation - This is similar to Artial Flutter, but the heart beats are chaotic and irregular, so there is no obvious ratio.

- Valve Regurgitation - During tachcardia, and sometimes normal (sinus) rhythm, the valve (I think Aortic, in Isaac's case) doesn't close tightly enough and allows blood to flow back into the heart. In Isaac this is presumed to be caused by all the tachyarryhthmias and should resolve once everything else resolves.

I have another amazing RN today - Sarah. She was a doula and is now a nurse. I am her only patient, b/c they've discharged a lot of patients. We walked/rode around the hospital, talked a bunch, looked through old pregnancy books from the 70's & 80's that she found when she was reorganizing the antepartum unit nurses station.

Ups & Downs

Isaac has been up and down, so my mood has been down and up, but mostly his heart has been low in the last 24 hours!!!

My RN is taking me on a wheel chair ride outside today! I'm so excited!

...

I'm going a little crazy right now.
Isaac has been great since about 1 this morning and the Dr. who came in this morning mentioned either inducing at 37 weeks OR going home at 37 weeks if he is stable.
This should be / is GREAT news, but I'm so tired of the roller coaster ride that I'd rather just know that we are delivering at 37 weeks.

I really hate the uncertainty of everything.

Day 14

I'm hesitant to give any updates, since whenever I do, things seem to rapidly change, but here's the latest.

After a beautiful stretch on Saturday and Sunday morning with minimal SVT/AF, Isaac had one of the worst afternoons/nights we've had so far. He spent well over 50% of the time in SVT from yesterday around 2pm until this morning. (Right now he is thumping along in the perfect 130s.)

The doctors came to see us this morning to discuss the new plan.
At this point they are considering increasing the sotalol, although it is not clear how much it is doing anything, and there is another medication, flecainide that also might be tried. Flecainide has more serious side effects for me, so they will be weighing the risks / benefits of medication or early delivery without cardioversion.

Right now it doesn't look like I will be going home until I deliver and the goal is to keep him in until 36 or 37 weeks. 37 weeks is considered full term, so it will minimize any risks of early delivery. If he is still breech it will definitely be a c-section, if not, it depends on lots of factors. I will be getting ultrasounds every other day to check for hydrops or increased low fluid.

After he is born he will go to the NICU. There is still a chance that the transition the heart makes at birth will regulate everything. If not, they will try medications to control his SVT and if not he will be transferred to Children's for an ablation.

U.S. News ranks Children's as one of the best hospitals in the nation for Cardiology and Heart Surgery. The Cardiovascular Surgery Department is recognized for "Integration of advanced electrophysiologic testing, arrhythmia ablation and surgery" with "outcomes among the best in the nation for catheter ablation of arrhythmias." So if Isaac ends up there, we will be in great hands!

I heard the term, "fetal heart disease" yesterday. I knew this was serious, but that description was a little shocking.

My dear friend wrote to me about the feeling of disconnection. Her husband has a very intense job in the military and she has gracefully handled some very difficult and sometimes sudden deployments.

Her words express my feelings perfectly...

When I read about you feeling "numb" it struck a chord. When my husband goes off on deployment I go numb too. It is survival, because allowing yourself to fully feel the place that you are in and all the emotions teeters on a breakdown that you don't know if you can recover from. Scared, sad, worried, anxious....and so much more. So, we go numb... feel and cry a little now and then like a little valve release... and keep moving forward. Being analytical almost. Focused on tasks or steps, doing things self-created to keep busy, watching shows that allow us to turn our minds off. It is normal and ok.

I'm Sorry...

I have missed a lot of calls in the past few days - the reception here isn't great and I haven't been feeling 100% emotionally or physically (the newest side effect of the medicine is feeling like I've been bruised everywhere - it is weird and uncomfortable). I feel kind of numb about Isaac and I'm definitely avoiding talking about it (not an option though with the Dr's and nurses.) I also REALLY miss Andrew and Isla and being a Mama.

Andrew & I were talking today about how it already feels like we've transitioned to life with a new baby, except we don't have the joy of having our little boy with us yet.

I really love all the support and love and prayers! We are so blessed to have such amazing family and friends!
I can't thank you you all enough and hopefully I'll be home and feeling in higher spirits soon & more up for talking.
Hugs!

Contractions!

I've had some contractions off and on all night!
I'm definitely NOT in labor, but it is exciting to know that things are happening.
Of course, this could be the norm for the next 5 weeks.

Also Isaac has only had 70 minutes of SVT in the last 12 hours!!!
The increased meds seem to be helping!
I am really hesitant to say this, but there is talk of going home tomorrow!!!

Room to Myself

Just a quick update - my roomate had her baby today (her protein and blood pressure were too high) and she is getting a new room. Now I'm in the giant room all by myself. They said that it is supposed to be a single room, so it is really unlikely I'll have a roommate.

Also, the cardiologist decided I can be off the telemetry monitor, so I will not have a tele nurse tonight! Just Nurse Stephanie.

Stephanie just brought in her essential oils & I picked a blend to promote sleep. With no disruptions, other than meds and vitals, I'm going to try just benadryl to help me sleep tonight.

NICU Tour

Kendall & I toured the NICU today. I almost lost it when we went in, but managed to hold it together. I had already read about it and heard about it, but oh.my.goodness. that is a lot of equipment! (and a lot of sweet babies).

The Dr. was very nice, but very serious. He said that when we deliver Isaac, Andrew & I will get to look at him and then he will go to the NICU for observation, etc. When he will "graduate" from the NICU depends onhow he does. The Dr. asked how far along I was and when I told him almost 35 weeks he started wheeling us towards the lower level of care. When I mentioned the SVT, he turned us around to tour the high level intensive care and explained that there is also a possibility of transfer to Children's if he needs surgery, but that he would have to be stabilized here first. Again, I almost lost it, but didn't. I have really been focusing on the best case scenario of Isaac recovering from SVT upon delivery.

If Isaac has to stay in the NICU we will be able to visit him during 21 hours of the day (except during rounds, which makes sense to me.) and they will work with me to nurse him. Isla won't be able to visit, but that is understandable.


Saturday RN - Martha
Saturday Tele RN - Kendall

Day to Day

I've watched tons of TCL & Food Network, googled everything I can on fetal SVT, PAC, & AF, googled my medicines, googled all of Isaac and my Drs, read blogs about SVT, read the story of a child at our local Children's hospital who was treated for SVT, read my e-mails (Thank you for all the wonderful distracting e-mails), eaten dinner and snacks (Thank you ladies!), checked out facebook (Fridays are slow), and looked at some of the wonderful magazines my friends brought me (Thank you again ladies!), and obsessed over Isaac's monitor, so I thought I'd blog some more (This is my baby book / journal).

Here's a day in the life of the antepartum unit...

In my head my day starts at night, since that is when I first arrived, but I'll start in the morning...

- 5:00 AM - I wake up on my own, check Isaac's heart rate, and if it is low, snooze a little until the phlebotomist comes in to do my blood draw (for medication levels and magnesium and potassium levels around 5:05 AM)
- 6:00 AM - Medication, IV flush, & vitals time. After this I'm awake and watch the sky lighten, the fog role in and the traffic pick up and try to ignore the side effects of the medications as they kick in. The nurses rush in to adjust the monitors and find Isaac's heart beat on my monitor - it always disappears when I change positions.
- 6: 15 - EKG guy comes in and I try to beat him to remove the stickies when he is done. He'll be off this weekend, so I won't get any updates on his garden.
- 6:30 AM - The residents do their rounds (The residents are all OB-Gyns learning to be perinatologists.) and I try to remember all the questions I had from the night before.
- 7:00 AM - I watch the Duggars on TLC and feel sick. Also time to say goodbye to the night shift and hello to the day shift. It is always fun to see who will be working. I also drag myself out of bed, unhook from the leg squishies the heart monitor, baby monitor and contraction monitor and go potty.
- 8:00 AM Breakfast Time!
- 9:00 AM More vitals. If my heart rate is too low I walk around before taking medications - the next hour is sort of a dizzy haze, hopefully nap time.
- 10:00 AM More vitals and the perinatologist arrives. We discuss the current plan.

- During the day...
Visitors, ultrasounds, take a shower, IV flushes, vitals, lots of reading, google, TV and looking out the window, gossip with the nurses, explain what is going on to the break Tele nurses, debate whether filling out the menu will jinx the plans to go home, find out the lab results, chart my Is & Os, cry, wonder why I'm feeling numb and not crying, and always, constantly, continuously leaning over my bed to check out Isaac's heart rate.

Also, usually at some point someone decides my magnesium is too low & they d0 a magnesium drip.
I get to go on one walk a day, so the baby monitors come off and I get to cruise around the hall with the heart monitor.

- 12:00 PM - Lunch! & more medication... Usually I can't get up for an hour or so after the medicine, so this is major veg out time.
- 6:00 PM - More medication and dinner - hook up the leg squishies that I neglected to put on after the last pee.
- 7:00 PM - New shift & new nurses and CNA's to greet. Wash my face & brush my teeth.
- 9:00 PM - More Medications & Vitals (they are every four hours & before and after the heart meds.)
- 10:00 PM - More medicines, lie down and adjust monitors to find the baby on the monitor and drift off into an ambein & sotalol induced sleep. (At first I was really reluctant to take ambien, but it helps s0 much and doesn't make me feel weird)
- 12:00 AM - more vitals & getting unhooked from the wires to go potty.
- 1:00 - 4:00 AM hopefully sleep with wake ups every time my heart rate gets too low.
- 4:00 AM Vitals - Blood pressure is 80's over 40's usually - amazing! Go back to sleep...this is why the ambien is so important.