Too Soon

I’m terribly glad to be well-informed about my complete placenta previa.  Had I not been aware, I would have thought the bleeding I had in the shower yesterday was a miscarriage.  Don’t get me wrong, it was still shocking and scary as hell, but it was also expected. 

It was 7:15 and Daughter needed to be dropped off at school.  Chris and I had a few moments of panic.  Do we take her to school and then go to the hospital?  Do we just take her with us to the hospital?  Does Chris drop me at the hospital and then take her to school?  Should we call 911?  We were confused and unable to think clearly.  All we knew was that we needed to get to the emergency room as quickly as possible.  Eventually, we found our reasonable thinking skills and dropped Daughter at Chris’ sister a few blocks away.  They were able to take her to school, no problem.  Huge Relief! 

Off we went to the ER.  My darling husband may have (safely) ran a few red lights on the way, making sure there was no opposing traffic before scooting across the intersections.  I did a great job of keeping cool on the way to the hospital, even when I could feel the gushes of blood, but when we walked through the hospital doors, I couldn’t keep it together anymore.  I lost my ability to speak and the tears started flowing.  We got into ER and here’s what not to do:  Go into Admitting when you’re pregnant and terrified-looking.  They wondered what the hell we were doing there and immediately sent me up to maternity.  Chris plopped me into a wheelchair and steered me upstairs.  Triage took me in and turned me into a patient within minutes.  The nurse told me to lie down flat.  Gravity was the enemy at that point.  She hooked me up to the standard 2 monitors:  one for baby and one for my uterus.  She also started a rapid fire IV to hydrate me.  Baby was hard to keep track of because he’s only 29 weeks and still has quite a bit of space to move around.  He also doesn’t like to sit still, so the nurse had to keep adjusting the monitor and eventually gave up with the logic that if he’s moving this much, he’s okay. 

 A lot of things happened very quickly.  Turns out if you’re bleeding and have complete placenta previa, you are deemed a priority.  They took 4 or 5 vials of blood to determine if my placenta was still attached to the uterine wall.  I don’t quite understand the science behind this, but I took their word for it.  Because of the previa, I couldn’t be examined normally, so I got examined via a speculum.  Oh.  My.  God!  Was that uncomfortable.  I get queasy just thinking about it.  The cervix was still closed, meaning no dilation, meaning I wasn’t in labor.  That’s the best news we could have gotten. 

They wanted two sets of eyes examining me to be sure I wasn’t in labor.  The first doctor talked to me while we waited for the second.  When the second doctor walked in, she was someone that I knew! Unbelievable!  She is a woman who used to run with my running club and she also has kids that go to the same classes as my daughter.  What a huge relief to actually know the doctor on staff that day.  She’s going to be my doctor from here on out, too, since I can no longer be a midwife patient.  I am absolutely thrilled about that.  An OB doctor that’s a marathon runner who I know is about as good as I could have hoped for.  It’s fantastic!

The two doctors started preparing Chris and I for what may come.  They said that if it looked like I was in labor or if I was losing too much blood they would transfer me to a different hospital for delivery – one that is more specially equipped to deal with 29 week-old babies.  My hospital has the resources to treat babies that are 32 weeks or older.  They would take the baby if I lost too much blood because the blood is coming from the placenta.  Too much blood loss from that organ means Baby is not getting his share of oxygen and essential nutrients.  I couldn’t get my head around delivering a 29 week old baby.  I still can’t.  Regardless, they gave me a series of steroid shots to help develop Baby’s lungs, should he come early. 

Thankfully, everything resolved nicely.  The bleeding stopped and my uterus stopped showing signs of irritability after it was adequately hydrated.  My runner-doctor-friend decided to keep me for 24 hour observation, so I spent the night in the hospital.  

Since nothing was really happening, Chris left to pick Daughter up from school.  They came to visit for a while.  She was scared of me when she first walked in with her dad, clinging closely to him and hiding her eyes from me.  She came around pretty quickly, though.  I offered her ice cream and that was the magic formula.  We sat together on my hospital bed and ate ice cream and watched Bolt.  I think it was a good first experience for her to see me laid up like that, since she’s destined to see it again in the near future.  She also thought my “dress” was beautiful.  It warmed my heart that she found good in the situation. 

Me & Daughter in the hospital last night, eating ice cream and watching cartoons

They released me at noon today.  I am now on modified bedrest and I’m still trying to figure out what that means.  I’m reluctant to do much of anything besides sitting or laying down.  There’s a pile of dishes that I’m staring at in the sink, but I’m not ready to cave.  I’m too scared of having another episode.  I’m only allowed to do desk work at work, which as a naturalist, is a very small percentage of my day.  That will take some getting used to.  No more hiking.  No more hauling.  No more raptor care.  I’ll have to be creative in finding ways to be useful to my work team.  I’ll miss my walks around Lake Harriet and Lake of the Isles, but I can still go and sit by the bandshell and soak in the summer.  I might even be able to talk Chris into pushing me around the lake in a wheelchair. 

We called our moms to come for back up and they will make their way north tomorrow.  I'm concerned about Chris getting enough time to study for the Bar Exam and I hope that he actually gets to take it.  I’m not sure how much I’ll be able to care for Daughter with my restrictions.  I can’t pick her up until after Baby comes.  That's why having grandmas around will be extremely helpful.  

I have an inkling that I’ll be back in the hospital sooner rather than later.  I’m no longer annoyed with the prospect of bedrest because I’m much more fearful of delivering a baby 11 weeks premature.  He’d miss out on a quarter of his development in my womb.  I’m trying to prepare myself for that and in the meantime, I’m willing him to grow fast and stay put.  Right now, if things remain stable, we’re looking at C section delivery at 36-37 weeks, somewhere between July 26-31.  I will be immensely grateful for every week that goes by with him still on the inside. 

I got another strong dose of fear as I was being discharged.  The nurse told me to call 911 immediately if I have any more significant bleeding.  Because of that, I don’t want to leave the couch.  Here’s hoping the next several weeks are uneventful and extremely boring.  

Groundhog Day

     Today felt like Groundhog Day to me.  Earlier this afternoon, I had my ultrasound and there were contingencies attached to the results.  If the placenta migrated away from my cervix, I could carry on with a normal pregnancy as if nothing was ever wrong.  I’d be able to deliver my baby naturally at full-term, or whenever Baby decided he was ready.  If the placenta started to move, but hadn’t quite cleared the cervix yet, I’d have another scan in a few weeks to check the progress.  If the placenta didn’t move at all, a C-section would be imminent, most likely at 37 weeks if the condition would allow the pregnancy to go on that long. 

     I expected the second option, where I would have to wait and see.  Wait and see has been the medical theme of my pregnancy so far.  Surprisingly, though, the real scenario was option 3.  Rose, the radiologist, pointed out the placenta up in black and white on the screen.  She then interpreted how my cervix was completely blocked.  The placenta couldn’t possibly be any more in the way.  It hadn’t moved at all since my original ultrasound nine weeks ago.  

     So what does this mean?  Well, I’m still waiting for a call from the clinic for the official medical prognosis.  But what I already know is the following:

• The previa will not resolve. Baby will have no way out other than through my abdomen.   
•  I will no longer be seeing the midwives.  Since I am now high-risk, I will be seeing the Big-Guns, aka the OB/GYN surgeons, exclusively.
• We will be scheduling the birth-surgery, most likely in early August if Baby stays put that long.  This leaves 8 more weeks of pregnancy for me.
• Previa can get ugly in the third trimester.    
•  Baby Boy will probably be premature.  

Daughter & me earlier today leaving our last day of ECFE Terrific Twos

    

     I’m still taking it all in.  I expect the next few days and weeks will be filled with equal parts of joy, excitement, and concern.  Baby looked great on the screen today.  He’s really cute.  Rose gave me a beautiful picture of him.  He’s become a lot more human-looking in the last nine weeks, with chubby cheeks even!  I think he’s going to pull through this just fine.  As I type, I’m feeling more concern for Daughter.  How will she react to Mom being laid up in the hospital?  I’m trying to decide how to prepare her for what’s going to happen without freaking her out too much.  How do I explain it to her without her then placing blame on her brother?  This will be the first of the delicate negotiations that come with having multiple offspring.  

The Waiting Place

I’ve decided to give up waiting.  Waiting doesn’t do me any good.  I’ve been waiting for Baby to be born.  Waiting for ultrasounds.  Waiting to run again.  Waiting for Chris’ law school to be over.  Waiting to find a real job.  Waiting to get back into shape.  I don’t want to wait anymore and this conviction has been solidified by reading and re-reading Oh the Places You Will Go to Daughter at bedtime. 

                The waiting place . . .

                . . . for people just waiting

                Waiting for a train to go

                Or a bus to come or a plane to go

                Or the mail to come or the rain to go

                Or the phone to ring, or the snow to snow

                Or waiting around for a Yes or No

                Or waiting for their hair to grow

                Everyone is just waiting

                Waiting for the fish to bite

                Or waiting for the wind to fly a kite

                Or waiting around for Friday night

                Or waiting, perhaps, for their Uncle Jake

                Or a pot to boil, or a Better Break

                Or a string of pearls, or a pair of pants

                Or a wig with curls, or Another Chance.

                Everyone is just waiting.   

On Monday, I had another appointment with the midwives.  This was the third midwife I have seen in the last 2 months.  Like the most recent midwife I had seen, this one encouraged me to remain optimistic that my previa would resolve.  Baby’s heart rate was in the 150s and the Doppler picked up all of his movements.  Hearing him move at the same time I could feel him move was a surprise and gave me the giggles.  Chris just thought I was nuts.  I guess that’s one of the perks about being the mom:  Doppler giggles.  The best news I got was that if my previa clears up, all of my physical restrictions will be removed.  I can go running the same day as my ultrasound if things are looking favorable.   It would probably be an awkward run since I will be 10 weeks more pregnant than the last time I ran, and about 15 pounds heavier.  But I would be able to get my heart rate up again and I could really use that.

I also had my gestational diabetes test on Monday.   The easy version of the test consists of drinking a bottle of sugar water, waiting an hour, and having blood drawn to determine what my blood sugar level is.  The number I wanted to beat was 139.  I came in at 142.  Not quite good enough.   This earned me a trip back to the lab this morning to take the more extensive version of the test, involving 4 blood draws over the course of 3 hours.  Turns out I didn’t pass this test either, but just barely.  It was only my fasting blood sugar level that was too high.  96 instead of 95.  This was before I drank the sugar water.  The rest of my numbers, post sugar-drink, were well below the critical range.  So instead of diagnosing me with gestational diabetes, they want me to retake the longer test in a couple weeks.  I pushed back a bit while I was chatting with the nurse on the phone today.  If it’s borderline, can’t I just make changes to my diet and call it good?  Do I have to give up another 3 hours?  She said she chatted with the midwives about my case and they want to keep close tabs on me.  Then she listed all the reasons why:  my previous C section, the low amniotic fluid level I had in the last pregnancy, the infection I got during labor, and the previa I’m currently dealing with.  She said that all of those combined factors put me at higher risk.  In other words, she convinced me that taking the test again in a couple weeks is a good idea. 

In the meantime, I’m not going to wait for 2 weeks before I start making changes to my diet.  I’m going to be more mindful of my food choices.  Less pasta, bread, and ice cream.  More meat, dairy, and oatmeal.  I’ll admit, I’ve been letting myself go since running was removed from my regimen.  Finding the time to walk has been challenging.  But this diabetes scare is just what I need to get myself moving in the right direction again.  I had an epiphany.   I don’t have to wait to get myself in shape for running.  There are things I can do today, at 27 weeks, to help me reach my running goals.  Whether it’s more exercise (which is only walking in my world right now) or less junk food.   Somewhere along this pregnancy, I’ve given up my good choices and my priorities without giving it a second thought.  That’s a place I don’t want to be.  That’s the waiting place.  

A Step Back

                Today marks my 25^th week of pregnancy.  This is the week that expectant moms are told is a critical week.  If a baby is delivered at 25 weeks, he or she has a chance at surviving.  Granted, it’s not a very good chance, and the future would be filled with many, many days in the hospital.  But it is possible for a 25 week old fetus to survive.  Thankfully, my little sprout has given me no indication that he wants to come out.  Instead, he’s content doing his acrobatics in my womb.  In fact, Chris is a bit worried about how active Baby is.  He’s concerned that Baby is going to be hyperactive.  I tell him that‘s how boys are. 

25 weeks

                We went in for our first post-ultrasound consult a couple weeks ago.  Looking back, I should have been in there much sooner to find out the details of my condition, but the midwife clinic seemed to think a phone conversation was adequate at the time.   If you recall, my previous midwife, who has since left the practice in pursuit of a new opportunity, told me running was still fine.  We found out quite a bit of new and conflicting information at the in-person consult.  The new midwife told me that I could not perform any exercises more strenuous than walking.  No elliptical, no weightlifting, and certainly no running. 

                She told us that if things (aka, my placenta) stay as is, my C-section will be scheduled for 37 weeks.  That’s the critical time when baby is hopefully developed enough to not have complications and before natural labor would start.  Supposedly, it’s really, really bad to go into labor when the placenta is blocking the exit.  The midwife said words like “excessive” and “hemorrhaging.”  The medical experts will do everything they can to prevent labor in my current state.  She also mentioned that an amniocentesis would be performed at 36-37 weeks to determine if Baby’s lungs are developed enough for life outside the womb.  For those who don’t know, amniocentesis is a procedure where they take a very long needle and stick into a pregnant woman’s belly to extract amniotic fluid.  This fluid can tell oodles of information, like if Baby will be able to breathe.   It doesn’t sound like a fun procedure.  37 weeks would give me an amended due date of July 30^th.  Did I mention that Chris is taking the bar exam on July 24^th & 25^th?  That’s just how we roll.

      However . . .

                While the previous midwife seemed very doom and gloom that the placenta was not going to move, the new midwife encouraged us to remain optimistic that things would resolve.  My next scan will be at 29 weeks, or June 4^th.  At that point, we’ll see if there is any forward progress.  If not, they’ll probably schedule another scan for a few weeks after.  One of the frustrations I’ve found with my medical care is that I always go into my appointments excited and optimistic and leave feeling unsettled.  My questions get answered, but most of them are a “Wait & See” response.  It’s maddening. 

                One thing I realized is that if my placenta does clear completely out of the way of my cervix, I would be able to run again.  Granted, I probably wouldn’t be doing 5 mile hill workouts like I was doing at 20 weeks, but to be able to run a single mile at 30 weeks would be exhilarating.  It would probably also be painful.   We’ll worry about that if and when I get there. 

     Yesterday, I took Daughter with me to cheer at a half marathon I was registered for.  Obviously, I couldn’t run, but a lot of my friends were running the race and I still wanted to be a part of it.  It was an enlightening experience and one that I’m pretty sure will benefit me as a runner. 

Me and my girl

There were pacers who held signs as they ran to help runners reach their goal times.  The first sign read 1:30 and each subsequent sign increased by 5 minutes.  With these signs, I could see exactly where I would fit in, pre-pregnancy, based on my fall marathon time.  I’d be a 1:41. Incidentally, this was exactly the time that Victor ended up with. 

Watching the 1:41ers run past me was profound.  I couldn’t imagine myself moving that fast.  Those runners were really flying!  Yet I know what my abilities were.  I have the data on my Garmin to prove it.  For one of the first times, I really impressed myself as a runner . . . and I was only watching.  It was like seeing how good I was, and how good I will be again, from outside of myself.  It was a wonderful experience.

This may sound strange, but I already feel faster than my best marathon PR.  I’m better than a 3:35.  It will just take me a little bit of time to get to my potential.   I know it’s there already.    I just needed to take a step back to really see how good I am.  A 3:20 lives inside of me.  

Running in the Rain

          Yesterday on the way to work, it was raining.  It was a Saturday morning and I had to be at work early to set up for a big event I was hosting.  My plan was to be there by 7.  On my drive in, it occurred to me that 7 a.m. on Saturday is when I usually meet my running club for our long run.  The first clue was hearing the 90s hits on the radio I used to listen to on my way to Saturday club.  The second was all the runners who were out on the roads and trails. 

          It was the kind of morning I used to dread as a runner.  Cold and rainy.  Even so, I never considered not running on those days.  My motivation was always very high and kept me running through all kinds of annoying conditions, whether it was below zero and blustery, just above freezing and raining, or 90 degrees and sticky.  In club, we joke that running in the elements builds character.  And it’s true, it really does.  I used to feel invincible after those long runs last winter when every Saturday was colder and snowier than the Saturday before.  I’ll admit they would sometimes make me crabby, too.  But crabby AND invincible. 

          It’s been three weeks since I last went running.  Yesterday was the first day in these past three weeks that I really missed it.  I wanted to be out there running in the rain with all the other runners.  I wanted to be hard core and invincible like they were.  Like I used to be.  The sentiment surprised me.  Why would I miss the most miserable of runs?  The answer, I realized, is that the miserable runs are badges of honor.  They prove how important running is to me.  And more often than not, they’re pretty damn ridiculous and as a result, oodles of fun. 

          All in all, my exercise restriction hasn’t been as hard on me as I thought it would be.  It’s given me perspective and it’s pushed me out of my regular routine.  That’s been a good thing for me.  I went for a walk with Coach Mitch last week and admitted to him that running was really hurting the last month I was still doing it.  But I’m stubborn and I’m not one to let discomfort stop my workouts. I don’t like change and I wanted to prove I could still do it.  In retrospect, I was doing far too much.  I didn’t want to adjust, even though my body was and is going through a massive reorganization. 

          My spirits have been good.  I owe it to the temporary nature of pregnancy.  I’m already raring to get back to it after baby comes . . .  like an antsy horse forced to wait behind the starting gate.  But it will be a slow and unpredictable return back to the sport.  I’ll be dealing with excess weight, nursing, and two children instead of one.  Still, I want it.  I know I’ll get it back.  And I’m appreciating the time I have now to step back reflect on it.    

   

My Last Run

     I set my alarm for 6:30 this morning.  I finally got myself up at 5:10 after tossing and turning all night.  I keep thinking about running and previa. 

     It’s hard for me to imagine not running.  I love the camaraderie of my running club.  I love seeing other runners on the lakes and knowing  I am one of them.  I love how it empowers me and gives me confidence that I didn’t have in my pre-running years.   I love looking down at my legs and seeing how powerful they are.  I love the calm it brings me when I get home after a run . . . how it makes me a better wife, mom, and person.  I absolutely love how running makes me feel. 

     Everything I read online says no running with previa.  Yet, my midwife says it’s ok.  I decided I will call for another opinion when the clinics open up later today.  Even so, my gut instinct is that I should hang up my running shoes, as much as I don’t want to. 

     I’m honestly scared about what I’ll be like without running in my life.  Running brought me out of postpartum depression two years ago.  It’s a lot of what keeps me going.  I’m trying to stay on the positive side, though.  I like walking and will probably use my usual running time to walk around the lakes.  I’m looking forward to the challenge of staying healthy without running, and probably without weightlifting in my life.  It will be different, to say the least.  But as scared as I am about not running, it doesn’t come close to the terrified I am about delivering a baby at 32 weeks or even sooner. 

      The gist of what I’ve been finding out about previa is that bedrest is common as is a baby that comes prematurely.  What really pulls at my heartstrings, though, is a scenario where I’m on bedrest in the hospital and I don’t get to see Daughter for more than a few minutes a day.  The thought of that kills me.  I also think about a situation where Chris and I try to juggle one newborn in the NICU and one toddler in the real world for an extended amount of time.  The upside is I haven’t had any symptoms to suggest either of those two results.  I am extremely grateful for that. 

     I’ve decided that I’m going to go out for one last run with the club tonight and savor it.  I need a firm goodbye from the activity that brings me so much happiness.  I will certainly miss taking my baby boy on runs with me, but it’s what’s best for both of us.  He’ll understand.  And if things go well, I won’t go out for another run until October.  Going out sooner would mean baby came too early.  

Previa

    My midwife called me first thing yesterday morning.  She had just seen my ultrasound notes from the previous day and wanted to brief me on the implications.  Baby boy looks perfect, no need to worry about anything with him.   I, on the other hand, have a slightly bigger problem than I realized.  The radiology tech didn’t give anything away the day before during the procedure. 

     The midwife explained that placenta previa is a legitimate concern.  Previa means the placenta is growing over my cervix.  In some cases, the placenta partially covers cervix.  In my case, it’s completely covering it.  The visual that pops into my head is a washcloth covering a drain.   A lot times, this issue resolves itself as the uterus continues to grow.  However, because of my placenta’s location, my midwife is fairly certain it’s not going to go anywhere.  She told me to start psyching myself up for a C section. 

Diagram taken from babycenter.com

      

     With my complete previa comes some restrictions.  Mainly, I need what the nurses call pelvic rest.  My midwife told me to give Chris her apologies for that.  We don’t want to risk detaching the placenta since it’s right there.   In fact, she told me I couldn’t even get checked by medical staff for dilation, etc., for the same reason.  She went on to explain that bleeding is more likely with this type of placenta placement.  And if bleeding does occur, it’s a big deal that will likely lead to bedrest.  You can read more about it here. 

     It’s funny how a little bit of information can make you feel so different.  Suddenly, I feel more fragile.  Coach Mitch asked the obvious question of me that I didn’t think to ask the midwife:  Should I stop running?  I called her back to find out, fighting back tears at the prospect of not running for 28 weeks.  That’s more than half a year!   Surprisingly, she said running is still okay.  What a relief!  Not only for my mental and physical health, but I took it as a good sign that things are not as bad as they originally seemed.   If I can still run 25 miles a week, how bad of a complication can this be?  (Unless you’re Chris.)

     If things stay on course, I will probably curb my running at the beginning of the third trimester.  As of yesterday, I’ve given up my hope of running until my due date.  The risk is not worth the gain.  It’s during the third trimester that bleeding is more likely with complete previa.  I don’t want to provoke it.  As Coach Mitch says, not being able to run is nothing compared to being stuck in bed.  I believe him. 

     In the meantime, I’m trying to decide what Baby’s birthday should be.