James' birthday is coming!!

When I met with my doctors today, we decided to schedule James' birthday!! How exciting!
If James and I both stay stable, James will have his birthday on the morning of Monday, August 31st .

Keith will arrive at 6:30am, I'll be wheeled down to Labor and Delivery at 7:00 am to be prepped for my c-section and they should begin by 7:30-ish, and I should be back in recovery by around 9:00 am. James will be taken care of in a small room off of the OR for the first hour or so (until my surgery is finished) and then he'll be taken down to the NICU.

We'd love prayer for the following concerns:
1. That all aspects of my surgery would go smoothly, including no adverse reactions to the medications, minimal bleeding, good pain management, etc. so that I can recover quickly and therefore get to see James quickly.

2. A gentle birth for James and that his lungs would begin functioning to their full ability right away, with only the usual interventions needed. That he wouldn't need to be put on a ventilator, have other physical struggles or be in pain--so that he can focus all his energy on learning to breathe with a little help, maintaining his temperature and blood sugar, and learning how to feed. Prayer for no bleeding in his brain (they'll check for that after the first week, but there's nothing they can do to stop it or treat it) or problems with other organs.

3. Strength and courage for Keith as he deals with the emotions of going through surgery with me and a son in the NICU; that we both would feel God's peace and comfort instead of being overwhelmed and feeling helpless.

4. A smooth transition for Maddie, both now and as the weeks go by, getting used to visiting the hospital daily to see James and having to develop new routines.

5. A speedy physical recovery for me and continued health for Maddie, since we will only have about 3 weeks between when I come home from the hospital and Sept. 21st, when we have to take her to OHSU for kidney surgery. Prayer to be able to balance having two kids in different hospitals for that crazy week!

6. Praise for my parents, who help out with Maddie a lot, and that Keith's mom Darlene will be here for the next two weeks to help take care of Maddie and then me, when I get to go home! What a blessing!

7. Praise for all of you who have been faithfully praying for James and our family throughout this rollercoaster ride of pregnancy! THANK YOU!!!

One Week

Today was my one week anniversary of being in the hospital on bedrest! You know how they say that things are 7 times longer in dog years? Well... :-)

In case you are wondering "What the heck do you do all day when you're stuck in the hospital?", here's a sample rundown of a Day in the Life...

Midnight or later: nurse comes in to take my vital signs & put compression wraps on my legs (for better bloodflow and to discourage blood clots), which inflate and squeeze my legs every 5 seconds ...all night long
5:00 am: tech wakes me up to draw blood
6:00 am: nurse comes in to take vitals again
6:15am: the construction crew outside my window begins working for the day (against orders to wait until 7:30am)...cranes drilling and putting in re-bar, backhoes breaking up pavement and dropping it into dump trucks...you get the idea.
6:30am: fall back asleep (aren't you supposed to get lots of rest when you're in the hospital? more like lots of sleep deprivation!)
7:30am: nurse wakes me up so I can go down to ultrasound for tests
9:00 am: finally get back to my room, ask to reheat the lovely hospital food that's been sitting out for the past hour
10:00-11:00 am: hooked up to the monitors to check James' heartbeat patterns
11:15 am: shower and get dressed
12:00 am: lunch
12:30-2:00 pm: free time...read, check email and blogs, watch TV
2:00 pm: Keith and Maddie arrive for their first visit of the day & I get to use my "wheelchair time" to take her up to the playroom up on the Pediatrics floor, which is her new favorite hangout
3:30 pm: Keith and Maddie head home; I *attempt* to take a nap
4:00 pm: nurse comes in to take vitals
5:00 pm: dinner (can I just tell you how much I can't wait to be home and cooking for myself again?!)
5:30-6:30 pm: knit baby hat while watching Food Network or HGTV
6:30 or 7:00 pm: Keith and Maddie arrive for their evening visit...another visit to the playroom, then snuggling and reading bedtime books with Maddie
8:30 pm: Keith and Maddie head home for bedtime
9:00 pm-10:30 pm: I get hooked up to the monitors again to check James' heartrate patterns...he's being a little stinker and keeps wiggling off the monitors, so it takes an extra 30 minutes to get the tracking we need on him
10:30 pm - 11:30 pm: eat a snack, more time on the computer or knitting or reading, take meds, get ready for bed
Midnight: start the routine all over again! :-)

There, now wasn't that super exciting?! I know you're all so jealous. (It's funny...on days I was really busy and feeling "so pregnant" and achey and tired, I'd joke with Keith that it would be nice to be in the hospital just so that I could have the freedom to relax and put my feet up and read for awhile. Well, I was pretty much over that after the first few hours I'd been admitted last week!!)

In terms of health/baby updates, I have finally developed pre-eclampsia, just like my doctors suspected I would. At this point my blood pressure is a bit on the high side, but it's staying pretty steady and isn't too bad, but since it does impact James' growth and the protein in my urine has been rising, they are calling it "severe"...even though I feel fine. James is still a teeny guy, but he's been doing great on all of his tests and has remained really active.

Here's the BIG NEWS: Today my doctors told me that if things stay stable, the latest they would make me wait to deliver is when I hit 34 weeks. Apparently at that gestational age, the risks of me getting sicker or my placenta deteriorating too much outweigh the benefits of keeping James in utero any longer...so best to go ahead and deliver. That means James' birthday will probably be next Monday, August 31st!! For me, it's a relief to have an end in sight and know that we'll be moving on to the next phase of things! It will be nerve-wracking to see how he does in the NICU, but I know he's a fighter. I've nicknamed him "Little Stinker" since I've been in the hospital because he always knows when the doctors or nurses are trying to mess with him...any time they use the Doppler wand or the probes on my stomach, he kicks directly underneath it and wiggles away! He's a clever little guy. :-)

His Will

Today's Quote:

Somewhere in this trial His will must be hidden, and you must accept His
will whether known or unknown...Say "Thy will be done!" again and again.
Shut out every thought but the one thought of submission to His will and
of trust in His love.

Hanging in there

Today was "decision day" here at the hospital. I had my ultrasound at 7:30 this morning and then waited for my perinatologist to come fill me in on the plan...would I be delivering??

James has gained 7 ounces over the past two weeks, so he now weighs 2 pounds 5 ounces and is 27 weeks in size. It's not great, but it's progress! My doctors decided that since he is still gaining weight, they are going to give him more time in the womb to grow...which means no delivery just quite yet. They will continue my daily monitoring and I will get new ultrasounds on Monday/Tuesday and Friday next week. I've been told that I will have to stay in the hospital until I deliver, whenever that may be! I am glad that James is growing, but in a way I was disappointed that the delivery was postponed...I had psyched myself up for it! I even got to take a tour of the NICU and see the itty-bitty babies today. But better for him to spend his time inside me at this point than having to spend it in the NICU...even if mommy hates being cooped up in the hospital! :-)

To the hospital we go

So apparently somebody wasn't listening to my "no more drama please" post! :-)
On Tuesday I had my regular appointment for monitoring Baby James' heartbeat patterns, which unfortunately he failed. I guess they look for a certain number/pattern of accelerations and decelerations in the heartrate within 20 minutes and his was apparently too steady. So then I had to get an ultrasound where they looked at my amniotic fluid levels, his muscle tone and movement and practice breathing. He'd been kicking all morning, so apparently he decided the ultrasound was a good time to hunker down and sleep...failed that test too. Next they measured the blood flow in the umbilical cord, his heart and his brain. A new development was that he'd started to shift more blood flow to his brain and less to his abdomen/other organs...a survival mechanism which isn't immediately dangerous, but is a sign that my placenta is probably on its last legs and isn't effectively providing him what he needs anymore.

All these signs added up to doctor's orders for me to head over to Labor and Delivery at Emanuel Hospital for extended monitoring and bedrest. Lucky me! I was admitted Tuesday afternoon and found out today that I'll have to stay at least through Friday (this is the "hurry up and wait" game now). That's when they'll do another ultrasound to check his blood flow and measurements/weight. Two weeks ago he was 1 pound 14 ounces and I just have a feeling that he hasn't gained much since...maybe 6 ounces if we're lucky. (To put this in perspective, most babies at 32 weeks should weigh about 3.5-4 pounds and are gaining 1/2 a pound every week, so James is probably more the size of a 26-27 weeker.) I have been given steroids to develop his lungs faster, so hopefully that will help.

My doctor is being very cautious and my gut feeling is that if the measurements on Friday aren't great, she'll want me to deliver on Friday or Saturday. It's a harrowing thought, but I've had some time to get at least a little bit used to it, so I'm not freaking out just yet. I'm sure the freaking will come after I see him in the NICU. But I am reassured that we're in a great hospital that has one of the top two NICU's in the state...so we are in good hands. Please continue to keep us in your prayers!!

P.S.--Maddie's kidney surgery has been rescheduled to September 21st.

No More Drama, Please!

Did you read my last post about our relaxing vacation? Well, the drama hit the fan the day we left and has been going strong ever since. :-)

The morning we left the lake for our 10-hour car ride home, Maddie came down with a fever. She'd also had a bad diaper rash for a few days prior, which we attributed to being in and out of the water so much. Now, normally this would be no big deal, but her kidney reflux surgery at OHSU was scheduled for this coming Monday and the doctors said she couldn't show any signs of sickness (even diaper rash) for the week prior to surgery. When we left Montana around noon her fever was at 100 degrees. A few hours down the road in a car with luke-warm air conditioning and an outside temp of 102, her fever was 102.7. Once we hit Spokane, WA it was 105 outside and her poor little body had rocketed to a dangerous 104 degrees! She was being a real trooper in the car, but you could tell she was just so miserable. I tried cold packs on her head, a portable fan blowing on her, baby Tylenol...nothing was working. We called her pediatrician who said we could either take her to the emergency room when we got to Portland or just come to his office in the morning--he suspected a bad urinary tract infection and/or kidney infection, which was the exact reason she was scheduled for surgery. We finally arrived home at 10:30pm and I spent a restless night sleeping next to her as she was in and out of sleep, deleriously narrating her strange dreams. The next day at the dr. she had to be catheterized for a urine sample AND get a shot of high-powered antibiotics (sooo not fun). Her fever went away for about 12 hours, but then spiked again...so the next day was another shot. The lab results came back that she had a urinary tract infection that turned into a kidney infection (thus the 104 fever) and since she wasn't responding to the regular forms of antibiotics, she'd need to go on Cipro for 10 days. When the doctor prefaces this news by saying, "We usually don't use this drug on anyone under age 18. It can cause bone problems and she's at risk for rupturing tendons. It's often used after people have chemo or are exposed to anthrax"--well, you know that's not good! In light of these developments, her surgery was cancelled. Yes, the surgery that we've been waiting on for the last 6 months!! Dang it! We'll find out on Monday when it'll be rescheduled...hopefully sooner than later.

Although, not too soon...because I have drama of my own. The last time James was measured (three weeks ago) he weighed 1 lb. 8 ounces and was the size of a 24-25 week baby (2-2.5 weeks behind). Yesterday he was measured again and only went up to 1 lb. 14 ounces and is the size of a 26 week old (now 4 weeks behind) and his growth curve is flattening out at a time when it should be spiking. This really troubled my doctor. Also, my blood pressure was up again, so I have to do another 24-hour-urine test for pre-eclampsia. Strangely enough, I told Keith just a couple days ago that I just had this gut feeling that James was going to come early. I didn't have any physical symptoms to back this up, but I just felt like a change was coming. My doctor said, "There is a possibility you could make it another 5-6 weeks [I'm now 30.5 weeks along], but I just have this feeling that something is going to develop...like pre-eclampsia or that James will stop growing...and I wouldn't be surprised if we have to deliver you in the next 2-3 weeks. I want to see you again on Tuesday for testing and we may give you steroid shots to help the baby's lungs develop more rapidly." Holy cow, 2-3 WEEKS! He's not even 2 pounds yet! Actually, he weighs less right now than I did when I was born at 26 weeks. That's scary premature!

So now we need your prayers badly! Of course, if my womb is no longer able to provide what James needs and he has a better chance on the outside, then I'm okay with delivering early...but it will be no easy road. Probably a month in the NICU at Emanuel, problems with breathing, maintaining body temperature, jaundice, feeding. Preemies are also at high risk for bleeding in the brain, which could cause significant damage. He'll need to be one heck of a fighter and have God's angels watching over him every step of the way.

Considering all this, deciding when to reschedule Maddie's surgery gets tricky...it would be a nightmare to have me in the hospital and/or James in the NICU at the same time that Maddie would be having surgery at OHSU. I know all the details are in the Lord's hands, but things could get rather tricky around here!

Oh, the other big development was from those 12 vials of blood they took from me a couple weeks ago. Turns out they did discover something! I have a double genetic mutation of the MTHFR C677T gene. I inherited one faulty gene from both my mom and dad. This gene controls the homocysteine levels in your blood, which controls blood clotting. This mutation has been linked to all my pregnancy problems...early miscarriage (2), stillbirth (1), pre-eclampsia (with Maddie and possibly again), and can cause blood clots in the placenta/umbilical cord which block nutrients and oxygen to the baby (growth restriction in both Nicholas and James) because my body does not process folic acid normally, which is key for preventing birth defects and growth problems. There's also been links to cardiovascular disease, heart attacks, stroke, Alzheimers (all conditions in my family history). {People in my family, take note! You could have this too and just not know it! Get tested!}

My doctor said this condition is fairly rare...only 1% of their high-risk pregnant patients have the double mutation. The key to preventing problems is to keep the homocysteine levels low. And how do you do this? Some complicated treatment? Nope. Take an extra folic acid vitamin and a baby asprin once a day. When she told me this, all I could think was SERIOUSLY?!! You've got to be joking. You're telling me that we've lost THREE babies, gone to endless doctor visits and been riddled with stress and there's a possibility that this all could have been avoided by me taking a VITAMIN!!! Honestly, I was ticked about it. I remember doing research about blood clotting disorders years ago and mentioned it to both my OB/GYN and to a perinatologist in this same office that I had a consultation with after we lost Nicholas. Both of them said, "Well, you've had one healthy baby, so I really don't think it's a blood issue." Of course, how was I to know, but now I wish I had pushed for the testing! Hindsight is 20/20.

Vacations = Ahhhhhh, relaxing

We've been home from our Montana vacation for almost a week now and I feel so behind! Lots of new developments since then, but that'll be my next post. :-) For now, let's see some vacation photos!

We had such an awesome time with my family and relatives at my grandparents' house at Flathead Lake in Montana. We try to make it there every year during the last week of July/1st week of August, but it had been a few years since Keith had been there (he'd been too busy remodeling our house for the past two summers!). My parents lovingly offered to take Maddie in their car for the whole drive there (Day 1: 6 hours to Spokane, Day 2: 4.5 hours to lake) so that Keith and I could drive straight through the following day. Of course, Maddie thought this was an awesome idea--two whole days of Nana & Papa to herself, going on the huge carousel in Spokane, going out to dinner, swimming and staying in a hotel--that's big girl stuff! My sister Dana & bro-in-law Travis arrived the next day from London and they're just such a hoot to be around. Both of them have larger-than-life personalities and always bring lots of laughs and conversation to the party. It just feels so natural to have them around, which makes it all the more difficult to say goodbye at the end of the week. But luckily, Dana is planning a trip home in November, so we'll see her again soon!

Dana & Maddie practicing kisses in their "movie star sunglasses".

Life at the lake is quite relaxing...read books on the dock, go on boat rides, innertube rides or wakeboarding (if you're so inclined). If you're a 2.5 year old, this also includes playing with toys, reading books, doing playdough, chasing bubbles, playing in the water with floatie toys and throwing about 10,000 rocks into the water on a daily basis. Also, with 12 people to feed on a daily basis, you can't forget the *daily* run to the grocery store which fills up 2 fridges. We all take turns cooking dinner for the group, but when it's your turn, just be prepared to spend all afternoon in the kitchen. :-)

This is what Keith probably wanted to spend each day doing.

This is what Keith, my dad & Trav ended up doing for 3-4 days...rebuilding parts of both of the rotting docks! Fun, relaxing times! :-)

Let the rock throwing begin!

(white chocolate pretzel + blueberry pie "war paint" = very entertaining dessert)

Dancing with baby dolls & Nana

More throwing rocks with Daddy.

This is the true glamour of the lake...check out the knot in those dishwashing gloves! Heck, we don't throw anything away! :-)

GiGi (great-grandma) & Nana


Maddie decided to be brave this year and try going on the innertubes for the first time! As anyone who's tried this with little kids knows, finding the right speed at the beginning can be tricky! Go too slow and you'll sink the innertube. Go too fast and the kids get freaked out.

Here's the "almost sinking" at the beginning...all you see are Keith & Maddie's feet!

Maddie did great up until the very end, when we had to slow way down...and the innertube flipped. Keith immediately pushed her up out of the water, but she was totally freaked out & didn't calm down until she was safely snuggled in the boat. But she said she'd do it all again!

Maddie loved going on boat rides (plus it was the only way we could coax her into taking a nap!) so one day we packed a picnic and took a ride over to a large island for a private picnic. Do you like our primo docking spot? Just climb through the tree brances, over the rock slabs...



I promised Allison that I'd take pictures of the lake house this year. She's been hearing me talk about it my whole life and apparently she had a Pottery Barn-esque picture in her mind...wicker furniture with pristine white and navy overstuffed cushions, bowls of artfully-arranged beach sand and shells, etc. Well...just wipe that idea right out of your heads. It's cozy and homey, but not in that way. (I forgot to take pics of the upstairs bedrooms, which are the "best"--both rooms have full-wall photo murals of either a forest landscape or a lake/mountain range--very hip and modern for the 1970's!) But it doesn't matter what the decor looks like...it's all about the years of memories we've created there, which are priceless.



On our last full day, we drove 1.5 hours to Glacier National Park with my parents, Dana & Trav and my Uncle Craig, Aunt Susan and cousins Ian & Emma from New Mexico. Maddie has been into totem poles lately (she learned about them on Little Einsteins), so we had to take pictures in front of them!

Dana, Maddie, Emma (Maddie's new best buddy) & me (29 weeks preggo)

Craig, Ian, Emma & Susan

One of the spectacular views.

Super-cool old-school tour busses (the tops roll down so you can get a full view!)

As we went on a mini-hike, we spotted this family of mountain goats. Maddie asked, "Which one is young? Which one is old? Which one is about to die?" Umm...WHAT?!

Keith, Travis, Nana & Dana

The tradition: family photo on the dock right before getting in the car to drive home.

Sisters

The whole fam. Love you! :-)