day 4 @ UTMC - starting to feel the routine

Today is a much easier day.  A little boring just because the daily activities at the hospital is starting to become routinary - blood pressure monitoring every hour or so, stress test, baby monitoring, glucose test, etc...  Nothing new today really.

Oh!  of course except for the fact that I learned a few things today.  Like the reason why my blood pressure has been acting up yesterday is because they screwed up my blood pressure medication dosage - instead of giving me 60 mg, i am only being given 30 mg of the blood pressure medicine.   There has been improvement today since they changed the dosage and I have been hovering around 130s/90s once again.  Not too low but not too high as well..

No more shortness of breath thank God! :)  I think being off the IV bag helped alot just because there is so much liquid in my body that it's squishing all my organs together.  I saw Dr. H again today and even he said I look so much better today.  Maybe I do not look too purple coz I can breathe easily.

Unfortunately the swelling on my legs and things and feet has not improved any.  But I did feel lesser pressure on my back (which I noticed the other day is starting to swell too) so it's actually easier to move around.

Ryan went to work today and went home for about 4-5 hours to get some sleep.   My poor baby has had much sleep over the last few days that he said that  4 hours of nap helped alot!  He came back to the hospital at around 5 in the afternoon with some homecooked food (rice,  eggs, meat, grilled cheese sandwhich) and it was yummy!  We both missed home cooked meals coz it's been 4 days that we are eating hospital cafeteria and restaurant food. He is so sweet to cook for us and his rice is perfect :)

Today I got a chance to see little Apollo on ultrasound to just check how he is doing and as usual he is doing great!  His heartbeat rate is stable at 135-145 per minute and fetal movement is consistent.  My little Polo is growing big too :)

I took advantage of my wheelchair rights again with my Ryan and we went down to get some Starbucks coffee. :)  It's just a few minutes but the fact that we get to spend time together means alot to us. :)

day 3 @ UTMC - our new temporary home

Day three I am starting to get more used to being cooped up here at the hospital room. Ryan has to go back to work today (yeah theres a little one who is about to pop out soon so one of us has to work haha) so I am alone here at the room with the nurses to keep me company.  Thank god for WIFI and cable TV.  the first three days are not too bad, but i know here pretty soon I am going to go insane haha.

OK so the biggest thing today is I am having shortness of breathe since last night.  It happens everytime I stand up for a long time or I am talking too much.  I reported it to the nurse and within an hour, I've got three doctors hovering over me in the morning because accordingly it's not a good sign.  They said that they don't want any shortness of breathe because that could be a sign of water developing around my lungs.  And of course I do not want that coz it could lead to complications.  I was a little scared because Dr. Fields said that if it does not improve, they really might need to have me deliver that day.  Dr. H on the other hand suggested that I might be having too much fluid because I was more swollen today than the previous day.  So he ordered for the IV fluid bag to be taken off me (yay!!) and I was hooked up to an Oxygen monitor which monitors the O2 level in my body.

I would say that over the last few hours its been a little easier to breathe.  I think its all the weight that I am carrying.

Anyhow, my blood pressure has not improved today.  I am back up to about 150/100 most of the day last night so I was given more blood pressure medication which significantly imrpoved my BP in the afternoon.  My glucose level is still good.  I am not peeing as much today just because I am off the IV fluid.  Apollo, on the other hand - STILL AWESOME!!! :)

Ryan got back from work around 4 or 5 in the afternoon and I got the best gift from my Doctor today.  I got three (3) wheelchair rights a day!  Yes!  I know its not much but I will be able to roam around the hospital, eat at the cafeteria, hang out at Starbucks and visit the gift shop and the courtyard with my lovey dovey! :)  Which is exactly what we did after Ryan gave me my shower. :)

He took me to Starbucks and I got some iced white chocolate mocha (decaf!) and he got himself his usual venti coffee of the day.  then we went out to the courtyard so I can get some sunshine (no more vitamin D coz it's already past 7 when we went out) and fresh air.   It maybe just a tiny thing but for me being able to get out of the confines of the four walls of my hospital room is a big thing.

I could never thank my husband enough for all that he has been doing the last 3 days.  I know he is very tired but he never complains.  He washes our clothes and takes care of all the things I need at the hospital.  He gives me a shower everyday because both my hands are indisposed. He prepares my meals and arranges the room because he knows I hate clutter haha.   I just hate the fact that he has to sleep on this crappy couch here in the hospital room and we missed sharing our bed.   Nevertheless he does not complain and is always by my side.  He is the best!

day 2 @ UTMC - results of 24 hour monitoring

I could say today is a much better day.  Ryan and I did not get much sleep but felt much better just because we are getting all the information that we need to make informed decisions and understanding of what is going on.

Today we got the results of my 24 hour urine test and its not looking good.  I am at 1,800 protein level range and the minimum for pre-eclempsia is 300 only.  At that point I thought my OB is going to make the decision to have me have an early delivery.  My blood pressure has gone down to normal at 130/85 but my swelling is getting worse.  It's like a mild case of Edema now.

After getting these results I was given orders that I am to stay at the hospital until I deliver (GASP!!).  When is that?  No one knows.  Dr. H said that it is best for babies to be at least 34 weeks old to ensure full lung development.  So the goal is to keep me here in the hospital on close monitoring 24 hours of my pee, blood pressure, etc... and to keep me pregnant as long as they can without compromising mine and the baby's health.  At that point I was both disappointed (of course I wanna go home) and a bit relieved at the same time because I know that there is still a good chance that my baby can develop and grow more before delivery.  Apollo is only 32 weeks and 2 days as of today and if we can wait for another 2 weeks (OR MORE!) that would  be better.

So today Ryan did end up going home to pack a big suitcase of clothing and things for the both of us since we are pretty much gonna be living the hospital facility for who knows how long.  At this point, all I am thinking about is I would be a good patient and would not mind staying here as long as i can to make sure Apollo is developing and growing and I am still safe.



My stats today -

• BP is running at 140/85
• protein level in my urine at 1800
• weight - did not get updated weight but my legs, thighs, hands and face have swollen twice its size (disgusting!)
• Apollo - superb!  heartbeat per minute is at 135-140, fetal movement is good too!

Today I am still assigned Tyler as my nurse and as usual she is great!  Did I tell you she also has pre-eclempsia and delivered her baby boy Owen 10 months ago at only 30 weeks.  She is awesome and sweet and knows exactly what I am going through.  We spent some good time today talking about her experience and she reassured me that me and my baby are going to be fine because she was.  It as great to have a great nurse!

Oh and I also got a visit from Dad Mike, Mom Jan and Mom Bev today.  It's great to have them because it's like having my parents around.  :)

I am starting to like the hospital food here just because there are so many variety.  I know I will eat these words back next week coz I will eventually get sick and tired of the menu haha.  Today I had the parmesan crusted tilapia with rice and veggies.  It's pretty good!

Today I also got alot of supportive words, prayers and messages from our families and friends and it means alot to us.  I know everything is going to work out and I trust all  my doctors to take care of me and my little Apollo.

day 1 @ UTMC - freakout day!

so today I got admitted here at UT Medical Center to be monitored for possible pre-eclempsia.  of course ryan and i are not thrilled about it but we will do everything to make sure out little Apollo and me are in good health.  How did we end up here?  ha!  well i wrote it on the previous blog but pretty much to cut the long short, i was referred to by Women's Care Group at Blount Memorial Hospital to Dr. Hennessey for potential pre-eclempsia.

I came in and I was ushered to the lab where they got my blood pressure, urine sample, weight, blood tests results (from Blount Memorial) and an ultrasound.  Dr. Hennesey and Dr. Fields came in to see me and the first thing that he told me is I look absolutely different from the last time he saw me. I was so swollen and as he feared my protein level in my urine and my blood pressure and just my physical appearance points him to the direction that I may have pre-eclempsia.  He did not hesitate and requested I be admitted for 24 hour monitoring of my urine and blood pressure to allow them to assess if I have to deliver Apollo soon.  

This is the first time that I ever saw Ryan scared shit, he was literally shaking.  When Dr. Hennessey and Dr. Fields said I might deliver today, it was way too much to take, I thought I am going to faint.  Well, they made the decision that I would go first through the 24 hour urine monitoring, constant blood pressure checks, fetal stress test, etc..  In a matter of an hour, we were admitted into our private room and things are being stucked all over me including IV fluids, blood pressure medication, etc..

Well, once in the room Ryan and I had a chance to step back, take a deep breath and go back again to all the conversation that just happened a few hours ago.  It's really difficult to take everything in so we decided to say a little prayer before we even try to understand everything. 

I am pretty much still in a stage where even the doctors still do not know if I need to deliver today.  Again all the results are still pending and the best thing that I can do is follow doctor's orders and have that bed rest in the hospital.

As of today, here are the stats that they are reading - 

• +3 protein level in my urine (which accordingly should be at 0 zero)
• 160/100 blood pressure (which has been running all night long)
• gained almost 15 lbs in less then 5 days (water retention)

 The good news is Apollo is "perfect" according to Dr. Hennessey.  His vital stats are stable, fetal movement and heartbeat rate is normal and his size, weight and other vital signs are great.  I am so happy about this!

Ryan and I had a chance to organize our game plan.  He is of course going to stay at the hospital with me but will take some time off for a few days until we hear back on what the decision is from Dr. H.  He went home to get a few things from the house and we will spend the night here tonight.

Today i am freaked out just because of all the information overload and its just hard to take everything all at once.  but hopefully tomorrow will be a better day.  we know it will be better.

what is pre-eclempsia?

I have not had time to update this blog site of what is happening to me at the moment.  There's been a lot of stuff happening and I have to backtrack for about a week to get everyone up to speed.

Anywho the other day I blogged how I have to go visit my OB at Blount hospital because I am super swollen.  They are afaid I am developing pre-eclempsia. Well it was 1AM at Monday morning (Sunday night) May 23 2011 when I started feeling this annoying pain on the left side of my neck.   So I called WCG at Blount and they asked me to go back to the family birthing center to get my blood pressure monitored again.  I was already afraid that my neck pain is connected to my high blood pressure because Ryan and I monitored my BP that Sunday morning and I am up at 150/95.  So off we went and my BP monitoring and fetal stress test started at 2AM.  Ryan stayed with me the whole time despite the fact that he was on call for work that time.  My BP went ballistic and it did not go down from 160/100 from 2AM to 6AM EST.  Apollo is doing good but my BP is a big concern.  they took another urine test and blood sample from me and once again they found +3 protein level in my urine, but my blood test is fine.  Dr. Metelka finally saw me at around 5AM and told me that he has to refer me to Dr. Hennessy at UT medical because he is afraid I am developing pre-eclempsia. 

He took time to explain that pre-eclempsia is a rare medical condition in which hypertension or high blood pressure arises in pregnancy (pregnancy-induced hypertension) in association with significant amounts of protein in the urine.  I am showing all these significant symptoms coupled by the immediate swelling in my body.   I started to get scared when he said that its a dangerous condition and most of the time the only cure is to deliver the baby early.  PANIC MODE!!

He sent us over to UT Medical where Dr. Hennessy (who saw me 3 months prior for my thrombophilia) will look at my case.  So sleepless and tired, Ryan and I went over to UT Medical to meet with Dr. H and based on the initial consultation and looking at my labs, he said that I am a potential pre-eclempsia patient. 

I have been reading about Pre-eclempsia and found some really good information about it.  (see link below).  Basically what I have been learning from my OBs and from reading is that there is no cause why a pregnant women would develop this abnormal hypertension and protein in the urine.  At the same time there really is no cure except to deliver the baby to avoid any complication that the mother and baby can develop from that hypertension.  It's too much data to absorb so I cannot describe how Ryan and I have been today. 

Anywho I am tired and stressed out so I will just write more about my trip to UT medical in another blog.  Have alot of thinking to do..

http://www.mayoclinic.com/health/preeclampsia/DS00583

http://en.wikipedia.org/wiki/Pre-eclampsia

Visit at University of Tennessee Medical Center - High Risk Obstetrics

So yesterday, Ryan and I went over to the University of Tennessee Medical Center to meet up with the High-Risk Obstetrician who is going to look through my case and assess if I have a high-risk pregnancy case.

You see, I have already gone through several tests, the major being the Thrombophilia Panel, where they found an abnormality in my blood consistency.  I was recommended by Dr. John McAcmis of the WCG at Blount Memorial Hospital to also have another consult with a high-risk obstetrician at UT Med tthrough the results of the tests with me and make recommendations based on his findings.

Before we went there I asked around about UT Medical Center and I got great feedback. Apparently, the hospital is known for it's reputation on medical education, research and producing some of the best surgeons and practitioners around the country.  I love hearing that!

http://www.utmedicalcenter.org/

I was pretty impressed with the hospital coz it's huge and the lobby looks like a hotel lobby haha.

I also learned from Dr. McAmis that UT Medical is known for their High-Risk Obstetrics group, which specializes in dealing with difficult pregnancies and high-risk prenatal care.  And that's what I am there for.

http://www.utmedicalcenter.org/cms/High-Risk+Pregnancy/724.html

Anyhow, when we got there, as usual they got my vitals, take my urine sample, then I was headed for my ultrasound....

The Ultrasound Trauma - 

I remember it was exactly February 5 2010 at 7PM, when Ryan and I went to get an ultrasound at Makati Medical Center in the Philippines during my first pregnancy.  It was not a pleasant experience because that was the time we discovered we are losing our Joaquin. So yesterday, when we were inside the sonograph room to get my 2nd ultrasound, we are bloth clutching each other's hands, our hearts pounding.  At the back of our minds is the memory of the sonographer from Makati Medical saying that she cannot appreciate the baby's heartbeat.

So the moment that the transducer of the ultrasound landed on my belly, we are holding back our breathe until we heard that most awesome sound of our little bube's heartbeat!  I swear Ryan drained the blood from my hands while he was waiting for the sonographer to say something bad.  It was amazing.

The sonographer did not introduce herself and Ryan said she did not have bedside manners hahaha.  Well I think she is a teacher coz there is another medical student with us observing the proceedings, and she just kept on talking to the student and answering questions for us when we only ask.  Nevertheless, we found out some great things yesterday


Our baby grew by 2 ounces.  It is now 8 ounces at 18 weeks and 3 days.  We saw the legs, feet, 10 toes, arms, 2 hands, 10 fingers, face, heart beating, brain, skull, spine, bladder, liver, kidney, oh and we saw the balls! haha.  It's great to know we are gonna have a little Ryan again :)

Meeting Dr. Mark Hennesy - 

http://www.utmedicalcenter.org/FindaDoc.asp?Doctor=251



After my ultrasound, Ryan and I get to spend time with Dr. Mark Hennnesy, OB-Gyn for maternal and fetal-medicine.  He went through my case as submitted by Dr. McAmis and he delivered several news to me -

• Based on the thrombophilia panel results, I am categorized at the lowest risk of the high-risk pregnancy.  He said he was quite happy with what he saw, and surprised too because it was not as bad as he thought it was.  He said that my blood abnormality is just right on the edge of being normal but at the same time, Dr. McAmis is exercising extra precaution by giving me Lovenox to help regulate my blood consistency.
• My ultrasound looks great - the baby is in good shape.  
• Mommy's vital stats looks good too.
• There was a minor discovery found in my ultrasound that he said we should not concern ourselves about too much.  In my placenta, there were only 2 vessel cords instead of 3.  The 3 vessels are attached to the umbilical cord.  one vein (which carries oxygen and nutrients from you to the baby) and two arteries (which shuttle that waste back to you, to be processed and disposed of by your kidneys). Instead of those three vessels, our baby's cord has only two: one vein and one artery.  Two-vessel cord — also known as single umbilical artery (SUA).  Dr. Hennesy said that 5% of pregnant women has SUA.  He said he will recommend to Dr. McAmis to keep a close monitor of the baby's development.  He said that some of the risks associated with having only 2 vessel cords is the ability of the placenta to provide all the baby's needs. 
• I was recommended to do Quad Screening as a result of the discovery of the 2 vessel cords.  The Quad screen is a chromosomal analysis to rule out any genetic abnormalities or other congenital problems. 

The Quad Screen test - 
http://www.americanpregnancy.org/prenataltesting/quadscreen.html


I took the liberty of going through some literature of the Quad screen test.

• The quad screen test is a maternal blood screening test that looks for four specific substances: AFP, hCG, Estriol, and Inhibin-A.
  
  • AFP: alpha-fetoprotein is a protein that is produced by the fetus
  • hCG: human chorionic gonadotropin is a hormone produced within the placenta
  • Estriol: estriol is an estrogen produced by both the fetus and the placenta
  • Inhibin-A: inhibin-A is a protein produced by the placenta and ovaries

• The quad screen measures high and low levels of AFP, abnormal levels of hCG and estriol, and high levels of Inhibin-A. The results are combined with the mother's age and ethnicity in order to assess probabilities of potential genetic disorders.
   
• High levels of AFP may suggest that the developing baby has a neural tube defect such as spina bifida
  or anencephaly. However, the most common reason for elevated AFP levels is inaccurate dating of the pregnancy.
   
• Low levels of AFP and abnormal levels of hCG and estriol may indicate that the developing baby has Trisomy 21(Down syndrome), Trisomy 18 (Edwards Syndrome) or another type of chromosome abnormality.
  

It's a Ryan Junior!

Yay!  We are gonna have a baby boy! :)  Funny coz Ryan wanted to name a baby girl Chris Ann Junior haha.  Now we have a Ryan Jr.!

We found out today when we went to get an ultrasound at University of Tennessee  Medical Center High-Risk Obstetrics.  Ryan and I really have no preference.  We have been looking at baby girl's names over the last couple of days but deep inside, we have a feeling we are gonna have another baby boy.

Can you see the little  teeny baby balls on the ultrasound picture? Our little one is exactly 18 weeks and 3 days and weight 8 ounces!  He grew by 2 ounces in a matter of one week! :) We  are so happy to hear that our baby is doing well and as far as mommy is concerned, I am doing well too!  I will write more about my visit with Dr. Hennessey, High-Risk OB-Gyn, in another blog.  Right now I am just excited because now it's easier to plan and start preparing for our little Ryan. :)

Now we can call our baby a "he", and not an "it." :)  So precious! Now its time to hit that giant baby name  book that we have been holding on for the last one and a half years! :)