… I was thinking it would be nice to revisit Woman’s Hospital and review the lay of the land before we had to come “for real” in a few more weeks. Two admissions in six days is *not* what I had in mind.
First off, our girls are fine. They’re growing like crazy — both over 5 pounds each now — they still make time for “swim practice” several times a day, and they’re cooperating with periodic fetal monitoring. Based on their heart rates, one nurse today described them as “the prettiest girls on the floor,” which I’m sure she says to all the moms, but it’s still nice to hear. So the babies are still inside me and taking whatever they need.
How okay I will be for how long remains to be seen.
After 20+ weeks of boringly healthy pregnancy, I surfaced some issues on Friday, Oct 1st, at our 33-week checkup. I knew I’d been feeling dehydrated (and peeing less), and that my blood pressure had been up for several days (140/85, which is significantly higher than my pre-pregnancy 110/70). However, I was caught off guard when the nurse detected protein in my routine urine sample. After the ultrasound, they had me sit in the waiting room for two hours, drink 3-4 bottles (~80 oz) of water, and test again to demonstrate that my kidneys could clear the protein if given enough fluid to work with. I did, and they sent me home admonished to work harder at staying hydrated. They indicated that if I did that, my BP should improve.
However, on Saturday, Oct 2nd, I woke up with an intestinal bug that seemed determined to eject any and all of the fluids I was consuming out the other end. By evening I couldn’t pee at all (which is obviously the opposite of staying hydrated), and my BP was up off and on all day, peaking at 162/94(!!!) near bedtime. After I got the scary high BP reading, I called Dr. K’s answering service, talked with the doctor on call, and got sent to Woman’s for overnight tests and observation by the labor & delivery team.
They did a bunch of monitoring to confirm that I was not in pre-term labor. Phew! They did a bunch of lab work which confirmed that I was seriously dehydrated, but my liver enzymes were normal which meant I had not developed pre-eclampsia. They said I would need to take it easier and make sure my BP doesn’t keep creeping up. After 7 hours and 2 liters of IV saline later, they sent me home with “just” a gut bug.
The upside is I essentially got a trial run of going to the hospital for delivery. The labor & delivery floor was super quiet between midnight and 6 am, and I was my nurse’s only patient, so I got to ask lots of questions. (Interesting revelations: getting an IV feels ok if they shoot lidocaine first, and cold saline via IV can give you chills from the inside out. Funniest advice: if you’re planning to have an epidural, shave your back before you go to avoid the “wax job” when the anesthesiologist removes the catheter and all the tape afterward.) The trip left me less nervous about the whole hospital process, and that was a good thing.
* * *
I stayed sick and tired for several days, but I worked to drink more water, and I kept expecting to feel better. But as this week wore on, I could tell I was getting dehydrated again. Thursday afternoon I had a revelation: I remembered the part of my twin pregnancy book that says sitting reclined with the full weight of two babies (and placentas and amniotic fluid) on your kidneys will impair renal function, and it’s essential to spend lots of time lying down on your side, especially late in the pregnancy. I abandoned my laptop, moved to the couch, drank more water, and sure enough: I returned to having to pee every hour. Woo-hoo! I was delighted to have found a solution to my problem!
Except my blood pressures didn’t come down at all Thursday night, and they were up all day yesterday, too. When I went in for our 34-week checkup, the nurse found even more protein in my urine and Dr. K surmised that I’m developing pre-eclampsia, or pregnancy-induced hypertension. (He said that being a first-time mom, 40, and carrying twins all make me a “prime candidate” for developing pre-eclampsia.) If unmitigated, pre-eclampsia can impair blood flow to the babies and/or damage my kidneys, liver, brain, and other vital organs. It’s life-threatening, and the only cure is to deliver the babies (which at 34 weeks, I’m not yet eager to do).
So I was admitted to the hospital again last night for more testing and monitoring. Dr. K said I should expect to be here until at least Monday, and prepared to deliver the babies sometime next week. (Yikes!) On the one hand, my initial blood work yesterday was all normal, and one nurse said that since I don’t have the “full constellation” of pre-eclamptic problems, I may be able to “limp along” on bed rest (here and/or at home) and still make it a few more weeks toward my due date. On the other hand, the results of the essential kidney tests aren’t back yet and I won’t see a doctor again until Sunday afternoon, so it’s too soon to speculate what’s next. Wish us luck.
p.s. That took about all the sitting up I have in me tonight, so I’m going to hit post. However, Bill and my Mom each took some interesting photos and I aspire to come back and add them when I’m able.
UPDATE (from Bill): Bob concluded her fist 24 hour kidney function test (yes, foreshadowing…), and her protein levels were still too high. As a result, Sunday morning will find Bob re-starting the test(at 4 a.m.), which will then obviously run through into Monday morning. Add a couple of hours for them to get the results back, and something on the order of 6 a.m. or 7 a.m. would be when we might be done with this latest episode. That being said, we might also end-up determining that it’s time to pull the rip-cord on the girls. If that happens, we’ll try to let everyone know as timely as we can. For my part, I’ve got most of a UPS truck of stuff arriving on Tuesday from Amazon. Time to make the donuts, er, um, cribs…
