May 13, 2006

Well, I didn't think it would happen this week, but once again the fetal gods have smiled on me and I am at home for a few hours. It's been quite a seven days.

The first of the week started out just fine. In fact, I even commented to favorite nurse Paula that things were going too well and that I fully expected all hell to break loose at any time.

The girls were consistently doing well in their monitoring, staying still for the duration of the hour and moving at the opportune times. All looked well with me, too, with minimal swelling and strong vital signs.

But lo and behold, Thursday rolled around and my blood pressure shot up to a totally unusual ~180/90. Now I'm a 105/40 kind of girl, so this was more than a little bit alarming. My nurse at the time took my pressure a number of times, in a number of positions (apparently lying on your left side is the way to achieve the lowest blood pressure possible), but it still stayed elevated. The doctor on call (mine is on vacation) saw me first thing in the morning and still my pressure was up. So labs were ordered to check for elevated enzymes and proteins. Should either or both come up too high, the diagnosis would be preeclampsia or pregnancy-induced hypertension.

I made sure to ask a lot of questions (who? me?) and found out a few things about preeclampsia. Of course, I am sure that these things are common knowledge to a lot of people (even those who've never had it), but I'd never bothered to look into the disease.

1. It's not caused by anything -- it's a disease of pregnancy that can strike anyone without regard to their normal blood pressure.
2. The risks are not on the babies (at least not primarily or even secondarily), but rather on the mom.
3. There is no cure. Mild and moderate preeclampsia are treated with strict bedrest. Severe preeclampsia is treated with delivery.

Okay, so, where did that leave me? Waiting on tests that took 24 hours, that's where. It was a long 24 hours, with most of my time spent in bed, lying down. Thank God for narcotics -- I don't know how I could have survived the back pain otherwise.

Thursday afternoon brought results from the first round of tests and while my enzymes were elevated, they were not in the "risky" zone. It would be up to the protein results to tell the rest of the story and they weren't due until mid-morning on Friday.

Thankfully, that night, was my bi-weekly ultrasound and Dr. Higby arrived around 7:00. Ahhh...a change in scenery! I was wheeled (apparently preeclampsia brings the need for a wheelchair) down to the ultrasound room with Todd in tow and we saw the usual stuff. Thankfully, once again, there is nothing to report but increased weights and growth. I was 30 weeks and 4 days at the time, and the girls looked like this:

Faith: 3 lbs, 2 oz, 29.0 weeks
Grace: 3 lbs, 6 oz, 29.0 weeks

We discussed the c-section and Dr. Higby reminded himself that he needed to schedule the operating room for the 22nd. Ummmm...hello? Please do it NOW! I'm so afraid that they won't have a space for me in the OR that day and that I'll be pushed to the 23rd or further!

It's normal for twins at this age to fall behind in gestational growth, we were told, and an hour later, I was back in my room. Luckily, it's sweeps week so all of the Thursday night shows on NBC were new episodes. "The Office" was one of the best season finales I've ever seen and Todd stayed through "ER" to make sure we caught all of the action. A brief reprieve from the monotony that is my recent life.

Friday morning I awoke to high blood pressure again and was told to stay put and don't sit up too much. Ugh...the misery!

The protein test came back around 10:00, though, and like the enzyme test, the proteins were elevated, but not indicative of preeclampsia. However, I was still having the high pressure, so I was told that I needed to take it easy. I had to cancel the volleyball tournament I was in that afternoon and take myself off the list for the marathon I was going to run today, but it's all for the best I, guess.

What else was I to do but take it easy??? I've become a freakin' expert on it!

By this morning, though, my pressure was back to closer to my norm... 117/72 and around there. The doc-on-call told me that if all looked well by afternoon, I could leave on my weekend pass. Freedom, albeit temporary!

We did monitoring around 11:00 and both girls started out looking good. A contraction here (they're more frequent and boy, when they come, they arrive with a vengence!) and a variable (dip in heartrate for one or both of the girls) there, but everything was good.

Of course, 15 minutes before I was to come off the monitor and be release for four hours, Grace decided to act up. Her heartrate is usually in the mid-150s with variables to 120 or 115. Well, today she wanted to show off and did something or another to increase her heartrate to the 180s and 190s with accelerations into the 200s. That meant more monitoring, to make sure that her heartrate came down. So we waited. And waited. And waited.

My nurse was in and out of my room with obvious concern for our little devil child (I say that with a lot of love, of course) and informed me that I wouldn't be able to leave until her rate went down and stayed down. As much as I hated to hear it, I knew it was the right thing to do. Thankfully, accelerations are less harmful that decelerations, although certainly not something to take lightly.

Finally, after about 30 minutes, her rate came down to her usual 150s. We breathed a sigh of relief (Todd and Devin were there) and I was told I could leave as long as I kept track of the girls, making sure they were kicking and moving about. It makes me laugh that they think it's something that could be ignored.

So here I am -- two close calls that nearly kept me from my weekly sabatical, but rising above the challenge anyway. :)

I guess I've expected this from the beginnning. There was no way I was going to be watching these girls nearly constantly for five weeks without seeing some drama here or there. I mean, it's just not feasible for my life or for theirs. :)

As of tomorrow, I'm 31 weeks, giving me only one week to go. Of course, the longer the girls cook, the better off they'll be, but I'm pretty ready for all of this to be over. I'm miserable and uncomfortable and home sick. If you will, please say a prayer that the 23rd will be open for my c-section and that the girls arrive without incident.

If, for some reason, I can't come home next weekend (I'm not sure why I won't, but I'm trying to cover all of my bases), I'll make sure Todd posts for me. It's exciting to think we're as close as we are and the Pruetz family is anxiously awaiting becoming the Pruetz Five in a week.

Love to all and thanks for everything...

E