And I'm Back in the Hospital at 32 Weeks. Part II: Kathy vs. Beef Ragout, Mark vs. Curtains

The prognosis is pretty much the same now (the doctors think I'll make it to 34 weeks, maybe 35), but they think I'm stable enough to send home this weekend (a.k.a. right now). My bed rest will be a bit stricter than before (less standing, even more laying, and no occasional trips to restaurants). My doctors want me to start walking a little more each day to give me strength in advance of my going home. Right now just walking across the room is extremely tiring. The first night I left my room with Mark to take a walk I wore a hospital gown, a nursing gown as a coat (so I wouldn't flash anyone while wearing my hospital gown), and my "leg irons" (not plugged in) that cover my calves and keep me from having blood clots. (Wearing the "leg irons" reminded me of those movies where an escaped convict wears handcuffs even though the chain connecting them has been cut away.) Basically I looked like an escaped mental patient. My nurse hadn't gotten the "start walking around" memo from the doctor so she rushed over and told me I couldn't do this and I was supposed to be on bed rest.


My doctor wanted me to stand and walk around the hospital more so first order of business? Belly pics!

Previous belly pics

11/17 (33 weeks; Mark: 7 1/2 months; Kathy: 8 months)

Note: Mark thinks the months should follow the Gregorian calendar, and while I agree in theory, pregnant ladies seem to all go by a 4 week month culminating in a 10 month/40 week pregnancy. I'm including these numbers so you'll be able to compare me against other pregnant chicks.

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Guest rebuttal from Mark: Yeah, I think months should follow the Gregorian calendar. This is all my crazy fantasizing about how months should work and not, say, the accepted calendar of the near-entirety of the civilized world. I suppose when Kathy's in power, school children will learn the mnemonic:

Twenty-eight days hath September,
April, June, and November.
All the rest have twenty-eight,
except February, it has twenty-eight we find;
unless it's leap year, then it has twenty-eight

And by the way, who ever heard of a ten month pregnancy? In what species? Panda bears? Everyone knows the human gestational period is nine months. That's elementary school knowledge. The people on Are You Smarter Than A Fifth Grader? know this - even the adults!

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Speaking of doctors, twice during this stay I've met two doctors for the first time and had them say to me, "I know you were worried when you were here last time but there's nothing to worry about this time." This makes me think I must have some coded message across the top of my file. Perhaps "WW" for "worrywart"? Can any medical doctors confirm if this type of code exists?

A dietician came by with their full menu of meal options. This sounded great at first but only half the time do I actually get what I order. For instance when I ordered the bagel and cream cheese for breakfast one day I received a tray that was completely empty except for a couple packs of crackers and peanut butter. (Where's me breakfast? -Hospitalized Leprechaun) This time around, instead of Salisbury Steak, they're trying to get rid of something which looks equally unappetizing called Beef Ragout; like maybe they found an overturned Beef Ragout truck by the side of the highway. Several times they've pulled a Folger's switch and replaced my actual choices with this monstrosity. ("Let's see if she notices...")

This Beef Ragout looks decent. It's obviously not Kaiser's Beef Ragout.

Last time the best thing about being in the hospital was a visit by some therapy dogs and it wasn't until I got home that I realized I could have requested more visits. This time I requested frequent visits but it didn't go quite as well. Since I'm allergic I don't want to pet the dogs - and I can sense the owners thinking "Then, why I am here?" Also some of the dogs are tiny which just doesn't interest me. (Sorry, tiny dog lovers.) And lastly they come by when I'm alone (often when I'm sleeping) and then I have to make awkward small talk with the owners. So now I've requested that they visit only on weekends so that Mark can pet the dogs and there are two of us to engage the owners in awkward small talk.


Therapy golden retriever, Boston, and me. (You may recognize my leg irons from my last hospital stay.)


Boston close-up. Wait, what's on his harness?

Boston's Kaiser badge!

Meanwhile, Mark wages war against the curtain in my room... and loses.


Mark walks into the curtain Blair Witch style.
As Suzanne Vega sang in Luka, "Yes I think I'm okay. I walked into the curtain again."

No pictures please.

Mark "Houdinis" his way out.

Yeah, I got stuck in a curtain. Jealous?

And I'm Back in the Hospital at 32 Weeks. Part I: Not Again...

On 11/11 the twins chose to celebrate Veterans Day by making another break for it. (Next time they should try a rock hammer and a Rita Hayworth poster.) I noticed a few contractions (which is normal), and laid down to watch Top Chef and see if there were any more. They were occurring every 8 minutes which is problematic because when they're at a regular interval they could lead to labor. Mark and I grabbed our things. By now I really should have a travel bag ready instead of my usual tactic of dumping a camera, magazines, and a diabetes kit in a plastic Target bag. Mark predicted we'd be at the hospital for 2 1/2 hours. I said 7. The correct answer will be 255 by noon this Sunday morning.

As usual I felt like it took Kaiser forever to process me, have a nurse see me, set me up on contraction and fetal heart monitors, and finally see a doctor. The whole time I worried that the longer it took them the more likely I was to dilate further and go into labor. So, chop chop, people! The doctor (sorry - not the zombie gynecologist, whom I haven't seen all week) apologized for her cold speculum (as though that's the uncomfortable part of the exam). She determined I was 3.5 cm dilated, compared to 1 cm just a week before. Two days later another doctor said I was dilated 3 cm, but I think it's just variation among doctors - the cervix is measured with the fingers so the process is inherently imprecise. It's highly unlikely it's another case of the incredible shrinking cervix. (I can't decide if that would be the best or worst Nancy Drew book ever.)

Just replace "mansion" with cervix.

I was given a shot of terbutaline like last time. It's pretty much the only thing that can stop the contractions (apart from the nifedipine I was already taking), but if you go into active labor it won't do anything. The side effects are not unlike drinking a Jolt Soda. I also received steroid injections again to strengthen the babies' lungs and hearts. They gave me an IV because I couldn't have food in my system if I were to go into labor. I had that IV until 2:30 p.m. the next day. You might think you'd feel full while on an IV, but not true - I was starving.

The first day was pretty scary - contractions seemed to die down and then start up again. After I was stabilized I had a couple scary moments here and there like the time I had a lot more contractions than usual (they were at regular intervals, too), and was then hooked up to fetal heart rate and contraction machines all night. (I got to sleep at 6:30 a.m.) For the most part, however, it was nowhere near as scary as my pre-term labor scare at 26 weeks, mostly because the expected outcome of a delivery at 32 weeks is much much better.


Mark made me a new sign and posted it in my hospital room a few days ago when I made it to 33 weeks. He's added a new star every week since week 29. I now have a 5 star uterus! Also, note Mark's new pregnancy beard. It's the longest it's ever been - he guesses it's four weeks of growth, but I think five. (You can see it in its early stages here.) Whether or not he'll keep it until the babies are born is still a mystery...

The prognosis when I arrived was that I would probably go to 34 weeks, maybe 35. If you go into labor at 34 weeks the doctors generally don't try to stop it, but the babies would spend some time in the ICU. 35 weeks would mean the twins could probably stay in my room (with maybe a day in the ICU), and go home with us. 36 weeks is considered full term for twins (moms just run out of belly space). One thing in my favor is that at my last ultrasound appointment two weeks ago, Twin A (the boy) was estimated to be 3 lbs, 9 oz. and Twin B (the girl) was 3 lbs., 11 oz. Those are 49th and 57th percentiles respectively, on the same scale used for singletons, which means they're quite big for twins. Gestational age is the best predictor of fetal health, followed by weight. Apparently it's unusual for Twin B's to be bigger because Twin A's usually have the "better" placentas.


When I'm unable to blow dry my hair and have to lie down on a pillow after washing my hair, after a few hours I look like Russell Brand (hopefully sans facial hair).


Next Time:
Part II: Kathy vs. Beef Ragout, Mark vs. Curtains

Pre-Term Labor Scare Part IV: I Tunnel Out of the Hospital

Dr. Lin (one of my many doctors - I inwardly referred to her as female Asian Doogie since she looked so young but was very bright) came to check on me the morning of 10/13 and perform a cervical exam.


Right after this picture was taken Dr. Lin turned to her computer to compose a diary message, paused, looked thoughtful, backspaced a bit, and made a meaningful generality about the universe and the dilation of my cervix. And then Vinnie climbed in through her window.

Doogie Howser's Diary or Random Twitter Update
http://www.mentalfloss.com/quiz/quiz.php?q=619?cnn=yes

As she digitally measured my cervical dilation she looked thoughtful. (Note: It's weird to watch doctors look thoughtful when they're manually measuring your vagina.) "You're only 1 centimeter dilated," she told me. I had been measured at 4 centimeters previously by three different doctors. But she said I had a previously undiagnosed tilted cervix and she thought they were measuring the wrong thing. Alternately, it's possible (though rare) my cervix closed 3 centimeters since I was last measured. She said that this changed everything - I didn't have the same preterm labor risk and that it was even possible I could carry to term. She said she didn't see why I should stay in the hospital any longer and that I could be on modified bed rest at home. Modified bed rest in this case meant I should lay down a lot but could also sit for periods of time and walk around as needed (say, to prepare my lunch), and also do things that "made me happy" like go out to eat or go to a friend's house (assuming I'd sit or lay down once there).

And here I woke up that day thinking I was a major preterm labor risk that would be on strict bed rest until delivery!

But before accepting her diagnosis I wanted a second and third opinion. The second one came from one of the doctors who measured me before. She hadn't remembered previously measuring my cervical dilation, and she said something like, "I don't know who measured you before but you're only 1 centimeter." I said, "Actually you were one of the ones who measured me." Enter awkward pause. The third opinion in agreement came from Dr. Miller. One look into his cold, remorseless eyes told me he was a zombie gynecologist (sounds like a terrible horror movie).

Here's the zombie gynecologist who's the primary doctor for my pregnancy until the end of the month when he retires and is able to devote all his free time to eating brains.

I had been so worried the past week that I cried tears of joy after the third opinion and was in a state of disbelief the rest of the day. Mark came to pick me up in the early evening and had to transport five loads of my stuff to the car. I actually cried again when we pulled out of the parking lot. When I checked in I just didn't think I'd see this (yes, the parking lot!) again until after labor.

While in the hospital Mark came up with the idea of not shaving until the twins were born. It would be a sort of measure to mark how far they'd come. That sounded good to me (even though Mark's true motive might have partially been laziness), and for the first time in my life I supported Mark in growing a beard.

Here's Mark about a week into his pre-term labor pregnancy beard. Once we got home from the hospital he shaved it off.

You may remember Mark's last attempt at a pregnancy beard.

28 weeks is a big line in the sand in terms of baby development. When I was in the hospital, Mark and I focused on my making it to 28 weeks. At home at midnight that night as I hit the 28 week mark, Mark presented me with something he'd made. It was intended to go on my hospital room wall but now I displayed it on the refrigerator.


Since then Mark's made a 29 week version with a gold star, a 30 week version with two gold stars, and a 31 week version from this past Wednesday with three gold stars.

Pre-Term Labor Scare Part III: Food, Dogs, and Evil Contraction Monitors

I was hooked up to fetal heart monitors once a day. They were supposed to be on for an hour, but the babies moved so much that it took at least an hour and a half, once three hours, and I was to move as little as possible during that time (lest the babies fall off the monitors). They also hooked me up to contraction monitors twice a day for an hour each. It was really nerve-wracking to here the skritch skritch of the needle of the monitor recording contractions on paper like a seismograph. Every time I heard a skritch I imagined it was a new contraction. (As it turned out, the noises weren't correlated to the contractions, but I only discovered this near the end of my stay after I'd already worried myself silly over it.)

My nemesis, the contraction monitor.

After several days in the hospital I started having non-labor inducing contractions (which are normal), but I was constantly worried that it meant I was going to go back into labor. It was very stressful and I cried at some point every day but one. On my first full day in the hospital, right after telling my mom why I was there, I was pretty upset. (It wasn't until later I found out that my mom and Mark's mom thought I was in my 24th week instead of my 26th from looking at this blog which I've been slow to update.) Anyway right then some therapy dogs happened by my room that really cheered me up. One was, Dante, a border collie/German shepherd mix who did all sorts of tricks; but I was more amused by Rubi, a Golden retriever whose tail kept thumping against my bed.

I didn't realize I could request therapy dogs to come by until my last day. Guess who's coming to my room every day after I give birth?

Because of all the nurse/doctor/monitor interruptions, being on hospital bed rest kept me busier than you might think. In my spare time I used a laptop to check websites and e-mail (but could only hunt and peck to type because I wasn't supposed to sit up) and watched TV shows that Mark had uploaded. I was very happy when my friends, Rachel, Lila, and Brendan visited, as well as our real estate agent (now that's dedication!).

The hospital food was both better and worse than you'd expect. The desserts were at the "better" end of that equation. Often, something like Salisbury Steak would arrive and, trying to be as non-annoying as possible, I'd ask if there were any other options. (Every meal seemed to come with a tasteless dinner roll - I started to make a fortress out of them - and Wheatsworth crackers, which Mark decided was the name of his British butler.) One day Lila and Brendan brought me Indian food and that was the best food I'd tasted in a week. A few times a nurse came by with Haagen Dazs bars. I stupidly turned one down the first day, but thankfully had one the night before fasting 12 hours for my diabetes test the next morning. (I didn't pass the test so it tasted all the better.) Often while eating my meals, I'd make fun of the default TV channel that consisted solely of soothing nature scenes and music.

Haagen Dazs bar, how can I say no to you...

Wheatsworth. You there. I say, my good man...

After a day in my new room I was told I could eventually be released to strict bed rest at home. Both moms volunteered to come help me at home if that happened. I took that as a good sign of my recovery, but I was also worried about being at home without physicians in case the bad labor-inducing contractions came back.

Mark was great the entire time. He went back to work but came to visit me every morning for two hours and again in the evening from when he left work until around midnight.


Next time...
Part IV: I Tunnel Out of the Hospital

Pre-Term Labor Scare Part II: Living in a Hospital for Over a Week

I was originally given a room intended for high risk pregnancies where I could deliver if necessary. I was on the strictest bed rest so I couldn't get up at all - even to use the bathroom. This meant that I got to discover the joys of bed pans. For those of you uninitiated into the joy of emptying your bowels into a plastic container, basically you form a human bridge over a small plastic tub, relieve yourself, and then stew in your own filth while you wait for the nurse to come back to wipe you. I actually would point out if I thought they missed a spot while wiping. Once when I was concerned that my over-full bladder might make the bed pan runneth over, the nurse left an extra bed pan and told Mark that he could switch them out if necessary. (Uh, no.)

Bed pan montage!

The next day I was given a new room, and let me tell you, it was really exciting just to get wheeled down the corridor to see something other than the confines of my old room. Thankfully this time I was given bathroom privileges which meant I got to stand for the first time in 36 hours. I was given a chair for showering.

Shower chair! Not sure why mine has the hole in the seat...

However, something new was added, leg irons. My calves were encased in wraps that squeezed in and out (much like blood pressure gauges) in order to prevent me from developing deep vein thrombosis. The wraps were plugged into the end of my bed so I always had to get unpluged just so I could get up to go to the bathroom. (Usually my calls to the nurse would go something like this: "Can you unshackle me? I need to pee.")

Me, my leg irons, and lots of random junk on my table.

Leg iron close-up! Mark painted my toenails a few weeks ago.

This new room was a post-delivery room, and included another chair-bed for Mark. He slept over the first two nights, but after that I told him to sleep at home, because it's really hard to sleep in a hospital. I was regularly awakened to:

• take drugs at least 3 times a night
• pee (being pregnant that's at least every 2 hours). Each time I had to call the nurse twice - once to unshackle me and then again to reshackle me.
• be alerted that the nurse shift was changing at 4:30 a.m. (the new nurse would come in and turn on the light to put her phone number on the dry erase board)
• talk to doctors who would start arriving at 6 a.m. to see how I was doing

Next time...
Part III: Food, Dogs, and Evil Contraction Monitors

Pre-Term Labor Scare Part I: The Twins Make a Break for it in my 26th Week

Three and a half weeks ago, late on Sunday night I was laying on my side doing a contraction count. (Because I'm having twins and therefore have a greater pre-term labor risk, I'm supposed to lie down twice a day for an hour and check for any tightening of the belly, which is a Braxton Hicks contraction.) For the first time ever I felt tightening. And then 4 minutes later tightening again. And again. And again. It's normal to have some tightening this far along in a pregnancy but if I feel six contractions in an hour I'm supposed to call the hospital. I called after about 4 contractions since only 20 minutes had passed. The nurse said to keep checking and they'd see how I was doing in 45 minutes. At that time the contractions started to be accompanied by a little pain, and the nurse said to immediately go to the hospital.

We really didn't think this was going to progress into labor, but I grabbed a camera and some magazines just in case. Mark thought I was overreacting...

At the hospital, the doctor did a cervical exam (um, ouch) and told me I was 3 cm dilated. (Ironically at my OB appointment less than a week before, my doctor told me I was 0 cm dilated and said everything looked great and I could cancel the next appointment in two weeks.) The doctor said they were going to start giving me medicine to stop the contractions and give me steroids (shot into my butt a la Jose Canseco) to strengthen the babies' lungs. She told us it was quite likely that I was going to deliver in the next 24 hours. And I would be on strict bed rest at the hospital until the end of my pregnancy.

Mark and I were pretty much in shock.

I was given a room that had a chair in the corner for Mark that folded out into a bed and we were up all night while I was visited by a steady stream of doctors and given various drugs, ultrasounds, and contraction and fetal heart monitors. I was attached to an IV and not allowed solid food in case I was to go into labor. I was given another cervical exam (ouch again - I've never had a doctor brace against me so she could go in as far as possible), and was told I was now 4 cm dilated.

Thankfully, the drugs kicked in and the contractions stopped by the next day.

Mark and his chair-bed. If I had been at Kaiser for a month we joked about how we could save money on rent by having him just move in with me and sublet our place.

Mark and I talked later about how we're glad we didn't know how serious giving birth in my 26th week was. We knew it wasn't good, but the reality didn't hit home for another day. For instance the following morning a perinatology doctor visited and told us that the babies had a very good chance of survival - 90% chance for each. I'm sure she thought she was comforting us, but those odds sounded terrible to me. And I knew if that was the survival rate, the chance of a baby having developmental problems (unhealthy heart and lungs, learning disorders, etc.) must be awfully high. The majority of the doctors seemed to think that I'd be very lucky if I was able to carry the babies another three weeks.

I felt so frustrated because I felt like I had been trying so hard to do everything right with this pregnancy - from my diet to exercise to using natural (read: hippie) products. And now I was failing at doing the one thing I needed to do - keeping them in there cooking to term.

I'd never had flowers delivered to me before. My mother-in-law sent me this beautiful bouquet. Love the Casablanca lilies!

Due to being pregnant and the warmth of having all my limbs touching each other, I had the AC cranked to its highest level and no sheet on me. Meanwhile, Mark would often visit wearing a sweater and he still had to put on the sweatshirt hoodie I was admitted in and, as seen here, a blanket.

Next time...
Part II: Living in a Hospital for Over a Week

(For anyone who doesn't know how the hospital story concludes, I'm home now on modified bed rest and the babies are continuing to cook inside me. I'm still a pre-term labor risk but if I'm really lucky they'll stay there awhile, maybe even to term.)