Friday, April 29, 2011

Week 21

With hopes and anxiety about going home; sleeping on Friday night was almost impossible. My Dr would be doing a complete exam on Saturday morning of babies and me to make sure everything is still holding up. As much as I have given God complete control; I found myself being consumed with worrisome emotions. The Dr started out by looking at each baby and his heart to find (as always)  they are all perfect. Then the moment I anticipated...the cervical length. She measured my cervix at its high and low and found that it was unchanged since the cerclage; instant relief set in! She explained the importance of me following the same strict bed rest at home as I did here and gave us instructions to how to operate and manage my "pharmacy." With all of the reservations I have with going home after what we have been through; I just have to remind myself who is in control and the goal we are reaching for.

Knowing now that in a matter of hours (as soon as the IV antibiotics are complete, the pharmacy has everything we need, and the discharge papers are finalized) I will be going home to my own bed, my own shower, my own sheets, and my little babies (the feline babies that is); I can hardly wait. I get a couple week break of no strange nurses coming into my room at all hours of the day and night, no 10 times a day blood work done that leaves me feeling like a pin cushion, no IV to have to worry about....I am beside myself. I know that it is only for a few short weeks; but I can use this break to prepare myself for the next stay.

A week ago when my cervix had shortened to an extreme low and I got badly ill after the surgery; this day would never have seemed real. It is not that I am strong or that things just worked out; God has truly been in control this entire pregnancy and has got us all five through the hardest of times. The ride home was anything less than desirable...bumps just hurt!!!! Walking into my house to smell the almost forgotten smell was wonderful. Jeff and his mom had spent the day shopping for everything I would need to make this home vacation as comfortable and safe as possible. I instantly found refuge in my new recliner where I would live surrounded by a fortress of pillows for the next few weeks. Once I reclined back my little boy (Felix the cat) sought refuge in my lap; now that I missed!!!! The next day I made the feared journey up the stairs to shower; we only have a 1/2 bath downstairs. Showers are no longer enjoyable as they once were; having to use a shower chair and being careful not to over exert or extend sucks the fun out of it. Nevertheless; that endeavor was conquered. Initially we planned I would shower at night, sleep in bed, and make the one time a day journey down the stairs in the mornings to live out the duration of the day in my recliner...plan A changed to plan B as soon as I tried to recline in bed to blow dry my hair. My bed could not support me in the places I need to allow me not to have to put pressure on my stomach or plan; live and sleep in the recliner only to venture up the stairs when necessary to shower. I am certain no one wants to be completely helpless or to live out everyday in a chair, getting up only to use the restroom which still requires help to get up....I refuse to complain or throw a pity party; how could I? I have four little boys baking in my womb who make each day a gift and something to look forward to as their health, development and arrival is the ultimate blessing and reward!

Even when I did not receive the best of news at times when I was in the hospital, I was spoiled with getting daily updates of myself and my boys. Although my faith has never been waived during any of the pregnancy and I trust God to keep us all safe, I do struggle with anticipation and worry that I daily ask for relief and help with. That being said; I have anticipated today's appointment since I was released from the hospital Saturday night to ensure both my body and the boys are doing well. We started the morning bright and early to a field trip to the hospital for a glucose tolerance test since I failed the one hour test. I wake up craving breakfast; so the fact that I wouldn't be able to feed the five of us until noon was just no fun!!!! Never did a Subway sandwich taste so gourmet than it did at noon today!!! After lunch Jeff wheeled me to the high risk clinic for the appointment to begin!! Our wonderful ultrasound tech checked my cervical length as well as looking at each babies ductus (area of a babies heart that is open in the womb to allow the baby to get oxygen but closes once the baby is born since it will breathe as we do) and fluid. One of the medications, Endocin, that I am on to control contractions comes with the risk of closing the ductus of each baby's heart if used for a prolonged time. All of the heart rates and fluid was well. After a long 2 hour wait after the ultrasound to see our Dr (he was in a emergency C-Section) another high risk Dr who we had seen at the start of our hospital stay came in to review all of us. My cervix is still hanging long and strong at 4.2 which just simply amazes me (all credit goes straight to heaven). The babies fluid and heart rates were all good but when she checked the velocity of each of the boys' ductus one baby's had increased. Although the baby is not in danger now; continuing the medication could prove to be fatal. My Dr had finished in surgery and they both discussed what steps should be taken next. It was decided to stop the medicine and just continue on the blood pressure medication used also to limit contractions.

Last night I did what I was told and just discontinued the medication. I have faith that the contractions will stay at rest, allowing my cervix to stay long and strong and the babies to bake as long as possible. How blessed we are to have made it to 21 weeks despite the rough patches; and I just have that since of peace that everything is going to be fine with all four boys healthy and born later rather than sooner.

This past month my days and nights run together as I do the same thing....lay down!!! Tomorrow my mom and sister are hosting a baby shower where I of course can not be there; but I will be skyping in to be apart of the festivities....another occasion to celebrate the four gifts given to us by God!!!

Me at 21 weeks off to a field trip of appointments!

Brock at 21 weeks; mid yawn

Grayson James at 21 weeks

Keaton John at 21 weeks

Camden James (baby on top) at 21 weeks

Friday, April 22, 2011

20 Weeks

Just as I had thought that things were turning round, this past Sunday I had noticed my left leg had swollen to 3 times the size of my right. I automatically began to think of the worse (right down to, "Oh my goodness my leg is going to have to be chopped off!!!")! The Dr's were also puzzled as they did not think it was fluid since only one leg had swollen. I was told it could very likely be a blood clot and they would begin to treat it whether it was or not with a blood  thinning shot twice a day. They wanted to do another CT scan but had to wait 72 hours for the dye to metabolize. The first CT scan did not show a potential clot in my lungs as they did not let the dye sit long enough prior to imaging. I was sent to get an ultrasound of my leg where they noted the major veins and arteries and then squeezed down to see if a clot had formed. The only issue is that the ultrasound does not take view of the pelvis where a blood clot could be very likely.

As we waited for Wednesday to arrive to get some answers as to what caused my leg to swell; my heart rate and pneumonia were still being monitored and treated. Amongst the several EKGs I had done on my high heart rate, they also placed a heart monitor on to track my heart beats and rythms. I also had an ECHO done to make sure there were no abnormalities (other than the stress my heart was under to pump the 100% increase in blood volume due to the quads). Besides the what I felt like was "elephantitis" in my leg, I was finally beginning to feel like my pregnant self. The time seemed to go by so much faster with Jeff's mother and my mamma to keep me company (I haven't picked up one crossword of Sudoku puzzle yet!)!!!

 I had reached my two week mark and was looking forward to many more "anniversaries".  The heart monitor was taken off and the findings from it along with the other tests had shown that I had tachycardia but it was normal for me and my pregnancy situation. I went for the CT scan where I ensured that they covered my belly (all of it) with the lead aprons as best as possible to shield my boys from radiation. Knowing that the dye did not sit long enough during the prior scan, I asked and asked to ensure they allowed the dye to sit so I did not have the scan and potentially expose my children to unnecessary radiation.. They assured me that all was scanned well. It barely took an hour for my Dr to come and tell me the results....inconclusive. Yet again, the dye was not allowed to sit long enough to see all parts of the lungs to conclude if I had a blood clot stemming from my lung or not; I was frustrated to say the least.  Directly after the CT, I had an ultrasound of my right leg as it began to swell as well (Really??? Elephantitis in both legs now!!!?). They did the same type of ultrasound as was done with my left and the results came back negative. Although we still don't know if a blog clot has is at fault; my Dr's felt that it was very likely the culprit. Now I will do the shot twice a day throughout the entire pregnancy with an additional six weeks after birth of the boys. The shot is suppose to help dissipate the blood clots (wherever they may be) as well as prevent from any more clots from forming. My legs are still gargantuan in my eyes; but this is yet another small price for the ultimate reward; four beautiful boys!!!!!!

That same night our nurse came into my room and told me they were sending me to another floor for more monitoring... "What??? This has become my home; I am finally use to the nurses and my surrounding and do not want to go anywhere else!!!" I instantly wanted to speak to my Dr to hear for myself what is going on. Three hours of long waiting and I was informed that the labor and delivery floor had admitted too many women and were extremely understaffed and short beds (The labor and delivery floor has downsized drastically with the upcoming move to the Army hospital. I was told that the women arriving were going into delivery or were not stable; and since I was stable with the pregnancy I would be temporarily moved until a bed opened back up. As much as I understood the predicament; I did not understand how they would move a severe high risk pregnancy who has encountered one too many complications to a floor who knew nothing on providing care to someone like me. I had allowed myself to become angry. I reluctantly moved and survived the first night in the foreign room thanks to my mom. Sleep was even more nonexistent as I had to take my medical care into my own hands to ensure I was receiving the correct medications at the correct time (good thing I was extremely knowledgeable on all my medications for pregnancy, contractions, and IV antibiotics for the pneumonia!)! I was at ease knowing this stay would only last a couple of we thought. The next morning, a never before seen OB did our daily ultrasound which was a far cry from being thorough (the purpose of the daily ultrasounds are to ensure the babies heart rates are on target and that the fluid surrounding them is appropriate since one of the contraction medicines can be harmful). She also told us that we could go home...go home??? How could I go home with every complication that we have encountered; on top of that we were told from the beginning we were not leaving)! I did not know what to think! Not to mention I told her my concern for more than usual contractions which she said she would bring me back downstairs to monitor or bring up a monitor; neither happened. This was my concern with moving floors; out of sight out of mind

Later that day one of  Jeff's higher ups came for a visit and was confused as to why we were not on the labor and delivery floor; he was told that I had a heart condition and required extra care that they could not provide...this was knew to me!!!!! He left with the intention of getting to the bottom of it all, ensuring adequate care was provided. A few hours later and several of Jeff's bosses showed up with an intent. Patient advocacy contacted the fifth floor and an hour later we got answers; but not comforting ones. To back up a bit; the entire hospital is being moved to the Army hospital, the floor I was moved to has 4 open beds and is a surgical unit; no knowledge of maternity or of quad complicated pregnancies for that matter. One of the high risk Dr's told us that if I were to stay in the hospital than they feared that I would contract a hospital illness and they felt that I would be safer at home....One could imagine the uneasiness I was feeling. How can it go from Dr's being adamant that I stay on hospital bed rest for close monitoring especially with the cervical issues and contractions I have experienced to I could go home for bed rest; I was baffled to say the least. I have to finish out the IV antibiotics for the pneumonia and come Saturday (tomorrow) I would finish out the IV meds and move to oral meds. They want to see how I respond to the oral meds and have a full examination by a high risk Dr on Sunday and then I would be discharged for at most 3 weeks (or when I am 24 weeks pregnant). I would give myself the two pills every 6 hours for contractions (checking my blood pressure prior to ensure it is not too low to take one of the pills which primarily serves as a blood pressure med but works to control contractions as well) on top of the oral meds and vitamins and supplements and in addition to the two shots of the blood thinner medicine to treat the suspected blood clots. I can not help but to feel that I am being sent home for this short time due to the lack of beds and nurses at this hospital because of the transition to the other military hospital (so much so that a nurse on this floor had said the same).

With all of the reservations and concerns I have with going home, I would rather be at home being  responsible for my own care than on a floor who is completely clueless and unconcerned as they have no idea of how to care for me. Just as I find myself being dragged into the doldrums of worry, I have to remind myself of where we started and who has been in control this entire time. The Dr's and nurses do what they do with a guided hand; my care and the boys' well doing is ultimately being controlled by God. I have trust and faith that all will be well; this too is just another bump in the road that He has pre planned for us.

The boys at week 20

Thursday, April 21, 2011

Week 19

It is official...I have been in my "new home" for one entire week. 1 down ??? hopefully more than not to come! Things have been the same since I first arrived and by what I understand will continue like this. They measured my contractions and frequency using the TOCO for five days and came to the realization that I will probably continue to contract as I am until the birth of the babies. I am taking and have been taking Procardia since the Endocin stopped 72 hours into my stay. I was told that if I feel anything more frequent or stonger than what I have been feeling to let myh nurse know. As long as my cervical length is not changing then it is fine (for a pregnant woman of quads) to contract. My Dr. (one of the several ones I see) informed me that my uterus is the size of a full term pregnancy so it contracts in what it thinks is preparation for birth. Little does my uterus know, my boys are not done in there and still have several more weeks to finish baking.

The last time my cervix was checked was the day I was admitted; last Wednesday. I am anxiously awaiting for them to come and get me to go to the COB (Complicated OB Clinic) to get my cervix checked. I have decided (as hard as it is for me to relinquish control) to completely stand on faith and believe that my cervix will be obedient and stay as long as possible (I pray it will grow back to its starting point) and that the contractions stop. I was talking to my Dad last night and he was reiterating how important it what to tell my body what it is going to do and pray for the same, rather then worrying about the what ifs (as what ifs are not standing on faith). Even though, worrying is in my nature I am giving the weakness to God and believing only positive; who knows, I might get wheeled into the clinic for my cerix to have grown and then when they have no explanation and I enlighten them:) Anything is possible!!!

I could sit here and throw myself a pity party and say how hard and terrible and boring staying in a hospital bed can be (which all of those are true), but I must admit time has continued to pass. I am not a big TV person so I leave it on for background noise; but keep myself busy with puzzles (Soduko happens to be a bit addiciting)!!!  And when things good to mundane; why not throw some excitement into the day!!! This past Monday I was showering and was obviously enjoying it too much to realize I was flooding my bathroom floor. As I finished and went to grab for a towell I noticed the "great flood." I am sure the nurse and housekeeping was thrilled with that one!!!

Well, here I sit after getting the news I was not prepared for but seep down afraid of getting. My cervix shortened to a low of 1.8cm; not good and I knew that. The Dr that told me the news had just started her rotation for two weeks; thank God for her. We have been told this entire time that a cerclage was completely out of the question as there is not much research for multiples and is unchartered territory. She told me she felt that if they just kept pummping me with medicine that obviously was not stopping the contractions enough to give my cervix a brake; than she thought she would waqtch me go into labor. She brought up the idea of a cerclage and how at this point it was worth giving it a try despite our odds and the risks; but wanted to get all of the 4 high risk OBs input and education before deciding. About an hour later she came in with a 3rd year resident who had been doing my daily ultrasounds and told me that they were split; two were for it and two were completely against it and the decision was ultimately up to me. Really?! I am not a Dr and am an emotional wreck at this point; how do I decide what to do without adequate information, other than the terrible risks; hurt my bladder, brake my water, go into full this poing this is the hardest decision I have been faced in making. She gave us about an hour to discuss our options. Once talking the pros and cons over and saying some long prayers; both Jeff and I were at peace with getting the circlage. It was the longest night ever; not knowing how the surgery the next morning would go...but as I have said from the start of this journey; I just feel that in the end i will have 4 beautiful babies.

Beside a few minor complications; the surgery went well; although it would not be known if preterm labor, etc would occur until a bit later. I was given Magnesium to calm my cervix and uterus from contracting as the cerclage does initially put the cervix into stress. I was the normal over paranoid mom being overly concerned with every contraction or foreign sight I saw.  The next day came and we had feared that something was wrong as there was more fluid than normal. After being checked we were relieved with the blessing that God did answer my prayer of my cervix growing; just not in the way I had originally anticipated. My cervix was just as long as it was at the start of my pregnancy.

Just as things were looking up; Saturday took us by surprise. My heart was racing the duration of the day, the fluid was greater than even the previous, and I just did not feel well at all. It took several hours after consulting our nurse that I was taken to triage to get examined further. All they could tell me was something was wrong but wanted to perform a CT scan on top of numerous blood and urine tests to help determine the decline in my health. I can only go through so much until having to call for mom to come down. She booked a flight for the following morning. Jeff's mother drove down with his sister that day before all of this had set in to help Jeff juggle home, work, and being at the hospital. The CT scan came back semi- clear. They dye was not left in long enough for them to know if I had a blood clot in my lowers lungs but they were able to see I had developed hospital pneumonia. I was given a one on one nurse and the antibiotics began to flow as the tests and cultures continued (I was assured that even if an infection had settled in; the antibiotics were of such power that it too would be conquered). The next day after receiving the loading doses of the multiple antibiotics I began to feel a bit better.

Never have I been so relieved to see my mother's face; mamma's just have a way of making things better. Knowing that prayers were being poured into the heavens from all over I was comforted.

The boys at 19 weeks; not the best pictures since my emotions were flowing and my stomach wasn't still; but still my little boys.

Sunday, April 10, 2011

Week 18

A mother's love...I never thought this bond would be sooo strong even before my bundles graced me with their presence; but it is. Before being pregnant with my boys, my cats and lizard were my "kids" and the love I have for them is beyond words (the way I speak about them, most would think they were human children rather than animals). My love and bond I have with my growing babies is a million times that I have for my animal children. Just days ago I was worrying about getting at least one nursery completed and lived on the hope for getting a PCS back home to Panama City. Little did I know that my concerns and cares would abruptly shift.

Just like usual, this past Wednesday was our appointment with our high risk Dr. I had already prepared myself for a long afternoon as I would more than likely have to have an iron transfusion...however; I did not expect for what we would be faced with. They routinely checked each baby's heart rate and my cervical length. Measuring my cervix usually takes a matter of a minute or two; I should have known something was out of the norm when it took nearly ten. A resident was the one checking, and when he uttered the number 2.8cm, my heart sank. I am fairly aware of all of my norms and numbers and knew that 2.8cm was a strong difference from the 3.8cm it was the prior Monday. He was unsure of his number so he went and got my actual high risk OB to have a second opinion. Once he had checked and rechecked; he found my cervix to be between 3.1-3.2cm. Much better from the 2.8cm, but a far stretch from the week's previous measurement. Mother's worrying instinct began to set in as he explained when I would get the iron transfusion I would also be monitored for contractions that could be shortening my cervix.

After a quick bite to eat, Jeff and I went back to labor and delivery to get the iron and to monitor the contractions. At the appointment, we were told that bed rest at home would be starting as soon as we went home. Little did I know that bed rest would end up in the hospital indefinitely until the boys are born. I walked into the appointment thinking everything was dandy and well; and walked out of the transfusion room a wreck to a hospital room that was anything but like home. I didn't know if I should worry about my cats, what to have Jeff bring, whether I was going into labor, or what...I was a whirlwind of emotions (& still a bit that way if I am to be truthful). After seeing what felt like 10 different Doctors and hearing what seemed like 10 different answers as to why all of this was happening; I was left with the notion that I was having contractions which ultimately caused my cervix to shorten. I automatically began to think of what I did to cause this, how I should have not done so much at home, how I should have felt a contraction prior to being told I was having them.

I was told for weeks now to expect to be admitted between weeks 20-24...being admitted at 18 and some days turned my world upside down. I am a planner and control freak by nature; so not having control or not being aware that this is where we were headed left me a mess of emotions. I am so happy I am married to the nurturing and loving man that I am; especially living so far from family and friends. He instantly went home and brought back every comfort item possible to make this indefinite stay a little more tolerable. As soon as I got into my new home away from home, I was given medicine that I would take every eight hours for forty eight hours to stop the contractions. The first night I was monitored non stop for contraction; which were lessening. Thursday came and I was graced with physical therapy and nutrition. If there is one positive to my two month stay, it is knowing that I get to choose what I eat (to a certain extent). Good thing burgers and fries are always an option as I could nearly live off of just that:) Wednesday night and Thursday were very emotional and trying. I also thought I still had the chance of going home once the contractions had stopped; well they never fully stopped and I am not going home!!! But everything could be worse. I am blessed nonetheless and have the same sense of peace I had when I first found out about the quads.

Friday started out just lovely!! The mattress I had the first two days was causing me to sink and sleep and comfort were not attainable! I brought it to the nurse's attention on Thursday morning and she said an egg crate mattress was ordered. Friday a patient advocate started into the room with the egg was a rolled up piece of foam!!!! I didn't complain but was not thrilled. She must have noticed my expression when she instantly said she did better than the egg crate; another man wheeled in the mother of all hospital beds. My face instantly lit up...Oh the small things:) She got the bed from the ICU and it is just wonderful (comparatively speaking). Friday seemed to be going great and that my uterus was calming down...until later that night. I began to feel the contractions in my back and knew that when I was being monitored for the contractions that it did not look good again. On top of the endocin I was given for the initial 48 hours to stop the contractions; I was also given a blood pressure medicine that was suppose to calm the uterus. Saturday we were blessed with less contractions and also with an ultrasound of the boys. Come to find out, we will get an ultrasound daily to review the boys heart rates and such. I have now begun to feel the actual kicks and pushes rather than just flutters. Baby A (Brock) is the closest to my cervix and is the wild child; the ultrasound proved the same!!!! Then we have out flasher who is obviously proud of hin man hood as every time he is on the screes he shows his goods off!! Another baby always has his hands by his chin and is chilled out while the other just looks like he wants his space; as you see his neighboring brothers limbs pushing through the membrane that separates each boy. Moments like these remind me of why I am here and make living in the hospital completely worth it. It is not hard to find complaints, whether it be the food or the mattress or the solitude; but I am four times blessed which their constant movements remind me!!!!

Today is Sunday, the beginning of a new week. I know with all of the weeks to come trials and tribulations will set in as the pregnancy progresses. At the same time, I know with all of my heart as I sit blogging with just the company of the TV; I am not alone. God knew what he was doing the second he graciously put these four boys in my stomach; and he is constantly in control and will see us all through until the boys are ready to come into the world!!!