Friday, March 28, 2008

33 Weeks & 3 Days

Home again, home again, jiggity jig! Oh wait..... I am not home, I am at my new home away from home. Yes that is correct, I am back in the hospital!

This morning I had my appointments and things started off as well as could be expected. There was no protein detected in my urine screen but my blood pressure was up again to 138/100. I met with Dr. Dixon and he attributed the higher blood pressure during visits to the additional strain that is associated with me getting myself to the appointment. He was ok with me continuing on home bed rest with visits to his office twice a week. He concluded my visit with a follow-up appointment on Tuesday. However, he wanted to speak to the Maternal-Fetal Specialist, Dr. Willis, once the boys were evaluated. I then headed upstairs for my next visit.

This visit was the growth check that we had been waiting for since a couple weeks ago when we were told their growth had slowed. The ultrasound revealed all three boys are still breathing well. Baby A's position still prevented him from having his weight determined so his weight remains a mystery. I can't wait to meet Baby A because we know so little about him compared to his brothers. Baby B weighed in at 4.5 lbs and Baby C weighed in at 4 lbs. The doctor stated this was about the 18th percentile which is great interval growth since their last check. I was relieved to hear their weights because they are finally hitting a weight in which they would do well outside of me.

Dr. Willis proceeded to take my blood pressure since I was admitted the week prior for high blood pressure. My pressure at this check was 158/100. He was not pleased. He then proceeded to call Dr. Dixon to discuss next steps. Both agreed that there is not a need to deliver at this point; however, he felt I needed to be admitted to the hospital until I deliver (ugh!). While this was his recommendation, he left the final decision up to Dr. Dixon since he is my primary so there was still hope.

I was sent back downstairs to meet with Dr. Dixon. He was still considering at home bed rest until he read Dr. Willis' report which put the recommendation for hospitalization in black and white. Once he saw this documentation, he was left with no options but to admit. And... here I am back at the great Tallahassee Memorial Hospital! I should mention that my first blood pressure reading once settled into bed was 134/91. It was already starting to come down once I was in a resting state.

There is one more symptom of the mild preeclampsia that I am starting to notice and that is the swelling. I am starting to swell more each day. This is evidenced by the amount of water weight I have gained in the past 2 weeks. At the 31 week mark, I had gained 30 pounds with the pregnancy. This was low for triplets. Well….. in the past 2 weeks, I have gained 24 lbs! Oh my is right! I am quickly catching up to where I should be but this is all due to the fluid retention. The good thing is that I should loose this pretty quick after delivery.

They are very nice here and treat me very well. Everyone is so interested in the fact that I am having triplets! As such, the staff from housekeeping to nutrition to the nurses seems to take a little extra care with "us." While I don't want to stay here very long, everyday in the hospital helps the boys prepare that much more for their eventual arrival. My target now is 34 weeks and after that we can focus on 35 weeks.

I will post again if our situation changes!

Take care,

Kellie

Monday, March 24, 2008

32 Weeks & 6 Days

I AM GOING HOME!!!!

Dr. Dixon, who is my primary OB, was back on duty today and he reviewed all my tests through the weekend and he is comfortable discharging me on home bed rest! He did tell me that everything looked good while I was in the hospital so if things change when I am home, I will be back in the hospital.

My next follow-up appointments with Dr. Dixon and the Maternal-Fetal Specialists will be on Friday. I want to thank everyone that showed their support while I was here at the hospital.

Take care,

Kellie

Sunday, March 23, 2008

32 Weeks & 5 Days

Happy Easter everyone!! When I think back to last Easter, I remember that I spent this morning in Jacksonville for my first appointment to evaluate my progress on egg development. I remember thinking this was cute that I was making eggs on Easter. This year, I find myself in the hospital with three of these eggs getting very close to entering the world as little men! What a journey this has been and will be.

Yes, I am still in the hospital. It appears I will remain on hospitalized bed rest until the babies are born. My blood pressure has come down considerably and is now within the normal ranges. The outcome of my lab work has been normal and the protein levels in my urine have reduced to trace amounts. After my 24 urine was collected, there was one problem. My "output" was extremely low. This is a symptom of preeclampsia and can indicate that my kidneys are struggling and I am not able to filter out my fluid "input." In a 24 period, I had only produced 750 cc of "output."

We were tasked with strictly tracking my input and output. I track the input and the nurse has to measure the output. This started at 4pm yesterday and I was told that if my output dropped below 500 cc in 24 hours, this would result in immediate delivery of the babies. Well, that sounded like a challenge!! BRING IT ON!!! Since that time, I have produced 2,500 cc of output and I still have 4hr & 45 min in the 24 hour timeframe. See, all I needed was a challenge! So, it appears I get to keep the babies until at least tomorrow.

This morning, I was visited by the Maternal-Fetal Specialist to complete another bio-physical profile. All babies are doing well and he checked the growth on Baby B to determine that he is probably between 4 & 5 pounds at this point. The weights at this point are not 100% and should be considered estimates but in his opinion all babies are looking great. The steroid shot also enhances the lung development of the babies about 2 weeks. It takes 48 hours for full effect. As of tomorrow, the almost 33 week lungs of the babies should be functioning at about the 35 week level. Based on all of this, he said it is possible that a delivery this week may not result in an extended nursery stay. I was VERY happy to hear this but will not count my chickens before they hatch! I am scheduled to have a tour of the NICU (Neonatal Intensive Care Unit) today so I will be prepared if they are in there upon delivery.

The decisions regarding when the babies will arrive is a day to day decision at this point. It is really based on how my body can handle the preeclampsia. As soon as they see anything with me that causes too much concern, they will deliver the babies. Delivery is the only cure for preeclampsia. I am feeling well and I do not have any discomfort from this condition. Everyone here keeps telling me how impressive it is to make it all the way to 32 weeks before exhibiting complications. Usually with triplets, this happens much sooner. While this should bring me comfort, I will finally feel comfortable once I have delivered three healthy babies which may be some time this week or next week.

Again, I hope everyone is having a wonderful Easter!

Take care,

Kellie

Friday, March 21, 2008

32 Weeks

Reaching the 32nd week is a great milestone with triplets. It is the average mark for when triplets are delivered. This week started with a follow-up visit with Dr. Dixon. At this appointment, I received the results of the 24 urine test that we did over the weekend. My protein levels were within normal limits. At my appointment on Monday, there were also only trace amounts of protein in my urine. My blood pressure remained elevated (124/100) and I was allowed to go back home still on bed rest.

My next appointment was the weekly bio-physical profiles for the babies. This appointment was today and the babies are doing well, no concerns noted. However, due to mama's hypertension, they checked my blood pressure. Alas, my blood pressure was elevated. The doctor checked it twice and the first result was 148/108. The second result was 146/89. At that point, the decision was made to admit me to the hospital for observation.

So far, they have checked my blood pressure twice and my second check was 131/79. Hopefully this is a good sign and they will release me before the end of the weekend to cook these babies a little longer at home. I was given a steroid shot today and will get another one tomorrow to help the babies lung development in case they are arrive sooner than expected.

The hospital has internet access so I am hooked up to communicate to the outside world!

I hope everyone has a Happy Easter and I hope the Easter Bunny knows how to find me here!

Take care,

Kellie

Friday, March 14, 2008

31 Weeks

Good news.... we have made it to the 31 week mark!!! Here is an updated photo of my growth. For all of those interested, as of 31 weeks, I have gained 30 pounds.

We had our follow visits with the doctors today. The first visit started with the Maternal-Fetal Specialists to evaluate the eskimos. During the visit, they completed a bio-physical profile through an ultrasound. The test consisted of monitoring all three boys to observe their behavior, their breathing and the flow in and out of the umbilical cords. All boys look healthy and no concerns were noted during this appointment. They did not determine their weight during this visit. I will return next week for another bio-physical profile and the week following (3/28), they will check growth and let us if the boys are still growing.

After this visit, we proceeded downstairs to Dr. Dixon's (OB/GYN) office. We needed this follow up because during my visit last week, my blood pressure was elevated and there was trace proteins in my urine. In my update last week, I indicated my blood pressure was 112/96. I need to correct this as she told me today that last week it was actually 112/90. Today, they checked my urine and blood pressure again. At this point, there was more protein in my urine and my blood pressure was still elevated 121/93. When we saw Dr. Dixon, he indicated that it appears I am probably starting to show signs of mild preeclampsia (additional info at http://www.webmd.com/baby/guide/preeclampsia-eclampsia). He sent me to triage at labor and delivery for some additional tests. During these tests, they monitored my blood pressure for about 3 hours, took another urine sample and took a blood sample to evaluate my liver. The tests revealed my liver is fine but I do have protein in my urine and my blood pressure remained elevated for the entire time I was there. The nurse told me that with great reluctance, Dr. Dixon approved my discharge but ordered "strict bed rest." This means I am only able to get up to use the bathroom and to get something to eat. He also ordered for me to collect my urine for the next 24 hours and return the jug to the hospital tomorrow. I have a follow-up in his office on Monday at lunch time to evaluate the results.

He was not 100% but indicated the mild preeclampsia is possibly the cause of the slow down in the growth of the babies. So, I am now laying down and Mike is doing a wonderful job taking care of all of us. I should also mention the support I am receiving from my current babies. Chewie, as seen below, apparently believes he can help me by trying to hatch the babies:


Many have asked if Chewie is ready for the new babies.... I am not so convinced that he will be ready for what is too come.... however, who is???

Well, this is our 31 week update and I will keep everyone up dated as we will be having more frequent visits from now until we have babies!!!

Take care,

Kellie

Saturday, March 8, 2008

30 Weeks

Good news, we have made it to 30 weeks and in only a couple days we will reach the 31 week mark! Dr. Dixon started my visit yesterday by saying that my name is starting to make it's way through the "circles" with a triplet pregnancy making it to 30 weeks without 1 visit to the hospital. However, the information obtained during the visits revealed that this is no longer the "perfect" pregnancy it use to be.

Yesterday, we had two appointments with the Maternal-Fetal Specialists and our OB/GYN. We started with a visit to the Maternal-Fetal Specialist to evaluate their growth. The appointment started as usual, struggles to see Baby A. With the three babies in there, they were unable to fully evaluate Baby A because of his position. They were able to evaluate the size of his head and the flow through the umbilical cord. Both appeared on target and therefore there were no concerns identified with Baby A.

Then, we proceeded to Baby B and Baby C. Both of these boys were able to be evaluated. The appointment proceeded as usual at this point until the doctor told us that the babies weighed 2lb-14oz and 3lb-1oz respectively. While this alone did not cause concern, it was the low growth between their last visit and this visit (4 weeks) that caused the doctor to do some additional testing. Baby B went from the 75th percentile for growth to the 12th percentile and Baby C went from the 43rd percentile to the 15th percentile. The bio-physical profile that he then completed on B and C identified no problems and it appears they are both in good health. However, he wants to keep a closer eye on the babies from this point forward. The boys will now have bio-physical profiles on a weekly basis and they are going to evaluate growth in another three weeks.

In trying to determine a reason for the low growth, they were unable to pinpoint the exact reason but provided some possible reasons. One possibility is that the placentas are starting to struggle in supporting the babies. For this I was encouraged to spend as much time horizontal as possible. He did not prescribe bed rest but he indicated the placentas are at top performance when I am laying on my side. To help out, I am going to start working from home to spend the days in bed. A placenta starting to fail is apparently something that can be common among multiple pregnancies. If this is the reason, they will need to decide at some point if the babies are better off in the nursery than in me.

Other things that could help at this point are making sure my water and protein intake are high. As many know, I have been struggling to eat but I plan to increase my efforts to force it down from this point forward. The last thing that may be a sign of problems is that my blood pressure was 112/96. The top number is fine but the bottom number is elevated. The doctors want to keep an eye on this as well so I will be reporting weekly for blood pressure checks.

My next appointments are next Friday. I will provide an update following the visits. Also, we did not get any pictures from these visits. It really was difficult to see what they were looking at because the baby parts are all over the place.

Hope everyone else is doing well!

Take care,

Kellie